Top-Down and Bottom-Up Mechanisms in Mind-Body Medicine: Development of an Integrative Framework for Psychophysiological Research

Abstract

It has become increasingly evident that bidirectional ("top-down and bottom-up") interactions between the brain and peripheral tissues, including the cardiovascular and immune systems, contribute to both mental and physical health. Therapies directed toward addressing functional links between mind/brain and body may be particularly effective in treating the range of symptoms associated with many chronic diseases. In this paper, we describe the basic components of an integrative psychophysiological framework for research aimed at elucidating the underlying substrates of mind-body therapies. This framework recognizes the multiple levels of the neuraxis at which mind-body interactions occur. We emphasize the role of specific fronto-temporal cortical regions in the representation and control of adverse symptoms, which interact reciprocally with subcortical structures involved in bodily homeostasis and responses to stress. Bidirectional autonomic and neuroendocrine pathways transmit information between the central nervous system (CNS) and the periphery and facilitate the expression of affective, autonomic, hormonal, and immune responses. We propose that heart rate variability (HRV) and markers of inflammation are important currently available indices of central-peripheral integration and homeostasis within this homeostatic network. Finally, we review current neuroimaging and psychophysiological research from diverse areas of mind-body medicine that supports the framework as a basis for future research on the specific biobehavioral mechanisms of mind-body therapies.

Electroencephalographic Indicators in Default Mode, Habituation, and Visual-motor Association in Female College Students

“…The descriptions presented herein provide support to the hypothesis that, when beta syntonizes in the different cortical regions, it coordinates the attention and sensory-perception processes and motor functions 32,38,41,42 . Other authors have described this condition, as the manifestation of the up-down regulation of organisms 43 .…”

Fasciatherapy and Reflexology compared to Hypnosis and Music Therapy in Daily Stress Management

“…These two methods are both mind and body therapies of bottom-up mechanism, initiated by stimulation of peripheral receptors as somato-, viscero-or chemosensory receptors that influence central neural processing and mental activities from the periphery to the brain system and cerebral cortex. (8) To compare them to others but of top-down mechanism (initiated via mental processing at the level of cerebral cortex), two more arms are implemented with, respectively, Hp and Mt. A non-intervention resting arm is the control group.…”

“…(19) ) In the Hp domain, which is out of the field of this study, literature about the therapeutic mechanisms on anxiety is also available. (8) Previous studies have already been carried out on the management of psychosocial stress with CAMs, but few of them have been with people in reasonably good health. A study reviewing intervention trials on maternal anxiety in pregnancy (46) measured by the STAI showed that scores appear amenable to change after a single session of CAMs interventions, but neither Fs nor Rf were assessed.…”

Neurobiology and the Changing Face of Eating Disorder Treatment: Healing the Eating Disordered Brain

“…In instances where continued physiological hyperarousal and altered stress hormone secretion afect the ongoing evaluation of sensory stimuli, it has been shown that botom-up neurophysiological interventions more efectively address "the repetitive, unbidden, physical sensations, movement inhibitions, and somatosensory intrusions of unresolved trauma, than do top-down interventions" [54]. In such cases, a therapeutic model that efectively integrates both top-down (where the cranial brain sends messages to the body) and botom-up interventions (embodied sensory receptors communicate with cranial based sensory receptors) best serves recovery [55].…”