Health Psychology Intervention – Identifying Early Symptoms in Neurological Disorders
Cortisol is essential to the regulation of the immune
system and pathological yawning is a symptom of multiple sclerosis
(MS). Electromyography activity (EMG) in the jaw muscles typically
rises when the muscles are moved – extended or flexed; and yawning
has been shown to be highly correlated with cortisol levels in healthy
people as shown in the Thompson Cortisol Hypothesis. It is likely
that these elevated cortisol levels are also seen in people with MS.
The possible link between EMG in the jaw muscles and rises in saliva
cortisol levels during yawning were investigated in a randomized
controlled trial of 60 volunteers aged 18-69 years who were exposed
to conditions that were designed to elicit the yawning response.
Saliva samples were collected at the start and after yawning, or at the
end of the presentation of yawning-provoking stimuli, in the absence
of a yawn, and EMG data was additionally collected during rest and
yawning phases. Hospital Anxiety and Depression Scale, Yawning
Susceptibility Scale, General Health Questionnaire, demographic,
and health details were collected and the following exclusion criteria
were adopted: chronic fatigue, diabetes, fibromyalgia, heart
condition, high blood pressure, hormone replacement therapy,
multiple sclerosis, and stroke. Significant differences were found
between the saliva cortisol samples for the yawners, t (23) = -4.263, p
= 0.000, as compared with the non-yawners between rest and poststimuli,
which was non-significant. There were also significant
differences between yawners and non-yawners for the EMG
potentials with the yawners having higher rest and post-yawning
potentials. Significant evidence was found to support the Thompson
Cortisol Hypothesis suggesting that rises in cortisol levels are
associated with the yawning response. Further research is underway
to explore the use of cortisol as a potential diagnostic tool as an assist
to the early diagnosis of symptoms related to neurological disorders.
Bournemouth University Research & Ethics approval granted:
JC28/1/13-KA6/9/13. Professional code of conduct, confidentiality,
and safety issues have been addressed and approved in the Ethics
submission. Trials identification number: ISRCTN61942768.
http://www.controlled-trials.com/isrctn/
[1] S. B. N. Thompson, “Born to yawn? Cortisol linked to yawning: a new
hypothesis,” Medical Hypotheses, vol. 77, pp. 861-862, 2011.
[2] A. C. Gallup, and G. G. Jr. Gallup, “Yawning as a brain cooling
mechanism: nasal breathing and forehead cooling diminish the incidence
of contagious yawning,” Evolutionary Psychology, Vol. 5, no. 1, pp. 92-
101, 2007.
[3] S. B. N. Thompson, and P. Bishop, “Born to yawn? Understanding
yawning as a warning of the rise in cortisol levels: randomized trial,”
Interactive J Medical Research, vol. 1, no. 5, pp. 1-9, 2012, doi:
10.2196/ijmr.2241.
[4] O. Walusinski, “Historical perspectives,” in The mystery of yawning in
physiology and disease, J. Bogousslavsky, Eds. Basel: Karger, 2010, pp.
1-21.
[5] M. J. Vigier (translated by), “Les aphorismes d’Hippocrate,” J-A. Lyon:
Huguetan, 1620.
[6] Z. A. Erkut, E. Endert, I. Huitinga, and D.F. Swaab, “Cortisol is
increased in post-mortem cerebrospinal fluid of multiple sclerosis
patients: relationship with cytokines and sepsis,” Multiple Sclerosis,
2002, vol. 8, pp. 229-236.
[7] F. M. Butterworth, G. E. Ristow, and E. Collarini, “Fluctuation of
plasma cortisol levels in multiple sclerosis,” Le Journal Canadien des
Sciences Neurologiques, 1979, vol. 6, no. 1, pp. 59-63.
[8] G. Flesner, A. Ek, and O. Soderhamn, “Lived experience of MS-related
fatigue – a phenomenological interview study,” International J Nursing
Studies, 2003, vol. 40, pp. 707-717.
[9] B. Périn, O. Gogefroy, S. Fall, and G. de Marco, “Alertness in young
healthy subjects: an fMRI study of brain region interactivity enhanced
by a warning signal,” Brain and Cognition, 2010, vol. 72, pp. 271-281.
[10] R. J. Mills, and C. A. Young, “A medical definition of fatigue in
multiple sclerosis,” Quarterly J Medicine, 2008, vol. 101, pp. 49-60.
[11] J. Iriarte, M. L. Subira, and P. De Castro, “Modalities of fatigue in
multiple sclerosis: correlation with clinical and biological factors,”
Multiple Sclerosis, 2000, vol. 6, pp. 124-130.
[12] A. Morelli, S. Ravera, and I. Panfoli, “Myelin sheath: a new possible
role in sleep mechanism,” Sleep Medicine, 2011, vol. 12, pp. 198-199.
[13] T. Postert, D. Pöhlau, S. Meves, I. Nastos, and H. Przuntek,
“Pathological yawning as a symptom of multiple sclerosis,” J
Neurology, 1996, vol. 243, no. 3, pp. 300-301.
[14] A. C. Gallup, and G. G. Jr. Gallup, “Yawning and thermoregulation,”
Physiology and Behavior, 2008, vol. 95, pp. 10-16.
[15] A. C. Gallup, G. G. Jr. Gallup, and C. Feo, “Yawning, sleep, and
symptom relief in patients with multiple sclerosis,” Sleep Medicine,
2010, vol. 11, pp. 329-330.
[16] A. C. Gallup, M. L. Miller, and A. B. Clark, “The direction and range of
ambient temperature influences yawning in budgerigars (Melopsittacus
undulates),” J Comparative Psychology, 2010, vol. 124, pp. 133-138.
[17] F. Zellini, G. Niepel, and C. R. Tench, “Constantinescu CS.
Hypothalamic involvement assessed by T1 relaxation time in patients
with relapsing-remitting multiple sclerosis,” Multiple Sclerosis, 2009,
vol. 15, no. 12, pp. 1442-1449.
[18] F. Nahab, “Exploring yawning with neuroimaging,” in The mystery of
yawning in physiology and disease, J. Bogousslavsky, Eds. Basel:
Karger, 2010, pp. 128-133.
[19] J. Anias-Calderon, L. Verdugo-Diaz, and R. Drucker-Colin,
“Adrenalectomy and dexamethasone replacement on yawning behavior,”
Behavior Brain Res, 2004, vol. 154, pp. 255-259.
[20] H. Krestel, C. Weisstanner, C. Hess, C. Bassetti, A. Nirkko, and R.
Wiest, “Insular and caudate lesions release abnormal yawning in stroke
patients,” Brain Struct Funct, 2013, doi 10.1007/s00429-013-0684-6.
[21] R. P. Snaith RP, and A. S. Zigmond, “Hospital Anxiety and Depression
Scale,” Acta Psych Scand, 1994, vol. 67, pp. 361-370.
[22] O. A. Abiodun, “A validity study of the Hospital Anxiety and
Depression Scale in general hospital units and a community sample in
Nigeria,” Br J Psychiatry, 1994, vol. 165, pp. 169-172.
[23] D. Goldberg, “Use of the General Health Questionnaire in clinical
work,” Br Med J, 1986, vol. 293, pp. 1188-1189.
[24] M. H.Banks, “Validation of the General Health Questionnaire in a young
community sample,” Psychological Medicine, 1983, vol.13, pp. 349-
353.
[25] A. Lobo, M. J. Pérez-Echeverría, and J. Artal, “Validation of the scaled
version of the General Health Questionnaire (GHQ28) in a Spanish
population,” Psychological Medicine, 1986, vol. 16, pp. 135-140.
[26] K. W. Bridges, and D. Goldberg, “The validation of the GHQ28 and the
use of the MMSE in neurological in-patients,” Br J Psychiatry, 1986,
vol. 148, pp. 548-553.
[27] O. Walusinki, “How yawning switches the default-mode network to the
attentional network by activating the cerebrospinal fluid flow,” Clinical
Anatomy, 2014, vol. 27, pp. 201-209.
[28] S. B. N. Thompson, “Dementia and memory. A handbook for students
and professionals,” Aldershot: Ashgate, 2006, pp. 117-118.
[29] G. Abbey, S. B. N. Thompson, T. Hickish, and D. Heathcote, “A metaanalysis
of prevalence rates and moderating factors for cancer-related
post-traumatic stress disorder,” Psycho-Oncology, 2014, vol. 23, pp. 1-
12, doi: 10.1002/pon.3654.
[1] S. B. N. Thompson, “Born to yawn? Cortisol linked to yawning: a new
hypothesis,” Medical Hypotheses, vol. 77, pp. 861-862, 2011.
[2] A. C. Gallup, and G. G. Jr. Gallup, “Yawning as a brain cooling
mechanism: nasal breathing and forehead cooling diminish the incidence
of contagious yawning,” Evolutionary Psychology, Vol. 5, no. 1, pp. 92-
101, 2007.
[3] S. B. N. Thompson, and P. Bishop, “Born to yawn? Understanding
yawning as a warning of the rise in cortisol levels: randomized trial,”
Interactive J Medical Research, vol. 1, no. 5, pp. 1-9, 2012, doi:
10.2196/ijmr.2241.
[4] O. Walusinski, “Historical perspectives,” in The mystery of yawning in
physiology and disease, J. Bogousslavsky, Eds. Basel: Karger, 2010, pp.
1-21.
[5] M. J. Vigier (translated by), “Les aphorismes d’Hippocrate,” J-A. Lyon:
Huguetan, 1620.
[6] Z. A. Erkut, E. Endert, I. Huitinga, and D.F. Swaab, “Cortisol is
increased in post-mortem cerebrospinal fluid of multiple sclerosis
patients: relationship with cytokines and sepsis,” Multiple Sclerosis,
2002, vol. 8, pp. 229-236.
[7] F. M. Butterworth, G. E. Ristow, and E. Collarini, “Fluctuation of
plasma cortisol levels in multiple sclerosis,” Le Journal Canadien des
Sciences Neurologiques, 1979, vol. 6, no. 1, pp. 59-63.
[8] G. Flesner, A. Ek, and O. Soderhamn, “Lived experience of MS-related
fatigue – a phenomenological interview study,” International J Nursing
Studies, 2003, vol. 40, pp. 707-717.
[9] B. Périn, O. Gogefroy, S. Fall, and G. de Marco, “Alertness in young
healthy subjects: an fMRI study of brain region interactivity enhanced
by a warning signal,” Brain and Cognition, 2010, vol. 72, pp. 271-281.
[10] R. J. Mills, and C. A. Young, “A medical definition of fatigue in
multiple sclerosis,” Quarterly J Medicine, 2008, vol. 101, pp. 49-60.
[11] J. Iriarte, M. L. Subira, and P. De Castro, “Modalities of fatigue in
multiple sclerosis: correlation with clinical and biological factors,”
Multiple Sclerosis, 2000, vol. 6, pp. 124-130.
[12] A. Morelli, S. Ravera, and I. Panfoli, “Myelin sheath: a new possible
role in sleep mechanism,” Sleep Medicine, 2011, vol. 12, pp. 198-199.
[13] T. Postert, D. Pöhlau, S. Meves, I. Nastos, and H. Przuntek,
“Pathological yawning as a symptom of multiple sclerosis,” J
Neurology, 1996, vol. 243, no. 3, pp. 300-301.
[14] A. C. Gallup, and G. G. Jr. Gallup, “Yawning and thermoregulation,”
Physiology and Behavior, 2008, vol. 95, pp. 10-16.
[15] A. C. Gallup, G. G. Jr. Gallup, and C. Feo, “Yawning, sleep, and
symptom relief in patients with multiple sclerosis,” Sleep Medicine,
2010, vol. 11, pp. 329-330.
[16] A. C. Gallup, M. L. Miller, and A. B. Clark, “The direction and range of
ambient temperature influences yawning in budgerigars (Melopsittacus
undulates),” J Comparative Psychology, 2010, vol. 124, pp. 133-138.
[17] F. Zellini, G. Niepel, and C. R. Tench, “Constantinescu CS.
Hypothalamic involvement assessed by T1 relaxation time in patients
with relapsing-remitting multiple sclerosis,” Multiple Sclerosis, 2009,
vol. 15, no. 12, pp. 1442-1449.
[18] F. Nahab, “Exploring yawning with neuroimaging,” in The mystery of
yawning in physiology and disease, J. Bogousslavsky, Eds. Basel:
Karger, 2010, pp. 128-133.
[19] J. Anias-Calderon, L. Verdugo-Diaz, and R. Drucker-Colin,
“Adrenalectomy and dexamethasone replacement on yawning behavior,”
Behavior Brain Res, 2004, vol. 154, pp. 255-259.
[20] H. Krestel, C. Weisstanner, C. Hess, C. Bassetti, A. Nirkko, and R.
Wiest, “Insular and caudate lesions release abnormal yawning in stroke
patients,” Brain Struct Funct, 2013, doi 10.1007/s00429-013-0684-6.
[21] R. P. Snaith RP, and A. S. Zigmond, “Hospital Anxiety and Depression
Scale,” Acta Psych Scand, 1994, vol. 67, pp. 361-370.
[22] O. A. Abiodun, “A validity study of the Hospital Anxiety and
Depression Scale in general hospital units and a community sample in
Nigeria,” Br J Psychiatry, 1994, vol. 165, pp. 169-172.
[23] D. Goldberg, “Use of the General Health Questionnaire in clinical
work,” Br Med J, 1986, vol. 293, pp. 1188-1189.
[24] M. H.Banks, “Validation of the General Health Questionnaire in a young
community sample,” Psychological Medicine, 1983, vol.13, pp. 349-
353.
[25] A. Lobo, M. J. Pérez-Echeverría, and J. Artal, “Validation of the scaled
version of the General Health Questionnaire (GHQ28) in a Spanish
population,” Psychological Medicine, 1986, vol. 16, pp. 135-140.
[26] K. W. Bridges, and D. Goldberg, “The validation of the GHQ28 and the
use of the MMSE in neurological in-patients,” Br J Psychiatry, 1986,
vol. 148, pp. 548-553.
[27] O. Walusinki, “How yawning switches the default-mode network to the
attentional network by activating the cerebrospinal fluid flow,” Clinical
Anatomy, 2014, vol. 27, pp. 201-209.
[28] S. B. N. Thompson, “Dementia and memory. A handbook for students
and professionals,” Aldershot: Ashgate, 2006, pp. 117-118.
[29] G. Abbey, S. B. N. Thompson, T. Hickish, and D. Heathcote, “A metaanalysis
of prevalence rates and moderating factors for cancer-related
post-traumatic stress disorder,” Psycho-Oncology, 2014, vol. 23, pp. 1-
12, doi: 10.1002/pon.3654.
@article{"International Journal of Medical, Medicine and Health Sciences:71140", author = "Simon B. N. Thompson", title = "Health Psychology Intervention – Identifying Early Symptoms in Neurological Disorders", abstract = "Cortisol is essential to the regulation of the immune
system and pathological yawning is a symptom of multiple sclerosis
(MS). Electromyography activity (EMG) in the jaw muscles typically
rises when the muscles are moved – extended or flexed; and yawning
has been shown to be highly correlated with cortisol levels in healthy
people as shown in the Thompson Cortisol Hypothesis. It is likely
that these elevated cortisol levels are also seen in people with MS.
The possible link between EMG in the jaw muscles and rises in saliva
cortisol levels during yawning were investigated in a randomized
controlled trial of 60 volunteers aged 18-69 years who were exposed
to conditions that were designed to elicit the yawning response.
Saliva samples were collected at the start and after yawning, or at the
end of the presentation of yawning-provoking stimuli, in the absence
of a yawn, and EMG data was additionally collected during rest and
yawning phases. Hospital Anxiety and Depression Scale, Yawning
Susceptibility Scale, General Health Questionnaire, demographic,
and health details were collected and the following exclusion criteria
were adopted: chronic fatigue, diabetes, fibromyalgia, heart
condition, high blood pressure, hormone replacement therapy,
multiple sclerosis, and stroke. Significant differences were found
between the saliva cortisol samples for the yawners, t (23) = -4.263, p
= 0.000, as compared with the non-yawners between rest and poststimuli,
which was non-significant. There were also significant
differences between yawners and non-yawners for the EMG
potentials with the yawners having higher rest and post-yawning
potentials. Significant evidence was found to support the Thompson
Cortisol Hypothesis suggesting that rises in cortisol levels are
associated with the yawning response. Further research is underway
to explore the use of cortisol as a potential diagnostic tool as an assist
to the early diagnosis of symptoms related to neurological disorders.
Bournemouth University Research & Ethics approval granted:
JC28/1/13-KA6/9/13. Professional code of conduct, confidentiality,
and safety issues have been addressed and approved in the Ethics
submission. Trials identification number: ISRCTN61942768.
http://www.controlled-trials.com/isrctn/", keywords = "Cortisol, Electromyography, Neurology, Yawning.", volume = "9", number = "4", pages = "356-5", }