Optimizing the Social Engagement System in Prader-Willi Syndrome: Insights From the Polyvagal Theory
- Conditions
- Prader-Willi Syndrome
- Interventions
- Behavioral: Listening Project Protocol
- Registration Number
- NCT03101826
- Lead Sponsor
- Indiana University
- Brief Summary
The Polyvagal Theory focuses on how function and structure changed in the vertebrate autonomic nervous system during evolution. The theory is named for the vagus, a major cranial nerve that regulates bodily state. As a function of evolution, humans and other mammals have a "new" vagal pathway that links the regulation of bodily state to the control of the muscles of the face and head including the middle ear muscles. These pathways regulating body state, facial gesture, listening (i.e., middle ear muscles), and vocal communication collectively function as a Social Engagement System (SES). Because the Social Engagement System is an integrated system, interventions influencing one component of this system (e.g., middle ear muscles) may impact on the other components.
Individuals with Prader-Willi Syndrome (PWS) exhibit many behaviors that are consistent with a compromised Social Engagement System. Atypical function of the Social Engagement System results in problems associated with state regulation (e.g., impulsivity, tantrums, and difficulty with change in routine), ingestion (e.g., difficulties in sucking at birth, hyperphagia), coordination of suck/swallow/breathe, intonation of vocalizations, auditory processing and hypersensitivity, and socialization. We propose to confirm that several features of the behavioral phenotype of PWS may be explained within the context of a dysfunctional SES (Specific Aim I), which may be partially rehabilitated via an intervention designed as a 'neural exercise' of the SES (Specific Aim II).
Specific Aims:
Aim I: To demonstrate that children with PWS have atypical regulation of the SES. We hypothesize these effects will be manifested by dampened vagal regulation of the heart (low parasympathetic tone); poor middle ear muscle regulation resulting in auditory hypersensitivities and poor auditory processing; lack of voice intonation (prosody), and difficulties in accurately detecting the emotions of others.
Aim II: To demonstrate the effectiveness of the Listening Project Protocol (LPP) in decreasing the atypical features of the SES in adolescents with PWS. We hypothesize that individuals who complete the LPP will have improved vagal regulation of the heart, improved middle ear muscle regulation, increased voice intonation and improved ability to accurately detect the emotions of others.
- Detailed Description
Not available
Recruitment & Eligibility
- Status
- TERMINATED
- Sex
- All
- Target Recruitment
- 5
- Participants must be current residents at Latham Centers (LC) School in Brewster MA
- Participants must meet criteria for Prader-Willi Syndrome
- Participants must be between ages 13 - 25 years
- Participants must have normal hearing
- Participants must have normal vision (or corrected vision)
- Individuals with current (or a history of) heart disease
- Individuals who are hearing-impaired
- Individuals who are being treated for seizure disorder
- Individuals who do not read/speak English
- Individuals who are sight-impaired without correction
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- SINGLE_GROUP
- Arm && Interventions
Group Intervention Description Filtered Music Intervention Listening Project Protocol All participants will participate in pre-intervention assessments (6 months, 1 week prior) and post-intervention assessments (1 week, 1 month post). The Filtered Music Intervention (i.e., Listening Project Protocol) will last for 1 hour per day, for 5 consecutive days.
- Primary Outcome Measures
Name Time Method Effect of Intervention on Autonomic regulation Change from 1 week pre-intervention RSA to 1 month post-intervention Respiratory sinus arrhythmia (RSA)
- Secondary Outcome Measures
Name Time Method Effect of Intervention on Heart period Change from 1 week pre-intervention heart period to 1 month post-intervention heart period
Effect of Intervention on Sensory Sensitivities Change from 1 week pre-intervention BBC Sensory Scales to 1 month post-intervention BBC Sensory Scales (questionnaire)
Effect of Intervention on Vasopressin Change from 1 week pre-intervention vasopressin to 1 month post-intervention vasopressin levels derived from salivary sample
Effect of Intervention on Latency to Affect recognition Change from 1 week pre-intervention DARE (latency) to 1 month post-intervention Dynamic Affect Recognition Evaluation (DARE) - latency
Effect of Intervention on Accuracy of Affect recognition Change from 1 week pre-intervention DARE (accuracy) to 1 month post-intervention Dynamic Affect Recognition Evaluation (DARE) - accuracy
Effect of Intervention on Prosody Change from 1 week pre-intervention Prosody to 1 month post-intervention Analyses of vocal recordings
Effect of Intervention on Social behavior Change from 1 week post-intervention LPP to 1 month post-intervention Listening Project Parent (LPP) Questionnaire
Effect of Intervention on Auditory processing Change from 1 week pre-intervention Competing Words to 1 month post-intervention Competing Words subtest of SCAN
Effect of Intervention on Oxytocin Change from 1 week pre-intervention oxytocin to 1 month post-intervention oxytocin levels derived from salivary sample
Effect of Intervention on Disruptive Behavior Change from 1 week pre-intervention DBC to 1 month post-intervention Developmental Behavior Checklist (DBC) (questionnaire)
Trial Locations
- Locations (1)
Latham Centers School
🇺🇸Brewster, Massachusetts, United States