title: A bihemispheric autonomic model for traumatic stress effects on health and behavior.
abstract: A bihemispheric autonomic model (BHAM) may support advanced understanding of traumatic stress effects on physiology and behavior. The model builds on established data showing hemispheric lateralization in management of the autonomic nervous system, and proposes that traumatic stress can produce dominant asymmetry in activity of bilateral homologous brain regions responsible for autonomic management. Rightward and leftward dominant asymmetries are associated with sympathetic high arousal or parasympathetic freeze tendencies, respectively, and return to relative symmetry is associated with improved autonomic regulation. Autonomic auto-calibration for recovery (inverse of Jacksonian dissolution proposed by polyvagal theory) has implications for risk behaviors associated with traumatic life stress. Trauma-induced high arousal may be associated with risk for maladaptive behaviors to attenuate arousal (including abuse of alcohol or sedative-hypnotics). Trauma-induced freeze mode (including callous-unemotional trait) may be associated with low resting heart rate and risk for conduct disorders. The model may explain higher prevalence of leftward hemispheric abnormalities reported in studies of violence. Implications of the BHAM are illustrated through case examples of a military special operations officer with history of traumatic brain injury and post-traumatic stress disorder, and a university student with persisting post-concussion symptoms. Both undertook use of a noninvasive closed-loop neurotechnology - high-resolution, relational, resonance-based, electroencephalic mirroring - with ensuing decrease in hemispheric asymmetry, improvement in heart rate variability, and symptom reduction. Finally, the BHAM aligns with calls for researchers to use brain-behavioral constructs (research domain criteria or RDoC, proposed by the National Institutes of Mental Health) as building blocks for assessment and intervention in mental health science.
authors.affiliation: Brain State Technologies LLC Scottsdale, AZ, USA.
authors.forename: Sung W
authors.initials: SW
authors.lastname: Lee
authors.affiliation: Brain State Technologies LLC Scottsdale, AZ, USA.
authors.forename: Lee
authors.initials: L
authors.lastname: Gerdes
authors.affiliation: Department of Neurology, Wake Forest School of Medicine Winston-Salem, NC, USA.
authors.forename: Catherine L
authors.initials: CL
authors.lastname: Tegeler
authors.affiliation: Hypertension and Vascular Research Center, Wake Forest School of Medicine Winston-Salem, NC, USA ; Department of Obstetrics and Gynecology, Wake Forest School of Medicine Winston-Salem, NC, USA.
authors.forename: Hossam A
authors.initials: HA
authors.lastname: Shaltout
authors.affiliation: Department of Neurology, Wake Forest School of Medicine Winston-Salem, NC, USA.
authors.forename: Charles H
authors.initials: CH
authors.lastname: Tegeler
keywords: RDoC; autonomic nervous system; hemispheric asymmetry; polyvagal theory; post-traumatic stress disorder; trauma; traumatic brain injury; violence