Form of brain stimulation using magnetic fields

Transcranial magnetic stimulation (TMS) is a noninvasive form of brain stimulation in which a changing magnetic field is used to induce an electric current at a specific area of the brain through electromagnetic induction. An electric pulse generator, or stimulator, is connected to a magnetic coil connected to the scalp. The stimulator generates a changing electric current within the coil which creates a varying magnetic field, which induces a current within a region in the brain itself.[1]:3[2]

TMS has shown diagnostic and therapeutic potential in the central nervous system with a wide variety of disease states in neurology and mental health, with research still evolving.[3][4][5][6][7][8][9][10]

Adverse effects of TMS appear rare and include fainting and seizure.[11] Other potential issues include discomfort, pain, hypomania, cognitive change, hearing loss, and inadvertent current induction in implanted devices such as pacemakers or defibrillators.[11] A number of reports detail significant other adverse experiences, such as new seizures, psychotic symptoms, and other effects.[12][13]

TMS does not require surgery or electrode implantation. Its use can be divided into diagnostic and therapeutic applications. Effects vary based on frequency and intensity of the magnetic pulses as well as the length of treatment, which dictates the total number of pulses given.[15] TMS treatments are approved by the FDA in the US and by NICE in the UK for the treatment of depression and are predominantly provided by private clinics. TMS stimulates cortical tissue without the pain sensations produced in transcranial electrical stimulation.[16]

TMS can be used clinically to measure activity and function of specific brain circuits in humans, most commonly with single or paired magnetic pulses.[3] The most widely accepted use is in measuring the connection between the primary motor cortex of the central nervous system and the peripheral nervous system to evaluate damage related to past or progressive neurologic insult.[3][17][18][19]

Repetitive high frequency TMS (rTMS) has shown diagnostic and therapeutic potential with the central nervous system in a variety of disease states, particularly in the fields of neurology and mental health.[3][4][5][7][8][9][10]

Although TMS is generally regarded as safe, risks are increased for therapeutic rTMS compared to single or paired diagnostic TMS.[20] Adverse effects generally increase with higher frequency stimulation.[11]

The greatest immediate risk from TMS is fainting, though this is uncommon. Seizures have been reported, but are rare.[11][21][22] Other adverse effects include short term discomfort, pain, brief episodes of hypomania, cognitive change, hearing loss, impaired working memory, and the induction of electrical currents in implanted devices such as cardiac pacemakers.[11]

During the procedure, a magnetic coil is positioned at the head of the person receiving the treatment using anatomical landmarks on the skull, in particular the inion and nasion.[14] The coil is then connected to a pulse generator, or stimulator, that delivers electric current to the coil.[2]

TMS uses electromagnetic induction to generate an electric current across the scalp and skull.[23][24] A plastic-enclosed coil of wire is held next to the skull and when activated, produces a varying magnetic field oriented orthogonal to the plane of the coil. The changing magnetic field then induces an electric current in the brain that activates nearby nerve cells in a manner similar to a current applied superficially at the cortical surface.[25]

The magnetic field is about the same strength as an MRI, and the pulse generally reaches no more than 5 centimeters into the brain, unless using a modified coil and technique for deeper stimulation.[24]

Transcranial magnetic stimulation is achieved by quickly discharging current from a large capacitor into a coil to produce pulsed magnetic fields between 2 and 3 Tesla in strength.[26] Directing the magnetic field pulse at a targeted area in the brain causes a localized electrical current which can then either depolarize or hyperpolarize neurons at that site. The induced electric field inside the brain tissue causes a change in transmembrane potentials resulting in depolarization or hyperpolarization of neurons, causing them to be more or less excitable, respectively.[26]

Deep TMS can reach up to 6cm into the brain to stimulate deeper layers of the motor cortex, such as that which controls leg motion. The path of this current can be difficult to model because the brain is irregularly shaped with variable internal density and water content, leading to a nonuniform magnetic field strength and conduction throughout its tissues.[27]

The effects of TMS can be divided based on frequency, duration and intensity (amplitude) of stimulation:[28]

Most devices use a coil shaped like a figure-eight to deliver a shallow magnetic field that affects more superficial neurons in the brain.[9] Differences in magnetic coil design are considered when comparing results, with important elements including the type of material, geometry and specific characteristics of the associated magnetic pulse.

The core material may be either a magnetically inert substrate ('air core'), or a solid, ferromagnetically active material ('solid core'). Solid cores result in more efficient transfer of electrical energy to a magnetic field and reduce energy loss to heat, and so can be operated with the higher volume of therapy protocols without interruption due to overheating. Varying the geometric shape of the coil itself can cause variations in focality, shape, and depth of penetration. Differences in coil material and its power supply also affect magnetic pulse width and duration.[32]

A number of different types of coils exist, each of which produce different magnetic fields. The round coil is the original used in TMS. Later, the figure-eight (butterfly) coil was developed to provide a more focal pattern of activation in the brain, and the four-leaf coil for focal stimulation of peripheral nerves. The double-cone coil conforms more to the shape of the head.[33] The Hesed (H-core), circular crown and double cone coils allow more widespread activation and a deeper magnetic penetration. They are supposed to impact deeper areas in the motor cortex and cerebellum controlling the legs and pelvic floor, for example, though the increased depth comes at the cost of a less focused magnetic pulse.[11]

Luigi Galvani (17371798) undertook research on the effects of electricity on the body in the late-eighteenth century and laid the foundations for the field of electrophysiology.[34] In the 1830s Michael Faraday (17911867) discovered that an electrical current had a corresponding magnetic field, and that changing one could induce its counterpart.[35]

Work to directly stimulate the human brain with electricity started in the late 1800s, and by the 1930s the Italian physicians Cerletti and Bini had developed electroconvulsive therapy (ECT).[34] ECT became widely used to treat mental illness, and ultimately overused, as it began to be seen as a panacea. This led to a backlash in the 1970s.[34]

In 1980 Merton and Morton successfully used transcranial electrical stimulation (TES) to stimulate the motor cortex. However, this process was very uncomfortable, and subsequently Anthony T. Barker began to search for an alternative to TES.[36] He began exploring the use of magnetic fields to alter electrical signaling within the brain, and the first stable TMS devices were developed in 1985.[34][35] They were originally intended[by whom?] as diagnostic and research devices, with evaluation of their therapeutic potential being a later development.[34][35] The United States' FDA first approved TMS devices in October 2008.[34]

TMS has shown potential therapeutic effect on neurologic conditions such as Alzheimer's disease,[4] amyotrophic lateral sclerosis,[4][37] persistent vegetative states,[4] epilepsy,[4][38] stroke related disability,[4][11][18][19][39][40] tinnitus,[4][41] multiple sclerosis,[4] schizophrenia,[4][10] and traumatic brain injury.[42]

With Parkinson's disease, early results suggest that low frequency stimulation may have an effect on medication associated dyskinesia, and that high frequency stimulation improves motor function.[43] The most effective treatment protocols appear to involve high frequency stimulation of the motor cortex, particularly on the dominant side,[44] but with more variable results for treatment of the dorsolateral prefrontal cortex.[45] It is less effective than electroconvulsive therapy for motor symptoms, though both appear to have utility.[46][47][48] Cerebellar stimulation has also shown potential for the treatment of levodopa associated dyskinesia.[49]

In psychiatry, it has shown potential with anxiety disorders, including panic disorder[50] and obsessivecompulsive disorder (OCD).[4] The most promising areas to target for OCD appear to be the orbitofrontal cortex and the supplementary motor area.[51] Older protocols that targeted the prefrontal dorsal cortex were less successful.[52] It has also been studied with autism,[53] substance abuse,[4] addiction,[4][54] and post-traumatic stress disorder (PTSD).[4] For treatment-resistant major depressive disorder, high-frequency (HF) rTMS of the left dorsolateral prefrontal cortex (DLPFC) appears effective and low-frequency (LF) rTMS of the right DLPFC has probable efficacy.[4][5][7][8][9] Research on the efficacy of rTMS in non-treatment-resistant depression is limited.[55]

TMS can also be used to map functional connectivity between the cerebellum and other areas of the brain.[56]

Mimicking the physical discomfort of rTMS with placebo to discern its true effect is a challenging issue in research.[4][11][57][58] It is difficult to establish a convincing placebo for TMS during controlled trials in conscious individuals due to the neck pain, headache and twitching in the scalp or upper face associated with the intervention.[4][11] In addition, placebo manipulations can affect brain sugar metabolism and MEPs, which may confound results.[59] This problem is exacerbated when using subjective measures of improvement.[11] Placebo responses in trials of rTMS in major depression are negatively associated with refractoriness to treatment.[60]

A 2011 review found that most studies did not report unblinding. In the minority that did, participants in real and sham rTMS groups were not significantly different in their ability to correctly guess their therapy, though there was a trend for participants in the real group to more often guess correctly.[61]

TMS research in animal studies is limited due to its early US Food and Drug Administration approval for treatment-resistant depression, limiting development of animal specific magnetic coils.[62]

Nexstim obtained United States Federal Food, Drug, and Cosmetic ActSection 510(k) clearance for the assessment of the primary motor cortex for pre-procedural planning in December 2009[63] and for neurosurgical planning in June 2011.[64]

Depression The National Institutes of Health estimates depression medications work for only 60 percent to 70 percent of people who take them.[65][66] It is approved as a Class II medical device under the "de novo pathway".[67][68] The National Institutes of Health estimates depression medications work for only 60 percent to 70 percent of people who take them.[69] In addition, the World Health Organization reports that the number of people living with depression has increased nearly 20 percent since 2005.[70] In a 2012 study, TMS was found to improve depression significantly in 58 percent of patients and provide complete remission of symptoms in 37 percent of patients.[71]

In the European Economic Area, various versions of Deep TMS H-coils have CE marking for Alzheimer's disease,[72] autism,[72] bipolar disorder,[73] epilepsy,[74] chronic pain,[73] major depressive disorder,[73] Parkinson's disease,[44][75] post-traumatic stress disorder (PTSD),[73] schizophrenia (negative symptoms)[73] and to aid smoking cessation.[72] One review found tentative benefit for cognitive enhancement in healthy people.[76]

In August 2018, the US Food and Drug Administration authorized the use of TMS in the treatment of obsessivecompulsive disorder (OCD).[77]

The United Kingdom's National Institute for Health and Care Excellence (NICE) issues guidance to the National Health Service (NHS) in England, Wales, Scotland and Northern Ireland (UK). NICE guidance does not cover whether or not the NHS should fund a procedure. Local NHS bodies (primary care trusts and hospital trusts) make decisions about funding after considering the clinical effectiveness of the procedure and whether the procedure represents value for money for the NHS.[78]

NICE evaluated TMS for severe depression (IPG 242) in 2007, and subsequently considered TMS for reassessment in January 2011 but did not change its evaluation.[79] The Institute found that TMS is safe, but there is insufficient evidence for its efficacy.[79]

In January 2014, NICE reported the results of an evaluation of TMS for treating and preventing migraine (IPG 477). NICE found that short-term TMS is safe but there is insufficient evidence to evaluate safety for long-term and frequent uses. It found that evidence on the efficacy of TMS for the treatment of migraine is limited in quantity, that evidence for the prevention of migraine is limited in both quality and quantity.[80]

Subsequently, in 2015, NICE approved the use of TMS for the treatment of depression in the UK and IPG542 replaced IPG242.[81] NICE said "The evidence on repetitive transcranial magnetic stimulation for depression shows no major safety concerns. The evidence on its efficacy in the short-term is adequate, although the clinical response is variable. Repetitive transcranial magnetic stimulation for depression may be used with normal arrangements for clinical governance and audit."

In 2013, several commercial health insurance plans in the United States, including Anthem, Health Net, and Blue Cross Blue Shield of Nebraska and of Rhode Island, covered TMS for the treatment of depression for the first time.[82][83][84][85] In contrast, UnitedHealthcare issued a medical policy for TMS in 2013 that stated there is insufficient evidence that the procedure is beneficial for health outcomes in patients with depression. UnitedHealthcare noted that methodological concerns raised about the scientific evidence studying TMS for depression include small sample size, lack of a validated sham comparison in randomized controlled studies, and variable uses of outcome measures.[86] Other commercial insurance plans whose 2013 medical coverage policies stated that the role of TMS in the treatment of depression and other disorders had not been clearly established or remained investigational included Aetna, Cigna and Regence.[87][88][89]

Policies for Medicare coverage vary among local jurisdictions within the Medicare system,[90] and Medicare coverage for TMS has varied among jurisdictions and with time. For example:

Manufacturers of TMS devices include[when?] Brainsway, Deymed [1], MagVenture [2], Mag&More [3], Magstim, Magnus Medical [4], Nexstim [5], Neuronetics, Neurosoft [6] and Sebers Medical [7].[98][99]

See more here:
Transcranial magnetic stimulation - Wikipedia

As newborns, we enter the world by inhaling. In leaving, we exhale. (In fact, in many languages the word exhale is synonymous with dying.) Breathing is so central to life that it is no wonder humankind long ago noted its value not only to survival but to the functioning of the body and mind and began controlling it to improve well-being.

As early as the first millennium B.C., both the Tao religion of China and Hinduism placed importance on a vital principle that flows through the body, a kind of energy or internal breath, and viewed respiration as one of its manifestations. The Chinese call this energy qi, and Hindus call it prana (one of the key concepts of yoga).

A little later, in the West, the Greek term pneuma and the Hebrew term rah referred both to the breath and to the divine presence. In Latin languages, spiritus is at the root of both spirit and respiration.

Recommendations for how to modulate breathing and influence health and mind appeared centuries ago as well. Pranayama (breath retention) yoga was the first doctrine to build a theory around respiratory control, holding that controlled breathing was a way to increase longevity.

In more modern times, German psychiatrist Johannes Heinrich Schultz developed autogenic training in the 1920s as a method of relaxation. The approach is based partly on slow and deep breathing and is probably still the best-known breathing technique for relaxation in the West today. The contemporary forms of mindfulness meditation also emphasize breathing-based exercises.

In fact, every relaxation, calming or meditation technique relies on breathing, which may be the lowest common denominator in all the approaches to calming the body and mind. Research into basic physiology and into the effects of applying breath-control methods lends credence to the value of monitoring and regulating our inhalations and exhalations.

Even a rudimentary understanding of physiology helps to explain why controlled breathing can induce relaxation. Everyone knows that emotions affect the body. When you are happy, for instance, the corners of your mouth turn up automatically, and the edges of your eyes crinkle in a characteristic expression. Similarly, when you are feeling calm and safe, at rest, or engaged in a pleasant social exchange, your breathing slows and deepens. You are under the influence of the parasympathetic nervous system, which produces a relaxing effect. Conversely, when you are feeling frightened, in pain, or tense and uncomfortable, your breathing speeds up and becomes shallower. The sympathetic nervous system, which is responsible for the bodys various reactions to stress, is now activated. Less well known is that the effects also occur in the opposite direction: the state of the body affects emotions. Studies show that when your face smiles, your brain reacts in kindyou experience more pleasant emotions. Breathing, in particular, has a special power over the mind.

This power is evident in patients who have breathing difficulties. When these difficulties are sporadic and acute, they can trigger panic attacks; when they are chronic, they often induce a more muted anxiety. It is estimated that more than 60 percent of people with chronic obstructive pulmonary disease (COPD) have anxiety or depressive disorders. These disorders probably stem in part from concerns about the consequences of the disease (what could be more distressing than struggling to breathe?), but purely mechanical factors may contribute as well: the difficulty these patients experience often leads to faster breathing, which does not necessarily improve the quality of their oxygen supply but can aggravate their physical discomfort and anxiety.

Rapid breathing can contribute to and exacerbates panic attacks through a vicious circle: fear triggers faster breathing, which increases fear. In 2005 Georg Alpers, now at the University of Mannheim in Germany, and his colleagues observed significant and unconscious hyperventilation when people who had a driving phobia took their vehicles on the highway (where they might not be able to pull over if they become agitated).

Whether anxiety derives from breathing problems or other causes, it can be eased by a number of breathing techniques derived from traditional Eastern approaches (see Six Techniques for Relieving Stress). For example, follow your breath, an exercise that focuses attention on breathing, is one of the first steps in mindfulness meditation, whereas alternate nostril breathing comes from yoga. Combining reassuring thoughts with breathing is an approach incorporated into sophrology, a technique that emphasizes harmony of body and mind and that borrows exercises from many approaches, including yoga and mindfulness.

Overall, research shows that these techniques reduce anxiety, although the anxiety does not disappear completely. Breathing better is a tool, not a panacea. Some methods have been validated by clinical studies; others have not. But all of those I describe in this article apply principles that have been proved effective. They aim to slow, deepen or facilitate breathing, and they use breathing as a focal point or a metronome to distract attention from negative thoughts.

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A close look at one popular techniquecardiac coherenceoffers more detail about the ways that breathing exercises promote relaxation. With the help of biofeedback, the approach attempts to coordinate breathing with heart rate, slowing and steadying breathing to slow and stabilize the heartbeat.

The method was developed based on the understanding that slow, deep breathing increases the activity of the vagus nerve, a part of parasympathetic nervous system; the vagus nerve controls and also measures the activity of many internal organs. When the vagus nerve is stimulated, calmness pervades the body: the heart rate slows and becomes regular; blood pressure decreases; muscles relax. When the vagus nerve informs the brain of these changes, it, too, relaxes, increasing feelings of peacefulness. Thus, the technique works through both neurobiological and psychological mechanisms.

Cardiac coherences stabilization of the heartbeat can dampen anxiety powerfully. Conversely, patients with overactive heartbeats are sometimes misdiagnosed as victims of panic attacks because their racing heartbeat affects their mind.

A typical cardiac coherence exercise involves inhaling for five seconds, then exhaling for the same amount of time (for a 10-second respiratory cycle). Biofeedback devices make it possible to observe on a screen how this deep, regular breathing slows and stabilizes the beats. (The space between two heartbeats on the display is never exactly the same, but it becomes increasingly more consistent with this technique.) Several studies have confirmed the anxiety-diminishing effect of these devices, although the equipment probably has more influence on the motivation to do the exercises (It makes it seem serious, real) than on the physiological mechanisms themselves. Simply applying slow breathing with the same conviction and rigor could well give the same result.

Some versions of cardiac coherence recommend spending more time on exhaling than on inhaling (for example, six and four seconds). Indeed, your heart rate increases slightly when you inhale and decreases when you exhale: drawing out the second phase probably exerts a quieting effect on the heart and, by extension, on the brain. This possibility remains to be confirmed by clinical studies, however.

Other work suggests that the emotional impact of the breathing done in cardiac coherence and various other kinds of exercises stems not only from effects on the peripheryon the parasympathetic nervous systembut also from effects on the central nervous system. Breathing may well act directly on the brain itself.

In 2017, for instance, Mark Krasnow of Stanford University and his colleagues showed in mice that a group of neurons that regulates respiratory rhythms (the pre-Btzinger complex in the brain stem) controls some of the activity of the locus coeruleus, a region involved in attention, wakefulness and anxiety. Breathing techniques may influence this seat of emotions by modulating the activity of the pre-Btzinger complex.

Beyond any direct effects produced by slowed breathing, the attention given to inhaling and exhaling may play a role in the brains response. In 2016 Anselm Doll and his colleagues, all then at the Technical University of Munich, showed that this attentional focus eases stress and negative emotions, in particular by activating the dorsomedial prefrontal cortex, a regulatory area of the brain, and by reducing activity in the amygdala, which is involved in these emotions.

In addition, paying attention to breathing causes most people to slow it down and to deepen it, which as I have mentioned, is soothing. Cognitive resources are limited, and so when individuals concentrate on breathing, they are not thinking about their worries. Those who practice mindfulness learn to notice when their attention drifts away from breathing and goes back to their concerns, and they train themselves to return periodically to their breathing. This refocusing has a relaxing effect on anyone and helps to combat ruminative thinking in people who have anxiety or depression, especially those who are particularly prone to negative thoughts that run in a loop.

What is the best time to apply slow-breathing techniques? One is during occasional episodes of stressfor example, before taking an exam, competing in a sporting event or even attending a routine meeting at work. In 2017 Ashwin Kamath of Manipal University in India and his colleagues studied stage fright before a public speaking engagement. The participants, all medical students, spent 15 minutes doing alternate nostril breathingthat is, slowly inhaling through one nostril and exhaling through the other by applying finger pressure to the side of the nose not being used. Compared with members of the control group, participants experienced somewhat less stress when speaking publicly.

These exercises may also help when insomnia strikes. In 2012 Suzanne M. Bertisch of Harvard Medical School and her colleagues reported, based on survey data, that more than 20 percent of American insomniacs do these breathing exercises to sleep better. They may be on to something. In 2015 Cheryl Yang and her team at National Yang-Ming University in Taiwan showed that 20 minutes of slow breathing exercises (six respiration cycles per minute) before going to bed significantly improves sleep. Insomniac participants went to sleep faster, woke up less frequently in the night and went back to sleep faster when they did wake up. On average, it took them only 10 minutes to fall asleep, almost three times faster than normal. The investigators attributed the results both to the calming mediated by the parasympathetic system and to the relaxing effect of focused breathing.

But respiratory techniques do not work only for acute stresses or sleep problems; they can also relieve chronic anxiety. They are particularly effective in people with psychiatric disorders such as phobias, depression and post-traumatic stress disorder. In 2015 Stefania Doria and her colleagues at Fatebenefratelli e Oftalmico Hospital in Milan, Italy, offered 10 training sessions of two hours each, spread out over two weeks, to 69 patients with anxiety or depressive disorders. The training included a varied set of breathing techniques (such as abdominal breathing, acceleration and deceleration of rhythm, and alternate nostril breathing.), combined with some yoga stretches. The researchers observed a significant decrease in symptoms at the end of the protocol. Even better, improvement was maintained two and six months later, with follow-up sessions just once a week and some home practice during this period.

Breathing exercises also help to counter the accumulation of minor physical tension associated with stress. Therapists recommend doing them regularly during the day, during breaks or at moments of transition between two activities: you simply stop to adjust your posture and allow yourself a few minutes of quiet breathing. Therapists often suggest the 365 method: at least three times a day, breathe at a rhythm of six cycles per minute (five seconds inhaling, five seconds exhaling) for five minutes. And do it every day, 365 days a year. Some studies even suggest that, in addition to providing immediate relief, regular breathing exercises can make people less vulnerable to stress, by permanently modifying brain circuits. In a practice that may seem counterintuitive, however, counselors may encourage some anxious patients to breathe rapidly instead of slowly, as part of an effort to train them to cope with their anxieties (see box Inhale for Panic!).

But why confine breathing techniques to negative emotions? It is also worth applying them during pleasurable moments, to take the time to appreciate and remember them. In short, one can pause and breathe for enjoyment as well as to calm down.

Tradition and experience encourage the use of respiratory-control techniques, and scientific studies increasingly suggest that it is a good idea. Nevertheless, further research is still needed, particularly given that some studies lack control groups. One exception stands out: focusing on breathing often is not a good idea for people having a panic attack that stems from anxiety over their physical state (also known as interoceptive anxiety). In this case, focusing on physiology, such as muscle tension or breathing, may actually amplify panic (Now that Im paying attention to it, my breathing doesnt seem regular. Am I choking? What will happen if I suddenly stop breathing?) For these people, breathing techniques should be tested and practiced under the supervision of a therapist.

Otherwise, considering how often everyone experiences emotional discomfort in their everyday life and its negative consequences on health, we would all do well to regularly pay attention to the way we breathe. Start with brief periods of conscious, quiet breathing several times a day. Breathing is like solar energy for powering relaxation: its a way to regulate emotions that is free, always accessible, inexhaustible and easy to use.

In fact, I am mystified that controlled breathing is not recommended and practiced more widely. Perhaps it is perceived as too simple, commonplace and obvious to be a remedy. Faced with the complexity of negotiating the ups and downs of human life, many people may assume that simple solutions cannot be effective.

Or maybe we are intimidated by the sacred aspect of breathing, by its connection to life and, especially, to death. In the 1869 novel The Man Who Laughs, Victor Hugo wrote: Generations are puffs of breath, that pass away. Man respires, aspires, and expires. Ultimately, we dont like to think that we are nothing more than puffs of breath.

Six Techniques for Relieving Stress

Here are some commonly used breathing techniques. Five to 10 minutes of exercise can relieve sporadic stress and even fend off panic attacks. More regular practice can lower the daily levels of anxiety.

Stand Up Straight

Posture is important for breathing: hold yourself straight, without stiffness, shoulders back, sitting or standing. This body posture facilitates the free play of the respiratory muscles (of the diaphragm and between the ribs). Good posture enables your body to breathe properly on its own.

Follow Your Breath*

Simply observe your respiratory movements: be aware of each inhalation and exhalation. Focus on the sensations you feel as air passes through your nose and throat or on the movements of your chest and belly. When you feel your thoughts drift (which is natural), redirect your attention to your breath.

Abdominal Breathing

Breathe through your stomach as much as possible: start by inflating your belly by inhaling, as if to fill it with air, then swell your chest; as you exhale, first empty your stomach, then your chest. This type of breathing is easier to observe and test while lying down, with one hand on your stomach.

Rhythmic Breathing

Near the end of each inhalation, pause briefly while mentally counting 1, 2, 3 and holding the air before exhaling. This counting while not breathing can also be done after exhaling or between each inhalation or exhalation. It is often recommended for anxious patients to calm anxiety attacks because it induces a beneficial slowing of the breathing rate.

Alternate Nostrils*

Breathe in and out slowly through one nostril, holding the other one closed using your finger; then reverse and continue by alternating regularly. There are many variations of this exercisefor example, inhaling through one nostril and exhaling through the other. Research suggests that what is most important, aside from slowing the breathing rhythm, is breathing through the nose, which is somewhat more soothing than breathing through your mouth.

Think Reassuring Thoughts While Breathing

With each breath, think soothing thoughts (I am inhaling calm). With each exhalation, imagine that you are expelling your fears and worries (I am exhaling stress).

*Technique validated by clinical studies.

Inhale for Panic!

Whereas slow breathing soothes, overly rapid breathing can induce feelings of stress and anxiety. This phenomenon is used in behavioral therapy sessions to train anxious patients to confront their emotions directly. By deliberately hyperventilating, patients artificially trigger an unpleasant anxiety, which they get accustomed to feeling and learn to put in perspective. This technique also enables them to see that poor breathing habits amplify their fear.

See the original post:
Proper Breathing Brings Better Health - Scientific American

Deep-field space image

Hubble Deep UV (HDUV) Legacy Survey; 15k galaxies, released August 16, 2018

ABYSS WFC3/IR Hubble Ultra Deep Field; released January 24, 2019

The Hubble Ultra-Deep Field (HUDF) is a deep-field image of a small region of space in the constellation Fornax, containing an estimated 10,000 galaxies. The original data for the image was collected by the Hubble Space Telescope from September 2003 to January 2004. It includes light from galaxies that existed about 13 billion years ago, some 400 to 800 million years after the Big Bang.

The HUDF image was taken in a section of the sky with a low density of bright stars in the near-field, allowing much better viewing of dimmer, more distant objects. Located southwest of Orion in the southern-hemisphere constellation Fornax, the rectangular image is 2.4 arcminutes to an edge,[1] or 3.4 arcminutes diagonally. This is about one-tenth of the angular diameter of a full moon viewed from Earth (less than 34 arcminutes),[2] smaller than a 1mm2 piece of paper held 1m away, and equal to roughly one twenty-six-millionth of the total area of the sky. The image is oriented so that the upper left corner points toward north (46.4) on the celestial sphere.

In August and September 2009, the HUDF field was observed at longer wavelengths (1.0 to 1.6m) using the infrared channel of the recently fitted Wide Field Camera 3 (WFC3). This additional data enabled astronomers to identify a new list of potentially very distant galaxies.[3][4]

On September 25, 2012, NASA released a new version of the Ultra-Deep Field dubbed the eXtreme Deep Field (XDF). The XDF reveals galaxies from 13.2 billion years ago, including one thought to have formed only 450 million years after the Big Bang.[5]

On June 3, 2014, NASA released the Hubble Ultra Deep Field 2014 image, the first HUDF image to use the full range of ultraviolet to near-infrared light.[6] A composite of separate exposures taken in 2002 to 2012 with Hubble's Advanced Camera for Surveys and Wide Field Camera 3, it shows some 10,000 galaxies.[7]

On January 23, 2019, the Instituto de Astrofsica de Canarias released an even deeper version[8] of the infrared images of the Hubble Ultra Deep Field obtained with the WFC3 instrument, named the ABYSS Hubble Ultra Deep Field. The new images improve the previous reduction of the WFC3/IR images, including careful sky background subtraction around the largest galaxies on the field of view. After this update, some galaxies were found to be almost twice as big as previously measured.[9][10]

In the years since the original Hubble Deep Field, the Hubble Deep Field South and the GOODS sample were analyzed, providing increased statistics at the high redshifts probed by the HDF. When the Advanced Camera for Surveys (ACS) detector was installed on the HST, it was realized that an ultra-deep field could observe galaxy formation out to even higher redshifts than had currently been observed, as well as providing more information about galaxy formation at intermediate redshifts (z~2).[11] A workshop on how to best carry out surveys with the ACS was held at STScI in late 2002. At the workshop Massimo Stiavelli advocated an Ultra Deep Field as a way to study the objects responsible for the reionization of the Universe.[12] Following the workshop, the STScI Director Steven Beckwith decided to devote 400 orbits of Director's Discretionary time to the UDF and appointed Stiavelli as the lead of the Home Team implementing the observations.

Unlike the Deep Fields, the HUDF does not lie in Hubble's Continuous Viewing Zone (CVZ). The earlier observations, using the Wide Field and Planetary Camera 2 (WFPC2) camera, were able to take advantage of the increased observing time on these zones by using wavelengths with higher noise to observe at times when earthshine contaminated the observations; however, ACS does not observe at these wavelengths, so the advantage was reduced.[11]

As with the earlier fields, this one was required to contain very little emission from our galaxy, with little Zodiacal dust. The field was also required to be in a range of declinations such that it could be observed both by southern hemisphere instruments, such as the Atacama Large Millimeter Array, and northern hemisphere ones, such as those located on Hawaii. It was ultimately decided to observe a section of the Chandra Deep Field South, due to existing deep X-ray observations from Chandra X-ray Observatory and two interesting objects already observed in the GOODS sample at the same location: a redshift 5.8 galaxy and a supernova. The coordinates of the field are right ascension 3h 32m 39.0s, declination 274729.1 (J2000). The field is 200 arcseconds to a side, with a total area of 11 square arcminutes,[11] and lies in the constellation of Fornax.[13]

Four filters were used on the ACS, centered on 435, 606, 775 and 850nm, with exposure times set to give equal sensitivity in all filters. These wavelength ranges match those used by the GOODS sample, allowing direct comparison between the two. As with the Deep Fields, the HUDF used Directors Discretionary Time. In order to get the best resolution possible, the observations were dithered by pointing the telescope at slightly different positions for each exposurea process trialled with the Hubble Deep Fieldso that the final image has a higher resolution than the pixels on their own would normally allow.[11]

The observations were done in two sessions, from September 23 to October 28, 2003, and December 4, 2003, to January 15, 2004. The total exposure time is just under 1 million seconds, from 400 orbits, with a typical exposure time of 1200 seconds.[11] In total, 800 ACS exposures were taken over the course of 11.3 days, two per orbit; NICMOS observed for 4.5 days. All the individual ACS exposures were processed and combined by Anton Koekemoer into a set of scientifically useful images, each with a total exposure time ranging from 134,900 seconds to 347,100 seconds. To observe the whole sky to the same sensitivity, the HST would need to observe continuously for a million years.[13]

The sensitivity of the ACS limits its capability of detecting galaxies at high redshift to about 6. The deep NICMOS fields obtained in parallel to the ACS images could in principle be used to detect galaxies at redshift 7 or higher but they were lacking visible band images of similar depth. These are necessary to identify high redshift objects as they should not be seen in the visible bands. In order to obtain deep visible exposures on top of the NICMOS parallel fields a follow-up program, HUDF05, was approved and granted 204 orbits to observe the two parallel fields (GO-10632).[14] The orientation of the HST was chosen so that further NICMOS parallel images would fall on top of the main UDF field.

After the installation of WFC3 on Hubble in 2009, the HUDF09 programme (GO-11563) devoted 192 orbits to observations of three fields, including HUDF, using the newly available F105W, F125W and F160W infra-red filters (which correspond to the Y, J and H bands):[4][15]

Hidden to visible light, another object above the galaxy

The HUDF is the deepest image of the universe ever taken and has been used to search for galaxies that existed between 400 and 800 million years after the Big Bang (redshifts between 7 and 12).[13] Several galaxies in the HUDF are candidates, based on photometric redshifts, to be amongst the most distant astronomical objects. The red dwarf UDF 2457 at distance of 59,000 light-years is the furthest star resolved by the HUDF.[16] The star near the center of the field is USNO-A2.0 0600-01400432 with apparent magnitude of 18.95.[17][bettersourceneeded]

The field imaged by the ACS contains over 10,000 objects, the majority of which are galaxies, many at redshifts greater than 3, and some that probably have redshifts between 6 and 7.[11] The NICMOS measurements may have discovered galaxies at redshifts up to 12.[13]

The HUDF has revealed high rates of star formation during the very early stages of galaxy formation, within a billion years after the Big Bang.[11] It has also enabled improved characterization of the distribution of galaxies, their numbers, sizes and luminosities at different epochs, aiding investigation into the evolution of galaxies.[11] Galaxies at high redshifts have been confirmed to be smaller and less symmetrical than ones at lower redshifts, illuminating the rapid evolution of galaxies in the first couple of billion years after the Big Bang.[11]

The Hubble eXtreme Deep Field (HXDF), released on September 25, 2012, is an image of a portion of space in the center of the Hubble Ultra Deep Field image. Representing a total of two million seconds (about 23 days) of exposure time collected over 10 years, the image covers an area of 2.3 arcminutes by 2 arcminutes,[18] or about 80% of the area of the HUDF. This represents approximately one thirty-two millionth of the sky.

The HXDF contains about 5,500 galaxies, the oldest of which are seen as they were 13.2 billion years ago. The faintest galaxies are one ten-billionth the brightness of what the human eye can see. The red galaxies in the image are the remnants of galaxies after major collisions during their elderly years. Many of the smaller galaxies in the image are very young galaxies that eventually developed into major galaxies, similar to the Milky Way and other galaxies in our galactic neighborhood.[5]

XDF size compared with the size of the Moon

HXDF image shows mature galaxies in the foreground plane, nearly mature galaxies from 5 to 9 billion years ago, and protogalaxies beyond 9 billion years.

Video (02:42) about how the Hubble eXtreme Deep Field image was made.

Continued here:
Hubble Ultra-Deep Field - Wikipedia

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Google in talks to invest $200 million into AI startup | Mint - Mint

For many of us, relaxation means zoning out in front of the TV at the end of a stressful day. But this does little to reduce the damaging effects of stress. To effectively combat stress, we need to activate the bodys natural relaxation response. The Relaxation Response was discovered and coined by AIS Founding Trustee and Fellow,Dr. Herbert Benson . The relaxation response is a physical state of deep rest that changes the physical and emotional responses to stress (e.g., decreases in heart rate, blood pressure, rate of breathing, and muscle tension).

When eliciting the relaxation response:

Your metabolism decreases

Your heart beats slower and your muscles relax

Your breathing becomes slower

Your blood pressure decreases

Your levels of nitric oxide are increased

At AIS we are often asked, What is the best way to relive my stress and relax? Our typical answer includes an explanation that just as the definition of stress is different for everyone, so are the best stress reduction techniques. However, there is one Super Stress Buster that evokes the relaxation response that we widely recommend as useful for everyone- even kids. Can you guess what it is? BREATHING! That is right, simply breathing. It is free and can be practiced anywhere- I bet you are even breathing right now! The key, of course, is focused breathing.

The relaxation response is not lying on the couch or sleeping but a mentally active process that leaves the body relaxed, calm, and focused.

Abdominal breathing for 20 to 30 minutes each day will reduce anxiety and reduce stress. Deep breathing increases the supply of oxygen to your brain and stimulates the parasympathetic nervous system, which promotes a state of calmness. Breathing techniques help you feel connected to your bodyit brings your awareness away from the worries in your head and quiets your mind.

AIS endorses several breathing techniques and even a few tools that can be useful for progression in mastering your breathing, reconnecting your body and mind and stopping the stress response.

1. Quieting Response utilizes visualization and deep breathing (a powerful combination) to stop an acute stress response in its tracks. The entire exercise only takes 6 seconds! First smile inwardly with your eyes and mouth and release the tension in your shoulders. This is a powerful muscle release in the places where most people hold their muscles tense. Then imagine holes in the soles of your feet. As you take a deep breath in, visualize hot air flowing through these holes moving slowly up your legs, through your abdomen and filling your lungs. Relax your muscles sequentially as the hot air moves through them up your body. When you exhale reverse the visualization so you see hot air coming out the same holes in your feet. Repeat throughout the day whenever you need to feel calm and relaxed.

2. Sudarshan Kriya or SKY incorporates specific natural rhythms of the breath which harmonize the body, mind and emotions. This unique breathing technique eliminates stress, fatigue and negative emotions such as anger, frustration and depression, leaving you calm yet energized, focused yet relaxed. There are a series of exercises that you can practice to find relief. To read more about SKY visit one of our new AIS Certified organizations: The Art of Living at http://www.artofliving.org. We will soon post several Art of Living breath courses in our Learning Center.

3. This one is for kidsTeddy Bear Breathing Lie on your back, place one hand on your chest and place your favorite teddy bear on your belly button. Close your eyes and relax your whole body. Breath in slowly through your nose. Your teddy bear should slowly rise, but your chest should not. When you have taken a full deep breath, hold it, count to three then slowly breathe out. Repeat a few times, until your feel relaxed.

1. Stress Eraser-The StressEraser is an award-winning portable biofeedback device that helps you learn to activate your bodys natural relaxation response in minutes without the use of medication. Read More

2. EmWave-The emWave 2 and the emWave Desktop is a scientifically validated heart-rate monitoring system that facilitates learning techniques to create an optimal state in which the heart, mind and emotions are operating in-sync and balanced. Read More

Learning the basics of these breathing techniques isnt difficult, but it does take practice. AIS stress experts recommend setting aside at least 10 to 20 minutes a day for your relaxation practice. If that sounds like a daunting commitment, remember that many of these techniques can be incorporated into your existing daily schedulepracticed at your desk over lunch or on the bus during your morning commute.

If possible, schedule a set time to practice each day. Set aside one or two periods each day. You may find that its easier to stick with your practice if you do it first thing in the morning, before other tasks and responsibilities get in the way.

Practice relaxation techniques while youre doing other things. Meditate while commuting to work on a bus or train, or waiting for a dentist appointment. Try deep breathing while youre doing housework or mowing the lawn. Mindfulness walking can be done while exercising your dog, walking to your car, or climbing the stairs at work instead of using the elevator. Once youve learned techniques such as tai chi or yoga, you can practice them in your office or in the park at lunchtime.

If you exercise, improve the relaxation benefits by adopting mindfulness. Instead of zoning out or staring at a TV as you exercise, try focusing your attention on your body. If youre resistance training, for example, focus on coordinating your breathing with your movements and pay attention to how your body feels as you raise and lower the weights.

Avoid practicing when youre sleepy. These techniques can relax you so much that they can make you very sleepy, especially if its close to bedtime. You will get the most benefit if you practice when youre fully awake and alert. Do not practice after eating a heavy meal or while using drugs, tobacco, or alcohol. Absolutely do not practice any relaxation technique that might make you drowsy while driving.

Expect ups and downs. Dont be discouraged if you skip a few days or even a few weeks. It happens. Just get started again and slowly build up to your old momentum.

I want to hear from you. Do you use focused breathing to reduce stress? What works, what doesnt? Post a comment here or start a conversation in the AIS forum. To read more about these and other stress topics visit The American Institute of Stresss website: http://www.stress.org

Contributed by: Kellie Marksberry

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Take a Deep Breath - The American Institute of Stress