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Why some people can't tell left from right

By Kelly Oakes12th January 2023

It can seem like an almost childish mistake, but a surprising number of adults confuse left from right and scientists are only just starting to understand why.


When British brain surgeon Henry Marsh sat down beside his patient's bed following surgery, the bad news he was about to deliver stemmed from his own mistake. The man had a trapped nerve in his arm that required an operation – but after making a midline incision in his neck, Marsh had drilled out the nerve on the wrong side of his spinal column.

Preventable medical mistakes frequently involve wrong-sided surgery: an injection to the wrong eye, for example, or a biopsy from the wrong breast. These "never events" – serious and largely preventable patient safety accidents – highlight that, while most of us learn as children how to tell left from right, not everyone gets it right.

While for some people, telling left from right is as easy as telling up from down, a significant minority – around one in six people, according to a recent study – struggle with the distinction. Even for those who believe they have no issues, distractions such as ambient noise, or having to answer unrelated questions, can get in the way of making the right choice.


"Nobody has difficulty in saying [something is] front and back, or top and bottom," says Ineke van der Ham, professor of neuropsychology at Leiden University in the Netherlands. But telling left from right is different, she says. "It's because of the symmetry, and because when you turn around, it's the other way around, and that makes it so confusing." 

Left-right discrimination is actually quite a complex process, calling upon memory, language, visual and spatial processing, and mental rotation. In fact, researchers are only just beginning to get to the bottom of exactly what's going on in our brains when we do it – and why it's much easier for some people than others.

Former US President Donald Trump was briefly flummoxed when leaders were asked to cross hands at a summit in the Philippines in 2017 (Credit: AFP/Getty Images)



Around one in 10 people are left-handed, and studies on twins have shown that genetics has a role to play. A study at the University of Oxford recently revealed four regions in human DNA that seem to play a role in determining if someone is left or right handed.

Those who were left-handed were found to have "mutations" in four genes that code for the body's cytoskeleton – the complex scaffolding that sits within cells to help organise them. Scans of people with these mutations showed that the white matter in their brains had a different structure. The left and right sides of the brains of left-handed people were also better connected than in right-handed people.

"Some individuals can tell right from left innately, just can do it without thinking," says Gerard Gormley, a GP and clinical professor at Queen's University Belfast in Northern Ireland. "But others have to go through a process." In an effort to understand what happens in wrong-sided medical errors, Gormley and his colleagues have conducted research on medical students' experience of making left-right decisions and examined the process.

"First of all, you have to orient right from left in yourself," he says. When the answer doesn't come instantly, participants described various techniques, from making an L shape with their thumb and index finger, to thinking about which hand they use to write, or strum a guitar. "For some people it's a tattoo on their body or a piercing," Gormley says.

Then, when figuring out which side is someone else's left or right, the next step is mentally rotating yourself so you're facing in the same direction as the other person. "If I'm facing you, my left hand will be opposite your right hand," says Gormley. "That idea of mentally rotating an object adds an extra degree of complexity." Other research shows that people tend to find it easier to judge if an image shows a left or right hand by imagining their own hand or body rotating.

Research published by Van der Ham and her colleagues in 2020 found that around 15% of people rate themselves as insufficient when it comes to identifying left and right. Almost half of the four hundred participants in the study said they used a hand-related strategy to identify which is which.

The more asymmetrical someone's body is – in terms of writing hand preference, for example – the easier they find it to tell left and right apart

The researchers used something called the Bergen right-left discrimination test to dig deeper into how these strategies work. Participants looked at pictures of stick people either facing toward or away from them, with their arms in various positions, and had to identify their highlighted hand as their left or right. "It seems simple, but it's kind of frustrating if you have to do a hundred of these as quickly as you can," says Van der Ham.

In the first experiment, the participants sat with their hands on a table in front of them. "There was a very clear effect from how this little stick figure was positioned," says Van der Ham. "If you were looking at the back of the head, so it was aligned with you, people were a lot faster and more accurate." Similarly, when the stick person was facing the participant but had their hands crossed, so their left hand was on the same side as the participant's left hand, people tended to do better.

"That tells us that the body really is involved in this," says Van der Ham. The next question was whether participants were using cues from their body at the time of the test to identify left and right, or referring to a stored idea of their body instead.

To answer that, the researchers repeated their experiment, but this time tested four different scenarios: participants sat with their hands either crossed or uncrossed on the table in front of them, and had their hands either visible during the test, or covered with a black cloth.

But the researchers found that none of those changes influenced test performance. In other words, participants didn't need to actually see their hands in order to use their own body to distinguish right from left.

"We haven't completely solved the issue," says Van der Ham. "But we were able to identify our bodies as being a key element in identifying left from right, and that we consult our body representation as we have it in a more static way."

Mistakes made during medical procedures due to left-right errors have led some surgeons to take extra steps to ensure they operate in the right place (Credit: Tommy London/Alamy)

In Van der Ham's experiments, the boost in performance that came from being in line with the stick person was more pronounced in people who said they use a hand-related strategy to tell left from right in their daily lives, as well as in women generally. The researchers also found that men tended to be faster in responding than women, but the data did not back up previous research showing that men perform better overall in left-right discrimination tests.

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Exactly why people differ in their ability to tell left from right isn't clear, though research suggests that the more asymmetrical someone's body is (in terms of writing hand preference, for example) the easier they find it to tell left and right apart. "If one side of your brain is slightly larger than the other, you tend to have a better right-left discrimination," says Gormely.

But it could also be something that we learn in childhood, like other aspects of spatial cognition, says Van der Ham. "If kids are in charge of finding the way around, if you just let them walk in front of you for a couple of metres and make the decisions, those are the kids that ended up being better navigators," she says.

Research by Alice Gomez and colleagues at the Lyon Neuroscience Research Center in France hints that left-right discrimination is something that children can pick up quickly. Gomez designed a two-week intervention programme, delivered by teachers, designed to increase five-to-seven-year-olds' body representation and motor skills.

When they were tested on their ability to locate the correct body part on themselves or a partner – their right knee, for example – after the programme, the number of left-right discrimination errors were almost halved. "It was very easy for us to increase the abilities of children to be able to locate the [body part] on the basis of the name," says Gomez.

One reason for this might be that the children were taught a strategy – to think about their writing hand – for when they couldn't remember right and left. The programme's focus on children's own bodies is another possible explanation, especially as other research shows that an egocentric reference frame is key when we make left-right decisions.

In a typical classroom, children might label body parts on a diagram rather than their own bodies, because the latter is more time-consuming and difficult to assess for a teacher, says Gomez. "It's very rare that they will have the time to be egocentric," she says.

Most of us can distinguish up and down intuitively, but working out left from right can take more mental gymnastics (Credit: Alamy)

While there are plenty of everyday scenarios where knowing left from right is important, there are some situations where it's absolutely critical. Brain surgeon Marsh was able to put right his wrong-sided trapped nerve surgery – but a surgeon removing the wrong kidney or amputating the wrong limb, for example, would have devastating consequences.

Medicine is not the only field where left-right errors can make the difference between life and death: it's possible that a steersman turning the ship right instead of left was a contributing factor in the sinking of the Titanic.

But while some people have to put in more effort to judge left and right, everybody has the ability to get left-right decisions wrong, says Gormley. He hopes that more awareness of how easy it is to make such a mistake will lead to less stigma for those who need to double check their decision.

"As health care professionals, we spend a lot of time labelling spatial orientations: proximal, distal, superior, inferior, but really pay no attention to right or left," he says. "But actually, of all the spatial orientations, that is the most challenging."


Neuroscience of Drumming: Rhythms that Heal "The primitive drumbeat, mimicking the pulsating sound of the human heart, has reverberated through human culture across the globe since the dawn of civilization. In ancient societies, the rhythmic thunder of drums guided tribal dances, marked ceremonial rites, and even served as a form of long-distance communication. This rich cultural tapestry of drumming holds an allure that is far more than just ceremonial; the drum's beat resonates deep within our biological fabric, stirs our shared human narrative, and reaches into the heart of our individual well-being. Neuroscience has begun unraveling the mysteries of this age-old instrument, revealing a profound mind-body connection induced by the primal language of the drum."

Drumming as a Neurobiological Orchestra "When a drummer begins their rhythmic performance, they are not merely creating music. They are engaging in an intense neurobiological exercise that involves numerous brain areas and cognitive processes:

  • The tactile handling of drumsticks requires precise coordination and motor planning, calling upon the functions of the motor cortex.

  • The ability to maintain a steady rhythm or to modify it in response to changing tempos involves the prefrontal cortex, which governs executive functions, decision-making, and adaptive behavior.

  • Simultaneously, the auditory cortex processes the rhythmic sounds, mapping them into comprehensible patterns, while the limbic system - the emotional center of the brain - reacts to the emotional resonance of the beat.

"Thus, drumming creates a unique neurobiological orchestra, where diverse cognitive functions harmonize, fostering creativity, coordination, focus, and emotional expression."

The Drum's Beat: A Resonance with Health "Science has begun to elucidate how this engagement with drumming can have far-reaching effects on mental and physical health.

  • One of the notable impacts of drumming is its ability to alleviate stress and anxiety. A study by Bittman et al., 2001, found that group drumming resulted in significant increases in natural killer cell activity, a marker of immune system function that can help the body combat stress and illness. This effect was attributed to drumming's meditative quality, allowing individuals to enter a state of flow where external worries are set aside, and focus is directed solely towards the rhythm.

  • Moreover, drumming has been shown to facilitate the release of endorphins, the body's natural painkillers, suggesting a role for drumming in managing chronic pain conditions.

  • The rhythmic pulsations of drumming can also entrain brain rhythms, helping to promote the slow, synchronous brain waves seen in relaxation and sleep, thereby offering a natural remedy for insomnia and other sleep disorders."

Drumming Together: Harmonizing Individual Hearts into a Collective Rhythm "Beyond the individual, drumming is a potent tool for fostering social cohesion and connectedness. The act of creating a shared rhythm in a drum circle cultivates a sense of unity and mutual understanding, helping individuals feel more connected to others. Neurobiologically, this might be underpinned by the release of neurochemicals such as oxytocin, which promote feelings of trust and bonding."

"This communal aspect of drumming has significant therapeutic implications for populations struggling with social communication, such as those on the autism spectrum. Group drumming can serve as a non-verbal medium of expression, allowing individuals to communicate and connect through shared rhythms."

A Beat for Every Disorder: Therapeutic Drumming and Rehabilitation The multifaceted nature of drumming has made it a tool of interest in therapeutic settings. The rhythmic structure and repetitive movements of drumming can help:

  • Restore motor function in stroke patients

  • Improve gait in Parkinson's disease

  • Enhance focus and impulse control in ADHD. Neurologic

  • Music Therapy, a certified health profession, uses rhythmic interventions like drumming as part of a broader therapeutic toolkit to rehabilitate individuals following neurological injury or disease."

Drumming Your Own Rhythm: Accessing the Power of the Beat "The transformative power of drumming is not confined to the realm of professional drummers or therapists.

  • Drumming is an accessible activity that requires minimal equipment and can be tailored to individual abilities and preferences.

  • More importantly, it offers an outlet for creative expression

  • A medium for catharsis, and a pathway towards meditative mindfulness.

The power of drumming extends far beyond its musical charm. It represents a fusion of art and neuroscience, a blend of culture and therapy, and a rhythm that resonates with our collective human spirit and individual well-being. As we delve deeper into the neuroscience of drumming, we uncover the profound wisdom inherent in our ancestral heritage, reminding us that sometimes, health and happiness are but a beat away."

From John Hopkins Medicine:Health

"If you’ve ever “gone with your gut” to make a decision or felt “butterflies in your stomach” when nervous, you’re likely getting signals from an unexpected source: your second brain. Hidden in the walls of the digestive system, this “brain in your gut” is revolutionizing medicine’s understanding of the links between digestion, mood, health and even the way you think."

"Scientists call this little brain the enteric nervous system (ENS). And it’s not so little. The ENS is two thin layers of more than 100 million nerve cells lining your gastrointestinal tract from esophagus to rectum."

What The Gut Does "Unlike the big brain in your skull, the ENS can’t balance your checkbook or compose a love note. “Its main role is controlling digestion, from swallowing to the release of enzymes that break down food to the control of blood flow that helps with nutrient absorption to elimination,” explains Jay Pasricha, M.D., director of the Johns Hopkins Center for Neurogastroenterology, whose research on the enteric nervous system has garnered international attention. “The enteric nervous system doesn’t seem capable of thought as we know it, but it communicates back and forth with our big brain—with profound results.” The ENS may trigger big emotional shifts experienced by people coping with irritable bowel syndrome (IBS) and functional bowel problems such as constipation, diarrhea, bloating, pain and stomach upset. “For decades, researchers and doctors thought that anxiety and depression contributed to these problems. But our studies and others show that it may also be the other way around,” Pasricha says. Researchers are finding evidence that irritation in the gastrointestinal system may send signals to the central nervous system (CNS) that trigger mood changes. “These new findings may explain why a higher-than-normal percentage of people with IBS and functional bowel problems develop depression and anxiety,” Pasricha says. “That’s important, because up to 30 to 40 percent of the population has functional bowel problems at some point.”

Understanding Can Lead to New Treatments "This new understanding of the ENS-CNS connection helps explain the effectiveness of IBS and bowel-disorder treatments such as antidepressants and mind-body therapies like cognitive behavioral therapy (CBT) and medical hypnotherapy. “Our two brains ‘talk’ to each other, so therapies that help one may help the other,” Pasricha says. “In a way, gastroenterologists (doctors who specialize in digestive conditions) are like counselors looking for ways to soothe the second brain.” Gastroenterologists may prescribe certain antidepressants for IBS, for example—not because they think the problem is all in a patient’s head, but because these medications calm symptoms in some cases by acting on nerve cells in the gut, Pasricha explains. “Psychological interventions like CBT may also help to “improve communications” between the big brain and the brain in our gut,” he says.

Can Probiotics Improve Your Mood? By now, we know that a healthy diet is important for physical well-being. Researchers are studying whether probiotics — live bacteria that are safe to eat — can improve gastrointestinal health and your mood."

More Research to Come "Pasricha says research suggests that digestive-system activity may affect cognition (thinking skills and memory), too. “This is an area that needs more research, something we hope to do here at Johns Hopkins,” he says. Another area of interest: Discovering how signals from the digestive system affect metabolism, raising or reducing risk for health conditions like type 2 diabetes. “This involves interactions between nerve signals, gut hormones and microbiota—the bacteria that live in the digestive system,” Pasricha says. "

For all you with inquiring minds here's the entire article from our PeggyJudyTimeKnewsletter

Emotional Rescue: The Heart-Brain Connection Michael Miller, M.D "The silent, often subconscious conversation that is taking place inside us is one of the most vital communications we will ever find ourselves engaged in. It’s the dialogue of emotion-based signals between our hearts and our brains, also known as the heart-brain connection. Our author tells us what research has uncovered and some of the keys to a longer, healthier life."

"We’ve known for decades that smoking, hypertension, high cholesterol, and diabetes account for most cardiovascular problems. But it wasn’t until publication of the Interheart study (25,000 volunteers spanning 52 countries) that emotional stress was identified as another key risk factor, accounting for about one-third of heart attacks and strokes. Previously, in the 1970s, when volunteers were asked to begin to count to 100 and then to serially subtract seven’s in quick succession (in a test of “mental stress”), blood vessels constricted as if they had taken and failed a cardiac stress test. Except in these cases, testing occurred at rest. In other words, external stressors that are not effectively managed have direct internal implications by placing undue stress on the heart. Fast forward from the 1970s to the present era, and a recent study of more than 135,000 men and women in Sweden that found a history of stress-related disorders, such as post-traumatic stress syndrome, increased the risk of cardiovascular disease by more than 60 percent within just the first year of diagnosis. Mechanistically, the underlying cause of a heart attack is a sudden rupture of an unstable plaque within a coronary artery. During stressful situations, the “fight-or-flight” response jumps into full gear, releasing biochemical compounds such as adrenaline, which raises heart rate and blood pressure, and signals platelets to release a chemical, neuropeptide Y, that can cause spasm and transient occlusion of the coronary artery."

"Another cardiac condition that can result from acute emotional stress is Takotsubo cardiomyopathy, named for the Japanese octopus-trapping pot that the heart comes to resemble. Most commonly occurring after a sudden catastrophic event such as losing a spouse, an outpouring of adrenaline creates a transiently “shocked” state characterized by markedly abnormal contractions in a section of left ventricle and by heart failure. Resolution of the emotional crisis coupled with supportive care generally, but not always, leads to recovery of heart function."

"Beyond single, severely stressful events, living day-to-day with stress is clearly associated with increased risk of heart attack and stroke. We have only recently begun to understand the neurochemical pathways that generate atherosclerosis and cardiovascular disease. They include close communication between the central nervous system, heart, adrenal gland, and kidneys involved in the activation and release of stress hormones such as cortisol and heart damaging neuropeptides. On another level, we have come to appreciate that chronic psychosocial or mental stress accelerates cardiovascular disease by promoting inflammation, oxidative stress, and abnormal function of the endothelium, the protective inner lining of our blood vessels."

Connecting to the Brain’s Emotional Coding Center "If we are to understand how to improve emotional health, it would be useful to probe the brain’s emotional coding center, the amygdala. As an undergraduate at Rutgers University, I had the opportunity to work with Drs. Arthur Kling and Robert Deutsch, a psychiatrist and a neuroscientist doing seminal research into the role of the amygdala in socialization and emotion. After Kling’s team induced frontal lobe lesions in rhesus monkeys and severed connections to the amygdala, their social interactions came to a near halt. Similar behavioral patterns have been reported following amygdalotomy for other emotional behaviors in humans, including pathologic aggression. Loss of socialization skills also occurred after prefrontal lobotomy, as I directly encountered when recording social interactions in patients who had undergone the procedure."

"The association between high levels of social connectivity and favorable cardiovascular effects, including better outcomes after stroke, raises the possibility that a larger amygdala may afford cardioprotection. The Leiden Longevity Study supports this concept: large left amygdala volumes were not only associated with a high level of emotional health, but also correlated with familial longevity. By contrast, reduced social interactions caused by panic disorders have been associated with reduced amygdala volumes in the lateral and basal regions believed to process fear and anxiety. These disorders correlate with reduced parasympathetic tone, a known contributor to cardiovascular disease risk. Amygdala activity has also been suggested to play a role in cardiovascular disease risk prediction. For example, residing in high-paced, crowded, noisy, and polluted cities leads to activation of the perigenual anterior cingulate cortex, a brain region that regulates amygdala activity and response to psychosocial stress. Chronic exposure to stress results in allostatic load that adversely impacts brain plasticity and cardiovascular risk factors, including an exaggerated blood pressure response owing to activation of the perigenual cingulate cortex."

"In a study conducted in Boston, increased amygdala activity at rest, assessed by PET/CT imaging, was also associated with blood vessel inflammation and risk of cardiovascular events over the next four years. The authors proposed that emotional stress signals a region of the amygdala to activate the sympathetic nervous system, promoting the production of pro-inflammatory white blood cells that may trigger heart attack, stroke, or sudden death. This study, among the first to demonstrate a direct relationship between emotional stressors and risk of cardiovascular events builds upon prior work identifying a direct association between amygdala reactivity (in response to threatening facial expressions) and increased carotid intima-media thickness, an anatomic biomarker of atherosclerosis and cardiovascular risk predictor."

"Does counteracting negative stressors reduce cardiovascular risk? While no clinical outcome trials have been conducted to date, adoption of lifestyle strategies aimed at improving positive emotions seems to improve biomarkers of cardiovascular health, such as inflammation, arterial stiffness, and endothelial function. In my cardiology practice and as elaborated upon below, I recommend that my patients employ these five strategies to reduce day-to-day stressors:"

  1. Meditation (serotonin activated relaxation practices)

  2. Yoga (GABA induced mood stabilization)

  3. Laughter (endorphin mediated visual effects)

  4. Music (dopamine regulated auditory effects

  5. Massages, hugging (oxytocin activated tactile responses)

Relaxation Practices "There are several mechanisms by which relaxation strategies such as these improve biomarkers of cardiovascular risk. The first is improvement in parasympathetic tone, the heart’s ability to maintain blood pressure and/or heart rate in the face of daily stressors. (This contrasts with the “fight-or-flight” response described earlier, an adaptive physiological mechanism characterized by increased sympathetic tone with associated rise in blood pressure and heart rate). Examples include the inordinate or “hysterical” strength that arose in a daughter attempting to save her father who was pinned under a car and a mother fighting off a lion that attacked her son."

"Such isolated “spring into action” situations have no lasting cardiovascular consequences in otherwise healthy individuals. But regularly occurring stressful situations can result in persistently heightened sympathetic tone. Under these conditions, the heart is chronically stressed by exaggerated blood pressure and heart rate responses that endure after the stressful situation is resolved. A persistent increase in sympathetic tone, moreover, raises the likelihood of inflammation, abnormal heart rhythms, and increased risk of sudden cardiac death. On the other hand, reduced sympathetic or increased parasympathetic or vagal tone enables the heart to manage stressors, keeping blood pressure and heart rate under better control during stress, and shortening recovery time after activities that raise heart rate (such as aerobic activity). Relaxation strategies like those described above are among the most effective ways to improve parasympathetic tone. Their benefits are also indicated by tests using heat mapping to evaluate the expression of genes that promote oxidative stress and inflammation, important biomarkers for cardiovascular disease."

"One recent study, for example, found that in a group that had practiced meditation on a regular basis, the expression of pro-inflammatory genes was reduced compared to those who had never mediated. In the second stage of the study, one half of the non-meditating group was randomly assigned to relaxation training sessions incorporating meditation, prayer, and yoga. After two months, genetic expression of pro-inflammatory genes resembled that of long-time meditators. Practicing relaxation also reduced the expression of genes promoting insulin resistance, the forerunner of Type 2 diabetes. The results of this study not only affirmed the importance of brain-heart connections on a molecular level but found that relaxation can have a robust effect in a very short time, supporting the adage “never too late to start.”

"Mindfulness meditation, which has become one of the most popular relaxation practices over the past decade, combines heightened, non-judgmental awareness of one’s surroundings and feelings with slow deep breathing exercises. A stress-reduction program based on mindfulness has been associated with improvement in hypertension and depression, while strengthening the immune system and raising activity of telomerase, an enzyme that slows biological aging. Researchers have also studied the cardiovascular impact of practices that incorporate relaxation and movement. Yoga and Tai Chi, for example, improve balance and coordination to help the elderly prevent falls and fractures, and bolster strength and stabilization. In cardiovascular terms, yoga is associated with reduced systolic blood pressure and cholesterol: a recent meta-analysis of 49 trials found that three sessions of yoga weekly reduced systolic blood pressure as much as low-dose antihypertensive medication. Tai Chi has been shown to help suppress inflammation and depression, both cardiovascular disease risk factors. Finally, yoga may also raise brain levels of γ-aminobutyric acid (GABA), a neurotransmitter involved in mood stabilization and stress reduction and both yoga and meditation practices lead to the release of serotonin, another important neurotransmitter involved in mood regulation."

Comic Relief "While it has long been thought that laughter can induce a sense of well-being through the release of endorphins, its connection to cardiovascular health has only become apparent in recent years. Specifically, the β-endorphins released by a hearty belly laugh bind to receptors on the surface of the vascular endothelium to release nitric oxide, a molecule with multiple cardioprotective properties. Recent studies have, in fact, found the risk of heart attack and stroke is reduced in individuals who laugh on a regular basis, compared to those who never or rarely laugh. Laughter also reduces stiffness and aging of blood vessels, including those in the brain."

"A popular way to combine laughter with deep breathing techniques is through laughter yoga. The origins of this practice date back to 1995 when Dr. Madan Kataria, a family physician, assembled a small group in a public park in Mumbai, who met each morning to laugh together through a series of funny expressions and movements that Dr. Kataria devised. Nearly 25 years later, more than 15,000 laughter yoga clubs exist in more than 70 countries worldwide."

"A typical session lasts from 30 to 60 minutes, during which a leader engages participants in exercises designed to elicit forced laughter that converts to emotional laughter as the session wears on. One popular exercise is “milkshake or cocktail laughter,” where participants pretend to pour a glass of milk (or cocktail) into one hand saying “here” then into the other hand repeating “here” and then pretending to drink it or discard it behind their shoulder with repeated laughter. The benefits of laughter yoga include decreased cortisol levels and systolic blood pressure, as well as improvement in indices of depression and overall life satisfaction. While research in this field remains sparse, the encouraging results from these small-scaled studies support the development of a clinical trial in which laughter therapy is one component of an integrated therapeutic lifestyle designed to reduce cardiovascular events."

Music to Your Ears "A number of studies have demonstrated that listening to joyful music offers cardioprotective and neurobiological effects, including reduced inflammation, blood pressure and heart rate, improved parasympathetic tone, and shortened recovery following surgery. The “frisson effect” or the feeling of chills down the spine is a physiological consequence related to the release of dopamine in response to listening to or anticipating pleasurable music. A pilot study suggested that focusing on this sensation (i.e., mindful music) may be a useful intervention to speed recovery following stroke."

The Moral Molecule "The hormone and neurotransmitter oxytocin, released from the posterior pituitary during physical encounters such as touching and hugging, can lower blood pressure and heart rate. More surprisingly, research in recent years has demonstrated that the compound has a direct cardioprotective effect. In animal models, administration of oxytocin not only prevents the death of heart tissue that results in heart failure but may also regenerate new cells. In human studies, intranasal oxytocin has been shown to improve parasympathetic tone during a mental stress test and may offer relief in chronic pain; the latter has intriguing cardiovascular implications, because chronic pain is associated with increased risk of death from heart disease and stroke. More work needs to be done to pinpoint the impact of many of the practices mentioned above. But there is already enough research to conclude that effective management of day-to-day psychosocial stressors is vital to good overall heart and brain health. Beyond good nutrition and regular physical activity, then, consider practicing meditation or yoga on a routine basis. Laugh, listen to music, and hug your favorite people and pets. Such are the keys to a longer, happier life."

Michael Miller, M.D., is Professor of Cardiovascular Medicine at the University of Maryland School of Medicine and serves on the American Heart Association Leadership Council for Lifestyle and Cardiometabolic Health. He is past president of the American Society of Preventive Cardiology, serves as consultant for the National Library of Medicine and assisted the US Postal Service in developing the “Heart Health Stamp.” Miller earned his medical degree at Rutgers Medical School and completed residency at the University of Cincinnati Hospital and fellowships in metabolism and cardiovascular diseases at the Johns Hopkins Hospital. He has published more than 250 original scientific publications, book chapters and three books. His most recent book is Heal Your Heart, The Positive Emotions Prescription to Prevent and Reverse Heart Disease (Random House, 2014). Miller’s twitter feed is @mmillermd1

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