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Augmented cognitive behavioral therapy for post stroke depressive symptoms: a randomized controlled trial

Publication date: Available online 12 November 2016
Source:Archives of Physical Medicine and Rehabilitation
Author(s): Joyce A. Kootker, Sascha MC. Rasquin, Frederik C. Lem, Caroline M. van Heugten, Luciano Fasotti, Alexander C. Geurts
ObjectiveTo evaluate the effectiveness of individually tailored cognitive behavioral therapy (CBT) for reducing depressive symptoms with or without anxiety post stroke.DesignMulti-center, assessor-blinded, randomized controlled trial.SettingSix ambulatory rehabilitation settings in The Netherlands.ParticipantsPatients who had a Hospital Anxiety and Depression Scale – subscale Depression (HADS-D) score > 7 at least three months post stroke.InterventionsSixty-one participants were randomly allocated to either augmented CBT or computerized cognitive training (CCT). The CBT intervention was based on the principles of recognizing, registering, and altering negative thoughts and cognitions. CBT was augmented with goal-directed real-life activity training given by an occupational or movement therapist.Main outcome measuresHADS–D was the primary outcome and measures of participation and quality of life were secondary outcomes. Outcome measurements were performed at baseline, directly post treatment, and at four and eight months follow-up. Analysis was performed with linear mixed models using group (CBT vs CCT) as between-subjects factor and time (4 assessments) as within-subjects factor.ResultsMixed model analyses showed a significant and persistent time effect for HADS–D (MD:-4.6, 95%CI=-5.7;-3.75, p<0.00) as well as for participation and quality of life in both groups. There was no significant group x time effect for any of the outcome measures.ConclusionsOur augmented CBT intervention was not superior to computerized cognitive training for the treatment of mood disorders after stroke. Future studies should determine whether both interventions are better compared to natural history.



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Coping food craving with neurofeedback. Evaluation of the usefulness of alpha/theta training in a non-clinical sample

Publication date: Available online 12 November 2016
Source:International Journal of Psychophysiology
Author(s): Claudio Imperatori, Enrico Maria Valenti, Giacomo Della Marca, Noemi Amoroso, Chiara Massullo, Giuseppe Carbone, Giulia Maestoso, Maria Isabella Quintiliani, Anna Contardi, Benedetto Farina
The aim of the present study was to explore the usefulness of the alpha/theta (A/T) training in reducing Food Craving (FC) in a non-clinical sample. The modifications of electroencephalographic (EEG) power spectra associated with A/T training was also investigated. Fifty subjects were enrolled in the study and randomly assigned to receive ten sessions of A/T training [neurofeedback group (NFG)=25], or to act as controls [waiting list group (WLG)=25]. All participants were administered the Food Cravings Questionnaire-Trait, the Eating Disorder Examination Questionnaire and the Symptom Check list 90. In the post training assessment, compared to the WLG, the NFG showed a significant reduction of intentions and plans to consume food (F1; 49=4.90; p=.033; d=0.626) and of craving as hunger (F1; 49=8.09; p=.007; d=803). In NFG, changes in FC persisted after 4months follow-up. Furthermore, A/T training was also associated with significant increase of resting state EEG alpha power in several brain areas involved in FC (e.g., insula) and food cue reactivity (e.g., parahippocampal gyrus, inferior and superior temporal gyrus). Taken together, our results showed that ten sessions of A/T training are associated with a decrease of self-reported FC in a non-clinical sample. The findings suggest that this brain-directed intervention may be useful in the treatment of dysfunctional eating behaviors characterized by FC.



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Genetic correlates of the development of theta event related oscillations in adolescents and young adults

Publication date: Available online 12 November 2016
Source:International Journal of Psychophysiology
Author(s): David B. Chorlian, Madhavi Rangaswamy, Niklas Manz, Jacquelyn L. Meyers, Sun J. Kang, Chella Kamarajan, Ashwini K. Pandey, Jen-Chyong Wang, Leah Wetherill, Howard Edenberg, Bernice Porjesz
The developmental trajectories of theta band (4–7Hz) event-related oscillations (EROs), a key neurophysiological constituent of the P3 response, were assessed in 2170 adolescents and young adults ages 12 to 25. The theta EROs occurring in the P3 response, important indicators of neurocognitive function, were elicited during the evaluation of task-relevant target stimuli in visual and auditory oddball tasks. Associations between the theta EROs and genotypic variants of 4 KCNJ6 single nucleotide polymorphisms (SNPs) were found to vary with age, sex, scalp location, and task modality. Three of the four KCNJ6 SNPs studied here were found to be significantly associated with the same theta EROs in adults in a previous family genome wide association study. Since measures of the P3 response have been found to be a useful endophenotypes for the study of a number of clinical and behavioral disorders, studies of genetic effects on its development in adolescents and young adults may illuminate neurophysiological factors contributing to the onset of these conditions.



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Ultrasound and magnetic resonance imaging are not interchangeable to assess the Achilles tendon cross-sectional-area

Abstract

Purpose

The major aim of this study was to compare ultrasound (US) and magnetic resonance imaging (MRI) measurements of the Achilles tendon cross-sectional area (CSA). Further aims were to conduct reliability analyses and to assess the influence of transducer pressure on the tendon properties in US measurements.

Methods

The Achilles tendon CSA of 15 participants was assessed at two positions with US and MRI by use of a standardized protocol. Method comparison was performed by two-way analysis of variance (ANOVA) and paired t test. Reliability was assessed by coefficients of variation (CV), intraclass correlation (ICC_2,2), standard error of measurement (SEM), and minimal detectable change (MDC₉₅). A paired t test was performed to investigate the effect of probe pressure on tendon CSA and thickness.

Results

Mean US measurements provided a ~5.5% smaller CSA compared to MRI measurements. Intra-rater reliability analyses of US demonstrated CV values of 1.5–4.9%, ICC of 0.89–0.97, SEM and MDC₉₅ values of 0.22–0.77 mm² and 0.61–2.16 mm² for both raters, whereby CV values for intra-rater reliability of MRI ranged from 1.0 to 3.7%. Inter-rater reliability was lower for both modalities. Pressure applied on the transducer altered Achilles tendon CSA and thickness significantly (p < 0.05).

Conclusions

Our findings show that US and MRI cannot be used interchangeably for Achilles tendon CSA assessments, however, each imaging modality separately is reliable to assess this property. Pressure applied on the transducer during US measurements causes alterations of the tendon's morphology and should be avoided.

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Interlukin-10 gene polymorphisms (-819T/C and -1082A/G) and Type 2 diabetes mellitus in North Indian population

2016-11-12T09-48-37Z
Source: Disease and Molecular Medicine
SUSHMA VERMA, HONEY CHANDRA, MONISHA BANERJEE.
Diabetes is a metabolic disorder characterized by chronic hyperglycemia and impaired cytokine levels leading to inflammation. Interlukin-10 (IL-10) is an anti-inflammatory cytokine which acts as macrophage deactivator affecting the synthesis of TNF-a, IL-1, IL-6, IL-8 and GM-CSF. Single-nucleotide polymorphisms (SNPs) viz. -592A/C, -819T/C and -1082A/G in IL-10 promoter are associated with IL-10 production. Low IL-10 levels in T2DM cases may be regulated by such gene variants. The present study was undertaken to evaluate the association of two genetic polymorphisms viz. IL-10 -819T/C and -1082A/G with T2DM in a North Indian population. Blood samples from 402 subjects (201 each of controls and T2DM cases) were collected after ethical approval and individual written consent. All subjects were genotyped by polymerase chain reaction-restriction length polymorphism (PCR-RFLP) using specific primers and restriction enzymes. Genotypic, allelic, carriage rate frequencies were calculated and haplotypic analysis performed by SPSS (version 21.0) and SHEsis (online version). All biochemical parameters except WHR and TG showed significant association with T2DM (P


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Altered uterine contractility in response to β-adrenoceptor agonists in ovarian cancer

Abstract

We aimed to prospectively examine β-adrenoceptor-mediated uterine contractility in women suffering from gynecological malignancies. Myometrial specimens were obtained from non-pregnant women undergoing hysterectomy for benign gynecological disorders, and ovarian, endometrial, synchronous ovarian–endometrial, and cervical cancer. Contractions of myometrial strips in an organ bath before and after cumulative dosages of β₂- and β₃-adrenoceptor agonists with preincubation of propranolol, SR 59230A, and butoxamine were studied. All agonists induced a dose-dependent attenuation for uterine contractility in endometrial or cervical cancer, similar to that observed in the reference group. Contradictory effects were observed for ovarian cancer alone or in combination with endometrial cancer. CL 316243 or ritodrine abolished the relaxation, whereas BRL 37344 increased the uterine contractility in ovarian cancer. Moreover, β-adrenoceptor antagonists caused varied effects for β₂- or β₃-adrenoceptor agonists. Our experiments demonstrate that ovarian cancer, alone or as synchronous ovarian–endometrial cancer, substantially alters uterine contractility in response to β-adrenoceptor agonists.

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