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Remore LG, Tolossa M, Wei W, Karnib M, Tsolaki E, Rifi Z, Bari AA. Deep Brain Stimulation of the Medial Forebrain Bundle for Treatment-Resistant Depression: A Systematic Review Focused on the Long-Term Antidepressive Effect. Neuromodulation 2024; 27:690-700. [PMID: 37115122 DOI: 10.1016/j.neurom.2023.03.011] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2022] [Revised: 03/11/2023] [Accepted: 03/20/2023] [Indexed: 04/29/2023]
Abstract
OBJECTIVE Major depression affects millions of people worldwide and has important social and economic consequences. Since up to 30% of patients do not respond to several lines of antidepressive drugs, deep brain stimulation (DBS) has been evaluated for the management of treatment-resistant depression (TRD). The superolateral branch of the medial forebrain bundle (slMFB) appears as a "hypothesis-driven target" because of its role in the reward-seeking system, which is dysfunctional in depression. Although initial results of slMFB-DBS from open-label studies were promising and characterized by a rapid clinical response, long-term outcomes of neurostimulation for TRD deserve particular attention. Therefore, we performed a systematic review focused on the long-term outcome of slMFB-DBS. MATERIALS AND METHODS A literature search using Preferred Reporting Items for Systematic Reviews and Meta-Analyses criteria was conducted to identify all studies reporting changes in depression scores after one-year follow-up and beyond. Patient, disease, surgical, and outcome data were extracted for statistical analysis. The Montgomery-Åsberg Depression Rating Scale (ΔMADRS) was used as the clinical outcome, defined as percentage reduction from baseline to follow-up evaluation. Responders' and remitters' rates were also calculated. RESULTS From 56 studies screened for review, six studies comprising 34 patients met the inclusion criteria and were analyzed. After one year of active stimulation, ΔMADRS was 60.7% ± 4%; responders' and remitters' rates were 83.8% and 61.5%, respectively. At the last follow-up, four to five years after the implantation, ΔMADRS reached 74.7% ± 4.6%. The most common side effects were stimulation related and reversible with parameter adjustments. CONCLUSIONS slMFB-DBS appears to have a strong antidepressive effect that increases over the years. Nevertheless, to date, the overall number of patients receiving implantations is limited, and the slMFB-DBS surgical technique seems to have an important impact on the clinical outcome. Further multicentric studies in a larger population are needed to confirm slMFB-DBS clinical outcomes.
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Affiliation(s)
- Luigi Gianmaria Remore
- Department of Neurosurgery, University of California Los Angeles, Los Angeles, CA, USA; University of Milan "La Statale," Milan, Italy.
| | - Meskerem Tolossa
- Department of Neurosurgery, University of California Los Angeles, Los Angeles, CA, USA
| | - Wexin Wei
- Department of Neurosurgery, University of California Los Angeles, Los Angeles, CA, USA
| | | | - Evangelia Tsolaki
- Department of Neurosurgery, University of California Los Angeles, Los Angeles, CA, USA
| | - Ziad Rifi
- University of California Los Angeles, Los Angeles, CA, USA
| | - Ausaf Ahmad Bari
- Department of Neurosurgery, University of California Los Angeles, Los Angeles, CA, USA; David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
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2
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Yang M, Li QS, Baser RE, Li X, Hou J, Mao JJ. Nocebo expectations rather than placebo expectations affect topical pain relief: A randomized clinical trial. Biomed Pharmacother 2024; 175:116728. [PMID: 38733772 DOI: 10.1016/j.biopha.2024.116728] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2024] [Revised: 05/01/2024] [Accepted: 05/06/2024] [Indexed: 05/13/2024] Open
Abstract
Patients' expectations and beliefs regarding the potential benefits and harms of medical interventions may induce placebo and nocebo effects, and affect the response to pain therapies. In a randomized clinical trial, we examined the effect of placebo and nocebo expectations on pain relief and adverse events (AEs) in association with a topical treatment among 65 cancer survivors experiencing chronic musculoskeletal pain. Participants received either a 1% camphor-based topical pain patch or a placebo treatment for 14 days. We measured pain severity with the worst pain item of the Brief Pain Inventory (BPI) at baseline and 14 days and treatment expectations at baseline with validated expectation questionnaires. We found that high vs. low nocebo expectations decreased pain severity improvements by 2.5 points (95% confidence interval [CI] -3.8 to -1.2; p<0.001) on a 0-10 numeric rating scale of the BPI and pain response rate by 42.7% (95% CI 0.2-0.6; p<0.001) at day 14, irrespective of placebo expectation status or treatment arms. Patients with high vs. low nocebo expectations in the true arm reported 22.4% more unwanted AEs. High nocebo expectations were associated with increased AEs by 39.5% (odds ratio: 12.0, 95% CI 1.2, 145.5; p=0.029) and decreased pain response in the true arm vs. placebo. Our study demonstrated that nocebo expectations, rather than placebo expectations, elevate the risk of AEs and compromise the effect of topical pain interventions. The findings raise the possibility that nocebo expectations may worsen somatic symptoms through heightening central pain amplification and should be further investigated.
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Affiliation(s)
- Mingxiao Yang
- Department of Medical Oncology, Dana-Farber Cancer Institute, and Harvard Medical School, 450 Brookline Ave, Boston, MA 02115, USA
| | - Qing S Li
- Integrative Medicine Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, 321 East 61st Street, New York, NY 10065, USA
| | - Raymond E Baser
- Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, 1250 First Avenue, New York, NY 10065, USA
| | - Xiaotong Li
- Integrative Medicine Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, 321 East 61st Street, New York, NY 10065, USA
| | - Jason Hou
- Integrative Medicine Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, 321 East 61st Street, New York, NY 10065, USA
| | - Jun J Mao
- Integrative Medicine Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, 321 East 61st Street, New York, NY 10065, USA.
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3
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Mollan SP, Fraser CL, Digre KB, Diener HC, Lipton RB, Juhler M, Miller NR, Pozo-Rosich P, Togha M, Brock K, Dinkin MJ, Chan CKM, Tassorelli C, Sinclair AJ, Terwindt GM, Jensen RH. Guidelines of the International Headache Society for Controlled Clinical Trials in Idiopathic Intracranial Hypertension. Cephalalgia 2023; 43:3331024231197118. [PMID: 37661711 DOI: 10.1177/03331024231197118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/05/2023]
Abstract
The quality of clinical trials is essential to advance treatment, inform regulatory decisions and meta-analysis. With the increased incidence of idiopathic intracranial hypertension and the emergence of clinical trials for novel therapies in this condition, the International Headache Society Guidelines for Controlled Clinical Trials in Idiopathic Intracranial Hypertension aims to establish guidelines for designing state-of-the-art controlled clinical trials for idiopathic intracranial hypertension.
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Affiliation(s)
- Susan P Mollan
- Neuro-ophthalmology, Queen Elizabeth Hospital, University Hospital Birmingham NHS Foundation Trust, Birmingham, Birmingham, UK
- Translational Brain Science, Institute of Metabolism and Systems Research, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK
| | - Clare L Fraser
- Save Sight Institute, University of Sydney, Sydney, NSW, Australia
| | - Kathleen B Digre
- Neuro-ophthalmology Division, John A. Moran Eye Center, University of Utah, Salt Lake City, USA
| | - Hans-Christoph Diener
- Institut für Medizinische Informatik, Biometrie undEpidemiologie (IMIBE), Medizinische Fakultät der Universität Duisburg-Essen, Essen, Germany
| | - Richard B Lipton
- The Saul R. Korey Department of Neurology, and the Montefiore Headache Center, Albert Einstein College of Medicine, Bronx, New York, USA
| | - Marianne Juhler
- Department of Neurosurgery, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
- Institute of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Neil R Miller
- Wilmer Eye Institute and Departments of Ophthalmology, Neurology, and Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Patricia Pozo-Rosich
- Headache Unit, Neurology Department, Hospital Universitari Vall d'Hebron, Barcelona, Spain
- Headache and Neurological Pain Research Group, Vall d'Hebron Research Institute, Department of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Mansoureh Togha
- Headache Department, Iranian Centre of Neurological Research, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
- Headache Department, Neurology Ward, Sina Hospital, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Kristian Brock
- Cancer Research Clinical Trials Unit, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK
| | - Marc J Dinkin
- Department of Ophthalmology, Weill Cornell Medical College, NY Presbyterian Hospital, New York, New York, USA
- Department of Neurology, Weill Cornell Medical College, NY Presbyterian Hospital, New York, New York, USA
| | - Carmen K M Chan
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong SAR, China
- Hong Kong Eye Hospital, Hong Kong SAR, China
| | - Cristina Tassorelli
- Unit of Translational Neurovascular Research, IRCCS Mondino Foundation, 27100, Pavia, Italy
- Department of Brain and Behavioural Sciences, University of Pavia, 27100, Pavia, Italy
| | - Alex J Sinclair
- Translational Brain Science, Institute of Metabolism and Systems Research, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK
- Department of Neurology, University Hospitals Birmingham, Queen Elizabeth Hospital, Birmingham, UK
| | - Gisela M Terwindt
- Department of Neurology, Leiden University Medical Center, Leiden, the Netherlands
| | - Rigmor H Jensen
- Department of Neurology, Danish Headache Center, Rigshospitalet-Glostrup, University of Copenhagen, Copenhagen, Denmark
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4
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Vera J, Redondo B, Ocaso E, Martinez‐Guillorme S, Molina R, Jiménez R. Manipulating expectancies in optometry practice: Ocular accommodation and stereoacuity are sensitive to placebo and nocebo effects. Ophthalmic Physiol Opt 2022; 42:1390-1398. [PMID: 35959593 PMCID: PMC9804873 DOI: 10.1111/opo.13036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Revised: 07/06/2022] [Accepted: 07/06/2022] [Indexed: 01/09/2023]
Abstract
INTRODUCTION There is scientific evidence that an individual's beliefs and/or expectations play a role in the behavioural and physiological response to a given treatment. This study aimed to assess whether the dynamics of the accommodative response and stereoacuity are sensitive to experimentally induced placebo and nocebo effects. METHODS Nineteen healthy university students performed three experimental sessions (placebo, nocebo and control) in randomised order, with the dynamics of the accommodative response (magnitude and variability), stereoacuity and subjective measures being assessed in all sessions. For the experimental manipulation, participants ingested an inert capsule that was alleged to have positive (white capsule, placebo condition) or negative (yellow capsule, nocebo conditions) effects on the human physiology. In the control condition, participants did not ingest a capsule. RESULTS The data revealed that the variability of accommodation was sensitive to experimentally induced placebo and nocebo effects, showing a more stable accommodative response for the placebo compared with the nocebo condition (corrected p-value = 0.04, Cohen's d = 0.60). In addition, better stereoacuity was found with the placebo, compared with the nocebo (corrected p-value = 0.01, Cohen's d = 0.69) and control (corrected p-value = 0.03, Cohen's d = 0.59) conditions. Successful experimental manipulation was confirmed by the analysis of subjective perceptions. CONCLUSIONS These findings provide evidence that manipulating expectations about the efficacy of an inert treatment affect the dynamics of the accommodative response (variability of accommodation) and stereoacuity. The results have important applications in both clinical and research outcomes, where individuals´ beliefs/expectations could modulate the visual function.
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Affiliation(s)
- Jesús Vera
- CLARO (Clinical and Laboratory Applications of Research in Optometry) Research Group, Department of Optics, Faculty of SciencesUniversity of GranadaGranadaSpain
| | - Beatriz Redondo
- CLARO (Clinical and Laboratory Applications of Research in Optometry) Research Group, Department of Optics, Faculty of SciencesUniversity of GranadaGranadaSpain
| | - Elena Ocaso
- Óptica del Penedes Optometry CenterZaragozaSpain
| | | | - Rubén Molina
- CLARO (Clinical and Laboratory Applications of Research in Optometry) Research Group, Department of Optics, Faculty of SciencesUniversity of GranadaGranadaSpain
| | - Raimundo Jiménez
- CLARO (Clinical and Laboratory Applications of Research in Optometry) Research Group, Department of Optics, Faculty of SciencesUniversity of GranadaGranadaSpain
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Figee M, Riva-Posse P, Choi KS, Bederson L, Mayberg HS, Kopell BH. Deep Brain Stimulation for Depression. Neurotherapeutics 2022; 19:1229-1245. [PMID: 35817944 PMCID: PMC9587188 DOI: 10.1007/s13311-022-01270-3] [Citation(s) in RCA: 31] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/28/2022] [Indexed: 11/29/2022] Open
Abstract
Deep brain stimulation has been extensively studied as a therapeutic option for treatment-resistant depression (TRD). DBS across different targets is associated with on average 60% response rates in previously refractory chronically depressed patients. However, response rates vary greatly between patients and between studies and often require extensive trial-and-error optimizations of stimulation parameters. Emerging evidence from tractography imaging suggests that targeting combinations of white matter tracts, rather than specific grey matter regions, is necessary for meaningful antidepressant response to DBS. In this article, we review efficacy of various DBS targets for TRD, which networks are involved in their therapeutic effects, and how we can use this information to improve targeting and programing of DBS for individual patients. We will also highlight how to integrate these DBS network findings into developing adaptive stimulation and optimal trial designs.
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Affiliation(s)
- Martijn Figee
- Nash Family Center for Advanced Circuit Therapeutics, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
| | - Patricio Riva-Posse
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Georgia, GA, USA
| | - Ki Sueng Choi
- Nash Family Center for Advanced Circuit Therapeutics, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Lucia Bederson
- Nash Family Center for Advanced Circuit Therapeutics, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Helen S Mayberg
- Nash Family Center for Advanced Circuit Therapeutics, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Brian H Kopell
- Nash Family Center for Advanced Circuit Therapeutics, Icahn School of Medicine at Mount Sinai, New York, NY, USA
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6
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Konstantinidou H, Chartonas D, Rogalski D, Lee T. Will this tablet make me happy again? The contribution of relational prescribing in providing a pragmatic and psychodynamic framework for prescribers. BJPSYCH ADVANCES 2022. [DOI: 10.1192/bja.2022.43] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
SUMMARY
We describe the importance of relational factors in prescribing practices and discuss how they may influence treatment outcomes. Although relational factors play a part in every clinician–patient interaction, they are particularly relevant when managing patients with complex emotional needs. We discuss how relational prescribing can add value when incorporated into standard practice. We introduce psychodynamic theory principles, and we suggest a framework to facilitate reflection and support decision-making when clinicians are faced with complex prescribing decisions.
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7
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Watanabe T, Sieg M, Lunde SJ, Taneja P, Baad-Hansen L, Pigg M, Vase L. What is the nocebo effect and does it apply to dentistry? A narrative review. J Oral Rehabil 2022; 49:586-591. [PMID: 35043415 PMCID: PMC9310768 DOI: 10.1111/joor.13306] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Revised: 10/08/2021] [Accepted: 01/07/2022] [Indexed: 11/29/2022]
Abstract
Background Evidence for the nocebo effect, a phenomenon characterised by suboptimal treatment efficacy, worsening of symptoms, or the occurrence of adverse events caused by an individual’s negative treatment expectations, is growing across a multitude of medical fields. However, little attention has been paid to patients’ negative expectations and the nocebo effect within dentistry. Aim This review summarises essential evidence of the nocebo phenomenon especially in relation to pain and drug administration. Subsequently, an overview of the current evidence of the nocebo phenomenon in the dental field is presented. Methods A PubMed search was performed using keywords related to “nocebo,” “placebo,” “expectations,” and “dentistry.” In addition to the articles selected from the search, placebo/nocebo researchers and dental researchers added important references from their respective fields. Results Although research on the nocebo effect in dentistry is limited, available current evidence suggests that the factors, which is related to the nocebo effect are likely to play a role in dental practice. Conclusion Preliminary evidence from the review warrants further investigation into the nocebo effect in dentistry. Finally, based on the general knowledge of the nocebo effect, the review indicates fruitful arrays of research into the nocebo effect in dentistry.
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Affiliation(s)
- Takeshi Watanabe
- Department of Psychology and Behavioural Sciences, School of Business and Social Sciences, Aarhus University, Aarhus, Denmark.,Department of Preventive Medicine, Tokushima University Graduate School of Biomedical Sciences, Tokushima, Japan
| | - Mette Sieg
- Department of Psychology and Behavioural Sciences, School of Business and Social Sciences, Aarhus University, Aarhus, Denmark
| | - Sigrid Juhl Lunde
- Department of Psychology and Behavioural Sciences, School of Business and Social Sciences, Aarhus University, Aarhus, Denmark
| | - Pankaj Taneja
- Section of Oral and Maxillofacial Surgery and Oral Pathology, Department of Dentistry and Oral Health, Aarhus University, Aarhus, Denmark.,Scandinavian Center of Orofacial Neurosciences, Aarhus, Denmark, Malmö, Sweden
| | - Lene Baad-Hansen
- Section of Orofacial Pain and Jaw Function, Department of Dentistry and Oral Health, Aarhus University, Aarhus, Denmark.,Scandinavian Center of Orofacial Neurosciences, Aarhus, Denmark, Malmö, Sweden
| | - Maria Pigg
- Scandinavian Center of Orofacial Neurosciences, Aarhus, Denmark, Malmö, Sweden.,Department of Endodontics, Faculty of Odontology, Malmö University, Malmö, Sweden
| | - Lene Vase
- Department of Psychology and Behavioural Sciences, School of Business and Social Sciences, Aarhus University, Aarhus, Denmark
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8
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Walther LM, von Känel R, Heimgartner N, Zuccarella-Hackl C, Stirnimann G, Wirtz PH. Alpha-Adrenergic Mechanisms in the Cardiovascular Hyperreactivity to Norepinephrine-Infusion in Essential Hypertension. Front Endocrinol (Lausanne) 2022; 13:824616. [PMID: 35937820 PMCID: PMC9355707 DOI: 10.3389/fendo.2022.824616] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Accepted: 06/10/2022] [Indexed: 12/15/2022] Open
Abstract
AIMS Essential hypertension (EHT) is characterized by cardiovascular hyperreactivity to stress but underlying mechanism are not fully understood. Here, we investigated the role of α-adrenergic receptors (α-AR) in the cardiovascular reactivity to a norepinephrine (NE)-stress reactivity-mimicking NE-infusion in essential hypertensive individuals (HT) as compared to normotensive individuals (NT). METHODS 24 male HT and 24 male NT participated in three experimental trials on three separate days with a 1-min infusion followed by a 15-min infusion. Trials varied in infusion-substances: placebo saline (Sal)-infusions (trial-1:Sal+Sal), NE-infusion without (trial-2:Sal+NE) or with non-selective α-AR blockade by phentolamine (PHE) (trial-3:PHE+NE). NE-infusion dosage (5µg/ml/min) and duration were chosen to mimic duration and physiological effects of NE-release in reaction to established stress induction protocols. We repeatedly measured systolic (SBP) and diastolic blood pressure (DBP) as well as heart rate before, during, and after infusions. RESULTS SBP and DBP reactivity to the three infusion-trials differed between HT and NT (p's≤.014). HT exhibited greater BP reactivity to NE-infusion alone compared to NT (trial-2-vs-trial-1: p's≤.033). Group differences in DBP reactivity to NE disappeared with prior PHE blockade (trial-3: p=.26), while SBP reactivity differences remained (trial-3: p=.016). Heart rate reactivity to infusion-trials did not differ between HT and NT (p=.73). CONCLUSION Our findings suggest a mediating role of α-AR in DBP hyperreactivity to NE-infusion in EHT. However, in SBP hyperreactivity to NE-infusion in EHT, the functioning of α-AR seems impaired suggesting that the SBP hyperreactivity in hypertension is not mediated by α-AR.
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Affiliation(s)
- Lisa-Marie Walther
- Biological Work and Health Psychology, University of Konstanz, Konstanz, Germany
- Centre for the Advanced Study of Collective Behaviour, University of Konstanz, Konstanz, Germany
| | - Roland von Känel
- Department of Consultation-Liaison Psychiatry and Psychosomatic Medicine, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Nadja Heimgartner
- Division of Clinical Psychology and Psychotherapy, University of Basel, Basel, Switzerland
| | - Claudia Zuccarella-Hackl
- Department of Consultation-Liaison Psychiatry and Psychosomatic Medicine, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Guido Stirnimann
- Department of Visceral Surgery and Medicine, University Hospital Inselspital and University of Bern, Bern, Switzerland
| | - Petra H. Wirtz
- Biological Work and Health Psychology, University of Konstanz, Konstanz, Germany
- Centre for the Advanced Study of Collective Behaviour, University of Konstanz, Konstanz, Germany
- *Correspondence: Petra H. Wirtz,
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Myga KA, Kuehn E, Azanon E. Autosuggestion: a cognitive process that empowers your brain? Exp Brain Res 2021; 240:381-394. [PMID: 34797393 PMCID: PMC8858297 DOI: 10.1007/s00221-021-06265-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Accepted: 10/30/2021] [Indexed: 11/16/2022]
Abstract
Autosuggestion is a cognitive process that is believed to enable control over one’s own cognitive and physiological states. Despite its potential importance for basic science and clinical applications, such as in rehabilitation, stress reduction, or pain therapy, the neurocognitive mechanisms and psychological concepts that underlie autosuggestion are poorly defined. Here, by reviewing empirical data on autosuggestion and related phenomena such as mental imagery, mental simulation, and suggestion, we offer a neurocognitive concept of autosuggestion. We argue that autosuggestion is characterized by three major factors: reinstantiation, reiteration, and volitional, active control over one’s own physiological states. We also propose that autosuggestion might involve the ‘overwriting’ of existing predictions or brain states that expect the most common (but not desired) outcome. We discuss potential experimental paradigms that could be used to study autosuggestion in the future, and discuss the strengths and weaknesses of current evidence. This review provides a first overview on how to define, experimentally induce, and study autosuggestion, which may facilitate its use in basic science and clinical practice.
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Affiliation(s)
- Kasia A Myga
- Faculty of Natural Sciences, Otto Von Guericke University Magdeburg, 39106, Magdeburg, Germany. .,Department of Behavioral Neurology, Leibniz Institute for Neurobiology, 39118, Magdeburg, Germany.
| | - Esther Kuehn
- Institute for Cognitive Neurology and Dementia Research (IKND), Otto-Von-Guericke University Magdeburg, 39120, Magdeburg, Germany.,Center for Behavioral Brain Sciences (CBBS) Magdeburg, 39120, Magdeburg, Germany
| | - Elena Azanon
- Department of Behavioral Neurology, Leibniz Institute for Neurobiology, 39118, Magdeburg, Germany.,Center for Behavioral Brain Sciences (CBBS) Magdeburg, 39120, Magdeburg, Germany.,Department of Neurology, Otto-Von-Guericke University, 39120, Magdeburg, Germany
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10
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De Oliveira Chami V, Maracci LM, Tomazoni F, Centeno ACT, Porporatti AL, Ferrazzo VA, Marquezan M. Rapid LLLT protocol for myofascial pain and mouth opening limitation treatment in the clinical practice: An RCT. Cranio 2020; 40:334-340. [PMID: 32491956 DOI: 10.1080/08869634.2020.1773660] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
OBJECTIVE To evaluate the effect of a rapid treatment protocol of low-level laser therapy (LLLT) in patients with myofascial pain and mouth opening limitation. METHODS Twenty patients were randomly allocated into the laser group (LG) (n = 10) and the placebo group (PG) (n = 10). Two LLLT sessions or placebo were performed. They were applied to the pain points upon palpation, with a 48-hr interval. Patients were evaluated for spontaneous pain sensitivity during mandibular movements and for oral health-related quality of life, which was assessed using the Oral Health Impact Profile for Temporomandibular Disorders (OHIP/TMD) questionnaire. RESULTS Two patients from the placebo group were lost during the study. A significant increase in the maximum mouth opening (p = 0.04) and improvement in OHIP/TMD scores (p = 0.003) were observed in the LG after 30 days. CONCLUSION Spontaneous pain was reduced in both groups with low-level laser therapy.
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Affiliation(s)
| | | | - Fernanda Tomazoni
- Department of Physiology, Federal University of Santa Maria , Santa Maria, Brazil
| | | | - André Luiz Porporatti
- Department of Dentistry, Federal University of Santa Catarina , Florianópolis, Brazil
| | | | - Mariana Marquezan
- Department of Stomatology, Federal University of Santa Maria , Santa Maria, Brazil
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11
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Magri LV, Bataglion C, Leite-Panissi CRA. Follow-up results of a randomized clinical trial for low-level laser therapy in painful TMD of muscular origins. Cranio 2019; 39:502-509. [PMID: 31585522 DOI: 10.1080/08869634.2019.1673588] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Objective: To characterize short- and long-term assessment of the low-intensity laser therapy (LLLT) effectiveness in women with TMD of muscular origins and to evaluate whether the information about the treatment received (active or placebo) modifies the pain intensity.Methods: Forty-one women with painful TMD (31.7 ± 5.2 years) were divided into laser (n = 20) and placebo (n = 21) groups. The pain intensity was measured at the baseline, after the LLLT (T8), 6 and 12 months. At the 6-month follow-up, the groups received information about the active or placebo treatment.Results: At T8 and 6-month, both active and placebo LLLT were effective in reducing pain (p < .05). After one year, the groups showed similar pain. Active LLLT was more effective in reducing pain palpation (p = .001) and referred pain (p = .04) in the region of the TMJs. The information about the treatment modified the perceived pain intensity.Conclusion: Active and placebo LLLT are effective for painful TMD of muscular origins in the short-term. Information about the treatment impairs the subjective perception of pain.
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Affiliation(s)
- Laís Valencise Magri
- Department of Psychology, School of Philosophy, Science and Literature of Ribeirão Preto, University of São Paulo, Ribeirão Preto, SP, Brazil.,Department of Restorative Dentistry of Dentistry School of Ribeirão Preto, University of São Paulo, São Paulo, SP, Brazil
| | - César Bataglion
- Department of Restorative Dentistry of Dentistry School of Ribeirão Preto, University of São Paulo, São Paulo, SP, Brazil
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12
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Bergemann N, Bruhn K, Loscheider K, Vogt D, Böhnke JR, Gerhards F. How to determine whether conceptual endophenotypes can improve clinical outcomes in patients suffering from major depression: An exploratory approach. Psychoneuroendocrinology 2019; 105:195-204. [PMID: 30954330 DOI: 10.1016/j.psyneuen.2019.03.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2018] [Revised: 02/07/2019] [Accepted: 03/14/2019] [Indexed: 11/19/2022]
Abstract
Depression is a complex mental health disorder, resulting in a high degree of disability. Since symptom constellation, course, and outcome are heterogeneous in these patients, current research initiatives are striving to establish stratified diagnostic and treatment approaches. In the past two decades, Dirk Hellhammer and his team introduced Neuropattern, a new diagnostic concept, which is based on conceptual endophenotypes of the stress response network. We explore how to use this concept in clinical practice in order to ultimately determine whether it brings any value over standard care. In view of the novelty of the concept and the difficulties dealing with such a concept at a practical level, it was necessary to initiate an exploratory study to determine key factors for planning future clinical trials. We report results and knowledge gained from an exploratory single-site study investigating the use and potential benefits of Neuropattern in standard care. Inpatients (ICD-10 diagnosis F32, F33; Nö=ö178) were allocated to either treatment as usual (standard group, SG) or a novel Neuropattern oriented exploratory treatment (intervention group, IG). Symptom severity was assessed with psychometric tests at admission to hospital, during the first six weeks, and upon discharge from the hospital. In addition, direct and indirect costs were assessed for the 3-month-intervals prior to and after the hospital stay. Compared to the SG, depression scores of patients in the IG showed a faster decline once psychotherapeutic and pharmacological treatment were based on an individualized explanatory model. The patients in the IG with an F33 diagnosis showed a more pronounced reduction of depression severity during the stay in the hospital and a stronger and quicker reduction of general symptom severity. Comparing the average depression scores at the start of the study and after six weeks, symptom severity was reduced in all Neuropattern groups. Some limitations of the study have to be mentioned: The study was not blinded, was single-site, included highly depressed inpatients only, and was conducted for no longer than 8 months. The results highlight some important issues regarding taking the Neuropattern approach to the bedside and researching its efficacy and effectiveness to support personalized treatments in clinical care.
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Affiliation(s)
- N Bergemann
- Schoen Clinic, Hofgarten 10, D-34454 Bad Arolsen, Germany; Kitzberg Hospitals, Center for Psychosomatic Medicine and Psychotherapy, Erlenbachweg 22/24, D-97980 Bad Mergentheim, Germany.
| | - K Bruhn
- Schoen Clinic, Hofgarten 10, D-34454 Bad Arolsen, Germany; Department of Psychology, Division of Clinical and Physiological Psychology, Trier University, Johanniterufer 15, D-54290 Trier, Germany
| | - K Loscheider
- Schoen Clinic, Hofgarten 10, D-34454 Bad Arolsen, Germany; Stress Center Trier, Science Park, Max-Planck-Str. 22, D-54296 Trier, Germany
| | - D Vogt
- Department of Psychology, Division of Clinical and Physiological Psychology, Trier University, Johanniterufer 15, D-54290 Trier, Germany
| | - J R Böhnke
- Mental Health and Addiction Research Group, Hull York Medical School and Department of Health Sciences, University of York, Heslington, York, YO10 5DD, United Kingdom; Dundee Centre for Health and Related Research, School of Nursing and Health Sciences (SNHS), University of Dundee, 11 Airlie Place, Dundee, DD1 4HJ, United Kingdom
| | - F Gerhards
- Department of Psychology, Division of Clinical and Physiological Psychology, Trier University, Johanniterufer 15, D-54290 Trier, Germany
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Diener HC, Tassorelli C, Dodick DW, Silberstein SD, Lipton RB, Ashina M, Becker WJ, Ferrari MD, Goadsby PJ, Pozo-Rosich P, Wang SJ, Mandrekar J. Guidelines of the International Headache Society for controlled trials of acute treatment of migraine attacks in adults: Fourth edition. Cephalalgia 2019; 39:687-710. [PMID: 30806518 PMCID: PMC6501455 DOI: 10.1177/0333102419828967] [Citation(s) in RCA: 100] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
The quality of clinical trials is an essential part of the evidence base for the treatment of headache disorders. In 1991, the International Headache Society Clinical Trials Standing Committee developed and published the first edition of the Guidelines for controlled trials of drugs in migraine. Scientific and clinical developments in headache medicine led to second and third editions in 2000 and 2012, respectively. The current, fourth edition of the Guidelines retains the structure and much content from previous editions. However, it also incorporates evidence from clinical trials published after the third edition as well as feedback from meetings with regulators, pharmaceutical and device manufacturers, and patient associations. Its final form reflects the collective expertise and judgement of the Committee. These updated recommendations and commentary are intended to meet the Society's continuing objective of providing a contemporary, standardized, and evidence-based approach to the conduct and reporting of randomised controlled trials for the acute treatment of migraine attacks.
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Affiliation(s)
| | - Cristina Tassorelli
- 2 Headache Science Center, IRCCS Mondino Foundation, Pavia, Italy.,3 Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - David W Dodick
- 4 Department of Neurology, Mayo Clinic, Phoenix, AZ, USA
| | | | - Richard B Lipton
- 6 Montefiore Headache Center, Department of Neurology and Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Messoud Ashina
- 7 Danish Headache Center, Department of Neurology, Rigshospitalet Glostrup, Faculty of Health and Medical Sciences, University of Copenhagen, Glostrup, Denmark
| | - Werner J Becker
- 8 Department of Clinical Neurosciences, University of Calgary, Calgary, Alberta, Canada.,9 Hotchkiss Brain Institute, University of Calgary, Calgary, Canada
| | - Michel D Ferrari
- 10 Department of Neurology, Leiden University Medical Center, Leiden, The Netherlands
| | - Peter J Goadsby
- 11 National Institute for Health Research Wellcome Trust King's Clinical Research Facility, King's College London, London, England
| | - Patricia Pozo-Rosich
- 12 Headache Research Group, Vall d'Hebron Institute of Research, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Shuu-Jiun Wang
- 13 Headache & Craniofacial Pain Unit, Neurology Department, Hospital Universitari Vall d'Hebron, Barcelona, Spain.,14 Neurological Institute, Taipei Veterans General Hospital and Brain Research Center, National Yang-Ming University, Taipei, Taiwan
| | - Jay Mandrekar
- 15 Department of Health Sciences Research, Mayo Clinic Rochester, MN, USA
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The Effect of 4-Week Stroboscopic Training on Visual Function and Sport-Specific Visuomotor Performance in Top-Level Badminton Players. Int J Sports Physiol Perform 2019; 14:343-350. [PMID: 30160560 DOI: 10.1123/ijspp.2018-0302] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
PURPOSE Stroboscopic training is suggested to improve visuomotor abilities in sports. However, previous research has primarily focused on untrained participants and only considered behavioral data. Because visuomotor performance is substantially determined by neural visual processes, this study aimed to examine the effects of stroboscopic training on visuomotor performance and neural visual function of athletes. METHODS A total of 10 German top-level badminton players (intervention: n = 5 and control: n = 5) participated in this study. Over a 4-week training period, athletes performed badminton-specific visuomotor tasks either wearing shutter glasses (intervention) or under normal visual conditions (control). Prior to and after the training period, behavioral smash-defense tests and neurophysiologic investigations of the N2 motion onset visual evoked potential were used to identify modulations in the athletes' visuomotor performance and visual perception speed, respectively. RESULTS Badminton training improved visuomotor performance in both groups; however, stroboscopic training resulted in superior posttraining performance compared with normal visual conditions (P = .007). Training-induced modulations in N2 latency did not reach significance, although a strong relationship was observed between changes in N2 latency and changes in visuomotor performance (r = -.55), indicating that higher performance gains following training were associated with a stronger reduction in N2 latency. CONCLUSIONS The results indicate that stroboscopic training may be more effective than conventional visuomotor training for improving visuomotor abilities even in athletes performing at high skill levels. Furthermore, visuomotor performance gains could potentially be mediated by neural adaptations in the visual motion system. These findings should be confirmed for athletes from different disciplines.
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Belpomme D, Hardell L, Belyaev I, Burgio E, Carpenter DO. Thermal and non-thermal health effects of low intensity non-ionizing radiation: An international perspective. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2018; 242:643-658. [PMID: 30025338 DOI: 10.1016/j.envpol.2018.07.019] [Citation(s) in RCA: 82] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/06/2018] [Revised: 05/31/2018] [Accepted: 07/04/2018] [Indexed: 05/24/2023]
Abstract
Exposure to low frequency and radiofrequency electromagnetic fields at low intensities poses a significant health hazard that has not been adequately addressed by national and international organizations such as the World Health Organization. There is strong evidence that excessive exposure to mobile phone-frequencies over long periods of time increases the risk of brain cancer both in humans and animals. The mechanism(s) responsible include induction of reactive oxygen species, gene expression alteration and DNA damage through both epigenetic and genetic processes. In vivo and in vitro studies demonstrate adverse effects on male and female reproduction, almost certainly due to generation of reactive oxygen species. There is increasing evidence the exposures can result in neurobehavioral decrements and that some individuals develop a syndrome of "electro-hypersensitivity" or "microwave illness", which is one of several syndromes commonly categorized as "idiopathic environmental intolerance". While the symptoms are non-specific, new biochemical indicators and imaging techniques allow diagnosis that excludes the symptoms as being only psychosomatic. Unfortunately standards set by most national and international bodies are not protective of human health. This is a particular concern in children, given the rapid expansion of use of wireless technologies, the greater susceptibility of the developing nervous system, the hyperconductivity of their brain tissue, the greater penetration of radiofrequency radiation relative to head size and their potential for a longer lifetime exposure.
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Affiliation(s)
- Dominique Belpomme
- European Cancer Environment Research Institute, Brussels, Belgium; Paris V University Hospital, Paris, France
| | - Lennart Hardell
- European Cancer Environment Research Institute, Brussels, Belgium; Department of Oncology, Orebro University Hospital, Faculty of Medicine, Orebro, Sweden
| | - Igor Belyaev
- European Cancer Environment Research Institute, Brussels, Belgium; Department of Radiobiology, Cancer Research Institute, Biomedical Research Center, Slovak Academy of Science, Bratislava, Slovak Republic; Laboratory of Radiobiology, Institute of General Physics, Russian Academy of Science, Moscow, Russian Federation
| | - Ernesto Burgio
- European Cancer Environment Research Institute, Brussels, Belgium; Instituto Scientifico Biomedico Euro Mediterraneo, Mesagne, Italy
| | - David O Carpenter
- European Cancer Environment Research Institute, Brussels, Belgium; Institute for Health and the Environment, University at Albany, Albany, NY, USA; Child Health Research Centre, The University of Queensland, Faculty of Medicine, Brisbane, Australia.
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Whoever is Free from "Placebo Sensitivity", Cast the First Stone! Am J Gastroenterol 2018; 113:1255. [PMID: 29967476 DOI: 10.1038/s41395-018-0172-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2018] [Accepted: 05/08/2018] [Indexed: 12/11/2022]
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17
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L’effet Nocebo : particularités et conséquences pour le clinicien. Rev Med Interne 2018; 39:315-320. [DOI: 10.1016/j.revmed.2018.02.021] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2018] [Accepted: 02/26/2018] [Indexed: 11/21/2022]
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18
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Non-specific effects and clusters of women with painful TMD responders and non-responders to LLLT: double-blind randomized clinical trial. Lasers Med Sci 2017; 33:385-392. [DOI: 10.1007/s10103-017-2406-4] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2017] [Accepted: 11/28/2017] [Indexed: 12/20/2022]
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19
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Titova E, Salvesen Ø, Bentsen SB, Sunde S, Steinshamn S, Henriksen AH. Does an Integrated Care Intervention for COPD Patients Have Long-Term Effects on Quality of Life and Patient Activation? A Prospective, Open, Controlled Single-Center Intervention Study. PLoS One 2017; 12:e0167887. [PMID: 28060921 PMCID: PMC5218408 DOI: 10.1371/journal.pone.0167887] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2015] [Accepted: 11/18/2016] [Indexed: 12/13/2022] Open
Abstract
Background Implementation of the COPD-Home integrated disease management (IDM) intervention at discharge after hospitalizations for acute exacerbations of COPD (AECOPD) led to reduced hospital utilization during the following 24 months compared to the year prior to study start. Aims To analyze the impact of the COPD-Home IDM intervention on health related quality of life, symptoms of anxiety and depression, and the degree of patient activation during 24 months of follow-up and to assess the association between these outcomes. Methods A single center, prospective, open, controlled clinical study. Changes in The St. George Respiratory Questionnaire (SGRQ), the Hospital anxiety (HADS-A) and depression (HADS-D) and the patient activation measure (PAM) scores were compared between the patients in the integrated care group (ICG) and the usual care group (UCG) 6, 12 and 24 months after enrolment. Results The questionnaire response rate was 80–96%. There were no statistically significant differences in the change of the SGRQ scores between the groups during follow up. After 12 months of follow-up there was a trend towards a reduction in the mean HADS–A score in the ICG compared to the UCG. The HADS-D scores remained stable in the ICG compared with an increasing trend in the UCG. Clinically significant difference in the PAM score was achieved only in the ICG, 6.7 (CI95% 0.7 to 7.5) compared to 3.6 (CI95% -1.4 to 8.6) in the UCG. In a logistic regression model a higher HADS-D score and current smoking significantly increased the odds for a low PAM score. Conclusion The COPD–Home IDM intervention did not result in any statistically significant changes in mean SGRQ, HADS-A, HADS- D or PAM scores during the 24 months of follow-up. Trial registration The ID number for the study in the Clinical.Trials.gov registration system is 17417. ClinicalTrials.gov Identifier: NCT 00702078
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Affiliation(s)
- Elena Titova
- Department of Circulation and Medical Imaging, Norwegian University of Science and Technology, Trondheim, Norway
- Department of Thoracic and Occupational Medicine, Trondheim University Hospital, Trondheim, Norway
- * E-mail:
| | - Øyvind Salvesen
- The Faculty of medicine, Norwegian University of Science and Technology, Trondheim, Norway
| | | | - Synnøve Sunde
- Department of Thoracic and Occupational Medicine, Trondheim University Hospital, Trondheim, Norway
| | - Sigurd Steinshamn
- Department of Circulation and Medical Imaging, Norwegian University of Science and Technology, Trondheim, Norway
- Department of Thoracic and Occupational Medicine, Trondheim University Hospital, Trondheim, Norway
| | - Anne Hildur Henriksen
- Department of Circulation and Medical Imaging, Norwegian University of Science and Technology, Trondheim, Norway
- Department of Thoracic and Occupational Medicine, Trondheim University Hospital, Trondheim, Norway
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Mancini GJ, Baker S, Bergeron J, Fitchett D, Frohlich J, Genest J, Gupta M, Hegele RA, Ng D, Pearson GJ, Pope J, Tashakkor AY. Diagnosis, Prevention, and Management of Statin Adverse Effects and Intolerance: Canadian Consensus Working Group Update (2016). Can J Cardiol 2016; 32:S35-65. [DOI: 10.1016/j.cjca.2016.01.003] [Citation(s) in RCA: 160] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2015] [Revised: 01/03/2016] [Accepted: 01/05/2016] [Indexed: 12/24/2022] Open
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Meister R, von Wolff A, Mohr H, Härter M, Nestoriuc Y, Hölzel L, Kriston L. Comparative Safety of Pharmacologic Treatments for Persistent Depressive Disorder: A Systematic Review and Network Meta-Analysis. PLoS One 2016; 11:e0153380. [PMID: 27187783 PMCID: PMC4871495 DOI: 10.1371/journal.pone.0153380] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2015] [Accepted: 03/29/2016] [Indexed: 11/19/2022] Open
Abstract
We aimed to compare the safety of antidepressants for the treatment of persistent depressive disorder (PDD) with each other and with placebo. We conducted a systematic electronic search and included randomized controlled trials that investigated antidepressants for the treatment of PDD in adults. Outcomes were the incidence of experiencing any adverse event, specific adverse events and related treatment discontinuations. We analyzed the data using traditional and network meta-analyses. Thirty-four studies that comprised 4,769 patients and examined 20 individual agents in nine substance classes were included. Almost all analyzed substance classes were associated with higher discontinuation rates than placebo including tricyclic antidepressants (TCAs), selective serotonin reuptake inhibitors (SSRIs), monoamine oxidase inhibitors (MAOIs), antipsychotics, and the serotonin antagonist and reuptake inhibitor (SARI) trazodone. The odds of experiencing any adverse event were significantly higher for TCAs and serotonin noradrenaline reuptake inhibitors (SNRIs) compared to placebo. Pairwise comparisons among the substance classes revealed that more patients receiving TCAs or SNRIs experienced any adverse event and that more patients receiving TCAs or the SARI trazodone discontinued treatment. The complementary treatment with acetyl-l-carnitine showed lower rates of experiencing any adverse event and related discontinuations than all other comparators. TCAs were primarily associated with (anti-)cholinergic and sedating adverse events. SSRIs primarily showed gastrointestinal adverse events. Patients treated with the antipsychotic amisulpride were more likely to manifest weight gain and endocrine adverse events. The comparative evidence for further agents was insufficient or lacking. The identified safety differences may be used to inform the selection among the antidepressants.
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Affiliation(s)
- Ramona Meister
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Alessa von Wolff
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Hannes Mohr
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Martin Härter
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Yvonne Nestoriuc
- Clinical Psychology and Psychotherapy, Institute of Psychology, University of Hamburg, Hamburg, Germany
| | - Lars Hölzel
- Department of Psychiatry and Psychotherapy, University Medical Center Freiburg, Freiburg, Germany
| | - Levente Kriston
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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Prätzlich M, Kossowsky J, Gaab J, Krummenacher P. Impact of short-term meditation and expectation on executive brain functions. Behav Brain Res 2015; 297:268-76. [PMID: 26462570 DOI: 10.1016/j.bbr.2015.10.012] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2015] [Revised: 08/25/2015] [Accepted: 10/05/2015] [Indexed: 11/17/2022]
Abstract
Meditation improves executive functions such as attention and working memory processes. However, it remains unclear to what extent contextual effects contribute to these improvements, since the role of meditation-associated expectations has not been investigated so far. In a randomized, single-blind, deceptive, between-subject design we compared the impact of short-term meditation (MG) on executive functioning with an expectation (ECG) and a passive control group (CG) as well as the effect of positive and negative outcome expectations. Fifty-nine healthy meditation-naïve volunteers participated on three consecutive days (20 min/session). Five groups were examined: 2 MGs, 2 ECGs and 1 CG. While one MG and one ECG were given positive suggestions concerning the effect of meditation on attention, the other two groups were given negative suggestions. MGs practised a focused attention meditation technique; ECGs were told that they were practising meditation but were given instructions for a sham meditation. CG participants sat in silence with their eyes closed. Interference control (Stroop task), selective sustained attention (d2 task), figural and verbal fluency measures of executive functions were assessed. Results indicate that suggestions have a substantial impact on interference control and verbal fluency, with positive suggestions leading to an increase in performance, whereas negative suggestions impeded improvement. This proof of concept study demonstrates the importance of the implementation of a credible ECG to elucidate context effects in meditation processes. It also indicates that suggestions can modulate the small effect of meditation on verbal fluency.
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Affiliation(s)
- Martin Prätzlich
- Division of Clinical Psychology and Psychotherapy, Department of Psychology, University of Basel, Missionsstrasse 60/62, 4055 Basel, Switzerland; Department of Child and Adolescent Psychiatry, Psychiatric University Clinics, Schanzenstrasse 13, 4056 Basel, Switzerland
| | - Joe Kossowsky
- Division of Clinical Psychology and Psychotherapy, Department of Psychology, University of Basel, Missionsstrasse 60/62, 4055 Basel, Switzerland; Department of Anesthesiology, Perioperative and Pain Medicine, Boston Children's Hospital, Harvard Medical School, Boston, USA
| | - Jens Gaab
- Division of Clinical Psychology and Psychotherapy, Department of Psychology, University of Basel, Missionsstrasse 60/62, 4055 Basel, Switzerland
| | - Peter Krummenacher
- Division of Clinical Psychology and Psychotherapy, Department of Psychology, University of Basel, Missionsstrasse 60/62, 4055 Basel, Switzerland; Collegium Helveticum, Schmelzbergstrasse 25, CH-8092 Zurich, Switzerland; Brainability LLC, CH-8057 Zurich, Switzerland.
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Dieudonné M. Does electromagnetic hypersensitivity originate from nocebo responses? Indications from a qualitative study. Bioelectromagnetics 2015; 37:14-24. [PMID: 26369906 DOI: 10.1002/bem.21937] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2015] [Accepted: 09/03/2015] [Indexed: 11/09/2022]
Abstract
Idiopathic Environmental Intolerance attributed to Electromagnetic Fields (IEI-EMF) is a condition in which symptoms are attributed to electromagnetic field (EMF) exposure. As electro-hypersensitive (EHS) people have repeatedly been observed, during provocation trials, to report symptoms following perceived rather than actual exposure, the hypothesis has been put forward that IEI-EMF originates from psychological mechanisms, especially nocebo responses. This paper examines this hypothesis, using data from a qualitative study aimed at understanding how EHS people come to regard themselves as such. Forty self-diagnosed EHS people were interviewed. A typified model of their attribution process was then elaborated, inductively, from their narratives. This model is linear and composed of seven stages: (1) onset of symptoms; (2) failure to find a solution; (3) discovery of EHS; (4) gathering of information about EHS; (5) implicit appearance of conviction; (6) experimentation; (7) conscious acceptance of conviction. Overall, symptoms appear before subjects start questioning effects of EMF on their health, which is not consistent with the hypothesis that IEI-EMF originates from nocebo responses to perceived EMF exposure. However, such responses might occur at the sixth stage of the process, potentially reinforcing the attribution. It remains possible that some cases of IEI-EMF originate from other psychological mechanisms.
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Affiliation(s)
- Maël Dieudonné
- Centre Max Weber and Université Lumière-Lyon 2, Lyon, France
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Repetitive peripheral magnetic stimulation to reduce pain or improve sensorimotor impairments: A literature review on parameters of application and afferents recruitment. Neurophysiol Clin 2015; 45:223-37. [DOI: 10.1016/j.neucli.2015.08.002] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2014] [Revised: 08/06/2015] [Accepted: 08/06/2015] [Indexed: 11/22/2022] Open
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Menendez-Baceta G, Aceituno-Mata L, Reyes-García V, Tardío J, Salpeteur M, Pardo-de-Santayana M. The importance of cultural factors in the distribution of medicinal plant knowledge: a case study in four Basque regions. JOURNAL OF ETHNOPHARMACOLOGY 2015; 161:116-27. [PMID: 25499311 DOI: 10.1016/j.jep.2014.12.007] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/19/2014] [Revised: 12/01/2014] [Accepted: 12/01/2014] [Indexed: 05/04/2023]
Abstract
ETHNOBOTANICAL RELEVANCE Previous research suggests that the use of medicinal plants by a given group is mainly driven by biological variables such as the chemical composition or the ecological distribution of plants. However, other studies highlight the importance of cultural aspects such as the curative meaning given to a plant, beliefs, religion or the historical context. Such aspects could play an important role in the use, diffusion or even in the effectiveness of a plant remedy. MATERIALS AND METHODS Fieldwork consisted of 233 orally consented semi-structured interviews with 178 informants about medicinal uses of plants. Interviews were conducted in four historically and geographycally delimited regions of Alava and Biscay with similar environmental conditions but different sociolinguistic backgrounds: two regions were Basque- and two Spanish-speaking. Data were structured in use-reports. A Between Class Analysis was conducted to assess the intercultural and intracultural variability of medicinal plants knowledge. RESULTS The results show the existence of four clearly different medicinal ethnofloras. While the four ethnofloras share remedies widely distributed through the territory, each of them also includes remedies that are only shared among closely related communities. The ecological availability and chemical composition of the plants may explain why there are widely used plant remedies. On the contrary, the distribution of the locally shared remedies matches up with the cultural heterogeneity of the territory, so cultural factors, such as, language, social networks or the meaning response of the plants seem to explain the use of many traditional plant remedies. In Addition, we also found that Basque speaking territories show higher knowledge levels than Spanish speaking territories. In this sense, the development and reinforcement of Basque identity by Basque nationalism seems to have contributed to maintain the traditional knowledge in the Basque speaking regions. CONCLUSIONS Despite the fact that pharmacological effectiveness and ecological availability are usually considered as the main variables that shape the traditional use of medicinal plants, our results suggest that cultural factors can be at least as important as ecological and chemical factors. In fact, differences in language, in the cultural meaning of the plants, in the context related to cultural identities, and in social networks seem to play a fundamental role in the use and diffusion and maintenance or erosion of traditional knowledge about medicinal plants in the study area.
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Affiliation(s)
- Gorka Menendez-Baceta
- Departamento de Biología (Botánica), Universidad Autónoma de Madrid, C/Darwin 2, Campus de Cantoblanco, 28049 Madrid, Spain
| | - Laura Aceituno-Mata
- Departamento de Biología (Botánica), Universidad Autónoma de Madrid, C/Darwin 2, Campus de Cantoblanco, 28049 Madrid, Spain; Instituto Madrileño de Investigación y Desarrollo Rural, Agrario y Alimentario, Apdo. 127, 28800 Alcalá de Henares, Madrid, Spain
| | - Victoria Reyes-García
- Institut de Ciència i Tecnologia Ambientals, Universitat Autónoma de Barcelona, Bellaterra, 08193 Barcelona, Spain; Institució Catalana de Recerca i Estudis Avançats (ICREA), Barcelona, Spain
| | - Javier Tardío
- Instituto Madrileño de Investigación y Desarrollo Rural, Agrario y Alimentario, Apdo. 127, 28800 Alcalá de Henares, Madrid, Spain
| | - Matthieu Salpeteur
- Institut de Ciència i Tecnologia Ambientals, Universitat Autónoma de Barcelona, Bellaterra, 08193 Barcelona, Spain
| | - Manuel Pardo-de-Santayana
- Departamento de Biología (Botánica), Universidad Autónoma de Madrid, C/Darwin 2, Campus de Cantoblanco, 28049 Madrid, Spain.
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