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Hosseini E. Ubiquitous extremely low frequency electromagnetic fields induces anxiety-like behavior: mechanistic perspectives. Electromagn Biol Med 2024:1-16. [PMID: 39074042 DOI: 10.1080/15368378.2024.2380305] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Accepted: 07/10/2024] [Indexed: 07/31/2024]
Abstract
Anxiety is an adaptive condition characterized by heightened uneasiness, which in the long term can cause complications such as reducing the quality of life and problems related to the mental and physical health. Concerns have been raised regarding the potential dangers of extremely low frequency electromagnetic fields (ELF-EMF) ranging from 3 to 3000 Hz, which are omnipresent in our daily lives and there have been studies about the anxiogenic effects of these fields. Studies conducted in this specific area has revealed that ELF-EMF can have an impact on various brain regions, such as the hippocampus. In conclusion, studies have shown that ELF-EMF can interfere with hippocampus-prefrontal cortex pathway, inducing anxiety behavior. Also, ELF-EMF may initiate anxiety behavior by generating oxidative stress in hypothalamus and hippocampus. Moreover, ELF-EMF may induce anxiety behavior by reducing hippocampus neuroplasticity and increasing the NMDA2A receptor expression in the hippocampus. Furthermore, supplementation with antioxidants could serve as an effective protective measure against the adverse effects of FLF-FMF in relation to anxiety behavior.
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Affiliation(s)
- Ehsan Hosseini
- Division of Physiology, Department of Basic Science, Faculty of Veterinary Medicine, Urmia University, Urmia, Iran
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2
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Srinivasan V, Ruthuvalan V, Raja S, Jayaraj V, Sridhar S, Kothandaraman M, Suganthirababu P, Abathsagayam K, Vishnuram S, Alagesan J, Vasanthi RK. Efficacy of Vagal nerve stimulation on anxiety among elderly retired teachers during COVID-19 pandemic. Work 2024:WOR230356. [PMID: 38489208 DOI: 10.3233/wor-230356] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/17/2024] Open
Abstract
BACKGROUND Excessive fear, worry and behavioral disturbances define anxiety, with particular significance attributed to vagal nerve, a crucial transmitter of information to the brain regions governing anxiety. Highlighting the importance of vagal nerve, transcutaneous auricular vagal nerve stimulation (TaVNS) emerges as a tolerable and safe technique. The success of non-invasive vagal nerve stimulation in alleviating anxiety underscores the pivotal role of the vagal nerve. OBJECTIVES The purpose of this study was to assess the effectiveness of physiotherapy interventions in mitigating anxiety among retired teachers during the COVID-19 pandemic, emphasizing the relevance of targeting the vagal nerve for improved mental well-being. METHODS 60 retired teachers diagnosed with anxiety were chosen through random allocation. Participants were divided into two groups: Group A (Experimental group) received transcutaneous auricular vagal nerve stimulation (TaVNS), and Group B (Control group) underwent the Jacobson relaxation technique. Intervention period spanned 4 weeks, with four sessions per week, lasting 30 minutes. The outcome measures included Generalized Anxiety Disorder-7 (GAD-7) questionnaire and salivary cortisol levels. RESULTS Following the 4-week intervention, both groups exhibited a significant reduction in Generalized Anxiety Disorder-7 (GAD-7) scores and salivary cortisol levels (P < 0.001). Notably, Group A demonstrated a significantly higher effectiveness rate compared to Group B. CONCLUSION The study concludes that transcutaneous auricular vagal nerve stimulation (TaVNS) is effective in reducing anxiety among retired teachers. Transcutaneous auricular vagal nerve stimulation (TaVNS) proves to be a powerful and effective intervention in alleviating anxiety among retired teachers, emphasizing its potential significance in enhancing mental well-being.
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Affiliation(s)
- Vignesh Srinivasan
- Saveetha College of Physiotherapy, Saveetha Institute of Medical & Technical Sciences, Chennai, Tamilnadu, India
| | - Varalakshmi Ruthuvalan
- Saveetha College of Physiotherapy, Saveetha Institute of Medical & Technical Sciences, Chennai, Tamilnadu, India
| | - Sakthi Raja
- Saveetha College of Physiotherapy, Saveetha Institute of Medical & Technical Sciences, Chennai, Tamilnadu, India
| | - Vanitha Jayaraj
- Saveetha College of Physiotherapy, Saveetha Institute of Medical & Technical Sciences, Chennai, Tamilnadu, India
| | - Swathi Sridhar
- Saveetha College of Physiotherapy, Saveetha Institute of Medical & Technical Sciences, Chennai, Tamilnadu, India
| | - Muthulakshmi Kothandaraman
- Saveetha College of Physiotherapy, Saveetha Institute of Medical & Technical Sciences, Chennai, Tamilnadu, India
| | - Prathap Suganthirababu
- Saveetha College of Physiotherapy, Saveetha Institute of Medical & Technical Sciences, Chennai, Tamilnadu, India
| | - Kumaresan Abathsagayam
- Saveetha College of Physiotherapy, Saveetha Institute of Medical & Technical Sciences, Chennai, Tamilnadu, India
| | - Surya Vishnuram
- Saveetha College of Physiotherapy, Saveetha Institute of Medical & Technical Sciences, Chennai, Tamilnadu, India
| | - Jagatheesan Alagesan
- Saveetha College of Physiotherapy, Saveetha Institute of Medical & Technical Sciences, Chennai, Tamilnadu, India
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Iosifescu DV, Song X, Gersten MB, Adib A, Cho Y, Collins KM, Yates KF, Hurtado-Puerto AM, McEachern KM, Osorio RS, Cassano P. Protocol Report on the Transcranial Photobiomodulation for Alzheimer's Disease (TRAP-AD) Study. Healthcare (Basel) 2023; 11:2017. [PMID: 37510458 PMCID: PMC10378818 DOI: 10.3390/healthcare11142017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2023] [Revised: 07/04/2023] [Accepted: 07/10/2023] [Indexed: 07/30/2023] Open
Abstract
BACKGROUND Alzheimer's disease's (AD) prevalence is projected to increase as the population ages and current treatments are minimally effective. Transcranial photobiomodulation (t-PBM) with near-infrared (NIR) light penetrates into the cerebral cortex, stimulates the mitochondrial respiratory chain, and increases cerebral blood flow. Preliminary data suggests t-PBM may be efficacious in improving cognition in people with early AD and amnestic mild cognitive impairment (aMCI). METHODS In this randomized, double-blind, placebo-controlled study with aMCI and early AD participants, we will test the efficacy, safety, and impact on cognition of 24 sessions of t-PBM delivered over 8 weeks. Brain mechanisms of t-PBM in this population will be explored by testing whether the baseline tau burden (measured with 18F-MK6240), or changes in mitochondrial function over 8 weeks (assessed with 31P-MRSI), moderates the changes observed in cognitive functions after t-PBM therapy. We will also use changes in the fMRI Blood-Oxygenation-Level-Dependent (BOLD) signal after a single treatment to demonstrate t-PBM-dependent increases in prefrontal cortex blood flow. CONCLUSION This study will test whether t-PBM, a low-cost, accessible, and user-friendly intervention, has the potential to improve cognition and function in an aMCI and early AD population.
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Affiliation(s)
- Dan V. Iosifescu
- Nathan S. Kline Institute for Psychiatric Research, Orangeburg, NY 10962, USA; (K.M.C.); (K.F.Y.); (R.S.O.)
- Department of Psychiatry, New York University Grossman School of Medicine, New York, NY 10016, USA; (X.S.); (A.A.)
| | - Xiaotong Song
- Department of Psychiatry, New York University Grossman School of Medicine, New York, NY 10016, USA; (X.S.); (A.A.)
| | - Maia B. Gersten
- Department of Psychiatry, Division of Neuropsychiatry, Massachusetts General Hospital, Boston, MA 02129, USA; (M.B.G.); (Y.C.); (A.M.H.-P.); (K.M.M.); (P.C.)
| | - Arwa Adib
- Department of Psychiatry, New York University Grossman School of Medicine, New York, NY 10016, USA; (X.S.); (A.A.)
| | - Yoonju Cho
- Department of Psychiatry, Division of Neuropsychiatry, Massachusetts General Hospital, Boston, MA 02129, USA; (M.B.G.); (Y.C.); (A.M.H.-P.); (K.M.M.); (P.C.)
- Department of Psychiatry, Harvard Medical School, Boston, MA 02115, USA
| | - Katherine M. Collins
- Nathan S. Kline Institute for Psychiatric Research, Orangeburg, NY 10962, USA; (K.M.C.); (K.F.Y.); (R.S.O.)
| | - Kathy F. Yates
- Nathan S. Kline Institute for Psychiatric Research, Orangeburg, NY 10962, USA; (K.M.C.); (K.F.Y.); (R.S.O.)
- Department of Psychiatry, New York University Grossman School of Medicine, New York, NY 10016, USA; (X.S.); (A.A.)
| | - Aura M. Hurtado-Puerto
- Department of Psychiatry, Division of Neuropsychiatry, Massachusetts General Hospital, Boston, MA 02129, USA; (M.B.G.); (Y.C.); (A.M.H.-P.); (K.M.M.); (P.C.)
| | - Kayla M. McEachern
- Department of Psychiatry, Division of Neuropsychiatry, Massachusetts General Hospital, Boston, MA 02129, USA; (M.B.G.); (Y.C.); (A.M.H.-P.); (K.M.M.); (P.C.)
| | - Ricardo S. Osorio
- Nathan S. Kline Institute for Psychiatric Research, Orangeburg, NY 10962, USA; (K.M.C.); (K.F.Y.); (R.S.O.)
- Department of Psychiatry, New York University Grossman School of Medicine, New York, NY 10016, USA; (X.S.); (A.A.)
| | - Paolo Cassano
- Department of Psychiatry, Division of Neuropsychiatry, Massachusetts General Hospital, Boston, MA 02129, USA; (M.B.G.); (Y.C.); (A.M.H.-P.); (K.M.M.); (P.C.)
- Department of Psychiatry, Harvard Medical School, Boston, MA 02115, USA
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Buis L, Breeze E, Crawley E, Nabney I. The Feasibility of Using Smartphone Sensors to Track Insomnia, Depression, and Anxiety in Adults and Young Adults: Narrative Review. JMIR Mhealth Uhealth 2023; 11:e44123. [PMID: 36800211 PMCID: PMC9984993 DOI: 10.2196/44123] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Revised: 01/25/2023] [Accepted: 02/03/2023] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Since the era of smartphones started in early 2007, they have steadily turned into an accepted part of our lives. Poor sleep is a health problem that needs to be closely monitored before it causes severe mental health problems, such as anxiety or depression. Sleep disorders (eg, acute insomnia) can also develop to chronic insomnia if not treated early. More specifically, mental health problems have been recognized to have casual links to anxiety, depression, heart disease, obesity, dementia, diabetes, and cancer. Several researchers have used mobile sensors to monitor sleep and to study changes in individual mood that may cause depression and anxiety. OBJECTIVE Extreme sleepiness and insomnia not only influence physical health, they also have a significant impact on mental health, such as by causing depression, which has a prevalence of 18% to 21% among young adults aged 16 to 24 in the United Kingdom. The main body of this narrative review explores how passive data collection through smartphone sensors can be used in predicting anxiety and depression. METHODS A narrative review of the English language literature was performed. We investigated the use of smartphone sensors as a method of collecting data from individuals, regardless of whether the data source was active or passive. Articles were found from a search of Google Scholar records (from 2013 to 2020) with keywords including "mobile phone," "mobile applications," "health apps," "insomnia," "mental health," "sleep monitoring," "depression," "anxiety," "sleep disorder," "lack of sleep," "digital phenotyping," "mobile sensing," "smartphone sensors," and "sleep detector." RESULTS The 12 articles presented in this paper explain the current practices of using smartphone sensors for tracking sleep patterns and detecting changes in mental health, especially depression and anxiety over a period of time. Several researchers have been exploring technological methods to detect sleep using smartphone sensors. Researchers have also investigated changes in smartphone sensors and linked them with mental health and well-being. CONCLUSIONS The conducted review provides an overview of the possibilities of using smartphone sensors unobtrusively to collect data related to sleeping pattern, depression, and anxiety. This provides a unique research opportunity to use smartphone sensors to detect insomnia and provide early detection or intervention for mental health problems such as depression and anxiety if insomnia is detected.
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Affiliation(s)
| | - Emma Breeze
- Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - Esther Crawley
- Centre for Academic Child Health, University of Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - Ian Nabney
- Department of Computer Science, University of Bristol, Bristol, United Kingdom
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5
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Mordeno IG, Bigcas JD, Mordeno ER. Examining the Latent Dimensions of Social Anxiety Disorder. Psychol Rep 2023:332941231156815. [PMID: 36773037 DOI: 10.1177/00332941231156815] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
Abstract
While the body of literature has investigated the latent dimensions of Social Anxiety Disorder (SAD), only few have directly anchored in the DSM-5 SAD symptoms. Similarly, a continuing issue on measuring mental health disorders pertains to whether a symptom's frequency, intensity, or both, are appropriate and sufficient indicators of severity. To address this gap, the present study developed and validated a DSM-5-based measurement tool, the Social Anxiety Symptom Severity Inventory (SASSI), which assesses both the intensity (intensity of disturbance) and frequency (frequency of occurrence) of SAD symptoms. In study 1 (n = 6458, college students), the results revealed a two-factor structure using exploratory structural equation modeling. In study 2 (n = 425, left-behind emerging adults), confirmatory factor analysis, measurement invariance testing, and latent class analysis were used. Findings demonstrated the importance of using both frequency and intensity of symptoms in assessing SAD severity. Moreover, a five-class solution best fitted the sample. Studies 1 and 2 demonstrated the good psychometric properties of SASSI and filled an important gap among available measures in assessing SAD severity through symptom frequency and intensity.
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Affiliation(s)
- Imelu G Mordeno
- Department of Professional Education, College of Education, 69330Mindanao State University-Iligan Institute of Technology, Iligan City, Philippines
| | - Jimayma D Bigcas
- School of Graduate Studies, College of Education, 69330Mindanao State University-Iligan Institute of Technology, Iligan City, Philippines
| | - Emelyn R Mordeno
- Department of Psychology, College of Arts and Social Sciences, 69330Mindanao State University-Iligan Institute of Technology, Iligan City, Philippines
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McConaghy K, Rullan P, Murray T, Molloy R, Heinberg LJ, Piuzzi NS. Team Approach: Management of Mental Health in Orthopaedic Patients. JBJS Rev 2023; 11:01874474-202302000-00003. [PMID: 36763707 DOI: 10.2106/jbjs.rvw.22.00167] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
Abstract
» Mental health evaluation should be considered an essential part of the routine preoperative assessment and should be managed by a multidisciplinary team composed of the primary care physician, orthopaedic provider, and behavioral health specialist. » The scientific literature indicates that patients without comorbid psychiatric symptoms and adaptive coping strategies, resilience, and well-managed expectations have improved functional outcomes and satisfaction after orthopaedic procedures. » Psychological issues are multifaceted and require treatment tailored to each individual patient. Therefore, close communication between all members of the care team is required to create and execute the perioperative plan.
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Affiliation(s)
- Kara McConaghy
- Case Western Reserve University School of Medicine, Cleveland, Ohio
| | - Pedro Rullan
- Department of Orthopedic Surgery, Cleveland Clinic, Cleveland, Ohio
| | - Trevor Murray
- Department of Orthopedic Surgery, Cleveland Clinic, Cleveland, Ohio
| | - Robert Molloy
- Department of Orthopedic Surgery, Cleveland Clinic, Cleveland, Ohio
| | - Leslie J Heinberg
- Department of Psychiatry and Psychology, Cleveland Clinic, Cleveland, Ohio
| | - Nicolas S Piuzzi
- Department of Orthopedic Surgery, Cleveland Clinic, Cleveland, Ohio.,Department of Biomedical Engineering, Cleveland Clinic, Cleveland, Ohio.,Department of Orthopaedic Surgery, Cleveland Clinic, Cleveland, Ohio
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7
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Chin PW, Augustine GJ. The cerebellum and anxiety. Front Cell Neurosci 2023; 17:1130505. [PMID: 36909285 PMCID: PMC9992220 DOI: 10.3389/fncel.2023.1130505] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Accepted: 01/24/2023] [Indexed: 02/24/2023] Open
Abstract
Although the cerebellum is traditionally known for its role in motor functions, recent evidence points toward the additional involvement of the cerebellum in an array of non-motor functions. One such non-motor function is anxiety behavior: a series of recent studies now implicate the cerebellum in anxiety. Here, we review evidence regarding the possible role of the cerebellum in anxiety-ranging from clinical studies to experimental manipulation of neural activity-that collectively points toward a role for the cerebellum, and possibly a specific topographical locus within the cerebellum, as one of the orchestrators of anxiety responses.
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Affiliation(s)
- Pei Wern Chin
- Program in Neuroscience & Mental Health, Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore
| | - George J Augustine
- Program in Neuroscience & Mental Health, Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore
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8
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A study in University of Ruhuna for investigating prevalence, risk factors and remedies for psychiatric illnesses among students. Sci Rep 2022; 12:12763. [PMID: 35896566 PMCID: PMC9326135 DOI: 10.1038/s41598-022-16838-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Accepted: 07/18/2022] [Indexed: 11/08/2022] Open
Abstract
There is no comprehensive study on the mental health of Sri Lankan undergraduate in higher education, as most existing studies have been done for medical students only. It is unknown how academic and environmental factors contribute for the prevalence of psychiatric illnesses. Further, there is no sufficient information on the student/university based remedies to reduce the psychological distress of students. This research is carried out to find the overall psychological distress, well-being, prevalence percentages of psychiatric illnesses, associated risk factors, and student/university remedies to overcome them. We use standard questionnaires to screen for psychiatric illnesses, and we analyze the responses for our own questionnaire using Binary logistic regression analysis to identify demographic factors, academic factors, and environmental factors causing each mental disorder. We use Pearson correlation coefficient to identify correlation between prevalence of each psychiatric illnesses. All 13 psychiatric illnesses were found with a moderate correlation among diseases having a mean prevalence percentage of 28 and a standard deviation of 14.36, despite the prevalence of well-being factors among students and only 8% are clinically diagnosed. 89% of the students were suffering from at least one psychiatric illness and 68% were found to be psychologically distressed. Sets of overall and individual demographic, academic, and environmental risk factors contributing for the prevalence of a psychiatric illness in general and in particular were identified respectively after a binary logistic regression analysis. 61% of the students don’t receive psychiatric help from the university and are using their own remedies. The universities must consider the environmental and academic risk factors associated with psychiatric illnesses and design curriculum, expand resources, and provide counseling services to reduce the impact of risk factors.
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Shahbazi F, Shahbazi M, Poorolajal J. Association between socioeconomic inequality and the global prevalence of anxiety and depressive disorders: an ecological study. Gen Psychiatr 2022; 35:e100735. [PMID: 35677849 PMCID: PMC9114840 DOI: 10.1136/gpsych-2021-100735] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/24/2021] [Accepted: 04/25/2022] [Indexed: 11/16/2022] Open
Affiliation(s)
- Fatemeh Shahbazi
- Department of Epidemiology, School of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran
- Students Research Committee, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Marjan Shahbazi
- Department of Occupational Therapy, School of Rehabilitation, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Jalal Poorolajal
- Department of Epidemiology, School of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran
- Modeling of Noncommunicable Diseases Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
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Microglial Activation of GLP-1R Signaling in Neuropathic Pain Promotes Gene Expression Adaption Involved in Inflammatory Responses. Neural Plast 2021; 2021:9923537. [PMID: 34512747 PMCID: PMC8426070 DOI: 10.1155/2021/9923537] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Revised: 07/07/2021] [Accepted: 08/04/2021] [Indexed: 01/13/2023] Open
Abstract
Background Neuropathic pain is a common chronic pain, which is related to hypersensitivity to stimulus and greatly affects the quality of life of patients. Maladaptive gene changes and molecular signaling underlie the sensitization of nociceptive pathways. We previously found that the activation of microglial glucagon-like peptide 1 receptor (GLP-1R) could potently relieve formalin-, bone cancer-, peripheral nerve injury-, and diabetes-induced pain hypersensitivity. So far, little is known about how the gene profile changes upon the activation of GLP-1R signaling in the pathophysiology of neuropathic pain. Methods Spinal nerve ligation (SNL) was performed to induce neuropathic pain in rats. Mechanical allodynia was assessed using von Frey filaments. The expression of IL-10, β-endorphin, and μ-opioid receptor (MOR) was examined by real-time quantitative polymerase chain reaction (qPCR) and whole-cell recording. Measurements of cellular excitability of the substantia gelatinosa (SG) neurons by whole-cell recording were carried out. R packages of differential gene expression analysis based on the negative binomial distribution (DESeq2) and weighted correlation network analysis (WGCNA) were used to analyze differential gene expression and the correlated modules among GLP-1R clusters in neuropathic pain. Results The GLP-1R agonist, exenatide, has an antiallodynic effect on neuropathic pain, which could be reversed by intrathecal injections of the microglial inhibitor minocycline. Furthermore, differential gene expression analysis (WGCNA) indicated that intrathecal injections of exenatide could reverse the abnormal expression of 591 genes in the spinal dorsal horn induced by nerve injury. WGCNA revealed 58 modules with a close relationship between the microglial GLP-1R pathway and features of nerve injuries, including pain, ligation, paw withdrawal latency (PWL), and anxiety. The brown module was identified as the highest correlated module, and the Kyoto Encyclopedia of Genes and Genomes (KEGG) analysis indicated that inflammatory responses were most correlated with PWL. To further unravel the changes of hyperalgesia-related neuronal electrophysiological activity mediated by microglia GLP-1 receptors, whole-cell recording identified that MOR agonism stimulated a robust outward current in the sham groups compared with the spinal nerve ligation (SNL) groups. This inhibitory effect on the SNL group was more sensitive than that of the sham group after bath application of β-endorphin. Conclusions Our results further confirmed that the GLP-1R pathway is involved in alleviating pain hypersensitivity mediated by spinal microglia activation, and inflammatory responses were the most correlated pathway associated with PWL changes in response to exenatide treatment. We found that the identification of gene regulation in response to GLP-1R activation is an effective strategy for identifying new therapeutic targets for neuropathic pain. Investigation for the activation of spinal microglial GLP-1R which might ameliorate inflammatory responses through gene expression and structural changes is providing a potential biomarker in pain management.
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12
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American Academy of Orthopaedic Surgeons Appropriate Use Criteria: Early Screening for Psychosocial Risk and Protective Factors. J Am Acad Orthop Surg 2021; 29:e760-e765. [PMID: 34101679 DOI: 10.5435/jaaos-d-20-00810] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2020] [Accepted: 05/11/2021] [Indexed: 02/01/2023] Open
Abstract
The Major Extremity Trauma and Rehabilitation Consortium and the American Academy of Orthopaedic Surgeons (AAOS) have developed Appropriate Use Criteria for the Early Screening for Psychosocial Risk and Protective Factors. Evidence and clinical expertise were used to develop criteria for addressing mental and social health opportunities to help people recover from musculoskeletal injuries to the extremity, spine, and pelvis. The criteria were developed by identifying observable symptoms and results of screening that suggest mental and social health challenges among patients with lower extremity trauma in clinical practice. The 32 patient scenarios and three interventions (evaluate for psychological distress, evaluate for social health opportunities, and evaluate coping and resilience strategies) were developed by the writing panel of clinicians who are specialists in mental and social health in musculoskeletal illness. Next, a separate, multidisciplinary, voting panel made up of specialists and nonspecialists rated the appropriateness of treatment for each patient scenario using a 9-point scale to designate a treatment as "appropriate" (median rating, 7 to 9), "may be appropriate" (median rating, 4 to 6), or "rarely appropriate" (median rating, 1 to 3). Notably, with a high level of agreement, the voting panel determined that interventions to address mental and social health were appropriate in all scenarios as follows: 86% were rated appropriate, 14% were rated possibly appropriate, and none were rated rarely appropriate.
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13
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Chen G, Hu Z, Guan N, Wang X. Finding therapeutic music for anxiety using scoring model. INT J INTELL SYST 2021. [DOI: 10.1002/int.22460] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Affiliation(s)
- Gong Chen
- Shenzhen Research Institute The Hong Kong Polytechnic University Shenzhen China
- Department of Computing The Hong Kong Polytechnic University, Hung Hom Kowloon China
| | - Zhejing Hu
- Department of Computing The Hong Kong Polytechnic University, Hung Hom Kowloon China
| | - Nianhong Guan
- The Third Affiliated Hospital Sun Yat‐Sen University Guangzhou China
| | - Xiaoying Wang
- The Third Affiliated Hospital Sun Yat‐Sen University Guangzhou China
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14
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Uzunova G, Pallanti S, Hollander E. Presentation and management of anxiety in individuals with acute symptomatic or asymptomatic COVID-19 infection, and in the post-COVID-19 recovery phase. Int J Psychiatry Clin Pract 2021; 25:115-131. [PMID: 33635172 DOI: 10.1080/13651501.2021.1887264] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
COVID-19 is associated with neuropsychiatric complications, the most frequent one being anxiety. Multiple biological and psychosocial factors contribute to anxiety in COVID-19. Among the biological factors, stress, genetics, gender, immune system, resilience, anosmia, hypogeusia, and central nervous system infection with SARS-CoV-2 are key. Anxiety is a complication of COVID-19 that may exacerbate the infection course, and the infection may exacerbate anxiety. We present the mechanisms of anxiety in symptomatic or asymptomatic COVID-19. We discuss the presentation of anxiety in patients without or with prior psychiatric illness, and with co-morbidities. Timely diagnosis and management of anxiety in COVID-19 patients is important. Given the frequent complication of COVID-19 with Acute Respiratory Distress Syndrome and Intensive Care Unit stay, anxiety may be a long-term complication. We review the diagnostic tools for anxiety in COVID-19, and summarise pharmacologic and non-pharmacologic treatments. We provide recommendations for diagnosis, treatment, prevention and follow up of anxiety in COVID-19.Key pointsPatients with COVID-19 (symptomatic or asymptomatic) exhibit a high frequency of neuropsychiatric complications with highest percentage attributed to anxiety.Multiple biological and psychosocial risk factors for anxiety exist in COVID-19-ill individuals. Biological risk factors include stress, resilience, genetics, gender, age, immune system, direct infection of the central nervous system (CNS) with SARS-CoV-2, comorbid psychiatric and general medical illnesses, ARDS and ICU stay. Anosmia and hypogeusia are COVID-19-specific anxiety risk factors. Knowledge of the anxiety risk factors is essential to focus on timely interventions, because anxiety may be a complication of and exacerbate the COVID-19 course.An inverse correlation exists between resilience and anxiety because of COVID-19, and therefore efforts should be made to increase resilience in COVID-19 patients.In COVID-19, important anxiety mechanism is neuroinflammation resulting from activation of the immune system and an ensuing cytokine storm.The general approach to management of anxiety in COVID-19 should be compassionate, similar to that during trauma or disaster, with efforts focussed on instilling a sense of hope and resilience.In selecting pharmacological treatment of anxiety, the stress response and immune system effects should be key. Medications with cardio-respiratory adverse effects should be avoided in patients with respiratory problems.Anxiety is a disorder that will require for long-term follow up at least one month after COVID-19.
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Affiliation(s)
- Genoveva Uzunova
- Psychiatric Research Institute at Montefiore-Einstein, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Stefano Pallanti
- Istituto di Neuroscienze, Firenze, Italy.,Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Eric Hollander
- Autism and Obsessive Compulsive Spectrum Program, Department of Psychiatry and Behavioral Sciences, Psychiatric Research Institute at Montefiore-Einstein, Albert Einstein College of Medicine, Bronx, NY, USA
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Nasiriavanaki Z, Barbour T, Farabaugh AH, Fava M, Holmes AJ, Tootell RBH, Holt DJ. Anxious attachment is associated with heightened responsivity of a parietofrontal cortical network that monitors peri-personal space. NEUROIMAGE-CLINICAL 2021; 30:102585. [PMID: 33773165 PMCID: PMC8024770 DOI: 10.1016/j.nicl.2021.102585] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Revised: 12/17/2020] [Accepted: 01/29/2021] [Indexed: 12/13/2022]
Abstract
A parietofrontal cortical network is more active when stimuli are near the body. Responses of this network were positively correlated with “attachment anxiety”. No other types of attachment or symptoms accounted for this association. Connectivity strength within this network was not linked with attachment anxiety.
Background Attachment, or affiliative bonding among conspecifics, is thought to involve neural mechanisms underlying behavioral responses to threat and reward-related social signals. However, attachment-oriented responses may also rely on basic sensorimotor processes. One sensorimotor system that may play a role in attachment is the parietofrontal cortical network that responds to stimuli that are near or approaching the body, the peripersonal space (PPS) monitoring system. We hypothesized that this network may vary in responsivity to such potentially harmful stimuli, particularly those with social salience, based on individual differences in attachment styles. Methods Young adults viewed images of human faces or cars that appeared to move towards or away from them, while functional magnetic resonance imaging data were collected. Correlations between each of four adult attachment styles, measured using the Relationship Questionnaire, and responses of the PPS network to approaching (versus withdrawing) stimuli were measured. Results A region-of-interest (ROI) analysis, focused on six cortical regions of the PPS network that showed significant responses to approaching versus withdrawing face stimuli in an independent sample (n = 80), revealed that anxious attachment style (but not the other 3 attachment styles) was significantly positively correlated with responses to faces (but not to cars) in all six ROIs (r = 0.33–0.49, p = 0.01–0.0001, n = 50). Conclusions These findings suggest that anxious attachment is associated with over-responsivity of a sensorimotor network involved in attending to social stimuli near the body.
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Affiliation(s)
- Zahra Nasiriavanaki
- Department of Psychiatry, Massachusetts General Hospital, Charlestown, MA, United States; Harvard Medical School, Boston, MA, United States
| | - Tracy Barbour
- Department of Psychiatry, Massachusetts General Hospital, Charlestown, MA, United States; Harvard Medical School, Boston, MA, United States
| | - Amy H Farabaugh
- Department of Psychiatry, Massachusetts General Hospital, Charlestown, MA, United States; Harvard Medical School, Boston, MA, United States
| | - Maurizio Fava
- Department of Psychiatry, Massachusetts General Hospital, Charlestown, MA, United States; Harvard Medical School, Boston, MA, United States
| | - Avram J Holmes
- Department of Psychology, Yale University, New Haven, CT, United States
| | - Roger B H Tootell
- Harvard Medical School, Boston, MA, United States; Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Boston, MA, United States; Department of Radiology, Massachusetts General Hospital, Charlestown, MA, United States
| | - Daphne J Holt
- Department of Psychiatry, Massachusetts General Hospital, Charlestown, MA, United States; Harvard Medical School, Boston, MA, United States; Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Boston, MA, United States.
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Lipton RB, Seng EK, Chu MK, Reed ML, Fanning KM, Adams AM, Buse DC. The Effect of Psychiatric Comorbidities on Headache-Related Disability in Migraine: Results From the Chronic Migraine Epidemiology and Outcomes (CaMEO) Study. Headache 2020; 60:1683-1696. [PMID: 33448374 PMCID: PMC7496280 DOI: 10.1111/head.13914] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2020] [Revised: 06/25/2020] [Accepted: 06/26/2020] [Indexed: 01/19/2023]
Abstract
OBJECTIVE To examine the influences of depression and anxiety on headache-related disability in people with episodic migraine or chronic migraine. BACKGROUND Depression and anxiety are common comorbidities in people with migraine, especially among those with chronic migraine. METHODS This cross-sectional analysis of data from the longitudinal, internet-based Chronic Migraine Epidemiology and Outcomes Study assessed sociodemographic and headache features, and headache-related disability (Migraine Disability Assessment Scale). Four groups were defined based on scores from validated screeners for depression (9-item Patient Health Questionnaire) and anxiety (7-item Generalized Anxiety Disorder Scale): depression alone, anxiety alone, both, or neither. RESULTS Respondents (N = 16,788) were predominantly women (74.4% [12,494/16,788]) and white (84.0% [14,044/16,788]); mean age was 41 years. Depression was more likely in persons with chronic migraine vs episodic migraine (56.6% [836/1476] vs 30.0% [4589/15,312]; P < .001), as were anxiety (48.4% [715/1476] vs 28.1% 4307/15,312]; P < .001) and coexisting depression and anxiety (42.0% [620/1476] vs 20.8% [3192/15,312]; P < .001). After controlling for headache frequency and other covariates, depression alone, and anxiety alone were associated with 56.0% (rate ratio [RR], 1.56; 95% confidence interval [CI], 1.46-1.66) and 39.0% (RR, 1.39; 95% CI, 1.30-1.50) increased risks of moderate/severe migraine-related disability (both P < .001), respectively; the combination had an even greater effect on risk of moderate/severe disability (79.0% increase; RR, 1.79; 95% CI, 1.71-1.87; P < .001). CONCLUSIONS Depression alone and anxiety alone are associated with greater headache-related disability after controlling for sociodemographic and headache features. Coexisting depression and anxiety are more strongly associated with disability than either comorbidity in isolation. Interventions targeting depression and anxiety as well as migraine itself may improve headache-related disability in people with migraine.
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Affiliation(s)
- Richard B Lipton
- Department of Neurology, Albert Einstein College of Medicine, Bronx, NY, USA.,Department of Neurology, Montefiore Medical Center, Bronx, NY, USA.,Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Elizabeth K Seng
- Department of Neurology, Albert Einstein College of Medicine, Bronx, NY, USA.,Department of Neurology, Montefiore Medical Center, Bronx, NY, USA.,Department of Psychology, Ferkauf Graduate School of Psychology, Yeshiva University, New York, NY, USA
| | - Min Kyung Chu
- Department of Neurology, Severance Hospital, Yonsei University, Seoul, Korea
| | | | | | | | - Dawn C Buse
- Department of Neurology, Albert Einstein College of Medicine, Bronx, NY, USA.,Department of Psychology, Ferkauf Graduate School of Psychology, Yeshiva University, New York, NY, USA
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