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Moccia L, Bartolucci G, Pepe M, Marcelli I, Grisoni F, Brugnami A, Caso R, Bardi F, Calderoni C, Giannico AM, Benini E, Di Nicola M, Sani G. Heart Rate Variability as a Potential Predictor of Response to Intranasal Esketamine in Patients with Treatment-Resistant Depression: A Preliminary Report. J Clin Med 2024; 13:4767. [PMID: 39200909 PMCID: PMC11355362 DOI: 10.3390/jcm13164767] [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: 07/03/2024] [Revised: 08/02/2024] [Accepted: 08/09/2024] [Indexed: 09/02/2024] Open
Abstract
Background: Esketamine has received approval as a nasal spray (ESK-NS) for treatment-resistant depression (TRD) and evidence from real-world investigations has confirmed the effectiveness of ESK-NS, albeit with interindividual differences in response. Heart rate variability (HRV), defined as the fluctuation in time interval between consecutive heartbeats, can be used to measure autonomic dysfunction in psychiatric disorders and its role has been investigated in diagnosis and prognosis of depression. Methods: This preliminary report aims to evaluate HRV parameters and their association with treatment outcome in 18 patients (55.6% males, 55.6 ± 9.39 years old) with TRD treated with a target dose of ESK-NS for one month (mean dose: 80.9 ± 9.05 mg). The Beck Depression Inventory (BDI) and a 3 min resting electrocardiogram were used to assess changes in depressive symptoms and HRV measurements before and after treatment. Results: Responders (n = 8, 44.5%; based on ≥30% BDI scores reduction) displayed lower HRV values than non-responders at baseline (p = 0.019), which increased at one month (p = 0.038). Receiver-Operating Characteristic (ROC) curves obtained from a logistic regression displayed a discriminative potential for baseline HRV in our sample (AUC = 0.844). Conclusions: These preliminary observations suggest a mutual interaction between esketamine and HRV, especially in relation to treatment response. Further studies are required to investigate electrophysiological profiles among predictors of response to ESK-NS and allow for personalized intervention strategies in TRD that still represent a public health concern.
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Affiliation(s)
- Lorenzo Moccia
- Department of Psychiatry, Fondazione Policlinico Universitario “A. Gemelli” IRCCS, 00168 Rome, Italy
| | - Giovanni Bartolucci
- Department of Neuroscience, Section of Psychiatry, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Maria Pepe
- Department of Psychiatry, Fondazione Policlinico Universitario “A. Gemelli” IRCCS, 00168 Rome, Italy
- Department of Neuroscience, Section of Psychiatry, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Ilaria Marcelli
- Department of Neuroscience, Section of Psychiatry, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Flavia Grisoni
- Department of Neuroscience, Section of Psychiatry, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Andrea Brugnami
- Department of Neuroscience, Section of Psychiatry, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Romina Caso
- Department of Neuroscience, Section of Psychiatry, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Francesca Bardi
- Department of Neuroscience, Section of Psychiatry, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Claudia Calderoni
- Department of Neuroscience, Section of Psychiatry, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | | | - Elisabetta Benini
- Department of Neuroscience, Section of Psychiatry, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Marco Di Nicola
- Department of Psychiatry, Fondazione Policlinico Universitario “A. Gemelli” IRCCS, 00168 Rome, Italy
- Department of Neuroscience, Section of Psychiatry, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Gabriele Sani
- Department of Psychiatry, Fondazione Policlinico Universitario “A. Gemelli” IRCCS, 00168 Rome, Italy
- Department of Neuroscience, Section of Psychiatry, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
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Soman C, Faisal AT, Alsaeygh MM, Al Saffan AD, Salma RG. Driving Stress-Induced Effects on the Orofacial Region and Its Functions and Health Behaviors in Riyadh: A Cross-Sectional Survey. Healthcare (Basel) 2024; 12:1538. [PMID: 39120241 PMCID: PMC11311540 DOI: 10.3390/healthcare12151538] [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: 05/31/2024] [Revised: 07/30/2024] [Accepted: 07/31/2024] [Indexed: 08/10/2024] Open
Abstract
Driving stress is a multifaceted phenomenon, and the experience of driving invokes stress. Driving causes the activation of stress-response mechanisms, leading to short-term and long-term stress responses resulting in physiological and behavioral changes. The aim of this study was to evaluate driving stress-initiated effects on orofacial functions and health behaviors in the Riyadh population. A cross-sectional survey was conducted in Riyadh using a pre-validated set of questionnaires for habitual information, a driving stress assessment using a driving-behavior inventory, and an assessment of parafunctional habits and effects on orofacial functions. The results indicate that nearly 50% of the sample spends more than two hours commuting, and more than 50% of the sample has inadequate sleep and insufficient exercise. Oral parafunctional habits like nail biting (p = 0.039) and lip or object biting (p = 0.029) had a significant correlation with aggressive driving behaviors, whereas the grinding of teeth (p = 0.011), the clenching of jaws (p = 0.048), lip or object biting (p = 0.018), and pain in mastication (p = 0.036) had a positive correlation with driving dislikes. Driving stress can be detrimental to one's health and not only impacts health behaviors but also induces oral parafunctional habits and adversely affects orofacial regions and functions. Acute driving stress responses may be transient. However, prolonged driving stress can be maladaptive and can increase the risk of chronic diseases including chronic temporomandibular joint disorders and parafunctional habit-related changes in the oral cavity.
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Affiliation(s)
- Cristalle Soman
- Department of Oral Maxillofacial Surgery and Diagnostic Sciences, College of Medicine and Dentistry, Riyadh Elm University, Riyadh 11681, Saudi Arabia
| | - Aya Tarek Faisal
- College of Medicine and Dentistry, Riyadh Elm University, Riyadh 11681, Saudi Arabia
| | | | | | - Ra’ed Ghaleb Salma
- Department of Oral Maxillofacial Surgery and Diagnostic Sciences, College of Medicine and Dentistry, Riyadh Elm University, Riyadh 11681, Saudi Arabia
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3
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Dattagupta J, Banerjee A, Maji BK, Chattopadhyay PK. A multifaceted approach to identifying and managing juvenile delinquency by integrating psycho-physiological indicators. Int J Adolesc Med Health 2024; 36:321-333. [PMID: 38760876 DOI: 10.1515/ijamh-2024-0052] [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: 03/28/2024] [Accepted: 05/01/2024] [Indexed: 05/19/2024]
Abstract
To understand and treat juvenile delinquency, the study explores the relevance of psycho-physiological indicators. It also emphasizes the necessity for thorough research to minimize the gap existing between psycho-physiological measurements and conventional psychosocial components. The study focuses on the relevance of personality features, habituation, and autonomic arousal required to monitor the proper management of delinquent conduct. Through the integration of biological, psychological, and social elements into a multidimensional approach, researchers can uncover novel insights and create cutting-edge therapies for youths who are at risk of delinquent behavior. The study proposes to develop a comprehensive framework that considers biological antecedents in addition to conventional metrics to reach the root cause of delinquency; thereby drawing special attention to current literature and research that emphasizes the psycho-physiological correlates of delinquency. By examining the complex interactions between stress, physiology, emotions, behavior, and social structures, the study highlights the intricacy of delinquent conduct and the necessity for adopting a multifaceted strategy to fully address the problematic areas. Future research paths are emphasized, with a focus on the significance of longitudinal studies, moderating and mediating variables, and creative treatment techniques. By utilizing psycho-physiological markers and psychosocial traits, researchers can tailor intervention strategies to meet individual needs effectively. Early identification of psycho-physiological deficits in children is crucial for implementing successful behavior modification techniques and promoting the well-being of future generations. This is expected to help the government agencies to save time and public money.
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Affiliation(s)
- Jayita Dattagupta
- Department of Controller of Examinations, 30163 University of Calcutta , Kolkata, West Bengal, India
| | - Arnab Banerjee
- Department of Physiology (UG & PG), 212035 Serampore College , Serampore, West Bengal, India
| | - Bithin Kumar Maji
- Department of Physiology (UG & PG), 212035 Serampore College , Serampore, West Bengal, India
| | - Prabal Kumar Chattopadhyay
- Department of Psychology, University Professor & Head of the Department (Retired), University of Calcutta, West Bengal, India
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4
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Philippi CL, Weible E, Ehlers A, Walsh EC, Hoks RM, Birn RM, Abercrombie HC. Effects of cortisol administration on heart rate variability and functional connectivity across women with different depression histories. Behav Brain Res 2024; 463:114923. [PMID: 38408523 PMCID: PMC10942667 DOI: 10.1016/j.bbr.2024.114923] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Revised: 02/15/2024] [Accepted: 02/23/2024] [Indexed: 02/28/2024]
Abstract
Abnormalities within the hypothalamic-pituitary-adrenal (HPA) axis and autonomic nervous system have been implicated in depression. Studies have reported glucocorticoid insensitivity and reduced heart rate variability (HRV) in depressive disorders. However, little is known about the effects of cortisol on HRV and resting-state functional connectivity (rsFC) of the central autonomic network (CAN) in depression. We collected resting-state fMRI and cardiac data for women with different depression histories (n = 61) after administration of cortisol and placebo using a double-blind crossover design. We computed rsFC for R-amygdala and L-amygdala seeds and assessed the change in HRV after cortisol (cortisol-placebo). Analyses examined the effects of acute cortisol administration on HRV and rsFC of the R-amygdala and L-amygdala. There was a significant interaction between HRV and treatment for rsFC between the amygdala and CAN regions. We found lower rsFC between the L-amygdala and putamen for those with a greater decrease in HRV after cortisol. There was also reduced rsFC between the R-amygdala and dorsomedial prefrontal cortex, putamen, middle cingulate cortex, insula, and cerebellum in those with lower HRV after cortisol. These results remained significant after adjusting for depression symptoms, age, and race. Our findings suggest that the effect of cortisol on CAN connectivity is related to its effects on HRV. Overall, these results could inform transdiagnostic interventions targeting HRV and the stress response systems across clinical and non-clinical populations.
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Affiliation(s)
- Carissa L Philippi
- Department of Psychological Sciences, University of Missouri-St. Louis, 1 University Blvd, St. Louis, MO 63121, USA.
| | - Emily Weible
- Department of Psychological Sciences, University of Missouri-St. Louis, 1 University Blvd, St. Louis, MO 63121, USA
| | - Alissa Ehlers
- Department of Psychiatry, University of Wisconsin-Madison, University of Wisconsin-Madison, 6001 Research Park Blvd, Madison, WI 53719, USA
| | - Erin C Walsh
- Department of Psychiatry, University of North Carolina at Chapel Hill School of Medicine, CB# 7167, Chapel Hill, NC 27599, USA
| | - Roxanne M Hoks
- Department of Psychiatry, University of Wisconsin-Madison, University of Wisconsin-Madison, 6001 Research Park Blvd, Madison, WI 53719, USA; Center for Healthy Minds, University of Wisconsin-Madison., 625 W. Washington Ave, Madison, WI 53703, USA
| | - Rasmus M Birn
- Department of Psychiatry, University of Wisconsin-Madison, University of Wisconsin-Madison, 6001 Research Park Blvd, Madison, WI 53719, USA
| | - Heather C Abercrombie
- Department of Psychiatry, University of Wisconsin-Madison, University of Wisconsin-Madison, 6001 Research Park Blvd, Madison, WI 53719, USA; Center for Healthy Minds, University of Wisconsin-Madison., 625 W. Washington Ave, Madison, WI 53703, USA
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5
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Adil M, Atiq I, Younus S. Effectiveness of the Apple Watch as a mental health tracker. J Glob Health 2024; 14:03010. [PMID: 38332682 PMCID: PMC10853680 DOI: 10.7189/jogh.14.03010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/10/2024] Open
Affiliation(s)
- Mariam Adil
- Department of Internal Medicine, Dow University of Health Sciences, Karachi, Pakistan
| | - Isha Atiq
- Department of Internal Medicine, Dow University of Health Sciences, Karachi, Pakistan
| | - Sumaiya Younus
- Institute of Professional Psychology, Bahria University, Karachi, Pakistan
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6
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Xu C, Song Y, Sempionatto JR, Solomon SA, Yu Y, Nyein HYY, Tay RY, Li J, Heng W, Min J, Lao A, Hsiai TK, Sumner JA, Gao W. A physicochemical-sensing electronic skin for stress response monitoring. NATURE ELECTRONICS 2024; 7:168-179. [PMID: 38433871 PMCID: PMC10906959 DOI: 10.1038/s41928-023-01116-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Accepted: 12/19/2023] [Indexed: 03/05/2024]
Abstract
Approaches to quantify stress responses typically rely on subjective surveys and questionnaires. Wearable sensors can potentially be used to continuously monitor stress-relevant biomarkers. However, the biological stress response is spread across the nervous, endocrine, and immune systems, and the capabilities of current sensors are not sufficient for condition-specific stress response evaluation. Here we report an electronic skin for stress response assessment that non-invasively monitors three vital signs (pulse waveform, galvanic skin response and skin temperature) and six molecular biomarkers in human sweat (glucose, lactate, uric acid, sodium ions, potassium ions and ammonium). We develop a general approach to prepare electrochemical sensors that relies on analogous composite materials for stabilizing and conserving sensor interfaces. The resulting sensors offer long-term sweat biomarker analysis of over 100 hours with high stability. We show that the electronic skin can provide continuous multimodal physicochemical monitoring over a 24-hour period and during different daily activities. With the help of a machine learning pipeline, we also show that the platform can differentiate three stressors with an accuracy of 98.0%, and quantify psychological stress responses with a confidence level of 98.7%.
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Affiliation(s)
- Changhao Xu
- Andrew and Peggy Cherng Department of Medical Engineering, Division of Engineering and Applied Science, California Institute of Technology, Pasadena, CA, USA
- These authors contributed equally to this work
| | - Yu Song
- Andrew and Peggy Cherng Department of Medical Engineering, Division of Engineering and Applied Science, California Institute of Technology, Pasadena, CA, USA
- These authors contributed equally to this work
| | - Juliane R. Sempionatto
- Andrew and Peggy Cherng Department of Medical Engineering, Division of Engineering and Applied Science, California Institute of Technology, Pasadena, CA, USA
- These authors contributed equally to this work
| | - Samuel A. Solomon
- Andrew and Peggy Cherng Department of Medical Engineering, Division of Engineering and Applied Science, California Institute of Technology, Pasadena, CA, USA
- These authors contributed equally to this work
| | - You Yu
- Andrew and Peggy Cherng Department of Medical Engineering, Division of Engineering and Applied Science, California Institute of Technology, Pasadena, CA, USA
| | - Hnin Y. Y. Nyein
- Department of Chemical and Biological Engineering, Hong Kong University of Science and Technology, Hong Kong, China
| | - Roland Yingjie Tay
- Andrew and Peggy Cherng Department of Medical Engineering, Division of Engineering and Applied Science, California Institute of Technology, Pasadena, CA, USA
| | - Jiahong Li
- Andrew and Peggy Cherng Department of Medical Engineering, Division of Engineering and Applied Science, California Institute of Technology, Pasadena, CA, USA
| | - Wenzheng Heng
- Andrew and Peggy Cherng Department of Medical Engineering, Division of Engineering and Applied Science, California Institute of Technology, Pasadena, CA, USA
| | - Jihong Min
- Andrew and Peggy Cherng Department of Medical Engineering, Division of Engineering and Applied Science, California Institute of Technology, Pasadena, CA, USA
| | - Alison Lao
- Andrew and Peggy Cherng Department of Medical Engineering, Division of Engineering and Applied Science, California Institute of Technology, Pasadena, CA, USA
| | - Tzung K. Hsiai
- Division of Cardiology, David Geffen School of Medicine, University of California, Los Angeles, CA, USA
| | - Jennifer A. Sumner
- Department of Psychology, University of California, Los Angeles, CA, USA
| | - Wei Gao
- Andrew and Peggy Cherng Department of Medical Engineering, Division of Engineering and Applied Science, California Institute of Technology, Pasadena, CA, USA
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7
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Schricker IF, Nayman S, Reinhard I, Kuehner C. Trait and state effects of different modes of thinking on salivary cortisol in daily life in patients with recurrent major depression and healthy individuals. Psychoneuroendocrinology 2023; 155:106307. [PMID: 37290378 DOI: 10.1016/j.psyneuen.2023.106307] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Revised: 05/23/2023] [Accepted: 05/23/2023] [Indexed: 06/10/2023]
Abstract
Habitual modes of thinking such as repetitive negative thinking (RNT), but also momentary cognitive processes such as mindwandering could be vulnerability factors for the course of Major Depressive Disorder (MDD). On the physiological level, cortisol represents an important biological stress marker of the hypothalamic-pituitary-adrenal (HPA) axis. Being a dynamic and non-invasive measure, salivary cortisol can be assessed in daily life via Ambulatory Assessment (AA). So far, consensus exists on a dysregulation of the HPA axis in MDD. However, findings are ambiguous and AA-studies examining both trait and state level effects of cognitive processes on cortisol release in daily life in patients with recurrent major depression (rMDD) and healthy controls (HCs) are lacking. A sample of 119 (nrMDD=57, nHCs=62) participants underwent a baseline session, including self-rated questionnaires (RNT, mindfulness) followed by a 5-day AA, where participants indicated the occurrence of mindwandering and levels of mentalshift problems ten times per day via smartphone, and collected saliva cortisol samples five times per day. Via multilevel models, we found habitual RNT, but not mindfulness, to predict higher cortisol levels, with the effects being stronger in rMDD patients. State mindwandering and mentalshift problems predicted increased cortisol 20 min later across groups. State cognitions did not mediate the effects of habitual RNT on cortisol release. Our results suggest independent mechanisms of action for trait and state cognitions on cortisol activity in daily life and indicate a greater physiological vulnerability toward trait RNT and the tendency to experience mentalshift problems in patients with recurrent major depression.
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Affiliation(s)
- Isabelle Florence Schricker
- Research Group Longitudinal and Intervention Research, Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, University of Heidelberg, Medical Faculty Mannheim, Mannheim, Germany
| | - Sibel Nayman
- Research Group Longitudinal and Intervention Research, Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, University of Heidelberg, Medical Faculty Mannheim, Mannheim, Germany
| | - Iris Reinhard
- Department of Biostatistics, Central Institute of Mental Health, University of Heidelberg, Medical Faculty Mannheim, Mannheim, Germany
| | - Christine Kuehner
- Research Group Longitudinal and Intervention Research, Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, University of Heidelberg, Medical Faculty Mannheim, Mannheim, Germany.
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8
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Antunes JL, Amado J, Veiga F, Paiva-Santos AC, Pires PC. Nanosystems, Drug Molecule Functionalization and Intranasal Delivery: An Update on the Most Promising Strategies for Increasing the Therapeutic Efficacy of Antidepressant and Anxiolytic Drugs. Pharmaceutics 2023; 15:pharmaceutics15030998. [PMID: 36986859 PMCID: PMC10054777 DOI: 10.3390/pharmaceutics15030998] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2023] [Revised: 03/09/2023] [Accepted: 03/16/2023] [Indexed: 03/30/2023] Open
Abstract
Depression and anxiety are high incidence and debilitating psychiatric disorders, usually treated by antidepressant or anxiolytic drug administration, respectively. Nevertheless, treatment is usually given through the oral route, but the low permeability of the blood-brain barrier reduces the amount of drug that will be able to reach it, thus consequently reducing the therapeutic efficacy. Which is why it is imperative to find new solutions to make these treatments more effective, safer, and faster. To overcome this obstacle, three main strategies have been used to improve brain drug targeting: the intranasal route of administration, which allows the drug to be directly transported to the brain by neuronal pathways, bypassing the blood-brain barrier and avoiding the hepatic and gastrointestinal metabolism; the use of nanosystems for drug encapsulation, including polymeric and lipidic nanoparticles, nanometric emulsions, and nanogels; and drug molecule functionalization by ligand attachment, such as peptides and polymers. Pharmacokinetic and pharmacodynamic in vivo studies' results have shown that intranasal administration can be more efficient in brain targeting than other administration routes, and that the use of nanoformulations and drug functionalization can be quite advantageous in increasing brain-drug bioavailability. These strategies could be the key to future improved therapies for depressive and anxiety disorders.
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Affiliation(s)
- Jéssica L Antunes
- Department of Pharmaceutical Technology, Faculty of Pharmacy, University of Coimbra, 3000-548 Coimbra, Portugal
| | - Joana Amado
- Department of Pharmaceutical Technology, Faculty of Pharmacy, University of Coimbra, 3000-548 Coimbra, Portugal
| | - Francisco Veiga
- Department of Pharmaceutical Technology, Faculty of Pharmacy, University of Coimbra, 3000-548 Coimbra, Portugal
- REQUIMTE/LAQV, Group of Pharmaceutical Technology, Faculty of Pharmacy, University of Coimbra, 3000-548 Coimbra, Portugal
| | - Ana Cláudia Paiva-Santos
- Department of Pharmaceutical Technology, Faculty of Pharmacy, University of Coimbra, 3000-548 Coimbra, Portugal
- REQUIMTE/LAQV, Group of Pharmaceutical Technology, Faculty of Pharmacy, University of Coimbra, 3000-548 Coimbra, Portugal
| | - Patrícia C Pires
- Department of Pharmaceutical Technology, Faculty of Pharmacy, University of Coimbra, 3000-548 Coimbra, Portugal
- REQUIMTE/LAQV, Group of Pharmaceutical Technology, Faculty of Pharmacy, University of Coimbra, 3000-548 Coimbra, Portugal
- Health Sciences Research Centre (CICS-UBI), University of Beira Interior, Av. Infante D. Henrique, 6200-506 Covilhã, Portugal
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9
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Guo X, Angulo A, Tavakoli A, Robartes E, Chen TD, Heydarian A. Rethinking infrastructure design: evaluating pedestrians and VRUs' psychophysiological and behavioral responses to different roadway designs. Sci Rep 2023; 13:4278. [PMID: 36922522 PMCID: PMC10017812 DOI: 10.1038/s41598-023-31041-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Accepted: 03/06/2023] [Indexed: 03/18/2023] Open
Abstract
The integration of human-centric approaches has gained more attention recently due to more automated systems being introduced into our built environments (buildings, roads, vehicles, etc.), which requires a correct understanding of how humans perceive such systems and respond to them. This paper introduces an Immersive Virtual Environment-based method to evaluate the infrastructure design with psycho-physiological and behavioral responses from the vulnerable road users, especially for pedestrians. A case study of pedestrian mid-block crossings with three crossing infrastructure designs (painted crosswalk, crosswalk with flashing beacons, and a smartphone app for connected vehicles) are tested. Results from 51 participants indicate there are differences between the subjective and objective measurement. A higher subjective safety rating is reported for the flashing beacon design, while the psychophysiological and behavioral data indicate that the flashing beacon and smartphone app are similar in terms of crossing behaviors, eye tracking measurements, and heart rate. In addition, the smartphone app scenario appears to have a lower stress level as indicated by eye tracking data, although many participants do not have prior experience with it. Suggestions are made for the implementation of new technologies, which can increase public acceptance of new technologies and pedestrian safety in the future.
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Affiliation(s)
- Xiang Guo
- Department of Engineering Systems and Environment, University of Virginia, Charlottesville, VA, 22904, USA
| | - Austin Angulo
- Department of Civil, Structural and Environmental Engineering, University at Buffalo, State University of New York, Buffalo, NY, 14260, USA
| | - Arash Tavakoli
- Department of Civil and Environmental Engineering, Stanford University, Stanford, CA, 94305, USA
| | - Erin Robartes
- Department of Engineering Systems and Environment, University of Virginia, Charlottesville, VA, 22904, USA
| | - T Donna Chen
- Department of Engineering Systems and Environment, University of Virginia, Charlottesville, VA, 22904, USA
| | - Arsalan Heydarian
- Department of Engineering Systems and Environment, University of Virginia, Charlottesville, VA, 22904, USA.
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10
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Dobson R, Li LL, Garner K, Tane T, McCool J, Whittaker R. The Use of Sensors to Detect Anxiety for In-the-Moment Intervention: Scoping Review. JMIR Ment Health 2023; 10:e42611. [PMID: 36729590 PMCID: PMC9936367 DOI: 10.2196/42611] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2022] [Revised: 12/20/2022] [Accepted: 01/12/2023] [Indexed: 02/03/2023] Open
Abstract
BACKGROUND With anxiety a growing issue and barriers to accessing support services, there is a need for innovative solutions to provide early intervention. In-the-moment interventions support individuals to recognize early signs of distress and use coping mechanisms to prevent or manage this distress. There is potential for wearable sensors linked to an individual's mobile phone to provide in-the-moment support tailored to individual needs and physiological responses. OBJECTIVE The aim of this scoping review is to examine the role of sensors in detecting the physiological signs of anxiety to initiate and direct interventions for its management. METHODS Relevant studies were identified through searches conducted in Embase, MEDLINE, APA PsycINFO, ProQuest, and Scopus. Studies were identified if they were conducted with people with stress or anxiety or at risk of anxiety and included a wearable sensor providing real-time data for in-the-moment management of anxiety. RESULTS Of the 1087 studies identified, 11 studies were included in the review, including 5 randomized controlled trials and 6 pilot or pretesting studies. The results showed that most studies successfully demonstrated improvements in their target variables. This included overall anxiety and stress levels, and the implementation of in-the-moment stress and anxiety management techniques such as diaphragmatic breathing. There was wide variation in the types of sensors used, physiological measures, and sensor-linked interventions. CONCLUSIONS This review indicates that sensors are potentially a useful tool in detecting anxiety and facilitating the implementation of a known control mechanism to reduce anxiety and improve mood, but further work is needed to understand the acceptability and effectiveness of this type of intervention.
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Affiliation(s)
- Rosie Dobson
- National Institute for Health Innovation, University of Auckland, Auckland, New Zealand.,Institute for Innovation and Improvement, Te Whatu Ora Waitematā, Auckland, New Zealand
| | - Linwei Lily Li
- School of Population Health, University of Auckland, Auckland, New Zealand
| | - Katie Garner
- National Institute for Health Innovation, University of Auckland, Auckland, New Zealand
| | - Taria Tane
- School of Population Health, University of Auckland, Auckland, New Zealand
| | - Judith McCool
- School of Population Health, University of Auckland, Auckland, New Zealand
| | - Robyn Whittaker
- National Institute for Health Innovation, University of Auckland, Auckland, New Zealand.,Institute for Innovation and Improvement, Te Whatu Ora Waitematā, Auckland, New Zealand
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11
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Monthé-Drèze C, Aris IM, Rifas-Shiman SL, Shivappa N, Hebert JR, Oken E, Sen S. The Role of Prenatal Psychosocial Stress in the Associations of a Proinflammatory Diet in Pregnancy With Child Adiposity and Growth Trajectories. JAMA Netw Open 2023; 6:e2251367. [PMID: 36662527 PMCID: PMC9860526 DOI: 10.1001/jamanetworkopen.2022.51367] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Accepted: 11/23/2022] [Indexed: 01/21/2023] Open
Abstract
Importance Prenatal psychosocial stress and nutrition may each program offspring adiposity, an important predictor of lifelong cardiometabolic health. Although increased stress and poor nutrition have been found to co-occur in pregnancy, little is known about their combined longitudinal associations in the offspring. Objective To investigate whether the associations of the Dietary Inflammatory Index (DII) with offspring adiposity differ by prenatal stress levels and whether these associations change with age. Design, Setting, and Participants Project Viva, a prospective prebirth cohort study of mother-child dyads in Massachusetts, included singleton children of mothers enrolled between April 1999 and July 2002, with follow-up visits at early childhood, midchildhood, and early adolescence. Data analysis was performed from October 31, 2020, to October 31, 2022. Exposures Food frequency-derived DII score in pregnancy was the exposure. Effect modifiers included stress-related measures in pregnancy; depressive symptoms assessed using the Edinburgh Postnatal Depression Scale (EPDS), dichotomized at scores greater than or equal to 13 vs less than 13; and census tract-level social vulnerability (overall Social Vulnerability Index and its 4 main subindices), dichotomized at the 75th percentile. Main Outcomes and Measures Overall adiposity, comprising sex- and age-standardized body mass index (BMI z), sum of subscapular and triceps skinfolds, fat mass index (FMI), and body fat percentage estimated using bioelectrical impedance analysis (BIA) and dual x-ray absorptiometry (DXA); and central adiposity, comprising waist circumference, ratio of subscapular to triceps skinfolds, and DXA-derived trunk FMI. Results Among 1060 mother-child dyads, mean (SD) maternal age was 32.6 (4.6) years, and 811 (77%) mothers were non-Hispanic White. Mean (SD) DII score was -2.7 (1.3) units, Social Vulnerability Index level was 38th (27th) percentile, and 8% of mothers had depressive symptoms. Mean (SD) age of the children was 3.3 (0.3) years at the early childhood visit, 7.9 (0.8) years at the midchildhood visit, and 13.2 (0.9) years at the early adolescence visit. In adjusted analyses, children born to mothers in the highest (vs lowest) quartile of DII had slower decrease in BMI z scores (β, 0.03 SD units/y; 95% CI, 0.01-0.05 SD units/y), and faster adiposity gain (eg, BIA total FMI β, 0.11 kg/m2/y; 95% CI, 0.03-0.19 kg/m2/y) over time. Associations of prenatal DII quartiles with childhood adiposity were stronger (eg, BIA total FMI quartile 4 vs quartile 1 change in β, 1.40 kg/m2; 95% CI, 0.21-2.59 kg/m2) among children of mothers with high vs low EPDS scores in pregnancy, although EPDS scores did not modify the change over time. Associations of prenatal DII with adiposity change over time, however, were greater among children whose mothers lived in neighborhoods with a high (BIA percentage body fat: β, 0.55% per year; 95% CI, 0.04%-1.07% per year) vs low (β, 0.13% per year; 95% CI, -0.20 to 0.46% per year), percentage of racial and ethnic minorities, and residents with limited English-language proficiency. Conclusions and Relevance The findings of this cohort study suggest that it may be useful to simultaneously evaluate prenatal diet and psychosocial stress in women as targets for interventions intended to prevent excess childhood adiposity.
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Affiliation(s)
- Carmen Monthé-Drèze
- Department of Pediatric Newborn Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts
| | - Izzuddin M. Aris
- Division of Chronic Disease Research Across the Lifecourse, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, Massachusetts
| | - Sheryl L. Rifas-Shiman
- Division of Chronic Disease Research Across the Lifecourse, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, Massachusetts
| | - Nitin Shivappa
- South Carolina Statewide Cancer Prevention and Control Program and Department of Epidemiology and Biostatistics, University of South Carolina, Columbia
- Department of Nutrition, Connecting Health Innovations LLC, Columbia, South Carolina
| | - James R. Hebert
- South Carolina Statewide Cancer Prevention and Control Program and Department of Epidemiology and Biostatistics, University of South Carolina, Columbia
- Department of Nutrition, Connecting Health Innovations LLC, Columbia, South Carolina
| | - Emily Oken
- Division of Chronic Disease Research Across the Lifecourse, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, Massachusetts
| | - Sarbattama Sen
- Department of Pediatric Newborn Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts
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12
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Nano and Microemulsions for the Treatment of Depressive and Anxiety Disorders: An Efficient Approach to Improve Solubility, Brain Bioavailability and Therapeutic Efficacy. Pharmaceutics 2022; 14:pharmaceutics14122825. [PMID: 36559318 PMCID: PMC9783281 DOI: 10.3390/pharmaceutics14122825] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Revised: 12/13/2022] [Accepted: 12/14/2022] [Indexed: 12/23/2022] Open
Abstract
Most drugs used for the treatment of depression, anxiety and related disorders have low absorption, high metabolism, low brain targeting and/or low water solubility, which can make it hard to formulate them at high strength and can also lead to decreased bioavailability. Incorporating these drugs into nanometric emulsions can solve these issues. Hence, the aim of the present review was to assess the potential of nano and micro emulsions for the delivery of antidepressant and anxiolytic drugs. The results from several studies showed that nanometric emulsions were able to increase drug strength up to 20,270-fold (compared to aqueous solubility). Moreover, in general, the formulations showed droplet size, polydispersity index, zeta potential, viscosity, osmolality, pH, in vitro drug release and ex vivo drug permeation as adequate for the intended effect and administration route. In vivo animal pharmacokinetic experiments showed that nanometric emulsions improved systemic drug bioavailability and/or brain targeting, and in vivo pharmacodynamic studies showed that they had antidepressant and/or anxiolytic effects, also being apparently safe. Hence, the current review provides proof of the potential of nano and microemulsions for improving solubilization and increasing the overall bioavailability of antidepressant and/or anxiolytic drugs, providing evidence of a possible useful strategy for future therapies.
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13
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Alberto M, Paiva-Santos AC, Veiga F, Pires PC. Lipid and Polymeric Nanoparticles: Successful Strategies for Nose-to-Brain Drug Delivery in the Treatment of Depression and Anxiety Disorders. Pharmaceutics 2022; 14:pharmaceutics14122742. [PMID: 36559236 PMCID: PMC9783528 DOI: 10.3390/pharmaceutics14122742] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2022] [Revised: 11/30/2022] [Accepted: 12/05/2022] [Indexed: 12/13/2022] Open
Abstract
Intranasal administration has gained an increasing interest for brain drug delivery since it allows direct transport through neuronal pathways, which can be quite advantageous for central nervous system disorders, such as depression and anxiety. Nanoparticles have been studied as possible alternatives to conventional formulations, with the objective of improving drug bioavailability. The present work aimed to analyze the potential of intranasal nanoparticle administration for the treatment of depression and anxiety, using the analysis of several studies already performed. From the carried-out analysis, it was concluded that the use of nanoparticles allows the drug's protection from enzymatic degradation, and the modulation of its components allows controlled drug release and enhanced drug permeation. Furthermore, the results of in vivo studies further verified these systems' potential, with the drug reaching the brain faster and leading to increased bioavailability and, consequently, therapeutic effect. Hence, in general, the intranasal administration of nanoparticles leads to a faster onset of action, with increased and prolonged brain drug concentrations and, consequently, therapeutic effects, presenting high potential as an alternative to the currently available therapies for the treatment of depression and anxiety.
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Affiliation(s)
- Margarida Alberto
- Faculty of Pharmacy, University of Coimbra (FFUC), Azinhaga de Santa Comba, 3000-548 Coimbra, Portugal
| | - Ana Cláudia Paiva-Santos
- Faculty of Pharmacy, University of Coimbra (FFUC), Azinhaga de Santa Comba, 3000-548 Coimbra, Portugal
- Rede de Química e Tecnologia/Laboratório Associado para a Química Verde (REQUIMTE/LAQV), Group of Pharmaceutical Technology, Faculty of Pharmacy, University of Coimbra, 3000-548 Coimbra, Portugal
- Correspondence: (A.C.P.-S.); (P.C.P.)
| | - Francisco Veiga
- Faculty of Pharmacy, University of Coimbra (FFUC), Azinhaga de Santa Comba, 3000-548 Coimbra, Portugal
- Rede de Química e Tecnologia/Laboratório Associado para a Química Verde (REQUIMTE/LAQV), Group of Pharmaceutical Technology, Faculty of Pharmacy, University of Coimbra, 3000-548 Coimbra, Portugal
| | - Patrícia C. Pires
- Faculty of Pharmacy, University of Coimbra (FFUC), Azinhaga de Santa Comba, 3000-548 Coimbra, Portugal
- Rede de Química e Tecnologia/Laboratório Associado para a Química Verde (REQUIMTE/LAQV), Group of Pharmaceutical Technology, Faculty of Pharmacy, University of Coimbra, 3000-548 Coimbra, Portugal
- Health Sciences Research Centre, University of Beira Interior (CICS-UBI), Av. Infante D. Henrique, 6200-506 Covilhã, Portugal
- Correspondence: (A.C.P.-S.); (P.C.P.)
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14
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Jarbou NS, Newell KA. Exercise and yoga during pregnancy and their impact on depression: a systematic literature review. Arch Womens Ment Health 2022; 25:539-559. [PMID: 35286442 DOI: 10.1007/s00737-021-01189-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Accepted: 10/11/2021] [Indexed: 12/24/2022]
Abstract
It is well established that exercise can improve depressive symptoms in the general population; however, it is not clear if these benefits are also seen in pregnancy. This review aimed to synthesize the evidence that examines whether exercise during pregnancy impacts depressive and associated symptoms (e.g. anxiety) during the perinatal period. The review was conducted in accordance with PRISMA guidelines and reporting criteria; literature was searched using PubMed, Scopus and Web of Science database engines. Clinical trials published in English evaluating the effects of a defined exercise protocol during pregnancy on depressive and/or anxiety symptoms during the perinatal period were included. Studies without a control group were excluded. Risk of bias was conducted by Cochrane assessment to appraise the quality of the included studies. Twenty-seven articles, between 1994 and 2019, were included. Of these, only 5 specifically recruited women with depression (n = 334), which all assessed a yoga-based intervention; 4 of these studies showed a statistically significant improvement in depressive and/or anxiety symptoms in the intervention group compared to baseline; however, 2 of these studies also showed an improvement in the control group. The remaining 22 studies used various exercise interventions in pregnant women (n = 4808) with 20 studies reporting that exercise during pregnancy has the ability to improve depressive and/or anxiety measures in the perinatal period compared to either baseline or control. The evidence suggests that exercise of various types in pregnancy can reduce depressive and/or anxiety symptoms in the perinatal period in otherwise healthy women. Specifically in women with antenatal depression, the incorporation of yoga in pregnancy can improve depressive/anxiety symptoms in the perinatal period; however, this is based on a small number of studies, and it is not clear whether this is superior to non-exercise controls. Further studies are needed to determine the potential therapeutic effects of exercise of various types during pregnancy on symptoms of antenatal depression.
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Affiliation(s)
- Noor S Jarbou
- Molecular Horizons and School of Medicine, Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, NSW, 2522, Australia.,Illawarra Health and Medical Research Institute, Wollongong, NSW, 2522, Australia
| | - Kelly A Newell
- Molecular Horizons and School of Medicine, Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, NSW, 2522, Australia. .,Illawarra Health and Medical Research Institute, Wollongong, NSW, 2522, Australia.
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15
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Maternal psychological distress during the COVID-19 pandemic and structural changes of the human fetal brain. COMMUNICATIONS MEDICINE 2022; 2:47. [PMID: 35647608 PMCID: PMC9135751 DOI: 10.1038/s43856-022-00111-w] [Citation(s) in RCA: 22] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2021] [Accepted: 04/11/2022] [Indexed: 12/12/2022] Open
Abstract
Abstract
Background
Elevated maternal psychological distress during pregnancy is linked to adverse outcomes in offspring. The potential effects of intensified levels of maternal distress during the COVID-19 pandemic on the developing fetal brain are currently unknown.
Methods
We prospectively enrolled 202 pregnant women: 65 without known COVID-19 exposures during the pandemic who underwent 92 fetal MRI scans, and 137 pre-pandemic controls who had 182 MRI scans. Multi-plane, multi-phase single shot fast spin echo T2-weighted images were acquired on a GE 1.5 T MRI Scanner. Volumes of six brain tissue types were calculated. Cortical folding measures, including brain surface area, local gyrification index, and sulcal depth were determined. At each MRI scan, maternal distress was assessed using validated stress, anxiety, and depression scales. Generalized estimating equations were utilized to compare maternal distress measures, brain volume and cortical folding differences between pandemic and pre-pandemic cohorts.
Results
Stress and depression scores are significantly higher in the pandemic cohort, compared to the pre-pandemic cohort. Fetal white matter, hippocampal, and cerebellar volumes are decreased in the pandemic cohort. Cortical surface area and local gyrification index are also decreased in all four lobes, while sulcal depth is lower in the frontal, parietal, and occipital lobes in the pandemic cohort, indicating delayed brain gyrification.
Conclusions
We report impaired fetal brain growth and delayed cerebral cortical gyrification in COVID-19 pandemic era pregnancies, in the setting of heightened maternal psychological distress. The potential long-term neurodevelopmental consequences of altered fetal brain development in COVID-era pregnancies merit further study.
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16
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Zhou H, Zou H, Dai Z, Zhao S, Hua L, Xia Y, Han Y, Yan R, Tang H, Huang Y, Du Y, Wang X, Yao Z, Lu Q. Interoception Dysfunction Contributes to the Negative Emotional Bias in Major Depressive Disorder. Front Psychiatry 2022; 13:874859. [PMID: 35479498 PMCID: PMC9035634 DOI: 10.3389/fpsyt.2022.874859] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2022] [Accepted: 03/08/2022] [Indexed: 11/13/2022] Open
Abstract
Background Previous research studies have demonstrated that impaired interoception is involved in emotional information processing in major depressive disorder (MDD). Heartbeat-evoked potential (HEP) amplitudes, an index for interoception, could be manipulated by emotional faces in healthy people. Considering negative emotional bias is the core characteristic in MDD, we hypothesized that interoception dysfunction was associated with the negative emotional bias in MDD. Methods An electroencephalogram (EEG) study under an emotional faces task was applied to explore the relationship between interoception and emotional bias. HEPs before emotional faces stimuli were used to predict the late positive potential (LPP) amplitudes and it worked as an index of emotional bias. Twenty-seven patients with MDD and 27 healthy controls (HCs) participated in this study. Source analysis gave an auxiliary description for results in sensory level. Results Major depressive disorders (MDDs) had poor performance in the heartbeat count task (HCT) and attenuate HEP average amplitudes (455-550 ms). Compared with HCs, cluster-based permutation t-tests revealed that MDDs had attenuated LPP amplitudes (300-1,000 ms) over centroparietal regions and enhanced LPP amplitudes over frontocentral regions. Furthermore, abnormal attenuated HEPs could predict aberrant LPPs under sad face stimuli in MDDs, which could be associated with the dysfunction of the anterior cingulate cortex (ACC) and right insula. Conclusion Mediated by ACC and insula, interoception dysfunction contributes to the negative emotional bias of MDD, highlighting the importance of interoception in the disorder.
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Affiliation(s)
- Hongliang Zhou
- Department of Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Haowen Zou
- Nanjing Brain Hospital, Medical School of Nanjing University, Nanjing, China
| | - Zhongpeng Dai
- School of Biological Sciences and Medical Engineering, Southeast University, Nanjing, China
| | - Shuai Zhao
- Department of Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Lingling Hua
- Nanjing Brain Hospital, Medical School of Nanjing University, Nanjing, China
| | - Yi Xia
- Department of Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Yingling Han
- Nanjing Brain Hospital, Medical School of Nanjing University, Nanjing, China
| | - Rui Yan
- Nanjing Brain Hospital, Medical School of Nanjing University, Nanjing, China
| | - Hao Tang
- Department of Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Yinghong Huang
- Nanjing Brain Hospital, Medical School of Nanjing University, Nanjing, China
| | - Yishan Du
- Department of Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Xiaoqin Wang
- Department of Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Zhijian Yao
- Department of Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
- Nanjing Brain Hospital, Medical School of Nanjing University, Nanjing, China
| | - Qing Lu
- School of Biological Sciences and Medical Engineering, Southeast University, Nanjing, China
- Key Laboratory of Child Development and Learning Science of Ministry of Education, Nanjing, China
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17
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Moon E, Yang M, Seon Q, Linnaranta O. Relevance of Objective Measures in Psychiatric Disorders-Rest-Activity Rhythm and Psychophysiological Measures. Curr Psychiatry Rep 2021; 23:85. [PMID: 34714422 PMCID: PMC8556205 DOI: 10.1007/s11920-021-01291-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/08/2021] [Indexed: 12/28/2022]
Abstract
PURPOSE OF REVIEW We present a review of recent methods of objective measurement in psychiatry and psychology with a focus on home monitoring and its utility in guiding treatment. RECENT FINDINGS For individualized diagnostics and treatment of insomnia, actigraphy can generate clinically useful graphical presentations of sleep timing and patterns. Psychophysiological measures may complement psychometrics by tracking parallel changes in physiological responses and emotional functioning, especially during therapy for trauma symptoms and emotion regulation. It seems that rather than defining universal cut-offs, an individualised range of variability could characterize treatment response. Wearable actigraphy and psychophysiological sensors are promising devices to provide biofeedback and guide treatment. Use of feasible and reliable technology during experimental and clinical procedures may necessitate defining healthy and abnormal responses in different populations and pathological states. We present a "call for action" towards further collaborative work to enable large scale use of objective measures.
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Affiliation(s)
- Eunsoo Moon
- Department of Psychiatry, Pusan National University School of Medicine, Yangsan, Republic of Korea
- Department of Psychiatry and Biomedical Institute, Pusan National University Hospital, Busan, Republic of Korea
| | - Michelle Yang
- Interdisciplinary Health Sciences, University of Ottawa, Ottawa, ON, Canada
| | - Quinta Seon
- Department of Psychiatry, McGill University, Montreal, QC, Canada
| | - Outi Linnaranta
- Department of Psychiatry, McGill University, Montreal, QC, Canada.
- Mental Health Unit, Finnish Institute for Health and Welfare, P.O. Box 30, 00271, Helsinki, Finland.
- Douglas Centre for Sleep and Biological Rhythms, Douglas Mental Health University Institute, 6875 LaSalle Boulevard, Montreal, QC, H4H 1R3, Canada.
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18
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Moscato S, Sichi V, Giannelli A, Palumbo P, Ostan R, Varani S, Pannuti R, Chiari L. Virtual Reality in Home Palliative Care: Brief Report on the Effect on Cancer-Related Symptomatology. Front Psychol 2021; 12:709154. [PMID: 34630217 PMCID: PMC8497744 DOI: 10.3389/fpsyg.2021.709154] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2021] [Accepted: 08/26/2021] [Indexed: 12/12/2022] Open
Abstract
Virtual reality (VR) has been used as a complementary therapy for managing psychological and physical symptoms in cancer patients. In palliative care, the evidence about the use of VR is still inadequate. This study aims to assess the effect of an immersive VR-based intervention conducted at home on anxiety, depression, and pain over 4days and to evaluate the short-term effect of VR sessions on cancer-related symptomatology. Participants were advanced cancer patients assisted at home who were provided with a VR headset for 4days. On days one and four, anxiety and depression were measured by the Hospital Anxiety and Depression Scale (HADS) and pain by the Brief Pain Inventory (BPI). Before and after each VR session, symptoms were collected by the Edmonton Symptom Assessment Scale (ESAS). Participants wore a smart wristband measuring physiological signals associated with pain, anxiety, and depression. Fourteen patients (mean age 47.2±14.2years) were recruited. Anxiety, depression (HADS), and pain (BPI) did not change significantly between days one and four. However, the ESAS items related to pain, depression, anxiety, well-being, and shortness of breath collected immediately after the VR sessions showed a significant improvement (p<0.01). A progressive reduction in electrodermal activity has been observed comparing the recordings before, during, and after the VR sessions, although these changes were not statistically significant. This brief research report supports the idea that VR could represent a suitable complementary tool for psychological treatment in advanced cancer patients assisted at home.
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Affiliation(s)
- Serena Moscato
- Department of Electrical, Electronic, and Information Engineering "Guglielmo Marconi" - DEI, University of Bologna, Bologna, Italy
| | - Vittoria Sichi
- National Tumor Assistance (ANT) Foundation, Bologna, Italy
| | | | - Pierpaolo Palumbo
- Department of Electrical, Electronic, and Information Engineering "Guglielmo Marconi" - DEI, University of Bologna, Bologna, Italy
| | - Rita Ostan
- National Tumor Assistance (ANT) Foundation, Bologna, Italy
| | - Silvia Varani
- National Tumor Assistance (ANT) Foundation, Bologna, Italy
| | | | - Lorenzo Chiari
- Department of Electrical, Electronic, and Information Engineering "Guglielmo Marconi" - DEI, University of Bologna, Bologna, Italy
- Health Sciences and Technologies - Interdepartmental Center for Industrial Research (CIRI-SDV), University of Bologna, Bologna, Italy
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Aragão WAB, Souza-Monteiro DD, Frazão DR, Né YGDS, Ferreira RDO, Rivera LFS, Saito MT, Rösing CK, Fagundes NCF, Maia LC, Lima RR. Is There Any Association Between Chronic Periodontitis and Anxiety in Adults? A Systematic Review. Front Psychiatry 2021; 12:710606. [PMID: 34413802 PMCID: PMC8368723 DOI: 10.3389/fpsyt.2021.710606] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Accepted: 06/22/2021] [Indexed: 12/12/2022] Open
Abstract
Periodontitis is a multifactorial disease triggered by dysbiotic biofilms, involving the host's immune response, systemic and behavioral factors, including psychosocial conditions. This systematic review aimed to investigate the possible association between periodontitis and anxiety in adults. Searches were performed in PubMed, Scopus, Web of Science, Lilacs, Cochrane, and OpenGrey databases, without language restrictions, considering studies in adults (P-Participants), with (E-Exposure) and without periodontitis (C- Comparison) in an outcome of association with anxiety (O-outcome). Methodological quality assessment was carried out using the Newcastle-Ottawa protocol for case-control and cross-sectional studies, followed by an analysis of the level of evidence using the GRADE tool. Metanalysis was not performed due to several differences in methods applied by authors in primary studies. Eleven observational studies were selected according to the inclusion criteria from the total of 6,380 studies retrieved from databases. Eight studies demonstrated higher anxiety levels in subjects with periodontitis, among which only one study presented a high risk of bias. The GRADE tool revealed a low level of evidence for the anxiety outcome measured by the State-Trait Anxiety Inventory (STAI), both for case-control and cross-sectional studies. However, since anxiety may affect the quality of life of many subjects, it reinforces the need for further studies that evaluate this association for more extended periods. Clinical Trial Registration:PROSPERO-CRD42020190445.
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Affiliation(s)
- Walessa Alana Bragança Aragão
- Laboratory of Functional and Structural Biology, Institute of Biological Sciences, Federal University of Pará, Belém, Brazil
| | - de Deiweson Souza-Monteiro
- Laboratory of Functional and Structural Biology, Institute of Biological Sciences, Federal University of Pará, Belém, Brazil
| | - Deborah Ribeiro Frazão
- Laboratory of Functional and Structural Biology, Institute of Biological Sciences, Federal University of Pará, Belém, Brazil
| | - Yago Gecy de Sousa Né
- Laboratory of Functional and Structural Biology, Institute of Biological Sciences, Federal University of Pará, Belém, Brazil
| | - Railson de Oliveira Ferreira
- Laboratory of Functional and Structural Biology, Institute of Biological Sciences, Federal University of Pará, Belém, Brazil
| | | | - Miki Taketomi Saito
- School of Dentistry, Institute of Health Sciences, Federal University of Pará, Belém, Brazil
| | - Cassiano Kuchenbecker Rösing
- Department of Periodontology, Faculty of Dentistry, Federal University of Rio Grande Do Sul, Porto Alegre, Brazil
| | | | - Lucianne Cople Maia
- Department of Pediatric Dentistry and Orthodontics, School of Dentistry, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Rafael Rodrigues Lima
- Laboratory of Functional and Structural Biology, Institute of Biological Sciences, Federal University of Pará, Belém, Brazil
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