1
|
Dassanayake TL, Wijesundara D, Kahathuduwa CN, Weerasinghe VS. Dose-response effect of L-theanine on psychomotor speed, sustained attention, and inhibitory control: a double-blind, placebo-controlled, crossover study. Nutr Neurosci 2023; 26:1138-1146. [PMID: 36263942 DOI: 10.1080/1028415x.2022.2136884] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
BACKGROUND L-theanine is a non-protein-forming amino acid found in tea. Previous research shows high doses (100-400 mg) of L-theanine enhances attention, mainly by reducing mind wandering and distracter processing. We hypothesized that these indirect mechanisms could significantly improve the performance of low-level attentional tasks, whereas the relative contribution could be less in complex attentional tasks that require active, higher-order processing of target stimuli. METHODS To test this hypothesis, we conducted a double-blind, placebo-controlled, counterbalanced, four-way crossover study in 32 healthy young adults, where we compared the effects of three doses of L-theanine (100, 200 and 400 mg) with a placebo (distilled water), administered before and 50 min after dosing, on three attentional tasks from the Cambridge Neuropsychological Test Automated Battery [viz. Reaction Time (RTI)-visuomotor speed, Rapid Visual Information Processing (RVP)-sustained attention, and Stop Signal Task (SST)-inhibitory control]. Results were analyzed in dose × time repeated measures ANOVA models, with subsequent pairwise comparisons. RESULTS Active doses significantly improved reaction times in the RTI (100-200 mg) and RVP (200-400 mg) tasks from baseline (p < 0.05), but once controlled for the change-from-baseline caused by placebo, only the RTI simple reaction times showed significant improvements, following 100 mg (Δ = 16.3 ms, p = 0.009) and 200 mg (Δ = 16.9 ms, p = 0.009) of L-theanine. CONCLUSIONS Consistent with our hypothesis, these findings suggest that L-theanine significantly improves attention in simple visuomotor tasks, but not in more complex sustained attention tasks, or executive control tasks that require top-down inhibition of pre-active responses.
Collapse
Affiliation(s)
- Tharaka L Dassanayake
- Department of Physiology, Faculty of Medicine, University of Peradeniya, Peradeniya, Sri Lanka
- School of Psychological Sciences, The University of Newcastle, Callaghan, Australia
| | - Devasmitha Wijesundara
- Department of Physiology, Faculty of Medicine, University of Peradeniya, Peradeniya, Sri Lanka
| | - Chanaka N Kahathuduwa
- Department of Psychiatry, School of Medicine, Texas Tech University Health Sciences Center, Lubbock, TX, USA
- Department of Laboratory Science and Primary Care, Texas Tech University Health Sciences Center, Lubbock, TX, USA
| | - Vajira S Weerasinghe
- Department of Physiology, Faculty of Medicine, University of Peradeniya, Peradeniya, Sri Lanka
| |
Collapse
|
2
|
Liu Y, Tan SX, Wu YK, Shen YK, Zhang LJ, Kang M, Ying P, Pan YC, Shu HY, Shao Y. Altered Intrinsic Regional Spontaneous Brain Activity in Patients With Severe Obesity and Meibomian Gland Dysfunction: A Resting-State Functional Magnetic Resonance Imaging Study. Front Hum Neurosci 2022; 16:879513. [PMID: 35664349 PMCID: PMC9161641 DOI: 10.3389/fnhum.2022.879513] [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: 02/19/2022] [Accepted: 04/11/2022] [Indexed: 11/17/2022] Open
Abstract
Purpose To evaluate potential regional homogeneity (ReHo) cerebrum function lesions in people with severe obesity and meibomian gland dysfunction (SM) and probe the connection between aberrant cerebrum activity and clinical manifestations. Patients and Methods An aggregation of 12 patients with SM, and 12 healthy controls (HCs) closely matched in age and gender were enrolled. We applied corneal confocal microscopy and fundus angiography to compare imaging distinctions between the two groups. SMs were required to carefully fill out the Hospital Anxiety Depression Scale (HADS) forms, and a correlation analysis was performed. ReHo was also utilized to appraise partial differences in spontaneous cerebrum function. Receiver operating characteristic (ROC) curves were created to partition ReHo values between patients with SM and the HCs. Results ReHo values for the left cerebellum (LC), right fusiform gyrus (RFG), left inferior temporal gyrus (LITG), left rectus gyrus (LRG), right thalamus (RT), right caudate (RC), left insula (LI), and left thalamus (LT) of subjects with SM were notably higher than those of the HCs (P < 0.05). ReHo values of the right middle frontal gyrus (RMFG) in subjects with SM were decreased notably compared to the HCs (P < 0.05). ReHo values for the RMFG showed a negative correlation with the anxiety scores (ASs; r = −0.961, P < 0.001) and ReHo values for the RFG showed a positive correlation with the depression scores (DSs; r = 0.676, P = 0.016). The areas under the ROC curve were 1.000 (P < 0.001) for the RMFG, LC, LITG, LRG, RC, LI, and LT and 0.993 (P < 0.001) for the RFG and RT. The results from the ROC curve analysis indicated that changes in the ReHo values of some brain regions may help diagnose SM. Conclusion Our research emphasized that patients with SM had lesions in synchronized neural activity in many encephalic areas. Our discoveries may provide beneficial information for exploring the neuromechanics of SM.
Collapse
Affiliation(s)
- Yi Liu
- Department of Gastrointestinal Surgery, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Sheng-Xing Tan
- Department of Gastrointestinal Surgery, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Yu-Kang Wu
- Department of Gastrointestinal Surgery, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Yan-Kun Shen
- Department of Gastrointestinal Surgery, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Li-Juan Zhang
- Department of Ophthalmology, The First Affiliated Hospital of Nanchang University, Jiangxi Branch of National Clinical Research Center for Ocular Disease, Nanchang, China
| | - Min Kang
- Department of Ophthalmology, The First Affiliated Hospital of Nanchang University, Jiangxi Branch of National Clinical Research Center for Ocular Disease, Nanchang, China
| | - Ping Ying
- Department of Ophthalmology, The First Affiliated Hospital of Nanchang University, Jiangxi Branch of National Clinical Research Center for Ocular Disease, Nanchang, China
| | - Yi-Cong Pan
- Department of Ophthalmology, The First Affiliated Hospital of Nanchang University, Jiangxi Branch of National Clinical Research Center for Ocular Disease, Nanchang, China
| | - Hui-Ye Shu
- Department of Ophthalmology, The First Affiliated Hospital of Nanchang University, Jiangxi Branch of National Clinical Research Center for Ocular Disease, Nanchang, China
| | - Yi Shao
- Department of Ophthalmology, The First Affiliated Hospital of Nanchang University, Jiangxi Branch of National Clinical Research Center for Ocular Disease, Nanchang, China
- *Correspondence: Yi Shao,
| |
Collapse
|
3
|
Electroacupuncture enhances resting-state functional connectivity between dorsal caudate and precuneus and decreases associated leptin levels in overweight/obese subjects. Brain Imaging Behav 2021; 16:445-454. [PMID: 34415492 DOI: 10.1007/s11682-021-00519-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/18/2021] [Indexed: 10/20/2022]
Abstract
Electroacupuncture (EA) is a safe and effective method for treating obesity. However, how it modulates reward-related brain activity/functional connectivity and gut hormones remains unclear. We employed resting-state functional magnetic resonance imaging (RS-fMRI) and resting-state functional connectivity (RSFC) to investigate EA induced changes in resting-state activity and RSFC in reward-related regions and its association with gut hormones in overweight/obese subjects who received real (n = 20) and Sham (n = 15) stimulation. Results showed reduced leptin levels was positively correlated with reduced body mass index (BMI) and negatively correlated with increased cognitive-control as measured with Three-Factor-Eating-Questionnaire (TFEQ). Significant time effects on RSFC between dorsal caudate (DC) and precuneus were due to significant increased RSFC strength in both EA and Sham groups. In addition, increased RSFC of DC-precuneus was negatively correlated with reduced BMI and leptin levels in the EA group. Mediation analysis showed that the relationship between increased DC-precuneus RSFC strength and reduced BMI was mediated by reduced leptin levels. These findings reflect the association between EA-induced brain reward-related RSFC and leptin levels, and decreased leptin levels mediated altered DC-precuneus RSFC strength and consequent weight-loss, suggesting the potential role of EA in reducing weight and appetite.
Collapse
|
4
|
Gwizdala KL, Ferguson DP, Kovan J, Novak V, Pontifex MB. Placebo controlled phase II clinical trial: Safety and efficacy of combining intranasal insulin & acute exercise. Metab Brain Dis 2021; 36:1289-1303. [PMID: 33856613 DOI: 10.1007/s11011-021-00727-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Accepted: 03/31/2021] [Indexed: 10/21/2022]
Abstract
A growing number of investigations are exploring the utility of intranasal insulin as a means of mitigating cognitive decline. However, as a basic tenant of dementia prevention programs is increasing physical activity, it is essential to obtain a preliminary assessment of the safety profile of combining intranasal insulin with physical activity; to ensure that undue risks are not incurred. Utilizing a randomized double-blind placebo-controlled design, a sample of 116 non-diabetic, fasted college-aged adults were randomly assigned to receive a dose of 0-to-120 IU of NovoLog (Insulin Aspart) before being randomized to 20 min of exercise or sitting control condition. The safety of intranasal insulin was assessed by examining the incidence of potential symptoms of hypoglycemia and changes in peripheral blood glucose. The efficacy of a combination therapeutic approach was assessed using behavioral measures of inhibition and sustained attention alongside neuroelectric indices of attentional engagement. The frequency of symptoms reported following administration of intranasal insulin were not observed to interact with exercise so as to make their occurrence any more or less prominent, nor was the frequency observed to relate to the dose of intranasal insulin. However, doses of intranasal insulin of 100 IU or more were observed to result in a 7-fold increase in the likelihood of a level 1 hypoglycemic event for those individuals in the exercise condition. This study provides preliminary evidence to suggest that exercise is not associated with an increase in risk when combined with lower doses of intranasal insulin.Clinical trial registration The trial is registered at ClinicalTrials.gov, number NCT04292535.
Collapse
Affiliation(s)
- Kathryn L Gwizdala
- Department of Kinesiology, Michigan State University, 126E IM Sports Circle, East Lansing, MI, 48824-1049, USA
| | - David P Ferguson
- Department of Kinesiology, Michigan State University, 126E IM Sports Circle, East Lansing, MI, 48824-1049, USA
| | - Jeffery Kovan
- Department of Intercollegiate Athletics, Michigan State University, East Lansing, MI, USA
| | - Vera Novak
- Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Matthew B Pontifex
- Department of Kinesiology, Michigan State University, 126E IM Sports Circle, East Lansing, MI, 48824-1049, USA.
| |
Collapse
|
5
|
Zheng W, Wang L, Chen Q, Li X, Chen X, Qin W, Li K, Lu J, Chen N. Functional Reorganizations Outside the Sensorimotor Regions Following Complete Thoracolumbar Spinal Cord Injury. J Magn Reson Imaging 2021; 54:1551-1559. [PMID: 34060693 DOI: 10.1002/jmri.27764] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Revised: 05/20/2021] [Accepted: 05/21/2021] [Indexed: 11/07/2022] Open
Abstract
BACKGROUND Studies have shown that loss of sensorimotor function in spinal cord injury (SCI) leads to brain functional reorganization, which may play important roles in motor function recovery. However, the specific functional changes following SCI are still poorly understood. PURPOSE To investigate whether there are functional reorganizations outside the sensorimotor regions after complete thoracolumbar SCI (CTSCI), and how these reorganizations are associated with clinical manifestations. STUDY TYPE Prospective. SUBJECTS Eighteen CTSCI patients (28-67 years of age; 16 men) and 18 age-, gender-matched healthy controls (HCs) (27-64 years of age; 16 men). FIELD STRENGTH/SEQUENCE Resting-state functional magnetic resonance imaging (RS-fMRI) using echo-planar-imaging (EPI) sequence at 3.0 T. ASSESSMENT Data preprocessing was performed using Data Processing Assistant for Resting-State fMRI (DPARSF). Amplitude of low-frequency fluctuations (ALFF) was used to characterize regional neural function, and seed-based functional connectivity (FC) was used to evaluate the functional integration of the brain network. STATISTICAL TESTS Two-sample t-tests were used for ALFF and FC measures (the data conform to the normal distribution), partial correlation analysis was used to analyze the correlation between clinical and imaging indicators, and receiver operating characteristic (ROC) analysis was used to search for sensitive imaging indicators. RESULTS Compared with HCs, CTSCI patients showed decreased ALFF in right lingual gyrus (LG), increased ALFF in right middle frontal gyrus (MFG), and decreased FC between the right LG and Vermis_3 (cluster-level FWE correction with P < 0.05). Subsequent correlation analyses revealed that decreased FC between the right LG and Vermis_3 positively correlated with the visual analog scale (VAS) (P = 0.043, r = 0.443). Finally, the ROC analysis showed that the area under the curve (AUC) of FC value between right LG and Vermis3 was 0.881. DATA CONCLUSION These findings suggest a possible theoretical basis of the mechanism of visual-, emotion-, and cognition-related techniques in rehabilitation training for CTSCI.
Collapse
Affiliation(s)
- Weimin Zheng
- Department of Radiology, Xuanwu Hospital, Capital Medical University, Beijing, China.,Beijing Key Laboratory of Magnetic Resonance Imaging and Brain Informatics, Beijing, China
| | - Ling Wang
- Department of Radiology, Xuanwu Hospital, Capital Medical University, Beijing, China.,Beijing Key Laboratory of Magnetic Resonance Imaging and Brain Informatics, Beijing, China
| | - Qian Chen
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Xuejing Li
- Department of Radiology, China Rehabilitation Research Center, Beijing, China
| | - Xin Chen
- Department of Radiology, Xuanwu Hospital, Capital Medical University, Beijing, China.,Beijing Key Laboratory of Magnetic Resonance Imaging and Brain Informatics, Beijing, China
| | - Wen Qin
- Department of Radiology, Tianjin Medical University General Hospital, Tianjin, China
| | - Kuncheng Li
- Department of Radiology, Xuanwu Hospital, Capital Medical University, Beijing, China.,Beijing Key Laboratory of Magnetic Resonance Imaging and Brain Informatics, Beijing, China
| | - Jie Lu
- Department of Radiology, Xuanwu Hospital, Capital Medical University, Beijing, China.,Beijing Key Laboratory of Magnetic Resonance Imaging and Brain Informatics, Beijing, China
| | - Nan Chen
- Department of Radiology, Xuanwu Hospital, Capital Medical University, Beijing, China.,Beijing Key Laboratory of Magnetic Resonance Imaging and Brain Informatics, Beijing, China
| |
Collapse
|
6
|
Balasubramanian P, Kiss T, Tarantini S, Nyúl-Tóth Á, Ahire C, Yabluchanskiy A, Csipo T, Lipecz A, Tabak A, Institoris A, Csiszar A, Ungvari Z. Obesity-induced cognitive impairment in older adults: a microvascular perspective. Am J Physiol Heart Circ Physiol 2021; 320:H740-H761. [PMID: 33337961 PMCID: PMC8091942 DOI: 10.1152/ajpheart.00736.2020] [Citation(s) in RCA: 53] [Impact Index Per Article: 17.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Revised: 11/30/2020] [Accepted: 12/12/2020] [Indexed: 02/07/2023]
Abstract
Over two-thirds of individuals aged 65 and older are obese or overweight in the United States. Epidemiological data show an association between the degree of adiposity and cognitive dysfunction in the elderly. In this review, the pathophysiological roles of microvascular mechanisms, including impaired endothelial function and neurovascular coupling responses, microvascular rarefaction, and blood-brain barrier disruption in the genesis of cognitive impairment in geriatric obesity are considered. The potential contribution of adipose-derived factors and fundamental cellular and molecular mechanisms of senescence to exacerbated obesity-induced cerebromicrovascular impairment and cognitive decline in aging are discussed.
Collapse
Affiliation(s)
- Priya Balasubramanian
- Vascular Cognitive Impairment and Neurodegeneration Program, Department of Biochemistry and Molecular Biology, Center for Geroscience and Healthy Brain Aging/Reynolds Oklahoma Center on Aging, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma
| | - Tamas Kiss
- Vascular Cognitive Impairment and Neurodegeneration Program, Department of Biochemistry and Molecular Biology, Center for Geroscience and Healthy Brain Aging/Reynolds Oklahoma Center on Aging, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma
- International Training Program in Geroscience, Theoretical Medicine Doctoral School, Departments of Medical Physics and Informatics & Cell Biology and Molecular Medicine, University of Szeged, Szeged, Hungary
| | - Stefano Tarantini
- Vascular Cognitive Impairment and Neurodegeneration Program, Department of Biochemistry and Molecular Biology, Center for Geroscience and Healthy Brain Aging/Reynolds Oklahoma Center on Aging, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma
- International Training Program in Geroscience, Doctoral School of Basic and Translational Medicine, Department of Public Health, Semmelweis University, Budapest, Hungary
- Department of Health Promotion Sciences, the Hudson College of Public Health, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma
| | - Ádám Nyúl-Tóth
- Vascular Cognitive Impairment and Neurodegeneration Program, Department of Biochemistry and Molecular Biology, Center for Geroscience and Healthy Brain Aging/Reynolds Oklahoma Center on Aging, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma
- International Training Program in Geroscience, Institute of Biophysics, Biological Research Centre, Szeged, Hungary
| | - Chetan Ahire
- Vascular Cognitive Impairment and Neurodegeneration Program, Department of Biochemistry and Molecular Biology, Center for Geroscience and Healthy Brain Aging/Reynolds Oklahoma Center on Aging, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma
| | - Andriy Yabluchanskiy
- Vascular Cognitive Impairment and Neurodegeneration Program, Department of Biochemistry and Molecular Biology, Center for Geroscience and Healthy Brain Aging/Reynolds Oklahoma Center on Aging, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma
| | - Tamas Csipo
- Vascular Cognitive Impairment and Neurodegeneration Program, Department of Biochemistry and Molecular Biology, Center for Geroscience and Healthy Brain Aging/Reynolds Oklahoma Center on Aging, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma
- International Training Program in Geroscience, Doctoral School of Basic and Translational Medicine, Department of Public Health, Semmelweis University, Budapest, Hungary
- International Training Program in Geroscience, Division of Clinical Physiology, Department of Cardiology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Agnes Lipecz
- Vascular Cognitive Impairment and Neurodegeneration Program, Department of Biochemistry and Molecular Biology, Center for Geroscience and Healthy Brain Aging/Reynolds Oklahoma Center on Aging, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma
- International Training Program in Geroscience, Doctoral School of Basic and Translational Medicine, Department of Public Health, Semmelweis University, Budapest, Hungary
| | - Adam Tabak
- International Training Program in Geroscience, Doctoral School of Basic and Translational Medicine, Department of Public Health, Semmelweis University, Budapest, Hungary
- Department of Internal Medicine and Oncology, Faculty of Medicine, Semmelweis University, Budapest, Hungary
- Department of Epidemiology and Public Health, University College London, London, United Kingdom
| | - Adam Institoris
- Hotchkiss Brain Institute, Department of Physiology and Pharmacology, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Anna Csiszar
- Vascular Cognitive Impairment and Neurodegeneration Program, Department of Biochemistry and Molecular Biology, Center for Geroscience and Healthy Brain Aging/Reynolds Oklahoma Center on Aging, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma
- International Training Program in Geroscience, Theoretical Medicine Doctoral School, Departments of Medical Physics and Informatics & Cell Biology and Molecular Medicine, University of Szeged, Szeged, Hungary
| | - Zoltan Ungvari
- Vascular Cognitive Impairment and Neurodegeneration Program, Department of Biochemistry and Molecular Biology, Center for Geroscience and Healthy Brain Aging/Reynolds Oklahoma Center on Aging, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma
- International Training Program in Geroscience, Theoretical Medicine Doctoral School, Departments of Medical Physics and Informatics & Cell Biology and Molecular Medicine, University of Szeged, Szeged, Hungary
- International Training Program in Geroscience, Doctoral School of Basic and Translational Medicine, Department of Public Health, Semmelweis University, Budapest, Hungary
- Department of Health Promotion Sciences, the Hudson College of Public Health, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma
| |
Collapse
|
7
|
Li B, Zhang L, Zhang Y, Chen Y, Peng J, Shao Y, Zhang X. Decreased Functional Connectivity Between the Right Precuneus and Middle Frontal Gyrus Is Related to Attentional Decline Following Acute Sleep Deprivation. Front Neurosci 2021; 14:530257. [PMID: 33408600 PMCID: PMC7779587 DOI: 10.3389/fnins.2020.530257] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2020] [Accepted: 11/18/2020] [Indexed: 12/21/2022] Open
Abstract
Objectives Acute sleep deprivation (SD) seriously affects cognitive functions, such as attention, memory, and response inhibition. Previous neuroimaging studies have demonstrated a close relationship between the functional activities of the precuneus (PC) and the function of alert attention. However, the specific effect of the PC on attention decline after acute SD has not been elucidated. In this study, we used resting-state functional magnetic resonance imaging (fMRI) to study the relationship between the changes of the PC functional connectivity and alertness decline after total SD. Methods Thirty healthy, right-handed adult men participated in the experiment. Alert attention and functional connectivity were assessed by the Psychomotor Vigilance Test and a resting-state fMRI scan before and after total SD. The region of interest to region of interest (“ROI-to-ROI”) correlation was employed to analyze the relationship between the PC and other brain regions after acute SD. Results Participants showed decreased alert attention after total SD. In addition, SD induced decreased functional connectivity between the right PC and the right middle frontal gyrus (MFG). Moreover, there was a significant correlation between the decreased PC functional connectivity and alertness decline after total SD. Conclusion Our findings suggest that the interruption of the connection between the right PC and the right MFG is related to the observed decline in alert attention after acute SD. These results provide evidence further elucidating the cognitive impairment model of SD.
Collapse
Affiliation(s)
- Bozhi Li
- Department of Neurology, The Second Medical Center, National Clinical Research Centre for Geriatric Diseases, Chinese PLA General Hospital, Beijing, China
| | - Liwei Zhang
- Key Laboratory of Behavioral Science, Institute of Psychology, Chinese Academy of Sciences, Beijing, China
| | - Ying Zhang
- Department of Psychology Medical, The Eighth Medical Center, Chinese PLA General Hospital, Beijing, China
| | - Yang Chen
- School of Biological Science and Medical Engineering, Beihang University, Beijing, China.,Beijing Advanced Innovation Centre for Biomedical Engineering, Beihang University, Beijing, China
| | - Jiaxi Peng
- School of Psychology, Beijing Sport University, Beijing, China
| | - Yongcong Shao
- School of Psychology, Beijing Sport University, Beijing, China
| | - Xi Zhang
- Department of Neurology, The Second Medical Center, National Clinical Research Centre for Geriatric Diseases, Chinese PLA General Hospital, Beijing, China
| |
Collapse
|
8
|
Hopman HJ, Choy HY, Ho WS, Lu H, Wong WHO, Chan SMS. The Effects of Repetitive Transcranial Magnetic Stimulation Antidepressant Response on Cold Cognition: A Single-Arm Prospective Longitudinal Study. Neuropsychiatr Dis Treat 2021; 17:1647-1658. [PMID: 34079262 PMCID: PMC8165208 DOI: 10.2147/ndt.s307119] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Accepted: 04/18/2021] [Indexed: 01/23/2023] Open
Abstract
PURPOSE The cognitive neuropsychological model of depression suggests that the cognitive deficits observed in depressed subjects are the result of attenuated top-down cognitive control resulting in increased bottom-up emotional processing. Remediation of cognitive impairments in cold cognition has been proposed as a valuable treatment for depression. The study aimed to examine the effects of clinical response to repetitive transcranial magnetic stimulation (rTMS) on cold cognition over the course of 8 weeks in medication-refractory depressed subjects. MATERIALS AND METHODS Twenty-two medication-refractory depressed subjects received twenty sessions of high-frequency rTMS targeting the left dorsolateral prefrontal cortex, one of the key nodes of the cognitive control network. Cold cognition and antidepressant treatment response were monitored at baseline, week 2, 4 and 8. Clinical response was defined as ≥50% reduction in Montgomery-Åsberg Depression Rating Scale score at week 8. Longitudinal changes in cold cognition were modeled using (generalized) linear mixed models. It was hypothesized that the excitatory effects of rTMS would improve cognition in the domains of executive function, memory, and attention. Additionally, responders were expected to show larger cognitive improvements than nonresponders. RESULTS A decrease in median latency was observed on a task that measured executive function, irrespective of treatment response status. Further, responders showed significantly larger improvements in A-Prime (the ability to detect target sequences) on a sustained attention task. Post hoc analysis indicated higher levels of rumination in non-responders. CONCLUSION Our findings suggest that distractions during tasks with low perceptual complexity affected nonresponders disproportionately possibly due to higher rumination levels. Overall, cold cognition in medication-resistant depressed subjects was minimally affected by rTMS, substantiating the safety of rTMS treatment. LIMITATIONS The sample size was small, and the study did not include a control group.
Collapse
Affiliation(s)
- Helene Janine Hopman
- Department of Psychiatry, The Chinese University of Hong Kong, Hong Kong, Hong Kong Special Administrative Region of China
| | - Hiu Ying Choy
- Department of Psychiatry, The Chinese University of Hong Kong, Hong Kong, Hong Kong Special Administrative Region of China
| | - Wing Sze Ho
- Department of Psychiatry, The Chinese University of Hong Kong, Hong Kong, Hong Kong Special Administrative Region of China
| | - Hanna Lu
- Department of Psychiatry, The Chinese University of Hong Kong, Hong Kong, Hong Kong Special Administrative Region of China
| | - Wing Ho Oscar Wong
- Department of Psychiatry, The Chinese University of Hong Kong, Hong Kong, Hong Kong Special Administrative Region of China
| | - Sau Man Sandra Chan
- Department of Psychiatry, The Chinese University of Hong Kong, Hong Kong, Hong Kong Special Administrative Region of China
| |
Collapse
|
9
|
Hyperpolarized 129Xe Time-of-Flight MR Imaging of Perfusion and Brain Function. Diagnostics (Basel) 2020; 10:diagnostics10090630. [PMID: 32854196 PMCID: PMC7554935 DOI: 10.3390/diagnostics10090630] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Revised: 08/22/2020] [Accepted: 08/23/2020] [Indexed: 02/07/2023] Open
Abstract
Perfusion measurements can provide vital information about the homeostasis of an organ and can therefore be used as biomarkers to diagnose a variety of cardiovascular, renal, and neurological diseases. Currently, the most common techniques to measure perfusion are 15O positron emission tomography (PET), xenon-enhanced computed tomography (CT), single photon emission computed tomography (SPECT), dynamic contrast enhanced (DCE) MRI, and arterial spin labeling (ASL) MRI. Here, we show how regional perfusion can be quantitively measured with magnetic resonance imaging (MRI) using time-resolved depolarization of hyperpolarized (HP) xenon-129 (129Xe), and the application of this approach to detect changes in cerebral blood flow (CBF) due to a hemodynamic response in response to brain stimuli. The investigated HP 129Xe Time-of-Flight (TOF) technique produced perfusion images with an average signal-to-noise ratio (SNR) of 10.35. Furthermore, to our knowledge, the first hemodynamic response (HDR) map was acquired in healthy volunteers using the HP 129Xe TOF imaging. Responses to visual and motor stimuli were observed. The acquired HP TOF HDR maps correlated well with traditional proton blood oxygenation level-dependent functional MRI. Overall, this study expands the field of HP MRI with a novel dynamic imaging technique suitable for rapid and quantitative perfusion imaging.
Collapse
|
10
|
Kazemi R, Rostami R, Dehghan S, Nasiri Z, Lotfollahzadeh S, L Hadipour A, Khomami S, Ishii R, Ikeda S. Alpha frequency rTMS modulates theta lagged nonlinear connectivity in dorsal attention network. Brain Res Bull 2020; 162:271-281. [PMID: 32619694 DOI: 10.1016/j.brainresbull.2020.06.018] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2020] [Revised: 05/14/2020] [Accepted: 06/26/2020] [Indexed: 11/24/2022]
Abstract
Dorsolateral prefrontal cortex (DLPFC) is a key structure in dorsal attention network (DAN) that facilitates sustained attention by modulating activity in task related and unrelated regions of the brain. Alpha and theta frequency bands enhance connectivity among different parts of the attention network and these connections are facilitated by long-range nonlinear connectivity in theta and alpha frequency bands. This study is an investigation of the behavioral and electrophysiological effects of alpha and theta frequency repetitive transcranial magnetic stimulation (rTMS) over RDLPFC. 20 healthy participants were randomly assigned to two groups of theta (n = 11, f = 6 Hz) and alpha (n = 9, f = 10 Hz) rTMS. Electroencephalogram (EEG) was recorded before and after each session while resting and performing tasks. Current source density (CSD) and functional connectivity (FC) in DAN and default mode network (DMN) and their correlations with rapid visual information processing task (RVIP) scores were calculated . Alpha frequency rTMS resulted in significant changes in RVIP scores. Active theta rTMS caused an increase in CSD in Postcentral gyrus and active alpha rTMS resulted in significant CSD changes in inferior parietal lobule (IPL). Theta lagged nonlinear connectivity was mudulated by alpha rTMSand FC changes were observed in DAN and DMN. Positive correlations were observed between DAN regions and RVIP scores in the alpha rTMS group. Increased activity in theta frequency band in left aPFC and left DLPFC correlated positively with higher total hits in RVIP. This study showed for the first time that theta and alpha frequency rTMS are able to modulate FC in DAN and DMN in a way that results in better performance in a sustained attention task.
Collapse
Affiliation(s)
- Reza Kazemi
- Cognitive Lab, Department of Psychology, University of Tehran, Tehran, Iran; Atieh Clinical Neuroscience Center, Tehran, Iran.
| | - Reza Rostami
- Department of Psychology, University of Tehran, Tehran, Iran
| | | | - Zahra Nasiri
- Atieh Clinical Neuroscience Center, Tehran, Iran
| | | | - Abed L Hadipour
- Atieh Clinical Neuroscience Center, Tehran, Iran; Department of Psychology, University of Tehran, Tehran, Iran
| | | | - Ryouhei Ishii
- Smart Rehabilitation Research Center, Osaka Prefecture University, Graduate School of Comprehensive Rehabilitation, Habikino, Japan; Department of Psychiatry, Osaka University, Graduate School of Medicine, Osaka, Japan
| | - Shunichiro Ikeda
- Department of Neuropsychiatry, Kansai Medical University, Osaka, Japan
| |
Collapse
|
11
|
Chandler MC, McGowan AL, Ferguson DP, Pontifex MB. Carbohydrate mouth rinse has no effects on behavioral or neuroelectric indices of cognition. Int J Psychophysiol 2020; 151:49-58. [PMID: 32087182 DOI: 10.1016/j.ijpsycho.2020.02.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2019] [Revised: 01/29/2020] [Accepted: 02/17/2020] [Indexed: 01/21/2023]
Abstract
Rinsing the mouth with a carbohydrate solution has been suggested as a means to enhance aspects of both physical and cognitive performance. However, evidence in support of these assertions is relatively weak. The purpose of this study was to investigate the effects of a carbohydrate mouth rinse solution on motor speed, inhibition, and sustained attention as indexed by both behavioral and neuroelectric measures. Using a double-blind, placebo-controlled, within-subjects crossover design, 50 college-aged young adults performed a battery of cognitive tasks both before and after rinsing their mouth for 10 s with 20 mL of either a carbohydrate mouth rinse solution or a sensory-matched placebo control solution. A simple tapping task was used as a measure of motor speed, a modified Eriksen flanker task was used to index inhibition, and a rapid visual information processing task was used as a measure of sustained attention. Participants demonstrated longer reaction times in the Flanker task after rinsing their mouths with the carbohydrate mouth rinse, relative to pretest. No differences in reaction time were observed for the placebo control condition. P3 latency in the Flanker task as an index of attentional processing speed was shorter at posttest than at pretest in the placebo control - but not the carbohydrate mouth rinse - condition. These results suggest that despite claims of cognitive enhancement, carbohydrate mouth rinses do not appear to alter motor speed, inhibition, or sustained attention as compared to a placebo control in non-physically-fatigued college-aged adults.
Collapse
Affiliation(s)
- Madison C Chandler
- Department of Kinesiology, Michigan State University, 308 W. Circle Drive, East Lansing, MI 48824, United States of America.
| | - Amanda L McGowan
- Department of Kinesiology, Michigan State University, 308 W. Circle Drive, East Lansing, MI 48824, United States of America.
| | - David P Ferguson
- Department of Kinesiology, Michigan State University, 308 W. Circle Drive, East Lansing, MI 48824, United States of America.
| | - Matthew B Pontifex
- Department of Kinesiology, Michigan State University, 308 W. Circle Drive, East Lansing, MI 48824, United States of America.
| |
Collapse
|
12
|
Network-based Responses to the Psychomotor Vigilance Task during Lapses in Adolescents after Short and Extended Sleep. Sci Rep 2019; 9:13913. [PMID: 31558730 PMCID: PMC6763427 DOI: 10.1038/s41598-019-50180-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2019] [Accepted: 09/04/2019] [Indexed: 11/20/2022] Open
Abstract
Neuroimaging studies of the Psychomotor Vigilance Task (PVT) have revealed brain regions involved in attention lapses in sleep-deprived and well-rested adults. Those studies have focused on individual brain regions, rather than integrated brain networks, and have overlooked adolescence, a period of ongoing brain development and endemic short sleep. This study used functional MRI (fMRI) and a contemporary analytic approach to assess time-resolved peri-stimulus response of key brain networks when adolescents complete the PVT, and test for differences across attentive versus inattentive periods and after short sleep versus well-rested states. Healthy 14–17-year-olds underwent a within-subjects randomized protocol including 5-night spans of extended versus short sleep. PVT was performed during fMRI the morning after each sleep condition. Event-related independent component analysis (eICA) identified coactivating functional networks and corresponding time courses. Analysis of salient time course characteristics tested the effects of sleep condition, lapses, and their interaction. Seven eICA networks were identified supporting attention, executive control, motor, visual, and default-mode functions. Attention lapses, after either sleep manipulation, were accompanied by broadly increased response magnitudes post-stimulus and delayed peak responses in some networks. Well-circumscribed networks respond during the PVT in adolescents, with timing and intensity impacted by attentional lapses regardless of experimentally shortened or extended sleep.
Collapse
|
13
|
Arulsamy A, Corrigan F, Collins-Praino LE. Age, but not severity of injury, mediates decline in executive function: Validation of the rodent touchscreen paradigm for preclinical models of traumatic brain injury. Behav Brain Res 2019; 368:111912. [PMID: 30998995 DOI: 10.1016/j.bbr.2019.111912] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2019] [Revised: 04/12/2019] [Accepted: 04/13/2019] [Indexed: 12/14/2022]
Abstract
Increasingly, it is being recognised that traumatic brain injury (TBI) is not just an acute event but instead results in ongoing neuronal injury that may lead to chronic impairments in multiple cognitive domains. Of these, deficits in executive function are one of the more common changes reported following TBI, and are a major predictor of well-being, social function and quality of life in individuals with a history of TBI. In order to fully understand the relationship between TBI and executive dysfunction, including brain mechanisms that may account for this, experimental models are clearly needed. However, to date, there have been a lack of preclinical studies systematically comparing the effect of injury severity on executive function, particularly at long-term timepoints post-injury. Furthermore, many previous studies have not used behavioural measures that are sensitive to the full range of executive function impairments that may manifest after injury, particularly in models of diffuse axonal injury (Lv et al.). The current study aimed to investigate the temporal profile, up to 12 months post-injury, of the evolution of executive dysfunction following different severities of injury in an experimental model of DAI. In order to do so, we utilised a rodent touchscreen paradigm to administer the 5 Choice- Continuous Performance Task (5C-CPT), an extension of the 5-choice serial reaction time task (5CSRT). Interestingly, there were no differences in learning, motivation, attention, response time or impulsivity at 1 month, 6 months or 12 months post-injury in any of the TBI groups compared to sham, regardless of the initial severity of the injury. Instead, most of the effects on executive function seen at the 12 month timepoint appeared to be a result of ageing, not injury. As even the 12-month timepoint represents middle age in the rat, future studies will be needed to further probe these effects, in order to determine whether DAI may influence the presentation of executive dysfunction in older age.
Collapse
Affiliation(s)
- Alina Arulsamy
- Cognition, Ageing and Neurodegenerative Disease Lab, Adelaide Medical School, The University of Adelaide, Adelaide, SA 5005 Australia
| | | | - Lyndsey E Collins-Praino
- Cognition, Ageing and Neurodegenerative Disease Lab, Adelaide Medical School, The University of Adelaide, Adelaide, SA 5005 Australia.
| |
Collapse
|
14
|
Song P, Lin H, Liu C, Jiang Y, Lin Y, Xue Q, Xu P, Wang Y. Transcranial Magnetic Stimulation to the Middle Frontal Gyrus During Attention Modes Induced Dynamic Module Reconfiguration in Brain Networks. Front Neuroinform 2019; 13:22. [PMID: 31001103 PMCID: PMC6456710 DOI: 10.3389/fninf.2019.00022] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2018] [Accepted: 03/14/2019] [Indexed: 01/11/2023] Open
Abstract
The interaction between dorsal and ventral attention networks (VANs) is mediated by the middle frontal gyrus (MFG), which is functionally connected to both networks. However, the direct role of the MFG in selective and sustained attention remains controversial. In the current study, we used transcranial magnetic stimulation (TMS) and electroencephalography (EEG) to probe the connectivity dynamic changes of MFG-associated regions during different attention modes. The participants underwent visual, selective, and sustained attention tasks to observe TMS-induced network changes. Twenty healthy participants received single-pulse TMS over the left or right MFG during tasks, while synchronous EEG data was acquired. Behavioral results were recorded and time-varying brain network analyses were performed. We found that the MFG is involved in attention processing and that sustained attention was preferentially controlled by the right MFG. Moreover, compared with the right hemisphere, the left hemisphere was associated with selective attention tasks. Visual and selective attention tasks induced MFG-related changes in network nodes were within the left hemisphere; however, sustained attention induced changes in network nodes were in the bilateral posterior MFG. Our findings indicated that the MFG plays a crucial role in regulating attention networks. In particular, TMS-induced MFG alterations influenced key nodes of the time-varying brain network, leading to the reorganization of brain network modules.
Collapse
Affiliation(s)
- Penghui Song
- Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Hua Lin
- Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Chunyan Liu
- Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Yuanling Jiang
- Key Laboratory for Neuroinformation of Ministry of Education, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, China
| | - Yicong Lin
- Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Qing Xue
- Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Peng Xu
- Key Laboratory for Neuroinformation of Ministry of Education, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, China
| | - Yuping Wang
- Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China.,Center of Epilepsy, Beijing Institute for Brain Disorders, Capital Medical University, Beijing, China.,Beijing Key Laboratory of Neuromodulation, Beijing, China
| |
Collapse
|
15
|
Leśniak MM, Iwański S, Szutkowska-Hoser J, Seniów J. Comprehensive cognitive training improves attention and memory in patients with severe or moderate traumatic brain injury. APPLIED NEUROPSYCHOLOGY-ADULT 2019; 27:570-579. [PMID: 30884968 DOI: 10.1080/23279095.2019.1576691] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Traumatic brain injury (TBI) leads to cognitive disorders, the most frequently affected functions being attention and memory. The present study aimed to investigate the effects of a cognitive rehabilitation program, consisting of individual and group interventions, on attention and memory in patients with TBI. Fifteen patients-in the postacute phase of recovery from moderate-to-severe TBI and subsequent cognitive disorders-were enrolled on a three-week waiting list and then underwent a three-week cognitive rehabilitation program. The patients were assessed using a set of five neuropsychological attention and memory tests. The patients and their caregivers were questioned to assess subjective changes in the everyday functioning of the former. The introduction of cognitive training was associated with improvement in one memory test and in two measures of attention. Mean effect size across all tests was higher over the period with treatment compared to the period without (d = 0.36 vs. 0.03). Both patients and caregivers reported significant improvements in everyday functioning (p < .05). There were no further improvements at the four-month follow-up assessment. A comprehensive program of cognitive rehabilitation may improve attention and memory, as well as everyday cognitive functioning, in patients with severe or moderate TBI.
Collapse
Affiliation(s)
| | - Szczepan Iwański
- 2nd Department of Neurology, Institute of Psychiatry & Neurology, Warsaw, Poland
| | | | - Joanna Seniów
- 2nd Department of Neurology, Institute of Psychiatry & Neurology, Warsaw, Poland
| |
Collapse
|
16
|
Baakman AC, Zuiker R, van Gerven JMA, Gross N, Yang R, Fetell M, Gershon A, Gilgun-Sherki Y, Hellriegel E, Spiegelstein O. Central nervous system effects of the histamine-3 receptor antagonist CEP-26401, in comparison with modafinil and donepezil, after a single dose in a cross-over study in healthy volunteers. Br J Clin Pharmacol 2019; 85:970-985. [PMID: 30710391 DOI: 10.1111/bcp.13885] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2018] [Revised: 12/19/2018] [Accepted: 01/07/2019] [Indexed: 01/27/2023] Open
Abstract
AIMS In previous studies, the histamine-3 receptor antagonist CEP-26401 had a subtle effect on spatial working memory, with the best effect seen at the lowest dose tested (20 μg), and a dose-dependent disruption of sleep. In the current study, 3 low-dose levels of CEP-26401 were compared with modafinil and donepezil. METHODS In this double-blind, placebo- and positive-controlled, randomized, partial 6-way cross-over study, 40 healthy subjects received single doses of placebo, CEP-26401 (5, 25 or 125 μg) or modafinil 200 mg or donepezil 10 mg. Pharmacokinetic and pharmacodynamic measurements were performed predose and at designated time points postdose. RESULTS The main endpoint between-errors of the spatial working memory-10-boxes task only improved for the 125 μg dose of CEP-26401 with a difference of 2.92 (confidence interval [CI] -1.21 to 7.05), 3.24 (CI -1.57 to 8.04) and 7.45 (CI 2.72 to 12.19) for respectively the 5, 25 and 125 μg dose of CEP-26401, -1.65 (CI -0.572 to 1.96) for modafinil and - 3.55 (CI -7.13 to 0.03) for donepezil. CEP-26401 induced an improvement of adaptive tracking, saccadic peak velocity and reaction time during N-back, but a dose-related inhibition of sleep and slight worsening of several cognitive parameters at the highest dose. CEP-26401 significantly changed several subjective visual analogue scales, which was strongest at 25 μg, causing the same energizing and happy feeling as modafinil, but with a more relaxed undertone. DISCUSSION Of the doses tested, the 25 μg dose of CEP-26401 had the most optimal balance between favourable subjective effects and sleep inhibition. Whether CEP-26401 can have beneficial effects in clinical practice remains to be studied.
Collapse
Affiliation(s)
| | - Rob Zuiker
- Centre for Human Drug Research, Leiden, Netherlands
| | | | - Nicholas Gross
- Research and Development Teva Pharmaceuticals, Frazer, Philadelphia, USA
| | - Ronghua Yang
- Research and Development Teva Pharmaceuticals, Frazer, Philadelphia, USA
| | - Michael Fetell
- Research and Development Teva Pharmaceuticals, Frazer, Philadelphia, USA
| | - Ari Gershon
- Global Patient Safety and Pharmacovigilance, Teva Pharmaceuticals, Petah Tikva, Israel.,Formerly Global Patient Safety and Pharmacovigilance, Teva Pharmaceuticals, Petah Tikva, Israel
| | | | - Edward Hellriegel
- Research and Development Teva Pharmaceuticals, West Chester, Pennsylvania, USA
| | | |
Collapse
|
17
|
Khassawneh BY, Bathgate CJ, Tsai SC, Edinger JD. Neurocognitive performance in insomnia disorder: The impact of hyperarousal and short sleep duration. J Sleep Res 2018; 27:e12747. [PMID: 30069961 DOI: 10.1111/jsr.12747] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2018] [Revised: 07/04/2018] [Accepted: 07/06/2018] [Indexed: 12/27/2022]
Abstract
Given the recent evidence on the association between hyperarousal in insomnia disorder and neurocognitive deficits, we aimed to examine the effect of short sleep duration on neurocognitive reaction time tests in insomnia disorder sufferers. We recruited subjects with insomnia disorder (n = 35, mean age = 40.6 years) who scored ≥29 on a Hyperarousal Scale, and a group of controls (n = 54, mean age = 31.5 years) who had no sleep disorders and scored <26 on the Hyperarousal Scale. Participants completed two in-home polysomnograms and four daytime trials of neurocognitive tests, including simple reaction time, choice reaction time, big circle-little circle, rapid visual information processing, attention switching task, and spatial working memory tests. Total sleep time divided study cohorts into subgroups of short (total sleep time <6 hr) and normal (total sleep time ≥6 hr) sleepers. ANCOVA showed a significant interaction between participant type (insomnia disorder versus controls) and sleep duration (short versus normal) for spatial working memory-latency (p = 0.020) and spatial working memory-errors (p = 0.025). The short-sleeping insomnia disorder group had longer spatial working memory-latencies and more spatial working memory-errors than did normal-sleeping controls. Regardless of sleep duration, those with insomnia disorder had more attentional deficits with longer attention switching task-latency (p = 0.011) and more attention switching task-incorrect trials (p = 0.015) than the control group. Normal-sleepers only had longer attention switching task-latency than short-sleepers (p = 0.004). A phenotype of insomnia disorder with hyperarousal and short sleep duration is associated with daytime cognitive deficits in complex attentional and spatial working memory tasks.
Collapse
Affiliation(s)
- Basheer Y Khassawneh
- Jordan University of Science and Technology, Irbid, Jordan.,National Jewish Health, Denver, Colorado
| | | | | | - Jack D Edinger
- National Jewish Health, Denver, Colorado.,Duke University Medical Center, Durham, North Carolina
| |
Collapse
|
18
|
Evans S, Clarke D, Dowell NG, Tabet N, King SL, Hutton SB, Rusted JM. Using event-related fMRI to examine sustained attention processes and effects of APOE ε4 in young adults. PLoS One 2018; 13:e0198312. [PMID: 29856823 PMCID: PMC5983530 DOI: 10.1371/journal.pone.0198312] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2017] [Accepted: 05/17/2018] [Indexed: 01/05/2023] Open
Abstract
In this study we investigated effects of the APOE ε4 allele (which confers an enhanced risk of poorer cognitive ageing, and Alzheimer’s Disease) on sustained attention (vigilance) performance in young adults using the Rapid Visual Information Processing (RVIP) task and event-related fMRI. Previous fMRI work with this task has used block designs: this study is the first to image an extended (6-minute) RVIP task. Participants were 26 carriers of the APOE ε4 allele, and 26 non carriers (aged 18–28). Pupil diameter was measured throughout, as an index of cognitive effort. We compared activity to RVIP task hits to hits on a control task (with similar visual parameters and response requirements but no working memory load): this contrast showed activity in medial frontal, inferior and superior parietal, temporal and visual cortices, consistent with previous work, demonstrating that meaningful neural data can be extracted from the RVIP task over an extended interval and using an event-related design. Behavioural performance was not affected by genotype; however, a genotype by condition (experimental task/control task) interaction on pupil diameter suggested that ε4 carriers deployed more effort to the experimental compared to the control task. fMRI results showed a condition by genotype interaction in the right hippocampal formation: only ε4 carriers showed downregulation of this region to experimental task hits versus control task hits. Experimental task beta values were correlated against hit rate: parietal correlations were seen in ε4 carriers only, frontal correlations in non-carriers only. The data indicate that, in the absence of behavioural differences, young adult ε4 carriers already show a different linkage between functional brain activity and behaviour, as well as aberrant hippocampal recruitment patterns. This may have relevance for genotype differences in cognitive ageing trajectories.
Collapse
Affiliation(s)
- Simon Evans
- School of Psychology, University of Sussex, Brighton, East Sussex, United Kingdom
- School of Psychology, University of Surrey, Guildford, Surrey, United Kingdom
| | - Devin Clarke
- School of Psychology, University of Sussex, Brighton, East Sussex, United Kingdom
| | - Nicholas G. Dowell
- Brighton and Sussex Medical School (BSMS), Brighton, East Sussex, United Kingdom
| | - Naji Tabet
- Brighton and Sussex Medical School (BSMS), Brighton, East Sussex, United Kingdom
| | - Sarah L. King
- School of Psychology, University of Sussex, Brighton, East Sussex, United Kingdom
| | - Samuel B. Hutton
- School of Psychology, University of Sussex, Brighton, East Sussex, United Kingdom
| | - Jennifer M. Rusted
- School of Psychology, University of Sussex, Brighton, East Sussex, United Kingdom
- * E-mail:
| |
Collapse
|
19
|
Bogler C, Vowinkel A, Zhutovsky P, Haynes JD. Default Network Activity Is Associated with Better Performance in a Vigilance Task. Front Hum Neurosci 2017; 11:623. [PMID: 29311878 PMCID: PMC5743927 DOI: 10.3389/fnhum.2017.00623] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2017] [Accepted: 12/07/2017] [Indexed: 11/13/2022] Open
Abstract
When attention has to be maintained over prolonged periods performance slowly fluctuates and errors can occur. It has been shown that lapses of attention are correlated with BOLD signals in frontal and parietal cortex. This raises the question how attentional fluctuations are linked to the fronto-parietal default network. Because the attentional state fluctuates slowly we expect that potential links between attentional fluctuations and brain activity should be observable on longer time scales and importantly also before the execution of the task. In the present study we used fMRI to identify brain activity that is correlated with vigilance, defined as fluctuations of reaction times (RT) during a sustained attention task. We found that brain activity in visual cortex, parietal lobe (PL), inferior and superior frontal gyrus, and supplementary motor area (SMA) was higher when the subject had a relatively long RT. In contrast to our expectations, activity in the default network (DN) was higher when subjects had a relatively short RT, that means when the performance was improved. This modulation in the DN was present already several seconds before the task execution, thus pointing to activity in the DN as a potential cause of performance increases in simple repetitive tasks.
Collapse
Affiliation(s)
- Carsten Bogler
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health (BIH), Bernstein Center for Computational Neuroscience, Berlin Center for Advanced Neuroimaging, Department of Neurology, and Excellence Cluster NeuroCure, Berlin, Germany
| | - Alexander Vowinkel
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health (BIH), Bernstein Center for Computational Neuroscience, Berlin Center for Advanced Neuroimaging, Department of Neurology, and Excellence Cluster NeuroCure, Berlin, Germany
| | - Paul Zhutovsky
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health (BIH), Bernstein Center for Computational Neuroscience, Berlin Center for Advanced Neuroimaging, Department of Neurology, and Excellence Cluster NeuroCure, Berlin, Germany
| | - John-Dylan Haynes
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health (BIH), Bernstein Center for Computational Neuroscience, Berlin Center for Advanced Neuroimaging, Department of Neurology, and Excellence Cluster NeuroCure, Berlin, Germany.,Berlin School of Mind and Brain and Institute of Psychology, Humboldt-Universität zu Berlin, Berlin, Germany.,SFB 940 Volition and Cognitive Control, Technische Universität Dresden, Dresden, Germany
| |
Collapse
|
20
|
Abstract
Effective pharmaceutical treatments for age-related cognitive decline have proved elusive. There is, however, compelling evidence that nutritional status and supplementation could play crucial roles in modifying the expression of cognitive change through the lifespan. Subjective memory impairment and mild cognitive impairment can be harbingers of dementia but this is by no means inevitable. Neurocognitive change is influenced by a variety of processes, many of which are involved in other aspects of systemic health, including cardiovascular function. Importantly, many of these processes are governed by mechanisms which may be modified by specific classes of bioactive nutrients. There is increasing, converging evidence from controlled trials that nutritional interventions can improve mood and cognitive function in both clinical and healthy populations. Specific examples include selected botanical extracts such as the flavonoids. Some nutritional supplements (e.g. broad-spectrum micronutrient supplementation) appear to support improved cognitive function, possibly through redressing insufficient nutrient status (i.e. suboptimal but above the threshold for frank deficiency). Recent mechanistic research has unveiled physiologically plausible, modifiable, cognition-relevant targets for nutrition and nutraceuticals. These include processes involved in both systemic and central vascular function, inflammation, metabolism, central activation, improved neural efficiency and angiogenesis. The advent and development of human neuroimaging methodology have greatly aided our understanding of the core central mechanisms of cognitive change. Different imaging modalities can provide insights into modifiable central mechanisms which may be targeted by bioactive nutrients. The latter may contribute to slowing age-related decline through supporting neurocognitive scaffolding mechanisms.
Collapse
|
21
|
Calvo-Marín J, Torrealba-Acosta G, Campbell M, Gaboury J, Ali A, Chen-Ku CH. Effect of insulin therapy and dietary adjustments on safety and performance during simulated soccer tests in people with type 1 diabetes: study protocol for a randomized controlled trial. Trials 2017; 18:338. [PMID: 28728559 PMCID: PMC5520333 DOI: 10.1186/s13063-017-2078-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2017] [Accepted: 06/28/2017] [Indexed: 11/15/2022] Open
Abstract
Background Despite the reduction in glycemic derangement in patients with type 1 diabetes mellitus (T1D) through dietary and therapeutic adjustments implemented before, during and after continuous exercise, evidence for its effectiveness with intermittent forms of exercise, such as soccer, is still lacking. Methods/design We designed a study protocol for a randomized, crossover, double-blinded, controlled trial, for the evaluation of the effect that a strategy of dietary and therapeutic modifications may have on safety and performance of persons with T1D in soccer training sessions and cognitive testing. Inclusion criteria comprise: age older than 18 years, more than 2 years since T1D diagnosis, low C-peptide level, a stable insulin regimen, HbA1c less than 9.0% and regular participation in soccer activities. Our primary outcome evaluates safety regarding hypoglycemia events in patients using dietary and therapeutic adjustments, compared with the performance under the implementation of current American Diabetes Association (ADA) usual recommendations for nutritional and pharmacological adjustments for exercise. Additionally, we will evaluate as secondary outcomes: soccer performance, indexed by performance in well-established soccer skill tests, cognitive functions (indexed by Stroop, digital vigilance test (DVT), Corsi block-tapping task (CBP), and rapid visual information processing (RVIP) tests), and glycemic control measured with a continuous glucose monitor (CGM). Discussion Dietary and insulin adjustments standardized under a 4-step method strategy have never been tested in a clinical trial setting with intermittent forms of exercise, such as soccer. We hypothesize that through this strategy we will observe better performance by persons with T1D in soccer and cognitive evaluations, and more stable control of glycemic parameters before, during and after exercise execution, indexed by CGM measurements. Trial registration ISRCTN, ISRCTN17447843. Registered on 5 January 2017. Electronic supplementary material The online version of this article (doi:10.1186/s13063-017-2078-1) contains supplementary material, which is available to authorized users.
Collapse
Affiliation(s)
- Javier Calvo-Marín
- Division of Endocrinology, Hospital San Vicente de Paul, Heredia, Costa Rica.
| | - Gabriel Torrealba-Acosta
- Neuromodulation Center, Spaulding Rehabilitation Hospital, Harvard Medical School, Boston, MA, USA
| | - Matthew Campbell
- School of Sport, Leeds Beckett University, Leeds, West Yorkshire, UK
| | - Jesse Gaboury
- Neuromodulation Center, Spaulding Rehabilitation Hospital, Harvard Medical School, Boston, MA, USA
| | - Ajmol Ali
- School of Sport and Exercise, College of Health, Massey University, Albany, New Zealand
| | - Chih Hao Chen-Ku
- Department of Pharmacology and Clinic Toxicology, University of Costa Rica - Division of Endocrinology, Hospital San Juan de Dios, San José, Costa Rica
| |
Collapse
|
22
|
White DJ, Cox KHM, Hughes ME, Pipingas A, Peters R, Scholey AB. Functional Brain Activity Changes after 4 Weeks Supplementation with a Multi-Vitamin/Mineral Combination: A Randomized, Double-Blind, Placebo-Controlled Trial Exploring Functional Magnetic Resonance Imaging and Steady-State Visual Evoked Potentials during Working Memory. Front Aging Neurosci 2016; 8:288. [PMID: 27994548 PMCID: PMC5133263 DOI: 10.3389/fnagi.2016.00288] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2016] [Accepted: 11/14/2016] [Indexed: 12/28/2022] Open
Abstract
This study explored the neurocognitive effects of 4 weeks daily supplementation with a multi-vitamin and -mineral combination (MVM) in healthy adults (aged 18–40 years). Using a randomized, double-blind, placebo-controlled design, participants underwent assessments of brain activity using functional Magnetic Resonance Imaging (fMRI; n = 32, 16 females) and Steady-State Visual Evoked Potential recordings (SSVEP; n = 39, 20 females) during working memory and continuous performance tasks at baseline and following 4 weeks of active MVM treatment or placebo. There were several treatment-related effects suggestive of changes in functional brain activity associated with MVM administration. SSVEP data showed latency reductions across centro-parietal regions during the encoding period of a spatial working memory task following 4 weeks of active MVM treatment. Complementary results were observed with the fMRI data, in which a subset of those completing fMRI assessment after SSVEP assessment (n = 16) demonstrated increased BOLD response during completion of the Rapid Visual Information Processing task (RVIP) within regions of interest including bilateral parietal lobes. No treatment-related changes in fMRI data were observed in those who had not first undergone SSVEP assessment, suggesting these results may be most evident under conditions of fatigue. Performance on the working memory and continuous performance tasks did not significantly differ between treatment groups at follow-up. In addition, within the fatigued fMRI sample, increased RVIP BOLD response was correlated with the change in number of target detections as part of the RVIP task. This study provides preliminary evidence of changes in functional brain activity during working memory associated with 4 weeks of daily treatment with a multi-vitamin and -mineral combination in healthy adults, using two distinct but complementary measures of functional brain activity.
Collapse
Affiliation(s)
- David J White
- Centre for Human Psychopharmacology, School of Health Sciences, Swinburne University, Hawthorn, VIC Australia
| | - Katherine H M Cox
- Centre for Human Psychopharmacology, School of Health Sciences, Swinburne University, Hawthorn, VIC Australia
| | - Matthew E Hughes
- Brain and Psychological Sciences Research Centre, School of Health Sciences, Swinburne University Hawthorn, VIC, Australia
| | - Andrew Pipingas
- Centre for Human Psychopharmacology, School of Health Sciences, Swinburne University, Hawthorn, VIC Australia
| | - Riccarda Peters
- Centre for Human Psychopharmacology, School of Health Sciences, Swinburne University, Hawthorn, VIC Australia
| | - Andrew B Scholey
- Centre for Human Psychopharmacology, School of Health Sciences, Swinburne University, Hawthorn, VIC Australia
| |
Collapse
|
23
|
Farr OM, Tsoukas MA, Triantafyllou G, Dincer F, Filippaios A, Ko BJ, Mantzoros CS. Short-term administration of the GLP-1 analog liraglutide decreases circulating leptin and increases GIP levels and these changes are associated with alterations in CNS responses to food cues: A randomized, placebo-controlled, crossover study. Metabolism 2016; 65:945-53. [PMID: 27282865 PMCID: PMC4902873 DOI: 10.1016/j.metabol.2016.03.009] [Citation(s) in RCA: 51] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2016] [Revised: 02/23/2016] [Accepted: 03/10/2016] [Indexed: 02/06/2023]
Abstract
BACKGROUND GLP-1 agonists, including liraglutide, have emerged as effective therapies for type 2 diabetes (DM) and obesity. Here, we attempted to delineate how liraglutide, at doses approved for DM, may impact circulating hormones influencing energy homeostasis in diabetics. BASIC PROCEDURES Using a randomized, placebo-controlled, double-blind, cross-over trial of 20 patients with type 2 diabetes, we examined the effects of liraglutide as compared to placebo on fasting levels of circulating hormones important to energy homeostasis, including leptin, ghrelin, PYY, and GIP. After 17days (0.6mg for 7days, 1.2mg for 7days and 1.8mg for 3days) of treatment, we also studied changes in fMRI responses to food cues. MAIN FINDINGS By design, to avoid any confounding by weight changes, subjects were studied for 17days, i.e. before body weight changed. Participants on liraglutide had significantly increased GLP-1 levels (p<0.001), decreased percent change in leptin levels (p<0.01) and increased GIP levels (p<0.03) in comparison to placebo treated subjects. Whole brain regressions of functional activity in response to food cues reveal that increased GIP levels were associated with deactivation of the attention- and reward-related insula. Decreases in leptin levels were associated with activations in the reward-related midbrain, precuneus, and dorsolateral prefrontal cortex (DLPFC), and sensorimotor-related motor cortex and with deactivations in the attention-related parietal cortex and the cognitive control-related thalamus and pre-SMA. PRINCIPAL CONCLUSIONS We demonstrate herein short-term changes to circulating levels of GIP and leptin in response to GLP-1 agonist liraglutide therapy. These findings suggest that liraglutide may alter the circulating levels of hormones important in energy homeostasis that, in turn, influence CNS perception of food cues. This could possibly lead to compensatory changes in energy homeostasis that could over time limit the efficacy of liraglutide to decrease body weight. These novel findings, which, pointing to the potential advantages of combination therapies, may have therapeutic implications, will need to be confirmed by larger and longer-term trials.
Collapse
Affiliation(s)
- Olivia M Farr
- Division of Endocrinology, Beth-Israel Deaconess Medical Center/Harvard Medical School, Boston, MA 02215.
| | - Michael A Tsoukas
- Division of Endocrinology, Beth-Israel Deaconess Medical Center/Harvard Medical School, Boston, MA 02215
| | - Georgios Triantafyllou
- Division of Endocrinology, Beth-Israel Deaconess Medical Center/Harvard Medical School, Boston, MA 02215
| | - Fadime Dincer
- Division of Endocrinology, Beth-Israel Deaconess Medical Center/Harvard Medical School, Boston, MA 02215
| | - Andreas Filippaios
- Division of Endocrinology, Beth-Israel Deaconess Medical Center/Harvard Medical School, Boston, MA 02215
| | - Byung-Joon Ko
- Division of Endocrinology, Beth-Israel Deaconess Medical Center/Harvard Medical School, Boston, MA 02215
| | - Christos S Mantzoros
- Division of Endocrinology, Beth-Israel Deaconess Medical Center/Harvard Medical School, Boston, MA 02215
| |
Collapse
|
24
|
Lin HC, Pan HC, Lin SH, Lo YC, Shen ETH, Liao LD, Liao PH, Chien YW, Liao KD, Jaw FS, Chu KW, Lai HY, Chen YY. Central Thalamic Deep-Brain Stimulation Alters Striatal-Thalamic Connectivity in Cognitive Neural Behavior. Front Neural Circuits 2016; 9:87. [PMID: 26793069 PMCID: PMC4710746 DOI: 10.3389/fncir.2015.00087] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2015] [Accepted: 12/18/2015] [Indexed: 02/03/2023] Open
Abstract
Central thalamic deep brain stimulation (CT-DBS) has been proposed as an experimental therapeutic approach to produce consistent sustained regulation of forebrain arousal for several neurological diseases. We investigated local field potentials (LFPs) induced by CT-DBS from the thalamic central lateral nuclei (CL) and the striatum as potential biomarkers for the enhancement of lever-pressing skill learning. LFPs were simultaneously recorded from multiple sites in the CL, ventral striatum (Vstr), and dorsal striatum (Dstr). LFP oscillation power and functional connectivity were assessed and compared between the CT-DBS and sham control groups. The theta and alpha LFP oscillations were significantly increased in the CL and striatum in the CT-DBS group. Furthermore, interhemispheric coherences between bilateral CL and striatum were increased in the theta band. Additionally, enhancement of c-Fos activity, dopamine D2 receptor (Drd2), and α4-nicotinic acetylcholine receptor (α4-nAChR) occurred after CT-DBS treatment in the striatum and hippocampus. CT-DBS strengthened thalamic-striatal functional connectivity, which demonstrates that the inter-regional connectivity enhancement might contribute to synaptic plasticity in the striatum. Altered dopaminergic and cholinergic receptors resulted in modulation of striatal synaptic plasticity's ability to regulate downstream signaling cascades for higher brain functions of lever-pressing skill learning.
Collapse
Affiliation(s)
- Hui-Ching Lin
- Department and Institute of Physiology, School of Medicine, National Yang Ming UniversityTaipei, Taiwan; Brain Research Center, National Yang Ming UniversityTaipei, Taiwan
| | - Han-Chi Pan
- Institute of Neuroscience, National Yang Ming University Taipei, Taiwan
| | - Sheng-Huang Lin
- Department of Neurology, Tzu Chi General Hospital, Tzu Chi UniversityHualien, Taiwan; Institute of Biomedical Engineering, National Taiwan UniversityTaipei, Taiwan
| | - Yu-Chun Lo
- Institute of Medical Device and Imaging, National Taiwan University College of Medicine Taipei, Taiwan
| | | | - Lun-De Liao
- Centre for Life Sciences, Singapore Institute for Neurotechnology, National University of SingaporeSingapore, Singapore; Institute of Biomedical Engineering and Nanomedicine, National Health Research InstitutesMiaoli, Taiwan
| | - Pei-Han Liao
- Department of Biomedical Engineering, National Yang Ming University Taipei, Taiwan
| | - Yi-Wei Chien
- Department of Biomedical Engineering, National Yang Ming University Taipei, Taiwan
| | - Kuei-Da Liao
- Graduate Institute of Biomedical Electronics and Bioinformatics, National Taiwan University Taipei, Taiwan
| | - Fu-Shan Jaw
- Institute of Biomedical Engineering, National Taiwan University Taipei, Taiwan
| | - Kai-Wen Chu
- Department and Institute of Physiology, School of Medicine, National Yang Ming University Taipei, Taiwan
| | - Hsin-Yi Lai
- Interdisciplinary Institute of Neuroscience and Technology, Qiushi Academy for Advanced Studies, Zhejiang University Hangzhou, China
| | - You-Yin Chen
- Department of Biomedical Engineering, National Yang Ming University Taipei, Taiwan
| |
Collapse
|