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Zapalac K, Miller M, Champagne FA, Schnyer DM, Baird B. The effects of physical activity on sleep architecture and mood in naturalistic environments. Sci Rep 2024; 14:5637. [PMID: 38454070 PMCID: PMC10920876 DOI: 10.1038/s41598-024-56332-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Accepted: 03/05/2024] [Indexed: 03/09/2024] Open
Abstract
Physical activity has been found to alter sleep architecture, but these effects have been studied predominantly in the laboratory and the generalizability of these findings to naturalistic environments and longer time intervals, as well as their psychological effects, have not been evaluated. Recent technological advancements in wearable devices have made it possible to capture detailed measures of sleep outside the lab, including timing of specific sleep stages. In the current study, we utilized photoplethysmography coupled with accelerometers and smartphone ambulatory assessment to collect daily measurements of sleep, physical activity and mood in a sample of N = 82 over multi-month data collection intervals. We found a robust inverse relationship between sedentary behavior and physical activity and sleep architecture: both low-intensity and moderate-to-vigorous physical activity were associated with increased NREM sleep and decreased REM sleep, as well as a longer REM latency, while higher levels of sedentary behavior showed the opposite pattern. A decreased REM/NREM ratio and increased REM latency were in turn associated with improved wellbeing, including increased energy, reduced stress and enhanced perceived restfulness of sleep. Our results suggest that physical activity and sleep account for unique variance in a person's mood, suggesting that these effects are at least partially independent.
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Affiliation(s)
- Kennedy Zapalac
- Department of Psychology, The University of Texas at Austin, 108 E Dean Keeton St, Austin, TX, 78712, USA
| | - Melissa Miller
- Department of Psychology, The University of Texas at Austin, 108 E Dean Keeton St, Austin, TX, 78712, USA
| | - Frances A Champagne
- Department of Psychology, The University of Texas at Austin, 108 E Dean Keeton St, Austin, TX, 78712, USA
| | - David M Schnyer
- Department of Psychology, The University of Texas at Austin, 108 E Dean Keeton St, Austin, TX, 78712, USA
| | - Benjamin Baird
- Department of Psychology, The University of Texas at Austin, 108 E Dean Keeton St, Austin, TX, 78712, USA.
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Wickwire EM, Albrecht JS, Capaldi VF, Jain S, Gardner RC, Smith MT, Williams SG, Collen J, Schnyer DM, Giacino JT, Nelson LD, Mukherjee P, Sun X, Werner JK, Mosti CB, Markowitz AJ, Manley GT, Krystal AD. Association Between Insomnia and Mental Health and Neurocognitive Outcomes Following Traumatic Brain Injury. J Neurotrauma 2023. [PMID: 37463057 DOI: 10.1089/neu.2023.0009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/20/2023] Open
Abstract
We previously described five trajectories of insomnia (each defined by a distinct pattern of insomnia severity over 12 months following traumatic brain injury [TBI]). Our objective in the present study was to estimate the association between insomnia trajectory status and trajectories of mental health and neurocognitive outcomes during the 12 months after TBI. In this study, participants included N = 2022 adults from the Federal Inter-agency Traumatic Brain Injury Repository database and Transforming Research and Clinical Knowledge in TBI (TRACK-TBI) study. The following outcome measures were assessed serially at 2 weeks, and 3, 6, and 12 months post-injury: Insomnia Severity Index, Patient Health Questionnaire, Post-Traumatic Stress Disorder (PTSD) Checklist for Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), Patient Reported Outcomes Measurement Information System-Pain, and Quality of Life After Brain Injury-Overall Scale. Neurocognitive performance was assessed at 2 weeks, and 6 and 12 months using the Wechsler Adult Intelligence Scales Processing Speed Index and the Trails Making Test Parts A and B. Results indicated that greater insomnia severity was associated with greater abnormality in mental health, quality of life, and neuropsychological testing outcomes. The pattern of insomnia over time tracked the temporal pattern of all these outcomes for all but a very small number of participants. Notably, severe insomnia at 3 or 6 months post-TBI was a risk factor for poor recovery at 12 months post-injury. In conclusion, in this well-characterized sample of individuals with TBI, insomnia severity generally tracked severity of depression, pain, PTSD, quality of life, and neurocognitive outcomes over 12 months post-injury. More intensive sleep assessment is needed to elucidate the nature of these relationships and to help inform best strategies for intervention.
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Affiliation(s)
- Emerson M Wickwire
- Sleep Disorders Center, Division of Pulmonary and Critical Care Medicine, Department of Medicine, University of Maryland School of Medicine, Baltimore, Maryland, USA
- Department of Psychiatry, University of Maryland School of Medicine, Baltimore, Maryland, USA
| | - Jennifer S Albrecht
- Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, Maryland, USA
| | - Vincent F Capaldi
- Center for Military Psychiatry and Neuroscience, Walter Reed Army Institute of Research, Silver Spring, Maryland, USA
- Department of Medicine, Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA
| | - Sonia Jain
- Biostatistics Research Center, Herbert Wertheim School of Public Health and Human Longevity Science, University of California, San Diego, San Diego, California, USA
| | - Raquel C Gardner
- Department of Neurology, University of California, San Francisco, San Francisco, California, USA
| | - Michael T Smith
- Department of Psychiatry, Division of Behavioral Medicine, Johns Hopkins University, Baltimore, Maryland, USA
| | - Scott G Williams
- Department of Medicine, Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA
- Department of Medicine, Fort Belvoir Community Hospital, Fort Belvoir, Virginia, USA
- Department of Psychiatry, Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA
| | - Jacob Collen
- Department of Medicine, Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA
- Sleep Disorders Center, Department of Medicine, Walter Reed National Military Medical Center, Bethesda, Maryland, USA
| | - David M Schnyer
- Department of Psychology, University of Texas Austin, Austin, Texas, USA
| | - Joseph T Giacino
- Department of Physical Medicine and Rehabilitation, Harvard Medical School, Boston, Massachusetts, USA
- Spaulding Rehabilitation Hospital, Charlestown, Massachusetts, USA
| | - Lindsay D Nelson
- Departments of Neurosurgery and Neurology, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Pratik Mukherjee
- Department of Radiology, University of California, San Francisco, San Francisco, California, USA
| | - Xiaoying Sun
- Biostatistics Research Center, Herbert Wertheim School of Public Health and Human Longevity Science, University of California, San Diego, San Diego, California, USA
| | - J Kent Werner
- Department of Neurology, Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA
- Department of Neurology, Division of Behavioral Medicine, Johns Hopkins University, Baltimore, Maryland, USA
| | - Caterina B Mosti
- Department of Psychiatry, University of California, San Francisco, San Francisco, California, USA
| | - Amy J Markowitz
- Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, California, USA
| | - Geoffrey T Manley
- Brain and Spinal Injury Center, University of California, San Francisco, San Francisco, California, USA
- Department of Neurosurgery, University of California, San Francisco, San Francisco, California, USA
| | - Andrew D Krystal
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, San Francisco, California, USA
- Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, California, USA
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Ray KL, Griffin NR, Shumake J, Alario A, Allen JJB, Beevers CG, Schnyer DM. Altered electroencephalography resting state network coherence in remitted MDD. Brain Res 2023; 1806:148282. [PMID: 36792002 DOI: 10.1016/j.brainres.2023.148282] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Revised: 02/10/2023] [Accepted: 02/11/2023] [Indexed: 02/16/2023]
Abstract
Individuals with remitted depression are at greater risk for subsequent depression and therefore may provide a unique opportunity to understand the neurophysiological correlates underlying the risk of depression. Research has identified abnormal resting-state electroencephalography (EEG) power metrics and functional connectivity patterns associated with major depression, however little is known about these neural signatures in individuals with remitted depression. We investigate the spectral dynamics of 64-channel EEG surface power and source-estimated network connectivity during resting states in 37 individuals with depression, 56 with remitted depression, and 49 healthy adults that did not differ on age, education, and cognitive ability across theta, alpha, and beta frequencies. Average reference spectral EEG surface power analyses identified greater left and midfrontal theta in remitted depression compared to healthy adults. Using Network Based Statistics, we also demonstrate within and between network alterations in LORETA transformed EEG source-space coherence across the default mode, fronto-parietal, and salience networks where individuals with remitted depression exhibited enhanced coherence compared to those with depression, and healthy adults. This work builds upon our currently limited understanding of resting EEG connectivity in depression, and helps bridge the gap between aberrant EEG power and brain network connectivity dynamics in this disorder. Further, our unique examination of remitted depression relative to both healthy and depressed adults may be key to identifying brain-based biomarkers for those at high risk for future, or subsequent depression.
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Affiliation(s)
| | | | | | - Alexandra Alario
- University of Texas, Austin, United States; University of Iowa, United States
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Clark AL, McGill MB, Ozturk ED, Schnyer DM, Chanfreau-Coffinier C, Merritt VC. Self-reported physical functioning, cardiometabolic health conditions, and health care utilization patterns in Million Veteran Program enrollees with Traumatic Brain Injury Screening and Evaluation Program data. Mil Med Res 2023; 10:2. [PMID: 36597157 PMCID: PMC9810242 DOI: 10.1186/s40779-022-00435-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Accepted: 11/30/2022] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND Examining the health outcomes of veterans who have completed the United States Veterans Health Administration's (VHA's) Traumatic Brain Injury (TBI) Screening and Evaluation Program may aid in the refinement and improvement of clinical care initiatives within the VHA. This study compared self-reported physical functioning, cardiometabolic health conditions, and health care utilization patterns in Million Veteran Program enrollees with TBI Screening and Evaluation Program data (collected between 2007 and 2019), with the goal of enhancing understanding of potentially modifiable health conditions in this population. METHODS In this observational cohort study, veterans (n = 16,452) were grouped based on the diagnostic outcome of the TBI Screening and Evaluation Program: 1) negative TBI screen (Screen-); 2) positive TBI screen but no confirmed TBI diagnosis [Screen+/ Comprehensive TBI Evaluation (CTBIE)-]; or 3) positive TBI screen and confirmed TBI diagnosis (Screen+/CTBIE+). Chi-square tests and analysis of covariance were used to explore group differences in physical functioning, cardiometabolic health conditions, and health care utilization patterns, and logistic regressions were used to examine predictors of Screen+/- and CTBIE+/- group status. RESULTS The results showed that veterans in the Screen+/CTBIE- and Screen+/CTBIE+ groups generally reported poorer levels of physical functioning (P's < 0.001, np2 = 0.02 to 0.03), higher rates of cardiometabolic health conditions (P's < 0.001, φ = 0.14 to 0.52), and increased health care utilization (P's < 0.001, φ = 0.14 to > 0.5) compared with the Screen- group; however, health outcomes were generally comparable between the Screen+/CTBIE- and Screen+/CTBIE+ groups. Follow-up analyses confirmed that while physical functioning, hypertension, stroke, healthcare utilization, and prescription medication use reliably distinguished between the Screen- and Screen+ groups (P's < 0.02, OR's 0.78 to 3.38), only physical functioning distinguished between the Screen+/CTBIE- and Screen+/CTBIE+ groups (P < 0.001, OR 0.99). CONCLUSIONS The findings suggest that veterans who screen positive for TBI, regardless of whether they are ultimately diagnosed with TBI, are at greater risk for negative health outcomes, signifying that these veterans represent a vulnerable group that may benefit from increased clinical care and prevention efforts.
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Affiliation(s)
- Alexandra L Clark
- Research Service, VA San Diego Healthcare System (VASDHS), San Diego, CA, 92161, USA.,Department of Psychology, The University of Texas at Austin, Austin, TX, 78712, USA
| | - Makenna B McGill
- Department of Psychology, The University of Texas at Austin, Austin, TX, 78712, USA
| | - Erin D Ozturk
- Research Service, VA San Diego Healthcare System (VASDHS), San Diego, CA, 92161, USA.,San Diego State University/University of California San Diego Joint Doctoral Program, San Diego, CA, 92120, USA
| | - David M Schnyer
- Department of Psychology, The University of Texas at Austin, Austin, TX, 78712, USA
| | - Catherine Chanfreau-Coffinier
- VA Informatics and Computing Infrastructure (VINCI), VA Salt Lake City Health Care System, Salt Lake City, UT, 84148, USA
| | - Victoria C Merritt
- Research Service, VA San Diego Healthcare System (VASDHS), San Diego, CA, 92161, USA. .,Department of Psychiatry, School of Medicine, University of California San Diego, La Jolla, CA, 29093, USA. .,Center of Excellence for Stress and Mental Health, VASDHS, San Diego, 92161, USA.
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Wickwire EM, Albrecht JS, Capaldi VF, Jain SO, Gardner RC, Werner JK, Mukherjee P, McKeon AB, Smith MT, Giacino JT, Nelson LD, Williams SG, Collen J, Sun X, Schnyer DM, Markowitz AJ, Manley GT, Krystal AD. Trajectories of Insomnia in Adults After Traumatic Brain Injury. JAMA Netw Open 2022; 5:e2145310. [PMID: 35080600 PMCID: PMC8792888 DOI: 10.1001/jamanetworkopen.2021.45310] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
Abstract
IMPORTANCE Insomnia is common after traumatic brain injury (TBI) and contributes to morbidity and long-term sequelae. OBJECTIVE To identify unique trajectories of insomnia in the 12 months after TBI. DESIGN, SETTING, AND PARTICIPANTS In this prospective cohort study, latent class mixed models (LCMMs) were used to model insomnia trajectories over time and to classify participants into distinct profile groups. Data from the Transforming Research and Clinical Knowledge in Traumatic Brain Injury (TRACK-TBI) study, a longitudinal, multisite, observational study, were uploaded to the Federal Interagency Traumatic Brain Injury Repository (FITBIR) database. Participants were enrolled at 1 of 18 participating level I trauma centers and enrolled within 24 hours of TBI injury. Additional data were obtained directly from the TRACK-TBI investigators that will be uploaded to FITBIR in the future. Data were collected from February 26, 2014, to August 8, 2018, and analyzed from July 1, 2020, to November 15, 2021. EXPOSURES Traumatic brain injury. MAIN OUTCOMES AND MEASURES Insomnia Severity Index assessed serially at 2 weeks and 3, 6, and 12 months thereafter. RESULTS The final sample included 2022 participants (1377 [68.1%] men; mean [SD] age, 40.1 [17.2] years) from the FITBIR database and the TRACK-TBI study. The data were best fit by a 5-class LCMM. Of these participants, 1245 (61.6%) reported persistent mild insomnia symptoms (class 1); 627 (31.0%) initially reported mild insomnia symptoms that resolved over time (class 2); 91 (4.5%) reported persistent severe insomnia symptoms (class 3); 44 (2.2%) initially reported severe insomnia symptoms that resolved by 12 months (class 4); and 15 (0.7%) initially reported no insomnia symptoms but had severe symptoms by 12 months (class 5). In a multinomial logistic regression model, several factors significantly associated with insomnia trajectory class membership were identified, including female sex (odds ratio [OR], 1.65 [95% CI, 1.02-2.66]), Black race (OR, 2.36 [95% CI, 1.39-4.01]), history of psychiatric illness (OR, 2.21 [95% CI, 1.35-3.60]), and findings consistent with intracranial injury on computed tomography (OR, 0.36 [95% CI, 0.20-0.65]) when comparing class 3 with class 1. CONCLUSIONS AND RELEVANCE These results suggest important heterogeneity in the course of insomnia after TBI in adults. More work is needed to identify outcomes associated with these insomnia trajectory class subgroups and to identify optimal subgroup-specific treatment approaches.
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Affiliation(s)
- Emerson M. Wickwire
- Department of Psychiatry, University of Maryland School of Medicine, Baltimore
- Sleep Disorders Center, Division of Pulmonary and Critical Care Medicine, Department of Medicine, University of Maryland School of Medicine, Baltimore
| | - Jennifer S. Albrecht
- Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore
| | - Vincent F. Capaldi
- Center for Military Psychiatry and Neuroscience, Walter Reed Army Institute of Research, Silver Spring, Maryland
- Department of Medicine, Uniformed Services University of the Health Sciences, Bethesda, Maryland
| | - Sonia O. Jain
- Biostatistics Research Center, Herbert Wertheim School of Public Health and Human Longevity Science, University of California, San Diego
| | | | - J. Kent Werner
- Department of Neurology, Uniformed Services University of the Health Sciences, Bethesda, Maryland
- Department of Neurology, The Johns Hopkins University, Baltimore, Maryland
| | - Pratik Mukherjee
- Department of Radiology, School of Medicine, University of California, San Francisco
| | - Ashlee B. McKeon
- Center for Military Psychiatry and Neuroscience, Walter Reed Army Institute of Research, Silver Spring, Maryland
| | - Michael T. Smith
- Division of Behavioral Medicine, Department of Psychiatry, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Joseph T. Giacino
- Department of Physical Medicine and Rehabilitation, Harvard Medical School, Boston, Massachusetts
- Spaulding Rehabilitation Hospital, Charlestown, Massachusetts
| | - Lindsay D. Nelson
- Department of Neurosurgery, Medical College of Wisconsin, Milwaukee
- Department of Neurology, Medical College of Wisconsin, Milwaukee
| | - Scott G. Williams
- Department of Medicine, Uniformed Services University of the Health Sciences, Bethesda, Maryland
- Department of Medicine, Fort Belvoir Community Hospital, Fort Belvoir, Virginia
- Department of Psychiatry, Uniformed Services University of the Health Sciences, Bethesda, Maryland
| | - Jacob Collen
- Department of Medicine, Uniformed Services University of the Health Sciences, Bethesda, Maryland
- Sleep Disorders Center, Department of Medicine, Walter Reed National Military Medical Center, Bethesda, Maryland
| | - Xiaoying Sun
- Biostatistics Research Center, Herbert Wertheim School of Public Health and Human Longevity Science, University of California, San Diego
| | | | - Amy J. Markowitz
- Department of Epidemiology and Biostatistics, School of Medicine, University of California, San Francisco
| | - Geoffrey T. Manley
- Brain and Spinal Injury Center, University of California, San Francisco
- Department of Neurosurgery, University of California, San Francisco
| | - Andrew D. Krystal
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco
- Weill Institute for Neurosciences, University of California, San Francisco
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Wu C, McMahon M, Fritz H, Schnyer DM. circadian rhythms are not captured equal: Exploring Circadian metrics extracted by differentcomputational methods from smartphone accelerometer and GPS sensors in daily life tracking. Digit Health 2022; 8:20552076221114201. [PMID: 35874860 PMCID: PMC9297448 DOI: 10.1177/20552076221114201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2022] [Accepted: 05/24/2022] [Indexed: 11/17/2022] Open
Abstract
Objective To identify the differences between circadian rhythm (CR) metrics characterized by different mobile sensors and computational methods. Methods We used smartphone tracking and daily survey data from 225 college student participants, applied four methods (survey construct automation, cosinor regression, non-parametric method, Fourier analysis) on two types of smartphone sensor data (GPS, accelerometer) to characterize CR. We explored the inter-relations among the extracted circadian metrics as well as between the circadian metrics and participants’ self-reported mood and sleep outcomes. Results Compared to GPS signals, smartphone accelerometer activity follows an intradaily distribution that starts earlier in the day, winds down later, reaches half cumulative activity about the same time, conforms less to a sinusoidal wave, and exhibits more intradaily fragmentation but higher CR strength and lower interdaily disruption. We found a notable negative correlation between intradaily variability and CR strength especially pronounced in GPS activity. Self-reported sleep and mood outcomes showed significant correlations with particular CR metrics. Conclusions We revealed significant inter-relations and discrepancies in the circadian metrics discovered from two smartphone sensors and four CR algorithms and their bearings on wellbeing indicators such as sleep quality and loneliness.
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Affiliation(s)
- Congyu Wu
- Department of Psychology, University of Texas at Austin, USA
| | - Megan McMahon
- Department of Psychology, University of Texas at Austin, USA
| | - Hagen Fritz
- Department of Civil, Environmental, and Architectural Engineering, University of Texas at Austin, USA
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Don HJ, Davis T, Ray KL, McMahon MC, Cornwall AC, Schnyer DM, Worthy DA. Neural regions associated with gain-loss frequency and average reward in older and younger adults. Neurobiol Aging 2021; 109:247-258. [PMID: 34818618 DOI: 10.1016/j.neurobiolaging.2021.10.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Revised: 10/04/2021] [Accepted: 10/05/2021] [Indexed: 11/17/2022]
Abstract
Research on the biological basis of reinforcement-learning has focused on how brain regions track expected value based on average reward. However, recent work suggests that humans are more attuned to reward frequency. Furthermore, older adults are less likely to use expected values to guide choice than younger adults. This raises the question of whether brain regions assumed to be sensitive to average reward, like the medial and lateral PFC, also track reward frequency, and whether there are age-based differences. Older (60-81 years) and younger (18-30 years) adults performed the Soochow Gambling task, which separates reward frequency from average reward, while undergoing fMRI. Overall, participants preferred options that provided negative net payoffs, but frequent gains. Older adults improved less over time, were more reactive to recent negative outcomes, and showed greater frequency-related activation in several regions, including DLPFC. We also found broader recruitment of prefrontal and parietal regions associated with frequency value and reward prediction errors in older adults, which may indicate compensation. The results suggest greater reliance on average reward for younger adults than older adults.
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Affiliation(s)
- Hilary J Don
- Texas A&M University, Department of Psychological & Brain Sciences, College Station, Texas, USA.
| | - Tyler Davis
- Texas Tech University, Department of Psychological Sciences, Lubbock, Texas, USA
| | - Kimberly L Ray
- University of Texas at Austin, Department of Psychology, Austin, Texas, USA
| | - Megan C McMahon
- University of Texas at Austin, Department of Psychology, Austin, Texas, USA
| | - Astin C Cornwall
- Texas A&M University, Department of Psychological & Brain Sciences, College Station, Texas, USA
| | - David M Schnyer
- University of Texas at Austin, Department of Psychology, Austin, Texas, USA
| | - Darrell A Worthy
- Texas A&M University, Department of Psychological & Brain Sciences, College Station, Texas, USA
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Beevers CG, Hsu KJ, Schnyer DM, Smits JAJ, Shumake J. Change in negative attention bias mediates the association between attention bias modification training and depression symptom improvement. J Consult Clin Psychol 2021; 89:816-829. [PMID: 34807657 DOI: 10.1037/ccp0000683] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE Attention bias modification training (ABMT) is purported to reduce depression by targeting and modifying an attentional bias for sadness-related stimuli. However, few tests of this hypothesis have been completed. METHOD The present study examined whether change in attentional bias mediated a previously reported association between ABMT condition (active ABMT, sham ABMT, assessments only; N = 145) and depression symptom change among depressed adults. The preregistered, primary measure of attention bias was a discretized eye-tracking metric that quantified the proportion of trials where gaze time was greater for sad stimuli than neutral stimuli. RESULTS Contemporaneous longitudinal simplex mediation indicated that change in attentional bias early in treatment partially mediated the effect of ABMT on depression symptoms. Specificity analyses indicated that in contrast to the eye-tracking mediator, reaction time assessments of attentional bias for sad stimuli (mean bias and trial level variability) and lapses in sustained attention did not mediate the association between ABMT and depression change. Results also suggested that mediation effects were limited to a degree by suboptimal measurement of attentional bias for sad stimuli. CONCLUSION When effective, ABMT may improve depression in part by reducing an attentional bias for sad stimuli, particularly early on during ABMT. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
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Affiliation(s)
| | - Kean J Hsu
- Department of Psychiatry, Georgetown University Medical Center
| | | | | | - Jason Shumake
- Department of Psychology, University of Texas at Austin
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McMahon M, Malneedi Y, Worthy DA, Schnyer DM. Rest-activity rhythms and white matter microstructure across the lifespan. Sleep 2021; 44:6017487. [PMID: 33269397 DOI: 10.1093/sleep/zsaa266] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Revised: 11/09/2020] [Indexed: 11/14/2022] Open
Abstract
STUDY OBJECTIVES The purpose of this study was to examine how rest-activity (RA) rhythm stability may be associated with white matter microstructure across the lifespan in healthy adults free of significant cardiovascular risk. METHODS We analyzed multi-shell diffusion tensor images from 103 healthy young and older adults using tract-based spatial statistics (TBSS) to examine relationships between white matter microstructure and RA rhythm stability. RA measures were computed using both cosinor and non-parametric methods derived from 7 days of actigraphy data. Fractional anisotropy (FA) and mean diffusivity (MD) were examined in this analysis. Because prior studies have suggested that the corpus callosum (CC) is sensitive to sleep physiology and RA rhythms, we also conducted a focused region of interest analysis on the CC. RESULTS Greater rest-activity rhythm stability was associated with greater FA across both young and older adults, primarily in the CC and anterior corona radiata. This effect was not moderated by age group. While RA measures were associated with sleep metrics, RA rhythm measures uniquely accounted for the variance in white matter integrity. CONCLUSIONS This study strengthens existing evidence for a relationship between brain white matter structure and RA rhythm stability in the absence of health risk factors. While there are differences in RA stability between age groups, the relationship with brain white matter was present across both young and older adults. RA rhythms may be a useful biomarker of brain health across both periods of adult development.
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Affiliation(s)
- Megan McMahon
- Department of Psychology, University of Texas at Austin, Austin, TX
| | - Yoshita Malneedi
- Department of Psychology, University of Texas at Austin, Austin, TX
| | - Darrell A Worthy
- Department of Psychological and Brain Sciences, Texas A&M University, College Station, TX
| | - David M Schnyer
- Department of Psychology, University of Texas at Austin, Austin, TX
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Wu C, Fritz H, Bastami S, Maestre JP, Thomaz E, Julien C, Castelli DM, de Barbaro K, Bearman SK, Harari GM, Cameron Craddock R, Kinney KA, Gosling SD, Schnyer DM, Nagy Z. Multi-modal data collection for measuring health, behavior, and living environment of large-scale participant cohorts. Gigascience 2021; 10:giab044. [PMID: 34155505 PMCID: PMC8216865 DOI: 10.1093/gigascience/giab044] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Revised: 03/09/2021] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND As mobile technologies become ever more sensor-rich, portable, and ubiquitous, data captured by smart devices are lending rich insights into users' daily lives with unprecedented comprehensiveness and ecological validity. A number of human-subject studies have been conducted to examine the use of mobile sensing to uncover individual behavioral patterns and health outcomes, yet minimal attention has been placed on measuring living environments together with other human-centered sensing data. Moreover, the participant sample size in most existing studies falls well below a few hundred, leaving questions open about the reliability of findings on the relations between mobile sensing signals and human outcomes. RESULTS To address these limitations, we developed a home environment sensor kit for continuous indoor air quality tracking and deployed it in conjunction with smartphones, Fitbits, and ecological momentary assessments in a cohort study of up to 1,584 college student participants per data type for 3 weeks. We propose a conceptual framework that systematically organizes human-centric data modalities by their temporal coverage and spatial freedom. Then we report our study procedure, technologies and methods deployed, and descriptive statistics of the collected data that reflect the participants' mood, sleep, behavior, and living environment. CONCLUSIONS We were able to collect from a large participant cohort satisfactorily complete multi-modal sensing and survey data in terms of both data continuity and participant adherence. Our novel data and conceptual development provide important guidance for data collection and hypothesis generation in future human-centered sensing studies.
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Affiliation(s)
- Congyu Wu
- Department of Psychology, University of Texas at Austin, 108 E Dean Keeton St, Austin, Texas, 78712, USA
| | - Hagen Fritz
- Department of Civil, Environmental, and Architectural Engineering, University of Texas at Austin, 301 E Dean Keeton St, Austin, Texas, 78712, USA
| | - Sepehr Bastami
- Department of Civil, Environmental, and Architectural Engineering, University of Texas at Austin, 301 E Dean Keeton St, Austin, Texas, 78712, USA
| | - Juan P Maestre
- Department of Civil, Environmental, and Architectural Engineering, University of Texas at Austin, 301 E Dean Keeton St, Austin, Texas, 78712, USA
| | - Edison Thomaz
- Department of Electrical and Computer Engineering, University of Texas at Austin, 2501 Speedway, Austin, Texas, 78712, USA
| | - Christine Julien
- Department of Electrical and Computer Engineering, University of Texas at Austin, 2501 Speedway, Austin, Texas, 78712, USA
| | - Darla M Castelli
- Department of Kinesiology and Health Education, University of Texas at Austin, 2109 San Jacinto Blvd, Austin, Texas, 78712, USA
| | - Kaya de Barbaro
- Department of Psychology, University of Texas at Austin, 108 E Dean Keeton St, Austin, Texas, 78712, USA
| | - Sarah Kate Bearman
- Department of Educational Psychology, University of Texas at Austin, 1912 Speedway, Austin, Texas, 78712, USA
| | - Gabriella M Harari
- Department of Communication, Stanford University, 450 Serra Mall, Stanford, California, 94305, USA
| | - R Cameron Craddock
- Department of Diagnostic Medicine, University of Texas at Austin, 1601 Trinity St, Austin, Texas, 78712, USA
| | - Kerry A Kinney
- Department of Civil, Environmental, and Architectural Engineering, University of Texas at Austin, 301 E Dean Keeton St, Austin, Texas, 78712, USA
| | - Samuel D Gosling
- Department of Psychology, University of Texas at Austin, 108 E Dean Keeton St, Austin, Texas, 78712, USA
- Melbourne School of Psychological Sciences, University of Melbourne, Grattan Street, Parkville, Victoria, 3010, Australia
| | - David M Schnyer
- Department of Psychology, University of Texas at Austin, 108 E Dean Keeton St, Austin, Texas, 78712, USA
| | - Zoltan Nagy
- Department of Civil, Environmental, and Architectural Engineering, University of Texas at Austin, 301 E Dean Keeton St, Austin, Texas, 78712, USA
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11
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Yue JK, Phelps RR, Hemmerle DD, Upadhyayula PS, Winkler EA, Deng H, Chang D, Vassar MJ, Taylor SR, Schnyer DM, Lingsma HF, Puccio AM, Yuh EL, Mukherjee P, Huang MC, Ngwenya LB, Valadka AB, Markowitz AJ, Okonkwo DO, Manley GT. Predictors of six-month inability to return to work in previously employed subjects after mild traumatic brain injury: A TRACK-TBI pilot study. J Concussion 2021; 5. [PMID: 34046212 PMCID: PMC8153496 DOI: 10.1177/20597002211007271] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
Introduction: Return to work (RTW) is an important milestone of mild traumatic brain injury (mTBI) recovery. The objective of this study was to evaluate whether baseline clinical variables, three-month RTW, and three-month postconcussional symptoms (PCS) were associated with six-month RTW after mTBI. Methods: Adult subjects from the prospective multicenter Transforming Research and Clinical Knowledge in Traumatic Brain Injury Pilot study with mTBI (Glasgow Coma Scale 13–15) who were employed at baseline, with completed three-and six-month RTW status, and three-month Acute Concussion Evaluation (ACE), were extracted. Univariate and multivariable analyses were performed for six-month RTW, with focus on baseline employment, three-month RTW, and three-month ACE domains (physical, cognitive, sleep, and/or emotional postconcussional symptoms (PCS)). Odds ratios (OR) and 95% confidence intervals [CI] were reported. Significance was assessed at p < 0.05. Results: In 152 patients aged 40.7 ± 15.0years, 72% were employed full-time at baseline. Three- and six-month RTW were 77.6% and 78.9%, respectively. At three months, 59.2%, 47.4%, 46.1% and 31.6% scored positive for ACE physical, cognitive, sleep, and emotional PCS domains, respectively. Three-month RTW predicted six-month RTW (OR = 19.80, 95% CI [7.61–51.52]). On univariate analysis, scoring positive in any three-month ACE domain predicted inability for six-month RTW (OR = 0.10–0.11). On multivariable analysis, emotional symptoms predicted inability to six-month RTW (OR = 0.19 [0.04–0.85]). Subjects who scored positive in all four ACE domains were more likely to be unable to RTW at six months (4 domains: 58.3%, vs. 0-to-3 domains: 9.5%; multivariable OR = 0.09 [0.02–0.33]). Conclusions: Three-month post-injury is an important time point at which RTW status and PCS should be assessed, as both are prognostic markers for six-month RTW. Clinicians should be particularly vigilant of patients who present with emotional symptoms, and patients with symptoms across multiple PCS categories, as these patients are at further risk of inability to RTW and may benefit from targeted evaluation and support.
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Affiliation(s)
- John K Yue
- Department of Neurological Surgery, University of California San Francisco, San Francisco, CA, USA.,Brain and Spinal Injury Center, Zuckerberg San Francisco General Hospital, San Francisco, CA, USA
| | - Ryan Rl Phelps
- Department of Neurological Surgery, University of California San Francisco, San Francisco, CA, USA.,Brain and Spinal Injury Center, Zuckerberg San Francisco General Hospital, San Francisco, CA, USA
| | - Debra D Hemmerle
- Department of Neurological Surgery, University of California San Francisco, San Francisco, CA, USA.,Brain and Spinal Injury Center, Zuckerberg San Francisco General Hospital, San Francisco, CA, USA
| | - Pavan S Upadhyayula
- Department of Neurological Surgery, University of California San Diego, San Diego, CA, USA
| | - Ethan A Winkler
- Department of Neurological Surgery, University of California San Francisco, San Francisco, CA, USA.,Brain and Spinal Injury Center, Zuckerberg San Francisco General Hospital, San Francisco, CA, USA
| | - Hansen Deng
- Department of Neurological Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - Diana Chang
- Department of Neurological Surgery, University of California San Francisco, San Francisco, CA, USA.,Brain and Spinal Injury Center, Zuckerberg San Francisco General Hospital, San Francisco, CA, USA
| | - Mary J Vassar
- Department of Neurological Surgery, University of California San Francisco, San Francisco, CA, USA.,Brain and Spinal Injury Center, Zuckerberg San Francisco General Hospital, San Francisco, CA, USA
| | - Sabrina R Taylor
- Department of Neurological Surgery, University of California San Francisco, San Francisco, CA, USA.,Brain and Spinal Injury Center, Zuckerberg San Francisco General Hospital, San Francisco, CA, USA
| | - David M Schnyer
- Department of Psychology, University of Texas, Austin, TX, USA
| | - Hester F Lingsma
- Department of Public Health, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Ava M Puccio
- Department of Neurological Surgery, University of California San Diego, San Diego, CA, USA
| | - Esther L Yuh
- Brain and Spinal Injury Center, Zuckerberg San Francisco General Hospital, San Francisco, CA, USA.,Department of Radiology, University of California San Francisco, San Francisco, CA, USA
| | - Pratik Mukherjee
- Brain and Spinal Injury Center, Zuckerberg San Francisco General Hospital, San Francisco, CA, USA.,Department of Radiology, University of California San Francisco, San Francisco, CA, USA
| | - Michael C Huang
- Department of Neurological Surgery, University of California San Francisco, San Francisco, CA, USA.,Brain and Spinal Injury Center, Zuckerberg San Francisco General Hospital, San Francisco, CA, USA
| | - Laura B Ngwenya
- Department of Neurological Surgery, University of Cincinnati, Cincinnati, OH, USA
| | - Alex B Valadka
- Department of Neurological Surgery, Virginia Commonwealth University, Richmond, VA, USA
| | - Amy J Markowitz
- Brain and Spinal Injury Center, Zuckerberg San Francisco General Hospital, San Francisco, CA, USA
| | - David O Okonkwo
- Department of Neurological Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - Geoffrey T Manley
- Department of Neurological Surgery, University of California San Francisco, San Francisco, CA, USA.,Brain and Spinal Injury Center, Zuckerberg San Francisco General Hospital, San Francisco, CA, USA
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12
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Wu C, Barczyk AN, Craddock RC, Harari GM, Thomaz E, Shumake JD, Beevers CG, Gosling SD, Schnyer DM. Improving prediction of real-time loneliness and companionship type using geosocial features of personal smartphone data. ACTA ACUST UNITED AC 2021. [DOI: 10.1016/j.smhl.2021.100180] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
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13
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McNamara ME, Shumake J, Stewart RA, Labrada J, Alario A, Allen JJB, Palmer R, Schnyer DM, McGeary JE, Beevers CG. Multifactorial prediction of depression diagnosis and symptom dimensions. Psychiatry Res 2021; 298:113805. [PMID: 33647705 PMCID: PMC8042639 DOI: 10.1016/j.psychres.2021.113805] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2020] [Accepted: 02/10/2021] [Indexed: 01/07/2023]
Abstract
While depression is a leading cause of disability, prior investigations of depression have been limited by studying correlates in isolation. A data-driven approach was applied to identify out-of-sample predictors of current depression from adults (N = 217) sampled on a continuum of no depression to clinical levels. The current study used elastic net regularized regression and predictors from sociodemographic, self-report, polygenic scores, resting electroencephalography, pupillometry, actigraphy, and cognitive tasks to classify individuals into currently depressed (MDE), psychiatric control (PC), and no current psychopathology (NP) groups, as well as predicting symptom severity and lifetime MDE. Cross-validated models explained 20.6% of the out-of-fold deviance for the classification of MDEs versus PC, 33.2% of the deviance for MDE versus NP, but -0.6% of the deviance between PC and NP. Additionally, predictors accounted for 25.7% of the out-of-fold variance in anhedonia severity, 65.7% of the variance in depression severity, and 12.9% of the deviance in lifetime depression (yes/no). Self-referent processing, anhedonia, and psychosocial functioning emerged as important differentiators of MDE and PC groups. Findings highlight the advantages of using psychiatric control groups to isolate factors specific to depression.
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Affiliation(s)
- Mary E McNamara
- Department of Psychology and Institute for Mental Health Research, University of Texas at Austin, Austin, Texas, USA.
| | - Jason Shumake
- Department of Psychology and Institute for Mental Health Research, University of Texas at Austin, Austin, Texas, USA
| | - Rochelle A Stewart
- Department of Psychology and Institute for Mental Health Research, University of Texas at Austin, Austin, Texas, USA
| | - Jocelyn Labrada
- Department of Psychology and Institute for Mental Health Research, University of Texas at Austin, Austin, Texas, USA
| | - Alexandra Alario
- Department of Psychology and Institute for Mental Health Research, University of Texas at Austin, Austin, Texas, USA
| | - John J B Allen
- Department of Psychology, University of Arizona, Tucson, Arizona, USA
| | - Rohan Palmer
- Department of Psychology, Emory University, Atlanta, Georgia, USA
| | - David M Schnyer
- Department of Psychology and Institute for Mental Health Research, University of Texas at Austin, Austin, Texas, USA
| | - John E McGeary
- Veterans Affairs, Providence RI and Department of Psychiatry and Human Behavior, Brown University School of Medicine, Providence, Rhode Island, USA
| | - Christopher G Beevers
- Department of Psychology and Institute for Mental Health Research, University of Texas at Austin, Austin, Texas, USA
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14
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Hsu KJ, Shumake J, Caffey K, Risom S, Labrada J, Smits JAJ, Schnyer DM, Beevers CG. Efficacy of attention bias modification training for depressed adults: a randomized clinical trial. Psychol Med 2021; 52:1-9. [PMID: 33766151 PMCID: PMC8464627 DOI: 10.1017/s0033291721000702] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Revised: 02/02/2021] [Accepted: 02/17/2021] [Indexed: 01/13/2023]
Abstract
BACKGROUND This study examined the efficacy of attention bias modification training (ABMT) for the treatment of depression. METHODS In this randomized clinical trial, 145 adults (77% female, 62% white) with at least moderate depression severity [i.e. self-reported Quick Inventory of Depressive Symptomatology (QIDS-SR) ⩾13] and a negative attention bias were randomized to active ABMT, sham ABMT, or assessments only. The training consisted of two in-clinic and three (brief) at-home ABMT sessions per week for 4 weeks (2224 training trials total). The pre-registered primary outcome was change in QIDS-SR. Secondary outcomes were the 17-item Hamilton Depression Rating Scale (HRSD) and anhedonic depression and anxious arousal from the Mood and Anxiety Symptom Questionnaire (MASQ). Primary and secondary outcomes were administered at baseline and four weekly assessments during ABMT. RESULTS Intent-to-treat analyses indicated that, relative to assessment-only, active ABMT significantly reduced QIDS-SR and HRSD scores by an additional 0.62 ± 0.23 (p = 0.008, d = -0.57) and 0.74 ± 0.31 (p = 0.021, d = -0.49) points per week. Similar results were observed for active v. sham ABMT: a greater symptom reduction of 0.44 ± 0.24 QIDS-SR (p = 0.067, d = -0.41) and 0.69 ± 0.32 HRSD (p = 0.033, d = -0.42) points per week. Sham ABMT did not significantly differ from the assessment-only condition. No significant differences were observed for the MASQ scales. CONCLUSION Depressed individuals with at least modest negative attentional bias benefitted from active ABMT.
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Affiliation(s)
- Kean J. Hsu
- Georgetown University Medical Center, Washington, DC, USA
- Institute for Mental Health Research and Department of Psychology, University of Texas at Austin, Austin, TX, USA
| | - Jason Shumake
- Institute for Mental Health Research and Department of Psychology, University of Texas at Austin, Austin, TX, USA
| | - Kayla Caffey
- Institute for Mental Health Research and Department of Psychology, University of Texas at Austin, Austin, TX, USA
| | - Semeon Risom
- Institute for Mental Health Research and Department of Psychology, University of Texas at Austin, Austin, TX, USA
| | - Jocelyn Labrada
- Institute for Mental Health Research and Department of Psychology, University of Texas at Austin, Austin, TX, USA
| | - Jasper A. J. Smits
- Institute for Mental Health Research and Department of Psychology, University of Texas at Austin, Austin, TX, USA
| | - David M. Schnyer
- Institute for Mental Health Research and Department of Psychology, University of Texas at Austin, Austin, TX, USA
| | - Christopher G. Beevers
- Institute for Mental Health Research and Department of Psychology, University of Texas at Austin, Austin, TX, USA
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15
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Jacquin AE, Bazarian JJ, Casa DJ, Elbin RJ, Hotz G, Schnyer DM, Yeargin S, Prichep LS, Covassin T. Concussion assessment potentially aided by use of an objective multimodal concussion index. Journal of Concussion 2021. [DOI: 10.1177/20597002211004333] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Objective Prompt, accurate, objective assessment of concussion is crucial as delays can lead to increased short and long-term consequences. The purpose of this study was to derive an objective multimodal concussion index (CI) using EEG at its core, to identify concussion, and to assess change over time throughout recovery. Methods Male and female concussed ( N = 232) and control ( N = 206) subjects 13–25 years were enrolled at 12 US colleges and high schools. Evaluations occurred within 72 h of injury, 5 days post-injury, at return-to-play (RTP), 45 days after RTP (RTP + 45); and included EEG, neurocognitive performance, and standard concussion assessments. Concussed subjects had a witnessed head impact, were removed from play for ≥ 5 days using site guidelines, and were divided into those with RTP < 14 or ≥14 days. Part 1 describes the derivation and efficacy of the machine learning derived classifier as a marker of concussion. Part 2 describes significance of differences in CI between groups at each time point and within each group across time points. Results Sensitivity = 84.9%, specificity = 76.0%, and AUC = 0.89 were obtained on a test Hold-Out group representing 20% of the total dataset. EEG features reflecting connectivity between brain regions contributed most to the CI. CI was stable over time in controls. Significant differences in CI between controls and concussed subjects were found at time of injury, with no significant differences at RTP and RTP + 45. Within the concussed, differences in rate of recovery were seen. Conclusions The CI was shown to have high accuracy as a marker of likelihood of concussion. Stability of CI in controls supports reliable interpretation of CI change in concussed subjects. Objective identification of the presence of concussion and assessment of readiness to return to normal activity can be aided by use of the CI, a rapidly obtained, point of care assessment tool.
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Affiliation(s)
| | - Jeffrey J Bazarian
- Department of Emergency Medicine, University of Rochester, Rochester, NY, USA
| | - Douglas J Casa
- Department of Kinesiology, Korey Stringer Institute, University of Connecticut, Storrs, CT, USA
| | - Robert J Elbin
- Department of Health, Human Performance and Recreation, Office for Sport Concussion Research, University of Arkansas, Fayetteville, AR, USA
| | - Gillian Hotz
- Department of Neurosurgery, University of Miami Miller School of Medicine, Miami, FL, USA
| | - David M Schnyer
- Department of Psychology, University of Texas at Austin, Austin, TX, USA
| | - Susan Yeargin
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | | | - Tracey Covassin
- Department of Kinesiology, Michigan State University, East Lansing, MI, USA
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16
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Bazarian JJ, Elbin RJ, Casa DJ, Hotz GA, Neville C, Lopez RM, Schnyer DM, Yeargin S, Covassin T. Validation of a Machine Learning Brain Electrical Activity-Based Index to Aid in Diagnosing Concussion Among Athletes. JAMA Netw Open 2021; 4:e2037349. [PMID: 33587137 PMCID: PMC7885039 DOI: 10.1001/jamanetworkopen.2020.37349] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
IMPORTANCE An objective, reliable indicator of the presence and severity of concussive brain injury and of the readiness for the return to activity has the potential to reduce concussion-related disability. OBJECTIVE To validate the classification accuracy of a previously derived, machine learning, multimodal, brain electrical activity-based Concussion Index in an independent cohort of athletes with concussion. DESIGN, SETTING, AND PARTICIPANTS This prospective diagnostic cohort study was conducted at 10 clinical sites (ie, US universities and high schools) between February 4, 2017, and March 20, 2019. A cohort comprising a consecutive sample of 207 athletes aged 13 to 25 years with concussion and 373 matched athlete controls without concussion were assessed with electroencephalography, cognitive testing, and symptom inventories within 72 hours of injury, at return to play, and 45 days after return to play. Variables from the multimodal assessment were used to generate a Concussion Index at each time point. Athletes with concussion had experienced a witnessed head impact, were removed from play for 5 days or more, and had an initial Glasgow Coma Scale score of 13 to 15. Participants were excluded for known neurologic disease or history within the last year of traumatic brain injury. Athlete controls were matched to athletes with concussion for age, sex, and type of sport played. MAIN OUTCOMES AND MEASURES Classification accuracy of the Concussion Index at time of injury using a prespecified cutoff of 70 or less (total range, 0-100, where ≤70 indicates it is likely the individual has a concussion and >70 indicates it is likely the individual does not have a concussion). RESULTS Of 580 eligible participants with analyzable data, 207 had concussion (124 male participants [59.9%]; mean [SD] age, 19.4 [2.5] years), and 373 were athlete controls (187 male participants [50.1%]; mean [SD] age, 19.6 [2.2] years). The Concussion Index had a sensitivity of 86.0% (95% CI, 80.5%-90.4%), specificity of 70.8% (95% CI, 65.9%-75.4%), negative predictive value of 90.1% (95% CI, 86.1%-93.3%), positive predictive value of 62.0% (95% CI, 56.1%-67.7%), and area under receiver operator characteristic curve of 0.89. At day 0, the mean (SD) Concussion Index among athletes with concussion was significantly lower than among athletes without concussion (75.0 [14.0] vs 32.7 [27.2]; P < .001). Among athletes with concussion, there was a significant increase in the Concussion Index between day 0 and return to play, with a mean (SD) paired difference between these time points of -41.2 (27.0) (P < .001). CONCLUSIONS AND RELEVANCE These results suggest that the multimodal brain activity-based Concussion Index has high classification accuracy for identification of the likelihood of concussion at time of injury and may be associated with the return to control values at the time of recovery. The Concussion Index has the potential to aid in the clinical diagnosis of concussion and in the assessment of athletes' readiness to return to play.
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Affiliation(s)
- Jeffrey J. Bazarian
- Department of Emergency Medicine, University of Rochester School of Medicine, Rochester, New York
| | - Robert J. Elbin
- Office for Sports Concussion Research, University of Arkansas, Fayetteville
| | | | - Gillian A. Hotz
- UHealth Concussion Program, University of Miami, Miami, Florida
| | - Christopher Neville
- Department of Physical Therapy Education, SUNY Upstate Medical University, Syracuse, New York
| | - Rebecca M. Lopez
- Morsani College of Medicine, Orthopedics and Sports Medicine, University of South Florida, Tampa
| | | | - Susan Yeargin
- Arnold School of Public Health, University of South Carolina, Columbia
| | - Tracey Covassin
- Department of Kinesiology, Michigan State University, East Lansing
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17
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Yue JK, Satris G, Dalle Ore CL, Huie JR, Deng H, Winkler EA, Lee YM, Vassar M, Taylor S, Schnyer DM, Lingsma HF, Puccio A, Yuh E, Mukherjee P, Valadka AB, Ferguson A, Okonkwo DO, Manley GT. Polytrauma is Associated with Worse 3- and 6-month Disability After Traumatic Brain Injury. Neurosurgery 2020. [DOI: 10.1093/neuros/nyaa447_452] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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18
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Affiliation(s)
| | - David M. Schnyer
- Department of Psychology, University of Texas at Austin, Austin, TX, USA
| | - Xiaoqing Hu
- Department of Psychology, The University of Hong Kong, Pok Fu Lam, Hong Kong
| | - Jennifer S. Beer
- Department of Psychology, University of Texas at Austin, Austin, TX, USA
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19
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Yue JK, Satris GG, Dalle Ore CL, Huie JR, Deng H, Winkler EA, Lee YM, Vassar MJ, Taylor SR, Schnyer DM, Lingsma HF, Puccio AM, Yuh EL, Mukherjee P, Valadka AB, Ferguson AR, Markowitz AJ, Okonkwo DO, Manley GT. Polytrauma Is Associated with Increased Three- and Six-Month Disability after Traumatic Brain Injury: A TRACK-TBI Pilot Study. Neurotrauma Rep 2020; 1:32-41. [PMID: 34223528 PMCID: PMC8240880 DOI: 10.1089/neur.2020.0004] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Polytrauma and traumatic brain injury (TBI) frequently co-occur and outcomes are routinely measured by the Glasgow Outcome Scale-Extended (GOSE). Polytrauma may confound GOSE measurement of TBI-specific outcomes. Adult patients with TBI from the prospective Transforming Research and Clinical Knowledge in Traumatic Brain Injury Pilot (TRACK-TBI Pilot) study had presented to a Level 1 trauma center after injury, received head computed tomography (CT) within 24 h, and completed the GOSE at 3 months and 6 months post-injury. Polytrauma was defined as an Abbreviated Injury Score (AIS) ≥3 in any extracranial region. Univariate regressions were performed using known GOSE clinical cutoffs. Multi-variable regressions were performed for the 3- and 6-month GOSE, controlling for known demographic and injury predictors. Of 361 subjects (age 44.9 ± 18.9 years, 69.8% male), 69 (19.1%) suffered polytrauma. By Glasgow Coma Scale (GCS) assessment, 80.1% had mild, 5.8% moderate, and 14.1% severe TBI. On univariate logistic regression, polytrauma was associated with increased odds of moderate disability or worse (GOSE ≤6; 3 month odds ratio [OR] = 2.57 [95% confidence interval (CI): 1.50-4.41; 6 month OR = 1.70 [95% CI: 1.01-2.88]) and death/severe disability (GOSE ≤4; 3 month OR = 3.80 [95% CI: 2.03-7.11]; 6 month OR = 3.33 [95% CI: 1.71-6.46]). Compared with patients with isolated TBI, more polytrauma patients experienced a decline in GOSE from 3 to 6 months (37.7 vs. 24.7%), and fewer improved (11.6 vs. 22.6%). Polytrauma was associated with greater univariate ordinal odds for poorer GOSE (3 month OR = 2.79 [95% CI: 1.73-4.49]; 6 month OR = 1.73 [95% CI: 1.07-2.79]), which was conserved on multi-variable ordinal regression (3 month OR = 3.05 [95% CI: 1.76-5.26]; 6 month OR = 2.04 [95% CI: 1.18-3.42]). Patients with TBI with polytrauma are at greater risk for 3- and 6-month disability compared with those with isolated TBI. Methodological improvements in assessing TBI-specific disability, versus disability attributable to all systemic injuries, will generate better TBI outcomes assessment tools.
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Affiliation(s)
- John K Yue
- Department of Neurological Surgery, University of California San Francisco, San Francisco, California, USA.,Brain and Spinal Injury Center, Zuckerberg San Francisco General Hospital, San Francisco, California, USA
| | - Gabriela G Satris
- Department of Neurological Surgery, University of California San Francisco, San Francisco, California, USA.,Brain and Spinal Injury Center, Zuckerberg San Francisco General Hospital, San Francisco, California, USA
| | - Cecilia L Dalle Ore
- Department of Neurological Surgery, University of California San Francisco, San Francisco, California, USA.,Brain and Spinal Injury Center, Zuckerberg San Francisco General Hospital, San Francisco, California, USA
| | - J Russell Huie
- Department of Neurological Surgery, University of California San Francisco, San Francisco, California, USA.,Brain and Spinal Injury Center, Zuckerberg San Francisco General Hospital, San Francisco, California, USA
| | - Hansen Deng
- Department of Neurological Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA
| | - Ethan A Winkler
- Department of Neurological Surgery, University of California San Francisco, San Francisco, California, USA.,Brain and Spinal Injury Center, Zuckerberg San Francisco General Hospital, San Francisco, California, USA
| | - Young M Lee
- Department of Neurological Surgery, University of California San Francisco, San Francisco, California, USA.,Brain and Spinal Injury Center, Zuckerberg San Francisco General Hospital, San Francisco, California, USA
| | - Mary J Vassar
- Department of Neurological Surgery, University of California San Francisco, San Francisco, California, USA.,Brain and Spinal Injury Center, Zuckerberg San Francisco General Hospital, San Francisco, California, USA
| | - Sabrina R Taylor
- Department of Neurological Surgery, University of California San Francisco, San Francisco, California, USA.,Brain and Spinal Injury Center, Zuckerberg San Francisco General Hospital, San Francisco, California, USA
| | - David M Schnyer
- Department of Psychology, University of Texas, Austin, Texas, USA
| | - Hester F Lingsma
- Department of Public Health, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Ava M Puccio
- Department of Neurological Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA
| | - Esther L Yuh
- Brain and Spinal Injury Center, Zuckerberg San Francisco General Hospital, San Francisco, California, USA.,Department of Radiology, University of California San Francisco, San Francisco, California, USA
| | - Pratik Mukherjee
- Brain and Spinal Injury Center, Zuckerberg San Francisco General Hospital, San Francisco, California, USA.,Department of Radiology, University of California San Francisco, San Francisco, California, USA
| | - Alex B Valadka
- Department of Neurological Surgery, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Adam R Ferguson
- Department of Neurological Surgery, University of California San Francisco, San Francisco, California, USA.,Brain and Spinal Injury Center, Zuckerberg San Francisco General Hospital, San Francisco, California, USA
| | - Amy J Markowitz
- Brain and Spinal Injury Center, Zuckerberg San Francisco General Hospital, San Francisco, California, USA
| | - David O Okonkwo
- Department of Neurological Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA
| | - Geoffrey T Manley
- Department of Neurological Surgery, University of California San Francisco, San Francisco, California, USA.,Brain and Spinal Injury Center, Zuckerberg San Francisco General Hospital, San Francisco, California, USA
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Hsu KJ, McNamara ME, Shumake J, Stewart RA, Labrada J, Alario A, Gonzalez GD, Schnyer DM, Beevers CG. Neurocognitive predictors of self-reported reward responsivity and approach motivation in depression: A data-driven approach. Depress Anxiety 2020; 37:682-697. [PMID: 32579757 PMCID: PMC7951991 DOI: 10.1002/da.23042] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2019] [Revised: 03/18/2020] [Accepted: 04/19/2020] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND Individual differences in reward-related processes, such as reward responsivity and approach motivation, appear to play a role in the nature and course of depression. Prior work suggests that cognitive biases for valenced information may contribute to these reward processes. Yet there is little work examining how biased attention, processing, and memory for positively and negatively valenced information may be associated with reward-related processes in samples with depression symptoms. METHODS We used a data-driven, machine learning (elastic net) approach to identify the best predictors of self-reported reward-related processes using multiple tasks of attention, processing, and memory for valenced information measured across behavioral, eye tracking, psychophysiological, and computational modeling approaches (n = 202). Participants were adults (ages 18-35) who ranged in depression symptom severity from mild to severe. RESULTS Models predicted between 5.0-12.2% and 9.7-28.0% of held-out test sample variance in approach motivation and reward responsivity, respectively. Low self-referential processing of positively valenced information was the most robust, albeit modest, predictor of low approach motivation and reward responsivity. CONCLUSIONS Self-referential processing of positive information is the strongest predictor of reward responsivity and approach motivation in a sample ranging from mild to severe depression symptom severity. Experiments are now needed to clarify the causal relationship between self-referential processing of positively valenced information and reward processes in depression.
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Affiliation(s)
- Kean J. Hsu
- Department of Psychiatry, Georgetown University Medical Center, Washington, DC,Institute for Mental Health Research and Department of Psychology, University of Texas at Austin, Austin, TX,Corresponding Author: Kean J. Hsu, Ph.D., Department of Psychiatry, Georgetown University Medical Center, 2115 Wisconsin Ave. NW, Suite 200, Washington, DC 20007 ()
| | - Mary E. McNamara
- Institute for Mental Health Research and Department of Psychology, University of Texas at Austin, Austin, TX
| | - Jason Shumake
- Institute for Mental Health Research and Department of Psychology, University of Texas at Austin, Austin, TX
| | | | - Jocelyn Labrada
- Institute for Mental Health Research and Department of Psychology, University of Texas at Austin, Austin, TX
| | - Alexandra Alario
- Interdisciplinary Graduate Program in Neuroscience, University of Iowa, Iowa City, IA
| | - Guadalupe D.S. Gonzalez
- Institute for Mental Health Research and Department of Psychology, University of Texas at Austin, Austin, TX
| | - David M. Schnyer
- Institute for Mental Health Research and Department of Psychology, University of Texas at Austin, Austin, TX
| | - Christopher G. Beevers
- Institute for Mental Health Research and Department of Psychology, University of Texas at Austin, Austin, TX
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Yue JK, Phelps RRL, Winkler EA, Deng H, Upadhyayula PS, Vassar MJ, Madhok DY, Schnyer DM, Puccio AM, Lingsma HF, Yuh EL, Mukherjee P, Valadka AB, Okonkwo DO, Manley GT. Substance use on admission toxicology screen is associated with peri-injury factors and six-month outcome after traumatic brain injury: A TRACK-TBI Pilot study. J Clin Neurosci 2020; 75:149-156. [PMID: 32173156 DOI: 10.1016/j.jocn.2020.02.021] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2019] [Accepted: 02/10/2020] [Indexed: 01/07/2023]
Abstract
Substance use is commonly associated with traumatic brain injury (TBI). We investigate associations between active substance use, peri-injury factors, and outcome after TBI across three U.S. Level I trauma centers. TBI subjects from the prospective Transforming Research and Clinical Knowledge in Traumatic Brain Injury Pilot (TRACK-TBI Pilot) with Marshall computed tomography (CT) score 1-3, no neurosurgical procedure/operation, and admission urine toxicology screen (tox+/-) were extracted. Associations between tox+/-, comorbidities, hospital variables, and six-month functional (GOSE) and neuropsychiatric (PCL-C, BSI18, RPQ-13, SWLS) outcomes were analyzed. Multivariable regression was performed for associations significant on univariate analysis with odds ratios (mOR) presented. Significance assessed at p < 0.05. In 133 subjects, tox+/tox- were 29.1%/72.9%. Tox+ was younger (35.5/43.6-years, p = 0.018), trended toward male sex (80.6%/63.9%, p = 0.067), was associated with history of seizures (27.8%/10.3%, p = 0.012), self-reported substance use (44.4%/17.5%, p = 0.001), prior TBI (58.8%/34.1%, p = 0.009), GCS < 15 (69.4%/48.4%, p = 0.031) and blood alcohol level >0.08-mg/dl (55.6%/30.8%, p = 0.022). In CT-negative subjects, tox+ was associated with increased hospital admission (95.7%/66.7%, p = 0.034). At six-months, tox+ was associated with screening positive for post-traumatic stress disorder (PCL-C: 40.0%/15.9%; mOR = 8.24, p = 0.022) and psychiatric symptoms (BSI18: 40.0%/14.3%, mOR = 11.06, p = 0.023). Active substance use in TBI may confound GCS assessment, triage to higher level of care, and be associated with increased six-month neuropsychiatric symptoms. Substance use screening should be integrated into standard emergency/acute care TBI protocols to optimize management and resource utilization. Clinicians should be vigilant in providing education, counselling, and follow-up for TBI patients with substance use.
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Affiliation(s)
- John K Yue
- Department of Neurosurgery, University of California San Francisco, San Francisco, CA, USA; Brain and Spinal Injury Center, Zuckerberg San Francisco General Hospital, San Francisco, CA, USA
| | - Ryan R L Phelps
- Department of Neurosurgery, University of California San Francisco, San Francisco, CA, USA; Brain and Spinal Injury Center, Zuckerberg San Francisco General Hospital, San Francisco, CA, USA
| | - Ethan A Winkler
- Department of Neurosurgery, University of California San Francisco, San Francisco, CA, USA; Brain and Spinal Injury Center, Zuckerberg San Francisco General Hospital, San Francisco, CA, USA
| | - Hansen Deng
- Department of Neurosurgery, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - Pavan S Upadhyayula
- Department of Neurosurgery, University of California San Diego, San Diego, CA, USA
| | - Mary J Vassar
- Department of Neurosurgery, University of California San Francisco, San Francisco, CA, USA; Brain and Spinal Injury Center, Zuckerberg San Francisco General Hospital, San Francisco, CA, USA
| | - Debbie Y Madhok
- Department of Emergency Medicine, University of California San Francisco, San Francisco, CA, USA
| | - David M Schnyer
- Department of Psychology, University of Texas in Austin, Austin, TX, USA
| | - Ava M Puccio
- Department of Neurosurgery, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - Hester F Lingsma
- Department of Public Health, Erasmus Medical Center, Rotterdam, the Netherlands
| | - Esther L Yuh
- Brain and Spinal Injury Center, Zuckerberg San Francisco General Hospital, San Francisco, CA, USA; Department of Radiology, University of California San Francisco, San Francisco, CA, USA
| | - Pratik Mukherjee
- Brain and Spinal Injury Center, Zuckerberg San Francisco General Hospital, San Francisco, CA, USA; Department of Radiology, University of California San Francisco, San Francisco, CA, USA
| | - Alex B Valadka
- Department of Neurosurgery, Virginia Commonwealth University, Richmond, VA, USA
| | - David O Okonkwo
- Department of Neurosurgery, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - Geoffrey T Manley
- Department of Neurosurgery, University of California San Francisco, San Francisco, CA, USA; Brain and Spinal Injury Center, Zuckerberg San Francisco General Hospital, San Francisco, CA, USA.
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Babakmehr M, Baecker L, Brambilla P, Bruin W, Castellani U, Garcia-Dias R, Hope TM, Kellmeyer P, Kherif F, Kia SM, Latypova A, Lopez Pinaya WH, Marquand AF, Mechelli A, Naselaris T, O'Donnell LJ, Pisner DA, Scarpazza C, Schnack H, Schnyer DM, Squarcina L, St-Yves G, Thomas RM, van Wingen G, Vieira S, Zhang F, Zhutovsky P. Contributors. Mach Learn 2020. [DOI: 10.1016/b978-0-12-815739-8.01002-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Yue JK, Winkler EA, Deng H, Phelps RRL, Chandra A, Vassar MJ, Schnyer DM, Puccio A, Lingsma HF, Yuh E, Mukherjee P, Valadka AB, Okonkwo DO, Manley GT. Brain Derived Neurotrophic Factor (BDNF) Val66Met Single Nucleotide Polymorphism (rs6265) is Associated With Decreased Functional Outcome After Traumatic Brain Injury: A Multicenter Cohort Study. Neurosurgery 2019. [DOI: 10.1093/neuros/nyz310_120] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Wickwire EM, Albrecht JS, Griffin NR, Schnyer DM, Yue JK, Markowitz AJ, Okonkwo DO, Valadka AB, Badjatia N, Manley GT. Sleep disturbances precede depressive symptomatology following traumatic brain injury. Curr Neurobiol 2019; 10:49-55. [PMID: 34040318 PMCID: PMC8148630] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
The purpose of the present study was to evaluate the impact of sleep disturbances on subsequent depressive symptomatology among a representative sample of patients following traumatic brain injury (TBI). Within a retrospective cohort design, our sample included 305 individuals from the Transforming Research and Clinical Knowledge in Traumatic Brain Injury Pilot (TRACK-TBI Pilot; NINDS-OD09-004) database. At 3-months post-TBI, symptoms of insomnia were reported by 34% of patients, and symptoms of hypersomnia were reported by 39% of patients. For the vast majority of individuals, sleep complaints were likely to persist through 6-month follow-up. Symptoms of hypersomnia but not insomnia at three months were associated with worsened depressive symptomatology at six months. These results highlight the importance of sleep disturbances in recovery from TBI and suggest targeted sleep treatments as a pathway to improve outcomes and quality of life following TBI.
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Affiliation(s)
- Emerson M. Wickwire
- Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD
- Sleep Disorders Center, Division of Pulmonary and Critical Care Medicine, Department of Medicine, University of Maryland School of Medicine, Baltimore, MD
| | - Jennifer S. Albrecht
- Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, MD
| | | | | | - John K. Yue
- Department of Neurosurgery, University of California, San Francisco, School of Medicine
| | - Amy J. Markowitz
- Department of Neurosurgery, University of California, San Francisco, School of Medicine
| | - David O. Okonkwo
- Department of Neurosurgery, University of Pittsburgh School of Medicine
| | - Alex B. Valadka
- Department of Neurosurgery, Virginia Commonwealth University School of Medicine
| | - Neeraj Badjatia
- Department of Neurology, University of Maryland School of Medicine, Baltimore, MD
| | - Geoffrey T. Manley
- Department of Neurosurgery, University of California, San Francisco, School of Medicine
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Yue JK, Cnossen MC, Winkler EA, Deng H, Phelps RRL, Coss NA, Sharma S, Robinson CK, Suen CG, Vassar MJ, Schnyer DM, Puccio AM, Gardner RC, Yuh EL, Mukherjee P, Valadka AB, Okonkwo DO, Lingsma HF, Manley GT. Pre-injury Comorbidities Are Associated With Functional Impairment and Post-concussive Symptoms at 3- and 6-Months After Mild Traumatic Brain Injury: A TRACK-TBI Study. Front Neurol 2019; 10:343. [PMID: 31024436 PMCID: PMC6465546 DOI: 10.3389/fneur.2019.00343] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2019] [Accepted: 03/20/2019] [Indexed: 11/17/2022] Open
Abstract
Introduction: Over 70% of traumatic brain injuries (TBI) are classified as mild (mTBI), which present heterogeneously. Associations between pre-injury comorbidities and outcomes are not well-understood, and understanding their status as risk factors may improve mTBI management and prognostication. Methods: mTBI subjects (GCS 13-15) from TRACK-TBI Pilot completing 3- and 6-month functional [Glasgow Outcome Scale-Extended (GOSE)] and post-concussive outcomes [Acute Concussion Evaluation (ACE) physical/cognitive/sleep/emotional subdomains] were extracted. Pre-injury comorbidities >10% incidence were included in regressions for functional disability (GOSE ≤ 6) and post-concussive symptoms by subdomain. Odds ratios (OR) and mean differences (B) were reported. Significance was assessed at p < 0.0083 (Bonferroni correction). Results: In 260 subjects sustaining blunt mTBI, mean age was 44.0-years and 70.4% were male. Baseline comorbidities >10% incidence included psychiatric-30.0%, cardiac (hypertension)-23.8%, cardiac (structural/valvular/ischemic)-20.4%, gastrointestinal-15.8%, pulmonary-15.0%, and headache/migraine-11.5%. At 3- and 6-months separately, 30.8% had GOSE ≤ 6. At 3-months, psychiatric (GOSE ≤ 6: OR = 2.75, 95% CI [1.44-5.27]; ACE-physical: B = 1.06 [0.38-1.73]; ACE-cognitive: B = 0.72 [0.26-1.17]; ACE-sleep: B = 0.46 [0.17-0.75]; ACE-emotional: B = 0.64 [0.25-1.03]), headache/migraine (GOSE ≤ 6: OR = 4.10 [1.67-10.07]; ACE-sleep: B = 0.57 [0.15-1.00]; ACE-emotional: B = 0.92 [0.35-1.49]), and gastrointestinal history (ACE-physical: B = 1.25 [0.41-2.10]) were multivariable predictors of worse outcomes. At 6-months, psychiatric (GOSE ≤ 6: OR = 2.57 [1.38-4.77]; ACE-physical: B = 1.38 [0.68-2.09]; ACE-cognitive: B = 0.74 [0.28-1.20]; ACE-sleep: B = 0.51 [0.20-0.83]; ACE-emotional: B = 0.93 [0.53-1.33]), and headache/migraine history (ACE-physical: B = 1.81 [0.79-2.84]) predicted worse outcomes. Conclusions: Pre-injury psychiatric and pre-injury headache/migraine symptoms are risk factors for worse functional and post-concussive outcomes at 3- and 6-months post-mTBI. mTBI patients presenting to acute care should be evaluated for psychiatric and headache/migraine history, with lower thresholds for providing TBI education/resources, surveillance, and follow-up/referrals. Clinical Trial Registration: www.ClinicalTrials.gov, identifier NCT01565551.
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Affiliation(s)
- John K. Yue
- Department of Neurosurgery, University of California, San Francisco, San Francisco, CA, United States
- Brain and Spinal Injury Center, Zuckerberg San Francisco General Hospital, San Francisco, CA, United States
| | - Maryse C. Cnossen
- Department of Public Health, Erasmus Medical Center, Rotterdam, Netherlands
| | - Ethan A. Winkler
- Department of Neurosurgery, University of California, San Francisco, San Francisco, CA, United States
- Brain and Spinal Injury Center, Zuckerberg San Francisco General Hospital, San Francisco, CA, United States
| | - Hansen Deng
- Department of Neurosurgery, University of California, San Francisco, San Francisco, CA, United States
- Brain and Spinal Injury Center, Zuckerberg San Francisco General Hospital, San Francisco, CA, United States
| | - Ryan R. L. Phelps
- Department of Neurosurgery, University of California, San Francisco, San Francisco, CA, United States
- Brain and Spinal Injury Center, Zuckerberg San Francisco General Hospital, San Francisco, CA, United States
| | - Nathan A. Coss
- Department of Neurosurgery, University of California, San Francisco, San Francisco, CA, United States
- Brain and Spinal Injury Center, Zuckerberg San Francisco General Hospital, San Francisco, CA, United States
| | - Sourabh Sharma
- Department of Neurosurgery, University of California, San Francisco, San Francisco, CA, United States
- Brain and Spinal Injury Center, Zuckerberg San Francisco General Hospital, San Francisco, CA, United States
| | - Caitlin K. Robinson
- Department of Neurosurgery, University of California, San Francisco, San Francisco, CA, United States
- Brain and Spinal Injury Center, Zuckerberg San Francisco General Hospital, San Francisco, CA, United States
| | - Catherine G. Suen
- Department of Neurosurgery, University of California, San Francisco, San Francisco, CA, United States
- Brain and Spinal Injury Center, Zuckerberg San Francisco General Hospital, San Francisco, CA, United States
- Department of Neurology, University of Utah, Salt Lake City, UT, United States
| | - Mary J. Vassar
- Department of Neurosurgery, University of California, San Francisco, San Francisco, CA, United States
- Brain and Spinal Injury Center, Zuckerberg San Francisco General Hospital, San Francisco, CA, United States
| | - David M. Schnyer
- Department of Psychology, University of Texas in Austin, Austin, TX, United States
| | - Ava M. Puccio
- Department of Neurosurgery, University of Pittsburgh Medical Center, Pittsburgh, PA, United States
| | - Raquel C. Gardner
- Department of Neurology, University of California, San Francisco, San Francisco, CA, United States
- Department of Neurology, Veterans Affairs Medical Center, San Francisco, CA, United States
| | - Esther L. Yuh
- Brain and Spinal Injury Center, Zuckerberg San Francisco General Hospital, San Francisco, CA, United States
- Department of Radiology, University of California, San Francisco, San Francisco, CA, United States
| | - Pratik Mukherjee
- Brain and Spinal Injury Center, Zuckerberg San Francisco General Hospital, San Francisco, CA, United States
- Department of Radiology, University of California, San Francisco, San Francisco, CA, United States
| | - Alex B. Valadka
- Department of Neurosurgery, Virginia Commonwealth University, Richmond, VA, United States
| | - David O. Okonkwo
- Department of Neurosurgery, University of Pittsburgh Medical Center, Pittsburgh, PA, United States
| | - Hester F. Lingsma
- Department of Public Health, Erasmus Medical Center, Rotterdam, Netherlands
| | - Geoffrey T. Manley
- Department of Neurosurgery, University of California, San Francisco, San Francisco, CA, United States
- Brain and Spinal Injury Center, Zuckerberg San Francisco General Hospital, San Francisco, CA, United States
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Gonzalez GDS, Schnyer DM. Attention and Working Memory Biases to Black and Asian Faces During Intergroup Contexts. Front Psychol 2019; 9:2743. [PMID: 30687191 PMCID: PMC6333710 DOI: 10.3389/fpsyg.2018.02743] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2018] [Accepted: 12/19/2018] [Indexed: 11/13/2022] Open
Abstract
Categorizing and individual as a racial ingroup or outgroup member results in processing and memory differences. However, despite processing differences for racial ingroups and outgroups, very little is known about processing of racial ingroup and outgroup members during intergroup contexts. Thus, the present research investigated attention and memory differences for racial ingroup and outgroup members during competition for attention (i.e., intergroup contexts). In experiment 1, event-related potentials (ERPs) were obtained while participants completed a working memory task that presented 4 faces (2 Black, 2 White) at once then, following a short delay, were probed to indicate the spatial location of one of the faces. Participants showed better location memory for Black than White faces. During encoding, ERP results revealed differences based on the race of the face in P300 amplitudes, such that there was greater motivated processing when attending to Black faces. At probe, the N170 indicated enhanced early processing of Black faces and greater LPCs were associated with better recollection of Black face location. In a follow-up study using the same task, we examined attention and working memory biases for Asian and White faces in Caucasian and Asian participants. Results for both Caucasian and Asian participants indicated better working memory for Asian relative to White faces. Together, results indicate that during intergroup contexts, racial minority faces capture attention, resulting in better memory for those faces. The study underscores that examining racial biases with single stimuli paradigms obscures important aspects of attention and memory biases during intergroup contexts.
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Affiliation(s)
- Guadalupe D S Gonzalez
- Cognitive Neuroscience Laboratory, Department of Psychology, The University of Texas at Austin, Austin, TX, United States
| | - David M Schnyer
- Cognitive Neuroscience Laboratory, Department of Psychology, The University of Texas at Austin, Austin, TX, United States
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Hsu KJ, Caffey K, Pisner D, Shumake J, Risom S, Ray KL, Smits JAJ, Schnyer DM, Beevers CG. Attentional bias modification treatment for depression: Study protocol for a randomized controlled trial. Contemp Clin Trials 2018; 75:59-66. [PMID: 30416089 PMCID: PMC6431548 DOI: 10.1016/j.cct.2018.10.014] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2018] [Revised: 10/16/2018] [Accepted: 10/25/2018] [Indexed: 11/21/2022]
Abstract
Theoretical models and empirical research point to negatively biased attention as a maintaining factor in depression. Although preliminary studies suggest experimentally modifying attentional biases (i.e., attentional bias modification; ABM) reduces depression symptoms and depression risk, relatively few rigorous studies with clinical samples have been completed. This clinical trial examines the impact of ABM on a sample of adults (N = 123) with elevated depression severity who also exhibit at least modest levels of negatively biased attention prior to treatment. Participants will be randomly assigned to either active ABM, placebo ABM, or an assessment-only control condition. Individuals assigned to ABM will complete 5 trainings per week (2 in-clinic, 3 brief trainings at-home) during a four-week period. Throughout this four-week period, participants will complete weekly assessments of symptom severity and putative treatment mediators measured across different levels of analysis (e.g., eye tracking, behavioral measures, and functional Magnetic Resonance Imaging). This article details the rationale and design of the clinical trial, including methodological issues that required more extensive consideration. Our findings may not only point to an easily-accessible, efficacious treatment for depression but may also provide a meaningful test of whether a theoretically important construct, negatively biased attention, maintains depression.
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Affiliation(s)
- Kean J Hsu
- University of Texas at Austin, USA; McLean Hospital, USA.
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29
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Yue JK, Winkler EA, Puffer RC, Deng H, Phelps RRL, Wagle S, Morrissey MR, Rivera EJ, Runyon SJ, Vassar MJ, Taylor SR, Cnossen MC, Lingsma HF, Yuh EL, Mukherjee P, Schnyer DM, Puccio AM, Valadka AB, Okonkwo DO, Manley GT, The Track-Tbi Investigators. Temporal lobe contusions on computed tomography are associated with impaired 6-month functional recovery after mild traumatic brain injury: a TRACK-TBI study. Neurol Res 2018; 40:972-981. [PMID: 30175944 DOI: 10.1080/01616412.2018.1505416] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
INTRODUCTION Mild traumatic brain injury (MTBI) can cause persistent functional deficits and healthcare burden. Understanding the association between intracranial contusions and outcome may aid in MTBI treatment and prognosis. METHODS MTBI patients with Glasgow Coma Scale 13-15 and 6-month outcomes [Glasgow Outcome Scale-Extended (GOSE)], without polytrauma from the prospective TRACK-TBI Pilot study were analyzed. Intracranial contusions on computed tomography (CT) were coded by location. Multivariable regression evaluated associations between intracranial injury type (temporal contusion [TC], frontal contusion, extraaxial [epidural/subdural/subarachnoid], other-intraaxial [intracerebral/intraventricular hemorrhage, axonal injury]) and GOSE. Odds ratios (OR) are reported. RESULTS Overall, 260 MTBI subjects were aged 44.4 ± 18.1-years; 67.7% were male. Ninety-seven subjects were CT-positive and 46 had contusions (41.3%-frontal, 30.4%-temporal, 21.7%-frontal + temporal, 2.2% each-parietal/occipital/brainstem); 95.7% had concurrent extraaxial hemorrhage. Mortality was 0% at discharge and 2.3% by 6-months. GOSE distribution was 2.3%-death, 1.5%-severe disability, 27.7%-moderate disability, 68.5%-good recovery. Forty-six percent of TC-positive subjects suffered moderate disability or worse (GOSE ≤6) and 41.7% were unable to return to baseline work capacity (RTBWC), compared to 29.1%/20.4% for CT-negative and 26.1%/20.9% for CT-positive subjects without TC. On multivariable regression, TC associated with OR = 3.33 (95% CI [1.16-9.60], p = 0.026) for GOSE ≤6, and OR = 4.48 ([1.49-13.51], p = 0.008) for inability to RTBWC. CONCLUSIONS Parenchymal contusions in MTBI are often accompanied by extraaxial hemorrhage. TCs may be associated with 6-month functional impairment. Their presence on imaging should alert the clinician to the need for heightened surveillance of sequelae complicating RTBWC, with low threshold for referral to services.
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Affiliation(s)
- John K Yue
- a Department of Neurological Surgery , University of California San Francisco , San Francisco , CA , USA.,b Brain and Spinal Injury Center , Zuckerberg San Francisco General Hospital , San Francisco , CA , USA
| | - Ethan A Winkler
- a Department of Neurological Surgery , University of California San Francisco , San Francisco , CA , USA.,b Brain and Spinal Injury Center , Zuckerberg San Francisco General Hospital , San Francisco , CA , USA
| | - Ross C Puffer
- c Department of Neurological Surgery , Mayo Clinic , Rochester , MN , USA.,d Department of Neurological Surgery , University of Pittsburgh Medical Center , Pittsburgh , PA , USA
| | - Hansen Deng
- a Department of Neurological Surgery , University of California San Francisco , San Francisco , CA , USA.,b Brain and Spinal Injury Center , Zuckerberg San Francisco General Hospital , San Francisco , CA , USA
| | - Ryan R L Phelps
- a Department of Neurological Surgery , University of California San Francisco , San Francisco , CA , USA.,b Brain and Spinal Injury Center , Zuckerberg San Francisco General Hospital , San Francisco , CA , USA
| | - Sagar Wagle
- e Department of Radiology , Mayo Clinic , Rochester , MN , USA
| | - Molly Rose Morrissey
- a Department of Neurological Surgery , University of California San Francisco , San Francisco , CA , USA.,b Brain and Spinal Injury Center , Zuckerberg San Francisco General Hospital , San Francisco , CA , USA
| | - Ernesto J Rivera
- a Department of Neurological Surgery , University of California San Francisco , San Francisco , CA , USA.,b Brain and Spinal Injury Center , Zuckerberg San Francisco General Hospital , San Francisco , CA , USA
| | - Sarah J Runyon
- a Department of Neurological Surgery , University of California San Francisco , San Francisco , CA , USA.,b Brain and Spinal Injury Center , Zuckerberg San Francisco General Hospital , San Francisco , CA , USA
| | - Mary J Vassar
- a Department of Neurological Surgery , University of California San Francisco , San Francisco , CA , USA.,b Brain and Spinal Injury Center , Zuckerberg San Francisco General Hospital , San Francisco , CA , USA
| | - Sabrina R Taylor
- a Department of Neurological Surgery , University of California San Francisco , San Francisco , CA , USA.,b Brain and Spinal Injury Center , Zuckerberg San Francisco General Hospital , San Francisco , CA , USA
| | - Maryse C Cnossen
- f Department of Public Health , Erasmus Medical Center , Rotterdam , The Netherlands
| | - Hester F Lingsma
- f Department of Public Health , Erasmus Medical Center , Rotterdam , The Netherlands
| | - Esther L Yuh
- b Brain and Spinal Injury Center , Zuckerberg San Francisco General Hospital , San Francisco , CA , USA.,g Department of Radiology , University of California San Francisco , San Francisco , CA , USA
| | - Pratik Mukherjee
- b Brain and Spinal Injury Center , Zuckerberg San Francisco General Hospital , San Francisco , CA , USA.,g Department of Radiology , University of California San Francisco , San Francisco , CA , USA
| | - David M Schnyer
- h Department of Psychology , University of Texas at Austin , Austin , TX , USA
| | - Ava M Puccio
- d Department of Neurological Surgery , University of Pittsburgh Medical Center , Pittsburgh , PA , USA
| | - Alex B Valadka
- i Department of Neurological Surgery , Virginia Commonwealth University , Richmond , VA , USA
| | - David O Okonkwo
- d Department of Neurological Surgery , University of Pittsburgh Medical Center , Pittsburgh , PA , USA
| | - Geoffrey T Manley
- a Department of Neurological Surgery , University of California San Francisco , San Francisco , CA , USA.,b Brain and Spinal Injury Center , Zuckerberg San Francisco General Hospital , San Francisco , CA , USA
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Wickwire EM, Schnyer DM, Germain A, Williams SG, Lettieri CJ, McKeon AB, Scharf SM, Stocker R, Albrecht J, Badjatia N, Markowitz AJ, Manley GT. Sleep, Sleep Disorders, and Circadian Health following Mild Traumatic Brain Injury in Adults: Review and Research Agenda. J Neurotrauma 2018; 35:2615-2631. [PMID: 29877132 DOI: 10.1089/neu.2017.5243] [Citation(s) in RCA: 50] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023] Open
Abstract
A rapidly expanding scientific literature supports the frequent co-occurrence of sleep and circadian disturbances following mild traumatic brain injury (mTBI). Although many questions remain unanswered, the preponderance of evidence suggests that sleep and circadian disorders can result from mTBI. Among those with mTBI, sleep disturbances and clinical sleep and circadian disorders contribute to the morbidity and long-term sequelae across domains of functional outcomes and quality of life. Specifically, along with deterioration of neurocognitive performance, insufficient and disturbed sleep can precede, exacerbate, or perpetuate many of the other common sequelae of mTBI, including depression, post-traumatic stress disorder, and chronic pain. Further, sleep and mTBI share neurophysiologic and neuroanatomic mechanisms that likely bear directly on success of rehabilitation following mTBI. For these reasons, focus on disturbed sleep as a modifiable treatment target has high likelihood of improving outcomes in mTBI. Here, we review relevant literature and present a research agenda to 1) advance understanding of the reciprocal relationships between sleep and circadian factors and mTBI sequelae and 2) advance rapidly the development of sleep-related treatments in this population.
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Affiliation(s)
- Emerson M Wickwire
- 1 Department of Psychiatry, University of Maryland School of Medicine , Baltimore, Maryland.,2 Sleep Disorders Center, Division of Pulmonary and Critical Care Medicine, Department of Medicine, University of Maryland School of Medicine , Baltimore, Maryland
| | - David M Schnyer
- 3 Department of Psychology, University of Texas , Austin, Texas
| | - Anne Germain
- 4 Department of Psychiatry, University of Pittsburgh School of Medicine , Pittsburgh, Pennsylvania
| | - Scott G Williams
- 5 Sleep Disorders Center, Department of Medicine, Walter Reed National Military Medical Center , Bethesda, Maryland.,6 Department of Medicine, Uniformed Services University of the Health Sciences , Bethesda, Maryland
| | - Christopher J Lettieri
- 5 Sleep Disorders Center, Department of Medicine, Walter Reed National Military Medical Center , Bethesda, Maryland.,6 Department of Medicine, Uniformed Services University of the Health Sciences , Bethesda, Maryland
| | - Ashlee B McKeon
- 4 Department of Psychiatry, University of Pittsburgh School of Medicine , Pittsburgh, Pennsylvania
| | - Steven M Scharf
- 2 Sleep Disorders Center, Division of Pulmonary and Critical Care Medicine, Department of Medicine, University of Maryland School of Medicine , Baltimore, Maryland
| | - Ryan Stocker
- 7 University of Pittsburgh Medical Center , Pittsburgh, Pennsylvania
| | - Jennifer Albrecht
- 8 Department of Epidemiology and Public Health, University of Maryland School of Medicine , Baltimore, Maryland
| | - Neeraj Badjatia
- 9 Department of Neurology, University of Maryland School of Medicine , Baltimore, Maryland
| | - Amy J Markowitz
- 10 UCSF Brain and Spinal Injury Center , San Francisco, California
| | - Geoffrey T Manley
- 11 Department of Neurosurgery, University of California , San Francisco, California
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Bonakdarpour B, Basu AS, Grasso SM, Schnyer DM, Henry ML. P1‐409: TREATMENT‐INDUCED CHANGES IN RESTING BRAIN ACTIVITY IN PRIMARY PROGRESSIVE APHASIA. Alzheimers Dement 2018. [DOI: 10.1016/j.jalz.2018.06.418] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
| | - Anisha S. Basu
- Northwestern University Feinberg School of MedicineChicagoILUSA
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Rubenstein R, Chang B, Yue JK, Chiu A, Winkler EA, Puccio AM, Diaz-Arrastia R, Yuh EL, Mukherjee P, Valadka AB, Gordon WA, Okonkwo DO, Davies P, Agarwal S, Lin F, Sarkis G, Yadikar H, Yang Z, Manley GT, Wang KKW, Cooper SR, Dams-O'Connor K, Borrasso AJ, Inoue T, Maas AIR, Menon DK, Schnyer DM, Vassar MJ. Comparing Plasma Phospho Tau, Total Tau, and Phospho Tau-Total Tau Ratio as Acute and Chronic Traumatic Brain Injury Biomarkers. JAMA Neurol 2017; 74:1063-1072. [PMID: 28738126 DOI: 10.1001/jamaneurol.2017.0655] [Citation(s) in RCA: 153] [Impact Index Per Article: 21.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Importance Annually in the United States, at least 3.5 million people seek medical attention for traumatic brain injury (TBI). The development of therapies for TBI is limited by the absence of diagnostic and prognostic biomarkers. Microtubule-associated protein tau is an axonal phosphoprotein. To date, the presence of the hypophosphorylated tau protein (P-tau) in plasma from patients with acute TBI and chronic TBI has not been investigated. Objective To examine the associations between plasma P-tau and total-tau (T-tau) levels and injury presence, severity, type of pathoanatomic lesion (neuroimaging), and patient outcomes in acute and chronic TBI. Design, Setting, and Participants In the TRACK-TBI Pilot study, plasma was collected at a single time point from 196 patients with acute TBI admitted to 3 level I trauma centers (<24 hours after injury) and 21 patients with TBI admitted to inpatient rehabilitation units (mean [SD], 176.4 [44.5] days after injury). Control samples were purchased from a commercial vendor. The TRACK-TBI Pilot study was conducted from April 1, 2010, to June 30, 2012. Data analysis for the current investigation was performed from August 1, 2015, to March 13, 2017. Main Outcomes and Measures Plasma samples were assayed for P-tau (using an antibody that specifically recognizes phosphothreonine-231) and T-tau using ultra-high sensitivity laser-based immunoassay multi-arrayed fiberoptics conjugated with rolling circle amplification. Results In the 217 patients with TBI, 161 (74.2%) were men; mean (SD) age was 42.5 (18.1) years. The P-tau and T-tau levels and P-tau-T-tau ratio in patients with acute TBI were higher than those in healthy controls. Receiver operating characteristic analysis for the 3 tau indices demonstrated accuracy with area under the curve (AUC) of 1.000, 0.916, and 1.000, respectively, for discriminating mild TBI (Glasgow Coma Scale [GCS] score, 13-15, n = 162) from healthy controls. The P-tau level and P-tau-T-tau ratio were higher in individuals with more severe TBI (GCS, ≤12 vs 13-15). The P-tau level and P-tau-T-tau ratio outperformed the T-tau level in distinguishing cranial computed tomography-positive from -negative cases (AUC = 0.921, 0.923, and 0.646, respectively). Acute P-tau levels and P-tau-T-tau ratio weakly distinguished patients with TBI who had good outcomes (Glasgow Outcome Scale-Extended GOS-E, 7-8) (AUC = 0.663 and 0.658, respectively) and identified those with poor outcomes (GOS-E, ≤4 vs >4) (AUC = 0.771 and 0.777, respectively). Plasma samples from patients with chronic TBI also showed elevated P-tau levels and a P-tau-T-tau ratio significantly higher than that of healthy controls, with both P-tau indices strongly discriminating patients with chronic TBI from healthy controls (AUC = 1.000 and 0.963, respectively). Conclusions and Relevance Plasma P-tau levels and P-tau-T-tau ratio outperformed T-tau level as diagnostic and prognostic biomarkers for acute TBI. Compared with T-tau levels alone, P-tau levels and P-tau-T-tau ratios show more robust and sustained elevations among patients with chronic TBI.
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Affiliation(s)
- Richard Rubenstein
- Laboratory of Neurodegenerative Diseases and CNS Biomarker Discovery, Departments of Neurology and Physiology/Pharmacology, State University of New York Downstate Medical Center, Brooklyn
| | - Binggong Chang
- Laboratory of Neurodegenerative Diseases and CNS Biomarker Discovery, Departments of Neurology and Physiology/Pharmacology, State University of New York Downstate Medical Center, Brooklyn
| | - John K Yue
- Brain and Spinal Injury Center, San Francisco General Hospital, San Francisco, California
| | - Allen Chiu
- Laboratory of Neurodegenerative Diseases and CNS Biomarker Discovery, Departments of Neurology and Physiology/Pharmacology, State University of New York Downstate Medical Center, Brooklyn
| | - Ethan A Winkler
- Brain and Spinal Injury Center, San Francisco General Hospital, San Francisco, California.,Department of Neurological Surgery, University of California, San Francisco
| | - Ava M Puccio
- Department of Neurosurgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania
| | | | - Esther L Yuh
- Brain and Spinal Injury Center, San Francisco General Hospital, San Francisco, California.,Department of Radiology, University of California, San Francisco
| | - Pratik Mukherjee
- Brain and Spinal Injury Center, San Francisco General Hospital, San Francisco, California.,Department of Radiology, University of California, San Francisco
| | - Alex B Valadka
- Department of Neurosurgery, Virginia Commonwealth University, Richmond
| | - Wayne A Gordon
- Department of Rehabilitation Medicine, Icahn School of Medicine at Mount Sinai, New York, New York
| | - David O Okonkwo
- Department of Neurosurgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania
| | - Peter Davies
- Litwin-Zucker Center for Research in Alzheimer's Disease, Feinstein Institute for Medical Research, Manhasset, New York
| | - Sanjeev Agarwal
- Department of Orthopedic Surgery and Rehabilitation Medicine, State University of New York Downstate Medical Center, Brooklyn
| | - Fan Lin
- Program for Neurotrauma, Neuroproteomics, and Biomarker Research, Department of Emergency Medicine, Psychiatry and Chemistry, University of Florida, Gainesville
| | - George Sarkis
- Program for Neurotrauma, Neuroproteomics, and Biomarker Research, Department of Emergency Medicine, Psychiatry and Chemistry, University of Florida, Gainesville.,Department of Chemistry, Faculty of Science, Alexandria University, Ibrahimia, Alexandria, Egypt
| | - Hamad Yadikar
- Program for Neurotrauma, Neuroproteomics, and Biomarker Research, Department of Emergency Medicine, Psychiatry and Chemistry, University of Florida, Gainesville.,Department of Biochemistry, Kuwait University, Khadiya, Kuwait
| | - Zhihui Yang
- Program for Neurotrauma, Neuroproteomics, and Biomarker Research, Department of Emergency Medicine, Psychiatry and Chemistry, University of Florida, Gainesville
| | - Geoffrey T Manley
- Brain and Spinal Injury Center, San Francisco General Hospital, San Francisco, California.,Department of Neurological Surgery, University of California, San Francisco
| | - Kevin K W Wang
- Program for Neurotrauma, Neuroproteomics, and Biomarker Research, Department of Emergency Medicine, Psychiatry and Chemistry, University of Florida, Gainesville
| | | | - Shelly R Cooper
- Department of Psychology, Washington University, St Louis, Missouri
| | - Kristen Dams-O'Connor
- Department of Rehabilitation Medicine, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Allison J Borrasso
- Department of Neurosurgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania
| | - Tomoo Inoue
- Brain and Spinal Injury Center, San Francisco General Hospital, San Francisco, California.,Department of Neurological Surgery, University of California, San Francisco
| | - Andrew I R Maas
- Department of Neurosurgery, Antwerp University Hospital, Edegem, Belgium
| | - David K Menon
- Departments of Anesthesia and Neurocritical Care, University of Cambridge, Cambridge, England
| | | | - Mary J Vassar
- Brain and Spinal Injury Center, San Francisco General Hospital, San Francisco, California.,Department of Neurological Surgery, University of California, San Francisco
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Dainer-Best J, Trujillo LT, Schnyer DM, Beevers CG. Sustained engagement of attention is associated with increased negative self-referent processing in major depressive disorder. Biol Psychol 2017; 129:231-241. [PMID: 28893596 PMCID: PMC5673529 DOI: 10.1016/j.biopsycho.2017.09.005] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2017] [Revised: 09/06/2017] [Accepted: 09/06/2017] [Indexed: 11/26/2022]
Abstract
This study investigated the link between self-reference and attentional engagement in adults with (n=22) and without (HC; n=24) Major Depressive Disorder (MDD). Event-related potentials (ERPs) were recorded while participants completed the Self-Referent Encoding Task (SRET). MDD participants endorsed significantly fewer positive words and more negative words as self-descriptive than HC participants. A whole-scalp data analysis technique revealed that the MDD participants had larger difference wave (negative words minus positive words) ERP amplitudes from 380 to 1000ms across posterior sites, which positively correlated with number of negative words endorsed. No group differences were observed for earlier attentional components (P1, P2). The results suggest that among adults with MDD, negative stimuli capture attention during later information processing; this engagement is associated with greater self-referent endorsement of negative adjectives. Sustained cognitive engagement for self-referent negative stimuli may be an important target for neurocognitive depression interventions.
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Affiliation(s)
- Justin Dainer-Best
- Department of Psychology, The University of Texas at Austin, United States.
| | | | - David M Schnyer
- Department of Psychology, The University of Texas at Austin, United States
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Abstract
Tattoo-like epidermal sensors are an emerging class of truly wearable electronics, owing to their thinness and softness. While most of them are based on thin metal films, a silicon membrane, or nanoparticle-based printable inks, we report sub-micrometer thick, multimodal electronic tattoo sensors that are made of graphene. The graphene electronic tattoo (GET) is designed as filamentary serpentines and fabricated by a cost- and time-effective "wet transfer, dry patterning" method. It has a total thickness of 463 ± 30 nm, an optical transparency of ∼85%, and a stretchability of more than 40%. The GET can be directly laminated on human skin just like a temporary tattoo and can fully conform to the microscopic morphology of the surface of skin via just van der Waals forces. The open-mesh structure of the GET makes it breathable and its stiffness negligible. A bare GET is able to stay attached to skin for several hours without fracture or delamination. With liquid bandage coverage, a GET may stay functional on the skin for up to several days. As a dry electrode, GET-skin interface impedance is on par with medically used silver/silver-chloride (Ag/AgCl) gel electrodes, while offering superior comfort, mobility, and reliability. GET has been successfully applied to measure electrocardiogram (ECG), electromyogram (EMG), electroencephalogram (EEG), skin temperature, and skin hydration.
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Affiliation(s)
| | | | | | - Li Tao
- School of Materials Science and Engineering, Southeast University , Nanjing 211189, China
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35
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Schnyer DM, Clasen PC, Gonzalez C, Beevers CG. Evaluating the diagnostic utility of applying a machine learning algorithm to diffusion tensor MRI measures in individuals with major depressive disorder. Psychiatry Res Neuroimaging 2017; 264:1-9. [PMID: 28388468 PMCID: PMC5486995 DOI: 10.1016/j.pscychresns.2017.03.003] [Citation(s) in RCA: 45] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2016] [Revised: 11/02/2016] [Accepted: 03/08/2017] [Indexed: 02/07/2023]
Abstract
Using MRI to diagnose mental disorders has been a long-term goal. Despite this, the vast majority of prior neuroimaging work has been descriptive rather than predictive. The current study applies support vector machine (SVM) learning to MRI measures of brain white matter to classify adults with Major Depressive Disorder (MDD) and healthy controls. In a precisely matched group of individuals with MDD (n =25) and healthy controls (n =25), SVM learning accurately (74%) classified patients and controls across a brain map of white matter fractional anisotropy values (FA). The study revealed three main findings: 1) SVM applied to DTI derived FA maps can accurately classify MDD vs. healthy controls; 2) prediction is strongest when only right hemisphere white matter is examined; and 3) removing FA values from a region identified by univariate contrast as significantly different between MDD and healthy controls does not change the SVM accuracy. These results indicate that SVM learning applied to neuroimaging data can classify the presence versus absence of MDD and that predictive information is distributed across brain networks rather than being highly localized. Finally, MDD group differences revealed through typical univariate contrasts do not necessarily reveal patterns that provide accurate predictive information.
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Affiliation(s)
- David M Schnyer
- Department of Psychology, University of Texas at Austin, Austin, TX, USA.
| | - Peter C Clasen
- Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle, WA, USA
| | - Christopher Gonzalez
- Department of Psychology, University of California, San Diego, San Diego, CA, USA
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36
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Palacios EM, Yuh EL, Chang YS, Yue JK, Schnyer DM, Okonkwo DO, Valadka AB, Gordon WA, Maas AIR, Vassar M, Manley GT, Mukherjee P. Resting-State Functional Connectivity Alterations Associated with Six-Month Outcomes in Mild Traumatic Brain Injury. J Neurotrauma 2017; 34:1546-1557. [PMID: 28085565 DOI: 10.1089/neu.2016.4752] [Citation(s) in RCA: 77] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Brain lesions are subtle or absent in most patients with mild traumatic brain injury (mTBI) and the standard clinical criteria are not reliable for predicting long-term outcome. This study investigates resting-state functional MRI (rsfMRI) to assess semiacute alterations in brain connectivity and its relationship with outcome measures assessed 6 months after injury. Seventy-five mTBI patients were recruited as part of the prospective multicenter Transforming Research and Clinical Knowledge in TBI (TRACK-TBI) pilot study and compared with matched 47 healthy subjects. Patients were classified following radiological criteria: CT/MRI positive, evidence of lesions; CT/MRI negative, without evidence of brain lesions. rsfMRI data were acquired and then processed using probabilistic independent component analysis. We compared the functional connectivity of the resting-state networks (RSNs) between patients and controls, as well as group differences in the interactions between RSNs, and related both to cognitive and behavioral performance at 6 months post-injury. Alterations were found in the spatial maps of the RSNs between mTBI patients and healthy controls in networks involved in behavioral and cognition processes. These alterations were predictive of mTBI patients' outcomes at 6 months post-injury. Moreover, different patterns of reduced network interactions were found between the CT/MRI positive and CT/MRI negative patients and the control group. These rsfMRI results demonstrate that even mTBI patients not showing brain lesions on conventional CT/MRI scans can have alterations of functional connectivity at the semiacute stage that help explain their outcomes. These results suggest rsfMRI as a sensitive biomarker both for early diagnosis and for prediction of the cognitive and behavioral performance of these patients.
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Affiliation(s)
- Eva M Palacios
- 1 Department of Radiology and Biomedical Imaging, University of California , San Francisco, California
| | - Esther L Yuh
- 1 Department of Radiology and Biomedical Imaging, University of California , San Francisco, California.,2 Brain and Spinal Cord Injury Center, San Francisco General Hospital and Trauma Center , San Francisco, California
| | - Yi-Shin Chang
- 1 Department of Radiology and Biomedical Imaging, University of California , San Francisco, California
| | - John K Yue
- 2 Brain and Spinal Cord Injury Center, San Francisco General Hospital and Trauma Center , San Francisco, California.,3 Department of Neurological Surgery and Brain and Spinal Injury Center, University of California , San Francisco, California
| | - David M Schnyer
- 4 Department of Psychology, University of Texas , Austin, Texas
| | - David O Okonkwo
- 5 Department of Neurological Surgery and Neurotrauma Clinical Trials Center, University of Pittsburgh Medical Center , Pittsburgh, Pennsylvania
| | - Alex B Valadka
- 6 Department of Neurosurgery, Virginia Commonwealth University , Richmond, Virginia
| | - Wayne A Gordon
- 7 Department of Rehabilitation Medicine, Ichan School of Medicine at Mount Sinai , New York, New York
| | - Andrew I R Maas
- 8 Department of Neurosurgery, Antwerp University Hospital , Edegem, Belgium
| | - Mary Vassar
- 2 Brain and Spinal Cord Injury Center, San Francisco General Hospital and Trauma Center , San Francisco, California.,3 Department of Neurological Surgery and Brain and Spinal Injury Center, University of California , San Francisco, California
| | - Geoffrey T Manley
- 2 Brain and Spinal Cord Injury Center, San Francisco General Hospital and Trauma Center , San Francisco, California.,3 Department of Neurological Surgery and Brain and Spinal Injury Center, University of California , San Francisco, California
| | - Pratik Mukherjee
- 1 Department of Radiology and Biomedical Imaging, University of California , San Francisco, California.,2 Brain and Spinal Cord Injury Center, San Francisco General Hospital and Trauma Center , San Francisco, California
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Palacios EM, Martin AJ, Boss MA, Ezekiel F, Chang YS, Yuh EL, Vassar MJ, Schnyer DM, MacDonald CL, Crawford KL, Irimia A, Toga AW, Mukherjee P. Toward Precision and Reproducibility of Diffusion Tensor Imaging: A Multicenter Diffusion Phantom and Traveling Volunteer Study. AJNR Am J Neuroradiol 2016; 38:537-545. [PMID: 28007768 DOI: 10.3174/ajnr.a5025] [Citation(s) in RCA: 75] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2016] [Accepted: 10/10/2016] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE Precision medicine is an approach to disease diagnosis, treatment, and prevention that relies on quantitative biomarkers that minimize the variability of individual patient measurements. The aim of this study was to assess the intersite variability after harmonization of a high-angular-resolution 3T diffusion tensor imaging protocol across 13 scanners at the 11 academic medical centers participating in the Transforming Research and Clinical Knowledge in Traumatic Brain Injury multisite study. MATERIALS AND METHODS Diffusion MR imaging was acquired from a novel isotropic diffusion phantom developed at the National Institute of Standards and Technology and from the brain of a traveling volunteer on thirteen 3T MR imaging scanners representing 3 major vendors (GE Healthcare, Philips Healthcare, and Siemens). Means of the DTI parameters and their coefficients of variation across scanners were calculated for each DTI metric and white matter tract. RESULTS For the National Institute of Standards and Technology diffusion phantom, the coefficients of variation of the apparent diffusion coefficient across the 13 scanners was <3.8% for a range of diffusivities from 0.4 to 1.1 × 10-6 mm2/s. For the volunteer, the coefficients of variations across scanners of the 4 primary DTI metrics, each averaged over the entire white matter skeleton, were all <5%. In individual white matter tracts, large central pathways showed good reproducibility with the coefficients of variation consistently below 5%. However, smaller tracts showed more variability, with the coefficients of variation of some DTI metrics reaching 10%. CONCLUSIONS The results suggest the feasibility of standardizing DTI across 3T scanners from different MR imaging vendors in a large-scale neuroimaging research study.
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Affiliation(s)
- E M Palacios
- From the Departments of Radiology and Biomedical Imaging (E.M.P., A.J.M., F.E., Y.S.C., E.L.Y., P.M.)
| | - A J Martin
- From the Departments of Radiology and Biomedical Imaging (E.M.P., A.J.M., F.E., Y.S.C., E.L.Y., P.M.)
| | - M A Boss
- National Institute of Standards and Technology (M.A.B.), Boulder, Colorado
| | - F Ezekiel
- From the Departments of Radiology and Biomedical Imaging (E.M.P., A.J.M., F.E., Y.S.C., E.L.Y., P.M.)
| | - Y S Chang
- From the Departments of Radiology and Biomedical Imaging (E.M.P., A.J.M., F.E., Y.S.C., E.L.Y., P.M.)
| | - E L Yuh
- From the Departments of Radiology and Biomedical Imaging (E.M.P., A.J.M., F.E., Y.S.C., E.L.Y., P.M.).,Brain and Spinal Cord Injury Center (E.L.Y., M.J.V., P.M.), San Francisco General Hospital and Trauma Center, San Francisco, California
| | - M J Vassar
- Neurological Surgery and Brain and Spinal Injury Center (M.J.V.).,Brain and Spinal Cord Injury Center (E.L.Y., M.J.V., P.M.), San Francisco General Hospital and Trauma Center, San Francisco, California
| | - D M Schnyer
- Department of Psychology (D.M.S.), University of Texas, Austin, Texas
| | - C L MacDonald
- Department of Neurological Surgery (C.L.M.), University of Washington, Seattle, Washington
| | - K L Crawford
- Mark and Mary Stevens Neuroimaging and Informatics Institute (K.L.C., A.I., A.W.T.), University of Southern California, Los Angeles, California
| | - A Irimia
- Mark and Mary Stevens Neuroimaging and Informatics Institute (K.L.C., A.I., A.W.T.), University of Southern California, Los Angeles, California
| | - A W Toga
- Mark and Mary Stevens Neuroimaging and Informatics Institute (K.L.C., A.I., A.W.T.), University of Southern California, Los Angeles, California
| | - P Mukherjee
- From the Departments of Radiology and Biomedical Imaging (E.M.P., A.J.M., F.E., Y.S.C., E.L.Y., P.M.) .,Bioengineering and Therapeutic Sciences (P.M.), University of California, San Francisco, San Francisco, California.,Brain and Spinal Cord Injury Center (E.L.Y., M.J.V., P.M.), San Francisco General Hospital and Trauma Center, San Francisco, California
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Beevers CG, Clasen PC, Enock PM, Schnyer DM. Attention bias modification for major depressive disorder: Effects on attention bias, resting state connectivity, and symptom change. J Abnorm Psychol 2016; 124:463-75. [PMID: 25894440 DOI: 10.1037/abn0000049] [Citation(s) in RCA: 115] [Impact Index Per Article: 14.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Cognitive theories of depression posit that selective attention for negative information contributes to the maintenance of depression. The current study experimentally tested this idea by randomly assigning adults with Major Depressive Disorder (MDD) to 4 weeks of computer-based attention bias modification designed to reduce negative attention bias or 4 weeks of placebo attention training. Findings indicate that compared to placebo training, attention bias modification reduced negative attention bias and increased resting-state connectivity within a neural circuit (i.e., middle frontal gyrus and dorsal anterior cingulate cortex) that supports control over emotional information. Further, pre- to post-training change in negative attention bias was significantly correlated with depression symptom change only in the active training condition. Exploratory analyses indicated that pre- to post-training changes in resting state connectivity within a circuit associated with sustained attention to visual information (i.e., precuenus and middle frontal gyrus) contributed to symptom improvement in the placebo condition. Importantly, depression symptoms did not change differentially between the training groups-overall, a 40% decrease in symptoms was observed across attention training conditions. Findings suggest that negative attention bias is associated with the maintenance of depression; however, deficits in general attentional control may also maintain depression symptoms, as evidenced by resting state connectivity and depression symptom improvement in the placebo training condition.
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39
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Wang KKW, Yang Z, Yue JK, Zhang Z, Winkler EA, Puccio AM, Diaz-Arrastia R, Lingsma HF, Yuh EL, Mukherjee P, Valadka AB, Gordon WA, Okonkwo DO, Manley GT, Cooper SR, Dams-O'Connor K, Hricik AJ, Inoue T, Maas AIR, Menon DK, Schnyer DM, Sinha TK, Vassar MJ. Plasma Anti-Glial Fibrillary Acidic Protein Autoantibody Levels during the Acute and Chronic Phases of Traumatic Brain Injury: A Transforming Research and Clinical Knowledge in Traumatic Brain Injury Pilot Study. J Neurotrauma 2016; 33:1270-7. [PMID: 26560343 DOI: 10.1089/neu.2015.3881] [Citation(s) in RCA: 53] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
We described recently a subacute serum autoantibody response toward glial fibrillary acidic protein (GFAP) and its breakdown products 5-10 days after severe traumatic brain injury (TBI). Here, we expanded our anti-GFAP autoantibody (AutoAb[GFAP]) investigation to the multicenter observational study Transforming Research and Clinical Knowledge in TBI Pilot (TRACK-TBI Pilot) to cover the full spectrum of TBI (Glasgow Coma Scale 3-15) by using acute (<24 h) plasma samples from 196 patients with acute TBI admitted to three Level I trauma centers, and a second cohort of 21 participants with chronic TBI admitted to inpatient TBI rehabilitation. We find that acute patients self-reporting previous TBI with loss of consciousness (LOC) (n = 43) had higher day 1 AutoAb[GFAP] (mean ± standard error: 9.11 ± 1.42; n = 43) than healthy controls (2.90 ± 0.92; n = 16; p = 0.032) and acute patients reporting no previous TBI (2.97 ± 0.37; n = 106; p < 0.001), but not acute patients reporting previous TBI without LOC (8.01 ± 1.80; n = 47; p = 0.906). These data suggest that while exposure to TBI may trigger the AutoAb[GFAP] response, circulating antibodies are elevated specifically in acute TBI patients with a history of TBI. AutoAb[GFAP] levels for participants with chronic TBI (average post-TBI time 176 days or 6.21 months) were also significantly higher (15.08 ± 2.82; n = 21) than healthy controls (p < 0.001). These data suggest a persistent upregulation of the autoimmune response to specific brain antigen(s) in the subacute to chronic phase after TBI, as well as after repeated TBI insults. Hence, AutoAb[GFAP] may be a sensitive assay to study the dynamic interactions between post-injury brain and patient-specific autoimmune responses across acute and chronic settings after TBI.
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Affiliation(s)
- Kevin K W Wang
- 1 Departments of Psychiatry and Neuroscience, University of Florida , Gainesville, Florida
| | - Zhihui Yang
- 1 Departments of Psychiatry and Neuroscience, University of Florida , Gainesville, Florida
| | - John K Yue
- 2 Brain and Spinal Injury Center, San Francisco General Hospital , San Francisco, California.,3 Department of Neurological Surgery, University of California , San Francisco, San Francisco, California
| | - Zhiqun Zhang
- 1 Departments of Psychiatry and Neuroscience, University of Florida , Gainesville, Florida
| | - Ethan A Winkler
- 2 Brain and Spinal Injury Center, San Francisco General Hospital , San Francisco, California.,3 Department of Neurological Surgery, University of California , San Francisco, San Francisco, California
| | - Ava M Puccio
- 4 Department of Neurological Surgery, University of Pittsburgh Medical Center , Pittsburgh, Pennsylvania
| | - Ramon Diaz-Arrastia
- 5 Department of Neurology, Uniformed Services University of the Health Sciences , and Center for Neuroscience and Regenerative Medicine, Bethesda, Maryland
| | - Hester F Lingsma
- 6 Department of Public Health, Erasmus Medical Center , Rotterdam, The Netherlands
| | - Esther L Yuh
- 2 Brain and Spinal Injury Center, San Francisco General Hospital , San Francisco, California.,7 Department of Radiology, University of California , San Francisco, San Francisco, California
| | - Pratik Mukherjee
- 2 Brain and Spinal Injury Center, San Francisco General Hospital , San Francisco, California.,7 Department of Radiology, University of California , San Francisco, San Francisco, California
| | | | - Wayne A Gordon
- 9 Department of Rehabilitation Medicine, Mount Sinai School of Medicine , New York, New York
| | - David O Okonkwo
- 4 Department of Neurological Surgery, University of Pittsburgh Medical Center , Pittsburgh, Pennsylvania
| | - Geoffrey T Manley
- 2 Brain and Spinal Injury Center, San Francisco General Hospital , San Francisco, California.,3 Department of Neurological Surgery, University of California , San Francisco, San Francisco, California
| | - Shelly R Cooper
- 2 Brain and Spinal Injury Center, San Francisco General Hospital , San Francisco, California.,3 Department of Neurological Surgery, University of California , San Francisco, San Francisco, California.,6 Department of Public Health, Erasmus Medical Center , Rotterdam, The Netherlands
| | - Kristen Dams-O'Connor
- 9 Department of Rehabilitation Medicine, Mount Sinai School of Medicine , New York, New York
| | - Allison J Hricik
- 4 Department of Neurological Surgery, University of Pittsburgh Medical Center , Pittsburgh, Pennsylvania
| | - Tomoo Inoue
- 2 Brain and Spinal Injury Center, San Francisco General Hospital , San Francisco, California.,3 Department of Neurological Surgery, University of California , San Francisco, San Francisco, California
| | - Andrew I R Maas
- 10 Department of Neurosurgery, Antwerp University Hospital , Edegem, Belgium
| | - David K Menon
- 11 Division of Anaesthesia, University of Cambridge and Addenbrooke's Hospital , Cambridge, United Kingdom
| | - David M Schnyer
- 12 Department of Psychology, University of Texas , Austin, Texas
| | - Tuhin K Sinha
- 7 Department of Radiology, University of California , San Francisco, San Francisco, California
| | - Mary J Vassar
- 2 Brain and Spinal Injury Center, San Francisco General Hospital , San Francisco, California.,3 Department of Neurological Surgery, University of California , San Francisco, San Francisco, California
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Goldwater MB, Markman AB, Trujillo LT, Schnyer DM. Licensing Novel Role-Governed Categories: An ERP Analysis. Front Hum Neurosci 2015; 9:633. [PMID: 26696859 PMCID: PMC4678187 DOI: 10.3389/fnhum.2015.00633] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2015] [Accepted: 11/05/2015] [Indexed: 11/22/2022] Open
Abstract
Markman and Stilwell (2001) argued that many natural categories name roles in relational systems, and so they are role-governed categories. This view predicts instantiating a novel relational structure licenses the creation of novel role-governed categories. This paper supports this claim and helps to specify the mechanisms underlying this licensing. Event-related potentials were recorded while participants read passages of text. Participants instantiated novel relational representations by interpreting novel verbs derived from nouns during reading. Sentences later, comprehension of novel role terms derived from the novel verb was facilitated relative to a control condition where the novel verb was paraphrased using the root noun in its familiar form. This comprehension facilitation was marked by a reduced negativity elicited from the role term in the Novel Verb condition relative to the Paraphrase from 400 to 500 ms post-stimulus-onset. This relative difference in negativity is consistent with both the N400, which is a marker of semantic integration, and the Nref effect, which reflects the working memory load required to resolve reference. Additionally, because this increased negativity persisted until 670 ms post-stimulus-onset, and not that the Paraphrase condition elicited an increased positivity (i.e., the P600), we ruled out that the licensing effect is rooted in morphosyntactic processes.
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Affiliation(s)
| | | | - Logan T Trujillo
- University of Texas at Austin Austin, TX, USA ; Texas State University San Marcos, TX, USA
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Korley FK, Diaz-Arrastia R, Wu AHB, Yue JK, Manley GT, Sair HI, Van Eyk J, Everett AD, Okonkwo DO, Valadka AB, Gordon WA, Maas AIR, Mukherjee P, Yuh EL, Lingsma HF, Puccio AM, Schnyer DM. Circulating Brain-Derived Neurotrophic Factor Has Diagnostic and Prognostic Value in Traumatic Brain Injury. J Neurotrauma 2015; 33:215-25. [PMID: 26159676 DOI: 10.1089/neu.2015.3949] [Citation(s) in RCA: 99] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Brain-derived neurotrophic factor (BDNF) is important for neuronal survival and regeneration. We investigated the diagnostic and prognostic values of serum BDNF in traumatic brain injury (TBI). We examined serum BDNF in two independent cohorts of TBI cases presenting to the emergency departments (EDs) of the Johns Hopkins Hospital (JHH; n = 76) and San Francisco General Hospital (SFGH, n = 80), and a control group of JHH ED patients without TBI (n = 150). Findings were subsequently validated in the prospective, multi-center Transforming Research and Clinical Knowledge in TBI (TRACK-TBI) Pilot study (n = 159). We investigated the association between BDNF, glial fibrillary acidic protein (GFAP), and ubiquitin C-terminal hydrolase-L1 (UCH-L1) and recovery from TBI at 6 months in the TRACK-TBI Pilot cohort. Incomplete recovery was defined as having either post-concussive syndrome or a Glasgow Outcome Scale Extended score <8 at 6 months. Median day-of-injury BDNF concentrations (ng/mL) were lower among TBI cases (JHH TBI, 17.5 and SFGH TBI, 13.8) than in JHH controls (60.3; p = 0.0001). Among TRACK-TBI Pilot subjects, median BDNF concentrations (ng/mL) were higher in mild (8.3) than in moderate (4.3) or severe TBI (4.0; p = 0.004. In the TRACK-TBI cohort, the 75 (71.4%) subjects with very low BDNF values (i.e., <the 1st percentile for non-TBI controls, <14.2 ng/mL) had higher odds of incomplete recovery than those who did not have very low values (odds ratio, 4.0; 95% confidence interval [CI]: 1.5-11.0). The area under the receiver operator curve for discriminating complete and incomplete recovery was 0.65 (95% CI: 0.52-0.78) for BDNF, 0.61 (95% CI: 0.49-0.73) for GFAP, and 0.55 (95% CI: 0.43-0.66) for UCH-L1. The addition of GFAP/UCH-L1 to BDNF did not improve outcome prediction significantly. Day-of-injury serum BDNF is associated with TBI diagnosis and also provides 6-month prognostic information regarding recovery from TBI. Thus, day-of-injury BDNF values may aid in TBI risk stratification.
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Affiliation(s)
- Frederick K Korley
- 1 Department of Emergency Medicine, Johns Hopkins University School of Medicine , Baltimore, Maryland
| | - Ramon Diaz-Arrastia
- 2 Center for Neuroscience and Regenerative Medicine, Uniformed Services University of the Health Sciences , Bethesda, Maryland
| | - Alan H B Wu
- 3 Clinical Chemistry Laboratory, San Francisco General Hospital , San Francisco, California
| | - John K Yue
- 4 Department of Neurological Surgery, University of California San Francisco , San Francisco, California
| | - Geoffrey T Manley
- 4 Department of Neurological Surgery, University of California San Francisco , San Francisco, California
| | - Haris I Sair
- 5 Department of Radiology, Johns Hopkins University School of Medicine , Baltimore, Maryland
| | - Jennifer Van Eyk
- 6 Department of Medicine, the Advanced Clinical Biosystems Research Institute , Cedars Sinai Medical Center, Los Angeles, California
| | - Allen D Everett
- 7 Department of Pediatrics, Johns Hopkins University School of Medicine , Baltimore, Maryland
| | | | - David O Okonkwo
- 8 The Transforming Research and Clinical Knowledge in TBI (TRACK-TBI) Investigators .,9 Department of Neurological Surgery, University of Pittsburgh Medical Center , Pittsburgh, Pennsylvania
| | - Alex B Valadka
- 8 The Transforming Research and Clinical Knowledge in TBI (TRACK-TBI) Investigators .,10 Seton Brain and Spine Institute , Austin, Texas
| | - Wayne A Gordon
- 8 The Transforming Research and Clinical Knowledge in TBI (TRACK-TBI) Investigators .,11 Department of Rehabilitation Medicine, Mount Sinai School of Medicine , New York, New York
| | - Andrew I R Maas
- 8 The Transforming Research and Clinical Knowledge in TBI (TRACK-TBI) Investigators .,12 Department of Neurosurgery, Antwerp University Hospital , Edegem, Belgium
| | - Pratik Mukherjee
- 8 The Transforming Research and Clinical Knowledge in TBI (TRACK-TBI) Investigators .,13 Department of Radiology and Biomedical Imaging University of California San Francisco , San Francisco, California
| | - Esther L Yuh
- 8 The Transforming Research and Clinical Knowledge in TBI (TRACK-TBI) Investigators .,13 Department of Radiology and Biomedical Imaging University of California San Francisco , San Francisco, California
| | - Hester F Lingsma
- 8 The Transforming Research and Clinical Knowledge in TBI (TRACK-TBI) Investigators .,14 Department of Public Health Center for Medical Decision Making Erasmas Medical Center , Rotterdam, the Netherlands
| | - Ava M Puccio
- 8 The Transforming Research and Clinical Knowledge in TBI (TRACK-TBI) Investigators .,9 Department of Neurological Surgery, University of Pittsburgh Medical Center , Pittsburgh, Pennsylvania
| | - David M Schnyer
- 8 The Transforming Research and Clinical Knowledge in TBI (TRACK-TBI) Investigators .,15 Department of Psychology, University of Texas , Austin, Texas
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Abstract
Older adults experience parallel changes in sleep, circadian rhythms, and episodic memory. These processes appear to be linked such that disruptions in sleep contribute to deficits in memory. Although more variability in circadian patterns is a common feature of aging and predicts pathology, little is known about how alterations in circadian activity rhythms within older adults influence new episodic learning. Following 10 days of recording sleep-wake patterns using actigraphy, healthy older adults underwent fMRI while performing an associative memory task. The results revealed better associative memory was related to more consistent circadian activity rhythms, independent of total sleep time, sleep efficiency, and level of physical activity. Moreover, hippocampal activity during successful memory retrieval events was positively correlated with associative memory accuracy and circadian activity rhythm (CAR) consistency. We demonstrated that the link between consistent rhythms and associative memory performance was mediated by hippocampal activity. These findings provide novel insight into how the circadian rhythm of sleep-wake cycles are associated with memory in older adults and encourage further examination of circadian activity rhythms as a biomarker of cognitive functioning.
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Affiliation(s)
- Stephanie M Sherman
- Department of Psychology, The University of Texas at Austin, 108 E. Dean Keeton A8000, Austin, TX 78712, USA.
| | - Jeanette A Mumford
- Center for Investigating Healthy Minds at the Waisman Center, University of Wisconsin-Madison, 1500 Highland Avenue, Suite S119, Madison, WI 53705, USA
| | - David M Schnyer
- Department of Psychology, The University of Texas at Austin, 108 E. Dean Keeton A8000, Austin, TX 78712, USA; The Institute for Neuroscience, The University of Texas at Austin, 1 University Station, C7000, Austin, TX 78712, USA
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Sherman SM, Cheng YP, Fingerman KL, Schnyer DM. Social support, stress and the aging brain. Soc Cogn Affect Neurosci 2015; 11:1050-8. [PMID: 26060327 DOI: 10.1093/scan/nsv071] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2014] [Accepted: 06/04/2015] [Indexed: 11/13/2022] Open
Abstract
Social support benefits health and well-being in older individuals, however the mechanism remains poorly understood. One proposal, the stress-buffering hypothesis states social support 'buffers' the effects of stress on health. Alternatively, the main effect hypothesis suggests social support independently promotes health. We examined the combined association of social support and stress on the aging brain. Forty healthy older adults completed stress questionnaires, a social network interview and structural MRI to investigate the amygdala-medial prefrontal cortex circuitry, which is implicated in social and emotional processing and negatively affected by stress. Social support was positively correlated with right medial prefrontal cortical thickness while amygdala volume was negatively associated with social support and positively related to stress. We examined whether the association between social support and amygdala volume varied across stress level. Stress and social support uniquely contribute to amygdala volume, which is consistent with the health benefits of social support being independent of stress.
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Schnyer DM, Beevers CG, deBettencourt MT, Sherman SM, Cohen JD, Norman KA, Turk-Browne NB. Neurocognitive therapeutics: from concept to application in the treatment of negative attention bias. Biol Mood Anxiety Disord 2015; 5:1. [PMID: 25905002 PMCID: PMC4405858 DOI: 10.1186/s13587-015-0016-y] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/17/2015] [Accepted: 04/07/2015] [Indexed: 01/27/2023]
Abstract
There is growing interest in the use of neuroimaging for the direct treatment of mental illness. Here, we present a new framework for such treatment, neurocognitive therapeutics. What distinguishes neurocognitive therapeutics from prior approaches is the use of precise brain-decoding techniques within a real-time feedback system, in order to adapt treatment online and tailor feedback to individuals’ needs. We report an initial feasibility study that uses this framework to alter negative attention bias in a small number of patients experiencing significant mood symptoms. The results are consistent with the promise of neurocognitive therapeutics to improve mood symptoms and alter brain networks mediating attentional control. Future work should focus on optimizing the approach, validating its effectiveness, and expanding the scope of targeted disorders.
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Affiliation(s)
- David M Schnyer
- Department of Psychology & Institute for Mental Health Research, University of Texas at Austin, Austin, TX 78712 USA
| | - Christopher G Beevers
- Department of Psychology & Institute for Mental Health Research, University of Texas at Austin, Austin, TX 78712 USA
| | - Megan T deBettencourt
- Princeton Neuroscience Institute, Princeton University, Princeton, NJ 08540-1010 USA
| | - Stephanie M Sherman
- Department of Psychology, University of Texas at Austin, Austin, TX 78712 USA
| | - Jonathan D Cohen
- Department of Psychology and Princeton Neuroscience Institute, Princeton University, Princeton, NJ 08540-1010 USA
| | - Kenneth A Norman
- Department of Psychology and Princeton Neuroscience Institute, Princeton University, Princeton, NJ 08540-1010 USA
| | - Nicholas B Turk-Browne
- Department of Psychology and Princeton Neuroscience Institute, Princeton University, Princeton, NJ 08540-1010 USA
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45
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Yuh EL, Cooper SR, Mukherjee P, Yue JK, Lingsma HF, Gordon WA, Valadka AB, Okonkwo DO, Schnyer DM, Vassar MJ, Maas AIR, Manley GT. Diffusion tensor imaging for outcome prediction in mild traumatic brain injury: a TRACK-TBI study. J Neurotrauma 2014; 31:1457-77. [PMID: 24742275 DOI: 10.1089/neu.2013.3171] [Citation(s) in RCA: 167] [Impact Index Per Article: 16.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
We evaluated 3T diffusion tensor imaging (DTI) for white matter injury in 76 adult mild traumatic brain injury (mTBI) patients at the semiacute stage (11.2±3.3 days), employing both whole-brain voxel-wise and region-of-interest (ROI) approaches. The subgroup of 32 patients with any traumatic intracranial lesion on either day-of-injury computed tomography (CT) or semiacute magnetic resonance imaging (MRI) demonstrated reduced fractional anisotropy (FA) in numerous white matter tracts, compared to 50 control subjects. In contrast, 44 CT/MRI-negative mTBI patients demonstrated no significant difference in any DTI parameter, compared to controls. To determine the clinical relevance of DTI, we evaluated correlations between 3- and 6-month outcome and imaging, demographic/socioeconomic, and clinical predictors. Statistically significant univariable predictors of 3-month Glasgow Outcome Scale-Extended (GOS-E) included MRI evidence for contusion (odds ratio [OR] 4.9 per unit decrease in GOS-E; p=0.01), ≥1 ROI with severely reduced FA (OR, 3.9; p=0.005), neuropsychiatric history (OR, 3.3; p=0.02), age (OR, 1.07/year; p=0.002), and years of education (OR, 0.79/year; p=0.01). Significant predictors of 6-month GOS-E included ≥1 ROI with severely reduced FA (OR, 2.7; p=0.048), neuropsychiatric history (OR, 3.7; p=0.01), and years of education (OR, 0.82/year; p=0.03). For the subset of 37 patients lacking neuropsychiatric and substance abuse history, MRI surpassed all other predictors for both 3- and 6-month outcome prediction. This is the first study to compare DTI in individual mTBI patients to conventional imaging, clinical, and demographic/socioeconomic characteristics for outcome prediction. DTI demonstrated utility in an inclusive group of patients with heterogeneous backgrounds, as well as in a subset of patients without neuropsychiatric or substance abuse history.
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Affiliation(s)
- Esther L Yuh
- 1 Brain and Spinal Injury Center, University of California , San Francisco, California
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Witkowski S, Trujillo LT, Sherman SM, Carter P, Matthews MD, Schnyer DM. An examination of the association between chronic sleep restriction and electrocortical arousal in college students. Clin Neurophysiol 2014; 126:549-57. [PMID: 25043966 DOI: 10.1016/j.clinph.2014.06.026] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2014] [Revised: 05/29/2014] [Accepted: 06/16/2014] [Indexed: 11/18/2022]
Abstract
OBJECTIVE The deleterious neurocognitive effects of laboratory-controlled short-term sleep deprivation are well-known. The present study investigated neurocognitive changes arising from chronic sleep restriction outside the laboratory. METHODS Sleep patterns of 24 undergraduates were tracked via actigraphy across a 15-week semester. At the semester beginning, at a midpoint, and a week before finals, students performed the Psychomotor Vigilance Test (PVT) and cortical arousal was measured via event-related potentials (ERP) and resting state electroencephalography (EEG). RESULTS Average daily sleep decreased between Session 1 and Sessions 2 and 3. Calculated circadian rhythm measures indicated nighttime movement increased and sleep quality decreased from Sessions 1 and 2 to Session 3. Parallel to the sleep/activity measures, PVT reaction time increased between Session 1 and Sessions 2 and 3 and resting state alpha EEG reactivity magnitude and PVT-evoked P3 ERP amplitude decreased between Session 1 and Sessions 2 and 3. Cross-sectional regressions showed PVT reaction time was negatively associated with average daily sleep, alpha reactivity, and P3 changes; sleep/circadian measures were associated with alpha reactivity and/or P3 changes. CONCLUSIONS Small, but persistent sleep deficits reduced cortical arousal and impaired vigilant attention. SIGNIFICANCE Chronic sleep restriction impacts neurocognition in a manner similar to laboratory controlled sleep deprivation.
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Affiliation(s)
- Sarah Witkowski
- Department of Psychology, The University of Texas at Austin, Austin, TX, USA.
| | - Logan T Trujillo
- Department of Psychology, The University of Texas at Austin, Austin, TX, USA
| | - Stephanie M Sherman
- Department of Psychology, The University of Texas at Austin, Austin, TX, USA
| | - Patricia Carter
- School of Nursing, University of Texas at Austin, United States
| | - Michael D Matthews
- Department of Behavioral Sciences & Leadership, United States Military Academy, United States
| | - David M Schnyer
- Department of Psychology, The University of Texas at Austin, Austin, TX, USA
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Clasen PC, Beevers CG, Mumford JA, Schnyer DM. Cognitive control network connectivity in adolescent women with and without a parental history of depression. Dev Cogn Neurosci 2013; 7:13-22. [PMID: 24270043 PMCID: PMC4209722 DOI: 10.1016/j.dcn.2013.10.008] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2013] [Revised: 10/18/2013] [Accepted: 10/30/2013] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND Adolescent women with a parental history of depression are at high risk for the onset of major depressive disorder (MDD). Cognitive theories suggest this vulnerability involves deficits in cognitive control over emotional information. Among adolescent women with and without a parental history of depression, we examined differences in connectivity using resting state functional connectivity analysis within a network associated with cognitive control over emotional information. METHODS Twenty-four depression-naïve adolescent women underwent resting state functional magnetic resonance imaging (fMRI). They were assigned to high-risk (n=11) and low-risk (n=13) groups based their parents' depression history. Seed based functional connectivity analysis was used to examine group differences in connectivity within a network associated with cognitive control. RESULTS High-risk adolescents had lower levels of connectivity between a right inferior prefrontal region and other critical nodes of the attention control network, including right middle frontal gyrus and right supramarginal gyrus. Further, greater severity of the parents' worst episode of depression was associated with altered cognitive control network connectivity in their adolescent daughters. CONCLUSIONS Depressed parents may transmit depression vulnerability to their adolescent daughters via alterations in functional connectivity within neural circuits that underlie cognitive control of emotional information.
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Affiliation(s)
- Peter C Clasen
- Department of Psychology, The University of Texas at Austin, United States; Institute for Mental Health Research, The University of Texas at Austin, United States; Imaging Research Center, The University of Texas at Austin, United States.
| | - Christopher G Beevers
- Department of Psychology, The University of Texas at Austin, United States; Institute for Mental Health Research, The University of Texas at Austin, United States; Imaging Research Center, The University of Texas at Austin, United States
| | - Jeanette A Mumford
- Department of Psychology, The University of Texas at Austin, United States; Imaging Research Center, The University of Texas at Austin, United States
| | - David M Schnyer
- Department of Psychology, The University of Texas at Austin, United States; Institute for Mental Health Research, The University of Texas at Austin, United States; Imaging Research Center, The University of Texas at Austin, United States
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48
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Vanderlind WM, Beevers CG, Sherman SM, Trujillo LT, McGeary JE, Matthews MD, Maddox WT, Schnyer DM. Sleep and sadness: exploring the relation among sleep, cognitive control, and depressive symptoms in young adults. Sleep Med 2013; 15:144-9. [PMID: 24332565 DOI: 10.1016/j.sleep.2013.10.006] [Citation(s) in RCA: 55] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2013] [Revised: 10/08/2013] [Accepted: 10/09/2013] [Indexed: 11/24/2022]
Abstract
BACKGROUND Sleep disturbance is a common feature of depression. However, recent work has found that individuals who are vulnerable to depression report poorer sleep quality compared to their low-risk counterparts, suggesting that sleep disturbance may precede depression. In addition, both sleep disturbance and depression are related to deficits in cognitive control processes. Thus we examined if poor sleep quality predicts subsequent increases in depressive symptoms and if levels of cognitive control mediated this relation. METHODS Thirty-five undergraduate students participated in two experimental sessions separated by 3 weeks. Participants wore an actigraph watch between sessions, which provided an objective measure of sleep patterns. We assessed self-reported sleep quality and depressive symptoms at both sessions. Last, individuals completed an exogenous cuing task, which measured ability to disengage attention from neutral and negative stimuli during the second session. RESULTS Using path analyses, we found that both greater self-reported sleep difficulty and more objective sleep stability measures significantly predicted greater difficulty disengaging attention (i.e., less cognitive control) from negative stimuli. Less cognitive control over negative stimuli in turn predicted increased depression symptoms at the second session. Exploratory associations among the circadian locomotor output cycles kaput gene, CLOCK, single nucleotide polymorphism (SNP), rs11932595, as well as sleep assessments and depressive symptoms also are presented. CONCLUSIONS These preliminary results suggest that sleep disruptions may contribute to increases in depressive symptoms via their impact on cognitive control. Further, variation in the CLOCK gene may be associated with sleep quality.
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Affiliation(s)
| | - Christopher G Beevers
- Department of Psychology, The University of Texas at Austin, United States; Institute for Mental Health Research, The University of Texas at Austin, United States
| | | | - Logan T Trujillo
- Department of Psychology, The University of Texas at Austin, United States
| | - John E McGeary
- Providence Veterans Affairs Medical Center and Division of Behavioral Genetics, Rhode Island Hospital, Brown University, United States
| | - Michael D Matthews
- Department of Behavioral Sciences & Leadership, United States Military Academy at West Point, United States
| | - W Todd Maddox
- Department of Psychology, The University of Texas at Austin, United States; Institute for Neuroscience, The University of Texas at Austin, United States; Institute for Mental Health Research, The University of Texas at Austin, United States
| | - David M Schnyer
- Department of Psychology, The University of Texas at Austin, United States; Institute for Neuroscience, The University of Texas at Austin, United States; Institute for Mental Health Research, The University of Texas at Austin, United States
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Dams-O'Connor K, Spielman L, Singh A, Gordon WA, Lingsma HF, Maas AIR, Manley GT, Mukherjee P, Okonkwo DO, Puccio AM, Schnyer DM, Valadka AB, Yue JK, Yuh EL. The impact of previous traumatic brain injury on health and functioning: a TRACK-TBI study. J Neurotrauma 2013; 30:2014-20. [PMID: 23924069 DOI: 10.1089/neu.2013.3049] [Citation(s) in RCA: 94] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
The idea that multiple traumatic brain injury (TBI) can have a cumulative detrimental effect on functioning is widely accepted. Most research supporting this idea comes from athlete samples, and it is not known whether remote history of previous TBI affects functioning after subsequent TBI in community-based samples. This study investigates whether a previous history of TBI with loss of consciousness (LOC) is associated with worse health and functioning in a sample of individuals who require emergency department care for current TBI. Twenty-three percent of the 586 individuals with current TBI in the Transforming Research and Clinical Knowledge in Traumatic Brain Injury study reported having sustained a previous TBI with LOC. Individuals with previous TBI were more likely to be unemployed (χ(2)=17.86; p=0.000), report a variety of chronic medical and psychiatric conditions (4.75≤χ(2)≥24.16; p<0.05), and report substance use (16.35≤χ(2)≥27.57; p<0.01) before the acute injury, compared to those with no previous TBI history. Those with a previous TBI had less-severe acute injuries, but experienced worse outcomes at 6-month follow-up. Results of a series of regression analyses controlling for demographics and acute injury severity indicated that individuals with previous TBI reported more mood symptoms, more postconcussive symptoms, lower life satisfaction, and had slower processing speed and poorer verbal learning, compared to those with no previous TBI history. These findings suggest that history of TBI with LOC may have important implications for health and psychological functioning after TBI in community-based samples.
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Affiliation(s)
- Kristen Dams-O'Connor
- 1 Department of Rehabilitation Medicine, Icahn School of Medicine at Mount Sinai , New York, New York
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Yue JK, Vassar MJ, Lingsma HF, Cooper SR, Okonkwo DO, Valadka AB, Gordon WA, Maas AIR, Mukherjee P, Yuh EL, Puccio AM, Schnyer DM, Manley GT. Transforming research and clinical knowledge in traumatic brain injury pilot: multicenter implementation of the common data elements for traumatic brain injury. J Neurotrauma 2013; 30:1831-44. [PMID: 23815563 DOI: 10.1089/neu.2013.2970] [Citation(s) in RCA: 227] [Impact Index Per Article: 20.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Traumatic brain injury (TBI) is among the leading causes of death and disability worldwide, with enormous negative social and economic impacts. The heterogeneity of TBI combined with the lack of precise outcome measures have been central to the discouraging results from clinical trials. Current approaches to the characterization of disease severity and outcome have not changed in more than three decades. This prospective multicenter observational pilot study aimed to validate the feasibility of implementing the TBI Common Data Elements (TBI-CDEs). A total of 650 subjects who underwent computed tomography (CT) scans in the emergency department within 24 h of injury were enrolled at three level I trauma centers and one rehabilitation center. The TBI-CDE components collected included: 1) demographic, social and clinical data; 2) biospecimens from blood drawn for genetic and proteomic biomarker analyses; 3) neuroimaging studies at 2 weeks using 3T magnetic resonance imaging (MRI); and 4) outcome assessments at 3 and 6 months. We describe how the infrastructure was established for building data repositories for clinical data, plasma biomarkers, genetics, neuroimaging, and multidimensional outcome measures to create a high quality and accessible information commons for TBI research. Risk factors for poor follow-up, TBI-CDE limitations, and implementation strategies are described. Having demonstrated the feasibility of implementing the TBI-CDEs through successful recruitment and multidimensional data collection, we aim to expand to additional study sites. Furthermore, interested researchers will be provided early access to the Transforming Research and Clinical Knowledge in TBI (TRACK-TBI) data set for collaborative opportunities to more precisely characterize TBI and improve the design of future clinical treatment trials. (ClinicalTrials.gov Identifier NCT01565551.).
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Affiliation(s)
- John K Yue
- 1 Brain and Spinal Injury Center, San Francisco General Hospital , San Francisco, California
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