A pilot add-on Randomized-Controlled Trial evaluating the effect of binaural beats on study performance, mind-wandering, and core symptoms of adult ADHD patients

Introduction

ADHD is a neurodevelopmental disorder that frequently persists throughout adulthood. Binaural Beats (BB) are auditory perceptions occurring when two soundwaves of slightly different frequency are carried separately to the ears; they might modulate brain activity and performance.

Objectives

To evaluate BB efficacy on studing performance, mind-wandering, and core symptoms of a sample of adult ADHD outpatients

Methods

In this randomized-controlled trial we recruited a sample of University students in pharmacological treatment for adult ADHD. A track with 15 Hz BB (415 Hz to right and 400 Hz to the left ear) was delivered to the intervention group; whereas, a placebo track consisting of two identical frequencies (400 Hz) was administered to control group. The RCT consisted of a baseline assessment (T0) and two fortnightly follow-ups (T1-T2). Each time, the patient filled the ADHD-RS-5 (ADHD Rating Scale-5) and the MEWS (Mind Excessively Wandering Scale) and executed an online version of SART (Sustained Attention to Response Task). The effect of self-administered acoustic stimulation during individual studying sessions was estimated by a subjective studying performance (SSP) evaluation questionnaire.

Results

A significant improvement of SSP from baseline assessment (T1) to the last observation (T3) was detected in BB group only (mean differences= 2.7, p<.001). A significant between-group contrast for SSP was also found at T3. No other significant changes were detected for ADHD-RS, MEWS and SART at p<.05 level.

Conclusions

BB seem to improve subjective studying performance and ADHD symptoms severity. These preliminary findings must be confirmed in larger sample.

Disclosure

No significant relationships.

Streptococcal infections, autoimmunity, and innate immune system in adult ADHD: A preliminary study

Introduction

High rate of streptococcus-like infections and related titers has been found in adult ADHD patients. No studies have expressively investigated innate immune system in ADHD patients.

Objectives

To evaluate the relationship between streptococcal infections, autoimmunity and innate immune system in adult ADHD patients.

Methods

The study sample consisted of adult DSM-5 ADHD outpatients referring to the adult ADHD center of “San Luigi Gonzaga” University Hospital and non-clinical adult controls recruited among general population (screened using Adult ADHD Self-Report Scale - ASRS-v.1). All titers were determined in patients’ plasma by specific microwell ELISA kits, whereas genetic polymorphisms were determined by PCR methodology. We compared anti-streptolysin O (ASO), anti-deoxyribonuclease B (anti-DNase B), and anti-basal ganglia antibodies (ABGA) titers of patients with those of controls. Data about history of previous streptococcus/ streptococcus-like infections were collected by ad-hoc form. Furthermore, to investigate the susceptibility to Gram+-borne infections of adult ADHD patients, due to innate immune system impairment, we also evaluated the polymorphism of Toll-like receptors 2, 4, and 9.

Results

Although ADHD patients did not show higher rate of both previous infections (52.7% vs. 66.7%, p=.678) and ASO titers (18.2% vs. 0.0%, p=.577), they had really higher levels of anti-DNase B (85.5% vs. 16.7%, p=.001) and ABGA titers (78.2% vs. 33.3%, p=.036). Genetic analysis did not underline differences in polymorphism compared to general population (GENOME browser).

Conclusions

The high association between previous streptococcal infections, basal ganglia autoimmunity among ADHD patients was confirmed. TLR polymorphism does not seem to be involved in this type of vulnerability.

Disclosure

No significant relationships.

Personality traits and disorders among adult adhd patients: Do they vary between males and females?

Introduction

Patients with Attention Deficit/Hyperactivity Disorder (ADHD) have shown an increased risk of developing a DSM Cluster B (i.e., Borderline, OR=13.16; Antisocial, OR=3.03; Narcissistic, OR=8.69) and DSM Avoidant Personality Disorder (PD; OR=9.77; Miller et al., 2008). Although different comorbidities affect males and females with ADHD (Kooij et al., 2013), gender differences in personality traits and disorders have not yet been investigated.

Objectives

To describe gender differences in personality traits and disorders among a sample of adult outpatients with ADHD.

Methods

A consecutive sample of DSM-5 ADHD outpatients was recruited at the Adult ADHD Center of the “San Luigi” University Hospital (Orbassano (TO), Italy) between Jan 2017 and Jan 2018. Patients’ personality was assessed by Millon Clinical Multiaxial Inventory (MCMI-III; Zennaro et al, 2008).

Results

The study sample consisted of 82 males and 31 females. Sixty percent of men vs. 77% of women had a personality disorder (

Conclusions

Women with ADHD showed a higher frequency of personality disorders and higher rate of Masochistic PD than men. Moreover, the two most important clusters detected in women included severe personality components (i.e., Borderline and Paranoid) when compared with men. Further studies on larger samples should be conducted to confirm more severe personality profiles in women than in men.

Disclosure

No significant relationships.

Compositional thresholds and anomalies in connection with stiffness transitions in network glasses

The structural and dynamical properties of amorphous and liquid As(x)Se(1-x) (0.2<x<0.4) are studied by first principles molecular dynamics. Within the above range of compositions, thresholds and anomalies are found in the behavior of reciprocal space properties that can be correlated to the experimental location of the so-called Boolchand intermediate phase in these glassy networks. These findings are associated with diffusion anomalies for the parent liquid phase, thereby linking structural and dynamical atomic-scale fingerprints for the onset of rigidity within the network, while also providing a much more complex picture than the one derived from mean-field approaches of stiffness transitions.

Ab initio simulations of photoinduced interconversions of oxygen deficient centers in amorphous silica

We have studied by ab initio molecular dynamics the interconversion between oxygen deficient centers (Si-Si bond, dicoordinated silicon =Si:, and E' centers) induced by UV irradiation in a-SiO2. By dynamical simulations in the excited state of a periodic model of a-SiO2 we have identified the reaction path and activation barrier for the Si-Si-->=Si: interconversion. A new competitive transformation of the excited, neutral Si-Si bond into two E' centers has been identified. Our results provide strong theoretical support to the viability of these processes, proposed experimentally on the basis of optical data only.

Hydrogen bonding and dipole moment of water at supercritical conditions: a first-principles molecular dynamics study

We present a first-principles molecular dynamics study of water near and above the critical point ( T = 647 K, rho = 0.32 g/cm(3)). We find that the systems undergo fast dynamics with continuous formation and breaking of H bonds. At low density, the system fragments mostly into trimers, dimers, and single molecules. At a higher density, more complex structures appear and an extended, albeit very dynamical, H-bond network can be identified. These structures have important consequences for the screening properties of the system. This offers a clue to understanding the peculiar chemical behavior of a supercritical system and allows thermodynamical tuning of its solvent properties.

Ab initio simulation of phase transitions and dissociation of H2S at high pressure

By ab initio constant pressure molecular dynamics, we have identified the structure of phase V and phase VI of H2S at 35 and 65 GPa, respectively. The theoretical IR spectra of both phases are consistent with experimental findings and support our proposed structural models. We find that phase V is characterized by the presence of charged SH+3 and SH- species which are created and destroyed dynamically, whereas phase VI is no longer a molecular phase but consists of sheets of S with the majority of H intercalated between the layers. The stability of the two phases with respect to dissociation into elemental crystalline hydrogen and sulfur is discussed.

Family treatment of symptomatic children with Helicobacter pylori infection

BACKGROUND

Familial clustering of Helicobacter pylori infection has been reported. We tested the hypothesis that simultaneously treating all Helicobacter pylori positive family contacts of infected symptomatic children results in lower treatment failure.

METHODS

Relatives of 47 children (index) with Helicobacter pylori gastritis had endoscopy to assess prevalence of infection in first degree cohabiting relatives. Controls included 60 children with dyspepsia and Helicobacter pylori gastritis whose infected family contacts were not treated. Index children, siblings younger than 18 years of age and control children received a 2-week course of amoxicillin and tinidazole. Parents of index children and their siblings over 18 years of age received a 2-week course of Colloidal Bismuth Subcytrate and tinidazole. The eradication rate in index children and their relatives was compared to controls whose infected family contacts were not treated.

RESULTS

Helicobacter pylori was found in 67% of 31 siblings younger than 18, in 82% of 22 siblings older than 18 years, and in 87% of 92 parents. Endoscopy, repeated four to six weeks after the end of treatment, showed Helicobacter pylori eradication in 94% of children and siblings younger than 18, and in 70% of parents and siblings over 18 years in the family treatment group, compared with 75% of control children (p < .01).

CONCLUSIONS

The high prevalence of the infection in family members suggests that person-to-person spread of Helicobacter pylori takes place. Furthermore our results show that if (or when) required, simultaneous treatment given to the whole family results in lower treatment failure, since it may promote compliance to treatment.

Pre-treatment levels of anti-HCV core IgM antibodies are closely associated with response to alpha interferon therapy in chronic hepatitis C patients

OBJECTIVES

To investigate the relationship between pre-treatment levels of anti-hepatitis C virus (HCV) immunoglobulin M (IgM) antibodies and the outcome of interferon therapy, and also the relationship with genotypes and quantitative viraemia.

PATIENTS

One hundred and four patients with biopsy-proven chronic hepatitis C without cirrhosis, consecutively enrolled in three general hospitals in Turin, Italy, and treated according to the same interferon schedule (3 MU of recombinant alpha-2b interferon three times a week for 6 months). Anti-HCV IgM were measured by a second-generation enzyme-linked immunoassay and results expressed as sample-cutoff ratio. In 30 patients, determination of viraemia by branched DNA (bDNA) and genotyping were performed and the correlation with anti-HCV IgM ratios was assessed.

RESULTS

According to univariate analysis, anti-HCV IgM ratios, age, serum gamma-glutamyltranspeptidase (gamma-GT) and ferritin levels were significantly associated with sustained response to therapy. A log-linear model, testing the effect of these variables on response to therapy, showed that anti-HCV IgM ratio was the only independently associated variable (P=0.00057). Anti-HCV IgM were associated with viraemia levels (r=0.57), but not with genotype distribution. Patients with anti-HCV IgM ratio less than 1 were sustained responders to the 'standard therapy' in 65% of cases. By contrast, among patients with a ratio greater than 3, sustained response was achieved in only one patient (3%), while 73% were non-responders; the majority of relapsers were found among patients with a ratio between 1 and 3.

CONCLUSION

Anti-HCV IgM antibodies provide an easily accessible and cheap serological marker of active viral replication, and are significantly related to the outcome of interferon therapy in patients with chronic hepatitis C.

Quantitative assessment of histological changes in chronic gastritis after eradication of Helicobacter pylori

AIMS

To evaluate the effect of 10 day triple treatment on H pylori eradication and associated gastritis.

METHODS

Fifty patients with H pylori positive non-ulcer dyspepsia were treated for 10 days with amoxicillin, tinidazole, and bismuth salts. Histological examination of the antral mucosa was performed before (T0), six weeks (T1), and six months (T2) after treatment. The new Sydney classification of gastritis was used, using a score from 0 to 3 to grade degree of inflammation, atrophy, activity (intraepithelial or lamina propria damage) and H pylori.

RESULTS

At T0 all patients had chronic active gastritis. Lymphoid follicules were present in 12 cases. At T1 33 patients were H pylori negative: the score showed a decrease of activity (from 2.5 to 0.54). The result was confirmed at T2 (mean score 0.22). Inflammation decreased from 1.8 to 1.4 at T2. Only one case of follicular gastritis was observed. In H pylori positive patients the scores did not show significant modifications.

CONCLUSIONS

Ten day triple treatment is effective in eradicating H pylori in 69% of cases, causing a decrease of the total score for gastritis. Activity, defined by polymorph infiltration, was promptly reduced when H pylori was eradicated. There was a trend to a reduction in inflammation, but atrophy was irreversible.

Helicobacter pylori in children with peptic ulcer and their families

Little is known about the source and spread of Helicobacter pylori, but transmission from infected family contacts has been suggested. We have therefore investigated 15 children with peptic ulcer and their first-degree relatives for H. pylori. Serum anti-H. pylori IgG, pepsinogen I, and gastrin levels were measured. Endoscopy was carried out on the children and relatives, and biopsies were taken from the gastric antrum for histology, microbiology, and urease testing. Six of 11 children with duodenal ulcer (55%) and two of four children with gastric ulcer (50%) were positive for H. pylori. Fourteen of 16 parents (87%) and eight of 13 siblings (61%) of H. pylori-positive children with peptic ulcer were also infected compared with eight of 14 parents (57%) and none of four siblings of H. pylori-negative children with peptic ulcer (P less than 0.10, greater than 0.05, and NS, respectively). The children with H. pylori-negative peptic ulcer and negative siblings combined were younger than positive children with peptic ulcer and positive siblings (P less than 0.001). The reliability of serum anti-H. pylori IgG level as a screening test for infection was confirmed. These findings call into question a pathogenetic role for H. pylori in some childhood peptic ulceration, but do suggest that person-to-person spread of infection occurs.

Monthly fluctuations of active duodenal ulcers

In an attempt to verify whether the periodicity of ulcer-related symptoms would be confirmed by a spring and fall exacerbation of peptic ulcers, we have analyzed the monthly variation of active duodenal ulcers found at endoscopy of the upper gastrointestinal tract in the years 1979-1981. Control diagnoses were active gastric ulcers, gastric and rectal adenocarcinomas, and rheumatoid arthritis. Data were also available on hospital admission for perforated ulcers. The calendar fluctuation of active duodenal ulcer is characterized by a significant fall in August which is associated with July and fall peaks. This pattern of variation for duodenal ulcer was evident in both sexes and across the different decades of age. Duodenal ulcer diagnosis and hospitalization for perforated ulcer fluctuated in a similar way. The shape of monthly variation for active duodenal ulcer was not paralleled by similar changes in gastric ulcers and in the control diagnoses, gastric and rectal carcinomas, and rheumatoid arthritis.

Candida overgrowth in gastric juice of peptic ulcer subjects on short- and long-term treatment with H2-receptor antagonists

Candida overgrowth in gastric juice of peptic ulcer subjects under therapy with H2-receptor (H2-R) antagonists has been detected in 21.4 and 53.8% of cases after short- and long-term treatment respectively, and in 8% of controls. Both types of H2-R antagonists, ranitidine and cimetidine, were equally associated with production of yeasts. The location of ulcers, whether gastric or duodenal, seems to have no influence on fungal growth. Females were more susceptible than males to develop Candida in gastric juice. In the short-term course with H2-R blockers fungal colonization of gastric juice was associated with delay of the rate of ulcer healing. Fungal detection in gastric juice was not associated with mucosal invasion by Candida since in none of the patients who had a biopsy for gastric ulcer was Candida detected by histology.