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Timmermann C, Roseman L, Schartner M, Milliere R, Williams LTJ, Erritzoe D, Muthukumaraswamy S, Ashton M, Bendrioua A, Kaur O, Turton S, Nour MM, Day CM, Leech R, Nutt DJ, Carhart-Harris RL. Neural correlates of the DMT experience assessed with multivariate EEG. Sci Rep 2019; 9:16324. [PMID: 31745107 PMCID: PMC6864083 DOI: 10.1038/s41598-019-51974-4] [Citation(s) in RCA: 112] [Impact Index Per Article: 22.4] [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: 05/13/2019] [Accepted: 10/04/2019] [Indexed: 12/22/2022] Open
Abstract
Studying transitions in and out of the altered state of consciousness caused by intravenous (IV) N,N-Dimethyltryptamine (DMT - a fast-acting tryptamine psychedelic) offers a safe and powerful means of advancing knowledge on the neurobiology of conscious states. Here we sought to investigate the effects of IV DMT on the power spectrum and signal diversity of human brain activity (6 female, 7 male) recorded via multivariate EEG, and plot relationships between subjective experience, brain activity and drug plasma concentrations across time. Compared with placebo, DMT markedly reduced oscillatory power in the alpha and beta bands and robustly increased spontaneous signal diversity. Time-referenced and neurophenomenological analyses revealed close relationships between changes in various aspects of subjective experience and changes in brain activity. Importantly, the emergence of oscillatory activity within the delta and theta frequency bands was found to correlate with the peak of the experience - particularly its eyes-closed visual component. These findings highlight marked changes in oscillatory activity and signal diversity with DMT that parallel broad and specific components of the subjective experience, thus advancing our understanding of the neurobiological underpinnings of immersive states of consciousness.
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Affiliation(s)
- Christopher Timmermann
- Centre for Psychedelic Research, Department of Brain Sciences, Faculty of Medicine, Imperial College, London, UK.
- Computational, Cognitive and Clinical Neuroscience Laboratory (C3NL), Faculty of Medicine, Imperial College, London, UK.
| | - Leor Roseman
- Centre for Psychedelic Research, Department of Brain Sciences, Faculty of Medicine, Imperial College, London, UK
| | - Michael Schartner
- Department of Basic Neurosciences, University of Geneva, Geneva, Switzerland
| | - Raphael Milliere
- Faculty of Philosophy, University of Oxford, Oxford, United Kingdom
| | - Luke T J Williams
- Centre for Psychedelic Research, Department of Brain Sciences, Faculty of Medicine, Imperial College, London, UK
| | - David Erritzoe
- Centre for Psychedelic Research, Department of Brain Sciences, Faculty of Medicine, Imperial College, London, UK
| | | | - Michael Ashton
- PKDM Unit, Department of Pharmacology, University of Gothenburg, Gothenburg, Sweden
| | - Adam Bendrioua
- PKDM Unit, Department of Pharmacology, University of Gothenburg, Gothenburg, Sweden
| | - Okdeep Kaur
- Imperial Clinical Research Facility, Imperial College London, London, UK
| | - Samuel Turton
- Centre for Psychiatry, Division of Brain Sciences, Department of Medicine, Imperial College, London, UK
| | - Matthew M Nour
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Camilla M Day
- Centre for Psychedelic Research, Department of Brain Sciences, Faculty of Medicine, Imperial College, London, UK
| | - Robert Leech
- Department of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - David J Nutt
- Centre for Psychedelic Research, Department of Brain Sciences, Faculty of Medicine, Imperial College, London, UK
- Centre for Psychiatry, Division of Brain Sciences, Department of Medicine, Imperial College, London, UK
| | - Robin L Carhart-Harris
- Centre for Psychedelic Research, Department of Brain Sciences, Faculty of Medicine, Imperial College, London, UK
- Department of Psychiatry, University of Oxford, Oxford, UK
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Chan W, Chin SH, Whittaker AC, Jones D, Kaur O, Bosch JA, Borrows R. The Associations of Muscle Strength, Muscle Mass, and Adiposity With Clinical Outcomes and Quality of Life in Prevalent Kidney Transplant Recipients. J Ren Nutr 2019; 29:536-547. [DOI: 10.1053/j.jrn.2019.06.009] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2019] [Revised: 06/02/2019] [Accepted: 06/08/2019] [Indexed: 12/20/2022] Open
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Chan W, Bosch JA, Phillips AC, Chin SH, Antonysunil A, Inston N, Moore S, Kaur O, McTernan PG, Borrows R. The Associations of Endotoxemia With Systemic Inflammation, Endothelial Activation, and Cardiovascular Outcome in Kidney Transplantation. J Ren Nutr 2017; 28:13-27. [PMID: 29089280 DOI: 10.1053/j.jrn.2017.06.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2016] [Revised: 05/09/2017] [Accepted: 06/14/2017] [Indexed: 02/07/2023] Open
Abstract
OBJECTIVE Cardiovascular disease is the leading cause of death in kidney transplant recipients (KTRs), yet incompletely accountable by traditional risk factors. Inflammation is an unconventional cardiovascular risk factor, with gut-derived endotoxemia potentially driving inflammation and endothelial disease. Comparable data are lacking in kidney transplantation. This study investigated the associations of endotoxemia with inflammation, endothelial activation, and 5-year cardiovascular events in KTRs. Determinants of endotoxemia were also explored. DESIGN AND METHODS This is a single-center cross-sectional study with prospective follow-up from a prevalent cohort of 128 KTRs. MAIN OUTCOME MEASURES Demographic, nutritional and clinical predictors of inflammation (high-sensitivity C-reactive protein [hsCRP]), endothelial activation (sE-selectin), and endotoxemia (endotoxin) were assessed. Follow-up data on 5-year cardiovascular event rates were collected. RESULTS Endotoxemia (P = .03), reduced 25-hydroxyvitamin D (P = .04), high fructose intake (P < .001), decreased fiber intake (P < .001), and abdominal obesity (P = .002) were independently associated with elevated hsCRP. In turn, endotoxemia (P = .007) and increasing hsCRP (P = .02) were both independently associated with raised sE-selectin. Furthermore, endotoxemia predicted increased cardiovascular event rate (P = .02), independent of hsCRP and a global measure of cardiovascular risk estimated by a validated algorithm of 7-year risk for major adverse cardiac events in kidney transplantation. Determinants of endotoxemia included reduced 25-hydroxyvitamin D (P < .001), hypertriglyceridemia (P < .001), increased fructose intake (P = .01), and abdominal obesity (P = .01). CONCLUSIONS Endotoxemia in KTRs contributes to inflammation, endothelial activation, and increased cardiovascular events. This study highlights the clinical relevance of endotoxemia in KTRs, suggesting future interventional targets.
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Affiliation(s)
- Winnie Chan
- Department of Nephrology & Kidney Transplantation, Queen Elizabeth Hospital Birmingham, Edgbaston, Birmingham, UK; School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Edgbaston, Birmingham, UK; Department of Nutrition & Dietetics, Queen Elizabeth Hospital Birmingham, Edgbaston, Birmingham, UK
| | - Jos A Bosch
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Edgbaston, Birmingham, UK; Department of Clinical Psychology, University of Amsterdam, Amsterdam, The Netherlands
| | - Anna C Phillips
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Edgbaston, Birmingham, UK
| | - Shui Hao Chin
- Department of Cardiovascular Sciences, Clinical Sciences Wing, University of Leicester, Glenfield Hospital, Leicester, UK
| | - Adaikala Antonysunil
- Division of Biomedical Sciences, Clinical Sciences Research Laboratories, Warwick Medical School, University of Warwick, Coventry, UK
| | - Nicholas Inston
- Department of Nephrology & Kidney Transplantation, Queen Elizabeth Hospital Birmingham, Edgbaston, Birmingham, UK
| | - Sue Moore
- Department of Nephrology & Kidney Transplantation, Queen Elizabeth Hospital Birmingham, Edgbaston, Birmingham, UK
| | - Okdeep Kaur
- Imperial Centre for Translational and Experimental Medicine, Imperial College London, Hammersmith Hospital, London, UK
| | - Philip G McTernan
- Division of Biomedical Sciences, Clinical Sciences Research Laboratories, Warwick Medical School, University of Warwick, Coventry, UK.
| | - Richard Borrows
- Department of Nephrology & Kidney Transplantation, Queen Elizabeth Hospital Birmingham, Edgbaston, Birmingham, UK; Centre for Translational Inflammation Research, University of Birmingham, Edgbaston, Birmingham, UK.
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Chan W, Bosch J, Kaur O, Phillips A, Borrows R. MO066ESTABLISHING THE RELATIONSHIP OF MUSCLE STRENGTH AND MUSCLE MASS WITH 5-YEAR CLINICAL OUTCOMES IN KIDNEY TRANSPLANTATION. Nephrol Dial Transplant 2016. [DOI: 10.1093/ndt/gfw142.03] [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: 11/14/2022] Open
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Chan W, Jones D, Bosch JA, McPhee J, Crabtree N, McTernan PG, Kaur O, Inston N, Moore S, McClean A, Harper L, Phillips AC, Borrows R. Cardiovascular, muscular and perceptual contributions to physical fatigue in prevalent kidney transplant recipients. Transpl Int 2016; 29:338-51. [DOI: 10.1111/tri.12727] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2015] [Revised: 08/18/2015] [Accepted: 11/24/2015] [Indexed: 11/30/2022]
Affiliation(s)
- Winnie Chan
- Department of Nephrology & Kidney Transplantation; Queen Elizabeth Hospital Birmingham; Birmingham UK
- School of Sport, Exercise and Rehabilitation Sciences; University of Birmingham; Birmingham UK
- Department of Nutrition & Dietetics; Queen Elizabeth Hospital Birmingham; Birmingham UK
| | - David Jones
- School of Healthcare Science; Manchester Metropolitan University; Manchester UK
| | - Jos A. Bosch
- School of Sport, Exercise and Rehabilitation Sciences; University of Birmingham; Birmingham UK
- Department of Clinical Psychology; University of Amsterdam; Amsterdam The Netherlands
| | - Jamie McPhee
- School of Healthcare Science; Manchester Metropolitan University; Manchester UK
| | - Nicola Crabtree
- Department of Nuclear Medicine; Queen Elizabeth Hospital Birmingham; Birmingham UK
| | - Philip G. McTernan
- Division of Metabolic and Vascular Health; Clinical Sciences Research Institute; Warwick Medical School; University of Warwick; Coventry UK
| | - Okdeep Kaur
- Department of Nephrology & Kidney Transplantation; Queen Elizabeth Hospital Birmingham; Birmingham UK
| | - Nicholas Inston
- Department of Nephrology & Kidney Transplantation; Queen Elizabeth Hospital Birmingham; Birmingham UK
| | - Sue Moore
- Department of Nephrology & Kidney Transplantation; Queen Elizabeth Hospital Birmingham; Birmingham UK
| | - Andrew McClean
- Department of Nephrology & Kidney Transplantation; Queen Elizabeth Hospital Birmingham; Birmingham UK
| | - Lorraine Harper
- Department of Nephrology & Kidney Transplantation; Queen Elizabeth Hospital Birmingham; Birmingham UK
| | - Anna C. Phillips
- School of Sport, Exercise and Rehabilitation Sciences; University of Birmingham; Birmingham UK
| | - Richard Borrows
- Department of Nephrology & Kidney Transplantation; Queen Elizabeth Hospital Birmingham; Birmingham UK
- Translational Inflammation Research; University of Birmingham; Birmingham UK
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Chan W, Bosch J, Jones D, Kaur O, McTernan P, Phillips A, Borrows R. SP405DIETARY FRUCTOSE: A NEW PARADIGM IN PREDICTING METABOLIC PROFILE IN KIDNEY TRANSPLANT RECIPIENTS. Nephrol Dial Transplant 2015. [DOI: 10.1093/ndt/gfv193.13] [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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Chan W, Phillips A, Bosch J, Jones D, Kaur O, McTernan P, Borrows R. SP413ENDOTOXEMIA: A NOVEL RISK FACTOR IN SYSTEMIC INFLAMMATION AND ENDOTHELIAL DYSFUNCTION IN KIDNEY TRANSPLANT RECIPIENTS. Nephrol Dial Transplant 2015. [DOI: 10.1093/ndt/gfv193.21] [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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Chan W, Ward D, Tselepis C, Bosch J, Jones D, Kaur O, McTernan P, Phillips A, Borrows R. FP393IS LOW VITAMIN D LEVEL AN INFLAMMATORY MEDIATOR OF ANAEMIA IN KIDNEY TRANSPLANTATION? Nephrol Dial Transplant 2015. [DOI: 10.1093/ndt/gfv176.17] [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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Sharma P, Dietrich T, Sidhu A, Vithlani V, Rahman M, Stringer S, Jesky M, Kaur O, Ferro C, Cockwell P, Chapple ILC. The periodontal health component of the Renal Impairment In Secondary Care (RIISC) cohort study: a description of the rationale, methodology and initial baseline results. J Clin Periodontol 2014; 41:653-61. [PMID: 24738870 DOI: 10.1111/jcpe.12263] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/13/2014] [Indexed: 12/27/2022]
Abstract
INTRODUCTION Chronic kidney disease (CKD) is associated with significant morbidity and mortality. There is a need to identify novel and modifiable risk factors in such patients. The periodontal component of the Renal Impairment In Secondary Care (RIISC) study aims to evaluate the association between chronic periodontitis and CKD progression. METHODS The RIISC study is a prospective, observational cohort study of patients with CKD from a renal clinic at a hospital in the West Midlands region of the UK. Patients undergo a periodontal examination and plaque and saliva sampling. To benchmark the oral health status of the RIISC cohort, we compared it to the Adult Dental Health Survey 2009 (ADHS), a representative survey of the oral health of community dwelling adults in the UK. RESULTS Of the first 500 patients recruited into the RIISC study, 469 patients underwent a dental examination and 80 (17%) were edentulous. Among dentate subjects, patients within RIISC were significantly more likely to have any (OR 4.0 95% CI 2.7-5.9) or severe (OR 3.8 95% CI 2.5-5.6) periodontitis compared to the ADHS sample. CONCLUSION The prevalence and severity of chronic periodontitis in this cohort of CKD patients is markedly higher than a geographically matched control population.
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Affiliation(s)
- Praveen Sharma
- Periodontal Research Group, School of Dentistry, University of Birmingham, Birmingham, UK
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Khanna U, Dhali TK, D'Souza P, Kaur O. Sporotrichoid distribution of a malignant peripheral nerve sheath tumour. J Eur Acad Dermatol Venereol 2014; 29:823-5. [PMID: 24593852 DOI: 10.1111/jdv.12428] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- U Khanna
- Department of Dermatology, Venereology and Leprology, ESIPGIMSR Basaidarpur, New Delhi, India
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Stringer S, Sharma P, Dutton M, Jesky M, Ng K, Kaur O, Chapple I, Dietrich T, Ferro C, Cockwell P. The natural history of, and risk factors for, progressive chronic kidney disease (CKD): the Renal Impairment in Secondary care (RIISC) study; rationale and protocol. BMC Nephrol 2013; 14:95. [PMID: 23617441 PMCID: PMC3664075 DOI: 10.1186/1471-2369-14-95] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.9] [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: 12/16/2012] [Accepted: 02/11/2013] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Chronic kidney disease (CKD) affects up to 16% of the adult population and is associated with significant morbidity and mortality. People at highest risk from progressive CKD are defined by a sustained decline in estimated glomerular filtration rate (eGFR) and/or the presence of significant albuminuria/proteinuria and/or more advanced CKD. Accurate mapping of the bio-clinical determinants of this group will enable improved risk stratification and direct the development of better targeted management for people with CKD. METHODS/DESIGN The Renal Impairment In Secondary Care study is a prospective, observational cohort study, patients with CKD 4 and 5 or CKD 3 and either accelerated progression and/or proteinuria who are managed in secondary care are eligible to participate. Participants undergo a detailed bio-clinical assessment that includes measures of vascular health, periodontal health, quality of life and socio-economic status, clinical assessment and collection of samples for biomarker analysis. The assessments take place at baseline, and at six, 18, 36, 60 and 120 months; the outcomes of interest include cardiovascular events, progression to end stage kidney disease and death. DISCUSSION The determinants of progression of chronic kidney disease are not fully understood though there are a number of proposed risk factors for progression (both traditional and novel). This study will provide a detailed bio-clinical phenotype of patients with high-risk chronic kidney disease (high risk of both progression and cardiovascular events) and will repeatedly assess them over a prolonged follow up period. Recruitment commenced in Autumn 2010 and will provide many outputs that will add to the evidence base for progressive chronic kidney disease.
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Affiliation(s)
- Stephanie Stringer
- Department of Nephrology, University Hospital Birmingham, Birmingham B15 2WB, UK
- School of Immunity and Infection, University of Birmingham, Birmingham B15 2TT, UK
| | - Praveen Sharma
- School of Immunity and Infection, University of Birmingham, Birmingham B15 2TT, UK
- Periodontal Research Group, School of Dentistry, University of Birmingham, Birmingham B4 6NN, UK
| | - Mary Dutton
- Department of Nephrology, University Hospital Birmingham, Birmingham B15 2WB, UK
| | - Mark Jesky
- Department of Nephrology, University Hospital Birmingham, Birmingham B15 2WB, UK
- School of Immunity and Infection, University of Birmingham, Birmingham B15 2TT, UK
| | - Khai Ng
- Department of Nephrology, University Hospital Birmingham, Birmingham B15 2WB, UK
- School of Immunity and Infection, University of Birmingham, Birmingham B15 2TT, UK
| | - Okdeep Kaur
- Department of Nephrology, University Hospital Birmingham, Birmingham B15 2WB, UK
| | - Iain Chapple
- School of Immunity and Infection, University of Birmingham, Birmingham B15 2TT, UK
- Periodontal Research Group, School of Dentistry, University of Birmingham, Birmingham B4 6NN, UK
- MRC Centre for Immune Regulation, Birmingham, UK
| | - Thomas Dietrich
- School of Immunity and Infection, University of Birmingham, Birmingham B15 2TT, UK
- Periodontal Research Group, School of Dentistry, University of Birmingham, Birmingham B4 6NN, UK
| | - Charles Ferro
- Department of Nephrology, University Hospital Birmingham, Birmingham B15 2WB, UK
- School of Immunity and Infection, University of Birmingham, Birmingham B15 2TT, UK
| | - Paul Cockwell
- Department of Nephrology, University Hospital Birmingham, Birmingham B15 2WB, UK
- School of Immunity and Infection, University of Birmingham, Birmingham B15 2TT, UK
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