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Tazza F, Schiavi S, Leveraro E, Cellerino M, Boffa G, Ballerini S, Dighero M, Uccelli A, Sbragia E, Aluan K, Inglese M, Lapucci C. Clinical and radiological correlates of apathy in multiple sclerosis. Mult Scler 2024; 30:247-256. [PMID: 38095151 DOI: 10.1177/13524585231217918] [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] [Indexed: 12/21/2023]
Abstract
BACKGROUND Although apathy has been associated with fronto-striatal dysfunction in several neurological disorders, its clinical and magnetic resonance imaging (MRI) correlates have been poorly investigated in people with multiple sclerosis (PwMS). OBJECTIVES To evaluate clinical variables and investigate microstructural integrity of fronto-striatal grey matter (GM) and white matter (WM) structures using diffusion tensor imaging (DTI). METHODS A total of 123 PwMS (age: 40.25 ± 11.5; female: 60.9%; relapsing-remitting multiple sclerosis: 75.6%) were prospectively enrolled and underwent neurological and neuropsychological evaluation, including Expanded Disability Status Scale (EDSS), Apathy Evaluation Scale (AES-S), Hospital Anxiety and Depression Scale (HADS), Modified Fatigue Impact Scale (MFIS) and brain 3T-MRI volumes of whole brain, frontal/prefrontal cortex (PFC) and subcortical regions were calculated. DTI-derived metrics were evaluated in the same GM regions and in connecting WM tracts. RESULTS Apathetic PwMS (32.5%) showed lower education levels, higher HADS, MFIS scores and WM lesions volume than nonapathetic PwMS. Significant differences in DTI metrics were found in middle frontal, anterior cingulate and superior frontal PFC subregions and in caudate nuclei. Significant alterations were found in the right cingulum and left striatal-frontorbital tracts. CONCLUSIONS Apathy in PwMS is associated with higher levels of physical disability, depression, anxiety and fatigue together with lower educational backgrounds. Microstructural damage within frontal cortex, caudate and fronto-striatal WM bundles is a significant pathological substrate of apathy in multiple sclerosis (MS).
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Affiliation(s)
- Francesco Tazza
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), University of Genoa, Genoa, Italy
- IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Simona Schiavi
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), University of Genoa, Genoa, Italy
- IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Elisa Leveraro
- Department of Neurology, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Maria Cellerino
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), University of Genoa, Genoa, Italy
- IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Giacomo Boffa
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), University of Genoa, Genoa, Italy
- IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Stefania Ballerini
- Department of Neuroradiology, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Mara Dighero
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), University of Genoa, Genoa, Italy
- IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Antonio Uccelli
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), University of Genoa, Genoa, Italy
- IRCCS Ospedale Policlinico San Martino, Genoa, Italy
- Department of Neurology, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Elvira Sbragia
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), University of Genoa, Genoa, Italy
- IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Kenda Aluan
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), University of Genoa, Genoa, Italy
- IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Matilde Inglese
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), University of Genoa, Genoa, Italy
- IRCCS Ospedale Policlinico San Martino, Genoa, Italy
- Department of Neurology, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Caterina Lapucci
- Department of Neurology, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
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Stein C, O'Keeffe F, Strahan O, McGuigan C, Bramham J. Systematic review of cognitive reserve in multiple sclerosis: Accounting for physical disability, fatigue, depression, and anxiety. Mult Scler Relat Disord 2023; 79:105017. [PMID: 37806233 DOI: 10.1016/j.msard.2023.105017] [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: 06/21/2023] [Revised: 08/03/2023] [Accepted: 09/17/2023] [Indexed: 10/10/2023]
Abstract
BACKGROUND Cognitive reserve (CR) describes an individual's ability to adapt cognitive processes in response to brain atrophy, and has been reported to explain some of the discrepancy between brain atrophy and cognitive functioning outcomes in multiple sclerosis (MS). CR in MS is typically investigated by assessing an individual's pre- and/or post-diagnosis enrichment, which includes premorbid intellectual abilities, educational level, occupational attainment, and engagement in cognitively enriching leisure activities. Common MS symptoms (e.g., physical disability, fatigue, depression, anxiety) may impact an individual's ability to engage in various CR-enhancing activities post-diagnosis. It is unknown to what extent these MS symptoms have been taken into account in MS research on CR. As such, we identified whether studies assessed CR using measures of premorbid or continuous (including post-diagnosis) enrichment. For studies investigating continuous enrichment, we identified whether studies accounted for MS-impact, which MS symptoms were accounted for, and how, and whether studies acknowledged MS symptoms as potential CR-confounds. METHODS Three electronic databases (PsycINFO, PubMed, Scopus) were searched. Eligible studies investigated CR proxies (e.g., estimated premorbid intellectual abilities, vocabulary knowledge, educational level, occupational attainment, cognitively enriching leisure activities, or a combination thereof) in relation to cognitive, brain atrophy or connectivity, or daily functioning outcomes in adult participants with MS. We extracted data on methods and measures used, including any MS symptoms taken into account. Objectives were addressed using frequency analyses and narrative synthesis. RESULTS 115 studies were included in this review. 47.8% of all studies investigated continuous enrichment. Approximately half of the studies investigating continuous enrichment accounted for potential MS-impact in their analyses, with only 31.0% clearly identifying that they treated MS symptoms as potential confounds for CR-enhancement. A narrative synthesis of studies which investigated CR with and without controlling statistically for MS-impact indicated that accounting for MS symptoms may impact findings concerning the protective nature of CR. CONCLUSION Fewer than half of the studies investigating CR proxies in MS involved continuous enrichment. Just over half of these studies accounted for potential MS-impact in their analyses. To achieve a more complete and accurate understanding of CR in MS, future research should investigate both pre-MS and continuous enrichment. In doing so, MS symptoms and their potential impact should be considered. Establishing greater consistency and rigour across CR research in MS will be crucial to produce an evidence base for the development of interventions aimed at improving quality of care and life for pwMS.
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Affiliation(s)
- Clara Stein
- University College Dublin, Belfield, Dublin 4, Ireland.
| | - Fiadhnait O'Keeffe
- University College Dublin, Belfield, Dublin 4, Ireland; St. Vincent's University Hospital, Elm Park, Dublin 4, Ireland
| | - Orla Strahan
- University College Dublin, Belfield, Dublin 4, Ireland
| | - Christopher McGuigan
- University College Dublin, Belfield, Dublin 4, Ireland; St. Vincent's University Hospital, Elm Park, Dublin 4, Ireland
| | - Jessica Bramham
- University College Dublin, Belfield, Dublin 4, Ireland; St. Vincent's University Hospital, Elm Park, Dublin 4, Ireland
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Schaechter JD, Kim M, Hightower BG, Ragas T, Loggia ML. Disruptions in Structural and Functional Connectivity Relate to Poststroke Fatigue. Brain Connect 2023; 13:15-27. [PMID: 35570655 PMCID: PMC9942175 DOI: 10.1089/brain.2022.0021] [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] [Indexed: 11/12/2022] Open
Abstract
Introduction: Poststroke fatigue (PSF) is a disabling condition with unclear etiology. The brain lesion is thought to be an important causal factor in PSF, although focal lesion characteristics such as size and location have not proven to be predictive. Given that the stroke lesion results not only in focal tissue death but also in widespread changes in brain networks that are structurally and functionally connected to damaged tissue, we hypothesized that PSF relates to disruptions in structural and functional connectivity. Materials and Methods: Twelve patients who incurred an ischemic stroke in the middle cerebral artery (MCA) territory 1-3 years prior, and currently experiencing a range of fatigue severity, were enrolled. The patients underwent structural and resting-state functional magnetic resonance imaging (MRI). The structural MRI data were used to measure structural disconnection of gray matter resulting from lesion to white matter pathways. The functional MRI data were used to measure network functional connectivity. Results: The patients showed structural disconnection in varying cortical and subcortical regions. Fatigue severity correlated significantly with structural disconnection of several frontal cortex regions in the ipsilesional (IL) and contralesional hemispheres. Fatigue-related structural disconnection was most severe in the IL rostral middle frontal cortex. Greater structural disconnection of a subset of fatigue-related frontal cortex regions, including the IL rostral middle frontal cortex, trended toward correlating significantly with greater loss in functional connectivity. Among identified fatigue-related frontal cortex regions, only the IL rostral middle frontal cortex showed loss in functional connectivity correlating significantly with fatigue severity. Conclusion: Our results provide evidence that loss in structural and functional connectivity of bihemispheric frontal cortex regions plays a role in PSF after MCA stroke, with connectivity disruptions of the IL rostral middle frontal cortex having a central role. Impact statement Poststroke fatigue (PSF) is a common disabling condition with unclear etiology. We hypothesized that PSF relates to disruptions in structural and functional connectivity secondary to the focal lesion. Using structural and resting-state functional connectivity magnetic resonance imaging (MRI) in patients with chronic middle cerebral artery (MCA) stroke, we found frontal cortex regions in the ipsilesional (IL) and contralesional hemispheres with greater structural disconnection correlating with greater fatigue. Among these fatigue-related cortices, the IL rostral middle frontal cortex showed loss in functional connectivity correlating with fatigue. These findings suggest that disruptions in structural and functional connectivity play a role in PSF after MCA stroke.
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Affiliation(s)
- Judith D. Schaechter
- Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Charlestown, Massachusetts, USA
| | - Minhae Kim
- Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Charlestown, Massachusetts, USA
| | - Baileigh G. Hightower
- Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Charlestown, Massachusetts, USA
| | - Trevor Ragas
- Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Charlestown, Massachusetts, USA
| | - Marco L. Loggia
- Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Charlestown, Massachusetts, USA
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Davis LA, Fogarty MJ, Brown A, Sieck GC. Structure and Function of the Mammalian Neuromuscular Junction. Compr Physiol 2022; 12:3731-3766. [PMID: 35950651 PMCID: PMC10461538 DOI: 10.1002/cphy.c210022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
The mammalian neuromuscular junction (NMJ) comprises a presynaptic terminal, a postsynaptic receptor region on the muscle fiber (endplate), and the perisynaptic (terminal) Schwann cell. As with any synapse, the purpose of the NMJ is to transmit signals from the nervous system to muscle fibers. This neural control of muscle fibers is organized as motor units, which display distinct structural and functional phenotypes including differences in pre- and postsynaptic elements of NMJs. Motor units vary considerably in the frequency of their activation (both motor neuron discharge rate and duration/duty cycle), force generation, and susceptibility to fatigue. For earlier and more frequently recruited motor units, the structure and function of the activated NMJs must have high fidelity to ensure consistent activation and continued contractile response to sustain vital motor behaviors (e.g., breathing and postural balance). Similarly, for higher force less frequent behaviors (e.g., coughing and jumping), the structure and function of recruited NMJs must ensure short-term reliable activation but not activation sustained for a prolonged period in which fatigue may occur. The NMJ is highly plastic, changing structurally and functionally throughout the life span from embryonic development to old age. The NMJ also changes under pathological conditions including acute and chronic disease. Such neuroplasticity often varies across motor unit types. © 2022 American Physiological Society. Compr Physiol 12:1-36, 2022.
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Affiliation(s)
- Leah A. Davis
- Department of Physiology & Biomedical Engineering, Mayo Clinic, Rochester, Minnesota, USA
| | - Matthew J. Fogarty
- Department of Physiology & Biomedical Engineering, Mayo Clinic, Rochester, Minnesota, USA
| | - Alyssa Brown
- Department of Physiology & Biomedical Engineering, Mayo Clinic, Rochester, Minnesota, USA
| | - Gary C. Sieck
- Department of Physiology & Biomedical Engineering, Mayo Clinic, Rochester, Minnesota, USA
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Abstract
Background Fatigue is a common and burdensome symptom in Rheumatoid Arthritis (RA), yet is poorly understood. Currently, clinicians rely solely on fatigue questionnaires, which are inherently subjective measures. For the effective development of future therapies and stratification, it is of vital importance to identify biomarkers of fatigue. In this study, we identify brain differences between RA patients who improved and did not improve their levels of fatigue based on Chalder Fatigue Scale variation (ΔCFS≥ 2), and we compared the performance of different classifiers to distinguish between these samples at baseline. Methods Fifty-four fatigued RA patients underwent a magnetic resonance (MR) scan at baseline and 6 months later. At 6 months we identified those whose fatigue levels improved and those for whom it did not. More than 900 brain features across three data sets were assessed as potential predictors of fatigue improvement. These data sets included clinical, structural MRI (sMRI) and diffusion tensor imaging (DTI) data. A genetic algorithm was used for feature selection. Three classifiers were employed in the discrimination of improvers and non-improvers of fatigue: a Least Square Linear Discriminant (LSLD), a linear Support Vector Machine (SVM) and a SVM with Radial Basis Function kernel. Results The highest accuracy (67.9%) was achieved with the sMRI set, followed by the DTI set (63.8%), whereas classification performance using clinical features was at the chance level. The mean curvature of the left superior temporal sulcus was most strongly selected during the feature selection step, followed by the surface are of the right frontal pole and the surface area of the left banks of the superior temporal sulcus. Conclusions The results presented evidence a superiority of brain metrics over clinical metrics in predicting fatigue changes. Further exploration of these methods may support clinicians to triage patients towards the most appropriate fatigue alleviating therapies.
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Affiliation(s)
- María Goñi
- Aberdeen Biomedical Imaging Centre (ABIC), Lilian Sutton Building, Foresterhill, University of Aberdeen, Aberdeen, United Kingdom
- * E-mail:
| | - Neil Basu
- Institute of Infection, Immunity and Inflammation, University of Glasgow, Glasgow, United Kingdom
| | - Alison D. Murray
- Aberdeen Biomedical Imaging Centre (ABIC), Lilian Sutton Building, Foresterhill, University of Aberdeen, Aberdeen, United Kingdom
| | - Gordon D. Waiter
- Aberdeen Biomedical Imaging Centre (ABIC), Lilian Sutton Building, Foresterhill, University of Aberdeen, Aberdeen, United Kingdom
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Kozlova EV, Carabelli B, Bishay AE, Liu R, Denys ME, Macbeth JC, Piamthai V, Crawford MS, McCole DF, Zur Nieden NI, Hsiao A, Curras-Collazo MC. Induction of distinct neuroinflammatory markers and gut dysbiosis by differential pyridostigmine bromide dosing in a chronic mouse model of GWI showing persistent exercise fatigue and cognitive impairment. Life Sci 2022; 288:120153. [PMID: 34801513 PMCID: PMC9048156 DOI: 10.1016/j.lfs.2021.120153] [Citation(s) in RCA: 1] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Accepted: 11/10/2021] [Indexed: 12/03/2022]
Abstract
AIMS To characterize neuroinflammatory and gut dysbiosis signatures that accompany exaggerated exercise fatigue and cognitive/mood deficits in a mouse model of Gulf War Illness (GWI). METHODS Adult male C57Bl/6N mice were exposed for 28 d (5 d/wk) to pyridostigmine bromide (P.O.) at 6.5 mg/kg/d, b.i.d. (GW1) or 8.7 mg/kg/d, q.d. (GW2); topical permethrin (1.3 mg/kg), topical N,N-diethyl-meta-toluamide (33%) and restraint stress (5 min). Animals were phenotypically evaluated as described in an accompanying article [124] and sacrificed at 6.6 months post-treatment (PT) to allow measurement of brain neuroinflammation/neuropathic pain gene expression, hippocampal glial fibrillary acidic protein, brain Interleukin-6, gut dysbiosis and serum endotoxin. KEY FINDINGS Compared to GW1, GW2 showed a more intense neuroinflammatory transcriptional signature relative to sham stress controls. Interleukin-6 was elevated in GW2 and astrogliosis in hippocampal CA1 was seen in both GW groups. Beta-diversity PCoA using weighted Unifrac revealed that gut microbial communities changed after exposure to GW2 at PT188. Both GW1 and GW2 displayed systemic endotoxemia, suggesting a gut-brain mechanism underlies the neuropathological signatures. Using germ-free mice, probiotic supplementation with Lactobacillus reuteri produced less gut permeability than microbiota transplantation using GW2 feces. SIGNIFICANCE Our findings demonstrate that GW agents dose-dependently induce differential neuropathology and gut dysbiosis associated with cognitive, exercise fatigue and mood GWI phenotypes. Establishment of a comprehensive animal model that recapitulates multiple GWI symptom domains and neuroinflammation has significant implications for uncovering pathophysiology, improving diagnosis and treatment for GWI.
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Affiliation(s)
- Elena V Kozlova
- Department of Molecular, Cell and Systems Biology, University of California, Riverside, CA, USA; Neuroscience Graduate Program, University of California, Riverside, CA, USA
| | - Bruno Carabelli
- Department of Molecular, Cell and Systems Biology, University of California, Riverside, CA, USA
| | - Anthony E Bishay
- Department of Molecular, Cell and Systems Biology, University of California, Riverside, CA, USA
| | - Rui Liu
- Department of Microbiology and Plant Pathology, University of California, Riverside, CA, USA; Graduate Program in Genetics, Genomics, and Bioinformatics, University of California, Riverside, CA, USA
| | - Maximillian E Denys
- Department of Molecular, Cell and Systems Biology, University of California, Riverside, CA, USA
| | - John C Macbeth
- Department of Microbiology and Plant Pathology, University of California, Riverside, CA, USA; Division of Biomedical Sciences, School of Medicine, University of California, Riverside, CA, USA
| | - Varadh Piamthai
- Department of Microbiology and Plant Pathology, University of California, Riverside, CA, USA
| | - Meli'sa S Crawford
- Division of Biomedical Sciences, School of Medicine, University of California, Riverside, CA, USA
| | - Declan F McCole
- Division of Biomedical Sciences, School of Medicine, University of California, Riverside, CA, USA
| | - Nicole I Zur Nieden
- Department of Molecular, Cell and Systems Biology, University of California, Riverside, CA, USA
| | - Ansel Hsiao
- Department of Microbiology and Plant Pathology, University of California, Riverside, CA, USA
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Minh LHN, Abozaid AA, Ha NX, Le Quang L, Gad AG, Tiwari R, Nhat‐Le T, Quyen DK, AL‐Manaseer B, Kien ND, Vuong NL, Zayan AH, Nhi LHH, Surya Dila KA, Varney J, Tien Huy N. Clinical and laboratory factors associated with coronavirus disease 2019 (Covid-19): A systematic review and meta-analysis. Rev Med Virol 2021; 31:e2288. [PMID: 34472152 PMCID: PMC8646520 DOI: 10.1002/rmv.2288] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Revised: 08/08/2021] [Accepted: 08/12/2021] [Indexed: 01/08/2023]
Abstract
SARS Coronavirus-2 is one of the most widespread viruses globally during the 21st century, whose severity and ability to cause severe pneumonia and death vary. We performed a comprehensive systematic review of all studies that met our standardised criteria and then extracted data on the age, symptoms, and different treatments of Covid-19 patients and the prognosis of this disease during follow-up. Cases in this study were divided according to severity and death status and meta-analysed separately using raw mean and single proportion methods. We included 171 complete studies including 62,909 confirmed cases of Covid-19, of which 148 studies were meta-analysed. Symptoms clearly emerged in an escalating manner from mild-moderate symptoms, pneumonia, severe-critical to the group of non-survivors. Hypertension (Pooled proportion (PP): 0.48 [95% Confident interval (CI): 0.35-0.61]), diabetes (PP: 0.23 [95% CI: 0.16-0.33]) and smoking (PP: 0.12 [95% CI: 0.03-0.38]) were highest regarding pre-infection comorbidities in the non-survivor group. While acute respiratory distress syndrome (PP: 0.49 [95% CI: 0.29-0.78]), (PP: 0.63 [95% CI: 0.34-0.97]) remained one of the most common complications in the severe and death group respectively. Bilateral ground-glass opacification (PP: 0.68 [95% CI: 0.59-0.75]) was the most visible radiological image. The mortality rates estimated (PP: 0.11 [95% CI: 0.06-0.19]), (PP: 0.03 [95% CI: 0.01-0.05]), and (PP: 0.01 [95% CI: 0-0.3]) in severe-critical, pneumonia and mild-moderate groups respectively. This study can serve as a high evidence guideline for different clinical presentations of Covid-19, graded from mild to severe, and for special forms like pneumonia and death groups.
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Affiliation(s)
- Le Huu Nhat Minh
- Cardiovascular Research DepartmentMethodist HospitalMerrillvilleIndianaUSA
- Online Research ClubNagasakiJapan
| | | | - Nam Xuan Ha
- Online Research ClubNagasakiJapan
- Hue University of Medicine and Pharmacy, Hue UniversityHue CityVietnam
| | - Loc Le Quang
- Online Research ClubNagasakiJapan
- University of Medicine and Pharmacy at Ho Chi Minh CityHo Chi Minh CityVietnam
| | | | - Ranjit Tiwari
- Online Research ClubNagasakiJapan
- Department of Internal MedicineInstitute of MedicineTribhuvan UniversityKathmanduNepal
| | - Tran Nhat‐Le
- Online Research ClubNagasakiJapan
- Hue University of Medicine and Pharmacy, Hue UniversityHue CityVietnam
| | - Dinh Kim Quyen
- Online Research ClubNagasakiJapan
- University of Medicine and Pharmacy at Ho Chi Minh CityHo Chi Minh CityVietnam
| | - Balqees AL‐Manaseer
- Online Research ClubNagasakiJapan
- School of MedicineUniversity of JordanAmmanJordan
| | - Nguyen Dang Kien
- Online Research ClubNagasakiJapan
- Department of Obstetrics and GynaecologyThai Binh University of Medicine and PharmacyThai BinhVietnam
| | - Nguyen Lam Vuong
- University of Medicine and Pharmacy at Ho Chi Minh CityHo Chi Minh CityVietnam
| | - Ahmad Helmy Zayan
- Online Research ClubNagasakiJapan
- Department of OtolaryngologyMenoufia UniversityMenoufiaEgypt
| | - Le Huu Hanh Nhi
- Department of RadiologyVinmec Central Park International HospitalHo Chi Minh CityVietnam
| | - Kadek Agus Surya Dila
- Online Research ClubNagasakiJapan
- Department of Emergency MedicineGiri Emas HospitalSingaraja CityBuleleng, BaliIndonesia
| | - Joseph Varney
- Online Research ClubNagasakiJapan
- School of MedicineAmerican University of the CaribbeanSint MaartenNetherlands
| | - Nguyen Tien Huy
- Online Research ClubNagasakiJapan
- School of Tropical Medicine and Global HealthNagasaki UniversityNagasakiJapan
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Brastianos PK, Strickland MR, Lee EQ, Wang N, Cohen JV, Chukwueke U, Forst DA, Eichler A, Overmoyer B, Lin NU, Chen WY, Bardia A, Juric D, Dagogo-Jack I, White MD, Dietrich J, Nayyar N, Kim AE, Alvarez-Breckenridge C, Mahar M, Mora JL, Nahed BV, Jones PS, Shih HA, Gerstner ER, Giobbie-Hurder A, Carter SL, Oh K, Cahill DP, Sullivan RJ. Phase II study of ipilimumab and nivolumab in leptomeningeal carcinomatosis. Nat Commun 2021; 12:5954. [PMID: 34642329 PMCID: PMC8511104 DOI: 10.1038/s41467-021-25859-y] [Citation(s) in RCA: 33] [Impact Index Per Article: 11.0] [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: 11/14/2020] [Accepted: 08/25/2021] [Indexed: 11/09/2022] Open
Abstract
Leptomeningeal disease (LMD) is a common complication from solid tumor malignancies with a poor prognosis and limited treatment options. We present a single arm Phase II study of 18 patients with LMD receiving combined ipilimumab and nivolumab until progression or unacceptable toxicity (NCT02939300). The primary end point is overall survival at 3 months (OS3). Secondary end points include toxicity, cumulative time-to-progression at 3 months, and progression-free survival. A Simon two-stage design is used to compare a null hypothesis OS3 of 18% against an alternative of 44%. Median follow up based on patients still alive is 8.0 months (range: 0.5 to 15.9 months). The study has met its primary endpoint as 8 of 18 (OS3 0.44; 90% CI: 0.24 to 0.66) patients are alive at three months. One third of patients have experienced one (or more) grade-3 or higher adverse events. Two patients have discontinued protocol treatment due to unacceptable toxicity (hepatitis and colitis, respectively). The most frequent adverse events include fatigue (N = 7), nausea (N = 6), fever (N = 6), anorexia (N = 6) and rash (N = 6). Combined ipilimumab and nivolumab has an acceptable safety profile and demonstrates promising activity in LMD patients. Larger, multicenter clinical trials are needed to validate these results.
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Affiliation(s)
| | - Matthew R Strickland
- Massachusetts General Hospital, 55 Fruit Street, Boston, MA, 02114, USA
- Dana-Farber Cancer Institute, 450 Brookline Avenue, Boston, MA, 02215, USA
| | - Eudocia Quant Lee
- Dana-Farber Cancer Institute, 450 Brookline Avenue, Boston, MA, 02215, USA
| | - Nancy Wang
- Massachusetts General Hospital, 55 Fruit Street, Boston, MA, 02114, USA
| | - Justine V Cohen
- Massachusetts General Hospital, 55 Fruit Street, Boston, MA, 02114, USA
| | - Ugonma Chukwueke
- Dana-Farber Cancer Institute, 450 Brookline Avenue, Boston, MA, 02215, USA
| | | | - April Eichler
- Massachusetts General Hospital, 55 Fruit Street, Boston, MA, 02114, USA
| | - Beth Overmoyer
- Dana-Farber Cancer Institute, 450 Brookline Avenue, Boston, MA, 02215, USA
| | - Nancy U Lin
- Dana-Farber Cancer Institute, 450 Brookline Avenue, Boston, MA, 02215, USA
| | - Wendy Y Chen
- Dana-Farber Cancer Institute, 450 Brookline Avenue, Boston, MA, 02215, USA
| | - Aditya Bardia
- Massachusetts General Hospital, 55 Fruit Street, Boston, MA, 02114, USA
| | - Dejan Juric
- Massachusetts General Hospital, 55 Fruit Street, Boston, MA, 02114, USA
| | | | - Michael D White
- Massachusetts General Hospital, 55 Fruit Street, Boston, MA, 02114, USA
| | - Jorg Dietrich
- Massachusetts General Hospital, 55 Fruit Street, Boston, MA, 02114, USA
| | - Naema Nayyar
- Massachusetts General Hospital, 55 Fruit Street, Boston, MA, 02114, USA
| | - Albert E Kim
- Massachusetts General Hospital, 55 Fruit Street, Boston, MA, 02114, USA
| | | | - Maura Mahar
- Massachusetts General Hospital, 55 Fruit Street, Boston, MA, 02114, USA
| | - Joana L Mora
- Massachusetts General Hospital, 55 Fruit Street, Boston, MA, 02114, USA
| | - Brian V Nahed
- Massachusetts General Hospital, 55 Fruit Street, Boston, MA, 02114, USA
| | - Pamela S Jones
- Massachusetts General Hospital, 55 Fruit Street, Boston, MA, 02114, USA
| | - Helen A Shih
- Massachusetts General Hospital, 55 Fruit Street, Boston, MA, 02114, USA
| | | | | | - Scott L Carter
- Dana-Farber Cancer Institute, 450 Brookline Avenue, Boston, MA, 02215, USA
| | - Kevin Oh
- Massachusetts General Hospital, 55 Fruit Street, Boston, MA, 02114, USA
| | - Daniel P Cahill
- Massachusetts General Hospital, 55 Fruit Street, Boston, MA, 02114, USA
| | - Ryan J Sullivan
- Massachusetts General Hospital, 55 Fruit Street, Boston, MA, 02114, USA
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Wang H, Liu Y, Zhao J, Guo X, Hu M, Chen Y. Possible inflammatory mechanisms and predictors of Parkinson's disease patients with fatigue (Brief Review). Clin Neurol Neurosurg 2021; 208:106844. [PMID: 34388595 DOI: 10.1016/j.clineuro.2021.106844] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [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: 11/08/2020] [Revised: 04/27/2021] [Accepted: 07/23/2021] [Indexed: 01/02/2023]
Abstract
Parkinson's disease (PD) is a progressive neurodegenerative disorder characterized by the loss of dopamine-producing neurons in the substantia nigra and the abnormal cytoplasmic accumulation of proteinaceous aggregates called Lewy bodies (LBs), mainly composed of α-synuclein (α-syn). In recent years, it has been gradually recognized that fatigue is one of the most common and disabling symptoms in PD patients, with a prevalence of approximately 50%. Although neuroinflammation, a pathological hallmark of PD, is closely associated with fatigue, present mechanisms of fatigue in PD patients have not yet been systematically summarized, with their inflammatory predictors remaining controversial. Therefore, the aim of this brief review is to fill in the gaps in our understanding on the inflammatory factors involved in the pathophysiological mechanisms of fatigue and predicting its occurrence in PD patients. The determination of fatigue is mainly assessed using the Parkinson Fatigue Scale 16 (PFS-16) and Fatigue Severity Scale 9 (FSS-9). Several studies have reported that inflammatory marker levels, such as interleukin-6 (IL-6), and other inflammatory predictors closely associated with fatigue, such as soluble IL-2 receptor (sIL-2R), tumor necrosis factor alpha (TNF-α), high-sensitivity C-reactive protein (hs-CRP), neutrophil-to-lymphocyte ratio (NLR), and red blood cell distribution width (RDW), may help detect fatigue. Moreover, the following inflammatory mechanisms may be involved. (1) Abnormal aggregation of α-syn undergoes a conformational change, which then activates toll-like receptor 4 (TLR4) to release a large number of proinflammatory cytokines, causing fatigue symptoms. (2) Chronic peripheral inflammation and immune activation responses induce elevated levels of proinflammatory cytokines in PD patients, which enter the brain mainly through the traditional endocrine route or via direct vagus nerve transmission. The rising levels of proinflammatory cytokines cause the destruction of the blood-brain barrier (BBB) by combining with BBB endothelial cells, allowing many proinflammatory cytokines to cross the destroyed BBB and enter the brain, preventing astrocytes from reuptaking glutamate and laying foundations for the occurrence of fatigue. Furthermore, studies have suggested that fatigue symptoms in PD patients often represent a poor prognosis. Nevertheless, if the aforementioned inflammatory markers can effectively predict the occurrence of fatigue and allow early intervention, the prognosis of PD patients could be significantly improved. At present, its management mainly includes medical treatment (levodopa, dopamine receptor agonists, rasagiline, and antidepressants) and non-medical treatment (acupuncture and yoga). Thus, it is of great significance to be able to practice early detection and intervention in fatigue and improve the prognosis of patients with PD.
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Affiliation(s)
- Haili Wang
- Department of Clinical Medicine, Dalian Medical University, Dalian, Liaoning Province, China; Neurology, Department of Clinical Medicine, Yangzhou University, Yangzhou, Jiangsu Province, China
| | - Yimin Liu
- Department of Clinical Medicine, Dalian Medical University, Dalian, Liaoning Province, China; Neurology, Department of Clinical Medicine, Yangzhou University, Yangzhou, Jiangsu Province, China
| | - Jingyi Zhao
- Department of Clinical Medicine, Dalian Medical University, Dalian, Liaoning Province, China; Neurology, Department of Clinical Medicine, Yangzhou University, Yangzhou, Jiangsu Province, China
| | - Xin Guo
- Department of Clinical Medicine, Dalian Medical University, Dalian, Liaoning Province, China
| | - Meng Hu
- Neurology, Department of Clinical Medicine, Yangzhou University, Yangzhou, Jiangsu Province, China; Department of Clinical Medicine, Central South University, Changsha, Hunan Province, China
| | - Yingzhu Chen
- Neurology, Department of Clinical Medicine, Yangzhou University, Yangzhou, Jiangsu Province, China.
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Agbejule OA, Hart NH, Ekberg S, Koczwara B, Ladwa R, Simonsen C, Pinkham EP, Chan RJ. Bridging the research to practice gap: a systematic scoping review of implementation of interventions for cancer-related fatigue management. BMC Cancer 2021; 21:809. [PMID: 34261438 PMCID: PMC8278687 DOI: 10.1186/s12885-021-08394-3] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Accepted: 05/23/2021] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Cancer-related fatigue (CRF) is one of the most common and distressing symptoms in people with cancer. Although efficacy of interventions for CRF have been extensively investigated, less has been done to ensure successful translation into routine clinical practice. The aim of this systematic scoping review was to synthesise knowledge surrounding the implementation of CRF interventions, summarise the processes and outcomes of implementation strategies used, and identify opportunities for further research. METHODS PubMed, Cochrane CENTRAL, EMBASE and CINAHL databases were searched (up to December 2020). The Cochrane Effective Practice and Organisation of Care (EPOC) Group taxonomy and the RE-AIM Framework were used to guide the evaluation of implementation strategies and outcomes, respectively. RESULTS Six studies were included. Three used an implementation framework (PARIHS, KTA, Cullens & Adams' Implementation Guide) to guide implementation. Overall, the implementation strategies used across all studies were reported to have directly resulted in immediate changes at the clinician level (e.g., increased clinician behaviours, self-efficacy, attitudes, knowledge of CRF management). No clear relationship was found between the use of implementation models and the number or type of implementation strategies used. For outcomes, Effectiveness and Implementation were the most highly reported RE-AIM measures followed by Reach then Maintenance. Adoption was the least reported. CONCLUSIONS Despite the high prevalence of CRF and evidence-based interventions for managing CRF, there is limited evidence informing the sustainable implementation of these interventions. This systematic scoping review emphasises the lack of quality CRF implementation studies presently available in the literature leading to a disconnect between effective CRF interventions, routine clinical care, and cancer survivors at present. This review highlights the need for robust study designs guided by established frameworks to methodically design and evaluate the implementation of CRF management interventions in the future.
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Affiliation(s)
- Oluwaseyifunmi Andi Agbejule
- Cancer and Palliative Care Outcomes Centre, School of Nursing, N Block, Kelvin Grove Campus,, Queensland University of Technology (QUT), Kelvin Grove, Queensland, 4059, Australia.
| | - Nicolas H Hart
- Cancer and Palliative Care Outcomes Centre, School of Nursing, N Block, Kelvin Grove Campus,, Queensland University of Technology (QUT), Kelvin Grove, Queensland, 4059, Australia
- Exercise Medicine Research Institute, Edith Cowan University, Perth, Western Australia, 6027, Australia
- Institute for Health Research, University of Notre Dame Australia, Fremantle, Western Australia, 6959, Australia
| | - Stuart Ekberg
- Cancer and Palliative Care Outcomes Centre, School of Nursing, N Block, Kelvin Grove Campus,, Queensland University of Technology (QUT), Kelvin Grove, Queensland, 4059, Australia
| | - Bogda Koczwara
- Flinders University and Flinders Medical Centre, Flinders Drive, Bedford Park, South Australia, 5048, Australia
| | - Rahul Ladwa
- Princess Alexandra Hospital, Metro South Hospital and Health Services, Woolloongabba, Queensland, 4102, Australia
- School of Medicine, University of Queensland, St Lucia, Queensland, 4072, Australia
| | - Camilla Simonsen
- Cancer and Palliative Care Outcomes Centre, School of Nursing, N Block, Kelvin Grove Campus,, Queensland University of Technology (QUT), Kelvin Grove, Queensland, 4059, Australia
- Princess Alexandra Hospital, Metro South Hospital and Health Services, Woolloongabba, Queensland, 4102, Australia
| | - Elizabeth P Pinkham
- Cancer and Palliative Care Outcomes Centre, School of Nursing, N Block, Kelvin Grove Campus,, Queensland University of Technology (QUT), Kelvin Grove, Queensland, 4059, Australia
- Princess Alexandra Hospital, Metro South Hospital and Health Services, Woolloongabba, Queensland, 4102, Australia
- School of Health and Behavioural Science, University of Queensland, St Lucia, Queensland, 4072, Australia
| | - Raymond Javan Chan
- Cancer and Palliative Care Outcomes Centre, School of Nursing, N Block, Kelvin Grove Campus,, Queensland University of Technology (QUT), Kelvin Grove, Queensland, 4059, Australia
- Princess Alexandra Hospital, Metro South Hospital and Health Services, Woolloongabba, Queensland, 4102, Australia
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Vang P, Baumann CW, Barok R, Larson AA, Dougherty BJ, Lowe DA. Impact of estrogen deficiency on diaphragm and leg muscle contractile function in female mdx mice. PLoS One 2021; 16:e0249472. [PMID: 33788896 PMCID: PMC8011782 DOI: 10.1371/journal.pone.0249472] [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] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Accepted: 03/18/2021] [Indexed: 12/28/2022] Open
Abstract
Female carriers of Duchenne muscular dystrophy (DMD) presenting with DMD symptomology similar to males with DMD, such as skeletal muscle weakness and cardiomyopathy, are termed manifesting carriers. There is phenotypic variability among manifesting carriers including the age of onset, which can range from the first to fourth decade of life. In females, estrogen levels typically begin to decline during the fourth decade of life and estrogen deficiency contributes to loss of muscle strength and recovery of strength following injury. Thus, we questioned whether the decline of estrogen impacts the development of DMD symptoms in females. To address this question, we studied 6-8 month-old homozygous mdx female mice randomly assigned to a sham or ovariectomy (OVX) surgical group. In vivo whole-body plethysmography assessed ventilatory function and diaphragm muscle strength was measured in vitro before and after fatigue. Anterior crural muscles were analyzed in vivo for contractile function, fatigue, and in response to eccentric contraction (ECC)-induced injury. For the latter, 50 maximal ECCs were performed by the anterior crural muscles to induce injury. Body mass, uterine mass, hypoxia-hypercapnia ventilatory response, and fatigue index were analyzed by a pooled unpaired t-test. A two-way ANOVA was used to analyze ventilatory measurements. Fatigue and ECC-injury recovery experiments were analyzed by a two-way repeated-measures ANOVA. Results show no differences between sham and OVX mdx mice in ventilatory function, strength, or recovery of strength after fatigue in the diaphragm muscle or anterior crural muscles (p ≥ 0.078). However, OVX mice had significantly greater eccentric torque loss and blunted recovery of strength after ECC-induced injury compared to sham mice (p ≤ 0.019). Although the results show that loss of estrogen has minimal impact on skeletal muscle contractile function in female mdx mice, a key finding suggests that estrogen is important in muscle recovery in female mdx mice after injury.
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Affiliation(s)
- Pangdra Vang
- Division of Rehabilitation Science, Department of Rehabilitation Medicine, University of Minnesota, Minneapolis, Minnesota, United States of America
| | - Cory W. Baumann
- Division of Rehabilitation Science, Department of Rehabilitation Medicine, University of Minnesota, Minneapolis, Minnesota, United States of America
| | - Rebecca Barok
- Division of Rehabilitation Science, Department of Rehabilitation Medicine, University of Minnesota, Minneapolis, Minnesota, United States of America
| | - Alexie A. Larson
- Department of Integrative Biology and Physiology, University of Minnesota, Minneapolis, Minnesota, United States of America
| | - Brendan J. Dougherty
- Division of Rehabilitation Science, Department of Rehabilitation Medicine, University of Minnesota, Minneapolis, Minnesota, United States of America
- Division of Physical Therapy, Department of Rehabilitation Medicine, University of Minnesota, Minneapolis, Minnesota, United States of America
| | - Dawn A. Lowe
- Division of Rehabilitation Science, Department of Rehabilitation Medicine, University of Minnesota, Minneapolis, Minnesota, United States of America
- Division of Physical Therapy, Department of Rehabilitation Medicine, University of Minnesota, Minneapolis, Minnesota, United States of America
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12
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Neuhaus O, Köhler W, Then Bergh F, Kristoferitsch W, Faiss J, Rosenkranz T, Reske D, Patejdl R, Hartung HP, Zettl UK. Glatiramer Acetate Treatment in Multiple Sclerosis-Associated Fatigue-Beneficial Effects on Self-Assessment Scales But Not on Molecular Markers. Biomolecules 2021; 11:biom11030393. [PMID: 33800033 PMCID: PMC8002075 DOI: 10.3390/biom11030393] [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] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2021] [Revised: 02/28/2021] [Accepted: 03/03/2021] [Indexed: 01/14/2023] Open
Abstract
Although fatigue is a common symptom in multiple sclerosis (MS), its pathomechanisms are incompletely understood. Glatiramer acetate (GA), an immunomodulatory agent approved for treatment of relapsing-remitting MS (RRMS), possesses unique mechanisms of action and has been shown to exhibit beneficial effects on MS fatigue. The objective of this study was to correlate clinical, neuropsychological, and immunological parameters in RRMS patients with fatigue before and during treatment with GA. In a prospective, open-label, multicenter trial, 30 patients with RRMS and fatigue were treated with GA for 12 months. Inclusion criterion was the presence of fatigue as one of the most frequent and disabling symptoms. Before and during treatment, fatigue was assessed using the Fatigue Severity Scale (FSS), the MS-FSS, and the Modified Fatigue Impact Scale (MFIS). In addition, fatigue and quality of life were assessed using the Visual Analog Scales (VAS). Laboratory assessments included screening of 188 parameters using real-time PCR microarrays followed by further analysis of several cytokines, chemokines, and neurotrophic factors. Fatigue self-assessments were completed in 25 patients. After 12 months of treatment with GA, 13 of these patients improved in all three scales (with the most prominent effects on the MFIS), whereas 5 patients had deteriorated. The remaining 7 patients exhibited inconsistent effects within the three scales. Fatigue and overall quality of life had improved, as assessed via VAS. Laboratory assessments revealed heterogeneous mRNA levels of cytokines, chemokines, and neurotrophic factors. In conclusion, we were not able to correlate clinical and molecular effects of GA in patients with RRMS and fatigue.
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Affiliation(s)
- Oliver Neuhaus
- Department of Neurology, Klinikum der Heinrich Heine Universität, 40225 Düsseldorf, Germany;
- Department of Neurology, SRH Kliniken Landkreis Sigmaringen GmbH, 72488 Sigmaringen, Germany
- Correspondence: ; Tel.: +49-7571-1002483
| | - Wolfgang Köhler
- Department of Neurology, Fachkrankenhaus Hubertusburg, 04779 Wermsdorf, Germany;
- Department of Neurology, Universität Leipzig, 04103 Leipzig, Germany;
| | | | - Wolfgang Kristoferitsch
- Department of Neurology, SMZ-Ost-Donauspital, 1220 Vienna, Austria;
- Karl Landsteiner Institute for Neuroimmunological and Neurodegenerative Disorders, 1220 Vienna, Austria
| | - Jürgen Faiss
- Department of Neurology, Asklepios Fachklinikum Teupitz, 15755 Teupitz, Germany;
- German Stroke Society, 10117 Berlin, Germany
| | - Thorsten Rosenkranz
- Department of Neurology, Asklepios Klinik St. Georg, 20099 Hamburg, Germany;
| | - Dirk Reske
- Department of Neurology, Klinikum der Universität zu Köln, 50937 Cologne, Germany;
- Department of Psychiatry, LVR-Klinik Köln, 51109 Cologne, Germany
| | - Robert Patejdl
- Department of Physiology, Universitätsmedizin Rostock, 18057 Rostock, Germany;
| | - Hans-Peter Hartung
- Department of Neurology, Klinikum der Heinrich Heine Universität, 40225 Düsseldorf, Germany;
| | - Uwe K. Zettl
- Department of Neurology, Universitätsmedizin Rostock, 18057 Rostock, Germany;
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González-Mercado VJ, Lim J, Marrero S, Pedro E, Saligan LN. Gut microbiota and fatigue in rectal cancer patients: a cross-sectional pilot study. Support Care Cancer 2021; 29:4615-4621. [PMID: 33495850 DOI: 10.1007/s00520-021-06013-2] [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] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Accepted: 01/19/2021] [Indexed: 12/17/2022]
Abstract
CONTEXT Although microbial-mediated disturbance of intestinal mucosal homeostasis (dysbiosis) is believed to contribute to the pathogenesis of chemotherapy and radiotherapy (CRT)-related fatigue, potential differences in the gut microbial diversity and in the abundance of gut microbial taxa between fatigued and non-fatigued patients have not been adequately examined, particularly in the rectal cancer population. PURPOSE In this cross-sectional study, we aim to examine the differences in (a) gut microbial diversity and gut microbial abundances and (b) predicted functional pathways of the gut microbiome between rectal cancer participants with and without fatigue at the end of CRT. METHODS Rectal cancer patients (n = 50) provided stool samples for 16S rRNA gene sequencing and symptom ratings for fatigue at the end of CRT. Gut microbiome data were analyzed using QIIME2, LEfSe, and the R statistical package. RESULTS Fatigued (n = 35) participants showed enriched bacterial abundances of Eubacterium, Streptococcus, Adlercreutzia, and Actinomyces, as well as enriched abundances of the microbial sucrose degradation pathway, compared to non-fatigued patients at the end of CRT (n = 15). CONCLUSIONS Differentially abundant microbial taxa were identified in fatigued and non-fatigued rectal cancer participants at the end of CRT. However, the exact role of these taxa (and identification of species) in the biology of CRT-related fatigue remains to be examined.
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Affiliation(s)
| | - Jean Lim
- University of Miami, Miami, FL, USA
| | - Sara Marrero
- College of Arts and Sciences, University of South Florida, Tampa, FL, USA
| | - Elsa Pedro
- School of Pharmacy, Medical Science Campus, University of Puerto Rico, San Juan, Puerto Rico
| | - Leorey N Saligan
- Symptom Science Center, Principal Investigator, Symptom Biology Unit, Division of Intramural Research, NINR, NIH, DHHS, Bethesda, MD, USA
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Cui J, Xia P, Zhang L, Hu Y, Xie Q, Xiang H. A novel fermented soybean, inoculated with selected Bacillus, Lactobacillus and Hansenula strains, showed strong antioxidant and anti-fatigue potential activity. Food Chem 2020; 333:127527. [PMID: 32683263 DOI: 10.1016/j.foodchem.2020.127527] [Citation(s) in RCA: 38] [Impact Index Per Article: 9.5] [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: 01/15/2020] [Revised: 06/01/2020] [Accepted: 07/05/2020] [Indexed: 11/25/2022]
Abstract
The aim of this study was to develop a novel fermented soybean food (FSF) using selected Bacillus subtilis GD1, Bacillus subtilis N4, Bacillus velezensis GZ1, Lactobacillus delbrueckii subsp. bulgaricus and Hansenula anomala, as well as to assess its antioxidant and anti-fatigue activity. These Bacillus strains had excellent enzyme producing and soybean transformation capacity. FSF showed the highest peptide, total phenol, total flavonoid content, antioxidant activity, and suitable organic acid and biological amine content. In intense exercise mice, FSF treatment markedly increased hepatic glycogen level, decreased metabolite accumulation, improved the activities of antioxidant enzymes and decreased malondialdehyde (MDA) level in serum and liver, respectively. Furthermore, FSF treatment increased nuclear factor-erythroid 2-related factor 2 (Nrf2) and antioxidant response element (ARE)-dependent gene expression. Together, the selection of microbial starter culture and mixed culture fermentation are essential for the effective enrichment of bioactive compounds, and FSF has stronger antioxidant and anti-fatigue activity.
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Affiliation(s)
- Jingwen Cui
- School of Life Sciences, Jilin University, Changchun, Jilin 130012, PR China
| | - Peibin Xia
- School of Life Sciences, Jilin University, Changchun, Jilin 130012, PR China
| | - Lingling Zhang
- School of Life Sciences, Jilin University, Changchun, Jilin 130012, PR China
| | - Yu Hu
- School of Life Sciences, Jilin University, Changchun, Jilin 130012, PR China
| | - Qiuhong Xie
- Key Laboratory for Molecular Enzymology and Engineering of Ministry of Education, School of Life Sciences, Jilin University, Changchun, Jilin 130012, PR China; National Engineering Laboratory for AIDS Vaccine, School of Life Sciences, Jilin University, Changchun, Jilin 130012, PR China; School of Life Sciences, Jilin University, Changchun, Jilin 130012, PR China.
| | - Hongyu Xiang
- Key Laboratory for Molecular Enzymology and Engineering of Ministry of Education, School of Life Sciences, Jilin University, Changchun, Jilin 130012, PR China; National Engineering Laboratory for AIDS Vaccine, School of Life Sciences, Jilin University, Changchun, Jilin 130012, PR China; School of Life Sciences, Jilin University, Changchun, Jilin 130012, PR China.
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15
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Renovanz M, Hickmann AK, Nadji-Ohl M, Keric N, Weimann E, Wirtz CR, Singer S, Ringel F, Coburger J. Health-related quality of life and distress in elderly vs. younger patients with high-grade glioma-results of a multicenter study. Support Care Cancer 2020; 28:5165-5175. [PMID: 32060706 PMCID: PMC7546979 DOI: 10.1007/s00520-020-05354-8] [Citation(s) in RCA: 2] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2019] [Accepted: 02/06/2020] [Indexed: 02/08/2023]
Abstract
OBJECTIVE Half of all newly diagnosed patients with glioblastoma are > 65 years still with a poor prognosis. Preserving quality of life is of high importance. However, patient reported outcome (PRO) data in this patient group is rare. The aim was to compare health-related quality of life (HRQoL) and distress between elderly and younger patients with high-grade glioma (HGG). METHODS We used baseline data of a prospective study where HGG patients were enrolled from 4 hospitals. Distress was measured using the distress thermometer (DT), HRQoL using the European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Core Questionnaire (QLQ-C30) plus brain module (BN20). We compared distress and HRQoL by age (≥ 65 vs. < 65 years), gender, performance score, and time since diagnosis using multivariate linear and logistic regressions. RESULTS A total of n = 93 (30%) out of n = 309 patients were ≥ 65 years (mean 70 years, range 65-86 years). Mean DT score of elderly patients (5.2, SD 2.6) was comparable with younger patients (4.9, SD 2.6). Elderly patients reported significantly lower global health (GHS, mean elderly vs. younger; 50.8 vs. 60.5, p = 0.003), worse physical (56.8 vs. 73.3, p < 0.001) and lower cognitive functioning (51.1 vs. 63.2, p = 0.002), worse fatigue (52.5 vs. 43.5, p = 0.042), and worse motor dysfunction (34.9 vs. 23.6, p = 0.030). KPS and not age was consistently associated with HRQoL. CONCLUSION Physical functioning was significantly reduced in the elderly compared with younger HGG patients, and at the same time, emotional functioning and DT scores were comparable. KPS shows a greater association with HRQoL than with calendric age in HGG patients reflecting the particular importance for adequate assessment of HRQoL and general condition in elderly patients.
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Affiliation(s)
- Mirjam Renovanz
- Department of Neurosurgery, University Medical Center, Mainz, Germany.
- Division of Neuro-Oncology, University Medical Center Tubingen, Tübingen, Germany.
| | | | - Minou Nadji-Ohl
- Department of Neurosurgery, Klinikum Stuttgart, Stuttgart, Germany
| | - Naureen Keric
- Department of Neurosurgery, University Medical Center, Mainz, Germany
| | - Elke Weimann
- Department of Neurology, RKH Kliniken Ludwigsburg, Ludwigsburg, Germany
| | | | - Susanne Singer
- Division of Epidemiology and Health Services Research, Institute of Medical Biostatistics, Epidemiology and Informatics, University Medical Center, Mainz, Germany
| | - Florian Ringel
- Department of Neurosurgery, University Medical Center, Mainz, Germany
| | - Jan Coburger
- Department of Neurosurgery, University Medical Center Ulm, Ulm, Germany
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Xiao C, Fedirko V, Beitler J, Bai J, Peng G, Zhou C, Gu J, Zhao H, Lin IH, Chico CE, Jeon S, Knobf TM, Conneely KN, Higgins K, Shin DM, Saba N, Miller A, Bruner D. The role of the gut microbiome in cancer-related fatigue: pilot study on epigenetic mechanisms. Support Care Cancer 2020; 29:3173-3182. [PMID: 33078326 DOI: 10.1007/s00520-020-05820-3] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [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: 06/08/2020] [Accepted: 10/07/2020] [Indexed: 12/13/2022]
Abstract
PURPOSE Recent evidence supports a key role of gut microbiome in brain health. We conducted a pilot study to assess associations of gut microbiome with cancer-related fatigue and explore the associations with DNA methylation changes. METHODS Self-reported Multidimensional Fatigue Inventory and stool samples were collected at pre-radiotherapy and one-month post-radiotherapy in patients with head and neck cancer. Gut microbiome data were obtained by sequencing the 16S ribosomal ribonucleic acid gene. DNA methylation changes in the blood were assessed using Illumina Methylation EPIC BeadChip. RESULTS We observed significantly different gut microbiota patterns among patients with high vs. low fatigue across time. This pattern was characterized by low relative abundance in short-chain fatty acid-producing taxa (family Ruminococcaceae, genera Subdoligranulum and Faecalibacterium; all p < 0.05), with high abundance in taxa associated with inflammation (genera Family XIII AD3011 and Erysipelatoclostridium; all p < 0.05) for high-fatigue group. We identified nine KEGG Orthology pathways significantly different between high- vs. low-fatigue groups over time (all p < 0.001), including pathways related to fatty acid synthesis and oxidation, inflammation, and brain function. Gene set enrichment analysis (GSEA) was performed on the top differentially methylated CpG sites that were associated with the taxa and fatigue. All biological processes from the GSEA were related to immune responses and inflammation (FDR < 0.05). CONCLUSIONS Our results suggest different patterns of the gut microbiota in cancer patients with high vs. low fatigue. Results from functional pathways and DNA methylation analyses indicate that inflammation is likely to be the major driver in the gut-brain axis for cancer-related fatigue.
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Affiliation(s)
- Canhua Xiao
- School of Nursing, Yale University, 400 West Campus Drive, Room 20102, Orange, CT, 06477, USA.
| | - Veronika Fedirko
- School of Public Health, Emory University, 201 Dowman Drive, Atlanta, GA, 30322, USA
| | - Jonathan Beitler
- Department of Radiation, School of Medicine, Emory University, 1365-C Clifton Road NE, Atlanta, GA, 30322, USA
| | - Jinbing Bai
- School of Nursing, Emory University, 1520 Clifton Road NE, Atlanta, 30322, USA
| | - Gang Peng
- Department of Epidemiology and Public Health, School of Medicine, Yale University, 300 George Street, New Haven, CT, 06510, USA
| | - Chao Zhou
- Department of Epidemiology and Public Health, School of Medicine, Yale University, 300 George Street, New Haven, CT, 06510, USA
| | - Jianlei Gu
- Department of Epidemiology and Public Health, School of Medicine, Yale University, 300 George Street, New Haven, CT, 06510, USA
| | - Hongyu Zhao
- Department of Epidemiology and Public Health, School of Medicine, Yale University, 300 George Street, New Haven, CT, 06510, USA
| | - I-Hsin Lin
- Department of Epidemiology and Biostatistics, Memorial Sloan-Kettering Cancer Center, 485 Lexington Ave, New York, NY, 10017, USA
| | - Cynthia E Chico
- Department of Psychiatry and Behavioral Sciences, School of Medicine, Emory University, 1365-B Clifton Road, Atlanta, GA, 30322, USA
| | - Sangchoon Jeon
- School of Nursing, Yale University, 400 West Campus Drive, Room 20102, Orange, CT, 06477, USA
| | - Tish M Knobf
- School of Nursing, Yale University, 400 West Campus Drive, Room 20102, Orange, CT, 06477, USA
| | - Karen N Conneely
- Department of Human Genetics, School of Medicine, Emory University, 201 Dowman Drive, Atlanta, GA, 30322, USA
| | - Kristin Higgins
- Department of Radiation, School of Medicine, Emory University, 1365-C Clifton Road NE, Atlanta, GA, 30322, USA
| | - Dong M Shin
- Department of Hematology and Medical Oncology, School of Medicine, Emory University, 1365-C Clifton Road NE, Atlanta, GA, 30322, USA
| | - Nabil Saba
- Department of Hematology and Medical Oncology, School of Medicine, Emory University, 1365-C Clifton Road NE, Atlanta, GA, 30322, USA
| | - Andrew Miller
- Department of Psychiatry and Behavioral Sciences, School of Medicine, Emory University, 1365-B Clifton Road, Atlanta, GA, 30322, USA
| | - Deborah Bruner
- School of Nursing, Emory University, 1520 Clifton Road NE, Atlanta, 30322, USA
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Wolff BS, Raheem SA, Alshawi SA, Regan JM, Feng LR, Saligan LN. Induction of fatigue-like behavior by pelvic irradiation of male mice alters cognitive behaviors and BDNF expression. PLoS One 2020; 15:e0235566. [PMID: 32614931 PMCID: PMC7332074 DOI: 10.1371/journal.pone.0235566] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2020] [Accepted: 06/18/2020] [Indexed: 11/18/2022] Open
Abstract
Fatigue and cognitive deficits are often co-occurring symptoms reported by patients after radiation therapy for prostate cancer. In this study, we induced fatigue-like behavior in mice using targeted pelvic irradiation to mimic the clinical treatment regimen and assess cognitive behavioral changes. We observed that pelvic irradiation produced a robust fatigue phenotype, a reduced rate of spontaneous alternation in a Y-maze test, and no behavioral change in an open field test. We found that reversal learning for fatigued mice was slower with respect to time, but not with respect to effort put into the test, suggesting that fatigue may impact the ability or motivation to work at a cognitive task without impairing cognitive capabilities. In addition, we found that mice undergoing pelvic irradiation show lower whole-brain levels of mature BDNF, and that whole-brain proBDNF levels also correlate with spontaneous alternation in a Y-maze test. These results suggest that changes in BDNF levels could be both a cause and an effect of fatigue-related changes in behavior.
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Affiliation(s)
- Brian S. Wolff
- National Institute of Nursing Research, National Institutes of Health, Bethesda, Maryland, United States of America
| | - Sumiyya A. Raheem
- National Institute of Nursing Research, National Institutes of Health, Bethesda, Maryland, United States of America
| | - Sarah A. Alshawi
- National Institute of Nursing Research, National Institutes of Health, Bethesda, Maryland, United States of America
| | - Jeniece M. Regan
- National Institute of Nursing Research, National Institutes of Health, Bethesda, Maryland, United States of America
| | - Li Rebekah Feng
- National Institute of Nursing Research, National Institutes of Health, Bethesda, Maryland, United States of America
| | - Leorey N. Saligan
- National Institute of Nursing Research, National Institutes of Health, Bethesda, Maryland, United States of America
- * E-mail:
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Koh YQ, Tan CJ, Toh YL, Sze SK, Ho HK, Limoli CL, Chan A. Role of Exosomes in Cancer-Related Cognitive Impairment. Int J Mol Sci 2020; 21:ijms21082755. [PMID: 32326653 PMCID: PMC7215650 DOI: 10.3390/ijms21082755] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2020] [Revised: 04/14/2020] [Accepted: 04/14/2020] [Indexed: 12/11/2022] Open
Abstract
A decline in cognitive function following cancer treatment is one of the most commonly reported post-treatment symptoms among patients with cancer and those in remission, and include memory, processing speed, and executive function. A clear understanding of cognitive impairment as a result of cancer and its therapy can be obtained by delineating structural and functional changes using brain imaging studies and neurocognitive assessments. There is also a need to determine the underlying mechanisms and pathways that impact the brain and affect cognitive functioning in cancer survivors. Exosomes are small cell-derived vesicles formed by the inward budding of multivesicular bodies, and are released into the extracellular environment via an exocytic pathway. Growing evidence suggests that exosomes contribute to various physiological and pathological conditions, including neurological processes such as synaptic plasticity, neuronal stress response, cell-to-cell communication, and neurogenesis. In this review, we summarize the relationship between exosomes and cancer-related cognitive impairment. Unraveling exosomes’ actions and effects on the microenvironment of the brain, which impacts cognitive functioning, is critical for the development of exosome-based therapeutics for cancer-related cognitive impairment.
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Affiliation(s)
- Yong Qin Koh
- Department of Pharmacy, Faculty of Science, National University of Singapore, Singapore 119077, Singapore
| | - Chia Jie Tan
- Department of Pharmacy, Faculty of Science, National University of Singapore, Singapore 119077, Singapore
| | - Yi Long Toh
- Department of Pharmacy, Faculty of Science, National University of Singapore, Singapore 119077, Singapore
| | - Siu Kwan Sze
- School of Biological Sciences, Nanyang Technological University, 60 Nanyang Drive, Singapore 637551, Singapore
| | - Han Kiat Ho
- Department of Pharmacy, Faculty of Science, National University of Singapore, Singapore 119077, Singapore
| | - Charles L. Limoli
- Department of Radiation Oncology, University of California, Irvine, CA 92697-2695, USA
| | - Alexandre Chan
- Department of Pharmacy, Faculty of Science, National University of Singapore, Singapore 119077, Singapore
- Department of Clinical Pharmacy Practice, University of California, Irvine, CA 92697, USA
- Correspondence: ; Tel.: +1-949-824-8896
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Kang SY, Bang M, Hong JY, Oh J, Kim JS, Han YM, Chang SK, Lee SA, Yoon U, Shin NY. Neural and dopaminergic correlates of fatigue in Parkinson's disease. J Neural Transm (Vienna) 2020; 127:301-309. [PMID: 31894419 DOI: 10.1007/s00702-019-02130-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [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: 10/06/2019] [Accepted: 12/19/2019] [Indexed: 11/25/2022]
Abstract
Fatigue is one of the most common non-motor symptoms in Parkinson's disease (PD). Despite its clinical importance, there are few studies on the cause or mechanism of fatigue. Our aim was to find brain areas related to fatigue and to explore the association between striatal dopaminergic dysfunction and fatigue. We consecutively screened forty-seven patients with de novo PD from 2012 to 2017 and enrolled 32 patients. The gray matter volumes, white matter tracts, and striatal dopaminergic activity between PD without fatigue and with fatigue were compared. The correlation between fatigue and striatal dopaminergic activity was also analyzed. Our data did not show any significant difference in gray matter volume between PD without fatigue and with fatigue (familywise error [FWE] corrected p > 0.05) but revealed significantly higher mean fractional anisotropy (FA) values for all analyzed white matter tracts in PD with fatigue (false discovery rate [FDR] corrected p < 0.05), except left cingulum-hippocampus (CH), right superior longitudinal fasciculus, and right longitudinal fasciculus temporal part (FDR corrected p > 0.06); lower mean diffusivity (MD) values for all analyzed white matter tracts in PD with fatigue (FDR corrected p < 0.05), except in the left CH and uncinate fasciculus (FDR corrected p > 0.05). The mean radial diffusivity (RD) values, except for the left CH (FDR corrected p = 0.0576), were also significantly lower (FDR corrected p < 0.05). There was no difference in dopaminergic deficits between PD without fatigue and PD with fatigue (p > 0.50). The alteration of the white matter tract may reflect the degree of fatigue in PD. This is not true of the gray matter and striatal dopaminergic activity. These results show the possibility that white matter changes can be used as a biomarker for fatigue.
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Affiliation(s)
- Suk Yun Kang
- Department of Neurology, Dongtan Sacred Heart Hospital, Hallym University College of Medicine, 7, Keunjaebong-gil, Hwaseong, Gyeonggi-do, 18450, Republic of Korea.
| | - Mirim Bang
- Department of Radiology, College of Medicine, The Catholic University of Korea, 222 Banpo-daero, Seocho-gu, Seoul, 06591, Republic of Korea
| | - Jing Yong Hong
- Department of Neurology, Yonsei University Wonju College of Medicine, Wonju, Republic of Korea
| | - Jungsu Oh
- Department of Nuclear Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Jae Seung Kim
- Department of Nuclear Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - You Mie Han
- Department of Nuclear Medicine, Dongtan Sacred Heart Hospital, College of Medicine, Hallym University, Hwaseong, Republic of Korea
| | - Suk Ki Chang
- Department of Radiology, Hallym University Dongtan Sacred Heart Hospital, Hwaseong, Republic of Korea
| | - Seun Ah Lee
- Department of Radiology, Hallym University Dongtan Sacred Heart Hospital, Hwaseong, Republic of Korea
| | - Uicheul Yoon
- Department of Biomedical Engineering, College of Health and Medical Science, Catholic University of Daegu, Gyeongsan, Republic of Korea
| | - Na-Young Shin
- Department of Radiology, College of Medicine, The Catholic University of Korea, 222 Banpo-daero, Seocho-gu, Seoul, 06591, Republic of Korea.
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20
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Shirzhiyan Z, Keihani A, Farahi M, Shamsi E, GolMohammadi M, Mahnam A, Haidari MR, Jafari AH. Introducing chaotic codes for the modulation of code modulated visual evoked potentials (c-VEP) in normal adults for visual fatigue reduction. PLoS One 2019; 14:e0213197. [PMID: 30840671 PMCID: PMC6402685 DOI: 10.1371/journal.pone.0213197] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2018] [Accepted: 02/16/2019] [Indexed: 11/19/2022] Open
Abstract
Code modulated Visual Evoked Potentials (c-VEP) based BCI studies usually employ m-sequences as a modulating codes for their broadband spectrum and correlation property. However, subjective fatigue of the presented codes has been a problem. In this study, we introduce chaotic codes containing broadband spectrum and similar correlation property. We examined whether the introduced chaotic codes could be decoded from EEG signals and also compared the subjective fatigue level with m-sequence codes in normal subjects. We generated chaotic code from one-dimensional logistic map and used it with conventional 31-bit m-sequence code. In a c-VEP based study in normal subjects (n = 44, 21 females) we presented these codes visually and recorded EEG signals from the corresponding codes for their four lagged versions. Canonical correlation analysis (CCA) and spatiotemporal beamforming (STB) methods were used for target identification and comparison of responses. Additionally, we compared the subjective self-declared fatigue using VAS caused by presented m-sequence and chaotic codes. The introduced chaotic code was decoded from EEG responses with CCA and STB methods. The maximum total accuracy values of 93.6 ± 11.9% and 94 ± 14.4% were achieved with STB method for chaotic and m-sequence codes for all subjects respectively. The achieved accuracies in all subjects were not significantly different in m-sequence and chaotic codes. There was significant reduction in subjective fatigue caused by chaotic codes compared to the m-sequence codes. Both m-sequence and chaotic codes were similar in their accuracies as evaluated by CCA and STB methods. The chaotic codes significantly reduced subjective fatigue compared to the m-sequence codes.
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Affiliation(s)
- Zahra Shirzhiyan
- Medical Physics & Biomedical Engineering Department, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
- Research Center for Biomedical Technologies and Robotics (RCBTR), Tehran University of Medical Sciences, Tehran, Iran
| | - Ahmadreza Keihani
- Medical Physics & Biomedical Engineering Department, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
- Research Center for Biomedical Technologies and Robotics (RCBTR), Tehran University of Medical Sciences, Tehran, Iran
| | - Morteza Farahi
- Medical Physics & Biomedical Engineering Department, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
- Research Center for Biomedical Technologies and Robotics (RCBTR), Tehran University of Medical Sciences, Tehran, Iran
| | - Elham Shamsi
- Medical Physics & Biomedical Engineering Department, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
- Research Center for Biomedical Technologies and Robotics (RCBTR), Tehran University of Medical Sciences, Tehran, Iran
| | - Mina GolMohammadi
- Research Center for Biomedical Technologies and Robotics (RCBTR), Tehran University of Medical Sciences, Tehran, Iran
| | - Amin Mahnam
- Department of Biomedical Engineering, Faculty of Engineering, University of Isfahan, Isfahan, Iran
| | - Mohsen Reza Haidari
- Section of Neuroscience, Department of Neurology, Faculty of Medicine, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Amir Homayoun Jafari
- Medical Physics & Biomedical Engineering Department, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
- Research Center for Biomedical Technologies and Robotics (RCBTR), Tehran University of Medical Sciences, Tehran, Iran
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Shortz AE, Mehta RK, Peres SC, Benden ME, Zheng Q. Development of the Fatigue Risk Assessment and Management in High-Risk Environments (FRAME) Survey: A Participatory Approach. Int J Environ Res Public Health 2019; 16:ijerph16040522. [PMID: 30781731 PMCID: PMC6406396 DOI: 10.3390/ijerph16040522] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/20/2018] [Revised: 02/02/2019] [Accepted: 02/10/2019] [Indexed: 12/26/2022]
Abstract
Existing risk assessment tools are not effective or sustainable in identifying Oil and Gas Extraction (OGE) workers at high risk of fatigue-related injuries or incidents. We developed a comprehensive Fatigue Risk Assessment and Management in high-risk Environments (FRAME) survey through an industry-academic participatory approach. The FRAME survey was developed through: (1) systematic gathering of existing fatigue scales; (2) refining the inventory using the Delphi Consensus technique; and (3) further refinement through employee/worker focus groups. The participatory approach resulted in a final FRAME survey across four fatigue dimensions—sleep, shiftwork, physical, and mental fatigue, and was composed of 26 items. The FRAME survey was founded on occupational fatigue science and refined and tailored to the OGE industry, through rigorous industry stakeholder input, for safer, effective, practical, and sustainable fatigue assessment and management efforts.
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Affiliation(s)
- Ashley E Shortz
- Department of Environmental and Occupational Health, Texas A&M University, College Station, TX 77843, USA.
| | - Ranjana K Mehta
- Department of Industrial and Systems Engineering, Texas A&M University, College Station, TX 77843, USA.
| | - S Camille Peres
- Department of Environmental and Occupational Health, Texas A&M University, College Station, TX 77843, USA.
| | - Mark E Benden
- Department of Environmental and Occupational Health, Texas A&M University, College Station, TX 77843, USA.
| | - Qi Zheng
- Department of Epidemiology and Biostatistics, Texas A&M University, College Station, TX 77843, USA.
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22
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Klinedinst NJ, Schuh R, Kittner SJ, Regenold WT, Kehs G, Hoch C, Hackney A, Fiskum G. Post-stroke fatigue as an indicator of underlying bioenergetics alterations. J Bioenerg Biomembr 2019; 51:165-174. [PMID: 30617735 DOI: 10.1007/s10863-018-9782-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [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: 07/18/2018] [Accepted: 12/18/2018] [Indexed: 12/13/2022]
Abstract
Approximately half of stroke survivors suffer from clinically significant fatigue, contributing to poor quality of life, depression, dependency, and increased mortality. The etiology of post-stroke fatigue is not well understood and treatment is limited. This study tested the hypothesis that systemic aerobic energy metabolism, as reflected by platelet oxygen consumption, is negatively associated with fatigue and systemic inflammation is positively associated with fatigue in chronic ischemic stroke survivors. Data on self-reported level of fatigue, platelet oxygen consumption rates (OCR) and plasma inflammatory markers were analyzed from 20 ischemic stroke survivors. DNA copy number for two mitochondrial genes was measured as a marker of platelet mitochondrial content. Basal and protonophore-stimulated maximal platelet OCR showed a biphasic relationship to fatigue. Platelet OCR was negatively associated with low to moderate fatigue but was positively associated with moderate to high fatigue. DNA copy number was not associated with either fatigue or platelet OCR. Fatigue was negatively associated with C-reactive protein but not with other inflammatory markers. Post-stroke fatigue may be indicative of a systemic cellular energy dysfunction that is reflected in platelet energy metabolism. The biphasic relationship of fatigue to platelet OCR may indicate an ineffective bioenergetic compensatory response that has been observed in other pathological states.
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Affiliation(s)
- N Jennifer Klinedinst
- University of Maryland School of Nursing, Room 325B, 655 W. Lombard Street, Baltimore, MD, 21201, USA.
| | - Rosemary Schuh
- University of Maryland School of Medicine, 655 W. Baltimore Street, Baltimore, MD, 21201, USA
| | - Steven J Kittner
- University of Maryland School of Medicine, 655 W. Baltimore Street, Baltimore, MD, 21201, USA
- Baltimore Veterans Administration Medical Center, 10 N. Greene Street, Baltimore, MD, 21201, USA
| | - William T Regenold
- University of Maryland School of Medicine, 655 W. Baltimore Street, Baltimore, MD, 21201, USA
| | - Glenn Kehs
- University of Maryland School of Medicine, 655 W. Baltimore Street, Baltimore, MD, 21201, USA
| | - Christine Hoch
- University of Maryland School of Nursing, Room 325B, 655 W. Lombard Street, Baltimore, MD, 21201, USA
| | - Alisha Hackney
- University of Maryland School of Nursing, Room 325B, 655 W. Lombard Street, Baltimore, MD, 21201, USA
| | - Gary Fiskum
- University of Maryland School of Medicine, 655 W. Baltimore Street, Baltimore, MD, 21201, USA
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23
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Bartlett SJ, Gutierrez AK, Butanis A, Bykerk VP, Curtis JR, Ginsberg S, Leong AL, Lyddiatt A, Nowell WB, Orbai AM, Smith KC, Bingham CO. Combining online and in-person methods to evaluate the content validity of PROMIS fatigue short forms in rheumatoid arthritis. Qual Life Res 2018; 27:2443-2451. [PMID: 29797175 PMCID: PMC6113070 DOI: 10.1007/s11136-018-1880-x] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [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] [Accepted: 05/08/2018] [Indexed: 12/14/2022]
Abstract
PURPOSE Fatigue is frequent and often severe and disabling in RA, and there is no consensus on how to measure it. We used online surveys and in-person interviews to evaluate PROMIS Fatigue 7a and 8a short forms (SFs) in people with RA. METHODS We recruited people with RA from an online patient community (n = 200) and three academic medical centers (n = 84) in the US. Participants completed both SFs then rated the comprehensiveness and comprehensibility of the items to their fatigue experience. Cognitive debriefing of items was conducted in a subset of 32 clinic patients. Descriptive statistics were calculated, and associations were evaluated using Pearson and Spearman correlation coefficients. RESULTS Mean SF scores were similar (p ≥ .61) among clinic patients reflecting mild fatigue (i.e., 54.5-55.9), but were significantly higher (p < .001) in online participants. SF Fatigue scores correlated highly (r ≥ 0.82; p < .000) and moderately with patient assessments of disease activity (r ≥ 0.62; p = .000). Most (70-92%) reported that the items "completely" or "mostly" reflected their experience. Almost all (≥ 94%) could distinguish general fatigue from RA fatigue. Most (≥ 85%) rated individual items questions as "somewhat" or "very relevant" to their fatigue experience, averaged their fatigue over the past 7 days (58%), and rated fatigue impact versus severity (72 vs. 19%). 99% rated fatigue as an important symptom they considered when deciding how well their current treatment was controlling their RA. CONCLUSIONS Results suggest that items in the single-score PROMIS Fatigue SFs demonstrate content validity and can adequately capture the wide range of fatigue experiences of people with RA.
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Affiliation(s)
- S J Bartlett
- Center for Health Outcomes Research, McGill University, 5252 de Maisonneuve West, #3D-57, Montreal, QC, H4A 3S5, Canada.
- Division of Rheumatology, Johns Hopkins School of Medicine, Mason F Lord Tower, 5200 Eastern Avenue, Rm 404, Baltimore, MD, 21224, USA.
| | - A K Gutierrez
- Division of Rheumatology, Johns Hopkins School of Medicine, Mason F Lord Tower, 5200 Eastern Avenue, Rm 404, Baltimore, MD, 21224, USA
- Ateneo School of Medicine and Public Health, Pasig City, Philippines
| | - A Butanis
- Division of Rheumatology, Johns Hopkins School of Medicine, Mason F Lord Tower, 5200 Eastern Avenue, Rm 404, Baltimore, MD, 21224, USA
| | - V P Bykerk
- Hospital for Special Surgery, Weill Cornell Medical College, 525 East 71st St, 7th floor, New York, NY, 10021, USA
| | - J R Curtis
- Division of Rheumatology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - S Ginsberg
- Global Healthy Living Foundation, Upper Nyack, NY, USA
| | - A L Leong
- Healthy Motivation, Santa Barbara, CA, USA
| | | | - W B Nowell
- Global Healthy Living Foundation, Upper Nyack, NY, USA
| | - A M Orbai
- Division of Rheumatology, Johns Hopkins School of Medicine, Mason F Lord Tower, 5200 Eastern Avenue, Rm 404, Baltimore, MD, 21224, USA
| | - K C Smith
- Johns Hopkins Bloomberg School of Public Health Center for Qualitative Studies in Health and Medicine, Baltimore, MD, USA
| | - C O Bingham
- Division of Rheumatology, Johns Hopkins School of Medicine, Mason F Lord Tower, 5200 Eastern Avenue, Rm 404, Baltimore, MD, 21224, USA
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24
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Solopchuk O, Sebti M, Bouvy C, Benoit CE, Warlop T, Jeanjean A, Zénon A. Locus Coeruleus atrophy doesn't relate to fatigue in Parkinson's disease. Sci Rep 2018; 8:12381. [PMID: 30120287 PMCID: PMC6098016 DOI: 10.1038/s41598-018-30128-y] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2018] [Accepted: 07/18/2018] [Indexed: 01/24/2023] Open
Abstract
Fatigue is a frequent complaint among healthy population and one of the earliest and most debilitating symptoms in Parkinson's disease (PD). Earlier studies have examined the role of dopamine and serotonin in pathogenesis of fatigue, but the plausible role of noradrenalin (NA) remains underexplored. We investigated the relationship between fatigue in Parkinsonian patients and the extent of degeneration of Locus Coeruleus (LC), the main source of NA in the brain. We quantified LC and Substantia Nigra (SN) atrophy using neuromelanin-sensitive imaging, analyzed with a novel, fully automated algorithm. We also assessed patients' fatigue, depression, sleep disturbance and vigilance. We found that LC degeneration correlated with the levels of depression and vigilance but not with fatigue, while fatigue correlated weakly with atrophy of SN. These results indicate that LC degeneration in Parkinson's disease is unlikely to cause fatigue, but may be involved in mood and vigilance alterations.
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Affiliation(s)
- Oleg Solopchuk
- Institute of Neuroscience, Université catholique de Louvain, Brussels, Belgium.
- INCIA, 33076, Bordeaux, France.
| | - Moustapha Sebti
- Institute of Neuroscience, Université catholique de Louvain, Brussels, Belgium
| | - Céline Bouvy
- Cliniques Universitaires Saint Luc, Université catholique de Louvain, Brussels, Belgium
| | | | - Thibault Warlop
- Cliniques Universitaires Saint Luc, Université catholique de Louvain, Brussels, Belgium
| | - Anne Jeanjean
- Cliniques Universitaires Saint Luc, Université catholique de Louvain, Brussels, Belgium
| | - Alexandre Zénon
- Institute of Neuroscience, Université catholique de Louvain, Brussels, Belgium
- INCIA, 33076, Bordeaux, France
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25
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Hyncicova E, Kalina A, Vyhnalek M, Nikolai T, Martinkovic L, Lisy J, Hort J, Meluzinova E, Laczó J. Health-related quality of life, neuropsychiatric symptoms and structural brain changes in clinically isolated syndrome. PLoS One 2018; 13:e0200254. [PMID: 29979757 PMCID: PMC6034869 DOI: 10.1371/journal.pone.0200254] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2017] [Accepted: 06/24/2018] [Indexed: 11/18/2022] Open
Abstract
Background Neuropsychiatric symptoms and reduced health-related quality of life (HRQoL) are frequent in multiple sclerosis, where are associated with structural brain changes, but have been less studied in clinically isolated syndrome (CIS). Objective To characterize HRQoL, neuropsychiatric symptoms (depressive symptoms, anxiety, apathy and fatigue), their interrelations and associations with structural brain changes in CIS. Methods Patients with CIS (n = 67) and demographically matched healthy controls (n = 46) underwent neurological and psychological examinations including assessment of HRQoL, neuropsychiatric symptoms and cognitive functioning, and MRI brain scan with global, regional and lesion load volume measurement. Results The CIS group had more, mostly mild, depressive symptoms and anxiety, and lower HRQoL physical and social subscores (p≤0.037). Neuropsychiatric symptoms were associated with most HRQoL subscores (β≤-0.34, p≤0.005). Cognitive functioning unlike clinical disability was associated with depressive symptoms and lower HRQoL emotional subscores (β≤-0.29, p≤0.019). Depressive symptoms and apathy were associated with right temporal, left insular and right occipital lesion load (ß≥0.29, p≤0.032). Anxiety was associated with lower white matter volume (ß = -0.25, p = 0.045). Conclusion Mild depressive symptoms and anxiety with decreased HRQoL are present in patients with CIS. Neuropsychiatric symptoms contributing to decreased HRQoL are the result of structural brain changes and require complex therapeutic approach in patients with CIS.
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Affiliation(s)
- Eva Hyncicova
- Department of Neurology, Charles University, 2nd Faculty of Medicine, Motol University Hospital, Prague, Czech Republic
| | - Adam Kalina
- Department of Neurology, Charles University, 2nd Faculty of Medicine, Motol University Hospital, Prague, Czech Republic
| | - Martin Vyhnalek
- Department of Neurology, Charles University, 2nd Faculty of Medicine, Motol University Hospital, Prague, Czech Republic
| | - Tomas Nikolai
- Department of Neurology, Charles University, 2nd Faculty of Medicine, Motol University Hospital, Prague, Czech Republic
| | - Lukas Martinkovic
- Department of Neurology, Charles University, 2nd Faculty of Medicine, Motol University Hospital, Prague, Czech Republic
| | - Jiri Lisy
- Department of Radiology, Charles University, 2nd Faculty of Medicine, Motol University Hospital, Prague, Czech Republic
| | - Jakub Hort
- Department of Neurology, Charles University, 2nd Faculty of Medicine, Motol University Hospital, Prague, Czech Republic
| | - Eva Meluzinova
- Department of Neurology, Charles University, 2nd Faculty of Medicine, Motol University Hospital, Prague, Czech Republic
| | - Jan Laczó
- Department of Neurology, Charles University, 2nd Faculty of Medicine, Motol University Hospital, Prague, Czech Republic
- * E-mail:
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26
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Estabrook R, Cella D, Zhao F, Manola J, DiPaola RS, Wagner LI, Haas NB. Longitudinal and dynamic measurement invariance of the FACIT-Fatigue scale: an application of the measurement model of derivatives to ECOG-ACRIN study E2805. Qual Life Res 2018; 27:1589-1597. [PMID: 29508208 PMCID: PMC6004788 DOI: 10.1007/s11136-018-1817-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [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] [Accepted: 02/20/2018] [Indexed: 10/17/2022]
Abstract
PURPOSE While quality of life measures may be used to assess meaningful change and group differences, their scaling and validation often rely on a single occasion of measurement. Using the 13-item FACIT-Fatigue questionnaire at three timepoints, this study tests whether individual items change together in ways consistent with a general fatigue factor. METHODS The measurement model of derivatives (MMOD) is a novel method for measurement evaluation that directly assesses whether a given factor structure accurately describes how individual test items change over time. MMOD transforms item-level longitudinal data into a set of orthogonal change scores, each one representing either a within-person longitudinal mean or a different type of longitudinal change. These change scores are then factor analyzed and tested for invariance. This approach is applied to the FACIT-Fatigue scale in a sample of patients with renal cell carcinoma treated on 'ECOG-ACRIN Cancer Research Group (ECOG-ACRIN) study 2805. RESULTS Analyses revealed strong evidence of unidimensionality, and apparent factorial invariance using traditional techniques. MMOD revealed a small but statistically significant difference in factor structure ([Formula: see text], [Formula: see text]), where factor loadings were weaker and more variable for measuring longitudinal change. CONCLUSIONS The differences in factor structure were not large enough to substantially affect scale usage in this application, but they do reveal some variability across items in the FACIT-Fatigue in their ability to detect change. Future applications should consider differential sensitivity of individual items in multi-item scales, and perhaps even capitalize upon these differences by selecting items that are more sensitive to change.
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Affiliation(s)
- Ryne Estabrook
- Department of Medical Social Sciences, Northwestern University, Chicago, IL, USA.
| | - David Cella
- Department of Medical Social Sciences, Northwestern University, Chicago, IL, USA
| | | | | | | | - Lynne I Wagner
- Wake Forest University Health Sciences, Winston-Salem, NC, USA
| | - Naomi B Haas
- Abramson Cancer Center, University of Pennsylvania, Philadelphia, PA, USA
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Abstract
Fatigue is a common and debilitating condition that affects most cancer patients. To date, fatigue remains poorly characterized with no diagnostic test to objectively measure the severity of this condition. Here we describe an optimized method for assessing mitochondrial function of PBMCs collected from fatigued cancer patients. Using a compact extracellular flux system and sequential injection of respiratory inhibitors, we examined PBMC mitochondrial functional status by measuring basal mitochondrial respiration, spare respiratory capacity, and energy phenotype, which describes the preferred energy pathway to respond to stress. Fresh PBMCs are readily available in the clinical setting using standard phlebotomy. The entire assay described in this protocol can be completed in less than 4 hours without the involvement of complex biochemical techniques. Additionally, we describe a normalization method that is necessary for obtaining reproducible data. The simple procedure and normalization methods presented allow for repeated sample collection from the same patient and generation of reproducible data that can be compared between time points to evaluate potential treatment effects.
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Affiliation(s)
- Li Rebekah Feng
- National Institute of Nursing Research, National Institutes of Health
| | - Quang Nguyen
- National Institute of Nursing Research, National Institutes of Health
| | - Alexander Ross
- National Institute of Nursing Research, National Institutes of Health
| | - Leorey N Saligan
- National Institute of Nursing Research, National Institutes of Health;
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Abstract
PURPOSE Cancer-related fatigue is a common complaint during cancer treatment and is often associated with cognitive impairment. This study examined cognitive deficits that were associated with fatigue symptoms during external-beam radiation therapy (EBRT) in men with localized prostate cancer. METHODS A total of 36 participants were enrolled and followed up at baseline, 24 h, 7 days, 14 days after EBRT initiation, at midpoint, and at completion of EBRT. Fatigue was measured by self-report using the Functional Assessment of Cancer Therapy - Fatigue (FACT-F), and cognitive impairment by the Computer Assessment of Mild Cognitive Impairment (CAMCI®). RESULTS Subjects with increased fatigue during EBRT reported a significant decline in cognitive function and had difficulties with CAMCI®'s route finding and item recall tasks during EBRT. Increased fatigue during EBRT was associated with perceived cognitive difficulties in executive function and recognition memory, but not with attention or verbal memory. CONCLUSIONS Our results suggest that there might be specific cognitive domains that are associated with increased fatigue during EBRT. These findings will provide important information for targeting specific cognitive domains using pharmacotherapy or behavioral interventions. CAMCI® is a valuable tool for psycho social providers to detect subtle cognitive impairment in fatigued cancer patients in a clinical setting.
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Ciampi E, Uribe-San-Martin R, Vásquez M, Ruiz-Tagle A, Labbe T, Cruz JP, Lillo P, Slachevsky A, Reyes D, Reyes A, Cárcamo-Rodríguez C. Relationship between Social Cognition and traditional cognitive impairment in Progressive Multiple Sclerosis and possible implicated neuroanatomical regions. Mult Scler Relat Disord 2018; 20:122-128. [PMID: 29414284 DOI: 10.1016/j.msard.2018.01.013] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [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: 07/07/2017] [Revised: 11/16/2017] [Accepted: 01/16/2018] [Indexed: 01/12/2023]
Abstract
BACKGROUND Cognitive impairment is a relevant contributor of the medical and social burden in Progressive MS. Social Cognition, the neurocognitive processes underlying social interaction, has been explored mainly in European and North American cohorts, influencing social aspects of quality of life (QOL) of early MS patients and families. Few studies have studied Social Cognition in Progressive MS and the literature on its neuroanatomical bases or brain atrophy measurements is still scarce. OBJECTIVES To explore the relationship between Social Cognition performance and its correlations with traditional cognitive domains, brain atrophy and QOL in primary and secondary Progressive MS patients. METHODS Cross-sectional analysis including: mini-Social-Cognition-and-Emotional-Assessment (mini-SEA), neuropsychological battery, disability, depression, fatigue, QOL, and brain volume. RESULTS Forty-three MS patients, 23 primary and 20 secondary Progressive, 65% women, mean age and disease duration of 57.2 and 15.7 years, respectively, with high levels of disability (median EDSS 6.0) and a widespread impairment in traditional domains (mostly episodic verbal/visual and working memories) were assessed. The Mini-SEA score was correlated with executive functions (cognitive shifts Rho:0.55; p = 0.001) analyzing the whole group, and with visual episodic memory (Rho:0.58, p = 0.009) in the primary Progressive MS group. Mini-SEA score was also correlated with total normalized grey matter volume (Rho:0.48; p = 0.004). Particularly, atrophy within bilateral cortical regions of orbitofrontal, insula and cerebellum, and right regions of fusiform gyrus and precuneus were significantly associated with higher Social Cognition impairment. In this cohort, QOL was not correlated with Social Cognition, but with EDSS, fatigue and depression. CONCLUSIONS In Progressive MS, Social Cognition is directly correlated with traditional cognitive domains such as executive function and episodic memory. It is also associated with global grey matter atrophy and regional atrophy within associative visual and executive cortical areas, but no correlations with QOL were found in this cohort. These findings may contribute to the understanding of the pathological bases behind Social Cognition in Progressive MS.
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Affiliation(s)
- E Ciampi
- Neurology Department, Pontifical Catholic University of Chile, Santiago, Chile; Neurology, Hospital Sotero del Rio, Santiago, Chile.
| | - R Uribe-San-Martin
- Neurology Department, Pontifical Catholic University of Chile, Santiago, Chile; Neurology, Hospital Sotero del Rio, Santiago, Chile
| | - M Vásquez
- Neurology Department, Pontifical Catholic University of Chile, Santiago, Chile
| | - A Ruiz-Tagle
- Centre for Advanced Research in Education, University of Chile, Santiago, Chile
| | - T Labbe
- Pontifical Catholic University of Chile, Santiago, Chile
| | - J P Cruz
- Radiology Department, Pontifical Catholic University of Chile, Santiago, Chile
| | - P Lillo
- Neurology Department South, Faculty of Medicine, University of Chile, Geroscience Center for Brain Health and Metabolism, Santiago, Chile
| | - A Slachevsky
- Centre for Advanced Research in Education, University of Chile, Santiago, Chile; Gerosciences Center for Brain Health and Metabolism, Santiago, Chile; Physiopathology Department, ICBM and East Neuroscience Department Faculty of Medicine University of Chile, Santiago, Chile; Cognitive Neurology and Dementia, Neurology Department, Salvador Hospital, Santiago, Chile; Neurology Service, Medicine Department, Alemana Clinic and Universidad del Desarrollo, Santiago, Chile
| | - D Reyes
- Faculty of Medicine, Pontifical Catholic University of Chile, Santiago, Chile
| | - A Reyes
- Neurology Department, Pontifical Catholic University of Chile, Santiago, Chile
| | - C Cárcamo-Rodríguez
- Neurology Department, Pontifical Catholic University of Chile, Santiago, Chile
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Zenouzi R, von der Gablentz J, Heldmann M, Göttlich M, Weiler-Normann C, Sebode M, Ehlken H, Hartl J, Fellbrich A, Siemonsen S, Schramm C, Münte TF, Lohse AW. Patients with primary biliary cholangitis and fatigue present with depressive symptoms and selected cognitive deficits, but with normal attention performance and brain structure. PLoS One 2018; 13:e0190005. [PMID: 29320524 PMCID: PMC5761833 DOI: 10.1371/journal.pone.0190005] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2017] [Accepted: 12/06/2017] [Indexed: 02/07/2023] Open
Abstract
Background In primary biliary cholangitis (PBC) fatigue is a major clinical challenge of unknown etiology. By demonstrating that fatigue in PBC is associated with an impaired cognitive performance, previous studies have pointed out the possibility of brain abnormalities underlying fatigue in PBC. Whether structural brain changes are present in PBC patients with fatigue, however, is unclear. To evaluate the role of structural brain abnormalities in PBC patients severely affected from fatigue we, therefore, performed a case-control cerebral magnetic resonance imaging (cMRI) study and correlated changes of white and grey brain matter with the cognitive and attention performance. Methods 20 female patients with PBC and 20 female age-matched controls were examined in this study. The assessment of fatigue, psychological symptoms, cognitive and attention performance included clinical questionnaires, established cognition tests and a computerized test battery of attention performance. T1-weighted cMRI and diffusion tensor imaging (DTI) scans were acquired with a 3 Tesla scanner. Structural brain alterations were investigated with voxel-based morphometry (VBM) and DTI analyses. Results were correlated to the cognitive and attention performance. Results Compared to healthy controls, PBC patients had significantly higher levels of fatigue and associated psychological symptoms. Except for an impairment of verbal fluency, no cognitive or attention deficits were found in the PBC cohort. The VBM and DTI analyses revealed neither major structural brain abnormalities in the PBC cohort nor correlations with the cognitive and attention performance. Conclusions Despite the high burden of fatigue and selected cognitive deficits, the attention performance of PBC patients appears to be comparable to healthy people. As structural brain alterations do not seem to be present in PBC patients with fatigue, fatigue in PBC must be regarded as purely functional. Future studies should evaluate, whether functional brain changes underlie fatigue in PBC.
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Affiliation(s)
- Roman Zenouzi
- 1st Department of Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- * E-mail:
| | | | - Marcus Heldmann
- Department of Neurology, University of Lübeck, Lübeck, Germany
| | - Martin Göttlich
- Department of Neurology, University of Lübeck, Lübeck, Germany
| | | | - Marcial Sebode
- 1st Department of Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Hanno Ehlken
- 1st Department of Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- Department of Interdisciplinary Endoscopy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Johannes Hartl
- 1st Department of Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Anja Fellbrich
- Department of Neurology, University of Lübeck, Lübeck, Germany
| | - Susanne Siemonsen
- Department of Diagnostic and Interventional Neuroradiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Christoph Schramm
- 1st Department of Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Thomas F. Münte
- Department of Neurology, University of Lübeck, Lübeck, Germany
| | - Ansgar W. Lohse
- 1st Department of Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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Bilanakis N, Vratsista A, Siorou S. A brain ependymoma with psychiatric manifestation. J BUON 2017; 22:1604-1605. [PMID: 29332363] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
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Pilleron S, Rajaobelina K, Tabue Teguo M, Dartigues JF, Helmer C, Delcourt C, Rigalleau V, Féart C. Accumulation of advanced glycation end products evaluated by skin autofluorescence and incident frailty in older adults from the Bordeaux Three-City cohort. PLoS One 2017; 12:e0186087. [PMID: 29040310 PMCID: PMC5645102 DOI: 10.1371/journal.pone.0186087] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2017] [Accepted: 09/25/2017] [Indexed: 12/04/2022] Open
Abstract
Aim We analyzed the cross-sectional and prospective relationships between the accumulation of advanced glycation end products (AGE), assessed by skin autofluorescence (AF) and frailty and its components. Methods A total of 423 participants of the Bordeaux sample of the Three-City study 75 years of age or older in 2009–2010 were included in the cross-sectional analysis. Among them, 255 initially non-frail participants were re-examined 4 years later. Skin AF (arbitrary units (AU)) was measured using the AGE Reader. Frailty was defined using Fried’s criteria. Associations were assessed with logistic regression models. Results Mean skin AF at baseline was 2.81 ±0.68 AU and 16.8% participants were frail. Adjusted for sociodemographic and health characteristics, skin AF was associated neither with prevalent frailty as a whole (Odds Ratio (OR) = 1.2; 95% Confidence Interval: 0.8–1.9) nor with any of its components. Among 255 non-frail participants, 32 became frail over 4 years. In multivariate analyses, skin AF was not associated with incident frailty as a whole (OR = 1.0; 0.5–2.0) but with a doubled risk of incident exhaustion (OR = 2.0; 1.2–3.6) and low energy expenditure (OR = 2.0; 1.1–3.7). No association was observed with other criteria. Conclusion In French older community-dwellers aged 75 years and over, the accumulation of AGEs evaluated by skin AF was not associated with prevalent or incident frailty but with the 4-year risk of exhaustion and low energy expenditure. Further studies with larger samples are needed to confirm our results.
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Affiliation(s)
- Sophie Pilleron
- Univ. Bordeaux, Inserm, Bordeaux Population Health Research Center, team LEHA, UMR 1219, Bordeaux, France
- * E-mail: (SP); (CF)
| | - Kalina Rajaobelina
- Univ. Bordeaux, Inserm, Bordeaux Population Health Research Center, team LEHA, UMR 1219, Bordeaux, France
| | - Maturin Tabue Teguo
- Univ. Bordeaux, Inserm, Bordeaux Population Health Research Center, team LEHA, UMR 1219, Bordeaux, France
| | - Jean-François Dartigues
- Univ. Bordeaux, Inserm, Bordeaux Population Health Research Center, team LEHA, UMR 1219, Bordeaux, France
| | - Catherine Helmer
- Univ. Bordeaux, Inserm, Bordeaux Population Health Research Center, team LEHA, UMR 1219, Bordeaux, France
| | - Cécile Delcourt
- Univ. Bordeaux, Inserm, Bordeaux Population Health Research Center, team LEHA, UMR 1219, Bordeaux, France
| | - Vincent Rigalleau
- Univ. Bordeaux, Inserm, Bordeaux Population Health Research Center, team LEHA, UMR 1219, Bordeaux, France
- CHU de Bordeaux, Service de Nutrition-Diabétologie, Hôpital Haut-Lévêque, Pessac, France
| | - Catherine Féart
- Univ. Bordeaux, Inserm, Bordeaux Population Health Research Center, team LEHA, UMR 1219, Bordeaux, France
- * E-mail: (SP); (CF)
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Geng P, Siu KC, Wang Z, Wu JY. Antifatigue Functions and Mechanisms of Edible and Medicinal Mushrooms. Biomed Res Int 2017; 2017:9648496. [PMID: 28890898 PMCID: PMC5584359 DOI: 10.1155/2017/9648496] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/26/2017] [Accepted: 07/16/2017] [Indexed: 12/14/2022]
Abstract
Fatigue is the symptom of tiredness caused by physical and/or psychological stresses. As fatigue is becoming a serious problem in the modern society affecting human health, work efficiency, and quality of life, effective antifatigue remedies other than pharmacological drugs or therapies are highly needed. Mushrooms have been widely used as health foods, because of their various bioactive constituents such as polysaccharides, proteins, vitamins, minerals, and dietary fiber. This paper reviews the major findings from previous studies on the antifatigue effects, the active components of mushrooms, and the possible mechanisms. Many studies have demonstrated the antifatigue effects of edible and medicinal mushrooms. These mushrooms probably mitigate human fatigue through effects on the functional systems, including the muscular, cardiovascular, hormone, and immune system. The bioactive constituents that contribute to the antifatigue effects of mushrooms may include polysaccharides, peptides, nucleosides, phenolic compounds, and triterpenoids. Further research is still needed to identify the active ingredients and to investigate their mechanism of action on the antifatigue effects. Since most previous studies have been carried out in animal models, more human trials should be performed to verify the antifatigue function of edible and medicinal mushrooms.
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Affiliation(s)
- Ping Geng
- Department of Applied Biology & Chemical Technology, State Key Laboratory of Chinese Medicine and Molecular Pharmacology in Shenzhen, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong
| | - Ka-Chai Siu
- Department of Applied Biology & Chemical Technology, State Key Laboratory of Chinese Medicine and Molecular Pharmacology in Shenzhen, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong
| | - Zhaomei Wang
- School of Food Science & Engineering, South China University of Technology, Guangzhou 510640, China
| | - Jian-Yong Wu
- Department of Applied Biology & Chemical Technology, State Key Laboratory of Chinese Medicine and Molecular Pharmacology in Shenzhen, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong
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Koutsos E, Cretu V, Georgiou P. A Muscle Fibre Conduction Velocity Tracking ASIC for Local Fatigue Monitoring. IEEE Trans Biomed Circuits Syst 2016; 10:1119-1128. [PMID: 27187971 DOI: 10.1109/tbcas.2016.2520563] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Electromyography analysis can provide information about a muscle's fatigue state by estimating Muscle Fibre Conduction Velocity (MFCV), a measure of the travelling speed of Motor Unit Action Potentials (MUAPs) in muscle tissue. MFCV better represents the physical manifestations of muscle fatigue, compared to the progressive compression of the myoelectic Power Spectral Density, hence it is more suitable for a muscle fatigue tracking system. This paper presents a novel algorithm for the estimation of MFCV using single threshold bit-stream conversion and a dedicated application-specified integrated circuit (ASIC) for its implementation, suitable for a compact, wearable and easy to use muscle fatigue monitor. The presented ASIC is implemented in a commercially available AMS 0.35 [Formula: see text] CMOS technology and utilizes a bit-stream cross-correlator that estimates the conduction velocity of the myoelectric signal in real time. A test group of 20 subjects was used to evaluate the performance of the developed ASIC, achieving good accuracy with an error of only 3.2% compared to Matlab.
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Abstract
We conducted a meta-analysis to investigate the efficacy of ginseng supplements on fatigue reduction and physical performance enhancement as reported by randomized controlled trials (RCTs). RCTs that investigated the efficacy of ginseng supplements on fatigue reduction and physical performance enhancement compared with placebos were included. The main outcome measures were fatigue reduction and physical performance enhancement. Out of 155 articles meeting initial criteria, 12 RCTs involving 630 participants (311 participants in the intervention group and 319 participants in the placebo group) were included in the final analysis. In the fixed-effect meta-analysis of four RCTs, there was a statistically significant efficacy of ginseng supplements on fatigue reduction (standardized mean difference, SMD = 0.34; 95% confidence interval [CI] = 0.16 to 0.52). However, ginseng supplements were not associated with physical performance enhancement in the fixed-effect meta-analysis of eight RCTs (SMD = -0.01; 95% CI = -0.29 to 0.27). We found that there was insufficient clinical evidence to support the use of ginseng supplements on reducing fatigue and enhancing physical performance because only few RCTs with a small sample size have been published so far. Further lager RCTs are required to confirm the efficacy of ginseng supplements on fatigue reduction.
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Affiliation(s)
- Hoang Viet Bach
- Department of Cancer Control and Policy, Graduate School of Cancer Science and Policy, National Cancer Center, Goyang, Korea
| | - Jeongseon Kim
- Department of Cancer Control and Policy, Graduate School of Cancer Science and Policy, National Cancer Center, Goyang, Korea
- Molecular Epidemiology Branch, Research Institute, National Cancer Center, Goyang, Korea
| | - Seung Kwon Myung
- Department of Cancer Control and Policy, Graduate School of Cancer Science and Policy, National Cancer Center, Goyang, Korea
- Molecular Epidemiology Branch, Research Institute, National Cancer Center, Goyang, Korea
- Department of Family Medicine, Center for Cancer Prevention and Detection, National Cancer Center, Goyang, Korea.
| | - Young Ae Cho
- Molecular Epidemiology Branch, Research Institute, National Cancer Center, Goyang, Korea
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Kitchigina VF. [Endogenous Cannabinoid System of the Brain as the Target for Influences at Neurodegenerate Diseases]. Zh Vyssh Nerv Deiat Im I P Pavlova 2016; 66:387-413. [PMID: 30695519] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
The review represents the analysis of works about role of endogenous cannabinoid (EC) system in the neuro- degenerate diseases (ND), in which the cellular death and disturbances of neuronal functions of the hippo- campus, neocortex and striatum are observed. Here, the diseases.ofAlzheimer, of Parkinson, of Hangtington, and the temporal lobe epilepsy are considered. Data, on the known or assumed mechanisms of these diseases are provided. In spite of the fact that the etiology.of the listed ND varies, their pathogenesis is characterized by common features: neural hyperexcitability, trophic deprivation, oxidative stress and energy deficite. Cognitive violations and/or deficiency of senso-motor integration are characteristic of patients with ND. Now reliable medicines for treatment of ND are absent. In recent years the fundamental role of EC system in regu- lation of neuroexcitability, energy metabolism, inflammatory and many other processes has been opened in ND pathogenesis. It points to possibility of development of therapeutic approaches which use the prepara- tions for activation of EC system. In the review various mechanisms of cellular survival and their reparations provided to EC system during action of pathological factors are stated.
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Ballak SB, Busé-Pot T, Harding PJ, Yap MH, Deldicque L, de Haan A, Jaspers RT, Degens H. Blunted angiogenesis and hypertrophy are associated with increased fatigue resistance and unchanged aerobic capacity in old overloaded mouse muscle. Age (Dordr) 2016; 38:39. [PMID: 26970774 PMCID: PMC5006008 DOI: 10.1007/s11357-016-9894-1] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/02/2015] [Accepted: 02/16/2016] [Indexed: 06/05/2023]
Abstract
We hypothesize that the attenuated hypertrophic response in old mouse muscle is (1) partly due to a reduced capillarization and angiogenesis, which is (2) accompanied by a reduced oxidative capacity and fatigue resistance in old control and overloaded muscles, that (3) can be rescued by the antioxidant resveratrol. To investigate this, the hypertrophic response, capillarization, oxidative capacity, and fatigue resistance of m. plantaris were compared in 9- and 25-month-old non-treated and 25-month-old resveratrol-treated mice. Overload increased the local capillary-to-fiber ratio less in old (15 %) than in adult (59 %) muscle (P < 0.05). Although muscles of old mice had a higher succinate dehydrogenase (SDH) activity (P < 0.05) and a slower fiber type profile (P < 0.05), the isometric fatigue resistance was similar in 9- and 25-month-old mice. In both age groups, the fatigue resistance was increased to the same extent after overload (P < 0.01), without a significant change in SDH activity, but an increased capillary density (P < 0.05). Attenuated angiogenesis during overload may contribute to the attenuated hypertrophic response in old age. Neither was rescued by resveratrol supplementation. Changes in fatigue resistance with overload and aging were dissociated from changes in SDH activity, but paralleled those in capillarization. This suggests that capillarization plays a more important role in fatigue resistance than oxidative capacity.
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Affiliation(s)
- Sam B Ballak
- School of Healthcare Science, Manchester Metropolitan University, Chester Street, John Dalton Building, Manchester, M1 5GD, UK
- Laboratory for Myology, Move Research Institute Amsterdam, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Tinelies Busé-Pot
- Laboratory for Myology, Move Research Institute Amsterdam, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Peter J Harding
- School of Healthcare Science, Manchester Metropolitan University, Chester Street, John Dalton Building, Manchester, M1 5GD, UK
| | - Moi H Yap
- School of Healthcare Science, Manchester Metropolitan University, Chester Street, John Dalton Building, Manchester, M1 5GD, UK
| | - Louise Deldicque
- Exercise Physiology Research Group, Department of Kinesiology, FaBeR, KU Leuven, Leuven, Belgium
| | - Arnold de Haan
- School of Healthcare Science, Manchester Metropolitan University, Chester Street, John Dalton Building, Manchester, M1 5GD, UK
- Laboratory for Myology, Move Research Institute Amsterdam, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Richard T Jaspers
- Laboratory for Myology, Move Research Institute Amsterdam, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Hans Degens
- School of Healthcare Science, Manchester Metropolitan University, Chester Street, John Dalton Building, Manchester, M1 5GD, UK.
- Lithuanian Sports University, Kaunas, Lithuania.
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Kim S, Bae WK, Kim JY, Jang M, Kim JH, Noh HH. Validation of the Korean Version of Schedule of Fatigue and Anergia: General Physician Questionnaire. J Korean Med Sci 2016; 31:159-63. [PMID: 26839466 PMCID: PMC4729493 DOI: 10.3346/jkms.2016.31.2.159] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2015] [Accepted: 11/09/2015] [Indexed: 11/20/2022] Open
Abstract
The Schedule of Fatigue and Anergy/General Physician (SOFA/GP) was developed to screen for prolonged fatigue in the primary care setting. We aimed to evaluate the reliability and validity of the Korean version of the SOFA/GP (SOFA/GP-K), which is adapted from the original English version. We performed translation and back translation, and after conducting a pilot study, we tested the final version of the questionnaire for its reliability and validity in a Korean primary care setting. Two hundred participants that visited a health examination center in a university hospital completed the survey between September and November 2012. A second survey was performed within 2 weeks of the primary survey to test for reliability. We evaluated concurrent validity between the SOFA/GP-K score, the Fatigue Severity Scale (FSS), and Brief Fatigue Index (BFI) scores. The Spearman correlation coefficient between SOFA/GP-K and FSS was 0.71 and 0.61 between SOFA/GP-K and BFI. Internal consistency of SOFA/GP-K was observed (Cronbach's alpha = 0.82) and construct validity was confirmed by factor analysis. The Kappa scores for test-retest reliability for each survey item were between 0.28 and 0.64. The SOFA/GP-K is a valid and reliable questionnaire for screening fatigue in a primary care setting.
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Affiliation(s)
- Sarah Kim
- Department of Family Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Woo Kyung Bae
- Health Promotion Center, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Ju Young Kim
- Department of Family Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Mijee Jang
- Department of Family Medicine, Seoul National University Hospital, Seoul, Korea
| | - Jeong Hyun Kim
- Department of Mental Health and Behavioral Medicine Services for Clinical Departments, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Hyun Hee Noh
- Department of Family Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
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Burri A, Ogata S, Livshits G, Williams F. The Association between Chronic Widespread Musculoskeletal Pain, Depression and Fatigue Is Genetically Mediated. PLoS One 2015; 10:e0140289. [PMID: 26599910 PMCID: PMC4657992 DOI: 10.1371/journal.pone.0140289] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2015] [Accepted: 09/23/2015] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND Chronic widespread muscoloskeletal pain (CWP) is prevalent in the general population and associated with high health care costs, so understanding the risk factors for chronic pain is important for both those affected and for society. In the present study we investigated the underlying etiological structure of CWP to understand better the association between the major clinical features of fatigue, depression and dihydroepiandrosterone sulphate (DHEAS) using a multivariate twin design. METHODOLOGY/PRINCIPLE FINDINGS Data were available in 463 UK female twin pairs including CWP status and information on depression, chronic fatigue and serum DHEAS levels. High to moderate heritabilities for all phenotypes were obtained (42.58% to 74.24%). The highest phenotypic correlation was observed between fatigue and CWP (r = 0.45), and the highest genetic correlation between CWP and fatigue (rg = 0.78). Structural equation modeling revealed the AE Cholesky model to provide the best model of the observed data. In this model, two additive genetic factors could be detected loading heavily on CWP-A2 explaining 40% of the variance and A3 20%. The factor loading heaviest on DHEAS showed only a small loading on the other phenotypes and none on fatigue at all. Furthermore, one distinct non-shared environmental factor loading specifically on CWP-but not on any of the other phenotypes-could be detected suggesting that the association between CWP and the other phenotypes is due only to genetic factors. CONCLUSIONS/SIGNIFICANCE Our results suggest that CWP and its associated features share a genetic predisposition but that they are relatively distinct in their environmental determinants.
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Affiliation(s)
- Andrea Burri
- Department of Twin Research and Genetic Epidemiology, King’s College London, St. Thomas´ Hospital, London, United Kingdom
- Department of Psychology, University of Zurich, Binzmühlestrasse 14, 8050, Zurich, Switzerland
| | - Soshiro Ogata
- Department of Health Promotion Science, Osaka University Graduate School of Medicine, Suita, 565–087, Osaka, Japan
| | - Gregory Livshits
- Department of Twin Research and Genetic Epidemiology, King’s College London, St. Thomas´ Hospital, London, United Kingdom
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, 69978, Israel
| | - Frances Williams
- Department of Twin Research and Genetic Epidemiology, King’s College London, St. Thomas´ Hospital, London, United Kingdom
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Abstract
Significant advances in the diagnosis and treatment of hairy cell leukemia (HCL) have recently been made. Improved distinction of HCL from its mimics though clinical presentations, morphologic and immunophenotypic features, and more recently molecular biology, has highlighted marked differences in treatment response and overall prognosis between these disorders. As our understanding of the unique pathobiology of HCL has grown, exciting new avenues of treatment as well as insight into immune function have been obtained. This review provides an overview of the clinical features and diagnostic attributes of HCL, with contrast to other mature B cell lymphoproliferative disorders with overlapping features.
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MESH Headings
- Antineoplastic Agents/therapeutic use
- B-Lymphocytes/drug effects
- B-Lymphocytes/pathology
- Diagnosis, Differential
- Fatigue/diagnosis
- Fatigue/pathology
- Female
- Humans
- Indoles/therapeutic use
- Leukemia, Hairy Cell/diagnosis
- Leukemia, Hairy Cell/drug therapy
- Leukemia, Hairy Cell/pathology
- Leukemia, Hairy Cell/surgery
- Leukemia, Prolymphocytic, B-Cell/diagnosis
- Leukemia, Prolymphocytic, B-Cell/drug therapy
- Leukemia, Prolymphocytic, B-Cell/pathology
- Leukemia, Prolymphocytic, B-Cell/surgery
- Lymphoma, B-Cell, Marginal Zone/diagnosis
- Lymphoma, B-Cell, Marginal Zone/drug therapy
- Lymphoma, B-Cell, Marginal Zone/pathology
- Lymphoma, B-Cell, Marginal Zone/surgery
- Male
- Mutation
- Proto-Oncogene Proteins B-raf/antagonists & inhibitors
- Proto-Oncogene Proteins B-raf/genetics
- Sex Factors
- Splenectomy
- Splenomegaly/diagnosis
- Splenomegaly/pathology
- Splenomegaly/surgery
- Sulfonamides/therapeutic use
- Vemurafenib
- Waldenstrom Macroglobulinemia/diagnosis
- Waldenstrom Macroglobulinemia/drug therapy
- Waldenstrom Macroglobulinemia/pathology
- Waldenstrom Macroglobulinemia/surgery
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Affiliation(s)
- Graeme R Quest
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Canada.
| | - James B Johnston
- Section of Hematology/Oncology, CancerCare Manitoba, University of Manitoba, Manitoba, Canada
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Slapsinskaite A, Razon S, Balagué Serre N, Hristovski R, Tenenbaum G. Local Pain Dynamics during Constant Exhaustive Exercise. PLoS One 2015; 10:e0137895. [PMID: 26421436 PMCID: PMC4589345 DOI: 10.1371/journal.pone.0137895] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2015] [Accepted: 08/24/2015] [Indexed: 11/25/2022] Open
Abstract
The purpose of this study was to delineate the topological dynamics of pain and discomfort during constant exercise performed until volitional exhaustion. Eleven physical education students were tested while cycling and running at a “hard” intensity level (e.g., corresponding to Borg’s RPE (6–20) = 15). During the tests, participants reported their discomfort and pain on a body map every 15s. “Time on task” for each participant was divided into five equal non-overlapping temporal windows within which their ratings were considered for analysis. The analyses revealed that the number of body locations with perceived pain and discomfort increased throughout the five temporal windows until reaching the mean (± SE) values of 4.2 ± 0.7 and 4.1 ± 0.6 in cycling and running, respectively. The dominant locations included the quadriceps and hamstrings during cycling and quadriceps and chest during running. In conclusion, pain seemed to spread throughout the body during constant cycling and running performed up to volitional exhaustion with differences between cycling and running in the upper body but not in the lower body dynamics.
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Affiliation(s)
- Agne Slapsinskaite
- Department of Health and Applied Science, INEFC University of Barcelona, Barcelona, Spain
- * E-mail:
| | - Selen Razon
- Department of Physical Education, Ball State University, Muncie, Indiana, United States of America
| | - Natàlia Balagué Serre
- Department of Health and Applied Science, INEFC University of Barcelona, Barcelona, Spain
| | - Robert Hristovski
- Department of Physical Education, Sport and Health, Ss. Cyril and Methodius University, Skopje, Macedonia
| | - Gershon Tenenbaum
- Department of Educational Psychology and Learning Systems, Florida State University, Tallahassee, Florida, United States of America
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42
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Harrison NA, Cooper E, Dowell NG, Keramida G, Voon V, Critchley HD, Cercignani M. Quantitative Magnetization Transfer Imaging as a Biomarker for Effects of Systemic Inflammation on the Brain. Biol Psychiatry 2015; 78:49-57. [PMID: 25526971 PMCID: PMC4503794 DOI: 10.1016/j.biopsych.2014.09.023] [Citation(s) in RCA: 84] [Impact Index Per Article: 9.3] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2014] [Revised: 09/12/2014] [Accepted: 09/30/2014] [Indexed: 11/17/2022]
Abstract
BACKGROUND Systemic inflammation impairs brain function and is increasingly implicated in the etiology of common mental illnesses, particularly depression and Alzheimer's disease. Immunotherapies selectively targeting proinflammatory cytokines demonstrate efficacy in a subset of patients with depression. However, efforts to identify patients most vulnerable to the central effects of inflammation are hindered by insensitivity of conventional structural magnetic resonance imaging. METHODS We used quantitative magnetization transfer (qMT) imaging, a magnetic resonance imaging technique that enables quantification of changes in brain macromolecular density, together with experimentally induced inflammation to investigate effects of systemic inflammatory challenge on human brain microstructure. Imaging with qMT was performed in 20 healthy participants after typhoid vaccination and saline control injection. An additional 20 participants underwent fluorodeoxyglucose positron emission tomography following the same inflammatory challenge. RESULTS The qMT data demonstrated that inflammation induced a rapid change in brain microstructure, reflected in increased magnetization exchange from free (water) to macromolecular-bound protons, within a discrete region of insular cortex implicated in representing internal physiologic states including inflammation. The functional significance of this change in insular microstructure was demonstrated by correlation with inflammation-induced fatigue and fluorodeoxyglucose positron emission tomography imaging, which revealed increased resting glucose metabolism within this region following the same inflammatory challenge. CONCLUSIONS Together these observations highlight a novel structural biomarker of the central physiologic and behavioral effects of mild systemic inflammation. The widespread clinical availability of magnetic resonance imaging supports the viability of qMT imaging as a clinical biomarker in trials of immunotherapeutics, both to identify patients vulnerable to the effects of systemic inflammation and to monitor neurobiological responses.
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Affiliation(s)
- Neil A Harrison
- Brighton and Sussex Medical School, University of Sussex, Brighton.; Sackler Centre for Consciousness Science, University of Sussex, Falmer.; Sussex Partnership National Health Service Trust, Brighton..
| | - Ella Cooper
- Brighton and Sussex Medical School, University of Sussex, Brighton
| | | | - Georgia Keramida
- Brighton and Sussex Medical School, University of Sussex, Brighton
| | - Valerie Voon
- Department of Psychiatry, University of Cambridge, Cambridge, United Kingdom.; Cambridge and Peterborough NHS Foundation Trust, Cambridge, United Kingdom
| | - Hugo D Critchley
- Brighton and Sussex Medical School, University of Sussex, Brighton.; Sackler Centre for Consciousness Science, University of Sussex, Falmer.; Sussex Partnership National Health Service Trust, Brighton
| | - Mara Cercignani
- Brighton and Sussex Medical School, University of Sussex, Brighton.; Neuroimaging Laboratory, Santa Lucia Foundation, Rome, Italy
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Ahlin Č, Stupica D, Strle F, Lusa L. medplot: a web application for dynamic summary and analysis of longitudinal medical data based on R. PLoS One 2015; 10:e0121760. [PMID: 25837352 PMCID: PMC4383594 DOI: 10.1371/journal.pone.0121760] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2014] [Accepted: 02/16/2015] [Indexed: 11/18/2022] Open
Abstract
In biomedical studies the patients are often evaluated numerous times and a large number of variables are recorded at each time-point. Data entry and manipulation of longitudinal data can be performed using spreadsheet programs, which usually include some data plotting and analysis capabilities and are straightforward to use, but are not designed for the analyses of complex longitudinal data. Specialized statistical software offers more flexibility and capabilities, but first time users with biomedical background often find its use difficult. We developed medplot, an interactive web application that simplifies the exploration and analysis of longitudinal data. The application can be used to summarize, visualize and analyze data by researchers that are not familiar with statistical programs and whose knowledge of statistics is limited. The summary tools produce publication-ready tables and graphs. The analysis tools include features that are seldom available in spreadsheet software, such as correction for multiple testing, repeated measurement analyses and flexible non-linear modeling of the association of the numerical variables with the outcome. medplot is freely available and open source, it has an intuitive graphical user interface (GUI), it is accessible via the Internet and can be used within a web browser, without the need for installing and maintaining programs locally on the user’s computer. This paper describes the application and gives detailed examples describing how to use the application on real data from a clinical study including patients with early Lyme borreliosis.
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Affiliation(s)
- Črt Ahlin
- PhD Candidate of Statistics Programme, University of Ljubljana, Ljubljana, Slovenia
| | - Daša Stupica
- Department of Infectious Diseases, University Medical Center Ljubljana, Ljubljana, Slovenia
| | - Franc Strle
- Department of Infectious Diseases, University Medical Center Ljubljana, Ljubljana, Slovenia
| | - Lara Lusa
- Institute for Biostatistics and Medical Informatics, University of Ljubljana, Slovenia
- * E-mail:
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44
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Denlinger CS, Ligibel JA, Are M, Baker KS, Demark-Wahnefried W, Friedman DL, Goldman M, Jones L, King A, Ku GH, Kvale E, Langbaum TS, Leonardi-Warren K, McCabe MS, Melisko M, Montoya JG, Mooney K, Morgan MA, Moslehi JJ, O'Connor T, Overholser L, Paskett ED, Raza M, Syrjala KL, Urba SG, Wakabayashi MT, Zee P, McMillian N, Freedman-Cass D. Survivorship: fatigue, version 1.2014. J Natl Compr Canc Netw 2015; 12:876-87. [PMID: 24925198 DOI: 10.6004/jnccn.2014.0082] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Many cancer survivors report that fatigue is a disruptive symptom even after treatment ends. Persistent cancer-related fatigue affects quality of life, because individuals become too tired to fully participate in the roles and activities that make life meaningful. Identification and management of fatigue remains an unmet need for many cancer survivors. This section of the NCCN Guidelines for Survivorship provides screening, evaluation, and management recommendations for fatigue in survivors. Management includes education and counseling, physical activity, psychosocial interventions, and pharmacologic treatments.
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45
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Tan D, Walmsley S, Shen S, Raboud J. Mild to Moderate Symptoms Do Not Correlate with Lactate Levels in HIV-Positive Patients on Nucleoside Reverse Transcriptase Inhibitors. HIV Clinical Trials 2015; 7:107-15. [PMID: 16880167 DOI: 10.1310/95ve-a6kj-wrq0-1f8y] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
PURPOSE Nucleoside reverse transcriptase inhibitors (NRTIs) are associated with mitochondrial toxicities ranging from asymptomatic hyperlactatemia to fatal lactic acidosis. It is uncertain whether mild clinical symptoms predict hyperlactatemia and the need to consider changes in antiretroviral therapy. This cross-sectional study evaluated whether an association exists between mild symptoms and lactate levels. METHOD HIV-positive patients on NRTIs attending routine clinic visits were surveyed about symptoms associated with hyperlactatemia. Symptom severity was quantified using Likert scales, and the sum was converted into a symptom score ranging from 0 to 30. Tourniquet-free blood specimens were collected simultaneously to measure serum lactate. Symptom scores were compared between patients with normal and elevated lactates. RESULTS 284 individuals were included. The most common NRTIs used included lamivudine (79%), zidovudine (50%), abacavir (39%), and stavudine (24%). Twenty-two patients (8%) had increased lactates (mean = 2.7 mmol/L; range, 2.1-4.5 mmol/L), while 262 patients (92%) had normal lactates (mean = 1.2 mmol/L, range, 0.1-2.0 mmol/L). Median symptom scores were similar between groups (3 vs. 2, p = .23). Spearman's correlation coefficient for lactate and symptom score was 0.07 (p = .22). CONCLUSIONS Mild symptoms did not correlate with lactate levels, and symptoms alone should not trigger clinicians to measure serum lactates and stop NRTIs if the levels are elevated.
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Affiliation(s)
- Darrell Tan
- Division of Infectious Diseases, University of Toronto, 200 Elizabeth Street, Toronto, Ontario, Canada M5G 2C4.
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Affiliation(s)
- Niklas Ivarsson
- Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden
| | - Håkan Westerblad
- Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden
- * E-mail:
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Gotts ZM, Ellis JG, Deary V, Barclay N, Newton JL. The association between daytime napping and cognitive functioning in chronic fatigue syndrome. PLoS One 2015; 10:e0117136. [PMID: 25575044 PMCID: PMC4289075 DOI: 10.1371/journal.pone.0117136] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2014] [Accepted: 12/19/2014] [Indexed: 02/06/2023] Open
Abstract
OBJECTIVES The precise relationship between sleep and physical and mental functioning in chronic fatigue syndrome (CFS) has not been examined directly, nor has the impact of daytime napping. This study aimed to examine self-reported sleep in patients with CFS and explore whether sleep quality and daytime napping, specific patient characteristics (gender, illness length) and levels of anxiety and depression, predicted daytime fatigue severity, levels of daytime sleepiness and cognitive functioning, all key dimensions of the illness experience. METHODS 118 adults meeting the 1994 CDC case criteria for CFS completed a standardised sleep diary over 14 days. Momentary functional assessments of fatigue, sleepiness, cognition and mood were completed by patients as part of usual care. Levels of daytime functioning and disability were quantified using symptom assessment tools, measuring fatigue (Chalder Fatigue Scale), sleepiness (Epworth Sleepiness Scale), cognitive functioning (Trail Making Test, Cognitive Failures Questionnaire), and mood (Hospital Anxiety and Depression Scale). RESULTS Hierarchical Regressions demonstrated that a shorter time since diagnosis, higher depression and longer wake time after sleep onset predicted 23.4% of the variance in fatigue severity (p <.001). Being male, higher depression and more afternoon naps predicted 25.6% of the variance in objective cognitive dysfunction (p <.001). Higher anxiety and depression and morning napping predicted 32.2% of the variance in subjective cognitive dysfunction (p <.001). When patients were classified into groups of mild and moderate sleepiness, those with longer daytime naps, those who mainly napped in the afternoon, and those with higher levels of anxiety, were more likely to be in the moderately sleepy group. CONCLUSIONS Napping, particularly in the afternoon is associated with poorer cognitive functioning and more daytime sleepiness in CFS. These findings have clinical implications for symptom management strategies.
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Affiliation(s)
- Zoe M. Gotts
- Faculty of Health and Life Sciences, Northumbria University, Newcastle-upon-Tyne, United Kingdom
| | - Jason G. Ellis
- Faculty of Health and Life Sciences, Northumbria University, Newcastle-upon-Tyne, United Kingdom
| | - Vincent Deary
- Faculty of Health and Life Sciences, Northumbria University, Newcastle-upon-Tyne, United Kingdom
| | - Nicola Barclay
- Faculty of Health and Life Sciences, Northumbria University, Newcastle-upon-Tyne, United Kingdom
| | - Julia L. Newton
- Institute of Cellular Medicine, Medical School, Newcastle University & Newcastle Hospitals NHS Foundation Trust and UK NIHR Biomedical Research Centre in Ageing, Newcastle-upon-Tyne, United Kingdom
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Tkachenko E, Oreshko LS, Soloveva EA, Shabanova AA, Zhuravleva MS. [Connective tissue dysplasia in patients with celiac desease as a problem of violation of adaptation reserve islands of the body]. Eksp Klin Gastroenterol 2015:4-10. [PMID: 25993866] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Clinically significant dysplasia of connective tissue in patients with celiac disease is often responsible for various visceral disorders. Different disturbances of motor and evacuation functions are often determined in this patients (gastroesophageal reflux, duodenogastral reflux, spastic and hyperkinetic dyskinesia). The clinical course of the celiac disease, associated with connective tissue dysplasia, is characterized by asthenovegetative syndrome, reduced tolerance to physical activity, general weakness, fatigue and emotional instability. These data should be considered in choosing a treatment.
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Höck AD. Review: Vitamin D3 deficiency results in dysfunctions of immunity with severe fatigue and depression in a variety of diseases. In Vivo 2014; 28:133-145. [PMID: 24425848] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Recent immune data on vitamin D3 deficiency help to more clearly understand chronic fatiguing illnesses, such as autoimmune disorders, cancer and chronic fatigue syndrome (CFS). The vitamin D3 pathway is activated by stress and requires sufficient stores of precursor 25-hydroxyvitamin D3 for proper cell and immune functions. In vitamin D3 deficiency, secretion of the antimicrobial peptide cathelicidin is reduced, leading to impaired auto/xenophagy. As a result, phagocytosis, cytotoxicity, antigen processing and antigen presentation become dysregulated. In addition, vitamin D3 deficiency affects T- and B-lymphocyte activation, as well as quantity, maturation and function of regulatory natural killer T-cells and their counterparts in the gut, i.e. T-cell receptor-αβ, cluster of differentiation-8αα-positive intraepithelial lymphocytes. Consequently, innate and adaptive immunity become de-regulated, with microbial effects contributing further to this. Persistent infections, chronic inflammation and fatigue follow. Vitamin D3 substitution in such conditions may help to prevent or to ameliorate such chronic conditions, even in patients with cancer.
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Cruz Gómez ÁJ, Ventura Campos N, Belenguer A, Ávila C, Forn C. Regional brain atrophy and functional connectivity changes related to fatigue in multiple sclerosis. PLoS One 2013; 8:e77914. [PMID: 24167590 PMCID: PMC3805520 DOI: 10.1371/journal.pone.0077914] [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] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2013] [Accepted: 09/13/2013] [Indexed: 11/23/2022] Open
Abstract
Fatigue is one of the most frequent symptoms in multiple sclerosis (MS), and recent studies have described a relationship between the sensorimotor cortex and its afferent and efferent pathways as a substrate of fatigue. The objectives of this study were to assess the neural correlates of fatigue in MS through gray matter (GM) and white matter (WM) atrophy, and resting state functional connectivity (rs-FC) of the sensorimotor network (SMN). Eighteen healthy controls (HCs) and 60 relapsing-remitting patients were assessed with the Fatigue Severity Scale (FSS). Patients were classified as fatigued (F) or nonfatigued (NF). We investigated GM and WM atrophy using voxel-based morphometry, and rs-FC changes with a seed-based method and independent component analysis (ICA). F patients showed extended GM and WM atrophy focused on areas related to the SMN. High FSS scores were associated with reductions of WM in the supplementary motor area. Seed analysis of GM atrophy in the SMN showed that HCs presented increased rs-FC between the primary motor and somatosensory cortices while patients with high FSS scores were associated with decreased rs-FC between the supplementary motor area and associative somatosensory cortex. ICA results showed that NF patients presented higher rs-FC in the primary motor cortex compared to HCs and in the premotor cortex compared to F patients. Atrophy reduced functional connectivity in SMN pathways and MS patients consequently experienced high levels of fatigue. On the contrary, NF patients experienced high synchronization in this network that could be interpreted as a compensatory mechanism to reduce fatigue sensation.
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Affiliation(s)
- Álvaro Javier Cruz Gómez
- Departament de Psicología Bàsica, Clínica i Psicobiología, Universitat Jaume I, Castelló de la Plana, Castellón, Spain
| | - Noelia Ventura Campos
- Departament de Psicología Bàsica, Clínica i Psicobiología, Universitat Jaume I, Castelló de la Plana, Castellón, Spain
| | - Antonio Belenguer
- Servicio de Neurología, Hospital General de Castellón, Castelló de la Plana, Castellón, Spain
| | - César Ávila
- Departament de Psicología Bàsica, Clínica i Psicobiología, Universitat Jaume I, Castelló de la Plana, Castellón, Spain
| | - Cristina Forn
- Departament de Psicología Bàsica, Clínica i Psicobiología, Universitat Jaume I, Castelló de la Plana, Castellón, Spain
- * E-mail:
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