The impact of an exercise therapy on psychosocial health of children with benign epilepsy: a pilot study

OBJECTIVES

The purposes of the current study were to test the feasibility of exercise therapy for children with benign epilepsy with centrotemporal spikes (BECTS) and to collect pilot data about the impact of exercise therapy on neurocognitive, emotional, and behavioral outcomes.

METHODS

Ten children with BECTS (9.7±1.42 years) participated in a therapeutic exercise program consisting of ten supervised exercise sessions and home-based exercises for five weeks. Electroencephalography (EEG), seizure frequency, and neurocognitive and psychological factors, including attention, executive function, depression, anxiety, behavioral problems, and quality of life, were assessed before and after the exercise program.

RESULTS

No clinical symptoms were observed to worsen during the study, demonstrating that the exercise therapy was safe and also feasible. After five weeks of exercise therapy, significant improvements in neurocognitive domains such as simple visual and auditory attention, sustained attention, divided attention, psychomotor speed, and inhibition-disinhibition were observed. Furthermore, parent ratings of internalizing behavioral problems and social problems and mood-related well-being from quality of life improved after exercise therapy. Although not statistically significant, trends were noted toward improvement in children's self-reports of negative mood/somatization, parent reports of somatic complaints, and general health on a quality-of-life measure.

CONCLUSIONS

A five-week structured exercise program was successfully implemented, with preliminary data suggesting beneficial impact on neurocognitive and psychobehavioral function. Exercise therapy should be further evaluated as a part of a comprehensive treatment program for children with benign epilepsy.

The association of social frailty with intrinsic capacity in community-dwelling older adults: a prospective cohort study

Background

Social frailty is associated with poor health outcomes; however, its effects on healthy aging indicators have not been adequately investigated. This study assessed the longitudinal association between social frailty and the intrinsic capacity of community-dwelling older adults.

Methods

A total of 663 participants (56.7% women) aged ≥60 years from in Nagoya, Japan, were included in the study. The first measurement occurred in 2014, and annual follow-ups occurred until 2017. Social frailty was determined based on four items: financial difficulty, household status, social activity, and regular contact with others. A deficit score of 0 represented social robustness, 1 represented social prefrailty, and ≥ 2 represented social frailty. Intrinsic capacity was evaluated by the locomotion, cognition, psychological function, vitality, and sensory function domains. The longitudinal association was analyzed using generalized estimating equations.

Results

The prevalence of social prefrailty and social frailty at baseline was 31.2 and 6.3%, respectively. The social prefrailty group (β = − 0.132, P < 0.001) and social frailty group (β = − 0.258, P < 0.001) were associated with a greater reduction in the composite intrinsic capacity scores than the social robustness group, especially in the cognition, psychological function, and vitality domains. Men with social prefrailty/social frailty demonstrated a greater decrease in the psychological function domain score (− 0.512 vs. − 0.278) than women. Additionally, the cognition domain score only decreased in men in the social prefrailty/social frailty group (β = − 0.122, P = 0.016).

Conclusions

Social frailty was associated with intrinsic capacity and its subdomains longitudinally. Men with social frailty were more vulnerable than women to a decline in their psychological function and cognition domains. Therefore, the advanced management of social frailty is necessary to facilitate healthy aging.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12877-021-02466-6.

Social attainment in physically well-functioning long-term survivors of pediatric brain tumour; the role of executive dysfunction, fatigue, and psychological and emotional symptoms

The purpose of this cross-sectional study was to investigate long-term social attainment in physically well-functioning adult survivors of pediatric brain tumour (PBT) and identify demographic, medical, and psychological factors related to poor social outcomes, with a special focus on the significance of executive dysfunction. One hundred and fourteen PBT survivors and a healthy control group provided personal data on social outcomes, i.e., education, work, and government benefits, and completed questionnaires on executive function (EF), psychological and emotional difficulties, and fatigue. A significantly higher number of survivors compared to healthy controls reported having received educational adjustments and substantial government benefits, and significantly more survivors than controls were currently not engaged in regular employment/training. PBT survivors and healthy controls did not differ on educational level or living situation. The factors most strongly associated with poor social outcomes were self-reported executive dysfunction, difficulties with adaptive functioning, and fatigue. The findings show that physically well-functioning PBT survivors are at risk of poorer social outcomes and financial dependence in adulthood compared to their healthy peers, and underline the importance of investigating EF in short- and long-term follow-ups. Future rehabilitation efforts should focus more on compensatory strategies for executive dysfunction and improving EF skills.

Functional roles of REM sleep

Rapid eye movement (REM) sleep is an enigmatic and intriguing sleep state. REM sleep differs from non-REM sleep by its characteristic brain activity and from wakefulness by a reduced anti-gravity muscle tone. In addition to these key traits, diverse physiological phenomena appear across the whole body during REM sleep. However, it remains unclear whether these phenomena are the causes or the consequences of REM sleep. Experimental approaches using humans and animal models have gradually revealed the functional roles of REM sleep. Extensive efforts have been made to interpret the characteristic brain activity in the context of memory functions. Numerous physical and psychological functions of REM sleep have also been proposed. Moreover, REM sleep has been implicated in aspects of brain development. Here, we review the variety of functional roles of REM sleep, mainly as revealed by animal models. In addition, we discuss controversies regarding the functional roles of REM sleep.

Resilience in older adults with cancer: A scoping literature review

INTRODUCTION

Resilience, the ability to respond to stressors by maintaining or rapidly returning to normal homeostasis, serves as a new paradigm to improve the care of older adults. However, resilience research in oncology is nascent. We aimed to describe the current research landscape on physical, cognitive, and psychosocial resilience in older cancer patients.

MATERIALS AND METHODS

We searched PubMed/MEDLINE from inception to January 28, 2022 for records with the terms "resilient OR resilience OR resiliency." We included studies that focused on persons over age 65 with cancer and assessed physical, cognitive, or psychological resilience. We excluded studies that did not report original data; did not have the full text available; assessed resilience on fewer than three time points; and published in non-English languages. Definitions and measures of resilience were extracted and categorized using qualitative analysis.

RESULTS

Of 473 articles screened, we found 29 articles that met criteria for inclusion in our review. There was a high degree of heterogeneity in the definitions and measures of resilience. Resilience was defined as robustness/resistance to decline (n = 11), recovery from trauma/stressor (n = 7), and adaptive and proactive coping behaviors (n = 6). Ten papers did not define resilience. 21 studies utilized longitudinal analysis, five studies used randomized and nonrandomized control trials, and four studies assessed pre-post analysis. Stressors included cancer diagnosis (n = 18), chemotherapy (n = 3), radiation (n = 3), acute illness (n = 3), surgery (n = 2), and hematopoietic cell transplant (n = 1).

DISCUSSION

Evidence for predictors and determinants of resilience in older adults with cancer is limited by the absence of standardized definitions and measurements. There is a fundamental need for a more precise definition, measures, and understanding of the physiologic mechanisms underlying the response to the physical, cognitive, and psychosocial stressors of cancer and its treatments.

Functional Outcomes after Behavioral Treatment of Paradoxical Vocal Fold Motion in Adults

OBJECTIVE

Paradoxical vocal fold motion (PVFM) is responsive to behavioral therapy, often resulting in a remission of symptoms, but little is known about whether treatment is beneficial with regard to PVFM-associated psychological symptoms or functional limitations. The goal of the study was to identify patient perceptions of the impact of treatment for PVFM and characteristics associated with treatment outcomes.

METHODS

A survey was conducted of all adults who had received at least 1 session of treatment for PVFM in our outpatient clinic over a 2-year period.

RESULTS

The 39 participants ranged in age from 18 to 82 and had received a median of 3 treatment sessions. At a median follow-up of 10 months following treatment, respondents reported improvements in a wide range of areas, including sports and leisure, daily activities, and social participation. The majority reported improvements in feelings of anxiety, helplessness, and control. Poorer outcomes were associated with more severe voice symptoms, fewer treatment sessions, and needing oral steroids for asthma control.

CONCLUSION

There was a reduction in a wide range of activity limitations after treatment. Feelings of control were strongly associated with positive outcomes. The therapy appeared to be equally effective for adults with exercise-induced and environmental variants of PVFM.

Predictors of improved psychological function after bariatric surgery

BACKGROUND

Negative psychological sequelae have been reported after bariatric surgery. It is unclear which factors affect psychological function in the first postoperative years.

OBJECTIVE

Evaluation of significant predictors of improved psychological function following bariatric surgery by analyzing data from the BODY-Q questionnaire.

SETTING

Multicenter prospective cohort in 3 centers located in The Netherlands and Denmark.

METHODS

The BODY-Q questionnaire was used to assess 6 domains of health-related quality of life. The domain of interest, psychological function, consists of 10 questions from which a converted score of 0 (low) to 100 (high) can be calculated. Linear mixed models were used to analyze which patient characteristics were most predictive of the psychological function score. Secondary outcomes of interest were cross-sectional scores of psychological function and the impact of weight loss, and the effect of major short-term complications on psychological function.

RESULTS

Data were analyzed from 836 patients who underwent bariatric surgery from 2015 to 2020. Patients with lower expectations concerning weight loss (<40% desired total weight loss), higher educational level, no history of psychiatric illness, and employment before bariatric surgery demonstrated the highest psychological function scores after bariatric surgery. At 1 and 2 years after bariatric surgery, more weight loss was associated with significantly higher psychological function scores. Experiencing a major short-term complication did not significantly impact psychological function.

CONCLUSIONS

Several relevant predictors of improved postoperative psychological function have been identified. This knowledge can be used to enhance patient education preoperatively and identify patients at risk for poor psychological functioning postoperatively.

Impact of physical, cognitive, and psychological functions on incident homebound status after discharge among hospitalized older patients: A clinical-based prospective study

PURPOSE

Physical and cognitive/psychological functions are risk factors for incident homebound status. However, there are only a few studies exploring the factors related to homebound status in hospitalized older patients. The aim of this study was to determine the relationship between physical, and cognitive/psychological function at discharge among hospitalized older patients and the risk of undergoing homebound status after discharge.

METHODS

We analyzed the cohort data of hospitalized older patients (age ≥65 years) with internal medical problems. The main outcome was the incidence of homebound status a month after discharge. Physical functions were measured by handgrip strength (HG), knee extension strength (KES), one-leg stance (OLS), and walking speed (WS). Cognitive and psychological functions were assessed using the Mini-Mental State Examination (MMSE) and Geriatric Depression Scale-5 (GDS-5), respectively. Poisson regression models were used to estimate the risk ratios (RR) and 95 % confidence intervals (CIs) of the relationships between physical, cognitive, and psychological functions as well as the homebound status.

RESULTS

A total of 178 participants who completed the follow-up were analyzed mean age (standard deviation) 76.2 (6.9) years. A month after discharge, 23 participants were deemed homebound, for a cumulative incidence (95 %CI) of 12.9 % (8.0 %-17.8 %). The RR (95 %CI) estimated by Poisson regression were 3.51 (1.30-9.48), 0.15 (0.03-0.72) and 0.11 (0.01-0.92) for low KES, maximum WS and comfortable WS, respectively. However, HG, OLS, MMSE, and GDS-5 were not significantly associated with the incidence of homebound status.

CONCLUSION

Physical functions can predict the incidence of homebound status after discharge among hospitalized older patients.

Aquaporin 4 beyond a water channel; participation in motor, sensory, cognitive and psychological performances, a comprehensive review

Aquaporin 4 (AQP4) is a protein highly expressed in the central nervous system (CNS) and peripheral nervous system (PNS) as well as various other organs, whose different sites of action indicate its importance in various functions. AQP4 has a variety of essential roles beyond water homeostasis. In this article, we have for the first time summarized different roles of AQP4 in motor and sensory functions, besides cognitive and psychological performances, and most importantly, possible physiological mechanisms by which AQP4 can exert its effects. Furthermore, we demonstrated that AQP4 participates in pathology of different neurological disorders, various effects depending on the disease type. Since neurological diseases involve a spectrum of dysfunctions and due to the difficulty of obtaining a treatment that can simultaneously affect these deficits, it is therefore suggested that future studies consider the role of this protein in different functional impairments related to neurological disorders simultaneously or separately by targeting AQP4 expression and/or polarity modulation.

The speech abilities and quality of life of Malaysian school-aged children with cleft lip and palate

PURPOSES

The study investigated the relationship between speech outcomes and quality of life (QoL) among Malay-speaking school-aged children with CLP.

METHODOLOGY

Forty-nine children with CLP (age range 7-11 years) completed an online or in-person speech assessment and filled in the CLEFT-Q (Malay Version) questionnaire, which assessed QoL. An experienced SLP rated the nasality and speech intelligibility of the patients' speech samples.

RESULTS

Based on the auditory-perceptual ratings, 63.3 % of the children had normal resonance, and 71.5 % had normal or near-normal speech intelligibility. The appearance of "teeth'' was rated as the poorest feature by all participants (52.71), while "psychological function" was rated as the best outcome (83.49). Weak correlations were found between speech intelligibility and speech distress (r = -0.450, p < 0.001), speech intelligibility and speech function (r = -0.370, p < 0.05), hypernasality and speech distress (r = -0.474, p < 0.001), and hypernasality and speech function (r = -0.308, p < 0.05).

CONCLUSION

Many children with CLP still presented with speech difficulties at school age and facial appearance dissatisfaction in the present study. However, the children's self-awareness of their speech difficulties did not negatively affect non-speech-related aspects of their QoL.