Mood and physiological effects of visual stimulation with images of the natural environment in individuals with depressive and anxiety disorders

BACKGROUND

Nature therapies are gaining attention as non-pharmacological treatments for depressive and anxiety disorders, but research on their effectiveness in patients is limited. This study investigates the mood-improving effects of visual stimulation with natural environmental images in patients with depressive and anxiety disorders.

METHODS

We conducted a randomized crossover comparison trial involving 60 right-handed adult participants with depressive or anxiety disorders and receiving outpatient treatment. Visual stimuli of natural environments consisted of green-themed nature images, while the control stimuli featured urban scenes dominated by buildings. The stimulation lasted for 3 min, during which orbital prefrontal brain activity was measured using a 2-channel Near-infrared Spectroscopy (NIRS) system, and heart rate variability was assessed using fingertip accelerated plethysmography.

RESULTS

Mood enhancement effects were observed in both the depressive and anxiety disorder groups following visual stimulation with nature images. In the depression group, orbital prefrontal oxygenated hemoglobin concentration significantly increased after visual stimulation with nature images, while there were no significant changes in the anxiety group. However, in the anxiety group, a correlation was found between reduced orbital prefrontal oxygenated hemoglobin in response to nature images and increased mood-enhancement. Furthermore, the severity of depressive symptoms did not significantly affect the intervention effects, whereas heightened anxiety symptoms was associated with a smaller mood enhancement effect.

DISCUSSION

Our study demonstrates the benefits of nature image stimulation for patients with depressive and anxiety disorders. Differential orbital prefrontal brain activity impacts notwithstanding, both conditions exhibited mood enhancement, affirming the value of nature image stimulation.

Prefrontal cortex activities during verbal fluency and emotional words tasks in major depressive, adjustment, and bipolar disorders with depressive states

BACKGROUND

It can be difficult to differentiate psychiatric disorders from depressive states, with little knowledge on how to differentiate them. This study aimed to evaluate changes in brain activity during cognitive and emotional tasks in patients with depressive state to help with differential diagnoses.

METHODS

Sixty-two patients with depressive states [17 with adjustment disorder (AD), 27 with major depressive disorder (MDD), and 18 with bipolar disorder (BD)] and 34 healthy controls (HC) were recruited. We used a verbal fluency task (VFT) and emotional word tasks with happy and threat words. Functional near-infrared spectroscopy measured the relative change in oxygenated hemoglobin in the frontotemporal areas.

RESULTS

During the VFT, patients with AD or MDD showed significantly reduced activation in the bilateral frontotemporal region (all p < 0.01), whereas patients with BD demonstrated significantly reduced activation in the right frontotemporal areas compared to HC (p < 0.01). During the emotional words task with happy words, patients with MDD showed significantly increased activity in the frontopolar area compared to HC (p = 0.023). Binary logistic regression analysis showed that MDD or BD was significantly associated with brain activity during the happy word task. In distinguishing MDD or BD from HC, the happy words task performed equally well, with an area under the curve of 0.70.

LIMITATIONS

All study patients were taking psychotropic drugs.

CONCLUSIONS

Brain activation in response to a combination of cognitive or emotional stimuli could assist in distinguishing patients with depressive states from healthy controls.

Computational markers of experience- but not description-based decision-making are associated with future depressive symptoms in young adults

BACKGROUND

Early prediction of high depressive symptoms is crucial for selective intervention and the minimization of functional impairment. Recent cross-sectional studies indicated decision-making deficits in depression, which may be an important contributor to the disorder. Our goal was to test whether description- and experience-based decision making, two major neuroeconomic paradigms of decision-making under uncertainty, predict future depressive symptoms in young adults.

METHODS

One hundred young adults performed two decision-making tasks, one description-based, in which subjects chose between two gambling options given explicitly stated rewards and their probabilities, and the other experience-based, in which subjects were shown rewards but had to learn the probability of those rewards (or cue-outcome contingencies) via trial-and-error experience. We evaluated subjects' depressive symptoms with BDI-II at baseline (T1) and half a year later (T2).

RESULTS

Comparing subjects with low versus high levels of depressive symptoms at T2 showed that the latter performed worse on the experience- but not description-based task at T1. Computational modeling of the decision-making process suggested that subjects with high levels of depressive symptoms had a more concave utility function, indicating enhanced risk aversion. Furthermore, a more concave utility function at T1 increased the odds of high depressive symptoms at T2, even after controlling depressive symptoms at T1, perceived stress at T2, and several covariates (OR = 0.251, 95% CI [0.085, 0.741]).

CONCLUSIONS

This is the first study to demonstrate a prospective link between experience-based decision-making and depressive symptoms. Our results suggest that enhanced risk aversion in experience-based decision-making may be an important contributor to the development of depressive symptoms.

The effect of positive autobiographical memory retrieval on decision-making under risk: A computational model-based analysis

Psychiatric disorders such as depressive and anxiety disorders are associated with altered decision-making under risk. Recent advances in neuroeconomics and computational psychiatry have further discomposed risk-based decision-making into distinct cognitive computational constructs and showed that there may be disorder-specific alterations in these constructs. As a result, it has been suggested these cognitive computational constructs may serve as useful behavioral biomarkers for these disorders. However, to date, little is known about what psychological or behavioral interventions can help to reverse and manage the altered cognitive computational constructs underlying risk-based decision-making. In the present study, we set out to investigate whether recalling positive autobiographical memories may affect risk-based decision-making in healthy volunteers using a description-based task. Specifically, based on theories of behavioral economics, we dissected risk preference into two cognitive computational constructs, utility sensitivity and probability weighting. We found that compared to recalling neutral memories, retrieving positive autobiographical memories increased utility sensitivity (Cohen's d = 0.447), indicating reduced risk aversion. Meanwhile, we also tested the influence of memory retrieval on probability weighting, the effect, however, was unreliable and requires further in-depth investigation. Of clinical relevance, the change in risk aversion after recalling positive memories was in the opposite direction compared to those reported in psychiatric disorders. These results argue for the potential therapeutic effect of positive autobiographical memory retrieval for the amendment of altered risk-based decision-making in psychiatric disorders.

Nonlinear Probability Weighting in Depression and Anxiety: Insights From Healthy Young Adults

Both depressive and anxiety disorders have been associated with excessive risk avoidant behaviors, which are considered an important contributor to the maintenance and recurrence of these disorders. However, given the high comorbidity between the two disorders, their independent association with risk preference remains unclear. Furthermore, due to the involvement of multiple cognitive computational factors in the decision-making tasks employed so far, the precise underlying mechanisms of risk preference are unknown. In the present study, we set out to investigate the common versus unique cognitive computational mechanisms of risk preference in depression and anxiety using a reward-based decision-making task and computational modeling based on economic theories. Specifically, in model-based analysis, we decomposed risk preference into utility sensitivity (a power function) and probability weighting (the one-parameter Prelec weighting function). Multiple linear regression incorporating depression (BDI-II) and anxiety (STAI state anxiety) simultaneously indicated that only depression was associated with one such risk preference parameter, probability weighting. As the symptoms of depression increased, subjects' tendency to overweight small probabilities and underweight large probabilities decreased. Neither depression nor anxiety was associated with utility sensitivity. These associations remained even after controlling covariates or excluding anxiety-relevant items from the depression scale. To our knowledge, this is the first study to assess risk preference due to a concave utility function and nonlinear probability weighting separately for depression and anxiety using computational modeling. Our results provide a mechanistic account of risk avoidance and may improve our understanding of decision-making deficits in depression and anxiety.

The Effect of Brief Stair-Climbing on Divergent and Convergent Thinking

Recent studies show that even a brief bout of aerobic exercise may enhance creative thinking. However, few studies have investigated the effect of exercise conducted in natural settings. Here, in a crossover randomized controlled trial, we investigated the effect of a common daily activity, stair-climbing, on creative thinking. As experimental intervention, subjects were asked to walk downstairs from the fourth to the first floor and back at their usual pace. As control intervention, they walked the same path but using the elevator instead. Compared to using the elevator, stair-climbing enhanced subsequent divergent but not convergent thinking in that it increased originality on the Alternate Use Test (d = 0.486). Subjects on average generated 61% more original uses after stair-climbing. This is the first study to investigate the effect of stair-climbing on creative thinking. Our findings suggest that stair-climbing may be a useful strategy for enhancing divergent thinking in everyday life.

Regular Vigorous-Intensity Physical Activity and Walking Are Associated with Divergent but not Convergent Thinking in Japanese Young Adults

The beneficial effects of regular physical activity (PA) on cognitive functions have received much attention. Recent research suggests that regular PA may also enhance creative thinking, an indispensable cognitive factor for invention and innovation. However, at what intensity regular PA brings the most benefits to creative thinking remains uninvestigated. Furthermore, whether the levels of regular PA affect the acute PA effects on creative thinking is also unclear. In the present study, using a previous dataset that investigated the effects of an acute bout of aerobic exercise on creative thinking in healthy Japanese young adults (22.98 ± 1.95 years old) in the year 2020, we tested the association between different intensities of regular PA (i.e., vigorous, moderate, and walking) and creative thinking with the cross-sectional baseline data using multiple linear regression. We also investigated whether regular PA levels were associated with the acute aerobic exercise intervention effects on creative thinking. The results showed that cross-sectionally, the regular PAs were differentially associated with divergent but not convergent thinking. Specifically, whereas the amount of vigorous-intensity PA was positively associated with fluency and flexibility, the amount of walking was positively associated with novelty on the alternate uses test (AUT) measuring divergent thinking. Importantly, the explained variances of fluency, flexibility, and novelty were 20.3% (p = 0.040), 18.8% (p = 0.055), and 20.1% (p = 0.043), respectively. None of the regular PAs predicted convergent thinking (i.e., an insight problem-solving task), nor were they associated with the acute aerobic exercise intervention effects on divergent and convergent thinking. These findings suggest that engaging in regular vigorous-intensity PA and walking may be useful strategies to enhance different aspects of divergent thinking in daily life.

The Negative Association Between Positive Psychological Wellbeing and Loss Aversion

When making decisions, people tend to overweigh the impact of losses compared to gains, a phenomenon known as loss aversion (LA). A moderate amount of LA may be adaptive as it is necessary for protecting oneself from danger. However, excessive LA may leave people few opportunities and ultimately lead to suboptimal outcomes. Despite frequent reports of elevated LA in specific populations such as patients with depression, little is known about what psychological characteristics are associated with the tendency of LA. Based on the neurobiological studies of LA, we hypothesized that positive psychological wellbeing may be negatively associated with people's tendency of LA. In the present study, we set out to test this hypothesis in a sample of young adults. We evaluated LA using a decision-making task in which subjects were asked to decide whether to accept or reject a series of coin-toss gambles. Our results revealed that individuals with more advanced personal growth as assessed by the Ryff's Psychological Well-being Inventory showed reduced LA. To our knowledge, this is the first report demonstrating an association between positive psychological wellbeing and LA. These findings suggest that personal growth might be employed as interventional targets for correcting excessive LA in vulnerable populations.

Regular Moderate- to Vigorous-Intensity Physical Activity Rather Than Walking Is Associated with Enhanced Cognitive Functions and Mental Health in Young Adults

The beneficial effect of physical activity (PA) on the brain has been well established. Both acute and regular PA can boost a range of cognitive functions and enhance mood and mental health. Notably, the effect of acute PA on the brain and cognitive functions is generally found to be dose-dependent, in terms of both the amount and intensity of the exercise episode. In contrast, in the case of regular PA, the literature has primarily focused on the amount of exercise, and limited studies have assessed the influence of the exercise intensity. Since PA in higher intensity causes more extensive, more powerful, and longer-lasting neurobiological changes, it may prove more beneficial to cognitive functions and mental health. In the present study, we set out to test this hypothesis by employing a battery of questionnaires and laboratory tests with a sample of young adults. We found that more frequent vigorous- and moderate-intensity PA rather than walking (considered low to moderate intensity) was associated with better cognitive and mental health measures. Meanwhile, compared with no moderate- to vigorous-intensity physical activity (MVPA) at all, as few as 1~2 days per week (lasting at least 10 min each time) of MVPA was associated with a variety of benefits, particularly related to coping with challenging situations. In light of the neurobiological literature, the present study speaks to the value of moderate- to vigorous- rather than low-intensity PA in enhancing cognitive functions and mental health.

Altered Connectivity of the Anterior Cingulate and the Posterior Superior Temporal Gyrus in a Longitudinal Study of Later-life Depression

Patients with later-life depression (LLD) show abnormal gray matter (GM) volume, white matter (WM) integrity and functional connectivity in the anterior cingulate cortex (ACC) and posterior superior temporal gyrus (pSTG), but it remains unclear whether these abnormalities persist over time. We examined whether structural and functional abnormalities in these two regions are present within the same subjects during depressed vs. remitted phases. Sixteen patients with LLD and 30 healthy subjects were studied over a period of 1.5 years. Brain images obtained with a 3-Tesla magnetic resonance imaging (MRI) system were analyzed by voxel-based morphometry of the GM volume, and diffusion tensor imaging (DTI) and resting-state functional MRI were used to assess ACC–pSTG connectivity. Patients with LLD in the depressed and remitted phases showed significantly smaller GM volume in the left ACC and left pSTG than healthy subjects. Both patients with LLD in the depressed and remitted phases had significantly higher diffusivities in the WM tract of the left ACC–pSTG than healthy subjects. Remitted patients with LLD showed lower functional ACC–pSTG connectivity compared to healthy subjects. No difference was found in the two regions between depressed and remitted patients in GM volume, structural or functional connectivity. Functional ACC–pSTG connectivity was positively correlated with lower global function during remission. Our preliminary data show that structural and functional abnormalities of the ACC and pSTG occur during LLD remission. Our findings tentatively reveal the brain pathophysiology involved in LLD and may aid in developing neuroanatomical biomarkers for this condition.

A Kirschner wire as a transverse-axis guide to improve acetabular cup positioning

PURPOSE

To compare cup-positioning accuracy in total hip arthroplasty (THA) with or without use of a Kirschner wire as a transverse-axis guide for pelvic alignment.

METHODS

Records of 18 men and 73 women (mean age, 60 years) who underwent primary THA with (n=49) or without (n=42) use of a Kirschner wire as a transverse-axis guide for pelvic alignment were reviewed. A 2.4-mm Kirschner wire as a transversea-xis guide was inserted to the anterior superior iliac spine and was parallel to a line linking the left and right anterior superior iliac spine. The safe zone for cup positioning was defined as 30º to 50° abduction and 10º to 30º anteversion. Of the 5 operative surgeons, 2 were classified as experienced (total surgical volume >300) and 3 as inexperienced (total surgical volume of <50). The proportion of patients with the cup in the safe zone was compared in patients with or without use of the transverse-axis guide and in experienced and inexperienced surgeons.

RESULTS

For inexperienced surgeons, the use of the transverse-axis guide significantly improved the proportion of patients with the cup in the safe zone from 90% to 100% for abduction, from 50% to 82.4% for anteversion, and from 40% to 82.4% for both. Patients with the cup inside or outside the safe zone were comparable in terms of body height, weight, BMI, subcutaneous fat thickness, incision length, and acetabular cup size.

CONCLUSION

The use of the transverse-axis guide improved the accuracy of cup positioning by inexperienced surgeons.

Inhibition of Notch pathway prevents osteosarcoma growth by cell cycle regulation

The study shows constitutive activation of the Notch pathway in various types of malignancies. However, it remains unclear how the Notch pathway is involved in the pathogenesis of osteosarcoma. We investigated the expression of the Notch pathway molecules in osteosarcoma biopsy specimens and examined the effect of Notch pathway inhibition. Real-time PCR revealed overexpression of Notch2, Jagged1, HEY1, and HEY2. On the other hand, Notch1 and DLL1 were downregulated in biopsy specimens. Notch pathway inhibition using γ-secretase inhibitor and CBF1 siRNA slowed the growth of osteosarcomas in vitro. In addition, γ-secretase inhibitor-treated xenograft models exhibited significantly slower osteosarcoma growth. Cell cycle analysis revealed that γ-secretase inhibitor promoted G1 arrest. Real-time PCR and western blot revealed that γ-secretase inhibitor reduced the expression of accelerators of the cell cycle, including cyclin D1, cyclin E1, E2, and SKP2. On the other hand, p21^cip1 protein, a cell cycle suppressor, was upregulated by γ-secretase inhibitor treatment. These findings suggest that inhibition of Notch pathway suppresses osteosarcoma growth by regulation of cell cycle regulator expression and that the inactivation of the Notch pathway may be a useful approach to the treatment of patients with osteosarcoma.

Synthesis, characterization, and stereochemistry of oxorhenium(V) complexes with 2-aminoethanethiolate

A series of oxorhenium(V) complexes with 2-aminoethanethiolate (aet), [ReO(aet-N,S)(D-pen-N,O,S)] (2), [[ReO(aet-N,S)(2)](2)O] (3), [ReO(Cl)(aet-N,S)(2)] (4), and [ReO(aet-N,S)(Haet-S)(2)]Cl(2) ([5]Cl(2)) was newly prepared starting from ReO(4)(-). The reaction of NH(4)ReO(4) with a 1:1 mixture of Haet.HCl and D-H(2)pen (D-penicillamine) in the presence of SnCl(2).2H(2)O in water gave 2, 3, and the known complex [ReO(D-Hpen-N,S)(D-pen-N,O,S)] (1). These complexes were fractionally precipitated by controlling the pH of the reaction solution. The complex 2 was also prepared in a higher yield by a similar reaction using methanol as a solvent. The crystal structure of 2 was determined by X-ray crystallography; 2 crystallizes in the tetragonal space group P4(3) with a = 9.621(1), c = 12.911(1) A, V = 1195.0(3) A(3), and Z = 4. The oxorhenium(V) core in 2 is coordinated by a bidentate-N,S aet ligand and a tridentate-N,O,S D-pen ligand, having a distorted octahedral geometry with a cis-N cis-S configuration in the equatorial plane perpendicular to the O-Re-O axis. The 1:2 reaction of NH(4)ReO(4) with Haet.HCl in the presence of SnCl(2).2H(2)O in methanol produced 4, which is interconvertible with 3, while the corresponding 1:3 reaction resulted in the isolation of [5]Cl(2). The complexes 4 and 5 were also structurally characterized; 4 crystallizes in the monoclinic space group P2(1)/c with a = 6.839(1), b = 10.0704(6), c = 14.1075(8) A, beta = 91.729(8) degrees, V = 971.2(2) A(3), and Z = 4, while [5]Cl(2) crystallizes in the triclinic space group P1 with a = 11.938(3), b = 12.366(3), c = 5.819(1) A, alpha = 102.71(2), beta = 101.28(2), gamma = 75.41(2) degrees, V = 802.0(3) A(3), and Z = 2. In 4, the oxorhenium(V) core is octahedrally coordinated by two bidentate-N,S aet ligands, which form a cis-N cis-S configurational equatorial plane with a Cl(-) ion trans to the oxo ligand. On the other hand, the oxorhenium(V) core in [5](2+) is coordinated by one bidenate-N,S aet and two monodentate-S Haet ligands, having a distorted trigonal-bipyramidal geometry with S and N donors at the apical positions.

(2-Aminoethanethiolato-N,S)bis(ethylenediamine-N,N')cobalt(III) dinitrate

In the title compound, [Co(C(2)H(6)NS)(C(2)H(8)N(2))(2)](NO(3))(2), the Co(III) atom has a slightly distorted octahedral geometry, coordinated by one 2-aminoethanethiolate and two ethylenediamine ligands. The three five-membered chelate rings adopt a gauche conformation with the unfavoured (lel)(2)(ob) form, which is ascribed to hydrogen bonds between the amine groups in the complex cation and the nitrate counter-anions [N.O 2.900 (3)-3.378 (3) A].