1
|
Zhang P, Song Y, Tadesse E, Khalid S, Gao C, Li W. An EPR study of the cognitive processes underlying the impact of self-relevant information on emotional word processing. BMC Psychol 2024; 12:90. [PMID: 38389094 PMCID: PMC10885381 DOI: 10.1186/s40359-024-01586-z] [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: 02/08/2023] [Accepted: 02/12/2024] [Indexed: 02/24/2024] Open
Abstract
Using the event-related potentials (ERPs) technique, this study successively presented names (in either a supra- or subthreshold manner) and emotional words to examine how self-relevant cue (self-name) affects emotional word processing in word class judgment task (to determine whether an emotional word is a noun or adjective) and valence judgment task (to determine whether an emotional word is positive or negative). At the suprathreshold condition, self-relevant positive words elicited a more significant Early posterior negativity (EPN) than negative words only in the valence judgment task. In contrast, at the subthreshold condition, self-relevant negative words elicited an enhanced Late positive potential (LPP) than positive words only in the word class judgment task. These results indicate that self-relevant cue affects emotional word processing at both suprathreshold and subthreshold conditions; nevertheless, the effect manifests as self-positive bias at the suprathreshold condition and self-negative bias at the subthreshold condition. The experimental task modulates these dynamics.
Collapse
Affiliation(s)
- Ping Zhang
- Shanghai Urban Construction Vocational College, Shanghai, China
| | - Yidan Song
- Research Center of Brain and Cognitive Neuroscience, Liaoning Normal University, Dalian, China
- Key Laboratory of Brain and Cognitive Neuroscience, Dalian, Liaoning Province, China
| | - Endale Tadesse
- Faculty of Education, Zhejiang Normal University, Jinhua, China
| | - Sabika Khalid
- Faculty of Education, Zhejiang Normal University, Jinhua, China
| | - Chunhai Gao
- Faculty of Education, Shenzhen University, 3688 Nanhai Avenue, Nanshan District, Shenzhen, China.
| | - Weijun Li
- Research Center of Brain and Cognitive Neuroscience, Liaoning Normal University, Dalian, China
- Key Laboratory of Brain and Cognitive Neuroscience, Dalian, Liaoning Province, China
| |
Collapse
|
2
|
Shanks MJ, Cirillo J, Stinear CM, Byblow WD. Reliability of a TMS-derived threshold matrix of corticomotor function. Exp Brain Res 2023; 241:2829-2843. [PMID: 37898579 PMCID: PMC10635992 DOI: 10.1007/s00221-023-06725-3] [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] [Received: 08/04/2023] [Accepted: 10/18/2023] [Indexed: 10/30/2023]
Abstract
Transcranial magnetic stimulation (TMS) studies typically focus on suprathreshold motor evoked potentials (MEPs), overlooking small MEPs representing subthreshold corticomotor pathway activation. Assessing subthreshold excitability could provide insights into corticomotor pathway integrity and function, particularly in neurological conditions like stroke. The aim of the study was to examine the test-retest reliability of metrics derived from a novel compositional analysis of MEP data from older adults. The study also compared the composition between the dominant (D) and non-dominant (ND) sides and explored the association between subthreshold responses and resting motor threshold. In this proof-of-concept study, 23 healthy older adults participated in two identical experimental sessions. Stimulus-response (S-R) curves and threshold matrices were constructed using single-pulse TMS across intensities to obtain MEPs in four upper limb muscles. S-R curves had reliable slopes for every muscle (Intraclass Correlation Coefficient range = 0.58-0.88). Subliminal and suprathreshold elements of the threshold matrix showed good-excellent reliability (D subliminal ICC = 0.83; ND subliminal ICC = 0.79; D suprathreshold ICC = 0.92; ND suprathreshold ICC = 0.94). By contrast, subthreshold elements of the matrix showed poor reliability, presumably due to a floor effect (D subthreshold ICC = 0.39; ND subthreshold ICC = 0.05). No composition differences were found between D and ND sides (suprathreshold BF01 = 3.85; subthreshold BF01 = 1.68; subliminal BF01 = 3.49). The threshold matrix reliably assesses subliminal and suprathreshold MEPs in older adults. Further studies are warranted to evaluate the utility of compositional analyses for assessing recovery of corticomotor pathway function after neurological injury.
Collapse
Affiliation(s)
- Maxine J Shanks
- Department of Exercise Sciences, University of Auckland, Auckland, New Zealand
- Centre for Brain Research, University of Auckland, Auckland, New Zealand
| | - John Cirillo
- Department of Exercise Sciences, University of Auckland, Auckland, New Zealand
- Centre for Brain Research, University of Auckland, Auckland, New Zealand
| | - Cathy M Stinear
- Centre for Brain Research, University of Auckland, Auckland, New Zealand
- Department of Medicine, University of Auckland, Auckland, New Zealand
| | - Winston D Byblow
- Department of Exercise Sciences, University of Auckland, Auckland, New Zealand.
- Centre for Brain Research, University of Auckland, Auckland, New Zealand.
| |
Collapse
|
3
|
Tang Y, Qiu S, Li H, Si F, Zhao M, Dong M, Pan M, Yue X, Liu L, Qian Q, Wang Y. The Clinical Manifestation, Executive Dysfunction, and Caregiver Strain in Subthreshold Attention-Deficit/Hyperactivity Disorder. Psychiatry Investig 2023; 20:789-798. [PMID: 37794660 PMCID: PMC10555518 DOI: 10.30773/pi.2023.0070] [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] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Revised: 05/22/2023] [Accepted: 06/07/2023] [Indexed: 10/06/2023] Open
Abstract
OBJECTIVE Subthreshold attention-deficit/hyperactivity disorder (ADHD) has been suggested to be a "morbid condition" which also needs medical attention. METHODS The present study recruited 89 children with subthreshold ADHD (sADHD), 115 children with diagnosed ADHD (cADHD), and 79 healthy controls (HC) to explore the clinical manifestation, executive functions (EFs) of sADHD, and the caregiver strain. The clinical manifestation was evaluated through clinical interviews and parent-reports. Executive functions were assessed both experimentally and ecologically. Caregiver strain was measured by a parent-reported questionnaire. RESULTS For the clinical manifestation, both sADHD and cADHD indicated impairments when compared with HC. The comorbidities and the scaled symptoms indicated that the externalizing behaviors were relatively less serious in sADHD than cADHD, whereas the internalizing behaviors between two groups were comparable. For ecological EFs, sADHD scored between cADHD and HC in inhibition and working memory. For experimental EFs, sADHD was comparable to cADHD in inhibition, shifting, and was worse than cADHD in verbal working memory. For the caregiver strain, all scores of sADHD were between that in cADHD and that in HC. CONCLUSION Our present findings supported the suggestion of subthreshold ADHD as "morbid condition," which should be treated with caution in clinical practice, especially for the internalizing behaviors and some key components of EFs.
Collapse
Affiliation(s)
- Yajing Tang
- Peking University Sixth Hospital, Peking University Institute of Mental Health, Beijing, China
- NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, China
| | - Sunwei Qiu
- Peking University Sixth Hospital, Peking University Institute of Mental Health, Beijing, China
- NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, China
| | - Haimei Li
- Peking University Sixth Hospital, Peking University Institute of Mental Health, Beijing, China
- NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, China
| | - Feifei Si
- Peking University Sixth Hospital, Peking University Institute of Mental Health, Beijing, China
- NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, China
| | - Mengjie Zhao
- Peking University Sixth Hospital, Peking University Institute of Mental Health, Beijing, China
- NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, China
| | - Min Dong
- Peking University Sixth Hospital, Peking University Institute of Mental Health, Beijing, China
- NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, China
| | - Meirong Pan
- Peking University Sixth Hospital, Peking University Institute of Mental Health, Beijing, China
- NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, China
| | - Xinxin Yue
- Peking University Sixth Hospital, Peking University Institute of Mental Health, Beijing, China
- NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, China
| | - Lu Liu
- Peking University Sixth Hospital, Peking University Institute of Mental Health, Beijing, China
- NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, China
| | - Qiujin Qian
- Peking University Sixth Hospital, Peking University Institute of Mental Health, Beijing, China
- NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, China
| | - Yufeng Wang
- Peking University Sixth Hospital, Peking University Institute of Mental Health, Beijing, China
- NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, China
| |
Collapse
|
4
|
Mohamed AA, Khaled E, Hesham A, Khalf A. Effectiveness and safety of subthreshold vibration over suprathreshold vibration in treatment of muscle fatigue in elderly people. World J Clin Cases 2023; 11:3434-3443. [PMID: 37383890 PMCID: PMC10294188 DOI: 10.12998/wjcc.v11.i15.3434] [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] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2023] [Revised: 03/29/2023] [Accepted: 04/20/2023] [Indexed: 05/25/2023] Open
Abstract
Muscle fatigue is common in many populations, particularly elderlies. Aging increases the incidence of muscle fatigue and delays its recovery. There is a huge debate about the current treatments for muscle fatigue, particularly in elderlies. Recently, it has been discovered that mechanoreceptors have an important role as a sensory system in sensing muscle fatigue which could enhance the body's response to muscle fatigue. The function of mechanoreceptors could be enhanced by applying either suprathreshold or subthreshold vibration. Although suprathreshold vibration improves muscle fatigue, it can cause desensitization of cutaneous receptors, discomfort, and paresthesia, which are barriers to clinical use. Subthreshold vibration has been approved as a safe and effective method of training for mechanoreceptors; however, its use and effectiveness in muscle fatigue have never been tested or explained. Possible physiological effects of subthreshold vibration in the treatment of muscle fatigue include: (1) Enhancing the function of mechanoreceptors themselves; (2) Increasing the firing rate and function of alpha motor neurons; (3) Increasing blood flow to fatigued muscles; (4) Decreasing the rate of muscle cell death in elderlies (sarcopenia); and (5) Driving motor commands and allow better performance of muscles to decrease fatigue incidence. In conclusion, the use of subthreshold vibration could be a safe and effective treatment for muscle fatigue in elderlies. It could enhance recovery from muscle fatigue. Finally, Subthreshold Vibration is safe and effective in treating muscle fatigue in comparison to suprathreshold vibration.
Collapse
Affiliation(s)
- Ayman A Mohamed
- Physical Therapy, Nahda University, Beni Suef 23435, Egypt
- Physical Therapy, Beni-Suef University, Beni Suef 32456, Egypt
| | - Esraa Khaled
- Physical Therapy, Nahda University, Beni Suef 23435, Egypt
| | - Asmaa Hesham
- Physical Therapy, Nahda University, Beni Suef 23435, Egypt
| | - Ahmed Khalf
- Physical Therapy, Nahda University, Beni Suef 23435, Egypt
| |
Collapse
|
5
|
Hu XY, Cao L, Gao Y, Luan J, Xu XD. Comparative Efficacy of Subthreshold Micropulse Laser Photocoagulation versus Conventional Laser Photocoagulation for Diabetic Macular Edema: A Meta-Analysis. Ophthalmic Res 2023; 66:611-619. [PMID: 36682350 DOI: 10.1159/000529224] [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: 02/07/2022] [Accepted: 01/06/2023] [Indexed: 01/22/2023]
Abstract
BACKGROUND Laser photocoagulation is an effective procedure for the treatment of diabetic macular edema (DME). However, the beneficial effects of conventional laser photocoagulation (CLP) are accompanied by the destruction of retinal photoreceptors. Therefore, subthreshold micropulse laser photocoagulation (SMLP) was proposed for DME. OBJECTIVES This meta-analysis study was performed to evaluate the efficacy and safety of SMLP compared with CLP for the management of DME. METHODS The PubMed, Embase, Web of Science, Cochrane, SinoMed, ClinicalTrials.gov, Wanfang, and China National Knowledge Infrastructure (CNKI) databases, published until Dec 2021, were searched to identify studies evaluating the clinical outcomes of SMLP for DME. RESULTS Eight randomized controlled trials were selected for this meta-analysis involving a total of 546 eyes (275 eyes in SMLP group and 271 eyes in CLP group). SMLP of different wavelengths (577 nm and 810 nm) and duty cycles (5% and 15%) was applied. The pooled outcomes showed that SMLP group, especially 577 nm and 810 nm 15% duty cycle parameter settings, had a statistically significant higher efficacy than CLP group in terms of BCVA (MD = -0.02, 95% CI: -0.03 to -0.01, p < 0.01; MD = -0.09, 95% CI: -0.09 to -0.09, p < 0.01) and showed more significant advantages than CLP group in resolving macular edema assessed by reduction of CMT (MD = -32.87, 95% CI: -37.61 to -28.13, p < 0.01; MD = -8.01, 95% CI: -9.06 to -6.96, p < 0.01), whereas the efficacy of 577 nm and 810 nm 5% duty cycle SMLP subgroups remained numerically superior to CLP group, but nonsignificantly (p > 0.05). In the field of CS, SMLP group (no matter parameter settings) resulted in better preservation of CS compared to CLP group (MD = 1.96, 95% CI: 1.47-2.46, p < 0.01). CONCLUSIONS Compared with CLP, SMLP may get superior efficacy and safety on improvement of BCVA, reduction of CMT, and preservation of CS. In clinical, SMLP can be considered as a safe and effective therapy in the management of DME.
Collapse
Affiliation(s)
- Xin-Ying Hu
- Department of Ophthalmology, Jiangyin People's Hospital, Jiangyin, China
| | - Li Cao
- Department of Ophthalmology, Jiangyin People's Hospital, Jiangyin, China
| | - Ye Gao
- Department of Ophthalmology, Jiangyin People's Hospital, Jiangyin, China
| | - Jie Luan
- Department of Ophthalmology, Southeast University Zhongda Hospital, Nanjing, China
| | - Xue-Dong Xu
- Department of Ophthalmology, Jiangyin People's Hospital, Jiangyin, China
| |
Collapse
|
6
|
Miyake Y, Okamoto Y, Takagaki K, Yoshihara M. Changes in Eating Attitudes and Risk for Developing Disordered Eating Behaviors in College Students with Subthreshold Eating Disorders: A Cohort Study. Psychopathology 2022:1-9. [PMID: 36509080 DOI: 10.1159/000527604] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Accepted: 10/10/2022] [Indexed: 12/14/2022]
Abstract
INTRODUCTION The number of young adults with eating disorders or subthreshold eating disorders has increased recently. Although disordered eating behaviors persist once they appear, there have been relatively few studies on factors that might cause disordered eating behaviors. The purpose of this study was to investigate how the eating attitudes of young adults change over time and the risk factors that increase disordered eating behaviors. METHODS A total of 1,141 college students, 639 males and 502 females, participated. We investigated changes in eating attitudes (using EAT-26 and BITE), depressive symptoms (using BDI-II), and stress coping (using CISS, which has three subscales) between 2 time points: at college entrance and in the fourth year of college. We divided the students into three groups (clinical, subthreshold, and healthy) based on EAT-26 scores and compared their BDI-II and CISS scores. Next, we identified students who developed disordered eating behaviors, both clinical and subthreshold, during their time at college (exacerbated students) and compared depressive symptoms and stress coping styles between exacerbated students and healthy students (unchanged students). RESULTS The students in the subthreshold group (both males and females) scored significantly higher on the BDI-II and emotion-oriented coping (CISS-E) than the students in the healthy group at college entrance. Additionally, the exacerbated students (both males and females) scored significantly higher on the CISS-E in the fourth year than unchanged students. The female exacerbated students scored significantly higher on the BDI-II than female unchanged students at both time points. CONCLUSIONS Our results show that depressive symptoms and nonadaptive stress coping are associated with an increased risk of disordered eating behaviors. This study suggests that early intervention may be necessary for both the clinical and subthreshold groups. The key to early intervention may be to manage not only eating behaviors but also depressive symptoms and stress coping.
Collapse
Affiliation(s)
- Yoshie Miyake
- Health Service Center, Hiroshima University, Hiroshima, Japan
| | - Yuri Okamoto
- Health Service Center, Hiroshima University, Hiroshima, Japan
| | - Koki Takagaki
- Health Service Center, Hiroshima University, Hiroshima, Japan
| | | |
Collapse
|
7
|
Johnson JCS, Byrne GJ, Pelecanos AM. The prevalence of subthreshold psychiatric symptoms and associations with alcohol and substance use disorders: from a nationally representative survey of 36,309 adults. BMC Psychiatry 2022; 22:270. [PMID: 35428242 PMCID: PMC9012038 DOI: 10.1186/s12888-022-03834-1] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Accepted: 02/08/2022] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND Our aim was to describe a broad number of subthreshold psychiatric symptoms (SPS) in a nationally representative population and evaluate associations with substance use. SPS describe groups of symptoms with significant pathology, but that do not quite meet full psychiatric diagnostic criteria. They have been associated with significant impairment and cost. METHODS The National Epidemiologic Survey on Alcohol and Related Conditions-III was a multistage, weighted, cross-sectional survey completed in the United States in 2013 comprising 36,309 noninstitutionalized adults. We report lifetime prevalence rates of 14 SPS related to mood, anxiety, trauma, eating, and personality disorders. We then evaluate associations with lifetime alcohol use disorders (AUD) and all substance use disorders (SUD) using logistic regression and adjusted odds ratios. SPS and psychiatric diagnoses were mutually exclusive (could not co-occur). RESULTS Lifetime prevalence of having at least one of 14 SPS was 57% compared with 37% for the related psychiatric disorders. This was similar for males and females, in contrast to psychiatric disorders in which prevalence was 42% in females and 31% in males. Otherwise, overall SPS and disorders had similar prevalence patterns across sociodemographic characteristics. Subthreshold personality symptoms had the highest prevalence rates (schizotypal 21.3%, antisocial 18.3%, and borderline 17.6%), followed by posttraumatic stress (13.1%). Subthreshold bipolar and depression had lifetime prevalence rates of 2.7 and 8.5%, respectively. Prevalence rates of subthreshold anxiety symptoms ranged from 2.2% (agoraphobia) to 9.8% (specific phobia). Subthreshold eating disorder related symptoms had the lowest prevalence rates (anorexia 1.5% and bulimia 1.7%). Half (seven) of the SPS had significantly increased odds of lifetime AUD. This number increased to 12 for all SUD. Subthreshold antisocial personality symptoms had the highest odds of AUD (2.2; 95% CI 2.00-2.37) and SUD (3.5; 95% CI 3.22-3.81). CONCLUSIONS We found high lifetime SPS prevalence rates and significant associations with AUD and SUD. To our knowledge, this is the first published study evaluating a broad number of SPS. This indicates possible opportunities for early intervention and prevention but requires additional research and development of infrastructure and guidelines to better understand and manage patients who experience SPS.
Collapse
Affiliation(s)
- Jeremy C. S. Johnson
- grid.1003.20000 0000 9320 7537The University of Queensland, Mental Health Centre, K Floor, Royal Brisbane & Women’s Hospital, Herston, QLD 4029 Australia ,grid.416100.20000 0001 0688 4634Department of Psychiatry, Royal Brisbane & Women’s Hospital, Butterfield St, Herston, QLD 4029 Australia
| | - Gerard J. Byrne
- grid.1003.20000 0000 9320 7537The University of Queensland, Mental Health Centre, K Floor, Royal Brisbane & Women’s Hospital, Herston, QLD 4029 Australia ,grid.416100.20000 0001 0688 4634Department of Psychiatry, Older Persons’ Mental Health Service, Royal Brisbane & Women’s Hospital, Butterfield St, Herston, QLD 4029 Australia
| | - Anita M. Pelecanos
- grid.1049.c0000 0001 2294 1395Statistics Unit, QIMR Berghofer Medical Research Institute, 300 Herston Rd, Herston, QLD 4006 Australia
| |
Collapse
|
8
|
Guymer RH, Chen FK, Hodgson LAB, Caruso E, Harper CA, Wickremashinghe SS, Cohn AC, Sivarajah P, Tindill N, Luu CD, Wu Z. Subthreshold Nanosecond Laser in Age-Related Macular Degeneration: Observational Extension Study of the LEAD Clinical Trial. Ophthalmol Retina 2021; 5:1196-1203. [PMID: 33662615 DOI: 10.1016/j.oret.2021.02.015] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Revised: 02/23/2021] [Accepted: 02/24/2021] [Indexed: 06/12/2023]
Abstract
PURPOSE To evaluate the long-term effect of subthreshold nanosecond laser (SNL) treatment on progression to late age-related macular degeneration (AMD). DESIGN Observational extension study of a randomized, sham-controlled trial. PARTICIPANTS Two hundred twelve participants with bilateral large drusen. METHODS The Laser Intervention in the Early Stages of AMD (LEAD) study was a 36-month trial where participants were randomized to receive SNL or sham treatment in 1 eye at 6-monthly intervals up to 30 months. After the completion of the LEAD study, the 2 largest recruiting sites offered remaining participants an opportunity to enroll in a 24-month observational extension study. This study thus examined all participants from these 2 sites who were enrolled in the LEAD study at baseline, including the additional observational data. MAIN OUTCOME MEASURES Time to develop late AMD, defined on multimodal imaging, between those randomized the SNL or sham treatment. RESULTS Overall, no significant difference was found in the rate of progression over a 60-month period in those randomized to the SNL compared with the sham group (adjusted hazard ratio [HR], 0.63; 95% confidence interval [CI], 0.36-1.09; P = 0.098), similar to the findings at 36 months in the LEAD Study. However, evidence of treatment effect modification continued to emerge based on the coexistence of reticular pseudodrusen (RPD; P = 0.007, adjusted interaction). Namely, progression was slowed significantly with SNL treatment for those without coexistent RPD (adjusted HR, 0.34; 95% CI, 0.16-0.71; P = 0.004), but it was not significantly different for those with RPD (adjusted HR, 1.81; 95% CI, 0.67-4.88; P = 0.239). CONCLUSIONS A 24-month observational extension study to the LEAD Study confirmed that SNL treatment did not significantly reduce the overall rate of progression to late AMD in a cohort with intermediate AMD. However, the persistence of a potential beneficial treatment effect in those without coexistent RPD over a longer follow-up duration of an additional 24 months without additional treatment is encouraging. These findings provide further justification for future trials to examine the potential value of SNL treatment for slowing progression in intermediate AMD.
Collapse
Affiliation(s)
- Robyn H Guymer
- Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, East Melbourne, Australia; Ophthalmology, Department of Surgery, The University of Melbourne, Melbourne, Australia.
| | - Fred K Chen
- Centre for Ophthalmology and Visual Science (incorporating Lions Eye Institute), The University of Western Australia, and the Department of Ophthalmology, Royal Perth Hospital, Perth, Australia
| | - Lauren A B Hodgson
- Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, East Melbourne, Australia
| | - Emily Caruso
- Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, East Melbourne, Australia
| | - Colin A Harper
- Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, East Melbourne, Australia; Ophthalmology, Department of Surgery, The University of Melbourne, Melbourne, Australia
| | - Sanjeewa S Wickremashinghe
- Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, East Melbourne, Australia; Ophthalmology, Department of Surgery, The University of Melbourne, Melbourne, Australia
| | - Amy C Cohn
- Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, East Melbourne, Australia
| | - Pyrawy Sivarajah
- Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, East Melbourne, Australia
| | - Nicole Tindill
- Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, East Melbourne, Australia
| | - Chi D Luu
- Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, East Melbourne, Australia; Ophthalmology, Department of Surgery, The University of Melbourne, Melbourne, Australia
| | - Zhichao Wu
- Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, East Melbourne, Australia; Ophthalmology, Department of Surgery, The University of Melbourne, Melbourne, Australia
| |
Collapse
|
9
|
Chhablani J, Kalra G, Alkwatli L, Fassbender B, Amoroso F, Chandra K, Ankireddy S, Maltsev D, Striebe NA, Souied E. Safety of various parameter sets with navigated microsecond pulsing laser in central serous chorioretinopathy. Int J Retina Vitreous 2021; 7:62. [PMID: 34656180 PMCID: PMC8520234 DOI: 10.1186/s40942-021-00335-3] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2021] [Accepted: 10/04/2021] [Indexed: 11/10/2022] Open
Abstract
Background Subthreshold microsecond pulsing laser is an increasingly common treatment approach for central serous chorioretinopathy. However, there is no literature available on the safety of microsecond laser using different fluence settings in this disease. While many publications can be obtained from conventional microsecond pulsing lasers, few parameter sets are published with the navigated microsecond pulsing laser. Therefore, this study aims to investigate the safety of different parameter sets in subthreshold microsecond pulsing laser treatments. Methods In this retrospective chart review, consecutive patients with central serous chorioretinopathy (> 3 months duration of symptoms) treated with navigated subthreshold microsecond pulsing laser and a follow up of at least five months after microsecond laser application were included. For each patient, the treatment parameters, plan layout, and adverse events related to laser were evaluated. Secondary outcomes included best-corrected visual acuity and anatomical improvements (central retinal thickness). Results One hundred and one eyes were included in the observation and followed for a mean of 10 months (range 5–36). Although a larger range of parameter sets and fluence settings have been used, no patient demonstrated adverse events from navigated microsecond pulsing laser. While 88% of the cases demonstrated stability, 13 cases lost five or more letters due to the persistence of the subretinal fluid. In mean, a best-corrected visual acuity improvement of 0.07logMar (± 0.2) was seen (p = 0.02). In 51% of the patients, a statistically significant improvement of the central retinal thickness was noted at the last follow-up with a mean thickness reduction of 70 µm (± 143) (p < 0.01). Conclusion In conclusion, none of the used parameter sets lead to tissue damage (when using a cautious titration) and, in summary, lead to an improvement in subretinal fluid and improvement in visual acuity. However, further prospective studies are needed to correctly identify the dependency of the treatment strategy on the outcome criteria.
Collapse
Affiliation(s)
- Jay Chhablani
- LV Prasad Eye Institute, Hyderabad, India. .,University of Pittsburgh, UPMC Eye Center, Pittsburgh, PA, 15213, USA.
| | - Gagan Kalra
- Cole Eye Institute, Cleveland Clinic, Cleveland, OH, 44195, USA
| | - Lubna Alkwatli
- Giers, V. Lovenberg-Prömper, Fassbender, Detmold, Germany
| | | | | | | | | | - Dmitrii Maltsev
- Department of Ophthalmology, Military Medical Academy, St. Petersburg, Russia
| | | | - Eric Souied
- Centre Hospitalier Intercommunal de Creteil, Paris, France
| |
Collapse
|
10
|
Milà-Alomà M, Shekari M, Salvadó G, Gispert JD, Arenaza-Urquijo EM, Operto G, Falcon C, Vilor-Tejedor N, Grau-Rivera O, Sala-Vila A, Sánchez-Benavides G, González-de-Echávarri JM, Minguillon C, Fauria K, Niñerola-Baizán A, Perissinotti A, Simon M, Kollmorgen G, Zetterberg H, Blennow K, Suárez-Calvet M, Molinuevo JL. Cognitively unimpaired individuals with a low burden of Aβ pathology have a distinct CSF biomarker profile. Alzheimers Res Ther 2021; 13:134. [PMID: 34315519 PMCID: PMC8314554 DOI: 10.1186/s13195-021-00863-y] [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] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/19/2020] [Accepted: 06/20/2021] [Indexed: 12/25/2022]
Abstract
Background Understanding the changes that occur in the transitional stage between absent and overt amyloid-β (Aβ) pathology within the Alzheimer’s continuum is crucial to develop therapeutic and preventive strategies. The objective of this study is to test whether cognitively unimpaired individuals with a low burden of Aβ pathology have a distinct CSF, structural, and functional neuroimaging biomarker profile. Methods Cross-sectional study of 318 middle-aged, cognitively unimpaired individuals from the ALFA+ cohort. We measured CSF Aβ42/40, phosphorylated tau (p-tau), total tau (t-tau), neurofilament light (NfL), neurogranin, sTREM2, YKL40, GFAP, IL6, S100B, and α-synuclein. Participants also underwent cognitive assessments, APOE genotyping, structural MRI, [18F]-FDG, and [18F]-flutemetamol PET. To ensure the robustness of our results, we used three definitions of low burden of Aβ pathology: (1) positive CSF Aβ42/40 and < 30 Centiloids in Aβ PET, (2) positive CSF Aβ42/40 and negative Aβ PET visual read, and (3) 20–40 Centiloid range in Aβ PET. We tested CSF and neuroimaging biomarker differences between the low burden group and the corresponding Aβ-negative group, adjusted by age and sex. Results The prevalence and demographic characteristics of the low burden group differed between the three definitions. CSF p-tau and t-tau were increased in the low burden group compared to the Aβ-negative in all definitions. CSF neurogranin was increased in the low burden group definitions 1 and 3, while CSF NfL was only increased in the low burden group definition 1. None of the defined low burden groups showed signs of atrophy or glucose hypometabolism. Instead, we found slight increases in cortical thickness and metabolism in definition 2. Conclusions There are biologically meaningful Aβ-downstream effects in individuals with a low burden of Aβ pathology, while structural and functional changes are still subtle or absent. These findings support considering individuals with a low burden of Aβ pathology for clinical trials. Trial registration NCT02485730 Supplementary Information The online version contains supplementary material available at 10.1186/s13195-021-00863-y.
Collapse
Affiliation(s)
- Marta Milà-Alomà
- Barcelonaβeta Brain Research Center (BBRC), Pasqual Maragall Foundation, Wellington 30, 08005, Barcelona, Spain.,IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain.,Universitat Pompeu Fabra, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Fragilidad y Envejecimiento Saludable (CIBERFES), Madrid, Spain
| | - Mahnaz Shekari
- Barcelonaβeta Brain Research Center (BBRC), Pasqual Maragall Foundation, Wellington 30, 08005, Barcelona, Spain.,IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain.,Universitat Pompeu Fabra, Barcelona, Spain
| | - Gemma Salvadó
- Barcelonaβeta Brain Research Center (BBRC), Pasqual Maragall Foundation, Wellington 30, 08005, Barcelona, Spain.,IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain.,Centro de Investigación Biomédica en Red de Fragilidad y Envejecimiento Saludable (CIBERFES), Madrid, Spain
| | - Juan Domingo Gispert
- Barcelonaβeta Brain Research Center (BBRC), Pasqual Maragall Foundation, Wellington 30, 08005, Barcelona, Spain.,IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain.,Universitat Pompeu Fabra, Barcelona, Spain.,Centro de Investigación Biomédica en Red Bioingeniería, Biomateriales y Nanomedicina, Madrid, Spain
| | - Eider M Arenaza-Urquijo
- Barcelonaβeta Brain Research Center (BBRC), Pasqual Maragall Foundation, Wellington 30, 08005, Barcelona, Spain.,IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain.,Centro de Investigación Biomédica en Red de Fragilidad y Envejecimiento Saludable (CIBERFES), Madrid, Spain
| | - Grégory Operto
- Barcelonaβeta Brain Research Center (BBRC), Pasqual Maragall Foundation, Wellington 30, 08005, Barcelona, Spain.,IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain.,Centro de Investigación Biomédica en Red de Fragilidad y Envejecimiento Saludable (CIBERFES), Madrid, Spain
| | - Carles Falcon
- Barcelonaβeta Brain Research Center (BBRC), Pasqual Maragall Foundation, Wellington 30, 08005, Barcelona, Spain.,IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain.,Centro de Investigación Biomédica en Red Bioingeniería, Biomateriales y Nanomedicina, Madrid, Spain
| | - Natalia Vilor-Tejedor
- Barcelonaβeta Brain Research Center (BBRC), Pasqual Maragall Foundation, Wellington 30, 08005, Barcelona, Spain.,Universitat Pompeu Fabra, Barcelona, Spain.,Centre for Genomic Regulation (CRG), The Barcelona Institute for Science and Technology, Barcelona, Spain.,Department of Clinical Genetics, ERASMUS MC, Rotterdam, the Netherlands
| | - Oriol Grau-Rivera
- Barcelonaβeta Brain Research Center (BBRC), Pasqual Maragall Foundation, Wellington 30, 08005, Barcelona, Spain.,IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain.,Centro de Investigación Biomédica en Red de Fragilidad y Envejecimiento Saludable (CIBERFES), Madrid, Spain.,Servei de Neurologia, Hospital del Mar, Barcelona, Spain
| | - Aleix Sala-Vila
- Barcelonaβeta Brain Research Center (BBRC), Pasqual Maragall Foundation, Wellington 30, 08005, Barcelona, Spain.,IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
| | - Gonzalo Sánchez-Benavides
- Barcelonaβeta Brain Research Center (BBRC), Pasqual Maragall Foundation, Wellington 30, 08005, Barcelona, Spain.,IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain.,Centro de Investigación Biomédica en Red de Fragilidad y Envejecimiento Saludable (CIBERFES), Madrid, Spain
| | - José Maria González-de-Echávarri
- Barcelonaβeta Brain Research Center (BBRC), Pasqual Maragall Foundation, Wellington 30, 08005, Barcelona, Spain.,IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
| | - Carolina Minguillon
- Barcelonaβeta Brain Research Center (BBRC), Pasqual Maragall Foundation, Wellington 30, 08005, Barcelona, Spain.,IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain.,Centro de Investigación Biomédica en Red de Fragilidad y Envejecimiento Saludable (CIBERFES), Madrid, Spain
| | - Karine Fauria
- Barcelonaβeta Brain Research Center (BBRC), Pasqual Maragall Foundation, Wellington 30, 08005, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Fragilidad y Envejecimiento Saludable (CIBERFES), Madrid, Spain
| | - Aida Niñerola-Baizán
- Centro de Investigación Biomédica en Red Bioingeniería, Biomateriales y Nanomedicina, Madrid, Spain.,Servei de Medicina Nuclear, Hospital Clínic, Barcelona, Spain
| | - Andrés Perissinotti
- Centro de Investigación Biomédica en Red Bioingeniería, Biomateriales y Nanomedicina, Madrid, Spain.,Servei de Medicina Nuclear, Hospital Clínic, Barcelona, Spain
| | - Maryline Simon
- Roche Diagnostics International Ltd., Rotkreuz, Switzerland
| | | | - Henrik Zetterberg
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, University of Gothenburg, Mölndal, Sweden.,Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden.,Department of Neurodegenerative Disease, UCL Institute of Neurology, Queen Square, London, UK.,UK Dementia Research Institute at UCL, London, UK
| | - Kaj Blennow
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, University of Gothenburg, Mölndal, Sweden.,Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden
| | - Marc Suárez-Calvet
- Barcelonaβeta Brain Research Center (BBRC), Pasqual Maragall Foundation, Wellington 30, 08005, Barcelona, Spain. .,IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain. .,Centro de Investigación Biomédica en Red de Fragilidad y Envejecimiento Saludable (CIBERFES), Madrid, Spain. .,Servei de Neurologia, Hospital del Mar, Barcelona, Spain.
| | - José Luis Molinuevo
- Barcelonaβeta Brain Research Center (BBRC), Pasqual Maragall Foundation, Wellington 30, 08005, Barcelona, Spain. .,Present address: H. Lundbeck A/S, Copenhagen, Denmark.
| | | |
Collapse
|
11
|
Sammartino F, Snell J, Eames M, Krishna V. Thermal Neuromodulation With Focused Ultrasound: Implications for the Technique of Subthreshold Testing. Neurosurgery 2021; 89:610-616. [PMID: 34245158 DOI: 10.1093/neuros/nyab238] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2020] [Accepted: 05/04/2021] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND During focused ultrasound ablation (FUSA), the presumed stereotactic target is tested with subthreshold sonications before permanent ablation. This testing relies on ultrasound-induced reversible clinical effects (thermal neuromodulation, TN). However, the thermal dose and spot size thresholds to induce TN are not yet defined. OBJECTIVE To define the thermal dose and spot size thresholds associated with TN. METHODS We performed a retrospective analysis of intraoperative FUSA data of essential tremor patients. Sonications with a thermal dose of less than 25 cumulative equivalent minutes (CEM) were classified as subthreshold. The intraoperative writing samples were independently rated by 2 raters using the clinical rating scale for tremor. The association between thermal dose and tremor scores was statistically analyzed, and the thermal dose and spot size thresholds for TN were computed using leave-one-out cross-validation analysis. RESULTS A total of 331 pairs of sonications and writing samples were analyzed; 97 were classified as subthreshold sonications. TN was observed in 23 (24%) subthreshold sonications. The median tremor improvement during TN was 20% (interquartile range = 41.6). The thermal dose threshold for TN was 0.67 CEM (equivalent to 30 s thermal exposure at 43°C). The spot size threshold for TN was 2.46 mm. Ventral intermediate medial nucleus was exposed to TN thermal dose during subablative and ablative sonications. CONCLUSION The TN thermal dose and spot size thresholds are significantly higher than the current FUSA standard of care. We recommend long duration (>30 s), subthreshold sonications for intraoperative testing during FUSA. Future investigations should test whether the thermal dose threshold is tissue-specific and determine the mechanisms underlying focused ultrasound TN.
Collapse
Affiliation(s)
| | - John Snell
- Department of Neurosurgery, University of Virginia, Charlottesville, Virginia, USA.,Focused Ultrasound Foundation, Charlottesville, Virginia, USA
| | - Matthew Eames
- Focused Ultrasound Foundation, Charlottesville, Virginia, USA.,Department of Radiology, University of Virginia, Charlottesville, Virginia, USA
| | - Vibhor Krishna
- Department of Neurosurgery, The Ohio State University, Columbus, Ohio, USA
| |
Collapse
|
12
|
Kim EHJ, Paredes D, Motoi L, Eckert M, Wadamori Y, Tartaglia J, Wade C, Green C, Hedderley DH, Morgenstern MP. Subthreshold chemesthetic stimulation can enhance flavor lastingness of a soft chewable candy. Food Res Int 2021; 140:109883. [PMID: 33648200 DOI: 10.1016/j.foodres.2020.109883] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Revised: 10/29/2020] [Accepted: 10/31/2020] [Indexed: 10/23/2022]
Abstract
In addition to taste and aroma components of a flavor, FEMA GRAS approved chemesthetic flavor ingredients deliver a trigeminal experience or chemesthetic effect and provide a third dimension to overall flavor experience. In this study, we explored the impact of chemesthetic stimulation on dynamic flavor perception, acceptability and salivation, with two base flavors (mint, watermelon), using a soft chewable candy as a model food. Each base flavor was augmented with three increasing levels of a mixture of chemesthetic flavor ingredients, which provided a cooling sensation; subthreshold, detection threshold, and supra-threshold levels. Thirty-six panelists were asked to rate the perceived flavor intensity of each sample during eating and after swallowing using time intensity analysis. Lastingness after swallowing was measured as the time for the flavor intensity to drop below 25% of the maximum intensity perceived during chewing. Compared with the control, the addition of chemesthetic flavor ingredients increased the perceived flavor intensity during chewing and the flavor lastingness after swallowing for both mint and watermelon flavor. These effects started from the addition of subthreshold concentration of chemesthetic flavor ingredients and further increased with increasing the concentration of chemesthetic flavor ingredients added. By adding the subthreshold concentration of chemesthetic flavor ingredients, the flavor lastingness was increased by 32% for mint flavor and 22% for watermelon flavor. The acceptability of these weak-flavored soft chewable candy test samples was significantly increased towards 'just right' with increasing concentrations of chemesthetic flavor ingredients, even at subthreshold level. However, chew time and saliva flow rate were not affected by the addition of chemesthetic flavor ingredients. The increased flavor lastingness by the addition of chemesthetic flavor ingredients could therefore be explained by perceptual interaction between chemesthesis and flavor perception.
Collapse
Affiliation(s)
- Esther H-J Kim
- The New Zealand Institute for Plant and Food Research Limited, Lincoln, New Zealand.
| | - Dulce Paredes
- Takasago International Corporation (USA), Rockleigh, NJ, USA
| | - Lidia Motoi
- The New Zealand Institute for Plant and Food Research Limited, Lincoln, New Zealand
| | - Markus Eckert
- Takasago International Corporation (USA), Rockleigh, NJ, USA
| | - Yukiko Wadamori
- The New Zealand Institute for Plant and Food Research Limited, Lincoln, New Zealand
| | | | - Cath Wade
- The New Zealand Institute for Plant and Food Research Limited, Lincoln, New Zealand
| | - Carter Green
- Takasago International Corporation (USA), Rockleigh, NJ, USA
| | - Duncan H Hedderley
- The New Zealand Institute for Plant and Food Research Limited, Palmerston North, New Zealand
| | - Marco P Morgenstern
- The New Zealand Institute for Plant and Food Research Limited, Lincoln, New Zealand
| |
Collapse
|
13
|
Destrée L, Albertella L, Torres AR, Ferrão YA, Shavitt RG, Miguel EC, Fontenelle LF. Social losses predict a faster onset and greater severity of obsessive-compulsive disorder. J Psychiatr Res 2020; 130:187-193. [PMID: 32828024 DOI: 10.1016/j.jpsychires.2020.07.027] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2020] [Revised: 07/09/2020] [Accepted: 07/20/2020] [Indexed: 11/19/2022]
Abstract
BACKGROUND While stressful life events increase the risk of developing a range of psychiatric disorders, including obsessive-compulsive disorder (OCD), their ability to precipitate specific obsessive-compulsive symptoms' dimensions is unknown. Here we aimed to evaluate the potential role of three different types of stressful life events, herein termed losses (death of a loved one, termination of a romantic relationship and severe illness) in predicting the speed of progression from subclinical to clinical OCD and the severity of specific OCD dimensions in a large multicentre OCD sample. METHODS Nine hundred and fifty-four OCD outpatients from the Brazilian OCD Research Consortium were included in this study. Several semi-structured and structured instruments were used, including the Structured Clinical Interview for DSM-IV Axis I Disorders, the Yale-Brown Obsessive-Compulsive Scale, the Dimensional Yale-Brown Obsessive-Compulsive Scale, the Brown Assessment of Beliefs Scale, the Beck Depression Inventory, the Beck Anxiety Inventory and the Yale OCD Natural History Questionnaire. Regression models investigated the interaction between types of loss and gender to predict speed of progression from subclinical obsessive-compulsive symptoms to OCD, and the severity of five symptom dimensions. RESULTS While termination of a relationship was associated with a faster speed of progression from subthreshold to clinical OCD, the death of a loved one was associated with increased severity of hoarding symptoms. There was also an interaction between gender and experiences of death, which predicted a faster speed of progression to OCD in males. CONCLUSIONS Stressful life events have the ability to accelerate the progression from subclinical to clinical OCD, as well as impact the severity of specific OCD dimensions. Gender also plays a role in both the progression and severity of symptoms. These findings suggest that stressful life events may represent a marker to identify individuals at risk of progressing to clinical OCD.
Collapse
Affiliation(s)
- Louise Destrée
- Brain & Mental Health Research Hub, Turner Institute for Brain and Mental Health, Monash University, Victoria, Australia
| | - Lucy Albertella
- Brain & Mental Health Research Hub, Turner Institute for Brain and Mental Health, Monash University, Victoria, Australia
| | - Albina R Torres
- Department of Neurology, Psychology and Psychiatry, Botucatu Medical School, Universidade Estadual Paulista (Unesp), Brazil
| | - Ygor A Ferrão
- Department of Psychiatry, Federal University of Health Sciences of Porto Alegre (UFCSPA), Brazil
| | - Roseli G Shavitt
- Obsessive-Compulsive Spectrum Disorders Program (PROTOC), Department and Institute of Psychiatry, University of São Paulo (USP), Brazil
| | - Euripedes C Miguel
- Obsessive-Compulsive Spectrum Disorders Program (PROTOC), Department and Institute of Psychiatry, University of São Paulo (USP), Brazil
| | - Leonardo F Fontenelle
- Brain & Mental Health Research Hub, Turner Institute for Brain and Mental Health, Monash University, Victoria, Australia; Department of Neurology, Psychology and Psychiatry, Botucatu Medical School, Universidade Estadual Paulista (Unesp), Brazil; Obsessive, Compulsive, and Anxiety Spectrum Research Program. Institute of Psychiatry, Federal University of Rio de Janeiro & D'Or Institute for Research and Education, Rio de Janeiro, Brazil.
| |
Collapse
|
14
|
Caranzano L, Stephan MA, Bedulli M, Herrmann FR, Benninger DH. Peripheral stimulation affects subthreshold Triple Stimulation Technique. J Neurosci Methods 2020; 347:108959. [PMID: 33002507 DOI: 10.1016/j.jneumeth.2020.108959] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2020] [Revised: 08/27/2020] [Accepted: 09/23/2020] [Indexed: 10/23/2022]
Abstract
BACKGROUND Compared to conventional transcranial magnetic stimulation (TMS), the triple stimulation technique (TST) strongly decrease the effects of desynchronization of descending discharges and accompanying phase cancellation that follow TMS and offers a more sensitive method to quantify motor evoked potentials (MEPs). NEW METHOD Using the TST, we explored as to whether sub-threshold TMS evokes peripheral motor neuron discharges (MNs). We compared the number of MEPs elicited by TMS and by TST in fifteen healthy participants. We used the subthreshold intensity of 80 % resting motor threshold. To control the TST assessment of the corticospinal tract, we included a peripheral stimulation control condition, which consisted of peripheral stimulation alone, in a subgroup of five volunteers. RESULTS Compared to TMS, TST at sub-threshold intensities did not detect significantly more responses unequivocally attributable to the cortical stimulation. In contrast, the peripheral supra-maximal stimuli produced confounding effects in the TST condition that were, in part, indistinguishable from cortical responses. COMPARISON WITH EXISTING METHODS At subthreshold TMS intensities, the TST does not detect more discharges of spinal MNs than conventional TMS and, in addition, it is confounded by effects from peripheral stimulation. CONCLUSION The TST can be useful in assessing the integrity of the MN pool and of the corticospinal tract. However, if used at near threshold intensity, the confounding effects of peripheral stimulation need to be considered; for instance, in paired-pulse stimulation paradigms assessing the cortical physiology.
Collapse
Affiliation(s)
- L Caranzano
- Neurology Service, Department of Clinical Neurosciences, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland; Faculté de Biologie et de Médecine, Doctoral School, Université de Lausanne, Lausanne, Switzerland.
| | - M A Stephan
- Neurology Service, Department of Clinical Neurosciences, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland.
| | - M Bedulli
- Neurology Service, Department of Clinical Neurosciences, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland.
| | - F R Herrmann
- Division of Geriatrics, Department of Rehabilitation and Geriatrics, University Hospitals and University of Geneva, Geneva, Switzerland.
| | - D H Benninger
- Neurology Service, Department of Clinical Neurosciences, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland.
| |
Collapse
|
15
|
Andrews JC, Sankar T, Stein RB, Roy FD. Characterizing the effect of low intensity transcranial magnetic stimulation on the soleus H-reflex at rest. Exp Brain Res 2020; 238:2725-2731. [PMID: 32955615 DOI: 10.1007/s00221-020-05879-8] [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] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2020] [Accepted: 07/08/2020] [Indexed: 11/30/2022]
Abstract
Modulation of a Hoffmann (H)-reflex following transcranial magnetic stimulation (TMS) has been used to assess the nature of signals transmitted from cortical centers to lower motor neurons. Further characterizing the recruitment and time-course of the TMS-induced effect onto the soleus H-reflex adds to the discussion of these pathways and may improve its utility in clinical studies. In 10 healthy controls, TMS was used to condition the soleus H-reflex using TMS intensities from 65 to 110% of the resting motor threshold (RMT). Early facilitation [- 5 to - 3 ms condition-test (C-T) interval] was evident when TMS was 110% of RMT (P < 0.05). By comparison, late facilitation (+ 10 to + 20 ms C-T interval) was several times larger and observed over a wider range of TMS intensities, including 65-110% of RMT. The early inhibition (- 3 to - 1 ms C-T interval) had a low TMS threshold and was elicited over a wide range of intensity from 65% to 95% of RMT (all P < 0.05). A second inhibitory phase was seen ~ 4 ms later (+ 1 to + 4 ms C-T intervals) and was only observed for a TMS intensity of 95% of RMT (P < 0.05). The present findings reaffirm that subthreshold TMS strongly modulates soleus motor neurons and demonstrates that distinct pathways can be selectively probed at discrete C-T intervals when using specific TMS intensities.
Collapse
Affiliation(s)
- Jennifer C Andrews
- Department of Surgery, University of Alberta Hospital, WMC 1C3.13, Edmonton, AB, T6G 2E1, Canada
| | - Tejas Sankar
- Division of Neurosurgery, University of Alberta, Edmonton, Canada
| | - Richard B Stein
- Department of Physiology, University of Alberta, Edmonton, Canada
| | - François D Roy
- Department of Surgery, University of Alberta Hospital, WMC 1C3.13, Edmonton, AB, T6G 2E1, Canada.
| |
Collapse
|
16
|
Schneidt A, Höhnle NM, Schönenberg M. Cognitive and electrophysiological markers of adult full syndrome and subthreshold attention-deficit/hyperactivity disorder. J Psychiatr Res 2020; 127:80-86. [PMID: 32502722 DOI: 10.1016/j.jpsychires.2020.05.004] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2020] [Revised: 04/08/2020] [Accepted: 05/07/2020] [Indexed: 02/09/2023]
Abstract
Attention-deficit/hyperactivity disorder (ADHD) has been often referred to as an executive function deficit disorder with a specific electrophysiological signature. Although previous research suggests that individuals with subthreshold symptoms also suffer from severe impairments in daily life, only few studies have investigated cognitive and neural alterations in this group. Here, we explored impairments in executive functions and their electrophysiological correlates in a sample of adults with full syndrome (N = 113) and subthreshold (N = 46) ADHD compared to controls (N = 42). Results suggest that adults with full syndrome ADHD exhibit more executive function deficits than controls, while there were no electrophysiological differences found between groups. Also, we observed only small differences in neuropsychological variables between subthreshold ADHD and controls and no evidence for altered neural activity in the resting state. While subthreshold ADHD was not associated with altered executive functions or abnormal electrophysiological activity, this group reported significant psychological impairments and comorbidity.
Collapse
Affiliation(s)
- Alexander Schneidt
- Department of Clinical Psychology and Psychotherapy, University of Tübingen, Germany.
| | - Nina Maria Höhnle
- Department of Clinical Psychology and Psychotherapy, University of Tübingen, Germany
| | - Michael Schönenberg
- Department of Clinical Psychology and Psychotherapy, University of Tübingen, Germany; Department of Psychiatry and Psychotherapy, University Hospital Tübingen, Germany
| |
Collapse
|
17
|
Filloy A, Chong V, Solé E. Subthreshold yellow laser for fovea-involving diabetic macular edema in a series of patients with good vision: effectiveness and safety of a fovea-sparing technique. BMC Ophthalmol 2020; 20:266. [PMID: 32631268 PMCID: PMC7339496 DOI: 10.1186/s12886-020-01536-4] [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] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Accepted: 06/30/2020] [Indexed: 11/10/2022] Open
Abstract
PURPOSE Patients with center-involved diabetic macular edema (CI-DME) with good visual acuity (VA) represent a controversial clinical scenario in which a subthreshold laser might be a reasonable approach. We report a case series of patients with CI-DME with VA better than 20/32 who were treated with a subthreshold 577 nm (yellow) laser. METHODS The area of retinal thickening on OCT was treated with confluent laser spots at individually titrated power. The fovea was spared from treatment. Effectiveness and safety were evaluated through OCT and autofluorescence (AF) as well as BCVA. RESULTS A total of 23 eyes from 19 patients were treated. VA ranged from 20/20 to 20/30. The follow-up period ranged from 6 to 18 months. Edema in OCT resolved completely at the end of follow-up in 56.5% (13/23) of the cases. Central retinal thickness was reduced at 12 weeks and at the end of follow-up, with a mean reduction of 16.9 μm and 22 μm, respectively (paired t-test p = 0.001 and 0.0003). VA remained stable. The laser was invisible (OCT, AF, Fundoscopy) in 91,3% (21/23) of eyes. CONCLUSIONS A fovea-sparing yellow subthreshold laser was safe and effective for treating CI-DME patients with good VA in this case series. This technique is of interest to prevent the progression of mild edema and might avoid or reduce the use of more invasive and expensive therapies. Excluding the fovea from the treated area does not seem to affect the results, which is of interest to novel laser practitioners.
Collapse
Affiliation(s)
- Alejandro Filloy
- Ophthalmology department, Joan XXIII University Hospital, Rovira i Virgili University, Mallafré i Guasch, 4, 43002, Tarragona, Spain.
| | - Victor Chong
- Arnott Eye Associates, London and University of Oxford, Oxford, UK
| | - Eduard Solé
- Ophthalmology department, Joan XXIII University Hospital, Rovira i Virgili University, Mallafré i Guasch, 4, 43002, Tarragona, Spain
| |
Collapse
|
18
|
Korte KJ, Schmidt NB. Transdiagnostic preventative intervention for subclinical anxiety: Development and initial validation. J Psychiatr Res 2020; 126:34-42. [PMID: 32416385 PMCID: PMC7366324 DOI: 10.1016/j.jpsychires.2020.04.001] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2019] [Revised: 03/25/2020] [Accepted: 04/16/2020] [Indexed: 10/24/2022]
Abstract
Risk factors associated with the development of anxiety disorders have been identified; however, the development of preventive interventions targeting these risk factors is in the nascent stage. To date, preventive interventions have tended to target specific anxiety disorder symptoms (e.g., panic attacks). Although these interventions are effective at reducing risk for the targeted disorder (e.g., panic disorder), the focus of the intervention is narrow, thereby limiting the dissemination of these interventions. One approach that may broaden the scope of our prevention efforts is the development of a transdiagnostic intervention. Currently, transdiagnostic interventions have only been used in those with diagnosed conditions (e.g., anxiety disorders); however, it stands to reason that a transdiagnostic approach may also be helpful for those at-risk for developing anxiety disorders. The present study reported on the development and use of a brief preventative intervention for those with subclinical anxiety (i.e., worry, social anxiety). Participants were randomized into either a transdiagnostic preventative intervention, focused on reduction of safety aids, or a health focused control group. Participants consisted of sixty-nine individuals with subclinical levels of anxiety. Results revealed significant between group differences in the reduction of social anxiety, worry, and levels of impairment with the active intervention group relative to the control group. Further, change in safety aid utilization was a significant mediator in the association between intervention group and social anxiety and worry at Week 1; however, it was not a significant mediator at Month 1. Implications of these results and avenues for future research are discussed.
Collapse
Affiliation(s)
- Kristina J. Korte
- Massachusetts General Hospital, Boston, MA,Harvard T.H. Chan School of Public Health, Boston, MA,Harvard Medical School, Boston, MA
| | | |
Collapse
|
19
|
Hede V, Favre S, Aubry JM, Richard-Lepouriel H. Bipolar spectrum disorder: What evidence for pharmacological treatment? A systematic review. Psychiatry Res 2019; 282:112627. [PMID: 31677696 DOI: 10.1016/j.psychres.2019.112627] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2019] [Revised: 10/17/2019] [Accepted: 10/19/2019] [Indexed: 12/16/2022]
Abstract
BACKGROUND AND OBJECTIVES Bipolar spectrum disorder (BSD) is an extended concept of bipolar disorder (BD) that includes conditions that do not fulfill the criteria. There is no recommendation today about its treatment. We reviewed relevant literature focusing on pharmacological treatments, looking for high-strength evidence leading to guidelines. METHODOLOGY A literature search was conducted using MedLine / PubMed database and Google Scholar up to September 2018. Search words were related to BSD and pharmacological treatment. RESULTS The literature search yielded 621 articles. Out of these, 35 articles met our selection criteria. There was limited high quality data. Only one randomized control trial (RCT) and one randomized open label trial were found. Most studies used different definition of BSD. CONCLUSIONS There is a considerable lack of data and no evidence supporting efficacy of pharmacological treatment for BSD. There is a need for a consensus on the definition of BSD and more evidence studies to evaluate drug's effectiveness in this condition.
Collapse
Affiliation(s)
- Vincent Hede
- Mood disorder unit, Psychiatric specialties service, Geneva University Hospital, Rue de Lausanne 20, CH-1201 Geneva, Switzerland.
| | - Sophie Favre
- Mood disorder unit, Psychiatric specialties service, Geneva University Hospital, Rue de Lausanne 20, CH-1201 Geneva, Switzerland.
| | - Jean-Michel Aubry
- Mood disorder unit, Psychiatric specialties service, Geneva University Hospital, Rue de Lausanne 20, CH-1201 Geneva, Switzerland; Department of Psychiatry, University of Geneva, Geneva, Switzerland.
| | - Hélène Richard-Lepouriel
- Mood disorder unit, Psychiatric specialties service, Geneva University Hospital, Rue de Lausanne 20, CH-1201 Geneva, Switzerland.
| |
Collapse
|
20
|
de la Osa N, Penelo E, Navarro JB, Trepat E, Ezpeleta L. Prevalence, comorbidity, functioning and long-term effects of subthreshold oppositional defiant disorder in a community sample of preschoolers. Eur Child Adolesc Psychiatry 2019; 28:1385-93. [PMID: 30834986 DOI: 10.1007/s00787-019-01300-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2018] [Accepted: 02/25/2019] [Indexed: 12/28/2022]
Abstract
To study the prevalence of subthreshold oppositional defiant disorder (ST ODD)-less than 4 symptoms, but nonetheless an impairing form of oppositional defiant disorder (ODD)-its coexistence with other homotypic externalizing and heterotypical internalizing problems in children and associated impairment, as well as the long-term effect of this condition. A population-based sample of 622 preschoolers (5.0% boys) was followed up from preschool to preadolescence. Parents were interviewed when the children were 3, 6 and 9 years old with the Diagnostic Interview for Preschoolers/Children and Adolescents versions following DSM-5 and the children's functioning was assessed by trained clinicians. ST ODD diagnosis is highly prevalent (19.4-25.5%), highly comorbid [homo- (1.9-18.4%) and heterotypical (5.8-23.7%)], resulting in functional impairment across child development in a similar way for both genders. ST is also a risk factor condition that predicts the presence of psychological problems and impairment in childhood and preadolescence from preschool age. A broader clinical assessment and intervention similar to that provided full syndrome cases is needed for children presenting subthreshold forms of ODD.
Collapse
|
21
|
Khattab AM, Hagras SM, AbdElhamid A, Torky MA, Awad EA, Abdelhameed AG. Aflibercept with adjuvant micropulsed yellow laser versus aflibercept monotherapy in diabetic macular edema. Graefes Arch Clin Exp Ophthalmol 2019; 257:1373-80. [PMID: 31127381 DOI: 10.1007/s00417-019-04355-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2019] [Revised: 05/02/2019] [Accepted: 05/06/2019] [Indexed: 12/20/2022] Open
Abstract
PURPOSE To assess the impact of micropulsed laser (MPL) on modifying the number of aflibercept injections when used as an adjuvant therapy in diabetic macular edema (DME). METHODS A prospective randomized interventional clinical study included patients with DME attending Al Hadi Clinic, Kuwait, during the period from May 2017 to December 2018. Patients were allocated in two groups; group A received aflibercept injections alone and group B received combined aflibercept injections followed by MPL within a week. The primary outcome was the number of Aflibercept injections in each group guided by the change in central macular thickness (CMT). All the patients were followed for 18 months. Secondary outcome measures included best corrected visual acuity (BCVA), contrast sensitivity (CS), and any recorded complications. RESULTS Fifty-four eyes of 51 patients were included (27 in each group). There was no statistically significant difference between the two groups in baseline characteristics except for the age that was statistically higher in group B (p = 0.001). The number of injections were significantly lower in group B (4.1 ± 1.1) than group A (7.3 ± 1.1) (p < 0.005). At 18th month, there was significant reduction in CMT in both groups (p < 0.005) with no statistical difference between the two groups (p = 0.989). Final BCVA in both groups showed statistically significant improvement (p < 0.005) without statistically significant difference between the two groups (p = 0.082). In both groups, the CS showed significant improvement from baseline (p < 0.005). No ocular or systemic adverse effects were observed in either group. CONCLUSION Supplemental MPL in eyes with DME may decrease the burden of the aflibercept injection frequency while resulting in comparable anatomical and visual outcomes.
Collapse
|
22
|
Kirova AM, Kelberman C, Storch B, DiSalvo M, Woodworth KY, Faraone SV, Biederman J. Are subsyndromal manifestations of attention deficit hyperactivity disorder morbid in children? A systematic qualitative review of the literature with meta-analysis. Psychiatry Res 2019; 274:75-90. [PMID: 30780065 PMCID: PMC8084709 DOI: 10.1016/j.psychres.2019.02.003] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2018] [Revised: 01/31/2019] [Accepted: 02/01/2019] [Indexed: 12/13/2022]
Abstract
We conducted a qualitative review (n = 15 manuscripts) and meta-analysis (n = 9 manuscripts) of the extant literature to evaluate the prevalence and morbidity of subthreshold Attention Deficit Hyperactivity Disorder (ADHD). Our qualitative review showed that a sizable minority (mean: 17.7%) of clinically referred and non-referred children met a priori definitions of subthreshold ADHD. Those affected exhibited significantly higher rates of family dysfunction, cognitive impairment, executive dysfunction, interpersonal and school deficits, temperament problems, psychiatric comorbidity, and juvenile delinquency compared to children with no ADHD symptoms. These deficits were highly consistent with those observed in children with full threshold ADHD. These findings indicate that children with subthreshold ADHD symptoms are at significantly greater risk for negative outcomes in a wide range of non-overlapping functional domains worthy of further clinical and scientific consideration.
Collapse
Affiliation(s)
- Anna-Mariya Kirova
- Clinical and Research Programs in Pediatric Psychopharmacology and Adult ADHD, Massachusetts General Hospital, Boston, MA, USA
| | - Caroline Kelberman
- Clinical and Research Programs in Pediatric Psychopharmacology and Adult ADHD, Massachusetts General Hospital, Boston, MA, USA
| | - Barbara Storch
- Clinical and Research Programs in Pediatric Psychopharmacology and Adult ADHD, Massachusetts General Hospital, Boston, MA, USA
| | - Maura DiSalvo
- Clinical and Research Programs in Pediatric Psychopharmacology and Adult ADHD, Massachusetts General Hospital, Boston, MA, USA
| | - K. Yvonne Woodworth
- Clinical and Research Programs in Pediatric Psychopharmacology and Adult ADHD, Massachusetts General Hospital, Boston, MA, USA
| | - Stephen V. Faraone
- Departments of Psychiatry and of Neuroscience and Physiology, SUNY Upstate Medical University, Syracuse, NY, USA;,K.G. Jebsen Centre for Psychiatric Disorders, Department of Biomedicine, University of Bergen, Bergen, Norway
| | - Joseph Biederman
- Clinical and Research Programs in Pediatric Psychopharmacology and Adult ADHD, Massachusetts General Hospital, Boston, MA, USA; Department of Psychiatry, Harvard Medical School, Boston, MA, USA.
| |
Collapse
|
23
|
Bosman RC, Ten Have M, de Graaf R, Muntingh AD, van Balkom AJ, Batelaan NM. Prevalence and course of subthreshold anxiety disorder in the general population: A three-year follow-up study. J Affect Disord 2019; 247:105-113. [PMID: 30660019 DOI: 10.1016/j.jad.2019.01.018] [Citation(s) in RCA: 37] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2018] [Revised: 12/07/2018] [Accepted: 01/13/2019] [Indexed: 01/09/2023]
Abstract
BACKGROUND This study examined the prevalence, course and risk indicators of subthreshold anxiety disorder to determine the necessity and possible risk indicators for interventions. METHODS Data were derived from the 'Netherlands Mental Health Survey and Incidence Study-2' (NEMESIS-2), a psychiatric epidemiological cohort study among the general population (n = 4528). This study assessed prevalence, characteristics, and three-year course of subthreshold anxiety disorder (n = 521) in adults, and compared them to a no anxiety group (n = 3832) and an anxiety disorder group (n = 175). Risk indicators for persistent and progressive subthreshold anxiety disorder were also explored, including socio-demographics, vulnerability factors, psychopathology, physical health and functioning. RESULTS The three-year prevalence of subthreshold anxiety disorder was 11.4%. At three-year follow-up, 57.3% had improved, 29.0% had persistent subthreshold anxiety disorder and 13.8% had progressed to a full-blown anxiety disorder. Prevalence, characteristics and course of subthreshold anxiety disorder were in between both comparison groups. Risk indicators for persistent course partly overlapped with those for progressive course and included vulnerability and psychopathological factors, and diminished functioning. LIMITATIONS Course analysis were restricted to the development of anxiety disorders, other mental disorders were not assessed. Moreover, due to the naturalistic design of the study the impact of treatment on course cannot be assessed. CONCLUSIONS Subthreshold anxiety disorder is relatively prevalent and at three-year follow-up a substantial part of respondents experienced persistent symptoms or had progressed into an anxiety disorder. Risk indicators like reduced functioning may help to identify these persons for (preventative) treatment and hence reduce functional limitations and disease burden.
Collapse
Affiliation(s)
- Renske C Bosman
- Department of Psychiatry, Amsterdam UMC, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Oldenaller 1, 1081 HJ Amsterdam, The Netherlands; GGZ InGeest Specialized Mental Health Care, Amsterdam, The Netherlands.
| | - Margreet Ten Have
- Netherlands Institute of Mental Health and Addiction (Trimbos Instituut), Utrecht, The Netherlands
| | - Ron de Graaf
- Netherlands Institute of Mental Health and Addiction (Trimbos Instituut), Utrecht, The Netherlands
| | - Anna Dt Muntingh
- Department of Psychiatry, Amsterdam UMC, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Oldenaller 1, 1081 HJ Amsterdam, The Netherlands; GGZ InGeest Specialized Mental Health Care, Amsterdam, The Netherlands
| | - Anton Jlm van Balkom
- Department of Psychiatry, Amsterdam UMC, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Oldenaller 1, 1081 HJ Amsterdam, The Netherlands; GGZ InGeest Specialized Mental Health Care, Amsterdam, The Netherlands
| | - Neeltje M Batelaan
- Department of Psychiatry, Amsterdam UMC, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Oldenaller 1, 1081 HJ Amsterdam, The Netherlands; GGZ InGeest Specialized Mental Health Care, Amsterdam, The Netherlands
| |
Collapse
|
24
|
Zhou Z, Cao J, Wang Y, Shi Y, Wang Z, Zhang B. A Nanoscale Low-Power Resistorless Voltage Reference with High PSRR. Nanoscale Res Lett 2019; 14:33. [PMID: 30680579 PMCID: PMC6346697 DOI: 10.1186/s11671-019-2864-7] [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] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/17/2018] [Accepted: 01/14/2019] [Indexed: 06/09/2023]
Abstract
In this paper, a nano-watt resistorless subthreshold voltage reference with high-power supply rejection ratio (PSRR) is presented. A self-biased MOS voltage divider is proposed to provide bias current for whole voltage reference, which is a positive temperature coefficient (TC) current containing threshold voltage characteristics. By injecting the generated current into a transistor with a different threshold voltage, a delta threshold voltage with a greatly reduced negative TC is realized and temperature-compensated by a generated positive TC item at the same time. Therefore, a temperature-stable voltage reference is achieved in the proposed compacted method with low power consumption and high PSRR. Verification results with 65-nm CMOS technology demonstrate that the minimum supply voltage can be as low as 0.35 V with a 0.00182-mm2 active area. The generated reference voltage is 148 mV, with a TC of 28 ppm/°C for the - 30 to 80 °C temperature range. The line sensitivity is 1.8 mV/V, and the PSRR without any filtering capacitor at 100 Hz is 53 dB with a 2.28-nW power consumption.
Collapse
Affiliation(s)
- Zekun Zhou
- State Key Laboratory of Electronic Thin Films and Integrated Devices, University of Electronic Science and Technology of China, Chengdu, 610054 Sichuan China
| | - Jianwen Cao
- State Key Laboratory of Electronic Thin Films and Integrated Devices, University of Electronic Science and Technology of China, Chengdu, 610054 Sichuan China
| | - Yunkun Wang
- State Key Laboratory of Electronic Thin Films and Integrated Devices, University of Electronic Science and Technology of China, Chengdu, 610054 Sichuan China
| | - Yue Shi
- College of Communication Engineering, Chengdu University of Information Technology, Chengdu, 610225 China
| | - Zhuo Wang
- State Key Laboratory of Electronic Thin Films and Integrated Devices, University of Electronic Science and Technology of China, Chengdu, 610054 Sichuan China
| | - Bo Zhang
- State Key Laboratory of Electronic Thin Films and Integrated Devices, University of Electronic Science and Technology of China, Chengdu, 610054 Sichuan China
| |
Collapse
|
25
|
Rodgers RF, DuBois R, Frumkin MR, Robinaugh DJ. A network approach to eating disorder symptomatology: Do desire for thinness and fear of gaining weight play unique roles in the network? Body Image 2018; 27:1-9. [PMID: 30086480 DOI: 10.1016/j.bodyim.2018.07.004] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2018] [Revised: 07/26/2018] [Accepted: 07/26/2018] [Indexed: 01/08/2023]
Abstract
This study used network analyses to test the hypotheses that desire for thinness and fear of gaining weight are related but distinct constructs that play a central role in disordered eating. Data from a sample of 251 college women were used. Sparse undirected eating disorder symptom networks were calculated. Bootstrapped difference tests for edge weights and centrality indices were used to compare the position of desire for thinness and fear of gaining weight. Desire for thinness and fear of gaining weight exhibited unique patterns of associations within the network. Desire for thinness was highly connected to body dissatisfaction, thoughts about dieting, and thoughts about binge eating. Fear of gaining weight was not. Desire for thinness emerged as the most central symptom. Our findings support the distinction between fear of gaining weight and desire for thinness and their different roles within the eating disorder symptom network.
Collapse
Affiliation(s)
- Rachel F Rodgers
- APPEAR, Department of Applied Psychology, Northeastern University, Boston, United States; Department of Psychiatric Emergency & Acute Care, Lapeyronie Hospital, CHRU Montpellier, France.
| | - Russell DuBois
- APPEAR, Department of Applied Psychology, Northeastern University, Boston, United States
| | - Madelyn R Frumkin
- Center for Anxiety and Traumatic Stress Disorders, Massachusetts General Hospital, Boston, United States
| | - Donald J Robinaugh
- Center for Anxiety and Traumatic Stress Disorders, Massachusetts General Hospital, Boston, United States
| |
Collapse
|
26
|
Okamoto Y, Miyake Y, Nagasawa I, Yoshihara M. Cohort survey of college students' eating attitudes: interventions for depressive symptoms and stress coping were key factors for preventing bulimia in a subthreshold group. Biopsychosoc Med 2018; 12:8. [PMID: 29849751 PMCID: PMC5968577 DOI: 10.1186/s13030-018-0127-y] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2017] [Accepted: 05/15/2018] [Indexed: 11/28/2022] Open
Abstract
Background The aim of this study was to examine the necessity of early intervention for students with potential bulimia by investigating how the eating attitudes of college students change and examining the relation between bulimic symptoms and depressive symptoms or the ability to cope with stress. Methods The study participants were students who entered Hiroshima University in 2014. This study was conducted at two time points: Time-1 in 2014 and Time-2 in 2017. The Eating Attitudes Test-26 (EAT-26), Bulimic Inventory Test, Edinburgh (BITE), Beck Depression Inventory-II (BDI-II), and Coping Inventory for Stressful Situations (CISS) were administered at Times 1 and 2, and the responses were compared between the time points. Next, we compared the BDI-II scores of the BITE improved and worsened groups. In addition, we divided the participants into a clinical group, subthreshold group, and healthy group based on the BITE score at Time-1to compared their depressive symptoms and the ability to cope with stress. Results Significantly higher BITE and BDI-II scores were recorded for both males and females at Time-2 than at Time-1. The BDI-II score at Time-1 was significantly higher in the BITE worsened group than in the BITE improved group. The BDI-II scores at Time-1 were significantly higher for both males and females in the subthreshold group than in the healthy group. Furthermore, significantly higher CISS-T and CISS-E scores were recorded at Time-1 for females in the subthreshold group than for females in the healthy group. Conclusions Based on these results, intervention for students the subthreshold group is important, and the key to intervention may be to address not only eating behaviors but also depressive symptoms and stress coping. Trial registration UMIN000029474 Registered 9 October, 2017 (retrospectively).
Collapse
Affiliation(s)
- Yuri Okamoto
- Health Service Center, Hiroshima University, 1-7-1, Kagamiyama, Higashihiroshima, Hiroshima, 739-8514 Japan
| | - Yoshie Miyake
- Health Service Center, Hiroshima University, 1-7-1, Kagamiyama, Higashihiroshima, Hiroshima, 739-8514 Japan
| | - Ichie Nagasawa
- Health Service Center, Hiroshima University, 1-7-1, Kagamiyama, Higashihiroshima, Hiroshima, 739-8514 Japan
| | - Masaharu Yoshihara
- Health Service Center, Hiroshima University, 1-7-1, Kagamiyama, Higashihiroshima, Hiroshima, 739-8514 Japan
| |
Collapse
|
27
|
Moisseiev E, Abbassi S, Thinda S, Yoon J, Yiu G, Morse LS. Subthreshold micropulse laser reduces anti-VEGF injection burden in patients with diabetic macular edema. Eur J Ophthalmol 2018; 28:68-73. [PMID: 28731494 DOI: 10.5301/ejo.5001000] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
PURPOSE To evaluate the efficacy of micropulse laser in the early treatment of diabetic macular edema (DME) and its associated burden of anti-vascular endothelial growth factor (VEGF) injections. METHODS This retrospective comparative study compared a group of 19 eyes with DME treated with micropulse laser to a matched control group of 19 eyes with DME treated with ranibizumab injections without micropulse laser. Recorded parameters included previous medical and ocular history, previous and subsequent ranibizumab injections administered for DME, visual acuity (VA), central macular thickness throughout the follow-up period, and the occurrence of any complications. RESULTS The improvement in VA was comparable in both groups, at 12 months and at the final follow-up. Patients treated with micropulse laser required significantly fewer ranibizumab injections than their controls, both at 12 months (1.7 ± 2.3 vs 5.6 ± 2.1) and by the end of the follow-up (2.6 ± 3.3 vs 9.3 ± 5.1) (p<0.001 for both). No complications related to the micropulse laser were encountered. CONCLUSIONS Micropulse laser is a safe and effective treatment for DME, which may achieve comparable improvement in VA along with a significant reduction in the burden of anti-VEGF injections. We suggest a treatment approach for its inclusion in the early stages of DME.
Collapse
|
28
|
Ratheesh A, Cotton SM, Davey CG, Lin A, Wood S, Yuen HP, Bechdolf A, McGorry PD, Yung A, Berk M, Nelson B. Pre-onset risk characteristics for mania among young people at clinical high risk for psychosis. Schizophr Res 2018; 192:345-350. [PMID: 28768599 DOI: 10.1016/j.schres.2017.04.036] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2017] [Revised: 03/18/2017] [Accepted: 04/17/2017] [Indexed: 10/19/2022]
Abstract
INTRODUCTION Psychosis and mania share conceptual, genetic and clinical features, which suggest the possibility that they have common antecedents. Participants identified to be at-risk for psychosis might also be at-risk for mania. We aimed to identify the rate and predictors of transition to mania in a cohort of youth with clinical or familial risk for psychosis. METHODS Among a cohort of 416 young people with an at-risk mental state for psychosis defined using the Ultra-High-Risk (UHR) criteria, 74.7% were followed up between 5 and 13years from their baseline assessment. We undertook a matched case-control examination of those who developed mania over the follow-up period compared to those who did not develop mania or psychosis. Transition to mania was determined using either a structured clinical interview, or diagnoses from a state-wide public mental health contact registry. Clinical characteristics and risk factors were examined at baseline using information from structured interviews, clinical file notes, rating scales and unstructured assessments. RESULTS Eighteen participants developed mania (UHR-Manic transition or UHR-M, 4.3%). In comparison with participants matched on age, gender and baseline-study who developed neither mania nor psychosis, more UHR-M participants had subthreshold manic symptoms or were prescribed antidepressants at baseline. They also had lower global functioning. DISCUSSION In addition to the UHR criteria, features such as subthreshold manic symptoms and antidepressant use may help identify at-risk groups that predict the onset of mania in addition to transition to psychosis. Presence of manic symptoms may also indicate syndrome specificity early in the prodromal phase.
Collapse
Affiliation(s)
- Aswin Ratheesh
- Orygen, the National Centre of Excellence in Youth Mental Health, Melbourne, Australia; Centre for Youth Mental Health, University of Melbourne, Australia.
| | - Susan M Cotton
- Orygen, the National Centre of Excellence in Youth Mental Health, Melbourne, Australia; Centre for Youth Mental Health, University of Melbourne, Australia
| | - Christopher G Davey
- Orygen, the National Centre of Excellence in Youth Mental Health, Melbourne, Australia; Centre for Youth Mental Health, University of Melbourne, Australia
| | - Ashleigh Lin
- Telethon Kids Institute, The University of Western Australia, Perth, Australia
| | - Stephen Wood
- Orygen, the National Centre of Excellence in Youth Mental Health, Melbourne, Australia; Centre for Youth Mental Health, University of Melbourne, Australia; School of Psychology, University of Birmingham, UK
| | - Hok Pan Yuen
- Orygen, the National Centre of Excellence in Youth Mental Health, Melbourne, Australia; Centre for Youth Mental Health, University of Melbourne, Australia
| | - Andreas Bechdolf
- Vivantes Hospital am Urban and Vivantes Hopital im Friedrichshain, Charite Medical University, Berlin, Germany
| | - Patrick D McGorry
- Orygen, the National Centre of Excellence in Youth Mental Health, Melbourne, Australia; Centre for Youth Mental Health, University of Melbourne, Australia
| | - Alison Yung
- Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
| | - Michael Berk
- Orygen, the National Centre of Excellence in Youth Mental Health, Melbourne, Australia; Florey Institute of Neuroscience and Mental Health, Melbourne, Australia; Deakin University, IMPACT Strategic Research Centre, Barwon Health, Geelong, Australia
| | - Barnaby Nelson
- Orygen, the National Centre of Excellence in Youth Mental Health, Melbourne, Australia; Centre for Youth Mental Health, University of Melbourne, Australia
| |
Collapse
|
29
|
Wong JG, Nguyen TTH. Yellow Pattern 577-nm Micropulse Laser: Treatment of Macular Edema from Radiation Retinopathy - A Case Report. Case Rep Ophthalmol 2017; 8:81-86. [PMID: 28413404 PMCID: PMC5346916 DOI: 10.1159/000456028] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2016] [Accepted: 01/09/2017] [Indexed: 01/08/2023] Open
Abstract
We report a case of a 60-year-old Asian male who developed radiation retinopathy 23 years after initial radiotherapy for nasopharyngeal carcinoma and was successfully treated with yellow pattern 577-nm micropulse laser. Secondary macular edema and visual acuity improved following a single treatment session with minimal scarring. Yellow pattern micropulse laser is a safe and effective treatment for macular edema secondary to radiation retinopathy.
Collapse
Affiliation(s)
- James G Wong
- Strathfield Retina Clinic, Sydney, NSW, Australia.,Medical Retina Unit, Sydney Eye Hospital, Sydney, NSW, Australia.,Save Sight Institute, University of Sydney, Sydney, NSW, Australia
| | | |
Collapse
|
30
|
Carrellas NW, Biederman J, Uchida M. How prevalent and morbid are subthreshold manifestations of major depression in adolescents? A literature review. J Affect Disord 2017; 210:166-73. [PMID: 28049101 DOI: 10.1016/j.jad.2016.12.037] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2016] [Revised: 11/21/2016] [Accepted: 12/22/2016] [Indexed: 12/16/2022]
Abstract
INTRODUCTION Major Depressive Disorder (MDD) among youth is a public health concern. Our aim was to examine the current body of knowledge to better characterize the prevalence and morbidity associated with subthreshold forms of MDD among youth. Given that MDD tends to develop gradually over time, we hypothesized a high prevalence and considerable impairment associated with youth suffering from depressive symptoms that fall short of full, syndromic status. METHODS A literature search was conducted using PubMed exclusively to identify studies assessing the prevalence and clinical characteristics of subthreshold MDD in adolescents. RESULTS Six scientific papers that met our priori inclusion and exclusion criteria were identified. All papers sampled adolescents. The prevalence of subthreshold MDD ranged from 5% over the past year, to 29% over the two weeks prior to screening. These papers reported clinically significant morbidity associated with subthreshold MDD among adolescents, with evidence for elevated rates of psychiatric comorbidities, impaired functioning in social and familial domains, increased suicidality, and frequent mental health service utilization. LIMITATIONS Though we examined a sizeable and diverse sample, we only identified six cross-sectional informative studies for this review. Variability of subthreshold MDD and major outcome definitions across studies, likely limits the specificity of findings. CONCLUSIONS Subthreshold MDD is prevalent among youth, and is associated with emotional and social impairments that reach the level of obtaining clinical care. These findings could lead to early intervention efforts aimed at mitigating the adverse outcomes associated with subthreshold MDD as well as the progression to full syndrome MDD. Our review documents that regardless of whether progression to full diagnostic status occurs, this condition is morbid.
Collapse
|
31
|
Abstract
The role of retinal photocoagulation as a first line therapy for various retinal pathologies has decreased with the introduction of anti-vascular endothelial growth factor therapy. However, retinal laser therapy remains an important treatment modality, especially with the emergence of micropulse subthreshold treatment and the integration of newer technology such as augmented reality and semi-automated delivery. This review summarizes current evidence for micropulse laser as a treatment modality and discusses the role of new technology such as augmented reality in the future of laser therapy.
Collapse
Affiliation(s)
- Daniel Su
- Stein Eye Institute, University of California, Los Angeles, CA, USA
| | | |
Collapse
|
32
|
Baek JH, Kim JH, Kim BN, Park SJ, Fava M, Mischoulon D, Lee D, Jeon HJ. Comparisons of Subthreshold Versus Full Posttraumatic Stress Disorder Distinguished by Subjective Functional Impairment Among Train Drivers: A Population-Based Nationwide Study in South Korea. Psychiatry Investig 2017; 14:1-7. [PMID: 28096868 PMCID: PMC5240462 DOI: 10.4306/pi.2017.14.1.1] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2016] [Revised: 03/06/2016] [Accepted: 03/15/2016] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE Subthreshold posttraumatic stress disorder (SPTSD), a condition that meets the full symptomatic criteria of posttraumatic stress disorder (PTSD) without subjective functional impairment, has yet to be fully investigated. In this study, we aimed to determine the prevalence and characteristics of SPTSD. METHODS The web-based survey including psychiatric diagnosis and experience of human error was conducted in actively working train drivers in South Korea. RESULTS Of the 4,634 subjects, 103 (2.23%) were categorized as full PTSD and 322 (6.96%) were categorized as having SPTSD. Individuals with full PTSD showed higher impulsivity and anxiety compared to those with SPTSD and those without PTSD, while those with SPTSD had more frequent clinically meaningful depression, posttraumatic stress, and alcohol and nicotine dependence and significant human error. CONCLUSION Despite not qualifying as a subjective functional disability, SPTSD still had significant psychiatric symptoms. More clinical attentions need to be given to the diagnosis and treatment of SPTSD.
Collapse
Affiliation(s)
- Ji Hyun Baek
- Department of Psychiatry, Depression Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Ji-Hae Kim
- Department of Psychiatry, Depression Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Bin-Na Kim
- Department of Psychology, Seoul National University, Seoul, Republic of Korea
| | - Seung Jin Park
- Department of Psychology, Seoul National University, Seoul, Republic of Korea
| | - Maurizio Fava
- Depression Clinical and Research Program, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - David Mischoulon
- Depression Clinical and Research Program, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Dongsoo Lee
- Department of Psychiatry, Depression Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Hong Jin Jeon
- Department of Psychiatry, Depression Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
- Depression Clinical and Research Program, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| |
Collapse
|
33
|
Korte KJ, Allan NP, Gros DF, Acierno R. Differential treatment response trajectories in individuals with subclinical and clinical PTSD. J Anxiety Disord 2016; 38:95-101. [PMID: 26874291 PMCID: PMC5097342 DOI: 10.1016/j.janxdis.2016.01.006] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2015] [Revised: 01/04/2016] [Accepted: 01/15/2016] [Indexed: 10/22/2022]
Abstract
Subclinical presentations of posttraumatic stress disorder (PTSD), wherein patients are one or two symptom criteria short of the full disorder, are prevalent and associated with levels of distress and impaired functioning approximating that of full PTSD. Nonetheless, research examining treatment efficacy for this group is in the nascent stage. The purpose of the present study was to examine whether the subclinical PTSD group would: (1) show a greater reduction in PTSD symptoms at pre and post treatment in response to an exposure based treatment and (2) show a greater rate of change over the course of treatment, when compared to the full criteria PTSD group. We also examined whether differences would emerge when examining PTSD symptom clusters. Consistent with predictions, the subclinical PTSD group demonstrated a greater reduction in PTSD symptoms at post-treatment (29%) than those with a PTSD diagnosis (14%). Further, the groups had different treatment trajectories, with the subclinical PTSD group showing a marginally greater rate of change during the course of treatment. Findings also varied by symptom cluster with the subclinical group showing a greater rate of change in the intrusions, hypervigilance, and avoidance symptom clusters. There was not a significant between group difference in the numbing symptom cluster. This study provides preliminary evidence that treating PTSD symptoms at the subclinical level may result in a larger, and more rapid symptom reduction, and thus has implications supporting treatment earlier in the developmental trajectory of the disorder.
Collapse
Affiliation(s)
- Kristina J. Korte
- Ralph H. Johnson Veterans Affairs Medical Center, Charleston, SC, United States,Medical University of South Carolina, Charleston, SC, United States
| | - Nicholas P. Allan
- Ralph H. Johnson Veterans Affairs Medical Center, Charleston, SC, United States,Medical University of South Carolina, Charleston, SC, United States
| | - Daniel F. Gros
- Ralph H. Johnson Veterans Affairs Medical Center, Charleston, SC, United States,Medical University of South Carolina, Charleston, SC, United States,Corresponding author at: Mental Health Service 116, Ralph H. Johnson VAMC, 109 Bee Street, Charleston, SC 29401, United States. Fax: +1 843 805 5782. (K.J. Korte), (D.F. Gros)
| | - Ron Acierno
- Ralph H. Johnson Veterans Affairs Medical Center, Charleston, SC, United States,Medical University of South Carolina, Charleston, SC, United States
| |
Collapse
|
34
|
Paksarian D, Merikangas KR, Calkins ME, Gur RE. Racial-ethnic disparities in empirically-derived subtypes of subclinical psychosis among a U.S. sample of youths. Schizophr Res 2016; 170:205-10. [PMID: 26711527 PMCID: PMC4790463 DOI: 10.1016/j.schres.2015.12.004] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2015] [Revised: 12/03/2015] [Accepted: 12/07/2015] [Indexed: 10/22/2022]
Abstract
INTRODUCTION Racial-ethnic minority status is a consistent risk factor for schizophrenia, with associations extending to bipolar disorder and subthreshold psychotic experiences. However, few epidemiologic studies have been conducted in the U.S., and evidence is inconsistent. Furthermore, no U.S. studies of youths have directly investigated the phenomenological overlap between schizophrenia and bipolar disorder. We aimed to do so at the subthreshold level in the Philadelphia Neurodevelopmental Cohort. METHODS Participants included 6533 individuals, age 11-21years, from a community healthcare network. Latent class analysis was used to form subtypes of sub-psychosis based on 12 attenuated positive items and 7 mania items without duration criteria. Associations between race-ethnicity (non-Hispanic white, non-Hispanic black, Hispanic, "other") and sub-psychosis subtype were estimated using latent class regression. RESULTS Four classes were identified: Sub-positive Only (13.4%), Mania Only (15.5%), Both (9.1%), and Neither (62.0%). Minority participants were generally more likely than non-Hispanic whites to belong to one of the three sub-psychosis classes compared to the Neither class. Associations for Hispanics and non-Hispanic blacks remained after adjustment for age, sex, and maternal education, and restriction to participants without significant physical health conditions. Racial-ethnic disparities were greater in magnitude for the two classes characterized by sub-positive symptoms, Sub-positive Only and Both, than for the Mania Only class. This pattern was statistically significant among non-Hispanic blacks. CONCLUSIONS We found evidence for racial-ethnic disparities in empirically-derived subtypes of subthreshold psychosis, broadly defined, among U.S. youths. Further research is needed to determine whether these disparities persist to the clinical disorder level in adulthood.
Collapse
Affiliation(s)
- Diana Paksarian
- Genetic Epidemiology Research Branch, Intramural Research Program, National Institute of Mental Health, 35A Convent Drive, MSC#3720, Bethesda, MD 20892, USA.
| | - Kathleen R. Merikangas
- Genetic Epidemiology Research Branch, Intramural Research Program, National Institute of Mental Health, 35A Convent Drive, MSC#3720, Bethesda, MD 20892, USA
| | - Monica E. Calkins
- Neuropsychiatry Section, Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, 3400 Spruce St., 10th Floor, Gates Bldg., Philadelphia, PA 19104, USA
| | - Raquel E. Gur
- Neuropsychiatry Section, Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, 3400 Spruce St., 10th Floor, Gates Bldg., Philadelphia, PA 19104, USA
| |
Collapse
|
35
|
Topuzoğlu A, Binbay T, Ulaş H, Elbi H, Tanık FA, Zağlı N, Alptekin K. The epidemiology of major depressive disorder and subthreshold depression in Izmir, Turkey: Prevalence, socioeconomic differences, impairment and help-seeking. J Affect Disord 2015; 181:78-86. [PMID: 25933098 DOI: 10.1016/j.jad.2015.04.017] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2014] [Revised: 04/08/2015] [Accepted: 04/08/2015] [Indexed: 11/18/2022]
Abstract
BACKGROUND Subclinical and clinical depression is common, widely distributed in the general population, and usually associated with role impairment and help-seeking. Reliable information at the population level is needed to estimate the disease burden of depression and associated care needs in Turkey. METHOD The cross-sectional study aimed to assess the prevalence of subthreshold (SubD) and clinical major depressive disorder (MDD) in Izmir, Turkey. In the 5242 eligible households, a total of 4011 individuals were successfully interviewed, yielding a response rate of 76.5%. Prevalence estimates of MDD and SubD depression were formed by using the responses to the questions of the CIDI section E. Short Form 36 (SF-36) to assess health status and functional impairments in eight scaled scores during the last four weeks. All respondents were questioned about receiving 12-month treatment for any psychological complaints, the route of help-seeking, as well as prescribed medicines and any hospitalization. RESULTS The one year prevalence estimate for CIDI/DSM IV MDD was 8.2% (95% CI, 7.4-9.1). Less educated, low income, uninsured, low SES, unemployed/disabled and housewives, slum area residents had higher one year MDD prevalence. Determined prevalence of help seeking from mental health services of SubD and MDD cases were 23.6%, 30.6% respectively. Only 24.8% of clinically depressive patients received minimally adequate treatment. LIMITATIONS Cross sectional design. CONCLUSION Higher MDD prevalence correlates with younger ages, female gender, unemployment, less education, lower monthly income, lower SES and uninsurance. Help seeking from mental health services were low. There are treatment gap and impairment in depressive group.
Collapse
Affiliation(s)
- Ahmet Topuzoğlu
- Dokuz Eylul University, Department of Psychiatry, Izmir, Turkey.
| | - Tolga Binbay
- Dokuz Eylul University, Department of Psychiatry, Izmir, Turkey
| | - Halis Ulaş
- Dokuz Eylul University, School of Medicine, Department of Psychiatry, Izmir, Turkey
| | - Hayriye Elbi
- Ege University, School of Medicine, Department of Psychiatry, Izmir, Turkey
| | - Feride Aksu Tanık
- Ege University, School of Medicine, Department of Public Health, Izmir, Turkey
| | - Nesli Zağlı
- Ege University, Department of Psychiatry, Izmir, Turkey
| | - Köksal Alptekin
- Dokuz Eylul University, Department of Psychiatry, Izmir, Turkey
| |
Collapse
|
36
|
Wei X, Chen Y, Lu M, Deng B, Yu H, Wang J, Che Y, Han C. An ephaptic transmission model of CA3 pyramidal cells: an investigation into electric field effects. Cogn Neurodyn 2013; 8:177-97. [PMID: 24808928 DOI: 10.1007/s11571-013-9269-6] [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] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2013] [Revised: 09/01/2013] [Accepted: 09/03/2013] [Indexed: 10/26/2022] Open
Abstract
Extracellular electric fields existing throughout the living brain affect the neural coding and information processing via ephaptic transmission, independent of synapses. A two-compartment whole field effect model (WFEM) of pyramidal neurons embedded within a resistive array which simulates the extracellular medium i.e. ephapse is developed to study the effects of electric field on neuronal behaviors. We derive the two linearized filed effect models (LFEM-1 and LFEM-2) from WFEM at the stable resting state. Through matching these simplified models to the subthreshold membrane response in experiments of the resting pyramidal cells exposed to applied electric fields, we not only verify our proposed model's validity but also found the key parameters which dominate subthreshold frequency response characteristic. Moreover, we find and give its underlying biophysical mechanism that the unsymmetrical properties of active ion channels results in the very different low-frequency response of somatic and dendritic compartments. Following, WFEM is used to investigate both direct-current (DC) and alternating-current field effect on the neural firing patterns by bifurcation analyses. We present that DC electric field could modulate neuronal excitability, with the positive field improving the excitability, the modest negative field suppressing the excitability, but interestingly, the larger negative field re-exciting the neuron back into spiking behavior. The neuron exposed to the sinusoidal electric field exhibits abundant firing patterns sensitive to the input frequency and intensity. In addition, the electrical properties of ephapse can modulate the efficacy of field effect. Our simulated results are qualitatively in line with the relevant experimental results and can explain some experimental phenomena. Furthermore, they are helpful to provide the predictions which can be tested in future experiments.
Collapse
Affiliation(s)
- Xile Wei
- School of Electrical Engineering and Automation, Tianjin University, Tianjin, 300072 China
| | - Yinhong Chen
- School of Electrical Engineering and Automation, Tianjin University, Tianjin, 300072 China
| | - Meili Lu
- School of Informational Technology and Engineering, Tianjin University of Technology and Education, Tianjin, 300222 China
| | - Bin Deng
- School of Electrical Engineering and Automation, Tianjin University, Tianjin, 300072 China
| | - Haitao Yu
- School of Electrical Engineering and Automation, Tianjin University, Tianjin, 300072 China
| | - Jiang Wang
- School of Electrical Engineering and Automation, Tianjin University, Tianjin, 300072 China
| | - Yanqiu Che
- School of Automation and Electrical Engineering, Tianjin University of Technology and Education, Tianjin, 300222 China
| | - Chunxiao Han
- School of Automation and Electrical Engineering, Tianjin University of Technology and Education, Tianjin, 300222 China
| |
Collapse
|
37
|
Wesselhoeft R, Sørensen MJ, Heiervang ER, Bilenberg N. Subthreshold depression in children and adolescents - a systematic review. J Affect Disord 2013; 151:7-22. [PMID: 23856281 DOI: 10.1016/j.jad.2013.06.010] [Citation(s) in RCA: 130] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2012] [Revised: 06/12/2013] [Accepted: 06/13/2013] [Indexed: 01/17/2023]
Abstract
BACKGROUND Depressive disorders are disabling conditions striking at all ages. In adults, subthreshold depression (SD) is viewed as being on a continuum with major depressive disorder (MDD). Whether this holds for children and adolescents, is still unclear. We performed the first systematic review of SD in subjects below 18 years, in order to explore if childhood SD and MDD share causal pathways, phenomenology and outcomes, supporting a dimensional view. METHODS A critical systematic review in accordance with preferred reporting items for systematic reviews and meta-analyses (PRISMA) statement. A review protocol was developed a priori, and all reports were assessed by two reviewers. RESULTS The literature search generated 941 eligible references and 24 studies were included. Although diagnostic criteria for SD showed great variability, similarities for SD and MDD were striking. Both were common conditions with similar risk factor patterns. Clinical characteristics in both groups were depressed mood, suicidal ideation and high comorbidity. Outcomes were almost equally poor, with increased psychiatric morbidity and health service use. SD intervention studies showed promising results. LIMITATIONS Reports with data on SD not reported in keywords or abstract may have been missed by the search strategy. CONCLUSION A dimensional view of depressive disorders is also supported in children and adolescents, suggesting SD to be a precursor to MDD. Although SD is a somewhat milder condition than MDD, it has severe outcomes with psychopathology and impairment. There is a need of identifying cost-efficient and longlasting interventions in order to prevent development of early SD into MDD.
Collapse
Affiliation(s)
- Rikke Wesselhoeft
- Department of Child and Adolescent Mental Health Odense, Research Unit (University Function), Mental Health Services in the Region of Southern Denmark, University of Southern Denmark, Odense, Denmark.
| | | | | | | |
Collapse
|
38
|
Kim HW, Cho SC, Kim BN, Kim JW, Shin MS, Kim Y. Perinatal and familial risk factors are associated with full syndrome and subthreshold attention-deficit hyperactivity disorder in a korean community sample. Psychiatry Investig 2009; 6:278-85. [PMID: 20140126 PMCID: PMC2808797 DOI: 10.4306/pi.2009.6.4.278] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2009] [Revised: 09/24/2009] [Accepted: 10/09/2009] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE The objective of this study was to examine the effect of perinatal and familial risk factors on full syndrome and subthreshold attention-deficit/hyperactivity disorder (ADHD) among Korean children and adolescents. METHODS A sample of 2,673 students was randomly selected from 19 representative schools in Seoul, Korea. The parents of the students completed the Diagnostic Interview Schedule for Children-version IV (DISC-IV), as well as questionnaires on perinatal and familial risk factors. RESULTS Maternal stress and alcohol use during pregnancy, parental marital discord, parental separation or divorce, changes in primary caregivers, and notbreastfeeding were significantly associated with full syndrome ADHD; however, maternal stress during pregnancy was the only variable that differentiated subthreshold ADHD from non-ADHD. CONCLUSION Our results provide evidence the perinatal and familial risk factors contribute to the development of ADHD in Korea children and adolescents, and suggest that these perinatal and familial risk factors are more closely related to full syndrome than to subthreshold ADHD.
Collapse
Affiliation(s)
- Hyo-Won Kim
- Division of Child and Adolescent Psychiatry, Department of Neuropsychiatry, Seoul National University College of Medicine, Seoul, Korea
| | - Soo-Churl Cho
- Division of Child and Adolescent Psychiatry, Department of Neuropsychiatry, Seoul National University College of Medicine, Seoul, Korea
| | - Boong-Nyun Kim
- Division of Child and Adolescent Psychiatry, Department of Neuropsychiatry, Seoul National University College of Medicine, Seoul, Korea
| | - Jae-Won Kim
- Division of Child and Adolescent Psychiatry, Department of Neuropsychiatry, Seoul National University College of Medicine, Seoul, Korea
| | - Min-Sup Shin
- Division of Child and Adolescent Psychiatry, Department of Neuropsychiatry, Seoul National University College of Medicine, Seoul, Korea
| | - Yeni Kim
- Department of Neuropsychiatry, Seoul National Hospital, Seoul, Korea
| |
Collapse
|