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Guo LY, Lee P, Hsu HJ, Spencer L. Validating the Use of Percent Grammatical Utterances for Assessing Mandarin-Speaking Children's Grammatical Skill: Evidence From 3-Year-Olds. J Speech Lang Hear Res 2024; 67:1173-1185. [PMID: 38536741 DOI: 10.1044/2024_jslhr-23-00557] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/10/2024]
Abstract
PURPOSE The study examined the use of percent grammatical utterances (PGUs) for assessing grammatical skills in Mandarin-speaking 3-year-old children. METHOD Participants were 30 Mandarin-speaking 3-year-olds with typical development. Language samples were collected in two visits for each child using a picture description task. Children were asked to talk about 16 pictures in response to questions and prompts at each visit. Pictures for the language sample collection were identical across the visits. PGUs were computed, and the grammatical errors that children produced in the task were coded and tallied for error types at each visit. Test-retest reliability, split-half reliability, and concurrent criterion validity of PGUs were evaluated. RESULTS The mean PGU level was approximately 78% at Visit 1 and 81% at Visit 2, both of which were significantly below the mastery level (i.e., 90%). The correlation coefficient for test-retest reliability of PGU was large (r = .70, p < .01); the correlation coefficient for split-half reliability was medium at Visit 1 (r = .47, p < .01) and large (r = .65, p < .01) at Visit 2. In addition, the correlation coefficient for concurrent criterion validity of PGU was medium for both visits (rs ≥ .35, ps ≤ .03). The ranking and proportion of each error type were similar between the visits. CONCLUSION The initial evidence from psychometric properties suggests that PGU computed from the picture description task is a reliable and valid measure for evaluating grammatical skills in Mandarin-speaking 3-year-old children. SUPPLEMENTAL MATERIAL https://doi.org/10.23641/asha.25395499.
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Affiliation(s)
- Ling-Yu Guo
- Department of Communicative Disorders and Sciences, University at Buffalo, NY
- Department of Audiology and Speech-Language Pathology, Asia University, Taichung, Taiwan
| | - Ping Lee
- Department of Rehabilitation, Chinese Medical University Hsinchu Hospital, Taiwan
| | - Hsin-Jen Hsu
- Department of Special Education, National Tsing Hua University, Hsinchu, Taiwan
| | - Linda Spencer
- MSSLP Program, Rocky Mountain University of Health Professions, Provo, UT
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Mottl-Santiago J, Dukhovny D, Cabral H, Rodrigues D, Spencer L, Valle EA, Feinberg E. Effectiveness of an Enhanced Community Doula Intervention in a Safety Net Setting: A Randomized Controlled Trial. Health Equity 2023; 7:466-476. [PMID: 37731785 PMCID: PMC10507922 DOI: 10.1089/heq.2022.0200] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/10/2023] [Indexed: 09/22/2023] Open
Abstract
Background Racial inequities in maternal health outcomes, the result of systemic racism and social determinants of health, require maternity care systems to implement interventions that reduce disparities. One such approach may be support from a community doula, a health worker who provides emotional support, peer education, navigation, and advocacy for pregnant, birthing, and postpartum people who share similar racial identities, cultural backgrounds, and/or lived experiences. While community support during birth has a long tradition within communities of Black Indigenous and People of Color (BIPOC), the reframing of community doula support as a social intervention that reduces disparities in clinical outcomes is recent. Methods We conducted a pragmatic randomized trial at an urban safety net hospital, comparing standard maternity care with standard care plus enhanced community doula support. We tested the effectiveness of a community doula program embedded in a safety net hospital in improving birth outcomes and explored the association between community doula support and health equity. Participants were nulliparous, insured by publicly funded health plans, and had lower risk pregnancies. The primary outcome was cesarean birth. Secondary outcomes included preterm birth and breastfeeding outcomes. Exploratory subgroup analysis was conducted by race-ethnicity. Results Three hundred sixty-seven participants were included in the primary analysis. In the intent-to-treat analysis, outcomes were similar between groups. There was a trend toward increased breastfeeding initiation (p=0.08). There was a statistically nonsignificant 12% absolute reduction in cesarean birth and 11.5% increase in exclusive breastfeeding during delivery hospitalization among Black non-Hispanic participants. Discussion While outcomes for the study sample were similar between randomization groups, health outcomes were improved for Black birthing people in cesarean and breastfeeding rates. Conclusion This study demonstrates the need for larger studies of community doula support for Black birthing people. Clinicaltrials.gov ID: NCT02550730.
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Affiliation(s)
- Julie Mottl-Santiago
- Department of Obstetrics and Gynecology, Boston Medical Center, Boston, Massachusetts, USA
| | - Dmitry Dukhovny
- Department of Pediatrics, Oregon Health & Science University, Portland, Oregon, USA
| | - Howard Cabral
- Department of Biostatistics, Boston University School of Public Health, Boston, Massachusetts, USA
| | - Dona Rodrigues
- Department of Obstetrics and Gynecology, Boston Medical Center, Boston, Massachusetts, USA
| | - Linda Spencer
- Department of Obstetrics and Gynecology, Boston Medical Center, Boston, Massachusetts, USA
| | - Eduardo A. Valle
- Department of Obstetrics and Gynecology, Boston Medical Center, Boston, Massachusetts, USA
| | - Emily Feinberg
- Department of Community Health Sciences, Boston University School of Public Health, Boston, Massachusetts, USA
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Redgate S, Spencer L, Adams EA, Arnott B, Brown H, Christie A, Hardy C, Harrison H, Kaner E, Mawson C, McGovern W, Phillips P, Rankin J, McGovern R. A realist approach to understanding alliancing within Local Government public health and social care service provision. Eur J Public Health 2023; 33:49-55. [PMID: 36453890 PMCID: PMC9898013 DOI: 10.1093/eurpub/ckac172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND Within the current context of continued austerity and post-pandemic recovery, it remains important that Local Government services address the increasing needs of residents as cost-effectively as possible. Alliancing, whereby services work collaboratively focusing on the 'whole-system', has gained popularity as a tool with the potential to support collaborative whole systems approaches. This synthesis aims to identify how alliancing can be successfully operationalised in the commissioning of public health, wider National Health Service (NHS) and social care-related services. METHODS A realist literature synthesis was undertaken in order to identify underlying generative mechanisms associated with alliancing, the contextual conditions surrounding the implementation and operationalisation of the alliancing approach mechanisms, and the outcomes produced as a result. An iterative approach was taken, using a recent systematic review of the effectiveness of Alliancing, online database searches, and grey literature searches. RESULTS Three mechanistic components were identified within the data as being core to the successful implementation of alliances in public health and social care-related services within Local Government: (i) Achieving a system-level approach; (ii) placing local populations at the heart of the system; and (iii) creating a cultural shift. Programme theories were postulated within these components. CONCLUSIONS The alliancing approach offers an opportunity to achieve system-level change with the potential to benefit local populations. The realist synthesis approach taken within this study has provided insights into the necessary contextual and mechanistic factors of the Alliancing approach, above and beyond effectiveness outcomes typically collected through more conventional evaluation methodologies.
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Affiliation(s)
- S Redgate
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, England
| | - L Spencer
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, England
| | - E A Adams
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, England
| | - B Arnott
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, England
| | - H Brown
- Health Research, Lancaster University, Lancaster, England
| | - A Christie
- Public Health, South Tyneside Council, South Shields, England
| | - C Hardy
- Public Health, South Tyneside Council, South Shields, England
| | - H Harrison
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, England
| | - E Kaner
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, England
| | - C Mawson
- Public Health, South Tyneside Council, South Shields, England
| | - W McGovern
- Social Work, Education and Community Wellbeing, Northumbria University, Newcastle upon Tyne, England
| | - P Phillips
- Public Health, South Tyneside Council, South Shields, England
| | - J Rankin
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, England
| | - R McGovern
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, England
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Colic L, Villa LM, Dauvermann MR, van Velzen LS, Sankar A, Goldman DA, Panchal P, Kim JA, Quatrano S, Spencer L, Constable RT, Suckling J, Goodyer IM, Schmaal L, van Harmelen AL, Blumberg HP. Brain grey and white matter structural associations with future suicidal ideation and behaviors in adolescent and young adult females with mood disorders. JCPP Adv 2022; 2:e12118. [PMID: 36817186 PMCID: PMC9937714 DOI: 10.1002/jcv2.12118] [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] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Background To reduce suicide in females with mood disorders, it is critical to understand brain substrates underlying their vulnerability to future suicidal ideation and behaviors (SIBs) in adolescence and young adulthood. In an international collaboration, grey and white matter structure was investigated in adolescent and young adult females with future suicidal behaviors (fSB) and ideation (fSI), and without SIBs (fnonSIB). Methods Structural (n = 91) and diffusion-weighted (n = 88) magnetic resonance imaging scans at baseline and SIB measures at follow-up on average two years later (standard deviation, SD = 1 year) were assessed in 92 females [age(SD) = 16.1(2.6) years] with bipolar disorder (BD, 28.3%) or major depressive disorder (MDD, 71.7%). One-way analyses of covariance comparing baseline regional grey matter cortical surface area, thickness, subcortical grey volumes, or white matter tensor-based fractional anisotropy across fSB (n = 40, 43.5%), fSI (n = 33, 35.9%) and fnonSIB (n = 19, 20.6%) groups were followed by pairwise comparisons in significant regions (p < 0.05). Results Compared to fnonSIBs, fSIs and fSBs showed significant decreases in cortical thickness of right inferior frontal gyrus pars orbitalis and middle temporal gyrus, fSIs of left inferior frontal gyrus, pars orbitalis. FSIs and fSBs showed lower fractional anisotropy in left uncinate fasciculus and corona radiata, and fSBs in right uncinate and superior fronto-occipital fasciculi. Conclusions The study provides preliminary evidence of grey and white matter alterations in brain regions subserving emotional and behavioral regulation and perceptual processing in adolescent and young adult females with mood disorders with, versus without, future SIBs. Findings suggest potential targets to prevent SIBs in female adolescents and young adults.
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Affiliation(s)
- Lejla Colic
- Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut, USA
- Department of Psychiatry and Psychotherapy, Jena University Hospital, Jena, Germany
- German Center for Mental Health, Jena, Germany
| | - Luca M. Villa
- Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut, USA
- Department of Psychiatry, University of Oxford, Oxford, UK
| | - Maria R. Dauvermann
- Department of Psychiatry, University of Cambridge, Cambridge, UK
- McGovern Institute for Brain Research, Massachusetts Institute of Technology, Cambridge, Massachusetts, USA
- Institute for Mental Health, School of Psychology, University of Birmingham, Birmingham, UK
| | - Laura S. van Velzen
- Orygen, Parkville, Victoria, Australia
- Centre for Youth Mental Health, The University of Melbourne, Parkville, Victoria, Australia
| | - Anjali Sankar
- Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut, USA
- Department of Neurology and Neurobiology Research Unit, Copenhagen University Hospital, Kobenhavn, Denmark
| | - Danielle A. Goldman
- Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut, USA
- Interdepartmental Neuroscience Program, Yale School of Medicine, New Haven, Connecticut, USA
| | - Priyanka Panchal
- Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut, USA
- Department of Psychiatry, University of Oxford, Oxford, UK
| | - Jihoon A. Kim
- Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut, USA
| | - Susan Quatrano
- Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut, USA
| | - Linda Spencer
- Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut, USA
| | - R. Todd Constable
- Department of Radiology and Biomedical Imaging, Yale School of Medicine, New Haven, Connecticut, USA
| | - John Suckling
- Department of Psychiatry, University of Cambridge, Cambridge, UK
| | - Ian M. Goodyer
- Department of Psychiatry, University of Cambridge, Cambridge, UK
| | - Lianne Schmaal
- Orygen, Parkville, Victoria, Australia
- Centre for Youth Mental Health, The University of Melbourne, Parkville, Victoria, Australia
| | - Anne-Laura van Harmelen
- Department of Psychiatry, University of Cambridge, Cambridge, UK
- Institute of Education and Child Studies, Leiden University, Leiden, The Netherlands
| | - Hilary P. Blumberg
- Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut, USA
- Department of Radiology and Biomedical Imaging, Yale School of Medicine, New Haven, Connecticut, USA
- Child Study Center, Yale School of Medicine, New Haven, Connecticut, USA
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Luo J, Xu L, Wang M, Xie D, Li J, Liu X, He S, Spencer L, Rost G, Guo LY. Characteristics of Early Expressive Vocabulary in Mandarin-Speaking Children With Cochlear Implants. J Speech Lang Hear Res 2022; 65:4369-4384. [PMID: 36282684 DOI: 10.1044/2022_jslhr-22-00183] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
PURPOSE The aim of this study is to evaluate whether Mandarin-speaking children with cochlear implants (CIs) demonstrated early lexical composition similar to their hearing peers who were at the same vocabulary level and the extent to which children with CIs were sensitive to linguistic and conceptual properties when developing early lexicon. METHOD Participants were 77 Mandarin-speaking children with CIs who received CIs before 30 months of age. Their expressive vocabulary was documented using the Infant Checklist of the Early Vocabulary Inventory for Mandarin Chinese 9 or 12 months after CI activation. Percent social words, common nouns, predicates (verbs, adjectives), and closed-class words in total vocabulary were computed for children at different vocabulary levels. Common nouns and verbs were further coded for their word class (noun, verb), word frequency, word length, and imageability to predict how likely a given noun or verb would be produced by children with CIs. RESULTS Like children with typical hearing, social words were the most dominant category when vocabulary size in children with CIs was smaller than 20 words; common nouns became the most dominant category when the vocabulary size reached 21 words. The difference in percent common nouns and percent predicates (i.e., noun bias) was similar in children with CIs and their hearing peers. In addition, verbs, common words, monosyllabic words, and more imageable words were more likely to be produced by children with CIs than their counterparts. CONCLUSIONS Mandarin children with CIs showed language-specific patterns in early lexical composition like their hearing peers. They were able to use multiple linguistic and conceptual cues when approaching early expressive vocabulary despite perceptual and processing constraints. SUPPLEMENTAL MATERIAL https://doi.org/10.23641/asha.21357723.
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Affiliation(s)
- Jianfen Luo
- Department of Otolaryngology-Head and Neck Surgery, Shandong Provincial ENT Hospital, Shandong University, Jinan, China
- Auditory Implant Center, Shandong Provincial ENT Hospital, Jinan, China
| | - Lei Xu
- Department of Otolaryngology-Head and Neck Surgery, Shandong Provincial ENT Hospital, Shandong University, Jinan, China
- Auditory Implant Center, Shandong Provincial ENT Hospital, Jinan, China
| | - Min Wang
- Department of Otolaryngology-Head and Neck Surgery, Shandong Provincial ENT Hospital, Shandong University, Jinan, China
- Auditory Implant Center, Shandong Provincial ENT Hospital, Jinan, China
| | - Dianzhao Xie
- Department of Otolaryngology-Head and Neck Surgery, Shandong Provincial ENT Hospital, Shandong University, Jinan, China
- Auditory Implant Center, Shandong Provincial ENT Hospital, Jinan, China
| | - Jinming Li
- Department of Otolaryngology-Head and Neck Surgery, Shandong Provincial ENT Hospital, Shandong University, Jinan, China
- Auditory Implant Center, Shandong Provincial ENT Hospital, Jinan, China
| | - Xianqi Liu
- Department of Otolaryngology-Head and Neck Surgery, Shandong Provincial ENT Hospital, Shandong University, Jinan, China
- Auditory Implant Center, Shandong Provincial ENT Hospital, Jinan, China
| | - Shuman He
- Department of Otolaryngology-Head and Neck Surgery, The Ohio State University, Columbus
- Department of Audiology, Nationwide Children's Hospital, Columbus, OH
| | - Linda Spencer
- MSSLP Program, Rocky Mountain University of Health Professions, Provo, UT
| | - Gwyneth Rost
- Department of Communication Disorders, University of Massachusetts at Amherst
| | - Ling-Yu Guo
- Department of Communicative Disorders and Sciences, University at Buffalo, NY
- Department of Audiology and Speech-Language Pathology, Asia University, Taichung, Taiwan
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Dhaher R, Bronen RA, Spencer L, Colic L, Brown F, Mian A, Sandhu M, Pittman B, Spencer D, Blumberg HP, Altalib H. The Dorsal Bed Nucleus of the Stria Terminalis in Depressed and Non-Depressed Temporal Lobe Epilepsy Patients. Epilepsia 2022; 63:2561-2570. [PMID: 35883245 DOI: 10.1111/epi.17377] [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: 03/24/2022] [Revised: 07/25/2022] [Accepted: 07/25/2022] [Indexed: 11/28/2022]
Abstract
OBJECTIVES Temporal lobe epilepsy (TLE) and depression are common comorbid disorders whose underlying shared neural network has yet to be determined. While animal studies demonstrate a role for the dorsal bed nucleus of the stria terminalis (dBNST) in both seizures and depression, and humans clinical studies demonstrate a therapeutic effect of stimulating this region on treatment-resistant depression, the role for the dBNST in depressed and non-depressed TLE patients is still unclear. Here, we tested the hypothesis that this structure is morphologically abnormal in these epilepsy patients, with an increased abnormality in TLE patients with comorbid depression. METHODS In this case-controlled study, three Tesla structural magnetic resonance imaging scans were obtained from TLE patients with no depression (TLEonly), with depression (TLEdep) and healthy comparison subjects (HC). TLE subjects were recruited from the Yale University Comprehensive Epilepsy Center, diagnosed with the International League Against Epilepsy 2014 Diagnostic Guidelines, and confirmed by video electroencephalography. Diagnosis of major depressive disorder was confirmed by a trained neuropsychologist through a Mini International Neuropsychiatric Interview based on the DSM-IV. The dBNST was delineated manually by reliable raters using Bioimage Suite software. RESULTS The number of patients and subjects included 35 TLEonly patients, 20 TLEdep patients, and 102 HC subjects. Both TLEonly and TLEdep patients had higher dBNST volumes compared to HC subjects, unilaterally in the left hemisphere in the TLEonly patients (p=0.003), and bilaterally in the TLEdep patients (p<0·0001). Furthermore, the TLEdep patients had a higher dBNST volume than the TLEonly patients in the right hemisphere (p=0.02). SIGNIFICANCE Here we demonstrate an abnormality of the dBNST in TLE patients, both without depression (left enlargement) and with depression (bilateral enlargement). Our results demonstrate this region to underlie both temporal lobe epilepsy with and without depression, implicating it as a target to treat the comorbidity between these two disorders.
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Affiliation(s)
- Roni Dhaher
- Department of Neurosurgery, Yale School of Medicine, New Haven, CT, USA
| | - Richard A Bronen
- Department of Neurosurgery, Yale School of Medicine, New Haven, CT, USA.,Department of Radiology and Biomedical Imaging, Yale School of Medicine, New Haven, CT, USA
| | - Linda Spencer
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
| | - Lejla Colic
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA.,Department of Psychiatry and Psychotherapy, University Hospital Jena, Jena, Germany.,Center for Intervention and Research on adaptive and maladaptive brain Circuits underlying mental health, Jena, Germany
| | - Franklin Brown
- Department of Neurology, Yale School of Medicine, New Haven, CT, USA
| | - Ali Mian
- Department of Radiology, Washington University School of Medicine, St Louis, MI, USA
| | - Mani Sandhu
- Department of Laboratory Medicine, Yale School of Medicine, New Haven, CT, USA
| | - Brian Pittman
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
| | - Dennis Spencer
- Department of Neurosurgery, Yale School of Medicine, New Haven, CT, USA
| | - Hilary P Blumberg
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA.,Child Study Center, Yale School of Medicine, New Haven, CT, USA.,Department of Radiology and Biomedical Imaging, Yale School of Medicine, New Haven, CT, USA
| | - Hamada Altalib
- Department of Neurology, Yale School of Medicine, New Haven, CT, USA
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Drachman R, Colic L, Sankar A, Spencer L, Goldman DA, Villa LM, Kim JA, Oquendo MA, Pittman B, Blumberg HP. Rethinking "aggression" and impulsivity in bipolar disorder: Risk, clinical and brain circuitry features. J Affect Disord 2022; 303:331-339. [PMID: 35181384 PMCID: PMC9109470 DOI: 10.1016/j.jad.2022.02.047] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Revised: 02/11/2022] [Accepted: 02/14/2022] [Indexed: 12/21/2022]
Abstract
BACKGROUND Elevated aggression and impulsivity are implicated in Bipolar Disorder (BD); however, relationships between these behavioral constructs have not been clarified, which can lead to misconceptions with negative consequences including stigma and adverse outcomes including suicide. The study aimed to clarify brain-based distinctions between the two constructs and their associations to risk factors, symptoms and suicide thoughts and behaviors. METHODS Self-rated Brown-Goodwin Aggression (BGA) and Barratt Impulsiveness Scale (BIS) scores were compared between adults with BD (n = 38, 74% female) and healthy controls (HC, n = 29, 64% female). Relationships were examined between BGA and BIS with childhood trauma questionnaire (CTQ), mood, comorbidities, and magnetic resonance imaging gray matter volume (GMV) assessments. RESULTS In BD, BGA and BIS total scores were both elevated and associated with childhood maltreatment (CM), particularly emotional CM, depression, substance use disorders (SUDs) and suicide attempts (SAs). BGA scores were increased by items corresponding to dysregulation of emotional and social behavior and associated with elevated mood states and suicide ideation and GMV decreases in bilateral orbitofrontal cortex and left posterior insula brain regions, previously associated with these behaviors and clinical features. BIS motor impulsiveness scores were associated with GMV decreases in anterior cingulate cortex implicated in mood and behavioral dyscontrol. LIMITATIONS modest sample size, self-reports CONCLUSIONS: The findings suggest separable brain-based domains of dysfunction in BD of motor impulsiveness versus emotionally dysregulated feelings that are primarily self-directed. Both domains are associated with suicide behavior and modifiable risk factors of CM, depression and SUDs that could be targeted for prevention.
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Affiliation(s)
- Rebecca Drachman
- Department of Psychiatry, Yale School of Medicine, 60 Temple Street, Suite 6B, New Haven, CT 06511, USA
| | - Lejla Colic
- Department of Psychiatry, Yale School of Medicine, 60 Temple Street, Suite 6B, New Haven, CT 06511, USA; Department of Psychiatry, Jena University Hospital, Jena, Germany
| | - Anjali Sankar
- Department of Psychiatry, Yale School of Medicine, 60 Temple Street, Suite 6B, New Haven, CT 06511, USA
| | - Linda Spencer
- Department of Psychiatry, Yale School of Medicine, 60 Temple Street, Suite 6B, New Haven, CT 06511, USA
| | - Danielle A Goldman
- Department of Psychiatry, Yale School of Medicine, 60 Temple Street, Suite 6B, New Haven, CT 06511, USA; Interdepartmental Neuroscience Program, Yale School of Medicine, New Haven, CT 06511, USA
| | - Luca M Villa
- Department of Psychiatry, Yale School of Medicine, 60 Temple Street, Suite 6B, New Haven, CT 06511, USA
| | - Jihoon A Kim
- Department of Psychiatry, Yale School of Medicine, 60 Temple Street, Suite 6B, New Haven, CT 06511, USA
| | - Maria A Oquendo
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Brian Pittman
- Department of Psychiatry, Yale School of Medicine, 60 Temple Street, Suite 6B, New Haven, CT 06511, USA
| | - Hilary P Blumberg
- Department of Psychiatry, Yale School of Medicine, 60 Temple Street, Suite 6B, New Haven, CT 06511, USA; Department of Radiology and Biomedical Imaging, Yale School of Medicine, New Haven, CT 06511, USA; Child Study Center, Yale School of Medicine, New Haven, CT 06511, USA.
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Xu L, Luo J, Wang M, Xie D, Chao X, Li J, Liu X, He S, Spencer L, Guo LY. Vocabulary Growth in Mandarin-Speaking Children With Bilateral Cochlear Implants, Bimodal Stimulation, or Unilateral Cochlear Implants During the First Year After Activation. J Speech Lang Hear Res 2022; 65:1630-1645. [PMID: 35302899 DOI: 10.1044/2021_jslhr-21-00454] [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] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
PURPOSE The purpose of this study was to evaluate vocabulary development in Mandarin-speaking children with bilateral cochlear implants (CIs), bimodal stimulation (CI plus hearing aids [HAs]), or unilateral CIs during the first year after CI activation. METHOD Participants included 23 children with simultaneous bilateral CIs, 23 children with bimodal stimulation, and 15 children with unilateral CIs. They all received CIs before 30 months of age. Parents were asked to endorse words that their child could understand only or understand and say using the Early Vocabulary Inventory for Mandarin Chinese at the day of CI activation and 1, 3, 6, 9, and 12 months after CI activation. Receptive and expressive vocabulary sizes were computed. RESULTS Growth curve analysis revealed that children with simultaneous bilateral CIs demonstrated faster growth of receptive vocabulary than those with bimodal stimulation, followed by those with unilateral CIs. Moreover, children with simultaneous bilateral CIs reached the 100-word mark for receptive vocabulary earlier than children with bimodal stimulation, followed by those with unilateral CIs. There were no significant differences among the three groups in expressive vocabulary. CONCLUSIONS Bilateral CIs have an advantage over bimodal stimulation in early receptive vocabulary development in Mandarin, a tone language. HA usage is still recommended for those who receive one CI.
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Affiliation(s)
- Lei Xu
- Department of Otolaryngology-Head and Neck Surgery, Shandong Provincial ENT Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
- Department of Auditory Implantation, Shandong Provincial ENT Hospital, Jinan, China
| | - Jianfen Luo
- Department of Otolaryngology-Head and Neck Surgery, Shandong Provincial ENT Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
- Department of Auditory Implantation, Shandong Provincial ENT Hospital, Jinan, China
| | - Min Wang
- Department of Otolaryngology-Head and Neck Surgery, Shandong Provincial ENT Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
- Department of Auditory Implantation, Shandong Provincial ENT Hospital, Jinan, China
| | - Dianzhao Xie
- Department of Otolaryngology-Head and Neck Surgery, Shandong Provincial ENT Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
- Department of Auditory Implantation, Shandong Provincial ENT Hospital, Jinan, China
| | - Xiuhua Chao
- Department of Otolaryngology-Head and Neck Surgery, Shandong Provincial ENT Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
- Department of Auditory Implantation, Shandong Provincial ENT Hospital, Jinan, China
| | - Jinming Li
- Department of Otolaryngology-Head and Neck Surgery, Shandong Provincial ENT Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
- Department of Auditory Implantation, Shandong Provincial ENT Hospital, Jinan, China
| | - Xianqi Liu
- Department of Otolaryngology-Head and Neck Surgery, Shandong Provincial ENT Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
- Department of Auditory Implantation, Shandong Provincial ENT Hospital, Jinan, China
| | - Shuman He
- Department of Otolaryngology-Head and Neck Surgery, The Ohio State University, Columbus
- Department of Audiology, Nationwide Children's Hospital, Columbus, OH
| | - Linda Spencer
- MSSLP Program, Rocky Mountain University of Health Professions, Provo, UT
| | - Ling-Yu Guo
- Department of Communicative Disorders and Sciences, University at Buffalo, NY
- Department of Audiology and Speech-Language Pathology, Asia University, Taichung, Taiwan
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9
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Spencer L, Fary R, McKenna L, Jacques A, Briffa K. Taking the strain: An examination of upper back musculoskeletal tissue sensitivity in relation to upper back pain and breast size. A cross-sectional study. Clin Biomech (Bristol, Avon) 2022; 92:105571. [PMID: 35051837 DOI: 10.1016/j.clinbiomech.2022.105571] [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: 12/30/2020] [Revised: 12/23/2021] [Accepted: 01/04/2022] [Indexed: 02/07/2023]
Abstract
BACKGROUND The physiological basis for upper back pain experienced by women with large breasts is unclear but could relate to sensitivity of musculoskeletal tissues strained from the postural adaptations to large breasts. The aim of this cross-sectional study was to examine if upper back pain and breast size were associated with greater localised sensitivity of upper back musculoskeletal tissues. METHODS 119 healthy postmenopausal women (mean age 61 years) had their upper back pain (numerical rating scale), breast size (breast size score), and upper back tissue sensitivity (pressure pain thresholds (digital algometry, kPa)) assessed. The pressure pain thresholds of six skeletal sites (T2, T4, T6, T8, T10 and T12) and six muscular sites (pectoralis major, levator scapulae, sternocleidomastoid, and upper, middle, and lower trapezius muscles) were examined. Linear mixed models with random subject effects were used to evaluate differences in sensitivity at each anatomical site between participants grouped by upper back pain (nil-mild, moderate-severe) and breast size (small, large). FINDINGS For most sites, the differences in sensitivity between upper back pain groups were highly significant (P < 0.002) with significantly lower pressure pain thresholds (Mean difference (MD): 74.6 to 151.1 kPa) recorded for participants with moderate-severe upper back pain. There were no differences in sensitivity between breast size groups. INTERPRETATION Increased upper back musculoskeletal sensitivity is related to perceived upper back pain but not to breast size. It remains unclear if and how structural or mechanical factors related to breast size contribute to upper back pain in women with large breasts.
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Affiliation(s)
- Linda Spencer
- School of Physiotherapy and Exercise Science, Curtin University, Western Australia, Australia.
| | - Robyn Fary
- School of Physiotherapy and Exercise Science, Curtin University, Western Australia, Australia.
| | - Leanda McKenna
- School of Physiotherapy and Exercise Science, Curtin University, Western Australia, Australia.
| | - Angela Jacques
- School of Physiotherapy and Exercise Science, Curtin University, Western Australia, Australia.
| | - Kathy Briffa
- School of Physiotherapy and Exercise Science, Curtin University, Western Australia, Australia.
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10
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Sankar A, Purves K, Colic L, Lippard ETC, Millard H, Fan S, Spencer L, Wang F, Pittman B, Constable RT, Gross JJ, Blumberg HP. Altered frontal cortex functioning in emotion regulation and hopelessness in bipolar disorder. Bipolar Disord 2021; 23:152-164. [PMID: 32521570 PMCID: PMC7790437 DOI: 10.1111/bdi.12954] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [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] [Indexed: 11/28/2022]
Abstract
OBJECTIVES Emotion regulation difficulties precipitate and exacerbate acute mood symptoms in individuals with bipolar disorder (BD), and contribute to suicidal behavior. However, few studies have examined regional brain responses in explicit emotion regulation during acute BD mood states, or hopelessness, a major suicide risk factor. We assessed brain responses during explicit emotion regulation, and their relationship with hopelessness, in acutely symptomatic and euthymic individuals with BD. METHODS Functional MRI data were obtained from individuals with BD who were either in acute negative (BD-A; n = 24) or euthymic (BD-E; n = 24) mood states, and from healthy volunteers (HV; n = 55), while participants performed a paradigm that instructed them to downregulate their responses to fearful (EmReg-Fear) and happy (EmReg-Happy) facial stimuli. Emotion regulation-related differences in brain responses during negative and euthymic BD states, as well as their associations with negative affective symptoms (hopelessness and depression), were examined. RESULTS Decreased responses were observed in ventral and dorsal frontal regions, including medial orbitofrontal (mOFC) and dorsal anterior cingulate cortices, during EmReg-Fear across symptomatic and euthymic states in participants with BD relative to HVs. The lowest responses were observed in the BD-A group. Across BD participants, negative associations were observed between mOFC responses and hopelessness, particularly due to loss of motivation. Differences were not significant during EmReg-Happy. CONCLUSIONS Lesser emotion regulation-related ventral and dorsal frontal engagement in BD could represent a trait abnormality that worsens during acute negative states. The reduced mOFC engagement in BD during explicit regulation of negative emotions may contribute to hopelessness particularly in the context of diminished motivation.
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Affiliation(s)
- Anjali Sankar
- Department of Psychiatry, Yale School of Medicine, New Haven, CT
| | - Kirstin Purves
- Department of Psychiatry, Yale School of Medicine, New Haven, CT,Social, Genetic Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, UK
| | - Lejla Colic
- Department of Psychiatry, Yale School of Medicine, New Haven, CT
| | - Elizabeth T Cox Lippard
- Department of Psychiatry, Yale School of Medicine, New Haven, CT,Department of Radiology and Biomedical Imaging, Yale School of Medicine, New Haven, CT,Department of Psychiatry, Dell Medical School, University of Texas, Austin, TX
| | - Hun Millard
- Department of Psychiatry, Yale School of Medicine, New Haven, CT,Child Study Center, Yale School of Medicine, New Haven, CT
| | - Siyan Fan
- Department of Psychiatry, Yale School of Medicine, New Haven, CT
| | - Linda Spencer
- Department of Psychiatry, Yale School of Medicine, New Haven, CT
| | - Fei Wang
- Department of Psychiatry, Yale School of Medicine, New Haven, CT
| | - Brian Pittman
- Department of Psychiatry, Yale School of Medicine, New Haven, CT
| | - R. Todd Constable
- Department of Radiology and Biomedical Imaging, Yale School of Medicine, New Haven, CT
| | - James J Gross
- Department of Psychology, Stanford University, Stanford, CA
| | - Hilary P Blumberg
- Department of Psychiatry, Yale School of Medicine, New Haven, CT,Department of Radiology and Biomedical Imaging, Yale School of Medicine, New Haven, CT,Child Study Center, Yale School of Medicine, New Haven, CT
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11
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Spencer L, McKenna L, Fary R, Ho R, Briffa K. Is Breast Size Related to Prevalent Thoracic Vertebral Fracture? A Cross-Sectional Study. JBMR Plus 2020; 4:e10371. [PMID: 32666022 PMCID: PMC7340439 DOI: 10.1002/jbm4.10371] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2019] [Revised: 03/06/2020] [Accepted: 04/19/2020] [Indexed: 11/08/2022] Open
Abstract
Large breasts may increase the likelihood of thoracic vertebral fractures by increasing the mechanical loading of the spine. We examined breast size as a factor associated with prevalent thoracic vertebral fractures, also considering its relationship with thoracic kyphosis and upper back extensor muscle endurance. Using a cross-sectional study, the design measurements collected were thoracic vertebral fractures (≥20% loss in vertebral body height on lateral radiograph), breast size (bra size converted to an ordinal breast size score), BMD (g/cm2 averaged femoral neck, DXA), upper back extensor muscle endurance (isometric chest raise test), body composition (DXA), thoracic kyphosis (radiograph), and upper back pain (numerical rating scale). Correlations and multivariable logistic regression examined relationships between characteristics and their association with vertebral fracture. Participants were 117 healthy postmenopausal women. The 17 (15%) women with ≥1 thoracic vertebral fracture had larger breast size (mean difference [MD]: 2.2 sizes; 95% CI, 0.6 to 3.8 sizes), less upper back extensor muscle endurance (MD: -38.6 s; 95% CI, -62.9 to -14.3 s), and greater thoracic kyphosis (MD: 7.3°; 95% CI, 1.7° to 12.8°) than those without vertebral fracture. There were no between group differences in age, height, weight, and BMD. Breast size (r = -0.233, p = 0.012) and thoracic kyphosis (r = -0.241, p = 0.009) correlated negatively with upper back extensor muscle endurance. Breast size was unrelated to thoracic kyphosis (r = 0.057, p = 0.542). A (final) multivariable model containing breast size (OR 1.85; 95% CI, 1.10 to 3.10) and thoracic kyphosis (OR 2.04; 95%CI, 1.12 to 3.70) explained 18% of the variance in vertebral fracture. Breast size had a significant, but weak relationship with vertebral fracture (R 2 = 0.10), which was independent of BMD and unrelated to thoracic kyphosis. Further work is needed to confirm larger breast size as a risk factor for vertebral fracture. © 2020 The Authors. JBMR Plus published by Wiley Periodicals, Inc. on behalf of American Society for Bone and Mineral Research.
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Affiliation(s)
- Linda Spencer
- School of Physiotherapy and Exercise Science Curtin University Perth Western Australia Australia
| | - Leanda McKenna
- School of Physiotherapy and Exercise Science Curtin University Perth Western Australia Australia
| | - Robyn Fary
- School of Physiotherapy and Exercise Science Curtin University Perth Western Australia Australia
| | - Richard Ho
- Perth Radiological Clinic Perth Western Australia Australia
| | - Kathy Briffa
- School of Physiotherapy and Exercise Science Curtin University Perth Western Australia Australia
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12
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Peck DS, Lacey JM, White AL, Pino G, Studinski AL, Fisher R, Ahmad A, Spencer L, Viall S, Shallow N, Siemon A, Hamm JA, Murray BK, Jones KL, Gavrilov D, Oglesbee D, Raymond K, Matern D, Rinaldo P, Tortorelli S. Incorporation of Second-Tier Biomarker Testing Improves the Specificity of Newborn Screening for Mucopolysaccharidosis Type I. Int J Neonatal Screen 2020; 6:10. [PMID: 33073008 PMCID: PMC7422968 DOI: 10.3390/ijns6010010] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [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: 01/07/2020] [Accepted: 02/05/2020] [Indexed: 11/17/2022] Open
Abstract
Enzyme-based newborn screening for Mucopolysaccharidosis type I (MPS I) has a high false-positive rate due to the prevalence of pseudodeficiency alleles, often resulting in unnecessary and costly follow up. The glycosaminoglycans (GAGs), dermatan sulfate (DS) and heparan sulfate (HS) are both substrates for α-l-iduronidase (IDUA). These GAGs are elevated in patients with MPS I and have been shown to be promising biomarkers for both primary and second-tier testing. Since February 2016, we have measured DS and HS in 1213 specimens submitted on infants at risk for MPS I based on newborn screening. Molecular correlation was available for 157 of the tested cases. Samples from infants with MPS I confirmed by IDUA molecular analysis all had significantly elevated levels of DS and HS compared to those with confirmed pseudodeficiency and/or heterozygosity. Analysis of our testing population and correlation with molecular results identified few discrepant outcomes and uncovered no evidence of false-negative cases. We have demonstrated that blood spot GAGs analysis accurately discriminates between patients with confirmed MPS I and false-positive cases due to pseudodeficiency or heterozygosity and increases the specificity of newborn screening for MPS I.
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Affiliation(s)
- Dawn S Peck
- Biochemical Genetics Laboratory, Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN 55905, USA; (J.M.L.); (A.L.W.); (G.P.); (A.L.S.); (D.G.); (D.O.); (K.R.); (D.M.); (P.R.)
| | - Jean M Lacey
- Biochemical Genetics Laboratory, Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN 55905, USA; (J.M.L.); (A.L.W.); (G.P.); (A.L.S.); (D.G.); (D.O.); (K.R.); (D.M.); (P.R.)
| | - Amy L White
- Biochemical Genetics Laboratory, Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN 55905, USA; (J.M.L.); (A.L.W.); (G.P.); (A.L.S.); (D.G.); (D.O.); (K.R.); (D.M.); (P.R.)
| | - Gisele Pino
- Biochemical Genetics Laboratory, Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN 55905, USA; (J.M.L.); (A.L.W.); (G.P.); (A.L.S.); (D.G.); (D.O.); (K.R.); (D.M.); (P.R.)
| | - April L Studinski
- Biochemical Genetics Laboratory, Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN 55905, USA; (J.M.L.); (A.L.W.); (G.P.); (A.L.S.); (D.G.); (D.O.); (K.R.); (D.M.); (P.R.)
| | - Rachel Fisher
- Division of Pediatric Genetics, Metabolism and Genomic Medicine, Department of Pediatrics, University of Michigan, Ann Arbor, MI 48109, USA; (R.F.); (A.A.)
| | - Ayesha Ahmad
- Division of Pediatric Genetics, Metabolism and Genomic Medicine, Department of Pediatrics, University of Michigan, Ann Arbor, MI 48109, USA; (R.F.); (A.A.)
| | - Linda Spencer
- Division of Genetic, Genomic and Metabolic Disorders, Children's Hospital of Michigan, Detroit, MI 48201, USA;
| | - Sarah Viall
- Rare Disease Institute, Children's National Health System, Washington, DC 20010, USA;
| | - Natalie Shallow
- Division of Medical Genetics and Genomic Medicine, Monroe Carell Jr. Children's Hospital at Vanderbilt, Nashville, TN 37232, USA;
| | - Amy Siemon
- Division of Genetic and Genomic Medicine, Nationwide Children's Hospital, Columbus, OH 43205, USA;
| | - J Austin Hamm
- Pediatric Genetics, East Tennessee Children's Hospital, Knoxville, TN 37916, USA;
| | - Brianna K Murray
- Division of Medical Genetics and Metabolism, Children's Hospital of the King's Daughters, Norfolk, VA 23507, USA; (B.K.M.); (K.L.J.)
| | - Kelly L Jones
- Division of Medical Genetics and Metabolism, Children's Hospital of the King's Daughters, Norfolk, VA 23507, USA; (B.K.M.); (K.L.J.)
| | - Dimitar Gavrilov
- Biochemical Genetics Laboratory, Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN 55905, USA; (J.M.L.); (A.L.W.); (G.P.); (A.L.S.); (D.G.); (D.O.); (K.R.); (D.M.); (P.R.)
| | - Devin Oglesbee
- Biochemical Genetics Laboratory, Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN 55905, USA; (J.M.L.); (A.L.W.); (G.P.); (A.L.S.); (D.G.); (D.O.); (K.R.); (D.M.); (P.R.)
| | - Kimiyo Raymond
- Biochemical Genetics Laboratory, Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN 55905, USA; (J.M.L.); (A.L.W.); (G.P.); (A.L.S.); (D.G.); (D.O.); (K.R.); (D.M.); (P.R.)
| | - Dietrich Matern
- Biochemical Genetics Laboratory, Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN 55905, USA; (J.M.L.); (A.L.W.); (G.P.); (A.L.S.); (D.G.); (D.O.); (K.R.); (D.M.); (P.R.)
| | - Piero Rinaldo
- Biochemical Genetics Laboratory, Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN 55905, USA; (J.M.L.); (A.L.W.); (G.P.); (A.L.S.); (D.G.); (D.O.); (K.R.); (D.M.); (P.R.)
| | - Silvia Tortorelli
- Biochemical Genetics Laboratory, Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN 55905, USA; (J.M.L.); (A.L.W.); (G.P.); (A.L.S.); (D.G.); (D.O.); (K.R.); (D.M.); (P.R.)
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13
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Guo LY, Eisenberg S, Schneider P, Spencer L. Finite Verb Morphology Composite Between Age 4 and Age 9 for the Edmonton Narrative Norms Instrument: Reference Data and Psychometric Properties. Lang Speech Hear Serv Sch 2020; 51:128-143. [DOI: 10.1044/2019_lshss-19-0028] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Purpose
The purpose of this study was to provide reference data and evaluate the psychometric properties for the finite verb morphology composite (FVMC) measure in children between 4 and 9 years of age from the database of the Edmonton Narrative Norms Instrument (ENNI;
Schneider, Dubé, & Hayward, 2005
).
Method
Participants included 377 children between age 4 and age 9, including 300 children with typical language and 77 children with language impairment (LI). Narrative samples were collected using a story generation task. FVMC scores were computed from the samples. Split-half reliability, concurrent criterion validity, and diagnostic accuracy for FVMC were further evaluated.
Results
Children's performance on FVMC increased significantly between age 4 and age 9 in the typical language and LI groups. Moreover, the correlation coefficients for the split-half reliability and concurrent criterion validity of FVMC were medium to large (
r
s ≥ .429,
p
s < .001) at each age level. The diagnostic accuracy of FVMC was good or acceptable from age 4 to age 7, but it dropped to a poor level at age 8 and age 9.
Conclusion
With the empirical evidence, FVMC is appropriate for identifying children with LI between age 4 and age 7. The reference data of FVMC could also be used for monitoring treatment progress.
Supplemental Material
https://doi.org/10.23641/asha.10073183
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Affiliation(s)
- Ling-Yu Guo
- Department of Communicative Disorders and Sciences, State University of New York at Buffalo
- Department of Audiology and Speech-Language Pathology, Asia University, Taichung, Taiwan
| | - Sarita Eisenberg
- Department of Communication Sciences and Disorders, Montclair State University, Bloomfield, NJ
| | - Phyllis Schneider
- Department of Communication Sciences and Disorders, University of Alberta, Edmonton, Canada
| | - Linda Spencer
- MSSLP Program, Rocky Mountain University of Health Professions, Provo, UT
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14
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Spencer L, Fary R, McKenna L, Jacques A, Lalor J, Briffa K. The relationship between breast size and aspects of health and psychological wellbeing in mature-aged women. Womens Health (Lond) 2020; 16:1745506520918335. [PMID: 32419664 PMCID: PMC7235664 DOI: 10.1177/1745506520918335] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/19/2018] [Revised: 12/12/2019] [Accepted: 03/02/2020] [Indexed: 11/16/2022]
Abstract
OBJECTIVES Increases in breast size with age are common but have not been widely examined as a factor that could affect the health and psychological wellbeing of mature-aged women. The purpose of this study was to examine the relationships between breast size and aspects of health and psychological wellbeing in mature-aged women. METHODS This was a cross-sectional study of mature-aged women (⩾40 years). Breast size (breast size score) was determined from self-reported bra size and was examined against health-related quality of life (Medical Outcomes Study Short-Form 36 and BREAST-Q), body satisfaction (numerical rating scale), breast satisfaction (BREAST-Q), physical activity levels (Human Activity Profile), the presence of upper back pain and breast and bra fit perceptions. RESULTS Two hundred sixty-nine women (40-85 years) with bra band sizes ranging from 8 to 26 and bra cup sizes from A to HH participated. The mean (standard deviation) breast size score of 7.7 (2.7) was equivalent to a bra size of 14DD. Increasing breast size was associated with significantly lower breast-related physical wellbeing (p < 0.001, R2 = 0.043) and lower ratings of body (p = 0.002, R2 = 0.024) and breast satisfaction (p < 0.001, R2 = 0.065). Women with larger breasts were more likely to be embarrassed by their breasts (odds ratio: 1.49, 95% confidence interval: 1.31 to 1.70); more likely to desire a change in their breasts (odds ratio: 1.55, 95% confidence interval: 1.37 to 1.75) and less likely to be satisfied with their bra fit (odds ratio: 0.84, 95% confidence interval: 0.76 to 0.92). Breast size in addition to age contributed to explaining upper back pain. For each one-size increase in breast size score, women were 13% more likely to report the presence of upper back pain. CONCLUSION Larger breast sizes have a small but significant negative relationship with breast-related physical wellbeing, body and breast satisfaction. Larger breasts are associated with a greater likelihood of upper back pain. Clinicians considering ways to improve the health and psychological wellbeing of mature-aged women should be aware of these relationships.
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Affiliation(s)
- Linda Spencer
- School of Physiotherapy and Exercise Science, Curtin University, Perth, WA, Australia
| | - Robyn Fary
- School of Physiotherapy and Exercise Science, Curtin University, Perth, WA, Australia
| | - Leanda McKenna
- School of Physiotherapy and Exercise Science, Curtin University, Perth, WA, Australia
| | - Angela Jacques
- School of Physiotherapy and Exercise Science, Curtin University, Perth, WA, Australia
| | - Jennifer Lalor
- School of Physiotherapy and Exercise Science, Curtin University, Perth, WA, Australia
| | - Kathy Briffa
- School of Physiotherapy and Exercise Science, Curtin University, Perth, WA, Australia
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15
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Guo LY, Eisenberg S, Schneider P, Spencer L. Percent Grammatical Utterances Between 4 and 9 Years of Age for the Edmonton Narrative Norms Instrument: Reference Data and Psychometric Properties. Am J Speech Lang Pathol 2019; 28:1448-1462. [PMID: 31433664 DOI: 10.1044/2019_ajslp-18-0228] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Purpose The purpose of this article was to provide the reference data and evaluate psychometric properties for the percent grammatical utterances (PGU; Eisenberg & Guo, 2013) in children between 4 and 9 years of age from the database of the Edmonton Narrative Norms Instrument (ENNI; Schneider, Dubé, & Hayward, 2005). Method Participants were 377 children who were between 4 and 9 years of age, including 300 children with typical language (TL) and 77 children with language impairment (LI). Narrative samples were collected using the ENNI protocol (i.e., a story generation task). PGU was computed from the samples. Split-half reliability, concurrent criterion validity, and diagnostic accuracy for PGU were further evaluated. Results PGU increased significantly in children between 4 and 9 years of age in both the TL and LI groups. In addition, the correlation coefficients for the split-half reliability and concurrent criterion validity of PGU were all large (rs ≥ .557, ps < .001). The diagnostic accuracy of PGU was also good or acceptable from ages 4 to 9 years. Conclusions With the attested psychometric properties, PGU computed from the ENNI could be used as an assessment tool for identifying children with LI between 4 and 9 years of age. The reference data of PGU could also be used for monitoring treatment progress. Supplemental Material https://doi.org/10.23641/asha.9630590.
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Affiliation(s)
- Ling-Yu Guo
- Department of Audiology and Speech-Language Pathology, Asia University, Taichung City, Taiwan
- Department of Communicative Disorders and Sciences, University at Buffalo, NY
| | - Sarita Eisenberg
- Department of Communication Sciences and Disorders, Montclair State University, Bloomfield, NJ
| | - Phyllis Schneider
- Department of Communication Sciences and Disorders, University of Alberta, Edmonton, Canada
| | - Linda Spencer
- Master of Science in Speech-Language Pathology Program, Rocky Mountain University of Health Professions, Provo, UT
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Spencer L, Fary R, McKenna L, Ho R, Briffa K. Thoracic kyphosis assessment in postmenopausal women: an examination of the Flexicurve method in comparison to radiological methods. Osteoporos Int 2019; 30:2009-2018. [PMID: 31230111 DOI: 10.1007/s00198-019-05023-5] [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] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2018] [Accepted: 05/17/2019] [Indexed: 11/28/2022]
Abstract
UNLABELLED The Flexicurve ruler is an alternative method to radiographs for measuring thoracic kyphosis (curvature), but it is not certain that it is comparable. This study shows that Flexicurve can estimate radiographic vertebral centroid angles with less error than Cobb angles but that its accuracy would be inadequate for most clinical purposes. INTRODUCTION The Flexicurve ruler provides a non-radiological method of measuring thoracic kyphosis (TK) that has moderately strong correlations with the gold-standard radiographic Cobb angle method, while consistently underestimating the TK angle. Cobb angles can include measurement errors that may contribute to poor agreement, particularly in older populations. The vertebral centroid angle could be a better radiographic reference method for the validation of Flexicurve. Using two separate radiographic measurements of TK, we examined the validity of Flexicurve. We aimed to ascertain the level of agreement between measures and to empirically explore reasons for between-method differences. METHODS TK angles determined using Flexicurve and radiographic Cobb and vertebral centroid methods were compared using data from 117 healthy postmenopausal women (mean (SD) age 61.4 (7.0) years). Bland and Altman plots were used to assess differences between methods. Age, bone mineral density and body mass index were examined as characteristics that might explain any differences. RESULTS Flexicurve angles were scaled prior to analysis. There was no statistically significant difference between angles produced by Flexicurve and vertebral centroid methods (MD - 2.16°, 95%CI - 4.35° to 0.03°) although differences increased proportionally with TK angles. Flexicurve angles were significantly smaller than radiographic Cobb angles and depending on the scaling method used, systematic error ranged between - 2.48° and - 5.19°. Age accounts for some of the differences observed (R2 < 0.08, p < 0.005). CONCLUSIONS TK measured using the Flexicurve shows better agreement with the radiographic vertebral centroid method, but inaccuracy of the Flexicurve increases with increasing angle of kyphosis.
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Affiliation(s)
- L Spencer
- School of Physiotherapy and Exercise Sciences, Curtin University, GPO Box U1987, Perth, WA, 6845, Australia.
| | - R Fary
- School of Physiotherapy and Exercise Sciences, Curtin University, GPO Box U1987, Perth, WA, 6845, Australia
| | - L McKenna
- School of Physiotherapy and Exercise Sciences, Curtin University, GPO Box U1987, Perth, WA, 6845, Australia
| | - R Ho
- Perth Radiological Clinic, Perth, WA, Australia
| | - K Briffa
- School of Physiotherapy and Exercise Sciences, Curtin University, GPO Box U1987, Perth, WA, 6845, Australia
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17
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Fan S, Lippard ET, Sankar A, Wallace A, Johnston JA, Wang F, Pittman B, Spencer L, Oquendo MA, Blumberg HP. Gray and white matter differences in adolescents and young adults with prior suicide attempts across bipolar and major depressive disorders. J Affect Disord 2019; 245:1089-1097. [PMID: 30699851 PMCID: PMC6903411 DOI: 10.1016/j.jad.2018.11.095] [Citation(s) in RCA: 42] [Impact Index Per Article: 8.4] [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: 07/02/2018] [Revised: 09/24/2018] [Accepted: 11/17/2018] [Indexed: 10/27/2022]
Abstract
BACKGROUND Findings regarding brain circuitry abnormalities in suicide attempters (SAs) converge across bipolar disorder (BD) and major depressive disorder (MDD), the most common disorders observed in suicides. These abnormalities appear to be present during adolescence/young adulthood when suicide rates increase steeply, and suicide is a leading cause of death in this age group. Identification of brain circuitry common to adolescent/young adult SAs with BD and MDD is important for generating widely effective early prevention strategies. We examined brain circuitry in SAs in adolescents/young adults across these two disorders. METHODS Eighty-three participants (ages 14-25 years), 46 with BD (21 SAs) and 37 with MDD (19 SAs), underwent structural and diffusion-weighted magnetic resonance scanning. Whole-brain analyses compared gray matter (GM) volume and white matter (WM) fractional anisotropy (FA) between SAs and non-suicide attempters (NSAs) across and within BD and MDD (p < 0.005). RESULTS Across and within BD and MDD, SAs showed differences compared to NSAs in ventral prefrontal cortex (PFC) GM volume and fronto-limbic (including uncinate fasciculus (UF)) WM FA. Exploratory analyses showed additional within-disorder differences for BD SAs in dorsolateral PFC (dlPFC) and hippocampus GM volume and UF FA, and for MDD SAs dorsomedial and dlPFC GM and dorsal frontal WM. However, there was no significant interaction between suicide attempt status and diagnosis. LIMITATIONS Modest sample size. CONCLUSIONS Common fronto-limbic gray and white matter alterations in adolescent/young adult SAs are potential targets for suicide prevention strategies across mood disorders. Preliminary findings of disorder-specific regional findings could suggest diagnostic-specific optimal targets may exist.
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Affiliation(s)
- Siyan Fan
- Departments of Psychiatry, Yale School of Medicine, New Haven, CT, USA.
| | - Elizabeth T.C. Lippard
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA,Department of Radiology and Biomedical Imaging, Yale School of Medicine, New Haven, CT, USA,Department of Psychiatry, Dell Medical School, University of Texas at Austin, Austin, TX, USA
| | - Anjali Sankar
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
| | - Amanda Wallace
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
| | | | - Fei Wang
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
| | - Brian Pittman
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
| | - Linda Spencer
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
| | - Maria A. Oquendo
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania; Philadelphia, PA; USA
| | - Hilary P. Blumberg
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA,Department of Radiology and Biomedical Imaging, Yale School of Medicine, New Haven, CT, USA,Department of Child Study Center, Yale School of Medicine, New Haven, CT, USA
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Dhillon HM, Bell ML, van der Ploeg HP, Turner JD, Kabourakis M, Spencer L, Lewis C, Hui R, Blinman P, Clarke SJ, Boyer MJ, Vardy JL. Impact of physical activity on fatigue and quality of life in people with advanced lung cancer: a randomized controlled trial. Ann Oncol 2018; 28:1889-1897. [PMID: 28459989 DOI: 10.1093/annonc/mdx205] [Citation(s) in RCA: 67] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
Abstract
Background Physical activity (PA) improves fatigue and quality of life (QOL) in cancer survivors. Our aim was to assess whether a 2-month PA intervention improves fatigue and QOL for people with advanced lung cancer. Methods Participants with advanced lung cancer, Eastern Cooperative Oncology Group performance status (PS) ≤2, >6 months life expectancy, and ability to complete six-min walk test, were stratified (disease stage, PS 0-1 versus 2, centre) and randomized (1:1) in an open-label study to usual care (UC) (nutrition and PA education materials) or experimental intervention (EX): UC plus 2-month supervised weekly PA and behaviour change sessions. Assessments occurred at baseline, 2, 4, and 6 months. The primary endpoint was fatigue [Functional Assessment of Cancer Therapy-Fatigue (FACT-F) questionnaire] at 2 months. The study was designed to detect a difference in mean FACT-F subscale score of 6. Analysis was intention-to-treat using linear mixed models. Results We recruited 112 patients: 56 (50.4%) were randomized to EX, 55(49.5%) to UC; 1 ineligible. Male 55%; median age 64 years (34-80); 106 (96%) non-small cell lung cancer; 106 (95.5%) stage IV. At 2, 4 and 6 months, 90, 73 and 62 participants were assessed, respectively, with no difference in attrition between groups. There were no significant differences in fatigue between the groups at 2, 4 or 6 months: mean scores at 2 months EX 37.5, UC 36.4 (difference 1.2, 95% CI - 3.5, 5.8, P = 0.62). There were no significant differences in QOL, symptoms, physical or functional status, or survival. Conclusions Adherence to the intervention was good but the intervention group did not increase their PA enough compared to the control group, and no difference was seen in fatigue or QOL. Trial Registration Australian New Zealand Clinical Trials Registry No. ACTRN12609000971235.
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Affiliation(s)
- H M Dhillon
- Centre for Medical Psychology and Evidence-Based Decision-Making, University of Sydney, Sydney, Australia
| | - M L Bell
- Mel & Enid Zuckerman College of Public Health, University of Arizona, Tucson, USA
| | - H P van der Ploeg
- Department of Public and Occupational Health and EMGO Institute for Health and Care Research, VU University Medical Center Amsterdam, Amsterdam, The Netherlands
| | - J D Turner
- Centre for Medical Psychology and Evidence-Based Decision-Making, University of Sydney, Sydney, Australia
| | - M Kabourakis
- Centre for Medical Psychology and Evidence-Based Decision-Making, University of Sydney, Sydney, Australia
| | - L Spencer
- Physiotherapy Department, Royal Prince Alfred Hospital, Camperdown
| | - C Lewis
- Medical Oncology Department, Prince of Wales Hospital, Randwick
| | - R Hui
- Crown Princess Mary Cancer Centre, Westmead Hospital, Westmead
| | - P Blinman
- Concord Cancer Centre, Concord Repatriation General Hospital, Concord
| | - S J Clarke
- Sydney Medical School, University of Sydney, Sydney
| | - M J Boyer
- Medical Oncology Department, Chris O'Brien Lifehouse, Camperdown, Australia
| | - J L Vardy
- Centre for Medical Psychology and Evidence-Based Decision-Making, University of Sydney, Sydney, Australia.,Concord Cancer Centre, Concord Repatriation General Hospital, Concord.,Sydney Medical School, University of Sydney, Sydney
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Weathers J, Lippard ETC, Spencer L, Pittman B, Wang F, Blumberg HP. Longitudinal Diffusion Tensor Imaging Study of Adolescents and Young Adults With Bipolar Disorder. J Am Acad Child Adolesc Psychiatry 2018; 57:111-117. [PMID: 29413143 PMCID: PMC5806147 DOI: 10.1016/j.jaac.2017.11.014] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2017] [Revised: 10/04/2017] [Accepted: 11/21/2017] [Indexed: 01/04/2023]
Abstract
OBJECTIVE Longitudinal neuroimaging during adolescence/young adulthood, when bipolar disorder (BD) commonly emerges, can help elucidate the neurodevelopmental pathophysiology of BD. Adults with BD have shown reduced structural integrity in the uncinate fasciculus (UF), a white matter (WM) tract providing major connections between the amygdala and ventral prefrontal cortex (vPFC), important in emotion regulation. In this longitudinal diffusion tensor imaging (DTI) study of adolescents/young adults, we hypothesized differences in age- and time-related changes in UF integrity in BD compared to healthy controls (HC). METHOD Two DTI scans were obtained in 27 adolescents/young adults with BD and 37 HC adolescents/young adults, on average approximately 2.5 years apart. Interactions between diagnosis with age and with time for UF fractional anisotropy (FA) were assessed. Exploratory analyses were performed including euthymic-only participants with BD, and for potential influences of demographic and clinical factors. Whole-brain analyses were performed to explore for interactions in other regions. RESULTS There were significant interactions between diagnosis with age and with time for UF FA (p < .05). Healthy control adolescents/young adults showed significant UF FA increases with age and over time (p < .05), whereas no significant changes with age or over time were observed in the adolescents/young adults with BD. Significant interactions with age and time were also observed in analyses including euthymic-only participants with BD (p < .05). CONCLUSION These findings provide neuroimaging evidence supporting differences in UF WM structural development during adolescence/young adulthood, suggesting that differences in the development of an amygdala-vPFC system subserving emotion regulation may be a trait feature of BD neurodevelopment.
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Affiliation(s)
- Judah Weathers
- Yale School of Medicine, New Haven, CT; Yale Child Study Center, New Haven
| | - Elizabeth T C Lippard
- Yale School of Medicine, New Haven, CT; Dell Medical School, University of Texas at Austin, TX
| | | | | | - Fei Wang
- Yale School of Medicine, New Haven, CT; First Affiliated Hospital, China Medical University, Shenyang, China
| | - Hilary P Blumberg
- Yale School of Medicine, New Haven, CT; Yale Child Study Center, New Haven.
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20
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Lippard ETC, Mazure CM, Johnston JAY, Spencer L, Weathers J, Pittman B, Wang F, Blumberg HP. Brain circuitry associated with the development of substance use in bipolar disorder and preliminary evidence for sexual dimorphism in adolescents. J Neurosci Res 2017; 95:777-791. [PMID: 27870392 DOI: 10.1002/jnr.23901] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [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: 04/01/2016] [Revised: 07/29/2016] [Accepted: 08/05/2016] [Indexed: 02/06/2023]
Abstract
Substance use disorders and mood disorders are highly comorbid and confer a high risk for adverse outcomes. However, data are limited on the neurodevelopmental basis of this comorbidity. Substance use initiation typically occurs during adolescence, and sex-specific developmental mechanisms are implicated. In this preliminary study, we review the literature and investigate regional gray matter volume (GMV) associated with subsequent substance use problems in adolescents with bipolar disorder (BD) and explore these associations for females and males. Thirty adolescents with DSM-IV-diagnosed BD and minimal alcohol/substance exposure completed baseline structural magnetic resonance imaging scans. At follow-up (on average 6 years post baseline), subjects were administered the CRAFFT interview and categorized into those scoring at high ( ≥ 2: CRAFFTHIGH ) vs. low ( < 2: CRAFFTLOW ) risk for alcohol/substance problems. Lower GMV in prefrontal, insular, and temporopolar cortices were observed at baseline among adolescents with BD reporting subsequent alcohol and cannabis use compared to adolescents with BD who did not (P < 0.005, clusters ≥ 20 voxels). Lower dorsolateral prefrontal GMV was associated with future substance use in both females and males. In females, lower orbitofrontal and insula GMV was associated with future substance use, while in males, lower rostral prefrontal GMV was associated with future use. Lower orbitofrontal, insular, and temporopolar GMV was observed in those who transitioned to smoking tobacco. Findings indicate that GMV development is associated with risk for future substance use problems in adolescents with BD, with results implicating GMV development in regions subserving emotional regulation in females and regions subserving executive processes and attention in males. © 2016 Wiley Periodicals, Inc.
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Affiliation(s)
- Elizabeth T C Lippard
- Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut.,Department of Radiology and Biomedical Imaging, Yale School of Medicine, New Haven, Connecticut
| | - Carolyn M Mazure
- Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut.,Women's Health Research at Yale, Yale School of Medicine, New Haven, Connecticut
| | | | - Linda Spencer
- Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut
| | - Judah Weathers
- Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut.,Child Study Center, Yale School of Medicine, New Haven, Connecticut
| | - Brian Pittman
- Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut
| | - Fei Wang
- Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut
| | - Hilary P Blumberg
- Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut.,Department of Radiology and Biomedical Imaging, Yale School of Medicine, New Haven, Connecticut.,Women's Health Research at Yale, Yale School of Medicine, New Haven, Connecticut.,Child Study Center, Yale School of Medicine, New Haven, Connecticut
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21
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Lippard ETC, Jensen KP, Wang F, Johnston JAY, Spencer L, Pittman B, Gelernter J, Blumberg HP. Effects of ANK3 variation on gray and white matter in bipolar disorder. Mol Psychiatry 2017; 22:1345-1351. [PMID: 27240527 PMCID: PMC5133179 DOI: 10.1038/mp.2016.76] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2015] [Revised: 02/23/2016] [Accepted: 04/05/2016] [Indexed: 01/22/2023]
Abstract
The single-nucleotide polymorphism rs9804190 in the Ankyrin G (ANK3) gene has been reported in genome-wide association studies to be associated with bipolar disorder (BD). However, the neural system effects of rs9804190 in BD are not known. We investigated associations between rs9804190 and gray and white matter (GM and WM, respectively) structure within a frontotemporal neural system implicated in BD. A total of 187 adolescent and adult European Americans were studied: a group homozygous for the C allele (52 individuals with BD and 56 controls) and a T-carrier group, carrying the high-risk T allele (38 BD and 41 controls). Subjects participated in high-resolution structural magnetic resonance imaging and diffusion tensor imaging (DTI) scanning. Frontotemporal region of interest (ROI) and whole-brain exploratory analyses were conducted. DTI ROI-based analysis revealed a significant diagnosis by genotype interaction within the uncinate fasciculus (P⩽0.05), with BD subjects carrying the T (risk) allele showing decreased fractional anisotropy compared with other subgroups, independent of age. Genotype effects were not observed in frontotemporal GM volume. These findings support effects of rs9804190 on frontotemporal WM in adolescents and adults with BD and suggest a mechanism contributing to WM pathology in BD.
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Affiliation(s)
- Elizabeth Thomas Cox Lippard
- Deparment of Psychiatry, Yale School of Medicine, New Haven, CT,Department of Radiology and Biomedical Imaging, Yale School of Medicine, New Haven, CT
| | - Kevin Patrick Jensen
- Deparment of Psychiatry, Yale School of Medicine, New Haven, CT,Department of Psychiatry, VA Connecticut Healthcare System, West Haven, CT
| | - Fei Wang
- Deparment of Psychiatry, Yale School of Medicine, New Haven, CT
| | | | - Linda Spencer
- Deparment of Psychiatry, Yale School of Medicine, New Haven, CT
| | - Brian Pittman
- Deparment of Psychiatry, Yale School of Medicine, New Haven, CT
| | - Joel Gelernter
- Deparment of Psychiatry, Yale School of Medicine, New Haven, CT,Department of Psychiatry, VA Connecticut Healthcare System, West Haven, CT
| | - Hilary Patricia Blumberg
- Deparment of Psychiatry, Yale School of Medicine, New Haven, CT,Department of Radiology and Biomedical Imaging, Yale School of Medicine, New Haven, CT,Department of Psychiatry, VA Connecticut Healthcare System, West Haven, CT
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22
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Lippard ETC, Jensen KP, Wang F, Johnston JAY, Spencer L, Pittman B, Gelernter J, Blumberg HP. Genetic variation of ANK3 is associated with lower white matter structural integrity in bipolar disorder. Mol Psychiatry 2017; 22:1225. [PMID: 28831200 DOI: 10.1038/mp.2017.169] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Affiliation(s)
- E T C Lippard
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA.,Department of Radiology and Biomedical Imaging, Yale School of Medicine, New Haven, CT, USA
| | - K P Jensen
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA.,Department of Psychiatry, VA Connecticut Healthcare System, West Haven, CT, USA
| | - F Wang
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
| | - J A Y Johnston
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
| | - L Spencer
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
| | - B Pittman
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
| | - J Gelernter
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA.,Department of Psychiatry, VA Connecticut Healthcare System, West Haven, CT, USA
| | - H P Blumberg
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA.,Department of Radiology and Biomedical Imaging, Yale School of Medicine, New Haven, CT, USA.,Department of Psychiatry, VA Connecticut Healthcare System, West Haven, CT, USA
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23
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Johnston JAY, Wang F, Liu J, Blond BN, Wallace A, Liu J, Spencer L, Cox Lippard ET, Purves KL, Landeros-Weisenberger A, Hermes E, Pittman B, Zhang S, King R, Martin A, Oquendo MA, Blumberg HP. Multimodal Neuroimaging of Frontolimbic Structure and Function Associated With Suicide Attempts in Adolescents and Young Adults With Bipolar Disorder. Am J Psychiatry 2017; 174:667-675. [PMID: 28135845 PMCID: PMC5939580 DOI: 10.1176/appi.ajp.2016.15050652] [Citation(s) in RCA: 146] [Impact Index Per Article: 20.9] [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] [Indexed: 11/30/2022]
Abstract
OBJECTIVE Bipolar disorder is associated with high risk for suicidal behavior that often develops in adolescence and young adulthood. Elucidation of involved neural systems is critical for prevention. This study of adolescents and young adults with bipolar disorder with and without a history of suicide attempts combines structural, diffusion tensor, and functional MR imaging methods to investigate implicated abnormalities in the morphology and structural and functional connectivity within frontolimbic systems. METHOD The study had 26 participants with bipolar disorder who had a prior suicide attempt (the attempter group) and 42 participants with bipolar disorder without a suicide attempt (the nonattempter group). Regional gray matter volume, white matter integrity, and functional connectivity during processing of emotional stimuli were compared between groups, and differences were explored for relationships between imaging modalities and associations with suicide-related symptoms and behaviors. RESULTS Compared with the nonattempter group, the attempter group showed significant reductions in gray matter volume in the orbitofrontal cortex, hippocampus, and cerebellum; white matter integrity in the uncinate fasciculus, ventral frontal, and right cerebellum regions; and amygdala functional connectivity to the left ventral and right rostral prefrontal cortex. In exploratory analyses, among attempters, there was a significant negative correlation between right rostral prefrontal connectivity and suicidal ideation and between left ventral prefrontal connectivity and attempt lethality. CONCLUSIONS Adolescent and young adult suicide attempters with bipolar disorder demonstrate less gray matter volume and decreased structural and functional connectivity in a ventral frontolimbic neural system subserving emotion regulation. Among attempters, reductions in amygdala-prefrontal functional connectivity may be associated with severity of suicidal ideation and attempt lethality.
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Affiliation(s)
| | - Fei Wang
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, US
| | - Jie Liu
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, US
| | - Benjamin N. Blond
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, US
| | - Amanda Wallace
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, US
| | - Jiacheng Liu
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, US
| | - Linda Spencer
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, US
| | | | - Kirstin L. Purves
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, US,Division of Psychology and Language Sciences, University College London, London, UK
| | - Angeli Landeros-Weisenberger
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, US,Child Study Center, Yale School of Medicine, New Haven, CT, USA
| | - Eric Hermes
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, US
| | - Brian Pittman
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, US
| | - Sheng Zhang
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, US
| | - Robert King
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, US,Child Study Center, Yale School of Medicine, New Haven, CT, USA
| | - Andrés Martin
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, US,Child Study Center, Yale School of Medicine, New Haven, CT, USA
| | - Maria A. Oquendo
- Department of Psychiatry, Columbia University, New York, NY, USA
| | - Hilary P. Blumberg
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, US,Child Study Center, Yale School of Medicine, New Haven, CT, USA
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24
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Bourdette DN, Edmonds E, Smith C, Bowen JD, Guttmann CRG, Nagy ZP, Simon J, Whitham R, Lovera J, Yadav V, Mass M, Spencer L, Culbertson N, Bartholomew RM, Theofan G, Milano J, Offner H, Vandenbark AA. A highly immunogenic trivalent T cell receptor peptide vaccine for multiple sclerosis. Mult Scler 2016; 11:552-61. [PMID: 16193893 DOI: 10.1191/1352458505ms1225oa] [Citation(s) in RCA: 53] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Background: T cell receptor (TCR) peptide vaccination is a novel approach to treating multiple sclerosis (MS). The low immunogenicity of previous vaccines has hindered the development of TCR peptide vaccination for MS. Objective: To compare the immunogenicity of intramuscular injections of TCR BV5S2, BV6S5 and BV13S1 CDR2 peptides in incomplete Freund’s adjuvant (IFA) with intradermal injections of the same peptides without IFA. Methods: MS subjects were randomized to receive TCR peptides/IFA, TCR peptides/saline or IFA alone. Subjects were on study for 24 weeks. Results: The TCR peptides/IFA vaccine induced vigorous T cell responses in 100% of subjects completing the 24-week study (9/9) compared with only 20% (2/10) of those receiving the TCR peptides/saline vaccine (P =0.001). IFA alone induced a weak response in only one of five subjects. Aside from injection site reactions, there were no significant adverse events attributable to the treatment. Conclusions: The trivalent TCR peptide in IFA vaccine represents a significant improvement in immunogenicity over previous TCR peptide vaccines and warrants investigation of its ability to treat MS.
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Affiliation(s)
- D N Bourdette
- Department of Neurology L226, School of Medicine, Oregon Health & Science University, Portland, OR 97239, USA.
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Najt P, Wang F, Spencer L, Johnston JAY, Cox Lippard ET, Pittman BP, Lacadie C, Staib LH, Papademetris X, Blumberg HP. Anterior Cortical Development During Adolescence in Bipolar Disorder. Biol Psychiatry 2016; 79:303-10. [PMID: 26033826 PMCID: PMC4595154 DOI: 10.1016/j.biopsych.2015.03.026] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [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: 09/01/2014] [Revised: 03/25/2015] [Accepted: 03/29/2015] [Indexed: 12/23/2022]
Abstract
BACKGROUND Increasing evidence supports a neurodevelopmental model for bipolar disorder (BD), with adolescence as a critical period in its development. Developmental abnormalities of anterior paralimbic and heteromodal frontal cortices, key structures in emotional regulation processes and central in BD, are implicated. However, few longitudinal studies have been conducted, limiting understanding of trajectory alterations in BD. In this study, we performed longitudinal neuroimaging of adolescents with and without BD and assessed volume changes over time, including changes in tissue overall and within gray and white matter. Larger decreases over time in anterior cortical volumes in the adolescents with BD were hypothesized. Gray matter decreases and white matter increases are typically observed during adolescence in anterior cortices. It was hypothesized that volume decreases over time in BD would reflect alterations in those processes, showing larger gray matter contraction and decreased white matter expansion. METHODS Two high-resolution magnetic resonance imaging scans were obtained approximately 2 years apart for 35 adolescents with bipolar I disorder (BDI) and 37 healthy adolescents. Differences over time between groups were investigated for volume overall and specifically for gray and white matter. RESULTS Relative to healthy adolescents, adolescents with BDI showed greater volume contraction over time in a region including insula and orbitofrontal, rostral, and dorsolateral prefrontal cortices (p < .05, corrected), including greater gray matter contraction and decreased white matter expansion over time, in the BD compared with the healthy group. CONCLUSIONS The findings support neurodevelopmental abnormalities during adolescence in BDI in anterior cortices, including altered developmental trajectories of anterior gray and white matter.
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Affiliation(s)
- Pablo Najt
- Departments of Psychiatry, New Haven, Connecticut
| | - Fei Wang
- Departments of Psychiatry, New Haven, Connecticut
| | | | | | | | | | | | - Lawrence H Staib
- Diagnostic Radiology, New Haven, Connecticut.; Electrical Engineering, New Haven, Connecticut
| | - Xenophon Papademetris
- Diagnostic Radiology, New Haven, Connecticut.; Biomedical Engineering, New Haven, Connecticut
| | - Hilary P Blumberg
- Departments of Psychiatry, New Haven, Connecticut.; Diagnostic Radiology, New Haven, Connecticut.; Child Study Center, Yale School of Medicine, New Haven, Connecticut..
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Spencer L, Illingworth S, Whyand T, Walker K. LB022-MON: An Audit of Compliance, Validity And Reliability of a Nutrition Screening Tool Used in The Acute Hospital Setting. Clin Nutr 2014. [DOI: 10.1016/s0261-5614(14)50680-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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27
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Jay AM, Conway RL, Feldman GL, Nahhas F, Spencer L, Wolf B. Outcomes of individuals with profound and partial biotinidase deficiency ascertained by newborn screening in Michigan over 25 years. Genet Med 2014; 17:205-9. [DOI: 10.1038/gim.2014.104] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2014] [Accepted: 07/07/2014] [Indexed: 11/09/2022] Open
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Li H, Spencer L, Nahhas F, Miller J, Fribley A, Feldman G, Conway R, Wolf B. Novel mutations causing biotinidase deficiency in individuals identified by newborn screening in Michigan including an unique intronic mutation that alters mRNA expression of the biotinidase gene. Mol Genet Metab 2014; 112:242-6. [PMID: 24797656 DOI: 10.1016/j.ymgme.2014.04.002] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [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: 02/26/2014] [Revised: 04/08/2014] [Accepted: 04/08/2014] [Indexed: 10/25/2022]
Abstract
Biotinidase deficiency (BD) is an autosomal recessive disorder resulting in the inability to recycle the vitamin biotin. Individuals with biotinidase deficiency can develop neurological and cutaneous symptoms if they are not treated with biotin. To date, more than 165 mutations in the biotinidase gene (BTD) have been reported. Essentially all the mutations result in enzymatic activities with less than 10% of mean normal serum enzyme activity (profound biotinidase deficiency) with the exception of the c.1330G>C (p.D444H) mutation, which results in an enzyme having 50% of mean normal serum activity and causes partial biotinidase deficiency (10-30% of mean normal serum biotinidase activity) if there is a mutation for profound biotinidase deficiency on the second allele. We now reported eight novel mutations in ten children identified by newborn screening in Michigan from 1988 to the end of 2012. Interestingly, one intronic mutation, c.310-15delT, results in an approximately two-fold down-regulation of BTD mRNA expression by Quantitative real-time reverse-transcription PCR (qRT-PCR). This is the first report of an intronic mutation in the BTD gene with demonstration of its effect on enzymatic activity by altering mRNA expression. This study identified three other mutations likely to cause partial biotinidase deficiency. These results emphasize the importance of full gene sequencing of BTD on patients with biotinidase deficiency to better understand the genotype and phenotype correlation in the future.
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Affiliation(s)
- H Li
- Carmen and Ann Adams Department of Pediatrics, Children's Hospital of Michigan, Wayne State University School of Medicine, Detroit, MI 48201, USA; Center for Molecular Medicine and Genetics, Wayne State University, Detroit, MI 48201, USA
| | - L Spencer
- Carmen and Ann Adams Department of Pediatrics, Children's Hospital of Michigan, Wayne State University School of Medicine, Detroit, MI 48201, USA; Center for Molecular Medicine and Genetics, Wayne State University, Detroit, MI 48201, USA
| | - F Nahhas
- Department of Pathology, Wayne State University School of Medicine, Detroit, MI 48201, USA; Molecular Genetics Laboratory, Detroit Medical Center University Laboratories, Detroit, MI 48201, USA
| | - J Miller
- Carmen and Ann Adams Department of Pediatrics, Children's Hospital of Michigan, Wayne State University School of Medicine, Detroit, MI 48201, USA; The Molecular Therapeutics Program, Barbara Ann Karmanos Cancer Institute, Detroit, MI 48201, USA
| | - A Fribley
- Carmen and Ann Adams Department of Pediatrics, Children's Hospital of Michigan, Wayne State University School of Medicine, Detroit, MI 48201, USA; The Molecular Therapeutics Program, Barbara Ann Karmanos Cancer Institute, Detroit, MI 48201, USA
| | - G Feldman
- Carmen and Ann Adams Department of Pediatrics, Children's Hospital of Michigan, Wayne State University School of Medicine, Detroit, MI 48201, USA; Center for Molecular Medicine and Genetics, Wayne State University, Detroit, MI 48201, USA
| | - R Conway
- Carmen and Ann Adams Department of Pediatrics, Children's Hospital of Michigan, Wayne State University School of Medicine, Detroit, MI 48201, USA; Center for Molecular Medicine and Genetics, Wayne State University, Detroit, MI 48201, USA
| | - B Wolf
- Center for Molecular Medicine and Genetics, Wayne State University, Detroit, MI 48201, USA; Genetics Research Laboratory of the Department of Research Administration, Henry Ford Hospital, Detroit, MI 48202, USA.
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Wright A, Helm J, Spencer L, Leonard C, Bishop P, Greaves M, Chaudhuri N. S12 Interstitial lung disease multidisciplinary discussion: six years of data from a tertiary service. Thorax 2013. [DOI: 10.1136/thoraxjnl-2013-204457.18] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Abstract
OBJECTIVES To investigate the process of speech development in five 42-month-old children with profound deafness who received cochlear implants (CIs) between 19 and 36 months of age and five normal hearing (NH) age mates. METHODS Conversational samples were collected and transcribed. Sounds produced correctly within meaningful words (target sounds) and recognizable sounds produced in spontaneous productions (target-less sounds) were analyzed for all 10 children. RESULTS Revealed that there was overlap in the total number of vowels and consonants produced by the two groups. The differences between the two groups were more evident in the target condition, whereas the two groups were more similar in the target-less condition. DISCUSSION The similarities documented in the target-less repertoire of CI and NH children underscore the importance of examining the emerging sound system to predict the end-point sound system in children with CIs. Using target and target-less speech sound comparisons offers a supplementary view of the emergent process of speech sound development and is a valid method of analysis. Results suggest that early implantation may help some children with profound deafness develop speech sounds in a manner similar to NH age mates.
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Spencer L, Briffa K. Breast size, thoracic kyphosis & thoracic spine pain - association & relevance of bra fitting in post-menopausal women: a correlational study. Chiropr Man Therap 2013; 21:20. [PMID: 23816160 PMCID: PMC3704920 DOI: 10.1186/2045-709x-21-20] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [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: 09/05/2012] [Accepted: 06/24/2013] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Menopause would seem to exist as a period of accelerated changes for women and their upper torso mechanics. Whether these anthropometric changes reflect changes in pain states remains unclear. Plausible mechanisms of pain exist for the independent and combined effect of increasing breast size and thoracic kyphosis. Bra fit has the potential to change when the anthropometric measures (chest circumference and bust circumference) used to determine bra size change, such as postmenopausally.Identifying an association between breast size, thoracic kyphosis and thoracic spine pain in postmenopausal women and identifying the relevance of bra fit to this association may be of importance to the future management and education of post-menopausal women presenting clinically with thoracic spine pain. METHODS A cross-sectional study design. Fifty-one postmenopausal bra-wearing women were recruited. Measures included breast size (Triumph International), thoracic kyphosis (flexible curve), bra fitted (Y/N) and pain (Short Form McGill Pain Questionnaire) and tenderness on palpation (posteroanterior pressure testing). These measures were collected in one session at a physiotherapy clinic. RESULTS The majority of the women in this study were overweight or obese and wearing an incorrect sized bra. Pain was significantly related to breast size, body weight and BMI at mid thoracic levels (T7-8). In contrast self-reported thoracic pain was not correlated with age or index of kyphosis (thoracic kyphosis). Women with thoracic pain were no more likely to have their bra professionally fitted whereas women with a higher BMI and larger breasts were more likely to have their bra professionally fitted. CONCLUSION The findings of this study show that larger breasts and increased BMI are associated with thoracic pain in postmenopausal women. This is unrelated to thoracic kyphosis. Increasing breast size and how a bra is worn may have biomechanical implications for the loaded thoracic spine and surrounding musculature. Post-menopause women present with a spectrum of anthropometrical changes that have the potential to contribute to altered biomechanics and affect pain states in the thoracic spine.
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Affiliation(s)
- Linda Spencer
- School of Physiotherapy, Faculty of Health Sciences, Curtin University, Bentley Campus, Perth, Western Australia
| | - Kathy Briffa
- School of Physiotherapy, Faculty of Health Sciences, Curtin University, Bentley Campus, Perth, Western Australia
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Wang F, Bobrow L, Liu J, Spencer L, Blumberg HP. Corticolimbic functional connectivity in adolescents with bipolar disorder. PLoS One 2012; 7:e50177. [PMID: 23185566 PMCID: PMC3503984 DOI: 10.1371/journal.pone.0050177] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2012] [Accepted: 10/22/2012] [Indexed: 11/19/2022] Open
Abstract
Convergent evidence supports regional dysfunction within a corticolimbic neural system that subserves emotional processing and regulation in adolescents and adults with bipolar disorder (BD), with abnormalities prominent within the amygdala and its major anterior paralimbic cortical connection sites including ventral anterior cingulate, orbitofrontal, insular and temporopolar cortices. Recent studies of adults with BD demonstrate abnormalities in the functional connectivity between the amygdala and anterior paralimbic regions suggesting an important role for the connections between these regions in the development of the disorder. This study tests the hypothesis that these functional connectivity abnormalities are present in adolescents with BD. Fifty-seven adolescents, twenty-one with BD and thirty-six healthy comparison (HC) adolescents, participated in functional magnetic resonance imaging while processing emotional face stimuli. The BD and HC groups were compared in the strength of functional connectivity from amygdala to the anterior paralimbic cortical regions, and explored in remaining brain regions. Functional connectivity was decreased in the BD group, compared to the HC group, during processing of emotional faces in ventral anterior cingulate (VACC), orbitofrontal, insular and temporopolar cortices (p<0.005). Orbitofrontal and VACC findings for the happy condition, and additionally right insula for the neutral condition, survived multiple comparison correction. Exploratory analyses did not reveal additional regions of group differences. This study provides evidence for decreased functional connectivity between the amygdala and anterior paralimbic cortices in adolescents with BD. This suggests that amygdala-anterior paralimbic connectivity abnormalities are early features of BD that emerge at least by adolescence in the disorder.
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Affiliation(s)
- Fei Wang
- Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut, United States of America
| | - Laurel Bobrow
- Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut, United States of America
| | - Jie Liu
- Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut, United States of America
| | - Linda Spencer
- Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut, United States of America
| | - Hilary P. Blumberg
- Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut, United States of America
- Child Study Center, Yale School of Medicine, New Haven, Connecticut, United States of America
- Department of Diagnostic Radiology, Yale School of Medicine, New Haven, Connecticut, United States of America
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Abstract
OBJECTIVES Convergent evidence supports limbic, anterior paralimbic, and prefrontal cortex (PFC) abnormalities in emotional processing in bipolar disorder (BD) and suggests that some abnormalities are mood-state dependent and others persist into euthymia. However, few studies have assessed elevated, depressed, and euthymic mood states while individuals processed emotional stimuli of varying valence to investigate trait- and state-related neural system responses. Here, regional brain responses to positive, negative, and neutral emotional stimuli were assessed in individuals with BD during elevated, depressed, and euthymic mood states. METHODS One hundred and thirty-four subjects participated in functional magnetic resonance imaging scanning while processing faces depicting happy, fearful, and neutral expressions: 76 with BD (18 in elevated mood states, 19 depressed, 39 euthymic) and 58 healthy comparison (HC) individuals. Analyses were performed for BD trait- and mood state-related features. RESULTS Ventral anterior cingulate cortex (VACC), orbitofrontal cortex (OFC), and ventral striatum responses to happy and neutral faces were decreased in the BD group, compared to the HC group, and were not influenced by mood state. Elevated mood states were associated with decreased right rostral PFC activation to fearful and neutral faces, and depression was associated with increased left OFC activation to fearful faces. CONCLUSIONS The findings suggest that abnormal VACC, OFC, and ventral striatum responses to happy and neutral stimuli are trait features of BD. Acute mood states may be associated with additional lateralized abnormalities of diminished right rostral PFC responses to fearful and neutral stimuli in elevated states and increased left OFC responses to fearful stimuli in depressed states.
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Affiliation(s)
- Jie Liu
- Department of Psychiatry, Yale School of Medicine, New Haven
| | | | | | - Linda Spencer
- Department of Psychiatry, Yale School of Medicine, New Haven
| | - Fei Wang
- Department of Psychiatry, Yale School of Medicine, New Haven
| | - Hilary P. Blumberg
- Department of Psychiatry, Yale School of Medicine, New Haven,Department of Diagnostic Radiology, Yale School of Medicine, New Haven,The Child Study Center, Yale School of Medicine, New Haven,Research Enhancement Award Program Depression Center, Veterans Affairs Connecticut Healthcare System, West Haven, CT, USA
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Chepenik LG, Wang F, Spencer L, Spann M, Kalmar JH, Womer F, Kale Edmiston E, Pittman B, Blumberg HP. Structure-function associations in hippocampus in bipolar disorder. Biol Psychol 2012; 90:18-22. [PMID: 22342942 DOI: 10.1016/j.biopsycho.2012.01.008] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2010] [Revised: 09/19/2011] [Accepted: 01/28/2012] [Indexed: 01/22/2023]
Abstract
Hippocampus volume decreases and verbal memory deficits have been reported in bipolar disorder (BD) as independent observations. We investigated potential associations between these deficits in subjects with BD. Hippocampus volumes were measured on magnetic resonance images of 31 subjects with BD and 32 healthy comparison (HC) subjects. The California Verbal Learning Test-Second Edition (CVLT) assessed verbal memory function in these subjects. Compared to the HC group, the BD group showed both significantly smaller hippocampus volumes and impaired performance on CVLT tests of immediate, short delay and long delay cued and free recall. Further, smaller hippocampus volume correlated with impaired performance in BD. Post hoc analyses revealed a trend towards improved memory in BD subjects taking antidepressant medications. These results support associations between morphological changes in hippocampus structure in BD and verbal memory impairment. They provide preliminary evidence pharmacotherapy may reverse hippocampus-related memory deficits.
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Affiliation(s)
- Lara G Chepenik
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, United States
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35
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Edmiston EE, Wang F, Kalmar JH, Womer FY, Chepenik LG, Pittman B, Gueorguieva R, Hur E, Spencer L, Staib LH, Constable RT, Fulbright RK, Papademetris X, Blumberg HP. Lateral ventricle volume and psychotic features in adolescents and adults with bipolar disorder. Psychiatry Res 2011; 194:400-402. [PMID: 22041535 PMCID: PMC3225709 DOI: 10.1016/j.pscychresns.2011.07.005] [Citation(s) in RCA: 17] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2010] [Revised: 06/27/2011] [Accepted: 07/09/2011] [Indexed: 11/26/2022]
Abstract
This magnetic resonance imaging study demonstrates increased lateral ventricle volume (LVV) in adolescents and adults with bipolar disorder (BD) with psychotic symptoms, but not without psychosis, compared to healthy adolescents and adults. This suggests LVV is a morphologic feature associated with psychosis in BD, present by adolescence.
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Affiliation(s)
- Erin E. Edmiston
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
| | - Fei Wang
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA,Department of Psychiatry, Veterans Affairs, West Haven, CT, USA
| | - Jessica H. Kalmar
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
| | - Fay Y. Womer
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
| | - Lara G. Chepenik
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA,Department of Psychiatry, Veterans Affairs, West Haven, CT, USA
| | - Brian Pittman
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
| | - Ralitza Gueorguieva
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA,Department of Epidemiology and Public Health, Yale School of Medicine, New Haven, CT, USA
| | - Esther Hur
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
| | - Linda Spencer
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
| | - Lawrence H. Staib
- Department of Diagnostic Radiology, Yale School of Medicine, New Haven, CT, USA
| | - R. Todd Constable
- Department of Diagnostic Radiology, Yale School of Medicine, New Haven, CT, USA
| | - Robert K. Fulbright
- Department of Diagnostic Radiology, Yale School of Medicine, New Haven, CT, USA
| | | | - Hilary P. Blumberg
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA,Department of Diagnostic Radiology, Yale School of Medicine, New Haven, CT, USA,Child Study Center, Yale School of Medicine, New Haven, CT, USA,Department of Psychiatry, Veterans Affairs, West Haven, CT, USA,Hilary Blumberg, M.D., Yale Department of Psychiatry, 300 George Street, New Haven, CT 06511, 203-785-6180,
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Kaplan BG, Connor A, Ferranti EP, Holmes L, Spencer L. Use of an Emergency Preparedness Disaster Simulation With Undergraduate Nursing Students. Public Health Nurs 2011; 29:44-51. [DOI: 10.1111/j.1525-1446.2011.00960.x] [Citation(s) in RCA: 50] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Wang F, Kalmar JH, Womer FY, Edmiston EE, Chepenik LG, Chen R, Spencer L, Blumberg HP. Olfactocentric paralimbic cortex morphology in adolescents with bipolar disorder. Brain 2011; 134:2005-12. [PMID: 21666263 DOI: 10.1093/brain/awr124] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
The olfactocentric paralimbic cortex plays a critical role in the regulation of emotional and neurovegetative functions that are disrupted in core features of bipolar disorder. Adolescence is thought to be a critical period in both the maturation of the olfactocentric paralimbic cortex and in the emergence of bipolar disorder pathology. Together, these factors implicate a central role for the olfactocentric paralimbic cortex in the development of bipolar disorder and suggest that abnormalities in this cortex may be expressed by adolescence in the disorder. We tested the hypothesis that differences in olfactocentric paralimbic cortex structure are a morphological feature in adolescents with bipolar disorder. Subjects included 118 adolescents (41 with bipolar disorder and 77 healthy controls). Cortical grey matter volume differences between adolescents with and without bipolar disorder were assessed with voxel-based morphometry analyses of high-resolution structural magnetic resonance imaging scans. Compared with healthy comparison adolescents, adolescents with bipolar disorder demonstrated significant volume decreases in olfactocentric paralimbic regions, including orbitofrontal, insular and temporopolar cortices. Findings in these regions survived small volume correction (P < 0.05, corrected). Volume decreases in adolescents with bipolar disorder were also noted in inferior prefrontal and superior temporal gyri and cerebellum. The findings suggest that abnormalities in the morphology of the olfactocentric paralimbic cortex may contribute to the bipolar disorder phenotype that emerges in adolescence. The morphological development of the olfactocentric paralimbic cortex has received little study. The importance of these cortices in emotional and social development, and support for a central role for these cortices in the development of bipolar disorder, suggest that study of the development of these cortices in health and in bipolar disorder is critically needed.
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Affiliation(s)
- Fei Wang
- Department of Psychiatry, Yale School of Medicine, New Haven, CT 06511, USA
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Arber A, Spencer L, Parker A. 'It's all bad news': the first 3 months following a diagnosis of malignant pleural mesothelioma (MPM). BMJ Support Palliat Care 2011. [DOI: 10.1136/bmjspcare-2011-000020.41] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Stephenson JA, Al-Taan O, Spencer L, Metcalfe M, Dennison A, Morgan B. The effect of omega-3 fatty acid infusion on magnetic resonance imaging biomarkers of angiogenesis in colorectal liver metastases: A randomised controlled trial. Eur J Surg Oncol 2010. [DOI: 10.1016/j.ejso.2010.08.078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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Womer FY, Wang F, Chepenik LG, Kalmar JH, Spencer L, Edmiston E, Pittman BP, Constable RT, Papademetris X, Blumberg HP. Sexually dimorphic features of vermis morphology in bipolar disorder. Bipolar Disord 2009; 11:753-8. [PMID: 19839998 PMCID: PMC2844245 DOI: 10.1111/j.1399-5618.2009.00745.x] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.8] [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] [Indexed: 11/28/2022]
Abstract
OBJECTIVES The cerebellar vermis is increasingly implicated in bipolar disorder (BD). In this study, we investigated vermis morphology in BD using a quantitative volumetric analysis. METHODS Volumes for total vermis and vermis subregions V1 (lobules I-V), V2 (lobules VI-VII), and V3 (lobules VIII-X) were calculated using high-resolution structural magnetic resonance imaging obtained from 44 individuals with BD (25 females and 19 males) and 43 healthy comparison (HC) subjects (26 females and 17 males). Total vermis volumes were compared between the BD and HC groups. Potential effects of vermis subregions and clinical features were explored. RESULTS Total vermis volumes were significantly larger in the BD group than in the HC group (p = 0.02). There was a significant group-by-sex interaction (p = 0.02). Total vermis volumes were significantly larger in males with BD than HC males (p = 0.004); vermis volumes did not differ significantly between females with and without BD (p = 0.95). Subregion analyses showed a trend-level interaction between diagnosis and subregion (p = 0.07) in which subregion V1 volumes were significantly larger in BD participants (p = 0.001), with differences primarily driven by males (p = 0.001). CONCLUSIONS Our findings demonstrate increases in cerebellar vermis volumes in males with BD. These findings support the presence of structural alterations in the cerebellar vermis in BD and furthermore the influence of sex on such changes.
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Affiliation(s)
- Fay Y. Womer
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT
| | - Fei Wang
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT,Department of Psychiatry, Veterans Affairs Connecticut Healthcare System, West Haven, CT
| | - Lara G. Chepenik
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT,Department of Psychiatry, Veterans Affairs Connecticut Healthcare System, West Haven, CT
| | - Jessica H. Kalmar
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT,Department of Psychiatry, Veterans Affairs Connecticut Healthcare System, West Haven, CT
| | - Linda Spencer
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT,Department of Psychiatry, Veterans Affairs Connecticut Healthcare System, West Haven, CT
| | - Erin Edmiston
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT,Department of Psychiatry, Veterans Affairs Connecticut Healthcare System, West Haven, CT
| | - Brian P. Pittman
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT
| | - R. Todd Constable
- Department of Diagnostic Radiology, Yale University School of Medicine, New Haven, CT
| | - Xenophon Papademetris
- Department of Diagnostic Radiology, Yale University School of Medicine, New Haven, CT
| | - Hilary P. Blumberg
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT,Department of Diagnostic Radiology, Yale University School of Medicine, New Haven, CT,Department of Psychiatry, Veterans Affairs Connecticut Healthcare System, West Haven, CT
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Roberts M, Spencer L, Grober E, Lo K, Jarvi K. Microtese avoidance program? Fertil Steril 2009. [DOI: 10.1016/j.fertnstert.2009.07.033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Ong SL, Garcea G, Pollard CA, Furness PN, Steward WP, Rajesh A, Spencer L, Lloyd DM, Berry DP, Dennison AR. A fuller understanding of pancreatic neuroendocrine tumours combined with aggressive management improves outcome. Pancreatology 2009; 9:583-600. [PMID: 19657214 DOI: 10.1159/000212085] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
BACKGROUND Neuroendocrine tumours of the pancreas (PNETs) represent 1-2% of all pancreatic tumours. The terms 'islet cell tumours' and 'carcinoids' of the pancreas should be avoided. The aim of this review is to offer an overview of the history and diagnosis of PNETs followed by a discussion of the available treatment options. METHODS A search on PubMed using the keywords 'neuroendocrine', 'pancreas' and 'carcinoid' was performed to identify relevant literature over the last 30 years. RESULTS The introduction of a revised classification of neuroendocrine tumours by the World Health Organisation (WHO) in 2000 significantly changed our understanding of and approach to the management of these tumours. Advances in laboratory and radiological techniques have also led to an increased detection of PNETs. Surgery remains the only treatment that offers a chance of cure with increasing number of non-surgical options serving as beneficial adjuncts. The better understanding of the behaviours of PNETs together with improvements in tumour localisation has resulted in a more aggressive management strategy with a concomitant improvement in symptom palliation and a prolongation of survival. CONCLUSION Due to their complex nature and the wide range of therapeutic options, the involvement of specialists from all necessary disciplines in a multidisciplinary team setting is vital to provide optimal treatment of this disease.
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Affiliation(s)
- S L Ong
- Department of Hepatobiliary and Pancreatic Surgery, Leicester General Hospital, Leicester, UK.
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Pearce DJ, Spencer L, Hu J, Balkrishnan R, Fleischer AB, Feldman SR. Class I topical corticosteroid use by psoriasis patients in an academic practice. J DERMATOL TREAT 2009; 15:235-8. [PMID: 15764038 DOI: 10.1080/09546630410033745] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
BACKGROUND Psoriasis is a chronic skin disorder that can have a profound impact on the quality of life of patients. The treatment of psoriasis is complicated by the availability of numerous topical agents, systemic agents, and phototherapy. Of the topical preparations available, the ultra-high potency, or Class I steroids, have an important role in treating psoriasis. Their use is most appropriate for the treatment of plaques in regions excluding the face, axilla, groin and genitals. OBJECTIVE The purpose of this study was to examine the prescribing patterns of Class I topical corticosteroids within a large academic dermatology practice for patients with all types of psoriasis. METHODS A retrospective chart review of 650 patients with psoriasis from an academic dermatology practice was performed. Class I steroid use was defined as those patients who were observed to be currently using clobetasol propionate, halobetasol propionate, diflorasone, or augmented betamethasone dipropionate. RESULTS A total of 79% of patients were prescribed topical steroids of any class while 46% of patients were prescribed a Class I steroid. In all, 58% of patients who received topical steroid therapy received a Class I agent; 11% of patients prescribed Class I steroids also received systemic therapy for their psoriasis. Conversely, 35% of patients who received systemic therapy were also receiving Class I topical therapy. DISCUSSION In our department, Class I topical steroids are commonly used in the treatment of psoriasis. The superpotent topicals are often used as an adjunct to systemic therapy and will likely remain a mainstay of psoriasis therapy.
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Affiliation(s)
- D J Pearce
- Center for Dermatology Research, Department of Dermatology, Wake Forest University of Helath Sciences, Winston-Salem, NC 27157-1071, USA
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Chepenik LG, Fredericks C, Papademetris X, Spencer L, Lacadie C, Wang F, Pittman B, Duncan JS, Staib LH, Duman RS, Gelernter J, Blumberg HP. Effects of the brain-derived neurotrophic growth factor val66met variation on hippocampus morphology in bipolar disorder. Neuropsychopharmacology 2009; 34:944-51. [PMID: 18704093 PMCID: PMC2837582 DOI: 10.1038/npp.2008.107] [Citation(s) in RCA: 92] [Impact Index Per Article: 6.1] [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] [Indexed: 02/01/2023]
Abstract
Histological and behavioral research in bipolar disorder (BD) implicates structural abnormalities in the hippocampus. Brain-derived neurotrophic growth factor (BDNF) protein is associated with hippocampal development and plasticity, and in mood disorder pathophysiology. We tested the hypotheses that both the BDNF val66met polymorphism and BD diagnosis are associated with decreased hippocampus volume, and that individuals with BD who carry the met allele have the smallest hippocampus volumes compared to individuals without BD and val/val homozygotes. We further explored localization of morphological differences within hippocampus in BD associated with the met allele. Twenty individuals with BD and 18 healthy comparison (HC) subjects participated in high-resolution magnetic resonance imaging scans from which hippocampus volumes were defined and measured. We used linear mixed model analysis to study effects of diagnosis and BDNF genotype on hippocampus volumes. We then employed three-dimensional mapping to localize areas of change within the hippocampus associated with the BDNF met allele in BD. We found that hippocampus volumes were significantly smaller in BD compared to HC subjects, and presence of the BDNF met allele was associated with smaller hippocampus volume in both diagnostic groups. The BD subgroup who carried the BDNF met allele had the smallest hippocampus volumes, and three-dimensional mapping identified these decreases as most prominent in left anterior hippocampus. These results support effects of BD diagnosis and BDNF genotype on hippocampus structure and suggest a genetic subgroup within BD who may be most vulnerable to deficits in hippocampus and may most benefit from interventions that influence BDNF-mediated signaling.
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Affiliation(s)
- Lara G. Chepenik
- Deparment of Psychiatry, Yale University School of Medicine, New Haven CT,Department of Psychiatry, Veterans Affairs Connecticut Healthcare System, West Haven CT
| | - Carolyn Fredericks
- Deparment of Psychiatry, Yale University School of Medicine, New Haven CT,Stanford University School of Medicine, Stanford, CA
| | - Xenophon Papademetris
- Department of Diagnostic Radiology, Yale University School of Medicine, New Haven CT
| | - Linda Spencer
- Deparment of Psychiatry, Yale University School of Medicine, New Haven CT,Department of Psychiatry, Veterans Affairs Connecticut Healthcare System, West Haven CT
| | - Cheryl Lacadie
- Department of Diagnostic Radiology, Yale University School of Medicine, New Haven CT
| | - Fei Wang
- Deparment of Psychiatry, Yale University School of Medicine, New Haven CT,Department of Psychiatry, Veterans Affairs Connecticut Healthcare System, West Haven CT
| | - Brian Pittman
- Deparment of Psychiatry, Yale University School of Medicine, New Haven CT
| | - James S. Duncan
- Department of Diagnostic Radiology, Yale University School of Medicine, New Haven CT
| | - Lawrence H. Staib
- Department of Diagnostic Radiology, Yale University School of Medicine, New Haven CT
| | - Ronald S. Duman
- Deparment of Psychiatry, Yale University School of Medicine, New Haven CT
| | - Joel Gelernter
- Deparment of Psychiatry, Yale University School of Medicine, New Haven CT,Department of Psychiatry, Veterans Affairs Connecticut Healthcare System, West Haven CT
| | - Hilary P. Blumberg
- Deparment of Psychiatry, Yale University School of Medicine, New Haven CT,Department of Diagnostic Radiology, Yale University School of Medicine, New Haven CT,Department of Psychiatry, Veterans Affairs Connecticut Healthcare System, West Haven CT
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Patry G, Jarvi K, Grober E, Lo K, Spencer L. Map: micro-testicular sperm extraction avoidance program. Fertil Steril 2008. [DOI: 10.1016/j.fertnstert.2008.07.1063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Wang F, Jackowski M, Kalmar JH, Chepenik LG, Tie K, Qiu M, Gong G, Pittman BP, Jones MM, Shah MP, Spencer L, Papademetris X, Constable RT, Blumberg HP. Abnormal anterior cingulum integrity in bipolar disorder determined through diffusion tensor imaging. Br J Psychiatry 2008; 193:126-9. [PMID: 18669996 PMCID: PMC2732002 DOI: 10.1192/bjp.bp.107.048793] [Citation(s) in RCA: 90] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
BACKGROUND Convergent evidence implicates white matter abnormalities in bipolar disorder. The cingulum is an important candidate structure for study in bipolar disorder as it provides substantial white matter connections within the corticolimbic neural system that subserves emotional regulation involved in the disorder. AIMS To test the hypothesis that bipolar disorder is associated with abnormal white matter integrity in the cingulum. METHOD Fractional anisotropy in the anterior and posterior cingulum was compared between 42 participants with bipolar disorder and 42 healthy participants using diffusion tensor imaging. RESULTS Fractional anisotropy was significantly decreased in the anterior cingulum in the bipolar disorder group compared with the healthy group (P=0.003); however, fractional anisotropy in the posterior cingulum did not differ significantly between groups. CONCLUSIONS Our findings demonstrate abnormalities in the structural integrity of the anterior cingulum in bipolar disorder. They extend evidence that supports involvement of the neural system comprising the anterior cingulate cortex and its corticolimbic gray matter connection sites in bipolar disorder to implicate abnormalities in the white matter connections within the system provided by the cingulum.
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Affiliation(s)
- Fei Wang
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT 06511, USA.
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Krell J, Nelson C, Spencer L, Miller S. An open-label study evaluating the efficacy and tolerability of alefacept for the treatment of scalp psoriasis. J Am Acad Dermatol 2008; 58:609-16. [DOI: 10.1016/j.jaad.2007.12.031] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2007] [Revised: 11/02/2007] [Accepted: 12/20/2007] [Indexed: 01/03/2023]
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Newton JR, Daly JM, Spencer L, Mumford JA. Description of the outbreak of equine influenza (H3N8) in the United Kingdom in 2003, during which recently vaccinated horses in Newmarket developed respiratory disease. Vet Rec 2007; 158:185-92. [PMID: 16474051 DOI: 10.1136/vr.158.6.185] [Citation(s) in RCA: 118] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Between March and May 2003, equine influenza virus infection was confirmed as the cause of clinical respiratory disease among both vaccinated and unvaccinated horses of different breeds and types in at least 12 locations in the UK. In the largest outbreak, 21 thoroughbred training yards in Newmarket, with more than 1300 racehorses, were affected, with the horses showing signs of coughing and nasal discharge during a period of nine weeks. Many of the infected horses had been vaccinated during the previous three months with a vaccine that contained representatives from both the European (A/eq/Newmarket/2/93) and American (A/eq/Newmarket/1/93) H3NN8 influenza virus lineages. Antigenic and genetic characterisation of the viruses from Newmarket and elsewhere indicated that they were all closely related to representatives of a sublineage of American viruses, for example, Kentucky/5/02, the first time that this sublineage had been isolated in the uk. In the recently vaccinated racehorses in Newmarket the single radial haemolysis antibody levels in acute sera appeared to be adequate, and there did not appear to be significant antigenic differences between the infecting virus and A/eq/Newmarket/1/93, the representative of the American lineage virus present in the most widely used vaccine, to explain the vaccine failure. However, there was evidence for significantly fewer infections among two-year-old horses than older animals, despite their having similar high levels of antibody, consistent with a qualitative rather than a quantitative difference in the immunity conveyed by the vaccination.
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Affiliation(s)
- J R Newton
- Centre for Preventive Medicine, Animal Health Trust, Lanwades Park, Kentford, Newmarket, Suffolk CB8 7UU
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Blumberg HP, Fredericks C, Wang F, Kalmar JH, Spencer L, Papademetris X, Pittman B, Martin A, Peterson BS, Fulbright RK, Krystal JH. Preliminary evidence for persistent abnormalities in amygdala volumes in adolescents and young adults with bipolar disorder. Bipolar Disord 2005; 7:570-6. [PMID: 16403182 PMCID: PMC2291299 DOI: 10.1111/j.1399-5618.2005.00264.x] [Citation(s) in RCA: 102] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECTIVES Abnormalities in volumes of the amygdala have been reported previously in adolescents and adults with bipolar disorder (BD). Several studies have reported reduced volumes in adolescents with BD; however, both decreases and increases in volumes have been reported in adults with BD. Understanding of potential developmental contributions to these disturbances in morphology of the amygdala has been limited by the absence of longitudinal data in persons with BD. Here we use a within-subject longitudinal design to investigate whether amygdala volume abnormalities persist in adolescents and young adults with BD over a time interval of approximately 2 years. METHODS Participants included 18 adolescents and young adults: 10 participants with BD I and 8 healthy comparison participants. Amygdala volumes were measured on high-resolution magnetic resonance imaging scans acquired twice for each subject over intervals of approximately 2 years. Amygdala volumes were the dependent measures in a mixed-model statistical analysis to compare amygdala volumes between groups over time while covarying for total brain volume. RESULTS Amygdala volumes were significantly smaller in adolescents and young adults with BD compared with healthy participants (p = 0.018). The effect of time was not significant. CONCLUSIONS Although the sample size is modest, this study provides preliminary evidence to support the presence of decreased amygdala volumes in adolescents and young adults with BD that persist during this developmental epoch.
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Affiliation(s)
- Hilary P Blumberg
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT 06511, USA.
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