scholarly journals Self-Referential Dysfunction and Default-Mode Hyperactivation in Psychophysiological Insomnia Patients

2018 ◽  
Vol 32 (3) ◽  
pp. 140-155 ◽  
Author(s):  
Daniel Ruivo Marques ◽  
Ana Allen Gomes ◽  
Vanda Clemente ◽  
José Moutinho dos Santos ◽  
Isabel Catarina Duarte ◽  
...  

Abstract. Psychophysiological insomnia (PI) is one of the most frequent sleep disorders. In this study we tested whether differences in terms of neural activation are present between a group of PI patients and a healthy-control group while they are exposed to idiosyncratic ruminations and worries, evoked visually by words, so as to explore their hypothetical link with default-mode network (DMN) dysfunction in PI. We recruited five PI patients diagnosed according to the International Classification of Sleep Disorders, version 2 (ICSD-2) of American Academy of Sleep Medicine (AASM) and five age- and sex-matched healthy controls. Patients were recruited at the outpatient Sleep Medicine Centre of the Coimbra University Hospital Centre. We used a functional magnetic resonance imaging (fMRI) block-design paradigm where the participants visualized lists of words related to past/present and future concerns and also emotionally neutral words. The results suggested that the PI patients showed a failure of the DMN to deactivate. Moreover, when these patients were exposed to words concerning both past/present ruminations and future worries, there was a pronounced and significant over-recruitment of brain areas related to DMN and self-referential processing when they were compared to healthy volunteers. The differences between the patient and control groups were also evident in self-report measures. In sum, despite the relatively small sample size, our study clearly suggests that in PI there is a dysfunction in brain regions pertaining to self-referential processing, which is corroborated by an overall pattern of hyperarousal in brain regions comprising the DMN. These data may be useful in the improvement of pathophysiological models, diagnostic and therapeutic interventions for insomnia.

2004 ◽  
Vol 16 (9) ◽  
pp. 1484-1492 ◽  
Author(s):  
Michael D. Greicius ◽  
Vinod Menon

Deactivation refers to increased neural activity during low-demand tasks or rest compared with high-demand tasks. Several groups have reported that a particular set of brain regions, including the posterior cingulate cortex and the medial prefrontal cortex, among others, is consistently deactivated. Taken together, these typically deactivated brain regions appear to constitute a default-mode network of brain activity that predominates in the absence of a demanding external task. Examining a passive, block-design sensory task with a standard deactivation analysis (rest epochs vs. stimulus epochs), we demonstrate that the default-mode network is undetectable in one run and only partially detectable in a second run. Using independent component analysis, however, we were able to detect the full default-mode network in both runs and to demonstrate that, in the majority of subjects, it persisted across both rest and stimulus epochs, uncoupled from the task waveform, and so mostly undetectable as deactivation. We also replicate an earlier finding that the default-mode network includes the hippocampus suggesting that episodic memory is incorporated in default-mode cognitive processing. Furthermore, we show that the more a subject's default-mode activity was correlated with the rest epochs (and “deactivated” during stimulus epochs), the greater that subject's activation to the visual and auditory stimuli. We conclude that activity in the default-mode network may persist through both experimental and rest epochs if the experiment is not sufficiently challenging. Time-series analysis of default-mode activity provides a measure of the degree to which a task engages a subject and whether it is sufficient to interrupt the processes—presumably cognitive, internally generated, and involving episodic memory—mediated by the default-mode network.


2020 ◽  
Author(s):  
James I. Rim ◽  
Jesse Caleb Ojeda ◽  
Connie Svob ◽  
Jürgen Kayser ◽  
Elisa Drews ◽  
...  

Religion and spirituality (R/S) have been prominent aspects of most human cultures through the ages; however, scientific inquiry into this phenomenon has been limited. We conducted a systematic literature review of research on the neurobiological correlates of R/S, which resulted in 25 reports studying primarily R/S with electroencephalography, structural neuroimaging (MRI), and functional neuroimaging (fMRI, PET). These studies investigated a wide range of religions (e.g., Christianity, Buddhism, Islam) and R/S states and behaviors (e.g., resting state, prayer, judgments) and employed a wide range of methodologies, some of which (e.g., no control group, varying measures of religiosity, small sample sizes) raise concerns about the validity of the results. Despite these limitations, the findings of these studies collectively suggest that the experience of R/S has specific neurobiological correlates and that these correlates are distinct from non-R/S counterparts. The findings implicate several brain regions potentially associated with R/S development and behavior, including the medial frontal cortex, orbitofrontal cortex, precuneus, posterior cingulate cortex, default mode network, and caudate. This research may suggest future clinical applications and interventions related to R/S and various disorders, including mood, anxiety, psychotic, pain, and vertiginous disorders. Further studies with more rigorous study designs are warranted to elucidate the neurobiological mechanisms of R/S and their potential clinical applications.


2018 ◽  
Vol 20 (4) ◽  
pp. 229-238 ◽  
Author(s):  
Kirsten McCallum

Purpose Given the amount of research examining the association between trauma and post-traumatic stress disorder (PTSD) with aggression and violence, few studies have focussed on a UK prison population. Additionally, few have examined the relationship between PTSD symptoms, aggression and violence perpetrated in custody. The purpose of this paper is to explore the association between PTSD and violence against the person in prison, and the association between PTSD and having a conviction for violence against the person. Design/methodology/approach The sample consisted of 110 participants from a male prison in England (young offenders and adult prisoners). They were assessed for PTSD symptoms using the Detailed Assessment of Posttraumatic Stress (DAPS; Briere, 2001), their criminal history and custodial behaviour was analysed. Findings The findings revealed that symptoms of PTSD were significantly associated with violence in prison, however, symptoms of PTSD were not found to be significantly associated with having a violent conviction. Further analysis using logistic regression found having a violent conviction, age and PTSD symptoms were significant predictors of violence in prison. Research limitations/implications The limitations of this study are the reliance on a self-report measure to assess symptoms of PTSD, the small sample size and the absence of a control group. Practical implications The results highlighted the need for staff training and the availability of a service to assess and treat PTSD. This would increase the well-being of offenders and support the current HM Prison Service violence reduction strategies. Originality/value This study provides new research into the UK prison population.


2019 ◽  
Vol 3 (s1) ◽  
pp. 17-18
Author(s):  
Rajpreet Chahal ◽  
Scott Marek ◽  
Veronika Vilgis ◽  
David Weissman ◽  
Paul Hastings ◽  
...  

OBJECTIVES/SPECIFIC AIMS: Earlier pubertal timing has been associated with risk for depression, particularly in girls (e.g., Keenan etal., 2014). Evidence suggests pubertal timing in girls also relates to alterations in the microstructural properties of brain white matter tracts in late adolescence (Chahal etal., 2018), and structural connectivity of cingulate and frontal regions (Chahal etal., in prep), though differences in pubertal development in both boys and girls have not been examined in the context of brain functional connectivity (FC). Individual differences in the course of puberty may have enduring effects on functional coupling among brain regions that may contribute to the risk for psychopathology. To address this question, we explored the relation between pubertal timing and tempo with depression symptoms (age 16). Then, we examined whether brain network FC (age 16) associates with pubertal indices and predicts concurrent and later depressive symptoms (age 18). METHODS/STUDY POPULATION: Sixty-eight adolescents (37 females) completed the Mini-Mood and Anxiety Symptom Questionnaire (MASQ; Clark & Watson, 1995) at ages 14-18. Gompertz growth curve modelling of pubertal development (age 10-15; Waves 1-6) was used to estimate pubertal timing and tempo per individual, separately for males and females (e.g., Chahal etal., 2018). Resting-state MRI data (age 16) were parcellated into 264 cortical and subcortical regions to create region-to-region FC matrices based on correlations of time-series. Individual matrices were fed to the GraphVar program (Kruschwitz etal., 2015) to assess the interaction of pubertal timing and pubertal tempo with functional network connectivity using Network-based statistic (NBS; Zalesky etal., 2010). Subnetworks showing alterations in relation to pubertal timing and tempo were then examined in association with concurrent (age 16) symptoms and used to predict future depressive symptoms (age 18). RESULTS/ANTICIPATED RESULTS: In all youth, earlier pubertal timing was associated with higher depressive symptoms at age 16 (p<.018). This association was stronger in girls with slower pubertal tempo (p<.039). Interregional connectivity analyses revealed that the interaction of earlier pubertal timing and slower tempo was associated with lower FC between the left cingulate gyrus and right precuneus (p<.0001), regions implicated in emotion processing (i.e., Affective Processing Network) and self-referential thinking (i.e., Default Mode Network). FC of the three other emotion- and self-referential processing network regions (i.g., left insula, superior parietal lobule, and precuneus) was lower in youth with greater age 16 depressive symptoms (p<.0001). Finally, lower FC of of the left and right inferior parietal lobule predicted greater depressive symptoms at age 18 (p<.0001). In summary, FC of overlapping affective and default mode network areas was related to earlier pubertal timing and higher concurrent and future depressive symptoms. DISCUSSION/SIGNIFICANCE OF IMPACT: These findings demonstrate individual differences in pubertal maturation are associated with depressive symptoms and differences in brain connectivity in mid-adolescence. Early pubertal development was associated with greater depression symptoms and lower FC of brain regions involved in emotion regulation and self-referential processing. Further, FC between these regions predicted higher depression symptoms two years later. These neurobiological mechanisms may, in part, underlie the link between off-time pubertal development and the risk for depression. These findings also have important implications for precision psychiatry, as we show that a risk-factor of depression (early pubertal timing) may manifest in developing neurobiology in region-specific ways. Previous network models of depression (e.g., Li etal., 2018) implicated affective network connectivity in sustained negative mood and the default mode/ self-referential network in rumination. Other networks implicated in these past models include the reward network, which may be involved in anhedonia and loss of pleasure. Our study only found associations between affective and self-referential regional connectivity, pubertal maturation, and depression, suggesting that pubertal risk factors may relate more closely with emotion-regulation and self-referential processing deficits.


2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Angela Calcan ◽  
Mark Holmes

Purpose The purpose of this paper is to offer a viewpoint on the impact that the COVID-19 pandemic has had on people’s engagement with an online alcohol service in the UK. This paper examines whether self-reported mental health concerns increased during the pandemic compared to pre-pandemic times. Design/methodology/approach A comparison was made between service data captured in one contract area – West Sussex, England – pre-pandemic (April 2019 to March 2020) and during pandemic (April 2020 to March 2021). Findings Self-reported mental health treatment needs increased during the pandemic period (71.2% of presentations compared to 50% pre-pandemic) via the online coaching service. Male referrals increased by 74% during the pandemic period compared to the previous year. Female referrals decreased by 4% in the same time period. Feelings of shame and guilt as well as loss of a confidential space to engage in online interventions were common concerns reported by service users. Research limitations/implications Research limitations include the relatively small sample size, the sample comprised of self-referred treatment seeking clients, and there was no control group. All data collected is self-report therefore subjective and not necessarily meeting diagnostic criteria. Practical implications Of note was the impact of the pandemic on women and their reduced access to the online service during the pandemic. Commissioners and services must adapt their service design and delivery alongside the new “normal” way of living and working. Routine screening of mental health and alcohol use are recommended. Originality/value This paper offers insight from an established online/digital service and the impact of the pandemic on people’s engagement with the service.


2013 ◽  
Vol 93 (5) ◽  
pp. 620-627 ◽  
Author(s):  
Cynthia A. Robinson ◽  
Patricia Noritake Matsuda ◽  
Marcia A. Ciol ◽  
Anne Shumway-Cook

Background Community walking is limited among survivors of stroke; however, the contributing factors are not clearly understood. Objective This study examined the association of features in the environment with frequency of community walking following stroke. Design An observational study design was used, with frequency of community walking data collected prospectively. Method Thirty survivors of stroke (mean age=67 years; mean months since stroke=40), and 30 older adults without stroke (mean age=68 years) participated. Frequency of community walking (number of trips, walking-related activities [WRA], and the ratio of WRA to trips) and satisfaction were measured using self-report. The Environmental Analysis of Mobility Questionnaire (EAMQ) was used to determine frequency of encounter with versus avoidance of environmental features during community walking. Negative binomial and linear regression models were used to analyze the association of environmental features with measures of community walking. Results Survivors of stroke reported reduced community walking and fewer encounters with and greater avoidance of features within 8 dimensions of the environment compared with a control group of adults without stroke. Following stroke, avoidance of features in some environmental dimensions was associated with frequency of community walking as measured by number of trips, number of WRA, and the ratio of WRA to trips. Environmental features explained little of the variability in community walking. Limitations Limitations included a small sample size and limited diversity among participants. This study examined only physical features in the environment and did not include other environmental factors, such as social support, which may influence participation. Conclusions Avoidance of features within some, but not all, environmental dimensions was associated with self-reported frequency of community walking following stroke, suggesting that some environmental features may limit community walking more than others.


Crisis ◽  
2001 ◽  
Vol 22 (2) ◽  
pp. 54-60 ◽  
Author(s):  
Lisheng Du ◽  
Gabor Faludi ◽  
Miklos Palkovits ◽  
David Bakish ◽  
Pavel D. Hrdina

Summary: Several lines of evidence indicate that abnormalities in the functioning of the central serotonergic system are involved in the pathogenesis of depressive illness and suicidal behavior. Studies have shown that the number of brain and platelet serotonin transporter binding sites are reduced in patients with depression and in suicide victims, and that the density of 5-HT2A receptors is increased in brain regions of depressed in suicide victims and in platelets of depressed suicidal patients. Genes that code for proteins, such as tryptophan hydroxylase, 5-HT transporter, and 5-HT2A receptor, involved in regulating serotonergic neurotransmission, have thus been major candidate genes for association studies of suicide and suicidal behavior. Recent studies by our group and by others have shown that genetic variations in the serotonin-system-related genes might be associated with suicidal ideation and completed suicide. We have shown that the 102 C allele in 5-HT2A receptor gene was significantly associated with suicidal ideation (χ2 = 8.5, p < .005) in depressed patients. Patients with a 102 C/C genotype had a significantly higher mean HAMD item #3 score (indication of suicidal ideation) than T/C or T/T genotype patients. Our results suggest that the 102T/C polymorphism in 5-HT2A receptor gene is primarily associated with suicidal ideation in patients with major depression and not with depression itself. We also found that the 5-HT transporter gene S/L polymorphism was significantly associated with completed suicide. The frequency of the L/L genotype in depressed suicide victims was almost double of that found in control group (48.6% vs. 26.2%). The odds ratio for the L allele was 2.1 (95% CI 1.2-3.7). The association between polymorphism in serotonergic genes and suicidality supports the hypothesis that genetic factors can modulate suicide risk by influencing serotonergic activity.


Crisis ◽  
2020 ◽  
pp. 1-7
Author(s):  
Karien Hill ◽  
Shawn Somerset ◽  
Ralf Schwarzer ◽  
Carina Chan

Abstract. Background: The public health sector has advocated for more innovative, technology-based, suicide prevention education for the community, to improve their ability to detect and respond to suicide risk. Emerging evidence suggests addressing the bystander effect through the Bystander Intervention Model (BIM) in education material may have potential for suicide prevention. Aims: The current study aimed to assess whether BIM-informed tools can lead to improved readiness, confidence and intent in the community to detect and respond to suicide risk in others. Method: A sample of 281 adults recruited from the community participated in a randomized controlled trial comprising a factsheet designed according to the BIM (intervention group) and a standard factsheet about suicide and mental health (control group). Participants' self-reported detecting and responding to suicide risk readiness, confidence, and intent when presented with a suicidal peer was tested pre- and postintervention and compared across time and between groups. Results: The intervention group had significantly higher levels of detecting and responding to suicide risk readiness, confidence, and intent than the control group at postintervention (all p < .001) with moderate-to-large effect sizes. Limitations: The study was limited by a homogenous sample, too low numbers at follow-up to report, and self-report data only. Conclusion: This study demonstrates BIM-informed suicide prevention training may enhance the community's intervention readiness, confidence, and intent better than current standard material. Further testing in this area is recommended. While results were statistically significant, clinical significance requires further exploration.


1970 ◽  
Vol 2 (3) ◽  
Author(s):  
Ermiati E ◽  
Imas Rafiyah ◽  
Devi Kusnanti

Anemia merupakan salah satu penyebab terjadinya perdarahan dan bisa mengakibatkan kematian pada ibu hamil. Suplementasi besi merupakan program pemerintah dalam mengatasi anemia pada wanita hamil dan beberapa wanita hamil masih ada yang belum patuh dalam mengkonsumsi tablet besi. Oleh karena itu, diperlukan sebuah metode yang bisa meningkatkan kepatuhan wanita hamil dalam mengonsumsi tablet besi yaitu dengan short message service (SMS) reminder. Penelitian ini bertujuan untuk mengidentifikasi efektivitas SMS reminderterhadap kepatuhan konsumsi tablet besi pada ibu hamil di (unit pelayanan terpadu) UPT Puskesmas Cibuntu Kota Bandung. Rancangan penelitian quasi experimentaldengan desain posttest-only with control group designdengan teknik pengambilan sampel yang digunakan adalah purposive sampling. Penelitian ini dilaksanakan dari bulan April–Mei tahun 2014 di Puskesmas X Kota Bandung. Sampel berjumlah 40 orang wanita hamil yang tidak patuh dalam mengonsumsi tablet besi yang dibagi menjadi 20 kelompok intervensi dan 20 kelompok kontrol. Data diperoleh melalui kuesioner dalam bentuk self report.Analisis data yang digunakan adalah analisis deskriptif dan uji chi square. Hasil penelitian menunjukkan sebagian besar kelompok intervensi 17 orang (85%) patuh dan sebagian besar kelompok kontrol 16 orang (80%) tidak patuh. Hasil analisis dengan menggunakan chi squaredidapatkan p(0.000) dengan taraf signifikan <0.05 sehingga dapat disimpulkan bahwa SMS reminder efektif terhadap kepatuhan konsumsi tablet besi pada wanita hamil dan bisa dijadikan bahan pertimbangan bagi pihak Puskesmas untuk menjalin kerjasama dengan pihak provideratau mengajukan dana ke Dinas Kesehatan untuk mengaktifkan SMS reminderdi Puskesmas.Kata kunci: Kepatuhan, SMS reminder,tablet besi, wanita hamil AbstractAnemia is one of the leading causes of hemorrhage during pregnancy, and it can cause death to expectant mothers. Iron supplementation is a government program to overcome anemia among expectant mothers, and some of the expectant mothers still do not obediently consume iron tablets. Therefore, to increase the obedience of the expectant mothers on consuming the iron tablets, SMS reminder is the appropriate method needed. This research aims to identify the effectiveness of SMS reminder to the obedience of iron tablets consumption among expectant mothers at UPT Puskesmas Cibuntu , Bandung. The research employed quasi-experimental design with posttest-only control group design using purposive sampling technique. The research was held on April–May 2014 at UPT Puskesmas Cibuntu, Bandung. Forty expectant mothers consuming iron tablets disobediently divided into 20 intervention groups and 20 control groups were taken as the samples. Questionnaire in form of self report was used to obtain data. In addition, descriptive analysis and chi square test were applied to analyze the data. The result of the research showed that 17 persons (85%) of intervention groups were mostly obedient, and 16 persons (80%) of control groups were mostly disobedient. From the analysis using chi square, it was found the difference of the obedience of iron tablets consumption after SMS reminder (p=0.00) had been delivered with significant level <0.05. Based on the result of this research, SMS reminder had an effective impact toward the obedience of iron tablets consumption among the expectant mothers. The result will be a good consideration for Puskesmas to cooperate with provider or proposed some funds to Dinas Kesehatan to activate SMS reminder.Key words:Expectant mothers, obedience, SMS reminder, iron tablets


2020 ◽  
Author(s):  
Qing Zhao ◽  
Pei Chen ◽  
Yu Zhang ◽  
Haining Liu ◽  
Xianwen Li

BACKGROUND Mobile health application has become an important tool for healthcare systems. One such tool is the delivery of assisting in people with cognitive impairment and their caregivers. OBJECTIVE This scoping review aims to explore and evaluate the existing evidence and challenges on the use of mHealth applications that assisting in people with cognitive impairment and their caregivers. METHODS Nine databases, including PubMed, EMBASE, Cochrane, PsycARTICLES, CINAHL, Web of Science, Applied Science & Technology Source, IEEE Xplore and the ACM Digital Library were searched from inception through June 2020 for the studies of mHealth applications on people with cognitive impairment and their caregivers. Two reviewers independently extracted, checked synthesized data independently. RESULTS Of the 6101 studies retrieved, 64 studies met the inclusion criteria. Three categories emerged from this scoping review. These categories are ‘application functionality’, ‘evaluation strategies’, ‘barriers and challenges’. All the included studies were categorized into 7 groups based on functionality: (1) cognitive assessment; (2) cognitive training; (3) life support; (4) caregiver support; (5) symptom management; (6) reminiscence therapy; (7) exercise intervention. The included studies were broadly categorized into four types: (1) Usability testing; (2) Pilot and feasibility studies; (3) Validation studies; and (4) Efficacy or Effectiveness design. These studies had many defects in research design such as: (1) small sample size; (2) deficiency in active control group; (3) deficiency in analyzing the effectiveness of intervention components; (4) lack of adverse reactions and economic evaluation; (5) lack of consideration about the education level, electronic health literacy and smartphone proficiency of the participants; (6) deficiency in assessment tool; (7) lack of rating the quality of mHealth application. Some progress should be improved in the design of smartphone application functionality, such as: (1) the design of cognitive measurements and training game need to be differentiated; (2) reduce the impact of the learning effect. Besides this, few studies used health behavior theory and performed with standardized reporting. CONCLUSIONS Preliminary results show that mobile technologies facilitate the assistance in people with cognitive impairment and their caregivers. The majority of mHealth application interventions incorporated usability outcome and health outcomes. However, these studies have many defects in research design that limit the extrapolation of research. The content of mHealth application is urgently improved to adapt to demonstrate the real effect. In addition, further research with strong methodological rigor and adequate sample size are needed to examine the feasibility, effectiveness, and cost-effectiveness of mHealth applications for people with cognitive impairment and their caregivers.


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