scholarly journals Effects of prismatic adaptation on balance and postural disorders in patients with chronic right stroke: protocol for a multicentre double-blind randomised sham-controlled trial

BMJ Open ◽  
2021 ◽  
Vol 11 (11) ◽  
pp. e052086
Author(s):  
Aurélien Hugues ◽  
Amandine Guinet-Lacoste ◽  
Sylvie Bin ◽  
Laurent Villeneuve ◽  
Marine Lunven ◽  
...  
Keyword(s):  
Controlled Trial ◽  
Weight Bearing ◽  
Body Axis ◽  
Double Blind ◽  
Longitudinal Body Axis ◽  
Stroke Lesion ◽  
The Right ◽  
Prismatic Adaptation ◽  
Straight Ahead ◽  
Postural Disorders

IntroductionPatients with right stroke lesion have postural and balance disorders, including weight-bearing asymmetry, more pronounced than patients with left stroke lesion. Spatial cognition disorders post-stroke, such as misperceptions of subjective straight-ahead and subjective longitudinal body axis, are suspected to be involved in these postural and balance disorders. Prismatic adaptation has showed beneficial effects to reduce visuomotor disorders but also an expansion of effects on cognitive functions, including spatial cognition. Preliminary studies with a low level of evidence have suggested positive effects of prismatic adaptation on weight-bearing asymmetry and balance after stroke. The objective is to investigate the effects of this intervention on balance but also on postural disorders, subjective straight-ahead, longitudinal body axis and autonomy in patients with chronic right stroke lesion.Methods and analysisIn this multicentre randomised double-blind sham-controlled trial, we will include 28 patients aged from 18 to 80 years, with a first right supratentorial stroke lesion at chronic stage (≥12 months) and having a bearing ≥60% of body weight on the right lower limb. Participants will be randomly assigned to the experimental group (performing pointing tasks while wearing glasses shifting optical axis of 10 degrees towards the right side) or to the control group (performing the same procedure while wearing neutral glasses without optical deviation). All participants will receive a 20 min daily session for 2 weeks in addition to conventional rehabilitation. The primary outcome will be the balance measured using the Berg Balance Scale. Secondary outcomes will include weight-bearing asymmetry and parameters of body sway during static posturographic assessments, as well as lateropulsion (measured using the Scale for Contraversive Pushing), subjective straight-ahead, longitudinal body axis and autonomy (measured using the Barthel Index).Ethics and disseminationThe study has been approved by the ethical review board in France. Findings will be submitted to peer-reviewed journals relative to rehabilitation or stroke.Trial registration numberNCT03154138.

scholarly journals Effects of topiramate on neural responses to alcohol cues in treatment-seeking individuals with alcohol use disorder: preliminary findings from a randomized, placebo-controlled trial

2021 ◽  
Author(s):  
Reagan R. Wetherill ◽  
Nathaniel Spilka ◽  
Kanchana Jagannathan ◽  
Paige Morris ◽  
Danielle Romer ◽  
...  
Keyword(s):  
Alcohol Use ◽  
Alcohol Use Disorder ◽  
Controlled Trial ◽  
Cue Reactivity ◽  
A Priori ◽  
Heavy Drinking ◽  
Double Blind ◽  
Alcohol Cues ◽  
Brain Responses ◽  
The Right

AbstractTopiramate, a GABA/glutamate modulator, is efficacious in reducing alcohol consumption, though the mechanisms underlying this effect are not well characterized. This study analyzed functional magnetic resonance imaging (fMRI) data from 22 heavy drinkers enrolled in a 12-week placebo-controlled, randomized clinical trial of topiramate to examine the effects of topiramate on alcohol cue-elicited brain responses, craving, and heavy drinking in individuals with DSM-5 alcohol use disorder. Patients were randomized to receive either topiramate (maximal daily dosage of 200 mg/day) or placebo and were administered an fMRI alcohol cue-reactivity task at baseline (before starting medication) and after 6 weeks of double-blind treatment. Analyses compared the topiramate (n = 12) and placebo (n = 8) groups on (1) the change in brain responses during alcohol cue exposure (vs non-alcohol cues) within five a priori regions of interest related to reward—the bilateral and medial orbitofrontal cortex (OFC) and bilateral ventral striatum (VS) and (2) change in craving and heavy drinking days (HDDs) from baseline and scan 2. Topiramate, relative to placebo, reduced alcohol cue-elicited activation of the left VS, bilateral OFC, and medial OFC, alcohol cue-elicited craving, and HDDs between baseline and 6 weeks of treatment. The reduction in alcohol cue-elicited activation in the medial OFC correlated with reductions in craving, and reduced activation in the right VS, right OFC, and medial OFC correlated with the reduction in HDD. This preliminary study provides evidence that topiramate’s attenuation of alcohol cue-elicited brain activation and craving are key elements of the drug’s neurobiological mechanism of action in reducing heavy drinking.

scholarly journals Translating the immediate effects of S-Ketamine using hippocampal subfield analysis in healthy subjects-results of a randomized controlled trial

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Anna Höflich ◽  
Christoph Kraus ◽  
Ruth M. Pfeiffer ◽  
Rene Seiger ◽  
Dan Rujescu ◽  
...  
Keyword(s):  
Animal Models ◽  
Controlled Trial ◽  
Double Blind ◽  
Ca1 Region ◽  
Hippocampal Ca1 Region ◽  
Hippocampal Ca1 ◽  
Magnetic Resonance Imaging Mri ◽  
The Right ◽  
Mri Study ◽  
Post Hoc

AbstractAntidepressant doses of ketamine rapidly facilitate synaptic plasticity and modify neuronal function within prefrontal and hippocampal circuits. However, most studies have demonstrated these effects in animal models and translational studies in humans are scarce. A recent animal study showed that ketamine restored dendritic spines in the hippocampal CA1 region within 1 h of administration. To translate these results to humans, this randomized, double-blind, placebo-controlled, crossover magnetic resonance imaging (MRI) study assessed ketamine’s rapid neuroplastic effects on hippocampal subfield measurements in healthy volunteers. S-Ketamine vs. placebo data were analyzed, and data were also grouped by brain-derived neurotrophic factor (BDNF) genotype. Linear mixed models showed that overall hippocampal subfield volumes were significantly larger (p = 0.009) post ketamine than post placebo (LS means difference=0.008, standard error=0.003). Post-hoc tests did not attribute effects to specific subfields (all p > 0.05). Trend-wise volumetric increases were observed within the left hippocampal CA1 region (p = 0.076), and trend-wise volumetric reductions were obtained in the right hippocampal—amygdaloid transition region (HATA) (p = 0.067). Neither genotype nor a genotype–drug interaction significantly affected the results (all p > 0.7). The study provides evidence that ketamine has short-term effects on hippocampal subfield volumes in humans. The results translate previous findings from animal models of depression showing that ketamine has pro-neuroplastic effects on hippocampal structures and underscore the importance of the hippocampus as a key region in ketamine’s mechanism of action.

scholarly journals Exploring the Impact of Mindfulness on False-Memory Susceptibility

2020 ◽  
Vol 31 (8) ◽  
pp. 968-977 ◽  
Author(s):  
Susan M. Sherman ◽  
James A. Grange
Keyword(s):  
False Memory ◽  
Controlled Trial ◽  
Mind Wandering ◽  
States Of Mind ◽  
Double Blind ◽  
Randomized Controlled ◽  
State Of Mind ◽  
Mindfulness Induction ◽  
The Right ◽  
The Impact

Wilson, Mickes, Stolarz-Fantino, Evrard, and Fantino (2015) presented data from three well-powered experiments suggesting that a brief mindfulness induction can increase false-memory susceptibility. However, we had concerns about some of the methodology, including whether mind wandering is the best control condition for brief mindfulness inductions. Here, we report the findings from a preregistered double-blind randomized controlled trial designed to replicate and extend Wilson et al.’s findings. Participants ( N = 287) underwent 15-min mindfulness or mind-wandering inductions or completed a join-the-dots task before being presented with lists of words related to nonpresented critical lures. This was followed by free-recall and recognition tasks. There was no evidence for an effect of state of mind on correct or false recall or recognition. Furthermore, manipulation checks revealed that mindfulness and mind-wandering inductions activated overlapping states of mind. Exploratory analyses provided some support for mindfulness increasing false memory, but it appears that mind wandering may not be the right control for brief mindfulness research.

scholarly journals Objective Comparison Between Spreader Grafts and Flaps for Mid-Nasal Vault Reconstruction: A Randomized Controlled Trial

2019 ◽  
Vol 28 (3) ◽  
pp. 137-141
Author(s):  
Nabil Galal Zeid ◽  
Ahmed Shawky Mohamed ◽  
Mahmoud ElSayed ElFouly ◽  
Khaled Omar Azooz ◽  
Mohamed Muddather Aleryan ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Controlled Trial ◽  
Statistical Significance ◽  
Nasal Resistance ◽  
Double Blind ◽  
Randomized Controlled ◽  
Group 2 ◽  
The Right ◽  
Nasal Vault ◽  
Active Anterior Rhinomanometry

Objective: The goal of rhinoplasty is not exclusively aesthetic and the nasal function should always be considered. Several rhinoplasty techniques can participate in nasal valve dysfunction (eg, dorsal hump reductions). Therefore, mid-nasal vault reconstruction by spreader grafts or flaps is mandatory in these cases. To date, there is a literature gap in comparing both techniques objectively. This study shows an objective comparison between spreader grafts and flaps for mid-nasal vault reconstruction. Material and Methods: This study was a double-blind randomized controlled trial including 40 patients who were randomly divided into 2 groups. Group 1 (20 patients) underwent spreader grafts insertion, whereas group 2 (20 patients) underwent spreader flap placement technique. Pre-operative active anterior rhinomanometry measurements were compared to 6-month post-operative measurements. Data were summarized as mean (standard deviation) for the quantitative variables. Comparisons between the 2 groups were done using unpaired t test. Results: In both groups, a significant decrease in nasal resistance was noted in both the right and left sides 6 months post-operatively ( P < .001). However, the comparison between the 2 both groups showed no statistical significance. Conclusion: Both spreader grafts and flaps, which are used for the mid-nasal vault reconstruction, have comparable and effective results in reducing the nasal resistance as evidenced by active anterior rhinomanometry measurements.

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