10 State dissociation and interoception in functional neurological disorder

2020 ◽  
Vol 91 (8) ◽  
pp. e4.2-e5
Author(s):  
Susannah Pick ◽  
Morgan Butler ◽  
Maya Rojas-Aguiluz ◽  
Timothy Nicholson ◽  
H Laura
Keyword(s):  
Neurological Disorder ◽  
Medical Documentation ◽  
Aetiological Factor ◽  
Healthy Controls ◽  
Induction Procedure ◽  
Before And After ◽  
Interoceptive Accuracy ◽  
Mirror Gazing ◽  
The Impact ◽  
Functional Neurological Disorder

Objective/aimsInteroceptive differences have been proposed as an aetiological factor in functional neurological disorder (FND) but there is limited supportive evidence. Previous studies are few, have mixed findings and assessed only (objective) interoceptive accuracy, but not (metacognitive) interoceptive awareness. The aim of this study was to explore interoception in FND in greater detail, by assessing interoceptive accuracy and awareness in individuals with a range of FND presentations. As dissociative symptoms (e.g., depersonalisation, derealisation) are common in FND and could influence interoception, we sought to examine the effects of induced acute dissociation on interoception. We hypothesised that interoceptive accuracy/awareness would be impaired at baseline in FND relative to healthy controls, but that the differences would be exacerbated following dissociation induction.MethodsTwenty adults with FND were recruited from online FND support groups. Diagnosis was confirmed by medical documentation from a relevant healthcare professional. The FND group was compared to a group of 20 healthy controls recruited from online community groups. A modified heart-beat tracking task measured interoceptive accuracy (correct detection of heart beats) and awareness (confidence judgements). A control task involved counting visually presented geometric shapes. Both tasks were completed before and after a validated dissociation induction procedure (mirror-gazing).ResultsThe FND group reported elevated dissociation at baseline relative to controls (p<0.01) but this difference was larger following mirror-gazing (p<0.001). Interoceptive accuracy did not differ significantly between groups at baseline; however, the FND group had significantly lower accuracy scores following mirror-gazing (p<0.05). There was no effect of group on shape counting accuracy at either timepoint. Confidence ratings on the interoception and shape counting tasks were significantly lower at both timepoints in the FND group relative to controls (all p-values <0.05 or <0.01).ConclusionsIndividuals with FND reported elevated dissociation both before and after a dissociation induction procedure, although this was exacerbated post-dissociation induction. In contrast, interoceptive accuracy was unimpaired at baseline, but impaired following dissociation induction, relative to controls. The FND group showed reduced metacognitive awareness for detection of bodily states and external (visual) stimuli. Future research should better determine the nature of interoceptive deficits in FND and assess the impact of dissociation on a range of cognitive and affective processes relevant to the disorder.

scholarly journals 0099 The Effects of Sleep on the Consolidation of Fearful Memories

SLEEP ◽  
2020 ◽  
Vol 43 (Supplement_1) ◽  
pp. A39-A40
Author(s):  
M Arsic ◽  
L Heiss ◽  
A M Chambers
Keyword(s):  
Memory Consolidation ◽  
Emotional Memory ◽  
Neutral Condition ◽  
Emotion Induction ◽  
Induction Procedure ◽  
Main Effect ◽  
Before And After ◽  
Real World Learning ◽  
Emotional Events ◽  
The Impact

Abstract Introduction Previous research has found that emotionally intense stimuli are better remembered than neutral stimuli, especially after a period of sleep. However, few studies have examined memory for experienced emotional events, especially fearful ones. The purpose of the current study was to investigate the impact of sleep on memory consolidation using a fearful emotion induction task. Methods Thirty-three young adults (18.94±1.06 years; 64% female) were randomly assigned to either a fearful or neutral emotion induction condition. Participants were induced into their assigned emotion by visualizing each of eight emotion-congruent scenarios while corresponding music played in the background. Emotional state was measured using the Affect Grid before and after the emotion induction procedure. Twelve hours later, spanning either a day of wakefulness (wake group) or night of sleep (sleep group), participants were asked to recall the previously presented scenarios. Results A 2 x 2 ANOVA examined differences in the number of scenarios recalled between the conditions. A significant main effect of sleep was found, F(1,29)=8.41, p=.007, η 2p=.23, reflecting better recall in the sleep (3.21±1.78) vs. the wake group (1.79±1.72). There was also a main effect of emotion, F(1,29)=22.17, p&lt;.001, η 2p=.43, reflecting better recall in the fear (3.58±1.54) vs. the neutral condition (1.29±1.44). However, there was no interaction. Results were similar for the number of details recalled between the conditions. The sleep group (12.74±9.09) recalled more details than the wake group (5.50±5.81), F(1,29)=8.05, p=.008, η 2p=.22. More details were also recalled in the fear condition (13.16±8.73) than the neutral condition (4.93±5.77), F(1,29)=10.54, p=.003, η 2p=.27. There was again no interaction. Conclusion Results demonstrate that both sleep and fearful emotion facilitate memory consolidation. This work both supports and extends existing research by examining emotional memory consolidation through the manipulation of experienced events, which may more closely approximate real world learning than previous methods. Support N/A

scholarly journals Postoperative Glycaemia in Patients Following the CABG Surgery

2008 ◽  
Vol 8 (1) ◽  
pp. 48-51
Author(s):  
Mirsad Kacila ◽  
Elnur Tahirović ◽  
Zina Lazović
Keyword(s):  
Artery Bypass ◽  
Medical Documentation ◽  
Control Group ◽  
Entire Study ◽  
Antidiabetic Therapy ◽  
Glucose Levels ◽  
Study Results ◽  
Before And After ◽  
Glycaemia Control ◽  
The Impact

In this study we analyzed patients glucose levels taken before and after coronary artery bypass surgery. The data are taken from University of Sarajevo Clinics Centre-medical documentation of Heart Center from January 1st, 2007 to October 31st, 2007. Therefore, the entire study is done retrospectively. The patients considered in this analysis were divided into three groups. The patients in the first group were treated with peroral antidiabetics. The second group included patients treated with insulin while the third group consisted of patients without diabetes and acted as control group. All the patients had increased BMI. In the first two groups glucose levels were elevated before the surgery. Data analysis showed that three patients from the first group changed from peroral antidiabetics to insulin during postoperative period, and they were dismissed from hospital with this therapy. In the control group, peroral antidiabetis were introduced in four patients. The study results show that all the three groups have had high glycaemia on the first postoperative day. This may be caused by a number of reasons: inadequate pre-operative antidiabetic therapy, the impact of stress during surgery, inadequate pre-operative treatment of glycaemia or avoidance of the proscribed therapy by patients themselves. Stress during operation and administration of several medications after operation may also cause increased insulin resistance and distort glycaemia control.

8 Functional neurological disorder (FND) patients’ experience of healthcare interventions

2020 ◽  
Vol 91 (8) ◽  
pp. e11.1-e11
Author(s):  
C Symeon ◽  
A Isaacs-Itua ◽  
A Saramandi
Keyword(s):  
Neurological Disorder ◽  
Small Sample ◽  
Waiting List ◽  
Patient Treatment ◽  
Healthcare Intervention ◽  
Survey Question ◽  
Subjective Opinion ◽  
Patients Experience ◽  
The Impact ◽  
Functional Neurological Disorder

ObjectivesDespite Functional Neurological Disorder (FND) accounting for approximately 25% of Neurology out-patient appointments, and being frequently comorbid with other neurological conditions, there are only 4 centres in the UK, offering in-patient treatment programmes. Subsequently, services are strained as patients face long waiting lists and likely deterioration of symptoms. We explored patients’ experience of this and the impact on their wellbeing.MethodsAn on-line survey was sent to patients with a diagnosis of FND, who had, at out- patient assessment been deemed appropriate candidates for in-patient rehabilitation, and had provided written consent to be included in research. The survey question themes included: demography, understanding of FND diagnosis, subjective opinion of symptom progression, use of primary care services and/or Emergency Departments, and access to support and employment opportunities.Response where subjective opinion was sought, e.g. understanding of diagnosis, was via Likert scale ratings (from 0 (no understanding at all) to 10 (full understanding). All responses were anonymous.Results12 patients completed the survey (n=12). Of these, 7 were female and 5, male. 11 patients were aged between 25–64 years and 1, aged over 65 years. More than half of patients had seen their GP or visited an Emergency Department with symptoms related to FND in the past year. Average understanding of FND diagnosis was rated as 6.5, of treatment options as 4.8 and confidence of the likelihood of full recovery as 3.5 (on a scale of 0–10). 7 patients had carers, of whom the majority were family members. 9 patients would consider the use of digital interventions or day therapy programmes and 10 patients had already completed an in-patient rehabilitation programme. Of these, 9 had been on the in-patient waiting list for over 6 months. 8 patients felt that their symptoms had deteriorated and 6 patients described their level of independence, as being ‘much worse’, while on the waiting list.ConclusionsWhile we appreciate that this is a small sample size, it does offer invaluable insight into the experiences of those with FND, particularly with regards to healthcare intervention. Patients with FND inevitably use what would be regarded as high levels of healthcare intervention, although this must be considered within the context of limited healthcare resources available to them.

Experimental Induction of Muscle Tenderness and Headache in Tension-Type Headache Patients

Cephalalgia ◽  
2005 ◽  
Vol 25 (11) ◽  
pp. 1061-1067 ◽  
Author(s):  
MB Christensen ◽  
L Bendtsen ◽  
M Ashina ◽  
R Jensen
Keyword(s):  
Tension Type Headache ◽  
Healthy Controls ◽  
Headache Intensity ◽  
Muscle Tenderness ◽  
Significant Difference ◽  
Static Contraction ◽  
Before And After ◽  
Type Headache ◽  
The Impact ◽  
Headache Patients

The aim of the present study was to investigate the impact of static contraction of the shoulder and neck muscles on muscle tenderness and headache in patients with tension-type headache. Twenty patients with frequent episodic tension-type headache and 20 healthy age- and sex-matched controls were examined using a placebo-controlled cross-over design. The subjects performed static contraction of the trapezius muscles (active procedure) or the anterior tibial muscles (placebo procedure) with 10% of maximal force for 30 min. Total tenderness score, local tenderness score and headache intensity were evaluated before and after the static work. Changes in headache intensity were followed for 24 h. Pericranial tenderness increased significantly more in patients than in controls after the active procedure ( P = 0.04). The increase in pericranial tenderness tended to be higher after the active procedure than after the placebo procedure in patients ( P = 0.08) and in controls ( P = 0.07). Sixty per cent of the patients and 20% of the healthy controls developed headache after the active procedure. Fifty per cent of the patients and none of the controls developed headache after the placebo procedure. There was no significant difference in headache development between the active and the placebo procedure in patients or controls. These findings demonstrate that tension-type headache patients are more liable to develop shoulder and neck pain in response to static exercise than healthy controls.

scholarly journals Sensory abnormalities and masticatory function after microvascular decompression or balloon compression for trigeminal neuralgia compared with carbamazepine and healthy controls

2015 ◽  
Vol 122 (6) ◽  
pp. 1315-1323 ◽  
Author(s):  
Michelle Cristina Ichida ◽  
Antonio Nogueira de Almeida ◽  
Jose Claudio Marinho da Nobrega ◽  
Manoel Jacobsen Teixeira ◽  
José Tadeu Tesseroli de Siqueira ◽  
...  
Keyword(s):  
Trigeminal Neuralgia ◽  
Microvascular Decompression ◽  
Motor Deficits ◽  
Healthy Controls ◽  
Thermal Thresholds ◽  
Masticatory Function ◽  
Balloon Compression ◽  
Before And After ◽  
Questionnaire Research ◽  
The Impact

OBJECT Idiopathic trigeminal neuralgia (iTN) is a neurological condition treated with pharmacotherapy or neurosurgery. There is a lack of comparative papers regarding the outcomes of neurosurgery in patients with iTN. The objective of this study was to investigate sensory thresholds and masticatory function in 78 patients with iTN who underwent microvascular decompression (MVD) or balloon compression (BC), and compare these treatments with carbamazepine and 30 untreated healthy controls. METHODS The authors conducted a case-controlled longitudinal study. Patients were referred to 1 of 3 groups: MVD, BC, or carbamazepine. All patients were evaluated before and after treatment with a systematic protocol composed of a clinical orofacial questionnaire, Research Diagnostic Criteria for temporomandibular disorders, Helkimo indices, and a quantitative sensory-testing protocol (gustative, olfactory, cold, warm, touch, vibration, superficial, and deep pain thresholds). RESULTS Both MVD and BC were effective at reducing pain intensity (p = 0.012) and carbamazepine doses (p < 0.001). Myofascial and articular complaints decreased in both groups (p < 0.001), but only the patients in the MVD group showed improvement in Helkimo indices (p < 0.003). Patients who underwent MVD also showed an increase in sweet (p = 0.014) and salty (p = 0.003) thresholds. The sour threshold decreased (p = 0.003) and cold and warm thresholds increased (p < 0.001) in patients after MVD and BC, but only the patients who underwent BC had an increase in touch threshold (p < 0.001). CONCLUSIONS Microvascular decompression and BC resulted in a reduction in myofascial and jaw articular complaints, and the impact on masticatory function according to Helkimo indices was greater after BC than MVD. MVD resulted in more gustative alterations, and both procedures caused impairment in thermal thresholds (warm and cold). However, only BC also affected touch perception. The sensorial and motor deficits after BC need to be included as targets directly associated with the success of the surgery and need to be assessed and relieved as goals in the treatment of iTN.

scholarly journals Gut Microbiota Associated with Effectiveness and Responsiveness to Mindfulness-Based Cognitive Therapy in Improving Trait Anxiety

2021 ◽  
Author(s):  
zonghua wang ◽  
xiaoxiao xu ◽  
shuang liu ◽  
Yufeng Xiao ◽  
min yang ◽  
...  
Keyword(s):  
Gut Microbiota ◽  
Cognitive Therapy ◽  
Trait Anxiety ◽  
Fecal Microbiota ◽  
Healthy Controls ◽  
Before And After ◽  
High Trait ◽  
Underlying Mechanisms ◽  
High Trait Anxiety ◽  
The Impact

Abstract ObjectiveThe mindfulness based interventions have been widely demonstrated effective on reducing stress, alleviating mood disorders and improving quality of life; however, the underlying mechanisms remained to be fully understood. Along with the advanced research in microbiota-gut-brain axis, this study aimed to explore the impact of gut microbiota on the effectiveness and responsiveness to mindfulness-based cognitive therapy (MBCT) among high trait anxiety populations.DesignA standard mindfulness-based cognitive therapy (MBCT) was performed among 21 young adults with high trait anxiety. A total of 29 healthy controls were matched for age and sex. The differences on gut microbiota between the two groups were compared. The changes of fecal microbiota and psychological indicators were also investigated before and after the intervention. ResultsCompared with healthy controls, we found markedly decreased bacterial diversity and distinctive clusters among high trait-anxiety populations, with significant overgrowth of bacteria such as Streptococcus, Blautia, Romboutsia, and decrease of genera such as Faecalibacterium, Coprococcus_3, Lachnoclostridium. Moreover, MBCT attenuated trait-anxiety and depression, improved mindfulness and resilience, and turned gut microbiota more close to that of healthy controls. Notably, high burden of intestinal Subdoligranulum pre-MBCT was associated with an increased responsiveness to MBCT. Decreases in Subdoligranulum post-MBCT were indicative of ameliorated trait anxiety. The tryptophan metabolism pathways were significantly over-represented among high-responders compared to low-responders.Conclusion The significantly increased diversity post-MBCT added evidence to gut-brain communication, and highlighted the utility of mycobiota-focused strategies for promoting effectiveness and responsiveness of the MBCT to improve trait anxiety.Trial registration: Chictr.org.cn, ChiCTR1900028389. Registered 20 December 2019, http://www.chictr.org.cn/edit.aspx?pid=47167&htm=4

Study the Relationship Between Estrogen Hormone and Calcium in Normal Females Before and After Menopause in Baghdad / Iraq

2018 ◽  
Vol 2 (1) ◽  
Author(s):  
Sameerah Mustafa ◽  
Asal Tawfeeq ◽  
Hadeel Hasan
Keyword(s):  
Oral Contraceptive ◽  
Healthy Controls ◽  
Serum Samples ◽  
Oral Contraceptive Pills ◽  
Contraceptive Pills ◽  
Menopausal Women ◽  
Before And After ◽  
Group A ◽  
Group B ◽  
Age Range

This study involved the collection of (90) samples of women serum which included (30) serum samples collected from women before menopause (reproductive women) in the age range of (22-43) years and were considered as (group A- control). While, (group B) included (30) serum samples collected from women using oral contraceptive pills between the ages of (22-43) years old. Whereas, another (30) serum samples were collected from women after menopause between the ages of (43-54) years and were considered as (group C). All of the collected serum samples were subjected to a number of serological and chemical tests for the measurement of (E2, HDL, LDL and Ca). Then, the obtained data were statistical analyzed and results showed a significant decrease (p˂ 0.05) in (E2 ,Ca and HDL) levels in menopausal women compared to that of the normal healthy controls. While, there were non-significant decrease (p> 0.05) in (E2, Ca and HDL) levels in women taking oral contraceptive when compared to the normal healthy controls. On the other hand, a significant increase (p˂ 0.05) was recorded in LDL level in menopausal women compared to that of the normal healthy controls whereas, no-significant increase (p˃ 0.05) in the LDL level in women taking oral contraceptives when compared to the control women.

Strategic Role of Zakat in Multidimensional Quality of Life in Sijunjung, Indonesia

2018 ◽  
Vol 15 (1) ◽  
pp. 55-72
Author(s):  
Herlin Hamimi ◽  
Abdul Ghafar Ismail ◽  
Muhammad Hasbi Zaenal
Keyword(s):  
Quality Of Life ◽  
Positive Impact ◽  
Wealth Distribution ◽  
Absolute Poverty ◽  
Before And After ◽  
The Status ◽  
Being There ◽  
The Impact

Zakat is one of the five pillars of Islam which has a function of faith, social and economic functions. Muslims who can pay zakat are required to give at least 2.5 per cent of their wealth. The problem of poverty prevalent in disadvantaged regions because of the difficulty of access to information and communication led to a gap that is so high in wealth and resources. The instrument of zakat provides a paradigm in the achievement of equitable wealth distribution and healthy circulation. Zakat potentially offers a better life and improves the quality of human being. There is a human quality improvement not only in economic terms but also in spiritual terms such as improving religiousity. This study aims to examine the role of zakat to alleviate humanitarian issues in disadvantaged regions such as Sijunjung, one of zakat beneficiaries and impoverished areas in Indonesia. The researcher attempted a Cibest method to capture the impact of zakat beneficiaries before and after becoming a member of Zakat Community Development (ZCD) Program in material and spiritual value. The overall analysis shows that zakat has a positive impact on disadvantaged regions development and enhance the quality of life of the community. There is an improvement in the average of mustahik household incomes after becoming a member of ZCD Program. Cibest model demonstrates that material, spiritual, and absolute poverty index decreased by 10, 5, and 6 per cent. Meanwhile, the welfare index is increased by 21 per cent. These findings have significant implications for developing the quality of life in disadvantaged regions in Sijunjung. Therefore, zakat is one of the instruments to change the status of disadvantaged areas to be equivalent to other areas.

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