scholarly journals The contributions of focused attention and open monitoring in mindfulness-based cognitive therapy for affective disturbances: A 3-armed randomized dismantling trial

PLoS ONE ◽  
2021 ◽  
Vol 16 (1) ◽  
pp. e0244838
Author(s):  
Brendan Cullen ◽  
Kristina Eichel ◽  
Jared R. Lindahl ◽  
Hadley Rahrig ◽  
Nisha Kini ◽  
...  
Keyword(s):  
Cognitive Therapy ◽  
Post Treatment ◽  
Anxiety And Depression ◽  
Focused Attention ◽  
Link Type ◽  
Long Term Treatment ◽  
Affective Disturbance ◽  
Open Monitoring ◽  
Rate Of Improvement

Objective Mindfulness-based cognitive therapy (MBCT) includes a combination of focused attention (FA) and open monitoring (OM) meditation practices. The aim of this study was to assess both short- and long-term between- and within-group differences in affective disturbance among FA, OM and their combination (MBCT) in the context of a randomized controlled trial. Method One hundred and four participants with mild to severe depression and anxiety were randomized into one of three 8-week interventions: MBCT (n = 32), FA (n = 36) and OM (n = 36). Outcome measures included the Inventory of Depressive Symptomatology (IDS), and the Depression Anxiety Stress Scales (DASS). Mixed effects regression models were used to assess differential treatment effects during treatment, post-treatment (8 weeks) and long-term (20 weeks). The Reliable Change Index (RCI) was used to translate statistical findings into clinically meaningful improvements or deteriorations. Results All treatments demonstrated medium to large improvements (ds = 0.42–1.65) for almost all outcomes. While all treatments were largely comparable in their effects at post-treatment (week 8), the treatments showed meaningful differences in rapidity of response and pattern of deteriorations. FA showed the fastest rate of improvement and the fewest deteriorations on stress, anxiety and depression during treatment, but a loss of treatment-related gains and lasting deteriorations in depression at week 20. OM showed the slowest rate of improvement and lost treatment-related gains for anxiety, resulting in higher anxiety in OM at week 20 than MBCT (d = 0.40) and FA (d = 0.36), though these differences did not reach statistical significance after correcting for multiple comparisons (p’s = .06). MBCT and OM showed deteriorations in stress, anxiety and depression at multiple timepoints during treatment, with lasting deteriorations in stress and depression. MBCT showed the most favorable pattern for long-term treatment of depression. Conclusions FA, OM and MBCT show different patterns of response for different dimensions of affective disturbance. Trial registration This trial is registered at (v NCT01831362); www.clinicaltrials.gov.

scholarly journals Lack of direct involvement of a diazepam long-term treatment in the occurrence of irreversible cognitive impairment: a pre-clinical approach

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Louise Carton ◽  
Candice Niot ◽  
Maéva Kyheng ◽  
Maud Petrault ◽  
Charlotte Laloux ◽  
...  
Keyword(s):  
Working Memory ◽  
Cognitive Impairment ◽  
Cognitive Functions ◽  
Term Treatment ◽  
Post Treatment ◽  
Control Group ◽  
Clinical Approach ◽  
Maze Test ◽  
Long Term Treatment

AbstractSeveral observational studies have found a link between the long-term use of benzodiazepines and dementia, which remains controversial. Our study was designed to assess (i) whether the long-term use of benzodiazepines, at two different doses, has an irreversible effect on cognition, (ii) and whether there is an age-dependent effect. One hundred and five C57Bl/6 male mice were randomly assigned to the 15 mg/kg/day, the 30 mg/kg/day diazepam-supplemented pellets, or the control group. Each group comprised mice aged 6 or 12 months at the beginning of the experiments and treated for 16 weeks. Two sessions of behavioral assessment were conducted: after 8 weeks of treatment and after treatment completion following a 1-week wash-out period. The mid-treatment test battery included the elevated plus maze test, the Y maze spontaneous alternation test, and the open field test. The post-treatment battery was upgraded with three additional tests: the novel object recognition task, the Barnes maze test, and the touchscreen-based paired-associated learning task. At mid-treatment, working memory was impaired in the 15 mg/kg diazepam group compared to the control group (p = 0.005). No age effect was evidenced. The post-treatment assessment of cognitive functions (working memory, visual recognition memory, spatial reference learning and memory, and visuospatial memory) did not significantly differ between groups. Despite a cognitive impact during treatment, the lack of cognitive impairment after long-term treatment discontinuation suggests that benzodiazepines alone do not cause irreversible deleterious effects on cognitive functions and supports the interest of discontinuation in chronically treated patients.

Assessment of trabectedin (T) induced liver toxicity with correlation to liver morphology in a phase I study of T + pegylated liposomal doxorubicin (PLD)

2006 ◽  
Vol 24 (18_suppl) ◽  
pp. 9568-9568 ◽  
Author(s):  
A. Yver ◽  
R. Cohen ◽  
D. Williams ◽  
M. Von Mehren
Keyword(s):  
Drug Exposure ◽  
Pegylated Liposomal Doxorubicin ◽  
Term Treatment ◽  
Post Treatment ◽  
Phase Iii ◽  
Synergistic Activity ◽  
Long Term Treatment ◽  
Liver Biopsies ◽  
Grade 3

9568 Background: T (ET-743) is a first-in-class compound that binds the minor groove of DNA. T has activity in soft tissue sarcoma and ovarian cancers with predictable, transient, non-cumulative and reversible hepatic toxicity, compatible with long term treatment. The combination of T and doxorubicin had preclinical synergistic activity. This study tested T + PLD in advanced malignancies. Methods: Eligibility included normal cardiac and liver functions, prior doxorubicin exposure <250 mg/m2. PLD 30 mg/m2 was administered iv 1-hour followed by 1 of 6 T doses (0.4 -1.3 mg/m2) iv 3 hours q 21 days. In select subjects (4 at pre/post cycle 1, 4 under long term treatment -cycle 14, 20, 30 and 30), liver biopsies were done with expert independent review. Results: Six dose levels of T were evaluated in 30 subjects. The DLTs were 1 grade 3 AST and 2 grade 4 ALT elevations seen at T 1.3 mg/m2. Grade 3–4 toxicities were: ALT elevation (4%), neutropenia (3%), hand-foot syndrome (2%), AST elevation (1%) and nausea/vomiting (1%). Liver biopsies were obtained from 8 subjects (1 in 0.6, 7 in 1.1 mg/m2 T dose cohorts), age 45–78 years, with sarcoma (4), and ovarian (2), uterine (1), and head and neck (1) cancers. T and PLD mean drug exposure for these subjects was 15 (2–36) and 12 (2–24) cycles, respectively. Mean total doses for T and PLD were 23.2 (3.4–39) and 597 (94–1296) mg, respectively. Findings included NASH (nonalcoholic steatohepatitis), severity ranging from minimal steatosis to moderate steatosis with fibrosis. Pre/post treatment biopsies showed no change in NASH pre/post in 3 cases, one subject had minimal post-treatment steatosis. No mitochondrial abnormalities or stellate cell activation were observed. Review concluded no evidence of persistent liver pathological abnormalities attributable to T. Conclusions: The MTD of T is 1.1 mg/m2 with 30 mg/m2 PLD q 21 days, and is well tolerated when both drugs are administered at near full therapeutic doses for prolonged periods. Liver biopsies did not demonstrate clinically relevant hepatic tissue toxicity. As reported previously, this is an active regimen which is being further evaluated in an ongoing Phase III study in relapsed ovarian cancer. [Table: see text]

scholarly journals Long-term treatment with ligelizumab achieves prolonged symptom control during the post-treatment follow-up

2020 ◽  
Vol 145 (2) ◽  
pp. AB341 ◽  
Author(s):  
Weily Soong ◽  
Jonathan Bernstein ◽  
Gordon Sussman ◽  
Bobby Lanier ◽  
Karl Sitz ◽  
...  
Keyword(s):  
Symptom Control ◽  
Term Treatment ◽  
Post Treatment ◽  
Long Term Treatment

068 Evaluation of the long-term treatment effect of teriflunomide on cognitive outcomes and association with brain volume change: data from temso and its extension study

2018 ◽  
Vol 89 (6) ◽  
pp. A28.1-A28 ◽  
Author(s):  
Till Sprenger ◽  
Jeannette Lechner-Scott ◽  
Maria P Sormani ◽  
Jerry S Wolinsky ◽  
Jens Wuerfel ◽  
...  
Keyword(s):  
Cognitive Function ◽  
Volume Change ◽  
Brain Volume ◽  
Term Treatment ◽  
Cognitive Outcomes ◽  
Link Type ◽  
Brain Volume Loss ◽  
Long Term Treatment ◽  
Z Scores

IntroductionIn a blinded SIENA (Structural Image Evaluation using Normalisation of Atrophy) analysis of TEMSO (NCT00134563), teriflunomide significantly reduced brain volume loss (BVL) over 2 years vs placebo. Further analysis indicated a strong correlation between 2 year BVL and disability worsening, showing better disability outcomes for patients with lower rates of BVL. Here, we explore the relationship between BVL and long-term changes in cognitive function in TEMSO and its extension (NCT00803049).MethodsThe effect of teriflunomide on cognitive function was assessed by change from baseline in Paced Auditory Serial Addition Test (PASAT)−3 scores in the TEMSO core (n=1086) and extension (n=740) studies. To evaluate change in PASAT-3 scores over 5 years, the TEMSO population was categorised into groups defined by percentage brain volume change from baseline to Year 2 (assessed by SIENA).ResultsAdjusted mean changes from baseline to Week 96 in PASAT-3 raw/Z-scores were –0.265/–0.022 and 0.870/0.073 for placebo and teriflunomide 14 mg, respectively (difference vs placebo, p=0.0435 in both instances). Long-term improvements in PASAT-3 Z-scores were observed with teriflunomide 14 mg treatment: mean (SD) changes from baseline at Weeks 156 and 276 were 0.194 (0.634) and 0.200 (0.677), respectively. Mean (SD) units of change from baseline in raw PASAT-3 scores for teriflunomide 14 mg–treated patients at Weeks 156 and 276 were 2.36 (7.73) and 2.43 (8.24), respectively. In an association analysis, the group with least BVL from baseline to Year 2 demonstrated a significant improvement in PASAT-3 score with teriflunomide treatment over 5 years vs the group with most BVL.ConclusionTeriflunomide significantly improved PASAT-3 performance vs placebo over 5 years in the TEMSO core and extension studies. Slower rates of BVL over 2 years correlated with better long-term PASAT-3 improvement. This study suggests that BVL earlier in the disease course predicts longer-term cognitive function.Study supportSanofi.

scholarly journals Short-term and long-term safety and efficacy of tenofovir alafenamide, tenofovir disoproxil fumarate and entecavir treatment of acute-on-chronic liver failure associated with hepatitis B

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Juan Li ◽  
Chunhua Hu ◽  
Yi Chen ◽  
Rou Zhang ◽  
Shan Fu ◽  
...  
Keyword(s):  
Hepatitis B ◽  
Term Treatment ◽  
Efficacy And Safety ◽  
Short Term ◽  
Serum Cystatin C ◽  
Short Term Treatment ◽  
Link Type ◽  
Long Term Treatment ◽  
Significant Difference

Abstract Background & Aims There is limited evidence on the efficacy and safety of nucleos(t) ide analogues (NAs) in the treatment of HBV-ACLF. Our objective was to evaluate the outcomes among TAF, TDF and ETV, three first-line antivirals against chronic hepatitis B, in patients with HBV-ACLF. Methods Patients with HBV-related ACLF were recruited and received daily TAF (25 mg/d), TDF (300 mg/d) and ETV (0.5 mg/d). They were prospectively followed-up. The primary endpoint was overall survival at week 12 and week 48, the secondary endpoints were virological response and biochemical response. Results Forty gender and age matched eligible subjects were recruited and divided into three groups: TAF group, TDF group and ETV group. By week 48, 8 (80%) patients in TAF group, 6 (60%) patients in TDF group and 17 (85%) patients in ETV group survived without liver transplantation (P = 0.251). After 4 weeks of NAs treatment, all three groups showed paralleling reduction of HBV DNA levels. All three groups presented similar biochemical responses at week 4, patients treated with TAF showed a priority in total bilirubin reduction, albumin and cholesterol maintenance. Additionally, although there was no significant difference in changes of serum urea, serum creatinine, serum cystatin C and estimated GFR among the three groups by treatment week 4, TDF showed unfavorable renal safety even in short -term treatment. The treatment using NAs was well-tolerated and there was no serious drug-related adverse event reported. Conclusions TAF, TDF and ETV are of similar efficacy and safety in short-term and long-term treatment of HBV-ACLF. Trial registration This study is ongoing and is registered with ClinicalTrials.gov, NCT03640728 (05/02/2019).

scholarly journals Mindfulness-based cognitive therapy for the treatment of current depressive symptoms: A meta-analysis

2019 ◽  
Author(s):  
Simon Goldberg ◽  
Raymond P. Tucker ◽  
Preston A. Greene ◽  
Richard J Davidson ◽  
David J. Kearney ◽  
...  
Keyword(s):  
Depressive Symptoms ◽  
Cognitive Therapy ◽  
Randomized Clinical Trials ◽  
Meta Analysis ◽  
Post Treatment ◽  
Long Term Effects ◽  
K 13 ◽  
The Impact

Mindfulness-based cognitive therapy (MBCT) appears to be a promising intervention for the prevention of relapse in major depressive disorder, but its efficacy in patients with current depres- sive symptoms is less clear. Randomized clinical trials of MBCT for adult patients with current depressive symptoms were included (k = 13, N = 1046). Comparison conditions were coded based on whether they were intended to be therapeutic (specific active con- trols) or not (non-specific controls). MBCT was superior to non- specific controls at post-treatment (k = 10, d = 0.71, 95% confidence interval [CI] [0.47, 0.96]), although not at longest follow-up (k = 2, d = 1.47, [−0.71, 3.65], mean follow-up = 5.70 months across all studies with follow-up). MBCT did not differ from other active thera- pies at post-treatment (k = 6, d = 0.002, [−0.43, 0.44]) and longest follow-up (k = 4, d = 0.26, [−0.24, 0.75]). There was some evidence that studies with higher methodological quality showed smaller effects at post-treatment, but no evidence that effects varied by inclusion criterion. The impact of publication bias appeared minimal. MBCT seems to be efficacious for samples with current depressive symptoms at post-treatment, although a limited number of studies tested the long-term effects of this therapy.

scholarly journals Consolidation and prediction of long-term treatment effect of group and online mindfulness-based cognitive therapy for distressed cancer patients

2018 ◽  
Vol 57 (10) ◽  
pp. 1293-1302 ◽  
Author(s):  
L. Cillessen ◽  
M. P. J. Schellekens ◽  
M. O. M. Van de Ven ◽  
A. R. T. Donders ◽  
F. R. Compen ◽  
...  
Keyword(s):  
Cognitive Therapy ◽  
Cancer Patients ◽  
Treatment Effect ◽  
Term Treatment ◽  
Long Term Treatment

scholarly journals Disentangling functional connectivity effects of age and expertise in long-term meditators

2019 ◽  
Author(s):  
Roberto Guidotti ◽  
Cosimo Del Gratta ◽  
Mauro Gianni Perrucci ◽  
Gian Luca Romani ◽  
Antonino Raffone
Keyword(s):  
Functional Connectivity ◽  
Brain Networks ◽  
Focused Attention ◽  
Brain Areas ◽  
Age Related ◽  
Connectivity Patterns ◽  
Open Monitoring ◽  
Multivariate Pattern ◽  
Neurocognitive Decline

AbstractThe effects of intensive meditation practices on the functional and structural organization of the human brain have been addressed by a growing number of neuroscientific studies. However, the different modulations of meditation expertise and of ageing, in the underlying brain areas and networks, have not yet been fully elucidated. These effects should be distinguished in order to clarify how long-term meditation can modulate the connectivity between brain areas. To address this issue, we tested whether meditation expertise and age can be predicted from the multivariate pattern of functional Magnetic Resonance Imaging connectivity, in Theravada Buddhist monks with long-term practice in two different meditation forms: Focused Attention (FA) and Open Monitoring (OM).We found that functional connectivity patterns in both meditation forms can be used to predict expertise and age of long-term meditators. Our findings suggest that meditation expertise is associated with meditation-specific brain networks modulations, while age-related modifications are general and independent from the meditation type. Specifically, expertise modulated patterns during FA meditation include nodes and connections implicated in focusing, sustaining and monitoring attention, while the predictive patterns during OM meditation include nodes associated with cognitive and affective monitoring. Thus, the two forms of meditation may differentially contribute to counteract the effects of neurocognitive decline with ageing by neuroplasticity of brain networks.

Methylphenidate in treatment of adults with Attention-Deficit/Hyperactivity Disorder

2002 ◽  
Vol 6 (1_suppl) ◽  
pp. 101-107 ◽  
Author(s):  
J. Biederman ◽  
T. Spencer
Keyword(s):  
Attention Deficit Hyperactivity Disorder ◽  
Antisocial Personality Disorder ◽  
Attention Deficit ◽  
Term Treatment ◽  
Anxiety And Depression ◽  
Future Research ◽  
Hyperactivity Disorder ◽  
Long Term Treatment ◽  
Dose Dependent

Attention-Deficit/Hyperactivity Disorder (ADHD) can persist into adulthood with a continuation of the pattern of childhood psychopathology, cognition and functioning. Adult comorbidities include substance use disorders, antisocial personality disorder, anxiety and depression. Studies have shown that as in children, methylphenidate treatment for adults can lead to a robust, dose-dependent improvement in ADHD symptoms. Future research is needed to evaluate the safety and efficacy of long-term treatment with methylphenidate (MPH).

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