Predictors of genetic diagnosis in individuals with developmental and epileptic encephalopathies.

OBJECTIVE: To evaluate the clinical predictors of positive genetic investigation in developmental and epileptic encephalopathies, beyond the influence of Dravet Syndrome. METHODS: The study included 98 patients diagnosed with developmental and epileptic encephalopathies. The patients underwent Sanger sequencing of SCN1A, Chromosomal Microarray Analysis, and Whole Exome Sequencing. The association of clinical variables with a positive genetic test was investigated using univariate and multivariate analysis. RESULTS: Genetic diagnosis was identified in 47 (48 %) patients with developmental and epileptic encephalopathies. Beyond Dravet Syndrome influence, first seizure in the context of fever (p < 0.01), seizures precipitated by temperature (p = 0.04), cognitive regression (p = 0.04), hypotonia (p < 0.01), and focal seizures (p = 0.03) increased the chances of a positive genetic investigation. In contrast, atonic seizures (p = 0.01) and generalized discharges on electroencephalogram (p = 0.02) decreased the chances. Dravet Syndrome was positively associated with a genetic developmental and epileptic encephalopathies etiology (p < 0.01), whereas epilepsy with myoclonic-atonic seizures (p = 0.01), developmental and epileptic encephalopathies with spike-wave activation in sleep (p = 0.04), and Lennox-Gastaut syndrome (p = 0.03) were negatively associated. In multivariate analysis, the first seizure in the context of fever (p < 0.01) and hypotonia (p = 0.02) were positively, and atonic seizures (p = 0.01) were negatively and independently associated with a genetic etiology. CONCLUSION: The predictive variables of genetic investigation in developmental and epileptic encephalopathies are first seizure in the context of fever and hypotonia, whereas atonic seizures decrease the chances of finding a genetic cause for developmental and epileptic encephalopathies. Regarding epileptic syndromes, Dravet Syndrome is highly associated with a positive genetic test, whereas epilepsy with myoclonic-atonic seizures, developmental and epileptic encephalopathies with spike-wave activation in sleep, and Lennox-Gastaut syndrome are rarely associated with a positive genetic investigation.

Oral 24-week probiotics supplementation did not decrease cardiovascular risk markers in patients with biopsy proven NASH: A double-blind placebo-controlled randomized study.

INTRODUCTION AND OBJECTIVES: Cardiovascular disease (CVD) is the major cause of death in non-alcoholic fatty liver disease (NAFLD), a clinical condition without any approved pharmacological therapy. Probiotics are often indicated for the disease, but their results are controversial in part due to the poor quality of studies. Thus, we investigated the impact of 24-week probiotics supplementation on cardiovascular risk (CVR) in biopsy-proven non-alcoholic steatohepatitis (NASH) patients. PATIENTS AND METHODS: Double-blind, placebo-controlled, single-center study (NCT03467282), adult NASH, randomized for 24 weeks daily sachets of probiotic mix (109CFU of Lactobacillus acidophilus, Lactobacillus rhamnosus, Lactobacillus paracasei and Bifidobacterium lactis) or placebo. Clinical scores (atherogenic indexes, atherosclerotic cardiovascular disease-ASCVD and systematic coronary risk evaluation-SCORE), biochemistry, miR-122, miR-33a, plasminogen activator inhibitor-1 (PAI-1), intercellular adhesion molecule-1 (ICAM-1), vascular cell adhesion molecule-1 (VCAM-1), were determined before and after the intervention. RESULTS: Forty-six patients were enrolled (23 received probiotics and 23 placebo), with a mean age of 51.7 years, most of them females and whites. Clinical and demographic features were similar between the groups at the baseline. The Median NAFLD activity score was 4.13 in both groups. Fibrosis was mild in most patients (15.2% and 65.2% F0 and F1, respectively). Treatment did not promote any clinically significant changes in body mass index or laboratory, including lipid and glucose profile. High CVR patients through atherogenic indexes decreased from baseline in both groups, as well as PAI-1 and miR-122 levels, although there was no difference between probiotics and placebo. CONCLUSIONS: A 24-week probiotic mix administration was not superior to placebo in reducing CVR markers in patients with NASH.

New avenues in molecular genetics for the diagnosis and application of therapeutics to the epilepsies.

Genetic epidemiology studies have shown that most epilepsies involve some genetic cause. In addition, twin studies have helped strengthen the hypothesis that in most patients with epilepsy, a complex inheritance is involved. More recently, with the development of high-density single-nucleotide polymorphism (SNP) microarrays and next-generation sequencing (NGS) technologies, the discovery of genes related to the epilepsies has accelerated tremendously. Especially, the use of whole exome sequencing (WES) has had a considerable impact on the identification of rare genetic variants with large effect sizes, including inherited or de novo mutations in severe forms of childhood epilepsies. The identification of pathogenic variants in patients with these childhood epilepsies provides many benefits for patients and families, such as the confirmation of the genetic nature of the diseases. This process will allow for better genetic counseling, more accurate therapy decisions, and a significant positive emotional impact. However, to study the genetic component of the more common forms of epilepsy, the use of high-density SNP arrays in genome-wide association studies (GWAS) seems to be the strategy of choice. As such, researchers can identify loci containing genetic variants associated with the common forms of epilepsy. The knowledge generated over the past two decades about the effects of the mutations that cause the monogenic epilepsy is tremendous; however, the scientific community is just starting to apply this information in order to generate better target treatments.

Is Strength Training as Effective as Aerobic Training for Depression in Older Adults? A Randomized Controlled Trial.

BACKGROUND: This study aimed to compare the effects of aerobic training (AT), strength training (ST) and low-intensity exercise in a control group (CG) as adjunct treatments to pharmacotherapy for major depressive disorder (MDD) in older persons. METHODS: Older persons clinically diagnosed with MDD (n = 27) and treated with antidepressants were blindly randomized into three groups: AT, ST and a CG. All patients were evaluated prior to and 12 weeks after the intervention. RESULTS: Compared with the CG, the AT and ST groups showed significant reductions in depressive symptoms (treatment -response = 50% decrease in the pre- to postintervention assessment) through the Hamilton Depression Rating Scale (AT group: χ2, p = 0.044) and Beck Depression Inventory (ST group: χ2, p = 0.044). CONCLUSION: Adding AT or ST with moderate intensity to the usual treatment promoted a greater reduction of MDD symptoms.

The impact of post-alignment processing procedures on whole-exome sequencing data.

The use of post-alignment procedures has been suggested to prevent the identification of false-positives in massive DNA sequencing data. Insertions and deletions are most likely to be misinterpreted by variant calling algorithms. Using known genetic variants as references for post-processing pipelines can minimize mismatches. They allow reads to be correctly realigned and recalibrated, resulting in more parsimonious variant calling. In this work, we aim to investigate the impact of using different sets of common variants as references to facilitate variant calling from whole-exome sequencing data. We selected reference variants from common insertions and deletions available within the 1K Genomes project data and from databases from the Latin American Database of Genetic Variation (LatinGen). We used the Genome Analysis Toolkit to perform post-processing procedures like local realignment, quality recalibration procedures, and variant calling in whole exome samples. We identified an increased number of variants from the call set for all groups when no post-processing procedure was performed. We found that there was a higher concordance rate between variants called using 1K Genomes and LatinGen. Therefore, we believe that the increased number of rare variants identified in the analysis without realignment or quality recalibration indicated that they were likely false-positives.

Does Testosterone Modulate Mood States and Physical Performance in Young Basketball Players?

This study aimed to examine and compare mood states profile and physical performance during different training phases between 2 groups of adolescent basketball players that were differentiated according to baseline testosterone concentration (T). The basketball players were submitted to an intensified training period (OVL) followed by a tapering period (TP). Twenty-three young male basketball players initiated the study. Experimental criteria data were used to stratify 16 players into high-testosterone (HTC) or low-testosterone (LTC) concentration groups. All the 16 athletes undertook 5 weeks of OVL followed by a 3-week TP. Saliva sampling, Yo-Yo intermittent recovery level 1 (Yo-Yo IRL1) test and the T-test were conducted at the beginning (T1), after OVL (T2), and after TP (T3). A similar increase in internal training load was observed during OVL when compared with TP in both groups (p < 0.05). No difference in mood states was observed between groups (p > 0.05); however, LTC displayed a higher score for fatigue (p < 0.05) and a lower score for energy index (p < 0.05) in OVL, compared with TP. A significant improvement in the Yo-Yo IRL1 test and the T-test was observed (T1 to T3) (p < 0.05), with no difference between groups (p > 0.05). In conclusion, these results suggest that LTC athletes may be more susceptible to changes in mood states during intensified training periods. In addition, data indicate that a periodized training program successfully improved the physical performance (endurance and agility) of young basketball players; however, this improvement was not affected by testosterone level.

Probiotic supplementation for 24 weeks in patients with non-alcoholic steatohepatitis: the PROBILIVER randomized clinical trial.

Background and aim: Considering the increasing prevalence of non-alcoholic steatohepatitis (NASH) and treatment gaps, this study aimed to evaluate the effect of probiotic supplementation on liver function markers, nutritional status, and clinical parameters. Methods: This double-blind, randomized clinical trial (ClinicalTrials.gov ID: NCT0346782) included adult outpatients with biopsy-proven NASH. The intervention consisted of 24 weeks of supplementation with the probiotic mix Lactobacillus acidophilus (1 × 109 CFU) + Lactobacillus rhamnosus (1 × 109 CFU) + Lactobacillus paracasei (1 × 109 CFU) + Bifidobacterium lactis (1 × 109 CFU), or placebo, twice a day. The following parameters were evaluated: demographic and clinical data, transient elastography (FibroScan), liver enzymes, NAFLD fibrosis score, fatty liver index, laboratory assessment, serum concentration of toll-like receptor-4 (sTLR-4) and cytokeratin 18 (CK-18), anthropometric data, dietary intake, and physical activity. Regarding data analysis, the comparison between the groups was based on the delta of the difference of each variable analyzed (value at the end of treatment minus the baseline value) using the t-test for independent samples or the Mann-Whitney U-test. Results: Forty-four patients with NASH completed the trial (51.4 ± 11.6 years). At baseline, 87% of participants had a mild liver fibrosis degree on biopsy, normal values of liver enzymes, transient elastography values consistent with grade 1 fibrosis in both groups, increased waist circumference (WC), a BMI of 30.97 kg/m2, and 76% presented with metabolic syndrome (MetS). After the intervention, no differences were observed between the probiotic and placebo groups in terms of MetS, WC, BMI scores, or liver enzyme levels (p > 0.05 for all). The elastography values remained consistent with grade 1 fibrosis in both groups. Although CK-18 was reduced in both groups, a larger effect size was noted in the probiotic group (D = 1.336). sTLR-4 was also reduced in both groups, with no difference between groups (p = 0.885). Conclusion: Intervention with probiotics in the early stages of NASH demonstrated no significant change in hepatic and clinical parameters. Clinical trial registration: ClinicalTrials.gov, identifier NCT0346782.

Physical exercise and clinically depressed patients: a systematic review and meta-analysis.

OBJECTIVE: The aim of this meta-analysis is to evaluate the effect of aerobic training and strength training as a treatment for depression in patients diagnosed with major depressive disorder. METHODS: PubMed (Medline), ISI knowledge (Institute for Scientific Information), SciELO (Scientific Electronic Library) and Scopus databases were consulted from January 1970 to September 2011. Data were collected on variables as follows: total number of patients (pre- and postintervention), age, randomized (yes or no), diagnostic criteria, assessment instruments, and the percentage of remission and treatment response. Subsequently, we collected information on time intervention, intensity, duration, frequency, method of training (aerobic training and strength training) and type of supervision. Standardized mean differences were used for pooling continuous variables as endpoint scores. Binary outcomes, such as proportion of remission (no symptoms) and at least 50% reduction of initial scores (response), were pooled using relative risks. Random effects models were used that take into account the variance within and between studies. RESULTS: Ten articles were selected and subdivided by their interventions, controlled training modality and levels of intensity. As there was no statistically significant difference between the two types of intervention (strength or aerobic training), we combined data which finally showed a 0.61 (95% CI: -0.88 to -0.33) standard deviation reduction in the intervention group compared to the control group. When the analysis was restricted only to those studies that used the Hamilton scale (n = 15), we observed a reduction of 3.49 points compared with the control group. CONCLUSION: Despite the heterogeneity of the studies, the present meta-analysis concluded that physical exercise improves the response to treatment, especially aerobic training. However, the efficacy of exercise in the treatment of depression was influenced by age and severity of symptoms.

Cortisol Reactivity to a physical stressor in Patients with Depression and Alzheimer's disease.

Some prevalent mental disorders in the elderly, such as Alzheimer's disease (AD) and major depression disorder (MDD), are associated with chronic stress and consequently with possible dysregulation of hypothalamic-pituitary-adrenal (HPA) axis and cortisol levels in basal conditions or in the reactivity of an acute stressor. However, evidence of cortisol behavior after a physical stressor in patients with AD and MDD is scarce. Objective: This study aimed to investigate the cortisol reactivity to a single session of physical exercise in patients with MDD and AD and compare it to healthy control (HC) older individuals. Methods: HC individuals (n=10) and elderly with clinical diagnostic of MDD (n=08) and AD (n=13) were submitted to a single bout of aerobic exercise in a treadmill during 30 minutes of moderate intensity. Salivary cortisol was collected before and after acute stressor. A repeated-measure analysis of variance (ANOVA), spearman correlation, and linear regression were performed. Results: The repeated-measure ANOVA revealed no interaction for cortisol on the moment×group [F(2.000, 28.000)=1.285; p=0.293] and no effect for group (F=0.323; p=0.727). However, a significant effect for moment [F(1.000, 28.000)=4.930; p=0.035] was found, with a decreased cortisol levels in postexercise for all groups. The effect size (ES) of cortisol reduction was small for patients with MDD (d=0.402) and trivial for patients with AD (d=0.166) and HC group (d=0.090). Conclusions: All participants show a decreased cortisol reactivity to a physical stressor, which can be associated with an impairment in coping with an acute stressor.

A doença de Alzheimer (DA) e o transtorno depressivo maior (TDM) são transtornos que acometem idosos e estão associadas ao estresse crônico e à desregulação do eixo hipotálamo-hipófise-adrenal (HPA), que repercute em alterações nos níveis de cortisol (basal e reatividade). Objetivo: Investigar a reatividade do cortisol em uma única sessão de exercício físico em pacientes com TDM e com DA e compará-la com a de idosos saudáveis. Métodos: Indivíduos controle saudáveis (n=10) e idosos com diagnóstico clínico de TDM (n=08) e DA (n=13) foram submetidos a uma única sessão de exercício aeróbio em esteira rolante, durante 30 minutos, em intensidade moderada. O cortisol salivar foi coletado antes e depois do estressor agudo. Na estatística, foram realizadas as análises de variância (ANOVA) de medidas repetidas, correlação de spearman e regressão linear. Resultados: Não foi encontrada interação para momento x grupo [F (2.000, 28.000)=1.285; p=0,293] e tampouco efeito para o grupo (F=0,323; p=0,727). Todavia, foi observado efeito significativo para o momento [F(1,000, 28,000)=4,930; p=0,035], mostrando diminuição dos níveis de cortisol no pós-exercício para todos os grupos. O tamanho do efeito (TE) foi considerado pequeno para o grupo TDM (d=0,402) e trivial para o DA (d=0,166) e o saudável (d=0,090). Conclusões: Todos os participantes apresentaram diminuição da reatividade do cortisol a um estressor físico, o que pode estar associado a um comprometimento no enfrentamento de um estressor agudo.

The effect of acute effort on EEG in healthy young and elderly subjects.

The effects of physical exercise on mental health have been extensively investigated, mainly in older people. Recent studies have looked into the acute effect of exercise on the brain using standardized low-resolution brain electromagnetic tomography (sLORETA). We assessed EEG power and mood changes after 20 min of aerobic exercise in elderly (N = 10) and young (N = 19) healthy individuals. Both groups showed improvement in total mood disturbance (TMD) post exercise (young: P = 0.03; elderly: P = 0.02). Only the young group showed significant improvement in anger (P = 0.05) and vigor (P = 0.006). Comparison pre versus post-exercise for each group separately revealed significant changes in the young group (an increase in alpha, beta-1 and beta-2 activity in Brodmann areas 24, 33 and 23, respectively). However, the elderly group did not show significant changes. An inverse correlation was found between alpha asymmetry and STAI (rs = -0.50; P = 0.029) in the young group. On the other hand, a significant correlation between beta-1 activity and TMD was observed in the elderly group (rs = 0.67; P = 0.045). We conclude that acute exercise can have distinct effects on brain activity and mood variables in young individuals when compared with elderly adults. However, additional studies are necessary to further investigate the role of exercise intensity in these results.

Effects of exercise on electroencephalographic mean frequency in depressed elderly subjects.

BACKGROUND: An analysis of cortical activity by electroencephalogram (EEG) may show different patterns in depressed and normal individuals. OBJECTIVES: Our study aimed (1) to compare the total mean frequency (TMF) and mean EEG frequency per bands (MFB) in depressed and healthy elderly individuals, and (2) to verify the effect of exercise as an additional treatment for major depressive disorder (MDD; according to DSM-IV) via an assessment of depressive symptoms, TMF and MFB. METHODS: This research was divided into 2 studies. In study 1, we assessed 45 elderly individuals (13 normal and 32 depressive) in a cross-sectional design to search for differences in TMF and MFB. In study 2, we conducted a longitudinal study to assess the effect of exercise on MDD. Twenty depressed elderly persons who were on clinical treatment were allocated to a control group or an exercise group. Subjects were assessed at baseline and after 6 months with the Hamilton Depression Rating Scale, also assessing the TMF and MFB. RESULTS: Our cross-sectional study showed that a lower mean frequency (MF) in posterior areas is related to depression in the elderly. Moreover, in our longitudinal study, we observed that depressed elderly individuals showed a better response to treatment and an increase in MF after physical training. CONCLUSION: The interaction between exercise and pharmacological treatment may increase the TMF in posterior areas of depressed elderly individuals after 6 months.

Exercise and mental health: many reasons to move.

The relationship between physical activity and mental health has been widely investigated, and several hypotheses have been formulated about it. Specifically, during the aging process, physical exercise might represent a potential adjunctive treatment for neuropsychiatric disorders and cognitive impairment, helping delay the onset of neurodegenerative processes. Even though exercise itself might act as a stressor, it has been demonstrated that it reduces the harmful effects of other stressors when performed at moderate intensities. Neurotransmitter release, neurotrophic factor and neurogenesis, and cerebral blood flow alteration are some of the concepts involved. In this review, the potential effects of exercise on the aging process and on mental health are discussed, concerning some of the recent findings on animal and human research. The overwhelming evidence present in the literature today suggests that exercise ensures successful brain functioning.

Effect of probiotic supplementation in nonalcoholic steatohepatitis patients: PROBILIVER TRIAL protocol.

BACKGROUND: Recently factors in the relationship between gut microbiota, obesity, diabetes and the metabolic syndrome have been suggested in the development and progression of nonalcoholic steatohepatitis (NASH). In this sense, this work aims to evaluate the effects of probiotic supplementation on intestinal microbiota modulation, degree of hepatic steatosis and fibrosis, inflammation, gut permeability, and body composition. METHODS: This double-blind, randomized clinical trial will include adult outpatients with a diagnosis of NASH confirmed by biopsy with or without transient elastography. All patients will undergo a complete anamnesis to investigate their alcohol consumption, previous history, medications, nutritional assessment (dietary intake and body composition), sarcopenia, physical activity level and physical and functional capacity, cardiovascular risk, biochemical parameters for assessment of inflammatory status, lipid profile, hepatic function, gut permeability, and assessment of microbiota. These procedures will be performed at baseline and repeated after 24 weeks (at the end of the study). Through the process of randomization, patients will be allocated to receive treatment A or treatment B. Both patients and researchers involved will be blinded (double-blind study). The intervention consists of treatment with a probiotic mix (Lactobacillus acidophillus + Bifidobacterium lactis + Lactobacillus rhamnosus + Lactobacillus paracasei, 1 x 109 CFU for each) and the placebo which is identical in all its characteristics and packaging. Patients will be instructed to consume two sachets/day during 24 weeks and to report any symptoms or side effects related to the use of the sachets. Adherence control will be carried out through the patient's notes on a form provided, and also by checking the number of sachets used. DISCUSSION: The final results of study will be analyzed and disseminated in 2020. TRIAL REGISTRATION: ClinicalTrials.gov, ID: NCT03467282 . Registered on 15 March 2018.

Hospital-acquired intestinal toxemia botulism in a newly diagnosed adult colon cancer patient.

This manuscript reports a case of intestinal toxemia botulism in an adult with recently diagnosed metastatic colon cancer in whom botulism symptoms began 23 days after hospital admission. Representing the rarest form of botulism presentation in clinical practice, this infectious disease may have developed due to a cluster of predisposing factors that favored Clostridium botulinum colonization and the endogenous production of neurotoxins, among which are previous use of broad-spectrum antibiotics and colon changes related to the development of the neoplasia. This case highlights the importance of considering intestinal toxemia botulism in the differential diagnosis of a patient presenting with symmetrical descending flaccid paralysis, since immediate treatment with botulinum antitoxin may improve clinical outcomes.

Can physical exercise modulate cortisol level in subjects with depression? A systematic review and meta-analysis.

INTRODUCTION: Major depressive disorder (MDD) is a prevalent medical illness that is associated with chronic stress. Patients with MDD can show an imbalance in cortisol levels, which can be restored with the remission of symptoms. Physical exercise training has been used as a tool to promote changes in cortisol levels in healthy individuals. However, it is unknown if exercise can produce the same results in individuals with MDD. OBJECTIVE: To review evidence of cortisol changes after exercise training in individuals with MDD. METHODS: We conducted a search on PubMed, SciELO, LILACS, ISI Web of Knowledge, Scopus, and PsycInfo databases. Random effects meta-analysis was performed and standardized mean difference (SMD) effect size was calculated. Analyses of forest and funnel plots was conducted using Stata v.11.0 software. RESULTS: At first, 463 studies were obtained in the search. After completion of the selection procedure, five articles with seven analyses were included. Type of exercise, frequency of training, cortisol measurement, and type of control group were analyzed. There was a reduction of cortisol levels in the exercise group (SMD = -0.65, 95%CI 1.30-0.01). Moreover, sensitivity analysis and subgroup analyses revealed an effect of type (aerobic exercise) and frequency (five times per week) of exercise on reduction of cortisol levels. However, these results should be interpreted cautiously due to the small number of studies and a substantial heterogeneity among them. CONCLUSION: Physical exercise promotes a reduction in cortisol levels in individuals with MDD. However, this finding can be influenced by type of exercise, weekly frequency, and type of cortisol measurement.

Heart Rate Variability Indexes in Dementia: A Systematic Review with a Quantitative Analysis.

BACKGROUND: Decreased heart rate variability (HRV) indexes indicate low vagal activity and may be associated with development of dementia. The neurodegenerative process is associated with the cardiovascular autonomic control. OBJECTIVE: The aim of this systematic review was to investigate the effect size (ES) magnitude of the HRV indexes in the evaluation of autonomic dysfunction in older persons with dementia. METHODS: PubMed (Medline), Web of Science, Scopus, Scielo, Lilacs, and APA Psycnet were consulted. Complete original articles published in English or Portuguese, investigating the association between autonomic dysfunction and dementia, using the HRV indexes were included. RESULTS: The search identified 97 potentially relevant articles. After screening the full text, eight articles were included in the qualitative analysis and six were included in the quantitative analysis. Almost all indexes showed a negative ES for all types of dementia and mild cognitive impairment. The most common frequency band of the power spectrum density function was the high frequency, which was reported by six studies. The meta-analysis of high frequency power in Alzheimer's disease group showed high heterogeneity and inconsistent results. CONCLUSION: The negative effect size suggests an autonomic dysfunction in all types of dementia as well as mild cognitive impairment. However, further analysis is necessary to support these results.

Beta and alpha electroencephalographic activity changes after acute exercise.

Exercise has been widely related to changes in cortical activation and enhanced brain functioning. Quantitative electroencephalography (qEEG) is frequently used to investigate normal and pathological conditions in the brain cortex. Therefore, the aim of the present study was to observe absolute power alterations in beta and alpha frequency bands after a maximal effort exercise. Ten healthy young volunteers were submitted to an eight-minute resting EEG (eyes closed) followed by a maximal exercise test using a mechanical cycle ergometer. Immediately after the exercise, another identical eight-minute EEG was recorded. Log transformation and paired student's t-test compared the pre and post exercise values (p<0.05). Results indicated a significant absolute power increase in beta after exercise at frontal (Fp1, F3 and F4) and central (C4) areas, which might be related to increased cortical activation.

The relation between EEG prefrontal asymmetry and subjective feelings of mood following 24 hours of sleep deprivation.

Several studies have investigated the relationship between asymmetrical EEG activity over the frontal cortex and mood. This study aimed at investigating the association between state fluctuations in frontal alpha EEG asymmetry and state changes followed by 24 h of sleep deprivation (SD). Our results show that sleep deprivation caused a significant alteration in the asymmetry values. Activation shifted from the left hemisphere, before SD, to the right hemisphere, after SD, in all frontal electrode pairs. In addition, according to the self-rating scale of SD-related mood effects, subjects became significantly less alerted and active, and sleepier. According to these results, increased right prefrontal activation might be potentially associated with the negative mood states typically seen after sleep deprivation, although the causal relationship is still uncertain. However, more studies will be necessary to establish the viability of EEG asymmetry and the cerebral lateralization hypothesis to explain the SD-related affective changes.

Electroencephalographic changes after one night of sleep deprivation.

Total or partial sleep deprivation (SD) causes degrading effects on different cognitive and psychomotor functions that might be related to electrophysiological changes frequently observed. In the present study, we investigated the effects of one night of sleep deprivation on waking EEG. Experimental protocol consisted of recording electroencephalographic data from eleven healthy young subjects before (baseline) and after (time 2) one night of sleep deprivation. A natural log transformation was carried out and showed a significant increase in theta T6 (p=0.041), O2 (p=0.018) and OZ (p=0.028); and delta T6 (p=0.043) relative power; and a decrease in alpha Fp1 (p=0.040), F3 (p=0.013), Fp2 (p=0.033), T4 (p=0.050), T6 (p=0.018), O2 (p=0.011) and Oz (p=0.025) and beta (p=0.022) absolute power. These outcomes show that the EEG power spectra, after sleep deprivation, exhibit site-specific differences in particular frequency bands and corroborate for the premise of local aspects of brain adaptation after sleep deprivation, rather than global.

Cortisol, DHEA, and depression in the elderly: the influence of physical capacity.

OBJECTIVE: Major depression have been associated with cortisol and dehydroepiandrosterone (DHEA) changes in old depressed patients. We examined the association between depression, cortisol, and DHEA, correcting for confounding variables, including physical capacity. In addition, the association between hormone levels and physical capacity in these two experimental groups was also analyzed. METHOD: Depressed patients (n = 32) and healthy control (n = 31) old adults, both matched for age, were analyzed. Subjects were submitted to a physical capacity evaluation, including physical activity levels, functional fitness test, and balance scale. RESULTS: Depressed patients showed significant lower levels of cortisol than controls, which became non-significant after controlling for physical capacity. A positive correlation was observed between cortisol levels and physical capacity. CONCLUSIONS: The data suggest that physical capacity modulates the relationship between depression and cortisol levels and needs to be taken into consideration in the future investigations.