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1.
J Behav Med ; 44(1): 84-93, 2021 02.
Artigo em Inglês | MEDLINE | ID: mdl-32770394

RESUMO

Psychosocial stress in cancer survivors may contribute to compromised quality of life and negative cancer outcomes, which can be exacerbated by poor coping skills and emotional reactivity. Mindfulness based interventions (MBIs) have shown effectiveness in reducing stress, improving quality of life and coping skills in cancer survivors. We tested whether an MBI would also improve reactivity to an acute laboratory stress task. A total of 77 women with a cancer diagnosis were recruited for a waitlist-controlled trial of Mindfulness-Based Cancer Recovery (MBCR). Participants completed a laboratory-based psychosocial stress paradigm (the Trier Social Stress Test-TSST) pre- and post-intervention, throughout which cortisol and cardiovascular profiles were measured. Neither cortisol nor cardiovascular reactivity to the TSST was changed pre-to post intervention, either between or within groups. Blunted cortisol, but not cardiovascular, reactivity was observed across both groups, which may have contributed to the lack of intervention effect. Previous research suggests that diurnal cortisol is blunted following cancer treatment; the current findings suggest this blunting may also occur during exposure to acute stress.


Assuntos
Sobreviventes de Câncer , Atenção Plena , Neoplasias , Feminino , Humanos , Hidrocortisona , Qualidade de Vida , Estresse Psicológico/terapia
2.
J Neurosci Res ; 95(1-2): 576-586, 2017 01 02.
Artigo em Inglês | MEDLINE | ID: mdl-27870395

RESUMO

Oxytocin (OT) and arginine vasopressin (AVP) exert robust and sexually dimorphic influences on cognition and emotion. How these hormones regulate relevant functional brain systems is not well understood. OT and AVP serum concentrations were assayed in 60 healthy individuals (36 women). Brain functional networks assessed with resting-state functional magnetic resonance imaging (rs-fMRI) were constructed with graph theory-based approaches that characterize brain networks as connected nodes. Sex differences were demonstrated in rs-fMRI. Men showed higher nodal degree (connectedness) and efficiency (information propagation capacity) in left inferior frontal gyrus (IFG) and bilateral superior temporal gyrus (STG) and higher nodal degree in left rolandic operculum. Women showed higher nodal betweenness (being part of paths between nodes) in right putamen and left inferior parietal gyrus (IPG). Higher hormone levels were associated with less intrinsic connectivity. In men, higher AVP was associated with lower nodal degree and efficiency in left IFG (pars orbitalis) and left STG and less efficiency in left IFG (pars triangularis). In women, higher AVP was associated with lower betweenness in left IPG, and higher OT was associated with lower nodal degree in left IFG (pars orbitalis). Hormones differentially correlate with brain networks that are important for emotion processing and cognition in men and women. AVP in men and OT in women may regulate orbital frontal cortex connectivity, which is important in emotion processing. Hormone associations with STG and pars triangularis in men and parietal cortex in women may account for well-established sex differences in verbal and visuospatial abilities, respectively. © 2016 Wiley Periodicals, Inc.


Assuntos
Arginina Vasopressina/sangue , Encéfalo/metabolismo , Vias Neurais/metabolismo , Ocitocina/sangue , Caracteres Sexuais , Adolescente , Adulto , Encéfalo/diagnóstico por imagem , Mapeamento Encefálico , Cognição/fisiologia , Emoções/fisiologia , Feminino , Humanos , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Vias Neurais/diagnóstico por imagem , Descanso , Adulto Jovem
3.
Exp Brain Res ; 234(3): 815-27, 2016 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-26645310

RESUMO

The Attention Network Test (ANT) is a frequently used computer-based tool for measuring the three attention networks (alerting, orienting, and executive control). We examined the psychometric properties of performance on a variant of the ANT, the Attention Network Test-Interaction (ANT-I) in healthy older adults (N = 173; mean age = 65.4, SD = 6.5; obtained from the Brain in Motion Study, Tyndall et al. BMC Geriatr 13:21, 2013. doi: 10.1186/1471-2318-13-21) to evaluate its usefulness as a measurement tool in both aging and clinical research. In terms of test reliability, split-half correlation analyses showed that all network scores were significantly reliable, although the strength of the correlations varied across networks as seen before (r = 0.29, 0.70, and 0.68, for alerting, orienting, and executive networks, respectively, p's < 0.05). In terms of construct validity, ANOVAs confirmed that each network score was significant (18.3, 59.4, and 109.2 ms for the alerting, orienting, and executive networks, respectively, p's < 0.01) and that these scores were generally independent from each other. Importantly, for criterion validity, a series of hierarchical linear regressions showed that the executive network score, in addition to demographic information, was a significant predictor of performance on tests of conflict resolution as well as verbal memory and retrieval (ß = -0.165 and -0.184, p's < 0.05, respectively). These results provide new information regarding the reliability and validity of ANT-I test performance in a healthy older adult population. The results provide insights into the psychometrics of the ANT-I and its potential utility in clinical research settings.


Assuntos
Envelhecimento/fisiologia , Atenção/fisiologia , Função Executiva/fisiologia , Orientação/fisiologia , Estimulação Acústica/métodos , Estimulação Acústica/normas , Idoso , Idoso de 80 Anos ou mais , Encéfalo/fisiologia , Estudos de Coortes , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estimulação Luminosa/métodos , Estudos Prospectivos , Tempo de Reação/fisiologia , Reprodutibilidade dos Testes
4.
J Int Neuropsychol Soc ; 21(10): 816-30, 2015 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-26581793

RESUMO

To determine if total lifetime physical activity (PA) is associated with better cognitive functioning with aging and if cerebrovascular function mediates this association. A sample of 226 (52.2% female) community dwelling middle-aged and older adults (66.5 ± 6.4 years) in the Brain in Motion Study, completed the Lifetime Total Physical Activity Questionnaire and underwent neuropsychological and cerebrovascular blood flow testing. Multiple robust linear regressions were used to model the associations between lifetime PA and global cognition after adjusting for age, sex, North American Adult Reading Test results (i.e., an estimate of premorbid intellectual ability), maximal aerobic capacity, body mass index and interactions between age, sex, and lifetime PA. Mediation analysis assessed the effect of cerebrovascular measures on the association between lifetime PA and global cognition. Post hoc analyses assessed past year PA and current fitness levels relation to global cognition and cerebrovascular measures. Better global cognitive performance was associated with higher lifetime PA (p=.045), recreational PA (p=.021), and vigorous intensity PA (p=.004), PA between the ages of 0 and 20 years (p=.036), and between the ages of 21 and 35 years (p.5), but partially mediated the relation between current fitness and global cognition. This study revealed significant associations between higher levels of PA (i.e., total lifetime, recreational, vigorous PA, and past year) and better cognitive function in later life. Current fitness levels relation to cognitive function may be partially mediated through current cerebrovascular function.


Assuntos
Envelhecimento/fisiologia , Encéfalo/fisiologia , Cognição/fisiologia , Estilo de Vida , Atividade Motora/fisiologia , Fatores Etários , Idoso , Circulação Cerebrovascular/fisiologia , Estudos de Coortes , Feminino , Humanos , Vida Independente , Masculino , Pessoa de Meia-Idade , Testes Neuropsicológicos , Análise de Regressão
5.
Front Integr Neurosci ; 14: 571683, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33224030

RESUMO

Aging is associated with subjective memory complaints. Approximately half of those with subjective memory complaints have objective cognitive impairment. Previous studies have provided evidence of an association between genetic risk for Alzheimer's disease (AD) and dementia progression. Also, aging is a significant risk factor for vascular pathology that may underlie at least some of the cognitive changes. This study investigates the relative contribution of subjective cognitive complaints (SCC), vascular function, and genetic risk for dementia in predicting objective cognitive performance. Multiple regression and relative importance analysis were used to investigate the relative contribution of vascular function, self-reported SCC, and dementia genetic risk, in predicting objective cognition in a sample of 238 healthy community-dwelling older adults. Age, sex, premorbid cognitive abilities, subjective verbal memory complaints, higher cerebrovascular blood flow during submaximal exercise, and certain dementia risk alleles were significant predictors of worse objective verbal memory performance (p < 0.001, R 2 = 35.2-36.4%). Using relative importance analysis, subjective verbal memory complaints, and certain dementia risk alleles contributed more variance than cerebrovascular measures. These results suggest that age-related changes in memory in healthy older adults can be predicted by subjective memory complaints, genetic risk, and to a lesser extent, cerebrovascular function.

6.
Neurology ; 94(21): e2245-e2257, 2020 05 26.
Artigo em Inglês | MEDLINE | ID: mdl-32404355

RESUMO

OBJECTIVE: To test the hypothesis that aerobic exercise is associated with improvements in cognition and cerebrovascular regulation, we enrolled 206 healthy low-active middle-aged and older adults (mean ± SD age 65.9 ± 6.4 years) in a supervised 6-month aerobic exercise intervention and assessed them before and after the intervention. METHODS: The study is a quasi-experimental single group pre/postintervention study. Neuropsychological tests were used to assess cognition before and after the intervention. Transcranial Doppler ultrasound was used to measure cerebral blood flow velocity. Cerebrovascular regulation was assessed at rest, during euoxic hypercapnia, and in response to submaximal exercise. Multiple linear regression was used to examine the association between changes in cognition and changes in cerebrovascular function. RESULTS: The intervention was associated with improvements in some cognitive domains, cardiorespiratory fitness, and cerebrovascular regulation. Changes in executive functions were negatively associated with changes in cerebrovascular resistance index (CVRi) during submaximal exercise (ß = -0.205, p = 0.013), while fluency improvements were positively associated with changes in CVRi during hypercapnia (ß = 0.106, p = 0.03). CONCLUSION: The 6-month aerobic exercise intervention was associated with improvements in some cognitive domains and cerebrovascular regulation. Secondary analyses showed a novel association between changes in cognition and changes in cerebrovascular regulation during euoxic hypercapnia and in response to submaximal exercise.


Assuntos
Circulação Cerebrovascular/fisiologia , Cognição/fisiologia , Exercício Físico/fisiologia , Voluntários Saudáveis/estatística & dados numéricos , Idoso , Função Executiva , Feminino , Humanos , Hipercapnia/fisiopatologia , Masculino , Memória/fisiologia , Testes Neuropsicológicos , Consumo de Oxigênio/fisiologia , Aptidão Física/fisiologia , Ultrassonografia Doppler Transcraniana
7.
Menopause ; 27(3): 269-277, 2020 03.
Artigo em Inglês | MEDLINE | ID: mdl-31913227

RESUMO

OBJECTIVE: Vasomotor symptoms (VMS) are associated with decreased memory performance and alterations in brain function. We conducted a preliminary examination of VMS and patterns of brain activity during a verbal memory task to provide insights into the VMS-related brain mechanisms that can contribute to memory problems in midlife women. METHODS: Fourteen postmenopausal women (mean age 53.5, 64% African-American) with moderate-to-severe VMS (>35/wk) and not taking hormone therapy completed functional magnetic resonance imaging (fMRI) assessments during word encoding and recognition, 24-hour physiologic VMS monitoring, symptom questionnaires, and two verbal memory tests. RESULTS: In regression analyses, a higher number of physiologic VMS, but not reported VMS, was associated with worse verbal memory on immediate and delayed logical memory (r = 0.53 and r = 0.72, P < 0.05). On fMRI assessments, a higher number of physiologic VMS, but not subjective VMS, was associated with greater activation in the left orbitofrontal cortex, left medial and superior frontal gyrus, right superior frontal gyrus, and right parahippocampal gyrus during the encoding task (P < 0.005). During the recognition task, physiologic VMS were associated with greater activation in the left medial and superior frontal gyrus, left parahippocampal gyrus and hippocampus, right medial and superior frontal gyrus, right parahippocampal gyrus and hippocampus (P < 0.005), and with decreased activation in the ventral medial prefrontal cortex (P < 0.005). Those associations were independent of symptoms and hormone levels. CONCLUSIONS: Preliminary data suggest that VMS may contribute to memory performance through effects on the hippocampus and prefrontal cortex. Larger studies are warranted to determine the robustness of these initial observations. : Video Summary:http://links.lww.com/MENO/A508.


Video Summary:http://links.lww.com/MENO/A508.


Assuntos
Fogachos/fisiopatologia , Transtornos da Memória/fisiopatologia , Pós-Menopausa/psicologia , Feminino , Hipocampo/fisiopatologia , Fogachos/psicologia , Humanos , Imageamento por Ressonância Magnética , Memória/fisiologia , Transtornos da Memória/etiologia , Pessoa de Meia-Idade , Córtex Pré-Frontal/fisiopatologia , Análise e Desempenho de Tarefas , Sistema Vasomotor/fisiopatologia , Aprendizagem Verbal
8.
Psychoneuroendocrinology ; 103: 241-248, 2019 05.
Artigo em Inglês | MEDLINE | ID: mdl-30721838

RESUMO

Evidence from both preclinical and clinical studies suggests aerobic exercise may dampen age-related decline in cognitive performance. Alterations in hypothalamic-pituitary-adrenal (HPA) axis function and reactivity may be a mechanism by which aerobic exercise benefits cognitive performance, and reduces perceived stress. This investigation was completed as an ancillary investigation of the Brain in Motion (BIM) study, a 6-month supervised aerobic exercise intervention. Participants were generally healthy and screened for inclusion/exclusion criteria for the parent study. Thirty-eight participants were recruited (Mean age = 65.0 [SD = 5.1]; 60% female) and the final longitudinal sample was 32 participants. Participants provided a passive drool sample at: waking, 15, 30, and 45 min post-waking to assess the cortisol awakening response (CAR) and 3, 6, 9, and 12 h post-waking to assess daily area under the curve for cortisol. Salivary cortisol was quantified by liquid chromatography coupled to tandem mass spectrometry. The exercise intervention increased CAR but no differences were observed in daily AUC. In addition, larger increases in CAR were positively associated with greater decreases in subjective stress. Thus, aerobic exercise improved the CAR in otherwise healthy, but sedentary older adults and greater improvements in CAR were associated with greater reductions in perceived stress.


Assuntos
Ritmo Circadiano/fisiologia , Exercício Físico/fisiologia , Hidrocortisona/metabolismo , Idoso , Feminino , Humanos , Hidrocortisona/análise , Sistema Hipotálamo-Hipofisário/fisiologia , Masculino , Pessoa de Meia-Idade , Sistema Hipófise-Suprarrenal/fisiologia , Saliva/química , Estresse Psicológico/metabolismo , Estresse Psicológico/fisiopatologia , Vigília/fisiologia
9.
High Alt Med Biol ; 20(4): 361-374, 2019 12.
Artigo em Inglês | MEDLINE | ID: mdl-31651199

RESUMO

Background: We investigated altitude effects on different cognitive domains among perennial shift-workers at the Atacama Large Millimeter/submillimeter Array Observatory (5050 m), Chile. Materials and Methods: Twenty healthy male workers were recruited and assigned to either a moderate-altitude first (MAF group, Test 1: 2900 m and Test 2: 5050 m) or to a high-altitude first (HAF group, Test 1: 5050 m and Test 2: 2900 m). Test 1 was conducted at the beginning and Test 2 at the end of the shift-work week. Processing speed (RTI, reaction time), attention (AST, attention-switching task, and RVP, rapid visual processing), and executive function (OTS, One Touch Stockings of Cambridge) were assessed. Results: Of the three cognitive domains assessed, only processing speed showed altitude-at-test group interaction (RTI median five choice reaction time: F1, 17 = 6.980, [Formula: see text] = 0.291, p = 0.017). With acclimatization, there was a decrease in AST reaction latency mean (t17 = -2.155, dz = 1.086, p = 0.046), an increase in RVP accuracy (t17 = 2.733, dz = 1.398, p = 0.014), and a decrease in OTS mean latency first choice (t17 = -2.375, dz = 1.211, p = 0.03). Decreased variability in cognitive function was observed in AST reaction latency standard deviation (t17 = -2.524, dz = 1.282, p = 0.022) and in RVP response latency standard deviation (t17 = -2.35, dz = 1.177, p = 0.03) with acclimatization. At 5050 m of elevation, SpO2 was positively correlated with executive function in the MAF group (OTS problems solved on first choice: r(5) = 0.839, p = 0.018) and negatively correlated with executive function latency standard deviations in the HAF group (OTS latency to first choice standard deviation: r(10) = -0.618, p = 0.032). Conclusions: Our findings highlight the importance of acclimatization and improvement of blood oxygen level, even among high altitude-experienced workers, to optimize performance of cognitively demanding work and reduce high altitude-associated health risks.


Assuntos
Doença da Altitude/psicologia , Disfunção Cognitiva/etiologia , Exposição Ambiental/efeitos adversos , Doenças Profissionais/psicologia , Exposição Ocupacional/efeitos adversos , Aclimatação/fisiologia , Adulto , Altitude , Doença da Altitude/etiologia , Chile , Cognição/fisiologia , Humanos , Masculino , Pessoa de Meia-Idade , Testes Neuropsicológicos , Doenças Profissionais/etiologia , Tempo de Reação
10.
Clin Nutr ; 37(5): 1690-1699, 2018 10.
Artigo em Inglês | MEDLINE | ID: mdl-28756038

RESUMO

BACKGROUND: Impaired glucose tolerance is a risk factor for non-age-related cognitive decline and is also associated with measures of physical activity (PA) and cardiorespiratory fitness (CRF). A low glycemic load (GL) diet can aid in the management of blood glucose levels, but little is known about its effect on cognition with poor glucoregulation. OBJECTIVE: We assessed the relation between GL and cognitive function by glucoregulation and possible mediatory effects by CRF and PA in older adults from the Brain in Motion Study. DESIGN: A cross-sectional analysis of 194 cognitively healthy adults aged ≥55 years (mean = 65.7, SD = 6.1) was conducted. GL was assessed using a quantitative food frequency questionnaire, and glucoregulation was characterized on the HOMA-IR index. Subjects also completed a cognitive assessment, CRF testing, a validated self-reported PA questionnaire, and a blood draw. Multiple linear regression models adjusted for significant covariates were used to evaluate the relation between GL and cognition, and mediation by CRF and PA was also assessed. RESULTS: GL was inversely associated with global cognition (ß = -0.014; 95% CI -0.024, -0.004) and figural memory (ß = -0.035; 95% CI -0.052, -0.018) in subjects with poor glucoregulation. Neither CRF nor PA mediated these relations. In subjects with good glucoregulation, no association was found between GL and cognitive function (p > 0.05). CONCLUSIONS: A low GL diet is associated with better cognitive function in older adults with poor glucoregulation. This study provides supportive evidence for the role of GL in maintaining better cognitive function during the aging process.


Assuntos
Cognição/fisiologia , Dieta , Carga Glicêmica/fisiologia , Idoso , Glicemia/análise , Encéfalo/fisiologia , Estudos Transversais , Exercício Físico/fisiologia , Feminino , Intolerância à Glucose , Humanos , Vida Independente , Insulina/sangue , Masculino , Pessoa de Meia-Idade , Aptidão Física
11.
Front Physiol ; 9: 1131, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30246787

RESUMO

Objective: Neurocognitive functions are affected by high altitude, however the altitude effects of acclimatization and repeated exposures are unclear. We investigated the effects of acute, subacute and repeated exposure to 5,050 m on cognition among altitude-naïve participants compared to control subjects tested at low altitude. Methods: Twenty-one altitude-naïve individuals (25.3 ± 3.8 years, 13 females) were exposed to 5,050 m for 1 week (Cycle 1) and re-exposed after a week of rest at sea-level (Cycle 2). Baseline (BL, 520 m), acute (Day 1, HA1) and acclimatization (Day 6, HA6, 5,050 m) measurements were taken in both cycles. Seventeen control subjects (24.9 ± 2.6 years, 12 females) were tested over a similar period in Calgary, Canada (1,103 m). The Reaction Time (RTI), Attention Switching Task (AST), Rapid Visual Processing (RVP) and One Touch Stockings of Cambridge (OTS) tasks were administered and outcomes were expressed in milliseconds/frequencies. Lake Louise Score (LLS) and blood oxygen saturation (SpO2) were recorded. Results: In both cycles, no significant changes were found with acute exposure on the AST total score, mean latency and SD. Significant changes were found upon acclimatization solely in the altitude group, with improved AST Mean Latency [HA1 (588 ± 92) vs. HA6 (526 ± 91), p < 0.001] and Latency SD [HA1 (189 ± 86) vs. HA6 (135 ± 65), p < 0.001] compared to acute exposure, in Cycle 1. No significant differences were present in the control group. When entering Acute SpO2 (HA1-BL), Acclimatization SpO2 (HA6-BL) and LLS score as covariates for both cycles, the effects of acclimatization on AST outcomes disappeared indicating that the changes were partially explained by SpO2 and LLS. The changes in AST Mean Latency [ΔBL (-61.2 ± 70.2) vs. ΔHA6 (-28.0 ± 58), p = 0.005] and the changes in Latency SD [ΔBL (-28.4 ± 41.2) vs. ΔHA6 (-0.2235 ± 34.8), p = 0.007] across the two cycles were smaller with acclimatization. However, the percent changes did not differ between cycles. These results indicate independent effects of altitude across repeated exposures. Conclusions: Selective and sustained attention are impaired at altitude and improves with acclimatization.The observed changes are associated, in part, with AMS score and SpO2. The gains in cognition with acclimatization during a first exposure are not carried over to repeated exposures.

12.
Schizophr Res ; 202: 173-179, 2018 12.
Artigo em Inglês | MEDLINE | ID: mdl-30539769

RESUMO

BACKGROUND: Oxytocin (OT) and arginine vasopressin (AVP) exert sexually dimorphic effects on cognition and emotion processing. Abnormalities in these hormones are observed in schizophrenia and may contribute to multiple established sex differences associated with the disorder. Here we examined sex-dependent hormone associations with resting brain activity and their clinical associations in schizophrenia patients. METHODS: OT and AVP serum concentrations were assayed in 35 individuals with schizophrenia (23 men) and 60 controls (24 men) from the Chicago BSNIP study site. Regional cerebral function was assessed with resting state fMRI by measuring the amplitude of low-frequency fluctuations (ALFF) which are believed to reflect intrinsic spontaneous neuronal activity. RESULTS: In female patients, lower OT levels were associated with lower ALFF in frontal and cerebellar cortices (p's < 0.05) and in female controls AVP levels were inversely associated with ALFF in the frontal cortex (p = 0.01). In male patients, lower OT levels were associated with lower ALFF in the posterior cingulate and lower AVP levels were associated with lower ALFF in frontal cortex (p's < 0.05). In male controls, lower OT levels were associated with lower ALFF in frontal cortex and higher ALFF in the thalamus (p's < 0.05). There were some inverse ALFF-behavior associations in patients. CONCLUSIONS: Alterations in peripheral hormone levels are associated with resting brain physiology in a sex-dependent manner in schizophrenia. These effects may contribute to sex differences in psychiatric symptom severity and course of illness in schizophrenia.


Assuntos
Encéfalo/fisiopatologia , Neurofisinas/sangue , Ocitocina/sangue , Precursores de Proteínas/sangue , Esquizofrenia/fisiopatologia , Caracteres Sexuais , Vasopressinas/sangue , Adulto , Encéfalo/diagnóstico por imagem , Mapeamento Encefálico , Estudos Transversais , Feminino , Humanos , Imageamento por Ressonância Magnética , Masculino , Descanso , Esquizofrenia/diagnóstico por imagem
13.
Neurology ; 87(17): 1836-1842, 2016 Oct 25.
Artigo em Inglês | MEDLINE | ID: mdl-27777343

RESUMO

BACKGROUND: It has been estimated that the prevalence of Alzheimer disease (AD) and related dementias will triple by 2035, unless effective interventions or treatments are found for the neurodegenerative disease. Understanding sleep changes as a marker for both AD risk and progression is a burgeoning area of investigation. Specifically, there is emerging evidence that both sleep disturbances and the APOE ε4 allele are associated with increased dementia risk. Previous research has suggested that in AD, individuals carrying the APOE ε4 allele have decreased sleep quality compared to individuals without the APOE ε4 allele. This observational trial aimed to determine if healthy older adults with the risk allele (APOE ε4+) have more sleep complaints or evidence of objective sleep disruption compared to healthy older adults without the risk allele (APOE ε4-). METHODS: Within the larger Brain in Motion study, a subset of participants completed at-home polysomnography (PSG) and actigraphy sleep assessment. Subjective sleep complaints were determined using the Pittsburgh Sleep Quality Index. RESULTS: This investigation found a significant relationship between presence of APOE ε4 allele and objective sleep disturbances measured by both actigraphy and PSG, but not subjective sleep complaints in a healthy population screened for dementia. CONCLUSIONS: These data suggest that the influence of APOE ε4 allele on objective sleep quality may precede subjective sleep complaints in individuals at increased risk for dementia.


Assuntos
Apolipoproteína E4/genética , Transtornos do Sono-Vigília/genética , Actigrafia , Idoso , Feminino , Estudos de Associação Genética , Genótipo , Humanos , Masculino , Pessoa de Meia-Idade , Projetos Piloto , Polissonografia , Fatores de Risco , Transtornos do Sono-Vigília/diagnóstico , Inquéritos e Questionários
14.
J Clin Epidemiol ; 80: 16-24, 2016 12.
Artigo em Inglês | MEDLINE | ID: mdl-27555082

RESUMO

Registry-based randomized controlled trials are defined as pragmatic trials that use registries as a platform for case records, data collection, randomization, and follow-up. Recently, the application of registry-based randomized controlled trials has attracted increasing attention in health research to address comparative effectiveness research questions in real-world settings, mainly due to their low cost, enhanced generalizability of findings, rapid consecutive enrollment, and the potential completeness of follow-up for the reference population, when compared with conventional randomized effectiveness trials. However several challenges of registry-based randomized controlled trials have to be taken into consideration, including registry data quality, ethical issues, and methodological challenges. In this article, we summarize the advantages, challenges, and areas for future research related to registry-based randomized controlled trials.


Assuntos
Pesquisa Comparativa da Efetividade/métodos , Pesquisa Comparativa da Efetividade/tendências , Projetos de Pesquisa Epidemiológica , Ensaios Clínicos Controlados Aleatórios como Assunto/métodos , Sistema de Registros/estatística & dados numéricos , Pesquisa Comparativa da Efetividade/estatística & dados numéricos , Humanos , Ensaios Clínicos Controlados Aleatórios como Assunto/estatística & dados numéricos
15.
Biol Psychiatry Cogn Neurosci Neuroimaging ; 1(2): 141-151, 2016 Mar 01.
Artigo em Inglês | MEDLINE | ID: mdl-26977453

RESUMO

BACKGROUND: The oxytocin (OT) system, including receptor epigenetic mechanisms, has been shown to influence emotion processing, especially in females. Whether OT receptor (OXTR) epigenetic alterations occur across psychotic disorders in relation to illness-related disturbances in social cognition and brain anatomy is unknown. METHODS: Participants with affective and nonaffective psychotic disorders (92 women, 75 men) and healthy controls (38 women, 37 men) from the Chicago site of the BSNIP study completed the Penn Emotion Recognition Test (ER-40), a facial emotion recognition task. We measured cytosine methylation at site -934 upstream of the OXTR start codon in DNA from whole blood, and for the first time their relationship with plasma OT levels assessed by enzyme-immunoassay. Volumes of brain regions supporting social cognition were measured from MRI scans using FreeSurfer. RESULTS: Patients with prototypic schizophrenia features showed higher levels of DNA methylation than those with prototypic bipolar features. Methylation was higher in women than men, and was associated with poorer emotion recognition only in female patients and controls. Greater methylation was associated with smaller volumes in temporal-limbic and prefrontal regions associated previously with social cognition, but only in healthy women and females with schizophrenia. CONCLUSION: DNA methylation of the OXTR site -934 was higher in schizophrenia spectrum than bipolar patients. Among patients, it was linked to behavioral deficits in social cognition and neuroanatomic structures known to support emotion processing only in schizophrenia spectrum individuals.

16.
Schizophr Res ; 166(1-3): 269-75, 2015 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-25990704

RESUMO

BACKGROUND: In women with schizophrenia, cognition has been shown to be enhanced following administration of hormone therapy or oxytocin. We examined how natural hormonal changes across the menstrual cycle influence cognition in women with schizophrenia. We hypothesized that female patients would perform worse on "female-dominant" tasks (verbal memory/fluency) and better on "male-dominant" tasks (visuospatial) during the early follicular phase (low estradiol and progesterone) compared to midluteal phase (high estradiol and progesterone) in relation to estradiol but not progesterone. METHODS: Fifty-four women (23 with schizophrenia) completed cognitive assessments and provided blood for sex steroid assays and oxytocin at early follicular (days 2-4) and midluteal (days 20-22) phases. Men were included to verify the expected pattern of sex differences on cognitive tests. RESULTS: Expected sex differences were observed on "female-dominant" and "male-dominant" tasks (p<0.001), but the magnitude of those differences did not differ between patients and controls (p=0.44). Cognitive performance did not change across the menstrual cycle on "female-dominant" or "male-dominant" tasks in either group. Estradiol and progesterone levels were unrelated to cognitive performance. Oxytocin levels did not change across the menstrual cycle but were positively related to performance on "female-dominant" tasks in female patients only (p<0.05). CONCLUSIONS: Sex differences in cognitive function are preserved in schizophrenia. Oxytocin levels do not change across the cycle, but relate to enhanced performance on female dominant tests in women. Physiological levels of oxytocin may thus have a more powerful benefit in some cognitive domains than estrogens in schizophrenia.


Assuntos
Cognição/fisiologia , Hormônios Esteroides Gonadais/sangue , Ciclo Menstrual/sangue , Ocitocina/sangue , Transtornos Psicóticos/psicologia , Psicologia do Esquizofrênico , Caracteres Sexuais , Adolescente , Adulto , Antipsicóticos/uso terapêutico , Feminino , Humanos , Masculino , Testes Neuropsicológicos , Transtornos Psicóticos/sangue , Transtornos Psicóticos/tratamento farmacológico , Esquizofrenia/sangue , Esquizofrenia/tratamento farmacológico , Adulto Jovem
17.
Schizophr Bull ; 40(6): 1374-84, 2014 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-24619535

RESUMO

Oxytocin (OT) and arginine vasopressin (AVP) exert robust influence on social affiliation and specific cognitive processes in healthy individuals. Abnormalities in these neuroendocrine systems have been observed in psychotic disorders, but their relation to impairments in behavioral domains that these endocrines modulate is not well understood. We compared abnormalities of OT and AVP serum concentrations in probands with schizophrenia (n = 57), schizoaffective disorder (n = 34), and psychotic bipolar disorder (n = 75); their first-degree relatives without a history of psychosis (n = 61, 43, 91, respectively); and healthy controls (n = 66) and examined their association with emotion processing and cognition. AVP levels were lower in schizophrenia (P = .002) and bipolar probands (P = .03) and in relatives of schizophrenia probands (P = .002) compared with controls. OT levels did not differ between groups. Familiality estimates were robust for OT (h(2) = 0.79, P = 3.97e-15) and AVP (h(2) = 0.78, P = 3.93e-11). Higher levels of OT were associated with better emotion recognition (ß = 0.40, P < .001) and general neuropsychological function (ß = 0.26, P = .04) in healthy controls as expected but not in any proband or relative group. In schizophrenia, higher OT levels were related to greater positive symptom severity. The dissociation of OT levels and behavioral function in all proband and relative groups suggests that risk and illness factors associated with psychotic disorders are not related to reduced OT levels but to a disruption in the ability of physiological levels of OT to modulate social cognition and neuropsychological function. Decreased AVP levels may be a marker of biological vulnerability in schizophrenia because alterations were seen in probands and relatives, and familiality was high.


Assuntos
Transtornos Psicóticos Afetivos/fisiopatologia , Arginina Vasopressina/sangue , Emoções/fisiologia , Ocitocina/sangue , Transtornos Psicóticos/fisiopatologia , Esquizofrenia/fisiopatologia , Percepção Social , Adulto , Transtornos Psicóticos Afetivos/sangue , Expressão Facial , Família , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Transtornos Psicóticos/sangue , Esquizofrenia/sangue
18.
Menopause ; 20(12): 1236-42, 2013 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-23676633

RESUMO

OBJECTIVE: Memory complaints increase as women transition from the premenopausal stage to the postmenopausal stage. We explored the extent to which subjective memory complaints were associated with objective cognitive test performance, affective symptoms, and menopausal symptoms in midlife women with moderate to severe vasomotor symptoms. We predicted that subjective memory complaints would be related to affective symptoms and lower performance on tests of memory and attention. METHODS: Sixty-eight midlife women (mean age, 53 y; 54% African American) with at least 35 hot flashes per week completed the Memory Functioning Questionnaire, a battery of objective cognitive tests, a menopausal symptom inventory, and mood questionnaires. Linear regression analyses were conducted to examine predictors (symptoms and objective cognitive scores) of ratings on each of four Memory Functioning Questionnaire subscales and a validated single-item rating of current memory. RESULTS: Negative affect and delayed verbal memory predicted a single-item rating of current memory. Negative affect and poorer scores on tests of attention and working memory predicted Frequency of Forgetting. Lower positive affect, higher vasomotor symptoms, and increased age predicted lower Retrospective Memory Functioning. Increased age predicted Use of Mnemonics. CONCLUSIONS: These findings strengthen the growing body of evidence indicating that women with memory complaints during the menopausal transition have an accurate appraisal of their memory function and that their complaints relate to affect and, to a lesser extent, vasomotor symptoms. Given that cognitive performance is within the reference range, these findings suggest that women can detect subtle changes in memory performance during the menopausal transition.


Assuntos
Cognição/fisiologia , Fogachos/complicações , Transtornos da Memória/etiologia , Menopausa , Saúde da Mulher , Feminino , Humanos , Pessoa de Meia-Idade , Testes Neuropsicológicos , Qualidade de Vida , Análise de Regressão , Índice de Gravidade de Doença , Inquéritos e Questionários
19.
Neurobiol Aging ; 30(1): 137-46, 2009 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-17570563

RESUMO

Little research has examined the influence of aging or sex on anatomical measures in the basolateral amygdala. We quantified spine density and dendritic material in Golgi-Cox stained tissue of the basolateral nucleus in young adult (3-5 months) and aged (20-24 months) male and female Long-Evans rats. Dendritic branching and spine density were measured in principal neurons. Age, but not sex, influenced the dendritic tree, with aged animals displaying significantly more dendritic material. Previous findings from our laboratory in the same set of subjects indicate an opposite effect of aging on dendritic material in the medial prefrontal cortex and hippocampus. We also report here a sex difference across ages in dendritic spine density, favoring males.


Assuntos
Envelhecimento/patologia , Tonsila do Cerebelo/patologia , Espinhas Dendríticas/patologia , Fatores Etários , Animais , Feminino , Hipertrofia/patologia , Masculino , Ratos , Ratos Long-Evans , Caracteres Sexuais , Fatores Sexuais
20.
Menopause ; 15(5): 848-56, 2008.
Artigo em Inglês | MEDLINE | ID: mdl-18562950

RESUMO

OBJECTIVE: To test the hypothesis that hot flashes specifically relate to verbal memory performance by examining the relationship between objective hot flashes and cognitive test performance in women with moderate to severe vasomotor symptoms. DESIGN: In an observational study, 29 midlife women (mean age, 53 y) with moderate to severe hot flashes provided measures of objective hot flashes with an ambulatory hot flash monitor, subjective hot flashes with a diary and questionnaire, and objective measures of verbal memory and other cognitive functions with standardized neuropsychological tests. RESULTS: The mean number of objective hot flashes was 19.5 per day (range, 6 to 35), including 15.3 (range, 6 to 35) during waking hours and 4.2 (range, 0 to 9) during sleep. The mean sensitivity (ie, subjective detection of objectively measured hot flashes) was 60%. Regression analyses revealed that total number of objective hot flashes, sleep duration, and verbal knowledge were significant predictors of delayed verbal memory. Verbal fluency correlated positively with objective daytime hot flashes. Hot flashes did not predict performance on any of the other secondary cognitive measures (ie, attention, working memory, visual memory), although poor sleep predicted worse performance on several outcome measures. CONCLUSIONS: Highly symptomatic women underreport the number of objective hot flashes that they experience by 43%. Verbal memory performance relates significantly to the objective number of hot flashes women experience but not to the number of hot flashes that they report. These findings suggest that physiological factors related to hot flashes, rather than psychological factors, predict poorer verbal memory function.


Assuntos
Cognição , Fogachos/complicações , Transtornos da Memória/etiologia , Memória , Aprendizagem Verbal , Feminino , Humanos , Menopausa , Pessoa de Meia-Idade , Testes Neuropsicológicos , Análise de Regressão , Índice de Gravidade de Doença , Inquéritos e Questionários , Saúde da Mulher
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