Exploring behavioral systems of the reinforcement sensitivity theory in people with epilepsy: A cross-sectional study.

OBJECTIVES: Although epilepsy has previously been associated with behavioral changes, no previous study has utilized the behavioral models of the reinforcement sensitivity theory (RST) to investigate the impact of epilepsy on behavior. Therefore, the objective of this cross-sectional study is to examine the potential relationship between epilepsy and the neurobehavioral systems of the RST. METHODS: Using the Reinforcement Sensitivity Theory-Personality Questionnaire (RST-PQ), this cross-sectional study assessed the behavioral systems of the RST in a sample of 27 epilepsy patients and 27 age- and gender-matched healthy individuals. The RST-PQ was designed to assess the different behavioral systems of the RST. The behavioral approach system (BAS) is responsible of the approach behavior, in high values related to risk seeking and addictive behavior and in low values well related to depression. The behavioral inhibition system (BIS) is well related to anxiety in high levels, and the fight flight freeze system (FFFS) is responsible for the avoidance behavior. RESULTS: After adjusting for age, no significant differences were found in demographic information (gender and marital status) between the general population and epilepsy patients. Gender distribution was similar, with 55.6% females in both groups. Marital status also showed no significant difference, with 74% single in the control group and 63% in the epilepsy group. Significant differences were observed in the behavioral systems of the RST. The epilepsy group had higher scores compared with the control group in several areas. BAS reward activity had a median score of 23 in the epilepsy group and 21 in the control group (p = 0.001). BAS goal drive persistence (p = 0.04), BAS impulsivity (p = 0.014), FFFS (p = 0.002), and BIS (median score of 77 in the epilepsy group and 66 in the control group) also showed significant differences, with p = 0.001. These significant differences remained consistent before and after matching the control group, indicating their robustness. The only exception was BAS reward activity, which did not show a significant difference after matching, with p = 0.106 and p = 0.051 before and after matching, respectively. CONCLUSIONS: The study suggests a potential positive association between epilepsy and the BIS, potentially mediated by the hippocampus. The relationship between epilepsy and the BAS, as well as the FFFS, may also be influenced by the BIS. These findings have clinical implications, but further research is needed to confirm these relationships.

Depression, Anxiety and Poor Sleep Quality are Associated with Chronotype and Financial Wellness in University Students.

Background: Evidence suggests the importance of a person's chronotype in predicting various aspects of an individual's physical and mental health. While the effect of depression on sleep is well established, the impact of a person's specific sleep timing and chronotype on the prevalence of both depression and anxiety has yet to be fully understood, especially among university students, vulnerable to mental health problems. In addition, other factors also seem to influence the occurrence of depression and anxiety among students as well as their quality of sleep, one of which being the students' financial wellness. The objective was to evaluate the association between chronotype and the severity and prevalence of depression among Lebanese university students, while also taking into account the possible connection between chronotype and financial wellness and both anxiety and sleep quality. Methods: This cross-sectional study was conducted between December 2021 and February 2022; 330 Lebanese university students was included (mean age 21.75 ± 2.43; 67.3% females). Results: The majority of the Lebanese university students in our sample were found to have an intermediate typology (63.0%), followed by the evening typology, which appeared to constitute 28.2% of the sample, while only 8.8% possessed a morning typology. In this study, having an intermediate or evening typology compared to a morning one was significantly associated with higher depression and worse sleep quality. In addition, having an evening chronotype compared to a morningness propensity was significantly associated with more anxiety. Conclusion: This study found a positive association between an evening typology (chronotype) and higher depression and anxiety and poorer quality of sleep. Although preliminary and based on cross-sectional data, this research could help provide a better understanding of the different chronotypes among university students, and of the possible increased susceptibility of some of these typologies (i.e., evening-type) to mental health problems.

Incidence of and Factors Associated with New-Onset Insomnia Among Lebanese Hospitalised Patients: A single-centre study.

OBJECTIVES: This study aimed to determine the incidence and post-discharge resolution of new-onset insomnia in hospitalised patients with no previous history of insomnia, as well as to define major correlates of in-hospital insomnia. METHODS: This prospective observational study was conducted between November 2019 and January 2020 at a tertiary care centre in Lebanon. All hospitalised patients >18 years of age with no history of insomnia were screened for new-onset insomnia using the Insomnia Severity Index (ISI) scale. Subsequently, patients were re-assessed two weeks after discharge to determine insomnia resolution. RESULTS: A total of 75 patients were included in the study. Of these, nine (12%) had no insomnia, 34 (45.3%) had subthreshold insomnia, 22 (29.3%) had moderate insomnia and 10 (13.3%) had severe insomnia. The mean ISI score was 14.95 ± 6.05, with 88% of patients having ISI scores of >7 (95% confidence interval: 0.822-0.965). The frequency of new-onset insomnia was significantly higher among patients who shared a room compared to those in single-bed rooms (95.7% versus 75%; P = 0.011). Other factors were not found to be associated with new-onset insomnia, including the administration of medications known to cause insomnia, in-hospital sedative use, overnight oxygen, cardiac monitoring and self-reported nocturnal toilet use. Overall, insomnia resolution occurred in 78.7% of patients two weeks after discharge. CONCLUSION: There was a high incidence of acute new-onset insomnia among hospitalised patients at a tertiary centre in Lebanon. Additional research is recommended to further examine inhospital sleep disturbance factors and to seek convenient solutions to limit insomnia.

Arabic version of the Hayling sentence completion test: scale validation, normative data and factors associated with executive functions in a sample of the Lebanese adults.

BACKGROUND: This study was conducted for several reasons, primarily because of the lack of an Arabic version of the HSCT that could be beneficial in our clinical practice. Another reason is the need to find potential relationships between various factors with executive functions, especially problematic mobile phone use as suggested by many previous studies, since smartphones have become, nowadays, a daily companion of people from all generations. Thus, it is important to conduct this study in Lebanon to be adapted to the ideas, customs and social behavior of the Lebanese citizens. Hence, the objectives of the current study are to use the Arabic version of the HSCT in healthy community-dwelling Arabic-speaking adults in Lebanon, to check its validity compared to other versions of the test, as well as to identify risk factors that might affect the executive functions in these adults. METHODS: Between August-December 2019, 350 participants were randomly selected. The Arabic version of the HSCT, divided into automatic and inhibition conditions, was used; in each condition, participants' response-time and number of errors committed were recorded. RESULTS: None of the scale items was removed. For the automatic condition, response-time items converged over one factor (αCronbach = 0.905) and number of errors converged over seven factors (αCronbach = 0.334). For the inhibition condition, response-time converged over one factor (αCronbach = 0.943) and number of errors converged over four factors (αCronbach = 0.728). Using electricity as a heating method inside the house was significantly associated with a lower response-time, whereas higher problematic mobile phone use was associated with higher response-time. Using wood as a heating system inside the house and higher problematic mobile phone use were associated with higher number of errors, while using Arabian incense (bakhour) inside the house was associated with lower number of errors. CONCLUSION: We were able to set normative data for the HSCT Arabic version for use in the Lebanese population. Problematic mobile phone use was associated with lower inhibitory control in terms of response-time and errors number.

Human poisoning after ingestion of puffer fish caught from Mediterranean Sea.

Puffer fish poisoning is due to a powerful neurotoxin produced by bacteria living in this kind of fish. Though the sea of Lebanon (Mediterranean) is not endemic of puffer fish and incidence of its serious poisoning is rare, yet occasional incidences do occur. The purpose of this presentation is to raise the awareness of fishermen, fish-restaurant frequenters, public health organizations and the Ministry of Health, of its serious symptomology and to seek medical help as soon as possible.

Identification of metabolic pathway disturbances using multimodal metabolomics in autistic disorders in a Middle Eastern population.

We analyzed for the first time the metabolic profile of Lebanese children affected by autistic disorders to compare this profile to other metabolomics studies and to identify the associated metabolic disturbances. Urine samples of 40 patients with Autism spectrum disorder (ASD) and 40 healthy matched controls were analyzed using nuclear magnetic resonance (NMR) and liquid chromatography coupled to high-resolution mass spectrometry (LC-MS). Multivariate analysis on analytical data fusion was conducted on the training set of 50 urine samples, and then validated with a test set of 30 samples, this repeated 10 times. The model was also evaluated using a receiver operating characteristic curve showing a specificity and a sensitivity of 86% and 80%, respectively. Among the most significant metabolites that contributed to the discrimination between ASD and controls, we confirmed the perturbations of tyrosine, 2-hydroxybutyrate, creatine and glutamate. We found new metabolites such as trigonelline, cysteic acid and guanine. We found metabolic perturbations including amino acids, carbohydrates and oxidative stress pathways which added value for the contribution of known metabolic disturbances in ASD observed in populations of other ethnic and geographic origins.