Cognitive Function Is Associated With Multiple Indices of Adiposity in the Canadian Longitudinal Study on Aging: A Cross-Sectional Analysis.

OBJECTIVE: Prior studies have suggested reciprocal relationships between cognitive function and adiposity, but this has not been investigated with population representative data sets. The purpose of this study was to examine the association between cognitive function and adiposity in a large population-based sample of middle-aged and older adults. It was hypothesized that better scores on tests of cognitive function would be associated with lower adiposity, and this association would be primarily mediated through life-style behavior and physical health status. METHODS: Using baseline data from the Canadian Longitudinal Study on Aging ( N = 30,097), we tested our hypotheses using three indicators of cognitive function (animal fluency, Stroop interference, and reaction time) and four indicators of adiposity (body mass index, total fat mass, waist circumference, and waist-hip ratio). Hierarchical multivariable linear regression modeling was conducted followed by tests for moderation by socioeconomic status and mediation through diet, physical activity, hypertension, and diabetes status. RESULTS: All measures of cognitive indicators were significantly associated with adiposity after adjusting for confounders. In general, superior performance on animal fluency, Stroop, and reaction time tasks were associated with lower adiposity by most metrics. Stroop interference was associated with lower adiposity across all metrics, including body mass index ( b = - 0.04, 95 % confidence interval [CI] = - 0.06 to - 0.01), total fat mass ( b = 19.35, 95 % CI = 8.57 to 30.12), waist circumference ( b = 33.83, 95 % CI = 10.08 to 57.58), and waist-hip ratio ( b = 0.13, 95 % CI = 0.01 to 0.24). These associations were more substantial for moderate- and high-income subpopulations. Mediation analyses suggested that the aforementioned effects were mediated through life-style behavior (e.g., diet and physical activity) and physical health conditions (e.g., diabetes and hypertension). CONCLUSIONS: Reliable associations exist between cognitive function and adiposity in middle-aged and older adults. The associations seem to be mediated through life-style behavior and physical health conditions.

Biobehavioral Aspects of the COVID-19 Pandemic: A Review.

OBJECTIVE: This review highlights the scope and significance of the coronavirus disease 2019 (COVID-19) pandemic with a focus on biobehavioral aspects and critical avenues for research. METHODS: A narrative review of the published research literature was undertaken, highlighting major empirical findings emerging during the first and second waves of the COVID-19 pandemic. RESULTS: Interactions among biological, behavioral, and societal processes were prominent across all regions of the globe during the first year of the COVID-19 emergency. Affective, cognitive, behavioral, socioeconomic, and technological factors all played a significant role in the spread of infection, response precautions, and outcomes of mitigation efforts. Affective symptoms, suicidality, and cognitive dysfunction have been widely described consequences of the infection, the economic fallout, and the necessary public health mitigation measures themselves. The impact of COVID-19 may be especially serious for those living with severe mental illness and/or chronic medical diseases, given the confluence of several adverse factors in a manner that appears to have syndemic potential. CONCLUSIONS: The COVID-19 pandemic has made clear that biological and behavioral factors interact with societal processes in the infectious disease context. Empirical research examining mechanistic pathways from infection and recovery to immunological, behavioral, and emotional outcomes is critical. Examination of how emotional and behavioral factors relate to the pandemic-both as causes and as effects-can provide valuable insights that can improve management of the current pandemic and future pandemics to come.

Medial prefrontal brain activity correlates with emerging symptoms of anxiety and depression in late adolescence: A fNIRS study.

The brain undergoes dramatic changes over the course of the adolescent years, and these developmental changes are implicated in the emergence of disorders that involve negative emotionality. Late adolescence might be the window within which brain networks manifest vulnerabilities to depressive and anxiety symptomology; particularly within the prefrontal cortex (PFC), which houses emotional control (dorsolateral) and emotional processing (medial) nodes. Given the comorbidity of depressive and anxious symptomology, it may be that the neural signature is similar for both within the developing PFC. In a sample of 67 adolescents (M = 15.97 years, SD = 1.36), we used functional near-infrared spectroscopy (fNIRS) to examine the neural signature of emergent anxiety and depressive symptoms among younger and older adolescents. We further examined the extent to which neural signatures of anxiety and depressive symptoms within the PFC were similar or different. Findings revealed that self-reported anxiety and depressive symptoms were highly correlated, and that the neural signatures of both within the PFC were similar, corresponding with the medial subregions of the PFC (i.e., those involved in evaluative processing). These findings were evident only in later adolescence, suggesting the possibility of a common vulnerability for anxiety and depressive disorders emerging around this developmental window.

Long noncoding RNA BHLHE40-AS1 promotes early breast cancer progression through modulating IL-6/STAT3 signaling.

Ductal carcinoma in situ (DCIS) is a nonobligate precursor to invasive breast cancer. Only a small percentage of DCIS cases are predicted to progress; however, there is no method to determine which DCIS lesions will remain innocuous from those that will become invasive disease. Therefore, DCIS is treated aggressively creating a current state of overdiagnosis and overtreatment. There is a critical need to identify functional determinants of progression of DCIS to invasive ductal carcinoma (IDC). Interrogating biopsies from five patients with contiguous DCIS and IDC lesions, we have shown that expression of the long noncoding RNA BHLHE40-AS1 increases with disease progression. BHLHE40-AS1 expression supports DCIS cell proliferation, motility, and invasive potential. Mechanistically, BHLHE40-AS1 modulates interleukin (IL)-6/signal transducer and activator of transcription 3 (STAT3) activity and a proinflammatory cytokine signature, in part through interaction with interleukin enhancer-binding factor 3. These data suggest that BHLHE40-AS1 supports early breast cancer progression by engaging STAT3 signaling, creating an immune-permissive microenvironment.

Quantifying Cortical Resilience in Experimental, Clinical, and Epidemiological Studies: A Conceptually Grounded Method Using Noninvasive Brain Stimulation.

OBJECTIVE: Cortical resilience can be defined as the ability of the cortex of the human brain to rebound efficiently from perturbation. This concept is important in both research and clinical practice contexts. However, no direct measure of cortical resilience exists. Inhibitory variants of repetitive transcranial magnetic stimulation, such as continuous theta burst stimulation, provide a standardized method for inducing a perturbation; when coupled with the assessment of recovery rate from the perturbation, such a paradigm might provide a standardized measure of cortical resilience. This article describes a standardized method for quantifying cortical resilience using theta burst stimulation protocols. METHODS: A descriptive overview of a method for assessing cortical resilience is presented. Links are drawn between critical facets of the resilience construct and the protocol described. RESULTS: The Cortical Challenge and Recovery Test (CCaRT) method makes use of existing stimulation parameters and cognitive testing paradigms to provide a flexible and conceptually meaningful measure of cortical resilience. CONCLUSIONS: The CCaRT paradigm is potentially useful in research and contexts where cortical resilience is to be measured. The CCaRT paradigm has applicability to epidemiological studies and laboratory experimentation as well as diagnostic practice and clinical trial outcome measures.

Considerations for an Individual-Level Population Notification System for Pandemic Response: A Review and Prototype.

The outbreak of the coronavirus disease (COVID-19), caused by severe acute respiratory syndrome coronavirus 2, spread worldwide after its emergence in China. Whether rich or poor, all nations are struggling to cope with this new global health crisis. The speed of the threat's emergence and the quick response required from public health authorities and the public itself makes evident the need for a major reform in pandemic surveillance and notification systems. The development and implementation of a graded, individual-level pandemic notification system could be an effective tool to combat future threats of epidemics. This paper describes a prototype model of such a notification system and its potential advantages and challenges for implementation. Similar to other emergency alerts, this system would include a number of threat levels (level 1-5) with a higher level indicating increasing severity and intensity of safety measures (eg, level 1: general hygiene, level 2: enhanced hygiene, level 3: physical distancing, level 4: shelter in place, and level 5: lockdown). The notifications would be transmitted to cellular devices via text message (for lower threat levels) or push notification (for higher threat levels). The notification system would allow the public to be informed about the threat level in real time and act accordingly in an organized manner. New Zealand and the United Kingdom have recently launched similar alert systems designed to coordinate the ongoing COVID-19 pandemic response more efficiently. Implementing such a system, however, faces multiple challenges. Extensive preparation and coordination among all levels of government and relevant sectors are required. Additionally, such systems may be effective primarily in countries where there exists at least moderate trust in government. Advance and ongoing public education about the nature of the system and its steps would be an essential part of the system, such that all members of the public understand the meaning of each step in advance, similar to what has been established in systems for other emergency responses. This educational component is of utmost importance to minimize adverse public reaction and unintended consequences. The use of mass media and local communities could be considered where mobile phone penetration is low. The implementation of such a notification system would be more challenging in developing countries for several reasons, including inadequate technology, limited use of data plans, high population density, poverty, mistrust in government, and tendency to ignore or failure to understand the warning messages. Despite the challenges, an individual-level pandemic notification system could provide added benefits by giving an additional route for notification that would be complementary to existing platforms.

Correction: Considerations for an Individual-Level Population Notification System for Pandemic Response: A Review and Prototype.

[This corrects the article DOI: 10.2196/19930.].

Time Perspective and All-Cause Mortality: Evidence From the English Longitudinal Study of Ageing.

BACKGROUND: Long-term future thinking has been associated with a range of favorable health behaviors. However, it is currently unclear whether this translates into an effect on morbidity and mortality. PURPOSE: The goal of this study was to study the relationship between time perspective and all-cause mortality and to examine the role of health behavior in explaining this association. METHODS: Participants (N = 9,949) aged 50 and over from the English Longitudinal Study of Ageing, a representative cohort of older English adults, estimated the length of their time horizon for financial planning (time perspective). Two thousand ninety-two deaths were recorded over a 9-year follow-up period (2002/2003-2012). Smoking, physical activity, and alcohol consumption were examined as factors that may underlie the time perspective-mortality link. RESULTS: Our prospective survival analyses showed that those who tend to plan for longer periods experienced a significantly reduced risk of all-cause mortality (HR = 0.83; 95% confidence interval [CI]: [0.80, 0.87], p < .001 per 1 SD increase in future time perspective). This association remained after adjusting for baseline socioeconomic status and health (HR = 0.92; 95% CI: [0.88, 0.97], p < .001). The link between time perspective and mortality was observed across the gradient of financial circumstances and did not appear to be due to reverse causality. Healthy behavior among the more future orientated explained 34% of the link between time perspective and mortality. CONCLUSIONS: Using a simply administered indicator of time perspective, this study suggests that a future-orientated time perspective may be an important predictor of reduced risk of death.

The neurocognitive mechanisms underlying food cravings and snack food consumption. A combined continuous theta burst stimulation (cTBS) and EEG study.

Regulation of food cravings is thought to be critical for modulating eating behavior, yet we do not fully understand the mechanisms by which cognitive control operates in the eating context. The current study combined rTMS and EEG paradigms to examine the causal role of the left dorsolateral prefrontal cortex (dlPFC) in modulating visceral and behavioral responses to high calorie foods, and the mediational mechanisms underlying this relation. 28 right-handed female participants received both active and sham continuous theta burst stimulation (cTBS; a rTMS variant used to decrease cortical activity) targeting the left dlPFC in a counterbalanced order. Prior to and following each stimulation session participants completed a flanker and food-cue presentation (high and low calorie food) task. Following cTBS participants had the opportunity to consume both high and low calorie foods during a taste test. Findings revealed a reliable effect of cTBS on food consumption, such that participants selectively ingested significantly more calories from appetitive calorie dense snack foods following active relative to sham cTBS; this effect did not translate to control (low calorie) food consumption. In addition, attenuation of dlPFC activity resulted in the significant increase in N2 amplitude and P3b latency to incongruent flanker trials, and the selective significant increase in the P3a amplitude to and P3a amplitude bias for high calorie food stimuli. Results from the parallel mediation analysis revealed that only the indirect effect of flanker task performance was significant; the indirect effects of stimulation induced changes in the P3 bias for high calorie foods, the urge to consume high calorie foods, and the general liking ratings for high calorie foods were not significant. These findings confirm the causal role of the left dlPFC in the modulation of calorie dense food consumption via inhibitory control capacity.

Non-invasive brain stimulation for food cravings, consumption, and disorders of eating: A review of methods, findings and controversies.

OBJECTIVE: To describe the state of the human research literature pertaining to the use of non-invasive brain stimulation (NIBS) procedures for modulating food cravings, food consumption, and treating disorders of eating (i.e., obesity, bulimia nervosa, and anorexia nervosa). METHODS: A narrative review of methods, empirical findings, and current areas of controversy. Both single-session experimental and multi-session therapeutic modalities are considered, separately for repetitive transcranial magnetic stimulation (rTMS) and transcranial direct current stimulation (tDCS) technologies. RESULTS: Single-session studies involving NIBS report more consistent effects of rTMS than tDCS, but this advantage is more clear in relation to food cravings than actual food consumption. Multisession therapeutic approaches have been applied to both obesity and eating disorders. With respect to obesity, the three published (tDCS) and one ongoing trial (rTMS) have yielded promising though very preliminary findings. Application of multi-session NIBS (predominantly rTMS) to eating disorders has also yielded promising but ultimately inconclusive results, both in relation to bulimia nervosa and binge eating disorder. Findings regarding excitatory NIBS in the context of anorexia are more controversial, with evidence of improvement in affective functioning, but a trend of iatrogenic weight loss. CONCLUSIONS: Excitatory NIBS-particularly rTMS-can reliably reduce food cravings in single and multi-session format. For multi-session treatment of clinical conditions, more studies are needed for both rTMS and tDCS, particularly in relation to obesity, bulimia, and binge eating disorder. Application of NIBS for anorexia is less clear at this point, and excitatory NIBS may be contraindicated on theoretical and empirical grounds.

Effects of left dlPFC modulation on social cognitive processes following food sampling.

BACKGROUND: The dorsolateral prefrontal cortex (dlPFC) plays a central role in the inhibition of eating, but also the modulation of conscious thought processes that might precede, accompany or follow initial food tasting. The latter might be particularly important to the extent that post-tasting cognitions may drive prolonged eating beyond the satiety point. However, we know very little about the effect of the dlPFC on conation following initial food sampling. This investigation compared the effects of dlPFC attenuation using repetitive transcranial magnetic stimulation (rTMS) on social cognition following (Study 1) and prior to (Study 2) a food consumption opportunity. METHODS: In Study 1, participants (N = 21; Mage = 21 years) were randomized to active or sham continuous theta-burst stimulation (cTBS; an inhibitory variant of rTMS) targeting the left dlPFC followed by an interference task. Participants subsequently completed measures of attitudes, norms and perceived control following a mock taste test. In Study 2, a second sample of right handed participants (N = 37; Mage = 21 years) were assigned to active or sham cTBS, followed by an interference task and two measures of attitudes (implicit and explicit), both assessed prior to the same taste test paradigm. RESULTS: In Study 1, findings revealed a reliable effect of cTBS on post-tasting attitudes (t(1,19) = 3.055, p = .007; d = 1.34), such that attitudes towards calorie dense snack foods were significantly more positive following active stimulation than following sham stimulation. Similar effects were found for social norms (t(1,19) = 3.024, p = .007, d = 1.31) and perceived control (t(1,20) = 19.247, p < .001, d = 0.50). In Study 2, no effects of cTBS were observed on pre-consumption attitudes, despite reliable effects on interference scores and subsequent consumption. CONCLUSIONS: The left dlPFC may selectively modulate facilitative social cognition following initial food sampling (but not pre-consumption).

The Neurobiology of Health Communication.

This issue of Psychosomatic Medicine describes findings from an innovative study by Kang et al that used neuroimaging methods to quantify neural responses to health communications. Findings indicated that sedentary individuals who hold self-transcendent values show attenuated limbic threat responses to communications about the benefits of physical activity. Furthermore, participants who were instructed to articulate such values showed some evidence of additional blunting of the same neural response. In this editorial, we provide context for the interpretation of these findings within the existing research using the brain-as-predictor approach, and other recent trends within biobehavioral medicine involving the use of neuroscience methods in the service of health behavior change.

Effects of Moderate Exercise on Cortical Resilience: A Transcranial Magnetic Stimulation Study Targeting the Dorsolateral Prefrontal Cortex.

OBJECTIVE: The beneficial effects of exercise on the brain regions that support cognitive control and memory are well documented. However, examination of the capacity of acute exercise to promote cortical resilience-the ability to recover from temporary pertubation-has been largely unexplored. The present study sought to determine whether single session of moderate-intensity aerobic exercise can accelerate recovery of inhibitory control centers in the dorsolateral prefrontal cortex after transient perturbation via continuous theta burst stimulation (cTBS). METHODS: In a within-participants experimental design, 28 female participants aged 18 to 26 years (mean [standard deviation] = 20.32 [1.79] years) completed a session each of moderate-intensity and very light-intensity exercise, in a randomized order. Before each exercise session, participants received active cTBS to the left dorsolateral prefrontal cortex. A Stroop task was used to quantify both the initial perturbation and subsequent recovery effects on inhibitory control. RESULTS: Results revealed a significant exercise condition (moderate-intensity exercise, very light-intensity exercise) by time (prestimulation, poststimulation, postexercise) interaction (F(2,52) = 5.93, p = .005, d = 0.38). Specifically, the proportion of the cTBS-induced decrement in inhibition restored at 40 minutes postexercise was significantly higher after a bout of moderate-intensity exercise (101.26%) compared with very light-intensity exercise (18.36%; t(27) = -2.17, p = .039, d = -.57, 95% confidence interval = -161.40 to -4.40). CONCLUSION: These findings support the hypothesis that exercise promotes cortical resilience, specifically in relation to the brain regions that support inhibitory control. The resilience-promoting effects of exercise have empirical and theoretical implications for how we conceptualize the neuroprotective effects of exercise.

Effects of Noninvasive Brain Stimulation on Food Cravings and Consumption: A Meta-Analytic Review.

OBJECTIVE: The primary aim of this review was to evaluate the effectiveness of noninvasive brain stimulation to the dorsolateral prefrontal cortex (dlPFC) for modulating appetitive food cravings and consumption in laboratory (via meta-analysis) and therapeutic (via systematic review) contexts. METHODS: Keyword searches of electronic databases (PubMed, Scopus, Web of Science, PsychoInfo, and EMBASE) and searches of previous quantitative reviews were used to identify studies (experimental [single-session] or randomized trials [multi-session]) that examined the effects of neuromodulation to the dlPFC on food cravings (n = 9) and/or consumption (n = 7). Random-effects models were employed to estimate the overall and method-specific (repetitive transcranial magnetic stimulation [rTMS] and transcranial direct current stimulation [tDCS]) effect sizes. Age and body mass index were examined as potential moderators. Two studies involving multisession therapeutic stimulation were considered in a separate systematic review. RESULTS: Findings revealed a moderate-sized effect of modulation on cravings across studies (g, -0.516; p = .037); this effect was subject to significant heterogeneity (Q, 33.086; p < .001). Although no statistically significant moderators were identified, the stimulation effect on cravings was statistically significant for rTMS (g, -0.834; p = .008) but not tDCS (g, -0.252; p = .37). There was not sufficient evidence to support a causal effect of neuromodulation and consumption in experimental studies; therapeutic studies reported mixed findings. CONCLUSIONS: Stimulation of the dlPFC modulates cravings for appetitive foods in single-session laboratory paradigms; when estimated separately, the effect size is only significant for rTMS protocols. Effects on consumption in laboratory contexts were not reliable across studies, but this may reflect methodological variability in delivery of stimulation and assessment of eating behavior. Additional single- and multi-session studies assessing eating behavior outcomes are needed.

The politics of social status: economic and cultural roots of the populist right.

This paper explores the factors that have recently increased support for candidates and causes of the populist right across the developed democracies, especially among a core group of working-class men. In the context of debates about whether the key causal factors are economic or cultural, we contend that an effective analysis must rest on understanding how economic and cultural developments interact to generate support for populism. We suggest that one way to do so is to see status anxiety as a proximate factor inducing support for populism, and economic and cultural developments as factors that combine to precipitate such anxiety. Using cross-national survey data from 20 developed democracies, we assess the viability of this approach. We show that lower levels of subjective social status are associated with support for right populist parties, identify a set of economic and cultural developments likely to have depressed the social status of men without a college education, and show that the relative social status of those men has declined since 1987 in many of the developed democracies. We conclude that status effects provide one pathway through which economic and cultural developments may combine to increase support for the populist right.

Prevention Neuroscience: A new frontier for preventive medicine.

Prevention neuroscience may be defined as follows: an interdisciplinary field concerned with the neurobiological factors that influence susceptibility to preventable disease, disability or mortality. It includes, but is not limited to: examination of brain health as an outcome, brain activity as a predictor of health outcomes, brain structures/systems as causal determinants of health outcomes (e.g., health behaviours), and the brain as a mediator of other causal influences (e.g., social conditions) on health outcomes. This commentary describes concepts, theory and research illustrating each of these scenarios using exercise, smoking cessation, dietary behaviour, and health disparities as examples. It is argued that neuroscience may provide both concepts and methods that may be possible (even fruitful) to incorporate into preventive medicine research and health promotion practise. Although public health practitioners and cognitive neuroscientists have not traditionally crossed paths outside of the context of neurodegenerative diseases such as Alzheimer's and other dementias, it is easy to envision a future where many common disease prevention activities involve collaboration between the two disciplines, and the cache of tools available to the preventive medicine expert includes neuroimaging and neuromodulation techniques.

An exploration of exercise-induced cognitive enhancement and transfer effects to dietary self-control.

The primary objective of this study was to examine the effects of aerobic exercise on executive function, specifically inhibitory control, and the transfer to self-control in the dietary domain. It was hypothesized that exercise would enhance inhibitory control, and that this enhancement would facilitate self-control in a laboratory taste test paradigm. Using a crossover design, 51 participants completed counterbalanced sessions of both moderate exercise (experimental condition) and minimal effort walking (control condition) using a treadmill; the intersession interval was 7days. Prior to each exercise bout participants completed a Stroop task. Following each bout participants completed a second Stoop task, as well as a bogus taste test involving three appetitive calorie dense snack foods and two control foods; the amount of each food type consumed during the taste test was covertly measured. Results revealed that moderate exercise significantly improved performance on the Stroop task, and also reduced food consumption during the taste test for appetitive calorie dense snack foods; there was no exercise effect on control food consumption. Exercise-induced gains in Stroop performance mediated the effects of moderate exercise on appetitive snack food consumption. Together these findings provide evidence that a bout of a moderate aerobic exercise can enhance inhibitory control, and support for cross-domain transfer effects to dietary self-control.

Executive Function in Adults With Type 2 Diabetes: A Meta-Analytic Review.

OBJECTIVE: To examine the extent to which Type 2 diabetes mellitus (T2DM) is associated with impairments in executive function (EF). METHODS: Medline, PsychoInfo, and Scopus databases and published references were used to identify articles examining the association between T2DM status (case versus control) and EF decrements. Results from studies were converted to standardized mean differences and compared using random-effects models. Moderator analysis was conducted for age, sex, and diabetes duration using maximum likelihood estimation. RESULTS: Sixty studies (59 articles) including 9815 individuals with T2DM and 69,254 controls were included. Findings indicated a small but reliable association between T2DM status and EF decrements (d = -0.248, p < .001), observed across all aspects of EF examined: verbal fluency, mental flexibility, inhibition, working memory, and attention. Disease duration significantly moderated the effect of T2DM status on EF. CONCLUSIONS: T2DM is associated with a mild-to-moderate EF decrements. Such decrements are stronger among those with shorter disease duration.