The role of nutraceuticals in the management of temporomandibular disorders.

OBJECTIVES: Temporomandibular disorders (TMDs) are usually treated with occlusal appliances and supportive treatments such as physical therapy and drugs. Supplements can be included among potential supportive therapies, with the aim of reducing the use of drugs. To evaluate the efficacy of nutraceuticals' short-term treatment in subjects with temporomandibular disorders. METHODS: The study started in January 2021 and ended in January 2022. Subjects with temporomandibular disorders and a verbal numeric scale >40 were recruited and randomly assigned to one of the following groups. If waiting to start a therapy, to the nutraceutical group or to the no treatment group, while if already undergoing splint therapy, to nutraceautical+splint group or to splint therapy group. Nutraceutical used was composed by Boswellia Serrata Casperome, Magnesium, Tryptophan and vitamins B2 and D with a posology of one tablet/day before sleep for 40 days. Presence of temporomandibular pain, headache, neck pain and sleep/emotional disorders were assessed at T0 and at T1, after 40 days. ANOVA was performed to compare treatments with nutraceuticals and their respective controls, as for the variables related to painful symptomatology. Chi- Squared was conducted to assess differences in sleep/emotional disorders between groups. The statistical significance was p<0.05. RESULTS: The groups using nutraceuticals showed statistically significant improvements over controls for most of the variables analyzed. CONCLUSIONS: The use of nutraceutical seems to be a valuable support for TMD therapy in the short term either alone or combined with occlusal splint therapy.

The protective role of cognitive reserve: an empirical study in mild cognitive impairment.

BACKGROUND: Mild cognitive impairment (MCI) describes an aging profile characterized by a cognitive decline that is worse than expected in normal aging but less pervasive and critical than full-blown dementia. In the absence of an effective treatment strategy, it is important to identify factors that can protect against progression to dementia. In this field, it is hypothesized that one aspect that may be a protective factor against the neurotypical outcome of dementia is cognitive reserve (CR). Cognitive reserve is the ability to maintain cognitive functionality despite accumulating brain pathology. OBJECTIVES: The present study aimed to identify and analyze the differences in CR between healthy adults and patients with MCI. Specifically, it is hypothesized that (i) healthy older adult people have higher CR than older adult people diagnosed with MCI, and (II) CR could predict the classification of subjects into people with or without MCI. METHODS: Two hundred forty-three adults (mean age = 60.4, SD = 7.4) participated in the present study and were classified into three groups based on Petersen's MCI criteria: healthy controls (HC), amnestic MCI (aMCI), and non-amnestic MCI (naMCI). The Cognitive Reserve Index questionnaire (CRIq) was administered to assess the level of CR, FINDINGS: Results showed that HC had significantly higher CR scores than participants diagnosed with aMCI and naMCI. Moreover, a binomial logistic regression suggested that low CR was a significant risk factor for the MCI diagnosis. CONCLUSIONS: The clinical picture that emerged from the results showed that lower CR could be considered a characteristic of pathological aging, such as MCI.Public significance statement, Since the brain attempts to cope with life-related changes or pathologies, it is fundamental for both clinicians and researchers to investigate further the factors that contribute to brain resilience. As an indirect expression of brain reserve, cognitive reserve may be both a marker and a predictor of adaptive aging.

Inhibition changes across the lifespan: experimental evidence from the Stroop task.

Individuals constantly exert inhibitory control over their thoughts and behaviors to plan actions that compete with habits and impulses. Cognitive inhibition enhances the selection of task-relevant stimuli and is closely related to neural changes that occur across the lifespan. Since few studies have focused on the entire lifespan, this study aimed to assess cognitive inhibition abilities in a sample of 425 healthy participants (age range: 7-88 years) using the Stroop task. The participants were grouped according to age into children, adolescents, young adults, adults, middle-aged adults, and older adults. A series of ANOVAs considered Group as the independent variable and Performance indices as the dependent variables. The children did not show an interference effect (Stroop effect), likely due to the lack of an automated reading process as a consequence of ongoing brain maturation. Adolescents and young adults performed significantly faster than older adults did. The results indicate that response speed reaches its peak during adolescence and young adulthood and then slightly decreases until older age. Nevertheless, when compared with the other groups, only older adults showed significant differences in the Stroop effect, suggesting that inhibitory abilities remain relatively consistent throughout adulthood but rapidly worsen in recent years due to the physiological decline in cognitive and brain functioning associated with aging.

Validation of the brief screening of Social Network Addiction Risk.

INTRODUCTION: This study aims to develop a valid and reliable tool to evaluate social network behavior in young adults. METHODS: To validate the Brief screening for Social Network Addiction Risk (BSNA), data from 776 Italian young adults (64.3 % of women) were collected. The suitability of the instrument was statistically assessed. Experts' opinions, item reliability, exploratory and confirmatory factor analyses, and convergent validity were adopted to validate the BSNA items. Internal consistency coefficients were also calculated. RESULTS: According to the statistical analyses, a 2-factor structure was confirmed. The two scales of BSNA assess behavior and motivation frame of social networks use. The second order model proved a global score of risk of social network addiction. Fit indices highlighted the high goodness of the model. Preliminary analyses of prevalence estimated that about 18 % of participants reported problematic Social Network use, which may overtime represent a marker of addictive behavior. CONCLUSION: The final version of the BSNA, with 11 items evaluated on a 5-point Likert- scale, is a short but valid tool for measuring the risk of social network addiction. It represents a promising screening tool aimed to not overpathologize a behavior, but to furnish adequate insight into this phenomenon.

The role of cognitive flexibility on higher level executive functions in mild cognitive impairment and healthy older adults.

BACKGROUND: Mild Cognitive Impairment (MCI) is a preclinical condition between healthy and pathological aging, which is characterized by impairments in executive functions (EFs), including cognitive flexibility. According to Diamond's model, cognitive flexibility is a core executive function, along with working memory and inhibition, but it requires the development of these last EFs to reach its full potential. In this model, planning and fluid intelligence are considered higher-level EFs. Given their central role in enabling individuals to adapt their daily life behavior efficiently, the goal is to gain valuable insight into the functionality of cognitive flexibility in a preclinical form of cognitive decline. This study aims to investigate the role of cognitive flexibility and its components, set-shifting and switching, in MCI. The hypotheses are as follows: (I) healthy participants are expected to perform better than those with MCI on cognitive flexibility and higher-level EFs tasks, taking into account the mediating role of global cognitive functioning; (II) cognitive flexibility can predict performance on higher-level EFs (i.e., planning and fluid intelligence) tasks differently in healthy individuals and those diagnosed with MCI. METHODS: Ninety participants were selected and divided into a healthy control group (N = 45; mean age 64.1 ± 6.80; 66.6% female) and an MCI group (N = 45; mean age 65.2 ± 8.14; 40% female). Cognitive flexibility, fluid intelligence, planning, and global cognitive functioning of all participants were assessed using standardized tasks. RESULTS: Results indicated that individuals with MCI showed greater impairment in global cognitive functioning and EFs performance. Furthermore, the study confirms the predictive role of cognitive flexibility for higher EFs in individuals with MCI and only partially in healthy older adults.

New Addictions in Late Adolescence and Emerging Adulthood: How Attachment Style May Predict Problematic Use of Social Networks and Binge-Watching.

As behavioral addictions (BAs) significantly affect well-being, paying attention to the characteristics associated with their onset is relevant. Current studies suggest that BAs should be addressed from an adaptive-maladaptive continuum perspective to define what and how some behaviors became problematic. The multi-faceted nature of behaviors attributed to possible BA involves psychological and individual backgrounds (e.g., attachment style). Given its role in affecting personality processes, social development, and motivational drives, the attachment style would be involved in addiction-like behaviors from adolescence, defined as a critical period for BA onset. This study analyzed the association between the attachment dimensions and two possible BAs that can be included in an adaptive-maladaptive continuum (i.e., social network use and TV series watching). A sample consisting of 493 late adolescents/emerging adults (age range: 18-24) completed questionnaires assessing social network use, TV series watching, and attachment style. The results showed a positive association between problematic attachment styles and BAs. High worry and need for relationships (anxious attachment) would be risk factors for problematic social network use and relationships as secondary (avoidant attachment) would be a risk factor for problematic TV series watching. These findings suggest the importance of further analyzing the role of attachment styles and their dimensions in influencing behavioral expression early to prevent the occurrence of BA.

The Efficiency of Attentional Networks in Takostubo Syndrome: A Study With the Attentional Network Task for Interaction.

INTRODUCTION: The role of cardiovascular risk factors in the occurrence and progression of cognitive impairment is relevant in aging studies. In this condition, attention is one of the processes less studied, but preliminary evidence suggests an association between cardiometabolic alterations and attentional decline. Attention is not a unitary process but a set of independent systems (Alerting, Orienting, Executive), which can interact in certain conditions to ensure maximum behavioral efficiency. METHODS: We investigated attentive networks and their interactions in patients with Takostubo syndrome (TTS). In all, 20 participants with TTS and 20 individuals without cardiovascular pathologies performed an Attention-Network Task for Interaction, which assesses attentional networks and their interactions. RESULTS: Patients with TTS showed an atypical orienting effect when compared to the control group. Moreover, only the control group exhibited an interaction between orienting and alerting. CONCLUSION: These findings establish the relevance of brain-heart interaction in identifying attentional impairment as a prodrome of progressively severe cognitive impairment in TTS.

Inhibition and Heart Rate Variability in Experimentally Induced Pain.

Introduction: Pain is a complex experience that requires executive functions (EFs) to be processed. The autonomic outcome of the neural networks involved in the cognitive evaluation of pain is reflected by heart rate variability (HRV), an index of self-regulation abilities. Although some results suggest a relationship between HRV, EFs, and pain, studies focusing on this three-way relationship are still scarce. Objective: This study aims to investigate the relationship between pain, cognitive, and autonomic mechanisms, hypothesizing an association between resting HRV and both cognitive and motor inhibition as indices of executive functioning. This relationship was investigated after an experimental-induced pain. Methods: Seventy-six young adults were exposed to the Cold Pressure Arm Warp to induce experimental pain. HRV was collected, and cognitive tasks were administered to assess executive performance. Results: The results showed that (1) HRV indices significantly increased during pain stimulation, (2) cognitive inhibition was positively correlated with vagal indices and with pain parameters, (3) both inhibition tasks significantly predicted pain threshold while the performance on the Stroop Task predicted pain tolerance. Conclusion: Results suggest a three-way relationship. Further research would focus on the role of HRV and cognitive strategies in pain management in chronic pain conditions.

I feel addicted to watching TV series: association between binge-watching and mental health.

Background: Binge-watching (BW) is the consecutive viewing of three or more episodes of the same series in one sitting. Although some negative effects on mental health were evidenced, the continuum of BW from leisure activity to problematic behavior is still unclear. This study aimed to analyze mental health (depression, trait anxiety, social anxiety, impulsivity, alexithymia) of people involved in different expressions of BW. Methods: A cross-sectional survey collected data from 482 respondents. According to a validated BW questionnaire, participants were divided into Problematic BW, Moderate BW, Non-BW, and No-viewer, and differences between groups were tested on psychological dimensions assessed via standardized questionnaires evaluating: trait and social anxiety, depression, impulsivity, and emotional dysregulation. Results: An association between problematic BW and worse mental health conditions was evidenced, and a positive effect of non-problematic BW was supported. A negative linear trend from the BW as a leisure activity to problematic BW was marked, indicating how a possible maladaptive behavior orientation of BW in specific mental health conditions could be figured out as a behavioral addiction.

To Binge Watch TV Series: How a Leisure Activity May Affect Sleep, Mood and Quality of Life.

Objective: New TV-watching patterns increased the practice of binge-watching (BW). Considering the adaptive-maladaptive continuum of BW, the relationship between BW and health outcomes is still unclear. This study aimed to analyze some features of BW related to quality of life, focusing on sleep quality. Methods: Four-hundred eighty-two young adults were classified into four groups according to their BW approach. Then, sleep quality, mood, and quality of life were assessed. Results: All the investigated variables were associated with problematic and moderate BW. No differences emerged between BW as a leisure activity and not watching TV series. Moreover, quality of life is directly affected by BW. Conclusion: Accordingly, BW should be considered a continuum of behavioral patterns from a leisure activity characterized by positive outcomes to a maladaptive behavior characterized by negative outcomes for sleep, mood, and quality of life.

Effect of elevated irrigation bottle height during cataract surgery on corneal endothelial cells in porcine eyes.

BACKGROUND: Cataract surgery induces corneal endothelial cell loss (ECL). This study investigates the relationship between bottle height (BH) and ECL induced due to irrigation and aspiration (I/A) in cataract surgery and quantifies protective effects of intraoperatively used ophthalmic viscoelastic substances. METHODS: Intermittent I/A without phacoemulsification was performed in porcine eyes for 10 min with varying BHs of 100 cm (BH100), 125 cm (BH125), 150 cm (BH150) or no treatment (control, no I/A). Additionally, in one group a dispersive ophthalmic viscoelastic substance was injected into the anterior eye chamber before treatment with I/A at a BH of 150 cm (BH150 + V). After exposure of the corneal endothelium to I/A, the corneas were prepared to split corneal buttons on day 0 and cultivated for 15 days. Endothelial cell density (ECD) was analyzed blinded on days 1, 8 and 15. RESULTS: Relative ECL significantly correlated with irrigation BH (control (n = 13): -9.69 ± 6.03% (average ± standard deviation); BH100 (n = 12): -9.69 ± 4.81%-p = 1.000; BH125 (n = 14): -19.44 ± 7.30% - p < 0.001; BH150 (n = 13): -21.99 ± 6.70%-p < 0.001). I/A-induced ECL was significantly decreased by the injection of ophthalmic viscoelastic, as BH150 + V (n = 14; -10.92 ± 4.09%-p = 1.000) showed a cell loss comparable to the control group. CONCLUSIONS: ECL is altered by I/A BH and reduced when viscoelastic substances are used.

Episodic and Semantic Autobiographical Memory in Mild Cognitive Impairment (MCI): A Systematic Review.

INTRODUCTION: Mild cognitive impairment (MCI) is a syndrome defined as a decline in cognitive performance greater than expected for an individual according to age and education level, not interfering notably with daily life activities. Many studies have focused on the memory domain in the analysis of MCI and more severe cases of dementia. One specific memory system is represented by autobiographical memory (AM), which has been largely studied in Alzheimer's disease and its effect on AM; however, the impairment of AM in moderate forms of decline, such as MCI, is still controversial. OBJECTIVE: The main aim of this systematic review is to analyze the functioning of autobiographical memory in patients with MCI, considering both the semantic and the episodic components. MATERIALS: The review process was conducted according to the PRISMA statement. The search was conducted until 20 February 2023 in the following bibliographical databases: PubMed, Web of Science, Scopus, and PsycInfo, and twenty-one articles were included. RESULTS: The results highlight controversial findings concerning the semantic component of AM since only seven studies have found a worse semantic AM performance in patients with MCI compared to the HC group. The results of impaired episodic AM in individuals with MCI are more consistent than those concerning semantic AM. CONCLUSIONS: Starting from the evidence of this systematic review, further studies should detect and investigate the cognitive and emotional mechanisms that undermine AM performance, allowing the development of specific interventions targeting these mechanisms.

Central retinal artery occlusion - detection score.

Purpose: To investigate the sensitivity and specificity of central retinal artery occlusion (CRAO)-Detection Score in diagnosing CRAO via questionnaire and without fundoscopy. Methods: This prospective study enrolled 176 emergency patients suffering from acute visual loss, of whom 38 were suffering from CRAO. Before conducting any examination, we administered our questionnaire containing six questions, followed by a thorough ophthalmologic examination to make the diagnosis. Statistical analysis involved a LASSO penalised multivariate logistic regression model. Results: Our receiver operating characteristic (ROC) analysis based on a LASSO penalised multivariate logistic regression model showed an area under the curve (AUC) of 0.9 - three out of six questions were selected by LASSO. Interestingly, the unweighted ROC analysis of only two questions (Short CRAO-Detection Score) yielded similar results with an AUC of 0.88. The short CRAO-Detection Score of 2 yielded 14% (4/28) false positive patients. Conclusion: This prospective study demonstrates that a high percentage of CRAO patients are detectable with a questionnaire. The CRAO-Detection Score might be used to triage patients suffering acute visual loss, which is important as intravenous fibrinolysis seem to be time-dependent to be effective.

The Protective Role of Cognitive Reserve in Mild Cognitive Impairment: A Systematic Review.

Cognitive reserve (CR) represents the ability to optimize performance and functioning to cope with brain damage or disease. CR reflects the capability to adaptively and flexibly use cognitive processes and brain networks to compensate for the deterioration typical of aging. Several studies have investigated the potential role of CR in aging, especially from the perspective of preventing and protecting against dementia and Mild Cognitive Impairment (MCI). This systematic literature review aimed to investigate the role of CR as a protective factor against MCI and associated cognitive decline. The review process was conducted according to the PRISMA statement. For this purpose, ten studies were analyzed. The results of this review show that high CR is significantly associated with a reduced risk of MCI. In addition, a significant positive relationship between CR and cognitive functioning is observed when comparing subjects with MCI and healthy subjects and within people with MCI. Thus, the results confirm the positive role of cognitive reserve in mitigating cognitive impairment. The evidence from this systematic review is consistent with the theoretical models of CR. Indeed, previous research hypothesized that specific individual experiences (such as leisure activities) allow a person to acquire successful neural resources over the years to cope with cognitive decline.

Poor Sleep Quality in Aging: The Association with Mental Health.

Sleep disturbances are common in the elderly. A primary sleep disorder can result from the physiological decline of aging; however, secondary sleep problems result from various causes involving physical and mental health. Since little is known about the relationships between sleep quality and mental health in aging, the present study aims to understand how different aspects generally associated with sleep (e.g., psychological and physiological factors, and sleep medication) may predict poor sleep quality in different stages of the lifespan. Therefore, we conducted several analyses (ANOVAs, Pearson correlations, and linear regressions) to test the hypotheses of the study. Accordingly, from a pool of 180 participants (elderly, middle-aged, and young adults), 143 individuals with poor sleep quality were selected. Different predictive patterns in the three groups emerged. Specifically, the use of sleep medication associated with worse sleep conditions is predicted by poor sleep quality in the elderly and by depression in young adults. In contrast, worsening sleep quality is predicted by depression in middle-aged adults. Previous studies focused on the transitions from good to poor sleep quality, while this is the first study to have examined the features of poor sleep quality in aging, highlighting different sleep patterns across the lifespan. This evidence should be considered from a preventive perspective.

Executive functioning during verbal fluency tasks in bilinguals: A systematic review.

BACKGROUND: Bilingualism is widespread and being bilingual is more common than being monolingual. The lifelong practice bilinguals receive from managing two languages seems to lead to a cognitive benefit. Conversely, bilingualism seems to affect language ability negatively due to less use of each known language. AIMS: This systematic review aims to summarize the results of the studies on the effect of bilingualism on executive functioning assessed by verbal fluency tasks. The verbal fluency task is a neuropsychological measure of lexical retrieval efficiency and executive functioning. METHODS: The review was conducted according to the PRISMA statement through searches in the scientific databases PsycINFO, PsycARTICLES, MEDLINE, PubMed, Web of Science and SCOPUS. Studies included in this review had at least one bilingual and monolingual group, participants over 18 years and one verbal fluency task. Studies that considered bimodal bilingual, second language learners, trilingual or multilingual people, and clinical populations were excluded. A total of 38 studies were included in the systematic review. MAIN CONTRIBUTION: Quantitative analysis of performance did not show significant differences between monolinguals and bilinguals. Qualitative results are mixed, and no definitive conclusions can be drawn about a bilingual advantage or disadvantage in the verbal fluency tasks. CONCLUSIONS: Normative data based on the monolingual population are not appropriate to test a bilingual population. It is necessary to take precautions in using this task, especially in clinical practice. WHAT THIS PAPER ADDS: What is already known on the subject Bilingualism seems to lead to a cognitive benefit due to constantly monitoring the known languages to select the most suitable one for each interactional context and to affect language ability negatively due to less use of each known language but also to language ability negatively. What this paper adds to the existing knowledge This systematic review summarizes the results of the studies on the effect of bilingualism on executive functioning assessed by verbal fluency tasks, a neuropsychological measure of lexical retrieval efficiency and executive functioning. What are the potential or actual clinical implications of this work? Normative data based on the monolingual population are not appropriate to test a bilingual population. It is necessary to take precautions in using this task, especially in clinical practice.

Personality and Behavioral Inhibition/Activation Systems in Behavioral Addiction: Analysis of Binge-Watching.

Binge-watching (BW) refers to a pattern of watching TV series characterized by the consecutive viewing of three or more episodes in one sitting. Although there is some evidence about its effects on mental health, little is known about predictive variables which may affect negative occurrences of BW, such as problematic and addictive behavior. This study aimed to assess the unique contribution of personality traits (i.e., neuroticism, extraversion, agreeableness, openness, and conscientiousness) to binge-watching, while also considering the role of two motivational systems: the behavioral inhibition system and the behavioral activation system. Cross-sectional data from 790 respondents were collected using standardized questionnaires evaluating: BW, personality traits, and the behavioral inhibition/activation system. The possible predictive roles of these variables were tested via hierarchical linear regression models. Our results underline a predictive high-risk role of neuroticism and the behavioral inhibition system and a protective role of conscientiousness in the continuum of BW from a leisure activity to a problematic one.

Eye-Gaze direction triggers a more specific attentional orienting compared to arrows.

Numerous studies have shown that eye-gaze and arrows automatically shift visuospatial attention. Nonetheless, it remains unclear whether the attentional shifts triggered by these two types of stimuli differ in some important aspects. It has been suggested that an important difference may reside in how people select objects in response to these two types of cues, eye-gaze eliciting a more specific attentional orienting than arrows. To assess this hypothesis, we examined whether the allocation of the attentional orienting triggered by eye-gaze and arrows is modulated by the presence and the distribution of reference objects (i.e., placeholders) on the scene. Following central cues, targets were presented either in an empty visual field or within one of six placeholders on each trial. In Experiment 2, placeholder-objects were grouped following the gestalt's law of proximity, whereas in Experiment 1, they were not perceptually grouped. Results showed that cueing one of the grouped placeholders spreads attention across the whole group of placeholder-objects when arrow cues were used, while it restricted attention to the specific cued placeholder when eye-gaze cues were used. No differences between the two types of cues were observed when placeholder-objects were not grouped within the cued hemifield, or no placeholders were displayed on the scene. These findings are consistent with the idea that socially relevant gaze cues encourage a more specific attentional orienting than arrow cues and provide new insight into the boundary conditions necessary to observe this dissociation.

Physical activity interventions have a moderate effect in increasing physical activity in university students-a meta-analysis.

INTRODUCTION: The transition to college is associated with changes in physical activity. This meta-analysis aims to quantify the effect of interventions on increasing physical activity in healthy university students. METHODS: We conducted a literature search (up to 2/3/2020) to identify randomized controlled trials with healthy undergraduate or graduate students enrolled in a college degree program. Moderator analyses were conducted to examine the effects of intervention modality delivery (delivered in-person or remotely) and the type of outcome measure (self-report or objective measures). RESULTS: 18 publications were included. Interventions had a medium effect on physical activity (Cohen's d = 0.52). Moderator analyses revealed no differences. CONCLUSION: Suggestions of how to improve the quality of physical activity intervention studies in college students are given. The moderate effect size of physical activity interventions in college students highlights the importance of developing and testing new interventions to promote physical activity in emerging adults.Supplemental data for this article can be accessed online at https://doi.org/10.1080/07448481.2021.1998070 .

Are there quantitative differences between eye-gaze and arrow cues? A meta-analytic answer to the debate and a call for qualitative differences.

Gaze acts from an early age as a cue to orient attention and, thereafter, to infer our social partners' intentions, thoughts, and emotions. Variants of the attentional orienting paradigm have been used to study the orienting capabilities associated to eye gaze. However, to date, it is still unclear whether this methodology truly assesses "social-specific" processes exclusively involved in attention to eye-gaze or the operation of domain-general attentional processes. The present study provides a comprehensive meta-analysis indicating that eye-gaze and non-social directional stimuli, such as arrows, produce equivalent attentional effects. This result casts doubt on the potential utility of the classic cueing task in revealing social-specific processes. On the other hand, we review behavioral evidence suggesting that eye-gaze stimuli may induce higher-order social processes when more specific experimental procedures that analyze qualitative rather than quantitative differences are used. These findings point to an integrated view in which domain-general and social specific processes both contribute to the attentional mechanisms induced by eye-gaze direction. Finally, some proposals about the social components specifically triggered by eye-gaze stimuli are discussed.