Ultrasound Blood-Brain Barrier Opening and Aducanumab in Alzheimer's Disease.

Antiamyloid antibodies have been used to reduce cerebral amyloid-beta (Aß) load in patients with Alzheimer's disease. We applied focused ultrasound with each of six monthly aducanumab infusions to temporarily open the blood-brain barrier with the goal of enhancing amyloid removal in selected brain regions in three participants over a period of 6 months. The reduction in the level of Aß was numerically greater in regions treated with focused ultrasound than in the homologous regions in the contralateral hemisphere that were not treated with focused ultrasound, as measured by fluorine-18 florbetaben positron-emission tomography. Cognitive tests and safety evaluations were conducted over a period of 30 to 180 days after treatment. (Funded by the Harry T. Mangurian, Jr. Foundation and the West Virginia University Rockefeller Neuroscience Institute.).

Vigilance to Spatialized Auditory Displays: Initial Assessment of Performance and Workload.

OBJECTIVE: The present study was designed to evaluate human performance and workload associated with an auditory vigilance task that required spatial discrimination of auditory stimuli. BACKGROUND: Spatial auditory displays have been increasingly developed and implemented into settings that require vigilance toward auditory spatial discrimination and localization (e.g., collision avoidance warnings). Research has yet to determine whether a vigilance decrement could impede performance in such applications. METHOD: Participants completed a 40-minute auditory vigilance task in either a spatial discrimination condition or a temporal discrimination condition. In the spatial discrimination condition, participants differentiated sounds based on differences in spatial location. In the temporal discrimination condition, participants differentiated sounds based on differences in stimulus duration. RESULTS: Correct detections and false alarms declined during the vigilance task, and each did so at a similar rate in both conditions. The overall level of correct detections did not differ significantly between conditions, but false alarms occurred more frequently within the spatial discrimination condition than in the temporal discrimination condition. NASA-TLX ratings and pupil diameter measurements indicated no differences in workload. CONCLUSION: Results indicated that tasks requiring auditory spatial discrimination can induce a vigilance decrement; and they may result in inferior vigilance performance, compared to tasks requiring discrimination of auditory duration. APPLICATION: Vigilance decrements may impede performance and safety in settings that depend on sustained attention to spatial auditory displays. Display designers should also be aware that auditory displays that require users to discriminate differences in spatial location may result in poorer discrimination performance than non-spatial displays.

Trust and Distrust of Automated Parking in a Tesla Model X.

OBJECTIVE: The present study aims to evaluate driver intervention behaviors during a partially automated parking task. BACKGROUND: Cars with partially automated parking features are becoming widely available. Although recent research explores the use of automation features in partially automated cars, none have focused on partially automated parking. Recent incidents and research have demonstrated that drivers sometimes use partially automated features in unexpected, inefficient, and harmful ways. METHOD: Participants completed a series of partially automated parking trials with a Tesla Model X and their behavioral interventions were recorded. Participants also completed a risk-taking behavior test and a post-experiment questionnaire that included questions about trust in the system, likelihood of using the Autopark feature, and preference for either the partially automated parking feature or self-parking. RESULTS: Initial intervention rates were over 50%, but declined steeply in later trials. Responses to open-ended questions revealed that once participants understood what the system was doing, they were much more likely to trust it. Trust in the partially automated parking feature was predicted by a model including risk-taking behaviors, self-confidence, self-reported number of errors committed by the Tesla, and the proportion of trials in which the driver intervened. CONCLUSION: Using partially automated parking with little knowledge of its workings can lead to high degree of initial distrust. Repeated exposure of partially automated features to drivers can greatly increase their use. APPLICATION: Short tutorials and brief explanations of the workings of partially automated features may greatly improve trust in the system when drivers are first introduced to partially automated systems.

Vigilance Tasks: Unpleasant, Mentally Demanding, and Stressful Even When Time Flies.

OBJECTIVE: To determine whether perceived time progression (PTP) moderates participants' negative reactions to vigilance tasks. BACKGROUND: Vigilance tasks are rated by participants to be unenjoyable and as having high levels of workload and stress. Based on the adage, "You are having fun when time flies," we tested the possibility that accelerating PTP might reduce these negative experiences. METHOD: Two studies were performed, involving a long 30-min and a short 12-min vigil. We manipulated participants' PTP by creating a mismatch between their expectations about how long they would perform the task and the actual time that they were engaged. RESULTS: PTP was significantly faster for participants who were led to expect that the vigilance task would last longer than it did relative to those led to expect that task duration would be shorter than it actually was and for controls for whom task duration was equal to the expected duration. However, accelerating PTP had no effect in either experiment on undesirable reactions to the vigilance tasks. Participants uniformly rated both tasks as unenjoyable, as having a high level of workload, and as stressful. Apparently, vigilance isn't fun even when time flies. CONCLUSION: Our findings greatly underscore the depth to which negative subjective reactions are embedded in the nature of vigilance tasks and therefore that these tasks can have potentially serious costs to participants in terms of health, safety, and productivity. APPLICATION: These costs must be considered at the operational level.

Beyond frequency counts: Novel conceptual recurrence analysis metrics to index semantic coordination in team communications.

Semantic alignment is a key process underlying interpersonal and team communication. However, semantic similarity is difficult to quantify, and statistical approaches designed to measure it often rely on methods that make the identification of the relative importance of key words difficult. This study outlines how conceptual recurrence analysis (CRA) can address these issues and can be used to detect conceptual structure in interpersonal communication. We developed several novel CRA metrics to analyze communication data reported previously by Mancuso, Finomore, Rahill, Blair, and Funke (Proceedings of the Human Factors and Ergonomics Society Annual Meeting, 58, 405-409, 2014), gathered from teams who worked cooperatively on a logic puzzle under different cognitive biasing contexts. CRA, like other measures of semantic coordination, relies on parameters whose values affect estimates of semantic alignment. We evaluated how the dimensionality of semantic spaces affects metrics quantifying the conceptual similarity of communicative exchanges, and whether metrics calculated from top-down, a priori semantic spaces or bottom-up semantic spaces empirically derived from each data set were more sensitive to biasing context. We found that the novel CRA measures were sensitive to manipulations of cognitive bias, and that higher-dimensional, bottom-up semantic spaces generally yielded more sensitivity to the experimental manipulations, though when the communication was evaluated with respect to specific key concepts, lower-dimensional, top-down spaces performed nearly as well. We conclude that CRA is sensitive to experimental manipulations in ways consistent with prior findings and that it presents a customizable framework for testing predictions about interpersonal communication patterns and other linguistic exchanges.

The Independence and Interdependence of Coacting Observers in Regard to Performance Efficiency, Workload, and Stress in a Vigilance Task.

OBJECTIVE: We investigated performance, workload, and stress in groups of paired observers who performed a vigilance task in a coactive (independent) manner. BACKGROUND: Previous studies have demonstrated that groups of coactive observers detect more signals in a vigilance task than observers working alone. Therefore, the use of such groups might be effective in enhancing signal detection in operational situations. However, concern over appearing less competent than one's cohort might induce elevated levels of workload and stress in coactive group members and thereby undermine group performance benefits. Accordingly, we performed the initial experiment comparing workload and stress in observers who performed a vigilance task coactively with those of observers who performed the vigilance task alone. METHOD: Observers monitored a video display for collision flight paths in a simulated unmanned aerial vehicle control task. Self-reports of workload and stress were secured via the NASA-Task Load Index and the Dundee Stress State Questionnaire, respectively. RESULTS: Groups of coactive observers detected significantly more signals than did single observers. Coacting observers did not differ significantly from those operating by themselves in terms of workload but did in regard to stress; posttask distress was significantly lower for coacting than for single observers. CONCLUSION: Performing a visual vigilance task in a coactive manner with another observer does not elevate workload above that of observers working alone and serves to attenuate the stress associated with vigilance task performance. APPLICATION: The use of coacting observers could be an effective vehicle for enhancing performance efficiency in operational vigilance.

Predicting battlefield vigilance: a multivariate approach to assessment of attentional resources.

Technological innovation increasingly requires operators in various applied settings to maintain vigilance for extended periods. However, standard psychometric tests typically predict less than 10% of performance variance. The present study (N = 462) aimed to apply the resource theory of sustained attention to construct a multivariate test battery for predicting battlefield vigilance. The battery included cognitive ability tests, a high-workload short vigilance task and subjective measures of stress response. Four versions of a 60- min simulated military battlefield monitoring task were constructed to represent different operational requirements. The test battery predicted 24-44% of criterion variance, depending on task version, suggesting that it may identify vigilant operators in military and other applied contexts. A multiple-groups path analysis showed that relationships between ability and vigilance were moderated by working memory demands. Findings are consistent with a diffuse theoretical concept of 'resources' in which performance energisation depends on multiple, loosely coupled processes.

Safety and feasibility clinical trial of nucleus accumbens deep brain stimulation for treatment-refractory opioid use disorder.

OBJECTIVE: There were more than 107,000 drug overdose deaths in the US in 2021, the most ever recorded. Despite advances in behavioral and pharmacological treatments, over 50% of those receiving treatment for opioid use disorder (OUD) experience drug use recurrence (relapse). Given the prevalence of OUD and other substance use disorders (SUDs), the high rate of drug use recurrence, and the number of drug overdose deaths, novel treatment strategies are desperately needed. The objective of this study was to evaluate the safety and feasibility of deep brain stimulation (DBS) targeting the nucleus accumbens (NAc)/ventral capsule (VC) and potential impact on outcomes in individuals with treatment-refractory OUD. METHODS: A prospective, open-label, single-arm study was conducted among participants with longstanding treatment-refractory OUD (along with other co-occurring SUDs) who underwent DBS in the NAc/VC. The primary study endpoint was safety; secondary/exploratory outcomes included opioid and other substance use, substance craving, and emotional symptoms throughout follow-up and 18FDG-PET neuroimaging. RESULTS: Four male participants were enrolled and all tolerated DBS surgery well with no serious adverse events (AEs) and no device- or stimulation-related AEs. Two participants sustained complete substance abstinence for > 1150 and > 520 days, respectively, with significant post-DBS reductions in substance craving, anxiety, and depression. One participant experienced post-DBS drug use recurrences with reduced frequency and severity. The DBS system was explanted in one participant due to noncompliance with treatment requirements and the study protocol. 18FDG-PET neuroimaging revealed increased glucose metabolism in the frontal regions for the participants with sustained abstinence only. CONCLUSIONS: DBS of the NAc/VC was safe, feasible, and can potentially reduce substance use, craving, and emotional symptoms in those with treatment-refractory OUD. A randomized, sham-controlled trial in a larger cohort of patients is being initiated.

Using cerebral hemovelocity to measure workload during a spatialised auditory vigilance task in novice and experienced observers.

This experiment was designed to assess cognitive load using transcranial Doppler sonography during the performance of a 40-min communication vigilance task in which messages were presented in different spatial locations or across a single monaural radio channel. In addition, some observers received 14 hours of practice to determine whether the neurophysiological measure was sensitive to a potential attenuation of workload. Critical messages were detected more frequently in the spatialised audio presentation mode condition, but there were no performance differences between experienced and novice observers. Neurophysiological data show that activation was greater in the novice condition than in the experienced condition, suggesting that novice observers expended greater effort. Furthermore, the neurophysiological measure showed more activation in the monaural radio condition than in the spatialised audio condition. The results support a resource account of vigilance and suggest that cerebral blood flow velocity can be used to diagnose the degree of attentional resource utilisation during vigilance tasks. PRACTITIONER SUMMARY: Due to high workload experienced during vigilance tasks, displays and methods are sought which enhance performance. This study shows that spatialising auditory communications in a monitoring task enhances performance and attenuates mental workload. Also, experience mitigates excessive workload, and cerebral hemovelocity can be used to diagnose attentional resource utilisation.

Identifying biomarkers of drug use recurrence using wearable device technologies and phone applications.

BACKGROUND: Identifying predictors of drug use recurrence (DUR) is critical to combat the addiction epidemic. Wearable devices and phone-based applications for obtaining self-reported assessments in the patient's natural environment (e.g., ecological momentary assessment; EMA) have been used in various healthcare settings. However, the utility of combining these technologies to predict DUR in substance use disorder (SUD) has not yet been explored. This study investigates the combined use of wearable technologies and EMA as a potential mechanism for identifying physiological/behavioral biomarkers of DUR. METHODS: Participants, recruited from an SUD treatment program, were provided with a commercially available wearable device that continuously monitors biometric signals (e.g., heart rate/variability [HR/HRV], sleep characteristics). They were also prompted daily to complete an EMA via phone-based application (EMA-APP) that included questionnaires regarding mood, pain, and craving. RESULTS: Seventy-seven participants are included in this pilot study (34 participants experienced a DUR during enrollment). Wearable technologies revealed that physiological markers were significantly elevated in the week prior to DUR relative to periods of sustained abstinence (p<0.001). Results from the EMA-APP revealed that those who experienced a DUR reported greater difficulty concentrating, exposure to triggers associated with substance use, and increased isolation the day prior to DUR (p<0.001). Compliance with study procedures during the DUR week was lower than any other period of measurement (p<0.001). CONCLUSIONS: These results suggest that data acquired via wearable technologies and the EMA-APP may serve as a method of predicting near-term DUR, thereby potentially prompting intervention before drug use occurs.

Blood-tumor barrier opening by MRI-guided transcranial focused ultrasound in a preclinical breast cancer brain metastasis model improves efficacy of combinatorial chemotherapy.

Patients with metastatic breast cancer have high and continually increasing rates of brain metastases. During the course of the disease, brain metastases can occur in up to 30% of these patients. In most cases, brain metastases are diagnosed after significant disease progression. The blood-tumor barrier increases the difficulty of treating brain metastasis by preventing accumulation of chemotherapy within metastases at therapeutically effective concentrations. Traditional therapies, such as surgical resection, radiotherapy, and chemotherapy, have poor efficacy, as reflected by a low median survival rate of 5-8% after post-diagnosis. Low-intensity focused ultrasound (LiFUS) is a new treatment for enhancing drug accumulation within the brain and brain malignancies. In this study, we elucidate the effect of clinical LiFUS combined with chemotherapy on tumor survival and progression in a preclinical model of triple-negative breast cancer metastasis to the brain. LiFUS significantly increased the tumor accumulation of 14C-AIB and Texas Red compared to controls (p< 0.01). LiFUS-mediated opening of the BTB is size-dependent, which is consistent with our previous studies. Mice receiving LiFUS with combinatorial Doxil and paclitaxel showed a significant increase in median survival (60 days) compared to other groups. LiFUS plus combinatorial chemotherapy of paclitaxel and Doxil also showed the slowest progression of tumor burden compared to chemotherapy alone or individual chemotherapy and LiFUS combinations. This study shows that combining LiFUS with timed combinatorial chemotherapeutic treatment is a potential strategy for improving drug delivery to brain metastases.

Low-intensity focused ultrasound targeting the nucleus accumbens as a potential treatment for substance use disorder: safety and feasibility clinical trial.

Introduction: While current treatments for substance use disorder (SUD) are beneficial, success rates remain low and treatment outcomes are complicated by co-occurring SUDs, many of which are without available medication treatments. Research involving neuromodulation for SUD has recently gained momentum. This study evaluated two doses (60 and 90 W) of Low Intensity Focused Ultrasound (LIFU), targeting the bilateral nucleus accumbens (NAc), in individuals with SUD. Methods: Four participants (three male), who were receiving comprehensive outpatient treatment for opioid use disorder at the time of enrollment and who also had a history of excessive non-opioid substance use, completed this pilot study. After confirming eligibility, these participants received 10 min sham LIFU followed by 20 min active LIFU (10 min to left then right NAc). Outcomes were the safety, tolerability, and feasibility during the LIFU procedure and throughout the 90-day follow-up. Outcomes also included the impact of LIFU on cue-induced substance craving, assessed via Visual Analog Scale (VAS), both acutely (pre-, during and post-procedure) and during the 90-day follow-up. Daily craving ratings (without cues) were also obtained for one-week prior to and one-week following LIFU. Results: Both LIFU doses were safe and well-tolerated based on reported adverse events and MRI scans revealed no structural changes (0 min, 24 h, and 1-week post-procedure). For the two participants receiving "enhanced" (90 W) LIFU, VAS craving ratings revealed active LIFU attenuated craving for participants' primary substances of choice relative to sham sonication. For these participants, reductions were also noted in daily VAS craving ratings (0 = no craving; 10 = most craving ever) across the week following LIFU relative to pre-LIFU; Participant #3 pre- vs. post-LIFU: opioids (3.6 ± 0.6 vs. 1.9 ± 0.4), heroin (4.2 ± 0.8 vs. 1.9 ± 0.4), methamphetamine (3.2 ± 0.4 vs. 0.0 ± 0.0), cocaine (2.4 ± 0.6 vs. 0.0 ± 0.0), benzodiazepines (2.8 ± 0.5 vs. 0.0 ± 0.0), alcohol (6.0 ± 0.7 vs. 2.7 ± 0.8), and nicotine (5.6 ± 1.5 vs. 3.1 ± 0.7); Participant #4: alcohol (3.5 ± 1.3 vs. 0.0 ± 0.0) and nicotine (5.0 ± 1.8 vs. 1.2 ± 0.8) (all p's < 0.05). Furthermore, relative to screening, longitudinal reductions in cue-induced craving for several substances persisted during the 90-day post-LIFU follow-up evaluation for all participants. Discussion: In conclusion, LIFU targeting the NAc was safe and acutely reduced substance craving during the LIFU procedure, and potentially had longer-term impact on craving reductions. While early observations are promising, NAc LIFU requires further investigation in a controlled trial to assess the impact on substance craving and ultimately substance use and relapse.

Focused ultrasound-mediated blood-brain barrier opening in Alzheimer's disease: long-term safety, imaging, and cognitive outcomes.

OBJECTIVE: MRI-guided low-intensity focused ultrasound (FUS) has been shown to reversibly open the blood-brain barrier (BBB), with the potential to deliver therapeutic agents noninvasively to target brain regions in patients with Alzheimer's disease (AD) and other neurodegenerative conditions. Previously, the authors reported the short-term safety and feasibility of FUS BBB opening of the hippocampus and entorhinal cortex (EC) in patients with AD. Given the need to treat larger brain regions beyond the hippocampus and EC, brain volumes and locations treated with FUS have now expanded. To evaluate any potential adverse consequences of BBB opening on disease progression, the authors report safety, imaging, and clinical outcomes among participants with mild AD at 6-12 months after FUS treatment targeted to the hippocampus, frontal lobe, and parietal lobe. METHODS: In this open-label trial, participants with mild AD underwent MRI-guided FUS sonication to open the BBB in ß-amyloid positive regions of the hippocampus, EC, frontal lobe, and parietal lobe. Participants underwent 3 separate FUS treatment sessions performed 2 weeks apart. Outcome assessments included safety, imaging, neurological, cognitive, and florbetaben ß-amyloid PET. RESULTS: Ten participants (range 55-76 years old) completed 30 separate FUS treatments at 2 participating institutions, with 6-12 months of follow-up. All participants had immediate BBB opening after FUS and BBB closure within 24-48 hours. All FUS treatments were well tolerated, with no serious adverse events related to the procedure. All 10 participants had a minimum of 6 months of follow-up, and 7 participants had a follow-up out to 1 year. Changes in the Alzheimer's Disease Assessment Scale-cognitive and Mini-Mental State Examination scores were comparable to those in controls from the Alzheimer's Disease Neuroimaging Initiative. PET scans demonstrated an average ß-amyloid plaque of 14% in the Centiloid scale in the FUS-treated regions. CONCLUSIONS: This study is the largest cohort of participants with mild AD who received FUS treatment, and has the longest follow-up to date. Safety was demonstrated in conjunction with reversible and repeated BBB opening in multiple cortical and deep brain locations, with a concomitant reduction of ß-amyloid. There was no apparent cognitive worsening beyond expectations up to 1 year after FUS treatment, suggesting that the BBB opening treatment in multiple brain regions did not adversely influence AD progression. Further studies are needed to determine the clinical significance of these findings. FUS offers a unique opportunity to decrease amyloid plaque burden as well as the potential to deliver targeted therapeutics to multiple brain regions in patients with neurodegenerative disorders.

Characterization of passive permeability after low intensity focused ultrasound mediated blood-brain barrier disruption in a preclinical model.

BACKGROUND: Systemic drug delivery to the central nervous system is limited by presence of the blood-brain barrier (BBB). Low intensity focused ultrasound (LiFUS) is a non-invasive technique to disrupt the BBB, though there is a lack of understanding of the relationship between LiFUS parameters, such as cavitation dose, time of sonication, microbubble dose, and the time course and magnitude of BBB disruption. Discrepancies in these data arise from experimentation with modified, clinically untranslatable transducers and inconsistent parameters for sonication. In this report, we characterize microbubble and cavitation doses as LiFUS variables as they pertain to the time course and size of BBB opening with a clinical Insightec FUS system. METHODS: Female Nu/Nu athymic mice were exposed to LiFUS using the ExAblate Neuro system (v7.4, Insightec, Haifa, Israel) following target verification with magnetic resonance imaging (MRI). Microbubble and cavitation doses ranged from 4-400 µL/kg, and 0.1-1.5 cavitation dose, respectively. The time course and magnitude of BBB opening was evaluated using fluorescent tracers, ranging in size from 105-10,000 Da, administered intravenously at different times pre- or post-LiFUS. Quantitative autoradiography and fluorescence microscopy were used to quantify tracer accumulation in brain. RESULTS: We observed a microbubble and cavitation dose dependent increase in tracer uptake within brain after LiFUS. Tracer accumulation was size dependent, with 14C-AIB (100 Da) accumulating to a greater degree than larger markers (~ 625 Da-10 kDa). Our data suggest opening of the BBB via LiFUS is time dependent and biphasic. Accumulation of solutes was highest when administered prior to LiFUS mediated disruption (2-fivefold increases), but was also significantly elevated at 6 h post treatment for both 14C-AIB and Texas Red. CONCLUSION: The magnitude of LiFUS mediated BBB opening correlates with concentration of microbubbles, cavitation dose as well as time of tracer administration post-sonication. These data help define the window of maximal BBB opening and applicable sonication parameters on a clinically translatable and commercially available FUS system that can be used to improve passive permeability and accumulation of therapeutics targeting the brain.

Prediction of viral symptoms using wearable technology and artificial intelligence: A pilot study in healthcare workers.

Conventional testing and diagnostic methods for infections like SARS-CoV-2 have limitations for population health management and public policy. We hypothesize that daily changes in autonomic activity, measured through off-the-shelf technologies together with app-based cognitive assessments, may be used to forecast the onset of symptoms consistent with a viral illness. We describe our strategy using an AI model that can predict, with 82% accuracy (negative predictive value 97%, specificity 83%, sensitivity 79%, precision 34%), the likelihood of developing symptoms consistent with a viral infection three days before symptom onset. The model correctly predicts, almost all of the time (97%), individuals who will not develop viral-like illness symptoms in the next three days. Conversely, the model correctly predicts as positive 34% of the time, individuals who will develop viral-like illness symptoms in the next three days. This model uses a conservative framework, warning potentially pre-symptomatic individuals to socially isolate while minimizing warnings to individuals with a low likelihood of developing viral-like symptoms in the next three days. To our knowledge, this is the first study using wearables and apps with machine learning to predict the occurrence of viral illness-like symptoms. The demonstrated approach to forecasting the onset of viral illness-like symptoms offers a novel, digital decision-making tool for public health safety by potentially limiting viral transmission.

Robot Authority in Human-Robot Teaming: Effects of Human-Likeness and Physical Embodiment on Compliance.

The anticipated social capabilities of robots may allow them to serve in authority roles as part of human-machine teams. To date, it is unclear if, and to what extent, human team members will comply with requests from their robotic teammates, and how such compliance compares to requests from human teammates. This research examined how the human-likeness and physical embodiment of a robot affect compliance to a robot's request to perseverate utilizing a novel task paradigm. Across a set of two studies, participants performed a visual search task while receiving ambiguous performance feedback. Compliance was evaluated when the participant requested to stop the task and the coach urged the participant to keep practicing multiple times. In the first study, the coach was either physically co-located with the participant or located remotely via a live-video. Coach type varied in human-likeness and included either a real human (confederate), a Nao robot, or a modified Roomba robot. The second study expanded on the first by including a Baxter robot as a coach and replicated the findings in a different sample population with a strict chain of command culture. Results from both studies showed that participants comply with the requests of a robot for up to 11 min. Compliance is less than to a human and embodiment and human-likeness on had weak effects on compliance.

Assessing the Accuracy of Popular Commercial Technologies That Measure Resting Heart Rate and Heart Rate Variability.

Commercial off-the shelf (COTS) wearable devices continue development at unprecedented rates. An unfortunate consequence of their rapid commercialization is the lack of independent, third-party accuracy verification for reported physiological metrics of interest, such as heart rate (HR) and heart rate variability (HRV). To address these shortcomings, the present study examined the accuracy of seven COTS devices in assessing resting-state HR and root mean square of successive differences (rMSSD). Five healthy young adults generated 148 total trials, each of which compared COTS devices against a validation standard, multi-lead electrocardiogram (mECG). All devices accurately reported mean HR, according to absolute percent error summary statistics, although the highest mean absolute percent error (MAPE) was observed for CameraHRV (17.26%). The next highest MAPE for HR was nearly 15% less (HRV4Training, 2.34%). When measuring rMSSD, MAPE was again the highest for CameraHRV [112.36%, concordance correlation coefficient (CCC): 0.04], while the lowest MAPEs observed were from HRV4Training (4.10%; CCC: 0.98) and OURA (6.84%; CCC: 0.91). Our findings support extant literature that exposes varying degrees of veracity among COTS devices. To thoroughly address questionable claims from manufacturers, elucidate the accuracy of data parameters, and maximize the real-world applicative value of emerging devices, future research must continually evaluate COTS devices.

Deep brain stimulation of the nucleus accumbens/ventral capsule for severe and intractable opioid and benzodiazepine use disorder.

Given high relapse rates and the prevalence of overdose deaths, novel treatments for substance use disorder (SUD) are desperately needed for those who are treatment refractory. The objective of this study was to evaluate the safety of deep brain stimulation (DBS) for SUD and the effects of DBS on substance use, substance craving, emotional symptoms, and frontal/executive functions. DBS electrodes were implanted bilaterally within the Nucleus Accumbens/Ventral anterior internal capsule (NAc/VC) of a man in his early 30s with >10-year history of severe treatment refractory opioid and benzodiazepine use disorders. DBS of the NAc/VC was found to be safe with no serious adverse events noted and the participant remained abstinent and engaged in comprehensive treatment at the 12-week endpoint (and 12-month extended follow-up). Using a 0-100 visual analog scale, substance cravings decreased post-DBS implantation; most substantially in benzodiazepine craving following the final DBS titration (1.0 ± 2.2) compared to baseline (53.4 ± 29.5; p < .001). A trend toward improvement in frontal/executive function was observed on the balloon analog risk task performance following the final titration (217.7 ± 76.2) compared to baseline (131.3 ± 28.1, p = .066). FDG PET demonstrated an increase in glucose metabolism in the dorsolateral prefrontal and medial premotor cortices at the 12-week endpoint compared to post-surgery/pre-DBS titration. Heart Rate Variability (HRV) improved following the final titration (rMSSD = 56.0 ± 11.7) compared to baseline (19.2 ± 8.2; p < .001). In a participant with severe, treatment refractory opioid and benzodiazepine use disorder, DBS of the NAc/VC was safe, reduced substance use and craving, and improved frontal and executive functions. Confirmation of these findings with future studies is needed. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Evaluations of Commercial Sleep Technologies for Objective Monitoring During Routine Sleeping Conditions.

PURPOSE: The commercial market is saturated with technologies that claim to collect proficient, free-living sleep measurements despite a severe lack of independent third-party evaluations. Therefore, the present study evaluated the accuracy of various commercial sleep technologies during in-home sleeping conditions. MATERIALS AND METHODS: Data collection spanned 98 separate nights of ad libitum sleep from five healthy adults. Prior to bedtime, participants utilized nine popular sleep devices while concurrently wearing a previously validated electroencephalography (EEG)-based device. Data collected from the commercial devices were extracted for later comparison against EEG to determine degrees of accuracy. Sleep and wake summary outcomes as well as sleep staging metrics were evaluated, where available, for each device. RESULTS: Total sleep time (TST), total wake time (TWT), and sleep efficiency (SE) were measured with greater accuracy (lower percent errors) and limited bias by Fitbit Ionic [mean absolute percent error, bias (95% confidence interval); TST: 9.90%, 0.25 (-0.11, 0.61); TWT: 25.64%, -0.17 (-0.28, -0.06); SE: 3.49%, 0.65 (-0.82, 2.12)] and Oura smart ring [TST: 7.39%, 0.19 (0.04, 0.35); TWT: 36.29%, -0.18 (-0.31, -0.04); SE: 5.42%, 1.66 (0.17, 3.15)], whereas all other devices demonstrated a propensity to over or underestimate at least one if not all of the aforementioned sleep metrics. No commercial sleep technology appeared to accurately quantify sleep stages. CONCLUSION: Generally speaking, commercial sleep technologies displayed lower error and bias values when quantifying sleep/wake states as compared to sleep staging durations. Still, these findings revealed that there is a remarkably high degree of variability in the accuracy of commercial sleep technologies, which further emphasizes that continuous evaluations of newly developed sleep technologies are vital. End-users may then be able to determine more accurately which sleep device is most suited for their desired application(s).