Repeated prefrontal tDCS for improving mental health and cognitive deficits in multiple sclerosis: a randomized, double-blind, parallel-group study.

BACKGROUND: Multiple Sclerosis (MS) is an autoimmune disease associated with physical disability, psychological impairment, and cognitive dysfunctions. Consequently, the disease burden is substantial, and treatment choices are limited. In this randomized, double-blind study, we conducted repeated prefrontal electrical stimulation in 40 patients with MS to evaluate mental health variables (quality of life, sleep difficulties, psychological distress) and cognitive dysfunctions (psychomotor speed, working memory, attention/vigilance), marking it as the third largest sample size tDCS research conducted in MS to date. METHODS: The patients were randomly assigned (block randomization method) to two groups of sham (n = 20), or 1.5-mA (n = 20) transcranial direct current stimulation (tDCS) targeting the left dorsolateral prefrontal cortex (F3) and right frontopolar cortex (Fp2) with anodal and cathodal stimulation respectively (electrode size: 25 cm2). The treatment included 10 sessions of 20 min of stimulation delivered every other day. Outcome measures were MS quality of life, sleep quality, psychological distress, and performance on a neuropsychological test battery dedicated to cognitive dysfunctions in MS (psychomotor speed, working memory, and attention). All outcome measures were evaluated at the pre-intervention and post-intervention assessments. Both patients and technicians delivering the stimulation were unaware of the type of stimulation being used. RESULTS: Repeated prefrontal real tDCS significantly improved quality of life and reduced sleep difficulties and psychological distress compared to the sham group. It, furthermore, improved psychomotor speed, attention, and vigilance compared to the sham protocol. Improvement in mental health outcome variables and cognitive outperformance were interrelated and could predict each other. CONCLUSIONS: Repeated prefrontal and frontopolar tDCS ameliorates secondary clinical symptoms related to mental health and results in beneficial cognitive effects in patients with MS. These results support applying prefrontal tDCS in larger trials for improving mental health and cognitive dysfunctions in MS. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT06401928.

Is obesity associated with impaired reaction time in youth?

BACKGROUND AND PURPOSE: Recent research demonstrates a significant relationship between weight status and impaired reaction time in young, adult, and elderly individuals. However, most such studies were performed on small samples, used only body mass index as the body obesity index, used simple reaction time, and oftentimes did not consider some potential confounders such as age, socioeconomic status, or physical activity in their studies. The present study explored the relationship between various reaction time tasks and various obesity indices in a sample of youth. METHODS: Two hundred and thirty-four young males (19-24 years) underwent standard anthropometry, various information processing tasks (e.g., clinical reaction time, simple audio and visual reaction time, and choice reaction time), as well as an inhibitory control task (congruent and incongruent Simon reaction time). RESULTS: Results revealed no significant relationship between any of the information processing tests and body mass index, nor for fat percentage, waist circumference, and waist-to-height ratio after adjustment for potential confounders. A weak positive association was observed only between congruent Simon reaction time (but not incongruent Simon reaction time) and waist circumference in participants (t value = 0.199; Std error = 0.0014; p = 0.047; Cohen's f2 = 0.09). CONCLUSION: Inhibitory control, but not information processing speed, was associated only with waist circumference in apparently healthy young men. LEVEL OF EVIDENCE: Level I, experimental study.

Impact of obesity on central processing time rather than overall reaction time in young adult men.

BACKGROUND AND PURPOSE: The association between weight status with simple cognitive tasks such as reaction time (RT) may not be observed in young people as cognitive functioning development has reached its peak. In the present study, we aimed to examine the association between overall and central adiposity with overall and central processing of RT in a sample of young adult men with different weight status from Ardabil, Iran. METHODS: Eighty-six young males between June-July 2018 completed RT tests as well as premotor time (PMT) using surface electromyography changes in isometric contraction response to an audio stimulus. RESULTS: No significant associations were observed between RT and PMT and different body mass index categories (underweight, normal weight, overweight and obese), as well as fat mass and fat to skeletal muscle mass ratio quartiles (Q). However, participants with greater waist to height ratio (WHtR) had longer PMT (but not RT) than their peers with lower WHtR (Q3 than Q2 and Q1 groups; p < 0.05, d = 1.23). Participants in the skeletal muscle mass quartile Q2 tended to have longer RT than participants in Q3 in an adjusted comparison model (p = 0.05, d = 0.72). CONCLUSIONS: Although the association between weight status and RT might be elusive in young adults, our results show that higher central adiposity is negatively associated with PMT in young adults. Longitudinal studies are needed to explore the changes in obesity indexes and process speed in longer terms. LEVEL OF EVIDENCE: Level I, experimental study.

Association Between Weight Status and Executive Function in Young Adults.

Background and objectives: To explore the association between weight status and executive function in young adults. Materials and Methods: Ninety-seven young males (age 17-26 years) underwent adiposity and body composition measurements using body composition analyzer. Inhibitory control and working memory were measured using the Cambridge Neuropsychological Test Battery (CANTAB). Results: Multiple linear regression using both unadjusted and adjusted analyses revealed no association between adiposity and body composition variables with executive tasks, apart from a significant association between skeletal muscle mass (SMM) and mean reaction time on go trial (standardized B = -0.28; p = 0.02). Multivariate analysis of covariance (MANCOVA) revealed that underweight participants presented inferior working memory compared to their normal weight (p = 0.001) or overweight peers (p = 0.008). However, according to the percentage fat quartiles (Q) participants with the highest quartile (Q4) were inferior in inhibitory control than their peers with Q2 (p = 0.04), and participants with the lowest quartile (Q1) were inferior in working memory compared with their peers with Q2 (p = 0.01) or Q3 (p = 0.02). A worse inhibitory control was observed for participants with the highest fat/SMM (Q4) compared to participants in Q3 (p = 0.03), and in contrast worse working memory was observed for participants with the lowest fat/SMM (Q1) compared to participants in Q2 (p = 0.04) or Q3 (p = 0.009). Conclusions: Low adiposity is associated with worse working memory, whereas high adiposity is associated with worse inhibitory control. Therefore, our findings show that normal adiposity, but greater SMM may have a positive impact on executive function in young adults.

Association between Physical and Motor Fitness with Cognition in Children.

Background and objective: There is an increased interest in exploring the association between fitness components with cognitive development in children in recent years. One of the scopes is to find the best exercise prescription to enhance health and cognition. Most of the studies so far have focused on cardiorespiratory fitness with little evidence on other fitness components. The present study aimed to explore the association between physical fitness (PF) and motor fitness (MF) with cognitive performance in children. Methods: Two hundred and six schoolboys (11.0 ± 0.8 y) underwent a battery of tests to measure information processing speed (i.e., simple and choice reaction time) and inhibitory control (i.e., Simon task). PF components (i.e., flexibility, muscular strength, and endurance) and MF components (speed and agility) were measured. Results: Multiple linear regression analysis adjusted for potential confounders (i.e., age, socioeconomic status, %fat and physical activity) revealed no relationship between flexibility, speed, muscular strength, and endurance with either information processing tasks or inhibitory control tasks. However, a positive association was observed between agility with both congruent reaction time and incongruent reaction time. Conclusions: No relationship was observed between the underlying fitness components with either information processing or inhibitory control. However, an association was observed between agility with inhibitory control.

Association between physical fitness and cognitive performance in 19-24 year old males.

The present study aimed to explore the association between physical fitness (PF) and cognitive performance in a sample of 19-24 year old males. Two hundred and eleven young males (20.2±1.5 years) participated in the study. Cognitive functioning tasks including information processing speed and inhibitory control were measured in addition to PF and motor fitness components such as aerobic fitness, static strength, explosive strength, agility and speed. Regression analysis showed that after adjustment for potential confounders (e.g. age, socioeconomic status, adiposity and physical activity), aerobic fitness (represented by shorter time in the one-mile run) was positively associated with composite inhibitory control scores (standardized ß=0.17; p=0.04) and negatively associated with ∆ Simon (standardized ß= -0.21; p=0.04). Explosive strength was negatively associated with composite information processing scores (standardized ß= -0.24; P=0.01), and composite inhibitory control scores (standardized ß= -0.22; p=0.02). Speed of movement, agility and static strength were not associated with any of the cognitive tests. In conclusion, aerobic fitness and explosive strength but not speed, agility or static strength might be indicators of underlying cognitive functioning tasks in 19-24 year old males.

Identification of injured elements in computational models of spinal cord injury using machine learning.

The purpose of this study was to use machine learning (ML) algorithms to identify tissue damage based on the mechanical outputs of computational models of spinal cord injury (SCI). Three datasets corresponding to gray matter, white matter, and the combination of gray and white matter tissues were used to train the models. These datasets were built from the comparison of histological images taken from SCI experiments in non-human primates and corresponding subject-specific finite element (FE) models. Four ML algorithms were evaluated and compared using cross-validation and the area under the receiver operating characteristic curve (AUC). After hyperparameter tuning, the AUC mean values for the algorithms ranged between 0.79 and 0.82, with a standard deviation no greater than 0.02. The findings of this study also showed that k-nearest neighbors and logistic regression algorithms were better at identifying injured elements than support vector machines and decision trees. Additionally, depending on the evaluated dataset, the mean values of other performance metrics, such as precision and recall, varied between algorithms. These initial results suggest that different algorithms might be more sensitive to the skewed distribution of classes in the studied datasets, and that identifying damage independently or simultaneously in the gray and white matter tissues might require a better definition of relevant features and the use of different ML algorithms. These approaches will contribute to improving the current understanding of the relationship between mechanical loading and tissue damage during SCI and will have implications for the development of prevention strategies for this condition.Clinical Relevance- Linking FE model predictions of mechanical loading to tissue damage is an essential step for FE models to provide clinically relevant information. Combined with imaging technologies, these models can provide useful insights to predict the extent of damage in animal subjects and guide the decision-making process during treatment planning.

Effectiveness of Group Cognitive-Behavioral Therapy for Managing Anxiety and Depression in Women Following Hysterectomy for Uterine Cancer.

OBJECTIVE: Hysterectomy as well as uterine cancer could be associated with a long-term risk of mental disorders. The purpose of this study is to investigate the effectiveness of group cognitive-behavioral therapy (GCBT) in reducing anxiety and depression in women who have undergone hysterectomy for uterine cancer. METHOD: This experimental, pretest-post-test study was conducted in an academic hospital. 26 women with uterine cancer who underwent hysterectomy were recruited and randomly divided into two equal groups as the experimental and control groups. The experimental group was treated by GCBT for eight 1-hour sessions (by a senior psychology expert) every week until 8 weeks. Otherwise, no intervention was performed for the control group. The anxiety and depression scores of all participants were assessed and compared before and after the therapy sessions by Beck Anxiety (BAI) and Beck Depression-second version (BDI-II) questionnaires. RESULTS: The mean±SD age of the participants was 33.6±4.1. Our result found significant different after GCBT in both anxiety (p=0.000) and depression (p=0.000) scores in the experimental group. However, no differences between pre and post-test scores in the control group were observed. Compared to the control group the rate of depression (p=0.000) and anxiety (p=0.000) in the case group was significantly decreased after therapy. CONCLUSION: GCBT is effective in reducing anxiety and depression in women after hysterectomy. The use of GCBT in oncology centers along with medical treatments to reduce mental distress, improve mental health, and accelerate the recovery process of patients with uterine cancer and other cancers seems necessary.

The effect of group assertive training on the self-esteem and quality of life in the spouses of drug-abusing patients.

OBJECTIVE: The present study aimed to examine the effect of group assertive training on self-esteem and quality of life among spouses of drug-abusing patients. METHODS: This randomized clinical trial assignment study with a control group. The statistical population included all spouses of drug users referring to private addiction treatment centers in Tehran-Iran in 2020 and the sample included 50 spouses of drug users who were selected by simple random sampling from among the volunteers. They were randomly divided into two groups control and experimental, each group consisting of 25 people. RESULTS: The results of data analysis showed that group assertive training increased self-esteem and quality of life in spouses of drug-abusing patients in the experimental group compared to the witness group (p < .001). CONCLUSION: As a result, group assertive training is effective in increasing the self-esteem and quality of life among the spouses of drug-abusing patients.

A pilot study of family-based management of behavioral excesses in young Iranian children with autism spectrum disorder.

OBJECTIVE: Parent-mediated early behavioral interventions are considered as effective approaches in the treatment of children with Autism Spectrum Disorder (ASD). The majority of these interventions focus on social-communication deficits rather than behavioral excesses which severely irrupt child and family social life as well as the child's appearance behavior and learning processes. The study examines the effectiveness and feasibility of Family-based Management of Behavioral Excesses of Autism Program (FMBEAP) on Iranian families. METHOD: This pre-post and follow-up intervention study involved 17 parents of children with DSM-5 diagnosis of ASD recruited from Tehran Autism Center. All parents conducted FMBEAP on their children while receiving 10-weekly group supervision on top of everyday on-line individual coaching. The study's measures were Repetitive Behavior Scale-R, video-monitoring of child-parent Interaction, Clinical Global Impression-Improvement Scale, Parental Self-Efficacy and Parenting Stress Index-short form. The measures were applied to the sample three times: pre and post-intervention and at one-month follow-up. RESULTS: The Results showed high and low order behavioral excesses significantly decreased at post-intervention and the follow-up. 15 out of 17 children reached to recovered or highly recovered at post-test. Parents showed significant improvements in self-efficacy and parenting stress scales. The intervention was highly accepted by them. CONCLUSION: FMBEAP is shown to be a feasible, acceptable and effective intervention to improve autistic behavioral. The parents should also benefit from the program in terms of self-efficacy and parenting stress. FMBEAP is highly recommended for overcoming behavioral excesses along with those interventions focus on behavioral deficits in ASD.

Allometrically scaled explosive strength, but not static strength or maximal oxygen uptake is associated with better central processing time in young males.

BACKGROUND: We aimed to examine the associations of cardiorespiratory fitness (CRF), static strength and explosive strength with cognitive functions in young males. METHODS: Eighty-six young males (age 16-24 years) participated in the study and took part in a number of tests including: static strength (grip strength test), explosive strength (Sargent jump test), and CRF (via direct measure of maximal oxygen uptake [VO2max]). Static strength and explosive strength were scaled by allometrically modeled skeletal muscle mass (SMM) and height while VO2max was scaled by SMM and body mass (BM). Cognition was assessed by inhibitory control, simple and choice reaction time tasks using computerized Cambridge Neuropsychological Test Battery (CANTAB). Central processing time was measured by surface electromyography changes in isometric contraction response to an audio stimulus. RESULTS: VO2max scaled by BM (but not SMM), was associated with better central processing time and stop-signal reaction time (SSRT). Explosive strength was also associated with better central processing time independent of VO2max. However, static strength was not associated with cognition. CONCLUSIONS: The results suggest that explosive strength is a better predictor of central processing than static strength or VO2max in young males. Longitudinal studies are needed to examine whether explosive strength training in youth would improve central processing time.

Antibacterial effect of different concentrations of sodium hypochlorite on Enterococcus faecalis biofilms in root canals.

Background. The aim of this study was to evaluate the effectiveness of different concentrations of sodium hypochlorite (NaOCl) solution in reducing bacterial growth in Enterococcus faecalis biofilms in root canals. Methods. The root canals of maxillary central incisors of 104 subjects underwent chemomechanical debridement. In order to remove the smear layer, 5.25% sodium hypochlorite solution was used for 3 minutes in the root canals. Then, the samples were immersed in 1 mL of 17% EDTA for 3 minutes. Finally, the root canals were irrigated with phosphate-buffered saline (PBS) solution. After removing the smear layer, the samples were sterilized. Then E. faecalis biofilms formed within the root canals at 4-, 6-, and 10-week intervals were evaluated. Each group was divided into 4 subgroups in terms of the antibacterial treatment: group 1: 1% NaOCl solution; group 2: 2.5% NaOCl solution; group 3: 5.25% NaOCl solution; and group 4: PBS solution. After preparation of root canal filings, the counts of live bacteria were calculated through the classic method of counting, i.e. colony forming units (CFU), followed by the analysis of data. Results. In groups 2 and 3, there was no bacterial growth due to complete removal of E. faecalis biofilms (P<0001), while the bacterial counts in group 1 at 4-, 6- and 10-week intervals decreased compared to the control group. Conclusion. The bacterial cells in mature and old biofilms have higher resistance to 1% NaOCl solution compared to the young biofilms. However, the 2.5% and 5.25% NaOCl solutions caused complete inhibition of the growth of E. faecalis biofilm in all the stages of development.

The Effect of Beck's Cognitive Therapy and Mindfulness-Based Cognitive Therapy on Sociotropic and Autonomous Personality Styles in Patients With Depression.

BACKGROUND: Depression is characterized by a great risk of relapse and recurrence. Mindfulness-based cognitive therapy (MBCT) and cognitive therapy are efficacious psychosocial interventions for recurrent depression. OBJECTIVES: The aim of the present research was to compare the effect of Beck's cognitive therapy (BCT) and MBCT on reduction of depression and sociotropic and autonomous personality styles in Iranian depressed patients. PATIENTS AND METHODS: The study sample consisted of 30 subjects randomly selected from patients with depression in Mashhad city, Iran. The subjects were assigned randomly to experimental groups. The 2 techniques used for treatment were BCT and MBCT. The data collection instruments used in the research consisted of psychological interview, the Beck Depression Inventory II and the revised Personal Style Inventory (RPSI). The research data was analyzed using repeated measures analysis of variance (ANOVA). RESULTS: BCT and MBCT were effective in reducing depression, but BCT and MBCT did not cause any change in the sociotropic and autonomous personality styles in patients with depression. CONCLUSIONS: The results provide support for the role of BCT and MBCT plays in reducing depression. However, the results did not approve their role in changing sociotropic and autonomous personality styles in patients with depression.

The role of family expressed emotion and perceived social support in predicting addiction relapse.

BACKGROUND: Emotional conditions governing the family and patients' perceived social support play important roles in the treatment or relapse process of the chronic disease. OBJECTIVES: The current study aimed to investigate the role of family expressed emotion and perceived social support in prediction of addiction relapse. PATIENTS AND METHODS: The descriptive-correlation method was used in the current study. The study population consisted of the individuals referred to the addiction treatment centers in Ardabil from October 2013 to January 2014. The subjects (n = 80) were randomly selected using cluster sampling method. To collect data, expressed emotion test by Cole and Kazaryan, and Multidimensional Scale of Perceived Social Support (MSPSS) were used, and the obtained data was analyzed using the Pearson's correlation coefficient and multiple regression analyses. RESULTS: Results showed a positive relationship between family expressed emotions and the frequency of relapse (r = 0.26, P = 0.011) and a significant negative relationship between perceived social support and the frequency of relapse (r = -0.34, P = 0.001). Multiple regression analysis also showed that perceived social support from family and the family expressed emotions significantly explained 12% of the total variance of relapse frequency. CONCLUSIONS: These results have implications for addicted people, their families and professionals working in addiction centers to use the emotional potential of families especially their expressed emotions and the perceived social support of addicts to increase the success rate of addiction treatment.

Response inhibition and cognitive appraisal in clients with acute stress disorder and posttraumatic stress disorder.

OBJECTIVE: The purpose of the present study was to compare response inhibition and cognitive appraisal in clients with acute stress disorder, clients with posttraumatic stress disorder, and normal individuals. METHOD: This was a comparative study. The sample consisted of 40 clients with acute stress disorder, 40 patients with posttraumatic stress disorder, and 40 normal individuals from Mazandaran province selected through convenience sampling method. Data were collected using Composite International Diagnostic Interview, Stroop Color-Word Test, Posttraumatic Cognitions Inventory, and the Impact of Event Scale. RESULTS: Results showed that individuals with acute stress disorder are less able to inhibit inappropriate responses and have more impaired cognitive appraisals compared to those with posttraumatic stress disorder. Moreover, results showed that response inhibition and cognitive appraisal explain 75% of the variance in posttraumatic stress disorder symptoms and 38% of the variance in posttraumatic stress disorder symptoms. CONCLUSION: The findings suggest that response inhibition and cognitive appraisal are two variables that influence the severity of posttraumatic stress disorder and acute stress disorder symptoms. Also, these results have important implications for pathology, prevention, and treatment of posttraumatic stress disorder and acute stress disorder.

The effectiveness of training acceptance / commitment and training emotion regulation on high-risk behaviors of students with dyscalculia.

BACKGROUND: Now a days the utilization of Acceptance / Commitment and Emotion Regulation Strategy as a comprehensive treatment plan has been discussed in both the prevention and the control of destructive and risky behaviors. Treatment based on Acceptance/Commitment and Emotion Regulation was effective in both the improvement and the control of high-risk behaviors of students with dyscalculia. OBJECTIVES: The purpose of this study was to investigate the effectiveness of Acceptance and Commitment, and Emotional Regulation training in high-risk behaviors of students with dyscalculia. MATERIALS AND METHODS: This research was experimental, with pre-test, post-test and a control group. The statistical universe of this study included all sixth-grade male students in Ardabil city in the academic year of 2012-2013 (A.H.). The subjects of this study involved 800 sixth-grade elementary students in Ardabil province, selected using a multi-stage cluster sampling. From among them, 60 students with dyscalculia were selected using random sampling method after the initial diagnosis by structured clinical interview and the Keymath Mathematic test. Twenty pupil were selected for either the experimental or the control group. To collect data, the questionnaires of "Keymath Mathematic test" and High-risk Behavior" were used. RESULTS: The results of Multivariate Analysis of Variance (MANOVA) showed that "Acceptance / Commitment and Emotion Regulation" treatment trainings were effective in reducing high-risk behaviors, in a manner that they led to a reduction in negative emotions, self-destructive and impulsive behaviors of students with math disorder (dyscalculia). CONCLUSIONS: It can be concluded that teaching these skills to the students has been influential in enhancing awareness level and change or positive attitude creation in the subjects. Therefore, it is essential to design and implement interventions based on "prevention caused by the peer group, in collaboration with the parents either at the school or at home among the family members".

Body dysmorphic traits and personality disorder patterns in rhinoplasty seekers.

The purpose of the study was to examine symptoms of body dysmorphic concerns, mental health indices and certain specific personality disorder patterns in seekers of cosmetic rhinoplasty. A sample of 100 consecutive female patients scheduled for esthetic rhinoplasty was recruited for the study. Findings reveal body dysmorphic concerns in 22% of the sample, though individual traits are observed in 5-85% of the sample. Appearance evaluation, but not preoccupation with appearance, correlates with anxiety and depression. Furthermore, dissatisfaction with appearance and body parts decrease, while preoccupation with appearance increases after the surgical intervention. Positive appearance evaluations are associated with histrionic and narcissistic traits, while dissatisfaction with body parts correlates positively with obsessive-compulsive traits. Overall, results imply that body dysmorphic concerns are better conceived of either as an obsessive-compulsive spectrum disorder or as morbid manifestations of inflexible perfectionistic tendencies seen in obsessive-compulsive personality disorders.

Is the cardiorespiratory fitness affected by height of young girls?

The purpose of the present study was to examine the effect of height in the predicted VO2max by the Queens Step test among short and tall young girls. A sample of 38 individuals was selected in two stages from a total of 500 individuals and was assigned to two groups of short (n = 20) and tall (n = 18). In order to examine the effect of height in the predicted VO2max, the Queens step protocol and the incremental treadmill speed test were used. Respiratory exchange was measured continuously throughout the test by an automated open-circuit gas analysis system. The study results showed that tall girls revealed a higher VO2max on the Queen's step and treadmill tests than short girls (Queen's: 44.09+/-2.66 vs. 38.96+/-1.65; Treadmill: 34.03+/-7.26 vs. 28.15+/-5.09 mL/kg/min). Based on the obtained findings it can be concluded that the higher VO2max seen in tall girls on the both protocols, may be due to their physiological and physical properties; therefore, it seems that designing of the adjustable steps to the height of subjects for optimizing the estimation of VO2max is not necessary and other physiological factors may be involved, which require further investigation.