Early morning physical activity is associated with healthier white matter microstructure and happier children: the ActiveBrains project.

The background of this study is to examine the associations of individual and combined early morning patterns (i.e., active commuting to school, physical activity before school, having breakfast and good sleep) with white matter microstructure (WMM) and, whether the associated white mater microstructure outcomes were related to mental health outcomes in children with overweight or obesity. 103 children with overweight or obesity (10.0 ± 1.1 years old, 42 girls) from the ActiveBrains project participated in this cross-sectional study. Early morning patterns and mental health indicators (i.e., self-esteem, optimism, positive and negative affect, stress, depression and anxiety) were self-reported by the children using validated questionnaires. WMM was assessed by magnetic resonance imaging using diffusion tensor imaging. When examined independently, early morning patterns were not related with WMM (all P > 0.05). However, the combination of early morning patterns was related with WMM (P < 0.05). Specifically, physically active early morning patterns (i.e., active commuting to school and physical activity before school) were associated with global fractional anisotropy (FA) (ß = 0.298, P = 0.013) and global radial diffusivity (RD) (ß = - 0.272, P = 0.021), as well as with tract-specific FA (ß = 0.314, P = 0.004) and RD (ß = - 0.234, P = 0.032) in the superior longitudinal fasciculus (SLF). Furthermore, combined physically active early morning pattern-associated global (i.e., FA and RD) and tract-specific (i.e., FA and RD in the SLF) WMM indicators were positively associated with happiness (ß absolute value range from 0.252 to 0.298, all P < 0.05). A combination of physically active early morning patterns may positively relate to white matter microstructure in children with overweight or obesity, and, in turn, happiness.

Early life factors and structural brain network in children with overweight/obesity: The ActiveBrains project.

BACKGROUND: The aims of this study were to investigate the association of early life factors, including birth weight, birth length, and breastfeeding practices, with structural brain networks; and to test whether structural brain networks associated with early life factors were also associated with academic performance in children with overweight/obesity (OW/OB). METHOD: 96 children with OW/OB aged 8-11 years (10.03 ± 1.16) from the ActiveBrains project were included. Early life factors were collected from birth records and reported by parents as weight, height, and months of breastfeeding. T1-weighted images were used to identify structural networks using a non-negative matrix factorization (NNMF) approach. Academic performance was evaluated by the Woodcock-Muñoz standardized test battery. RESULTS: Birth weight and birth length were associated with seven networks involving the cerebellum, cingulate gyrus, occipital pole, and subcortical structures including hippocampus, caudate nucleus, putamen, pallidum, nucleus accumbens, and amygdala. No associations were found for breastfeeding practices. None of the networks linked to birth weight and birth length were linked to academic performance. CONCLUSIONS: Birth weight and birth length, but not breastfeeding, were associated with brain structural networks in children with OW/OB. Thus, early life factors are related to brain networks, yet a link with academic performance was not observed. IMPACT: Birth weight and birth length, but not breastfeeding, were associated with several structural brain networks involving the cerebellum, cingulate gyrus, occipital pole, and subcortical structures including hippocampus, caudate, putamen, pallidum, accumbens and amygdala in children with overweight/obesity, playing a role for a normal brain development. Despite no academic consequences, other behavioral consequences should be investigated. Interventions aimed at improving optimal intrauterine growth and development may be of importance to achieve a healthy brain later in life.

Mortality in elderly patients starting hemodialysis program.

BACKGROUND: The incidence of older patients over 80 years old with chronic kidney disease who start hemodialysis (HD) program has been increasing in the last decade. METHODS: We aimed to identify risk factors for morbidity and mortality in patients older than 80 years with end-stage renal disease who started HD. We conducted a retrospective observational study of the Catalan Renal registry (RMRC). RESULTS: A total of 2833 patients equal or older than 80 years (of 15,137) who started HD between 2002 and 2019 from the RMRC were included in the study. In this group, the first dialysis was performed through an arteriovenous fistula in 44%, percutaneous catheter in 28.2%, and tunneled catheter in 26.6%. Conventional dialysis was used in 65.7% and online HD in 34.3%. The most frequent cause of death was cardiac disease (21.8%), followed by social problems (20.4%) and infections (15.9%). Overall survival in older HD during the first year was 84% versus 91% in younger than 80 years (p < 0.001). Cox regression analysis identified the start of HD in the period 2002-2010, chronic obstructive pulmonary disease (COPD), and the onset of HD through vascular graft depicted as risk factors for first-year mortality after dialysis initiation in patients older than 80 years with end-stage renal disease who started HD. CONCLUSIONS: In conclusion, patients older than 80 years who started HD program had higher mortality, especially those who presented exacerbation of kidney disease, those with COPD, and those who started with a vascular graft.

Adverse Childhood Events and Chronic Pain in Adolescents: The Role of Sleep Disturbance.

OBJECTIVES: This study aimed to (1) examine the extent to which the association between exposure to adverse childhood events (ACEs) and having chronic pain in adolescents is explained by the association between exposure to ACEs and sleep disturbance and (2) explore the role of sleep disturbance in the association between exposure to ACEs and anxiety and depressive symptoms in adolescents with chronic pain. METHODS: Cross-sectional data from 469 adolescents aged 13-18 years old were drawn from an epidemiological study on pediatric chronic pain conducted in Catalonia (Spain). Participants provided self-reports of demographic characteristics, exposure to ACEs, pain characteristics, sleep disturbance, anxiety, and depressive symptoms. Mediation and moderation models were conducted. RESULTS: Sleep disturbance explained a significant amount of the variance in the association between exposure to ACEs and the presence of chronic pain. Moreover, sleep disturbance explained a significant amount of the variance in the association between exposure to ACEs and depressive symptoms and moderated the association between exposure to ACEs and anxiety in adolescents with chronic pain. CONCLUSION: The study findings suggest the possibility that addressing sleep disturbance in adolescents exposed to ACEs may help to prevent the development of chronic pain, anxiety, and depressive symptoms in those adolescents who already have chronic pain.

Psychological factors and pain medication use in adolescents with chronic pain.

OBJECTIVE: The purpose of this study was to examine (1) the associations of anxiety, depressive symptoms, and pain catastrophizing with pain medication use in adolescents with chronic pain and (2) the extent to which these associations differed as a function of adolescents' sex. METHODS: Cross-sectional data from 320 adolescents 12-18 years of age with chronic pain were drawn from an epidemiological study on pediatric chronic pain conducted in Reus (Catalonia, Spain). Participants were asked to provide sociodemographic information and respond to measures assessing pain (location, frequency, intensity, and interference), pain medication use, anxiety, depressive symptoms, and pain catastrophizing. Point biserial correlations were conducted to examine univariate associations between the psychological variables and pain medication use. Hierarchical logistic regression analysis was used to examine these associations while controlling for demographic characteristics, pain intensity, and pain interference. RESULTS: Anxiety, depressive symptoms, and pain catastrophizing were significantly associated with pain medication use in univariate analyses. Regression analysis identified pain catastrophizing as a unique independent predictor of pain medication use after controlling for the effect of demographic variables (sex and age), pain intensity, and pain interference (odds ratio = 1.1, P < .05). No moderating effect of adolescents' sex on the associations between psychological factors and pain medication use was found. CONCLUSIONS: Adolescents with chronic pain with higher levels of pain catastrophizing use pain medications more often. Research to examine the impact of interventions targeting pain catastrophizing on pain medication use among adolescents with chronic pain would be an important next step.

Physical activity, sedentary time, and fitness in relation to brain shapes in children with overweight/obesity: Links to intelligence.

OBJECTIVES: To examine the association between physical activity, sedentary time, and physical fitness with the shapes of subcortical brain structures in children with overweight/obesity. Further, we analyzed whether differences in the shapes of subcortical brain structures were related to intelligence. We hypothesized that those children with higher physical activity levels, lower sedentary time, and better fitness, would show greater expansion of the brain regions analyzed, and these expansions would be associated with higher intelligence. STUDY DESIGN: 100 children (10.0 ± 1.1 years, 40 girls) were included in the analyses. Physical activity and sedentary time were measured by accelerometry, and physical fitness was evaluated by a fitness battery. Shapes of subcortical brain structures were assessed by magnetic resonance imaging. Intelligence was measured by the Kaufmann Brief Intelligence test. RESULTS: Physical activity was related to expansion of the right/left pallidum, right/left putamen, and right thalamus (p < 0.05). Higher sedentary time was related to contraction of the left thalamus and right nucleus accumbens (p < 0.05). Higher levels of cardiorespiratory fitness were associated with expansion of the right amygdala (p = 0.022). Greater strength in the upper-limb was related to expansion of the right/left pallidum and the left nucleus accumbens (p < 0.038), and contraction of the left amygdala (p = 0.030). Better speed-agility was associated with expansion of the left nucleus accumbens (p = 0.036). Physical activity- and fitness-related expansion of the right pallidum was associated with higher intelligence (all p < 0.05). CONCLUSION: Physical activity, sedentary time, and physical fitness were significantly related to the shapes of subcortical brain structures, which in turn were related to intelligence in children with overweight/obesity.

The Use of Rumination and Reappraisal in Adolescents Daily Life: Links to Affect and Emotion Regulation Style.

This study explored the association between temperament-i.e., positive affect (PA) and negative affect (NA)-and emotion regulation (ER), and what momentary factors influence the selection of rumination or reappraisal during adolescents' daily life. The type of social situation in which negative events occurred, the self-rated degrees of discomfort, the types of predominant emotions experienced, and the use of reappraisal and rumination were assessed at 24 different times with an ecological momentary assessment approach given to 71 adolescents. PA, NA, and ER style were evaluated using self-reports. Bivariate Pearson correlations analysis revealed that NA and negative ER style correlated positively with the rumination use whereas PA correlated negatively with the rumination use. Negative ER style moderated the relationship between NA and the frequency with which rumination was used. The moderated function of positive ER style could not be tested due to its lack of association with the rumination use. Adolescents selected rumination more often during family-related events and when experiencing depression-like emotions. No interaction effects were shown between negative ER style and the momentary factors related with the type of social situation and the type of prevailing emotion during negative event. No associations between study variables and reappraisal were found. This study provides a better understanding of ER patterns in adolescence.

COVID-19 in CKD Patients: Lessons from 553 CKD Patients with Biopsy-Proven Kidney Disease.

INTRODUCTION: Chronic kidney disease (CKD) patients infected with COVID-19 are at risk of serious complications such as hospitalization and death. The prognosis and lethality of COVID-19 infection in patients with established kidney disease has not been widely studied. METHODS: Data included patients who underwent kidney biopsy at the Vall d'Hebron Hospital between January 2013 and February 2020 with COVID-19 diagnosis during the period from March 1 to May 15, 2020. RESULTS: Thirty-nine (7%) patients were diagnosed with COVID-19 infection. Mean age was 63 ± 15 years and 48.7% were male. Hypertension was present in 79.5%, CKD without renal replacement therapy in 76.9%, and cardiovascular disease in 64.1%. Nasopharyngeal swab was performed in 26 patients; older (p = 0.01), hypertensive (p = 0.005), and immunosuppressed (p = 0.01) patients, those using RAS-blocking drugs (p = 0.04), and those with gastrointestinal symptoms (p = 0.02) were more likely to be tested for CO-VID-19. Twenty-two patients required hospitalization and 15.4% died. In bivariate analysis, mortality was associated with older age (p = 0.03), cardiovascular disease (p = 0.05), chronic obstructive pulmonary disease (p = 0.05), and low hemoglobin levels (p = 0.006). Adjusted Cox regression showed that low hemoglobin levels at admission had 1.81 greater risk of mortality. CONCLUSIONS: Patients with CO-VID-19 infection and kidney disease confirmed by kidney biopsy presented a mortality of 15.4%. Swab test for COVID-19 was more likely to be performed in older, hypertensive, and immunosuppressed patients, those using RAS-blocking drugs, and those with gastrointestinal symptoms. Low hemoglobin is a risk factor for mortality.

Decrements in Adolescent Cardiac Complexity During Mother-Adolescent Conflicts.

The present study aimed to provide further evidence on the usefulness of non-linear cardiac measures when examining the output of the cardiac system. Scale-invariant self-similarity and entropy, in addition to heart rate variability (HRV) given by time- and frequency-domain measures were calculated in a sample of N = 55 healthy adolescents (Mage = 14.122, SDage = 0.698) during 10-min positive (non-stressful) and negative (stressful) interactions with their mothers. We also explored sex influence in adolescents' cardiac output using both HRV measures and non-linear cardiac measures. Repeated measures MANOVA revealed a marginal within-group effect for HRV measures, F(3,51) = 2.438, p = 0.075, η2p = 0.125), and a significant within-group effect for non-linear cardiac measures, F(6, 48) = 3.296, p = 0.009, η2p = 0.292, showing a significant decrement in adolescents' cardiac complexity during the negative interaction. No significant effect for sex was found in either non-linear cardiac measures or HRV measures, but results suggest lower cardiac scaling in females than in males. These findings suggest a real-time scale predominance in heart rate output when adolescents face an aversive situation and support the importance of non-linear cardiac measures to gain insight into the cardiac system and its regulatory mechanisms. Further research is needed to examine sex-differences in cardiac complexity during aversive situations.

Stressing diets? Amygdala networks, cumulative cortisol, and weight loss in adolescents with excess weight.

OBJECTIVE: The amygdala is importantly involved in stress and obesity, but its role on weight change and diet-related stress remains unexplored among adolescents with excess weight. We aimed to examine the functional connectivity of the Central and Basolateral amygdala nuclei (CeA and BLA) among adolescents, and to explore the longitudinal association between brain connectivity measures and diet-related cortisol and weight loss in adolescents with excess weight. METHODS: We compared resting-state functional connectivity between adolescents with excess (EW, N = 34; Age = 16.44 ± 1.66) and normal weight (NW, N = 36; Age = 16.50 ± 1.40) using a seed-based (CeA and BLA) whole-brain approach. Then, in a subset of 30 adolescents with EW, followed-up after 3-months of dietary/lifestyle intervention, we explored for interactions between connectivity in the CeA/BLA networks and weight loss. Regression analyses were performed to explore the relationship between accumulated cortisol and weight loss, and to test the potential effect of the amygdala networks on such association. RESULTS: In EW compared with NW, the CeA regions showed higher functional connectivity with anterior portions, and lower connectivity with posterior portions of the cingulate cortex, while the left BLA regions showed lower connectivity with the dorsal caudate and angular gyrus. In addition, higher connectivity between the left CeA-midbrain network was negatively associated with weight loss. Hair cortisol significantly predicted weight change (p = 0.012). However, this association was no longer significant (p = 0.164) when considering the CeA-midbrain network in the model as an additional predictor. CONCLUSIONS: Adolescents with EW showed functional connectivity alterations within the BLA/CeA networks. The CeA-midbrain network might constitute an important brain pathway regulating weight change.

Adolescents at risk of anxiety in interaction with their fathers: Studying non-verbal and physiological synchrony.

Adolescence is a vulnerable period in terms of the onset of anxiety disorders, and dyadic parent-adolescent interactions may play a key role in either increasing or reducing the risk of psychopathologies. This study examines the presence of physiological synchrony (specifically, linkage in interbeat interval series) and non-verbal synchrony in positive and negative interactions between adolescents (aged 13-16) and their fathers. Non-verbal synchrony was quantified through the coordination of the interactants' body movements, using an automated video-analysis algorithm (motion energy analysis). Participants were made up of 53 parent-adolescent dyads, the latter at either low (n = 28) or high (n = 25) risk of anxiety. Adolescents at low risk of anxiety displayed statistically significant levels of non-verbal synchrony with their fathers during positive interactions. Non-verbal synchrony was not found in the father-adolescent dyads featuring adolescents at high risk of anxiety. Physiological synchrony was not significantly present above chance level in either of the groups of adolescents. Overall, the results suggest that adolescents at high risk of anxiety may have difficulties in managing non-distressing interactions with their fathers. The results also suggest that physiological synchrony is not a straightforward phenomenon.

Tracheostomy in the intensive care unit: Guidelines during COVID-19 worldwide pandemic.

PURPOSE: COVID-19 has become a pandemic with significant consequences worldwide. About 3.2% of patients with COVID-19 will require intubation and invasive ventilation. Moreover, there will be an increase in the number of critically ill patients, hospitalized and intubated due to unrelated acute pathology, who will present underlying asymptomatic or mild forms of COVID-19. Tracheostomy is one of the procedures associated with an increased production of aerosols and higher risk of transmission of the virus to the health personnel. The aim of this paper is to describe indications and recommended technique of tracheostomy in COVID-19 patients, emphasizing the safety of the patient but also the medical team involved. MATERIALS AND METHODS: A multidisciplinary group made up of surgeons with privileges to perform tracheostomies, intensive care physicians, infectious diseases specialists and intensive pulmonologists was created to update previous knowledge on performing a tracheostomy in critically ill adult patients (>18 years) amidst the SARS-CoV-2 pandemic in a high-volume referral center. Published evidence was collected using a systematic search and review of published studies. RESULTS: A guideline comprising indications, surgical technique, ventilator settings, personal protective equipment and timing of tracheostomy in COVID-19 patients was developed. CONCLUSIONS: A safe approach to performing percutaneous dilational bedside tracheostomy with bronchoscopic guidance is feasible in COVID-19 patients of appropriate security measures are taken and a strict protocol is followed. Instruction of all the health care personnel involves is key to ensure their safety and the patient's favorable recovery.

Molecular Modeling of Epithiospecifier and Nitrile-Specifier Proteins of Broccoli and Their Interaction with Aglycones.

Glucosinolates are secondary plant metabolites of Brassicaceae. They exert their effect after enzymatic hydrolysis to yield aglycones, which become nitriles and epithionitriles through the action of epithiospecifier (ESP) and nitrile-specifier proteins (NSP). The mechanism of action of broccoli ESP and NSP is poorly understood mainly because ESP and NSP structures have not been completely characterized and because aglycones are unstable, thus hindering experimental measurements. The aim of this work was to investigate the interaction of broccoli ESP and NSP with the aglycones derived from broccoli glucosinolates using molecular simulations. The three-dimensional structure of broccoli ESP was built based on its amino-acid sequence, and the NSP structure was constructed based on a consensus amino-acid sequence. The models obtained using Iterative Threading ASSEmbly Refinement (I-TASSER) were refined with the OPLS-AA/L all atom force field of GROMACS 5.0.7 and were validated by Veryfy3D and ERRAT. The structures were selected based on molecular dynamics simulations. Interactions between the proteins and aglycones were simulated with Autodock Vina at different pH. It was concluded that pH determines the stability of the complexes and that the aglycone derived from glucoraphanin has the highest affinity to both ESP and NSP. This agrees with the fact that glucoraphanin is the most abundant glucosinolate in broccoli florets.

Adolescents' Positive Cognitive Emotion Regulation Predicts Heart Trajectories During a Mother-Adolescent Conflict Interaction.

This paper aimed to (a) validate a novel technique that quantifies the length of the trajectories the cardiac system follows within a two-dimensional state-space, and (b) test its usefulness to better understand how cognitive emotion regulation (CER) style is associated with cardiac output. A positive CER style was assessed in a sample of healthy adolescents (n = 57), and mean and total distances, in addition to heart rate variability (HRV) measures and cardiac entropy (SampEn), were calculated during a conflict discussion with the adolescents' mothers. Associations between distances and HRV measures in time and frequency-domains and SampEn were examined to better understand the physiological meaning of distances; further, whether a positive CER style would predict distances, HRV, and SampEn. Correlation analysis revealed that associations of distances with time-domain HRV measures were stronger than associations with frequency-domain HRV measures, while correlations between distances and SampEn were moderate. Hierarchical multiple regression analysis revealed that a positive CER style predicted distances and SampEn, but not HRV measures. Distances are clearly time-domain measures of HRV, but only partly capture the complexity of the heart signal. The results highlight the importance of assessing heart rate dynamics beyond HRV in the study of CER.

Early life factors, gray matter brain volume and academic performance in overweight/obese children: The ActiveBrains project.

Early life factors may influence brain and academic outcomes later in life, especially during childhood. Here we investigate the associations of early life factors (i.e., birth weight, birth length, and breastfeeding) with gray matter volume, adjusted for body mass index and cardiorespiratory fitness, and ii) we test whether early-life factor-related differences in gray matter volume are associated with academic performance in overweight/obese children. 96 children with overweight/obesity aged 8-11 years participated. Birth weight, birth length and gestational age were collected from birth records, and breastfeeding practices were asked to parents. T1-weighted images were acquired with a 3.0 T Magnetom Tim Trio system. Academic performance was assessed with the Bateria III Woodcock-Muñoz Tests of Achievement. Whole-brain voxel-wise multiple regressions were used to test the associations of each early life factor with gray matter volume. Higher birth weight and birth length were associated with greater gray matter volume in 9 brain regions including the middle frontal gyrus, rectal gyrus, thalamus, putamen, middle temporal gyrus, lingual gyrus, middle occipital gyrus, calcarine cortex and cerebellum bilaterally (ß ranging from 0.361 to 0.539, t ranging from 3.46 to 5.62 and cluster size from 82 to 4478 voxels; p < 0.001); and greater duration of any breastfeeding was associated with greater gray matter volume in 3 regions including the bilateral inferior frontal gyrus and rolandic operculum (ß ranging from 0.359 to 0.408, t ranging from 4.01 to 4.32 and cluster size from 64 to 171 voxels; p < 0.001). No associations were found for duration of exclusive breastfeeding. Additionally, none of the gray matter regions that were associated with the early life factors were associated with academic performance (all p > 0.05). Our results demonstrate that birth weight, birth length, and breastfeeding are predictive of gray matter volume of numerous brain structures that are involved in higher order cognition and emotion regulation, but how these results relate to measures of academic achievement remain a matter of speculation.

Fitness, cortical thickness and surface area in overweight/obese children: The mediating role of body composition and relationship with intelligence.

Cortical thickness and surface area are thought to be genetically unrelated and shaped by independent neurobiological events suggesting that they should be considered separately in morphometric analyses. Although the developmental trajectories of cortical thickness and surface area may differ across brain regions and ages, there is no consensus regarding the relationships of physical fitness with cortical thickness and surface area as well as for its subsequent influence on intelligence. Thus, this study examines: (i) the associations of physical fitness components (i.e., cardiorespiratory fitness, speed-agility and muscular fitness) with overall and regional cortical thickness and surface area; (ii) whether body composition indicators (i.e., body mass index, fat-free mass index and fat mass index) mediate these associations; and (iii) the association of physical fitness and cortical thickness with intelligence in overweight/obese children. A total of 101 overweight/obese children aged 8-11 years were recruited in Granada, Spain. The physical fitness components were assessed following the ALPHA health-related fitness test battery. T1-weighted images were acquired with a 3.0 Tesla Siemens Magnetom Tim Trio system. We used FreeSurfer software version 5.3.0 to assess cortical thickness (mm) and surface area (mm2). The main results showed that cardiorespiratory fitness and speed-agility were related to overall cortical thickness (ß = 0.321 and ß = 0.302, respectively; both P < 0.05), and in turn, cortical thickness was associated with higher intelligence (ß = 0.198, P < 0.05). Muscular fitness was not related to overall cortical thickness. None of the three physical fitness components were related to surface area (p > 0.05). The associations of cardiorespiratory fitness and speed-agility with overall cortical thickness were mediated by fat mass index (56.86% & 62.28%, respectively). In conclusion, cardiorespiratory fitness and speed-agility, but not muscular fitness, are associated with overall cortical thickness, and in turn, thicker brain cortex is associated with higher intelligence in overweight/obese children. Yet, none of the three physical fitness components were related to surface area. Importantly, adiposity may hinder the benefits of cardiorespiratory fitness and speed-agility on cortical thickness. Understanding individual differences in brain morphology may have important implications for educators and policy makers who aim to determine policies and interventions to maximize academic learning and occupational success later in life.

Visceral adiposity and insular networks: associations with food craving.

BACKGROUND/OBJECTIVES: Accumulation of visceral adiposity can disrupt the brain's sensitivity to interoceptive feedback, which is coded in the insula. This study aimed to test the link between visceral fat and the functional connectivity of two insulae regions relevant for eating behavior: the middle-dorsal insula (mIns), which codes homeostatic changes, and the rostral insula (rIns), which codes stable representations of food properties. We also assessed the impact of visceral adiposity-associated insulae networks on food craving. SUBJECTS/METHODS: Seventy-five adults ranging in weight status (normal and excess weight) underwent resting-state functional magnetic resonance imaging (fMRI) and subjective food craving measures. We examined the association between visceral fat and seed-based functional connectivity of the mIns and the rIns, controlling for BMI, age, and sex, using multiple regressions in SPM8. We also tested if visceral fat mediated the association between insulae connectivity and food craving. RESULTS: Higher visceral adiposity was associated with decreased connectivity between the mIns and a cluster involving the hypothalamus and the bed nucleus of the stria terminalis. Decreased connectivity in this network was associated with greater food craving, a relation mediated by visceral adiposity. Visceral adiposity was also associated with increased connectivity between the mIns and the middle frontal gyri and the right intraparietal cortex, and between the rIns and the right amygdala. CONCLUSIONS: Accumulation of visceral adiposity is linked to disrupted functional connectivity within the mIns and rIns networks. Furthermore, the link between the mIns network and food craving is mediated by visceral fat. Findings suggest that visceral fat disrupts insula coding of bodily homeostatic signals, which may boost externally driven food cravings.

Maternal prepregnancy body mass index and offspring white matter microstructure: results from three birth cohorts.

BACKGROUND AND AIMS: Prepregnancy maternal obesity is a global health problem and has been associated with offspring metabolic and mental ill-health. However, there is a knowledge gap in understanding potential neurobiological factors related to these associations. This study explored the relation between maternal prepregnancy body mass index (BMI) and offspring brain white matter microstructure at the age of 6, 10, and 26 years in three independent cohorts. SUBJECTS AND METHODS: The study used data from three European birth cohorts (n = 116 children aged 6 years, n = 2466 children aged 10 years, and n = 437 young adults aged 26 years). Information on maternal prepregnancy BMI was obtained before or during pregnancy and offspring brain white matter microstructure was measured at age 6, 10, or 26 years. We used magnetic resonance imaging-derived fractional anisotropy (FA) and mean diffusivity (MD) as measures of white matter microstructure in the brainstem, callosal, limbic, association, and projection tracts. Linear regressions were fitted to examine the association of maternal BMI and offspring white matter microstructure, adjusting for several socioeconomic and lifestyle-related confounders, including education, smoking, and alcohol use. RESULTS: Maternal BMI was associated with higher FA and lower MD in multiple brain tracts, for example, association and projection fibers, in offspring aged 10 and 26 years, but not at 6 years. In each cohort maternal BMI was related to different white matter tract and thus no common associations across the cohorts were found. CONCLUSIONS: Maternal BMI was associated with higher FA and lower MD in multiple brain tracts in offspring aged 10 and 26 years, but not at 6 years of age. Future studies should examine whether our observations can be replicated and explore the potential causal nature of the findings.

Inflammatory biomarkers and brain health indicators in children with overweight and obesity: The ActiveBrains project.

INTRODUCTION: Chronic inflammation plays an important role on the pathogenesis of several cardiovascular and metabolic diseases, as well as on brain function and behaviour. The aim of the present study was to examine the associations between inflammatory biomarkers and a wide range of brain health indicators (i.e., academic performance, executive function, behavioural and emotional functioning, and brain volume) in children with overweight/obesity. METHODS: A total of 107 children (10.0 ±â€¯1.1 years, 41% girls) from the ActiveBrains project were included in the analysis. Five inflammatory biomarkers were analysed in plasma: white blood cell (WBC) count, interleukin-6 (IL-6), interleukin-1ß, tumor necrosis factor-α (TNF-α), and C-reactive protein (CRP). Academic performance was assessed by Woodcock-Muñoz Tests of Achievement. Executive function was assessed through the Design Fluency Test for cognitive flexibility, the Stroop test for cognitive inhibition, and the Delayed Non-Match-to-Sample task for working memory. Behavioural and emotional functioning was evaluated through the Behavior Assessment System for Children (BASC) questionnaire. Total and regional brain volume was assessed by magnetic resonance imaging. RESULTS: IL-6 was inversely associated with adaptive skills (ß = -0.228; p = 0.030), while TNF-α was related to mathematics (ß = -0.198; p = 0.034). In addition, CRP was positively associated with externalizing (ß = 0.246; p = 0.046) and internalizing problems (ß = 0.234; p = 0.039), as well as the behavioural symptoms index (ß = 0.236; p = 0.047). However, these significant associations disappeared after multiple comparisons correction. Inflammatory biomarkers were not associated with executive function and total brain volumes. Regarding regional brain analyses, WBC was positively associated with gray matter volume in the left middle temporal gyrus (ß = 0.387; p < 0.001, k = 44), and CRP was positively associated with gray matter volume in the right superior temporal gyrus (ß = 0.439; p < 0.001, k = 29). Additionally, when adjusting by total brain volume, CRP was positively associated with gray matter volume in the right supplementary motor cortex (ß = 0.453; p < 0.001, k = 51). Moreover, both, IL-6 (ß = 0.366; p < 0.001, k = 81) and TNF-α (ß = 0.368; p < 0.001, k = 62) were positively associated with white matter volume around the right inferior frontal gyrus pars opercularis, while CRP was inversely associated with white matter volume around the left superior frontal gyrus (ß = -0.482; p < 0.001, k = 82). After adjusting by total brain volume, CRP was also inversely associated with white matter volume in 3 additional clusters (ß ranging from -0.473 to -0.404; p < 0.001, k = 87). CONCLUSIONS: Inflammation was slightly associated with brain health (i.e., academic performance, behavioural and emotional functioning and regional brain volume) in children with overweight or obesity. Further larger longitudinal and interventional studies are warranted to elucidate the short-term and long-term effect of systemic low-grade inflammation on children's brain health.

Suicidal risk and executive functions in major depressive disorder: a study protocol.

BACKGROUND: Suicide is a serious public health concern. Depression is the main gateway to suicidal behavior. The already established relationship between depression and suicidal risk should now focus on the investigation of more specific factors: recent studies have suggested an association between vulnerability to suicidal behavior and neurocognitive alterations, a nuclear symptom of depression. This project aims to identify alterations in the Executive Functions (EF) of patients suffering a first depressive episode that might constitute a risk factor for suicidal ideation, suicidal attempts and suicide, to allow for more adequate suicide prevention. METHODS: Prospective longitudinal design involving two groups (first depressive episodes with and without alterations in their EF) and four repeated measures (0, 6, 12 and 24 months). The estimated minimum sample size is 216 subjects. The variables and measurement instruments will include socio-demographic variables, clinical variables (age of illness onset, family and personal antecedents, psychopathological and medical comorbidity, suicidal ideation, suicide attempts and completed suicides, severity of depression, including melancholic or atypical, remission of the depressive episode), and neuropsychological variables (EF and decision-making processes evaluated through the Cambridge Neuropsychological Test Automated Battery (CANTAB)). DISCUSSION: First and foremost, the identification of clinical and neuropsychological risk factors associated with suicidal behavior will open the possibility to prevent such behavior in patients with a first depressive episode in the context of clinical practice. Secondly, interventions aimed at cognitive impairment (in particular: EF) derived from the study may be incorporated into strategies for the prevention of suicidal behavior. Finally, impaired neurocognitive function (even in early stages) could become an identifiable endophenotype or "marker" in clinical and neurobiological studies about suicidal behavior in depressive patients.