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4.
BMJ Open ; 6(11): e012573, 2016 11 30.
Artigo em Inglês | MEDLINE | ID: mdl-27903561

RESUMO

INTRODUCTION: Obesity is a growing epidemic fuelled by unhealthy behaviours and associated with significant comorbidities and financial costs. While behavioural interventions produce clinically meaningful weight loss, weight loss maintenance is challenging. This may partially be due to failure to target stress and emotional reactivity. Mindfulness-based stress reduction (MBSR) reduces stress and emotional reactivity and may be a useful tool for behaviour change maintenance. This study seeks to provide a mechanistic understanding for clinical trials of the benefits of MBSR for weight loss maintenance by examining changes in functional connectivity (FC) and the association of these changes with clinical outcomes. METHODS AND ANALYSIS: Community-dwelling individuals (n=80) who intentionally lost ≥5% of their body weight in the past year will be recruited and randomised to an MBSR programme or educational control. FC using resting-state functional MRI will be measured at baseline and 8 weeks. Psychological factors, health behaviours, body mass index and waist circumference will be measured at baseline, 8 weeks and 6 months post intervention. A 12-month telephone follow-up will assess self-reported weight. Analyses will characterise FC changes in response to MBSR in comparison with a control condition, assess the relationship between baseline FC status and pre-post MBSR changes in FC and investigate the association of FC change with changes in psychological factors and weight loss maintenance. ETHICS AND DISSEMINATION: The University of Massachusetts Medical School Institutional Review Board has approved this study, Declaration of Helsinki protocols are being followed, and patients will give written informed consent. The Independent Monitoring Committee will monitor protocol adherence. Results from the study will be disseminated to the medical community at conferences and submitted for publication in peer-reviewed journals when the last patient included has been followed up for 12 months. TRIAL REGISTRATION NUMBER: NCT02189187.


Assuntos
Terapia Comportamental , Atenção Plena , Obesidade/psicologia , Estresse Psicológico/prevenção & controle , Adulto , Análise Custo-Benefício , Feminino , Humanos , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Obesidade/epidemiologia , Obesidade/fisiopatologia , Avaliação de Programas e Projetos de Saúde , Estudos Prospectivos , Ensaios Clínicos Controlados Aleatórios como Assunto , Estresse Psicológico/epidemiologia , Estresse Psicológico/psicologia , Resultado do Tratamento , Estados Unidos/epidemiologia , Programas de Redução de Peso
5.
J Magn Reson Imaging ; 26(3): 557-63, 2007 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-17729349

RESUMO

PURPOSE: To compare and contrast the pattern and characteristics of the cerebral blood volume (CBV) response to ethanol (EtOH) in rats under awake and anesthetized conditions. MATERIALS AND METHODS: Acute EtOH (0.75 g/kg) challenge-induced CBV changes were measured using a contrast-enhanced functional MRI CBV method in 15 male Sprague Dawley rats under three experimental conditions: 1.0% to 1.2% isoflurane (N = 5); 0.8% halothane (N = 5); and awake with no anesthetic (N = 5). Physiological parameters were collected from bench settings in nine rats from the above different conditions. Four parameters: 1) area under the curve (AUC%); 2) the maximum signal change (Max%); 3) EtOH absorption rate (alpha(2)); and 4) EtOH elimination rate (alpha(1)) were employed to compare EtOH-induced MRI signals between the awake and anesthetized groups. RESULTS: Both awake and anesthetized animals responded with an increase in CBV to EtOH challenge. However, the presence of anesthesia promoted a significant preferential flow to subcortical areas not seen in the awake condition. CONCLUSION: Unclear mechanisms of anesthesia add a layer of uncertainty to the already complex interpretation of EtOH's influence on neuronal activity, cellular metabolism, and hemodynamic coupling.


Assuntos
Anestesia , Circulação Cerebrovascular/efeitos dos fármacos , Prosencéfalo/patologia , Anestesiologia/métodos , Animais , Área Sob a Curva , Volume Sanguíneo , Córtex Cerebral/patologia , Etanol/farmacologia , Imageamento por Ressonância Magnética/métodos , Masculino , Neurônios/patologia , Ratos , Ratos Sprague-Dawley , Fatores de Tempo
7.
Epilepsia ; 44(9): 1133-40, 2003 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-12919383

RESUMO

PURPOSE: Functional magnetic resonance imaging (fMRI) was used to identify areas of brain activation during absence seizures in an awake animal model. METHODS: Blood-oxygenation-level-dependent (BOLD) fMRI in the brain was measured by using T2*-weighted echo planar imaging at 4.7 Tesla. BOLD imaging was performed before, during, and after absence seizure induction by using gamma-butyrolactone (GBL; 200 mg/kg, intraperitoneal). RESULTS: The corticothalamic circuitry, critical for spike-wave discharge (SWD) formation in absence seizure, showed robust BOLD signal changes after GBL administration, consistent with EEG recordings in the same animals. Predominantly positive BOLD changes occurred in the thalamus. Sensory and parietal cortices showed mixed positive and negative BOLD changes, whereas temporal and motor cortices showed only negative BOLD changes. CONCLUSIONS: With the BOLD fMRI technique, we demonstrated signal changes in brain areas that have been shown, with electrophysiology experiments, to be important for generating and maintaining the SWDs that characterize absence seizures. These results corroborate previous findings from lesion and electrophysiological experiments and show the technical feasibility of noninvasively imaging absence seizures in fully conscious rodents.


Assuntos
Córtex Cerebral/fisiologia , Epilepsia Tipo Ausência/fisiopatologia , Imageamento por Ressonância Magnética/métodos , Tálamo/fisiologia , Anestesia/métodos , Animais , Eletroencefalografia/métodos , Masculino , Vias Neurais/fisiologia , Ratos , Ratos Sprague-Dawley , Vigília/fisiologia
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