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1.
PLoS One ; 19(3): e0299528, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38466739

RESUMEN

BACKGROUND: Rates of depression and addiction have risen drastically over the past decade, but the lack of integrative techniques remains a barrier to accurate diagnoses of these mental illnesses. Changes in reward/aversion behavior and corresponding brain structures have been identified in those with major depressive disorder (MDD) and cocaine-dependence polysubstance abuse disorder (CD). Assessment of statistical interactions between computational behavior and brain structure may quantitatively segregate MDD and CD. METHODS: Here, 111 participants [40 controls (CTRL), 25 MDD, 46 CD] underwent structural brain MRI and completed an operant keypress task to produce computational judgment metrics. Three analyses were performed: (1) linear regression to evaluate groupwise (CTRL v. MDD v. CD) differences in structure-behavior associations, (2) qualitative and quantitative heatmap assessment of structure-behavior association patterns, and (3) the k-nearest neighbor machine learning approach using brain structure and keypress variable inputs to discriminate groups. RESULTS: This study yielded three primary findings. First, CTRL, MDD, and CD participants had distinct structure-behavior linear relationships, with only 7.8% of associations overlapping between any two groups. Second, the three groups had statistically distinct slopes and qualitatively distinct association patterns. Third, a machine learning approach could discriminate between CTRL and CD, but not MDD participants. CONCLUSIONS: These findings demonstrate that variable interactions between computational behavior and brain structure, and the patterns of these interactions, segregate MDD and CD. This work raises the hypothesis that analysis of interactions between operant tasks and structural neuroimaging might aide in the objective classification of MDD, CD and other mental health conditions.


Asunto(s)
Trastorno Depresivo Mayor , Trastornos Relacionados con Sustancias , Humanos , Trastorno Depresivo Mayor/diagnóstico por imagen , Encéfalo/diagnóstico por imagen , Imagen por Resonancia Magnética , Trastornos Relacionados con Sustancias/psicología
2.
JMIR Public Health Surveill ; 10: e47979, 2024 Mar 18.
Artículo en Inglés | MEDLINE | ID: mdl-38315620

RESUMEN

BACKGROUND: Despite COVID-19 vaccine mandates, many chose to forgo vaccination, raising questions about the psychology underlying how judgment affects these choices. Research shows that reward and aversion judgments are important for vaccination choice; however, no studies have integrated such cognitive science with machine learning to predict COVID-19 vaccine uptake. OBJECTIVE: This study aims to determine the predictive power of a small but interpretable set of judgment variables using 3 machine learning algorithms to predict COVID-19 vaccine uptake and interpret what profile of judgment variables was important for prediction. METHODS: We surveyed 3476 adults across the United States in December 2021. Participants answered demographic, COVID-19 vaccine uptake (ie, whether participants were fully vaccinated), and COVID-19 precaution questions. Participants also completed a picture-rating task using images from the International Affective Picture System. Images were rated on a Likert-type scale to calibrate the degree of liking and disliking. Ratings were computationally modeled using relative preference theory to produce a set of graphs for each participant (minimum R2>0.8). In total, 15 judgment features were extracted from these graphs, 2 being analogous to risk and loss aversion from behavioral economics. These judgment variables, along with demographics, were compared between those who were fully vaccinated and those who were not. In total, 3 machine learning approaches (random forest, balanced random forest [BRF], and logistic regression) were used to test how well judgment, demographic, and COVID-19 precaution variables predicted vaccine uptake. Mediation and moderation were implemented to assess statistical mechanisms underlying successful prediction. RESULTS: Age, income, marital status, employment status, ethnicity, educational level, and sex differed by vaccine uptake (Wilcoxon rank sum and chi-square P<.001). Most judgment variables also differed by vaccine uptake (Wilcoxon rank sum P<.05). A similar area under the receiver operating characteristic curve (AUROC) was achieved by the 3 machine learning frameworks, although random forest and logistic regression produced specificities between 30% and 38% (vs 74.2% for BRF), indicating a lower performance in predicting unvaccinated participants. BRF achieved high precision (87.8%) and AUROC (79%) with moderate to high accuracy (70.8%) and balanced recall (69.6%) and specificity (74.2%). It should be noted that, for BRF, the negative predictive value was <50% despite good specificity. For BRF and random forest, 63% to 75% of the feature importance came from the 15 judgment variables. Furthermore, age, income, and educational level mediated relationships between judgment variables and vaccine uptake. CONCLUSIONS: The findings demonstrate the underlying importance of judgment variables for vaccine choice and uptake, suggesting that vaccine education and messaging might target varying judgment profiles to improve uptake. These methods could also be used to aid vaccine rollouts and health care preparedness by providing location-specific details (eg, identifying areas that may experience low vaccination and high hospitalization).


Asunto(s)
Vacunas contra la COVID-19 , COVID-19 , Adulto , Humanos , Juicio , Estudios Transversales , COVID-19/epidemiología , COVID-19/prevención & control , Vacunación , Ciencia Cognitiva , Etnicidad
3.
JMIR Form Res ; 7: e40821, 2023 Apr 14.
Artículo en Inglés | MEDLINE | ID: mdl-36888554

RESUMEN

BACKGROUND: The COVID-19 pandemic has heightened mental health concerns, but the temporal relationship between mental health conditions and SARS-CoV-2 infection has not yet been investigated. Specifically, psychological issues, violent behaviors, and substance use were reported more during the COVID-19 pandemic than before the pandemic. However, it is unknown whether a prepandemic history of these conditions increases an individual's susceptibility to SARS-CoV-2. OBJECTIVE: This study aimed to better understand the psychological risks underlying COVID-19, as it is important to investigate how destructive and risky behaviors may increase a person's susceptibility to COVID-19. METHODS: In this study, we analyzed data from a survey of 366 adults across the United States (aged 18 to 70 years); this survey was administered between February and March of 2021. The participants were asked to complete the Global Appraisal of Individual Needs-Short Screener (GAIN-SS) questionnaire, which indicates an individual's history of high-risk and destructive behaviors and likelihood of meeting diagnostic criteria. The GAIN-SS includes 7 questions related to externalizing behaviors, 8 related to substance use, and 5 related to crime and violence; responses were given on a temporal scale. The participants were also asked whether they ever tested positive for COVID-19 and whether they ever received a clinical diagnosis of COVID-19. GAIN-SS responses were compared between those who reported and those who did not report COVID-19 to determine if those who reported COVID-19 also reported GAIN-SS behaviors (Wilcoxon rank sum test, α=.05). In total, 3 hypotheses surrounding the temporal relationships between the recency of GAIN-SS behaviors and COVID-19 infection were tested using proportion tests (α=.05). GAIN-SS behaviors that significantly differed (proportion tests, α=.05) between COVID-19 responses were included as independent variables in multivariable logistic regression models with iterative downsampling. This was performed to assess how well a history of GAIN-SS behaviors statistically discriminated between those who reported and those who did not report COVID-19. RESULTS: Those who reported COVID-19 more frequently indicated past GAIN-SS behaviors (Q<0.05). Furthermore, the proportion of those who reported COVID-19 was higher (Q<0.05) among those who reported a history of GAIN-SS behaviors; specifically, gambling and selling drugs were common across the 3 proportion tests. Multivariable logistic regression revealed that GAIN-SS behaviors, particularly gambling, selling drugs, and attention problems, accurately modeled self-reported COVID-19, with model accuracies ranging from 77.42% to 99.55%. That is, those who exhibited destructive and high-risk behaviors before and during the pandemic could be discriminated from those who did not exhibit these behaviors when modeling self-reported COVID-19. CONCLUSIONS: This preliminary study provides insights into how a history of destructive and risky behaviors influences infection susceptibility, offering possible explanations for why some persons may be more susceptible to COVID-19, potentially in relation to reduced adherence to prevention guidelines or not seeking vaccination.

4.
bioRxiv ; 2023 Mar 21.
Artículo en Inglés | MEDLINE | ID: mdl-36993354

RESUMEN

We previously observed sustained fMRI BOLD signal in the basal ganglia in focal hand dystonia patients after a repetitive finger tapping task. Since this was observed in a task-specific dystonia, for which excessive task repetition may play a role in pathogenesis, in the current study we asked if this effect would be observed in a focal dystonia (cervical dystonia [CD]) that is not considered task-specific or thought to result from overuse. We evaluated fMRI BOLD signal time courses before, during, and after the finger tapping task in CD patients. We observed patient/control differences in post-tapping BOLD signal in left putamen and left cerebellum during the non-dominant (left) hand tapping condition, reflecting abnormally sustained BOLD signal in CD. BOLD signals in left putamen and cerebellum were also abnormally elevated in CD during tapping itself and escalated as tapping was repeated. There were no cerebellar differences in the previously studied FHD cohort, either during or after tapping. We conclude that some elements of pathogenesis and/or pathophysiology associated with motor task execution/repetition may not be limited to task-specific dystonias, but there may be regional differences in these effects across dystonias, associated with different types of motor control programs.

5.
JMIR Form Res ; 6(10): e36656, 2022 Oct 25.
Artículo en Inglés | MEDLINE | ID: mdl-35763757

RESUMEN

BACKGROUND: Although the mental health impacts of COVID-19 on the general population have been well studied, studies of the long-term impacts of COVID-19 on infected individuals are relatively new. To date, depression, anxiety, and neurological symptoms associated with post-COVID-19 syndrome (PCS) have been observed in the months following COVID-19 recovery. Suicidal thoughts and behavior (STB) have also been preliminarily proposed as sequelae of COVID-19. OBJECTIVE: We asked 3 questions. First, do participants reporting a history of COVID-19 diagnosis or a close relative having severe COVID-19 symptoms score higher on depression (Patient Health Questionnaire-9 [PHQ-9]) or state anxiety (State Trait Anxiety Index) screens than those who do not? Second, do participants reporting a COVID-19 diagnosis score higher on PCS-related PHQ-9 items? Third, do participants reporting a COVID-19 diagnosis or a close relative having severe COVID-19 symptoms score higher in STB before, during, or after the first year of the pandemic? METHODS: This preliminary study analyzed responses to a COVID-19 and mental health questionnaire obtained from a US population sample, whose data were collected between February 2021 and March 2021. We used the Mann-Whitney U test to detect differences in the medians of the total PHQ-9 scores, PHQ-9 component scores, and several STB scores between participants claiming a past clinician diagnosis of COVID-19 and those denying one, as well as between participants claiming severe COVID-19 symptoms in a close relative and those denying them. Where significant differences existed, we created linear regression models to predict the scores based on COVID-19 response as well as demographics to identify potential confounding factors in the Mann-Whitney relationships. Moreover, for STB scores, which corresponded to 5 questions asking about 3 different time intervals (i.e., past 1 year or more, past 1 month to 1 year, and past 1 month), we developed repeated-measures ANOVAs to determine whether scores tended to vary over time. RESULTS: We found greater total depression (PHQ-9) and state anxiety (State Trait Anxiety Index) scores in those with COVID-19 history than those without (Bonferroni P=.001 and Bonferroni P=.004) despite a similar history of diagnosed depression and anxiety. Greater scores were noted for a subset of depression symptoms (PHQ-9 items) that overlapped with the symptoms of PCS (all Bonferroni Ps<.05). Moreover, we found greater overall STB scores in those with COVID-19 history, equally in time windows preceding, during, and proceeding infection (all Bonferroni Ps<.05). CONCLUSIONS: We confirm previous studies linking depression and anxiety diagnoses to COVID-19 recovery. Moreover, our findings suggest that depression diagnoses associated with COVID-19 history relate to PCS symptoms, and that STB associated with COVID-19 in some cases precede infection.

6.
JMIR Form Res ; 6(8): e36444, 2022 Aug 16.
Artículo en Inglés | MEDLINE | ID: mdl-35763758

RESUMEN

BACKGROUND: The COVID-19 disease results from infection by the SARS-CoV-2 virus to produce a range of mild to severe physical, neurological, and mental health symptoms. The COVID-19 pandemic has indirectly caused significant emotional distress, triggering the emergence of mental health symptoms in individuals who were not previously affected or exacerbating symptoms in those with existing mental health conditions. Emotional distress and certain mental health conditions can lead to violent ideation and disruptive behavior, including aggression, threatening acts, deliberate harm toward other people or animals, and inattention to or noncompliance with education or workplace rules. Of the many mental health conditions that can be associated with violent ideation and disruptive behavior, psychosis can evidence greater vulnerability to unpredictable changes and being at a greater risk for them. Individuals with psychosis can also be more susceptible to contracting COVID-19 disease. OBJECTIVE: This study aimed to investigate whether violent ideation, disruptive behavior, or psychotic symptoms were more prevalent in a population with COVID-19 and did not precede the pandemic. METHODS: In this preliminary study, we analyzed questionnaire responses from a population sample (N=366), received between the end of February 2021 and the start of March 2021 (1 year into the COVID-19 pandemic), regarding COVID-19 illness, violent ideation, disruptive behavior, and psychotic symptoms. Using the Wilcoxon rank sum test followed by multiple comparisons correction, we compared the self-reported frequency of these variables for 3 time windows related to the past 1 month, past 1 month to 1 year, and >1 year ago among the distributions of people who answered whether they tested positive or were diagnosed with COVID-19 by a clinician. We also used multivariable logistic regression with iterative resampling to investigate the relationship between these variables occurring >1 year ago (ie, before the pandemic) and the likelihood of contracting COVID-19. RESULTS: We observed a significantly higher frequency of self-reported violent ideation, disruptive behavior, and psychotic symptoms, for all 3 time windows of people who tested positive or were diagnosed with COVID-19 by a clinician. Using multivariable logistic regression, we observed 72% to 94% model accuracy for an increased incidence of COVID-19 in participants who reported violent ideation, disruptive behavior, or psychotic symptoms >1 year ago. CONCLUSIONS: This preliminary study found that people who reported a test or clinician diagnosis of COVID-19 also reported higher frequencies of violent ideation, disruptive behavior, or psychotic symptoms across multiple time windows, indicating that they were not likely to be the result of COVID-19. In parallel, participants who reported these behaviors >1 year ago (ie, before the pandemic) were more likely to be diagnosed with COVID-19, suggesting that violent ideation, disruptive behavior, in addition to psychotic symptoms, were associated with COVID-19 with an approximately 70% to 90% likelihood.

7.
ACS Appl Mater Interfaces ; 10(12): 9894-9899, 2018 Mar 28.
Artículo en Inglés | MEDLINE | ID: mdl-29528214

RESUMEN

An optimization of band alignment at the p-n junction interface is realized on alcohol-based solution-processed Cu(In,Ga)(S,Se)2 (CIGS) thin film solar cells, achieving a power-conversion-efficiency (PCE) of 14.4%. To obtain a CIGS thin film suitable for interface engineering, we designed a novel "3-step chalcogenization process" for Cu2- xSe-derived grain growth and a double band gap grading structure. Considering S-rich surface of the CIGS thin film, an alternative ternary (Cd,Zn)S buffer layer is adopted to build favorable "spike" type conduction band alignment instead of "cliff" type. Suppression of interface recombination is elucidated by comparing recombination activation energies using a dark J- V- T analysis.

8.
Brain Behav ; 6(5): e00459, 2016 05.
Artículo en Inglés | MEDLINE | ID: mdl-27257518

RESUMEN

INTRODUCTION: Decades of research have demonstrated the importance of social influence in initiation and maintenance of drug use, but little is known about neural mechanisms underlying social influence in young adults who use recreational drugs. METHODS: To better understand whether the neural and/or behavioral response to social influence differs in young adults using illicit drugs, 20 marijuana-using young adults (MJ) aged 18-25, and 20 controls (CON) performed a decision-making task in the context of social influence, while they underwent functional magnetic resonance imaging scans. A priori analyses focused on the nucleus accumbens (NAc), with post hoc analyses in the rest of the striatum. In this task, participants could choose to either follow or go against group influence. RESULTS: When subjects applied social information to response choice selection (independent of following or going against group influence), we observed activation in the middle striatum (caudate), in the MJ group only, that extended ventrally into the NAc. MJ users but not CON showed greater activation in the NAc but not the caudate while making choices congruent with group influence as opposed to choices going against group influence. Activation in the NAc when following social influence was associated with amount of drug use reported. In contrast, during the feedback phase of the task we observed significant NAc activation in both MJ and CON, along with dorsal caudate activation only in MJ participants. This NAc activation did not correlate with drug use. CONCLUSIONS: This study shows that MJ users, but not CON, show differential brain activation across striatal subregions when applying social information to make a decision, following versus going against a group of peers, or receiving positive feedback. The current work suggests that differential neural sensitivity to social influence in regions such as the striatum may contribute to the development and/or maintenance of marijuana use.


Asunto(s)
Núcleo Caudado/fisiología , Conducta de Elección/fisiología , Abuso de Marihuana/fisiopatología , Núcleo Accumbens/fisiología , Grupo Paritario , Conducta Social , Adolescente , Adulto , Núcleo Caudado/fisiopatología , Femenino , Humanos , Imagen por Resonancia Magnética , Masculino , Núcleo Accumbens/fisiopatología , Adulto Joven
9.
Front Hum Neurosci ; 9: 176, 2015.
Artículo en Inglés | MEDLINE | ID: mdl-25983682

RESUMEN

Loss aversion (LA), the idea that negative valuations have a higher psychological impact than positive ones, is considered an important variable in consumer research. The literature on aging and behavior suggests older individuals may show more LA, although it is not clear if this is an effect of aging in general (as in the continuum from age 20 and 50 years), or of the state of older age (e.g., past age 65 years). We also have not yet identified the potential biological effects of aging on the neural processing of LA. In the current study we used a cohort of subjects with a 30 year range of ages, and performed whole brain functional MRI (fMRI) to examine the ventral striatum/nucleus accumbens (VS/NAc) response during a passive viewing of affective faces with model-based fMRI analysis incorporating behavioral data from a validated approach/avoidance task with the same stimuli. Our a priori focus on the VS/NAc was based on (1) the VS/NAc being a central region for reward/aversion processing; (2) its activation to both positive and negative stimuli; (3) its reported involvement with tracking LA. LA from approach/avoidance to affective faces showed excellent fidelity to published measures of LA. Imaging results were then compared to the behavioral measure of LA using the same affective faces. Although there was no relationship between age and LA, we observed increasing neural differential sensitivity (NDS) of the VS/NAc to avoidance responses (negative valuations) relative to approach responses (positive valuations) with increasing age. These findings suggest that a central region for reward/aversion processing changes with age, and may require more activation to produce the same LA behavior as in younger individuals, consistent with the idea of neural efficiency observed with high IQ individuals showing less brain activation to complete the same task.

10.
J Neurosci ; 34(16): 5529-38, 2014 Apr 16.
Artículo en Inglés | MEDLINE | ID: mdl-24741043

RESUMEN

Marijuana is the most commonly used illicit drug in the United States, but little is known about its effects on the human brain, particularly on reward/aversion regions implicated in addiction, such as the nucleus accumbens and amygdala. Animal studies show structural changes in brain regions such as the nucleus accumbens after exposure to Δ9-tetrahydrocannabinol, but less is known about cannabis use and brain morphometry in these regions in humans. We collected high-resolution MRI scans on young adult recreational marijuana users and nonusing controls and conducted three independent analyses of morphometry in these structures: (1) gray matter density using voxel-based morphometry, (2) volume (total brain and regional volumes), and (3) shape (surface morphometry). Gray matter density analyses revealed greater gray matter density in marijuana users than in control participants in the left nucleus accumbens extending to subcallosal cortex, hypothalamus, sublenticular extended amygdala, and left amygdala, even after controlling for age, sex, alcohol use, and cigarette smoking. Trend-level effects were observed for a volume increase in the left nucleus accumbens only. Significant shape differences were detected in the left nucleus accumbens and right amygdala. The left nucleus accumbens showed salient exposure-dependent alterations across all three measures and an altered multimodal relationship across measures in the marijuana group. These data suggest that marijuana exposure, even in young recreational users, is associated with exposure-dependent alterations of the neural matrix of core reward structures and is consistent with animal studies of changes in dendritic arborization.


Asunto(s)
Amígdala del Cerebelo/patología , Fumar Marihuana/patología , Núcleo Accumbens/patología , Adolescente , Adulto , Femenino , Humanos , Procesamiento de Imagen Asistido por Computador , Imagen por Resonancia Magnética , Masculino , Fumar Marihuana/fisiopatología , Tamaño de los Órganos , Índice de Severidad de la Enfermedad , Adulto Joven
11.
PLoS One ; 5(11): e13945, 2010 Nov 29.
Artículo en Inglés | MEDLINE | ID: mdl-21124764

RESUMEN

BACKGROUND: Previous studies of major depressive disorder (MDD) have focused on abnormalities in the prefrontal cortex and medial temporal regions. There has been little investigation in MDD of midbrain and subcortical regions central to reward/aversion function, such as the ventral tegmental area/substantia nigra (VTA/SN), and medial forebrain bundle (MFB). METHODOLOGY/PRINCIPAL FINDINGS: We investigated the microstructural integrity of this circuitry using diffusion tensor imaging (DTI) in 22 MDD subjects and compared them with 22 matched healthy control subjects. Fractional anisotropy (FA) values were increased in the right VT and reduced in dorsolateral prefrontal white matter in MDD subjects. Follow-up analysis suggested two distinct subgroups of MDD patients, which exhibited non-overlapping abnormalities in reward/aversion circuitry. The MDD subgroup with abnormal FA values in VT exhibited significantly greater trait anxiety than the subgroup with normal FA values in VT, but the subgroups did not differ in levels of anhedonia, sadness, or overall depression severity. CONCLUSIONS/SIGNIFICANCE: These findings suggest that MDD may be associated with abnormal microstructure in brain reward/aversion regions, and that there may be at least two subtypes of microstructural abnormalities which each impact core symptoms of depression.


Asunto(s)
Trastorno Depresivo Mayor/fisiopatología , Recompensa , Sustancia Negra/fisiopatología , Área Tegmental Ventral/fisiopatología , Adulto , Anisotropía , Reacción de Prevención/fisiología , Mapeo Encefálico/métodos , Estudios de Cohortes , Femenino , Humanos , Masculino , Haz Prosencefálico Medial/fisiopatología , Persona de Mediana Edad , Sustancia Negra/anomalías , Área Tegmental Ventral/anomalías , Adulto Joven
12.
PLoS One ; 5(5): e10613, 2010 May 26.
Artículo en Inglés | MEDLINE | ID: mdl-20532247

RESUMEN

BACKGROUND: Approach and avoidance behavior provide a means for assessing the rewarding or aversive value of stimuli, and can be quantified by a keypress procedure whereby subjects work to increase (approach), decrease (avoid), or do nothing about time of exposure to a rewarding/aversive stimulus. To investigate whether approach/avoidance behavior might be governed by quantitative principles that meet engineering criteria for lawfulness and that encode known features of reward/aversion function, we evaluated whether keypress responses toward pictures with potential motivational value produced any regular patterns, such as a trade-off between approach and avoidance, or recurrent lawful patterns as observed with prospect theory. METHODOLOGY/PRINCIPAL FINDINGS: Three sets of experiments employed this task with beautiful face images, a standardized set of affective photographs, and pictures of food during controlled states of hunger and satiety. An iterative modeling approach to data identified multiple law-like patterns, based on variables grounded in the individual. These patterns were consistent across stimulus types, robust to noise, describable by a simple power law, and scalable between individuals and groups. Patterns included: (i) a preference trade-off counterbalancing approach and avoidance, (ii) a value function linking preference intensity to uncertainty about preference, and (iii) a saturation function linking preference intensity to its standard deviation, thereby setting limits to both. CONCLUSIONS/SIGNIFICANCE: These law-like patterns were compatible with critical features of prospect theory, the matching law, and alliesthesia. Furthermore, they appeared consistent with both mean-variance and expected utility approaches to the assessment of risk. Ordering of responses across categories of stimuli demonstrated three properties thought to be relevant for preference-based choice, suggesting these patterns might be grouped together as a relative preference theory. Since variables in these patterns have been associated with reward circuitry structure and function, they may provide a method for quantitative phenotyping of normative and pathological function (e.g., psychiatric illness).


Asunto(s)
Reacción de Prevención , Reconocimiento Visual de Modelos , Belleza , Alimentos , Humanos , Estimulación Luminosa , Reproducibilidad de los Resultados
13.
BMC Musculoskelet Disord ; 11: 103, 2010 May 28.
Artículo en Inglés | MEDLINE | ID: mdl-20507640

RESUMEN

BACKGROUND: Gel-type autologous chondrocyte (Chondron) implantations have been used for several years without using periosteum or membrane. This study involves evaluations of the clinical results of Chondron at many clinical centers at various time points during the postoperative patient follow-up. METHODS: Data from 98 patients with articular cartilage injury of the knee joint and who underwent Chondron implantation at ten Korean hospitals between January 2005 and November 2008, were included and were divided into two groups based on the patient follow-up period, i.e. 13~24-month follow-up and greater than 25-month follow-up. The telephone Knee Society Score obtained during telephone interviews with patients, was used as the evaluation tool. RESULTS: On the tKSS-A (telephone Knee Society Score-A), the score improved from 43.52 +/- 20.20 to 89.71 +/- 13.69 (P < 0.05), and on the tKSS-B (telephone Knee Society Score-B), the score improved from 50.66 +/- 20.05 to 89.38 +/- 15.76 (P < 0.05). The total improvement was from 94.18 +/- 31.43 to 179.10 +/- 24.69 (P < 0.05). CONCLUSION: Gel-type autologous chondrocyte implantation for chondral knee defects appears to be a safe and effective method for both decreasing pain and improving knee function.


Asunto(s)
Cartílago Articular/cirugía , Condrocitos/trasplante , Traumatismos de la Rodilla/cirugía , Articulación de la Rodilla/cirugía , Trasplante de Tejidos/métodos , Adolescente , Adulto , Anciano , Cartílago Articular/citología , Cartílago Articular/patología , Células Cultivadas , Condrocitos/citología , Condrocitos/fisiología , Femenino , Estudios de Seguimiento , Humanos , Traumatismos de la Rodilla/diagnóstico por imagen , Traumatismos de la Rodilla/patología , Articulación de la Rodilla/diagnóstico por imagen , Articulación de la Rodilla/patología , Masculino , Persona de Mediana Edad , Radiografía , Estudios Retrospectivos , Trasplante Autólogo/métodos , Resultado del Tratamiento , Adulto Joven
14.
Neuron ; 60(1): 174-88, 2008 Oct 09.
Artículo en Inglés | MEDLINE | ID: mdl-18940597

RESUMEN

The structural effects of cocaine on neural systems mediating cognition and motivation are not well known. By comparing the thickness of neocortical and paralimbic brain regions between cocaine-dependent and matched control subjects, we found that four of 18 a priori regions involved with executive regulation of reward and attention were significantly thinner in addicts. Correlations were significant between thinner prefrontal cortex and reduced keypresses during judgment and decision making of relative preference in addicts, suggesting one basis for restricted behavioral repertoires in drug dependence. Reduced effortful attention performance in addicts also correlated with thinner paralimbic cortices. Some thickness differences in addicts were correlated with cocaine use independent of nicotine and alcohol, but addicts also showed diminished thickness heterogeneity and altered hemispheric thickness asymmetry. These observations suggest that brain structure abnormalities in addicts are related in part to drug use and in part to predisposition toward addiction.


Asunto(s)
Corteza Cerebral/patología , Trastornos Relacionados con Cocaína/genética , Trastornos Relacionados con Cocaína/patología , Predisposición Genética a la Enfermedad/genética , Atención/fisiología , Conducta Adictiva/genética , Conducta Adictiva/patología , Conducta Adictiva/fisiopatología , Corteza Cerebral/fisiología , Trastornos Relacionados con Cocaína/fisiopatología , Estudios de Cohortes , Femenino , Humanos , Masculino , Trastornos Relacionados con Sustancias/genética , Trastornos Relacionados con Sustancias/patología , Trastornos Relacionados con Sustancias/fisiopatología
15.
Arch Gen Psychiatry ; 65(8): 882-92, 2008 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-18678793

RESUMEN

CONTEXT: Previous functional neuroimaging studies have identified a network of brain regions that process aversive stimuli, including anger. A polymorphism near the cyclic adenosine monophosphate response element binding protein gene (CREB1) has recently been associated with greater self-reported effort at anger control as well as risk for antidepressant treatment-emergent suicidality in men with major depressive disorder, but its functional effects have not been studied. OBJECTIVE: To determine whether this genetic variant is associated with altered brain processing of and behavioral avoidance responses to angry facial expressions. DESIGN AND PARTICIPANTS: A total of 28 white participants (mean age, 29.2 years; 13 women) were screened using the Structured Clinical Interview for DSM-IV to exclude any lifetime Axis I psychiatric disorder and were genotyped for rs4675690, a single-nucleotide polymorphism near CREB1. MAIN OUTCOME MEASURES: Blood oxygenation level-dependent signal by functional magnetic resonance imaging in the amygdala, insula, anterior cingulate, and orbitofrontal cortex during passive viewing of photographs of faces with emotional expressions. To measure approach and avoidance responses to anger, an off-line key-press task that traded effort for viewing time assessed valuation of angry faces compared with other expressions. RESULTS: The CREB1-linked single-nucleotide polymorphism was associated with significant differential activation in an extended neural network responding to angry and other facial expressions. The CREB1-associated insular activation was coincident with activation associated with behavioral avoidance of angry faces. CONCLUSIONS: A polymorphism near CREB1 is associated with responsiveness to angry faces in a brain network implicated in processing aversion. Coincident activation in the left insula is further associated with behavioral avoidance of these stimuli.


Asunto(s)
Ira/fisiología , Nivel de Alerta/genética , Reacción de Prevención/fisiología , Corteza Cerebral/fisiopatología , Proteína de Unión a Elemento de Respuesta al AMP Cíclico/genética , Expresión Facial , Procesamiento de Imagen Asistido por Computador , Imagen por Resonancia Magnética , Red Nerviosa/fisiopatología , Reconocimiento Visual de Modelos/fisiología , Polimorfismo de Nucleótido Simple/genética , Adulto , Alelos , Nivel de Alerta/fisiología , Conducta de Elección/fisiología , Dominancia Cerebral/genética , Femenino , Genotipo , Hostilidad , Humanos , Desequilibrio de Ligamiento , Masculino , Memoria a Corto Plazo/fisiología , Oxígeno/sangre , Inventario de Personalidad , Fenotipo , Desempeño Psicomotor/fisiología , Proteínas de Transporte de Serotonina en la Membrana Plasmática/genética
16.
Neuron ; 51(5): 661-70, 2006 Sep 07.
Artículo en Inglés | MEDLINE | ID: mdl-16950163

RESUMEN

It is generally assumed that sensitivity to different stimulus orientations is mapped in a globally equivalent fashion across primate visual cortex, at a spatial scale larger than that of orientation columns. However, some evidence predicts instead that radial orientations should produce higher activity than other orientations, throughout visual cortex. Here, this radial orientation bias was robustly confirmed using (1) human psychophysics, plus fMRI in (2) humans and (3) behaving monkeys. In visual cortex, fMRI activity was at least 20% higher in the retinotopic representations of polar angle which corresponded to the radial stimulus orientations (relative to tangential). In a global demonstration of this, we activated complementary retinotopic quadrants of visual cortex by simply changing stimulus orientation, without changing stimulus location in the visual field. This evidence reveals a neural link between orientation sensitivity and the cortical retinotopy, which have previously been considered independent.


Asunto(s)
Sesgo , Mapeo Encefálico , Orientación/fisiología , Corteza Visual/fisiología , Animales , Sensibilidad de Contraste/fisiología , Humanos , Macaca mulatta , Imagen por Resonancia Magnética , Masculino
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