Structural and functional brain markers of cognitive impairment in healthcare workers following mild SARS-CoV-2 infection during the original stream.

Severe acute respiratory syndrome coronavirus 2 infection often involves the nervous system, leading to cognitive dysfunctions, fatigue and many other neurological signs that are becoming increasingly recognized. Despite mild forms of the disease accounting for most cases worldwide, research on the pathophysiology driving mild coronavirus disease 2019 (COVID-19) has received little attention. In this respect, recent evidence has pointed out that around 30-40% of non-critical, mild-to-moderate severity COVID-19 survivors may display cognitive disturbances several months post-illness. Hence, the impact of COVID-19 on the brain structure and function, through potential neuropathological mechanisms underpinning cognitive alterations in post-mild COVID-19 infections, remains largely unexplored. This retrospective multicentre observational cohort study, entirely based on a healthcare worker sample (n = 65; 55% females, aged 21-61), investigated the cognitive status and the structural and functional brain integrity among non-hospitalized individuals who developed mild COVID-19 symptoms during the occurrence of severe acute respiratory syndrome coronavirus 2 variants Alpha to Delta, compared with healthy controls tested before the pandemic onset. All evaluations were performed at an average of 9-month follow-up post-infection period. Participants completed a comprehensive neuropsychological assessment and structural and functional MRI exams. Radiological inspection sought to detect the presence of white matter hyperintensities on axial fluid-attenuated inversion recovery images. Global and regional grey matter integrity assessment, analysing changes in grey matter volumes and cortical thinning, and functional connectivity alterations of resting-state brain networks were also conducted. Regression analyses tested the relationships between the presence of specific cognitive impairments and potential structural and functional brain findings. Our results revealed that clinical, cognitive screening and neuropsychological examinations were average between both groups, except for specific impairments related to executive functions in the mild COVID-19. Compared to healthy controls, mild COVID-19 subjects exhibited increased juxtacortical white matter hyperintensities, thalamic and occipital volume loss and diminished resting-state functional connectivity involving the left precuneus and cuneus in default-mode network and affecting the right angular gyrus and left precuneus in the dorsal attentional network. Reduced thalamic volume was the only variable selected in the final model explaining the observed executive function impairment in mild COVID-19. The presence of cognitive, structural and functional brain abnormalities over time suggests that the action of widespread neurovascular and inflammatory phenomena on the nervous system might also occur in mild forms following COVID-19 infection rather than permanent brain damage linked to the direct or indirect action of the virus. Our findings emphasize the need to pay attention to the long-term brain-related consequences of mild COVID-19 infections during the original stream.

Neuroimaging and serum biomarkers of neurodegeneration and neuroplasticity in Parkinson's disease patients treated by intermittent theta-burst stimulation over the bilateral primary motor area: a randomized, double-blind, sham-controlled, crossover trial study.

Background and objectives: Intermittent theta-burst stimulation (iTBS) is a patterned form of excitatory transcranial magnetic stimulation that has yielded encouraging results as an adjunctive therapeutic option to alleviate the emergence of clinical deficits in Parkinson's disease (PD) patients. Although it has been demonstrated that iTBS influences dopamine-dependent corticostriatal plasticity, little research has examined the neurobiological mechanisms underlying iTBS-induced clinical enhancement. Here, our primary goal is to verify whether iTBS bilaterally delivered over the primary motor cortex (M1) is effective as an add-on treatment at reducing scores for both motor functional impairment and nonmotor symptoms in PD. We hypothesize that these clinical improvements following bilateral M1-iTBS could be driven by endogenous dopamine release, which may rebalance cortical excitability and restore compensatory striatal volume changes, resulting in increased striato-cortico-cerebellar functional connectivity and positively impacting neuroglia and neuroplasticity. Methods: A total of 24 PD patients will be assessed in a randomized, double-blind, sham-controlled crossover study involving the application of iTBS over the bilateral M1 (M1 iTBS). Patients on medication will be randomly assigned to receive real iTBS or control (sham) stimulation and will undergo 5 consecutive sessions (5 days) of iTBS over the bilateral M1 separated by a 3-month washout period. Motor evaluation will be performed at different follow-up visits along with a comprehensive neurocognitive assessment; evaluation of M1 excitability; combined structural magnetic resonance imaging (MRI), resting-state electroencephalography and functional MRI; and serum biomarker quantification of neuroaxonal damage, astrocytic reactivity, and neural plasticity prior to and after iTBS. Discussion: The findings of this study will help to clarify the efficiency of M1 iTBS for the treatment of PD and further provide specific neurobiological insights into improvements in motor and nonmotor symptoms in these patients. This novel project aims to yield more detailed structural and functional brain evaluations than previous studies while using a noninvasive approach, with the potential to identify prognostic neuroprotective biomarkers and elucidate the structural and functional mechanisms of M1 iTBS-induced plasticity in the cortico-basal ganglia circuitry. Our approach may significantly optimize neuromodulation paradigms to ensure state-of-the-art and scalable rehabilitative treatment to alleviate motor and nonmotor symptoms of PD.

Psychosocial and sexual well-being in breast cancer survivors undergoing immediate breast reconstruction: The mediating role of breast satisfaction.

OBJECTIVE: This study aimed to explore (1) the levels of quality of life (psychosocial, physical and sexual well-being) and breast satisfaction in breast cancer patients (BCP) after immediate reconstruction (IR), considering surgery reason and surgical technique, and (2) the explanatory and predictive capacity of psychosocial well-being on breast satisfaction, and of both on sexual well-being. METHODS: This prospective study included 36 BCP who underwent IR between June 2006 and December 2014. RESULTS: Highest levels of quality of life were found in psychosocial well-being and sexual well-being, with no statistically significant differences by surgery reason or surgical technique in any quality of life indicator or breast satisfaction. Psychosocial, physical well-being and breast satisfaction explained 56.16% of the variance in sexual well-being, where 44.67% was attributed to psychosocial well-being. In addition, breast satisfaction statistically significantly mediated the relationship between psychosocial and sexual well-being, independently of physical well-being. CONCLUSION: Our findings highlight the importance of IR in reducing psychological morbidity and preserving the quality of life and breast satisfaction. Furthermore, this research indicated that psychosocial well-being should be considered a useful personal resource for improving the sexual well-being of BCP undergoing IR both through its direct effect and the mediated effect of breast satisfaction.

Idiosyncratic Profile of Perceived Emotional Intelligence and Post-Traumatic Growth in Breast Cancer Survivors: Findings of a Multiple Mediation Model.

Psycho-oncology research suggests that positive personal changes can occur after experiencing breast cancer. These changes can be understood as post-traumatic growth (PTG) and seem to be determined by emotional self-efficacy perception. This study aims to investigate the existence of different profiles of PTG and perceived emotional intelligence (PEI) among breast cancer survivors (BCSs) and healthy controls. Moreover, it aims to study the mechanisms through which PEI may mediate the relationship between disease survival and PTG. The total sample was 636 women divided into two groups: 56 BCS and 580 healthy controls who completed TMMS-24 and PTGI. The results displayed that BCSs apparently show a different profile of PTG and PEI compared to healthy women. The mediation analyses showed that survivorship explained 1.9% of PTG, increasing to 26.5% by the effect of PEI. An indirect effect showed that cancer survival predicts reduced levels of emotional attention, decreasing PTG. However, the most statistical indirect effect evidenced that BCSs regulate their emotions appropriately, having a powerful effect on PTG and counteracting the negative effects of poor emotional attention. Knowing the implications of PEI on PTG could improve follow-up from the time of diagnosis and supporting the patient to cope with the sequelae of the disease.

The Key Role of Emotional Repair and Emotional Clarity on Depression among Breast Cancer Survivors.

Breast cancer is the malignancy with the highest incidence in women worldwide. The empirical evidence is inconsistent with the prevalence of depression among breast cancer survivors (BCS), pointing to emotional competencies as protective factors against affective disorders. However, the mechanisms through which these competencies favor a more adaptive emotional state are unknown. Therefore, this study aims to explore the relationship between the experience of having survived the disease and depression levels in a group of BCS, and the mediating role of Perceived Emotional Intelligence (PEI) in this relation. This was a cross-sectional study with 237 women divided into two groups: 56 BCS and 181 healthy controls who completed the Trait Meta-Mood Scale 24 (TMMS-24) and the Hospital Anxiety and Depression Scale (HADS). Results showed that Survivorship and PEI explained and predicted 37.8% of the variance of depression, corresponding the 11.7% to the direct and/or the indirect effect of the PEI dimensions (Emotional Attention, Emotional Clarity, and Emotional Repair). In conclusion, interventions aimed at promoting an adequate PEI in this population-and in the Psycho-oncology field, in general-with a particular focus on the development of Emotional Clarity and Repair need to be implemented. Limitations and future research lines are discussed.

Boosting return to work after breast cancer: The mediator role of perceived emotional intelligence.

OBJECTIVE: This study aimed to explore work ability (WA) in breast cancer (BC) survivors and to examine the mechanism by which perceived emotional intelligence (PEI) acts as a covitality factor that preserves WA and promotes the return to work in this clinical population. METHODS: The sample was composed of 622 women divided into two groups: BC survivors (6.75%) and healthy controls (93.25%). Participants completed the Work Ability Index and Trait-Meta-Mood Scales. Descriptive statistical and serial mediation analyses were conducted to explore the mechanism by which PEI influences the relationship between BC survivors and WA. RESULTS: Preliminary descriptive analysis showed that BC survivors displayed lower levels of WA than healthy controls. The overall serial mediation analysis revealed that BC and PEI predicted 35.4% of the variance of WA. The direct effects showed that BC and age decrease WA. Regarding PEI, our results indicated that emotional clarity and mood repair lead to higher WA, while emotional attention decreased the ability to work in both, the BC sample and healthy controls. The mediation analysis revealed that WA could be preserved in BC survivors by an indirect effect through mood repair. CONCLUSIONS: Our findings support previous research demonstrating that BC patients have lower levels of WA compared to healthy controls. This study highlighted the relevance of PEI as a covitality factor that enhances WA. Our research offers vital support for the need to improve emotional competences in BC patients to increase WA levels and return to work odds.

Breast Cancer and Resilience: The Controversial Role of Perceived Emotional Intelligence.

Cancer is a chronic disease that causes the most deaths in the world, being a public health problem nowadays. Even though breast cancer affects the daily lives of patients, many women become resilient after the disease, decreasing the impact of the diagnosis. Based on a positive psychology approach, the concept of co-vitality arises understood as a set of socio-emotional competencies that enhance psychological adaptation. In this sense, emotional intelligence is one of the main protective factors associated with resilience. However, it is not always as beneficial as it seems, and can lead to collateral effects on psychological adjustment. Given this controversy, this study aims to find the specific processes through which the dimensions of Perceived Emotional Intelligence (PEI) (Emotional Attention, Emotional Clarity, and Mood Repair) can act as a risk or protective factor in the development of resilience. The total sample was 167 women (Age: M = 43.26; SD = 12.43), 46.7% were breast cancer survivors, and 53.3% were healthy controls. The selection of women with breast cancer carries out randomly, recruited through the Oncology Units. The sample completed measures of resilience and PEI, through Resilience Scale (Wagnild and Young, 1993) and TMMS-24 (Salovey et al., 1995). The results showed that breast cancer survivors showed higher age and greater levels of resilience and mood repair than healthy women. The mediation analysis revealed that breast cancer survival and PEI predicted 28% of the variance of resilience. The direct effects showed that emotional clarity and mood repair increased resilience levels. Although breast cancer did not predict resilience directly, it does through mood repair by an indirect process. Besides, the analysis showed that emotional attention played a role in vulnerability, decreasing mood repair, and resilience. These research support theories that point to a possible dark side of PEI, thus, a great level of emotional attention makes dark the positive effect of mood repair and personal growth if a clear perception of emotions does not complement it. These results provide empirical support concerning the need to work complementary each dimension of PEI to avoid unwanted effects on intrapersonal adjustment.

Lights and Shadows of Trait Emotional Intelligence: Its Mediating Role in the Relationship Between Negative Affect and State Anxiety in University Students.

Nowadays, students are experiencing difficult and stressful situations due to the Global Pandemic Alert. This changing world can evoke negative emotions that have been traditionally linked to higher anxiety. Researches have been focused on the positive outcomes of trait emotional intelligence (TEI) preventing psychological disorders. However, the possibility that TEI might have a dark side has been neglected. Hence, this study aimed to explore the mediating effect of the three dimensions of TEI in the relationship between negative affect and anxiety symptoms among college students. Participants of this research were 467 undergraduates who completed an online self-reported questionnaire including the Positive and Negative Affect Schedule (PANAS; Watson et al., 1988), the State-Trait Anxiety Inventory (STAI; Spielberger et al., 1970), and Trait Meta-Mood Scale (TMMS-24, Salovey et al., 1995). The global serial mediation model showed that the total amount of variance explained by the global model was 30.8% (R 2 = 0.31). Negative affectivity and age accounted for the 15.1% of state anxiety variance (R 2 = 0.15; c: B = 0.63, p < 0.001) while 15.7% of the variance of state anxiety was attributed to the direct or indirect effect of the three dimensions of TEI (R 2 = 0.16). Five indirect effects presented statistical significance (95% BootCI). The contrast analyses between mediators showed that three indirect effects had higher statistical weigh; the ability of negative affect to increase state anxiety through (i) emotional attention; (ii) emotional clarity, and (iii) serially through emotional clarity and mood repair. Our results indicated that students' negative emotions lead to higher emotional attention which in turn may enhance state anxiety in two ways: by a direct effect of emotional attention on state anxiety and by a serial effect through emotional clarity. Moreover, when negative affect is associated with lower emotional clarity, anxiety symptoms may also arise. However, when attention and clarity are connected, the negative effect is reversed into a positive one, decreasing state anxiety.

Facing Anxiety, Growing Up. Trait Emotional Intelligence as a Mediator of the Relationship Between Self-Esteem and University Anxiety.

The current study analyzed how trait emotional intelligence (trait EI) mediates the relationship between self-esteem and state anxiety and trait anxiety. The sample was composed of 153 undergraduate students from the University of Cádiz, Spain (71.9% women and 28.1% men). Students completed measures of self-esteem, state anxiety, trait anxiety, and trait EI. Mediation analyses were completed with three trait EI dimensions (EA, emotional attention; EC, emotional clarity; and MR, mood repair) as mediating variables, self-esteem as the independent variable, and state anxiety and trait anxiety as the dependent ones. Our results confirmed that self-esteem scores explained and predicted both, state and trait anxiety values (13% for state and 21% for trait anxiety). This explanatory capacity is increased by 8% when accounting for all trait EI dimensions. Considering state anxiety, the results of the direct effects showed that a decrease in their levels is predicted through the increases in the levels of both, self-esteem and MR. Regarding trait anxiety, the results of the direct effects showed that a decrease in their levels is predicted, in addition to an increment of self-esteem and MR values, by an increase of EC and a decrease of EA. Conversely, indirect effects revealed that higher levels of self-esteem were associated with worse scores in EA and worse MR, which in turn would enhance both state and trait anxiety levels. Moreover, regarding trait anxiety higher levels of self-esteem were associated with worse scores in EA and worse EC, therefore increasing trait anxiety levels. As shown, the negative association found between self-esteem and EA becomes a key element. The effect of self-esteem on EA and the influence that the latter had on EC and MR exerts an indirect mediated effect with the power to invert the influence that self-esteem wields on both types of anxiety. In this sense, the apparent protective role of self-esteem changed, turning into a risk factor that promotes higher anxiety values.

Emotion Regulation Ability and Resilience in a Sample of Adolescents from a Suburban Area.

Earlier research has identified a remarkable number of related factors to resilience during adolescence. Historically, theoretical treatments of resilience have been focused almost exclusively on psychosocial levels of analysis to derive explanatory models. However, there is insufficient understanding of the role of emotion regulation explaining competent functioning despite the experience of adversity (resilience), especially during adolescence. This study explores the relationship between both, emotional regulation abilities and strategies, and resilience in a sample of adolescents from suburbs high-schools (Jerez de la Frontera, Spain). The study also examines how using different emotional regulation strategies may help the development of resilience levels at this stage. Participants of the study were 164 adolescents ranging from 13 to 16 years old (M = 13.98; SD = 0.66). Emotion regulation was measured using the Cognitive Emotional Regulation Questionnaire (CERQ, Garnefski et al., 2001), and sections D and H of Mayer-Salovey-Caruso Emotional Intelligence Test, a performance test (Emotion Regulation Ability sections, MSCEIT, Spanish version, Mayer et al., 2003). Resilience was evaluated with ERE (Educative Resilience Scale for children and adolescents, Saavedra and Castro, 2009). Verbal Intelligence (Yuste, 1997) and personality traits (Cattell and Cattell, 1986) were assessed as two independent variables. Results supported the idea that emotion regulation ability (MSCEIT, D and H sections, Extremera et al., 2006) is a significant predictor of adolescents' resilience. Moreover, cognitive regulation strategies, such as positive reappraisal, predicted perceived resilience among students. Sociability (A factor of HSPQ, sociability) also correlated with resilience levels. Hence, these results are promising, implying that emotion regulation ability may act as a helpful tool preventing adolescents from irrational risky behaviors, commonly assumed at this developmental stage.