Perfil cognitivo en el Mareo Perceptual Postural Persistente: Implicancias sobre su fisiopatología como disfunción cognitiva viso-vestibular superior

Introducción: El mareo perceptual postural persistente (MPPP) es, probablemente, la causa más prevalente de mareo crónico. Sin embargo, su fisiopatología es aún motivo de duda y debate. En el presente artículo, proponemos que el MPPP se caracteriza por disfunciones cognitivas de orden superior, al punto de diferenciarse en estas dimensiones de controles sanos y pacientes con patologías vestibulares no-MPPP. Objetivo: Determinar si pacientes con MPPP presentan alteraciones discriminantes respecto a grupos controles, en ámbitos de atención, memoria de trabajo visoespacial, planificación espacial, funciones ejecutivas y rendimiento cognitivo global. Material y Método: Estudio descriptivo transversal con sujetos de entre 18 y 65 años, reclutados de una unidad de otoneurología ambulatoria. Se aplicaron pruebas Montreal Cognitive Assessment (MoCA), tarea de retención de dígitos, Trail Making Test, Corsi Block-Tapping Task y Torre de Londres. Resultados: 30 pacientes fueron categorizados en tres grupos: grupo MPPP (n = 14), grupo vestibular no-MPPP (n = 11) y grupo control (n = 5). El grupo MPPP exhibió un rendimiento significativamente inferior en pruebas de planificación, velocidad de procesamiento y funciones ejecutivas en ámbitos visoespaciales, mientras que en atención y memoria visoespacial no hubo diferencias entre grupos. Conclusión: El MPPP podría caracterizarse por una disfunción de procesos cognitivos superiores de construcción espacial de mayor complejidad, respetando funciones visoespaciales de menor orden como la memoria de trabajo. Estos hallazgos ofrecen nuevas luces para comprender la fisiopatología del MPPP y sus implicancias clínicas.

Introduction: Persistent postural-perceptual dizziness (PPPD) is probably the most prevalent cause of chronic dizziness. However, its pathophysiology is still a matter of uncertainty and debate. In this article, we propose that PPPD is characterized by higher-order cognitive dysfunctions, to the point of differentiating it from healthy controls and patients with non-PPPD vestibular pathologies. Aim: To determine whether patients with PPPD exhibit discriminant alterations compared to control groups in the areas of attention, visuospatial working memory, spatial planning, executive functions, and global cognitive performance. Materials and Methods: A cross-sectional descriptive study was conducted with subjects between the ages of 18 and 65 years, recruited from an outpatient otoneurology unit. Tests included the Montreal Cognitive Assessment (MoCA), digit retention task, Trail Making Test, Corsi Block-Tapping Task, and the Tower of London. Results: 30 patients were categorized into three groups: PPPD group (n = 14), non-PPPD vestibular group (n = 11), and control group (n = 5). The PPPD group showed significantly lower performance on tests of planning, processing speed, and executive function in visuospatial domains, while there were no differences between groups in attention and visuospatial memory. Conclusion: PPPD may be characterized by dysfunction of higher-order cognitive processes related to spatial construction of greater complexity, while sparing lower-order visuospatial functions such as working memory. These findings offer new insights into the pathophysiology of PPPD and its clinical implications.

Functional Dizziness as a Spatial Cognitive Dysfunction.

(1) Background: Persistent postural-perceptual dizziness (PPPD) is a common chronic dizziness disorder with an unclear pathophysiology. It is hypothesized that PPPD may involve disrupted spatial cognition processes as a core feature. (2) Methods: A cohort of 19 PPPD patients underwent psycho-cognitive testing, including assessments for anxiety, depression, memory, attention, planning, and executive functions, with an emphasis on spatial navigation via a virtual Morris water maze. These patients were compared with 12 healthy controls and 20 individuals with other vestibular disorders but without PPPD. Vestibular function was evaluated using video head impulse testing and vestibular evoked myogenic potentials, while brain magnetic resonance imaging was used to exclude confounding pathology. (3) Results: PPPD patients demonstrated unique impairments in allocentric spatial navigation (as evidenced by the virtual Morris water maze) and in other high-demand visuospatial cognitive tasks that involve executive functions and planning, such as the Towers of London and Trail Making B tests. A factor analysis highlighted spatial navigation and advanced visuospatial functions as being central to PPPD, with a strong correlation to symptom severity. (4) Conclusions: PPPD may broadly impair higher cognitive functions, especially in spatial cognition. We discuss a disruption in the creation of enriched cognitive spatial maps as a possible pathophysiology for PPPD.

Social Support and Depressive Symptoms in the Context of COVID-19 Lockdown: The Moderating Role of Attachment Styles.

Objectives: COVID-19 sanitary measures (social distancing, school closures) have deeply impacted social life, support networks, and their protective role in mental health. The present study aims to understand how attachment styles influence the way individuals experience social support. Particularly, investigating its moderating role in the relationship between social support and depression. Methods: An online survey was designed to clarify the role of adult attachment styles (ECR-S) in the perceived social support (MOSS) and self-reported depressive symptoms (BDI-SF) in the COVID-19 context. Results: Positive social interactions was the most important dimension of social support for lower depression symptoms. Individuals attachment strategies have a moderating role in the relation between of social support and depression. Crucially, insecure attachment style wanes the positive impact of social support in depression. Conclusion: Aligned with the existing literature, attachment security is an essential factor in our current understanding of relationships and mental health. Exploring specific and indivual attachment strategies might be a powerful tool to protect population's mental healt.

Social isolation after acquired brain injury: Exploring the relationship between network size, functional support, loneliness and mental health.

Social isolation can be a consequence of acquired brain injury (ABI). Few studies have examined the relationship between social isolation and mental health after ABI. In this cross-sectional and case-control study, we compared 51 ABI survivors and 51 matched healthy controls on measures of social isolation (network size, social support and loneliness) mental health and mental health problems. We explored the relationship between structural, functional and subjective components of social isolation and examined whether they were associated with mental health outcomes. No group differences were found on size of the network and perceived social support. The ABI group exhibited marginally higher levels of loneliness. The ABI group presented higher levels of depression, lower levels of quality of life and emotional wellbeing. In both groups, perception of social support was inversely related to subjective experience of loneliness. The relationship between network size and loneliness was only significant in the ABI group. Only loneliness significantly predicted quality of life, emotional wellbeing, depression and anxiety in people with brain injury. The relationship between social isolation variables in ABI is discussed, as well as the theoretical and clinical implications of focusing on loneliness to improve mental health after brain injury.

Coaching para el tratamiento de la obesidad y sobrepeso: una revisión sistemática / Coaching for the treatment of obesity and overweight: a systematic review

Coaching is increasingly used to treat obesity or overweight. We conducted a systematic review to explore the intervention's characteristics, effectivity, and quality of the published studies. The search was carried out on Pubmed, Scielo and Scopus databases. We considered studies published in peer-reviewed journals between 2014 and 2019 in English and Spanish. Following PRISMA guidelines, we selected and analyzed 22 articles, 46% of which were randomized controlled trials. Most of the studies had moderate quality, according to the risk of bias assessment carried out by three independent researchers based on the Study Quality Assessment Tool. Seventy seven percent of interventions targeted adults, and their duration ranged between two and 19 months. They were delivered in both private and public contexts, with face-to-face or remote interventions and combined techniques, mainly from the United States (82%). The interventions showed a 51% effectiveness in reducing weight, increasing physical activity, and changing eating habits. We conclude that coaching might be an effective therapeutic strategy for obesity and overweight.

Sexual dimorphism in classical conditioning? Sex differences in neophobia, latent inhibition, generalization, and extinction for rats (Rattus norvegicus) in a conditioned taste aversion preparation irrespective of housing conditions.

This study aimed to assess possible sex differences and a potential impact of social housing conditions for some Pavlovian conditioning effects in a conditioned taste aversion preparation with rats. The results of Experiment 1 suggest sex differences in neophobia, latent inhibition, and generalization. Specifically, for females, neophobia, and generalization appeared to be stronger while latent inhibition seemed to be attenuated. Experiment 2 confirmed these sex differences in neophobia and generalization, while also revealing slower extinction in males. Experiment 3 provided evidence for the same sex differences in neophobia and generalization, even when a perceptual learning effect was in operation following pre-exposures to the test stimulus. No effects of social housing conditions were found in either Experiment 1 or Experiment 2. In general, these findings appear to support the hypothesis of sexual dimorphism in Pavlovian conditioning, encouraging a systematic approach to the topic by means of further research. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Social Support and Cognition: A Systematic Review.

Although the influence of social support in health is a widely acknowledged factor, there is a significant gap in the understanding of its role on cognition. The purpose of this systematic review was, therefore, to determine the state-of-the-art on the literature testing the association between social support and cognition. Using six databases (WoS, PubMed, ProQuest, PsycINFO, Scopus and EBSCOhost), we identified 22 articles published between 1999 and 2019 involving an empirical quantitative focus which meet the inclusion criteria. Data extraction was performed following PRISMA recommendations. To summarize the extracted data, we used a narrative synthesis approach. Despite limitations, there is overall preliminary evidence of a relevant positive association between social support and cognition. Our results demonstrate there is enough information for an outbreak of experimental research in the area and an expansion of this body of knowledge. We argue that the present evidence lays the foundations for a more comprehensive theoretical model, one that corresponds with the complexity of the topic and possibly considers models derived from social interaction and active inference theories.

[Coaching for the treatment of obesity and overweight: a systematic review]. / Coaching para el tratamiento de la obesidad y sobrepeso: una revisión sistemática.

Coaching is increasingly used to treat obesity or overweight. We conducted a systematic review to explore the intervention's characteristics, effectivity, and quality of the published studies. The search was carried out on Pubmed, Scielo and Scopus databases. We considered studies published in peer-reviewed journals between 2014 and 2019 in English and Spanish. Following PRISMA guidelines, we selected and analyzed 22 articles, 46% of which were randomized controlled trials. Most of the studies had moderate quality, according to the risk of bias assessment carried out by three independent researchers based on the Study Quality Assessment Tool. Seventy seven percent of interventions targeted adults, and their duration ranged between two and 19 months. They were delivered in both private and public contexts, with face-to-face or remote interventions and combined techniques, mainly from the United States (82%). The interventions showed a 51% effectiveness in reducing weight, increasing physical activity, and changing eating habits. We conclude that coaching might be an effective therapeutic strategy for obesity and overweight.

Age, sex and pre-exposure effects on acquisition and generalization of conditioned taste aversion in rats.

The main aim of the present study was to assess the effect of sex and aging in two pre-exposure learning effects, latent inhibition (LI) and perceptual learning (PL), with a conditioned taste aversion paradigm. Young adult (90 days) and aged (more than 18 months) males and females received 8 pre-exposure trials either with stimulus AX (LI conditions) or BX (PL conditions). Then, all animals received a conditioning trial with AX and two test trials, one with AX and other with BX. The level of generalization between AX and BX was assessed by means of the absolute level of consumption of BX and by the difference in consumption between both stimuli. The results showed an attenuation of latent inhibition as well a stronger generalization of conditioned taste aversion in females when generalization is inferred from the BX consumption. A facilitation of conditioning for the aged animals was also found regardless of the pre-exposed stimulus. Pre-exposures to BX resulted in little generalization, but pre-exposures to AX resulted in a very similar consumption of both compounds, indicating a strong generalization between them. Overall, the study provided novel evidence about the effect of sex and aging on taste aversion, raising at the same time some relevant questions about perceptual learning and how such pre-exposure effect has been typically assessed.

Emotional Reactivity to Incentive Downshift in Adult Rats Exposed to Binge-Like Ethanol Exposure During Adolescence.

Alcohol use in adolescents is often characterized by binge-like ethanol consumption pattern, which is associated with long-term health consequences and even with important harms to his developing brain. Among this, ethanol exposure induces long-lasting alterations in anxiety-related neurobiological systems such as corticotropin releasing factor (CRF) or melanocortin system (MC). Recently, it has been demonstrated that adult rats exposed to adolescent intermittent ethanol (AIE) exposure exhibited anxiogenic-like behavior. Given that it has been demonstrated that negative affective state is relevant to development of addictive behavior, it is tempting to suggest that increased risk of adult abusive alcohol use exhibited in rats exposed to ethanol during adolescence may be related with differences in anxiety-related behavior. We conducted a study investigating the emotional reactivity after a reward devaluation (12-to-1 pellet or 32-to-4% sucrose downshift) in adult rats exposed to binge-like ethanol exposure during adolescence. For this aim, adolescent Sprague-Dawley rats were treated with ethanol (2.5 g/kg ip; AIE) or saline (AIS) for 2 consecutive days at 48-h intervals over a 14-day period (PND30-PND43). Following 25 free-ethanol days, adult rats were trained in consummatory and instrumental successive negative contrast task (cSNC and iSNC). Our data shows that both AIE and AIS groups exhibited suppression of the consummatory and instrumental behavior after reward devaluation relative to unshifthed control. Also, adult rats exposed to alcohol during adolescence exhibited a particularly strong negative affective state (lower sucrose consumption) with regards to the AIS group in the cSNC. This data demonstrated that adolescent binge-like ethanol exposure might trigger a greater emotional reactivity following incentive downshift, which might be linked to higher vulnerability to substance use disorder.