Combined functional magnetic resonance imaging and skin conductance to detect localized neural response to psychological stress: a pilot study.

OBJECTIVE: This preliminary study aims at investigating the neural correlates of the stress response, intended as an emotional and cognitive response, through the description of the activation of the autonomic nervous system in a problem-solving task and central functional data; in particular, we recorded skin conductance level (SCL) and response (SCR) and observed the correlation with fMRI data. MATERIALS AND METHODS: The results obtained from 6 healthy subjects, 3 males and 3 females, aged between 18 and 45 (average = 27, SD = 7.08) who voluntarily offered to participate in the study were examined. They were previously subjected to a brief clinical psychological assessment (MMPI-2) and then to a psychophysiological evaluation. The real experiment consisted in subjecting the participants to an adapted version of the Raven's Coloured Progressive Matrices 47 (CPM 47) test to evaluate some consequences on brain activity of attention, orientation, reflex and response to stress during fMRI data acquisition and SCL-SCR recording. RESULTS: SCR changes were found to be related to the activity of different brain regions such as bilateral precentral gyrus, right inferior frontal gyrus, right medial frontal gyrus, bilateral superior frontal gyri and left anterior cingulate suggesting a specific relationship between attentive processing and autonomic arousal. CONCLUSION: The association of SC measurement with neuroimaging allows to highlight the interaction between emotional and cognitive processes: although preliminary, these results partially confirm what previously found in literature on the neural correlates of psychological stress and underline the interaction between cognitive function and autonomic arousal system during a stressful problem-solving task.

Physical activity, mental exercise, and cognitive functioning in an Italian sample of healthy elderly males.

The influences of physical and mental activity on cognitive functioning were examined in a sample of Italian healthy elderly males. The aim of the present study was to suggest aerobic training as well as cognitively stimulating activity and provide recommendations for an overall healthy lifestyle. Seventy-five healthy adult males, aged 65-81, were assigned to four groups, two groups of active subjects practicing different levels of regular aerobic exercise, and two groups of sedentary subjects, one without any relevant mental stimulating activity and the other one regularly carrying out substantial mental activity. Each group was further divided into three subgroups based on their level of education. Cognitive functioning was assessed by the Italian version of MoCA. Data was analysed in a non-parametric two-factor model by Aligned Rank Transformation, and then compared with the normative data for the Italian population. Physically active subjects showed better cognitive performance than the other groups in all the cognitive domains, except for memory and orientation. Among the sedentary subjects, the mentally active ones showed better performance in some cognitive domains, specifically in attention and memory. The influence of education was highlighted in some scores, but significant interactions with activity levels were never highlighted. Moreover, the influence of life habits (i.e. physical and mental activity) on the MoCa scores always showed a higher effect size than education. Our findings showed that both physical and mental activity improve cognitive functions in the elderly, and that they affect specific cognitive domains.

Aerobic exercise effects upon cognition in Alzheimer's Disease: A systematic review of randomized controlled trials.

BACKGROUND: Previous reviews and meta-analysis have shown that physical activity has positive effects on cognition in healthy elderly as well as in patients with Mild Cognitive Impairment, even if with a minor effect whereas less is known about the effectiveness of aerobic exercise in patients with Alzheimer's Disease (AD). OBJECTIVES: The aim of the present study was to systematically review the evidence from randomized controlled trials (RCTs) designed to evaluate aerobic exercise effects upon cognition in AD patients. METHODS: PubMed, Cochrane, Web of Science and DARE databases were analytically searched for RCTs including aerobic exercise interventions for AD patients. RESULTS: There is scarce evidence that aerobic exercise improves cognition in AD patients. Overall, the included studies reported only positive effects for patients'global cognition after intervention, mainly due to a lack of accurate neuropsychological assessment of each cognitive domain. Whether the bene ts of exercise are evident in all stages of AD pathology remain also uncertain. CONCLUSIONS: Standardized protocols, larger and more rigorous RCTs with long-term follow-ups may provide better insight into the effects of aerobic exercise on cognitive deterioration characterizing people with AD.

Claimed effects, outcome variables and methods of measurement for health claims proposed under regulation (EC) 1924/2006 and related to cognitive function in adults.

Some food/food components have been the object of request of authorization to the use of health claims related to cognitive function in adults and compliant with the Regulation (EC) 1924/2006. Most of the requests have received a negative opinion by the European Food Safety Authority (EFSA) also because of the choice of not appropriate outcome variables (OVs) and methods of measurement (MMs) selected in the trials used to substantiate the claim. This manuscript referes to the collection, collation and critical analysis of OVs and MMs related to cognitive function in adults. OVs and MMs were collected from the EFSA Guidance document and the applications for authorization of health claims pursuant to the Articles 13(5). The critical analysis of OVs and MMs, performed by a literature review, was aimed at defining their appropriateness in the context of a specific claimed effect. The results highlight the importance of an adequate choice of OVs and MMs for an effective substantiation of the claims related to cognitive functioning. The information provided in this document may serve to EFSA for updating the guidance on the scientific requirements for health claims related to cognitive functions, but also for a better design of randomized controlled trials aimed at substantiating such health claims.

Physical Exercise Improves Total Antioxidant Capacity and Gene Expression in Rat Hippocampal Tissue.

Exercise may exert beneficial effects on cognitive functions and play an important role in the prevention of neurodegenerative diseases. Such effects seem to be mediated by changes in anti-oxidative status, but limited information is available on the nature of molecular pathways supporting the antioxidant effects of exercise in the brain. In this study 3-5-month-old male Wistar albino rats were subjected to three times/week moderate intensity exercise on a rodent treadmill for a period of 6 weeks. The tissue antioxidant activity towards various reactive oxygen species (ROS) was determined in the hippocampus. In addition, to identify the molecular pathways that may be involved in ROS metabolism, the expression of nerve growth factor (NGF) and sirtuins (SIRT1 and SIRT3) were measured. Our results showed a higher antioxidant activity in the hippocampus of physically trained rats compared to sedentary controls. Furthermore, exercise induced an up-regulation of NGF, possibly related to an improved redox balance in the hippocampus. These results suggest that physical exercise might prevent age-induced oxidative damage in the hippocampus.

Lifestyle, Physical Activity and Cognitive Functions: the impact on the scores of Montreal Cognitive Assessment (MoCa).

The Montreal Cognitive Assessment (MoCA) is a rapid screening tool, including subtests to assess several cognitive domains, developed to detect MCI from normal ageing cognitive changes. Several validation and normative studies have conducted around the world considering the influences of age and education on the MoCA score, but none takes into account the lifestyle and habits. However, lifestyles, and particularly physical activity (PA) have been positively associated with both physical and mental health in elderly. The aim of the present study is to investigate the influence of regularly practiced PA on the MoCA scores in a sample of Italian healthy elderly males. For this purpose sixty-five healthy adult males, aged 65-81 years were assigned to two groups, physically active group (PAG, N=33), and sedentary group (SG, N=32), according to recommended levels of physical activity by the World Health Organization. The Italian version of MoCA was administered to each participant. Raw data were analysed by a multiple regression model in which the independent variables were PA, age and education. Results showed a highly significant influence of PA on MoCA total score and on several cognitive domain sub-scores. Furthermore, multiple regression analysis indicated a larger impact on scores by PA than both age and education. In the light of these findings, it is advisable to pay attention to the life style of subject that undergoing a neuropsychological evaluation like the MoCa and in particular the level of PA practiced, as well as age and education.

Aerobic exercise effects upon cognition in Mild Cognitive Impairment: A systematic review of randomized controlled trials.

Several studies have shown that physical activity has positive effects on cognition in healthy older adults without cognitive complains but lesser is known about the effectiveness of aerobic exercise in patients suffering from Mild Cognitive Impairment (MCI). The aim of the present study was to systematically review the evidence from randomized controlled trials (RCTs) about the effects of aerobic exercise upon cognition in MCI patients. To this end, PubMed, Cochrane and Web of Science databases were analytically searched for RCTs including aerobic exercise interventions for MCI patients. There is evidence that aerobic exercise improves cognition in MCI patients. Overall research reported moderate effects for global cognition, logical memory, inhibitory control and divided attention. Due to methodological limitations of the investigated studies, findings should be interpreted with caution. Standardized training protocols, larger scale interventions and follow-ups may also provide better insight into the preventive effects of aerobic exercise on cognitive deterioration in MCI and its conversion into dementia.

Claimed effects, outcome variables and methods of measurement for health claims proposed under European Community Regulation 1924/2006 in the framework of protection against oxidative damage and cardiovascular health.

BACKGROUND AND AIMS: The high number of negative opinions from the European Food Safety Authority (EFSA) to the requests for authorization of health claims is largely due to the design of human intervention studies, including the inappropriate choice of outcome variables (OVs) and of their methods of measurement (MMs). The present manuscript reports the results of an investigation aimed to collect, collate and critically analyse the information in relation to claimed effects, OVs and MMs, in the context of protection against oxidative damage and cardiovascular health compliant with Regulation 1924/2006. METHODS AND RESULTS: Claimed effects, OVs and the related MMs were collected from EFSA Guidance documents and applications for authorization of health claims under Articles 13.5 and 14. The OVs and their MMs were evaluated only if the claimed effect was sufficiently defined and was considered beneficial by EFSA. The collection, collation and critical analysis of the relevant scientific literature consisted in the definition of the keywords, the PubMed search strategies and the creation of databases of references. The critical analysis of the OVs and their MMs was performed on the basis of the literature review and was aimed at defining the appropriateness of OVs and MMs in the context of the specific claimed effects. CONCLUSIONS: The information provided in this document could serve to EFSA for the development of further guidance on the scientific requirements for health claims, as well as to the stakeholders for the proper design of human intervention studies aimed to substantiate such health claims.

[Eating behaviour and body image: epidemiological study on 4,243 senior and junior high school's Italian students]. / Comportamento alimentare e immagine corporea. Studio epidemiologico su 4243 studenti italiani di scuole medie superiori e inferiori.

AIM: This preliminary study is focused on the description of some dysfunctional perceptions of the body's image and eating habits in a large sample of Italian adolescents. METHODS: A total of 4,243 secondary school adolescents were examined in the Tuscany and Liguria regions in north-west Italy. The age of the 2,024 male and 2,219 female adolescents ranged from 12 to 18 years. The Pisa Survey for Eating Disorder (PSED), a questionnaire aimed at examining eating behaviour and self perception of the body image, was administered. RESULTS: Answers given to items considered in this preliminary study have highlighted the recurrence of cognitive distortions and an excessively rigid attitude to bodily self perception, not to mention frequent and often daily dysfunctional eating behaviour. Particularly, females show a more severe attitude to their own body, a stronger desire to lose weight and more resolution to follow a diet. It is also true to say that girls present more often than their male peers irregular eating habits and moments of overeating. Also the recourse to self-induced vomiting, or other coercive expedients, appears to be more typical of female behaviour though this practice was widespread throughout the sample. CONCLUSIONS: The PSED questionnaire has proved to be a useful tool in revealing eating habits and self-perception in the examined sample. The results obtained confirm the urgent need for educational and preventive intervention.

Depressive symptoms and academic self-image in adolescence.

The aim of this paper was to specifically analyse the relationship between the different components of academic self-image, defined as the way adolescents represent themselves as students, and self-reported depressive symptoms, assessed with the Children's Depression Inventory (CDI), in a non-clinical sample of 298 adolescents. We considered both adolescents' beliefs about their own cognitive functioning in academic performance and beliefs about their emotional attitude in achievement situations. Our data indicate that the pattern of correlation between emotional beliefs about schooling and learning are significantly related to CDI scores, but this correlation is not evident for the cognitive beliefs. This pattern of correlation is affected by actual school functioning, because correlation between CDI and beliefs is much more significant in subjects without school failure. Differences between gender in CDI scores, beliefs about schooling and learning, and pattern of correlation are considered. These results can enable to focus supporting psychological interventions on more specific targets.

Cattell's 16 PF and PSY inventory: relationship between personality traits and behavioral responses in patients with acute myocardial infarction.

The aim of this study was to investigate the relationships between personality and behavioral responses in patients with acute myocardial infarction. In a first step, a new instrument (PSY Inventory) for assessment of six behavioral characteristics (Sense of Responsibility, Energy and Competitiveness, Obsessive Behavior, Anger and Hostility, Stress-related Disturbances, Time Urgency) was developed by using factor analysis on intercorrelations of responses from 524 subjects of the general population. Internal consistency reliability for each of the PSY subscales was estimated by Cronbach alpha coefficients. In a second step, the PSY Inventory was administered with the Cattell 16 PF Questionnaire to 838 patients affected by acute myocardial infarction. Significant correlations although relatively low in magnitude for PSY Inventory subscales and certain scales of the Cattell 16 PF were found. With factor analysis on 22 variables (including the six PSY Inventory subscales and the 16 scales of the Cattell 16 PF), five second-order factors were identified, namely, Extraversion, Neurotic Anxiety, Superego Strength, Pathemia, and Neurotic Hostility. While a Pathemia Factor (characterized by sensitivity, imagination, and self-sufficiency) was factorially independent of scales of the PSY Inventory, Extraversion, Neurotic Anxiety, Superego Strength, and Neurotic Hostility Factors were composed of the PSY Inventory scales and Cattell 16 PF scales combined. These relationships would reflect the concordance of internal constructs for behavioral measures of the PSY Inventory and those of personality traits of the 16 PF Questionnaire in patients with acute myocardial infarction.

Physiological response in healthy subjects and in patients after myocardial infarction, elicited by a new computerised version of the Raven Coloured PM 47 as a mental stress test.

The Raven Progressive Matrices Test, in its various versions, has frequently been used in research on stress related diseases. In this paper the preliminary data relating to the administration of this version of test performed by a personal computer are presented. The "Coloured" version of the PM 47 was used, with the addition of a series of visual and acoustic stress stimuli; a maximum 30-second matrix presentation time was also introduced. Two groups took part in the test modified in this way: the first was made up of 23 male subjects aged 30 to 65 who had had a myocardial infarction in the previous six months; the second, a control group of the first, was composed of an equal number of subjects, without present or past cardiovascular or psychiatric disorders or illness. Frontal EMG, skin conductance response, peripheral temperature, heart rate and respiration rate were recorded at rest and during the test administration. The results obtained from the psychophysiological profile carried out on the two groups demonstrated the effectiveness of the methodology used in eliciting constant and stable stress responses.

Subclinical hypothyroidism: neurobehavioral features and beneficial effect of L-thyroxine treatment.

Frank hypothyroidism is known to induce neurological and mental dysfunction. The aim of this study was to assess selected neuropsychological and behavioral features by means of standardized tests in a group of 14 patients with subclinical hypothyroidism who were free from neuropsychological complaints and to evaluate the possible effects of L-thyroxine treatment on their performance. Patients were submitted to the Crown and Crisp Experiential Index and to the Wechsler Memory Scale; their ratings on the neurobehavioral tests and their thyroid hormone profile were compared to those of a control group of 50 age- and sex-matched subjects. Comparison was also carried out between pretreatment ratings and those obtained following a 6-month L-thyroxine course (0.1-0.15 mg/day). The Wechsler Memory Scale ratings showed a significant impairment in patients' memory-related abilities [memory quotient (MQ) = 89.1 +/- 2.9; P = 0.002 (patients versus controls)]; the Crown and Crisp Experiential Index ratings demonstrated moderate differences between untreated patients and controls with respect to hysteria (P = 0.03), anxiety (P = 0.05), somatic complaints (P = 0.0005), and depressive features (P = 0.002) scales; the total score was also significantly higher (42.0 +/- 3.8; P = 0.005). After L-thyroxine treatment the patients' performances showed an improvement in memory skills, as evaluated by the Wechsler Memory Scale [MQ = 99.9 +/- 4.0; P = 0.002 (treated versus untreated)]; somatic complaints (P = 0.02) and obsessionality (P = 0.04) ratings and the Crown and Crisp Experiential Index total score (P = 0.04) significantly decreased with respect to untreated patients.(ABSTRACT TRUNCATED AT 250 WORDS)

[The type of coma as prognostic indicator in severe cranial trauma in childhood]. / Il tipo di coma quale indicatore prognostico nei gravi traumi cranici in età evolutiva.

Various methods are used by neurologists to evaluate posttraumatic brain damage. The most important and reliable are the length of posttraumatic amnesia and coma. In previous papers we have already described the value of the type of coma in the prognosis of serious head injury in childhood (Baracchini-Muratorio et al. 1985; Pruneti et al. 1985). In this study, 30 children (aged 6-12 years) with serious closed head injury and subsequent coma were evaluated. The children were divided into two groups according to the type of coma, using the Plum and Posner coma classification (1966) modified by Pagni et al. (1974). The children were followed up for at least two years (9 for five years) after the trauma by means of neurological, physical, EEG, CT scan and neuropsychological examinations. The neuropsychological test results confirm the hypothesis of a different evolution of sequelae in relation to the type of coma, independently of length of coma and site of brain damage.

[Preclinical hypothyroidism: early involvement of memory function, behavioral responsiveness and myocardial contractility]. / Ipotiroidismo preclinico: precoce interessamento delle funzioni mnestiche, della reattività comportamentale e della contrattilità cardiaca.

Subclinical hypothyroidism in characterized by elevated TSH levels in the face of normal thyroid hormone concentrations. The purpose of this study was to evaluate whether these subjects show alterations of neuropsychological and behavioural features and of myocardial contractility as patients with overt hypothyroidism do. We evaluated in 14 subjects the hormonal profile (total and free T3 and T4, TSH), memory ability (Wechsler Memory Scale), behavioural reactivity (Crown & Crisp Experimental Index) and the pre-ejection period (isometric systole). We found an evident impairment of some cognitive functions correlated to memory and a behavioural alteration, perhaps secondary to the disease state, and moreover an early defect of myocardial contractility, represented by prolonged pre-ejection period. These results suggest that these patients should be treated with adequate doses of L-Thyroxine, like in overt hypothyroidism.

Behavioral treatment of children after severe head injury: a pilot study.

Little has been written on the treatment of cognitive and behavioral disorders in children following serious head injuries with coma. We have used the behavioral modification method known as Token Economy in 20 head-injured patients having a mean age of 11 years. The treatment, which involved the children's families, proved at one-year follow-up to be highly successful in normalizing maladaptive behavior.

[Audiological and neuropsychological development study in a sample of school children from a low-iodine area of the Central Apennines that is endemic for cretinism]. / Studio audiologico e dello sviluppo neuropsichico in un campione di scolari di un'area a basso apporto iodico dell'Appennino Centrale con cretinismo endemico.

We have evaluated neuropsychic development in 70 normal schoolchildren in an area of severe endemic goitre and cretinism in the Central Apennines (Montefeltro). In each subject we have studied auxological, psychometric and audiometric parameters, together with tympanograms and stapedial reflexograms. Auxological data were in the normal range, as were the stapedial reflexograms and tympanograms. On the contrary, 54.8% of the sample performed below the 25th percentile in psychometric tests (Raven test PM-47), being also 22.8% below the 5th percentile. Audiometric data showed a neurological hearing impairment in 3.1% of the children tested, as compared with 0.28% in the area of Pisa. These data point out that an impairment of central nervous system function still persists in this area of severe endemic goitre.

Clinical characteristics of anginal pain in man.

The clinical recognition of the cardiac origin of chest pain or discomfort on the basis of the description made by the patient, is often difficult. Nevertheless, considering the importance of the correct diagnosis of such syndrome, much work has been done in this field. In this report we will comment data from the literature and from our own, on the quality, duration, irradiation and on the precipitating or relieving factors that are more frequently associated with anginal pain.

Neuropsychological sequelae after head injury with mesencephalic coma in childhood.

Eleven children aging between 4 years 11 months and 12 years 6 months were examined periodically over five years following closed head injury with mesencephalic coma (Plum and Posner's definition). It was found that although transient sequelae (neurological and cognitive) on coma resolution were severe, long-term recovery was generally good. The subjects had drug, neurological and psychological treatment during the 2-5-years period and showed apparently better recovery than reported in literature for trauma in adults. This suggests that the mildly controversial "age" variable is highly important in long-term prognosis of impairments following head injury. Further studies will be necessary; with the systematic use of the same standardised testing procedures in all studies, we suggest to obviate the problems in collation arising from discrepancies in methodological, neurological and psychological techniques.