Your browser doesn't support javascript.
loading
Show: 20 | 50 | 100
Results 1 - 20 de 478
Filter
1.
J Affect Disord ; 351: 971-976, 2024 Apr 15.
Article in English | MEDLINE | ID: mdl-38346649

ABSTRACT

BACKGROUND: Suicidal ideation is a major concern in clinical practice. Yet, little is known about prevalence rates of suicidal ideation in patients undergoing outpatient psychotherapeutic treatment. Therefore, the aim of the current study is to assess the prevalence of suicidal ideation in a large sample of psychotherapy outpatients in Germany. The data analyzed in this study is taken from the KODAP-project on the coordination of data collection and analysis at German university-based research and training outpatient clinics for psychotherapy. METHODS: A total of N = 10,357 adult outpatients (64.4 % female; age: M(SD) = 35.94 (13.54), range: 18-92 years of age) starting cognitive-behavioral therapy at one of 27 outpatient clinics in Germany were included in the current study. Prevalence of suicidal ideation was assessed with the Suicide Item (Item 9) of the Beck-Depression Inventory II. RESULTS: Suicidal ideation was reported by 36.7 % (n = 3795) of the participants. Borderline Personality Disorder, Posttraumatic Stress Disorder, and recurrent Major Depression were the diagnoses most strongly associated with the presence and severity of suicidal ideation. LIMITATION: Suicide ideation was assessed only with the respective item of the Beck Depression Inventory II. CONCLUSION: Suicidal ideation is very common among adult patients who start psychotherapy in Germany. A well-founded knowledge of risk assessment in suicidal patients and suicide-specific treatment options is therefore highly relevant.


Subject(s)
Depressive Disorder, Major , Suicidal Ideation , Adult , Humans , Female , Male , Outpatients , Prevalence , Depressive Disorder, Major/epidemiology , Depressive Disorder, Major/therapy , Depressive Disorder, Major/diagnosis , Psychotherapy , Risk Factors
3.
J Neurol Sci ; 449: 120646, 2023 06 15.
Article in English | MEDLINE | ID: mdl-37100018

ABSTRACT

INTRODUCTION: Uniform case definitions are required to ensure harmonised reporting of neurological syndromes associated with SARS-CoV-2. Moreover, it is unclear how clinicians perceive the relative importance of SARS-CoV-2 in neurological syndromes, which risks under- or over-reporting. METHODS: We invited clinicians through global networks, including the World Federation of Neurology, to assess ten anonymised vignettes of SARS-CoV-2 neurological syndromes. Using standardised case definitions, clinicians assigned a diagnosis and ranked association with SARS-CoV-2. We compared diagnostic accuracy and assigned association ranks between different settings and specialties and calculated inter-rater agreement for case definitions as "poor" (κ ≤ 0.4), "moderate" or "good" (κ > 0.6). RESULTS: 1265 diagnoses were assigned by 146 participants from 45 countries on six continents. The highest correct proportion were cerebral venous sinus thrombosis (CVST, 95.8%), Guillain-Barré syndrome (GBS, 92.4%) and headache (91.6%) and the lowest encephalitis (72.8%), psychosis (53.8%) and encephalopathy (43.2%). Diagnostic accuracy was similar between neurologists and non-neurologists (median score 8 vs. 7/10, p = 0.1). Good inter-rater agreement was observed for five diagnoses: cranial neuropathy, headache, myelitis, CVST, and GBS and poor agreement for encephalopathy. In 13% of vignettes, clinicians incorrectly assigned lowest association ranks, regardless of setting and specialty. CONCLUSION: The case definitions can help with reporting of neurological complications of SARS-CoV-2, also in settings with few neurologists. However, encephalopathy, encephalitis, and psychosis were often misdiagnosed, and clinicians underestimated the association with SARS-CoV-2. Future work should refine the case definitions and provide training if global reporting of neurological syndromes associated with SARS-CoV-2 is to be robust.


Subject(s)
COVID-19 , Encephalitis , Guillain-Barre Syndrome , Nervous System Diseases , Humans , COVID-19/complications , COVID-19/diagnosis , SARS-CoV-2 , Observer Variation , Uncertainty , Nervous System Diseases/etiology , Nervous System Diseases/complications , Encephalitis/complications , Headache/diagnosis , Headache/etiology , Guillain-Barre Syndrome/diagnosis , Guillain-Barre Syndrome/complications , COVID-19 Testing
4.
Behav Brain Res ; 439: 114222, 2023 02 15.
Article in English | MEDLINE | ID: mdl-36427590

ABSTRACT

In rats reared without play, or with limited access to play during the juvenile period, the dendrites of pyramidal neurons of the medial prefrontal cortex (mPFC) exhibit more branching than rats reared with more typical levels of play. This suggests that play is critical for pruning the dendritic arbor of these neurons. However, the rearing paradigms typically used to limit play involve physical separation from a peer or sharing a cage with an adult, causing stress that may disrupt pruning. To limit this potentially confounding source of stress, we used an alternative approach in this study: pairing playful Long Evans rats (LE) with low playing Fischer 344 (F344) rats throughout the juvenile period. We then examined the morphology of medial prefrontal cortex (mPFC) neurons, predicting that pruning should be reduced. LE rats reared with another LE rat had significantly greater pruning of mPFC pyramidal neurons compared to LE rats reared with a F344 partner. Furthermore, in previous studies, only one sex or the other was used, whereas in the present rearing paradigm, both sexes were tested, showing that play influences neuronal pruning in both. The neurons of the play deficient LE rats not only occupied more space, as determined by convex hull analyses, but the dendrites were also longer than in rats with more typical play experiences. Unlike studies using more stressful rearing paradigms, the present effects were limited to the apical dendritic projections, suggesting that the previously reported effects on the basilar dendrites may have resulted from developmental disruptions caused by stress. If correct, the present findings indicate that play experienced over the juvenile period affects how mPFC neurons develop and function.


Subject(s)
Dendrites , Neurons , Rats , Animals , Female , Male , Rats, Long-Evans , Rats, Inbred F344 , Dendrites/physiology , Neurons/physiology , Pyramidal Cells/physiology , Prefrontal Cortex/physiology
5.
Curr Protoc ; 2(1): e337, 2022 Jan.
Article in English | MEDLINE | ID: mdl-35030300

ABSTRACT

Rough-and-tumble play or play fighting is an important experience in the juvenile period of many species of mammals, as it facilitates the development of social skills, and for some species, play fighting is retained into adulthood as a tool for assessing and managing social relationships. Laboratory rats have been a model species for studying the neurobiology of play fighting and its key developmental and social functions. However, play fighting interactions are complex, involving competition and cooperation; therefore, no single measure to quantify this behavior is able to capture all its facets. Therefore, in this paper, we present a multilayered framework for scoring all the relevant facets of play that can be affected by experimental manipulations and the logic of how to match what is measured with the question being asked. © 2022 Wiley Periodicals LLC.


Subject(s)
Social Behavior , Animals , Rats
6.
Horm Behav ; 124: 104811, 2020 08.
Article in English | MEDLINE | ID: mdl-32592725

ABSTRACT

BACKGROUND: While there is evidence for increased food intake and craving during the luteal phase, underlying mechanisms are incompletely understood. The present study investigated electrophysiological responses to food pictures as a function of menstrual cycle phase. In addition, the moderating effects of progesterone, eating behaviors (restraint, emotional, orthorexic), negative affect, and premenstrual complaints were explored. METHODS: Using a within-subject design, 35 free-cycling women watched and rated pictures of food (high and low caloric) and control items during the follicular, the ovulatory, and the luteal phase (counterbalanced), while EEG was recorded to examine the late positive potentials (LPP). Salivary gonadal hormones and affect were examined at each occasion. Eating behaviors and premenstrual complaints were assessed once. RESULTS: For parietal regions, average LPPs were comparable between cycle phases but slightly larger LPP amplitudes were elicited by high caloric food pictures as compared to the neutral category. Descriptively, both food categories elicited larger parietal LPPs than neutral pictures during the luteal phase. Analyses of LPPs for central-parietal regions showed no effect of picture category or cycle phase, except higher amplitudes in the right area during the luteal phase. During the luteal phase, progesterone and functional interference from premenstrual symptoms (but not age, BMI, picture ratings, affect, estradiol, or eating behaviors) significantly predicted larger parietal LPPs towards high caloric (but not low caloric) pictures. CONCLUSION: Our findings suggest a heightened food cue reactivity during the luteal phase, which may relate to higher ovarian hormone secretion and more functional impact of premenstrual symptoms. This research contributes to a better understanding of menstrual health and the identification of preventive strategies for premenopausal women.


Subject(s)
Affect/physiology , Brain/physiology , Feeding Behavior/psychology , Food , Menstrual Cycle/psychology , Premenstrual Syndrome , Adolescent , Adult , Brain/diagnostic imaging , Cues , Electroencephalography , Emotions/physiology , Estradiol/analysis , Estradiol/metabolism , Evoked Potentials/physiology , Female , Humans , Luteal Phase/physiology , Menstrual Cycle/physiology , Premenstrual Syndrome/metabolism , Premenstrual Syndrome/physiopathology , Premenstrual Syndrome/psychology , Progesterone/analysis , Progesterone/metabolism , Saliva/chemistry , Saliva/metabolism , Young Adult
7.
Health Qual Life Outcomes ; 18(1): 58, 2020 Mar 05.
Article in English | MEDLINE | ID: mdl-32138734

ABSTRACT

BACKGROUND: Obesity can significantly reduce health-related quality of life (HRQoL) and may lead to numerous health problems even in youths. This study aimed to investigate whether HRQoL varies among youths with obesity depending on grade of obesity and other factors. METHODS: For the Youths with Extreme obesity Study (YES) (2012-2014), a prospective multicenter cohort study, a baseline sample of 431 obese and extremely obese adolescents and young adults (age 14 to 24 years, BMI ≥30 kg/m2) was recruited at four German university medical centers and one job center. Obesity grade groups (OGG) were defined according to BMI (OGG I: 30-34.9 kg/m2, OGG II: 35-39.9 kg/m2, OGG III (extreme obesity): ≥40 kg/m2). HRQoL was measured with the Euroqol-5D-3 L (EQ-5D-3 L), DISABKIDS chronic generic (DCGM-31) and the KINDLR obesity module. Differences between OGGs were assessed with logistic and linear regression models, adjusting for age, sex, and study center in the base model. In a second regression analysis, we included other characteristics to identify possible determinants of HRQoL. RESULTS: Three hundred fifty-two adolescents (mean age: 16.6 (±2.4), mean BMI: 39.1 (±7.5) kg/ m2) with available HRQoL data were analysed. HRQoL of youths in all OGGs was markedly lower than reference values of non-obese adolescents. Adjusting for age and sex, HRQoL of youths in OGG III significantly impaired compared to OGG I. Youths in OGG III were 2.15 times more likely to report problems with mobility in the EQ-5D-3 L than youths in OGG I. A mean difference of 9.7 and 6.6 points between OGG III and I were found for DCGM-31 and KINDL respectively and 5.1 points between OGG II and I for DCGM-31. Including further variables into the regression models, showed that HRQoL measured by DCGM-31 was significantly different between OGGs. Otherwise, female sex and having more than 4 h of daily screen time were also associated with lower HRQoL measured by DCGM-31 and KINDL. CONCLUSION: HRQoL of adolescents with obesity is reduced, but HRQoL of adolescents with extreme obesity is particularly affected. Larger and longitudinal studies are necessary to understand the relation of extreme obesity and HRQoL, and the impact of other lifestyle or socioeconomic factors. TRIAL REGISTRATION: Clinicaltrials.gov NCT01625325; German Clinical Trials Register (DRKS) DRKS00004172.


Subject(s)
Obesity, Morbid/psychology , Pediatric Obesity/psychology , Quality of Life , Adolescent , Female , Humans , Male , Prospective Studies , Regression Analysis , Sex Distribution , Socioeconomic Factors , Surveys and Questionnaires
8.
Diabet Med ; 37(10): 1752-1758, 2020 10.
Article in English | MEDLINE | ID: mdl-31834643

ABSTRACT

AIM: This cross-sectional study used a large nationwide claims data set to assess the excess medical costs of people with type 2 diabetes according to age group in 2015. METHODS: Data from 291 709 people with diabetes and 291 709 age- and sex-matched controls were analysed. Total costs (expressed as 2015 euros) of outpatient and inpatient services, medication, rehabilitation, and the provision of aids and appliances were examined. Overall and age-stratified excess costs of people with diabetes were estimated using gamma regression with a log-link. RESULTS: Overall, the estimated total direct costs of a person with type 2 diabetes are approximately double those of a person without diabetes: €4727 vs. €2196, respectively. Absolute excess costs were approximately the same in all age groups (around €2500), however, relative excess costs of persons with diabetes were much higher in younger (~ 334% for < 50 years) than in older age groups (~ 156% for ≥ 80 years). Regional costs, both absolute and excess, partly differed from the national level. CONCLUSIONS: This study complements and updates previous studies on the excess medical costs of people with diabetes in Germany. The results indicate the importance of preventing the development of type 2 diabetes, especially in younger age groups. Longitudinal and regional studies examining changes in prevalence and the development of excess costs in groups with different types of diabetes, and according to age, would be of interest to validate our findings and better understand the avoidable burden of having diabetes.


Subject(s)
Diabetes Complications/economics , Diabetes Mellitus, Type 2/economics , Health Care Costs/statistics & numerical data , Age Factors , Aged , Aged, 80 and over , Databases, Factual , Diabetes Complications/epidemiology , Diabetes Mellitus, Type 2/epidemiology , Female , Germany/epidemiology , Humans , Insurance, Health , Male , Middle Aged
9.
Clin Neurophysiol ; 130(11): 2019-2025, 2019 11.
Article in English | MEDLINE | ID: mdl-31539768

ABSTRACT

OBJECTIVE: Increasingly, serotonin selective reuptake inhibitor (SSRI) medications are prescribed in pregnancy. These medications pass freely into the developing fetus but little is known about their effect on brain development in humans. In this study we determine if prenatal maternal depression and SSRI medication change the EEG infant delta brush bursts which are an early marker of normal brain maturation. METHODS: We measured delta brush bursts from the term infants of three groups of mothers (controls (N = 52), depressed untreated (N = 15), and those taking serotonin SSRI medication (N = 10). High density EEGs were obtained during sleep at an average age of 44 weeks post conceptional age. We measured the rate of occurrence, brush amplitude, oscillation frequency and duration of the bursts. RESULTS: Compared to infants of control mothers, the parameters of delta brush bursts of the offspring of depressed and SSRI-using mothers are significantly altered: burst amplitude is decreased; the oscillation frequency increased, and the duration increased (SSRI only). These significant differences were found during both sleep states. CONCLUSIONS: Electrocortical bursting activity (i.e. delta brushes) is known to play an important role in early central nervous system (CNS) synaptic formation and function. SIGNIFICANCE: Maternal depression or SSRI use may alter brain function in their offspring.


Subject(s)
Brain/physiopathology , Depressive Disorder/drug therapy , Prenatal Exposure Delayed Effects/physiopathology , Selective Serotonin Reuptake Inhibitors/therapeutic use , Adult , Brain/drug effects , Depressive Disorder/physiopathology , Electroencephalography , Female , Humans , Infant, Newborn , Male , Pregnancy , Pregnancy Complications/drug therapy , Pregnancy Complications/physiopathology , Selective Serotonin Reuptake Inhibitors/administration & dosage , Young Adult
10.
Neurosci Biobehav Rev ; 105: 276-287, 2019 10.
Article in English | MEDLINE | ID: mdl-31415866

ABSTRACT

From an evolutionary perspective, sexual stimuli are highly salient and are assumed to be processed with high priority. Hence, attentional processing of sexual cues is expected to not only bias attention but to also distract from other cognitive (foreground) tasks. It is, however, unclear to what extent these stimuli capture attention and whether there are differences between men and women. This meta-analysis combined the results of 32 studies employing experiments of attentional bias toward and distraction by sexual stimuli. From these, 13 studies provided data to examine gender differences. Overall, attentional bias and distractibility was lower than anticipated (gz = 0.43, p < .001) and there was support for the assumption of higher attention bias/interference in men (gs = 0.29, p = .031). Importantly, there was evidence for the presence of publication bias. With this in mind, findings are discussed in the context of stimulus features, the impact of provoked sexual arousal and motivational state, and gender-specific and -nonspecific neural processing of sexual stimuli which influence attention toward them.


Subject(s)
Attentional Bias/physiology , Cues , Sex Characteristics , Sexual Behavior/physiology , Female , Humans , Male
11.
Neuroimage ; 176: 499-509, 2018 08 01.
Article in English | MEDLINE | ID: mdl-29729394

ABSTRACT

Attentional interference control is a prominent feature of human cognition. To what extent sexual stimuli attract attention and interfere with cognitive tasks has still little been studied. Our study aimed to identify associations between attentional interference, sexual arousal, trait sexual motivation, and neural activity to sexual distractors while accounting for gender differences. Therefore, the present study examined the neural correlates of attentional interference by arousing sexual distractors using functional magnetic resonance imaging (fMRI). Fifty women and 47 men underwent fMRI while indicating the orientation of two lines (equal or unequal) next to an explicit sexual (as compared to a neutral) picture. Results confirmed prolonged response times when a sexual image was shown. There was neither a difference between genders nor an effect of sexual arousal ratings or trait sexual motivation on distractibility. Neural activity specific to sexual images was found in brain regions implicated in motivation and reward processing. Men as compared to women showed stronger responses in the nucleus caudatus, the anterior cingulate cortex, and the nucleus accumbens. Trait sexual motivation was selectively correlated with nucleus caudatus activity. Taken together, findings support the notion that even when not in the focus, sexual images activate the brains' reward circuitry. Men's higher sensitivity to the rewarding value of sexual cues may be critical for their higher risk of addictive/compulsive sexual behaviors.


Subject(s)
Attention/physiology , Brain Mapping/methods , Caudate Nucleus/physiology , Gyrus Cinguli/physiology , Motivation/physiology , Nucleus Accumbens/physiology , Pattern Recognition, Visual/physiology , Reward , Sex Characteristics , Sexual Behavior/physiology , Adult , Caudate Nucleus/diagnostic imaging , Female , Gyrus Cinguli/diagnostic imaging , Humans , Magnetic Resonance Imaging , Male , Nucleus Accumbens/diagnostic imaging , Sex Factors , Young Adult
12.
Mucosal Immunol ; 11(3): 654-667, 2018 05.
Article in English | MEDLINE | ID: mdl-29139478

ABSTRACT

Resident memory T cells (TRM) reside in the lung epithelium and mediate protective immunity against respiratory pathogens. Although lung CD8+ TRM have been extensively characterized, the properties of CD4+ TRM remain unclear. Here we determined the transcriptional signature of CD4+ TRM, identified by the expression of CD103, retrieved from human lung resection material. Various tissue homing molecules were specifically upregulated on CD4+ TRM, whereas expression of tissue egress and lymph node homing molecules were low. CD103+ TRM expressed low levels of T-bet, only a small portion expressed Eomesodermin (Eomes), and although the mRNA levels for Hobit were increased, protein expression was absent. On the other hand, the CD103+ TRM showed a Notch signature. CD4+CD103+ TRM constitutively expressed high transcript levels of numerous cytotoxic mediators that was functionally reflected by a fast recall response, magnitude of cytokine production, and a high degree of polyfunctionality. Interestingly, the superior cytokine production appears to be because of an accessible interferon-γ (IFNγ) locus and was partially because of rapid translation of preformed mRNA. Our studies provide a molecular understanding of the maintenance and potential function of CD4+ TRM in the human lung. Understanding the specific properties of CD4+ TRM is required to rationally improve vaccine design.


Subject(s)
CD4-Positive T-Lymphocytes/physiology , Lung/physiology , Receptors, Notch/metabolism , Aged , Animals , Antigens, CD/metabolism , Cytotoxicity, Immunologic , Female , Gene Expression Regulation , Humans , Immunoglobulin J Recombination Signal Sequence-Binding Protein/genetics , Immunologic Memory , Integrin alpha Chains/metabolism , Interferon-gamma/metabolism , Male , Mice , Mice, Inbred C57BL , Mice, Knockout , Middle Aged , Receptors, Notch/genetics , T-Box Domain Proteins/genetics , T-Box Domain Proteins/metabolism , Transcriptome
13.
J Neuroendocrinol ; 29(5)2017 05.
Article in English | MEDLINE | ID: mdl-28380673

ABSTRACT

Ghrelin is a metabolic hormone that has neuroprotective actions in a number of neurological conditions, including Parkinson's disease (PD), stroke and traumatic brain injury. Acyl ghrelin treatment in vivo and in vitro also shows protective capacity in Alzheimer's disease (AD). In the present study, we used ghrelin knockout (KO) and their wild-type littermates to test whether or not endogenous ghrelin is protective in a mouse model of AD, in which human amyloid ß peptide 1-40 (Aß1-40 ) was injected into the lateral ventricles i.c.v. Recognition memory, using the novel object recognition task, was significantly impaired in ghrelin KO mice and after i.c.v. Aß1-40 treatment. These deficits could be prevented by acyl ghrelin injections for 7 days. Spatial orientation, as assessed by the Y-maze task, was also significantly impaired in ghrelin KO mice and after i.c.v. Aß1-40 treatment. These deficits could be prevented by acyl ghrelin injections for 7 days. Ghrelin KO mice had deficits in olfactory discrimination; however, neither i.c.v. Aß1-40 treatment, nor acyl ghrelin injections affected olfactory discrimination. We used stereology to show that ghrelin KO and Aß1-40 increased the total number of glial fibrillary acidic protein expressing astrocytes and ionised calcium-binding adapter expressing microglial in the rostral hippocampus. Finally, Aß1-40 blocked long-term potentiation induced by high-frequency stimulation and this effect could be acutely blocked with co-administration of acyl ghrelin. Collectively, our studies demonstrate that ghrelin deletion affects memory performance and also that acyl ghrelin treatment may delay the onset of early events of AD. This supports the idea that acyl ghrelin treatment may be therapeutically beneficial with respect to restricting disease progression in AD.


Subject(s)
Amyloid beta-Peptides/pharmacology , Cognition/drug effects , Ghrelin/pharmacology , Inflammation/drug therapy , Neuronal Plasticity/drug effects , Orientation, Spatial/drug effects , Peptide Fragments/pharmacology , Animals , Disease Models, Animal , Ghrelin/genetics , Ghrelin/metabolism , Inflammation/chemically induced , Maze Learning/drug effects , Mice , Mice, Knockout
15.
Nervenarzt ; 88(7): 765-778, 2017 Jul.
Article in German | MEDLINE | ID: mdl-27679515

ABSTRACT

AIM: This article gives a conspectus of the present state of research on the efficiency of exercise as a treatment for patients suffering from depression. METHODS: A systematic review of articles published between December 1980 and March 2016 was carried out. The review focused on studies that examined the effects of exercise compared to control conditions in the treatment of depression. Extracted and analyzed information from the articles included details about participants, characteristics of exercise and control conditions, assessments, study design and outcomes. RESULTS: A total of 34 of the 48 studies included in the literature search reported a significant reduction of depressive symptoms due to exercise interventions. There was a trend to reduced depressive symptoms following the exercise interventions in five studies. In nine studies no positive impact of exercise on depression and affective well-being could be detected. DISCUSSION: This review article shows that physical activity decreases depressive symptoms and increases affective well-being in patients with depressive diseases; therefore, exercise should be recommended as a component of depression treatment within the framework of a multi-dimensional approach.


Subject(s)
Depressive Disorder/therapy , Exercise/psychology , Controlled Clinical Trials as Topic , Depressive Disorder/diagnosis , Depressive Disorder/psychology , Evaluation Studies as Topic , Humans , Outcome and Process Assessment, Health Care
16.
Eur J Neurol ; 23(12): 1705-1712, 2016 12.
Article in English | MEDLINE | ID: mdl-27479917

ABSTRACT

BACKGROUND AND PURPOSE: The impact of body mass index (BMI) on outcome in stroke patients treated with intravenous thrombolysis (IVT) was investigated. METHODS: In a multicentre IVT-register-based observational study, BMI with (i) poor 3-month outcome (i.e. modified Rankin Scale scores 3-6), (ii) death and (iii) symptomatic intracranial haemorrhage (sICH) based on criteria of the ECASS II trial was compared. BMI was used as a continuous and categorical variable distinguishing normal weight (reference group 18.5-24.9 kg/m2 ) from underweight (<18.5 kg/m2 ), overweight (25-29.9 kg/m2 ) and obese (≥30 kg/m2 ) patients. Univariable and multivariable regression analyses with adjustments for age and stroke severity were done and odds ratios with 95% confidence intervals [OR (95% CI)] were calculated. RESULTS: Of 1798 patients, 730 (40.6%) were normal weight, 55 (3.1%) were underweight, 717 (39.9%) overweight and 295 (16.4%) obese. Poor outcome occurred in 38.1% of normal weight patients and did not differ significantly from underweight (45.5%), overweight (36.1%) and obese (32.5%) patients. The same was true for death (9.5% vs. 14.5%, 9.6% and 7.5%) and sICH (3.9% vs. 5.5%, 4.3%, 2.7%). Neither in univariable nor in multivariable analyses did the risks of poor outcome, death or sICH differ significantly between BMI groups. BMI as a continuous variable was not associated with poor outcome, death or sICH in unadjusted [OR (95% CI) 0.99 (0.97-1.01), 0.98 (0.95-1.02), 0.98 (0.94-1.04)] or adjusted analyses [OR (95% CI) 1.01 (0.98-1.03), 0.99 (0.95-1.05), 1.01 (0.97-1.05)], respectively. CONCLUSION: In this largest study to date, investigating the impact of BMI in IVT-treated stroke patients, BMI had no prognostic meaning with regard to 3-month functional outcome, death or occurrence of sICH.


Subject(s)
Body Mass Index , Brain Ischemia/drug therapy , Stroke/drug therapy , Thrombolytic Therapy/adverse effects , Aged , Aged, 80 and over , Female , Humans , Infusions, Intravenous , Intracranial Hemorrhages/etiology , Male , Middle Aged , Prognosis , Risk , Treatment Outcome
17.
Soc Cogn Affect Neurosci ; 11(9): 1411-21, 2016 09.
Article in English | MEDLINE | ID: mdl-27053767

ABSTRACT

Return of fear is a serious problem in exposure-based treatments of anxiety disorders. Renewal of the fear response may occur when re-encountering the conditioned stimulus within a novel context. Findings in rodents underpin the hippocampus' role in conditioned fear renewal in novel contexts, but it has yet to be investigated in humans. Forty-six healthy men took part in a 2-day, context-dependent, cued fear conditioning paradigm with fear acquisition, extinction learning (day 1) and extinction recall in the acquisition, extinction and a novel context one day later. Conditioned evaluative, skin conductance responses (SCRs) and blood-oxygen-level-dependent responses served as dependent variables. Context-dependent fear renewal was reflected in stronger conditioned SCRs. In the acquisition context, individuals with a higher renewal of conditioned SCRs showed stronger activation of the fear circuit. Hippocampal activation distinguished conditioned responding in the novel compared with the extinction context. Individuals with a stronger renewal of conditioned SCRs in the novel context showed increased effective connectivity of hippocampal activation foci with structures in the fear and extinction network. These results outline the pivotal role of the hippocampus and its connectivity in conditioned fear renewal in a novel context in humans and might have important implications for exposure therapy in anxiety disorders.


Subject(s)
Conditioning, Psychological/physiology , Fear/physiology , Hippocampus/physiology , Neural Pathways/physiology , Adult , Cues , Extinction, Psychological , Galvanic Skin Response/physiology , Humans , Magnetic Resonance Imaging , Male , Oxygen/blood , Young Adult
18.
EBioMedicine ; 2(9): 1133-44, 2015 Sep.
Article in English | MEDLINE | ID: mdl-26501111

ABSTRACT

BACKGROUND: Understanding the heterogeneous genotypes and phenotypes of prostate cancer is fundamental to improving the way we treat this disease. As yet, there are no validated descriptions of prostate cancer subgroups derived from integrated genomics linked with clinical outcome. METHODS: In a study of 482 tumour, benign and germline samples from 259 men with primary prostate cancer, we used integrative analysis of copy number alterations (CNA) and array transcriptomics to identify genomic loci that affect expression levels of mRNA in an expression quantitative trait loci (eQTL) approach, to stratify patients into subgroups that we then associated with future clinical behaviour, and compared with either CNA or transcriptomics alone. FINDINGS: We identified five separate patient subgroups with distinct genomic alterations and expression profiles based on 100 discriminating genes in our separate discovery and validation sets of 125 and 103 men. These subgroups were able to consistently predict biochemical relapse (p = 0.0017 and p = 0.016 respectively) and were further validated in a third cohort with long-term follow-up (p = 0.027). We show the relative contributions of gene expression and copy number data on phenotype, and demonstrate the improved power gained from integrative analyses. We confirm alterations in six genes previously associated with prostate cancer (MAP3K7, MELK, RCBTB2, ELAC2, TPD52, ZBTB4), and also identify 94 genes not previously linked to prostate cancer progression that would not have been detected using either transcript or copy number data alone. We confirm a number of previously published molecular changes associated with high risk disease, including MYC amplification, and NKX3-1, RB1 and PTEN deletions, as well as over-expression of PCA3 and AMACR, and loss of MSMB in tumour tissue. A subset of the 100 genes outperforms established clinical predictors of poor prognosis (PSA, Gleason score), as well as previously published gene signatures (p = 0.0001). We further show how our molecular profiles can be used for the early detection of aggressive cases in a clinical setting, and inform treatment decisions. INTERPRETATION: For the first time in prostate cancer this study demonstrates the importance of integrated genomic analyses incorporating both benign and tumour tissue data in identifying molecular alterations leading to the generation of robust gene sets that are predictive of clinical outcome in independent patient cohorts.


Subject(s)
Gene Dosage , Prostatic Neoplasms/genetics , Transcriptome/genetics , Adult , Aged , Aged, 80 and over , Cluster Analysis , Cohort Studies , Gene Expression Profiling , Gene Expression Regulation, Neoplastic , Genome, Human , Humans , Male , Middle Aged , Prognosis , RNA, Messenger/genetics , RNA, Messenger/metabolism , Recurrence , Reproducibility of Results , Risk Factors
19.
Neurosci Lett ; 604: 173-7, 2015 Sep 14.
Article in English | MEDLINE | ID: mdl-26219987

ABSTRACT

The cerebellum is known to contribute to the acquisition and retention of conditioned motor and emotional responses. Eyeblink conditioning and fear conditioning have been studied in greatest detail. Whereas a considerable number of studies have shown that the cerebellum is also involved in extinction of conditioned eyeblink responses, the likely contribution of the cerebellum to extinction of conditioned fear responses has largely been ignored. In the present study, we analyzed functional brain imaging data (fMRI) of previous work investigating extinction of conditioned fear in 32 young and healthy men, in which event-related fMRI analysis did not include the cerebellum. This dataset was analyzed using a spatial normalization method optimized for the cerebellum. During fear acquisition, an unpleasant electric shock (unconditioned stimulus; US) was paired with one of two pictures of geometrical figures (conditioned stimulus; CS+), while the other picture (CS-) was never paired with the US. During extinction, CS+ and CS- were presented without the US. During the acquisition phase, the fMRI signal related to the CS+ was significantly higher in hemispheric lobule VI in early compared to late acquisition (p<.05, permutation corrected). During the extinction phase, the fMRI signal related to the contrast CS+>CS- was significantly higher within the anterior vermis in early compared to late extinction (p<.05, permutation corrected). The present data show that the cerebellum is not only associated with the acquisition but also with the extinction of conditioned fear.


Subject(s)
Cerebellar Vermis/physiology , Conditioning, Classical , Extinction, Psychological , Fear , Adolescent , Adult , Brain Mapping , Humans , Magnetic Resonance Imaging , Male , Young Adult
20.
Acta Paediatr ; 104(7): 670-7, 2015 Jul.
Article in English | MEDLINE | ID: mdl-25772627

ABSTRACT

AIM: To assess the impact of Family Nurture Intervention (FNI) on cortical function in preterm infants at term age. METHODS: Family Nurture Intervention is a NICU-based intervention designed to establish emotional connection between mothers and preterm infants. Infants born at 26-34 weeks postmenstrual age (PMA) were divided into two groups, standard care (SC, N = 49) and FNI (FNI, N = 56). Infants had EEG recordings of ~one hour duration with 124 lead nets between 37 and 44 weeks PMA. Coherence was measured between all pairs of electrodes in ten frequency bands. Data were summarised both within and between 12 regions during two sleep states (active, quiet). RESULTS: Coherence levels were negatively correlated with PMA age in both groups. As compared to SC infants, FNI infants showed significantly lower levels of EEG coherence (1-18 Hz) largely within and between frontal regions. CONCLUSION: Coherence in FNI infants was decreased in regions where we previously found robust increases in EEG power. As coherence decreases with age, results suggest that FNI may accelerate brain maturation particularly in frontal brain regions, which have been shown in research by others to be involved in regulation of attention, cognition and emotion regulation; domains deficient in preterm infants.


Subject(s)
Cerebral Cortex/physiopathology , Critical Care , Infant, Premature, Diseases/therapy , Maternal Behavior , Mothers/psychology , Parent-Child Relations , Age Factors , Electroencephalography , Emotions , Female , Humans , Infant, Newborn , Infant, Premature , Infant, Premature, Diseases/physiopathology , Infant, Premature, Diseases/psychology , Male , Sleep
SELECTION OF CITATIONS
SEARCH DETAIL
...