Association between Salivary Alpha-Amylase and Executive Functioning in Healthy Children.

The main aim of this study was to confirm the relationship between executive performance and salivary alpha-amylase (SAA) activity in a sample of 64 healthy children (39 boys), and compare it to the association of SAA output and salivary flow rate (SFR). Executive functioning was assessed via fluency, trail-making, rings and inhibition tasks from the Batería de Evaluación Neuropsicológica de la Función Ejecutiva en Niños [Battery of Neuropsychological Assessment for Executive Function in Children] (ENFEN), merged into an ENFEN total score. SAA activity, output, and SFR were measured at baseline, one minute before, and one minute after the end of a neuropsychological testing session. Our results confirmed a direct, linear and significant association between SAA activity and executive functioning, r(64) = .351, p < .05, and extended it to SAA output, r(64) =.431, p < .05. The mean level of SAA output was the best predictor of executive functioning (ß = .431, p < .05) and explained 18.2 % of the variance in ENFEN total score. In sum, and compared to SAA activity, measuring SAA output may be a more precise and indirect marker to assess executive functioning in children.

Association of salivary alpha-amylase and salivary flow rate with working memory functioning in healthy children.

The aim of this study was to examine the association between auditory and visual working memory (WM) performance and salivary alpha-amylase (sAA) and salivary flow rate (SFR) in a sample of 63 children (38 boys). WM was assessed by means of WISC-V subtests: four auditory subtests (Digit Span and Letter-Number Sequencing) and one visual subtest (Picture Span). SAA activity, output, and SFR were measured at baseline (10 min prior to testing), one minute prior to testing, one minute after the end of the auditory WM subtests and one minute after the end of the visual WM subtest. Our statistical analyses showed an association among SAA activity, output and SFR levels and the number of recalled digits in the last attempt score in Letter-Number Sequencing subtest. Specifically, our results showed that working performance in this task was associated with a concurrent decrease in SFR (r(63) = -0.423, p < .05). This salivary measure was the best predictor of this specific index of working memory performance (ß = -0.423, p < .05). These results show that the changes in SFR, which represents changes in parasympathetic tone, could be employed in future studies as a noninvasive marker of working memory performance in child studies.

Association between salivary alpha-amylase and executive functioning in healthy children

The main aim of this study was to confirm the relationship between executive performance and salivary alpha-amylase (SAA) activity in a sample of 64 healthy children (39 boys), and compare it to the association of SAA output and salivary flow rate (SFR). Executive functioning was assessed via fluency, trail-making, rings and inhibition tasks from the Batería de Evaluación Neuropsicológica de la Función Ejecutiva en Niños [Battery of Neuropsychological Assessment for Executive Function in Children] (ENFEN), merged into an ENFEN total score. SAA activity, output, and SFR were measured at baseline, one minute before, and one minute after the end of a neuropsychological testing session. Our results confirmed a direct, linear and significant association between SAA activity and executive functioning, r(64) = .351, p < .05, and extended it to SAA output, r(64) =.431, p < .05. The mean level of SAA output was the best predictor of executive functioning (β = .431, p < .05) and explained 18.2 % of the variance in ENFEN total score. In sum, and compared to SAA activity, measuring SAA output may be a more precise and indirect marker to assess executive functioning in children

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Low levels of morning salivary alpha-amylase activity predict higher number of depressive symptoms in a community sample of children / Bajos niveles de actividad alfa-amilasa salivar predicen un número más elevado de síntomas depresivos en una muestra infantil comunitaria

Models of the etiology of depressive disorders suggest that the onset of a depressive episode is the result of a complex phenomenon based on the interaction between genetic background, critical environmental factors such as life stressors and traumatic events, and the effects of neuroendocrine changes associated with the stress response. Numerous studies have highlighted the usefulness of morning cortisol (C) as a potential predictor of depressive episodes. The aim of this study was to compare the effectiveness of C, salivary alpha-amylase (sAA) activity/output, and the sAA/C ratio in predicting depressive symptoms in a community sample of 99 children aged 8-11 years old. Two saliva samples were obtained in the morning on two different school days. Teachers described their pupils' behavior by using the internalizing problems scales of the Teacher's Report Form (TRF) questionnaire. Our results indicate that, regardless of gender, the best predictor of depressive/withdrawal scores and overall internalizing scores on the TRF was lower mean morning levels of sAA activity. Hence, sAA could be proposed as a biological marker for the risk of developing a first episode of depressive illness in child samples

Los modelos sobre la etiología de los trastornos depresivos sugieren que el inicio de un episodio depresivo es el resultado de un complejo fenómeno que se basa en la interacción entre la carga genética, factores ambientales críticos tales como eventos vitales estresantes y traumáticos, y el efecto de los cambios neuroendocrinos asociados con la respuesta de estrés. Numerosos estudios han resaltado la utilidad de los niveles matutinos de cortisol (C) como un potencial predictor de episodios depresivos. El objetivo del estudio fue comparar la efectividad del C, de la actividad/secreción de la alfa-amilasa salivar (AAs) y de su ratio para predecir la sintomatología depresiva en una muestra comunitaria de 99 niños con edades entre los 8-11 años. Dos muestras de saliva fueron obtenidas en la mañana en dos días escolares. Los profesores describieron el comportamiento de sus estudiantes usando la escala Teacher's Report Form (TRF). Nuestros resultados indican que, con independencia del género, el mejor predictor de las puntuaciones de depresión/aislamiento y del total de alteraciones internalizadas del TRF fue mostrar bajos niveles de actividad de AAs en la mañana. Por lo tanto, esta medida salivar podría ser usada como un marcador biológico del riesgo para el desarrollo de un primer episodio de depresivo infantil

Application of κ free light chains in cerebrospinal fluid as a biomarker in multiple sclerosis diagnosis: development of a diagnosis algorithm.

BACKGROUND: The determination of κ free light chains (KFLC) in cerebrospinal fluid (CSF) by nephelometry is a feasible alternative to immunoglobulin G oligoclonal bands (OCB) in the evaluation of intrathecal synthesis of immunoglobulin in multiple sclerosis (MS) and other demyelinating diseases. The aim of this study was to assess the diagnostic value of KFLC and its inclusion in a procedure algorithm along with OCB interpretation. METHODS: A cross-sectional study, which included 123 patients with a CSF OCB request, was carried out. Isoelectric focusing followed by immunofixation was used to detect OCB, and nephelometry was used to analyze KFLC. The KFLC index was calculated using CSF/serum quotient of KFLC and albumin. The KFLC index was compared with MS diagnosis to find the optimal cutoff. It was obtained from the receiver operating characteristic (ROC) curves and the Youden method. RESULTS: The CSF KFLC median was 1.66 mg/L in the MS group, whereas in other central nervous system diseases, KFLC showed generally no or only moderate increase in CSF (median 0.10 mg/L). KFLC index showed a significant difference between groups. ROC analysis for CSF KFLC concentration, and KFLC indexes were 91.88% and 93.94%, respectively. The best cutoff for the KFLC index was 2.91 for MS diagnosis (sensitivity: 83.78%; specificity: 85.88%). The proposed algorithm showed high sensitivity (89.19%) and specificity (84.71%). CONCLUSIONS: KFLC determination is rapid and automatized, but it has no higher sensitivity and specificity than OCB in MS diagnosis. Nevertheless, when used in screening, it could reduce the number of manual OCB tests.

Mid-regional pro-adrenomedullin as prognostic biomarker in septic shock.

BACKGROUND: The aim was to ascertain the prognostic value of mid-regional pro-adrenomedullin (MR-proADM), measured within 24 hours from the onset of septic shock (SS). METHODS: We performed a prospective, observational study on all patients admitted to our hospital's Intensive Care Unit with SS over a one year period from January to December 2011 to examine the outcomes in 100 consecutive SS cases. Demographic data and severity score (APACHEII and SOFA) were recorded. MR-proADM, C-reactive protein and procalcitonin were measured within the first 24 hours from SS onset. The outcome variable studied was 28-day mortality. Data were evaluated with non-parametric statistics bivariant and multivariate analyses for survival analysis. RESULTS: In patients who died within 28 days (36%), MR-proADM, Lactate, APACHE II as well as SOFA were significantly higher compared with survivors. MR-proADM showed the best association with 28-day mortality, as well as a prognostic value (logrank test: P=0.0012). Statistical significance was also seen in the Cox regression analysis (P=0.0004) for all patients with a Relative Risk of 1.26 times that of the baseline for each mmol/L of increase in MR-proADM. CONCLUSIONS: In our study MR-proADM levels measured on admission correlates with 28-day mortality in patients with septic shock.

Psychological and psychobiological stress in the relationship between basic cognitive function and school performance / El estrés psicológico y psicobiológico en la relación entre funcionamiento cognitivo básico y rendimiento académico

This study analyses the role played by daily stress, assessed through self-report and at the psychobiological level, in relation to basic cognitive function when predicting school performance. The sample comprised 100 schoolchildren (55 girls and 45 boys, age range 8 to 11 years) from a state school in the city of Malaga (Spain). Daily stress was assessed through the Children's Daily Stress Inventory (IIEC m Spanish; Tnanes et al., 2009). Psychobiological stress was measured through the cortisol/DHEAS ratio, derived from saliva samples taken in the morning on two consecutive days. Basic cognitive skills were assessed by means of the Computerized Cognitive Assessment System (CDR battery; Wesnes et al., 2003, 2000). Finally, the measure of school performance was the mean value of the final grades recorded in the child's school report. In addition to descriptive and correlational statistical analyses, multiple regression analyses were conducted in order to assess the model. The results show that children's daily stress self-reported contributes to predict school performance, and has proven to be more influential than basic cognitive function when it comes to predict school performance. Therefore, in order to achieve good school performance, a pupil not only requires good basic cognitive function, but must also present low levels of self-reported daily stress. These findings suggest a new way of explaining and predicting school failure

Este estudio analiza el papel desempeñado por el estrés cotidiano, evaluado a través de auto-informe y de los niveles psicobiológicos, en relación con la función cognitiva básica a la hora de predecir el rendirmento académico. La muestra está compuesta por 100 alumnos (55 niñas y niños de 45, con un rango de edad de 8 a 11 años) de una escuela pública de Málaga capital (España). El estrés diario se evaluó mediante el Inventario de estresores cotidianos en niños (IIEC; Trianes et al, 2009). El estrés psicobiológico se midió a través de la ratio cortisol / DHEA, derivado de varias muestras de saliva tomadas por la mañana en dos días consecutivos. Las habilidades cognitivas básicas se evaluaron por medio del sistema de evaluación cognitiva computarizada (batería CDR; Wesnes et al, 2003, 2000). Por último, el rendimiento académico se evaluó a través del valor medio de las calificaciones finales registradas en el informe de la escuela del niño. Además de los análisis estadísticos descriptivos y correlacionales, se realizaron análisis de regresión múltiple con el fin de evaluar el modelo. Los resultados muestran que el estrés diario autopercibido por los niños, actúa pronosticando el rendimiento académico con mayor peso que el funcionamiento cognitivo básico. Por lo tanto, a fin de lograr el buen rendimiento escolar, un alumno no sólo requiere una buena función cognitiva básica, sino que también debe presentar bajos niveles de estrés cotidiano auto-percibido. Estos hallazgos sugieren una nueva forma de explicar y predecir el fracaso escolar

Valoración de parámetros inmunitarios en pacientes con síntomas de ansiedad y depresión tras un programa de meditación "mindfulness" un estudio piloto / Assessment of immune parameters in anxious and depressive patients after a "mindfulness" meditation program: A pilot study

La meditación mindfulness implica concentrarse en el momento presente de forma activa y reflexiva. El objetivo del presente estudio fue investigar los efectos de esta forma de meditación sobre parámetros inmunitarios en pacientes con síntomas de ansiedad y depresión. Dieciséis pacientes fueron sometidos a un programa de meditación mindfulness de dos meses de duración. Diversos parámetros inmunitarios, como el recuento de leucocitos, linfocitos, monocitos, neutrófilos, eosinófilos y basófilos, así como los niveles de inmunoglobulinas (IgA, IgG, e IgM) y del complemento (C3 y C4), fueron evaluados antes y después del programa. Los resultados en el post-test revelaron un aumento significativo de las concentraciones de IgG, IgM, C3 y C4, así como un descenso en el recuento de monocitos. Estos hallazgos indican, por tanto, que la práctica de la meditación mindfulness parece ejercer una acción inmunomoduladora en pacientes con ansiedad y depresión, lo que sugiere interesantes implicaciones psicobiológicas y clínicas

Mindfulness meditation involves concentrating on the present moment in an active and reflexive way. The purpose of this study was to investigate the effects of this form of meditation on immune parameters in a sample of patients with depressive and anxious symptoms. Sixteen patients practiced mindfulness meditation for two months. Several immune parameters, including the total number of leucocytes, lymphocytes, monocytes, neutrophils, eosinophils, basophils, as well as the levels of immunoglobulins (IgA, IgG, IgM) and complement (C3, C4), were measured before and after the program. At post-test, results revealed a significant increase in the concentrations of IgG, IgM, C3 and C4, as well as a decreased monocyte count. Therefore, these findings indicate that mindfulness meditation appears to exert an immunomodulatory action in patients with anxious and depressive symptoms, which suggests interesting psychobiological and clinical implications

Salivary alpha-amylase changes promoted by sustained exposure to affective pictures.

We studied the changes in salivary alpha-amylase (sAA) and other psychophysiological indices (heart rate, skin conductance, and corrugator supercilii activity) elicited by sustained exposure to affective pictures. Thirty-nine subjects viewed five blocks of pictures depicting mutilations, human attack, neutral scenes, sport/adventure, and erotica. Each block comprised 12 pictures of the same content. Saliva samples were collected before and after each block of pictures. The results showed that mutilation pictures promoted the greatest increase in sAA activity and output, as well as greater corrugator supercilii activity than pleasant pictures. Skin conductance response did not differ among high arousal picture contents. Changes in sAA varied with the affective valence but not with the arousal ratings of the pictures. Our results point to sAA as an index directly related to the unpleasantness elicited by sustained exposure to affective stimuli.

Fear of falling among elderly patients with dizziness and syncope in a tilt setting.

The objectives of this study were to assess the prevalence of fear of falling (FOF) among patients over age 60 with dizziness, falls, or syncope; and to analyze risk factors associated with FOF, including data from the tilt table test. This study included 200 older patients referred to a geriatric outpatient clinic specializing in dizziness, falls, and syncope. The primary outcome measure was the proportion of patients who experienced FOF (yes vs. no) and whether FOF restricted leaving home alone or performing activities of daily living. FOF occurred in 50 per cent of patients in this population. Among these, 44 per cent gave up going out alone and 10 per cent stopped doing basic activities of daily living. Beyond age 75, FOF was associated with recurrent dizziness, depression, and symptoms on standing, but not prior falls.

Cognitive performance and morning levels of salivary cortisol and alpha-amylase in children reporting high vs. low daily stress perception.

The aim of the present study was to assess the effects of daily stress perception on cognitive performance and morning basal salivary cortisol and alpha-amylase levels in healthy children aged 9-12. Participants were classified by whether they had low daily perceived stress (LPS, n = 27) or a high daily perceived stress (HPS, n = 26) using the Children Daily Stress Inventory (CDSI). Salivary cortisol and alpha-amylase were measured at awakening and 30 minutes later. Cognitive performance was assessed using the Cognitive Drug Research assessment system. The HPS group exhibited significantly poorer scores on speed of memory (p < .05) and continuity of attention (p < .05) relative to the LPS group. The HPS group also showed significantly lower morning cortisol levels at awakening and at +30 minutes measures in comparison with the LPS group (p < .05), and mean morning cortisol levels were negatively correlated with speed of memory (p < .05) in the 53 participants. No significant differences were observed between both groups in alpha-amylase levels. These findings suggest that daily perceived stress in children may impoverish cognitive performance via its modulating effects on the HPA axis activity.

Cognitive Performance and Morning Levels of Salivary Cortisol and alfa-Amylase in Children Reporting High vs. Low Daily Stress Perception

The aim of the present study was to assess the effects of daily stress perception on cognitive performance and morning basal salivary cortisol and alpha-amylase levels in healthy children aged 9-12. Participants were classified by whether they had low daily perceived stress (LPS, n = 27) or a high daily perceived stress (HPS, n = 26) using the Children Daily Stress Inventory (CDSI). Salivary cortisol and alpha-amylase were measured at awakening and 30 minutes later. Cognitive performance was assessed using the Cognitive Drug Research assessment system. The HPS group exhibited significantly poorer scores on speed of memory (p < .05) and continuity of attention(p < .05) relative to the LPS group. The HPS group also showed significantly lower morning cortisol levels at awakening and at +30 minutes measures in comparison with the LPS group (p < .05), and mean morning cortisol levels were negatively correlated with speed of memory (p < .05) in the 53 participants. No significant differences were observed between both groups in alpha-amylase levels. These findings suggest that daily perceived stress in children may impoverish cognitive performance via its modulating effects on the HPA axis activity (AU)

El objetivo del presente estudio fue evaluar los efectos de la percepción de estrés diario sobre el rendimiento cognitivo y los niveles matutinos basales de cortisol y alfa-amilasa salivar en niños sanos de edades entre los 9y los 12 años. Los participantes fueron clasificados en función de si su nivel de percepción de estrés diario era bajo (LPS, n = 27) o alto (HPS, n = 26), empleando el Children Daily Stress Inventory (CDSI). Se midió el cortisol y la alfa-amilasa salivar al despertar y 30 minutos más tarde. El rendimiento cognitivo se evaluó mediante el sistema de evaluación Cognitive Drug Research. El grupo HPS obtuvo puntuaciones significativamente más bajasen velocidad de memoria (p < .05) y continuidad de la atención (p < .05) con respecto al grupo LPS. El grupo HPS también mostró niveles significativamente más bajos de cortisol matutino al despertar y a los 30 minutos en comparación con el grupo LPS (p < .05), y sus niveles medios de cortisol matutino correlacionaron negativamente con la velocidad de la memoria (p < .05) en los 53 participantes. No se observaron diferencias significativas entre los grupos en los niveles de alfa-amilasa. Estos resultados sugieren que la percepción de estrés diario en niños puede disminuir su ejecución cognitiva a través de sus efectos moduladores en la actividad del eje HPA (AU)