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1.
Eur J Pediatr ; 2024 May 01.
Artículo en Inglés | MEDLINE | ID: mdl-38691129

RESUMEN

Asthma during pregnancy is associated with a range of adverse perinatal outcomes. It is also linked to increased rates of neurodevelopmental conditions in the offspring. We aimed to assess whether fractional exhaled nitric oxide (FENO)-based asthma management during pregnancy improves child developmental and behavioural outcomes compared to usual care. The Breathing for Life Trial was a randomised controlled trial that compared FENO-based asthma management during pregnancy to usual care. Participants were invited to the developmental follow-up, the Breathing for Life Trial - Infant Development study, which followed up infants at 6 weeks, 6 months and 12 months. The primary outcomes were measured in infants at 12 months using the Bayley-III: Cognitive, Language and Motor composite scores. Secondary outcomes included Bayley-III social-emotional and adaptive behaviour scores, autism likelihood and sensory and temperament outcomes. The exposure of interest was the randomised intervention group. Two hundred and twenty-two infants and their 217 participating mothers were recruited to the follow-up; 107 mothers were in the intervention group and 113 were in the control group. There was no evidence of an intervention effect for the primary outcomes: Bayley-III cognitive (mean = 108.9 control, 108.5 intervention, p = 0.93), language (mean = 95.9 control, 95.6 intervention, p = 0.87) and motor composite scores (mean = 97.2 control, 97.9 intervention, p = 0.25). Mean scores for secondary outcomes were also similar among infants born to control and FENO group mothers, with few results reaching p < 0.05. CONCLUSION:  In this sample, FENO-guided asthma treatment during pregnancy did not improve infant developmental outcomes in the first year of life. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: ACTRN12613000202763. WHAT IS KNOWN: • Maternal asthma during pregnancy has been associated with increased rates of neurodevelopmental conditions in offspring, including intellectual disability and autism. WHAT IS NEW: • This is the first study to examine how managing asthma during pregnancy via a FENO-guided algorithm or usual care affects infant developmental and behavioural outcomes. While the results of the study showed no impact of the intervention, and therefore do not support the integration of FENO-based management of asthma in antenatal settings for optimal infant development, they do send a positive message about the implications of active asthma management during pregnancy on infant developmental outcomes.

2.
Int J Behav Nutr Phys Act ; 21(1): 11, 2024 Jan 30.
Artículo en Inglés | MEDLINE | ID: mdl-38291446

RESUMEN

BACKGROUND: Increasing physical activity (PA) is an effective strategy to slow reductions in cortical volume and maintain cognitive function in older adulthood. However, PA does not exist in isolation, but coexists with sleep and sedentary behaviour to make up the 24-hour day. We investigated how the balance of all three behaviours (24-hour time-use composition) is associated with grey matter volume in healthy older adults, and whether grey matter volume influences the relationship between 24-hour time-use composition and cognitive function. METHODS: This cross-sectional study included 378 older adults (65.6 ± 3.0 years old, 123 male) from the ACTIVate study across two Australian sites (Adelaide and Newcastle). Time-use composition was captured using 7-day accelerometry, and T1-weighted magnetic resonance imaging was used to measure grey matter volume both globally and across regions of interest (ROI: frontal lobe, temporal lobe, hippocampi, and lateral ventricles). Pairwise correlations were used to explore univariate associations between time-use variables, grey matter volumes and cognitive outcomes. Compositional data analysis linear regression models were used to quantify associations between ROI volumes and time-use composition, and explore potential associations between the interaction between ROI volumes and time-use composition with cognitive outcomes. RESULTS: After adjusting for covariates (age, sex, education), there were no significant associations between time-use composition and any volumetric outcomes. There were significant interactions between time-use composition and frontal lobe volume for long-term memory (p = 0.018) and executive function (p = 0.018), and between time-use composition and total grey matter volume for executive function (p = 0.028). Spending more time in moderate-vigorous PA was associated with better long-term memory scores, but only for those with smaller frontal lobe volume (below the sample mean). Conversely, spending more time in sleep and less time in sedentary behaviour was associated with better executive function in those with smaller total grey matter volume. CONCLUSIONS: Although 24-hour time use was not associated with total or regional grey matter independently, total grey matter and frontal lobe grey matter volume moderated the relationship between time-use composition and several cognitive outcomes. Future studies should investigate these relationships longitudinally to assess whether changes in time-use composition correspond to changes in grey matter volume and cognition.


Asunto(s)
Sustancia Gris , Imagen por Resonancia Magnética , Humanos , Masculino , Anciano , Persona de Mediana Edad , Sustancia Gris/diagnóstico por imagen , Sustancia Gris/patología , Estudios Transversales , Imagen por Resonancia Magnética/métodos , Australia , Cognición/fisiología
3.
Infant Behav Dev ; 72: 101860, 2023 08.
Artículo en Inglés | MEDLINE | ID: mdl-37478500

RESUMEN

PURPOSE: Mother-infant interactions during the first year of life are crucial to healthy infant development. The infant-directed speech (IDS), and specifically pitch contours, used by mothers during interactions are associated with infant language and social development. However, little research has examined pitch contours towards infants with socio-communication and language differences, such as those displaying early signs of autism spectrum disorder (autism). This study aimed to explore the association of infant autism signs and pitch contours used by mothers with their 12-month-old infants. METHOD: Mother-infant dyads (n = 109) were recruited from the University of Newcastle BabyLab. Parent-infant dyads completed a 15-min interaction, from which a total of 36,128 pitch contours were measured and correlated with infant autism signs. Infant autism signs were assessed via parent-report (First Year Inventory; Reznick et al., 2007). A subset of high-risk infants (admitted to a neonatal intensive care unit, n = 29) also received an observation-based assessment (Autism Detection in Early Childhood; Young & Nah, 2016). RESULTS: Mothers used fewer sinusoidal contours when they rated their infant as displaying more autism signs (rs = - .30, p = .004) and more autism-related sensory regulation issues (rs = - .31, p = .001). Mothers used fewer flat contours if their infant displayed more researcher-rated autism signs (r2 = - .39, p = .04). CONCLUSIONS: This study provides the early evidence that maternal pitch contours in IDS are related to early autism signs in infancy. If our findings are replicated in follow up studies where infants are followed to diagnosis, maternal IDS may be an important element of future early intervention protocols that focus on communication for infants with risk for autism.


Asunto(s)
Trastorno del Espectro Autista , Trastorno Autístico , Recién Nacido , Femenino , Niño , Lactante , Humanos , Preescolar , Habla , Trastorno Autístico/diagnóstico , Trastorno del Espectro Autista/diagnóstico , Madres , Relaciones Madre-Hijo
5.
Psychophysiology ; 60(7): e14241, 2023 07.
Artículo en Inglés | MEDLINE | ID: mdl-36633198

RESUMEN

In this study, we implement joint modeling of behavioral and single-trial electroencephalography (EEG) data derived from a cued-trials task-switching paradigm to test the hypothesis that trial-by-trial adjustment of response criterion can be linked to changes in the event-related potentials (ERPs) elicited during the cue-target interval (CTI). Specifically, we assess whether ERP components associated with preparation to switch task and preparation of the relevant task are linked to a response criterion parameter derived from a simple diffusion decision model (DDM). Joint modeling frameworks characterize the brain-behavior link by simultaneously modeling behavioral and neural data and implementing a linking function to bind these two submodels. We examined three joint models: The first characterized the core link between EEG and criterion, the second added a switch preparation input parameter and the third also added a task preparation input parameter. The criterion-EEG link was strongest just before target onset. Inclusion of switch and task preparation parameters did not improve the performance of the criterion-EEG link but was necessary to accurately model the ERP waveform morphology. While we successfully jointly modeled latent model parameters and EEG data from a task-switching paradigm, these findings show that customized cognitive models are needed that are tailored to the multiple cognitive control processes underlying task-switching performance. This is the first paper to implement joint modeling of behavioral measures and single-trial electroencephalography (EEG) data derived from the cue-target interval in a cued-trials task-switching paradigm. Model hyperparameters showed a strong link between response criterion and the pre-target negativity amplitude. Additional parameters (switch preparation, task preparation) were necessary to model the cue-locked ERP waveform morphology. This is consistent with multiple cognitive control processes underlying proactive control and points to the need for more nuanced models of task-switching performance.


Asunto(s)
Electroencefalografía , Potenciales Evocados , Humanos , Potenciales Evocados/fisiología , Encéfalo/fisiología , Señales (Psicología) , Tiempo de Reacción , Desempeño Psicomotor
6.
Front Hum Neurosci ; 16: 1051793, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-36504624

RESUMEN

Introduction: Physical activity, sedentary behaviour and sleep are associated with cognitive function in older adults. However, these behaviours are not independent, but instead make up exclusive and exhaustive components of the 24-h day. Few studies have investigated associations between 24-h time-use composition and cognitive function in older adults. Of these, none have considered how the quality of sleep, or the context of physical activity and sedentary behaviour may impact these relationships. This study aims to understand how 24-h time-use composition is associated with cognitive function across a range of domains in healthy older adults, and whether the level of recreational physical activity, amount of television (TV) watching, or the quality of sleep impact these potential associations. Methods: 384 healthy older adults (age 65.5 ± 3.0 years, 68% female, 63% non-smokers, mean education = 16.5 ± 3.2 years) participated in this study across two Australian sites (Adelaide, n = 207; Newcastle, n = 177). Twenty-four-hour time-use composition was captured using triaxial accelerometry, measured continuously across 7 days. Total time spent watching TV per day was used to capture the context of sedentary behaviours, whilst total time spent in recreational physical activity was used to capture the context of physical activity (i.e., recreational accumulation of physical activity vs. other contexts). Sleep quality was measured using a single item extracted from the Pittsburgh Sleep Quality Index. Cognitive function was measured using a global cognition index (Addenbrooke's Cognitive Examination III) and four cognitive domain composite scores (derived from five tests of the Cambridge Neuropsychological Test Automated Battery: Paired Associates Learning; One Touch Stockings of Cambridge; Multitasking; Reaction Time; Verbal Recognition Memory). Pairwise correlations were used to describe independent relationships between time use variables and cognitive outcomes. Then, compositional data analysis regression methods were used to quantify associations between cognition and 24-h time-use composition. Results: After adjusting for covariates and false discovery rate there were no significant associations between time-use composition and global cognition, long-term memory, short-term memory, executive function, or processing speed outcomes, and no significant interactions between TV watching time, recreational physical activity engagement or sleep quality and time-use composition for any cognitive outcomes. Discussion: The findings highlight the importance of considering all activities across the 24-h day against cognitive function in older adults. Future studies should consider investigating these relationships longitudinally to uncover temporal effects.

7.
Exp Gerontol ; 169: 111971, 2022 11.
Artículo en Inglés | MEDLINE | ID: mdl-36191833

RESUMEN

People's perceptions of the mental effort required for everyday activities may drive variation in the relationships between lifestyles and cognitive ability. We asked n = 259 healthy older adults aged 60 to 70 years (90 males, 169 females) to provide a rating of the Perceived Mental Effort (PME) for each activity instance they recalled over a 48-h period as part of a time-use recall. PME was rated on a 9-point scale from "very, very low" (score of 1) to "very, very high" (score of 9). Across the entire sample, participants rated a total of 196 different activities and 17,433 activity instances. The mean PME for individual activities was 3.50 ± 1.58. PMEs varied significantly by activity domain, with highest ratings being for Work (5.48 ± 1.72) and the lowest for Self-Care (2.89 ± 0.98). In multivariate analyses, PME ratings were higher in males than females (+0.30), PMEs were higher later in the day, increased with task duration, and decreased with age (all p < 0.0001). Time-weighted average individual PMEs across the two days of recall ranged from 1.86 to 6.50, and were 0.3 units higher for males, but unrelated to age. Repeated intra-individual PME ratings for the same activity were very reliable (ICC = 0.995, mean absolute difference = 0.03 ± 0.17). PMEs show promise as a reliable measure of mental effort.


Asunto(s)
Cognición , Recuerdo Mental , Anciano , Femenino , Humanos , Masculino , Actividades Cotidianas , Envejecimiento , Persona de Mediana Edad
8.
BMJ Open ; 12(1): e047888, 2022 Jan 05.
Artículo en Inglés | MEDLINE | ID: mdl-34987038

RESUMEN

INTRODUCTION: Approximately 40% of late-life dementia may be prevented by addressing modifiable risk factors, including physical activity and diet. Yet, it is currently unknown how multiple lifestyle factors interact to influence cognition. The ACTIVate Study aims to (1) explore associations between 24-hour time-use and diet compositions with changes in cognition and brain function; and (2) identify duration of time-use behaviours and the dietary compositions to optimise cognition and brain function. METHODS AND ANALYSIS: This 3-year prospective longitudinal cohort study will recruit 448 adults aged 60-70 years across Adelaide and Newcastle, Australia. Time-use data will be collected through wrist-worn activity monitors and the Multimedia Activity Recall for Children and Adults. Dietary intake will be assessed using the Australian Eating Survey food frequency questionnaire. The primary outcome will be cognitive function, assessed using the Addenbrooke's Cognitive Examination-III. Secondary outcomes include structural and functional brain measures using MRI, cerebral arterial pulse measured with diffuse optical tomography, neuroplasticity using simultaneous transcranial magnetic stimulation and electroencephalography, and electrophysiological markers of cognitive control using event-related potential and time frequency analyses. Compositional data analysis, testing for interactions between time point and compositions, will assess longitudinal associations between dependent (cognition, brain function) and independent (time-use and diet compositions) variables. CONCLUSIONS: The ACTIVate Study will be the first to examine associations between time-use and diet compositions, cognition and brain function. Our findings will inform new avenues for multidomain interventions that may more effectively account for the co-dependence between activity and diet behaviours for dementia prevention. ETHICS AND DISSEMINATION: Ethics approval has been obtained from the University of South Australia's Human Research Ethics committee (202639). Findings will be disseminated through peer-reviewed manuscripts, conference presentations, targeted media releases and community engagement events. TRIAL REGISTRATION NUMBER: Australia New Zealand Clinical Trials Registry (ACTRN12619001659190).


Asunto(s)
Demencia , Dieta , Anciano , Australia , Demencia/prevención & control , Humanos , Estudios Longitudinales , Persona de Mediana Edad , Estudios Prospectivos
9.
J Asthma ; 59(10): 2091-2099, 2022 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-34641750

RESUMEN

OBJECTIVE: Maternal asthma often complicates pregnancy and is linked with poorer quality of life. Additionally, individuals with asthma are at an increased risk of depression and anxiety. We examined whether asthma during pregnancy is related to parenting stress in the first year postpartum and if this relationship varies with level of asthma control. METHODS: This cohort survey-based study included mothers with (n = 157) and without (n = 79) asthma. Mothers with asthma participated in this study following participation in a randomized controlled trial of a novel asthma management strategy during pregnancy. Mothers completed the Parenting Stress Index - Short Form during the first 12 months postpartum. Mothers with asthma also completed the Asthma Control Questionnaire. RESULTS: Parenting stress did not differ between mothers with and without asthma. Additionally, for mothers with asthma, there were no differences in levels of parenting stress based on asthma control. CONCLUSIONS: This study suggests that mothers with asthma are not at an increased risk for excessive parenting stress. However, due to response and sampling bias, levels of parenting stress in asthmatic mothers may be underreported in our sample.


Asunto(s)
Asma , Responsabilidad Parental , Asma/epidemiología , Femenino , Humanos , Periodo Posparto , Embarazo , Calidad de Vida , Estrés Psicológico/complicaciones , Estrés Psicológico/epidemiología
10.
Front Psychol ; 12: 713804, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-34690871

RESUMEN

Maternal asthma in pregnancy is associated with an increased risk of adverse perinatal outcomes. Adverse perinatal outcomes may result in poorer infant developmental outcomes, such as temperament and sensory difficulties. This study aimed to (1) assess differences in temperament and sensory features between infants born to mothers with and without asthma and (2) investigate differences in these infant behaviours as a function of maternal asthma severity and asthma control. Mothers completed the Carey Temperament Scales and the Sensory Profile 2 at either 6 weeks, 6 months, or 12 months postpartum. Overall, we observed no significant differences between infants born to mothers with and without asthma in their temperament or sensory features; scores in both domains fell within the normative range. More infants in the asthma group, however, were reported to be highly distractible. When compared with normative data, infants in both groups were reported to have poor predictability of biological functions and fewer infants engaged in low levels of sensory behaviours. Some infants were observed to experience difficulties with hyper-reactivity within several domains. Maternal asthma severity and control during pregnancy were not linked to significant differences between infant temperament and sensory features. The present findings indicate that infants born to mothers with asthma are not at an increased risk overall for temperament or sensory difficulties, compared to control infants. However, a subset of infants across both groups may be at risk for attention or sensory hyper-reactivity difficulties. Further research into the developmental outcomes of infants born to mothers with asthma is warranted.

11.
Front Neurol ; 12: 612177, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-34163417

RESUMEN

Background and Purpose: Altered executive functions and resting-state functional connectivity (rsFC) are common following a minor stroke or transient ischemic attack (TIA). However, the long-term persistence of these abnormalities is not well-studied. We investigated whether there were cognitive and rsFC differences between (a) controls and minor cerebrovascular event (CVE) patients and (b) between CVE patients with and without an imaging confirmed infarct (i.e., minor stroke and TIA, respectively) at an average of 3.8 years following their event. Methods: Structural and resting-state imaging and cognitive assessments including the Montreal Cognitive Assessment, the Trail Making Task and the National Institute of Health (NIH) Cognition Toolbox were conducted on 42 patients (minor stroke = 17, TIA = 25) and 20 healthy controls (total N = 62). Results: Controls performed better than patients on two measures of executive functioning (both p < 0.046) and had reduced rsFC between the frontoparietal and default mode networks (FPN and DMN, respectively; p = 0.035). No cognitive differences were found between minor stroke and TIA patients, however, rsFC differences were found within the FPN and the DMN (both p < 0.013). Specifically, increased connectivity within the FPN was associated with faster performance in the minor stroke group but not the TIA group (p = 0.047). Conclusions: These findings suggest that transient or relatively minor cerebrovascular events are associated with persistent disruption of functional connectivity of neural networks and cognitive performance. These findings suggest a need for novel interventions beyond secondary prevention to reduce the risk of persistent cognitive deficits.

12.
Hum Brain Mapp ; 42(14): 4643-4657, 2021 10 01.
Artículo en Inglés | MEDLINE | ID: mdl-34184803

RESUMEN

During task-switching paradigms, both event-related potentials and time-frequency analyses show switch and mixing effects at frontal and parietal sites. Switch and mixing effects are associated with increased power in broad frontoparietal networks, typically stronger in the theta band (~4-8 Hz). However, it is not yet known whether mixing and switch costs rely upon common or distinct networks. In this study, we examine proactive and reactive control networks linked to task switching and mixing effects, and whether strength of connectivity in these networks is associated with behavioural outcomes. Participants (n = 197) completed a cued-trials task-switching paradigm with concurrent electroencephalography, after substantial task practice to establish strong cue-stimulus-response representations. We used inter-site phase clustering, a measure of functional connectivity across electrode sites, to establish cross-site connectivity from a frontal and a parietal seed. Distinct theta networks were activated during proactive and reactive control periods. During the preparation interval, mixing effects were associated with connectivity from the frontal seed to parietal sites, and switch effects with connectivity from the parietal seed to occipital sites. Lateralised occipital connectivity was common to both switch and mixing effects. After target onset, frontal and parietal seeds showed a similar pattern of connectivity across trial types. These findings are consistent with distinct and common proactive control networks and common reactive networks in highly practised task-switching performers.


Asunto(s)
Corteza Cerebral/fisiología , Conectoma , Electroencefalografía , Función Ejecutiva/fisiología , Red Nerviosa/fisiología , Desempeño Psicomotor/fisiología , Ritmo Teta/fisiología , Adolescente , Adulto , Femenino , Humanos , Masculino , Adulto Joven
13.
Front Aging Neurosci ; 12: 245, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32848715

RESUMEN

Aging is associated with an increased prevalence of vascular health conditions that are linked to a disruption in the cerebral vasculature and white matter microstructural organization. In people with cardiovascular risk factors, increased cerebral arterial pulsatility is associated with poorer white matter microstructural organization and cognitive functioning. This study examines the relationship among arterial pulsatility, white matter microstructural organization, and cognitive ability in a healthy adult lifespan sample. One hundred and eighty-nine adults were divided into a younger adult (<50 years, n = 97) and older adult (>50 years, n = 92). The latter were further subdivided into two subgroups with (CV+, n = 25) and without (CV-, n = 67) cardiovascular risk factors. Arterial pulsatility was measured using cardiac-gated phase-contrast flow quantification sequence and three indexes of whole-brain white matter microstructural organization [i.e., fractional anisotropy (FA), radial diffusivity (RaD), mean diffusivity (MD)] were derived from diffusion-weighted imaging (DWI). Cognitive ability was assessed using global cognitive functioning (MoCA) and a measure of working memory [sensitivity (d') from a 2-back task]. Neither the whole group analysis nor the younger adult group showed an association between measures of arterial pulsatility, global white matter microstructural organization, and cognition. In older adults, higher MD and RaD were associated with increased arterial pulsatility and poorer working memory performance. The indirect pathway from arterial pulsatility to working memory performance via both MD and RaD measures was significant in this group. Interestingly, a comparison of CV+ and CV- subgroups showed that this mediating relationship was only evident in older adults with at least one CV risk factor. These findings are consistent with cardiovascular risk factors as underlying arterial, white matter, and cognitive decline in cognitively normal older adults.

15.
Res Dev Disabil ; 104: 103711, 2020 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-32599501

RESUMEN

BACKGROUND: Temperament is an important construct that shapes child development. Temperament is suggested to present differently in different groups, such as children with neurodevelopmental disorders. However, it is not known whether there are specific temperament features associated with Autism Spectrum Disorder (ASD). AIM: This systematic review aimed to synthesise extant literature to determine whether there are temperament features associated with ASD in infancy, toddlerhood and childhood. METHODS AND PROCEDURES: Following the PRISMA guidelines for systematic reviews, we searched PsycINFO, CINAHL, Academic Search Ultimate and ProQuest for all available articles from database conception until January 2020. The Joanna Briggs Institute Critical Appraisal checklists were used to assess the methodological quality of included articles. OUTCOMES AND RESULTS: Twenty-six articles met the selection criteria: (1) reported on the temperament of children (0-12 years of age) diagnosed with ASD, (2) peer-reviewed; and (3) published in English. Articles varied in overall methodological quality. Infants later diagnosed with ASD were found to more frequently be described as having 'easy' temperament features in early infancy, compared to typically developing infants and infants with developmental concerns but not ASD. Once diagnosed, children with ASD were reported to, as a group, display more negative affect, less extraversion and less effortful control than typically developing children. CONCLUSIONS AND IMPLICATIONS: The literature suggests that more challenging temperament features are associated with ASD in childhood, but less is known about within group variability. Overall, this review highlights the need for further investigation into the variability of temperament in children with ASD.


Asunto(s)
Trastorno del Espectro Autista , Trastornos del Neurodesarrollo , Niño , Desarrollo Infantil , Humanos , Lactante , Temperamento
16.
Front Neurol ; 11: 216, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32373041

RESUMEN

Background: Cognitive impairment following a minor stroke or transient ischemic attack (TIA) is common; however, due to diagnostic difficulties, the prevalence and underlying cause of impairment remain poorly defined. We compared cognition in patients after a minor stroke, TIA, or mimic event at three time points in the first year following the event. We examine whether cognitive impairment occurs following these events and whether this impairment differs based on the event type. Further, we measure whether these findings persist after controlling for age, education, and the presence of vascular risk factors and whether the presence of vascular risk factors, independent of event etiology, is associated with cognitive impairment. Lastly, we investigate whether increased stroke risk, as assessed by the ABCD2, is associated with reduced cognition. Methods: Medical information, a cognitive screening test, and a measure of executive functioning were collected from 613 patients (123 minor stroke, 175 TIA, and 315 mimics) using phone interviews at three time points in the first year following the event. Linear mixed models were used to determine the effect of event type, vascular risk factors, and predicted stroke risk on cognitive performance while controlling for confounders. Results: There was no relationship between event type and performance on either cognitive measure. When all confounders are controlled for, performance on the cognitive screening test was uniquely accounted for by the presence of heart failure, myocardial infarction, angina, and hypertension (all p < 0.047), whereas the measure of executive functioning was uniquely accounted for by the presence of hypertension and angina (all p < 0.032). Increased stroke risk also predicted performance on the cognitive screening test and the measure of executive functioning (all p < 0.002). Conclusions: Our findings indicate that cognitive impairment following a minor stroke or TIA may be attributed to the high prevalence of chronic vascular risk factors in these patients. This highlights the importance of long-term management of vascular risk factors beyond event recovery to reduce the risk of cognitive impairment. Increased stroke risk (i.e., ABCD2 score) was also associated with reduced cognition, suggesting that it may be helpful in signaling the need for further cognitive evaluation and intervention post-event.

17.
Psychophysiology ; 57(5): e13533, 2020 05.
Artículo en Inglés | MEDLINE | ID: mdl-31994736

RESUMEN

Event-related potentials (ERPs) and total time-frequency power analyses have shown that performance costs during task switching are related to differential preparation to switch tasks (switch cost) and repeat the same task (mixing cost) during both proactive control (cue-to-target interval; CTI) and reactive control (post-target). The time-frequency EEG signal is comprised of both phase-locked activity (associated with stimulus-specific processes) and nonphase-locked activity (represents processes thought to persist over longer timeframes and do not contribute to the average ERP). In the present study, we used a cued task-switching paradigm to examine whether phase-locked and nonphase-locked power are differentially modulated by switch and mixing effects in intervals associated with the need for proactive control (CTI) and reactive control (post-target interval). Phase-locked activity was observed in the theta and alpha bands, closely resembled that seen for total power, and was consistent with switch and mixing ERP positivities. Nonphase-locked analyses showed theta and alpha power effects for both switch and mixing effects early in the CTI and as well as more sustained alpha and beta activity around cue onset, and extending from mid-CTI into the post-target interval. Nonphase-locked activity in pretarget alpha and posttarget theta power were both correlated with response time mixing cost. These findings provide novel insight into phase-locked and nonphase-locked activity associated with switch and mixing costs that are not evident with ERP or total time-frequency analyses.


Asunto(s)
Ondas Encefálicas/fisiología , Potenciales Evocados/fisiología , Función Ejecutiva/fisiología , Desempeño Psicomotor/fisiología , Tiempo de Reacción/fisiología , Adolescente , Adulto , Señales (Psicología) , Femenino , Humanos , Masculino , Adulto Joven
18.
J Asthma ; 57(8): 829-841, 2020 08.
Artículo en Inglés | MEDLINE | ID: mdl-31148493

RESUMEN

Objective: We aimed to examine the prevalence and severity of psychological distress of women with asthma in both the prenatal and postnatal periods, and to determine whether asthmatic women with and without mental health problems differ in self-management, medications knowledge, and asthma symptoms.Methods: We assessed spirometry performance and asthma symptoms in 120 women (mean age 29.8 years) before 23 weeks gestation, as part of the Breathing for Life Trial (Trial ID: ACTRN12613000202763). Prenatal depression data was obtained from medical records. At 6 weeks postpartum, we assessed general health, self-reported asthma control, depression symptoms (with the Edinburgh Postnatal Depression Scale) and adaptive functioning (with the Achenbach System of Empirically Based Assessment scales).Results: Twenty percent of our sample reported having a current mental health diagnosis, 14% reported currently receiving mental health care, while 47% reported having received mental health care in the past (and may/may not have received a diagnosis). The sample scored high on the Aggressive Behavior, Avoidant Personality, and Attention Deficit/Hyperactivity scales. Poorer self-reported postnatal asthma control was strongly correlated with elevated somatic complaints, externalizing problems, antisocial personality problems, and greater withdrawal. Prenatal spirometry or asthma severity and control were largely not associated with measures of psychopathology.Conclusions: These findings indicate that pregnant women with asthma frequently report issues with psychopathology during the prenatal and postnatal periods, and that the subjective perception of asthma control may be more related to psychopathology than objective asthma measures. However, due to sample bias, these findings are likely to be understated.


Asunto(s)
Ansiedad/epidemiología , Asma/psicología , Depresión/epidemiología , Salud Materna/estadística & datos numéricos , Salud Mental/estadística & datos numéricos , Complicaciones del Embarazo/psicología , Adulto , Antiasmáticos/uso terapéutico , Ansiedad/diagnóstico , Ansiedad/psicología , Asma/diagnóstico , Asma/tratamiento farmacológico , Depresión/diagnóstico , Depresión/psicología , Femenino , Conocimientos, Actitudes y Práctica en Salud , Humanos , Periodo Posparto , Embarazo , Complicaciones del Embarazo/tratamiento farmacológico , Prevalencia , Escalas de Valoración Psiquiátrica/estadística & datos numéricos , Autoinforme/estadística & datos numéricos , Automanejo/psicología , Automanejo/estadística & datos numéricos , Índice de Severidad de la Enfermedad , Espirometría , Adulto Joven
19.
Neurorehabil Neural Repair ; 33(11): 943-950, 2019 11.
Artículo en Inglés | MEDLINE | ID: mdl-31660787

RESUMEN

Cognitive impairment is an important target for rehabilitation as it is common following stroke, is associated with reduced quality of life and interferes with motor and other types of recovery interventions. Cognitive function following stroke was identified as an important, but relatively neglected area during the first Stroke Recovery and Rehabilitation Roundtable (SRRR I), leading to a Cognition Working Group being convened as part of SRRR II. There is currently insufficient evidence to build consensus on specific approaches to cognitive rehabilitation. However, we present recommendations on the integration of cognitive assessments into stroke recovery studies generally and define priorities for ongoing and future research for stroke recovery and rehabilitation. A number of promising interventions are ready to be taken forward to trials to tackle the gap in evidence for cognitive rehabilitation. However, to accelerate progress requires that we coordinate efforts to tackle multiple gaps along the whole translational pathway.


Asunto(s)
Investigación Biomédica , Disfunción Cognitiva/rehabilitación , Consenso , Rehabilitación Neurológica , Guías de Práctica Clínica como Asunto , Accidente Cerebrovascular/terapia , Investigación Biomédica Traslacional , Investigación Biomédica/normas , Disfunción Cognitiva/etiología , Humanos , Rehabilitación Neurológica/métodos , Rehabilitación Neurológica/normas , Guías de Práctica Clínica como Asunto/normas , Accidente Cerebrovascular/complicaciones , Rehabilitación de Accidente Cerebrovascular/métodos , Rehabilitación de Accidente Cerebrovascular/normas , Investigación Biomédica Traslacional/normas
20.
Int J Stroke ; 14(8): 774-782, 2019 10.
Artículo en Inglés | MEDLINE | ID: mdl-31514685

RESUMEN

Cognitive impairment is an important target for rehabilitation as it is common following stroke, is associated with reduced quality of life and interferes with motor and other types of recovery interventions. Cognitive function following stroke was identified as an important, but relatively neglected area during the first Stroke Recovery and Rehabilitation Roundtable (SRRR I), leading to a Cognition Working Group being convened as part of SRRR II. There is currently insufficient evidence to build consensus on specific approaches to cognitive rehabilitation. However, we present recommendations on the integration of cognitive assessments into stroke recovery studies generally and define priorities for ongoing and future research for stroke recovery and rehabilitation. A number of promising interventions are ready to be taken forward to trials to tackle the gap in evidence for cognitive rehabilitation. However, to accelerate progress requires that we coordinate efforts to tackle multiple gaps along the whole translational pathway.


Asunto(s)
Cognición , Disfunción Cognitiva/terapia , Rehabilitación de Accidente Cerebrovascular , Accidente Cerebrovascular/terapia , Consenso , Testimonio de Experto , Humanos , Selección de Paciente , Calidad de Vida , Recuperación de la Función , Investigación en Rehabilitación , Investigación Biomédica Traslacional
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