Efficacy of an eHealth self-management program in reducing irritable bowel syndrome symptom severity: a randomized controlled trial.

This study aimed to verify whether an eHealth-based self-management program can reduce irritable bowel syndrome (IBS) symptom severity. An open-label simple randomized controlled trial was conducted that compared an intervention group (n = 21) participating in an eHealth self-management program, which involved studying IBS-related information from an established self-help guide followed by in-built quizzes, with a treatment-as-usual group (n = 19) that, except for pharmacotherapy, had no treatment restrictions. Participants were female Japanese university students. The eHealth group received unlimited access to the self-management program for 8 weeks on computers and mobile devices. The primary outcome, participants' severity of IBS symptoms assessed using the IBS-severity index (IBS-SI), and the secondary outcomes of participants' quality of life, gut bacteria, and electroencephalography alpha and beta power percentages were measured at baseline and 8 weeks. A significant difference was found in the net change in IBS-SI scores between the eHealth and treatment-as-usual groups, and the former had significantly lower IBS-SI scores following the 8-week intervention than at baseline. Moreover, there was a significant difference in the net change in phylum Cyanobacteria between the eHealth and treatment-as-usual groups. Thus, the eHealth-based self-management program successfully reduced the severity of IBS symptoms.

A Method of Generating a Classifier that Determines the Presence or Absence of IBS Symptoms by Supervised Learning from the Frequency Analysis of Electroencephalogram Data.

BACKGROUND: Young adults with irritable bowel syndrome (IBS) occasionally exhibit specific abdominal symptoms, including abdominal pain associated with brain activity patterns. Decoded neural feedback (DecNef) is a biofeedback exercise that allows symptomatic people to exercise self-control over their brain activity patterns relative to those without symptoms. Thus, DecNef can be used to self-control abdominal pain in patients with IBS. To establish a DecNef practice for IBS, it is necessary to develop a classifier that can distinguish the electroencephalography (EEG) patterns (EEG signatures) of IBS between symptomatic and healthy people. Additionally, the accuracy of the "classifier" must be evaluated. METHODS: This study analyzed EEG data obtained from symptomatic and asymptomatic young adults with IBS to develop a support vector machine-based IBS classifier and verify its usefulness. EEG data were recorded for 28 university students with IBS and 24 without IBS. EEG data were frequency-analyzed by fast Fourier transform analysis, and IBS classifiers were created by supervised learning using a support vector machine. RESULTS: The diagnostic accuracy of IBS symptoms was verified for the whole brain and the frontal, parietal, and occipital regions. We estimated >90% accuracy of the IBS classifier in the whole brain and frontal region. CONCLUSIONS: The results of this study suggest that EEG data can be used to determine the presence or absence of IBS symptoms. With the IBS classifier, EEG may help provide feedback regarding the presence or absence of symptoms to patients, which is the basis for developing self-management strategies for IBS.

A Cross-sectional Study of Attention Bias for Facial Expression Stimulation in Patients with Stroke at the Convalescence Stage.

BACKGROUND: Post-stroke depression increases the likelihood of adverse physical symptoms. Attentional bias (AB) for negative stimuli is important in depression onset, maintenance, and remission. Stroke is more likely in older adults, who can have reduced cognitive function. Individuals with mild cognitive impairment (MCI) can have delayed reaction times (RTs). We hypothesized that RT to select neutral facial expression is affected by depressive symptoms and cognitive function in patients with stroke. METHODS: This study analyzed 61 patients with stroke. Beck Depression Inventory-Second Edition (BDI-II) and Profile of Mood States (short version) scores were determined. Task stimuli comprised eight pairs of facial expressions containing affective (angry) and neutral faces. AB was measured as the RT to select the neutral face in two simultaneously presented images using attention bias modification (ABM) software. Patients were grouped according to depressive symptoms using BDI-II scores. Between-subject factors of depressive symptoms and cognitive function were determined by ANCOVA. RESULTS: No significant interaction was found between depressive symptoms and cognitive function on RT. There was a main effect of cognitive function, but not depressive symptoms. In patients with hemiparesis and depressive symptoms, RT was significantly shorter in patients without MCI compared with patients with MCI. CONCLUSIONS: People with stroke and elevated depression symptoms with hemiparesis but without MCI quickly selected neutral facial expressions from neutral and aversive expressions, and thus do not need ABM to escape aversive stimuli. ABM in response to aversive stimuli may be useful in evaluating negative emotions in individuals with post-stroke depression without MCI.

Correction: The effects of locomotor activity on gastrointestinal symptoms of irritable bowel syndrome among younger people: An observational study.

[This corrects the article DOI: 10.1371/journal.pone.0234089.].

The effects of locomotor activity on gastrointestinal symptoms of irritable bowel syndrome among younger people: An observational study.

Irritable bowel syndrome (IBS) is a common bowel disorder that manifests as unexplained abdominal pain or discomfort and bowel habit changes in the form of diarrhea, constipation, or alternating patterns of the two. Some evidences demonstrate that increased physical activity improves IBS symptoms. Hence, daily exercise is recommended in these patients. In this study, we aimed to investigate the relationship between physical activity and gastrointestinal symptoms in 101 university students (female = 78) with IBS. Participants were examined by Gastrointestinal Symptoms Rating Scale (GSRS), and gait steps were measured for 1 week using a pedometer. The association between the GSRS score and pedometer counts was determined by ordinal logistic modeling analysis. The ordinal logistic regression model for GSRS and locomotor activity showed a significant stepwise fit (z = -3.05, p = 0.002). The logistic curve separated GSRS score of 5 points (moderately severe discomfort) from 2 points (minor discomfort) by locomotor activity. The probability for daily locomotor activity to discriminate between 5 and 4 points of GSRS (i.e., likely to have reverse symptoms) decreased in accordance with increment of steps per day: 78% probability for 4000 steps, 70% probability for 6000 steps, 59% probability for 8000 steps, and 48% probability for 10000 steps. This study demonstrated that the severity of GSRS is associated with the amount of walking in younger people with IBS. These results may be used as a measure to determine the daily step count to reduce the severity of gastrointestinal symptoms in individuals with IBS.

Anxiety, fatigue, and attentional bias toward threat in patients with hematopoietic tumors.

Cancer patients with hematopoietic tumors exhibit particularly high rates of anxiety disorders and depression, and often develop negative affect. In addition, psychological problems experienced by cancer patients impair their quality of life. When cancer patients feel anxious, they tend to direct their attention toward stimuli associated with threat in the surrounding environment. If attentional bias occurs in patients with hematopoietic tumors, who are at particular risk of developing negative affect, resolution of the bias could be useful in alleviating their anxiety. The current study examined the association between attentional bias and negative affect in patients with hematopoietic tumors and tested the hypothesis that negative affect would be more severe in those who exhibited greater attentional bias. Twenty-seven patients with hematopoietic tumors participated in the study. Reaction time (RT) was measured as the time between the presentation of the threatening and neutral images, and the subject's button press to indicate choice (neutral expressions). Eight combinations of "threatening" expressions with high emotional valence and "neutral" expressions with low emotional valence were presented. The images used to measure attentional bias were taken from the Japanese Female Facial Expression Database and had been rated as expressive of anger, sadness, or neutrality, with predetermined emotional valence. Psychological testing was performed with the Profile of Mood States (POMS). To examine the association between attentional bias and negative affect, we calculated Spearman's rank correlation coefficients for RTs and POMS. Subjects' mean RT was 882.9 (SD = 100.9) ms, and 19 of the 27 subjects exhibited slower RTs relative to healthy individuals. RT was significantly positively correlated with Tension-Anxiety (r = .679, p < .01) and Fatigue (r = .585, p < .01) subscale scores. The results of the study suggested that attentional bias toward threatening expressions could be positively correlated with the mental intensity of anxiety and fatigue in patients with hematopoietic tumors.