Breathing Right or Left! The Effects of Unilateral Nostril Breathing on Psychological and Cognitive Wellbeing: A Pilot Study.

The impact of controlled breathing on cognitive and affective processing has been recognized since ancient times, giving rise to multiple practices aimed at achieving different psychophysical states, mostly related to mental clarity and focus, stress reduction, and relaxation. Previous scientific research explored the effects of forced unilateral nostril breathing (UNB) on brain activity and emotional and cognitive functions. Some evidence concluded that it had a contralateral effect, while other studies presented controversial results, making it difficult to come to an unambiguous interpretation. Also, a few studies specifically addressed wellbeing. In the present study, we invited a pilot sample of 20 participants to take part in an 8-day training program for breathing, and each person was assigned to either a unilateral right nostril (URNB) or left nostril breathing condition (ULNB). Then, each day, we assessed the participants' wellbeing indices using their moods and mind wandering scales. The results revealed that, after the daily practice, both groups reported improved wellbeing perception. However, the effect was specifically related to the nostril involved. URNB produced more benefits in terms of stress reduction and relaxation, while ULNB significantly and increasingly reduced mind-wandering occurrences over time. Our results suggest that UNB can be effectively used to increase wellbeing in the general population. Additionally, they support the idea that understanding the effects of unilateral breathing on wellbeing and cognition requires a complex interpretive model with multiple brain networks to address bottom-up and top-down processes.

BCI Applications to Creativity: Review and Future Directions, from little-c to C2.

BCI devices are increasingly being used to create interactive interfaces between users and their own psychophysiological signals. Over the years, these systems have seen strong development as they can enable people with limited mobility to make certain decisions to alter their environment. Additionally, their portability and ease of use have allowed a field of research to flourish for the study of cognitive and emotional processes in natural settings. The study of creativity, especially little creativity (little-c), is one example, although the results of this cutting-edge research are often poorly systematized. The purpose of the present paper, therefore, was to conduct a scoping review to describe and systematize the various studies that have been conducted on the application potential of BCI to the field of creativity. Twenty-two papers were selected that collect information on different aspects of creativity, including clinical applications; art experience in settings with high ecological validity; BCI for creative content creation, and participants' engagement. Critical issues and potentialities of this promising area of study are also presented. Implications for future developments towards multi-brain creativity settings and C2 are discussed.

Nicotine-Free E-Cigarettes Might Promote Tobacco Smoking Reduction Better Than Nicotine Delivery Devices: Results of a Double-Blind Randomized Controlled Trial at 1 Year.

The purpose of the present study was to determine whether the use of e-cigarettes to aid in quitting contributed to the increase in the pulmonary health of chronic smokers. The efficacy of e-cigarettes to support a successful smoking cessation attempt was also investigated. A total of 210 smokers (78 women) were enrolled in a screening program for the early detection of lung cancer and distributed in three arms: nicotine e-cigarette plus support, nicotine-free e-cigarette plus support, and support. Results showed that participants in the nicotine e-cigarette arm had a significant and fast decrease in daily cigarettes, but that later they resume smoking more than the other two groups. Conversely, participants in the other two arms showed similar daily consumption at the two evaluation points. Among abstinent participants, only 12.5% reported cough, while 48% of current smokers had pulmonary symptoms. Our study suggests that, in the long run, the use of a nicotine-free liquid may favor reducing smoking and could be considered a good option in a clinical setting.

Using Neurofeedback to Restore Inter-Hemispheric Imbalance: A Study Protocol for Adults With Dyslexia.

Neurofunctional models of developmental dyslexia (DD) point out disruption of the left-lateralized reading network. In individuals with DD, the left temporo-parietal (TP) regions are underactivated during reading tasks and a dysfunctional activation of the contralateral regions is reported. After a successful reading intervention, left TP lateralization was found to be increased in children with DD. Previous studies measured the effect of modulating the excitability of the left TP cortex using non-invasive brain stimulation (NIBS) in individuals with reading difficulties, showing significant reading improvements. NIBS exclusion criteria and safety guidelines may limit its application in settings without medical supervision and in younger populations. Neurofeedback (NF) training could be an alternative intervention method for modulating the inter-hemispheric balance of the temporal-parietal regions in DD. To date, the effect of NF on reading has been scarcely investigated. Few protocols increasing beta activity in underactivated areas showed improved reading outcomes. However, none of the previous studies designed the NF intervention based on a neurofunctional model of DD. We aim to propose a study protocol for testing the efficacy of a NF training specifically designed for inducing a functional hemispheric imbalance of the tempo-parietal regions in adults with DD. A randomized clinical trial aimed at comparing two experimental conditions is described: (a) Enhancing left beta/theta power ratio NF training in combination with reducing right beta/theta power ratio NF training and (b) sham NF training. Clinical Trial Registration: www.ClinicalTrials.gov, identifier [NCT04989088].

Psychological and Behavioral Correlates of Readiness to Stop Smoking.

Accruing evidence strongly suggests that the motivation to give up smoking is a crucial predictor of tobacco cessation attempt. However, even motivated people often fail in their attempts and relapse is very common, even if most people who smoke are confident that the desire to quit is enough to change and maintain abstinence. According to this framework, the main objective of the current study was to identify psychological and lifestyle patterns that might characterize people who smoke cigarettes with different motivations to quit. A secondary aim was to compare the characteristics of people who are currently smoking with people who stopped or never smoked. A convenient sample of 360 volunteers (179 women, 181 men), with a mean age of 55 years (SD = 14.33), participated in this study. Participants completed a battery of psychological and behavioral scales aimed at assessing psychological characteristics as well as dependence level and readiness to stop. Our results strongly suggest that the behavior of people who smoke differs as a function of specific psychological variables. People who currently smoke may fall into two different clusters: In the first one, they have a healthy lifestyle and high self-perceived vitality and vigor, whereas those who fall in the second report lower psychological well-being and an unhealthier lifestyle. Unfortunately, the actual lifestyle does not seem to modulate the motivation to quit, and consequently, people keep on smoking anyway, although some participants tend to adopt compensative behaviors. However, the adoption of a healthier lifestyle might favor a successful cessation attempt once a ready-to-stop motivation level is achieved.

Gender Differences and Unfairness Processing during Economic and Moral Decision-Making: A fNIRS Study.

Decisional conflicts have been investigated with social decision-making tasks, which represent good models to elicit social and emotional dynamics, including fairness perception. To explore these issues, we created two modified versions of the UG framed within an economic vs. a moral context that included two kinds of unfair offers: advantageous (upside, U) or disadvantageous (downside, D) from the responder's perspective, and vice-versa for the proponent. The hemodynamic activity of 36 participants, 20 females and 16 males, was continuously recorded with fNIRS to investigate the presence of general or specific circuits between the different experimental conditions. Results showed that disadvantageous offers (D) are associated with an increased widespread cortical activation. Furthermore, we found that advantageous moral choices at the expense of others (U) were related to the activation of the right prefrontal cortex. Finally, we found gender-related differences in brain activations in the different frameworks. In particular, the DLPFC was recruited by females during the economic task, and by males during the moral frame. In conclusion, the present study confirmed and expanded previous data about the role of the prefrontal cortices in decision-making, suggesting the need for further studies to understand better the different prefrontal networks serving moral and economic decisions also considering gender-related differences.

Benefits of e-cigarettes in smoking reduction and in pulmonary health among chronic smokers undergoing a lung cancer screening program at 6 months.

INTRODUCTION: Electronic cigarettes (e-cigarettes) might be a valid and safe device to support smoking cessation. However, the available evidence is divergent. The aim of the present work was to assess the effects of an e-cigarette program on pulmonary health (cough, breath shortness, catarrh) and to evaluate the effectiveness of e-cigarettes in reducing tobacco consumption. METHODS: The study is a double-blind randomized controlled trial. Two hundred and ten smokers were randomized into three groups: nicotine e-cigarette (8 mg/mL nicotine concentration), nicotine-free e-cigarettes (placebo), and control with 1:1:1 ratio. All participants received a 3 months cessation program that included a cognitive-behavioral intervention aimed at supporting people in changing their behavior and improving motivation to quit. RESULTS: Pulmonary health, assessed with self-reported measures, clinical evaluations and the Leicester Cough Questionnaire, improved in participants who stopped smoking compared to their own baseline. No differences in pulmonary health were found between groups. Statistical tests showed a significant effect of Group (F (2, 118) = 4.005, p < .020) on daily cigarette consumption: after 6 months participants in the nicotine e-cigarette group smoked fewer cigarettes than any other group. Moreover, participants in this group showed the lowest level of exhaled carbon monoxide (CO) (M = 12.012, S.D. = 8.130), and the lowest level of dependence (M = 3.12, S.D. = 2.29) compared to the nicotine-free e-cigarette and control conditions. CONCLUSIONS: After 6 months about 20% of the entire sample stopped smoking. Participants who used e-cigarettes with nicotine smoked fewer tobacco cigarettes than any other group after 6 months (p < .020). Our data add to the efficacy and safety of e-cigarettes in helping smokers reducing tobacco consumption and improving pulmonary health status.

The Attentional Bias in Current and Former Smokers.

Attentional bias has been defined as the propensity of a person to allocate selective attention automatically to salient cues (Field and Powell, 2007). In the case of smoking, this bias implies that smokers are implicitly attracted by smoking-related stimuli, which produce behavioral, memory, and emotional effects (Volkow et al., 2006; Giardini et al., 2009). In more detail, scientific evidence pointed out that smoking is strongly supported by attentional bias that activates craving and urgency to smoke a cigarette. However, poor and conflicting data are available regarding the role of this cognitive bias on former smokers. The main aim of this study is to explore the occurrence of the attentional bias on of both current and former smokers, also with the aim to identify associations with behavioral, psychological and cognitive characteristic of participants. We collected data on 245 current, volunteers (male 50.6%; female 49.4%) aged 54.81 (SD = 14.352, range = 18-63), divided in current smokers (98), former smokers (102) and non-smokers (45). A combination of neuropsychology tests (Emotional Smoke Stroop Task and Go/no-Go task), and standardized questionnaires [Behavioral Inhibition System-Behavioral Approach System (BIS-BAS), Fagerström Test for Nicotine Dependence (FTND), Barratt Impulsiveness Scale, Motivational questionnaire] were used to assess the attentional bias, psychological variables, and smoking-related characteristics. Responses at the Emotional Smoke Stroop task revealed that current and former smokers are actually slower than non-smokers are when facing smoking cues, while performances at other Stroop conditions and at the Go/no-Go task are not statistically different. These results confirmed the occurrence of the attentional bias in current smokers, and above all points out that the same effect is present in former smokers. We found only small and selective correlations between attentional bias and psychological variables (e.g., impulsiveness and inhibition). In particular, impulsivity is not directly associated with the AB intensity. Also, smoking characteristics (e.g., years of smoking and dependence level) and the length of the period of abstinence do not seem to modulate implicit cognition of smoking cue. Our data support the idea that the attentional bias may be considered relevant in sustaining smoking and favoring relapse.

E-cigarettes May Support Smokers With High Smoking-Related Risk Awareness to Stop Smoking in the Short Run: Preliminary Results by Randomized Controlled Trial.

Introduction: E-cigarettes may be positively used in tobacco cessation treatments. However, neither the World Health Organization nor the American Food and Drug Administration has recognized them as effective cessation aids. Data about the efficacy and safety of e-cigarettes are still limited and controversial. Methods: This was a double-blind randomized controlled study. The main focus of this article is on a secondary outcome of the study, that is, the assessment of effectiveness and safety of e-cigarettes in achieving smoking cessation in a group of chronic smokers voluntarily involved in long-term lung cancer screening. Participants were randomized into three arms with a 1:1:1 ratio: e-cigarettes (Arm 1), placebo (Arm 2), and control (Arm 3). All subjects also received a low-intensity counseling. Results: Two hundred ten smokers were randomized (70 to nicotine e-cigarettes, 70 nicotine-free placebo e-cigarettes, and 70 to control groups). About 25% of participants who followed a cessation program based on the use of e-cigarettes (Arm 1 and Arm 2) were abstinent after 3 months. Conversely, only about 10% of smokers in Arm 3 stopped. A Kruskal-Wallis test showed significant differences in daily cigarettes smoking across the three arms (K-W = 6.277, p = .043). In particular, participants in Arm 1 reported a higher reduction rate (M = -11.6441, SD = 7.574) than participants in Arm 2 (M = -10.7636, SD = 8.156) and Arm 3 (M = -9.1379, SD = 8.8127). Conclusions: Our findings support the efficacy and safety of e-cigarettes in a short-term period. E-cigarettes use led to a higher cessation rate. Furthermore, although all participants reported a significant reduction of daily cigarette consumption compared to the baseline, the use of e-cigarettes (including those without nicotine) allowed smokers to achieve better results. Implications: E-cigarettes increased the stopping rate as well as the reduction of daily cigarettes in participants who continued smoking. In fact, although all participants reported a significant reduction of tobacco consumption compared to the baseline, the use of e-cigarettes allowed smokers to achieve a better result. It could be worthwhile to associate this device with new ICT-driven models of self-management support in order to enable people to better handle behavioral changes and side effects. This is true for ready-to-quit smokers (such as our participants) but can also be advantageous for less motivated smokers engaged in clinical settings.

Promoting Creativity Through Transcranial Direct Current Stimulation (tDCS). A Critical Review.

Creativity, meant as the ability to produce novel, original and suitable ideas, has received increased attention by research in the last years, especially from neuroaesthetics and social neuroscience. Besides the research conducted on the neural correlates of such capacities, previous work tried to answer the question of whether it is possible to enhance creativity through cognitive and neural stimulation. In particular, transcranial direct current stimulation (tDCS) has been applied to increase neuronal excitability in those areas related to creativity. However, being a complex construct that applies to a huge variety of situations, available results are often confusing and inconsistent. Thus, in the present critical review, after selecting original research articles investigating creativity with tDCS, results will be reviewed and framed according to the different effects of tDCS and its underlying mechanisms, which can be defined as follows: the promotion of self-focused attention; the disruption of inhibiting mechanisms; the enhancement of creative thinking; the promotion of artistic enactment. Finally, a theoretical perspective, the creative on/off model, will be provided to integrate the reported evidence with respect to both anatomical and functional issues and propose a cognitive explanation of the emergence of creative thinking.

Neuropsychiatric Burden in Huntington's Disease.

Huntington's disease is a disorder that results in motor, cognitive, and psychiatric problems. The symptoms often take different forms and the presence of disturbances of the psychic sphere reduces patients' autonomy and quality of life, also impacting patients' social life. It is estimated that a prevalence between 33% and 76% of the main psychiatric syndromes may arise in different phases of the disease, often in atypical form, even 20 years before the onset of chorea and dementia. We present a narrative review of the literature describing the main psychopathological patterns that may be found in Huntington's disease, searching for a related article in the main database sources (Medline, ISI Web of Knowledge, Scopus, and Medscape). Psychiatric conditions were classified into two main categories: affective and nonaffective disorders/symptoms; and anxiety and neuropsychiatric features such as apathy and irritability. Though the literature is extensive, it is not always convergent, probably due to the high heterogeneity of methods used. We summarize main papers for pathology and sample size, in order to present a synoptic vision of the argument. Since the association between Huntington's disease and psychiatric symptoms was demonstrated, we argue that the prevalent and more invalidating psychiatric components should be recognized as early as possible during the disease course in order to best address psychopharmacological therapy, improve quality of life, and also reduce burden on caregivers.

Helping patients to reduce tobacco consumption in oncology: a narrative review.

The present overview focuses on evidence of smoking cessation approaches in oncology settings with the aim to provide health personnel a critical perspective on how to help their patients. This narrative review is structured in two main sections: the first one describes the psycho-cognitive variables involved in the decision to continue smoking after a cancer diagnosis and during the treatment; the second section relates methods and tools may be recommended, being evidence-based, to support smoking cessation in oncology settings. Active smoking increases not only susceptibility to common cancers in the general population, but also increases disease severity and comorbidities in cancer patients. Nowadays, scientific evidence has identified many strategies to give up smoking, but a lack of knowledge exists for treatment of nicotine dependence in the cancer population. Health personnel is often ambiguous when approaching the problem, while their contribution is essential in guiding patients towards healthier choices. We argue that smoking treatments for cancer patients deserve more attention and that clinical features, individual characteristics and needs of the patient should be assessed in order to increase the attempts success rate. Health personnel that daily work and interact with cancer patients and their caregivers have a fundamental role in the promotion of the health changing. For this reason, it is important that they have adequate knowledge and resources in order to support cancer patients to stop tobacco cigarette smoking and promoting and healthier lifestyle.

Reversible Valproate Induced Pisa Syndrome and Parkinsonism in a Neuro-Oncology Patient with Depression and Epilepsy.

Neurological and psychiatric conditions frequently overlap in neuro-oncology. This overlapping negatively affects patients' quality of life and decreases the ability of providers to manage specific symptoms by therapy modulation, especially when psychopharmacotherapy needs to be prescribed. We describe here a patient with recurrent brain tumor, symptomatic epilepsy and depression who developed Pisa syndrome and parkinsonism after several months of valproic acid use. An accurate recognition of symptoms and treatment side effect allowed an appropriate clinical approach so as to rapidly improve both movement disorder and depression without increasing the risk of developing seizure. This has improved the autonomy and quality of life in a patient with poor prognosis.

Benefits of E-Cigarettes Among Heavy Smokers Undergoing a Lung Cancer Screening Program: Randomized Controlled Trial Protocol.

BACKGROUND: Smoking is a global public health problem. For this reason, experts have called smoking dependence a global epidemic. Over the past 5 years, sales of electronic cigarettes, or e-cigarettes, have been growing strongly in many countries. Yet there is only partial evidence that e-cigarettes are beneficial for smoking cessation. In particular, although it has been proven that nicotine replacement devices may help individuals stop smoking and tolerate withdrawal symptoms, e-cigarettes' power to increase the quitting success rate is still limited, ranging from 5% to 20% dependent on smokers' baseline conditions as shown by a recent Cochrane review. Consequently, it is urgent to know if e-cigarettes may have a higher success rate than other nicotine replacement methods and under what conditions. Furthermore, the effects of the therapeutic setting and the relationship between individual characteristics and the success rate have not been tested. This protocol is particularly innovative, because it aims to test the effectiveness of electronic devices in a screening program (the COSMOS II lung cancer prevention program at the European Institute of Oncology), where tobacco reduction is needed to lower individuals' lung cancer risks. OBJECTIVE: This protocol was designed with the primary aim of investigating the role of tobacco-free cigarettes in helping smokers improve lung health and either quit smoking or reduce their tobacco consumption. In particular, we aim to investigate the impact of a 3-month e-cigarettes program to reduce smoking-related respiratory symptoms (eg, dry cough, shortness of breath, mouth irritation, and phlegm) through reduced consumption of tobacco cigarettes. Furthermore, we evaluate the behavioral and psychological (eg, well-being, mood, and quality of life) effects of the treatment. METHODS: This is a prospective, randomized, placebo-controlled, double-blind, three-parallel group study. The study is organized as a nested randomized controlled study with 3 branches: a nicotine e-cigarettes group, a nicotine-free e-cigarettes group, and a control group. The study is nested in a screening program for early lung cancer detection in heavy smokers. RESULTS: The study is open and is still recruiting. CONCLUSIONS: Stopping or reducing tobacco consumption should be a main goal of any health organization. However, traditional antismoking programs are expensive and not always effective. Therefore, favoring a partial or complete shift to e-cigarettes in heavy smokers (eg, persons at high risk for a number of diseases) could be considered a moral imperative. However, before following this path, sound and reliable data on large samples and in a variety of contexts are required. TRIAL REGISTRATION: Clinicaltrials.gov NCT02422914; https://clinicaltrials.gov/ct2/show/NCT02422914 (Archived by WebCite at http://www.webcitation.org/6etwz1bPL).

Experiencing brain cancer: what physicians should know about patients.

UNLABELLED: During the last 20 years, numerous studies have highlighted the need to consider Quality of Life (QoL) issues in the treatment of brain cancer. However, gaps in scientific knowledge are still present as we have poor data surrounding the whole experience in patients and regarding their needs. The present study was aimed at evaluating QoL in brain cancer patients and correlated aspects. In particular, we aimed to assess QoL, mood state, and emotional issues in order to describe the patients' experience to find out the critical aspects involved. METHODS: We obtained data from 85 patients during chemotherapy treatment at the National Neurological Institute 'C. Besta' of Milan, Italy. We used standardised questionnaires to assess different aspects of patients' QoL. In particular, the functional assessment of cancer therapy-brain (FACT-Br) and the Hamilton scale were used. We also performed a semi-structured ad hoc interview in order to collect -narrative data about patients' experience. RESULTS: Our data depict a difficult adjustment process to the illness, even though positive elements emerged. Indeed, patients reported a satisfying self-perceived QoL, although specific concerns are still present. Further, even if many patients report depressive symptoms, only a minority have a severe condition. CONCLUSION: Brain cancer may heavily affect patients' QoL and well being. However, some element of the context may improve the -adjustment to the disease. In particular, we found that most patients found psychosocial resources to cope with cancer and that spiritual well being also seems to play a key role. These issues deserve further studies in order to obtain significant clinical recommendations.

Personal fable: optimistic bias in cigarette smokers.

BACKGROUND: Several empirical studies have shown the attitude of smokers to formulate judgments based on distortion in the risk perception. This alteration is produced by the activation of the optimistic bias characterized by a set of the unrealistic beliefs compared to the outcomes of their behavior. This bias exposes individuals to adopt lifestyles potentially dangerous for their health, underestimate the risks and overestimate the immediate positive effects. OBJECTIVES: This study aimed to analyze the relationship between optimistic bias and smoking habits. In particular, it was hypothesized that smokers develop optimistic illusions, able to facilitate the adoption and the maintenance over time of the unhealthy lifestyles, such as cigarette smoking, and the former smokers could acquire a belief system centered on own responsibility. PATIENTS AND METHODS: The samples (n = 633, female = 345, male = 288) composed of smokers (35.7%), ex-smokers (32.2%) and nonsmokers (32.1%). Each participant filled out two questionnaires including The Fagerström test and the motivational questionnaire as well as a set of items measured on a Likert scales to evaluate health beliefs. RESULTS: The results confirmed the presence of the optimistic bias in comparative judgments, and the attitude to overestimate the effectiveness of their preventive behaviors in the smokers. CONCLUSIONS: Cognitive bias in risk perception may influence health behaviors in negative way and reinforce cigarette smoking over the time. Future research should be conducted to identify the better strategies to overtake this cognitive bias to improve the quitting rate.