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1.
Psychol Med ; : 1-14, 2021 Nov 09.
Artigo em Inglês | MEDLINE | ID: mdl-34749836

RESUMO

BACKGROUND: Accumulating evidence suggests that alterations in inflammatory biomarkers are important in depression. However, previous meta-analyses disagree on these associations, and errors in data extraction may account for these discrepancies. METHODS: PubMed/MEDLINE, Embase, PsycINFO, and the Cochrane Library were searched from database inception to 14 January 2020. Meta-analyses of observational studies examining the association between depression and levels of tumor necrosis factor-α (TNF-α), interleukin 1-ß (IL-1ß), interleukin-6 (IL-6), and C-reactive protein (CRP) were eligible. Errors were classified as follows: incorrect sample sizes, incorrectly used standard deviation, incorrect participant inclusion, calculation error, or analysis with insufficient data. We determined their impact on the results after correction thereof. RESULTS: Errors were noted in 14 of the 15 meta-analyses included. Across 521 primary studies, 118 (22.6%) showed the following errors: incorrect sample sizes (20 studies, 16.9%), incorrect use of standard deviation (35 studies, 29.7%), incorrect participant inclusion (7 studies, 5.9%), calculation errors (33 studies, 28.0%), and analysis with insufficient data (23 studies, 19.5%). After correcting these errors, 11 (29.7%) out of 37 pooled effect sizes changed by a magnitude of more than 0.1, ranging from 0.11 to 1.15. The updated meta-analyses showed that elevated levels of TNF- α, IL-6, CRP, but not IL-1ß, are associated with depression. CONCLUSIONS: These findings show that data extraction errors in meta-analyses can impact findings. Efforts to reduce such errors are important in studies of the association between depression and peripheral inflammatory biomarkers, for which high heterogeneity and conflicting results have been continuously reported.

2.
Front Psychiatry ; 12: 636730, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34349676

RESUMO

Smartphones provide convenience in everyday life. Smartphones, however, can elicit adverse effects when used excessively. The purpose of this study was to examine the underlying neurobiological alterations that arise from problematic smartphone use. We performed resting state seed-based functional connectivity (FC) analysis of 44 problematic smartphone users and 54 healthy controls. This analysis assessed the salience, central executive, default mode, and affective networks. Compared to controls, problematic smartphone users showed enhanced FC within the salience network and between the salience and default mode network. Moreover, we observed decreased FC between the salience and central executive network in problematic smartphone users, compared to controls. These results imply that problematic smartphone use is associated with aberrant FC in key brain networks. Our results suggest that changes in FC of key networks centered around the salience network might be associated with problematic smartphone use.

3.
Sci Rep ; 11(1): 12105, 2021 06 08.
Artigo em Inglês | MEDLINE | ID: mdl-34103606

RESUMO

Cognitive complaints after chemotherapy are common in breast cancer patients, but the neural bases for these complaints remain unclear. This pilot study explored resting-state functional connectivity (FC) as a marker of subtle cognitive changes in breast cancer patients who experience cognitive complaints. Chemotherapy-treated (n = 20, at least 6 months off therapy) and untreated (n = 17, disease-control) female breast cancer patients with cognitive complaints and healthy controls (n = 20) were recruited. The FC of the right dorsolateral prefrontal cortex was calculated, and any correlations between this FC and neuropsychological assessments were determined. Chemotherapy-treated patients with cognitive complaints displayed increased FC between the right dorsolateral prefrontal cortex and both the contralateral cerebellar lobule VII and the cerebellar vermis XI, compared to the disease-control and healthy-control groups, despite unimpaired neuropsychological performance. The increased FC was negatively correlated with executive function and attention in breast cancer survivors with cognitive complaints. Our pilot study findings provide evidence that cerebellar-cortical FC changes may be a pathophysiological basis for chemotherapy-related cognitive complaints. In addition, the FC changes have the potential to reflect minor or compensated cognitive function impairment in breast cancer patients.


Assuntos
Antineoplásicos/farmacologia , Neoplasias da Mama/complicações , Neoplasias da Mama/fisiopatologia , Cerebelo/diagnóstico por imagem , Córtex Cerebral/diagnóstico por imagem , Transtornos Cognitivos/complicações , Adulto , Idoso , Idoso de 80 Anos ou mais , Mapeamento Encefálico , Sobreviventes de Câncer , Cerebelo/fisiopatologia , Córtex Cerebral/fisiopatologia , Cognição , Disfunção Cognitiva/fisiopatologia , Função Executiva/fisiologia , Feminino , Humanos , Imageamento por Ressonância Magnética , Pessoa de Meia-Idade , Vias Neurais/fisiopatologia , Testes Neuropsicológicos , Projetos Piloto , Córtex Pré-Frontal
4.
Addict Behav ; 116: 106823, 2021 05.
Artigo em Inglês | MEDLINE | ID: mdl-33460991

RESUMO

Many smartphone users spend excessive amounts of time online and cannot control their behavior, and the addictive overuse of social-networking services has been shown to be associated with diminished executive control. Attentional control is a cognitive process crucial to exerting executive functions. The purpose of this study was to investigate functional connectivity (FC) characteristics of attention networks in problematic social-network users. We performed seed-based resting-state FC analyses for 29 males and 10 females with excessive social network use and 32 healthy males and 17 healthy females. The right intraparietal sulcus and frontal eye fields were considered seeds of the dorsal attention network (DAN), and the right temporoparietal junction and ventral frontal cortex were considered seeds of the ventral attention network (VAN). Clinical characteristics predictive of FC findings in problematic social network users were identified through hierarchical multiple regression analysis. In FC analysis with DAN seeds, FC between the right intraparietal sulcus and the right middle occipital gyrus was stronger in problematic social network users than in controls, and FC between the right frontal eye field and the right dorsolateral prefrontal cortex was weaker than that in controls. There was no significant difference between the groups in FC analysis with VAN seeds. Hierarchical regression analyses showed that usage times on social networking platforms significantly predicted the negative effects on the strength of FC between the intraparietal sulcus and the dorsolateral prefrontal cortex. These findings indicated that problematic social network use reflects changes in the neural circuits underlying attentional control. Weaking of prefrontal control for attention networks would have a significant impact on failure to control one's time spent on social networks.


Assuntos
Imageamento por Ressonância Magnética , Lobo Parietal , Mapeamento Encefálico , Função Executiva , Feminino , Lobo Frontal , Humanos , Masculino , Lobo Parietal/diagnóstico por imagem , Rede Social
5.
Addict Biol ; 26(1): e12868, 2021 01.
Artigo em Inglês | MEDLINE | ID: mdl-31886611

RESUMO

Internet gaming disorder (IGD) is a behavioral addiction involving excessive online game use despite negative psychosocial consequences. Unrestricted online gaming may lead to changes in striatal activity and the relationship between the striatum and other cortical regions. This study investigated structural and functional abnormalities involving the striatum through longitudinal follow-up magnetic resonance imaging (MRI) assessments. Eighteen young males with IGD (mean age: 23.8 ± 2.0 years) and 18 controls (mean age: 23.9 ± 2.7 years) were evaluated. Subjects were reassessed ≥1 year after the first visit (mean follow-up duration: 22.8 ± 6.7 months), using voxel-based morphometry and seed-based resting-state functional connectivity (FC) analyses in seed regions of the dorsal and ventral striatum. Subjects with IGD had smaller gray matter volume (GMV) in the anterior/middle cingulate cortex compared with controls during initial and follow-up assessments. They exhibited decreased FC between the left dorsal putamen and left medial prefrontal cortex (mPFC) compared with controls. They exhibited increased FC strength between the right dorsal putamen and right middle occipital gyrus (MOG) during follow-up. Subjects with IGD showed a significant correlation between changes in the dorsal putamen-MOG FC and gaming time per day. Young males with IGD showed an altered FC pattern in the dorsal striatum during follow-up. FC of the dorsal striatum in IGD increased in the mPFC and decreased in the MOG. These findings showed that IGD was accompanied by weakening of prefrontal control and strengthening of the sensorimotor network, suggesting that uncontrolled gaming may be related with functional neural changes in the dorsal striatum.


Assuntos
Transtorno de Adição à Internet/diagnóstico por imagem , Imageamento por Ressonância Magnética , Estriado Ventral/diagnóstico por imagem , Adulto , Mapeamento Encefálico , Substância Cinzenta/diagnóstico por imagem , Humanos , Estudos Longitudinais , Masculino , Vias Neurais , Jogos de Vídeo/psicologia , Adulto Jovem
6.
Artigo em Inglês | MEDLINE | ID: mdl-33031858

RESUMO

OBJECTIVE: Recently, the addiction to online games, classified as Internet gaming disorder (IGD) on DSM-V, has emerged as an important mental health problem. The loss of control over gaming in IGD is associated with diminished cognitive control. This study aimed to link the neurobiological mechanism reflected by brain imaging and the diminished cognitive control reflected by heart rate variability (HRV) measurements during real-time gameplay. METHODS: HRV was assessed in 33 young males with IGD and 29 controls while playing their favorite games. Seed-based functional connectivity (FC) was evaluated in the dorsolateral prefrontal cortex, anterior cingulate cortex, and dorsal striatum. Associations between HRV and alterations in FC were tested. RESULTS: Individuals with IGD showed a reduction of high-frequency HRV during real-time gaming, which is correlated with self-reported severity of IGD. Subjects with IGD showed decreased FC between the right dorsolateral prefrontal cortex and the right inferior frontal gyrus, corresponding to the cognitive control network. They showed decreased FC between the right anterior cingulate cortex and the superior parietal lobule. They also showed increased FC between the left dorsal putamen and the postcentral gyrus, corresponding to the sensorimotor network. Game-related high-frequency HRV was correlated with dorsolateral prefrontal cortex-inferior frontal gyrus connectivity. CONCLUSION: The diminished cognitive control reflected by HRV measurements during real-time gameplay was associated with FC alterations, involving a weak FC in the cognitive control network. Individuals with IGD may have less cognitive control, particularly when playing games, and consequently end up playing games in a habitual manner rather than in a goal-oriented manner.

7.
J Behav Addict ; 9(3): 589-597, 2020 Oct 12.
Artigo em Inglês | MEDLINE | ID: mdl-32918802

RESUMO

Background and aims: The clinical significance of Internet gaming disorder (IGD) is spreading worldwide, but its underlying neural mechanism still remains unclear. Moreover, the prevalence of IGD seems to be the highest in adolescents whose brains are in development. This study investigated the functional connectivity between large-scale intrinsic networks including default mode network, executive control network, and salience network. We hypothesized that adolescents with IGD would demonstrate different functional connectivity patterns among large-scale intrinsic networks, implying neurodevelopmental alterations, which might be associated with executive dysfunction. Methods: This study included 17 male adolescents with Internet gaming disorder, and 18 age-matched male adolescents as healthy controls. Functional connectivity was examined using seed-to-voxel analysis and seed-to-seed analysis, with the nodes of large-scale intrinsic networks used as region of interests. Group independent component analysis was performed to investigate spatially independent network. Results: We identified aberrant functional connectivity of salience network and default mode network with the left posterior superior temporal sulcus (pSTS) in adolescents with IGD. Furthermore, functional connectivity between salience network and pSTS correlated with proneness to Internet addiction and self-reported cognitive problems. Independent component analysis revealed that pSTS was involved in social brain network. Discussion and conclusions: The results imply that aberrant functional connectivity of social brain network with default mode network and salience network was identified in IGD that may be associated with executive dysfunction. Our results suggest that inordinate social stimuli during excessive online gaming leads to altered connections among large-scale networks during neurodevelopment of adolescents.


Assuntos
Comportamento do Adolescente/fisiologia , Disfunção Cognitiva/fisiopatologia , Conectoma , Rede de Modo Padrão/fisiopatologia , Função Executiva/fisiologia , Transtorno de Adição à Internet/fisiopatologia , Rede Nervosa/fisiopatologia , Lobo Temporal/fisiopatologia , Adolescente , Disfunção Cognitiva/diagnóstico por imagem , Rede de Modo Padrão/diagnóstico por imagem , Humanos , Transtorno de Adição à Internet/diagnóstico por imagem , Imageamento por Ressonância Magnética , Masculino , Rede Nervosa/diagnóstico por imagem , Lobo Temporal/diagnóstico por imagem
8.
Psychiatry Res Neuroimaging ; 304: 111154, 2020 10 30.
Artigo em Inglês | MEDLINE | ID: mdl-32763759

RESUMO

Studies about social functioning in obsessive-compulsive disorder (OCD) are lacking, even though neuroimaging studies and metacognition evaluation results suggest abnormal neural responses during social interactions. This study examined neural responses of OCD patients during handshakes with a virtual avatar. Because of the nature of the handshaking task, we expected that OCD patients with predominantly contamination/washing symptoms (CON) would show different neural responses compared to healthy controls (HCs) and to disease-controlled (NCON) patients. Thirteen CON, 13 NCON, and 18 HC participants performed handshake tasks with clean or dirty virtual avatars while undergoing functional magnetic resonance imaging. During handshakes with a clean avatar, deactivation in the left anterior cingulate cortex was found in CON patients compared to NCON and HC subjects. This cortical deactivation also occurred with dirty-avatar handshakes, but the difference was significant only between the two OCD groups and HC patients. Deactivation in the left anterior cingulate cortex was correlated with both OCD symptom severity and social anxiety traits. This cortical deactivation in OCD, especially in CON patients, suggests that social dysfunction in OCD may be due to interactions between OCD symptoms and impairment in social cognition, including emotional processing.


Assuntos
Giro do Cíngulo/fisiopatologia , Transtorno Obsessivo-Compulsivo/fisiopatologia , Interação Social , Adulto , Emoções/fisiologia , Medo/fisiologia , Feminino , Giro do Cíngulo/diagnóstico por imagem , Humanos , Imageamento por Ressonância Magnética , Transtorno Obsessivo-Compulsivo/diagnóstico por imagem
9.
J Clin Sleep Med ; 16(11): 1871-1881, 2020 11 15.
Artigo em Inglês | MEDLINE | ID: mdl-32713419

RESUMO

STUDY OBJECTIVES: Social relationships are an understudied factor affecting insomnia. In particular, these effects have not been evaluated in the context of sex differences. In this study, we investigated differences between sexes with regard to the association between insomnia symptoms and social relationships. METHODS: We used data from 2681 middle-aged adults (aged 40-64 years; females, 68.8%) from the Cardiovascular and Metabolic Diseases Etiology Research Center project. Insomnia symptoms were defined as difficulty with sleep induction or maintenance ≥3 nights per week. We assessed social network size and bridging potentials as indicators of social relationships. Social network size is a quantitative measure of the size of social relationships, and bridging potential is a qualitative indicator of the diversity and independence of these relationships. Multivariate regression analysis controlling for confounding factors was performed to evaluate associations between social relationships and insomnia symptoms. RESULTS: Smaller social network size was significantly associated with sleep induction (adjusted odds ratio = 0.866, P = .015) and sleep maintenance (adjusted odds ratio = 0.862, P = .015) difficulties, but only in men. Poor bridging potential was also associated with sleep induction (adjusted odds ratio = 0.321, P = .024) and maintenance (adjusted odds ratio = 0.305, P = .031) difficulties only in men. For women, social relationship variables were not significantly associated with insomnia symptoms. CONCLUSIONS: The association between insomnia symptoms and social relationships varied by sex, as noted by statistical analyses accounting for covariates affecting insomnia symptoms. These results suggest that qualitative assessments of social relationship variables should be considered in clinical practice, since these variables can be interpreted differently for men and women.


Assuntos
Distúrbios do Início e da Manutenção do Sono , Adulto , Feminino , Humanos , Relações Interpessoais , Masculino , Pessoa de Meia-Idade , Razão de Chances , Caracteres Sexuais , Sono , Distúrbios do Início e da Manutenção do Sono/complicações , Distúrbios do Início e da Manutenção do Sono/epidemiologia
10.
Gen Hosp Psychiatry ; 66: 24-29, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32615333

RESUMO

OBJECTIVE: Insomnia is prevalent among dialysis patients and affects their mortality. Although cognitive behavioral therapy for insomnia (CBTi) is recommended, attending regular face-to-face CBTi sessions is a major challenge for patients. We evaluated the effectiveness of a self-directed computerized CBTi (cCBTi) in dialysis patients, and investigated changes in resting-state brain connectivity and inflammatory cytokines following cCBTi. METHOD: Thirty-five patients undergoing maintenance hemodialysis or peritoneal dialysis who had insomnia were screened for participation in the study, with 17 participants included in the final analyses. A self-directed cCBTi protocol accessed via tablet computer during dialysis or at home was developed and applied. Information about sleep, anxiety, depression, laboratory data, and resting-state functional magnetic resonance imaging data was obtained 3-5 days before and after cCBTi. RESULTS: cCBTi improved sleep quality, and this was correlated with increased resting-state brain connectivity between the default-mode network and the premotor/dorsolateral prefrontal cortex. The decrement of interleukin-1ß levels were correlated with improved sleep quality and increased brain connectivity after cCBTi. CONCLUSION: Our pilot study findings suggest that cCBTi is effective for dialysis patients with insomnia, and the therapeutic effects of cCBTi are related to changes in brain functional connectivity and inflammatory cytokines.


Assuntos
Terapia Cognitivo-Comportamental , Conectoma , Rede de Modo Padrão/fisiopatologia , Interleucina-1beta/sangue , Rede Nervosa/fisiopatologia , Diálise Renal , Distúrbios do Início e da Manutenção do Sono/sangue , Distúrbios do Início e da Manutenção do Sono/fisiopatologia , Distúrbios do Início e da Manutenção do Sono/terapia , Adulto , Rede de Modo Padrão/diagnóstico por imagem , Feminino , Humanos , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Rede Nervosa/diagnóstico por imagem , Projetos Piloto , Distúrbios do Início e da Manutenção do Sono/diagnóstico por imagem , Terapia Assistida por Computador
11.
Drug Saf ; 43(6): 539-547, 2020 06.
Artigo em Inglês | MEDLINE | ID: mdl-32034700

RESUMO

INTRODUCTION: Theoretically, benzodiazepines (BZDs) can narrow the iridocorneal angle and induce acute angle-closure glaucoma (AACG). However, little evidence exists regarding this association. OBJECTIVE: The objective of this study was to assess whether the use of BZDs is associated with the risk of AACG. METHODS: We conducted a population-based case-crossover study using the nationwide claims database of the National Health Insurance Service in Korea. Patients with newly diagnosed AACG-between 1 January 2013 and 31 December 2016-who had received at least one BZD prescription prior to AACG diagnosis were enrolled. The date of AACG diagnosis was set as the index date. We assessed BZD use by each patient during a 30-day case period prior to the index date and three consecutive control periods that preceded this date. We used conditional logistic regression that adjusted for concomitant medications to determine the odds ratio for the use of BZDs in the case period compared with that in the control period in patients with incident AACG. RESULTS: Of the 11,093 patients with incident AACG, 6709 received a prescription for BZD prior to diagnosis. BZD use was associated with an increased risk of AACG [adjusted odds ratio (aOR) = 1.40; 95% confidence interval (CI) 1.27-1.54]. AACG risk was similar for short-acting (aOR = 1.40, 95% CI 1.24-1.57) and long-acting BZDs (aOR = 1.33, 95% CI 1.18-1.50). CONCLUSION: We found that BZD use was associated with AACG risk in the Korean population. Clinicians should carefully monitor the occurrence of visual disturbance in BZD-treated patients.


Assuntos
Benzodiazepinas/efeitos adversos , Glaucoma de Ângulo Fechado/induzido quimicamente , Doença Aguda , Adulto , Idoso , Idoso de 80 Anos ou mais , Benzodiazepinas/administração & dosagem , Estudos Cross-Over , Bases de Dados Factuais/estatística & dados numéricos , Feminino , Glaucoma de Ângulo Fechado/epidemiologia , Humanos , Masculino , Pessoa de Meia-Idade , Programas Nacionais de Saúde , República da Coreia , Adulto Jovem
12.
Front Neurosci ; 13: 1183, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31736703

RESUMO

Cognitive control is essential for flexible, top-down, goal-directed behavior. Individuals with Internet gaming disorder (IGD) are characterized by impaired prefrontal cortex function and cognitive control. This results in an increase in stimulus-driven habitual behavior, particularly related to pathological gaming. In the present study, we investigated the electroencephalographic (EEG) activity in individuals with IGD. Twenty-four individuals with IGD and 35 healthy control (HC) subjects were recruited. We analyzed their EEG activity while the subjects played their favorite game (30-40 min duration). We compared the band power between the two groups. During gaming, the left frontal theta, alpha, and beta band activities were lower in subjects with IGD than in HCs. Moreover, the left frontal theta power negatively correlated with IGD severity. These results indicate that left frontal theta power could be used as a neurophysiological biomarker for the detection of diminished cognitive control patterns in individuals with IGD.

13.
PLoS One ; 14(11): e0225553, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31725798

RESUMO

[This corrects the article DOI: 10.1371/journal.pone.0211957.].

14.
J Behav Addict ; 8(3): 404-411, 2019 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-31545101

RESUMO

BACKGROUND AND AIMS: Smartphone use is becoming commonplace and exerting adequate control over smartphone use has become an important mental health issue. Little is known about the neurobiology underlying problematic smartphone use. We hypothesized that structural abnormalities in the fronto-cingulate brain region could be implicated in problematic smartphone use, similar to that has been reported for Internet gaming disorder and Internet addiction. This study investigated fronto-cingulate gray matter abnormalities in problematic smartphone users, particularly those who spend time on social networking platforms. METHODS: The study included 39 problematic smartphone users with excessive use of social networking platforms via smartphone and 49 normal control male and female smartphone users. We conducted voxel-based morphometric analysis with diffeomorphic anatomical registration using an exponentiated Lie algebra algorithm. Region of interest analysis was performed on the fronto-cingulate region to identify whether gray matter volume (GMV) differed between the two groups. RESULTS: Problematic smartphone users had significantly smaller GMV in the right lateral orbitofrontal cortex (OFC) than healthy controls, and there were significant negative correlations between GMV in the right lateral OFC and the Smartphone Addiction Proneness Scale (SAPS) score, including the SAPS tolerance subscale. CONCLUSIONS: These results suggest that lateral orbitofrontal gray matter abnormalities are implicated in problematic smartphone use, especially in social networking platform overuse. Small GMV in the lateral OFC was correlated with an increasing tendency to be immersed in smartphone use. Our results suggest that orbitofrontal gray matter abnormalities affect regulatory control over previously reinforced behaviors and may underlie problematic smartphone use.


Assuntos
Comportamento Aditivo/patologia , Comportamento Aditivo/fisiopatologia , Giro do Cíngulo/patologia , Córtex Pré-Frontal/patologia , Smartphone , Rede Social , Adolescente , Adulto , Comportamento Aditivo/diagnóstico por imagem , Feminino , Giro do Cíngulo/diagnóstico por imagem , Humanos , Imageamento por Ressonância Magnética , Masculino , Córtex Pré-Frontal/diagnóstico por imagem , Adulto Jovem
15.
JMIR Med Inform ; 7(3): e13139, 2019 Aug 30.
Artigo em Inglês | MEDLINE | ID: mdl-31471957

RESUMO

BACKGROUND: With the increase in the world's aging population, there is a growing need to prevent and predict dementia among the general population. The availability of national time-series health examination data in South Korea provides an opportunity to use deep learning algorithm, an artificial intelligence technology, to expedite the analysis of mass and sequential data. OBJECTIVE: This study aimed to compare the discriminative accuracy between a time-series deep learning algorithm and conventional statistical methods to predict all-cause dementia and Alzheimer dementia using periodic health examination data. METHODS: Diagnostic codes in medical claims data from a South Korean national health examination cohort were used to identify individuals who developed dementia or Alzheimer dementia over a 10-year period. As a result, 479,845 and 465,081 individuals, who were aged 40 to 79 years and without all-cause dementia and Alzheimer dementia, respectively, were identified at baseline. The performance of the following 3 models was compared with predictions of which individuals would develop either type of dementia: Cox proportional hazards model using only baseline data (HR-B), Cox proportional hazards model using repeated measurements (HR-R), and deep learning model using repeated measurements (DL-R). RESULTS: The discrimination indices (95% CI) for the HR-B, HR-R, and DL-R models to predict all-cause dementia were 0.84 (0.83-0.85), 0.87 (0.86-0.88), and 0.90 (0.90-0.90), respectively, and those to predict Alzheimer dementia were 0.87 (0.86-0.88), 0.90 (0.88-0.91), and 0.91 (0.91-0.91), respectively. The DL-R model showed the best performance, followed by the HR-R model, in predicting both types of dementia. The DL-R model was superior to the HR-R model in all validation groups tested. CONCLUSIONS: A deep learning algorithm using time-series data can be an accurate and cost-effective method to predict dementia. A combination of deep learning and proportional hazards models might help to enhance prevention strategies for dementia.

16.
J Psychosom Res ; 122: 1-5, 2019 07.
Artigo em Inglês | MEDLINE | ID: mdl-31126405

RESUMO

OBJECTIVE: Because benzodiazepines (BZDs) can affect pupillae muscles, their use could be a risk factor for acute angle-closure glaucoma (AACG), which is an ophthalmic emergency. However, there is no research evidence for the association between BZDs and AACG, except two case reports. We aimed to investigate whether BZDs increase the risk of AACG in a geriatric population. METHODS: We performed a case-control study using a geriatric cohort from the National Health Insurance database (2002-2013) in Korea. Case subjects (n = 1117) were patients diagnosed with AACG. Controls, people who have not been diagnosed with AACG, were randomly matched with the case according to age, sex, and index year (n = 4468). To examine the risk of BZD use for AACG, we performed conditional logistic regression analyses with potential confounders including comorbidities and concomitant medication. RESULTS: The use of BZD within 30 days was not significantly associated with AACG risk (adjusted odds ratio [aOR] = 1.14, 95% confidence interval [CI] = 0.94-1.37). Further analyses showed that, compared with non-use of BZD, new BZD use had a significantly increased risk for the development of AACG (aOR = 1.62, 95% CI = 1.09-2.37). The risk was higher in the new BZD users exposed within 7 days (aOR = 3.09, 95% CI = 1.58-5.88). CONCLUSION: We found that BZDs increase the risk of AACG at the beginning of its use among the Korean elderly. Clinicians should monitor visual disturbance in the elderly during the early period after prescription of BZD.


Assuntos
Benzodiazepinas/efeitos adversos , Glaucoma de Ângulo Fechado/induzido quimicamente , Doença Aguda , Idoso , Estudos de Casos e Controles , Estudos de Coortes , Feminino , Humanos , Masculino , Fatores de Risco
17.
PLoS One ; 14(2): e0211957, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30753205

RESUMO

The early identification and prevention of dementia is important for reducing its worldwide burden and increasing individuals' quality of life. Although several dementia prediction models have been developed, there remains a need for a practical and precise model targeted to middle-aged and Asian populations. Here, we used national Korean health examination data from adults (331,126 individuals, 40-69 years of age, mean age: 52 years) from 2002-2003 to predict the incidence of dementia after 10 years. We divided the dataset into two cohorts to develop and validate of our prediction model. Cox proportional hazards models were used to construct dementia prediction models for the total group and sex-specific subgroups. Receiver operating characteristics curves, C-statistics, calibration plots, and cumulative hazards were used to validate model performance. Discriminative accuracy as measured by C-statistics was 0.81 in the total group (95% confidence interval (CI) = 0.81 to 0.82), 0.81 in the male subgroup (CI = 0.80 to 0.82), and 0.81 in the female subgroup (CI = 0.80 to 0.82). Significant risk factors for dementia in the total group were age; female sex; underweight; current hypertension; comorbid psychiatric or neurological disorder; past medical history of cardiovascular disease, diabetes mellitus, or hypertension; current smoking; and no exercise. All identified risk factors were statistically significant in the sex-specific subgroups except for low body weight and current hypertension in the female subgroup. These results suggest that public health examination data can be effectively used to predict dementia and facilitate the early identification of dementia within a middle-aged Asian population.


Assuntos
Demência/epidemiologia , Adulto , Idoso , Estudos de Coortes , Feminino , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Modelos de Riscos Proporcionais , Saúde Pública , República da Coreia/epidemiologia , Medição de Risco , Fatores de Risco , Inquéritos e Questionários
18.
Brain Behav Immun ; 79: 309-313, 2019 07.
Artigo em Inglês | MEDLINE | ID: mdl-30685533

RESUMO

Increasing evidence suggests that systemic inflammation adversely affects social experiences and behaviors of older adults by changing the functional state of the brain. In this study, we investigated the relationships among systemic inflammation, functional network connectivity (FNC) of the whole brain, and social-network size using complete social-network data of older adults residing in a Korean village. Sixty-one participants were recruited from the Korean Social Life, Health, and Aging Project (KSHAP). Participants underwent a resting-state functional magnetic resonance imaging scan. High sensitivity C-reactive protein (hs-CRP) levels were measured as an inflammation marker. In-degree and out-degree network sizes were calculated based on the total number of intimate social relationships per participant. We demonstrated that hs-CRP levels were associated with decreased frontotemporal FNC. Stronger frontotemporal FNC was significantly correlated with a larger out-degree network size, suggesting that impaired frontotemporal communication in older adults decreases perceived social connectedness with other people. An exploratory mediation analysis supported the observation that increased systemic inflammation contributes to reduced out-degree social-network size among older adults by changing frontotemporal FNC. The present findings provide meaningful insight into the complex relationship between systemic inflammation and social quality of life.


Assuntos
Inflamação/metabolismo , Relações Interpessoais , Lobo Temporal/metabolismo , Idoso , Encéfalo , Mapeamento Encefálico , Proteína C-Reativa/análise , Conectoma/métodos , Feminino , Humanos , Vida Independente , Inflamação/imunologia , Imageamento por Ressonância Magnética/métodos , Masculino , Qualidade de Vida , República da Coreia , Características de Residência , Descanso , Rede Social , Lobo Temporal/diagnóstico por imagem , Lobo Temporal/imunologia
19.
Brain Imaging Behav ; 13(3): 660-668, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-29748773

RESUMO

Attention-deficit/hyperactivity disorder (ADHD) is commonly comorbid with Internet gaming disorder (IGD). Although childhood ADHD symptoms may decline during late brain maturation, structural alterations in some brain areas may persist into adulthood. This study investigated whether young adults with IGD and a history of childhood ADHD symptoms had gray matter volume (GMV) alterations that were distinct from subjects without a history of childhood ADHD. As an exploratory investigation, we conducted a whole-brain voxel-based morphometry with the diffeomorphic anatomical registration using an exponentiated Lie algebra algorithm and applied an uncorrected threshold at the voxel level for multiple comparisons. GMVs of IGD subjects with a history of childhood ADHD (IGDADHD+ group; n = 20; 24.5 ± 2.5 years) were compared to those of subjects without a history of childhood ADHD (IGDADHD- group; n = 20; 23.9 ± 2.5 years) and controls (n = 20; 22.7 ± 2.4 years). Compared with controls, both IGD groups had a smaller GMV in the right anterior cingulate cortex, the left inferior frontal gyrus, and the left insula, yet had a larger GMV in the right angular gyrus. The IGDADHD+ group had a larger GMV in the right precuneus than the IGDADHD- group and controls. When controlling for other comorbid psychiatric symptoms, the IGDADHD+ group also had a smaller GMV in the right inferior frontal gyrus. In conclusion, we found that young adults with IGD and a history of childhood ADHD symptoms had characteristic GMV alterations, which may be linked with their manifestation of childhood ADHD.


Assuntos
Substância Cinzenta/fisiologia , Jogos de Vídeo/efeitos adversos , Adulto , Transtorno do Deficit de Atenção com Hiperatividade/complicações , Encéfalo/fisiologia , Mapeamento Encefálico/métodos , Córtex Cerebral/fisiologia , Giro do Cíngulo/fisiologia , Humanos , Processamento de Imagem Assistida por Computador , Internet , Imageamento por Ressonância Magnética , Masculino , Tamanho do Órgão/fisiologia , Córtex Pré-Frontal/fisiologia , Dados Preliminares , Adulto Jovem
20.
Front Psychiatry ; 9: 380, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30233421

RESUMO

Depression is one of the most common comorbid conditions in Internet Gaming Disorder (IGD). Although there have been many studies on the pathophysiology of IGD, the neurobiological basis underlying the close association between depression and IGD has not been fully clarified. Previous neuroimaging studies have demonstrated functional and structural abnormalities in the anterior cingulate cortex (ACC) in IGD patients. In this study, we explored functional connectivity (FC) abnormalities involving subregions of the ACC in IGD subjects with comorbid depression. We performed a resting state seed-based FC analysis of 21 male young adults with IGD with comorbid depression (IGDdep+ group, 23.6 ± 2.4 years), 22 male young adults without IGD with comorbid depression (IGDdep- group, 24.0 ± 1.6 years), and 20 male age-matched healthy controls (24.0 ± 2.2 years). ACC-seeded FC was evaluated using the CONN-fMRI FC toolbox. The dorsal ACC (dACC), the pregenual ACC (pgACC), and the subgenual ACC (sgACC) were selected as seed regions. Both IGD groups had stronger pgACC FC with the right precuneus, the posterior cingulate cortex, and the left inferior frontal gyrus/insula than the control group. The IGDdep+ group had stronger dACC FC with the left precuneus and the right cerebellar lobule IX than the control and IGDdep- groups. The IGDdep+ group also had weaker pgACC FC with the right dorsomedial prefrontal cortex and the right supplementary motor area and had weaker sgACC FC with the left precuneus, the left lingual gyrus, and the left postcentral gyrus than the other groups. The strength of the connectivity between the sgACC and the left precuneus correlated positively with a higher omission error rate in the continuous performance test in the IGDdep+ group. In addition, the IGDdep- group had stronger sgACC FC with the left dorsolateral prefrontal cortex than the other groups. Our findings suggest that young males with IGD comorbid with depression have FC alterations of the default mode network and diminished FC with the prefrontal cortex. This altered FC pattern may be involved in the close association of IGD and depression.

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