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1.
J Vis Exp ; (168)2021 02 06.
Artigo em Inglês | MEDLINE | ID: mdl-33616111

RESUMO

Establishing an accurate diagnosis is crucial for patients with disorders of consciousness (DoC) following a severe brain injury. The Coma Recovery Scale-Revised (CRS-R) is the recommended behavioral scale for assessing the level of consciousness among these patients, but its long duration of administration is a major hurdle in clinical settings. The Simplified Evaluation of CONsciousness Disorders (SECONDs) is a shorter scale that was developed to tackle this issue. It consists of six mandatory items, observation, command-following, visual pursuit, visual fixation, oriented behaviors, and arousal, and two conditional items, communication and localization to pain. The score ranges between 0 and 8 and corresponds to a specific diagnosis (i.e., coma, unresponsive wakefulness syndrome, minimally conscious state minus/plus, or emergence from the minimally conscious state). A first validation study on patients with prolonged DoC showed high concurrent validity and intra- and inter-rater reliability. The SECONDs requires less training than the CRS-R and its administration lasts about 7 minutes (interquartile range: 5-9 minutes). An additional index score allows the more precise tracking of a patient's behavioral fluctuation or evolution over time. The SECONDs is therefore a fast and valid tool for assessing the level of consciousness in patients with severe brain injury. It can easily be used by healthcare staff and implemented in time-constrained clinical settings, such as intensive care units, to help decrease misdiagnosis rates and to optimize treatment decisions. These administration guidelines provide detailed instructions for administering the SECONDs in a standardized and reproducible manner, which is an essential requirement for achieving a reliable diagnosis.


Assuntos
Lesões Encefálicas/fisiopatologia , Transtornos da Consciência/diagnóstico , Estado de Consciência/fisiologia , Guias como Assunto , Adulto , Idoso , Nível de Alerta/fisiologia , Comunicação , Feminino , Fixação Ocular/fisiologia , Humanos , Masculino , Pessoa de Meia-Idade , Reprodutibilidade dos Testes
2.
Neurology ; 96(9): e1334-e1346, 2021 03 02.
Artigo em Inglês | MEDLINE | ID: mdl-33441453

RESUMO

OBJECTIVE: To determine whether the nucleus basalis of Meynert (NBM) may be a key network structure of altered functional connectivity in temporal lobe epilepsy (TLE), we examined fMRI with network-based analyses. METHODS: We acquired resting-state fMRI in 40 adults with TLE and 40 matched healthy control participants. We calculated functional connectivity of NBM and used multiple complementary network-based analyses to explore the importance of NBM in TLE networks without biasing our results by our approach. We compared patients to controls and examined associations of network properties with disease metrics and neurocognitive testing. RESULTS: We observed marked decreases in connectivity between NBM and the rest of the brain in patients with TLE (0.91 ± 0.88, mean ± SD) vs controls (1.96 ± 1.13, p < 0.001, t test). Larger decreases in connectivity between NBM and fronto-parietal-insular regions were associated with higher frequency of consciousness-impairing seizures (r = -0.41, p = 0.008, Pearson). A core network of altered nodes in TLE included NBM ipsilateral to the epileptogenic side and bilateral limbic structures. Furthermore, normal community affiliation of ipsilateral NBM was lost in patients, and this structure displayed the most altered clustering coefficient of any node examined (3.46 ± 1.17 in controls vs 2.23 ± 0.93 in patients). Abnormal connectivity between NBM and subcortical arousal community was associated with modest neurocognitive deficits. Finally, a logistic regression model incorporating connectivity properties of ipsilateral NBM successfully distinguished patients from control datasets with moderately high accuracy (78%). CONCLUSIONS: These results suggest that while NBM is rarely studied in epilepsy, it may be one of the most perturbed network nodes in TLE, contributing to widespread neural effects in this disabling disorder.


Assuntos
Núcleo Basal de Meynert/fisiopatologia , Epilepsia do Lobo Temporal/fisiopatologia , Rede Nervosa/fisiopatologia , Adolescente , Adulto , Idoso , Nível de Alerta/fisiologia , Núcleo Basal de Meynert/diagnóstico por imagem , Cognição , Eletroencefalografia , Epilepsia do Lobo Temporal/diagnóstico por imagem , Epilepsia do Lobo Temporal/psicologia , Feminino , Lateralidade Funcional , Humanos , Sistema Límbico/diagnóstico por imagem , Sistema Límbico/fisiopatologia , Modelos Logísticos , Imagem por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Modelos Neurológicos , Rede Nervosa/diagnóstico por imagem , Testes Neuropsicológicos , Adulto Jovem
3.
J Homosex ; 68(1): 138-156, 2021 Jan 02.
Artigo em Inglês | MEDLINE | ID: mdl-31430230

RESUMO

To determine the cerebral functionality associated with the perception and processing of erotic stimuli in men with different sexual orientation, this work evaluated the electroencephalographic activity (EEG) from several cortical areas, as well as subjective arousal in homosexual and heterosexual men during observation of an erotic film with heterosexual content. The heterosexual men rated the erotic video with higher general and sexual arousal than the homosexual participants. During observation of the neutral and erotic videos, both groups showed a decreased amplitude of the alpha band in prefrontal and parietal cortices, indicating increased attention. When watching the erotic video, the homosexual men showed an increased amplitude of the theta and fast bands only in the prefrontal cortex, which could be related to the cognitive processing of the erotic stimulus. These EEG results should broaden our knowledge of the cortical mechanisms related to the different perception and processing of erotic stimuli in men with different sexual orientations.


Assuntos
Cérebro/fisiologia , Literatura Erótica/psicologia , Heterossexualidade/psicologia , Homossexualidade Masculina/psicologia , Adulto , Nível de Alerta/fisiologia , Eletroencefalografia , Humanos , Masculino , Filmes Cinematográficos , Estimulação Luminosa , Adulto Jovem
4.
PLoS One ; 15(9): e0237873, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32877409

RESUMO

In this study we evaluate the convergent validity of a new graphical self-report tool (the EmojiGrid) for the affective appraisal of perceived touch events. The EmojiGrid is a square grid labeled with facial icons (emoji) showing different levels of valence and arousal. The EmojiGrid is language independent and efficient (a single click suffices to report both valence and arousal), making it a practical instrument for studies on affective appraisal. We previously showed that participants can intuitively and reliably report their affective appraisal (valence and arousal) of visual, auditory and olfactory stimuli using the EmojiGrid, even without additional (verbal) instructions. However, because touch events can be bidirectional and dynamic, these previous results cannot be generalized to the touch domain. In this study, participants reported their affective appraisal of video clips showing different interpersonal (social) and object-based touch events, using either the validated 9-point SAM (Self-Assessment Mannikin) scale or the EmojiGrid. The valence ratings obtained with the EmojiGrid and the SAM are in excellent agreement. The arousal ratings show good agreement for object-based touch and moderate agreement for social touch. For social touch and at more extreme levels of valence, the EmojiGrid appears more sensitive to arousal than the SAM. We conclude that the EmojiGrid can also serve as a valid and efficient graphical self-report instrument to measure human affective response to a wide range of tactile signals.


Assuntos
Emoções/fisiologia , Percepção do Tato/fisiologia , Adolescente , Adulto , Nível de Alerta/fisiologia , Intervalos de Confiança , Feminino , Humanos , Masculino , Estimulação Física , Adulto Jovem
5.
PLoS One ; 15(8): e0236521, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32756593

RESUMO

OBJECTIVES: The study aimed at determining the EEG correlates of concentration on either low or high-distressed tinnitus. METHODS: Sixty-seven patients (36 women, mean age = 50.34 ± 12.94 years) with chronic tinnitus were assigned to either a high (HD) or low (LD) tinnitus-related distress group based on THI results. All participants took part in the EEG study comprising two 3-4 min blocks of focusing on either tinnitus (Tinnitus Focus Condition, TFC) or the sensations from one's own body (Body Focus Condition, BFC). The absolute power and current density of 8 frequency bands in 7 clusters were compared between conditions and groups. RESULTS: The most pronounced differences were found in the HD patients in the TFC, relative to the BFC, i.e. reduced power of frontally distributed low alpha (8-10 Hz) and posterior high alpha (10-12 Hz) as well as lower current density of 8-10 Hz rhythm over the right frontal/anterior cingulate cortex and higher middle beta (15-18 Hz) density in the precuneus. The HD, relative to LD patients, in both conditions, exhibited increased low beta (12-15 Hz) power over the left middle area and greater higher beta (15-25 Hz) power in the left posterior region. CONCLUSIONS: The present study contrasted bioelectrical activity, acquired when concentrating on tinnitus with EEG data collected whilst patients focused on their body. Decreased alpha power and current density in the frontal/cingulate cortex when listening to bothersome tinnitus might reflect greater cortical arousal whereas increased beta power and density in the precuneus/posterior cingulate activity in this condition could be indicative for elevated tension or augmented cognitive/emotional processing of tinnitus sound. Enhanced beta rhythm in patients with high versus low tinnitus distress, observed independently of the study condition, may be due to greater self-focused attention or more active processing of sensations derived from the own body.


Assuntos
Atenção/fisiologia , Percepção Auditiva/fisiologia , Encéfalo/fisiopatologia , Zumbido/fisiopatologia , Adulto , Nível de Alerta/fisiologia , Encéfalo/diagnóstico por imagem , Mapeamento Encefálico , Eletroencefalografia , Emoções/fisiologia , Feminino , Giro do Cíngulo/diagnóstico por imagem , Giro do Cíngulo/fisiopatologia , Humanos , Masculino , Pessoa de Meia-Idade , Zumbido/complicações , Zumbido/diagnóstico por imagem
6.
Nat Commun ; 11(1): 4007, 2020 08 11.
Artigo em Inglês | MEDLINE | ID: mdl-32782282

RESUMO

Everyday life unfolds continuously, yet we tend to remember past experiences as discrete event sequences or episodes. Although this phenomenon has been well documented, the neuromechanisms that support the transformation of continuous experience into distinct and memorable episodes remain unknown. Here, we show that changes in context, or event boundaries, elicit a burst of autonomic arousal, as indexed by pupil dilation. Event boundaries also lead to the segmentation of adjacent episodes in later memory, evidenced by changes in memory for the temporal duration, order, and perceptual details of recent event sequences. These subjective and objective changes in temporal memory are also related to distinct temporal features of pupil dilations to boundaries as well as to the temporal stability of more prolonged pupil-linked arousal states. Collectively, our findings suggest that pupil measures reflect both stability and change in ongoing mental context representations, which in turn shape the temporal structure of memory.


Assuntos
Nível de Alerta/fisiologia , Memória Episódica , Pupila/fisiologia , Percepção do Tempo/fisiologia , Adulto , Percepção Auditiva/fisiologia , Discriminação Psicológica/fisiologia , Feminino , Humanos , Masculino , Tempo de Reação , Adulto Jovem
7.
Psychol Aging ; 35(5): 780-791, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32744858

RESUMO

Aging affects brain circuitry involved in both inhibition and arousal. In this study, we tested whether older adults are more or less prone to distraction from emotionally arousing events than young adults. To do so, we examined how arousing taboo distractor words affected concurrent 1-back task performance and subsequent memory for distractors. Our second goal was to examine how the arousal level of 1 item can modulate processing of preceding neutral distractors (taboo-minus-1 distractors). During the task, participants first made 1-back judgments about target pictures that were superimposed with to-be-ignored neutral or taboo distractors. Relative to young adults, older adults were more distracted by taboo than neutral words on the 1-back task and remembered more of the taboo distractors on a later incidental recognition task. Furthermore, young adults showed better suppression of taboo-minus-1 distractors than neutral distractors, whereas in older adults, arousal did not facilitate suppression of taboo-minus-1 distractors. This effect appeared to require attentional control as adding an unrelated attentional load during the 1-back task eliminated the beneficial effect of arousal for young adults' suppression of taboo-minus-1 distractors. Finally, when top-down attentional guidance was provided by increasing the goal relevance of target pictures, both groups showed enhanced suppression of taboo-minus-1 distractors versus other neutral distractors. Together, these findings imply that the effect of arousal on distractibility in aging may arise from an interaction between top-down and bottom-up processes. (PsycInfo Database Record (c) 2020 APA, all rights reserved).


Assuntos
Nível de Alerta/fisiologia , Atenção/fisiologia , Adulto , Fatores Etários , Idoso , Envelhecimento , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Adulto Jovem
8.
Artigo em Inglês | MEDLINE | ID: mdl-32748826

RESUMO

Endurance physical exercise is accompanied by subjective perceptions of exertion (reported perceived exertion, RPE), emotional valence, and arousal. These constructs have been hypothesized to serve as the basis for the exerciser to make decisions regarding when to stop, how to regulate pace, and whether or not to exercise again. In dual physical-cognitive tasks, the mental (executive) workload generated by the cognitive task has been shown to influence these perceptions, in ways that could also influence exercise-related decisions. In the present work, we intend to replicate and extend previous findings that manipulating the amount of executive load imposed by a mental task, performed concomitantly with a submaximal cycling session, influenced emotional states but not perceived exertion. Participants (experienced triathletes) were asked to perform a submaximal cycling task in two conditions with different executive demands (a two-back version of the n-back task vs. oddball) but equated in external physical load. Results showed that the higher executive load condition elicited more arousal and less positive valence than the lower load condition. However, both conditions did not differ in RPE. This experimental dissociation suggests that perceived exertion and its emotional correlates are not interchangeable, which opens the possibility that they could play different roles in exercise-related decision-making.


Assuntos
Nível de Alerta/fisiologia , Ciclismo/fisiologia , Função Executiva/fisiologia , Exercício Físico , Esforço Físico/fisiologia , Afeto , Emoções , Humanos , Carga de Trabalho
9.
J Music Ther ; 57(3): 353-378, 2020 Jul 18.
Artigo em Inglês | MEDLINE | ID: mdl-32651585

RESUMO

Patients diagnosed with both substance use disorder (SUD) and posttraumatic stress disorder (PTSD) often experience hypervigilance, increased fear, and difficulties regulating emotions. This dual diagnosis increases treatment complexity. Recently, a short-term music therapy intervention for arousal and attention regulation (the SMAART intervention) was designed based on neurobiological findings. Twelve patients with SUD and PTSD (50% females) in outpatient treatment participated in six weekly one-hour sessions of the SMAART intervention. Six patients completed the study. PTSD symptom severity was evaluated with the Posttraumatic Stress Disorder Symptom Scale Interview for DSM-5 (PSSI-5) pre- and post-intervention, and sustained attention was evaluated with the Bourdon-Wiersma (BW) test. A significant difference in measurements for the PSSI-5 overall symptom severity was found pre- and post-intervention. Furthermore, participants showed significant improvement on subscales of hyperarousal, mood and cognition, and attention. The BW test completion time decreased significantly. Two participants dropped out before the end of the intervention due to craving. Concerning future research, it is recommended to define the role of the music more explicitly and to change the design to a randomized controlled trial. A risk for future larger studies is a high dropout rate (50%). Several limitations of the study are discussed.


Assuntos
Nível de Alerta/fisiologia , Atenção/fisiologia , Musicoterapia , Transtornos de Estresse Pós-Traumáticos/complicações , Transtornos de Estresse Pós-Traumáticos/terapia , Transtornos Relacionados ao Uso de Substâncias/complicações , Transtornos Relacionados ao Uso de Substâncias/terapia , Adulto , Emoções , Estudos de Viabilidade , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Transtornos de Estresse Pós-Traumáticos/psicologia , Transtornos Relacionados ao Uso de Substâncias/psicologia , Resultado do Tratamento
10.
Neurophysiol Clin ; 50(3): 155-165, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32653111

RESUMO

OBJECTIVES: Although rare, neurological manifestations in SARS-CoV-2 infection are increasingly being reported. We conducted a retrospective systematic study to describe the electroencephalography (EEG) characteristics in this disease, looking for specific patterns. METHODS: EEGs performed in patients with positive PCR for SARS-CoV-2 between 25/03/2020 and 06/05/2020 in the University Hospital of Bicêtre were independently reviewed by two experienced neurologists. We used the American Clinical Neurophysiology Society's terminology for the description of abnormal patterns. EEGs were classified into five categories, from normal to critically altered. Interobserver reliability was calculated using Cohen's kappa coefficient. Medical records were reviewed to extract demographics, clinical, imaging and biological data. RESULTS: Forty EEGs were reviewed in 36 COVID-19 patients, 18 in intensive care units (ICU) and 22 in medicine units. The main indications were confusion or fluctuating alertness for 23 (57.5%) and delayed awakening after stopping sedation in ICU in six (15%). EEGs were normal to mildly altered in 23 (57.5%) contrary to the 42.5% where EEG alterations were moderate in four (10%), severe in eight (20%) and critical in five (12.5%). Generalized periodic discharges (GPDs), multifocal periodic discharges (MPDs) or rhythmic delta activity (RDA) were found in 13 recordings (32.5%). EEG alterations were not stereotyped or specific. They could be related to an underlying morbid status, except for three ICU patients with unexplained encephalopathic features. CONCLUSION: In this first systematic analysis of COVID-19 patients who underwent EEG, over half of them presented a normal recording pattern. EEG alterations were not different from those encountered in other pathological conditions.


Assuntos
Betacoronavirus , Confusão/etiologia , Infecções por Coronavirus/complicações , Recuperação Demorada da Anestesia/etiologia , Eletroencefalografia , Pneumonia Viral/complicações , Adulto , Idoso , Idoso de 80 Anos ou mais , Nível de Alerta/fisiologia , Betacoronavirus/isolamento & purificação , Ondas Encefálicas/fisiologia , Doenças Cardiovasculares/complicações , Doenças Cardiovasculares/fisiopatologia , Comorbidade , Confusão/fisiopatologia , Infecções por Coronavirus/fisiopatologia , Infecções por Coronavirus/psicologia , Sedação Profunda , Recuperação Demorada da Anestesia/fisiopatologia , Demência/complicações , Demência/fisiopatologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pandemias , Pneumonia Viral/fisiopatologia , Pneumonia Viral/psicologia , Reação em Cadeia da Polimerase , /fisiopatologia , Estudos Retrospectivos
11.
Nat Commun ; 11(1): 2769, 2020 06 02.
Artigo em Inglês | MEDLINE | ID: mdl-32488015

RESUMO

During obstructive sleep apnea, elevation of CO2 during apneas contributes to awakening and restoring airway patency. We previously found that glutamatergic neurons in the external lateral parabrachial nucleus (PBel) containing calcitonin gene related peptide (PBelCGRP neurons) are critical for causing arousal during hypercapnia. However, others found that genetic deletion of serotonin (5HT) neurons in the brainstem also prevented arousal from hypercapnia. To examine interactions between the two systems, we showed that dorsal raphe (DR) 5HT neurons selectively targeted the PBel. Either genetically directed deletion or acute optogenetic silencing of DRSert neurons dramatically increased the latency of mice to arouse during hypercapnia, as did silencing DRSert terminals in the PBel. This effect was mediated by 5HT2a receptors which are expressed by PBelCGRP neurons. Our results indicate that the serotonergic input from the DR to the PBel via 5HT2a receptors is critical for modulating the sensitivity of the PBelCGRP neurons that cause arousal to rising levels of blood CO2.


Assuntos
Nível de Alerta/fisiologia , Núcleo Dorsal da Rafe/metabolismo , Hipercapnia/metabolismo , Neurônios Serotoninérgicos/metabolismo , Animais , Tronco Encefálico/metabolismo , Peptídeo Relacionado com Gene de Calcitonina/metabolismo , Dióxido de Carbono , Modelos Animais de Doenças , Masculino , Camundongos , Camundongos Transgênicos , Optogenética , Núcleos Parabraquiais , Serotonina/genética , Proteínas da Membrana Plasmática de Transporte de Serotonina/genética
12.
Arch Sex Behav ; 49(5): 1517-1532, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-32504234

RESUMO

Sexual concordance-the agreement between physiological (genital) and psychological (emotional) sexual arousal-is, on average, substantially lower in women than men. Following social role theory, the gender difference in sexual concordance may manifest because women and men are responding in a way that accommodates gender norms. We examined genital and self-reported sexual arousal in 47 women and 50 men using a condition known to discourage conformity to gender norms (i.e., a bogus pipeline paradigm). Participants reported their feelings of sexual arousal during a sexually explicit film, while their genital arousal (penile circumference, vaginal vasocongestion), heart rate (HR), and galvanic skin (GS) responses were recorded. Half of the participants were instructed that their self-reported sexual arousal was being monitored for veracity using their HR and GS responses (bogus pipeline condition; BPC); the remaining participants were told that these responses were recorded for a comprehensive record of sexual response (typical testing condition; TTC). Using multi-level modeling, we found that only women's sexual concordance was affected by testing condition; women in the BPC exhibited significantly higher sexual concordance than those in the TTC. Thus, we provide the first evidence that the gender difference in sexual concordance may at least partially result from social factors.


Assuntos
Nível de Alerta/fisiologia , Frequência Cardíaca/fisiologia , Comportamento Sexual/fisiologia , Adolescente , Adulto , Feminino , Humanos , Masculino , Autorrelato , Adulto Jovem
14.
J Neurosci ; 40(23): 4551-4564, 2020 06 03.
Artigo em Inglês | MEDLINE | ID: mdl-32350040

RESUMO

Forming effective responses to threatening stimuli requires the adequate and coordinated emergence of stress-related internal states. Such ability depends on early-life experiences and, in connection, the adequate formation of neuromodulatory systems, particularly serotonergic signaling. Here, we assess the serotonergic background of experience-dependent behavioral responsiveness using male and female zebrafish (Danio rerio). For the first time, we have characterized a period during behavioral metamorphosis in which zebrafish are highly reactive to their environment. Absence of social stimuli during this phase established by isolated rearing fundamentally altered the behavioral phenotype of postmetamorphic zebrafish in a challenge-specific manner, partially due to reduced responsiveness and an inability to develop stress-associated arousal state. In line with this, isolation differentially affected whole-brain serotonergic signaling in resting and stress-induced conditions, an effect that was localized in the dorsal pallium and was negatively associated with responsiveness. Administration of the serotonin receptor 1A partial agonist buspirone prevented the isolation-induced serotonin response to novelty in the level of the whole brain and the forebrain as well, without affecting catecholamine levels, and rescued stress-induced arousal along with challenge-induced behaviors, which together indicates functional connection between these changes. In summary, there is a consistent negative association between behavioral responsiveness and serotonergic signaling in zebrafish, which is well recognizable through the modifying effects of developmental perturbation and pharmacological manipulations as well. Our results imply a conserved serotonergic mechanism that context-dependently modulates environmental reactivity and is highly sensitive to experiences acquired during a specific early-life time window, a phenomenon that was previously only suggested in mammals.SIGNIFICANCE STATEMENT The ability to respond to challenges is a fundamental factor in survival. We show that zebrafish that lack appropriate social stimuli in a sensitive developmental period show exacerbated alertness in nonstressful conditions while failing to react adequately to stressors. This shift is reflected inversely by central serotonergic signaling, a system that is implicated in numerous mental disorders in humans. Serotonergic changes in brain regions modulating responsivity and behavioral impairment were both prevented by the pharmacological blockade of serotonergic function. These results imply a serotonergic mechanism in zebrafish that transmits early-life experiences to the later phenotype by shaping stress-dependent behavioral reactivity, a phenomenon that was previously only suggested in mammals. Zebrafish provide new insights into early-life-dependent neuromodulation of behavioral stress-responses.


Assuntos
Nível de Alerta/fisiologia , Aprendizagem da Esquiva/fisiologia , Comportamento Animal/fisiologia , Receptor 5-HT1A de Serotonina/fisiologia , Agonistas do Receptor de Serotonina/farmacologia , Serotonina/fisiologia , Animais , Nível de Alerta/efeitos dos fármacos , Aprendizagem da Esquiva/efeitos dos fármacos , Comportamento Animal/efeitos dos fármacos , Feminino , Masculino , Isolamento Social/psicologia , Peixe-Zebra
15.
Am J Gastroenterol ; 115(5): 697-705, 2020 05.
Artigo em Inglês | MEDLINE | ID: mdl-32356952

RESUMO

INTRODUCTION: Night-time gastroesophageal reflux (nGER) symptoms are commonly associated with interrupted sleep. Most studies attempting to understand the relationship between sleep, arousal, and nGER events have been performed so using accelerometry; however, this technology is limited in its ability to precisely determine the temporal association between sleep and reflux events. We aimed to examine the temporal relationships between nGER events and arousal/awakening from sleep using high resolution, in-laboratory polysomnography (PSG). METHODS: Individuals between 18 and 70 years who had undergone a gastroscopy within 12 months underwent simultaneous 24-hour pH/impedance monitoring and in-laboratory PSG. The temporal relationship between each nGER event and sleep/arousals/awakenings was determined for each participant. Analyses were limited to the sleep period (between "lights out" and time of final waking). RESULTS: Analyses were conducted on the data from 25 individuals, 64% of whom had nGER episodes (5 ± 5 events per person, range 1-18) and 64% of whom had obstructive sleep apnea (OSA, mean apnea-hypopnea index 20 ± 11 events/hr, range 6-44). There were no differences in PSG-determined sleep duration, sleep efficiency, sleep architecture, arousals/awakenings, or sleep apnea severity between those with nGER and those without. Most nGER events (82%) occurred during a PSG epoch that had been classified as wake. Arousals/awakenings preceded almost all events (73/76), whereas fewer had an arousal/awakening after the event (15/76). DISCUSSION: As opposed to what is typically assumed, nGER does not seem to cause arousal from sleep, but rather arousal from sleep predisposes to nGER.


Assuntos
Nível de Alerta/fisiologia , Refluxo Gastroesofágico/fisiopatologia , Sono/fisiologia , Adolescente , Adulto , Idoso , Austrália/epidemiologia , Monitoramento do pH Esofágico/métodos , Feminino , Seguimentos , Refluxo Gastroesofágico/epidemiologia , Refluxo Gastroesofágico/metabolismo , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Polissonografia , Fatores de Tempo , Adulto Jovem
16.
Epilepsia ; 61(6): 1174-1182, 2020 06.
Artigo em Inglês | MEDLINE | ID: mdl-32385944

RESUMO

OBJECTIVE: High-frequency deep brain stimulation (DBS) of anterior thalamic nuclei (ANT) reduces the frequency and intensity of focal and focal to bilateral tonic-clonic epileptic seizures. We investigated the impact of high-frequency ANT-DBS on vigilance in epilepsy patients during relaxed and drowsy wakefulness, to better understand the effects and the mechanisms of action of this intervention in humans. METHODS: Four patients with different structural epileptic pathologies were included in this retrospective case-cohort study. Short- and long-term electroencephalography (EEG) was used to determine states of relaxed or drowsy wakefulness and the vigilance changes during stimulation-on and stimulation-off intervals. RESULTS: In relaxed, wakeful patients with eyes closed, the eyelid artifact rate increased acutely and reproducibly during stimulation-on intervals, suggesting an enhanced vigilance. This effect was accompanied by a slight acceleration of the alpha rhythm. In drowsy patients with eyes closed, stimulation generated acutely and reproducibly alpha rhythms, similar to the paradoxical alpha activation during eyes opening. The occurrence of the alpha rhythms reflected an increase in the vigilance of the drowsy subjects during ANT-DBS. SIGNIFICANCE: This is the first demonstration that ANT-DBS increases the vigilance of wakeful epilepsy patients. Our results deliver circumstantial evidence that high-frequency ANT-DBS activates thalamocortical connections that promote wakefulness.


Assuntos
Núcleos Anteriores do Tálamo/fisiologia , Nível de Alerta/fisiologia , Estimulação Encefálica Profunda/métodos , Epilepsia/terapia , Relaxamento/fisiologia , Vigília/fisiologia , Estudos de Coortes , Estimulação Encefálica Profunda/psicologia , Eletroencefalografia/métodos , Epilepsia/psicologia , Feminino , Humanos , Masculino , Relaxamento/psicologia , Estudos Retrospectivos
17.
PLoS One ; 15(5): e0232889, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32437352

RESUMO

Due to the complex role of sexual excitation in risky sexual behaviors, this study aimed to disentangle this phenomenon by jointly analyzing the combined role of three forms of sexual excitation: genital and subjective, and individual´s propensity. Therefore, we examined the relationship between the components of the Dual Control Model, that is, propensity for sexual excitation/inhibition, in addition to genital and subjective arousal, and sexual assertiveness and intention to engage in casual sexual encounters in which sexual risk was implicitly or explicitly present. The sample consisted of 99 heterosexual young adults (55 men and 45 women) with ages ranging from 18 to 32 years. Participants performed an experiment in the laboratory, which involved them watching a sexual clip and then being presented with two erotic excerpts (stories) depicting casual sexual encounters in which there was an existence of implicit and explicit sexual risks. In men, the propensity for sexual inhibition was the most determining variable in preventing them from sexual risk-taking. In women, intention to engage in risky sexual behaviors was better determined by their propensity for sexual excitation and sexual assertiveness in negotiating the use of contraceptive methods. This research highlights the relevance of excitation and inhibition as a trait, in addition to subjective arousal and sexual assertiveness in intention to engage in risky sexual behaviors.


Assuntos
Assertividade , Comportamentos de Risco à Saúde , Intenção , Assunção de Riscos , Sexo sem Proteção/psicologia , Adolescente , Adulto , Nível de Alerta/fisiologia , Comportamento Contraceptivo/psicologia , Tomada de Decisões , Feminino , Comportamentos de Risco à Saúde/fisiologia , Heterossexualidade/fisiologia , Heterossexualidade/psicologia , Humanos , Inibição Psicológica , Masculino , Sexo sem Proteção/fisiologia , Adulto Jovem
18.
Neuron ; 107(3): 487-495.e9, 2020 08 05.
Artigo em Inglês | MEDLINE | ID: mdl-32445624

RESUMO

At various stages of the visual system, visual responses are modulated by arousal. Here, we find that in mice this modulation operates as early as in the first synapse from the retina and even in retinal axons. To measure retinal activity in the awake, intact brain, we imaged the synaptic boutons of retinal axons in the superior colliculus. Their activity depended not only on vision but also on running speed and pupil size, regardless of retinal illumination. Arousal typically reduced their visual responses and selectivity for direction and orientation. Recordings from retinal axons in the optic tract revealed that arousal modulates the firing of some retinal ganglion cells. Arousal had similar effects postsynaptically in colliculus neurons, independent of activity in the other main source of visual inputs to the colliculus, the primary visual cortex. These results indicate that arousal modulates activity at every stage of the mouse visual system.


Assuntos
Nível de Alerta/fisiologia , Axônios/fisiologia , Neurônios/fisiologia , Orientação Espacial/fisiologia , Células Ganglionares da Retina/fisiologia , Colículos Superiores/fisiologia , Animais , Axônios/metabolismo , Locomoção , Camundongos , Neurônios/citologia , Neurônios/metabolismo , Trato Óptico , Terminações Pré-Sinápticas/metabolismo , Células Ganglionares da Retina/citologia , Células Ganglionares da Retina/metabolismo , Colículos Superiores/diagnóstico por imagem , Colículos Superiores/metabolismo , Vias Visuais/fisiologia , Vigília
19.
PLoS One ; 15(4): e0231659, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32324756

RESUMO

Pathological fear and anxiety disorders can have debilitating impacts on individual patients and society. The neural circuitry underlying fear learning and extinction has been known to play a crucial role in the development and maintenance of anxiety disorders. Pavlovian conditioning, where a subject learns an association between a biologically-relevant stimulus and a neutral cue, has been instrumental in guiding the development of therapies for treating anxiety disorders. To date, a number of physiological signal responses such as skin conductance, heart rate, electroencephalography and cerebral blood flow have been analyzed in Pavlovian fear conditioning experiments. However, physiological markers are often examined separately to gain insight into the neural processes underlying fear acquisition. We propose a method to track a single brain-related sympathetic arousal state from physiological signal features during fear conditioning. We develop a state-space formulation that probabilistically relates features from skin conductance and heart rate to the unobserved sympathetic arousal state. We use an expectation-maximization framework for state estimation and model parameter recovery. State estimation is performed via Bayesian filtering. We evaluate our model on simulated and experimental data acquired in a trace fear conditioning experiment. Results on simulated data show the ability of our proposed method to estimate an unobserved arousal state and recover model parameters. Results on experimental data are consistent with skin conductance measurements and provide good fits to heartbeats modeled as a binary point process. The ability to track arousal from skin conductance and heart rate within a state-space model is an important precursor to the development of wearable monitors that could aid in patient care. Anxiety and trauma-related disorders are often accompanied by a heightened sympathetic tone and the methods described herein could find clinical applications in remote monitoring for therapeutic purposes.


Assuntos
Algoritmos , Nível de Alerta/fisiologia , Condicionamento Clássico/fisiologia , Medo/fisiologia , Resposta Galvânica da Pele/fisiologia , Frequência Cardíaca/fisiologia , Sistema Nervoso Simpático/fisiologia , Simulação por Computador , Feminino , Humanos , Masculino , Adulto Jovem
20.
Epilepsia ; 61(5): 879-891, 2020 05.
Artigo em Inglês | MEDLINE | ID: mdl-32274803

RESUMO

OBJECTIVE: Tuberous sclerosis complex (TSC) is one of the most common genetic causes of epilepsy. Seizures in TSC typically first present in infancy or early childhood, including focal seizures and infantile spasms. Infantile spasms in TSC are particularly characteristic in its strong responsiveness to vigabatrin. Although a number of mouse models of epilepsy in TSC have been described, there are very limited electroencephalographic (EEG) or seizure data during the preweanling neonatal and infantile-equivalent mouse periods. Tsc1GFAP CKO mice are a well-characterized mouse model of epilepsy in TSC, but whether these mice have seizures during early development has not been documented. The objective of this study was to determine whether preweanling Tsc1GFAP CKO mice have developmental EEG abnormalities or seizures, including spasms. METHODS: Longitudinal video-EEG and electromyographic recordings were performed serially on Tsc1GFAP CKO and control mice from postnatal days 9-21 and analyzed for EEG background abnormalities, sleep-wake vigilance states, and spontaneous seizures. Spasms were also induced with varying doses of N-methyl-D-aspartate (NMDA). RESULTS: The interictal EEG of Tsc1GFAP CKO mice had excessive discontinuity and slowing, suggesting a delayed developmental progression compared with control mice. Tsc1GFAP CKO mice also had increased vigilance state transitions and fragmentation. Tsc1GFAP CKO mice had spontaneous focal seizures in the early neonatal period and a reduced threshold for NMDA-induced spasms, but no spontaneous spasms were observed. SIGNIFICANCE: Neonatal Tsc1GFAP CKO mice recapitulate early developmental aspects of EEG abnormalities, focal seizures, and an increased propensity for spasms. This mouse model may be useful for early mechanistic and therapeutic studies of epileptogenesis in TSC.


Assuntos
Convulsões/fisiopatologia , Esclerose Tuberosa/fisiopatologia , Animais , Animais Recém-Nascidos/fisiologia , Nível de Alerta/fisiologia , Modelos Animais de Doenças , Eletroencefalografia , Eletromiografia , Feminino , Masculino , Camundongos , Camundongos Endogâmicos C57BL , N-Metilaspartato/farmacologia , Convulsões/induzido quimicamente
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