Alcohol Use Predicts Face Perception Impairments and Difficulties in Face Recognition.

Background: Risky alcohol use is related to a variety of cognitive impairments, including memory and visuo-perceptual difficulties. Remarkably, no prior work has assessed whether usage of alcohol can predict difficulties perceiving facial identity. Objectives: Therefore, this study aimed to investigate whether riskier alcohol consumption predicted impairments in face perception and self-reported difficulties in face recognition. Results: Participants (N = 239, male = 77) were over 18 years old and had normal or corrected-to-normal vision. Alcohol use was assessed using the Alcohol Use Disorder Identification Test (AUDIT), while face recognition difficulties were determined by the 20-item Prosopagnosia Index questionnaire (PI20). A subsample of participants (N = 126, male = 51) completed the Cambridge Face Perception task (CFPT) to assess their face perception ability. Multiple linear regressions showed significant models of prediction on both face perception and face recognition when considering AUDIT score and age as predictors. Conclusion: This study suggested, for the first time, that risky alcohol use predicts both poorer visuo-perceptual processing for faces and self-reported difficulties in face recognition.

Risky decision-making and affective features of impulse control disorders in Parkinson's disease.

Impulse control disorders (ICDs) in Parkinson's disease (PD) are considered dopaminergic treatment side effects. Cognitive and affective factors may increase the risk of ICD in PD. The aim is to investigate risky decision-making and associated cognitive processes in PD patients with ICDs within a four-stage conceptual framework. Relationship between ICDs and affective factors was explored. Thirteen PD patients with ICD (ICD+), 12 PD patients without ICD (ICD-), and 17 healthy controls were recruited. Overall risky decision-making and negative feedback effect were examined with the Balloon Analogue Risk Task (BART). A cognitive battery dissected decision-making processes according to the four-stage conceptual framework. Affective and motivational factors were measured. ANOVA showed no effect of group on overall risky decision-making. However, there was a group × feedback interaction [F (2, 39) = 3.31, p = 0.047]. ICD+, unlike ICD- and healthy controls, failed to reduce risky behaviour following negative feedback. A main effect of group was found for anxiety and depression [F(2, 38) = 8.31, p = 0.001], with higher symptoms in ICD+ vs. healthy controls. Groups did not differ in cognitive outcomes or affective and motivational metrics. ICD+ may show relatively preserved cognitive function, but reduced sensitivity to negative feedback during risky decision-making and higher symptoms of depression and anxiety.

Are alcohol-related attentional biases and holistic perception independent processes?

Excessive alcohol consumption is associated with the development of attentional biases for alcohol-related cues and their prioritization in heavy drinkers. Recently, it has been hypothesized that holistic processing may also play a role in this prioritization, with higher alcohol consumers exhibiting stronger holistic perception for alcohol cues. However, it is unclear how processing stimuli holistically may be related to attentional biases. We explored potential relationships between attentional biases, holistic processing, and alcohol consumption in a sample of drinkers using two tasks. In the first, a visual probe task replicated previous findings by showing an increased attentional bias for alcohol-related stimuli in individuals with higher alcohol consumption. Surprisingly, using an inversion paradigm to measure holistic perception in our second task, we showed reduced holistic processing for both alcohol and nonalcohol cues in higher alcohol consumers compared to light alcohol consumers. Although alcohol consumption was positively associated with attentional biases and negatively associated with holistic processing, these cognitive processes were not associated with each other. This study supports a model of visual perception in which attentional biases and holistic processing are independently linked with alcohol use. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Smoking-related cue reactivity in a virtual reality setting: association between craving and EEG measures.

BACKGROUND: Cue-reactivity is the array of responses that smokers exhibit when exposed to conditioned and contextual stimuli previously associated to substance use. The difficulty to experimentally recreate the complexity of smokers' spatial experience and context requires more ecological models. Virtual reality (VR) creates a state of immersion close to reality allowing controlled assessments of behavioral responses. To date, no studies investigated brain activation associated to smoking cue-reactivity in VR using electroencephalography (EEG). AIMS: To investigate whether a VR cue-reactivity paradigm (a) may increase smoking craving, (b) is feasible with EEG recording, and (c) induces craving levels associated to EEG desynchronization. METHODS: Smokers (N = 20) and non-smokers (N = 20) were exposed to neutral and smoking-related VR scenarios, without and with smoking conditioned stimuli, respectively. EEG was recorded from occipital and parietal leads throughout the sessions to assess alpha band desynchronization. Smoking and food craving and presence visual analogue scales (VAS) were assessed during the session. RESULTS: To be smoker, but not non-smoker, significantly influenced smoking craving VAS induced by smoking cue VR but not by neutral VR. No significant food craving changes was observed during the VR sessions. The new finding was that EEG alpha band power in posterior leads was significantly increased by the smoking context scenario only in smokers, and that the degree of smoking (i.e., heavy vs. light) was significantly associated to this neurophysiological measure. CONCLUSIONS: This study demonstrated, for the first time, the feasibility of EEG recording in a VR setting, suggesting that EEG desynchronization may be a neurophysiological marker of smoking cue-reactivity.

Impulse Control Disorder in Parkinson's Disease: A Meta-Analysis of Cognitive, Affective, and Motivational Correlates.

Background: In Parkinson's disease (PD), impulse control disorders (ICDs) develop as side-effect of dopaminergic replacement therapy (DRT). Cognitive, affective, and motivational correlates of ICD in medicated PD patients are debated. Here, we systematically reviewed and meta-analyzed the evidence for an association between ICD in PD and cognitive, affective, and motivational abnormalities. Methods: A systematic review and meta-analysis was performed on PubMed, Science Direct, ISI Web of Science, Cochrane, EBSCO for studies published between 1-1-2000 and 8-3-2017 comparing cognitive, affective, and motivational measures in PD patients with ICD (ICD+) vs. those without ICD (ICD-). Exclusion criteria were conditions other than PD, substance and/or alcohol abuse, dementia, drug naïve patients, cognition assessed by self-report tools. Standardized mean difference (SMD) was used, and random-effect model applied. Results: 10,200 studies were screened (title, abstract), 79 full-texts were assessed, and 25 were included (ICD+: 625 patients; ICD-: 938). Compared to ICD-, ICD+ showed worse performance reward-related decision-making (0.42 [0.02, 0.82], p = 0.04) and set-shifting tasks (SMD = -0.49 [95% CI -0.78, -0.21], p = 0.0008). ICD in PD was also related to higher self-reported rate of depression (0.35 [0.16, 0.54], p = 0.0004), anxiety (0.43 [0.18, 0.68], p = 0.0007), anhedonia (0.26 [0.01, 0.50], p = 0.04), and impulsivity (0.79 [0.50, 1.09], p < 0.00001). Heterogeneity was low to moderate, except for depression (I2 = 61%) and anxiety (I2 = 58%). Conclusions: ICD in PD is associated with worse set-shifting and reward-related decision-making, and increased depression, anxiety, anhedonia, and impulsivity. This is an important area for further studies as ICDs have negative impact on the quality of life of patients and their caregivers.

Dopaminergic Neurotransmission in Patients With Parkinson's Disease and Impulse Control Disorders: A Systematic Review and Meta-Analysis of PET and SPECT Studies.

Background: Around 30% Parkinson's disease (PD) patients develop impulse control disorders (ICDs) to D2/3 dopamine agonists and, to a lesser extent, levodopa. We aim to investigate striatal dopaminergic function in PD patients with and without ICD. Methods: PubMed, Science Direct, EBSCO, and ISI Web of Science databases were searched (from inception to March 7, 2018) to identify PET or SPECT studies reporting striatal dopaminergic function in PD patients with ICD (ICD+) compared to those without ICD (ICD-). Studies which included drug naïve patients, explored non-pharmacological procedures (e.g., deep brain stimulation), and those using brain blood perfusion or non-dopaminergic markers were excluded. Standardized mean difference (SDM) was used and random-effect models were applied. Separate meta-analyses were performed for dopamine transporter level, dopamine release, and dopamine receptors availability in the putamen, caudate, dorsal, and ventral striatum. Results: A total of 238 studies were title and abstract screened, of which 19 full-texts were assessed. Nine studies (ICD+: N = 117; ICD-: N = 175 patients) were included in the analysis. ICD+ showed a significant reduction of dopamine transporter binding in the putamen (SDM = -0.46; 95% CI: -0.80, -0.11; Z = 2.61; p = 0.009), caudate (SDM = -0.38; 95% CI: -0.73, -0.04; Z = 2.18; p = 0.03) and dorsal striatum (SDM = -0.45; 95% CI: -0.77, -0.13; Z = 2.76; p = 0.006), and increased dopamine release to reward-related stimuli/gambling tasks in the ventral striatum (SDM = -1.04; 95% CI: -1.73, -0.35; Z = 2.95; p = 0.003). Dopamine receptors availability did not differ between groups. Heterogeneity was low for dopamine transporter in the dorsal striatum (I 2 = 0%), putamen (I 2 = 0%) and caudate (I 2 = 0%), and pre-synaptic dopamine release in the dorsal (I 2 = 0%) and ventral striatum (I 2 = 0%); heterogeneity was high for dopamine transporter levels in the ventral striatum (I 2 = 80%), and for dopamine receptors availability in the ventral (I 2 = 89%) and dorsal (I 2 = 86%) striatum, putamen (I 2 = 93%), and caudate (I 2 = 71%). Conclusions: ICD+ patients show lower dopaminergic transporter levels in the dorsal striatum and increased dopamine release in the ventral striatum when engaged in reward-related stimuli/gambling tasks. This dopaminergic imbalance might represent a biological substrate for ICD in PD. Adequately powered longitudinal studies with drug naïve patients are needed to understand whether these changes may represent biomarkers of premorbid vulnerability to ICD.

Comprehensive geriatric assessment adds information to Eastern Cooperative Oncology Group performance status in elderly cancer patients: an Italian Group for Geriatric Oncology Study.

PURPOSE: To appraise the performance of Comprehensive Geriatric Assessment (CGA) in elderly cancer patients (> or = 65 years) and to evaluate whether it could add further information with respect to the Eastern Cooperative Oncology Group performance status (PS). PATIENTS AND METHODS: We studied 363 elderly cancer patients (195 males, 168 females; median age, 72 years) with solid (n = 271) or hematologic (n = 92) tumors. In addition to PS, their physical function was assessed by means of the activity of daily living (ADL) and instrumental activities of daily living (IADL) scales. Comorbidities were categorized according to Satariano's index. The association between PS, comorbidity, and the items of the CGA was assessed by means of logistic regression analysis. RESULTS: These 363 elderly cancer patients had a good functional and mental status: 74% had a good PS (ie, lower than 2), 86% were ADL-independent, and 52% were IADL-independent. Forty-one percent of patients had one or more comorbid conditions. Of the patients with a good PS, 13.0% had two or more comorbidities; 9.3% and 37.7% had ADL or IADL limitations, respectively. By multivariate analysis, elderly cancer patients who were ADL-dependent or IADL-dependent had a nearly two-fold higher probability of having an elevated Satariano's index than independent patients. A strong association emerged between PS and CGA, with a nearly five-fold increased probability of having a poor PS (ie, > or = 2) recorded in patients dependent for ADL or IADL. CONCLUSION: The CGA adds substantial information on the functional assessment of elderly cancer patients, including patients with a good PS. The role of PS as unique marker of functional status needs to be reappraised among elderly cancer patients.

Breastfeeding difficulties and oral cavity anomalies: The influence of posterior ankyloglossia and upper-lip ties.

OBJECTIVE: Oral cavity anomalies may contribute to breastfeeding problems. The objective of this study was to describe our experience in a high-volume breastfeeding difficulty clinic with a focus on posterior ankyloglossia and upper-lip ties. METHODS: A retrospective review of patients from a dedicated breastfeeding difficulty clinic from January 2014 to December 2014 was performed. Those identified to have ankyloglossia and/or upper-lip ties underwent release procedures. Subjective breastfeeding changes were documented afterwards. RESULTS: Of the 618 total patients, 290 (47%) had anterior ankyloglossia, 120 (19%) had posterior ankyloglossia, and 14 (2%) had upper-lip tie. Some patients had both anterior ankyloglossia and upper lip-tie (6%), or posterior ankyloglossia and upper-lip tie (5%). For those with anterior ankyloglossia, 78% reported some degree of improvement in breastfeeding after frenotomy. For those with posterior ankyloglossia, 91% reported some degree of improvement in breastfeeding after frenotomy. Upper lip-tie release also led to improved breastfeeding (100%). CONCLUSIONS: Anterior and posterior ankyloglossia and upper-lip tie, or combinations thereof, were commonly recognized in our study population. Many newborns, however, also had no oral cavity anomalies. Although causation cannot be implied, these oral cavity anomalies may contribute to breastfeeding difficulties in some cases.

Carotid artery pseudoaneurysm: A rare complication following tonsillectomy.

Tonsillectomy is one of the most common surgical procedures performed in children. The most frequent complications are dehydration and bleeding. We present the case of a 6 year old child who developed an internal carotid artery pseudoaneurysm following elective tonsillectomy, necessitating urgent coil embolization and stenting. This is the first reported case in the pediatric population of a vascular injury that manifested in a delayed fashion (6 months) after routine tonsillectomy, and is also one of the youngest reported cases. It is imperative for the otolaryngologist to be aware of this rare complication.

Hoarseness as a presenting sign in children with Kawasaki disease.

We noted that many patients with Kawasaki disease (KD) were hoarse at presentation and thus evaluated the frequency of hoarseness in children with acute KD. New onset hoarseness was noted in 86 of 287 (30%) prospectively assessed KD patients. Laryngoscopic examination of 3 hoarse patients with acute KD revealed edema and erythema of the larynx.

Defining ankyloglossia: a case series of anterior and posterior tongue ties.

INTRODUCTION: Ankyloglossia is a congenital condition in which tongue mobility is limited due to an abnormality of the lingual frenulum. The impact of ankyloglossia on breastfeeding is poorly understood but there is a recent trend toward more recognition of this condition and early intervention when needed. Currently, there lacks clear definition of ankyloglossia and different subtypes have been proposed with no clinical correlation. OBJECTIVE: To determine the prevalence of anterior versus posterior ankyloglossia in a large series of consecutive patients and to assess clinical outcomes after frenotomy. METHODS: Retrospective chart review of patients from July 2007 to July 2009 who were diagnosed with ankyloglossia and underwent office frenotomy. Baseline characteristics, specific feeding issues, type of ankyloglossia, and clinical outcomes after frenotomy were reviewed. RESULTS: Of the 341 total patients, 322 (94%) had anterior ankyloglossia and 19 (6%) had posterior ankyloglossia. Median age at presentation was 2.7 weeks (range 1 day of life to 24 weeks); 227 were males and 114 were females. Revision frenotomy rates were significantly higher for the posterior ankyloglossia group (3.7% anterior and 21.1% posterior, p=0.008). CONCLUSION: Anterior ankyloglossia is much more common and readily managed when compared to posterior ankyloglossia. Posterior ankyloglossia is a poorly recognized condition that may contribute to breastfeeding difficulties. The diagnosis is difficult due to the subtle clinical findings but relevant health care providers should be aware of this condition. Frenotomy is a simple, safe, and effective intervention for ankyloglossia which improves breastfeeding.