Changes In Behavioral Measures Research Articles

Development of a Theory-Based Intervention to Increase Clinical Measurement of Reactive Balance in Adults at Risk of Falls.

Effective balance reactions are essential for avoiding falls, but are not regularly measured by physical therapists. Physical therapists report wanting to improve reactive balance assessment, and theory-based approaches are recommended as the foundation for the development of interventions. This article describes how a behavior change theory for health care providers, the theoretical domains framework (TDF), was used to develop an intervention to increase reactive balance measurement among physical therapists who work in rehabilitation settings and treat adults who are at risk of falls. We employed published recommendations for using the TDF-guided intervention development. We identified what health care provider behavior is in need of change, relevant barriers and facilitators, strategies to address them, and how we would measure behavior change. In this case, identifying strategies required selecting both a reactive balance measure and behavior change techniques. Previous research had determined that physical therapists need to increase reactive balance measurement, and identified barriers and facilitators that corresponded to 8 TDF domains. A published review informed the selection of the Balance Evaluation Systems Test (Reactive Postural Responses Section) as addressing the barriers and facilitators, and existing research informed the selection of 9 established behavior change techniques corresponding to each identified TDF domain. The TDF framework were incorporated into a 12-month intervention with interactive group sessions, local champions, and health record modifications. Intervention effect can be evaluated using health record abstraction, questionnaires, and qualitative semistructured interviews. Although future research will evaluate the intervention in a controlled study, the process of theory-based intervention development can be applied to other rehabilitation research contexts, maximizing the impact of this work.Video Abstract is available for more insights from the authors (see Supplemental Digital Content 1, http://links.lww.com/JNPT/A123).

Subacute neuroendocrine and behavioral effects of underwater trauma and predator exposure in rats

Traumatic stress physiological response and recovery encompasses a wide range of measurable behavioral and neuroendocrine changes in rats. Acute stress response and return to baseline may vary across differing neuroendocrine signaling molecules and behavioral manifestations, and may also be influenced by extrinsic factors such as the specific stressor presented or phase of the circadian cycle during which responses are evaluated. While rodent models of traumatic stress have been used to evaluate acute and chronic changes in these measures, few longitudinal studies have been done to characterize multiple interrelated neuroendocrine markers across the circadian cycle and compare to acute and lasting behavioral changes. We set out to describe the subacute effects of traumatic stress exposure on exploratory behavior, acoustic startle response, and a panel of neuroendocrine markers across the circadian cycle. Rats were exposed to either underwater trauma (UWT) or predator exposure (PRED). Then repeated behavioral tests (exploratory behavior on the elevated plus maze, acoustic startle) were conducted across 7 days, or in yoked cohorts, blood samples were collected at 10 time points over the next 7 days. Neuroendocrine markers were quantified from serum using LC‐MS or ELISA, analyzed over time, and compared against behavioral responses at several corresponding time points. Preliminary data show differential responses for UWT and PRED across the experimental timeline, and distinct response timelines for the different measures collected.Support or Funding InformationSupported by the Military Operational Medicine Research Program, US Army Medical Research and Materiel Command.

Evaluating new gerontechnologies: Proof of concept is necessary, but not sufficient

Background At a minimum, evaluation of a gerontechnology requires two steps: (i) a proof of concept demonstration that the product can operate as intended; and (ii) a demonstration that targeted aging and aged users can, want to, and will use the product as intended to achieve the ends as advertised. The second step is the more difficult; the present article describes some practical procedures for measuring the effect of the product on the individual’s behavior. Methods Single Case Experimental Designs (SCED) allow for efficient evaluation of a product by a small number of users; SCED are especially useful when one or very few prototypes are available for evaluation. Results The basic elements of SCEDs include a no-treatment baseline periods alternating with periods in which the gerontechnology is introduced, with the baseline phase representing a period in which the feature of the product being evaluated is disabled; measurable changes in user behavior with vs. without the product feature enabled constitutes the evaluation. Examples illustrating some ways the basic elements can be implemented are provided. Conclusions SCEDs provide a good alternative to the more expensive and complex Randomized Controlled Trials (RCTs) generally considered the ‘gold standard’ for evaluations.

The Role of Behavioral Counseling in Sexually Transmitted Disease Prevention Program Settings.

Behavioral counseling for sexually transmitted disease (STD) prevention is recommended for persons at risk, and the body of evidence yields numerous interventions that have STD preventive efficacy. What is needed is a review of the subset of these interventions that could be feasible in clinical settings, especially settings in STD prevention programs. We reviewed existing systematic reviews of the literature and abstracted from them studies that fit the following criteria in that the interventions: (1) used no more than 60 minutes of contact time in 1 to 2 sessions, (2) were individual level and face to face, (3) took place in a clinical setting, (4) had STD outcomes available, (5) were based in the United States, (6) were peer reviewed, and (7) had a control group. From 6 reviews (published 2006-2014) covering 91 studies, we found 13 analyses representing 11 intervention studies that fit the selection criteria. Of these 13, 5 returned lower STD rates in the intervention group at follow-up; one study reported a higher rate of STD in one subset of the intervention group (men who have sex with men). Studies with effects on STD at follow-up were quite similar to studies across populations, settings, and follow-up periods, although successful interventions were more likely to demonstrate behavioral effects as well (5/5 vs. 2/5 among 10 interventions measuring behavior change). Counseling is likely to benefit some STD clinic attendees, although unlikely to benefit men who have sex with men. The balance of costs and benefits of implementing behavioral counseling in STD programs is unclear, but feasibility would be improved if behavioral counseling were implemented in the context of other prevention efforts. Because populations outside typical STD clinic settings could also benefit, programs may exercise a valuable role through partnerships.

Theta and Alpha Band Modulations Reflect Error-Related Adjustments in the Auditory Condensation Task.

Error commission leads to adaptive adjustments in a number of brain networks that subserve goal-directed behavior, resulting in either enhanced stimulus processing or increased motor threshold depending on the nature of errors committed. Here, we studied these adjustments by analyzing post-error modulations of alpha and theta band activity in the auditory version of the two-choice condensation task, which is highly demanding for sustained attention while involves no inhibition of prepotent responses. Errors were followed by increased frontal midline theta (FMT) activity, as well as by enhanced alpha band suppression in the parietal and the left central regions; parietal alpha suppression correlated with the task performance, left central alpha suppression correlated with the post-error slowing, and FMT increase correlated with both behavioral measures. On post-error correct trials, left-central alpha band suppression started earlier before the response, and the response was followed by weaker FMT activity, as well as by enhanced alpha band suppression distributed over the entire scalp. These findings indicate that several separate neuronal networks are involved in post-error adjustments, including the midfrontal performance monitoring network, the parietal attentional network, and the sensorimotor network. Supposedly, activity within these networks is rapidly modulated after errors, resulting in optimization of their functional state on the subsequent trials, with corresponding changes in behavioral measures.

Lectin staining and flow cytometry reveals female-induced sperm acrosome reaction and surface carbohydrate reorganization.

All cells are covered by glycans, an individually unique layer of oligo- and polysaccharides that are critical moderators of self-recognition and other cellular-level interactions (e.g. fertilization). The functional similarity between these processes suggests that gamete surface glycans may also have an important, but currently overlooked, role in sexual selection. Here we develop a user-friendly methodological approach designed to facilitate future tests of this possibility. Our proposed method is based on flow cytometric quantification of female-induced sperm acrosome reaction and sperm surface glycan modifications in the Mediterranean mussel Mytilus galloprovincialis. In this species, as with many other taxa, eggs release water-soluble factors that attract conspecific sperm (chemoattraction) and promote potentially measurable changes in sperm behavior and physiology. We demonstrate that flow cytometry is able to identify sperm from other seawater particles as well as accurately measure both acrosome reaction and structural modifications in sperm glycans. This methodological approach can increase our understanding of chemically-moderated gamete-level interactions and individual-specific gamete recognition in Mytilus sp. and other taxa with similar, easily identifiable acrosome structure. Our approach is also likely to be applicable to several other species, since carbohydrate-mediated cellular-level interactions between gametes are universal among externally and internally fertilizing species.

Engaging communities in changing the environment to promote transport-related walking: Evaluation of route use in the ‘Fitter for Walking’ project

Abstract Promoting walking for transport may help to increase physical activity levels. Associations between the built environment and walking for transport have been well reported. Engaging communities in making small-scale changes to local routes is one potential low-cost strategy to improve neighbourhood environments. The purpose of this study was to evaluate changes in pedestrian use of local routes following environmental changes made by communities and local authorities (LAs) in the ‘Fitter for Walking’ (FFW) project, to assess route users’ awareness of the environmental improvements which were implemented and to make recommendations for future evaluation. FFW targeted deprived communities in twelve LA areas in England. Coordinators worked with communities and LA partners to improve local route environments based on identified barriers to walking. Route user counts and intercept surveys were conducted in five FFW case studies at baseline, 12 months and 14–20 months after the project activities had commenced. A wide range of environmental improvements were undertaken. After 12 months, there was a decrease in pedestrian route use overall (−19.4%) and in four case studies (range −42.1% to −10.4%). However, after 14–20 months, an increase in pedestrian route user overall (14.9%) and in all case studies (range 5.4–58.9%) was observed compared to baseline. Route users’ awareness of environmental improvements made to routes varied across case studies and was very low for some of the improvements which had been made. Engaging communities in making small-scale environmental improvements to key routes in local neighbourhoods may be an effective, low-cost strategy for increasing walking for transport. Increasing the number of people walking on newly improved routes may take a long time and require additional promotional initiatives. Evaluating these types of initiatives is challenging. These factors should be considered by health and transport professionals developing initiatives and by researchers interested in measuring behaviour change.

Evaluating Teen Pregnancy Prevention Programs: Decades of Evolving Strategies and Practices

This paper reviews the changing strategies for both process and outcome evaluations of teen pregnancy prevention programs over the past few decades. Implementation evaluations have emphasized discovery of what program attributes are most effective in reducing teen pregnancy and its antecedents. Outcome evaluations have moved from collecting data to measure knowledge, attitudes, and program satisfaction to measuring behavior change including postponement of sexual involvement, increased used of contraception, or reduction in teen pregnancy. High quality randomized control trials or quasi-experimental designs are being increasingly emphasized, as are sophisticated analysis techniques using multi-variate analyses, controls for cluster sampling, and other strategies designed to build a more solid knowledge base about how to prevent early pregnancy.

The influence of short term perceptual learning of pitch discrimination and modulation discrimination on subcortical envelope-following and cortical steady-state EEG responses

Many perceptual skills improve with training, and research suggests that long- and short-term experiences modify auditory neural structures and function. Long-term cortical and subcortical plasticity has been associated with musical training and fluency in tonal languages, and short-term training effects have been regularly observed in cortical responses. Less is known about short-term subcortical plasticity, or the simultaneous relationships between subcortical and cortical responses under training conditions. The current study examines short-term learning and neural plasticity, using behavioral measures in combination with simultaneous subcortical and cortical steady-state EEG responses. Untrained, naive subjects were randomly assigned to groups that were trained on fundamental-frequency (F0) discrimination, amplitude-modulation rate discrimination, or visual orientation discrimination. All auditory stimuli consisted of unresolved harmonic complexes with a nominal F0 of 137 Hz that were sinusoidally amplitude modulated at 100% depth and 13-Hz rate. Simultaneous subcortical envelope-following responses (EFR) to the F0 and cortical auditory steady-state responses (ASSR) to the modulation rate were measured pre- and post-training, and changes in the magnitude of phase locking to the respective frequency components were compared to changes in behavioral measures. The methods provide a new window on subcortical and cortical plasticity and their interactions. [Work supported by NIH grant R01DC05216.]

Examining the causal effects of changes in iron status on brain and attentional functioning using structural equation modeling

Iron deficiency (ID) in otherwise healthy adults can impair perceptual and cognitive functioning, along with brain dynamics (as measured by EEG). We used structural equation modeling (SEM) to test the hypothesis that changes in iron status lead to changes in brain functioning and then to changes in behavioral measures. The data used here were taken from 54 ID (sFt <15 µg/L) participants in a randomized double‐blind efficacy study. Blood, behavioral, and EEG measures were taken at baseline, endline, and at one of eight random time‐points in between. Five measures of iron status, behavioral data from three tasks measuring attentional capture and control, and peak amplitudes of a set of event related potentials (ERP) measures taken during the tasks at baseline were used as indicators of separate latent constructs in a set of contrasting SEMs. Thus far, a model with three latent factors provides the best description of the data, with the three latent factors being (a) systemic iron (sFt and sTfR) directly influencing (b) brain dynamics (ERP amplitudes), with brain dynamics then influencing (c) attentional function (reaction times from the three tasks). This model provides a better description of the data than does a model representing no causal link from blood to brain to behavior, or a model in which oxygen delivery (as indicated by hemoglobin, red blood cell distribution width, and mean cell volume) influences brain dynamics and then attentional functioning. These results suggest the utility of SEMs to relate changes in blood, brain, and behavior.

Quantifying behaviors of children with Sanfilippo syndrome: the Sanfilippo Behavior Rating Scale.

The Sanfilippo Behavior Rating Scale (SBRS), a 68 item questionnaire, has been developed to assess the behavioral phenotype of children with Sanfilippo syndrome and its progression over time. Fifteen scales rate orality, movement/activity, attention/self-control, emotional function including anger and fear, and social interaction. Items within scales intercorrelate; measures of internal consistency are adequate. Twelve scales are grouped into 4 abnormality clusters: Movement, Lack of fear, Social/emotional and Executive Dysfunction. A Loess age-trajectory analysis showed that Lack of Fear, Social/Emotional and Executive Dysfunction increased steadily with age; Orality and Mood/Anger/Aggression leveled off. Movement peaked around 6years, then declined as children's excessive/purposeless actions stopped. Compared with standard scales, SBRS Movement was appropriately associated with the Vineland Motor scale; SBRS Lack of Fear had significant associations with the Autism Diagnostic Observation Schedule (ADOS), indicating a symptom overlap between Sanfilippo syndrome and autism. This suggests that reduced fearfulness may be the most salient/sensitive SBRS marker of disease progression. Volumetric MRI showed that increased Lack of Fear was significantly associated with reduced amygdala volume, consistent with our hypothesis that the behavior seen in Sanfilippo syndrome is a variant of Klüver-Bucy syndrome. Hippocampal volume loss had twice the effect on Social-Emotional Dysfunction as amygdala loss, consistent with a hippocampal role in attachment and social emotions. In conclusion, the SBRS assesses the Sanfilippo behavioral phenotype; it can measure behavior change that accompanies disease progression and/or results from treatment.

Effects of a web-based educational module on pediatric emergency medicine physicians' knowledge, attitudes, and behaviors regarding youth violence.

Introduction:Youth seen in the emergency department (ED) with injuries from youth violence (YV) have increased risk for future violent injury and death. Pediatric emergency medicine (PEM) physicians rarely receive training in, or perform, YV screening and intervention. Our objective was to examine effects of a web-based educational module on PEM physicians' knowledge, attitudes, and behaviors regarding YV screening and interventions in the ED.Methods:We invited all PEM fellows and attendings at an urban Level I pediatric trauma center to complete an interactive web-based education module (and 1-month booster) with information on YV's public health impact and how to screen, counsel and refer YV-involved patients. Consenting subjects completed electronic assessments of YV prevention knowledge and attitudes (using validated measures when possible) before and after the initial module and after the booster. To measure behavior change, chart review identified use of YV-specific discharge instructions in visits by YV-injured PEM patients (age 12–17; identified by E codes) 6 months before and after the intervention. We analyzed survey data were analyzed with Fisher's exact for binary outcomes and Kruskal-Wallis for Likert responses. Proportion of patients given YV discharge instructions before and after the intervention was compared using chi-square.Results:Eighteen (67%) of 27 PEM physicians participated; 1 was lost at post-module assessment and 5 at 1 month. Module completion time ranged from 15–30 minutes. At baseline, 50% of subjects could identify victims' re-injury rate; 28% were aware of ED YV discharge instructions. After the initial module and at 1 month, there were significant increases in knowledge (p<0.001) and level of confidence speaking with patients about avoiding YV (p=0.01, df=2). Almost all (94%) said the module would change future management. In pre-intervention visits, 1.6% of patients with YV injuries were discharged with YV instructions, versus 15.7% in the post-intervention period (p=0.006, 95%CI for difference 3.6%-24.5%).Conclusion:A brief web-based module influenced PEM physicians' knowledge and attitudes about YV prevention and may have affected behavior changes related to caring for YV victims in the ED. Further research should investigate web-based educational strategies to improve care of YV victims in a larger population of PEM physicians.

Changes in functional connectivity correlate with behavioral gains in stroke patients after therapy using a brain-computer interface device.

Brain-computer interface (BCI) technology is being incorporated into new stroke rehabilitation devices, but little is known about brain changes associated with its use. We collected anatomical and functional MRI of nine stroke patients with persistent upper extremity motor impairment before, during, and after therapy using a BCI system. Subjects were asked to perform finger tapping of the impaired hand during fMRI. Action Research Arm Test (ARAT), 9-Hole Peg Test (9-HPT), and Stroke Impact Scale (SIS) domains of Hand Function (HF) and Activities of Daily Living (ADL) were also assessed. Group-level analyses examined changes in whole-brain task-based functional connectivity (FC) to seed regions in the motor network observed during and after BCI therapy. Whole-brain FC analyses seeded in each thalamus showed FC increases from baseline at mid-therapy and post-therapy (p < 0.05). Changes in FC between seeds at both the network and the connection levels were examined for correlations with changes in behavioral measures. Average motor network FC was increased post-therapy, and changes in average network FC correlated (p < 0.05) with changes in performance on ARAT (R2 = 0.21), 9-HPT (R2 = 0.41), SIS HF (R2 = 0.27), and SIS ADL (R2 = 0.40). Multiple individual connections within the motor network were found to correlate in change from baseline with changes in behavioral measures. Many of these connections involved the thalamus, with change in each of four behavioral measures significantly correlating with change from baseline FC of at least one thalamic connection. These preliminary results show changes in FC that occur with the administration of rehabilitative therapy using a BCI system. The correlations noted between changes in FC measures and changes in behavioral outcomes indicate that both adaptive and maladaptive changes in FC may develop with this therapy and also suggest a brain-behavior relationship that may be stimulated by the neuromodulatory component of BCI therapy.

FRI0201 Are Rheumatic Disease Patient Reported Outcomes Collected Passively and Directly through Smart Phones Feasible? Early Results from A Nation-Wide Pilot Study

BackgroundRheumatoid arthritis (RA) and other rheumatic diseases (RD) are associated with depression, fatigue, and disturbed sleep, symptoms that often impact behavior. Recent advances in reality mining technology combined with the...

The Framing Effects of Multipart Pricing on Consumer Purchasing Behavior of Customized Information Good Bundles

Applying behavioral economic theories, we hypothesize that consumers have sticky reference prices for individual information goods, but their perceived value for customizable bundle offers can be significantly influenced by the framing of a multipart pricing scheme. The potential impacts of these framing effects are measurable changes in consumer behavior and sales outcomes. We conducted a series of behavioral experiments and a large-scale natural field experiment involving actual purchases of customized information good bundles to confirm and analyze the hypothesized effects. The results demonstrate a consumer's willingness to purchase a customized bundle of information goods, the size of the resulting bundling, and the consumer's perceptions of the transaction are each significantly influenced by the design of the multipart pricing scheme. These results hold even when the final price and size of a customized bundle are the same across differing schemes. We discuss the potential tradeoffs in economic outcomes that result from price framing (e.g., likelihood of sale versus size of purchased bundles) and the implications for information good retailers.

SPERM COMPETITIVE ABILITY EVOLVES IN RESPONSE TO EXPERIMENTAL ALTERATION OF OPERATIONAL SEX RATIO

In naturally polygamous organisms such as Drosophila, sperm competitive ability is one of the most important components of male fitness and is expected to evolve in response to varying degrees of male-male competition. Several studies have documented the existence of ample genetic variation in sperm competitive ability of males. However, many experimental evolution studies have found sperm competitive ability to be unresponsive to selection. Even direct selection for increased sperm competitive ability has failed to yield any measurable changes. Here we report the evolution of sperm competitive ability (sperm defense-P1, offense-P2) in a set of replicate populations of Drosophila melanogaster subjected to altered levels of male-male competition (generated by varying the operational sex ratio) for 55-60 generations. Males from populations with female-biased operational sex ratio evolved reduced P1 and P2, without any measurable change in the male reproductive behavior. Males in the male-biased regime evolved increased P1, but there was no significant change in P2. Increase in P1 was associated with an increase in copulation duration, possibly indicating greater ejaculate investment by these males. This study is one of the few to provide empirical evidence for the evolution of sperm competitive ability of males under different levels of male-male competition.

Reversible aging behavior of La0.8Sr0.2MnO3 electrodes at open circuit

La0.8Sr0.2MnO3 (LSM) electrodes on yttria-stabilized zirconia (YSZ) electrolytes were characterized at open circuit by impedance spectroscopy. An initial irreversible change in the polarization resistance is observed for cells aged with no prior current activation. After the initial break-in, the polarization resistance rises with time at 700 °C and decays at 800 °C, reversibly, over repeated temperature cycles. The initial irreversible break-in and subsequent reversible cycling behavior suggests multiple processes happening within the time and temperatures measured. The authors propose that these processes are (1) changes in the wetting behavior of the LSM on the YSZ and (2) the reversible segregation/desegregation of cations within LSM. Between 700 °C and 800 °C, there is a transition temperature at which the segregation behavior of cations to the cathode surface changes. These measurable changes in the impedance behavior of LSM indicate that cation segregation, while considered by some to be part of the cathode activation process, may be dictated by thermodynamic factors, and thus not strictly dependent on the passage of current through the cathode.

The long term effectiveness of intensive stuttering therapy: A mixed methods study

PurposeThe purpose of this study was to gain a deeper understanding of client perceptions of an intensive stuttering therapy program that utilizes a multi-faceted approach to therapy. The study also proposed to gain a deeper understanding about the process involved in long-term maintenance of meaningful changes made in therapy. MethodsThe study used a mixed methods design. The core method was a phenomenological approach using semi-structured interviews. Objective clinical data was gathered concurrently. This included archival records and current measures on a variety of assessments to evaluate stuttering severity and attitudes toward communication. ResultsThe major themes generated from participants’ transcripts included (1) the positive effects of the Duration and Nature of the Program; (2) Speech Techniques Learned; (3) Attitude Change and Counseling; and (4) activities related to Desensitization and Transfer. The participants also reported positive effects of their personal motivation and clinician attitudes. Clinical data indicated that the participants made measurable clinical gains on all measures of stuttering severity and attitude change following the intensive clinic and these changes were maintained long after the program was completed. ConclusionsIt appears that this intensive stuttering therapy program is effective for making positive changes in behavioral measures of speech disfluencies, and attitudes. Clients reported multiple factors directly related to the program and personal factors that contributed to treatment effectiveness. Hence, future studies should explore and report on a variety of factors related to communication attitudes and overall quality of life in addition to behavioral measures of speech.Educational objectives: After reading this article, the learner will be able to: (a) identify the basic tenets of evidence-based practice; (b) summarize what we currently know about the effectiveness of behavioral treatments of stuttering; (c) identify factors that client report as important to treatment effectiveness.

Task-sensitivity of unconscious word processing in spatial neglect

Neuropsychological studies of spatial neglect have shown that ignored visual stimuli can produce measurable behavioral changes without eliciting subjective perceptual experience. However, such non-conscious, implicit cognitive processing may not be fully automatic but rather could be influenced by the patients’ voluntary behavioral control. Using a hemifield priming paradigm with two different task instructions, we studied spatial neglect patients to assess whether non-conscious processing of ignored words is modulated by behavioral task requirements. In each trial, participants named or categorized a centrally presented target following a masked prime flashed to the left or right hemifield. By delivering equally invisible stimuli to both hemifields, this design allowed rigorous testing of the impact of task instructions on non-conscious processing in neglect patients and control participants. We observed that neglect patients showed slightly different patterns of masked priming from those obtained in healthy and right-hemisphere control patients. Importantly, however, all these three groups showed strong sensitivity to task contexts during the unconscious processing of masked words. The present results provide neuropsychological evidence that robust task-sensitive neural pathways are covertly operating on weak and normally imperceptible visual stimuli even when visuospatial attention is severely compromised.

Triglyceride, nonesterified fatty acids, and prediabetic neuropathy: role for oxidative–nitrosative stress

Peripheral neuropathy develops in human subjects with prediabetes and metabolic syndrome before overt hyperglycemia. The contributions of impaired glucose tolerance and insulin signaling, hypertriglyceridemia and/or increased nonesterified fatty acids (NEFA), and hypercholesterolemia to this condition remain unknown. Niacin and its derivatives alleviate dyslipidemia with a minor effect on glucose homeostasis. This study evaluated the roles of impaired glucose tolerance versus dyslipidemia in prediabetic neuropathy using Zucker fatty (fa/fa) rats and the niacin derivative acipimox, as well as the interplay of hypertriglyceridemia, increased NEFA, and oxidative–nitrosative stress. Sixteen-week-old Zucker fatty rats with impaired glucose tolerance, obesity, hyperinsulinemia, hypertriglyceridemia, hypercholesterolemia, and increased NEFA displayed sensory nerve conduction velocity deficit, thermal and mechanical hypoalgesia, and tactile allodynia. Acipimox (100mgkg−1day−1, 4weeks) reduced serum insulin, NEFA, and triglyceride concentrations without affecting glucose tolerance and hypercholesterolemia. It alleviated sensory nerve conduction velocity deficit and changes in behavioral measures of sensory function and corrected oxidative–nitrosative stress, but not impaired insulin signaling, in peripheral nerve. Elevated NEFA increased total and mitochondrial superoxide production and NAD(P)H oxidase activity in cultured human Schwann cells. In conclusion, hypertriglyceridemia and/or increased NEFA concentrations cause prediabetic neuropathy through oxidative–nitrosative stress. Lipid-lowering agents and antioxidants may find a use in the management of this condition.