Examined Symptom Severity Research Articles

Intergenerational transmission of comorbid internalizing and externalizing psychopathology at age 11: Evidence from an adoption design for general transmission of comorbidity rather than homotypic transmission.

Psychopathology is intergenerationally transmitted through both genetic and environmental mechanisms via heterotypic (cross-domain), homotypic (domain-specific), and general (e.g., "p-factor") pathways. The current study leveraged an adopted-at-birth design, the Early Growth and Development Study (57% male; 55.6% White, 19.3% Multiracial, 13% Black/African American, 10.9% Hispanic/Latine) to explore the relative influence of these pathways via associations between adoptive caregiver psychopathology (indexing potential environmental transmission) and birth parent psychopathology (indexing genetic transmission) with adolescent internalizing and externalizing symptoms. We included composite measures of adoptive and birth parent internalizing, externalizing, and substance use domains, and a general "p-factor." Age 11 adolescent internalizing and externalizing symptom scores were the average of adoptive parent reports on the Child Behavior Checklist (n = 407). Examining domains independently without addressing comorbidity can lead to incorrect interpretations of transmission mode. Therefore, we also examined symptom severity (like the "p-factor") and an orthogonal symptom directionality score to more cleanly disentangle transmission modes. The pattern of correlations was consistent with mostly general transmission in families with youth showing comorbid internalizing and externalizing symptoms, rather than homotypic transmission. Findings more strongly supported potential environmental or evocative mechanisms of intergenerational transmission than genetic transmission mechanisms (though see limitations). Parent-specific effects are discussed.

The role of depression and anxiety symptom severity in remotely delivered mental health care.

This study examined differences in mental health characteristics of Veterans who received VA Video Connect (VVC) or audio-only care during initial phases of the COVID-19 pandemic. A cohort of Veterans with primary diagnoses of depressive or anxiety disorders (diagnosed between March 2019 and February 2020) was identified, and data were obtained for Veterans who engaged in virtual care from April to December 2020. Two groups were created: Veterans receiving audio-only care (n = 161,071) and Veterans receiving two or more VVC visits (n = 84,505). Multiple logistic regression models examined symptom severity in the year before COVID as a predictor of treatment modality during COVID. Chi-square tests examined associations between modality and the number of assessments. Symptom severity as evaluated by the nine-item Patient Health Questionnaire and Generalized Anxiety Disorder-7 significantly predicted modality of encounters during the pandemic such that those who had moderate or severe symptoms prior to COVID-19 were more likely than those with low or no symptoms to have two or more VVC encounters during the pandemic. Of those who received VVC, 55.62% had no Patient Health Questionnaire-9 assessments compared to 68.96% of those who received audio-only. In the VVC group, 70.36% had no Generalized Anxiety Disorder-7 assessments compared to 81.02% in the audio-only group. Taken together, these findings suggest that VVC, when compared to audio-only, was used during the pandemic to reach Veterans with more severe mental health symptomatology and to engage in administration of measurement-based care. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Smaller total and subregional cerebellar volumes in posttraumatic stress disorder: a mega-analysis by the ENIGMA-PGC PTSD workgroup

Although the cerebellum contributes to higher-order cognitive and emotional functions relevant to posttraumatic stress disorder (PTSD), prior research on cerebellar volume in PTSD is scant, particularly when considering subregions that differentially map on to motor, cognitive, and affective functions. In a sample of 4215 adults (PTSD n = 1642; Control n = 2573) across 40 sites from the ENIGMA-PGC PTSD working group, we employed a new state-of-the-art deep-learning based approach for automatic cerebellar parcellation to obtain volumetric estimates for the total cerebellum and 28 subregions. Linear mixed effects models controlling for age, gender, intracranial volume, and site were used to compare cerebellum volumes in PTSD compared to healthy controls (88% trauma-exposed). PTSD was associated with significant grey and white matter reductions of the cerebellum. Compared to controls, people with PTSD demonstrated smaller total cerebellum volume, as well as reduced volume in subregions primarily within the posterior lobe (lobule VIIB, crus II), vermis (VI, VIII), flocculonodular lobe (lobule X), and corpus medullare (all p-FDR < 0.05). Effects of PTSD on volume were consistent, and generally more robust, when examining symptom severity rather than diagnostic status. These findings implicate regionally specific cerebellar volumetric differences in the pathophysiology of PTSD. The cerebellum appears to play an important role in higher-order cognitive and emotional processes, far beyond its historical association with vestibulomotor function. Further examination of the cerebellum in trauma-related psychopathology will help to clarify how cerebellar structure and function may disrupt cognitive and affective processes at the center of translational models for PTSD.

Examination of posture and balance in children with primary monosymptomatic nocturnal enuresis.

This study aimed to examine symptom severity, posture, and balance of children with primary monosymptomatic nocturnal enuresis (PMNE) and compare to a healthy control group. Thirty-five children with PMNE and 34 healthy children were included in this study. Physical and sociodemographic characteristics of the children were recorded. Symptom severity was assessed with a Vancouver Non-Neurogenic Lower Urinary Tract Dysfunction/Dysfunctional Elimination Syndrome Questionnaire (NLUTD/DES), a four-day bladder diary and a seven-day bowel diary. Standing postural alignment was assessed with the Spinal Mouse device, and the sensory integration of static balance and dynamic standing balance was assessed with the Biodex Balance System SD. Compared to healthy controls, children with PMNE demonstrated increased symptom severity (p = 0.001), increased upright lumbar lordosis (p = 0.018) and sacral-hip angles (p = 0.029), decreased static balance in the sensory condition of unstable surface with eyes closed (p = 0.001), and decreased mediolateral dynamic balance (p = 0.049). Children with PMNE demonstrate altered postural alignment, static and dynamic postural instability, and greater symptom severity on the Vancouver NLUTD/DES than age-matched controls.

Post hoc analysis examining symptom severity reduction and symptom absence during food challenges in individuals who underwent oral immunotherapy for peanut allergy: results from three trials

PurposePeanut allergy and its current management, involving peanut avoidance and use of rescue medication during instances of accidental exposure, are burdensome to patients and their caregivers and can be a source of stress, uncertainty, and restriction. Physicians may also be frustrated with a lack of effective and safe treatments other than avoidance in the current management of peanut allergy. Efficacy, determined using double-blind, placebo-controlled food challenges (DBPCFCs), of oral immunotherapy with peanut (Arachis hypogaea) allergen powder-dnfp (PTAH; Palforzia®) was demonstrated versus placebo in children and adolescents aged 4 to 17 years in multiple phase 3 trials; continued benefit of PTAH was shown in a follow-on trial. The DBPCFC is a reproducible, rigorous, and clinically meaningful assessment accepted by regulatory authorities to evaluate the level of tolerance as an endpoint for accidental exposures to peanut in real life. It also provides useful clinical and patient-relevant information, including the amount of peanut protein an individual with peanut allergy can consume without experiencing dose-limiting symptoms, severity of symptoms, and organs affected upon ingestion of peanut protein. We explored symptoms of peanut exposure during DBPCFCs from phase 3 and follow-on trials of PTAH to further characterize treatment efficacy from a perspective relevant to patients, caregivers, and clinicians.MethodsSymptom data recorded during screening and/or exit DBPCFCs from participants aged 4 to 17 years receiving PTAH or placebo were examined post hoc across three PTAH trials (PALISADE [ARC003], ARC004 [PALISADE follow-on], and ARTEMIS [ARC010]). The maximum peanut protein administered as a single dose during DBPCFCs was 1000 mg (PALISADE and ARTEMIS) and 2000 mg (ARC004). Symptoms were classified by system organ class (SOC) and maximum severity. Endpoints were changes in symptom severity and freedom from symptoms (ie, asymptomatic) during DBPCFC. Relative risk (RR) was calculated for symptom severity by SOC and freedom from symptoms between groups; descriptive statistics were used to summarize all other data.ResultsThe risk of any respiratory (RR 0.42 [0.30–0.60], P < 0.0001), gastrointestinal (RR 0.34 [0.26–0.44], P < 0.0001), cardiovascular/neurological (RR 0.17 [0.08–0.39], P < 0.001), or dermatological (RR 0.33 [0.22–0.50], P < 0.0001) symptoms was significantly lower in participants treated with PTAH versus placebo upon exposure to peanut at the end of the PALISADE trial (ie, exit DBPCFC). Compared with placebo-treated participants (23.4%), the majority (76.3%) of PTAH-treated participants had no symptoms at the exit DBPCFC when tested at the peanut protein dose not tolerated (ie, reactive dose) during the screening DBPCFC. Significantly higher proportions of PTAH-treated participants were asymptomatic at doses ≤ 100 mg in the exit DBPCFC compared with placebo-treated participants (PALISADE: 69.35% vs 12.10%, RR 5.73 [95% confidence interval (CI) 3.55–9.26]; P < 0.0001; ARTEMIS: 67.42% vs 13.95%, RR 4.83 [95% CI 2.28–10.25]; P < 0.0001); findings were similar at peanut protein doses ≤ 1000 mg (PALISADE: RR 15.56 [95% CI 5.05–47.94]; P < 0.0001; ARTEMIS: RR 34.74 [95% CI 2.19–551.03]; P < 0.0001). In ARC004, as the period of PTAH maintenance became longer, greater proportions of participants were asymptomatic at doses of peanut protein ≤ 1000 mg in the exit DBPCFC (from 37.63% after ~ 6 months of maintenance treatment [exit DBPCFC of PALISADE] to 45.54% after ~ 13 months and 58.06% after ~ 20 months of overall PTAH maintenance treatment).ConclusionsPTAH significantly reduced symptom severity due to exposure to peanut, which is clinically relevant. When exposed to peanut, participants with peanut allergy treated with PTAH rarely had moderate or severe respiratory or cardiovascular/neurological symptoms. Oral immunotherapy with PTAH appears to reduce frequency and severity of allergic reactions in individuals with peanut allergy after accidental exposure to peanut and may enable them and their families to have an improved quality of life.Trial registration ClinicalTrials.gov, NCT02635776, registered 17 December 2015, https://clinicaltrials.gov/ct2/show/NCT02635776?term=AR101&draw=2&rank=7; ClinicalTrials.gov, NCT02993107, registered 08 December 2016, https://clinicaltrials.gov/ct2/show/NCT02993107?term=AR101&draw=2&rank=6; ClinicalTrials.gov, NCT03201003, registered 22 June 2017, https://clinicaltrials.gov/ct2/show/NCT03201003? term = AR101&draw = 2&rank = 9

The unique association of posttraumatic stress disorder with hypertension among veterans: A replication of Kibler et al. (2009) using Bayesian estimation and data from the United States-Veteran Microbiome Project.

Kibler et al. (2009) reported that hypertension was related to PTSD independent of depression. These two conditions have significant diagnostic overlap. The present study sought to conceptually replicate this work with a veteran sample, using Bayesian estimation to directly update past results, as well as examine symptom severity scores in relation to hypertension. This was a secondary analysis of data obtained from the United States-Veteran Microbiome Project. Lifetime diagnoses of PTSD and major depressive disorder (MDD) were obtained from a structured clinical interview and hypertension diagnoses were extracted from electronic medical records. PTSD and depressive symptom severity were obtained from self-report measures. Logistic regressions with Bayesian estimation were used to estimate the associations between hypertension and (a) psychiatric diagnostic history and (b) symptom severity scores. Compared with veterans without lifetime diagnoses of either disorder, the PTSD-only group was estimated to have a 29% increase in hypertension risk, and the PTSD + MDD group was estimated to have a 66% increase in hypertension risk. Additionally, higher levels of PTSD symptom severity were associated with a higher risk of hypertension. PTSD diagnosis and symptom severity are uniquely associated with hypertension, independent of MDD or depressive symptom severity. These results support previous findings that PTSD might be a modifiable risk factor for the prevention and treatment of hypertension. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Are β3 -adrenoceptor gene polymorphisms relevant for urology?

β3 -adrenoceptors (ARs) are an important drug target for the treatment of overactive bladder syndrome (OAB) and are under investigation for other indications. The human β3 -AR gene is polymorphic; an exchange of amino acid tryptophan (Trp) for arginine (Arg) in position 64 of the receptor protein is the most frequent and best-studied polymorphism. A narrative review on the impact of β3 -AR polymorphisms on urological disease and its treatment is presented. Two out of four studies have reported that the 64Arg allele was found more frequently in subjects with OAB thanin healthy controls. A large study in a highly selective population (men undergoing prostatectomy for cancer treatment) did not confirm this. On the other hand, studies examining symptom severity typically found little difference between 64Arg and 64Trp carriers. In vitro studies with endogenously expressed β3 -AR reported a decreased lipolytic response in human adipose tissue. Studies with heterologously expressed receptors sometimes found a decreased responsiveness to agonists including β3 -AR agonists, but others did not confirm that. The overall evidence points to carriers of the 64Arg genotype expressing fewer and/or hypofunctional β3 -ARs and being associated with the presence of OAB but such findings were only detected inconsistently. If this hypofunctionality exists, the consequences may be of insufficient magnitude to allow a robust detection. Only adequately powered studies comparing responses with a β3 -AR agonist in 64Arg carriers versus wild-type patients can address this.

Increased symptom severity in adults and adolescents admitting to an inpatient psychiatric hospital during the COVID-19 pandemic

While the negative effects of Coronavirus Disease-2019 (COVID-19) on general mental health are well-established, less is known about the impact on those with severe mental illness. Thus, this study examined symptom severity among psychiatric inpatients admitted prior to versus during the COVID pandemic. Self-reported anxiety (GAD-7), depression (PHQ-9), emotional dysregulation (DERS-SF), sleep quality (PSQI), nightmares (DDNSI), and suicidal ideation (SBQ-R) were examined in 470 adults (n = 235 admitted pre-pandemic) and 142 children and adolescents (n = 65 admitted pre-pandemic) at admission. Adults also completed measures of disability (WHODAS) and substance use (WHOASSIST). Adults admitted during the COVID pandemic reported significantly higher levels of anxiety [p < .001, partial η2=0.18], depression [p < .001, partial η2=0.06], emotion dysregulation [p < .001, partial η2=0.05], nightmares [p = .013, partial η2=0.01], and disability [p < .001, partial η2=0.04] compared to adults admitted pre-COVID. Levels of anxiety [p = .005, partial η2=0.05], depression [p = .005, partial η2=0.06], and sleep quality [p = .011, partial η2=0.05] were significantly higher among adolescents admitted during COVID compared to pre-COVID. The findings help identify areas of prioritization for future mental health prevention/intervention efforts for future disease outbreaks.

Integrating genetic variation with DNA methylation at SKA2 rs7208505 in analyses of obsessive-compulsive disorder disease risk and symptom severity

BackgroundObsessive-Compulsive Disorder (OCD) has a complex genetic component and may be preceded by environmental stressors. The spindle and kinetochore associated complex subunit 2 (SKA2)gene interacts with the glucocorticoid receptor and is implicated in mediating hypothalamic–pituitary-adrenal (HPA) axis function but has yet to be examined in OCD. We hypothesized that genetic and epigenetic variation of SKA2 may be involved in OCD disease risk and symptom severity. MethodsOCD patients (n = 54) were rated for disease severity using the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS). Genotyping of SKA2 rs7208505 was performed using Taqman TM, while DNA methylation levels were quantified using bisulfite pyrosequencing. OCD genotype frequencies were compared to the general population (n = 379, 1000 Genomes Project Consortium) using Pearson’s chi-square test. The relationships among the rs7208505 variant, methylation density, and symptom severity were modeled using linear regression. ResultsGenotype distributions significantly differed between OCD patients and the 1000 Genomes sample (χ2 (2, n = 433) = 8.66, p = 0.013). The odds of having OCD was 1.66 times more likely for individuals carrying a C allele (OR 1.66 [95% CI: 1.09–2.55]; p = 0 0.02). Specifically, the odds of having the CC genotype was 2.58 times more likely for OCD patients (OR 2.58 [95% CI: 1.23–5.23]; p = 0.007). When examining symptom severity there was no effect of genotype (p > 0.05). Finally, epigenetic variation was not significantly associated with symptom severity in our statistical models. ConclusionsThese results provide preliminary evidence that SKA2 genetic variation may be associated with OCD disease status, while no association was detected when examining symptom severity, or methylation density at this locus. The rs7208505 minor allele occurs more frequently in OCD patients than in the general population, suggesting that there is merit in pursing further studies of this marker in larger sample sizes.

Severe symptoms persist for Up to one year after diagnosis of stage I-III lung cancer: An analysis of province-wide patient reported outcomes

ObjectivesLung cancer is associated with significant disease- and treatment-related morbidity. The Edmonton Symptom Assessment System (ESAS) is a tool developed to elicit patients' own assessment of the severity of common cancer-associated symptoms. The objective of this study was to examine symptom severity in the 12 months following diagnosis of lung cancer, and to identify predictors of high symptom burden. Materials and Methods: This was a retrospective population-based cohort study, including patients with stage I-III lung cancer diagnosed between 2007–2016, and who had symptom screening in the 12 months following diagnosis. The proportion of patients reporting severe symptoms (ESAS ≥ 7) in the year following diagnosis was plotted over time. Multivariable regression models were constructed to identify factors associated with severe symptoms. Results69,440 unique symptom assessments were reported by 11,075 lung cancer patients. Tiredness was the most prevalent severe symptom (47.3 %), followed by shortness of breath (39.4 %) and poor wellbeing (36.5 %) among all disease stages. Patients diagnosed with higher stage disease reported more severe symptoms, but symptom trajectories were similar for all stages in the year following diagnosis. Disease stage (RR 1.10–2.01), comorbidity burden (RR 1.17–1.51), degree of socioeconomic marginalization (RR1.15-1.45), and female sex (RR 1.15–1.50) were associated with reporting severe symptoms in the year following diagnosis. ConclusionSevere physical and psychological symptoms persist throughout the first year following lung cancer diagnosis, regardless of disease stage. Those at risk of experiencing high symptom burden may benefit from targeted supportive care interventions, including psychosocial support aimed at improving health-related quality of life.

Does Physical Therapy Produce Value for Post-Operative and/or Non-Operative Foot and Ankle Patients?

Category:OutcomesIntroduction/Purpose:Healthcare is at a unique time in history where patient reported outcomes have become important in assessing value and subsequent reimbursement with pay-4-performance initiatives. It is unclear whether physical function, pain and depressive symptoms can assist providers determine if additional physical therapy may improve care for foot and ankle patients considering post-op and/or non-operative care. The purpose of this research was to examine symptom severity (PROMIS PF, PI, and Dep) after surgery or with non-operative care at the start of formal physical therapy to determine if this symptom severity presentation and/or change in symptoms over time are predictors of improvement in physical function as assessed by PROMIS PF.Methods:PROMIS scales were available at the start and end of physical therapy treatment for 377 patients with foot and ankle ICD10 codes. The mean age (40.2±18.1 years), body mass index (BMI) (28.9±7.9 kg/m2), and proportion of females (62.1%) were recorded. The median number of physical therapy visits was 5 (interquartile range=5). Clinical categories of greater than 20 were identified for 7 groups including: Achilles rupture (n=24), Fracture (n=34), Ankle Pain (n=105), Foot Pain (n= 50), Ankle Sprain (n=51), Achilles Non-Rupture (n=45) and Other (n=68). Two multivariate linear regression models; 1) solely using data available at the start of therapy (age, gender, BMI, diagnosis category, PROMIS scores at the start of physical therapy); And, 2) a second model adding change in PROMIS PI, DP and completed visits to model 1 were examined for their ability to predict change in PF (Start to end of physical therapy).Results:The average change in PROMIS PF was 6.5±8.8 with a range of -20 to 49.1. Correlations of PROMIS scales at the start of therapy with change in PROMIS PF were r-values <0.48. Correlations among change in PROMIS PI and Dep with PF scales were r- values <0.38. The first model predicting change in PF based on available data at the start of physical therapy included PROMIS PF(p<0.01), PI(p<0.01) and Dep(p=0.03) at the start of physical therapy (r-value = 0.58 an r-value increase of 0.1 over univariate correlations). No other variables were significant. The second model included PROMIS PF(p<0.01), PI(p<0.01) and Dep (p=0.05) and change in PI(p<0.01), Dep(p=0.01) and visits completed (p<0.01) achieving an r-value = 0.75 (an r-value increase of 0.27 over univariate values) (Figure 1).Conclusion:Providers should consider patients who present with more severe symptoms as good candidates for formal physical therapy. Positive trends during therapy suggest that patient may continue to improve. Severity of PI and Dep at the start of PT were independent predictors of improvements in PF. Using PROMIS assessments, appropriate referrals can be made to physical therapy to improve physical function and add value to the health of our patients.

Assessment of baseline symptom burden in treatment-naïve patients with lung cancer: an observational study.

Patients with newly diagnosed lung cancer who have not yet begun treatment may already be experiencing major symptoms produced by their disease. Understanding the symptomatic effects of cancer treatment requires knowledge of pretreatment symptoms (both severity and interference with daily activities). We assessed pretreatment symptom severity, interference, and quality of life (QOL) in treatment-naïve patients with lung cancer and report factors that correlated with symptom severity. This was a retrospective analysis of data collected at initial intake. Symptoms/interference were rated on the MD Anderson Symptom Inventory (MDASI) between 30days prediagnosis and 45days postdiagnosis. We examined symptom severity by disease stage and differences in severity by histology. Linear regression analyses identified significant predictors of severe pain and dyspnea. Of 460 eligible patients, 256 (62%) had adenocarcinoma, 30 (7%) had small cell carcinoma, and 100 (24%) had squamous cell carcinoma; > 30% reported moderate-to-severe (rated ≥ 5, 0-10 scale) pretreatment symptoms. The most-severe were fatigue, disturbed sleep, distress, pain, dyspnea, sadness, and drowsiness. Symptoms affected work, enjoyment of life, and general activity (interference) and physical well-being (QOL) the most. Patients with advanced disease (n = 289, 63%) had more-severe symptoms. Cancer stage was associated with pain severity; both histology and cancer stage were associated with severe dyspnea. One third of lung cancer patients were symptomatic at initial presentation. Quantification of pretreatment symptom burden can inform patient-specific palliative therapy and differentiate disease-related symptoms from treatment-related toxicities. Poorly controlled symptoms could negatively affect treatment adherence and therapeutic outcomes.

Examining Symptom Severity, Compensatory Maneuvers, and Healthcare Seeking Among Adults With Dysphagia in the U.S.: Results From a Population-Based Survey of 5,000 Americans: Presidential Poster Award

Examining Symptom Severity, Compensatory Maneuvers, and Healthcare Seeking Among Adults With Dysphagia in the U.S.: Results From a Population-Based Survey of 5,000 Americans: Presidential Poster Award

Sociodemographic differences in symptom severity and duration among women referred to secondary care for menorrhagia in England and Wales: a cohort study from the National Heavy Menstrual Bleeding Audit

ObjectiveTo examine symptom severity and duration at time of referral to secondary care for heavy menstrual bleeding (HMB) by socioeconomic deprivation, age and ethnicityDesignCohort analysis of data from the National...

Factors underlying metastatic breast cancer patients' perceptions of symptom importance: a qualitative analysis.

The symptom literature in cancer has primarily examined symptom severity, frequency and distress. Assessing cancer patients' perceptions of symptom importance-how important it is for them to see improvement in a symptom following an intervention-and factors influencing these judgments would also inform patient-centred care, but this analysis has not been undertaken. This qualitative study aimed to identify factors underlying perceptions of symptom importance among 25 symptomatic metastatic breast cancer (MBC) patients. Participants were recruited from a cancer centre in the Midwestern USA. Semi-structured interviews focused on patients' rationale for considering common symptoms (i.e., anxiety, sadness, sleep problems, pain or fatigue) to be important. Thematic analyses revealed five interrelated factors underlying MBC patients' perceptions of symptom importance: activity restriction, concentration difficulties, exacerbation of other physical symptoms, symptom-related long-term health concerns and negative impact on their relationships with others. Patients most frequently stated that a physical or psychological symptom was important because of the resulting activity restriction. Additionally, some patients considered pain to be important because it signalled potential long-term health concerns, such as worsening metastatic disease. Findings suggest that clinicians should take into account MBC patients' perceptions of symptom importance and factors underlying these judgments when making shared treatment decisions.

The Presence of Symptoms With Comorbid Conditions in Individuals With Multiple Sclerosis (MS).

Individuals with multiple sclerosis (MS) may experience symptoms that impact comorbid conditions and quality of life (QOL). There is some evidence that symptom severity may vary in certain common health conditions in this population. We aimed to examine symptom severity in light of comorbid conditions commonly seen in individuals with MS (N = 339). Using a cross-sectional Internet survey, we found there was a significant increase in symptom severity of common symptoms of fatigue, imbalance, and weakness, specifically with presence or absence of certain comorbid conditions (depression, arthritis, migraine headaches, coronary artery disease [CAD]). These findings endorse the presence of more severe symptoms with certain comorbid conditions compared with individuals with MS who do not report having comorbid conditions. The findings support the importance of symptom management in individuals with MS who also have comorbid conditions.

Need for medication and stuffy nose predict the severity of allergic rhinitis.

Need for medication and stuffy nose predict the severity of allergic rhinitis.

Journal Digest

Journal Digest

Sex differences in structural organization of motor systems and their dissociable links with repetitive/restricted behaviors in children with autism.

BackgroundAutism spectrum disorder (ASD) is diagnosed much less often in females than males. Emerging behavioral accounts suggest that the clinical presentation of autism is different in females and males, yet research examining sex differences in core symptoms of autism in affected children has been limited. Additionally, to date, there have been no systematic attempts to characterize neuroanatomical differences underlying the distinct behavioral profiles observed in girls and boys with ASD. This is in part because extant ASD studies have included a small number of girls.MethodsLeveraging the National Database for Autism Research (NDAR), we first analyzed symptom severity in a large sample consisting of 128 ASD girls and 614 age- and IQ-matched ASD boys. We then examined symptom severity and structural imaging data using novel multivariate pattern analysis in a well-matched group of 25 ASD girls, 25 ASD boys, 19 typically developing (TD) girls, and 19 TD boys, obtained from the Autism Brain Imaging Data Exchange (ABIDE).ResultsIn both the NDAR and ABIDE datasets, girls, compared to boys, with ASD showed less severe repetitive/restricted behaviors (RRBs) and comparable deficits in the social and communication domains. In the ABIDE imaging dataset, gray matter (GM) patterns in the motor cortex, supplementary motor area (SMA), cerebellum, fusiform gyrus, and amygdala accurately discriminated girls and boys with ASD. This sex difference pattern was specific to ASD as the GM in these brain regions did not discriminate TD girls and boys. Moreover, GM in the motor cortex, SMA, and crus 1 subdivision of the cerebellum was correlated with RRB in girls whereas GM in the right putamen—the region that discriminated TD girls and boys—was correlated with RRB in boys.ConclusionsWe found robust evidence for reduced levels of RRB in girls, compared to boys, with ASD, providing the strongest evidence to date for sex differences in a core phenotypic feature of childhood ASD. Sex differences in brain morphometry are prominent in the motor system and in areas that comprise the “social brain.” Notably, RRB severity is associated with sex differences in GM morphometry in distinct motor regions. Our findings provide novel insights into the neurobiology of sex differences in childhood autism.Electronic supplementary materialThe online version of this article (doi:10.1186/s13229-015-0042-z) contains supplementary material, which is available to authorized users.

Serum Immune Proteins in Moderate and Severe Chronic Fatigue Syndrome/Myalgic Encephalomyelitis Patients.

Immunological dysregulation is present in Chronic Fatigue Syndrome/Myalgic Encephalomyelitis (CFS/ME), with recent studies also highlighting the importance of examining symptom severity. This research addressed this relationship between CFS/ME severity subgroups, assessing serum immunoglobulins and serum cytokines in severe and moderate CFS/ME patients. Participants included healthy controls (n= 22), moderately (n = 22) and severely (n=19) affected CFS/ME patients. The 1994 Fukuda Criteria defined CFS/ME and severity scales confirmed mobile and housebound CFS/ME patients as moderate and severe respectively. IL-1β was significantly reduced in severe compared with moderate CFS/ME patients. IL-6 was significantly decreased in moderate CFS/ME patients compared with healthy controls and severe CFS/ME patients. RANTES was significantly increased in moderate CFS/ME patients compared to severe CFS/ME patients. Serum IL-7 and IL-8 were significantly higher in the severe CFS/ME group compared with healthy controls and moderate CFS/ME patients. IFN-γ was significantly increased in severe CFS/ME patients compared with moderately affected patients. This was the first study to show cytokine variation in moderate and severe CFS/ME patients, with significant differences shown between CFS/ME symptom severity groups. This research suggests that distinguishing severity subgroups in CFS/ME research settings may allow for a more stringent analysis of the heterogeneous and otherwise inconsistent illness.