Reactivity Scores Research Articles

Reduced vagal tone in intimate partner violence perpetrators is partly explained by anger rumination

Polyvagal theory proposed that an autonomous nervous system imbalance might be characteristic of violent individuals, especially reduced parasympathetic or vagal tone. Accordingly, some studies concluded that when intimate partner violence (IPV) perpetrators deal with acute stress, they tend to present a sympathetic predominance over the parasympathetic nervous system once the stress has ended. However, less is known about cognitive mechanisms that explain this phenomenon. In fact, this functioning might be explained by inner speech and/or angry thoughts (anger rumination) in reactive aggressors. Nonetheless, there is a gap in the scientific literature assessing whether this psychophysiological functioning in IPV perpetrators is explained by anger rumination. For this reason, the first aim of this study was to assess the cardiorespiratory (heart rate (HR), pre-ejection period (PEP), and respiratory sinus arrhythmia (RSA)) and electrodermal (skin conductance level (SCL)) changes, as well as the anger state, when coping with an acute laboratory stressor, comparing a group of reactive IPV perpetrators (n = 47) and a group of non-violent men (n = 36). The second aim was two-fold. After checking whether the groups differed on their anger rumination and manifestation of aggression (reactive and/or proactive) scores, we studied whether these variables explained psychophysiological and psychological responses to a laboratory task (changes and levels during the recovery period) in each group. Our results demonstrated that, compared to the control group, IPV perpetrators presented lower RSA levels (vagal tone). Even though the groups did not differ on their anger rumination or manifestation of aggression scores (except for proactive aggression), only in the IPV perpetrators, high anger rumination and reactive aggression partly explained the lower vagal tone (RSA levels) and high levels of anger state at post-task. Consequently, this study contributes to understanding the psychobiological basis for violence proneness in IPV perpetrators, making it possible to explore new therapeutic strategies.

Abstract 12758: Maternal Gestational Diabetes is Associated With Increased Aortic Stiffness in Pre-Adolescent Children

Introduction: Population studies have suggested adults born to mothers with gestational diabetes mellitus (GDM) have increased risk of cardiovascular (CV) disease. Whether GDM exposure before birth is associated with abnormal CV health in childhood is unknown. In the present study, we prospectively explored the CV health of children of mothers with GDM (CGDM) with comparison to children of healthy mothers (controls) and examined relationships with maternal variables. Methods: CGDM and age- and sex-matched controls were recruited from the longitudinal Alberta Pregnancy Outcomes and Nutrition Birth Cohort Study and underwent CV assessments. Outcome measures included left ventricular mass Z-score, EndoPAT reactive hyperemia index score (endothelial function), Doppler-based aortic and peripheral (common carotid to posterior tibial artery) pulse wave velocity (PWV), and carotid intima-media thickness. CGDM were further stratified into groups according to how maternal GDM was controlled (diet vs insulin). The mother’s pre-pregnancy body mass index (BMI), adherence to the 2007 Canada’s Food Guide, and intake of less healthy foods in the 2 nd and 3 rd trimesters of pregnancy were also examined. Results: We assessed 25 CGDM and 27 controls (mean age 10.9±0.7 years) with comparable birth and baseline characteristics (Table). Aortic PWV was higher in CGDM vs controls (p=0.03), and higher in CGDM of insulin vs diet controlled mothers (p=0.03). No other measures of CV health differed. Mothers with GDM, but not controls, showed evidence of dietary improvement from the 2 nd to 3 rd trimester with improved adherence and reduced less healthy foods. Maternal BMI was unrelated to the child’s CV health. Conclusions: Even with maternal dietary improvement, CGDM have increased aortic stiffness, highest in offspring of mothers managed with insulin. Further work is needed to investigate the mechanisms by which GDM impacts the child’s vascular health and long-term implications.

Abstract 13297: Higher Maternal Serum Ferritin in the Third Trimester is Associated With Reduced Endothelial Function in the Preadolescent Child

Introduction: Elevated iron status in pregnancy has been implicated in gestational diabetes (GDM) development and in cardiovascular (CV) disease progression in adults. Animal models, however, have suggested maternal iron deficiency anemia may increase the offspring’s risk of CV disease. Whether maternal iron levels impact the CV health of the child in humans is unknown. This study investigated the relationship between maternal iron markers and the child’s CV health. Methods: This is a nested observational study tied to the Alberta Pregnancy Outcomes and Nutrition (APrON) Study. Children of mothers with and without GDM but otherwise uncomplicated pregnancies were prospectively recruited. Maternal serum ferritin, total iron binding capacity, and hemoglobin in the 2 nd and 3 rd trimesters were obtained. CV outcomes included: left ventricular mass Z-score, reactive hyperemia index score (lnRHI, EndoPAT), Doppler-based aortic and peripheral arterial pulse wave velocity, and carotid intima-media thickness. Univariate and multiple linear regression models, including maternal GDM as a covariate, were built to explore relationships between maternal iron markers and the child’s CV health. Results: Fifty-two children, 40 (77%) female, were assessed at a mean age of 10.9±0.7 years. Maternal serum ferritin in the 2 nd (median (IQR): 38.8 (39.2) ng/mL; B=-0.0039, p=0.01) and 3 rd trimesters (13.7 (9.0); B=-0.011, p=0.008) inversely related to the child’s lnRHI in univariate analyses, whereas no other relationships were observed between maternal iron markers and the child’s CV health. While the effect of 2 nd trimester serum ferritin was attenuated in a multiple linear model adjusting for maternal GDM, another model demonstrated a persistent relationship of 3 rd trimester serum ferritin with lnRHI (B=-0.028, p=0.007), not impacted by maternal GDM (B=-0.37, p=0.11) or their interaction term (B=0.020, p=0.07). Conclusions: High maternal serum ferritin in the 3 rd trimester may be associated with reduced endothelial function of the child. If validated, further work is needed to understand pathogenic mechanisms, and the impact of supplementation guidelines in pregnancy.

Approach to Software Integration of Heterogeneous Sources of Medical Data Based on Microservice Architecture

The task of processing medical information is currently being solved in our country and abroad by means of heterogeneous medical information systems, mainly at the local and regional levels. The ever-increasing volume and complexity of the accumulated information, along with the need to ensure transparency and continuity in the processing of medical data (in particular, for bronchopulmonary diseases) in various organizations, requires the development of a new approach to integrating their heterogeneous sources. At the same time, an important requirement for solving the problem is the possibility of web-oriented implementation, which will make the corresponding applications available to a wide range of users without high requirements for their hardware and software capabilities. The paper considers an approach to the integration of heterogeneous sources of medical information, which is based on the principles of building microservice web architectures. Each data processing module can be used independently of other program modules, providing a universal entry point and the resulting data set in accordance with the accepted data schema. Sequential execution of processing steps implies the transfer of control to the corresponding program modules in the background according to the Cron principle. The schema declares two types of data schemas - local (from medical information systems) and global (for a single storage system), between which the corresponding display parameters are provided according to the principle of constructing XSLT tables. An important distinguishing feature of the proposed approach is the modernization of the medical information storage system, which consists in creating mirror copies of the main server with periodic replication of the relevant information. At the same time, the interaction between clients and data storage servers is carried out according to the type of content delivery systems with the creation of a connection session between end points based on the principle of the nearest distance between them, calculated using the haversine formula. The computational experiments carried out on test data on bronchopulmonary diseases showed the effectiveness of the proposed approach both for loading data and for obtaining them by individual users and software systems. Overall, the reactivity score of the corresponding web-based applications was improved by 40% on a stable connection.

Temperament and children’s accuracy and attention during word learning

When hearing a novel word, children typically rule out familiar objects and assume a speaker is referring to a novel object. This strategy is known as fast mapping, and young children use this with a high degree of accuracy. However, not all children engage in fast mapping to the same extent and temperament can play a role. Shyness is associated with poorer fast mapping and less attention to target objects, which is associated with poorer retention (Hilton et al., 2019; Hilton & Westermann, 2017). We further investigated the relationship between temperament and fast mapping by presenting 2.5-year-old children with 8 familiar target fast mapping trials and 4 novel target trials presented twice. We considered two temperamental dimensions: approachability due to its similarity to shyness; and reactivity, which could predict children’s capacity to engage during fast mapping. We found an association between approachability and fast mapping accuracy the second time children fast-mapped novel targets, and approachability was associated with greater retention accuracy. Reactivity predicted proportions of target looking during fast mapping with less reactive temperament scores associated with greater focus on targets. This provides support for a relationship between two dimensions of temperament and fast mapping and retention. Approachability may be associated with a further opportunity to fast map and memory for novel words, and/or how willing children are to guess the targets. Reactivity may be associated with the capacity to focus during word learning situations. Different aspects of temperament could have implications for children’s capacity to disambiguate and learn words.

Associations between emotion reactivity and eating disorder symptoms in a transdiagnostic treatment-seeking sample.

Individuals with eating disorders (EDs) demonstrate difficulties with emotion regulation, and these difficulties have been associated with severity and maintenance of ED symptoms. Although emotion reactivity (i.e., the strength and duration of emotional experiences) is distinct from emotion regulation, few studies have examined emotion reactivity in the context of EDs. The purpose of the current study was to examine longitudinal associations between emotion reactivity and ED symptoms and impairment in individuals with EDs. Individuals seeking outpatient ED treatment (N=265) completed questionnaires assessing ED symptoms and severity, emotion reactivity, and emotion regulation difficulties at treatment intake and bi-monthly during treatment. Individuals with anorexia nervosa or binge eating or purging presentations had higher emotion reactivity scores than a non-ED comparison group. Controlling for age, diagnosis, and emotion regulation difficulties, emotion reactivity was positively associated with ED severity, ED-related impairment, and loss of control eating severity. Moreover, emotion reactivity, but not emotion regulation difficulties, was associated with change in ED symptoms during treatment. Findings support that emotion reactivity may differ based on ED presentations and may be an important correlate of ED symptom severity. Emotion reactivity refers to the strength and duration of an emotional experience. This study found that higher emotion reactivity was related to greater eating disorder symptom severity and eating disorder-related impairment. It may be beneficial to consider the role of emotion reactivity in conceptualizations of eating disorders, particularly those characterized by binge eating or purging.

A modified video-feedback intervention for carers of foster children aged 6 years and under with reactive attachment disorder: a feasibility study and pilot RCT.

Looked-after children are at risk of suboptimal attachment patterns and reactive attachment disorder. However, access to interventions varies widely and there are no evidence-based interventions for this disorder. (1) To adapt an existing video-feedback intervention to meet the specific needs of foster children in the UK with reactive attachment symptoms, (2) to conduct a case series to road-test the treatment manual and study procedures, (3) to conduct a scoping study of the key hurdles in a pilot trial and (4) to conduct a pilot randomised controlled trial of the adapted intervention to determine the feasibility of a future full-scale trial. This was a mixed-methods study. The adapted treatment manual was developed with expert input and tested on a small case series. Qualitative interviews with key stakeholders were used in the scoping study in preparation for the trial and later with foster carers who received the new intervention. The final stage was a feasibility and pilot randomised controlled trial of the new intervention, compared with usual care. Researchers assessing the outcomes were blinded to group assignment. The study was set in outpatient child and adolescent mental health services and partner social services departments. Sites included urban and rural/semirural areas. Participants were foster carers with children aged ≤ 6 years presenting with difficulties in the domain of reactive attachment disorder. Key stakeholders included children's services managers and mental health service practitioners in the scoping study. Foster carers who received the modified intervention participated in qualitative interviews. The video-feedback intervention to promote positive parenting and sensitive discipline is an extensively evaluated and effective treatment approach. This intervention was modified (based on the adapted version for foster care in the Netherlands) to suit the needs of young children with reactive attachment symptoms in foster care in the UK and was delivered to improve the sensitive responding of foster carers, foster carer-child relationships and child outcomes. The modified intervention was delivered in-home by trained mental health professionals over a period of 4-6 months. The main outcome was reactive attachment symptom scores on the Disturbances of Attachment Interview. A series of minor changes to the intervention programme were introduced, which focused on improving its suitability for the UK foster care context. Challenges in recruitment meant that, despite numerous modifications to the protocol and the inclusion of additional sites, only 30 families (target, n = 40) were recruited to the randomised controlled trial (15 allocated to each group). However, most other trial parameters were deemed feasible and acceptable, particularly the high levels of data and treatment completeness. All randomised families were available for baseline analyses, but two in the treatment arm were not available for post-treatment analyses. The revised intervention was positively received by practitioners and foster carers. Only three-quarters of the target sample size was recruited. Furthermore, the sites' own exclusion of potential participants and the low return rates of screening questionnaires raise the possibility of non-randomness of non-responses. A larger-scale trial may be feasible, but only if recruitment barriers can be overcome. Dedicated resources to support recruitment within local authorities and wider inclusion criteria are recommended. Central resourcing of intervention capacity to supplement NHS staff is also recommended. This trial is registered as ISRCTN18374094. This project was funded by the National Institute for Health and Care Research ( NIHR ) Health Technology Assessment programme and will be published in full in Health Technology Assessment; Vol. 26, No. 35. See the NIHR Journals Library website for further project information.

Evli Bireylerin Bağlanma Stillerinin Benliğin Ayrımlaşması ile İlgili İlişkilerinin İncelenmesi

Bu araştırmada, evli bireylerin bağlanma stilleri ile benliğin ayrımlaşması arasındaki ilişkiyi incelemek amacıyla hazırlanmıştır.Araştırma grubu 350 gönüllü evli çiftten rastlantısal olarak oluşturulmuştur. Evli bireylerde bağlanma stillerinin benliğin ayrımlaşması ile ilgili ilişkileri inceleyen bu çalışma ilişkisel tarama modelinde gerçekleştirilmiş nicel bir araştırmadır. Yapılan araştırmada veri toplama araçları olarak 2 ölçme aracı ve 1 adet kişisel bilgi anketi kullanılmıştır. "Benliğin Ayrımlaşması Ölçeği" ile bireyin ayrımlaşma düzeyini ve ilişkilerde bağlanma stillerini ölçmek için ise ‘‘kişilerarası ilişkilerde bağlanma stilleri ölçek formu’’ kullanılmıştır. Yapılan bu araştırma da akademisyenler tarafından uyarlanan ve geliştirilen ölçekler için kullanım izinleri alınmıştır. 350 veri öncelikle ‘‘normallik testi, ölçeklere ilişkin iç tutarlık katsayısı testi, korelasyon analizi, regresyon analizi ve iki bağımsız örneklem t-testi’’ ve üç dahil üçten fazla bağımsız değişken için ise One Way Anova uygulanmıştır. Yapılan çalışma sonucunda evli bir bireyin duygusal tepkisellik puanı yükseldikçe güvensiz kaygılı bağlanma puanının düştüğü söylenebilir. Benliğin ayrımlaşması alt boyutlarının güvensiz kaygılı bağlanma varyansını %51’ini açıklayabildiği görülmüştür. Ölçeğin alt alt boyutlarından olan başkalarına bağımlılık, duygusal tepkisellik ve ben pozisyonu güvensiz kaygılı bağlanma varyansını anlamlı ve güçlü bir şekilde açıklamıştır. Ayrıca cinsiyet değişkenine göre sadece ben pozisyonu alt boyutunun istatistiksel olarak anlamlı ve farklılık gösterdiği söylenebilir.

Is a blunted cortisol response to stress a premorbid risk for insomnia?

Study objectivesVulnerability to stress-related sleep disturbances (sleep reactivity) is an established heritable risk factor for insomnia disorder with unclear biological underpinnings. Preliminary research points to a blunted cortisol response to stress as a biological predisposition to familial risk for insomnia, but the role of cortisol response in sleep reactivity is unknown. Therefore, the current studies examined whether sleep reactivity is associated with a blunted cortisol response to two laboratory stressors among participants without insomnia. MethodsTwo community samples of adults with no lifetime history of insomnia completed the Trier Social Stress Test (N = 35) or the Cold Pressor Task (N = 34). Participants were grouped by insomnia-risk using sleep reactivity scores from the Ford Insomnia Response to Stress Test (FIRST). Physiological responses were measured via markers of the hypothalamic-pituitary-adrenal (HPA) axis (salivary cortisol) and autonomic nervous system (ANS; heart rate, mean arterial pressure, and salivary alpha amylase). ResultsParticipants with high insomnia-risk (FIRST score > 18) exhibited blunted cortisol responses to both stressors. There were no group differences in ANS responses across stressors. ConclusionsInsomnia-risk as indicated by sleep reactivity is associated with blunted cortisol responses to psychosocial and physical laboratory stressors among premorbid adults without insomnia disorder. This study replicates previous research and supports a blunted cortisol response to stress as a biomarker for insomnia vulnerability that may be detected using the FIRST. Prospective research is needed to elucidate whether a blunted cortisol response to stress is one mechanism by which sleep reactive individuals may be at risk of developing insomnia.

The genetics of ME: A commentary on Hajdarevic et al.

Depression is characterized by altered neurobiological responses to threat and inflammation may be involved in the development and maintenance of symptoms. However, the mechanistic pathways underlying the relationship between the neural underpinnings of threat, inflammation and depressive symptoms remain unknown.Twenty participants with major depressive disorder (MDD) and 17 healthy controls (HCs) completed this study. Peripheral blood mononuclear cells (PBMCs) were collected and stimulated ex vivo with lipopolysaccharide (LPS). We then measured a broad array of secreted proteins and performed principal component analysis to compute an aggregated immune reactivity score. Subjects completed a well-validated emotional face processing task during functional magnetic resonance imaging (fMRI). Amygdala activation was measured during perception of threat for the main contrast of interest: fear > happy face. Participants completed the Mood and Anxiety Symptom Questionnaire (MASQ) and the Perceived Stress Scale (PSS). Correlation analyses between amygdala activation, the aggregate immune score, and symptom were computed across groups. A mediation analysis was also performed across groups to further explore the relationship between these three variables.In line with our hypotheses and with prior work, the MDD group showed greater amygdala activation in response to threat compared to the HC group [t35 = -2.038, p = 0.049]. Internal consistency of amygdala activation to threat was found to be moderate. Response to an ex vivo immune challenge was greater in MDD than HC based on the computed immune reactivity score (PC1; t35 = 2.674, p = 0.011). Amygdala activation was positively correlated with the immune score (r = 0.331, p = 0.045). Moreover, higher amygdala activation was associated with greater anxious arousal measured by the MASQ (r = 0.390, p = 0.017). Exploring the role of stress, we found that higher perceived stress was positively associated with both inflammatory response (r = 0.367, p = 0.026) and amygdala response to threat (r = 0.325, p = 0.050). Mediation analyses showed that perceived stress predicted anxious arousal, but neither inflammation nor amygdala activation fully accounted for the effect of perceived stress on anxious arousal.These data highlight the potential importance of threat circuitry hyperactivation in MDD, consistent with prior reports. We found that higher levels of inflammatory biomarkers were associated with higher amygdala activation, which in turn was associated with anxious arousal. Future research utilizing larger sample sizes are needed to replicate these preliminary results.

Cardiovascular reactivity during sadness induction predicts inhibitory control performance

Higher negative affectivity has an association with decreased executive function and cognitive control. Heart rate variability (HRV) serves as an index of cardiac vagal regulation differences in the autonomic nervous system for both cognition and emotion. The current study investigates this association using a classic as well as emotional antisaccade paradigm to study inhibitory control performance. Ninety participants completed affective questionnaires (Beck Depression Inventory-II, and Mood Scale), a 6-minute baseline electrocardiogram, and two different antisaccade tasks. After the baseline, subjects were presented with a video sequence with either neutral, sad, or emotionally arousing content. By subtracting the baseline from the video sequence, we computed HRV reactivity and tested whether the reactivity score could predict inhibitory control performance. We hypothesized that this would be the case in both the sadness and arousal group, but not in the neutral one. Furthermore, we awaited significant performance differences between experimental groups. Contrary to our assumption, inhibitory control performance did not differ between experimental groups. Moreover, there was no significant relation between affective measures and task performance. Nevertheless, cardiovascular reactivity in terms of HRV was predictive of error rates in both antisaccade tasks in the sadness group. We could find this effect neither in the neutral nor in the arousal group. In addition, BDI scores moderated the effect in the emotional task. Results indicate that emotional reactivity to a sad video stimulus as indexed by HRV as well as the interaction with current emotional state predict inhibitory control performance.

Exaggerated amygdala response to threat and association with immune hyperactivity in depression

BackgroundDepression is characterized by altered neurobiological responses to threat and inflammation may be involved in the development and maintenance of symptoms. However, the mechanistic pathways underlying the relationship between the neural underpinnings of threat, inflammation and depressive symptoms remain unknown. MethodsTwenty participants with major depressive disorder (MDD) and 17 healthy controls (HCs) completed this study. Peripheral blood mononuclear cells (PBMCs) were collected and stimulated ex vivo with lipopolysaccharide (LPS). We then measured a broad array of secreted proteins and performed principal component analysis to compute an aggregated immune reactivity score. Subjects completed a well-validated emotional face processing task during functional magnetic resonance imaging (fMRI). Amygdala activation was measured during perception of threat for the main contrast of interest: fear > happy face. Participants completed the Mood and Anxiety Symptom Questionnaire (MASQ) and the Perceived Stress Scale (PSS). Correlation analyses between amygdala activation, the aggregate immune score, and symptom were computed across groups. A mediation analysis was also performed across groups to further explore the relationship between these three variables. ResultsIn line with our hypotheses and with prior work, the MDD group showed greater amygdala activation in response to threat compared to the HC group [t35 = -2.038, p = 0.049]. Internal consistency of amygdala activation to threat was found to be moderate. Response to an ex vivo immune challenge was greater in MDD than HC based on the computed immune reactivity score (PC1; t35 = 2.674, p = 0.011). Amygdala activation was positively correlated with the immune score (r = 0.331, p = 0.045). Moreover, higher amygdala activation was associated with greater anxious arousal measured by the MASQ (r = 0.390, p = 0.017). Exploring the role of stress, we found that higher perceived stress was positively associated with both inflammatory response (r = 0.367, p = 0.026) and amygdala response to threat (r = 0.325, p = 0.050). Mediation analyses showed that perceived stress predicted anxious arousal, but neither inflammation nor amygdala activation fully accounted for the effect of perceived stress on anxious arousal. ConclusionThese data highlight the potential importance of threat circuitry hyperactivation in MDD, consistent with prior reports. We found that higher levels of inflammatory biomarkers were associated with higher amygdala activation, which in turn was associated with anxious arousal. Future research utilizing larger sample sizes are needed to replicate these preliminary results.

Translating core intervention strategies into action: Interpersonal validation among self-injuring adolescents and their mothers.

Most evidence-supported treatments for psychiatric problems teach clients skills to incorporate into their daily lives. Yet little research rigorously examines the extent to which individuals absorb these strategies and can competently apply them outside of the therapeutic relationship. The current study examined the degree to which self-injuring adolescents and their mothers (n = 30 dyads) and typical control mother-daughter dyads (n = 30) were able to utilize a multicomponent interpersonal validation-oriented skill from dialectical behavior therapy, after a single teaching. We also aimed to assess whether variance in Gentle, Interested, Validate, and Easy(GIVE) skill practice was associated with a physiological index of emotion regulation (respiratory sinus arrhythmia [RSA]). An observational coding system was developed to measure skill-related behavior across four key domains (be[ing] gentle, act[ing] interested, validation, and us[ing] an easy manner; GIVE) and applied during two family conflict discussions (pre- and postskills training). Mother and adolescent RSA data were collected at rest and across discussion tasks. Behavioral indicators of skill use improved pre-to-post skills training across the entire sample, except in one GIVE domain (easy manner). Self-injuring youth and their mothers demonstrated greater improvements than control dyads with respect to being gentle. RSA reactivity scores predicted behavioral validation, such that higher RSA was associated with higher validation scores. As a field, we currently have a limited understanding of how intervention skills are used, and what factors predict effective skill application. Results suggest self-injuring adolescents and their mothers can learn and improve on most aspects of a core intervention strategy after a single teaching and that better physiological regulation during conflict is associated with more validating behaviors.

Neural Correlates of Reactive Aggression in Adult Attention-Deficit/Hyperactivity Disorder.

Despite not being part of the core diagnostic criteria for attention-deficit/hyperactivity disorder (ADHD), emotion dysregulation is a highly prevalent and clinically important component of (adult) ADHD. Emotionally dysregulated behaviors such as reactive aggression have a significant impact on the functional outcome in ADHD. However, little is known about the mechanisms underlying reactive aggression in ADHD. In this study, we aimed to identify the neural correlates of reactive aggression as a measure of emotionally dysregulated behavior in adults with persistent ADHD during implicit emotion regulation processes. We analyzed associations of magnetic resonance imaging-based whole-brain activity during a dynamic facial expression task with levels of reactive aggression in 78 adults with and 78 adults without ADHD, and also investigated relationships of reactive aggression with symptoms and impairments. While participants with ADHD had higher reactive aggression scores than controls, the neural activation patterns of both groups to processing of emotional faces were similar. However, investigating the brain activities associated with reactive aggression in individuals with and without ADHD showed an interaction of diagnosis and reactive aggression scores. We found high levels of activity in the right insula, the hippocampus, and middle and superior frontal areas to be particularly associated with high reactive aggression scores within the ADHD group. Furthermore, the limbic activity was associated with more hyperactivity/impulsivity symptoms. These results suggest a partly differential mechanism associated with reactive aggression in ADHD as compared to controls. Emotional hyper-reactivity in the salience network as well as more effortful top–down regulation from the self-regulation network might contribute to emotionally dysregulated behavior as measured by reactive aggression.

The immunogenetics of viral antigen response is associated with subtype-specific glioma risk and survival

Glioma is a highly fatal cancer with prognostically significant molecular subtypes and few known risk factors. Multiple studies have implicated infections in glioma susceptibility, but evidence remains inconsistent. Genetic variants in the human leukocyte antigen (HLA) region modulate host response to infection and have been linked to glioma risk. In this study, we leveraged genetic predictors of antibody response to 12 viral antigens to investigate the relationship with glioma risk and survival. Genetic reactivity scores (GRSs) for each antigen were derived from genome-wide-significant (p<5×10-8) variants associated with immunoglobulin G antibody response in the UK Biobank cohort. We conducted parallel analyses of glioma risk and survival for each GRS and HLA alleles imputed at two-field resolution by using data from 3,418 glioma-affected individuals subtyped by somatic mutations and 8,156 controls. Genetic reactivity scores to Epstein-Barr virus (EBV) ZEBRA and EBNA antigens and Merkel cell polyomavirus (MCV) VP1 antigen were associated with glioma risk and survival (Bonferroni-corrected p<0.01). GRSZEBRA and GRSMCV were associated in opposite directions with risk of IDH wild-type gliomas (ORZEBRA= 0.91, p= 0.0099/ORMCV= 1.11, p= 0.0054). GRSEBNA was associated with both increased risk for IDH mutated gliomas (OR= 1.09, p= 0.040) and improved survival (HR= 0.86, p= 0.010). HLA-DQA1∗03:01 was significantly associated with decreased risk of glioma overall (OR= 0.85, p= 3.96×10-4) after multiple testing adjustment. This systematic investigation of the role of genetic determinants of viral antigen reactivity in glioma risk and survival provides insight into complex immunogenomic mechanisms of glioma pathogenesis. These results may inform applications of antiviral-based therapies in glioma treatment.

Temperament, anxiety, and depression in school-age children who stutter

Purpose: The main aim of this study was to gain insight into whether temperament and/or stuttering severity were associated with anxiety and depression in children who stutter. Additionally, the study also provided an indication into the prevalence of anxiety and depression in children who stutter in a clinical cohort.Method: The participants were 132 English-speaking children (105 boys and 27 girls) between 9;0 and 14;11 years old (M = 11;8, SD = 1;10) and their mothers. At their first visit to a specialist center for children who stutter, mothers and children completed the relevant versions of the Early Adolescent Temperament Questionnaire-Revised (EATQ-R; Ellis & Rothbart, 2001) and a screening of children's anxiety and depression, using the Revised Children's Anxiety and Depression Scale (RCADS; Chorpita et al., 2000). Stuttering was evaluated using the Stuttering Severity Instrument Fourth Edition (SSI-4). Correlations were conducted between child and parent versions of the EATQ-R and RCADS; EATQ-R and RCADS; as well as the SSI-4 and RCADS. A comparison was made between those children who scored below the clinical threshold for anxiety and depression, and those who scored above.Results: Significant correlations were found for all mother and child EATQ-R factors and RCADS scales (except for Obsessive Compulsive Disorder). Correlations were also found between the child- and mother-reported temperament factors of positive reactivity, negative reactivity, and self-regulation and anxiety and depression. Children who scored above the clinical threshold for any category of anxiety or depression had significantly lower positive reactivity and higher negative reactivity scores, compared to those who scored below the threshold. There were no differences between the two groups with regard to SSI-4 scores.Conclusions: This is the first study to evaluate associations between temperament and anxiety and depression in children who stutter. Higher negative reactivity scores and lower positive reactivity and self-regulation scores are associated with elevated levels of anxiety and depression in children who stutter. Further, those who score above the clinical threshold have significantly higher levels of negative reactivity and lower levels of positive reactivity compared to those scoring below the threshold. Findings suggest that levels of anxiety that reach clinical threshold are more prevalent in children who stutter than would be expected based on population data. Current findings have implications for both the assessment and therapy of children who stutter presenting at clinics for support.

Quantitative Assessment of Electroencephalogram Reactivity in Comatose Patients on Extracorporeal Membrane Oxygenation.

Objective assessment of the brain's responsiveness in comatose patients on Extracorporeal Membrane Oxygenation (ECMO) support is essential to clinical care, but current approaches are limited by subjective methodology and inter-rater disagreement. Quantitative electroencephalogram (EEG) algorithms could potentially assist clinicians, improving diagnostic accuracy. We developed a quantitative, stimulus-based algorithm to assess EEG reactivity features in comatose patients on ECMO support. Patients underwent a stimulation protocol of increasing intensity (auditory, peripheral, and nostril stimulation). A total of 129 20-s EEG epochs were collected from 24 patients (age [Formula: see text], 10 females, 14 males) on ECMO support with a Glasgow Coma Scale[Formula: see text]8. EEG reactivity scores ([Formula: see text]-scores) were calculated using aggregated spectral power and permutation entropy for each of five frequency bands ([Formula: see text], [Formula: see text], [Formula: see text], [Formula: see text], [Formula: see text]. Parameter estimation techniques were applied to [Formula: see text]-scores to identify properties that replicate the decision process of experienced clinicians performing visual analysis. Spectral power changes from audio stimulation were concentrated in the [Formula: see text] band, whereas peripheral stimulation elicited an increase in spectral power across multiple bands, and nostril stimulation changed the entropy of the [Formula: see text] band. The findings of this pilot study on [Formula: see text]-score lay a foundation for a future prediction tool with clinical applications.

Vitamin D Levels and its Association with Inflammatory Markers, Severity and Outcome in Hospitalised COVID-19 Patients - An Indian Perspective

Background: The recent COVID-19 pandemic has taken over the world in enormous proportions like none other in recent times. Vitamin D plays an essential role in the immune system and has proven to have importance in the context of many respiratory infections. This study aims to unveil the possible correlation between vitamin D levels and disease outcome and affirm the role of hypovitaminosis D as an independent risk factor for severity in COVID 19.Methods: We studied 209 RTPCR confirmed COVID 19 positive cases. Serum 25(OH) D levels were done at the time of admission. HRCT chest and inflammatory markers (serum ferritin, D dimer, IL6 and CRP) were estimated on admission and repeated on case-to-case basis.Results: Out of 209 patients studied, 44.49% had vitamin D deficiency, 24.40% had Vitamin D insufficiency, and 31.11% had normal Vitamin D levels. Vitamin D deficiency significantly increased with advancing age. The mean vitamin D level in our study is 27.47 ± 21.86. 27.8% had mild COVID-19 disease as evidenced by HRCT imaging, 21.1% showed moderate disease, and 51.2% showed severe COVID-19. The mean values of inflammatory markers in Vitamin Ddeficient patients were as follows: D dimer (3298.88 ± 2230.14), Serum Ferritin (530.88 ± 497.14) CRP (175.34 ± 87.27) IL6 (125.39 ± 275.72). Significant correlation of Vitamin D with C reactive protein (r = -0.18, p ≤ 0.05), D-Dimer (r = -0.42, p &lt; 0.0001), and CT severity score (r = -0.24, p ≤ 0.0001) was noted. Conclusion: In our study, Vitamin D inversely proportional levels were inversely proportional to CRP, D-Dimer, and CT severity.

Irritable Bowel Syndrome Onset after New Coronavirus Infection COVID-19

Aim. A psychometric comparison in patients with previous irritable bowel syndrome (IBS) vs. those with IBS presenting six months or later since COVID-19 infection.Materials and methods. The study included patients having had COVID-19 infection over 6 months ago and complying with Rome IV criteria (2016). The study cohort was 100 patients with gastrointestinal symptoms. Fourteen patients (cohort 1) complied with the IBS criteria, 5 males and 9 females. A comparison cohort was 40 patients with IBS verified prior to the COVID-19 pandemic (cohort 2), 12 males and 28 females. Data were obtained from the SIPSITEST 9.0 DBMS resource. The control cohort comprised 50 healthy respondents (cohort 3), 23 males and 27 females. Depression was scored with the Beck Inventory, anxiety — with Spielberger—Khanin (adapted STAI) questionnaire; childhood psychogeny has also been assessed.Results. In statistical analysis of cohort 1, mean depression, personality and reactive anxiety scores were 11 ± 2.27, 43.8 ± 1.93 and 46.7 ± 2.05, respectively. Mean values in cohort 2: personality anxiety 47.3 ± 1.46, reactive anxiety 50.7 ± 1.96 and depression 12.85 ± 1.13. With childhood psychogeny, positive answers to at least one question were reported in 9 of 14 (65%) patients in cohort 1 and 33 (82.5%) — in cohort 2. No study inter-cohort differences have been observed for personality or reactive anxiety and depression, nor for the history of childhood psychogeny.Conclusion. The new coronavirus infection entails postinfectious IBS in 6 months after COVID-19.

Parental Pain Catastrophizing, Communication Ability, and Post-surgical Pain Outcomes Following Intrathecal Baclofen Implant Surgery for Patients With Cerebral Palsy.

There is strong evidence that psychosocial variables, including pain catastrophizing, influence parental and child ratings of pain, pain expression, and long-term outcomes among children with chronic pain. The role of these factors among children who have communication deficits due to cerebral palsy (CP) and other intellectual and developmental disabilities is currently unclear. In this study, parental pain catastrophizing was assessed before intrathecal baclofen (ITB) pump implantation for spasticity management in 40 children and adolescents with CP, aged 4 to 24 years. Pain was assessed before and after surgery with two methods: a parent-reported pain interference scale, and behavioral pain signs during a standardized range of motion exam. Linear mixed models with clinical/demographic factors and scores from the Pain Catastrophizing Scale for Parents (PCS-P), and child spoken language ability as predictors and the pain variables as the outcomes were implemented. On average, both pain outcomes improved after surgery. Only child spoken language ability predicted change in behavioral reactivity scores, with children with phrase speech showing an increase in reactivity at follow-up compared to pre-surgery levels, on average. A significant interaction between PCS-P scores and spoken language ability on change in pain interference scores over time showed that dyads with children with phrase speech whose parents reported high PCS-P scores reported the least improvement in pain interference at follow-up. Due to the preliminary nature of the study, future work is needed to investigate the parental behaviors that mediate the relationships between parental catastrophizing and pain outcomes in this population.