Sham Training Research Articles

Effects of Inspiratory Muscle Strength Training on Cognitive and Motor Function in Middle‐Aged and Older Adults with Above‐Normal Systolic Blood Pressure

Aging and above normal systolic blood pressure (SBP) are independently and additively associated with decreased cognitive and motor function, which increase the risk of developing dementia and physical disabilities, respectively. Traditional aerobic exercise regimens may reduce the risk of cognitive and physical decline with aging. However, they are associated with relatively poor adherence among older adults, and only modest reductions in SBP (e.g., ≤5mmHg). As such, there is an unmet need for novel exercise modalities with improved adherence and SBP‐lowering effects. High‐intensity inspiratory muscle strength training (IMST) is a time‐efficient (~5 min/day) form of exercise with excellent adherence and strong SBP‐lowering effects in select groups. Whether IMST improves cognitive and motor function and/or lowers SBP in middle‐aged and older adults is unknown. The purpose of this study was to determine if 6‐weeks of IMST improves cognitive and motor function, while lowering SBP in middle‐aged to older adults with above‐normal SBP (≥120 mmHg).MethodsMiddle‐aged and older adults (50–79 years) with above‐normal SBP were recruited. Subjects were randomly allocated to perform 6‐weeks of IMST (30 breaths/day; 6 days/week; 75% maximum inspiratory pressure [PIMAX]) (n=7 age: 68±2, SBP: 137±3 mmHg) or sham (15% PIMAX) training (n=7; age: 67±3, SBP: 134±5 mmHg). Motor and cognitive function was measured at baseline and post‐intervention with the NIH Toolbox cognitive and motor battery of tests and other standardized measurements, including trail making test (TMT) parts A and B.ResultsNeither treatment altered body weight, body composition or blood clinical markers (all p>0.05). 6‐weeks of IMST significantly reduced SBP (−10±2 mmHg, p=0.001) compared with sham training (−4±2 mmHg, p=0.13). Selective domains of fluid cognition, including episodic memory (picture sequence memory test; +11±2 AU, p=0.04) and processing speed (TMT‐A; −6±1 sec, p=0.02) were improved after 6‐weeks of IMST, as was overall fluid cognition (composite score; +7±2 AU, p=0.02). The improvement in episodic memory was inversely related to changes in SBP (R2=0.40, p=0.01). Crystallized cognition (e.g., verbal knowledge) was unchanged with IMST (composite score; +2±2 AU, p=0.37). No domains of cognitive function changed in the sham group (all p>0.05). There was no effect of IMST on any measures of motor function, while gait speed improved slightly in the sham group (+0.22±0.07 m/s; p=0.002).ConclusionsThese data suggest IMST improves processing speed and episodic memory in middle‐aged to older adults, and the improvements may be related to IMST‐induced reductions in SBP.Support or Funding InformationAHA 18POST33990034, T32 DK007135, UL1 TR002535, R25 HL115473This abstract is from the Experimental Biology 2019 Meeting. There is no full text article associated with this abstract published in The FASEB Journal.

Protracted amygdalar response predicts efficacy of a computer-based intervention targeting attentional patterns in transdiagnostic clinical anxiety

Individuals with clinical anxiety demonstrate an attention bias toward threatening information, which is thought to be partially driven by heightened amygdala activity to perceived threat. Attention Bias Modification (ABM) is a computer-based treatment that trains attention toward neutral stimuli and away from threatening stimuli. Alterations in initial processing of threat have been linked to ABM responses, but the impact of protracted processing in the aftermath of neutral and threatening information on ABM outcomes has not been well studied. Our study tested whether sustained activity in the amygdala, which occurred after neutral and threatening stimuli had been removed, could predict which individuals would respond well to ABM. Unmedicated anxious individuals underwent a baseline fMRI assessment during performance of a task sensitive to protracted emotional processing. Afterward, they were randomized to complete eight sessions of ABM (n = 38) or a sham training (n = 19). ABM patients who displayed greater sustained bilateral amygdalar response in the aftermath of neutral stimuli displayed the least improvement in self-reported (but not clinician-rated) vigilance symptoms. In contrast, amygdalar response did not predict improvement in sham patients. Results suggest that in certain anxious individuals, the amygdala may have a robust protracted response even to subjectively neutral cues, which could make these individuals a poor fit for ABM because of its focus on repeatedly retraining attention toward neutral cues. Findings may help elucidate neural mechanisms of ABM and promote the identification of a subset of anxious patients who would be good candidates for this intervention.

Effect of Reactive Balance Training Involving Repeated Slips and Trips on Balance Recovery Among Older Adults: A Blinded Randomized Controlled Trial.

This study examined whether reactive balance training (exposures to slips and trips) could improve balance recovery and reduce perturbation-induced falls among older adults. Forty-four community-dwelling older adults participated in a parallel, blinded randomized controlled trial conducted in a research institute in Sydney, Australia in 2017-2018 (ACTRN12617000564358). The intervention group (n = 22) underwent three 40 minutes sessions (total 120 minutes) that exposed them to (1) 20 trips, (2) 20 slips, and (3) 10 trips and 10 slips in mixed order, over 2 days. The control group (n = 22) received one 40 minutes session of sham training. The primary outcome was falls (>30% body weight in harness) when exposed to trips and slips at post-assessment. At post-assessment, a total of 51 falls (23 and 27 falls from induced slips and trips, respectively) were recorded in the laboratory. Relative to the control group, the intervention group experienced fewer total falls (rate ratio [RR] = 0.40, 95% confidence interval [CI] = 0.22-0.76), slip falls (RR = 0.33, 95% CI = 0.12-0.90) and trip falls (RR = 0.49, 95% CI = 0.21-1.12). Eight participants reported adverse events (5 in the intervention group and 3 in the control group) which were related mainly to discomfort caused by a suboptimal harness used in the initial stages of the trial. The reactive balance training reduced perturbation-induced falls by 60% indicating improved balance recovery from trips and slips. A comfortable safety harness system is essential to prevent discomfort. Reactive balance training may complement traditional exercise programs in fall prevention interventions.

Taking stimulation home: The STIMADOM project

We will present and discuss an internet-based system for direct-current transcranial stimulation (tDCS) at-home, under hospital control. After a 5-day period of sham stimulation and training at hospital, each patient is allotted a password-protected Web space, which they access to perform tDCS daily sessions during one full month. Each session is validated by hospital personnel, who also control via internet that stimulation is correctly performed. Daily ratings of pain, sleep, fatigue and rescue medication are obtained during 11 weeks, then via iterative visits or phone contacts. More than 700 home-based tDCS sessions have been conducted so far (20% sham tDCS) in 20 patients with drug-resistant neuropathic pain. Patients' compliance was excellent. No serious adverse effects were recorded, but occasional headache and superficial burning can occur. All patients reporting such incidences wished to pursue stimulation. The procedure proved efficacious in half of the patients, in whom daily pain reports dropped 2.5 to 6 standard deviations from baseline ratings. Drug intake and quality of life correlated well with daily pain reports. Clinical improvement could last up to 6 months, and the whole procedure could be iterated when pain resumed again. Adequate teaching, device safety and a good communication proved essential for successful home therapy.

Cognitive bias modification in problem and pathological gambling using a web-based approach-avoidance task: A pilot trial

There is evidence that training addicted participants to implicitly avoid disorder-related stimuli by using a training version of the Approach-Avoidance Task (AAT) results in reduced substance consumption (i.e., Approach Bias Modification [AppBM]). The aim of the present web-based study was to investigate the feasibility and effectiveness of AppBM in reducing gambling-related symptoms. A self-selected sample of participants with problem/pathological slot-machine gambling completed an online survey and received either AppBM or Sham training (final N = 131). Attrition during study participation was high (66%). In both conditions slot-machine related and neutral pictures were presented. Within the AppBM condition all slot-machine related pictures had to be pushed and all neutral pictures had to be pulled, whereas in the Sham condition the contingency was 50:50. Eight weeks after baseline, participants were re-assessed. Both groups showed a similar reduction in gambling-related symptoms. Findings are at odds with the hypothesis claiming that only contingency trainings yield beneficial effects. However, it cannot be ruled out that effects result from other factors unrelated to training such as expectancy effects. We think this study holds valuable information how to conduct larger trials in the future and may prove helpful to improve training and its delivery.

Approach-avoidance modification as an add-on in smoking cessation: A randomized-controlled study

Biases in information processing are attributed an important role in the maintenance of tobacco dependence. As these biases are not sufficiently taken into account in current treatments, the aim of the present study was to investigate whether clinical outcome can be improved by combining treatment-as-usual (TAU) with Approach-Avoidance Modification Training (AAMT). A two group parallel (1:1) randomized-controlled single-blind study with adult smokers (N = 105) was conducted (DRKS00011406). Participants received three sessions of TAU and either six sessions of AAMT or Sham training. During AAMT, participants were trained to implicitly avoid all smoking-related and to approach all smoking-unrelated pictures, while the contingency was 50:50 in Sham training. Participants were assessed after the intervention and 6 months later. Primary outcome was daily cigarette consumption at follow-up. Participants receiving TAU + AAMT did not show a significantly greater reduction of daily cigarette consumption at follow-up compared to TAU + Sham (per-protocol: 95% CI: -2.56–4.89, p = .608; intention-to-treat: 95% CI: -3.11–2.96, p = .968). Using an implicit AAMT (vs. Sham) as an add-on to TAU did not improve clinical outcome. However, no consistent evidence for a change of bias was found. It is important for future research to explore the effectiveness of optimized training versions (e.g., explicit instructions). Pre-registrationGerman Clinical Trials Register (DRKS00011406).

Web-based Approach Bias Modification in smokers: A randomized-controlled study

Smoking is associated with automatic approach tendencies towards smoking-related stimuli. Therefore, it has been investigated whether training smoking individuals to consistently avoid smoking-related stimuli exerts positive effects on smoking behavior (Approach-Bias Modification [AppBM]). A web-based pilot study provided preliminary evidence for the effectiveness of AppBM in smokers; however, interpretability was constrained by several limitations. The aim of the present study was to replicate and extend previous findings. A web-based three group parallel (1:1:1) randomized-controlled study with adult smokers (N = 149) was conducted (DRKS00011901). Upon completion of a baseline assessment, participants were randomized to either six sessions of AppBM or Sham training or a waitlist control group. In both trainings, participants were presented smoking-related and neutral pictures. While all smoking-related pictures were associated with pushing and all neutral pictures with pulling in AppBM training, the contingency was 50:50 in Sham training. Participants were re-assessed directly and six months after training. Primary outcome was daily cigarette consumption at follow-up. At follow-up, no significant group differences emerged, although AppBM training significantly reduced daily cigarette consumption directly after training. No consistent change of bias through AppBM training emerged. This study does not provide support for the long-term effectiveness of AppBM training as a stand-alone training in smoking. Pre-registrationGerman Clinical Trials Register (DRKS00011901).

Relapse prevention in abstinent alcoholics by cognitive bias modification: Clinical effects of combining approach bias modification and attention bias modification.

Alcohol-dependent patients show attentional and approach biases for alcohol-related stimuli. Computerized cognitive bias modification (CBM) programs aim to retrain these biases and reduce relapse rates as add-ons to treatment. Retraining of alcohol-approach tendencies has already yielded significant reductions of relapse rates in previous studies, and retraining of biased attention toward alcohol is promising approach. The current large-scale randomized controlled trial compared the clinical effects of these training methods-separately and in combination-to those of sham training methods and a no-training control, as an add-on to regular treatment. Participants were 1,405 alcohol-dependent patients of an inpatient rehabilitation clinic. In addition to regular treatment, patients were randomized to receive 6 sessions of approach-bias retraining, 6 sessions of attention-bias retraining, 3 sessions of each of these CBM training varieties, 6 sessions of variants of sham training, or no training. Effects of the training methods were evaluated by measuring treatment success at 1-year follow-up. Primary outcome: The 3 active training conditions yielded higher success rates at 1-year follow-up than sham training or no training (8.4%, on average). Secondary results (available for half of the sample): Both varieties of CBM had only small effects on the targeted biases (significant only for the combined training). Moreover, neither significant mediation of the clinical effect by the change in trained bias nor significant moderation of the clinical effect was found. Both alcohol-avoidance training and alcohol-attention training increased success rates effectively, as did the combination of both methods. Future studies should test ways to increase training effectiveness further. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Combination of inspiratory and expiratory muscle training in same respiratory cycle versus different cycles in COPD patients: a randomized trial

BackgroundDifference between combined inspiratory and expiratory muscle training in same respiratory cycle or different cycles remained unclarified. We explored the difference between both patterns of combined trainings in patients with COPD.MethodsIn this randomized, open-label, controlled trial, stable COPD subjects trained for 48 minutes daily, for 8 weeks, using a monitoring device for quality control. Ninety-two subjects were randomly and equally assigned for sham training, inspiratory muscle training(IMT), combined inspiratory and expiratory muscle training in same cycle(CTSC) or combined inspiratory and expiratory muscle training in different cycles(CTDC). Respiratory muscle strength, as the primary endpoint, was measured before and after training. Registry: ClinicalTrials.gov (identifier: NCT02326181).ResultsRespiratory muscle training improved maximal inspiratory pressure(PImax), while no significant difference was found in PImax among IMT, CTSC and CTDC. Maximal expiratory pressure(PEmax) in CTSC and CTDC was greater than IMT(P = 0.026, and P=0.04, respectively) and sham training (P = 0.001). IMT, CTSC, and CTDC shortened inhalation and prolonged exhalation(P < 0.01). Subjects with respiratory muscle weakness in IMT and CTDC exhibited greater increase in PImax than those without. IMT, CTSC and CTDC showed no difference in symptoms and quality of life scales among themselves(P > 0.05).ConclusionBoth patterns of CTSC and CTDC improved inspiratory and expiratory muscle strength, while IMT alone only raised PImax. Respiratory muscle training might change the respiratory cycles, and be more beneficial for COPD patients with inspiratory muscle weakness.

A double-blind, randomized, placebo-controlled trial of a computer-based Interpretation Bias Training for youth with severe irritability: a study protocol

BackgroundSevere, chronic, and impairing irritability is a common presenting clinical problem in youth. Indeed, it was recently operationalized as disruptive mood dysregulation disorder (DMDD) in the DSM-5. However, to date, there are no evidence-based treatments that were specifically developed for DMDD. The current randomized controlled trial assesses the efficacy of a computer-based cognitive training intervention (Interpretation Bias Training; IBT) in youth with DMDD. IBT aims to reduce irritability by altering judgments of ambiguous face-emotions through computerized feedback. IBT is based on previous findings that youth with irritability-related psychopathology rate ambiguous faces as more hostile and fear producing.Methods/designThis is a double-blind, randomized controlled trial of IBT in 40 youth with DMDD. Participants will be randomized to receive four IBT sessions (Active vs. Sham training) over 4 days. Active IBT provides computerized feedback to change ambiguous face-emotion interpretations towards happy interpretations. Face-emotion judgments are performed pre and post training, and for 2 weeks following training. Blinded clinicians will conduct weekly clinical ratings. Primary outcome measures assess changes in irritability using the clinician-rated Affective Reactivity Index (ARI) and Clinical Global Impressions-Improvement (CGI-I) scale for DMDD, as well as parent and child reports of irritability using the ARI. Secondary outcome measures include clinician ratings of depression, anxiety, and overall impairment. In addition, parent and child self-report measures of depression, anxiety, anger, social status, and aggression will be collected.DiscussionThe study described in this protocol will perform the first RCT testing the efficacy of IBT in reducing irritability in youth with DMDD. Developing non-pharmacological treatment options for youth suffering from severe, chronic irritability is important to potentially augment existing treatments.Trial registrationClinicalTrials.gov, ID: NCT02531893. Registered on 25 August 2015.

Positivity-approach training for depressive symptoms: A randomized controlled trial

ObjectiveDepression is highly comorbid and depressive symptoms are very common. Symptom severity adversely affects treatment outcome and later health status. Established interventions for depression leave ample room for improvement. Short interventions that target specific vulnerabilities emerge as plausible augmentation strategies. In this study, we tested the efficacy of a computerized general positivity-approach training and its effect on depressive symptoms. MethodsPatients (N = 240) with various diagnoses of mental disorders who received treatment-as-usual in an inpatient setting were randomly assigned to also receive either 4 sessions of a positivity-approach training or 4 sessions of sham training. Depression severity was assessed at baseline and post-treatment. Training data were analyzed for a subset of 111 patients. ResultsDepressive symptoms were reduced more after positivity-approach training than after sham training. Initial depression symptom severity moderated the intervention effects, such that approach tendencies and depression symptoms were only affected positively among patients with higher levels of initial depression symptom severity. ConclusionsThe findings provide preliminary support for positivity-approach training as an add-on treatment option for depressive symptoms.

Protocol for a randomised controlled trial of cognitive bias modification training during inpatient withdrawal from alcohol use disorder

BackgroundPeople with alcohol use disorders often exhibit an “alcohol approach bias”, the automatically triggered action tendency to approach alcohol. Approach bias is likely to persist following withdrawal from alcohol, and contribute to the high rate of relapse following withdrawal treatment. Cognitive bias modification (CBM) training has been shown to attenuate approach biases and lead to reduced relapse rates. However, no large multisite trial of CBM specifically within a residential withdrawal treatment setting has previously been conducted. This study aims to test whether CBM delivered during residential withdrawal treatment leads to reduced relapse rates and reduced use of acute health services following discharge, and to test possible moderators of CBM’s effect on alcohol use.MethodsThree hundred alcohol-dependent inpatients are being recruited from three withdrawal treatment units in the Melbourne metropolitan area. Participants complete baseline measures of alcohol approach bias and cue-evoked desire for alcohol, followed by four daily sessions of computerised CBM training (or sham training if randomised to the control group). Approach bias and cue-evoked desire are re-assessed following the fourth training session. Follow-up assessments administered 2 weeks and 3, 6, and 12 months following discharge from the withdrawal treatment unit compare abstinence rates and acute and emergency healthcare service use between conditions. Pre-admission and follow-up substance use is derived from the timeline follow-back method, and approach bias towards alcohol with a computerised Approach Avoidance Task.DiscussionThis study is the first multisite randomised controlled trial of cognitive bias modification delivered during acute alcohol withdrawal treatment. Withdrawal is theoretically an ideal period to deliver neurocognitive interventions due to heightened neuroplasticity and cognitive recovery. If effective, the low cost and easy implementation of CBM training means it could be widely used as a standard part of alcohol withdrawal treatment to improve treatment outcomes. Moderation analyses may help better determine whether certain subgroups of patients are most likely to benefit from it and therefore should be prioritised for CBM during alcohol withdrawal treatment.Trial RegistrationVersion 4 of the protocol (dated 1 August 2017) is registered with the Australian New Zealand Clinical Trials Registry, ACTRN12617001241325. Registered on 25 August 2017 (retrospectively registered).

Influence of mirror therapy and motor imagery on intermanual transfer effects in upper-limb prosthesis training of healthy participants: A randomized pre-posttest study.

The effect that a motor skill trained on one side can lead to improvement in the untrained side is called intermanual transfer. Intermanual transfer can help enhance upper limb prosthetic training. To determine the influence of mirror therapy and motor imagery on intermanual transfer in upper limb prosthesis training, a pseudo-randomized clinical trial, single blinded, with a pre-posttest design was used. Forty-seven able-bodied, right-handed participants were pseudo-randomly assigned to two training groups and one control group. One training group undertook an intermanual transfer training program, using an upper-limb prosthetic simulator with added mirror therapy and motor imagery. The second training group completed only the intermanual transfer training program. The control group completed a sham training: a dummy training without using the prosthesis simulator. The program lasted five consecutive days. To determine the improvement in skill, a test was administered before, immediately after, and six days after the training program. Training used the “unaffected” arm; tests were performed with the “affected” arm, resembling the amputated limb. Movement time, the time from the beginning of the movement until completion of the task; hand opening, the duration of the maximum prosthetic hand opening; and grip-force control, the deviation from the required force during a tracking task. No intermanual transfer effects were found: neither the intermanual transfer training program, nor the additional mirror therapy and motor imagery affected prosthesis skills. A limitation of the study was that the training program was applied to able-bodied subjects instead of patients with an amputation. Contrary to previous studies, no intermanual transfer effects were found. Additional mirror therapy and motor imagery did not ameliorate intermanual transfer effects.

Does attention bias modification training impact on task performance in the context of pain: An experimental study in healthy participants.

Attention has been theorized to play a key role in the experience of pain and associated task interference. Training attention away from pain via attention bias modification (ABM) training techniques has been proposed to improve pain-related outcomes, but evidence is inconsistent. In an experimental study, we investigated the impact of a single session ABM training -using a visual probe paradigm with idiosyncratic pain words- on cold pressor test (CPT) pain experience and task interference by pain. Fifty-eight healthy volunteers were randomly assigned to an ABM training group (N = 28; attending away from pain) and a sham training group (N = 30; no training direction). At pre-training, participants performed a baseline Random-Interval-Repetition (RIR) task and the CPT. Participants reported on sensations they experienced during the baseline CPT. Relevant descriptors were integrated in the visual probe paradigm during the training phase. At post-training, participants completed the RIR task again while experiencing CPT pain. Participants also reported on the extent they attended to the pain and the intensity/unpleasantness of the pain. Results indicated that, in contrast with our hypotheses, ABM training did also not reduce task interference due to CPT pain. Furthermore, ABM training did not change self-reported attending to CPT pain. Finally, ABM training did not reduce CPT pain intensity or pain unpleasantness. Overall, the current study provides no support for the effectiveness of a single session ABM training in improving pain-related outcomes. Future research addressing the conditions under which ABM training improves or fails to improve pain-related outcomes is warranted.

Attentional bias modification alters intrinsic functional network of attentional control: A randomized controlled trial

IntroductionAttentional bias modification (ABM) alleviates anxiety by moderating biased attentional processing toward threat; however, its neural mechanisms remain unclear. We examined how ABM changes functional connectivity (FC) and functional network measures, leading to anxiety reduction. MethodsFifty-four healthy anxious individuals received either ABM or sham training for 1 month in a double-blind randomized controlled trial. Anxious traits, attentional control, and attentional bias were assessed. Thirty-five participants completed resting-state functional magnetic resonance imaging (MRI) scans before and after training. ResultsABM significantly mitigated an anxious traits regarding physical stress vulnerability (η2 = 0.12, p = 0.009). As compared to sham training, ABM significantly strengthened FC between the pulvinar and transverse temporal gyrus along the temporoparietal junction (T = 3.90, FDR-correctedp = 0.010), whereas it decreased FC between the postCG and ventral fronto-parietal network (vFPN) regions such as the anterior insula and ventrolateral prefrontal cortex (all T ≤ − 3.19, FDR-correctedp ≤ 0.034). Although ABM diminished network measures of the postcentral gyrus (postCG) (all T ≤ − 4.30, FDR-correctedp ≤ 0.006), only the pulvinar-related FC increase was specifically correlated with anxiety reduction (r = − 0.46, p = 0.007). LimitationsPer-protocol analysis and reduced sample size in MRI analysis. ConclusionsABM might augment the pulvinar's control over vFPN to maintain endogenous attention to a behavioral goal, while diminishing the information exchanges of the postCG with vFPN to inhibit the capture of exogenous attention by potential threats. The pulvinar might play a critical role in ABM anxiolytic efficacy.

Influence of Inspiratory Muscle Training on Sympatho‐excitation in Healthy Young Adults

Inspiratory muscle training (IMT) lowers blood pressure in healthy young adults and adults with obstructive sleep apnea (Vranish &amp; Bailey, 2015; 2016). Importantly, in healthy young adults, 6 weeks IMT also is associated with significant declines in systemic vascular resistance (Delucia et al. 2017). In light of these outcomes, in the current study we test the hypothesis that 6 weeks IMT reduces sympathetic outflow. Accordingly, we recruited healthy college‐aged students and randomly allocated them to either IMT or to Sham training groups. At intake (Week 1) and study completion (Week 6) we recorded MSNA as subjects performed sympatho‐excitatory challenges as follows: Valsalva maneuver, Mueller maneuver, submaximal grip test, cold pressor test, and mental stress tests (Stroop and mental arithmetic). Additionally, we performed weekly (blinded) assessments of systolic and diastolic blood pressures (SBP and DBP), and assessed maximal inspiratory pressure and respiratory function. Our preliminary results indicate subjects in the IMT group have lowered systolic (114.3 ± 3.4 mmHg vs. 106.7 ± 1.8 mmHg, p=0.0115) and diastolic (68.39 ± 1.58 mmHg vs. 63.5 ± 0.97 mmHg, p=0.0413) blood pressures relative to Sham trained subjects (SBP 114.7 ± 2.94 mmHg vs. 108.9 ± 1.34 mmHg and DBP 72.47 ± 3.29 mmHg vs. 69.99 ± 1.75 mmHg). Consistent with our hypothesis, preliminary analyses highlight lowered sympathetic burst frequency in the IMT group during Valsalva maneuvers (Week 1:15 ± 2.2 bursts per 15 seconds vs. Week 6: 11 ± 1.5 bursts per 15 seconds) as compared to Sham trained subjects (Week 1:12.13 ± 1.48 bursts per 15 seconds vs. Week 6:11.63 ± 0.83 bursts per 15 seconds). Data collection is ongoing however, our early findings show a reduction in sympathetic outflow during respiratory challenges which may underpin declines in peripheral resistance and blood pressure seen in healthy young adults following IMT.Support or Funding InformationThis work was supported by start up monies awarded to EFB.This abstract is from the Experimental Biology 2018 Meeting. There is no full text article associated with this abstract published in The FASEB Journal.

Retraining of automatic action tendencies in individuals with obesity: A randomized controlled trial

Obesity is a major health concern, characterized by an automatically activated tendency to (over)-eat. Recent research suggests that an effective way to counteract automatic approach tendencies in unhealthy consumption behavior might be approach bias modification. Therefore, we investigated an approach-avoidance training for unhealthy food cues in 189 patients with obesity of a psychosomatic inpatient clinic who were participating in a nutrition advice program. Patients in the active training group were trained to make avoidance movements (pushing a joystick) in response to unhealthy food pictures and approach movements (pulling the joystick) in response to positive pictures, while the control group received sham training (approaching and avoiding both picture types). Approach-avoidance bias, body mass index, eating pathology and food-specific implicit associations were assessed before and after the training. In line with our hypothesis, approach-avoidance bias improved in the active training group after the training, in comparison to the sham training group. Moreover, this effect generalized to new, untrained stimuli. However, no effects of the training were found in a food-specific Single-Target Implicit Association Test, or on eating pathology questionnaires or body mass index. While the training results are promising, the effect of approach-avoidance bias modification on relevant behavior in obesity has yet to be established before it may be implemented as an add-on treatment.

A Test of Multisession Automatic Action Tendency Retraining to Reduce Alcohol Consumption Among Young Adults in the Context of a Human Laboratory Paradigm

Young adult heavy drinking is an important public health concern. Current interventions have efficacy but with only modest effects, and thus, novel interventions are needed. In prior studies, heavy drinkers, including young adults, have demonstrated stronger automatically triggered approach tendencies to alcohol-related stimuli than lighter drinkers. Automatic action tendency retraining has been developed to correct this tendency and consequently reduce alcohol consumption. This study is the first to test multiple iterations of automatic action tendency retraining, followed by laboratory alcohol self-administration. A total of 72 nontreatment-seeking, heavy drinking young adults ages 21 to 25 were randomized to automatic action tendency retraining or a control condition (i.e., "sham training"). Of these, 69 (54% male) completed 4 iterations of retraining or the control condition over 5days with an alcohol drinking session on Day 5. Self-administration was conducted according to a human laboratory paradigm designed to model individual differences in impaired control (i.e., difficulty adhering to limits on alcohol consumption). Automatic action tendency retraining was not associated with greater reduction in alcohol approach tendency or less alcohol self-administration than the control condition. The laboratory paradigm was probably sufficiently sensitive to detect an effect of an experimental manipulation given the range of self-administration behavior observed, both in terms of number of alcoholic and nonalcoholic drinks and measures of drinking topography. Automatic action tendency retraining was ineffective among heavy drinking young adults without motivation to change their drinking. Details of the retraining procedure may have contributed to the lack of a significant effect. Despite null primary findings, the impaired control laboratory paradigm is a valid laboratory-based measure of young adult alcohol consumption that provides the opportunity to observe drinking topography and self-administration of nonalcoholic beverages (i.e., protective behavioral strategies directly related to alcohol use).

Interventions for eye movement disorders due to acquired brain injury.

Interventions for eye movement disorders due to acquired brain injury.

Eye-Tracking Based Attention Bias Modification (ET-ABM) Facilitates Disengagement from Negative Stimuli in Dysphoric Individuals

To address shortcomings of purely reaction-time based attention bias modification (ABM) paradigms, a novel eye-tracking based ABM training (ET-ABM) was developed. This training targets the late disengagement from negative stimuli and the lack of attention for positive information, which are characteristics of depression. In the present study, 75 dysphoric students (BDI ≥ 9) were randomly assigned to either this positive training (PT), or a sham-training (ST) that did not train any valence-specific gaze pattern (positive and negative pictures had to be disengaged from and attended to equally often). Results showed that the PT induced a positive attentional bias (longer fixations of positive than negative pictures). Although the ST group showed an increase in positive attentional bias as well, this increase was not as strong as in the PT group. Compared to the ST, the PT specifically induced faster disengagement from negative pictures. No differential training effects were found on stress responses or state rumination. These results show that the ET-ABM successfully modifies attentional processes, specifically late disengagement from negative stimuli, in dysphoric students, and hence might be a promising alternative to existing ABM paradigms.