Stimuli In Patients Research Articles

Komunikacja w grupie pacjentów z zaburzeniami świadomości – wnioskiz projektu InteRDoCTor

Thanks to recent advances in health care an increased number of patients may recover from severe brain injuries, but some of them are still assessed as non-responsive. Reliance on behavioural measures in communication with DoC patients seems be too prone to errors. There is need for solutions providing more objective attempts of bidirectional communication (intentional questions/commands and adequate related responses) in patients with DoC using significant processed by the patient stimuli and novel technologies (EEG-, fMRI-, BCI-based, etc.) based on recent scientific and clinical evidences. Such communication may be fulfilled even in the absence of behavior. This article aims at assessment the extent to which current possibilities in the area of devices for extended communication has been exploited, including own experiences within InteRDoCTor project.

Altered processing of rewarding and aversive basic taste stimuli in symptomatic women with anorexia nervosa and bulimia nervosa: An fMRI study

Functional magnetic resonance imaging (fMRI) studies have displayed a dysregulation in the way in which the brain processes pleasant taste stimuli in patients with anorexia nervosa (AN) and bulimia nervosa (BN). However, exactly how the brain processes disgusting basic taste stimuli has never been investigated, even though disgust plays a role in food intake modulation and AN and BN patients exhibit high disgust sensitivity. Therefore, we investigated the activation of brain areas following the administration of pleasant and aversive basic taste stimuli in symptomatic AN and BN patients compared to healthy subjects. Twenty underweight AN women, 20 symptomatic BN women and 20 healthy women underwent fMRI while tasting 0.292 M sucrose solution (sweet taste), 0.5 mM quinine hydrochloride solution (bitter taste) and water as a reference taste. In symptomatic AN and BN patients the pleasant sweet stimulus induced a higher activation in several brain areas than that induced by the aversive bitter taste. The opposite occurred in healthy controls. Moreover, compared to healthy controls, AN patients showed a decreased response to the bitter stimulus in the right amygdala and left anterior cingulate cortex, while BN patients showed a decreased response to the bitter stimulus in the right amygdala and left insula. These results show an altered processing of rewarding and aversive taste stimuli in ED patients, which may be relevant for understanding the pathophysiology of AN and BN.

Blunted cortisol response to psychosocial stress in atopic patients is associated with decrease in salivary alpha-amylase and aldosterone: Focus on sex and menstrual cycle phase

A decreased responsiveness of the hypothalamic-pituitary-adrenocortical axis to stress stimuli in patients with atopy is well documented. The aim of this study was to investigate personality traits, salivary alpha-amylase activity and the aldosterone response to psychosocial stress procedure based on public speech in atopic patients with respect to sex and the menstrual cycle (MC) phase. The study was performed in 106 subjects of both sexes, 53 atopic patients suffering from allergic rhinitis, allergic asthma or atopic dermatitis and 53 age-, sex-, the MC phase- and BMI- matched healthy controls. Substantially attenuated activity of alpha-amylase and reduced secretion of aldosterone during the psychosocial stress were observed in the whole sample of patients with atopy. Higher activity of alpha-amylase observed in the follicular compared to the luteal phase in healthy women was not present in atopic patients. In both males and females, atopy was associated with blunted cortisol response but no changes in the heart rate. Psychological characterization revealed a significantly higher trait anxiety and higher preference for avoidance-oriented coping strategy in female but not male atopic patients. These findings provide evidence that patients with atopy exhibit insufficient alpha-amylase and aldosterone responsiveness to psychosocial stress, thus suggesting decreased sympathetic activity. Potential disturbances in sex hormone status during the MC in female patients with atopy have to be considered in future research. Changes in personality traits were demonstrated in female atopic patients, but not in male patients.

Specific features of bronchial inflammation in asthma patients with airway hyper-responsiveness to cold and osmotic stimuli

Background. Excessive airway reaction to combined effects of environmental factors is very common in patients with asthma. The understanding of the molecular-cellular mechanisms of this hyperresponsiveness is very important. Aim. The aim of the work was to study granulocyte segment of bronchial inflammation in correlation with cytokine regulation and lipid peroxidation in patients with airway hyperresponsiveness to cold and osmotic stimuli. Materials and м ethods. In 43 patients with partially controlled and uncontrolled persistent asthma with cold and osmotic airway hyperresponsiveness (group 1) asthma symptoms and lung function were assessed, the level of IL-5, IL-12 in exhaled breath condensate (EBC) and the total amount of myeloperoxidase (MPO) in induced sputum (IS) were measured; the number of neutrophils and eosinophils in smears of IS was counted. Basing on cytological and cytochemical analysis of smears of IS, the activity coefficients of MPO in granular leukocytes, the degree of cell destruction and the intensity of cytolysis were calculated. The contents of lipid hydroperoxide (LHP) and MPO in the blood serum were measured. A control group (group 2) consisted of asthma patients without airway reaction to cold and osmotic stimuli (11 people). Results. In the first group in comparison with the second one high levels of IL-12 were found (2,94 ± 0,09 vs. 2,53 ± 0,13 pg/mL; р = 0,024), IL-5 (3,64 ± 0,37 vs. 2,15 ± 0,14 pg/mL; р = 0,0001); the increase of neutrophils in IM (35,4 ± 3,5 vs. 17,2 ± 2,0%; р = 0,014); higher granulocytes cytolysis (0,38 ± 0,02 vs. 0,26 ± 0,02; р = 0,013), which correlated for neutrophils with the level of IL-12 (r = 0,46; р = 0,026); there was found out the increase of MPO concentration in IS (199,7 ± 49,0 vs. 81,4 ± 26,2 pixels; р = 0,039). The increased level of LHP in the blood serum correlated with the level of MPO in IS (r = 0,48; р = 0,039) and IL-5 in EBC (r = 0,71; р = 0,031). Conclusion. Airway hyperresponsiveness to cold and osmotic stimuli in patients with asthma is characterized by the relationship between the nature of Th1 and Th2 cytokine profile, the structure of granulocyte segment of bronchial inflammation, the enzymatic function of granulocytes, MPO activity and systemic formation of suboxidized lipid peroxidation products. Activation of granulocyte segment of inflammatory pattern in patients with asthma may be considered a factor of influence on the development and maintenance of airway hyperresponsiveness due to the escalation of oxidative stress and persistent inflammation.

The role of nociceptive input and tissue injury on stress regulation in borderline personality disorder.

Approximately 60% to 90% of patients with borderline personality disorder (BPD) show nonsuicidal self-injurious behavior (NSSI) with cutting being the most frequently applied method. One of NSSI's functions is to reduce aversive tension. Previous studies have found a tension-reducing effect of painful tissue injury by an incision. It is still unclear whether this effect is based on the effect of tissue injury or the effect of pain experience, or both. The aim of this study was to determine whether tissue injury leads to a stronger stress reduction than a sole pain stimulus in patients with BPD. After stress induction, 57 BPD patients and 60 healthy controls (HCs) received either an incision or a non-tissue-injuring mechanical nociceptive stimulus ("blade") typically perceived as painful or a non-nociceptive tactile sham stimulus (blunt end of scalpel). Participants were unaware of which procedure was applied. For stress assessment, subjective and objective parameters were measured. As immediate response to the stimulus application, we found greater stress reduction after both painful stimuli (incision and blade) in BPD patients but no difference in stress decrease between the tissue-injuring incision and the non-tissue-injuring pain stimulus (blade). Compared with HCs, incision and blade were followed by greater immediate decrease of arousal in BPD patients. Our findings confirm that among BPD patients, the nociceptive input leads to stress reduction. In contrast, the impact of tissue damage on stress reduction was relatively small. In addition, the results suggest that painful stimuli lead to a greater stress reduction in BPD patients compared with HCs.

Deficient median nerve prepulse inhibition of the blink reflex in cervical dystonia.

We analyzed prepulse inhibition (PPI) of the blink reflex (BR) in patients with cervical dystonia (CD) to examine the sensory modulation of the motor system. This study enrolled 22 consecutive patients with idiopathic CD and 25 age- and gender-matched healthy subjects. Prepulse inhibition of the BR was recorded after stimulating the median nerve at the wrist using an electrical stimulus twice at a perception threshold 100ms before a test stimulus to the supraorbital nerve. The R2 area and amplitude were significantly reduced and the R2 latency delayed after the conditioned stimulus in patients with CD. The R1 latency and amplitude did not differ between trials in patients with CD. In healthy subjects, the R1 amplitude was higher, whereas the R2 latency was delayed and the R2 amplitude and area were reduced after the conditioned stimulus. However, there was significantly less R2 and R2c area suppression in patients compared with healthy subjects. ANOVA showed that reduction of R2 area after conditioned stimulus (F=6.620, p=0.003) and percentage change of R2 area (F=5.217, p=0.009) were lower in patients with and without sensory tricks compared with healthy subjects, whereas the reduction in PPI was pronounced in patients without a sensory trick compared with healthy subjects. Patients with CD show significantly less prepulse R2 inhibition than healthy subjects, but this occurred without R1 facilitation. The absence of a sensory trick leads to the more pronounced reduction of PPI. The modulatory effects of sensory inputs are lost in patients with CD without sensory tricks.

Analysis of retinal function using chromatic pupillography in retinitis pigmentosa and the relationship to electrically evoked phosphene thresholds.

To analyse pupil responses to specific chromatic stimuli in patients with advanced retinitis pigmentosa (RP) to ascertain whether chromatic pupillography can be used as an objective marker for residual retinal function. To examine correlations between parameters of the pupil response and the perception threshold of electrically evoked phosphenes. Chromatic pupillography was performed in 40 patients with advanced RP (visual acuity<0.02 or visual field ≤5°, non-recordable ERGs) and 40 age-matched healthy subjects. Pupil responses to full-field red (605nm) and blue (420nm) stimuli of 28 lx corneal illumination were recorded and analysed for two stimulus durations (1 and 4seconds). The perception threshold of phosphenes to transcorneal electrostimulation was ascertained and correlated to the pupil responses and visual acuity. Patients with RP showed significantly reduced pupil responses to red and blue stimuli compared with the controls. With red stimuli, pupillary escape could be observed; blue stimuli resulted in a well-preserved postillumination pupil response. Phosphene thresholds were significantly increased in patients with RP and correlated with the parameters of the pupil response if all subjects were considered. Within the RP group alone, this relationship was less pronounced and statistically not significant. Chromatic pupillography demonstrated a significant decrease in outer retinal photoreceptor responses but a persisting and disinhibited intrinsic photosensitive retinal ganglion cell function in advanced RP. These phenomena may be useful as an objective marker for the efficacy of any interventional treatment for hereditary retinal diseases as well as for the selection of suitable patients for an electronic retinal implant.

Visual object categorisation in people with glaucoma

PurposeThere is evidence that people with glaucoma exhibit difficulties with some complex visual tasks such as face recognition, motion perception and scene exploration. The purpose of this study was to...

Effects of repetitive imagination of alcohol consumption on craving in alcohol-dependent patients: A pilot study

BackgroundIn the majority of patients with alcohol use disorder (AUD), the clinical course is characterized by multiple relapses to drinking, frequently preceded by intense craving for alcohol. The present pilot study aimed to assess the effects of a repetitive imaginary cue-exposure protocol in reducing craving in recently abstinent alcohol-dependent patients. MethodsSixty-four patients were randomly assigned to six intervention groups and were instructed to repetitively imagine: i) drinking a glass of their preferred alcoholic drink (low vs. high number of repetitions); or ii) drinking a glass of water (low vs. high number of repetitions); or iii) performing an analogous movement or performed no imagination. Additionally, 10 healthy controls were instructed to repetitively imagine drinking a glass of their preferred alcoholic drink (high number of repetitions). The levels of craving before and after intervention were measured using the Alcohol Urge Questionnaire (AUQ) and the Visual Analogue Scale for Craving (VASC). ResultsRepetitive imagination of alcohol consumption did not lead to a significant decrease in craving in alcohol-dependent patients as measured by the AUQ and VASC. In contrast, healthy controls showed a nearly significant decrease of the urge to drink alcohol after applying the protocol with a high number of repetitions. ConclusionsThe findings of this pilot study might indicate an aberrant ability to habituate to alcohol-related stimuli in patients with AUD compared to healthy subjects. Future studies in larger samples are needed to further explore the effectiveness of imaginary cue-exposure interventions in alcohol dependence.

Mechanisms of Stress-Induced Visceral Pain: Implications in Irritable Bowel Syndrome.

Visceral pain is a term describing pain originating from the internal organs of the body and is a common feature of many disorders, including irritable bowel syndrome (IBS). Stress is implicated in the development and exacerbation of many visceral pain disorders. Recent evidence suggests that stress and the gut microbiota can interact through complementary or opposing factors to influence visceral nociceptive behaviours. The Young Investigator Forum at the International Society of Psychoneuroendocrinology (ISPNE) annual meeting reported experimental evidence suggesting the gut microbiota can affect the stress response to affect visceral pain. Building upon human imaging data showing abnormalities in the central processing of visceral stimuli in patients with IBS and knowledge that the amygdala plays a pivotal role in facilitating the stress axis, the latest experimental evidence supporting amygdala-mediated mechanisms in stress-induced visceral pain was reviewed. The final part of the session at ISPNE reviewed experimental evidence suggesting that visceral pain in IBS may be a result, at least in part, of afferent nerve sensitisation following increases in epithelial permeability and mucosal immune activation.

Immunologic and cerebrovascular reactivity relationships in patients with initial manifestations of chronic cerebral ischemia

Introduction. The influence of cardiovascular risk factors has a long asymptomatic course, since the vessels are the main target body. Functionally and structurally restructuring of vessels mainly target bodies in terms of the most supple period is like prevention of irreversible changes in organs and tissues and the development of cardiovascular events. We conducted a study whose purpose was to investigate the presence and assessment of the nature of relationships between indicators immunoreactivity to structural components of cardiovascular and cerebrovascular reactivity in carotid and vertebral-basilar basins in response to the multidirectional metabolic and myogenic stimuli in patients with initial manifestations of chronic cerebral ischemia (ChCI). Material and methods. We have examined 55 people of middle age 51,3 ± 7,0 years with initial manifestations of the ChCI. All patients performed general clinical, clinical-neurological, clinical and instrumental and clinical laboratory tests. The level of auto antibodies (auto AB) antigens to platelets, cardiomyocytes and vascular endothelial serum of patients was determined by the method Poletayeva O.B. (Russia). Indicators of cerebrovascular reactivity (CVR) received during trans cranial ultrasound scan using multidirectional metabolic and myogenic functional stress stimulus (FSS). Results and discussion. There was a statistically significant association between (index of reactivity) IR infringement in response to hyperkapnia trial in carotid basin and a deviation of up to autoAB NOS (X 2 (1) = 3.6 ; VKramer = 0.354, p = 0.05) and plasminogen / angiostatin (X 2 (1) = 6.22; VKramer = 0.463, p = 0.013). It was found association between IR deviation in response to hypokapnia trial in carotid basin and a deviation of autoAB to rheumatoid factor (X 2 (1) = 7.03; VKramer = 0.493, p =0.008, Fisher's exact test = 0.016) and the association between deviation IR hypokapnia on trial in carotid pool and adeviation of autoAB to plasminogen / angiostatin (X 2 (1) =6.75;VKramer = 0.482, p = 0.009, Fisher's exact test = 0.05). Violation CVR in response to the multidirectional FSS metabolic and myogenic orientation in carotid and vertebral-basilar basins associated with the rejection of аverage individual level of immunoreactivity (X 2 (1) = 6.39; VKramer = 0.478, p = 0.011, Fisher's exact test = 0.026) and violation of autoAB to plasminogen / angiostatin (X 2 (1) = 4.77; VKramer = 0.406, p = 0.029). Conclusions. It was found that the ability CVR is in conjunction with a violation of the structural and functional integrity of the cardiovascular system, such as endothelial function directed to the regulation of the structural integrity of the vascular system, hemostasis and inflammation.

Reduced amygdala responsivity during conditioning to trauma-related stimuli in posttraumatic stress disorder.

Exaggerated conditioned fear responses and impaired extinction along with amygdala overactivation have been observed in posttraumatic stress disorder (PTSD). These fear responses might be triggered by cues related to the trauma through higher-order conditioning, where reminders of the trauma may serve as unconditioned stimuli (US) and could maintain the fear response. We compared arousal, valence, and US expectancy ratings and BOLD brain responses using fMRI in 14 traumatized persons with PTSD and 14 without PTSD (NPTSD) and 13 matched healthy controls (HC) in a differential aversive conditioning paradigm. The US were trauma-specific pictures for the PTSD and NPTSD group and equally aversive and arousing for the HC; the conditioned stimuli (CS) were graphic displays. During conditioning, the PTSD patients compared to the NPTSD and HC indicated higher arousal to the conditioned stimulus that was paired with the trauma picture (CS+) compared to the unpaired (CS-), increased dissociation during acquisition and extinction, and failure to extinguish the CS/US-association compared to NPTSD. During early and late acquisition, the PTSD patients showed a significantly lower amygdala activation to CS+ versus CS- and a negative interaction between activation in the amygdala and dorsolateral prefrontal cortex (PFC), while NPTSD and HC displayed a negative interaction between amygdala and medial PFC. These findings suggest maladaptive anticipatory coping with trauma-related stimuli in patients with PTSD, indicated by enhanced conditioning, with related abnormal amygdala reactivity and connectivity, and delayed extinction.

State Anxiety Subjective Imbalance and Handicap in Vestibular Schwannoma.

Evidence is emerging for a significant clinical and neuroanatomical relationship between balance and anxiety. Research has suggested a potentially priming effect with anxiety symptoms predicting a worsening of balance function in patients with underlying balance dysfunction. We propose to show that a vestibular stimulus is responsible for an increase in state anxiety, and there is a relationship between increased state anxiety and worsening balance function. (1) To quantify state anxiety following a vestibular stimulus in patients with a chronic vestibular deficit. (2) To determine if state anxiety during a vestibular stimulus would correlate with the severity of chronic balance symptoms and handicap. Two separate cohorts of vestibular schwannoma (VS) patients underwent vestibular tests (electronystagmography, cervical and ocular vestibular evoked myogenic potentials, and caloric responses) and questionnaire assessments [vertigo handicap questionnaire (VHQ), vertigo symptom scale (VSS), and state-trait anxiety inventory (STAIY)]. Fifteen post-resection VS patients, with complete unilateral vestibular deafferentation, were assessed at a minimum of 6 months after surgery in Experiment 1 (Aim 1). Forty-five patients with VS in situ formed the cohort for Experiment 2 (Aim 2). Experiment 1: VS subjects (N = 15) with a complete post-resection unilateral vestibular deafferentation completed a state anxiety questionnaire before caloric assessment and again afterward with the point of maximal vertigo as the reference (Aim 1). Experiment 2: state anxiety measured at the point of maximal vertigo following a caloric assessment was compared between two groups of patients with VS in situ presenting with balance symptoms (Group 1, N = 26) and without balance symptoms (Group 2, N = 11) (Aim 2). The presence of balance symptoms was defined as having a positive score on the VSS-VER. In Experiment 1, a significant difference (p < 0.01) was found when comparing STAIY at baseline and at the peak of the subjective vertiginous response in post-resection patients with a unilateral vestibular deafferentation. In Experiment 2, VS in situ patients with balance symptoms had significantly worse state anxiety at the peak vertiginous response than patients without balance symptoms (p < 0.001), as did patients with a balance-related handicap (p < 0.001). Anxiety symptoms during a vestibular stimulus may contribute to a priming effect that could explain worsening balance function.

Mémoire émotionnelle et activités électrocorticales en schizophrénie

Context Abnormal emotion processing is frequent in schizophrenia and affects social and functional outcome. Past event-related potential (ERP) research investigating processing of affective stimuli in schizophrenia was done mainly with facial expressions and revealed impaired facial emotion recognition in patients relative to control subjects. Experimentations involving fMRI with this group of patients, showed alteration of limbic and frontal regions in response to emotional unpleasant images, compared to neutral stimuli during a memory task. Other studies have also noted an increase in brain activity when the activation of the stimuli was high compared to low arousal stimuli. This may indicate a different sensitivity threshold to emotional arousal and emotional valence involving frontal pathways in these patients. But very few studies attempted to separate the contributions of emotional valence and arousal within an episodic memory protocol with ERP, in that population.Goal The aim of the current research is to investigate brain electro-cortical activity in schizophrenia in response to emotional images during an episodic memory task.Method ERP components were analyzed in 16 schizophrenic and 17 control participants matched for age, sex and intelligence. ERPs were obtained from 56 EEG electrodes. The tasks consisted in a classical episodic memory task that presented 100 repeated old and 100 new photographic images divided into four categories (unpleasant-high arousal, unpleasant-low arousal, pleasant-high arousal and pleasant-low arousal) selected from the International Affective Picture System. The N200, P300 and late positive component (LPC) mean amplitude, were analyzed using repeated-measure analyses of variance (MANOVA).Results Patients with schizophrenia and control subjects gave comparable subjective evaluations of arousal and valence. However, the frontalN200 and theP300 both showed an interaction of the group x memory x valence x hemisphere (F [1.32]=8.36; p <.01). Thus, this complex interaction denotes an increase of the episodic memory effect in the right hemisphere in response to unpleasant stimuli, with schizophrenic patients. With respect to the control group, there is also an increase of this memory effect in the right hemisphere, but in response to pleasant stimuli. The schizophrenic patients presented a smaller LPC memory effect, especially at the frontal region. More specifically, the frontal LPC was reduced, and the clinical group was less reactive to the emotional arousal content, compared to the control group.Discussion Altogether, our results revealed that while the subjective evaluation of emotional pictures is equivalent across groups, cerebral differences are present in schizophrenic patients during emotional recognition. N200 and P300 results in the frontal region suggest impaired selective attention and episodic memory to unpleasant stimuli in patients, while later processes related to conscious recollection (parietal LPC) are not affected with patients affected with schizophrenia.Conclusion This finding provides further support for the notion of a possible discrepancy between the subjective experience and the physiological expression of emotions in schizophrenia patients. Those results could open the door to new clinical research investigations in psychiatry, particularly in the comprehension of a relationship between frontal cortex vulnerability and episodic memory often present in psychosis.

Neurophenotypes in Airway Diseases. Insights from Translational Cough Studies.

Most airway diseases, including chronic obstructive pulmonary disease (COPD), are associated with excessive coughing. The extent to which this may be a consequence of increased activation of vagal afferents by pathology in the airways (e.g., inflammatory mediators, excessive mucus) or an altered neuronal phenotype is unknown. Understanding whether respiratory diseases are associated with dysfunction of airway sensory nerves has the potential to identify novel therapeutic targets. To assess the changes in cough responses to a range of inhaled irritants in COPD and model these in animals to investigate the underlying mechanisms. Cough responses to inhaled stimuli in patients with COPD, healthy smokers, refractory chronic cough, asthma, and healthy volunteers were assessed and compared with vagus/airway nerve and cough responses in a cigarette smoke (CS) exposure guinea pig model. Patients with COPD had heightened cough responses to capsaicin but reduced responses to prostaglandin E2 compared with healthy volunteers. Furthermore, the different patient groups all exhibited different patterns of modulation of cough responses. Consistent with these findings, capsaicin caused a greater number of coughs in CS-exposed guinea pigs than in control animals; similar increased responses were observed in ex vivo vagus nerve and neuron cell bodies in the vagal ganglia. However, responses to prostaglandin E2 were decreased by CS exposure. CS exposure is capable of inducing responses consistent with phenotypic switching in airway sensory nerves comparable with the cough responses observed in patients with COPD. Moreover, the differing profiles of cough responses support the concept of disease-specific neurophenotypes in airway disease. Clinical trial registered with www.clinicaltrials.gov (NCT 01297790).

Task and Resting-State fMRI Reveal Altered Salience Responses to Positive Stimuli in Patients with Major Depressive Disorder.

Altered brain function in patients with major depressive disorder (MDD) has been repeatedly demonstrated by task-based and resting-state studies, respectively. However, less is known concerning whether overlapped abnormalities in functional activities across modalities exist in MDD patients. To find out the answer, we implemented an fMRI experiment and collected both task and resting-state data from 19 MDD patients and 19 matched, healthy, controls. A distraction paradigm involving emotionally valenced pictures was applied to induce affective responses in subjects. As a result, concurrent deficits were found in arousing activation during a positive task in both the reward circuit and salience network (SN) that is composed of the dorsal part of anterior cingulate cortex (dACC) and bilateral anterior insulae (AI) in only the MDD group. Subsequent amplitude of low frequency fluctuations (ALFF) and functional connectivity analyses based on resting-state data exhibited consistent alterations in the bilateral AI of MDD patients, and indicated patients’ difficulties in regulating the balance between central executive network (CEN) and default mode network (DMN) due to altered connectivity among the CEN, DMN, and SN. Our findings provide new evidence demonstrating impaired salience processing and resulting alterations in responses to positive stimuli in MDD patients. Furthermore, brain abnormalities synchronized across functional states in MDD patients can be evidenced by a combination of task and resting-state fMRI analyses.

Emotion, working memory, and cognitive control in patients with first-onset and previously untreated minor depressive disorders.

ObjectiveTo explore working memory and the ability to process different emotional stimuli in patients with first-onset and untreated minor (mild or moderate) depression.MethodsPatients with first-onset and previously untreated minor depression, and healthy controls, were enrolled. Using a modified Sternberg working memory paradigm to investigate the combined effects of emotional stimuli with working memory, participants were exposed to experimental stimuli comprising pictures that represented positive, neutral and negative emotions. Working memory ability was measured using reaction time and accuracy, and emotion-processing ability was measured using pupil diameter.ResultsOut of 36 participants (18 patients with minor depression and 18 controls), there were no statistically significant between-group differences in response time and accuracy. Positive stimuli evoked changes in pupil diameter that were significantly smaller in patients with minor depression versus controls, but changes in pupil diameter evoked by negative stimuli were not significantly different between the two groups.ConclusionsHealthy subjects showed a stronger emotional response to positive emotional stimuli than patients with first onset and previously untreated minor depression, but there were no differences in response to negative emotions. There were no statistically significant between-group differences in terms of speed of cognitive response, but this may have been due to the relatively small samples sizes assessed. Studies with larger sample populations are required to further investigate these results.

Changes in portal vein flow mean velocity after glucagon application measured by magnetic resonance imaging flowmetry indicates presence of severe sinusoidal injury in patients with colorectal liver metastases

Aims: Non-invasive methods like aspartate aminotransferase to platelets ratio index (APRI) score or spleen volume changes were proposed to identify patients with sinusoidal injury after preoperative chemotherapies for colorectal liver metastases. Magnetic resonance imaging flowmetry can be used to measure changes in portal vein hemodynamics in patients with sinusoidal injury. The present study evaluates the changes in portal vein flow mean velocity (VELO) after glucagon application and analyzes their ability to predict severe sinusoidal injury (SSI) in comparison to other methods. Methods: Magnetic resonance imaging flowmetry of portal vein was estimated in 28 fasting patients and repeated five minutes after 0.5 mg glucagon injection the day before liver surgery. APRI score was estimated the same day. Spleen volume changes were calculated from segmented spleen volumes on imaging before chemotherapy start and the day before surgery. Resected non-tumorous liver parenchyma was evaluated for sinusoidal injury; parenchymal extinction lesion or nodular regenerative hyperplasia was recognized as SSI. Results: SSI was observed in 6 of 28 patients. Patients with SSI demonstrated higher APRI score 0.65 vs. 0.36, p = 0.028; and non-significant change in spleen volume, 36% vs. 12%, p = 0.764. Percentage of change in VELO five minutes after glucagon in SSI patients was 11% vs. – 3%, p = 0.039. Change in VELO <= – 0.5% predicted SSI with 83% sensitivity and 73% specificity (cross-validated classification error rate 29%), similarly to APRI score >=0.43 with the same sensitivity and specificity but higher classification error rate 32%. Conclusions: Relative changes of VELO five minutes after glucagon administration showed lowered ability of portal system to react on glucagon stimuli in patients with SSI. Application of glucagon as a stress test of portal vein hemodynamic facilitates magnetic resonance imaging flowmetry ability to predict SSI non-invasively.

Electroencephalography (EEG) Measures of Neural Connectivity in the Assessment of Brain Responses to Salient Auditory Stimuli in Patients with Disorders of Consciousness.

Disorders of consciousness (DOC) present a clinical challenge in diagnosis, prognosis and defining appropriate treatments that aim at improving the patient's care and quality of life. As there is no universally accepted definition of consciousness, DOC are difficult to define, elucidate and diagnose (Giacino et al., 2014; Schiff et al., 2014).

Mindfulness Meditation and Cognitive Behavioral Therapy Intervention Reduces Pain Severity and Sensitivity in Opioid-Treated Chronic Low Back Pain: Pilot Findings from a Randomized Controlled Trial.

To assess benefits of mindfulness meditation and cognitive behavioral therapy (CBT)-based intervention for opioid-treated chronic low back pain (CLBP). 26-week parallel-arm pilot randomized controlled trial (Intervention and Usual Care versus Usual Care alone). Outpatient. Adults with CLBP, prescribed ≥30 mg/day of morphine-equivalent dose (MED) for at least 3 months. The intervention comprised eight weekly group sessions (meditation and CLBP-specific CBT components) and 30 minutes/day, 6 days/week of at-home practice. Outcome measures were collected at baseline, 8, and 26 weeks: primary-pain severity (Brief Pain Inventory) and function/disability (Oswestry Disability Index); secondary-pain acceptance, opioid dose, pain sensitivity to thermal stimuli, and serum pain-sensitive biomarkers (Interferon-γ; Tumor Necrosis Factor-α; Interleukins 1ß and 6; C-reactive Protein). Thirty-five (21 experimental, 14 control) participants were enrolled and completed the study. They were 51.8 ± 9.7 years old, 80% female, with severe CLBP-related disability (66.7 ± 11.4), moderate pain severity (5.8 ± 1.4), and taking 148.3 ± 129.2 mg/day of MED. Results of the intention-to-treat analysis showed that, compared with controls, the meditation-CBT group reduced pain severity ratings during the study (P = 0.045), with between-group difference in score change reaching 1 point at 26 weeks (95% Confidence Interval: 0.2,1.9; Cohen's d = 0.86), and decreased pain sensitivity to thermal stimuli (P < 0.05), without adverse events. Exploratory analyses suggested a relationship between the extent of meditation practice and the magnitude of intervention benefits. Meditation-CBT intervention reduced pain severity and sensitivity to experimental thermal pain stimuli in patients with opioid-treated CLBP.