Symptom Inventory Questionnaire Research Articles

Clinical and pathology characterization of small nerve fibers neuro(no)pathy in Cerebellar Ataxia with Neuropathy and Vestibular Areflexia Syndrome.

biallelic mutation/expansion of the gene RFC1 has been described in association with a spectrum of manifestation ranging from isolate sensory neuro(no)pathy to a complex presentation as Cerebellar Ataxia with Neuropathy and Vestibular Areflexia Syndrome (CANVAS). Our aim was to define the frequency and characteristics of small fiber neuropathy (SFN) in RFC1-disease at different stages. RFC1-cases were screened for SFN using the Neuropathic Pain Symptom Inventory (NPSI) and Composite Autonomic Symptom Score-31 (COMPASS-31) questionnaires. Clinical data were retrospectively collected. If available, lower limb skin biopsy samples were evaluated for somatic epidermal and autonomic subepidermal structures innervation and compared to healthy controls (HC). we enrolled 40 patients, median age at onset 54 years (IQR 49-61) and disease duration 10 years (IQR 6-16). Mild-to-moderate positive symptoms (median NPSI score 12.1/50, IQR 5.5-22.3) and relevant autonomic disturbances (median COMPASS-31 score 37.0/100, IQR 17.7-44.3) were frequently reported and showed scarce correlation with disease duration. A non-length-dependent impairment in nociception was evident on both clinical and paraclinical investigations. An extreme somatic denervation was observed in all patients at both proximal (fibers/mm RFC1-cases 0.0 vs HC 20.5, p < .0001) and distal sites (fibers/mm RFC1-cases 0.0 vs HC 13.1, p < .0001), instead only a slight decrease was observed in cholinergic and adrenergic innervation of autonomic structures. RFC1-disease is characterized by a severe and widespread somatic SFN. Skin denervation may potentially represent the earliest feature and drive towards the suspicion of this disorder.

User profile of an online cognitive behavioral therapy self-help platform in Turkey.

Online mental health self-help services are of societal importance and increasingly popular. Therefore, we have developed an online platform offering free self-help to the Turkish public with modules based on Cognitive Behavioral Therapy (CBT) targeting depression, anxiety, and stress respectively. The main purpose of this study is to describe the user profile of this platform. A pre-intervention self-report assessment including general demographic information and the Brief Symptom Inventory questionnaire during October 2020 until September 2022. 8331 participants completed the assessment and created an account out of the 11.228 users who registered during a two-year period, of which 8.331 (74%) completed the assessment and created an account. The majority of these users were female (76.17%), highly educated (82%), single (68%) and actively studying or working (84%). Slightly more than half (57%) of the platform user had not received psychological assistance before, while those who did receive previous assistance indicate to have benefitted from that (74%). The psychological symptoms of users are widely distributed, encompassing a broad range of user profiles. Approximately half of all users actively used the platform, while the other half did not complete any module. Among active users, the course "coping with depressive mood" was the most popular (41.45%), followed by "coping with anxiety" (37.25%) and "coping with stress" (21.30%). Offering a free online CBT self-help platform to the Turkish public seems feasible, with strong uptake among both man and woman struggling with a variety of psychological symptoms. Further research is needed to assess user satisfaction and change in symptoms over time during platform use by means of a feasibility trial.

Abstract P5-07-13: Effect of a 12 Week Virtual Supervised Exercise Program on Cardiorespiratory Fitness in Breast Cancer Patients Undergoing Chemotherapy: Results from the STRENGTH Trial

Abstract Background: Chemotherapy (CTX) for breast cancer (BC) can have a detrimental effect on cardiorespiratory fitness (CRF), as measured by VO2max. This decline may be attenuated by physical activity, which can also reduce mortality risk and improve quality of life (QoL) for patients (pts) with BC. During the COVID-19 pandemic, many have pivoted to home-based exercise routines, which have been shown to be safe and feasible for pts with BC receiving CTX. We conducted the STRENGTH Trial to evaluate the effect of a 12-week virtual supervised exercise program in BC pts receiving CTX on CRF. Methods: This is a single-center, prospective, single-arm study designed to evaluate the effect of a 12-week virtual supervised exercise training program on CRF in BC pts receiving CTX. Participants aged ≥18 years with stage I-IV BC who were planned to receive at least 12 weeks of CTX of investigator’s choice were eligible for inclusion. Participants were asked to complete a total of 150 minutes (min) of moderate intensity physical activity/week, as a combination of a 45 min weekly virtual personal training session and workout classes streamed from the Peloton® Digital platform (i.e. walking, running, cardio, yoga, strength training, and cycling). The primary endpoint was the distance walked on a Six-Minute Walk Test (6MWT), an accepted surrogate marker for VO2max, at the start and completion of the program. Secondary endpoints included assessment of QoL using the Functional Assessment of Cancer Therapy - General (FACT-G) and symptom assessment using the MD Anderson Symptom Inventory (MDASI) questionnaires at the beginning, middle and end of the study. Exploratory endpoints included treatment adherence, toxicities, completion and response. Results: 33 participants signed consent for the clinical trial and 2 withdrew voluntarily prior to beginning the program. 5 participants discontinued prematurely due to a diagnosis of COVID-19 (N=3) and pulmonary embolism (N=2) and were not included in the primary endpoint. One participant remains on study at this time. Median age 49 yrs; range 33-68. Mean BMI 29.55; range 18.1-46.5. 13 HR+/HER2-, 7 HR-/HER2-, 11 HER2+. 14 (45%) pts had Stage I, 11 (35%) pts had Stage 2, 5 (16%) pts had Stage 3, 1 (3%) pt had Stage 4. 23 pts (70%) received either an anthracycline or HER2-based therapy. 19 pts (61%) received neoadjuvant CTX on study, 11 pts (35%) received adjuvant CTX and 1 pt (3%) received treatment in metastatic setting. The average number of exercise min per week per participant was 123.2 min (95% CI, 104.1-142.2), with a relative dose intensity of 82%. In the pts that completed the study thus far (N=25), there was no statistically significant difference between the distance walked during the 6MWT at the start and end of the study (median difference= -10m, range: -129-150m, p= 0.67). There was no statistically significant difference in the FACT-G score at the start and end of the study (median difference= -1.0, range -17.83- 30.0, p=0.54). Pts scored higher on the MDASI (median difference= 0.33, range -1.55-4.62, p=0.04) at the end of the exercise program compared to the beginning. There were no new or unexpected treatment toxicities observed. Conclusion: Pts who participated in a 12-week virtual supervised exercise program during CTX for BC did not experience a statistically significant difference in the distance walked during the 6MWT between the beginning and end of the exercise program. Exercise may attenuate the decline in cardiorespiratory function that has historically been observed with CTX for BC. Some pts were not able to adhere to the recommended 150 min of exercise/week suggesting a potential need for modified exercise targets for pts with BC undergoing CTX. This study is limited by a small sample size and larger, randomized clinical trials are needed to further evaluate optimal exercise recommendations for patients with BC undergoing CTX in order to maintain and potentially, even improve, cardiorespiratory function. Citation Format: Eleonora Teplinsky, Amanda Podolski, Kasey Bessada, John Rutledge, Benita Burke, Moira Christoudias, Laura Klein, Kariann Abbate. Effect of a 12 Week Virtual Supervised Exercise Program on Cardiorespiratory Fitness in Breast Cancer Patients Undergoing Chemotherapy: Results from the STRENGTH Trial [abstract]. In: Proceedings of the 2022 San Antonio Breast Cancer Symposium; 2022 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2023;83(5 Suppl):Abstract nr P5-07-13.

Associations of financial toxicity with symptoms and unplanned healthcare utilization among cancer patients taking oral chemotherapy at home: a prospective observational study

BackgroundCancer patients with financial toxicity experience psychological distress and often miss medical appointments and quit treatments early, which could be a barrier to the effective management of oral chemotherapy drugs at home. This study explores whether financial toxicity predicts symptoms and unplanned healthcare utilization among cancer patients taking oral chemotherapy at home, which will contribute to the safe management of oral chemotherapy.MethodsData in this study was from a prospective observational study, which was conducted between October 2018 and December 2019. 151 patients completed the Comprehensive Score for Financial Toxicity at discharge and completed the MD Anderson Symptom Inventory and unplanned healthcare utilization questionnaires after finishing one cycle of oral chemotherapy at home. Regression analyses were conducted to explore the associations of financial toxicity with symptoms and unplanned healthcare utilization.ResultsAmong 151participants, 88.08% reported severe or moderate financial toxicity, 43.05% reported symptom interference, and 31.79% reported unplanned healthcare utilization while taking oral chemotherapy at home. Patients between the age of 45-60y (p = 0.042) have higher financial toxicity, while those living in urban areas (p = 0.016) have lower financial toxicity. Patients with worse financial toxicity suffered increased symptoms of fatigue, emotional distress, disturbed sleep, and lack of appetite. Consequently, their mood and personal relation with other significant suffered. However, no statistical differences in unplanned healthcare utilization were found among patients with different levels of financial toxicity.ConclusionMiddle-aged adults and those living in suburban or rural areas experienced worse financial toxicity than other groups. Patients with worse financial toxicity experienced more severe psychological symptoms (e.g., fatigue, distress, disturbed sleep, and lack of appetite) and affective interference (e.g., mood and relations with others). Identifying at-risk patients is necessary to offer tailored support for psychological symptom management.

Characteristics of Diverse Verbal Pain Descriptors in South Korean Patients With Peripheral Neuropathic Pain: 'Jeorim' (Tingling) and 'Sirim' (Cold) as Key Neuropathic Pain Descriptors.

The description of pain is the most-important indicator leading to the adequate treatment of patients with neuropathic pain (NeP). The purpose of this study was to identify and characterize the unique features of Korean verbal descriptions in patients with peripheral NeP. This study included 400 patients (167 males and 233 females) and their 1,387 pain-description responses. Patients with peripheral NeP freely described their symptoms in Korean. Collected verbal descriptions were grouped according to terminologies with similar meanings. Participants completed validated patient-reported outcome scales including the neuropathic pain symptom inventory (NPSI) and painDETECT questionnaire (PD-Q). The frequencies of each verbal pain descriptor were compared between the NPSI and PD-Q scores. 'Jeorim' (tingling) was the most common among 17 types of organized verbal pain descriptors, and the 'Sirim' (cold) symptom had a significantly higher rate of use in the 2 high-severity groups when participants were classified by their total scores on the NPSI and PD-Q. Korean verbal NeP descriptors were significantly diverse. The Jeorim (tingling) and Sirim (cold) descriptors can be utilized in evaluations of Korean patients with NeP.

Smartphone pain app for assessment of radiation-induced oral mucositis pain.

420 Background: Oral Mucositis related pain is one of the most common radiation therapy (RT) related toxicities associated with the treatment of head and neck cancer (HNC). Questionnaire-based assessment of mucositis pain is based on a patient's recall which can be inaccurate sometimes. Therefore, real-time monitoring of patient-reported pain is required for better evaluation of mucositis pain. Methods: We performed a single-arm, observational study (NCT02727062) to investigate the feasibility of a smartphone-based pain app (OMP) in assessing mucositis pain in locally advanced HNC patients(pts) undergoing a course of definitive or adjuvant RT (&gt; 50 Gy), +/- chemotherapy, for oral cavity or oropharynx cancer. The app prompted pts to input pain severity scores using a visual analog (0-10) scale (VAS) at multiple time points during a day throughout the study. OMP software-generated time-weighted average weekly summary measure of pain by integrating multiple serial daily pain assessments. In addition, pts completed weekly Brief pain inventory (BPI) and MD Anderson head &amp; neck symptom inventory (MDASI-HN) questionnaires. Feasibility surveys were also collected to assess the ease of use of OMP and the burden of study participation. Responses to questions on this survey were scored on a scale of 0-3, with 0 standing for not at all and 3 for extremely. Linear mixed models (LMM) controlling for person random effects were used to evaluate association and quantify differences between average weekly pain (AWP) calculated by OMP and AWP recorded using VAS by BPI survey (question 5). LMM was also used to evaluate the association between AWP score from OMP and BPI pain score with MDASI-HN scores. Descriptive statistics, including averages and frequency, were used to analyze feasibility surveys. Results: We report results of 15 pts who have complete data out of 18 registered pts. Using LMM, we compared AWP score curves calculated from BPI and OMP. We observed that both curves followed a parallel trajectory. However, pain scores calculated from OMP were 0.40 units higher than BPI pain. The Bland-Altman plot also confirmed that BPI pain and OMP did not clearly agree. Additionally, AWP scores from OMP had a positive correlation with fatigue (p &lt; 0.001), drowsiness (p &lt; 0.001), decreased activity (p &lt; 0.001), and interference with work (p &lt; 0.001) related scores recorded in MDASI-HN. In terms of feasibility, most surveys indicated that it was extremely easy for subjects to enter responses and not at all difficult for them to use all features of OMP. Furthermore, study participation did not interfere with subjects’ usual activities. Conclusions: Our study showed that pain scores calculated through OMP were, on average higher than those reported by BPI. It also showed the correlation between pain and physical activity. Hence, utilization of OMP in conjunction with questionnaires may improve our understanding of the severity of mucositis-related pain. Clinical trial information: NCT02727062.

Comparison of characteristics between neuropathic pain and non-neuropathic pain in patients with diabetic carpal tunnel syndrome: A cross-sectional study

BackgroundThe aim of the study was to compare the clinical characteristics of diabetic carpal tunnel syndrome between patients with neuropathic pain (NeuP) and non-NeuP.MethodsWe enrolled 276 patients with diabetic carpal tunnel syndrome. Pain symptoms were evaluated using a visual analog scale. Douleur Neuropathique 4, the Neuropathic Pain Symptoms Inventory questionnaire, and the body map were used to assess neuropathic symptoms. Baseline information, clinical manifestations, electrophysiological test results, and psychological status were compared between the neuropathic pain (NeuP) and non-NeuP to identify the risk factor for NeuP occurrence.ResultsResults showed that the degree of pain was more severe in NeuP patients than in nociceptive pain patients (p = 0.025). The frequencies of light touch and pinprick were more pronounced in the NeuP group than in the non-NeuP group (light touch: p = 0.001; pinprick: p = 0.004). There were 48 and 27 NeuP patients with extramedian and proximal spread, respectively, whereas in the non-NeuP group, there were 11 and 9 patients, respectively (p = 0.03). Electrophysiological results showed that patients in the NeuP group exhibited greater sensory nerve conduction velocity impairment compared with the non-NeuP group (p = 0.033). Pain Catastrophizing Scale total scores of the NeuP group were significantly higher than those of the non-NeuP group (p = 0.006).ConclusionOf the 276 diabetic carpal tunnel syndrome patients studied, the majority had NeuP. Furthermore, light touch, electrophysiological test results, and psychological factors were found to be related to NeuP occurrence in patients with diabetic carpal tunnel syndrome.

Predicting South Korea adolescents vulnerable to depressive disorder using Bayesian nomogram: A community-based cross-sectional study

BACKGROUNDAlthough South Korea has developed and carried out evidence-based interventions and prevention programs to prevent depressive disorder in adolescents, the number of adolescents with depressive disorder has increased every year for the past 10 years.AIMTo develop a nomogram based on a naïve Bayesian algorithm by using epidemiological data on adolescents in South Korea and present baseline data for screening depressive disorder in adolescents.METHODSEpidemiological data from 2438 subjects who completed a brief symptom inventory questionnaire were used to develop a model based on a Bayesian nomogram for predicting depressive disorder in adolescents.RESULTSPhysical symptoms, aggression, social withdrawal, attention, satisfaction with school life, mean sleeping hours, and conversation time with parents were influential factors on depressive disorder in adolescents. Among them, physical symptoms were the most influential.CONCLUSIONActive intervention by periodically checking the emotional state of adolescents and offering individual counseling and in-depth psychological examinations when necessary are required to mitigate depressive disorder in adolescents.

Association of genetic variants of Glutamate Metabotropic Receptor 5 gene and state-anhedonia

IntroductionAndedonia is one of the core symptoms of depression. It is known that in case of depressed individuals experiencing anhedonia, the classical antidepressants are often ineffective, thus investigation of this symptom would be essential. Recent studies highlight the possible role of the glutamatergic system in anhedonia however, the genetic background of these assumptions is still unclear.ObjectivesOur goal was to investigate the possible associations between state-anhedonia and genetic variants from GRM5 (Glutamate Metabotropic Receptor 5) gene.MethodsFor our analysis we used data from the NewMood (New Molecules in Mood Disorders, LSHM-CT-2004-503474) project. Participants (n = 1820) aged between 18-60, were recruited in Budapest and in Manchester. All volunteers filled out mental-health questionnaires and provided DNA sample. Genotyping was performed by Illumina’s CoreExom PsychChip. Altogether 1282 variants from GRM5 gene survived the genetic quality control steps. State-anhedonia was measured with an item from the Brief Symptom Inventory questionnaire. We performed logistic regression using Plink 2.0. During our analyses, age, gender, population and the top10 principal components of the genome were added into the model as covariates. Correction for linkage-disequilibrium were performed with LDlink.ResultsAfter the correction of linkage-disequilibrium, three independent variables (r2&lt;0.2), (rs1827603, rs6483520, rs35669869) yielded significant (p&lt;0.05) results, both in additive and in dominant model. In case of recessive model, only rs11020880 showed significant (p&lt;0.05) effect.ConclusionsThe detected nominally significant associations between state-anhedonia and genetic variants from GRM5 gene strengthen previous assumptions about the possible relationship between glutamatergic system and anhedonia.DisclosureThis study was supported by: MTA-SE Neuropsychopharmacology and Neurochemistry Research Group; 2017-1.2.1-NKP-2017-00002; KTIA_13_NAPA-II/14; KTIA_NAP_13-1-2013- 0001; KTIA_NAP_13-2- 2015-0001; 2020-4.1.1.-TKP2020 and 2019-2.1.7-ERA-NET-2020-00005 (TRAJEC

Correlations Between the Neurobehavioral Symptom Inventory and Other Commonly Used Questionnaires for Traumatic Brain Injury.

To evaluate the correlations between the Neurobehavioral Symptom Inventory (NSI) and other questionnaires commonly administered within military traumatic brain injury clinics. Military outpatient traumatic brain injury clinics. In total, 15,428 active duty service members who completed 24,162 NSI questionnaires between March 2009 and May 2020. Observational retrospective analysis of questionnaires collected as part of standard clinical care. NSI, Post-Traumatic Stress Disorder Checklist for DSM-5 and Military Version, Patient Health Questionnaire (PHQ), Generalized Anxiety Disorder, Headache Impact Test (HIT-6), Insomnia Severity Index (ISI), Epworth Sleepiness Scale (ESS), Activities-Specific Balance Confidence Scale (ABC), Dizziness Handicap Inventory (DHI), Alcohol Use Disorders Identification Test (AUDIT), and the World Health Organization Quality of Life Instrument-Abbreviated Version. Only questionnaires completed on the same date as the NSI were examined. The total NSI score was moderately to strongly correlated with all questionnaires except for the AUDIT. The strongest correlation was between the NSI Affective Score and the PHQ9 (r = 0.86). The NSI Vestibular Score was moderately correlated with the ABC (r = -0.55) and strongly correlated with the DHI (r = 0.77). At the item level, the HIT-6 showed strong correlation with NSI headache (r = 0.80), the ISI was strongly correlated with NSI difficulty sleeping (r = 0.63), and the ESS was moderately correlated with NSI fatigue (r = 0.39). Clinicians and healthcare administrators can use the correlations reported in this study to determine if questionnaires add incremental value for their clinic as well as to make more informed decisions regarding which questionnaires to administer.

Attachment and Therapeutic Alliance in Substance Use Disorders: Initial Findings for Treatment in the Therapeutic Community.

Background: There is convincing evidence that individuals suffering from Substance Use Disorder (SUD) often present insecure attachment patterns. In contrast, a strong therapeutic alliance in treatment of SUD has been found to lead to a more positive treatment outcome. However, insecure attachment has been observed to be linked with weaker therapeutic alliance strength. The primary aim of this explorative study was to gain initial insights regarding the influence of attachment and personality characteristics on therapeutic alliance and therapy motivation in SUD patients undergoing treatment at a therapeutic community. Furthermore, SUD patients were compared to healthy controls regarding attachment, personality and mood pathology.Methods: A total sample of 68 participants, 34 inpatients in SUD treatment and 34 age-gender and education adjusted controls, were investigated. Both groups filled in the Adult Attachment Scale (AAS), the Inventory of Personality Organization (IPO-16), and the Brief Symptom Inventory (BSI-18) questionnaires. Additionally, SUD patients filled in the Working Alliance Inventory (WAI-SR) and the adapted German version of the University of Rhode Island Change Assessment scale (FEVER).Results: In line with our assumptions, SUD patients exhibited a decreased amount of attachment security (AAS) which was related to higher personality (IPO-16) and mood pathology (BSI-18). Furthermore, correlational analysis revealed the WAI-SR dimension Bond being positively associated with more secure attachment. A strong task alliance was linked to the Action stage of change (FEVER) and decreased mood but not personality pathology.Conclusion: Our findings confirm the putative negative effect of attachment and personality pathology on therapy motivation and therapeutic alliance in addiction therapy as well as more specifically in therapeutic community treatment. Future research in enhanced samples might focus more on the long-term effects of the interaction of attachment, personality and therapeutic alliance variables.

The Parent–Child Movement Scale (PCMS): Observing emotional facets of mother–child relationships through joint dance

The motor arousal of children with emotional and behavioral difficulties influences and is influenced by the quality of the non-verbal interactions with their parents. The aim of the present study was to validate the Parent–Child Movement Scale (PCMS), a reliable observation tool for joint dances between parents and their preschool children. To test the tool's discriminant validity scores of four mother–child groups on the PCMS: BH (both high), BL (both low), MH–CL (mother high–child low) and ML–CH (mother-low, child-high) were compared. Sixty mothers of children with dysregulation and behavior problems were filmed as they engaged in a “mirror game” in which each led the other in spontaneous movements. The mothers completed the Child Behavior Checklist (CBCL) and the Brief Symptom Inventory (BSI) questionnaires. Analysis of the distribution of the participants’ mean scores and a Kruskal–Wallis non-parametric test showed that there were significant differences between groups. Mother–child dyads in which the child scored low on the PCMS was associated with more introversion/depression problems than in dyads in which the child and mother scored high on the PCMS. A high score for the mother and a low score for the child on the PCMS was associated with more anxiety for mothers compared to mothers in groups where the mother and child had the same score. The discussion focuses on the contribution of nonverbal parameters to the assessment of depression.

Predicting late symptoms of head and neck cancer treatment using LSTM and patient reported outcomes.

Patient-Reported Outcome (PRO) surveys are used to monitor patients' symptoms during and after cancer treatment. Acute symptoms refer to those experienced during treatment and late symptoms refer to those experienced after treatment. While most patients experience severe symptoms during treatment, these usually subside in the late stage. However, for some patients, late toxicities persist negatively affecting the patient's quality of life (QoL). In the case of head and neck cancer patients, PRO surveys are recorded every week during the patient's visit to the clinic and at different follow-up times after the treatment has concluded. In this paper, we model the PRO data as a time-series and apply Long-Short Term Memory (LSTM) neural networks for predicting symptom severity in the late stage. The PRO data used in this project corresponds to MD Anderson Symptom Inventory (MDASI) questionnaires collected from head and neck cancer patients treated at the MD Anderson Cancer Center. We show that the LSTM model is effective in predicting symptom ratings under the RMSE and NRMSE metrics. Our experiments show that the LSTM model also outperforms other machine learning models and time-series prediction models for these data.

The role of emotion regulation and maternal symptoms in Turkish mothers' caregiving helplessness during toddlerhood.

To support mothers’ positive parenting practices and designing effective early interventions in developing countries like Turkey, understanding the factors associated with feelings of helplessness in caregiving can play an important role. Therefore, we explored how mothers’ depression and anxiety symptoms, and emotion regulation strategies of expressive suppression and cognitive reappraisal can contribute to caregiving helplessness during toddlerhood. We also examined whether depression and anxiety can mediate the relationship between emotion regulation strategies and caregiving helplessness. A sample of 552 healthy Turkish mothers (MAge = 32.11) with 1–4 year old healthy children (MAge = 1.51) replied to advertisements we shared face-to-face and filled out a pack of questionnaires including a demographic form, Emotion Regulation Questionnaire, Brief Symptom Inventory and Caregiving Helplessness Questionnaire. A series of path analysis were conducted to reveal the association between emotion regulation strategies (cognitive reappraisal and emotional suppression), depression and anxiety symptoms, and caregiving helplessness. After controlling for socio-economic status (SES), maternal anxiety but not maternal depression positively predicted caregiving helplessnes. Unlike cognitive reappraisal, expressive suppression positively predicted caregiving helplessness. SES had an indirect effect (via suppression) on caregiving helplessness on caregiving helplessness. In toddlerhood, maternal anxiety rather than depression, and expressive supression rather than cogntivie reappraisal could be potential risk factors for caregiving helplessness. Thus, these can be critical target areas for effective early interventions.

Improvement in Quality of Life Following Surgical Resection of Benign Intradural Extramedullary Tumors: A Prospective Evaluation of Patient-Reported Outcomes.

Historically, symptomatic, benign intradural extramedullary (IDEM) spine tumors have been managed with surgical resection. However, minimal robust data regarding patient-reported outcomes (PROs) following treatment of symptomatic lesions exists. Moreover, there are increasing reports of radiosurgical management of these lesions without robust health-related quality of life data. To prospectively analyze PROs among patients with benign IDEM spine tumors undergoing surgical resection to define the symptomatic efficacy of surgery. Prospective, single-center observational cohort study of patients with benign IDEM spine tumors undergoing open surgical resection. Pre- and postoperative Brief Pain Index (BPI) and MD Anderson Symptom Inventory (MDASI) questionnaires were used to quantitatively assess their symptom control after surgical intervention. Matched pairs were analyzed with the Wilcoxon signed-rank test. A total of 57 patients met inclusion criteria with both pre- and postoperative PROs. There were 35 schwannomas, 18 meningiomas, 2 neurofibromas, 1 paraganglioma, and 1 mixed schwannoma/neurofibroma. Most patients were American Spinal Injury Association Impairment (ASIA) E (93%) with high-grade spinal cord compression (77%), and underwent either a 2 or 3 level laminectomy (84%). Surgical resection resulted in statistically significant improvement in all 3 composite BPI constructs of pain-severity, pain-interference, and overall patient pain experience (P<.0001). Surgical resection resulted in statistically significant improvements in all composite scores for the MDASI core symptom severity, spine tumor, and disease interference constructs (P<.01). Three patients (5%) had postoperative complications requiring surgical interventions (2 wound revisions and 1 ventriculo-peritoneal shunt). Surgical resection of IDEM spine tumors provides rapid, significant, and durable improvement in PROs.

Cohort study protocol to characterize the incidence and severity of neuropathic pain in patients with severe acute respiratory syndrome coronavirus 2 infection.

The coronavirus disease 2019 (COVID-19) pandemic has resulted in patients experiencing symptoms that include neurological dysfunction. As many viral infections are associated with neuropathy, the aim of the study is to characterize the incidence and severity of neuropathic pain in patients with COVID-19. A cohort study will be conducted in adult (≥18 years) patients who were tested for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) at Washington University/Barnes-Jewish Hospital. Participants who are deceased, with incomplete test results, or who cannot be contacted will be excluded. Approximately 1320 participants will be recruited in a 1:2 ratio of those with a positive-to-negative SARS-CoV-2 test result. Each participant will be invited to complete a survey to assess their symptoms related to neuropathy, 30 to 90 days after their initial SARS-CoV-2 test. Survey responses, demographics, and clinical data from the electronic health record will be used for analysis. The primary outcome is the incidence of new symptoms of neuropathic pain. The self-reported DN4 and Neuropathic Pain Symptom Inventory questionnaires (Appendix 1, http://links.lww.com/PR9/A103) will be used for neuropathic pain screening and severity assessment, respectively. Exploratory analyses will be performed to investigate other potential clinical endpoints and trends. Similar to previous coronavirus infections, an increased incidence of new-onset neuropathic pain after COVID-19 disease is expected, along with an increase in the severity experienced by patients with COVID-19 with pre-existing chronic pain. Comprehensive understanding of how COVID-19 affects the nervous system can provide a better framework for managing pain in this disease.

Semantic and logopenic primary progressive aphasia differ in pitch variation during a motor speech task

AbstractBackgroundSemantic variant primary progressive aphasia (svPPA) is an uncommon neurodegenerative disease associated with selective atrophy of the dominant temporal lobe. Previous observations of left hemisphere damage suggest that prosodic expression (mediated predominantly by the right hemisphere and dorsal processing streams) is often preserved and may even be enhanced as a release phenomenon in some aphasic syndromes. We predicted left temporal injury would be associated with increased pitch variation, thereby distinguishing it from other PPA syndromes such as the logopenic variant of primary progressive aphasia (lvPPA).Method8 patients with svPPA and 10 patients with lvPPA repeated the syllable "Pa" as part of a motor speech evaluation. We compared the coefficient of variation of fundamental frequency, perceived as vocal pitch, using a separate variances two‐way t‐test. To better understand what may drive differences in pitch variation, we also correlated pitch variation with disinhibition measures on the Neuropsychiatric Symptoms Inventory Questionnaire (NPI‐Q) and the Frontal Assessment Battery (FAB).ResultCompared to 10 patients with lvPPA (M 4.5, SD 1.6), patients with svPPA (M 14.0, SD 10.3) displayed more variation of fundamental frequency (T = 2.6, p = 0.02). There was no correlation with either the NPIQ or FAB disinhibition measures.ConclusionPitch variation during simple motor speech tasks may serve as an additional diagnostic feature to distinguish between subtypes of PPA. The temporal atrophy associated with svPPA may release hyperprosodic performances on a simple motor speech task, through a mechanism beyond behavioral disinhibition as assessed in either the NPI‐Q or the FAB. Further research is needed to better understand the neural underpinnings of prosodic differences between PPA subtypes.

The effect of nocturnal “meat” versus “vegetarian” dinners on sleep quality and daily functioning

Sleep and nutrition are central to an organism's continued physiological existence. Moreover, both of these functions include significant social-behavioral, educational, and cultural elements. This study examined the effects of two types of nocturnal dinners ("vegetarian" versus "meat") on the quality and quantity of sleep, as well as on subjective sleepiness and attention levels the following morning. 20 healthy subjects (10 men and 10 women) participated in a lab polysomnography study for two non-consecutive nights at the Sleep Institute at Tel-Hai College. They completed questionnaires (Karolinska Sleepiness Scale (KSS) and Brief Symptom Inventory Questionnaire (BSI)), as well as a computerized attention and concentration test (Conner's Continuous Performance Test-III (CPT-III)), on the mornings after each night of polysomnography. On the first night, subjects consumed a vegetarian meal made up of non-animal ingredients (vegetables and vegetable proteins). On the second night, they were given a meat meal composed of carbohydrates, fats, and animal proteins. No significant differences were measured in the various sleep parameters: efficacy, structure, and quality of sleep. There were also no significant differences found in the behavioral measures examined: subjective sleepiness (KSS), mood (BSI), and attention and concentration abilities (CPT-III). The findings of this study indicate that, contrary to popular belief, consuming a meat dinner may not affect a person's quality of sleep, or their ability to function the morning after, differently than a vegetarian dinner. Future studies should further examine the relationship between sleep and nutrition. The clinical trial is registered under the number 0010-18ASMC.

Musculoskeletal Injuries In Charity Team Marathoners Training For The Boston Marathon

PURPOSE: There is a gap in the sports medicine literature about injury types and rates in runners training for a marathon with a charity team. Our objectives were to: 1. Determine the types of injuries among members of a charity marathon team, and 2. Estimate the rates of injuries in this group. METHODS: This is a survey study with a secondary medical record review of the 2019 Stepping Strong charity marathon team at Brigham and Women’s Hospital, Boston, MA (140 runners). Measures were: 1. Self-report baseline questionnaire, and 2. Symptom and function inventory questionnaires completed during the training cycle and after the Boston Marathon. We generated descriptive statistics and determined injury types and rates from these measures. RESULTS: Participants had a mean of 10.2 (SD 8.8) years of running experience, and most commonly averaged 10 to 19.9 miles per week (41.8%). The mean number of previous marathons trained for and completed was 5 (SD 10.3), and 94.9% raised $7,500.00 or more. 26.3% of runners reported a medical-provider diagnosed injury, 43.8% reported an injury not diagnosed by a medical provider lasting more than 1 week, 40% reported pain due to running lasting more than 1 week, and 53.8% reported pain due to running of any duration. Injury locations are displayed in Figure 1. More than 50% of runners reported pain that interfered with their ability to run their usual distance at their usual pace, and approximately 25% of runners reported pain that interfered with their ability to walk. 76% of respondents to the post-race questionnaire reported they developed pain at some point during the marathon training cycle, and 88% of respondents indicated they would run a marathon again. CONCLUSIONS: Less stringent injury definitions resulted in greater percentages of participants reporting injuries. The knee, foot and hip were common injury sites. Though most participants developed pain during the marathon training cycle, almost all indicated they would run a marathon again.

Corneal confocal microscopy detects small nerve fibre damage in patients with painful diabetic neuropathy

Neuropathic pain is believed to arise from damage to nociceptive C fibres in diabetic neuropathy (DN). We have utilised corneal confocal microscopy (CCM) to quantify the severity of small nerve fibre damage in relation to the severity of neuropathic pain and quality of life (QoL) in patients with and without painful DN. 30 controls and patients with painful (n = 78) and painless (n = 62) DN underwent assessment of large and small nerve fibre function, CCM, neuropathic symptoms (small fibre neuropathy symptom inventory questionnaire, neuropathic pain scale) and QoL (SF-36, pre-R-ODS and hospital anxiety and depression scale). Patients with painful compared to painless DN, had comparable neurophysiology and vibration perception, but lower corneal nerve fibre density (20.1 ± 0.87 vs. 24.13 ± 0.91, P = 0.005), branch density (44.4 ± 3.31 vs. 57.74 ± 3.98, P = 0.03), length (19.61 ± 0.81 vs. 22.77 ± 0.83, P = 0.01), inferior whorl length (18.03 ± 1.46 vs. 25.1 ± 1.95, P = 0.005) and cold sensation threshold (21.35 ± 0.99 vs. 26.08 ± 0.5, P < 0.0001) and higher warm sensation threshold (43.7 ± 0.49 vs. 41.37 ± 0.51, P = 0.004) indicative of small fibre damage. There was a significant association between all CCM parameters and the severity of painful neuropathic symptoms, depression score and QoL. CCM identifies small nerve fibre loss, which correlates with the severity of neuropathic symptoms and reduced QoL in patients with painful diabetic neuropathy.