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1.
Front Hum Neurosci ; 16: 920383, 2022.
Article in English | MEDLINE | ID: covidwho-2022807

ABSTRACT

Background: Repetitive transcranial magnetic stimulation (rTMS) is a novel treatment for smoking cessation and delay discounting rate is novel therapeutic target. Research to determine optimal therapeutic targets and dosing parameters for long-term smoking cessation is needed. Due to potential biases and confounds introduced by the COVID-19 pandemic, we report preliminary results from an ongoing study among participants who reached study end prior to the pandemic. Methods: In a 3 × 2 randomized factorial design, participants (n = 23) received 900 pulses of 20 Hz rTMS to the left dorsolateral prefrontal cortex (PFC) in one of three Durations (8, 12, or 16 days of stimulation) and two Intensities (1 or 2 sessions per day). We examined direction and magnitude of the effect sizes on latency to relapse, 6-month point-prevalence abstinence rates, research burden, and delay discounting rates. Results: A large effect size was found for Duration and a medium for Intensity for latency to relapse. Increasing Duration increased the odds of abstinence 7-8-fold while increasing Intensity doubled the odds of abstinence. A large effect size was found for Duration, a small for Intensity for delay discounting rate. Increasing Duration and Intensity had a small effect on participant burden. Conclusion: Findings provide preliminary support for delay discounting as a therapeutic target and for increasing Duration and Intensity to achieve larger effect sizes for long-term smoking cessation and will provide a pre-pandemic comparison for data collected during the pandemic. Clinical Trial Registration: [www.ClinicalTrials.gov], identifier [NCT03865472].

2.
Frontiers in human neuroscience ; 16, 2022.
Article in English | EuropePMC | ID: covidwho-1958389

ABSTRACT

Background Repetitive transcranial magnetic stimulation (rTMS) is a novel treatment for smoking cessation and delay discounting rate is novel therapeutic target. Research to determine optimal therapeutic targets and dosing parameters for long-term smoking cessation is needed. Due to potential biases and confounds introduced by the COVID-19 pandemic, we report preliminary results from an ongoing study among participants who reached study end prior to the pandemic. Methods In a 3 × 2 randomized factorial design, participants (n = 23) received 900 pulses of 20 Hz rTMS to the left dorsolateral prefrontal cortex (PFC) in one of three Durations (8, 12, or 16 days of stimulation) and two Intensities (1 or 2 sessions per day). We examined direction and magnitude of the effect sizes on latency to relapse, 6-month point-prevalence abstinence rates, research burden, and delay discounting rates. Results A large effect size was found for Duration and a medium for Intensity for latency to relapse. Increasing Duration increased the odds of abstinence 7–8-fold while increasing Intensity doubled the odds of abstinence. A large effect size was found for Duration, a small for Intensity for delay discounting rate. Increasing Duration and Intensity had a small effect on participant burden. Conclusion Findings provide preliminary support for delay discounting as a therapeutic target and for increasing Duration and Intensity to achieve larger effect sizes for long-term smoking cessation and will provide a pre-pandemic comparison for data collected during the pandemic. Clinical Trial Registration [www.ClinicalTrials.gov], identifier [NCT03865472].

3.
Brain Behav Immun Health ; 21: 100454, 2022 May.
Article in English | MEDLINE | ID: covidwho-1930758

ABSTRACT

Background: SARS-CoV-2 infection is believed to adversely affect the brain, but the degree of impact on socially relevant cognitive functioning and decision-making is not well-studied, particularly among those less vulnerable to age-related mortality. The current study sought to determine whether infection status and COVID-19 symptom severity are associated with cognitive dysfunction among young and middled-aged adults in the general population, using self-reported lapses in executive control and a standardized decision-making task. Method: The survey sample comprised 1958 adults with a mean age of 37 years (SD â€‹= â€‹10.4); 60.8% were female. Participants reported SARS-CoV-2 infection history and, among those reporting a prior infection, COVID-19 symptom severity. Primary outcomes were self-reported symptoms of cognitive dysfunction assessed via an abbreviated form of the Barkley Deficits in Executive Functioning Scale (BDEFS) and performance on a validated delay-discounting task. Results: Young and middle-aged adults with a positive SARS-CoV-2 infection history reported a significantly higher number of cognitive dysfunction symptoms (M adj  â€‹= â€‹1.89, SE â€‹= â€‹0.08, CI: 1.74, 2.04; n â€‹= â€‹175) than their non-infected counterparts (M adj  â€‹= â€‹1.63, SE â€‹= â€‹0.08, CI: 1.47,1.80; n â€‹= â€‹1599; ߠ​= â€‹0.26, p â€‹= â€‹.001). Among those infected, there was a dose-response relationship between COVID-19 symptom severity and level of cognitive dysfunction reported, with moderate (ߠ​= â€‹0.23, CI: 0.003-0.46) and very/extremely severe (ߠ​= â€‹0.69, CI: 0.22-1.16) COVID-19 symptoms being associated with significantly greater cognitive dysfunction. These effects remained reliable and of similar magnitude after controlling for demographics, vaccination status, mitigation behavior frequency, and geographic region, and after removal of those who had been intubated during hospitalization. Very similar-and comparatively larger-effects were found for the delay-discounting task, and when using only PCR confirmed SARS-CoV-2 cases. Conclusions: Positive SARS-CoV-2 infection history and moderate or higher COVID-19 symptom severity are associated with significant symptoms of cognitive dysfunction and amplified delay discounting among young and middle-aged adults with no history of medically induced coma.

4.
Brain, behavior, & immunity - health ; 2022.
Article in English | EuropePMC | ID: covidwho-1749462

ABSTRACT

Background Prior studies have documented reliable associations between SARS-CoV-2 infection and adverse cognitive impact, at least in older adults. The current study sought to determine whether SARS-CoV-2 infection and COVID-19 symptom severity are associated with cognitive dysfunction among young and middled-aged adults in the general population. Method The Canadian COVID-19 Experiences Project (CCEP) survey involves 1958 adults with equal representation of vaccinated and vaccine hesitant adults between the ages of 18 and 54 years. The sample comprised 1958 adults with a mean age of 37 years (SD = 10.4);60.8% were female. The primary outcome was symptoms of cognitive dysfunction assessed via an abbreviated form of the Barkley Deficits in Executive Functioning Scale (BDEFS) and performance on a validated delay-discounting task. Results Young and middle-aged adults with a positive SARS-CoV-2 infection history reported a significantly higher number of symptoms of executive dysfunction (Madj = 1.89, SE = 0.08, CI: 1.74, 2.04;n = 175) than their non-infected counterparts (Madj = 1.63, SE = 0.08, CI: 1.47,1.80;n = 1599;β = 0.26, p = .001). Among those infected, there was a dose-response relationship between COVID-19 symptom severity and level of executive dysfunction, with moderate (β = 0.23, CI: 0.003–0.46) and very/extremely severe (β = 0.69, CI: 0.22–1.16) COVID-19 symptoms being associated with significantly greater dysfunction, compared to asymptomatic. These effects remained reliable and of similar magnitude after controlling for demographics, vaccination status, mitigation behavior frequency, and geographic region, and after removal of those who had been intubated during hospitalization. Very similar—and comparatively stronger—effects were found for the delay-discounting task, and when using only PCR confirmed SARS-CoV-2 cases. Conclusions Positive SARS-CoV-2 infection history and COVID-19 symptom severity are associated with executive dysfunction among young and middle-aged adults with no history of medically induced coma. These findings are evident on self-reported and task-related indicators of cognitive function.

5.
J Behav Med ; 45(2): 227-239, 2022 04.
Article in English | MEDLINE | ID: covidwho-1616193

ABSTRACT

People with prediabetes are at risk for type 2 diabetes. They may discount the future delay discounting (DD), and not engage in preventive health behaviors. Episodic future thinking (EFT) can reduce DD when future scenarios are cued, but research is needed to assess long-term effects of EFT and when EFT is not cued. This study tested EFT training compared to control for people with prediabetes enrolled in a 6-month weight loss program on DD, weight, HbA1c, and physical activity. Results showed a reliable EFT effect on reducing DD in cued (p = 0.0035), and uncued DD tasks (p = 0.048), and significant overall changes in weight (p < 0.001), HbA1c (p, 0.001) and physical activity (p = 0.003), but no significant differences in these outcomes by group (p's > 0.05). Sixty-eight percent of the sample ended below the prediabetes HbA1c range. These results suggest that DD can be modified over extended periods, and the effects of EFT can be observed without EFT cues. However, these data do not suggest that changes in weight, HbA1c or physical activity were due to EFT training. The study was initiated before the COVID-19 pandemic which provided the opportunity to compare differences for people treated in-person or remotely. Analyses showed no differences in DD, weight, HBA1c or physical activity outcomes were observed between in-person and remote treatment, suggesting telehealth is a scalable approach to treating prediabetes.


Subject(s)
Delay Discounting , Diabetes Mellitus, Type 2 , Glycated Hemoglobin A , Prediabetic State , Weight Loss , Diabetes Mellitus, Type 2/psychology , Humans , Prediabetic State/psychology , Thinking
6.
Exp Clin Psychopharmacol ; 2021 Jun 24.
Article in English | MEDLINE | ID: covidwho-1281676

ABSTRACT

The coronavirus disease pandemic of 2019 (COVID-19) is a worldwide threat to public health that has significantly affected the United States. The pandemic poses a variety of health risks including stressful disruptions in social and economic activity. Understanding the pandemic's effects on already vulnerable populations, such as individuals with chronic pain, may inform healthcare preparation for future catastrophic events. Given the association between excessive discounting of delayed rewards and chronic pain, this study examined relationships between delay discounting, pain severity, and COVID-19 perceived stress in individuals with chronic pain. Individuals reporting chronic pain (N = 180; 41% female; 86% white; 59% with a college degree) were recruited via the Amazon Mechanical Turk platform in this cross-sectional study. Measures of pain severity, delay discounting, probability discounting, and COVID-19 perceived stress were collected. Delay discounting was a significant predictor of overall pain severity (p < .02) and COVID-19 perceived stress (p < .001). Also, the magnitude of COVID-19 perceived stress fully mediated the relationship between delay discounting and overall pain severity (p = .004). Probability discounting was not a significant predictor of pain severity or COVID-19 perceived stress (p > .05). These findings highlight the importance of excessive discounting of delayed rewards as a potential determinant of pain severity as well as predictor of perceived stress related to the COVID-19 pandemic. Thus, the discounting of delayed rewards is of particular therapeutic importance for individuals with chronic pain in the context of stressful events. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

7.
J Subst Abuse Treat ; 120: 108150, 2021 01.
Article in English | MEDLINE | ID: covidwho-1023674

ABSTRACT

The response to the COVID-19 crisis has created direct pressure on health care providers to deliver virtual care, and has created the opportunity to develop innovations in remote treatment for people with substance use disorders. Remote treatments provide an intervention delivery framework that capitalizes on technological innovations in remote monitoring of behaviors and can efficiently use information collected from people and their environment to provide personalized treatments as needed. Interventions informed by behavioral economic theories can help to harness the largely untapped potential of virtual care in substance use treatment. Behavioral economic treatments, such as contingency management, the substance-free activity session, and episodic future thinking, are positioned to leverage remote monitoring of substance use and to use personalized medicine frameworks to deliver remote interventions in the COVID-19 era and beyond.


Subject(s)
COVID-19 , Substance-Related Disorders/therapy , Telemedicine/methods , Behavior Therapy/methods , Economics, Behavioral , Humans , Precision Medicine
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