Brief mindfulness-based training and mindfulness trait attenuate psychological stress in university students: a randomized controlled trial.

BACKGROUND: Psychological distress in University settings has grown and became a public health concern. In this context, contemplative practices such as mindfulness have been proposed as a strategy to help students on stress management. METHODS: Forty university students (20 female), aged between 18 to 30 years (mean = 24.15; SD = 3.56), with no previous experience with meditation or yoga were recruited at the Federal University of Rio Grande do Norte and randomized to a mindfulness training (MT) or active control (AC) groups. We analyzed measures of anxiety, affect, stress, as well as state and trait mindfulness in order to evaluate the effects of trait mindfulness and a brief mindfulness intervention in forty healthy young students. Participants were classified as Low (n = 27, females = 13) or High (n = 13, females = 7) Trait Mindfulness by k-means clustering and compared between them using Wilcoxon sum rank test. Furthermore, the sample was randomly allocated to an AC (n = 20, females = 10) or a MT (n = 20, females = 10) group, and mixed analysis of variance was performed to analyze the effect of interventions. The mechanisms and role of trait mindfulness in the intervention was assessed by a moderated mediation analysis. RESULTS: We found that High Trait individuals have lower anxiety trait, anxiety state and perceived stress levels. Only the MT group reduced their anxiety state and perceived stress after the intervention and increased their state mindfulness. Both groups reduced negative affect and cortisol, and no change was found in positive affect. Moderated mediation analysis showed that the training-induced change in state mindfulness mediated the increase in positive affect and the decrease in perceived stress and cortisol, regardless of trait mindfulness. For anxiety state the decrease only occurred in individuals with High Trait Mindfulness. CONCLUSIONS: Together, these results suggest that higher trait mindfulness is associated with low levels of psychological distress and that a brief mindfulness-based intervention seems to be useful to reduce distress measures in university students. TRIAL REGISTRATION: ReBEC, U1111-1194-8661. Registered 28 March 2017-Retrospectively registered, http://www.ensaiosclinicos.gov.br/rg/RBR-7b8yh8.

Galvanic vestibular stimulator for fMRI studies

INTRODUCTION: Areas of the brain that are associated with the vestibular system can be activated using galvanic vestibular stimulation. These areas can be studied through a combination of galvanic vestibular stimulation with functional magnetic resonance imaging (fMRI). In order to provide an appropriate sequence of galvanic stimulation synchronous with the MRI pulse sequence, a specific electronic device that was built and assessed is presented. METHODS: The electronic project of the GVS is divided in analog and digital circuits. The analog circuits are mounted in an aluminum case, supplied by sealed batteries, and goes inside the MRI room near to the feet of the subject. The digital circuits are placed in the MRI control room. Those circuits communicate through each other by an optical fiber. Tests to verify the GVS-MRI compatibility were conducted. Silicone (in-house) and Ag/AgCl (commercial) electrodes were evaluated for maximum balance and minimal pain sensations. fMRI experiments were conducted in eight human volunteers. RESULTS: GVS-MRI compatibility experiments demonstrate that the GVS did not interfere with the MRI scanner functionality and vice versa. The circular silicone electrode was considered the most suitable to apply the galvanic vestibular stimulation. The 1 Hz stimulation sinusoid frequency produced the biggest balance and the less pain sensations when compared to 2 Hz. The GVS was capable of eliciting activation in the precentral and postcentral gyri, in the central sulcus, in the supplementary motor area, in the middle and inferior frontal gyri, in the inferior parietal lobule, in the insula, in the superior temporal gyrus, in the middle cingulate cortex, and in the cerebellum. CONCLUSION: This study shows the development and description of a neurovestibular stimulator that can be safely used inside the MRI scanner room without interfering on its operation and vice versa. The developed GVS could successfully activate the major areas involved with multimodal functions of the vestibular system, demonstrating its validity as a stimulator for neurovestibular research. To the best of our knowledge, this is the first work that shows the development and the construction of a galvanic vestibular stimulator that could be safely used inside the MRI room.

Neuroimaging in stroke and non-stroke pusher patients / Análise de neuroimagens de pacientes com síndrome do empurrador decorrente de AVC e outras etiologias

Pusher behavior (PB) is a disorder of postural control affecting patients with encephalic lesions. This study has aimed to identify the brain substrates that are critical for the occurrence of PB, to analyze the influence of the midline shift (MS) and hemorrhagic stroke volume (HSV) on the severity and prognosis of the PB. We identified 31 pusher patients of a neurological unit, mean age 67.4±11.89, 61.3 percent male. Additional neurological and functional examinations were assessed. Neuroimaging workup included measurement of the MS, the HSV in patients with hemorrhagic stroke, the analysis of the vascular territory, etiology and side of the lesion. Lesions in the parietal region (p=0.041) and thalamus (p=0.001) were significantly more frequent in PB patients. Neither the MS nor the HSV were correlated with the PB severity or recovery time.

A síndrome do empurrador (SE) é um distúrbio de controle postural que acomete indivíduos com lesões encefálicas. Os objetivos deste estudo foram identificar as estruturas encefálicas envolvidas na SE, analisar a influência dos desvios de linha média (DLM) e volume do hematoma (VH) na gravidade e duração da SE. Dentre os pacientes internados na enfermaria de neurologia, foram identificados 31 pacientes com SE, idade média 67,4±11,89, 61,3 por cento homens. Foram realizados exames neurológico e funcional. As análises das neuroimagens incluíram medidas de VH em pacientes com doença cerebrovascular (DC) hemorrágica, DLM, análise do território vascular, etiologia e lado da lesão. Lesão nas regiões parietal (p=0,041) e talâmica (p=0,001) foram significativamente mais frequentes nos pacientes com SE. Não foi observada correlação dos DLM e volume do hematoma com a gravidade e duração da SE.

Neuroimaging in stroke and non-stroke pusher patients.

Pusher behavior (PB) is a disorder of postural control affecting patients with encephalic lesions. This study has aimed to identify the brain substrates that are critical for the occurrence of PB, to analyze the influence of the midline shift (MS) and hemorrhagic stroke volume (HSV) on the severity and prognosis of the PB. We identified 31 pusher patients of a neurological unit, mean age 67.4 ± 11.89, 61.3% male. Additional neurological and functional examinations were assessed. Neuroimaging workup included measurement of the MS, the HSV in patients with hemorrhagic stroke, the analysis of the vascular territory, etiology and side of the lesion. Lesions in the parietal region (p=0.041) and thalamus (p=0.001) were significantly more frequent in PB patients. Neither the MS nor the HSV were correlated with the PB severity or recovery time.

Variable fMRI activation during two different language tasks in a patient with cognitive delay

Functional MRI produces a more accurate localization of the language areas for epilepsy surgery purpose, but requires the patient cooperation. We report a 34 years-old woman with mental retardation who underwent two different verbal fluency tasks, category and word naming. We found a strong activation of the Broca’s area in the most difficult task. We suggest that a multi-task fMRI study could be successful in patients with cognitive delay.

A ressonância magnética funcional permite uma localização acurada da área da linguagem para fins de cirurgia de epilepsia, mas requer a colaboração do paciente na execução da tarefa proposta, o que pode limitar a sua utilização em pacientes com retardo mental. Nós apresentamos o caso de uma mulher com 34 anos de idade, com retardo mental, que foi submetida a duas tarefas distintas de geração silenciosa de palavras, por categoria e letras. Encontramos forte ativação da área de Broca na tarefa mais complexa. Sugerimos que um estudo com múltiplas tarefas pode ser útil em pacientes com retardo mental.

Controle postural na síndrome de Pusher: influência dos canais semicirculares laterais / Posture control in Pusher syndrome: influence of lateral semicircular canals

A síndrome de Pusher caracteriza-se por uma alteração do equilíbrio na qual pacientes com lesões encefálicas empurram-se em direção ao lado parético utilizando o membro não-afetado. O papel do sistema vestibular na alteração postural da síndrome de Pusher ainda não foi devidamente elucidado. OBJETIVO: Neste estudo objetivamos avaliar o papel dos canais semicirculares horizontais na expressão clínica da síndrome de Pusher, através da aplicação das provas calórica e rotatória. FORMA DE ESTUDO: Observacional, clínico e prospectivo. MATERIAL E MÉTODO: Avaliamos 9 pacientes com AVC e síndrome de Pusher internados na Enfermaria de Neurologia do HCFMRP-USP. Os pacientes foram submetidos à avaliação neurológica clínica e neuropsicológica, NIHSS, Scale for Contraversive Pushing - SCP, teste calórico e teste rotatório. RESULTADOS: Foram estudados 9 pacientes (5 homens) com idade média de 71,8 ± 5,9 anos e com NIHSS médio de 18.33. Três pacientes apresentaram preponderância direcional contralateral à lesão encefálica na prova calórica. Na prova rotatória, foram observados quatro pacientes com preponderância direcional na análise de velocidade da componente lenta. CONCLUSÃO: Os resultados do presente estudo indicam que a disfunção dos canais semicirculares não parece ser fundamental para a expressão da síndrome de Pusher.

Posture control in Pusher syndrome: influence of lateral semicircular canals.

UNLABELLED: Pusher syndrome is an interesting disorder of balance in patients with encephalic lesions characterized by the peculiar behavior of actively pushing away from the non-hemiparetic side and resisting against passive correction, with a tendency to fall toward the paralyzed side. The role of vestibular system on the pushing behavior is not clear. AIM: To evaluate horizontal semicircular canal function in patients with Pusher syndrome, using caloric and rotation tests. STUDY DESIGN: Observational prospective. MATERIAL AND METHOD: We evaluated 9 inpatients with stroke and Pusher syndrome at the neurological unit of HCFMRP-USP. We applied neurological and neuropsychological exams, NIHSS, Scale for contraversive pushing (SCP), caloric and rotation tests. RESULTS: We evaluated 9 patients (5 men) with mean age of 71.8 +/- 5.9 and mean NIHSS of 18.33. Three patients presented contralateral directional preponderance on caloric test and we found four patients with directional preponderance on analysis of the slow phase velocity of rotation test response. CONCLUSION: Our findings indicate that a dysfunction of semicircular canals does not seem to be relevant for the clinical manifestations of the Pusher syndrome.