Your browser doesn't support javascript.
loading
Show: 20 | 50 | 100
Results 1 - 20 de 70
Filter
1.
Sci Rep ; 14(1): 15256, 2024 07 02.
Article in English | MEDLINE | ID: mdl-38956202

ABSTRACT

Posttraumatic stress disorder (PTSD) can develop after trauma exposure. Some studies report that women develop PTSD at twice the rate of men, despite greater trauma exposure in men. Lipids and their metabolites (lipidome) regulate a myriad of key biological processes and pathways such as membrane integrity, oxidative stress, and neuroinflammation in the brain by maintaining neuronal connectivity and homeostasis. In this study, we analyzed the lipidome of 40 adults with PTSD and 40 trauma-exposed non-PTSD individuals (n = 20/sex/condition; 19-39 years old). Plasma samples were analyzed for lipidomics using Quadrupole Time-of-Flight (QToF) mass spectrometry. Additionally, ~ 90 measures were collected, on sleep, and mental and physical health indices. Poorer sleep quality was associated with greater PTSD severity in both sexes. The lipidomics analysis identified a total of 348 quantifiable known lipid metabolites and 1951 lipid metabolites that are yet unknown; known metabolites were part of 13 lipid subclasses. After adjusting for BMI and sleep quality, in women with PTSD, only one lipid subclass, phosphatidylethanolamine (PE) was altered, whereas, in men with PTSD, 9 out of 13 subclasses were altered compared to non-PTSD women and men, respectively. Severe PTSD was associated with 22% and 5% of altered lipid metabolites in men and women, respectively. Of the changed metabolites, only 0.5% measures (2 PEs and cholesterol) were common between women and men with PTSD. Several sphingomyelins, PEs, ceramides, and triglycerides were increased in men with severe PTSD. The correlations between triglycerides and ceramide metabolites with cholesterol metabolites and systolic blood pressure were dependent upon sex and PTSD status. Alterations in triglycerides and ceramides are linked with cardiac health and metabolic function in humans. Thus, disturbed sleep and higher body mass may have contributed to changes in the lipidome found in PTSD.


Subject(s)
Lipidomics , Stress Disorders, Post-Traumatic , Humans , Stress Disorders, Post-Traumatic/metabolism , Stress Disorders, Post-Traumatic/blood , Male , Female , Adult , Lipidomics/methods , Young Adult , Lipids/blood , Cohort Studies , Lipid Metabolism
2.
Pharmaceuticals (Basel) ; 17(4)2024 Mar 27.
Article in English | MEDLINE | ID: mdl-38675388

ABSTRACT

Cancers and neurological disorders are two major types of diseases in humans. We developed the concept called the "Aberrant Cell Cycle Disease (ACCD)" due to the accumulating evidence that shows that two different diseases share the common mechanism of aberrant cell cycle re-entry. The aberrant cell cycle re-entry is manifested as kinase/oncoprotein activation and tumor suppressor (TS) inactivation, which are associated with both tumor growth in cancers and neuronal death in neurological disorders. Therefore, some cancer therapies (e.g., kinase/oncogene inhibition and TS elevation) can be leveraged for neurological treatments. MicroRNA (miR/miRNA) provides a new style of drug-target binding. For example, a single tumor suppressor miRNA (TS-miR/miRNA) can bind to and decrease tens of target kinases/oncogenes, producing much more robust efficacy to block cell cycle re-entry than inhibiting a single kinase/oncogene. In this review, we summarize the miRNAs that are altered in both cancers and neurological disorders, with an emphasis on miRNA drugs that have entered into clinical trials for neurological treatment.

3.
bioRxiv ; 2024 Mar 05.
Article in English | MEDLINE | ID: mdl-38464224

ABSTRACT

Posttraumatic stress disorder (PTSD) can develop after trauma exposure. Some studies report that women develop PTSD at twice the rate of men, despite greater trauma exposure in men. Lipids and their metabolites (lipidome) regulate a myriad of key biological processes and pathways such as membrane integrity, oxidative stress, and neuroinflammation in the brain by maintaining neuronal connectivity and homeostasis. In this study, we analyzed the lipidome of 40 individuals with PTSD and 40 trauma-exposed non-PTSD individuals. Plasma samples were analyzed for lipidomics using Quadrupole Time-of-Flight (QToF) mass spectrometry. Additionally, ~ 90 measures were collected, on sleep, mental and physical health indices. Sleep quality worsened as PTSD severity increased in both sexes. The lipidomics analysis identified a total of 348 quantifiable known lipid metabolites and 1951 lipid metabolites that are yet unknown; known metabolites were part of 13 classes of lipids. After adjusting for sleep quality, in women with PTSD, only one lipid subclass, phosphatidylethanolamine (PE) was altered, whereas, in men with PTSD, 9 out of 13 subclasses were altered compared to non-PTSD women and men, respectively. Severe PTSD was associated with 22% and 5% of altered lipid metabolites in men and women, respectively. Of the changed metabolites, only 0.5% measures (2 PEs and cholesterol) were common between women and men with PTSD. Several sphingomyelins, PEs, ceramides, and triglycerides were increased in men with severe PTSD. The triglycerides and ceramide metabolites that were most highly increased were correlated with cholesterol metabolites and systolic blood pressure in men but not always in women with PTSD. Alterations in triglycerides and ceramides are linked with cardiac health and metabolic function in humans. Thus, disturbed sleep and higher weight may have contributed to changes in the lipidome found in PTSD.

4.
J Trauma Stress ; 2023 Dec 04.
Article in English | MEDLINE | ID: mdl-38049964

ABSTRACT

Alternative models of traumatic stress and broader psychopathology have been proposed to address issues of heterogeneity, comorbidity, clinical utility, and equitable representation. However, systematic and practical methods and guidelines to organize and apply these models remain scarce. The Middle-Out Approach is a novel, integrative, contextually informed framework for organizing and applying existing empirical methods to evaluate current and alternative traumatic stress reactions. Rather than beginning to identify traumatic stress reactions from the top-down (i.e., disorder-first approach) or bottom-up (i.e., symptom-first approach), constructs are evaluated from the middle out (i.e., presentation-first approach), unconstrained by higher-order disorders or lower-order diagnostic symptoms. This approach provides innovation over previous methods at multiple levels, including the conceptualization of traumatic stress reactions as well as the type of assessments and data sources used and how they are used in statistical analyses. Conceptualizations prioritize the identification of middle-order phenotypes, representing person-centered clinical presentations, which are informed by the integration of multidimensional, transdiagnostic, and multimodal (e.g., psychosocial, physiological) assessments and/or data sources. Integrated data are then analyzed concurrently using person-centered statistical models to identify precise, discrete, and representative health outcomes within broader heterogeneous samples. Subsequent variable-centered analyses are then used to identify culturally sensitive and contextually informed correlates of phenotypes, their clinical utility, and the differential composition within and between broader traumatic stress reactions. Examples from the moral injury literature are used to illustrate practical applications that may increase clinical utility and the accurate representation of health outcomes for diverse individuals and communities.

5.
Geriatrics (Basel) ; 8(6)2023 Nov 29.
Article in English | MEDLINE | ID: mdl-38132487

ABSTRACT

BACKGROUND: Evidence suggests that lipoprotein subclass particles are critical markers of cardiovascular disease (CVD) risk. Older women have increased CVD risk related to age. The purpose of this study was to determine whether low and moderate doses of exercise influence lipoprotein subclasses. METHODS: Women (60-75 years) were randomized into groups for 16 weeks of moderate-intensity exercise training at a low or moderate dose (33.6 and 58.8 kJ/kg body weight weekly, respectively). Lipoprotein subclasses were determined by nuclear magnetic resonance spectroscopy before and after the training. RESULTS: The average weekly exercise duration was 109 and 164 min, for low- and moderate-dose groups, respectively. In the low-dose group, high-density lipoprotein particle (HDL-P) concentration decreased (Δ = -1.9 ± 3.1 µmol/L, mean ± SD, p = 0.002) and mean HDL-P size increased (Δ = 0.1 ± 0.3 nm, p = 0.028). In the moderate-dose group, mean HDL-P size (Δ = 0.1 ± 0.2 nm; p = 0.024) and low-density lipoprotein particle size increased (Δ = 0.4 ± 3.9 nm; p = 0.007). Baseline body mass index, peak oxygen consumption and age were associated with changes in a few lipoprotein subclasses. CONCLUSIONS: In this sample of inactive older women, moderate-intensity exercise training at a dose equivalent to or even lower than the minimally recommended level by public health agencies induced changes in lipoprotein subclasses in line with reduced CVD risk. However, higher doses are encouraged for greater health benefits.

6.
Menopause ; 30(4): 370-375, 2023 04 01.
Article in English | MEDLINE | ID: mdl-36753121

ABSTRACT

OBJECTIVE: Over a third of women in the United States report a lifetime history of intimate partner violence. Although a recent review found that intimate partner violence is related to poor subjective sleep, the majority of studies involved reproductive-aged women and used suboptimal measures of interpersonal violence and/or insomnia. We examined the relationship between lifetime intimate partner violence and current clinical insomnia in a cross-sectional sample of midlife women veterans. METHODS: Cross-sectional data were drawn from the Midlife Women Veterans Health Survey. Women Veterans (N = 232) aged 45 to 64 years enrolled in Department of Veterans Affairs health care in Northern California completed an adapted version of the Extended-Hurt, Insult, Threaten, Scream to assess lifetime history of intimate partner violence (screening threshold score and any physical, sexual, and psychological intimate partner violence) and the Insomnia Severity Index to assess current insomnia. RESULTS: In multivariable analyses, lifetime history of intimate partner violence was associated with twofold to fourfold odds of current clinical insomnia, including overall intimate partner violence (odds ratio, 3.24; 95% confidence interval, 1.57-6.69), physical intimate partner violence (odds ratio, 2.01; 95% confidence interval, 1.09-3.70), psychological intimate partner violence (odds ratio, 3.98; 95% confidence interval, 2.06-7.71), and sexual intimate partner violence (odds ratio, 2.09; 95% confidence interval, 1.08-4.07). CONCLUSIONS: Lifetime history of intimate partner violence is common and may be associated with clinical insomnia during midlife. Findings highlight the importance of screening midlife women for intimate partner violence and recognizing the potential role of this traumatic exposure on women's health.


Subject(s)
Intimate Partner Violence , Sleep Initiation and Maintenance Disorders , Veterans , Humans , Female , United States/epidemiology , Adult , Cross-Sectional Studies , Sleep Initiation and Maintenance Disorders/epidemiology , Intimate Partner Violence/psychology , Surveys and Questionnaires , Prevalence , Risk Factors
7.
Learn Mem ; 29(9): 332-339, 2022 09.
Article in English | MEDLINE | ID: mdl-36206397

ABSTRACT

Sex differences in the neurobiological mechanisms involved in fear conditioning and extinction have been suggested to contribute to differential vulnerability for the development of posttraumatic stress disorder (PTSD) in women compared with men. Reproductive hormones, such as estradiol, have been shown to facilitate fear conditioning and extinction learning and may explain some of these differences. However, the effect of commonly used hormonal contraceptives on the neurobiological mechanisms of fear conditioning and extinction is poorly understood. A laboratory study was conducted in trauma-exposed men and women with and without full or partial PTSD to examine effects of sex and use of hormonal birth control on fear conditioning, fear extinction learning, and extinction retention. Participants underwent fear conditioning with stimuli that were paired (CS+) or unpaired (CS-) with shock. Extinction learning occurred 72 h later, and extinction retention was tested 1 wk after extinction. Women on hormonal contraceptives (HCs) demonstrated enhanced acquisition of fear conditioning and enhanced extinction of fear as compared with women off hormonal birth control and men. While clinical implications have yet to be determined, these results suggest that hormonal contraceptives may facilitate learning during both fear acquisition and extinction. Understanding the impact of sex and hormones on fear conditioning and extinction processes may lead to new insights into the pathophysiology of PTSD and result in advancements in treatment that may vary by sex.


Subject(s)
Fear , Stress Disorders, Post-Traumatic , Conditioning, Classical/physiology , Contraceptive Agents , Estradiol , Extinction, Psychological/physiology , Fear/physiology , Female , Humans , Male , Sex Characteristics
8.
Am J Psychother ; 75(4): 168-176, 2022 Dec 01.
Article in English | MEDLINE | ID: mdl-36052450

ABSTRACT

OBJECTIVE: As mobile health technologies proliferate, their use during exposure-based therapies has the potential to illuminate treatment mechanisms. The primary purpose of this study was to examine three approaches to using continuously collected physiological data of patients with posttraumatic stress disorder during prolonged exposure (PE) therapy, in an effort to examine physiological markers of treatment response. METHODS: Photoplethysmogram-measured heart rates from three non-Hispanic White male veterans, during clinic-based PE therapy sessions, were analyzed to assess three potential therapeutic mechanisms: emotional engagement (examined via correlation analysis between self-reported peak distress ratings and objectively measured peak heart rate in the minute prior to distress ratings), initial emotion activation (examined through time to peak heart rate and peak self-reported distress), and extinction processes within and between therapy sessions (examined via multilevel modeling of within- and between-person changes in heart rate over time and across imaginal PE therapy sessions). RESULTS: Results for each analytical approach with each patient are presented, and benefits and limitations of each approach are discussed. Treatment outcomes were as follows: one participant with overengagement did not benefit from PE, one participant with initial underengagement demonstrated clinical improvement, and one participant with optimal engagement had associated clinical improvements. CONCLUSIONS: Mobile health technologies may provide a new avenue toward unveiling treatment mechanisms in psychotherapy. Use of standardized analytical approaches will enable cross-study comparison and greater understanding of treatment mechanisms, ultimately leading to increased treatment response.


Subject(s)
Implosive Therapy , Stress Disorders, Post-Traumatic , Veterans , Humans , Male , Implosive Therapy/methods , Heart Rate/physiology , Stress Disorders, Post-Traumatic/diagnosis , Stress Disorders, Post-Traumatic/therapy , Veterans/psychology , Treatment Outcome
9.
Womens Health Issues ; 32(5): 509-516, 2022.
Article in English | MEDLINE | ID: mdl-35821182

ABSTRACT

BACKGROUND: Approximately 1 in 3 women veterans endorse military sexual trauma (MST) during Veterans Health Administration (VHA) screening. Higher rates have been reported in anonymous surveys. OBJECTIVE: We compared MST identified by VHA screening to survey-reported MST within the same sample and identified participant characteristics associated with discordant responses. METHODS: Cross-sectional data were drawn from an observational study of women veterans aged 45-64 enrolled in VHA care in Northern California, with data from mail- and web-based surveys linked to VHA electronic health records (EHRs). Between March 2019 and May 2020, participants reported sociodemographic characteristics, current depressive (Patient Health Questionnaire-9) and posttraumatic stress (PTSD checklist for DSM-5) symptoms, and MST (using standard VHA screening questions) in a survey; depression and posttraumatic stress disorder diagnoses (ICD-10 codes) and documented MST were identified from EHRs. Associations between sociodemographic characteristics, mental health symptoms and diagnoses, and discordant MST reports (EHR-documented MST vs. MST reported on survey, not in EHR) were examined with multivariable logistic regression. RESULTS: In this sample of midlife women veterans (n = 202; mean age 56, SD = 5), 40% had EHR-documented MST, and 74% reported MST on the survey. Sociodemographic characteristics, mental health symptoms, and diagnosed depression were not associated with discordant MST responses. Women with an EHR-documented PTSD diagnosis had fivefold higher odds of having EHR-documented MST (vs. survey only; odds ratio 5.2; 95% confidence interval 2.3-11.9). CONCLUSIONS: VHA screening may not capture more than half of women who reported MST on the survey. VHA screening may underestimate true rates of MST, which could lead to a gap in recognition and care for women veterans.


Subject(s)
Military Personnel , Sex Offenses , Stress Disorders, Post-Traumatic , Veterans , Cross-Sectional Studies , Female , Humans , Middle Aged , Military Personnel/psychology , Sexual Trauma , Stress Disorders, Post-Traumatic/diagnosis , Stress Disorders, Post-Traumatic/epidemiology , Stress Disorders, Post-Traumatic/psychology , United States/epidemiology , United States Department of Veterans Affairs , Veterans/psychology , Veterans Health
10.
Int J Biol Macromol ; 211: 94-106, 2022 Jun 30.
Article in English | MEDLINE | ID: mdl-35568154

ABSTRACT

Herein, wound dressing membranes based on covalently linked Chitosan (Ch) to Gelatin (GE) via Glutaraldehyde (GA) to have (Ch-GA-GE) copolymer have been developed. In addition, Anisaldehyde (An) was immobilized onto Ch-GA-GE to has An-(Ch-GA-GE) membrane. The changes of the Ch-GA-GE membranes wettability, from 26 ± 1.3° to 45.3 ± 2.27° of the An-(Ch-GA-GE) copolymer membrane, indicating the reduction of copolymers hydrophilicity. The thermal characterization was done using TGA and DSC, while the morphological analysis was done using SEM. The antibacterial properties were assessed against four bacterial strains (P. aeruginosa, S. aureus, Streptococcus, and E. coli). In-vitro evaluation of the fabricated membranes to be used as wound dressings was investigated by measuring their hemocompatibility, cytotoxicity, and biodegradability. Finally, the in-vivo assessment of the developed membranes to encourage skin regeneration was assessed utilizing adult Wistar albino rats. The results illustrated that the An-(Ch-GA-GE) copolymer membranes significantly enhanced the rat's full-thickness injuries, as monitored by reducing the wound region. Furthermore, histological analyses of the injuries covered with An-(Ch-GA-GE) membranes demonstrated a notable re-epithelialisation contrasted with wounds treated with the cotton gauze Ch-GA-GE membranes dressings proving the efficiency of Anisaldehyde. Those findings indicate that the An-(Ch-GA-GE) membrane has considerable potential for wound healing and skin regeneration.


Subject(s)
Chitosan , Animals , Anti-Bacterial Agents/pharmacology , Bandages , Benzaldehydes , Escherichia coli , Gelatin , Glutaral , Pseudomonas aeruginosa , Rats , Rats, Wistar , Staphylococcus aureus
11.
Sleep ; 45(1)2022 01 11.
Article in English | MEDLINE | ID: mdl-34792165

ABSTRACT

STUDY OBJECTIVES: Published research indicates that sleep is involved in emotional information processing. Using a fear-potentiated startle (FPS) and nap sleep protocol, we examined the relationship of emotional learning with REM sleep (REMS) in trauma-exposed participants. We also explored the roles of posttraumatic stress disorder (PTSD) symptoms, biological sex, and an integrative measure of polysomnography-measured (PSG) sleep in the learning-sleep relationship. METHODS: After an adaptation nap, participants (N = 46) completed two more visits (counterbalanced): a stress-condition visit, which included FPS conditioning procedures prior to a nap and assessment of learning retention and fear extinction training after the nap, and a control visit, which included a nap opportunity without stressful procedures. FPS conditioning included a "fear" visual stimulus paired with an air blast to the neck and a "safety" visual stimulus never paired with an air blast. Retention and extinction involved presentation of the visual stimuli without the air blast. Primary analyses examined the relationship between FPS responses pre- and post-sleep with stress-condition REMS duration, controlling for control-nap REMS duration. RESULTS: Higher safety learning predicted increased REMS and increased REMS predicted more rapid extinction learning. Similar relationships were observed with an integrative PSG sleep measure. They also showed unexpected effects of PTSD symptoms on learning and showed biological sex effects on learning-sleep relationships. CONCLUSIONS: Findings support evidence of a relationship between adaptive emotional learning and REMS. They underscore the importance of examining sex effects in sleep-learning relationships. They introduce an integrative PSG sleep measure with potential relevance to studies of sleep and subjective and biological outcomes.


Subject(s)
Stress Disorders, Post-Traumatic , Extinction, Psychological , Fear/psychology , Female , Humans , Male , Polysomnography , Sleep , Sleep, REM , Stress Disorders, Post-Traumatic/psychology
12.
Neuropsychopharmacology ; 47(11): 1945-1952, 2022 10.
Article in English | MEDLINE | ID: mdl-34799682

ABSTRACT

Fear extinction underlies prolonged exposure, one of the most well-studied treatments for posttraumatic stress disorder (PTSD). There has been increased interest in exploring pharmacological agents to enhance fear extinction learning in humans and their potential as adjuncts to PE. The objective of such adjuncts is to augment the clinical impact of PE on the durability and magnitude of symptom reduction. In this study, we examined whether hydrocortisone (HC), a corticosteroid, and D-Cycloserine (DCS), an N-methyl-D-aspartate receptor partial agonist, enhance fear extinction learning and consolidation in individuals with PTSD. In a double-blind placebo-controlled 3-group experimental design, 90 individuals with full or subsyndromal PTSD underwent fear conditioning with stimuli that were paired (CS+) or unpaired (CS-) with shock. Extinction learning occurred 72 h later and extinction retention was tested one week after extinction. HC 25 mg, DCS 50 mg or placebo was administered one hour prior to extinction learning. During extinction learning, the DCS and HC groups showed a reduced differential CS+/CS- skin conductance response (SCR) compared to placebo (b = -0.19, CI = -0.01 to -37, p = 0.042 and b = -0.25, CI = -08 to -0.43, p = 0.005, respectively). A nonsignificant trend for a lower differential CS+/CS- SCR in the DCS group, compared to placebo, (b = -0.25, CI = 0.04 to -0.55, p = 0.089) was observed at retention testing, one week later. A single dose of HC and DCS facilitated fear extinction learning in participants with PTSD symptoms. While clinical implications have yet to be determined, our findings suggest that glucocorticoids and NMDA agonists hold promise for facilitating extinction learning in PTSD.


Subject(s)
Cycloserine , Stress Disorders, Post-Traumatic , Cycloserine/pharmacology , Cycloserine/therapeutic use , Double-Blind Method , Extinction, Psychological , Fear , Glucocorticoids , Humans , Hydrocortisone/pharmacology , N-Methylaspartate/pharmacology , Receptors, N-Methyl-D-Aspartate/agonists , Stress Disorders, Post-Traumatic/drug therapy
14.
J Psychiatr Res ; 142: 337-344, 2021 10.
Article in English | MEDLINE | ID: mdl-34425486

ABSTRACT

While the BDNF Val66Met polymorphism has been linked to various trauma and anxiety - related psychiatric disorders, limited focus has been on the neural structures that might modulate its relationship with objective measures of threat sensitivity. Therefore, we assessed whether there was an interaction of Val66Met polymorphism with brain area volumes previously associated with anxiety and PTSD, such as the ventromedial prefrontal cortex (vmPFC), insular cortex (IC), and dorsal and ventral anterior cingulate cortices (dACC and vACC), in predicting fear-potentiated psychophysiological response in a clinical sample of Veterans. 110 participants engaged in a fear-potentiated acoustic startle paradigm and provided genetic and imaging data. Fear conditions included no, ambiguous, and high threat conditions (shock). Psychophysiological response measures included electromyogram (EMG), skin conductance response (SCR), and heart rate (HR). PTSD status, trauma history, and demographics were also assessed. There was an interaction of Met allele carrier status with vmPFC, IC, dACC, and vACC volumes for predicting SCR (p < 0.001 for all regions). However, only vmPFC and IC significantly moderated the relationship between Val66Met and psychophysiological response (SCR). The Val66met polymorphism may increase susceptibility to PTSD and anxiety disorders via an interaction with reduced vmPFC and IC volume. Future research should examine whether these relationships might be associated with a differential course of illness longitudinally or response to treatments.


Subject(s)
Brain-Derived Neurotrophic Factor , Stress Disorders, Post-Traumatic , Brain-Derived Neurotrophic Factor/genetics , Fear , Humans , Magnetic Resonance Imaging , Prefrontal Cortex , Stress Disorders, Post-Traumatic/diagnostic imaging , Stress Disorders, Post-Traumatic/genetics
15.
J Nurs Educ ; 60(7): 397-399, 2021 Jul.
Article in English | MEDLINE | ID: mdl-34232818

ABSTRACT

BACKGROUND: This article describes how a college of nursing (CON) converted its traditional undergraduate academic program to a 100% online program within 2 weeks of being informed of the need for curricular modifications due to the COVID-19 pandemic. METHOD: The college faculty met online prior to implementation to discuss student needs and special considerations. Clinical simulation experiences were developed based on International Association for Clinical Simulation and Learning (INACSL) standards and delivered through virtual simulation. RESULTS: Students evaluated the clinical simulation experiences in each course using Likert-style measures and reported positive experiences overall. Each cohort of students, including the May 2020 graduating seniors, successfully completed all of their classes for progression to the next semester or graduation. CONCLUSION: The successful conversion of traditional academic programs into a virtual environment requires leadership, collaboration, and teamwork. This CON had positive outcomes and offers lessons learned for future implementation. [J Nurs Educ. 2021;60(7): 397-399.].


Subject(s)
COVID-19 , Education, Distance , Education, Nursing, Baccalaureate , Students, Nursing , Humans , Pandemics , SARS-CoV-2
17.
Psychiatry Res ; 293: 113468, 2020 11.
Article in English | MEDLINE | ID: mdl-32977054

ABSTRACT

Changes to the DSM-5's conceptualization of posttraumatic stress disorder (PTSD) highlight the importance of impulsivity within the context of PTSD-related arousal dysregulation. While the relationship between PTSD and threat sensitivity is well defined, how they relate to impulsivity remains understudied. We examined the relationship between PTSD symptom severity, threat sensitivity, and impulsivity. 124 participants completed the PTSD Checklist (PCL-C) and the Barratt Impulsiveness Scale 11th ed (BIS-11). BIS-11 items were separated to define cognitive and behavioral impulsivity subdomains. A trauma-exposed subsample of 39 participants were also exposed to no, ambiguous, and high threat conditions in a threat-enhanced acoustic startle paradigm with psychophysiological response as the outcome variable. PTSD severity was significantly associated with greater overall impulsivity and behavioral impulsivity. Greater overall impulsivity and both cognitive and behavioral impulsivity subdomains were significantly associated with psychophysiological magnitudes across threat conditions in the traumatized subsample. Our results suggest PTSD severity may linked to behavioral impulsivity and both cognitive and behavioral impulsivity are associated with threat sensitivity and hyperarousal. Assessing impulsivity within the context of PTSD, particularly in terms of its cognitive and behavioral subdomains, may provide important, clinically relevant information.


Subject(s)
Impulsive Behavior/physiology , Reflex, Startle/physiology , Stress Disorders, Post-Traumatic/physiopathology , Adult , Arousal , Biomarkers , Female , Humans , Male , Psychophysiology , Severity of Illness Index , Stress Disorders, Post-Traumatic/epidemiology , Stress Disorders, Post-Traumatic/psychology , Tunisia , Young Adult
18.
Sleep ; 43(10)2020 10 13.
Article in English | MEDLINE | ID: mdl-32303763

ABSTRACT

STUDY OBJECTIVES: Hypnotic medications can adversely affect behavior during unanticipated awakenings during the night. Animals treated with the hypocretin (Hcrt) receptor antagonist almorexant (ALM) have less acute cognitive impairment compared to the GABAA receptor modulator zolpidem (ZOL). This study aimed to determine whether ALM produces less acute cognitive impairment than ZOL in human subjects. METHODS: Healthy, young adult, unmedicated male and female subjects participated in a controlled trial of a single dose of ALM 100 mg (N = 48), ALM 200 mg (N = 53), ZOL 10 mg (N = 49), and placebo (PBO, N = 52). RESULTS: ZOL and both doses of ALM produced similar levels of subjective sleepiness and impaired the ability of subjects to remain awake in a dark, low-stimulus setting relative to PBO. For most cognitive measures, performance under ZOL was significantly worse than ALM or PBO. For tasks involving verbal memory or visual-motor coordination, ZOL impaired performance, whereas the two doses of ALM were no different than PBO. For tasks involving higher-order executive function, ZOL produced impairment in processing speed and inhibitory control, whereas the two doses of ALM were no different than PBO. Performance decrements for ALM were less than ZOL but greater than PBO for some reaction time measures. CONCLUSIONS: The data provide support for the hypothesis that Hcrt receptor antagonists produce less functional impairment than a benzodiazepine receptor agonist (BzRA). These observations are particularly relevant to patients treated with sedative-hypnotics who are at elevated risk for falls and other untoward events during the intended hours for sleep.


Subject(s)
Hypnotics and Sedatives , Pyridines , Acetamides , Animals , Cognition , Double-Blind Method , Female , Humans , Hypnotics and Sedatives/adverse effects , Isoquinolines , Male , Orexin Receptors , Orexins/pharmacology , Psychomotor Performance , Pyridines/adverse effects , Young Adult , Zolpidem/pharmacology
19.
J Clin Sleep Med ; 16(6): 917-924, 2020 06 15.
Article in English | MEDLINE | ID: mdl-32048595

ABSTRACT

STUDY OBJECTIVES: Our objective was to examine the ability of a consumer-grade wearable device (Basis B1) with accelerometer and heart rate technology to assess sleep patterns compared with polysomnography (PSG) and research-grade actigraphy in healthy adults. METHODS: Eighteen adults underwent consecutive nights of sleep monitoring using Basis B1, actigraphy, and PSG; 40 nights were used in analyses. Discrepancies in gross sleep parameters and epoch-by-epoch agreements in sleep/wake classification were assessed. RESULTS: Basis B1 accuracy was 54.20 ± 8.20%, sensitivity was 98.90 ± 2.70%, and specificity was 8.10 ± 15.00%. Accuracy, sensitivity, and specificity for distinguishing between the different sleep stages were 60-72%, 48-62%, and 57-86%, respectively. Pearson correlations demonstrated strong associations between Basis B1 and PSG estimates of sleep onset latency and total sleep time; moderate associations for sleep efficiency, duration of light sleep, and duration of rapid eye movement sleep; and a weak association for duration of deep sleep. Basis B1 significantly overestimates total sleep time, sleep efficiency, and duration of light sleep and significantly underestimates wake after sleep onset and duration of deep sleep. CONCLUSIONS: Basis B1 demonstrated utility for estimates of gross sleep parameters and performed similarly to actigraphy for estimates of total sleep time. Basis B1 specificity was poor, and Basis B1 is not useful for the assessment of wake. Basis B1 accuracy for sleep stages was better than chance but is not a suitable replacement for PSG assessment. Despite low cost, ease of use, and attractiveness for patients, consumer devices are not yet accurate or reliable enough to guide treatment decision making in clinical settings.


Subject(s)
Actigraphy , Wearable Electronic Devices , Humans , Polysomnography , Reproducibility of Results , Sleep , Young Adult
20.
Psychophysiology ; 57(1): e13356, 2020 01.
Article in English | MEDLINE | ID: mdl-30807663

ABSTRACT

After exposure to a traumatic event, a subset of people develop post-traumatic stress disorder (PTSD). One of the key deficits in PTSD is regulation of fear, and impaired inhibition of fear-potentiated startle (FPS) has been identified as a potential physiological biomarker specific to PTSD. As part of a larger clinical trial, this study investigated the effects of a CRF receptor 1 antagonist, GSK561679, on inhibition of fear-potentiated startle during a conditional discrimination fear-conditioning paradigm, termed AX+/BX-. Prior research using this paradigm has demonstrated deficits in inhibition of conditioned fear in several PTSD populations. The randomized, double-blind, placebo-controlled clinical trial compared fear inhibition between female PTSD participants taking 350 mg/day GSK561679 (n = 47 pre- and 29 post-treatment) and patients taking a placebo pill (n = 52 pre- and 30 post-treatment) daily for 6 weeks. There was no significant difference between the two groups in their acquisition of fear or discrimination between threat and safety cues, and no pre-post-treatment effect on these measures. However, there was a significant effect of treatment on inhibition of FPS during the AB trials in the AX+/BX- transfer test (p < 0.05). While all PTSD participants showed typical impairments in fear inhibition prior to treatment, GSK561679 enhanced fear inhibition post-treatment, independent of clinical effects. The current study suggests that CRF receptor 1 antagonism may have specific effects within neural circuitry mediating fear inhibition responses, but not overall symptom presentation, in PTSD.


Subject(s)
Azabicyclo Compounds/pharmacology , Conditioning, Classical/drug effects , Fear/drug effects , Inhibition, Psychological , Oxadiazoles/pharmacology , Receptors, Corticotropin-Releasing Hormone/antagonists & inhibitors , Reflex, Startle/drug effects , Stress Disorders, Post-Traumatic/drug therapy , Stress Disorders, Post-Traumatic/physiopathology , Adult , Azabicyclo Compounds/administration & dosage , Double-Blind Method , Female , Humans , Middle Aged , Oxadiazoles/administration & dosage , Treatment Outcome
SELECTION OF CITATIONS
SEARCH DETAIL
...