Rationale and design of a double-blinded, randomized placebo-controlled trial of 40 Hz light neurostimulation therapy for depression (FELIX).

BACKGROUND: Major depressive disorder (MDD) is a debilitating condition that affects more than 300 million people worldwide. Current treatments are based on a trial-and-error approach, and reliable biomarkers are needed for more informed and personalized treatment solutions. One of the potential biomarkers, gamma-frequency (30-80 Hz) brainwaves, are hypothesized to originate from the excitatory-inhibitory interaction between the pyramidal cells and interneurons. The imbalance between this interaction is described as a crucial pathological mechanism in neuropsychiatric conditions, including MDD, and the modulation of this pathological interaction has been investigated as a potential target. Previous studies attempted to induce gamma activity in the brain using rhythmic light and sound stimuli (GENUS - Gamma Entrainment Using Sensory stimuli) that resulted in neuroprotective effects in Alzheimer's disease (AD) patients and animal models. Here, we investigate the antidepressant, cognitive, and electrophysiological effects of the novel light therapy approach using 40 Hz masked flickering light for patients diagnosed with MDD. METHODS AND DESIGN: Sixty patients with a current diagnosis of a major depressive episode will be enrolled in a randomized, double-blinded, placebo-controlled trial. The active treatment group will receive 40 Hz masked flickering light stimulation while the control group will receive continuous light matched in color temperature and brightness. Patients in both groups will get daily light treatment in their own homes and will attend four follow-up visits to assess the symptoms of depression, including depression severity measured by Hamilton Depression Rating Scale (HAM-D17), cognitive function, quality of life and sleep, and electroencephalographic changes. The primary endpoint is the mean change from baseline to week 6 in depression severity (HAM-D6 subscale) between the groups.

An NMR Metabolomics Approach to Investigate Factors Affecting the Yoghurt Fermentation Process and Quality.

A great number of factors can influence milk fermentation for yoghurt production such as fermentation conditions, starter cultures and milk characteristics. It is important for dairy companies to know the best combinations of these parameters for a controlled fermentation and for the desired qualities of yoghurt. This study investigates the use of a 1H-NMR metabolomics approach to monitor the changes in milk during fermentation from time 0 to 24 h, taking samples every hour in the first 8 h and then at the end-point at 24 h. Three different starter cultures (L. delbrueckii ssp. bulgaricus, S. thermophilus and their combination) were used and two different heat treatments (99 or 105 °C) were applied to milk. The results clearly show the breakdown of proteins and lactose as well as the concomitant increase in acetate, lactate and citrate during fermentation. Formate is found at different initial concentrations depending on the heat treatment of the milk and its different time trajectory depends on the starter cultures: Lactobacillus cannot produce formate, but needs it for growth, whilst Streptococcus is able to produce formate from pyruvate, therefore promoting the symbiotic relationship between the two strains. On the other hand, Lactobacillus can hydrolyze milk proteins into amino acids, enriching the quality of the final product. In this way, better insight into the protocooperation of lactic acid bacteria strains and information on the impact of a greater heat treatment in the initial matrix were obtained. The global chemical view on the fermentations provided using NMR is key information for yoghurt producers and companies producing starter cultures.