Acute and Long-Term Effects of App-Delivered Heartfulness Meditation on Psychological Outcomes and the Endocannabinoid Signaling System in Cyclic Vomiting Syndrome.

INTRODUCTION: Cyclic vomiting syndrome (CVS) is a disorder of gut-brain interaction often triggered by stress. Interventions such as meditation may improve psychological outcomes and health-related quality of life (HRQoL), but their efficacy and the underlying mechanism are unknown. METHODS: We conducted a 6-week single-arm pilot study to assess the effects of heartfulness meditation (HFM) in CVS using a custom-designed meditation app. Primary outcomes included state and trait anxiety and mood state changes pre vs post-meditation, and secondary outcomes were psychological distress, coping, sleep quality, and HRQoL at baseline and at weeks 3 and 6. Serum concentrations of endocannabinoids N -arachidonylethanolamine and 2-arachidonoylglycerol and related lipids were measured pre- and post-HFM at baseline and week 6. RESULTS: In 30 treatment completers, there was a significant improvement in state anxiety ( P < 0.001), total mood disturbance ( P < 0.001), and other mood states (all P values < 0.05) across the 3 time points. Trait anxiety was also improved at week 6. There was a significant improvement in psychological distress (Global Severity Index), sleep quality (daytime dysfunction), coping (using religion/spirituality), and HRQoL (mental and physical) across the 3 time points (all P < 0.05). Significant increases in N -arachidonylethanolamine and related lipids N -oleoylethanolamine and palmitoylethanolamide post vs pre-HFM were observed at week 6 ( P < 0.001, 0.002, 0.003, respectively). No adverse effects were noted. DISCUSSION: App-delivered HFM is feasible, safe, and effective and improves psychological outcomes and augments endocannabinoids. This provides insight into the mechanism underlying HFM and has potential for widespread use as a digital therapeutic in CVS and other disorder of gut-brain interaction.

Clinical characteristics and long-term outcomes in patients with cyclic vomiting syndrome: A 15-year experience at a tertiary referral center.

BACKGROUND: Cyclic vomiting syndrome (CVS) is a disorder of gut-brain interaction (DGBI) characterized by recurrent episodes of nausea and vomiting. Most children outgrow their CVS symptoms and develop migraine headaches, but there are limited data in adults. We thus sought to determine the natural history of CVS in adults. METHODS: We conducted a retrospective analysis of patients at a specialized tertiary care clinic. Frequency of CVS episodes, emergency department (ED) visits, and hospitalizations were recorded at the index visit and at follow-up. KEY RESULTS: Of 455 CVS patients with complete data, mean age was 33 ± 13 years, 294 (65%) were female, and 392 (86%) were Caucasian. Mean duration of follow-up was 47.4 ± 37.2 months. There was a significant reduction in frequency of CVS episodes/year (18 to 6.8), ED visits (6.1 to 2), and hospitalizations (2.3 to 0.7) (all p-values < 0.001) but only 88 (19%) of patients had complete resolution of episodes at follow-up. On multivariable regression analysis, non-white race [0.33 (0.11-0.98) p = 0.01], comorbidity count [0.77 (0.62-0.95) p = 0.01], cannabis use [0.36 (0.2-0.65) p = 0.0007], and aprepitant use [0.2 (0.08-0.005) p < 0.001] were associated with a reduced odds of complete resolution of CVS episodes. Of note, 19 patients (4%) died. CONCLUSIONS AND INFERENCES: While most adults with CVS improved with specialized care, in contrast to children, only a small subset (~1 in 5) had complete resolution of symptoms. Reasons for the effects of race, cannabis use, and comorbidity burden on outcomes in CVS are unclear and warrant further investigation.

Orthographic consistency and word-frequency effects in auditory word recognition: new evidence from lexical decision and rime detection.

Many studies have repeatedly shown an orthographic consistency effect in the auditory lexical decision task. Words with phonological rimes that could be spelled in multiple ways (i.e., inconsistent words) typically produce longer auditory lexical decision latencies and more errors than do words with rimes that could be spelled in only one way (i.e., consistent words). These results have been extended to different languages and tasks, suggesting that the effect is quite general and robust. Despite this growing body of evidence, some psycholinguists believe that orthographic effects on spoken language are exclusively strategic, post-lexical, or restricted to peculiar (low-frequency) words. In the present study, we manipulated consistency and word-frequency orthogonally in order to explore whether the orthographic consistency effect extends to high-frequency words. Two different tasks were used: lexical decision and rime detection. Both tasks produced reliable consistency effects for both low- and high-frequency words. Furthermore, in Experiment 1 (lexical decision), an interaction revealed a stronger consistency effect for low-frequency words than for high-frequency words, as initially predicted by Ziegler and Ferrand (1998), whereas no interaction was found in Experiment 2 (rime detection). Our results extend previous findings by showing that the orthographic consistency effect is obtained not only for low-frequency words but also for high-frequency words. Furthermore, these effects were also obtained in a rime detection task, which does not require the explicit processing of orthographic structure. Globally, our results suggest that literacy changes the way people process spoken words, even for frequent words.

Feedback consistency effects in visual and auditory word recognition: where do we stand after more than a decade?

The role of phonology-to-spelling consistency (i.e., feedback consistency) was investigated in 3 lexical decision experiments in both the visual and auditory modalities in French and English. No evidence for a feedback consistency effect was found in the visual modality, either in English or in French, despite the fact that consistency was manipulated for different kinds of units (onsets and rimes). In contrast, robust feedback consistency effects were obtained in the auditory lexical decision task in both English and French when exactly the same items that produced a null effect in the visual modality were used. Neural network simulations are presented to show that previous demonstrations of feedback consistency effects in the visual modality can be simulated with a model that is not sensitive to feedback consistency, suggesting that these effects might have come from various confounds. These simulations, together with the authors' results, suggest that there are no feedback consistency effects in the visual modality. In contrast, such effects are clearly present in the auditory modality. Given that orthographic information is absent from current models of spoken word recognition, the present findings present a major challenge to these models.

Metabolic profiling of lignan variability in Linum species of section Syllinum native to Bulgaria.

Lignans in eighteen samples of Linum species ( L. tauricum ssp. tauricum, serbicum, bulgaricum and linearifolium; L. elegans; L. flavum ssp. sparsiflorum, L. capitatum var. laxiflorum), all members of the section Syllinum occurring in Bulgaria, were analysed by HPLC-ESI/MS and HPLC-UV/DAD. The ESI/MS fragmentation pathways recently established for aryltetralin lignans are now extended to ester and glycoside derivatives. In total, 22 different lignans, mainly of the aryltetralin type, were identified. 6-Methoxypodophyllotoxin and its glucoside were present as major constituents in all samples. Differences between the investigated taxa were observed especially with respect to the accumulation of 6-deoxy-7-hydroxy-aryltetralins such as podophyllotoxin and of 6-hydroxy-7-deoxy-aryltetralin lignans of the peltatin type. The distribution of aryltetralin lignans with different oxygenation patterns in the various samples, and correlations between the chemical data and the molecular phylogeny based on an analysis of ITS sequences of the investigated species are discussed.