Psychobiotic Supplementation of PS128TM Improves Stress, Anxiety, and Insomnia in Highly Stressed Information Technology Specialists: A Pilot Study.

Background: Information technology (IT) is an industry related to the production of computers, information processing, and telecommunications. Such industries heavily rely on the knowledge and solutions provided by IT specialists. Previous reports found that the subjective stress scores were higher in IT specialists who developed diabetes, hypertension, and depression. Specific probiotics, known as psychobiotics, may alleviate stress and mood symptoms. This study aimed to examine whether an 8-week intervention of a novel psychobiotic, Lactobacillus plantarum PS128TM (PS128TM), improved self-perceived stress and mood symptoms among high-stress IT specialists. Methods: This open-label, single-arm, baseline-controlled study included IT specialists from a large IT company in Northern Taiwan. Participants with a Perceived Stress Scale (PSS) 10-item version score of 27 or higher were included. Participants were asked to take two capsules containing PS128TM powder, equivalent to 20 billion colony-forming units, daily. Self-report measures, such as the Job Stress Scale, Visual Analog Scale of Stress, the Insomnia Severity Index, the State and Trait Anxiety Index, the Questionnaire for Emotional Trait and State, the Patient Health Questionnaire, the Quality of Life Enjoyment and Satisfaction Questionnaire, and Gastrointestinal Severity Index were compared at baseline and at the end of the trial period. The primary outcome was a 20% reduction in the PSS score at endpoint. Objective measures included salivary levels of stress biomarkers, including cortisol, α-amylase, immunoglobulin A, lactoferrin, and lysozymes, as well as results of the Test of Attentional Performance. Results: Of the 90 eligible IT specialists, 36 met the inclusion criteria. After the 8-week trial period, significant improvements in self-perceived stress, overall job stress, job burden, cortisol level, general or psychological health, anxiety, depression, sleep disturbances, quality of life, and both positive and negative emotions were found. Conclusion: Our results suggest that PS128TM has the distinct advantage of providing stress relief and can improve mental health for people with a high-stress job. Future placebo-controlled studies are warranted to explore the effect and underlying mechanisms of action of PS128TM. Clinical Trial Registration: https://clinicaltrials.gov/ (identifier: NCT04452253-sub-project 2).

Neuropsychological functions and quality of life in survived patients with intracranial germ cell tumors after treatment.

BACKGROUND: The notable survival chances of intracranial germ cell tumors (icGCTs) lead to a rising concern over long-term neurocognitive outcome. Yet, prior evidence related to this issue fails to provide a comprehensive examination of the effects of tumor location and radiotherapy. We attempt to explore their impacts on the neuropsychological functions and life quality in children with icGCT after multimodality treatments. METHODS: A retrospective review of 56 patients diagnosed with icGCTs at age <20 and treated at the Taipei Veterans General Hospital was provided. Intelligence, memory, visual organization, attention, and executive function were assessed by neurocognitive tests; adaptation to life, emotional and behavioral changes, interpersonal relationships, and impact on the family were evaluated by parent-report instruments. Effects of tumor locations (germinomas and nongerminomatous malignant germ cell tumors in the pineal, suprasellar, and basal ganglia) and irradiation on these measurements were examined. RESULTS: Patients with tumors in the basal ganglia region had lower full-scale IQs than those with tumors in the pineal or suprasellar regions. Subscores of intelligence scale and short-term retention of verbal and visual stimuli showed evident group differences, as did the quality of life and adaptive skills, particularly in psychosocial domains. Patients treated with whole-ventricular irradiation had better outcomes. Extensive irradiation field and high irradiation dosage influenced intellectual functions, concept crystallization, executive function, and memory. CONCLUSIONS: Tumor location and irradiation field/dosage appear to be the crucial factors related to certain neuropsychological, emotional, and behavioral dysfunctions that in turn alter the quality of life in children with icGCTs who survive after treatment.

Symptomatic resolution among Chinese patients with schizophrenia and associated factors.

BACKGROUND/PURPOSE: The remission and resolution criteria for schizophrenia were defined by the Remission in Schizophrenia Working Group in 2005, using eight core items of the positive and negative symptoms scale for schizophrenia. Subsequent studies of Caucasians have reported similar remission/resolution rates of approximately one-third. However, the remission/resolution rate in Chinese patients has not previously been reported. The present study assessed symptom resolution rates and associated factors among medicated and clinically stable Chinese schizophrenia patients. METHODS: Chinese patients with a diagnosis of schizophrenia were followed-up 1 month after their last psychiatric hospitalization. Cross-sectional clinical assessments for psychopathology, side effect profiles, quality of life, psychosocial function, and neurocognition tests were performed. RESULTS: Thirty-three (36.7%) of a total of 90 patients met the resolution criteria. They had a significantly higher level of education and lower scores for positive symptoms, negative symptoms, and general psychopathology on the positive and negative symptoms scale; they had lower scores on the Udvalg for Kliniske Undersøgelser Side Effect Rating Scale, and Simpson Angus Scale; and higher scores on the Global Assessment of Functioning and Subjective Well-being under Neuroleptics scales, compared with patients who did not meet the resolution criteria. Multiple regression analyses controlling for age, sex, duration of illness, education, duration of index hospitalization, and antipsychotic dosage revealed that a higher Udvalg for Kliniske Undersøgelser Side Effect Rating Scale score was related to lower rate of symptom resolution. The patients treated with clozapine and combinations of first generation antipsychotics and second generation antipsychotics had more severe psychopathology and side effects and showed a significantly lower resolution rate than did patients treated with first generation antipsychotics or second generation antipsychotics alone. CONCLUSION: Consistent with studies of Caucasian patients, one-third of clinically stable Chinese patients met the resolution criteria, as well as having fewer general side effects, better global functioning and subjective well-being.

The Wada memory test and prediction of outcome after anterior temporal lobectomy.

We reviewed the records of 77 Chinese-speaking adult patients to investigate the relationship between the Wada memory test and outcomes after anterior temporal lobectomy (ATL). The ipsilateral memory scores, contralateral memory scores and Wada asymmetry index (WAI) were calculated to evaluate their relationships with seizure and cognitive outcomes. The seizure outcomes did not correlate with the unilateral memory scores or the WAI. Patients who had a smaller WAI tended to have a post-operative decline in verbal intelligence quotient (VIQ) (odds ratio: 13.54, 95% confidence interval: 1.17-156.11, p=0.037). The seven patients who failed the Wada memory test after ipsilateral injection had a higher percentage of VIQ deterioration than the 70 who passed (p=0.039). However, no patient displayed global amnesia after surgery. The Wada memory test was a predictor for post-operative VIQ changes in our study. Patients who failed the Wada memory test still benefitted from the ATL and showed good seizure outcomes.

Adult normative data of the Wisconsin Card Sorting Test in Taiwan.

BACKGROUND: The Wisconsin Card Sorting Test (WCST) is a widely used neuropsychological test for assessing executive functions. However, the lack of culture-specific norms has often limited clinical interpretation of performance on the WCST. The aims of this study were to establish adult norms for the WCST in Taiwan, and to understand the development of performance on the WCST among age groups. METHODS: A total of 475 participants (233 males, 242 females) aged from 20 to 89 years were divided into 10 age groups. All of the participants completed the WCST, and 6 indices of WCST were calculated, including percent errors (PE), percent perseverative responses (PPR), percent perseverative errors (PPE), percent non-perseverative errors (PNPE), percent conceptual-level responses (PCLR), and categories completed (CC). RESULTS: There were several findings. First, our data showed that there was no evidence of a significant difference between manual card and computerized card presentation versions of WCST on the PE, PPR, PPE, PNPE, PCLR, and CC indices. Second, no education and gender effects on WCST performance were found. Third, although WCST indices were significantly different among age groups, no remarkable differences among the groups after 30 years of age were found. Finally, compared with Heaton's USA norms, WCST performance in Taiwanese was poorer than the USA sample in most age groups. CONCLUSION: The WCST is not sensitive enough to detect aging-related cognitive changes in the Taiwanese population, and there are different performances on WCST between Taiwanese and USA people. The adult norms for WCST in Taiwan will provide an important reference for future research and clinical practice.

Selective posterior cerebral artery amobarbital test in patients with temporal lobe epilepsy for surgical treatment.

PURPOSE: To evaluate whether the selective posterior cerebral artery amobarbital test (PCAAT) can predict postoperative memory function in patients with temporal lobe epilepsy (TLE) for surgical treatment and its clinical safety. METHODS: The database included adult patients with intractable TLE undergoing presurgical evaluation at Taipei Veterans General Hospital between 1995 and 2002. The PCAAT was carried out on patients who had failed conventional intracarotid amobarbital test (IAT) or had IAT results that evoked a concern of postoperative memory function decline. A battery of learning and memory testing was performed immediately before and after injection of amobarbital into the peduncular segment of the posterior cerebral artery (PCA) on the presumed hemisphere of epileptogenicity. Neuropsychological assessments were followed in surgically treated patients. RESULTS: A total of 16 patients completed PCAAT successfully and underwent anterior temporal lobectomy (ATL). Four patients failed PCAAT angiographic procedures due to technical difficulty in one patient, transient signs of vasospasm in two patients, and subarachnoid hemorrhage in one patient. Of the 12 patients who performed well in PCAAT learning and memory testing items by free recall or recognition, only 1 patient demonstrated postoperative memory decline in follow-up neuropsychological assessments. In contrast, two of the four patients with a deficit in PCAAT memory testing showed postoperative memory decline. Regarding subjective memory function (not necessarily associated with objective memory decline), patients not seizure-free after ATL were more likely to have memory complaints (in 3 out of 6 patients) than patients with seizure-free outcomes (in 1 out of 10 patients). CONCLUSIONS: The PCAAT memory test reliably predicts postoperative memory function in patients with TLE for surgical treatment. However, the inherent risks of PCAAT must be considered and it should be used judiciously.

Effect of 5 Hz repetitive transcranial magnetic stimulation on cognition during a Go/NoGo task.

Repetitive transcranial magnetic stimulation (rTMS) has been developed as a novel tool for modulating cognition by delivering stimulation in the brain. However, the effects of rTMS on cognition are still controversial. This randomized, sham-controlled, crossover study was designed to determine whether rTMS of the left dorsolateral prefrontal cortex (DLPFC) interferes with the Go/NoGo task and whether personal parameters such as age affect rTMS. A total of 24 healthy subjects (12 male and 12 female, aged 20-37 years) underwent one session of active rTMS followed by sham rTMS (total of 1600 pulses, 100% of motor threshold, 5 Hz, 8 s), or vice versa. The results did not show any differences between active and sham rTMS stimulation in terms of performance accuracy, response speed, or choice reaction time (cRT) implicating that short-term rTMS will not enhance or deteriorate cognition. However, percentage cRT shortening induced by active rTMS was negatively correlated with age (r = -0.57, P = 0.005), whereas that induced by sham rTMS was not (r = -0.23, P > 0.05), suggesting that cognition of younger subjects might have greater modulation by active stimulation than older ones. This finding may help explain some of the controversies or paradoxical results observed in studies of the effect of left DLPFC rTMS on cognition.