Depression is associated with decreased blood pressure, but antidepressant use increases the risk for hypertension

The present study compared blood pressure levels between subjects with clinical anxiety and depressive disorders with healthy controls. Cross-sectional data were obtained in a large cohort study, the Netherlands Study of Depression and Anxiety (N=2981). Participants were classified as controls (N=590) or currently or remittedly depressed or anxious subjects (N=2028), of which 1384 were not and 644 were using antidepressants. Regression analyses calculated the contributions of anxiety and depressive disorders and antidepressant use to diastolic and systolic blood pressures, after controlling for multiple covariates. Heart rate and heart rate variability measures were subsequently added to test whether effects of anxiety/depression or medication were mediated by vagal control over the heart. Higher mean diastolic blood pressure was found among the current anxious subjects (β=0.932; P=0.03), although anxiety was not significantly related to hypertension risk. Remitted and current depressed subjects had a lower mean systolic blood pressure (β=-1.74, P=0.04 and β=-2.35, P=0.004, respectively) and were significantly less likely to have isolated systolic hypertension than controls. Users of tricyclic antidepressants had higher mean systolic and diastolic blood pressures and were more likely to have hypertension stage 1 (odds ratio: 1.90; 95% CI: 0.94 to 3.84; P=0.07) and stage 2 (odds ratio: 3.19; 95% CI: 1.35 to 7.59; P=0.008). Users of noradrenergic and serotonergic working antidepressants were more likely to have hypertension stage 1. This study shows that depressive disorder is associated with low systolic blood pressure and less hypertension, whereas the use of certain antidepressants is associated with both high diastolic and systolic blood pressures and hypertension. (Hypertension. 2009;53:631-638.) © 2009 American Heart Association, Inc

Speed Matters: Relationship between Speed of Eye Movements and Modification of Aversive Autobiographical Memories

Eye movement desensitization and reprocessing (EMDR) is an efficacious treatment for post-traumatic stress disorder. In EMDR, patients recall a distressing memory and simultaneously make eye movements (EM). Both tasks are considered to require limited working memory (WM) resources. Because this leaves fewer resources available for memory retrieval, the memory should become less vivid and less emotional during future recall. In EMDR analogue studies, a standardized procedure has been used, in which participants receive the same dual task manipulation of 1 EM cycle per second (1 Hz). From a WM perspective, the WM taxation of the dual task might be titrated to the WM taxation of the memory image. We hypothesized that highly vivid images are more affected by high WM taxation and less vivid images are more affected by low WM taxation. In study 1, 34 participants performed a reaction time task, and rated image vividness, and difficulty of retrieving an image, during five speeds of EM and no EM. Both a high WM taxing frequency (fast EM; 1.2 Hz) and a low WM taxing frequency (slow EM; 0.8 Hz) were selected. In study 2, 72 participants recalled three highly vivid aversive autobiographical memory images (n = 36) or three less vivid images (n = 36) under each of three conditions: recall + fast EM, recall + slow EM, or recall only. Multi-level modeling revealed a consistent pattern for all outcome measures: recall + fast EM led to less emotional, less vivid and more difficult to retrieve images than recall + slow EM and recall only, and the effects of recall + slow EM felt consistently in between the effects of recall + fast EM and recall only, but only differed significantly from recall + fast EM. Crucially, image vividness did not interact with condition on the decrease of emotionality over time, which was inconsistent with the prediction. Implications for understanding the mechanisms of action in memory modification and directions for future research are discussed

Vulnerability in acquisition, language impairments in Dutch: Creating a VALID data archive

The VALID Data Archive is an open multimedia data archive (under construction) with data from speakers suffering from language impairments. We report on a pilot project in the CLARIN-NL framework in which five data resources were curated. For all data sets concerned, written informed consent from the participants or their caretakers has been obtained. All materials were anonymized. The audio files were converted into wav (linear PCM) files and the transcriptions into CHAT or ELAN format. Research data that consisted of test, SPSS and Excel files were documented and converted into CSV files. All data sets obtained appropriate CMDI metadata files. A new CMDI metadata profile for this type of data resources was established and care was taken that ISOcat metadata categories were used to optimize interoperability. After curation all data are deposited at the Max Planck Institute for Psycholinguistics Nijmegen where persistent identifiers are linked to all resources. The content of the transcriptions in CHAT and plain text format can be searched with the TROVA search engin

High Sustained Antibody Titers in Patients with Classic Infantile Pompe Disease Following Immunomodulation at Start of Enzyme Replacement Therapy

Objective: To evaluate whether immunomodulation at start of enzyme replacement therapy induces immune tolerance to recombinant human acid alpha-glucosidase (rhGAA) in patients with classic infantile Pompe disease. Study design: Three patients (1 cross reactive immunologic material negative, 2 cross reactive immunologic material positive) were treated with 4 weekly doses of rituximab, weekly methotrexate, and monthly intravenous immunoglobulin and enzyme replacement therapy at 40 mg/kg/week. Antibody titers were measured using enzyme-linked immunosorbent assay. Neutralizing effects on rhGAA activity and cellular uptake were determined and combined with pharmacokinetic analysis. Clinical efficacy was evaluated by (ventilator-free) survival, reduction in left ventricular mass index, and improvement of motor function. Results: Immunomodulation induced B cell depletion that was accompanied by absence of antibody formation in all 3 patients. Upon cessation of rituximab treatment, all 3 patients showed B cell recovery, which was accompanied by formation of very high sustained antibody titers in 2 patients. Neutralizing effects on infused rhGAA were low to mild/moderate. All patients were alive at study end, learned to walk, and showed (near) normalization of left ventricular mass index. Conclusions: Immunomodulation as recommended in the literature prevented formation of rhGAA antibodies only during B cell depletion but failed to induce immune tolerance in 2 out of 3 patients

Facial-muscle weakness, speech disorders and dysphagia are common in patients with classic infantile Pompe disease treated with enzyme therapy

Classic infantile Pompe disease is an inherited generalized glycogen storage disorder caused by deficiency of lysosomal acid α-glucosidase. If left untreated, patients die before one year of age. Although enzyme-replacement therapy (ERT) has significantly prolonged lifespan, it has also revealed new aspects of the disease. For up to 11 years, we investigated the frequency and consequences of facial-muscle weakness, speech disorders and dysphagia in long-term survivors. Sequential photographs were used to determine the timing and severity of facial-muscle weakness. Using standardized articulation tests and fibreoptic endoscopic evaluation of swallowing, we investigated speech and swallowing function in a subset of patients. This study included 11 patients with classic infantile Pompe disease. Median age at the start of ERT was 2.4 months (range 0.1-8.3 months), and median age at the end of the study was 4.3 years (range 7.7 months −12.2 years). All patients developed facial-muscle weakness before the age of 15 months. Speech was studied in four patients. Articulation was disordered, with hypernasal resonance and reduced speech intelligibility in all four. Swallowing function was studied in six patients, the most important findings being ineffective swallowing with residues of food (5/6), penetration or aspiration (3/6), and reduced pharyngeal and/or laryngeal sensibility (2/6). We conclude that facial-muscle weakness, speech disorders and dysphagia are common in long-term survivors receiving ERT for classic infantile Pompe disease. To improve speech and reduce the risk for aspiration, early treatment by a speech therapist and regular swallowing assessments are recommended

Ecologische effecten van metaalverontreiniging in het overstromingsgebied van de Dommel. Triade onderzoek, ecologische risico's en mogelijkheden voor inrichting en beheer

De rivier de Dommel is sterk verontreinigd met cadmium en zink als gevolg van historische activiteiten van de zinkindustrie. Bij overstroming worden deze metalen, gebonden aan organisch stof en kleideeltjes, afgezet op de bodem in het overstromingsgebied. Als gevolg hiervan is ook het overstromingsgebied van de Dommel plaatselijk sterk verontreinigd. De overheid heeft voor een belangrijk deel van het Dommeldal natuurdoelstellingen opgesteld, waaronder het realiseren van de Ecologische Hoofd Structuur. Onduidelijkheid over de invloed van de metaalverontreiniging op de ecologie en natuurontwikkeling heeft geleid tot stagnatie van grondaankopen om deze EHS te kunnen realiseren. Om deze stagnatie op te heffen heeft het projectbureau Actief Bodembeheer de Kempen nader onderzoek laten uitvoeren. Het onderzoek heeft zich gericht op de vraag wat de locatiespecifieke ecologische risico’s zijn van de cadmium- en zinkverontreinigingen bij verschillende natuur(doel)typen die in het Dommeldal aanwezig zijn of ontwikkeld gaan worden. Het betreft hier de natuur(doel)typen die zich in een gebied bevinden dat gemiddeld één of meerdere keren per tien jaar overstroomd wordt. Deze natuur(doel)typen zijn voornamelijk bloemrijk grasland, nat schraalgrasland, moeras en elzenbroekbos. Het onderzoek is stapsgewijs uitgevoerd en wordt TRIADE genoemd vanwege de drie componenten waaruit het is opgebouwd te weten chemie, toxicologie en veldmetinge