Does Meditation Alter Brain Responses to Negative Stimuli? A Systematic Review

Background: Despite several attempts to review and explain how meditation alters the brain and facilitates emotion regulation, the extent to which meditation and emotion regulation strategies share the same neural mechanisms remains unclear.Objective: We aim to understand the influence of meditation on the neural processing of negative emotional stimuli in participants who underwent meditation interventions (naive meditators) and long-term meditators.Methodology: A systematic review was conducted using standardized search operators that included the presence of terms related to emotion, meditation and neuro-imaging techniques in PsycInfo, PubMed, Scopus, and Web of Science databases.Results: Searches identified 882 papers, of which 11 were eligible for inclusion. Results showed a predominance of greater prefrontal/frontal activity related to meditation, which might indicate the increased recruitment of cognitive/attentional control resources in naïve and long-term meditators. This increased frontal activity was also observed when participants were asked to simply react to negative stimuli. Findings from emotion-related areas were scarce but suggested increased insular activity in meditators, potentially indicating that meditation might be associated with greater bodily awareness.Conclusions: Meditation practice prompts regulatory mechanisms when participants face aversive stimuli, even without an explicit request. Moreover, some studies reported increased insular activity in meditators, consistent with the hypothesis that meditation helps foster an interoceptive awareness of bodily and emotional states

American College of Rheumatology Provisional Criteria for Clinically Relevant Improvement in Children and Adolescents With Childhood-Onset Systemic Lupus Erythematosus

10.1002/acr.23834ARTHRITIS CARE & RESEARCH715579-59

Anti-RO/SSA and anti-La/SSB antibodies: Association with mild lupus manifestations in 645 childhood-onset systemic lupus erythematosus

Background: To our knowledge there are no studies assessing anti-Ro/SSA and anti-La/SSB autoantibodies in a large population of childhood-systemic lupus erythematosus (cSLE) patients. Methods: This was a retrospective multicenter cohort study performed in 10 Pediatric Rheumatology services, Sao Paulo state, Brazil. Anti-Ro/SSA and anti-La/SSB antibodies were measured by enzyme linked immunosorbent assay (ELISA) in 645 cSLE patients. Results: Anti-Ro/SSA and anti-La/SSB antibodies were evidenced in 209/645 (32%) and 102/645 (16%) of cSLE patients, respectively. Analysis of cSLE patients with and without anti-Ro/SSA antibodies revealed higher frequencies of malar rash (79% vs. 71%, p = 0.032), photosensitivity (73% vs. 65%, p = 0.035), cutaneous vasculitis (43% vs. 35%, p = 0.046) and musculoskeletal involvement (82% vs. 75%, p = 0.046) in spite of long and comparable disease duration in both groups (4.25 vs. 4.58 years, p = 0.973). Secondary Sjogren syndrome was observed in only five patients with this antibody (2.5% vs. 0%, p = 0.0035), two of them with concomitant anti-La/SSB. The presence of associated autoantibodies: anti-Sm (50% vs. 30%, p < 0.0001), anti-RNP (39% vs. 21%, p < 0.0001) and anti-ribossomal P protein (46% vs. 21%, p = 0.002) was also significantly higher in patients with anti-Ro/SAA antibodies. Further evaluation of cSLE patients with the presence of anti-La/SSB antibodies compared to those without these autoantibodies showed that the frequency of alopecia (70% vs. 51%, p = 0.0005), anti-Sm (59% vs. 31%, p < 0.0001) and anti-RNP (42% vs. 23%, p < 0.0001) were significantly higher in the former group. Conclusions: Our large multicenter cohort study provided novel evidence in cSLE that anti-Ro/SSA and/or anti-La/SSB antibodies were associated with mild manifestations, particularly cutaneous and musculoskeletal. Secondary Sjogren syndrome was rarely observed in these patients, in spite of comparable frequencies of anti-Ro/SSA and/or anti-La/SSB reported for adult SLE. (C) 2016 Elsevier B.V. All rights reserved.Conselho Nacional de Desenvolvimento Cientifico e Tecnologico (CNPq)Federico FoundationNucleo de Apoio a Pesquisa "Sande da Crianca e do Adolescente" da USP (NAP-CriAd)Univ Sao Paulo, Fac Med, Childrens Inst, Pediat Rheumatol Unit, BR-05508 Sao Paulo, BrazilUniv Sao Paulo, Fac Med, Div Rheumatol, BR-05508 Sao Paulo, BrazilUniv Fed Sao Paulo, Pediat Rheumatol Unit, Sao Paulo, BrazilSao Paulo State Univ, UNESP, Div Pediat Rheumatol, Fac Med Botucatu, Sao Paulo, SP, BrazilInnandade Santa Casa de Misericordia Sao Paulo, Pediat Rheumatol Unit, Sao Paulo, BrazilUniv Estadual Campinas, UNICAMP, Pediat Rheumatol Unit, Campinas, SP, BrazilUniv Sao Paulo, Ribeirao Preto Med Sch, Pediat Rheumatol Unit, BR-05508 Sao Paulo, BrazilHosp Infantil Darcy Vargas, Pediat Rheumatol Unit, Sao Paulo, BrazilHosp Menino Jesus, Pediat Rheumatol Unit, Sao Paulo, BrazilPontifical Catholic Univ Sorocaba, Sao Paulo, BrazilUniv Fed Sao Paulo, Pediat Rheumatol Unit, Sao Paulo, BrazilCNPq: 301805/2013-0CNPq: 303752/2015-7CNPq: 301479/2015-1CNPQ: 305068/2014-8CNPQ: 303422/2015-7Web of Scienc

American college of rheumatology provisional criteria for clinically relevant improvement in children and adolescents with childhood-onset systemic Lupus erythematosus

To develop a Childhood Lupus Improvement Index (CHILI) as a tool to measure response to therapy in childhood-onset systemic lupus erythematosus (cSLE), with a focus on clinically relevant improvement (CRIcSLE). Methods Pediatric nephrology and rheumatology subspecialists (n = 213) experienced in cSLE management were invited to define CRIcSLE and rate a total of 433 unique patient profiles for the presence/absence of CRIcSLE. Patient profiles included the following cSLE core response variables (CRVs): global assessment of patient well-being (patient-global), physician assessment of cSLE activity (MD-global), disease activity index score (here, we used the Systemic Lupus Erythematosus Disease Activity Index), urine protein-to-creatinine ratio, and Child Health Questionnaire physical summary score. Percentage and absolute changes in these cSLE-CRVs (baseline versus follow-up) were considered in order to develop candidate algorithms and validate their performance (sensitivity, specificity, area under the receiver operating characteristic curve [AUC]; range 0-1). Results During an international consensus conference, unanimous agreement on a definition of CRIcSLE was achieved; cSLE experts (n = 13) concurred (100%) that the preferred CHILI algorithm considers absolute changes in the cSLE-CRVs. After transformation to a range of 0-100, a CHILI score of >= 54 had outstanding accuracy for identifying CRIcSLE (AUC 0.93, sensitivity 81.1%, and specificity 84.2%). CHILI scores also reflect minor, moderate, and major improvement for values exceeding 15, 68, and 92, respectively (all AUC >= 0.92, sensitivity >= 93.1%, and specificity >= 73.4%). Conclusion The CHILI is a new, seemingly highly accurate index for measuring CRI in cSLE over time. This index is useful to categorize the degree of response to therapy in children and adolescents with cSLE.715579590CNPQ - Conselho Nacional de Desenvolvimento Científico e TecnológicoFAPESP – Fundação de Amparo à Pesquisa Do Estado De São Paulo303422/2015-7; 7/2016-9; 304255/2015-7215/03756-