A comparative DC-EEG study about learned helplessness

Erlernte Hilflosigkeit tritt auf wenn ein Individuum keine Erwartung mehr hat Kontrolle ausüben zu können und dadurch passiv wird. Der Frage wie Hilflosigkeit mit neuronalen Prozessen zusammen hängt sind bisher nur wenige Studien nachgegangen. EEG-Studien (Bauer et al., 2002; Fretska et al., 1999) zeigten dass hilflose Personen signifikant positive Veränderungen der langsamen kortikalen Potentiale während der Hilflosigkeitsinduktion aufwiesen im Vergleich zur Kontrollbedingung. Darüber hinaus gab es Hinweise darauf dass Frauen eher zu Hilflosigkeit neigen und auch auf neuronaler Ebene signifikante Veränderungen zeigen im Vergleich zu den Männern die eher weniger emotional reagierten. Die Analyse der neuronalen Quellenlokalisation mit LORETA wies auf eine erniedrigte Aktivität des anterioren cingulären cortex (ACC) während der Hilflosigkeitsinduktion hin. Die vorliegende Studie untersuchte angelehnt an Bauer et al. (2003) langsame kortikale Potentiale bei Personen die hilflos wurden und Personen die nicht hilflos wurden. Hilflosigkeit wurde mit Hilfe von unlösbaren Zahlenreihenaufgaben induziert und die Hilflosigkeitsklassifikation wurde anhand eines Scores aus dem Hilflosigkeitsfragebogen (Bauer et al., 2003) ermittelt. Insgesamt wurden 57,1 % der Teilnehmer hilflos. Obwohl etwas mehr Frauen (63,2 %) als Männer (52,2%) hilflos wurden, war dieser Effekt nicht signifikant. Hilflose zeigten Veränderungen ihrer langsamen kortikalen Potentiale in Richtung Positivität während der Phase der Hilflosigkeitsinduktion im Vergleich zu nicht hilflosen Personen. Dieser Trend stellte sich als statistisch nicht signifikant heraus. Jedoch ergaben sich Geschlechtsunterschiede in der Hinsicht, dass Frauen signifikant positivere langsame kortikale Potenziale während der Bearbeitung unlösbarer Aufgaben zeigten. Diese Ergebnisse stimmen mit den Studien von Fretska et al. (1999) und Bauer et al. (2003) überein. Für die gesamte Stichprobe hat sich gezeigt dass langsame kortikale Potenziale am positivsten in den Elektroden frontal-rechts waren. Die Analyse der neuronalen Quellenlokalisation mit sLORETA brachte keine signifikanten Unterschiede zwischen den einzelnen Gruppen (hilflos und nicht hilflos, Männer und Frauen) und konnte somit das Ergebnis von Bauer et al. (2003) nicht bestätigen.Learned helplessness emerges when individuals do not have any expectancy of control any more and therefore become passive. So far only a few studies have dealt with the question how learned helplessness is associated with neuronal processes. EEG studies (Bauer et al., 2002; Fretska et al., 1999) showed that helpless subjects had significant positive going slow cortical potential shifts (SCP-shifts) during helplessness induction compared to the control phase. Furthermore, the studies indicated that women became more helpless or more often helpless than men. Moreover, analysis of neuronal source localization with LORETA demonstrated a significant decrease in activity of the anterior cingulate cortex (ACC) during helplessness. Based on the study of Bauer et al. (2003), the present study investigated SCPs in 42 subjects (23 females). Helplessness was induced by unolvable numerical series and was assessed via a score from the helplessness questionnaire (Bauer et al., 2003). Data analysis revealed that overall 57.1 % of the participants became helpless. Although slightly more women became helpless (63.2%) than men (52.2%), this effect was not significant. Helpless subjects showed positive going SCP shifts during the helplessness induction compared to non-helpless subjects. However these trends were only limited to posterior regions and were statistically not significant. Female participants though, showed significant positive going SCP shifts in the unsolvable condition (helplessness induction) which is consistent with the findings of Fretska et al. (1999) and Bauer et al. (2003). For the whole sample, SCPs appeared to be most positive in frontal-right electrodes. The neuronal source localization analysis with sLORETA did not reveal any significant differences between the groups (helpless and non helpless subjects, male and female) and could not confirm the findings of Bauer et al. (2003)

Cognitive impairment and response inhibition deficits in alcohol use disorders: impact on relapse and neural processing

The present dissertation focused on cognitive control processes and impulsivity in the context of AUDs with an emphasis on response inhibition towards alcohol-related and neutral stimuli. Overall, different paradigms, methods and samples have been used in three studies including behavioural tasks, questionnaire data and fMRI recordings. For the assessment of specific response inhibition processes a go/no-go paradigm with pictures of the preferred alcoholic drinks and neutral stimuli has been further developed for this work to combine the aspects of behavioural inhibition and salience of drug-associated cues. Study 1 investigated the association between binge drinking, trait impulsivity and behavioural impulse control. The results revealed that only binge drinkers showed an alcohol-specific impairment of response inhibition and that the number of commission errors towards alcohol related stimuli was the only significant predictor for binge drinking. However, binge drinkers did not significantly differ from non-binge drinkers in regard to self-reported impulsivity and overall response inhibition performance. In study 2, a large sample of recently detoxified ADP and HC were compared with respect to their performance on five different behavioural tasks assessing different aspects of cognitive control processes and the association between cognitive control deficits in ADP and relapse behaviour in a six-month follow-up period has been investigated. Compared to HC, ADP showed an impairment in response inhibition, response initiation, complex sustained attention and executive functions. Both groups made more commission errors when they had to inhibit their reactions towards alcohol pictures compared to geometrical stimuli. This suggests a specific response inhibition deficit for alcoholic cues, however not specifically for the group of ADP. The strongest predictor for relapse has been the interaction between the number of previous detoxifications and response inhibition deficits, revealing that ADP with a higher number of detoxifications and a pronounced impairment in response inhibition had the highest relapse risk. Study 3 focused on neuronal activity patterns, assessed with fMRI, in ADP and HC during a response inhibition task. During successful inhibition towards all stimuli, ADP showed enhanced neural activity compared to HC in brain areas linked to cognitive control, including the anterior cingulate gyrus, medial frontal gyrus and medial orbitofrontal cortex. These results are interpreted as an additional demand for neural resources, respectively a compensation due to a deficit in cognitive control processes in ADP. In summary, it can be stated that ADP show a pronounced impairment in several cognitive control processes and that especially a deficit in response inhibition combined with many detoxifications in the past, is related to an enhanced relapse risk. Regarding the impact of alcoholic cues on response inhibition, the results suggest that alcohol-related stimuli interfere with response inhibition performance and are associated with more errors. Interventions for people with AUDs, including binge drinkers, should take those factors in account and clinicians should be particularly aware of patients with many detoxifications and poor response inhibition, as those factors comprise the high risk relapse group.Kognitive Kontrollprozesse ermöglichen eine zielgerichtete und adäquate Steuerung von Verhaltensreaktionen. Ausgehend von der Literatur zu kognitiver Kontrolle (oder Impulsivität) bei Abhängigkeitserkrankungen (de Wit, 2009; Crews & Boettiger, 2009) wird kognitive Kontrolle als ein multi-dimensionales Konstrukt betrachtet, das u.a. Prozesse der Aufmerksamkeitssteuerung, des Entscheidungsverhaltens und der Inhibition von Verhaltensreaktionen umfasst. Dabei wird postuliert, dass es sich um separate kognitive Prozesse handelt. Bisherige Studien untersuchten meist nur ein bis drei verschiedene kognitive Prozesse bei Alkoholabhängigkeit und auch wurde der Zusammenhang zwischen Beeinträchtigungen kognitiver Kontrollprozesse und der Wiederaufnahme des Alkoholkonsums nach einer Abstinenzphase zuvor nicht untersucht. Vor diesem Hintergrund, war der Fokus dieser Dissertation die umfassende Untersuchung verschiedener kognitiver Kontrollprozesse, insbesondere der Impulskontrolle, in Bezug auf Alkoholabhängigkeit sowie Rauschtrinken sowie die Bedeutung dieser kognitiven Prozesse für das Rückfallrisiko (Rückfallprädiktion). Ferner sollte die Bedeutung einer möglicherweise spezifischen Beeinträchtigung der Inhibition bei Präsentation alkohol-assoziierter Reize untersucht werden sowie unterschiedliche neuronale Aktivitätsmuster während einer erfolgreichen Inhibitionsreaktion untersucht werden

Relationship between nutritional status and length of hospital stay among patients with atrial fibrillation – a result of the nutritional status heart study

BackgroundNutritional status is related to the prognosis and length of hospital stay (LOHS) of patients with atrial fibrillation (AF). This study aimed to assess how nutritional status affects LOHS for patients with AF.MethodsWe performed retrospective analysis of the medical records of 1,813 patients admitted urgently with a diagnosis of AF to the Institute of Heart Diseases of the University Clinical Hospital in Wroclaw, Poland.ResultsIn total, 1,813 patients were included in the analysis. The average LOHS in the entire group was 3.53 ± 3.41 days. The mean BMI was 28.7 kg/m2 (SD: 5.02). Patients who were hospitalized longer were statistically more likely to have a Nutritional Risk Score (NRS) ≥3 (p = 0.028). A higher percentage of longer hospitalized patients with LDL levels below 70 mg/dl (p < 0.001) and those with HDL ≥40 mg/dl (p < 0.001) were observed. Study participants with NRS ≥3 were an older group (M = 76.3 years), with longer mean LOHS (M = 4.44 days). The predictors of LOHS in the univariate model were age (OR = 1.04), LDL (OR = 0.99), HDL (OR = 0.98), TC (OR = 0.996), CRP (OR = 1, 02, p < 0.001), lymphocytes (OR = 0.97, p = 0.008) and in the multivariate model were age, LDL (mg/dl), HDL (mg/dl), Na, and K.ConclusionFor nutritional status, factors indicating the risk of prolonged hospitalization in patients with AF are malnutrition, lower serum LDL, HDL, potassium, and sodium levels identified at the time of admission to the cardiology department. Assessment of nutritional status in patients with AF is important both in the context of evaluating obesity and malnutrition status, as both conditions can alter the prognosis of patients. Further studies are needed to determine the exact impact of the above on the risk of prolonged hospitalization

A patient with heart failure, who is frail: How does this affect therapeutic decisions?

Patients with heart failure (HF) are heterogeneous, not only related to comorbidities but also in the presentation of frailty syndrome. Frailty syndrome also affects patients with HF across the lifespan. Frailty in patients with HF has a significant impact on clinical features, diagnosis, management, adverse medical outcomes and costs. In everyday clinical practice, frail patients with HF require an individualized approach, often imposing the need to modify therapeutic decisions. The aim of this review is to illustrate how frailty and multimorbidity in HF can affect therapeutic decisions. The scientific evidence underlying this publication was obtained from an analysis of papers indexed in the PubMed database. The search was limited to articles published between 1990 and July 2022. The search was limited to full-text papers published in English. The database was searched for relevant MeSH phrases and their combinations and keywords including: “elderly, frail”; “frailty, elderly”; “frail older adults”; “frailty, older adults”; “adult, frail older”; “frailty, heart failure”; “frailty, multimorbidity”; “multimorbidity, heart failure”; “multimorbidity, elderly”; “older adults, cardiovascular diseases”. In therapeutic decisions regarding patients with HF, additionally burdened with multimorbidity and frailty, it becomes necessary to individualize the approach in relation to optimization and treatment of coexisting diseases, frailty assessment, pharmacological and non-pharmacological treatment and in the implementation of invasive procedures in the form of implantable devices or cardiac surgery

The concurrent impact of mild cognitive impairment and frailty syndrome in heart failure

Pathological processes associated with ageing increase the risk of cognitive deficits and dementia. Frailty syndrome, also known as weakness or reserve depletion syndrome, may significantly accelerate these pathological processes in the elderly population. Frailty syndrome is characterized by decreased physiological function and neuropsychiatric symptoms, including cognitive decline and depressive states. In people with cardiovascular disease, the risk of frailty is 3 times higher. Frailty syndrome is particularly prevalent in severe heart failure, which increases the risk of mortality, increases hospital readmission, and reduces patients’ quality of life. In addition, co-occurrence of cognitive impairment and frailty syndrome significantly increases the risk of dementia and other adverse outcomes, including mortality, in the heart failure population

Troska o zdrowie w aspekcie społecznym. Cz. 2

Praca recenzowana / peer-reviewed pape

Zagrożenia zdrowotne wśród dzieci i młodzieży. T. 3

Praca recenzowana / Peer-reviewed pape

Frailty Syndrome in Older Adults with Cardiovascular Diseases–What Do We Know and What Requires Further Research?

Cardiovascular diseases (CVD) affect 60% of people over 60 years of age and are one of the main causes of death in the world. Diagnosed cardiovascular disease also triples the likelihood of Frailty syndrome (FS). FS has become increasingly relevant in cardiology and cardiac surgery and occurs in a significant number of patients with CVD, with prevalence ranging from 25% to 62%. Viewed in a multidimensional, biopsychosocial perspective, FS increases a patient’s vulnerability, making them susceptible to several adverse clinical outcomes. Frailty syndrome also is a predictor of mortality in patients with CVD regardless of age, severity of disease, multi-morbidity, and disability. Frailty syndrome potentially can be prevented in patients with CVD and its early identification is important to avoid the development of disability, dependence on others and reduced quality of life. The aim of this paper is to show the relationship between FS and specific CVDs (coronary artery disease, hypertension, atrial fibrillation, heart failure) and cardiac procedures (device implantation, cardiac surgery, and transcatheter aortic valve implantation). Furthermore, we highlight those areas that require further research to fully understand the relationship between FS and CVD and to be able to minimize or prevent its adverse effects

The Association between Nutritional Status and Length of Hospital Stay among Patients with Hypertension

Background: Nutritional status is related to the prognosis and length of hospital stay (LOS) of patients with hypertension (HT). This study aimed to assess how nutritional status and body mass index (BMI) affect LOS for patients with hypertension. Method: We performed a retrospective analysis of 586 medical records of patients who had been admitted to the Institute of Heart Diseases of the University Clinical Hospital in Wroclaw, Poland. Results: A total of 586 individuals were included in the analysis. Individuals who were at a nutritional risk represented less than 2% of the study population, but more than 60% were overweight or obese. The mean BMI was 28.4 kg/m(2) (SD: 5.16). LOS averaged 3.53 days (SD = 2.78). In the case of obese individuals, hospitalisation lasted for 3.4 ± 2.43 days, which was significantly longer than for patients of normal weight. For underweight patients, hospitalisation lasted for 5.14 ± 2.27 days, which was also significantly longer than for those in other BMI categories (p = 0.017). The independent predictors of shorter hospitalisations involved higher LDL concentration (parameter of regression: −0.015) and HDL concentration (parameter of regression: −0.04). Conclusions: The study revealed that with regard to the nutritional status of hypertensive patients, being either underweight or obese was associated with longer LOS. Additional factors that related to prolonged LOS were lower LDL and HDL levels and higher CRP concentrations