Efficacy of Neurofeedback on the Increase of Mindfulness-Related Capacities in Healthy Individuals: a Controlled Trial

Electroencephalogram (EEG) studies of mindfulness have shown it can lead to increases in alpha power, which are similar to those obtained by alpha-based neurofeedback (NF) interventions. It has been hypothesized there may be relationships between mindfulness and NF in terms of the neural pathways through which they induce salutary outcomes. The aim of the study was to evaluate possible changes in mindfulness and cognitive functioning following an alpha-based NF intervention, and the role of alpha power as a mediator of improvements. A controlled, non-randomized, trial with 50 healthy participants was conducted with two experimental conditions: a six-session NF intervention and a waiting-list control group. Both groups were administered mindfulness questionnaires (Mindful Attention Awareness Scale (MAAS), Five Facet Mindfulness Questionnaire (FFMQ)) and cognitive measures (Paced Auditory Serial Addition Task (PASAT)), at pre- and post-test. The NF intervention focused on the up-regulation of upper alpha power. Differences among groups were estimated using ANCOVAs, and mediation assessment through path analyses. Compared to controls, the NF group showed enhanced task-related upper alpha power (effect size (ES) = 1.16, p < 0.001), mindfulness outcomes (MAAS: ES = 0.94, p = 0.004; FFMQ: ES = 1.38, p < 0.001), and a trend of cognitive functioning (PASAT time: ES = 0.59, p = 0.062). Upper alpha power had a mediating effect for cognitive functioning (PASAT errors: indirect effect = 0.81, 95% CI = 0.21–1.85), but not for mindfulness. These results demonstrate the effectiveness of NF for increasing mindfulness in healthy individuals with no previous experience in mindfulness or neurofeedback training, suggesting that NF may be an acceptable method of augmenting mindfulness-related capacities in the general population

Opportunistic infections and AIDS malignancies early after initiating combination antiretroviral therapy in high-income countries

Background: There is little information on the incidence of AIDS-defining events which have been reported in the literature to be associated with immune reconstitution inflammatory syndrome (IRIS) after combined antiretroviral therapy (cART) initiation. These events include tuberculosis, mycobacterium avium complex (MAC), cytomegalovirus (CMV) retinitis, progressive multifocal leukoencephalopathy (PML), herpes simplex virus (HSV), Kaposi sarcoma, non-Hodgkin lymphoma (NHL), cryptococcosis and candidiasis. Methods: We identified individuals in the HIV-CAUSAL Collaboration, which includes data from six European countries and the US, who were HIV-positive between 1996 and 2013, antiretroviral therapy naive, aged at least 18 years, hadCD4+ cell count and HIV-RNA measurements and had been AIDS-free for at least 1 month between those measurements and the start of follow-up. For each AIDS-defining event, we estimated the hazard ratio for no cART versus less than 3 and at least 3 months since cART initiation, adjusting for time-varying CD4+ cell count and HIV-RNA via inverse probability weighting. Results: Out of 96 562 eligible individuals (78% men) with median (interquantile range) follow-up of 31 [13,65] months, 55 144 initiated cART. The number of cases varied between 898 for tuberculosis and 113 for PML. Compared with non-cART initiation, the hazard ratio (95% confidence intervals) up to 3 months after cART initiation were 1.21 (0.90-1.63) for tuberculosis, 2.61 (1.05-6.49) for MAC, 1.17 (0.34-4.08) for CMV retinitis, 1.18 (0.62-2.26) for PML, 1.21 (0.83-1.75) for HSV, 1.18 (0.87-1.58) for Kaposi sarcoma, 1.56 (0.82-2.95) for NHL, 1.11 (0.56-2.18) for cryptococcosis and 0.77 (0.40-1.49) for candidiasis. Conclusion: With the potential exception of mycobacterial infections, unmasking IRIS does not appear to be a common complication of cART initiation in high-income countries