Functional MRI and the Wada test provide complementary information for predicting post-operative seizure control

AbstractPrediction of post-surgical seizure relief and potential cognitive deficits secondary to anterior temporal lobectomy (ATL) are important to pre-surgical planning. Although the intracarotid amobarbital test (IAT) is predictive of post-ATL seizure outcome, development of non-invasive and more precise means for determining post-ATL seizure relief are needed. We previously reported on a technique utilizing functional MRI (fMRI) to evaluate the relative functional adequacy of mesial temporal lobe structures in preparation for ATL . In the present study, we report follow-up outcome data on eight temporal lobe epilepsy (TLE) patients 1-year post-ATL who were evaluated pre-surgically using IAT and fMRI. Functional memory lateralization using fMRI predicted post-ATL seizure outcome as effectively as the IAT. In general, asymmetry of functional mTL activation favouring the non-epileptic hemisphere was associated with seizure-free status at 1-year follow-up. Moreover, when combined, fMRI and IAT provided complementary data that resulted in improved prediction of post-operative seizure control compared with either procedure alone

Sleep and Resilience during the COVID-19 Pandemic

Since early 2020, the COVID-19 pandemic has had a profound effect on the mental health and wellbeing of much of the population. Rates of depression, anxiety, loneliness, suicidal ideation, and other mental health concerns increased during the first year of the pandemic, with heightened fears of the virus, social isolation, and economic instability. Psychological resilience remains a key factor in sustaining healthy emotional functioning during the crisis and facilitating rapid recovery as we move forward to build a better post-pandemic world. Our research, and that of others, suggests that healthy sleep is one of the most powerful aspects of psychological resilience. This chapter will summarize the current literature on psychological resilience, particularly as it relates to the pandemic, and describe the important role of sleep as a key component of resilience capacity. We will discuss novel empirical data linking sleep and resilience during the pandemic. We will conclude with concrete, empirically based suggestions for modulating sleep to sustain psychological resilience during the present crisis and those that may emerge in the future

Yearning predicts subgenual anterior cingulate activity in bereaved individuals

Complicated grief, or persistent complex bereavement disorder, is a condition that affects approximately 10% of bereaved individuals and is marked by intense longing and yearning for the deceased. Little is known about the neurocognitive mechanisms contributing to this syndrome, but previous research suggests that reward pathways in the brain may play a role. Twenty-five older adults were categorized based on grief severity into one of three groups: complicated grief (CG), non-complicated grief (NCG) and non-bereaved married controls (NB). Neural activation was examined using fMRI while participants viewed a countdown on the screen (anticipation) followed by a photo of their (living or deceased) spouse. There was no significantly differential activation between the three groups for the spouse v. stranger photo contrast, nor for anticipation period v. spouse photo. Post-hoc analyses were conducted using self-reported yearning scores as a regressor across all bereaved participants, which revealed that greater symptoms of yearning predicted greater activation in the subgenual anterior cingulate cortex (sgACC). Given the small sample size, the results should be considered preliminary and in need of replication, but may suggest a more nuanced, transdiagnostic role of the sgACC. This region of the brain has been previously linked to depression and suggests that symptoms of yearning may present an opportune place to intervene to improve outcomes in CG

Sleep deprivation impairs recognition of specific emotions

Emotional processing is particularly sensitive to sleep deprivation, but research on the topic has been limited and prior studies have generally evaluated only a circumscribed subset of emotion categories. Here, we evaluated the effects of one night of sleep deprivation and a night of subsequent recovery sleep on the ability to identify the six most widely agreed upon basic emotion categories (happiness, surprise, fear, sadness, disgust, anger). Healthy adults (29 males; 25 females) classified a series of 120 standard facial expressions that were computer morphed with their most highly confusable expression counterparts to create continua of expressions that differed in discriminability between emotion categories (e.g., combining 70% happiness+30% surprise; 90% surprise+10% fear). Accuracy at identifying the dominant emotion for each morph was assessed after a normal night of sleep, again following a night of total sleep deprivation, and finally after a night of recovery sleep. Sleep deprivation was associated with significantly reduced accuracy for identifying the expressions of happiness and sadness in the morphed faces. Gender differences in accuracy were not observed and none of the other emotions showed significant changes as a function of sleep loss. Accuracy returned to baseline after recovery sleep. Findings suggest that sleep deprivation adversely affects the recognition of subtle facial cues of happiness and sadness, the two emotions that are most relevant to highly evolved prosocial interpersonal interactions involving affiliation and empathy, while the recognition of other more primitive survival-oriented emotional face cues may be relatively robust against sleep loss. Keywords: Sleep deprivation, Emotion recognition, Facial expression, Perceptio

Insomnia and daytime sleepiness: risk factors for sports-related concussion

Objective/Background: Poor quality and inadequate sleep are associated with impaired cognitive, motor, and behavioral components of sport performance and increased injury risk. While prior work identifies sports-related concussions as predisposing factors for poor sleep, the role of sleep as a sports-related concussion risk factor is unknown. The purpose of this study was to quantify the effect of poor sleep quality and insomnia symptoms on future sports-related concussion risk. Patients/Methods: In this study, 190 NCAA Division-1 athletes completed a survey battery, including the Insomnia Severity Index (ISI) and National Health and Nutrition Examination Survey (NHANES) Sleep module. Univariate risk ratios for future sports-related concussions were computed with ISI and NHANES sleepiness scores as independent predictors. An additional multiple logistic regression model including sport, sports-related concussion history, and significant univariate predictors jointly assessed the odds of sustaining a concussion. Results: Clinically moderate-to-severe insomnia severity (RR = 3.13, 95% CI: 1.320-7.424, p = 0.015) and excessive daytime sleepiness two or more times per month (RR = 2.856, 95% CI: 0.681-11.977, p = 0.037) increased concussion risk. These variables remained significant and comparable in magnitude in a multivariate model adjusted for sport participation. Conclusion: Insomnia and daytime sleepiness are independently associated with increased sports-related concussion risk. More completely identifying bidirectional relationships between concussions and sleep requires further research. Clinicians and athletes should be cognizant of this relationship and take proactive measures - including assessing and treating sleep-disordered breathing, limiting insomnia risk factors, improving sleep hygiene, and developing daytime sleepiness management strategies e to reduce sports-related concussion risk and support overall athletic performance. (C) 2019 Elsevier B.V. All rights reserved.Innovations grant from the National Collegiate Athletic Association; US Army Medical Research and Materiel Command grant [W81XWH14-1-0571]; [R01 MD011600]12 month embargo; published online: 25 March 2019This item from the UA Faculty Publications collection is made available by the University of Arizona with support from the University of Arizona Libraries. If you have questions, please contact us at [email protected]

Increasing aggression during the COVID-19 lockdowns

Background: To combat the spread of COVID-19, many communities implemented restrictions on personal movement, often referred to as “lockdowns.” We hypothesized that continued lockdowns might be associated with increased feelings of aggression. Methods: Over the first six months of the COVID-19 pandemic, the Buss-Perry Aggression Questionnaire (BPAQ) was administered to a total of 5,928 adults distributed proportionally from across the United States during independent online cross-sectional surveys collected each month. Data across the 6-month period were compared between those under lockdown versus those not under such restrictions. Results: BPAQ Total Aggression scores showed a significant main effect for both month and lockdown status as well as a significant interaction effect, with increasing scores evident for those reporting that they were under lockdown relative to those reporting no restrictions. This same pattern was evident for all four subscales of the BPAQ, including Physical Aggression, Verbal Aggression, Anger, and Hostility. Limitations: Random sampling of the entire population was not possible, so generalization of the results should be made with caution. Additionally, data were collected cross-sectionally and cannot be considered to reflect longitudinal change within individuals. Finally, the cross-sectional survey design means that it is impossible to infer that the lockdowns caused the increase in aggression. Conclusions: Lockdowns were associated with elevated levels of aggression that were higher in later months of the national pandemic response

Insomnia and the Interpersonal Theory of suicide among civilians, service members, and veterans

Background: Insomnia is associated with suicide risk in civilian and military populations. Thwarted belongingness is proposed as a mediator of this relationship under the Interpersonal Theory of Suicide (IPTS). The present study explored how insomnia relates to suicidal ideation in conjunction with thwarted belongingness among civilians, Service members, and Veterans. Methods. Data from the Military Suicide Research Consortium for N = 6556 individuals (6316 with non-missing suicidal ideation status) were divided into 4 subgroups: civilians, never deployed Service members, previously deployed Service members, and Veterans. Robust Poisson models evaluated the associations between insomnia severity/subtype and current suicidal ideation, with bootstrap mediation models assessing thwarted belongingness as a mediator. Results. A 5-point increase in insomnia severity was associated with a 38% increased risk for current suicidal ideation among civilians, a 56% greater risk among never deployed Service members, an 83% greater risk among previously deployed Service members, and a 37% greater risk among Veterans. Moreover, active Service members showed greater associations between difficulty falling asleep and staying asleep with suicidal ideation than civilians. These associations were independent of covariates and only mediated by thwarted belongingness among Veterans. Conclusions. The relationship between insomnia and suicide is not purely explained by thwarted belongingness except among Veterans. Future research should explore additional psychological and neurobiological mechanisms connecting insomnia and suicidality.US Department of Defense12 month embargo; available online: 27 September 2022This item from the UA Faculty Publications collection is made available by the University of Arizona with support from the University of Arizona Libraries. If you have questions, please contact us at [email protected]