Frequency of infant stroking reported by mothers moderates the effect of prenatal depression on infant behavioural and physiological outcomes

Animal studies find that prenatal stress is associated with increased physiological and emotional reactivity later in life, mediated via fetal programming of the HPA axis through decreased glucocorticoid receptor (GR) gene expression. Post-natal behaviours, notably licking and grooming in rats, cause decreased behavioural indices of fear and reduced HPA axis reactivity mediated via increased GR gene expression. Post-natal maternal behaviours may therefore be expected to modify prenatal effects, but this has not previously been examined in humans. We examined whether, according to self-report, maternal stroking over the first weeks of life modified associations between prenatal depression and physiological and behavioral outcomes in infancy, hence mimicking effects of rodent licking and grooming. From a general population sample of 1233 first time mothers recruited at 20 weeks gestation we drew a stratified random sample of 316 for assessment at 32 weeks based on reported inter-partner psychological abuse, a risk to child development. Of these 271 provided data at 5, 9 and 29 weeks post delivery. Mothers reported how often they stroked their babies at 5 and 9 weeks. At 29 weeks vagal withdrawal to a stressor, a measure of physiological adaptability, and maternal reported negative emotionality were assessed. There was a significant interaction between prenatal depression and maternal stroking in the prediction of vagal reactivity to a stressor (p = .01), and maternal reports of infant anger proneness (p = .007) and fear (p = .043). Increasing maternal depression was associated with decreasing physiological adaptability, and with increasing negative emotionality, only in the presence of low maternal stroking. These initial findings in humans indicate that maternal stroking in infancy, as reported by mothers, has effects strongly resembling the effects of observed maternal behaviours in animals, pointing to future studies of the epigenetic, physiological and behavioral effects of maternal stroking

The relationship of gross upper and lower limb motor competence to measures of health and fitness in adolescents aged 13–14 years

Introduction: Motor competence (MC) is an important factor in the development of health and fitness in adolescence. Aims: This cross-sectional study aims to explore the distribution of MC across 13-14 year old school students and the extent of the relationship of MC to measures of health and fitness across genders. Methods: A total of 718 participants were tested from three different schools in the UK, 311 girls, and 407 boys (aged 13-14 years), pairwise deletion for correlation variables reduced this to 555 (245 girls, 310 boys). Assessments consisted of, body mass index, aerobic capacity, anaerobic power, upper limb and lower limb MC. The distribution of MC and the strength of the relationships between MC and health/fitness measures were explored. Results: Girls performed lower for MC and health/fitness measures compared to boys. Both measures of MC showed a normal distribution and a significant linear relationship of MC to all health and fitness measures for boys, girls, and combined genders. A stronger relationship was reported for upper limb MC and aerobic capacity when compared to lower limb MC and aerobic capacity in boys (t= -2.21, df= 307, p = 0.03, 95%CI -0.253 -0.011). Conclusion: Normally distributed measures of upper and lower limb MC are linearly related to health and fitness measures in adolescents in a UK sample. Trial Registration: NCT0251733

Physical activity, fatigue, and sleep in people with Parkinson’s disease: A secondary per protocol analysis from an intervention trial

Symptoms of Parkinson’s can result in low physical activity and poor sleep patterns which can have a detrimental effect on a person’s quality of life. To date, studies looking into exercise interventions for people with Parkinson’s (PwP) for symptom management are promising but inconclusive. The aim of this study is to estimate the effect of a clearly defined exercise prescription on general physical activity levels, fatigue, sleep, and quality of life in PwP. Method. PwP randomised into either an exercise group (29; 16 males, 13 females; mean age 67 years (7.12)) or a control handwriting group (36; 19 males; 17 females; mean age 67 years (5.88)) as part of a larger trial were included in this substudy if they had completed a 6-month weekly exercise programme (intervention group) and had complete objective physical activity data (intervention and control group). Sleep and fatigue were recorded from self-reported measures, and physical activity levels measured through the use of accelerometers worn 24 hours/day over a seven-day testing period at baseline and following the 24-week intervention. A Wilcoxon’s test followed by a Mann–Whitney post hoc analysis was used, and effect sizes were calculated. Results. Participants showed a significant increase in time spent in sedentary and light activities during the overnight period postintervention in both exercise and handwriting groups (p < 0.05) with a moderate effect found for the change in sedentary and light activities in the overnight hours for both groups, over time (0.32 and 0.37-0.38, resp.). There was no impact on self-reported fatigue or sleep. Conclusion. The observed moderate effect on sedentary and light activities overnight could suggest an objective improvement in sleep patterns for individuals participating in both exercise and handwriting interventions. This supports the need for further studies to investigate the role of behavioural interventions for nonmotor symptoms

The relationship between motor competence, physical activity, cardiorespiratory fitness and BMI in UK adolescents

Purpose: This study set out to identify the extent of the relationships between subsections of the Movement Assessment Battery for Children 2nd Edition - MABC2 (manual dexterity, aiming and catching, and balance) to PA, CRF and BMI in adolescents. Methods: Height, BMI, the MABC2, a 20m shuttle run test and wrist-worn accelerometery PA levels (mins) were measured. Multivariable linear regression models, adjusting for sex, height and BMI were used to assess the relationship of the three subsections of the MABC2 with PA, CRF and BMI. Results: A total of 155 adolescents, aged 13-14 years, took part in this study (77 girls, 78 boys). Balance reported significant relationships with moderate to vigorous PA (unstandardised Beta B=0.15, 95%CI 0.02-0.28), vigorous PA (B=0.06, 95%CI 0.02-0.09) and BMI (B=-0.01, 95%CI -0.02-0.005). Balance in addition to aiming and catching skills were both significantly related to adolescent CRF (B=0.30, 95%CI 0.17-0.42 and B=0.29, 95%CI 0.14-0.45, respectively). Conclusion: This study suggests that balance is the strongest correlate skill to achieving the highest intensities of PA and healthier BMI status in adolescents

Prenatal maternal depression alters amygdala functional connectivity in 6-month-old infants

10.1038/tp.2015.3Translational Psychiatry52GUSTO (Growing up towards Healthy Outcomes

Motor learning in developmental coordination disorder: behavioral and neuroimaging study

Developmental coordination disorder (DCD) is characterized by motor learning deficits that are poorly understood within whole-body activities context. Here we present results of one of the largest non-randomized interventional trials combining brain imaging and motion capture techniques to examine motor skill acquisition and its underpinning mechanisms in adolescents with and without DCD. A total of 86 adolescents with low fitness levels (including 48 with DCD) were trained on a novel stepping task for a duration of 7 weeks. Motor performance during the stepping task was assessed under single and dual-task conditions. Concurrent cortical activation in the prefrontal cortex (PFC) was measured using functional near-infrared spectroscopy (fNIRS). Additionally, structural and functional magnetic resonance imaging (MRI) was conducted during a similar stepping task at the beginning of the trial. The results indicate that adolescents with DCD performed similarly to their peers with lower levels of fitness in the novel stepping task and demonstrated the ability to learn and improve motor performance. Both groups showed significant improvements in both tasks and under single- and dual-task conditions at post-intervention and follow-up compared to baseline. While both groups initially made more errors in the Stroop task under dual-task conditions, at follow-up, a significant difference between single- and dual-task conditions was observed only in the DCD group. Notably, differences in prefrontal activation patterns between the groups emerged at different time points and task conditions. Adolescents with DCD exhibited distinct prefrontal activation responses during the learning and performance of a motor task, particularly when complexity was increased by concurrent cognitive tasks. Furthermore, a relationship was observed between MRI brain structure and function measures and initial performance in the novel stepping task. Overall, these findings suggest that strategies that address task and environmental complexities, while simultaneously enhancing brain activity through a range of tasks, offer opportunities to increase the participation of adolescents with low fitness in physical activity and sports

Effects of a programme of vigorous physical activity during secondary school physical education on academic performance, fitness, cognition, mental health and the brain of adolescents (Fit to Study): Study protocol for a cluster randomised trial

Background. Early adolescence is a period of dynamic neurobiological change. Converging lines of research suggest that regular physical activity (PA) and improved aerobic fitness have the potential to stimulate positive brain changes, improve cognitive function and boost academic attainment in this age group, but high-quality studies are needed to substantiate these findings. The primary aim of the Fit to Study trial is to investigate whether short infusions of vigorous PA (VPA) delivered during secondary school physical education (PE) can improve attainment in maths, as described in a protocol published by NatCen Social Research. The present protocol concerns the trial’s secondary outcome measures, which are variables thought to moderate or mediate the relationship between PA and attainment, including the effect of the intervention on cardiorespiratory fitness, cognitive performance, mental health and brain structure and function. Method. The Fit to Study project is a cluster-randomised controlled trial that includes Year 8 pupils (aged 12–13) from secondary state schools in South/Mid-England. Schools were randomised into an intervention condition in which PE teachers delivered an additional 10 min of VPA per PE lesson for one academic year, or a ‘PE as usual’ control condition. Intervention and control groups were stratified according to whether schools were single-sex or co-educational. Assessments take place at baseline (end of Year 7, aged 11–12) and after 12 months (Year 8). Secondary outcomes are cardiorespiratory fitness, objective PA during PE, cognitive performance and mental health. The study also includes exploratory measures of daytime sleepiness, attitudes towards daily PA and PE enjoyment. A sub-set of pupils from a sub-set of schools will also take part in a brain imaging sub-study, which is embedded in the trial. Discussion. The Fit to Study trial could advance our understanding of the complex relationships between PA and aerobic fitness, the brain, cognitive performance, mental health and academic attainment during adolescence. Further, it will add to our understanding of whether school PE is an effective setting to increase VPA and fitness, which could inform future PA interventions and education policy

A randomised controlled trial of a walking training with simultaneous cognitive demand (dual task) in chronic stroke

Objective. To evaluate the tolerability of, adherence to and efficacy of a community walking training programme with simultaneous cognitive demand (dual‐task) compared to a control walking training programme without cognitive distraction. Methods. Adult stroke survivors, at least 6 months after stroke with a visibly obvious gait abnormality or reduced two‐minute walk distance were included into a 2‐arm parallel randomized controlled trial of complex intervention with blinded assessments. Participants received a 10 week, bi‐weekly, 30 minutes treadmill program at an aerobic training intensity (55‐85% heart rate maximum), either with, or without simultaneous cognitive demands. Outcome measured at 0, 11 and 22 weeks. Primary: two‐minute‐walk tests with and without cognitive distraction, dual task effect on walking and cognition; secondary: SF‐36, EuroQol‐5D‐5L, Physical Activity Scale for Elderly (PASE), and step activity. Results. Fifty stroke patients were included, 43 received allocated training and 45 completed all assessments. The experimental group (n = 26) increased mean (SD) two‐minute walking distance from 90.7 (8.2) to 103.5 (8.2) metres, compared with 86.7 (8.5) to 92.8 (8.6) in the control group, and their PASE score from 74.3 (9.1) to 89.9 (9.4), compared with 94.7 (9.4) to 77.3 (9.9) in the control group. Statistically, only the change in the PASE differed between the groups (p = 0.029), with the dual‐task group improving more. There were no differences in other measures. Conclusions. Walking with specific additional cognitive distraction (dual‐task training) might increase activity more over 12 weeks, but the data are not conclusive

Exercise response in Parkinson’s Disease : insights from a cross-sectional comparison with sedentary controls and a per protocol analysis of a randomised controlled trial

Objectives: To investigate the acute and adaptation cardiovascular and metabolic training responses in people with Parkinson’s (pwP). Design: 1) A cross sectional study of exercise response of pwP compared to sedentary controls,2) an interventional study of exercise training in pwP. Setting: Community leisure facilities. Participants: pwP (n=83) & sedentary controls (n=55) Interventions: Study (1) included participants from a two arm parallel single blind phase II Randomised Controlled Trial (RCT), that undertook a baseline maximal incremental exercise test and study (2) included those randomised to the exercise group in the RCT, who completed a six-month weekly exercise programme (n=37). The intervention (study (2) was a prescribed exercise program consisting of sessions lasting 60 minutes, twice a week over a six-month period. The control group followed the same protocol which derived the same cardio respiratory parameters, except the they were instructed to aim for a cadence of ~60rpm and the unloaded phase lasted 3minutes with an initial step of 25watts. Primary and secondary outcome measures: Stepwise incremental exercise test to volitional exhaustion was the primary outcome measure. Results: Study (1) showed higher maximum values for heart rate, VO2l.min-1, VCO2l.min-1 and Ventilation l.min-1 for the control group; Respiratory Exchange Ratio (RER), perceived exertion and O2 Pulse (VO2l.min-1/ HR) did not differ between groups. In study (2), for pwP who adhered to training (n=37), RER increased significantly and although there was no significant change in aerobic capacity or heart rate response, reduced blood pressure was found. Conclusions: An abnormal cardiovascular response to exercise was observed in pwP compared to controls. After the exercise programme, metabolic deficiencies remained for pwP. These observations add to the pathogenic understanding of PD, acknowledge an underling metabolic contribution and support that certain cardiovascular symptoms may improve as a result of this type of exercise Trial registration: ClinicalTrials.Gov (NCT01439022)