The therapeutic potential of exercise to improve mood, cognition, and sleep in Parkinson's disease

Published in final edited form as: Mov Disord. 2016 January ; 31(1): 23–38. doi:10.1002/mds.26484.In addition to the classic motor symptoms, Parkinson's disease (PD) is associated with a variety of nonmotor symptoms that significantly reduce quality of life, even in the early stages of the disease. There is an urgent need to develop evidence‐based treatments for these symptoms, which include mood disturbances, cognitive dysfunction, and sleep disruption. We focus here on exercise interventions, which have been used to improve mood, cognition, and sleep in healthy older adults and clinical populations, but to date have primarily targeted motor symptoms in PD. We synthesize the existing literature on the benefits of aerobic exercise and strength training on mood, sleep, and cognition as demonstrated in healthy older adults and adults with PD, and suggest that these types of exercise offer a feasible and promising adjunct treatment for mood, cognition, and sleep difficulties in PD. Across stages of the disease, exercise interventions represent a treatment strategy with the unique ability to improve a range of nonmotor symptoms while also alleviating the classic motor symptoms of the disease. Future research in PD should include nonmotor outcomes in exercise trials with the goal of developing evidence‐based exercise interventions as a safe, broad‐spectrum treatment approach to improve mood, cognition, and sleep for individuals with PD.This work was supported by the National Institute of Mental Health (F31MH102961 to G.O.R.)

A latent class analysis of parental bipolar disorder: examining associations with offspring psychopathology

Bipolar disorder (BD) is highly heterogeneous, and course variations are associated with patient outcomes. This diagnostic complexity challenges identification of patients in greatest need of intervention. Additionally, course variations have implications for offspring risk. First, latent class analysis (LCA) categorized parents with BD based on salient illness characteristics: BD type, onset age, polarity of index episode, pole of majority of episodes, rapid cycling, psychosis, anxiety comorbidity, and substance dependence. Fit indices favored three parental classes with some substantively meaningful patterns. Two classes, labeled “Earlier-Onset Bipolar-I” (EO-I) and “Earlier-Onset Bipolar-II” (EO-II), comprised parents who had a mean onset age in mid-adolescence, with EO-I primarily BD-I parents and EO-II entirely BD-II parents. The third class, labeled “Later-Onset BD” (LO) had an average onset age in adulthood. Classes also varied on probability of anxiety comorbidity, substance dependence, psychosis, rapid cycling, and pole of majority of episodes. Second, we examined rates of disorders in offspring (ages 4–33, Mage=13.46) based on parental latent class membership. Differences emerged for offspring anxiety disorders only such that offspring of EO-I and EO-II parents had higher rates, compared to offspring of LO parents, particularly for daughters. Findings may enhance understanding of BD and its nosologyThis study was funded by two Brain & Behavior Research Foundation (formerly NARSAD) Independent Investigator Awards (PI: Nierenberg), a Brain & Behavior Research Foundation Young Investigator Award (PI: Henin) generously supported in part by the SHINE Initiative, and an MGH Claflin Award (PI: Henin). We thank David A. Langer, Ph.D., Thomas M. Olino, Ph.D., and Meredith Lotz Wallace, Ph.D. for their consultation. (Brain & Behavior Research Foundation; Brain & Behavior Research Foundation Young Investigator Award; SHINE Initiative; MGH Claflin Award)Accepted manuscrip

Attending to Emotional Cues for Drug Abuse: Bridging the Gap Between Clinic and Home Behaviors

Classical conditioning models of addiction provide keys to understanding the vexing discrepancy between substance abuse patients’ desire to abstain when they are in therapy sessions and their tendency to relapse. Experiments using these models demonstrate the power of environmental relapse cues and support clinical approaches, including active exposure, aimed at helping patients recognize and withstand them. Internal cues, including emotions and somatic states such as withdrawal, can trigger urges as powerfully as external cues such as people, places, and things associated with prior abuse. The authors describe a cognitive-behavioral therapy approach that focuses on identifying and actively inducing each patient’s high-risk emotions, then helping him or her develop and practice healthy responses. Clinical trials support the approach for patients with panic disorder who have trouble discontinuing benzodiazepines, and early trials suggest it may be useful for patients addicted to other drugs as well

Tax evasion and exchange equity: a reference-dependent approach

The standard portfolio model of tax evasion with a public good produces the perverse conclusion that when taxpayers perceive the public good to be under-/overprovided, an increase in the tax rate increases/decreases evasion. The author treats taxpayers as thinking in terms of gains and losses relative to an endogenous reference level, which reflects perceived exchange equity between the value of taxes paid and the value of public goods supplied. With these alternative behavioral assumptions, the author overturns the aforementioned result in a direction consistent with the empirical evidence. The author also finds a role for relative income in determining individual responses to a change in the marginal rate of tax

Does d-cycloserine facilitate the effects of homework compliance on social anxiety symptom reduction?

BACKGROUND: Prior studies examining the effect of d-cycloserine (DCS) on homework compliance and outcome in cognitive-behavior therapy (CBT) have yielded mixed results. The aim of this study was to investigate whether DCS facilitates the effects of homework compliance on symptom reduction in a large-scale study for social anxiety disorder (SAD). METHODS: 169 participants with generalized SAD received DCS or pill placebo during 12-session exposure-based group CBT. Improvements in social anxiety were assessed by independent raters at each session using the Liebowitz social anxiety scale (LSAS). RESULTS: Controlling for LSAS at the previous session, and irrespective of treatment condition, greater homework compliance in the week prior related to lower LSAS at the next session. However, DCS did not moderate the effect of homework compliance and LSAS, LSAS on homework compliance, or the overall augmenting effect of DCS on homework compliance. Furthermore, LSAS levels were not predictive of homework compliance in the following week. CONCLUSION: The findings support the general benefits of homework compliance on outcome, but not a DCS-augmenting effect. The comparably small number of DCS-enhanced sessions in this study could be one reason for the failure to find a facilitating effect of DCS

Fish community response to in-channel woody debris in a channelized river system

Additions of large wood (LW) have become a go-to technique for recovering altered river ecosystems. However, successful applications of this technique are generally limited to unchannelized rivers and headwater streams. Channelization of rivers, that is, engineering river channels to reduce recruitment and retention of in-channel structure, may, by definition, limit success of this restoration technique. Moreover, sufficient time has passed (a century or more) since initial channelization of many large rivers that portions of the fish community associated with LW may have become extirpated. Thus, the maxim that LW leads to a positive fish community response may not hold true. We examined fish community associations in habitats with and without LW in the channelized Missouri River to gain an understanding of the role of LW in large, channelized rivers. There were some differences between habitats with wood present compared to those without, but the differences were not evident once year, season and channel modifications intended to create aquatic habitat were taken into account. We assert that careful planning is necessary to ensure that additions of LW in channelized rivers are made to appropriate locations such that it will be retained in-channel for use as fish habitat and that LW-associated species are found in the system

Enhancement of psychosocial treatment with D-cycloserine: models, moderators, and future directions

Advances in the understanding of the neurobiology of fear extinction have resulted in the development of d-cycloserine (DCS), a partial glutamatergic N-methyl-D-aspartate agonist, as an augmentation strategy for exposure treatment. We review a decade of research that has focused on the efficacy of DCS for augmenting the mechanisms (e.g., fear extinction) and outcome of exposure treatment across the anxiety disorders. Following a series of small-scale studies offering strong support for this clinical application, more recent larger-scale studies have yielded mixed results, with some showing weak or no effects. We discuss possible explanations for the mixed findings, pointing to both patient and session (i.e., learning experiences) characteristics as possible moderators of efficacy, and offer directions for future research in this area. We also review recent studies that have aimed to extend the work on DCS augmentation of exposure therapy for the anxiety disorders to DCS enhancement of learning-based interventions for addiction, anorexia nervosa, schizophrenia, and depression. Here, we attend to both DCS effects on facilitating therapeutic outcomes and additional therapeutic mechanisms beyond fear extinction (e.g., appetitive extinction, hippocampal-dependent learning).F31 MH103969 - NIMH NIH HHS; K24 DA030443 - NIDA NIH HHS; R34 MH099309 - NIMH NIH HHS; R34 MH086668 - NIMH NIH HHS; R21 MH102646 - NIMH NIH HHS; R34 MH099318 - NIMH NIH HH

Beyond SELinux: the Case for Behavior-Based Policy and Trust Languages

Despite the availability of powerful mechanisms for security policy and access control, real-world information security practitioners---both developers and security officers---still find themselves in need of something more. We believe that this is the case because available policy languages do not provide clear and intelligible ways to allow developers to communicate their knowledge and expectations of trustworthy behaviors and actual application requirements to IT administrators. We work to address this policy engineering gap by shifting the focus of policy language design to this communication via behavior-based policies and their motivating scenarios

Identifying and Correcting Biases in Digital Image Correlation at Multiple Length Scales

Accurate strain measurement at grain and sub-grain levels is important to predict and understand crack initiation during fatigue of materials. During cyclic loading, low magnitude strain is accumulated in the material and any distortion in the images can lead to inaccurate strain measurements and false prediction of the material’s behavior. Digital Image Correlation (DIC) is a reliable tool used to measure strain localization by correlating images before, during, and after cyclic loading. DIC tracks the deformation of nano/micro-scale patterns placed on the surface of the specimens to determine strain fields. However, DIC software does not account for biases due to specimen misalignment, stress relaxation, light and contrast divergences, or image distortions when using Scanning Electron Microscopy (SEM). The work presented here establishes a protocol to collect and correct images that accounts for the biases induced during SEM capture. This protocol describes a procedure for image capture and a specific post-processing computational technique for distortion correction on SEM images. The combination of both methodologies allows for unbiased strain measurement and localization when using DIC software at different length scales