Risk Ahead:Actigraphy-Based Early-Warning Signals of Increases in Depressive Symptoms During Antidepressant Discontinuation

Antidepressant discontinuation increases the risk of experiencing depressive symptoms. In a repeated single-subject design, we tested whether transitions in depression were preceded by increases in actigraphy-based critical-slowing-down-based early-warning signals (EWSs; variance, kurtosis, autocorrelation), circadian-rhythm-based indicators, and decreases in mean activity levels. Four months of data from 16 individuals with a transition in depression and nine without a transition in depression were analyzed using a moving-window method. As expected, more participants with a transition showed at least one EWS (50% true positives; 22.2% false positives). Increases in circadian rhythm variables (25.0% true positives vs. 44.4% false positives) and decreases in activity levels (37.5% true positives vs. 44.4% false positives) were more common in participants without a transition. None of the tested risk indicators could confidently predict upcoming transitions in depression, but some evidence was found that critical-slowing-down-based EWSs were more common in participants with a transition.</p

Risk Ahead:Actigraphy-Based Early-Warning Signals of Increases in Depressive Symptoms During Antidepressant Discontinuation

Antidepressant discontinuation increases the risk of experiencing depressive symptoms. In a repeated single-subject design, we tested whether transitions in depression were preceded by increases in actigraphy-based critical-slowing-down-based early-warning signals (EWSs; variance, kurtosis, autocorrelation), circadian-rhythm-based indicators, and decreases in mean activity levels. Four months of data from 16 individuals with a transition in depression and nine without a transition in depression were analyzed using a moving-window method. As expected, more participants with a transition showed at least one EWS (50% true positives; 22.2% false positives). Increases in circadian rhythm variables (25.0% true positives vs. 44.4% false positives) and decreases in activity levels (37.5% true positives vs. 44.4% false positives) were more common in participants without a transition. None of the tested risk indicators could confidently predict upcoming transitions in depression, but some evidence was found that critical-slowing-down-based EWSs were more common in participants with a transition.</p

Risk Ahead:Actigraphy-Based Early-Warning Signals of Increases in Depressive Symptoms During Antidepressant Discontinuation

Antidepressant discontinuation increases the risk of experiencing depressive symptoms. In a repeated single-subject design, we tested whether transitions in depression were preceded by increases in actigraphy-based critical-slowing-down-based early-warning signals (EWSs; variance, kurtosis, autocorrelation), circadian-rhythm-based indicators, and decreases in mean activity levels. Four months of data from 16 individuals with a transition in depression and nine without a transition in depression were analyzed using a moving-window method. As expected, more participants with a transition showed at least one EWS (50% true positives; 22.2% false positives). Increases in circadian rhythm variables (25.0% true positives vs. 44.4% false positives) and decreases in activity levels (37.5% true positives vs. 44.4% false positives) were more common in participants without a transition. None of the tested risk indicators could confidently predict upcoming transitions in depression, but some evidence was found that critical-slowing-down-based EWSs were more common in participants with a transition.</p

Risk Ahead:Actigraphy-Based Early-Warning Signals of Increases in Depressive Symptoms During Antidepressant Discontinuation

Antidepressant discontinuation increases the risk of experiencing depressive symptoms. In a repeated single-subject design, we tested whether transitions in depression were preceded by increases in actigraphy-based critical-slowing-down-based early-warning signals (EWSs; variance, kurtosis, autocorrelation), circadian-rhythm-based indicators, and decreases in mean activity levels. Four months of data from 16 individuals with a transition in depression and nine without a transition in depression were analyzed using a moving-window method. As expected, more participants with a transition showed at least one EWS (50% true positives; 22.2% false positives). Increases in circadian rhythm variables (25.0% true positives vs. 44.4% false positives) and decreases in activity levels (37.5% true positives vs. 44.4% false positives) were more common in participants without a transition. None of the tested risk indicators could confidently predict upcoming transitions in depression, but some evidence was found that critical-slowing-down-based EWSs were more common in participants with a transition.</p

Risk Ahead:Actigraphy-Based Early-Warning Signals of Increases in Depressive Symptoms During Antidepressant Discontinuation

Antidepressant discontinuation increases the risk of experiencing depressive symptoms. In a repeated single-subject design, we tested whether transitions in depression were preceded by increases in actigraphy-based critical-slowing-down-based early-warning signals (EWSs; variance, kurtosis, autocorrelation), circadian-rhythm-based indicators, and decreases in mean activity levels. Four months of data from 16 individuals with a transition in depression and nine without a transition in depression were analyzed using a moving-window method. As expected, more participants with a transition showed at least one EWS (50% true positives; 22.2% false positives). Increases in circadian rhythm variables (25.0% true positives vs. 44.4% false positives) and decreases in activity levels (37.5% true positives vs. 44.4% false positives) were more common in participants without a transition. None of the tested risk indicators could confidently predict upcoming transitions in depression, but some evidence was found that critical-slowing-down-based EWSs were more common in participants with a transition.</p

Results of Fetal Ultrasound Imaging and Doppler Ultrasound Study in Pregnant Women with Extragenital Pathology

The aim of this research was to study the parameters of fetal ultrasound imaging and Doppler ultrasound study in pregnant women with extragenital diseases (EGDs) during the treatment regimes with and without hyperbaric oxygen therapy (HBOT). Materials and Methods: A total of 235 pregnant women were examined prospectively at 5 to 40 weeks of gestation. The main group included 191 women with EGDs (anemia, arterial hypertension, chronic pyelonephritis); the control group included 44 women with physiological pregnancy without EGDs. Evaluation of treatment efficacy was based on data from clinical and laboratory findings before treatment and after its completion. The following hardware methods of research were performed: ultrasonography, fetometry, dopplerometric study of fetoplacental complex. Results: Based on data obtained from this study, the following findings were made: - In the early stages of gestation, there were no disturbances in fetoplacental blood circulation. - Starting the 19th week of pregnancy, there is a significant increase in the uterine artery resistive index in pregnant women with arterial hypertension. - In women with a high perinatal risk on the background of the studied EGDs, the third trimester of pregnancy, despite the ongoing conventional treatment, is characterized by persistent impairment in fetoplacental blood circulation. - The inclusion of HBOT in complex therapy in the early stages of pregnancy in women with a high perinatal risk allows leveling out the inevitable disturbances in fetoplacental blood circulation on the background of the studied EGDs

Concussion, Microvascular Injury, and Early Tauopathy in Young Athletes After Impact Head Injury and an Impact Concussion Mouse Model

The mechanisms underpinning concussion, traumatic brain injury, and chronic traumatic encephalopathy, and the relationships between these disorders, are poorly understood. We examined post-mortem brains from teenage athletes in the acute-subacute period after mild closed-head impact injury and found astrocytosis, myelinated axonopathy, microvascular injury, perivascular neuroinflammation, and phosphorylated tau protein pathology. To investigate causal mechanisms, we developed a mouse model of lateral closed-head impact injury that uses momentum transfer to induce traumatic head acceleration. Unanaesthetized mice subjected to unilateral impact exhibited abrupt onset, transient course, and rapid resolution of a concussion-like syndrome characterized by altered arousal, contralateral hemiparesis, truncal ataxia, locomotor and balance impairments, and neurobehavioural deficits. Experimental impact injury was associated with axonopathy, blood-brain barrier disruption, astrocytosis, microgliosis (with activation of triggering receptor expressed on myeloid cells, TREM2), monocyte infiltration, and phosphorylated tauopathy in cerebral cortex ipsilateral and subjacent to impact. Phosphorylated tauopathy was detected in ipsilateral axons by 24 h, bilateral axons and soma by 2 weeks, and distant cortex bilaterally at 5.5 months post-injury. Impact pathologies co-localized with serum albumin extravasation in the brain that was diagnostically detectable in living mice by dynamic contrast-enhanced MRI. These pathologies were also accompanied by early, persistent, and bilateral impairment in axonal conduction velocity in the hippocampus and defective long-term potentiation of synaptic neurotransmission in the medial prefrontal cortex, brain regions distant from acute brain injury. Surprisingly, acute neurobehavioural deficits at the time of injury did not correlate with blood-brain barrier disruption, microgliosis, neuroinflammation, phosphorylated tauopathy, or electrophysiological dysfunction. Furthermore, concussion-like deficits were observed after impact injury, but not after blast exposure under experimental conditions matched for head kinematics. Computational modelling showed that impact injury generated focal point loading on the head and seven-fold greater peak shear stress in the brain compared to blast exposure. Moreover, intracerebral shear stress peaked before onset of gross head motion. By comparison, blast induced distributed force loading on the head and diffuse, lower magnitude shear stress in the brain. We conclude that force loading mechanics at the time of injury shape acute neurobehavioural responses, structural brain damage, and neuropathological sequelae triggered by neurotrauma. These results indicate that closed-head impact injuries, independent of concussive signs, can induce traumatic brain injury as well as early pathologies and functional sequelae associated with chronic traumatic encephalopathy. These results also shed light on the origins of concussion and relationship to traumatic brain injury and its aftermath.awx350media15713427811001