Genetic Risk Score Predicts Late-Life Cognitive Impairment

Introduction. A family history of Alzheimer's disease is a significant risk factor for its onset, but the genetic risk associated with possessing multiple risk alleles is still poorly understood. Methods. In a sample of 95 older adults (Mean age = 75.1, 64.2% female), we constructed a genetic risk score based on the accumulation of risk alleles in BDNF, COMT, and APOE. A neuropsychological evaluation and consensus determined cognitive status (44 nonimpaired, 51 impaired). Logistic regression was performed to determine whether the genetic risk score predicted cognitive impairment above and beyond that associated with each gene. Results. An increased genetic risk score was associated with a nearly 4-fold increased risk of cognitive impairment (OR = 3.824, P = .013) when including the individual gene polymorphisms as covariates in the model. Discussion. A risk score combining multiple genetic influences may be more useful in predicting late-life cognitive impairment than individual polymorphisms

Cognitive and behavioral predictors of light therapy use

Objective: Although light therapy is effective in the treatment of seasonal affective disorder (SAD) and other mood disorders, only 53-79% of individuals with SAD meet remission criteria after light therapy. Perhaps more importantly, only 12-41% of individuals with SAD continue to use the treatment even after a previous winter of successful treatment. Method: Participants completed surveys regarding (1) social, cognitive, and behavioral variables used to evaluate treatment adherence for other health-related issues, expectations and credibility of light therapy, (2) a depression symptoms scale, and (3) self-reported light therapy use. Results: Individuals age 18 or older responded (n = 40), all reporting having been diagnosed with a mood disorder for which light therapy is indicated. Social support and self-efficacy scores were predictive of light therapy use (p's<.05). Conclusion: The findings suggest that testing social support and self-efficacy in a diagnosed patient population may identify factors related to the decision to use light therapy. Treatments that impact social support and self-efficacy may improve treatment response to light therapy in SAD. © 2012 Roecklein et al

Standards in Pupillography

The number of research groups studying the pupil is increasing, as is the number of publications. Consequently, new standards in pupillography are needed to formalize the methodology including recording conditions, stimulus characteristics, as well as suitable parameters of evaluation. Since the description of intrinsically photosensitive retinal ganglion cells (ipRGCs) there has been an increased interest and broader application of pupillography in ophthalmology as well as other fields including psychology and chronobiology. Color pupillography plays an important role not only in research but also in clinical observational and therapy studies like gene therapy of hereditary retinal degenerations and psychopathology. Stimuli can vary in size, brightness, duration, and wavelength. Stimulus paradigms determine whether rhodopsin-driven rod responses, opsin-driven cone responses, or melanopsin-driven ipRGC responses are primarily elicited. Background illumination, adaptation state, and instruction for the participants will furthermore influence the results. This standard recommends a minimum set of variables to be used for pupillography and specified in the publication methodologies. Initiated at the 32nd International Pupil Colloquium 2017 in Morges, Switzerland, the aim of this manuscript is to outline standards in pupillography based on current knowledge and experience of pupil experts in order to achieve greater comparability of pupillographic studies. Such standards will particularly facilitate the proper application of pupillography by researchers new to the field. First we describe general standards, followed by specific suggestions concerning the demands of different targets of pupil research: the afferent and efferent reflex arc, pharmacology, psychology, sleepiness-related research and animal studies

Surface facial electromyography, skin conductance, and self-reported emotional responses to light- and season-relevant stimuli in seasonal affective disorder

Background: Learned associations between depressive behavior and environmental stimuli signaling low light availability and winter season may play a role in seasonal affective disorder (SAD). The purpose of this study was to determine whether light and season environmental cues elicit emotional responses that are distinct in individuals with SAD. Methods: Twenty-four currently depressed SAD participants were compared to 24 demographicallymatched controls with no depression history on emotional responses to outdoor scenes captured under two light intensity (i.e., clear, sunny vs. overcast sky) and three season (i.e., summer with green leaves, fall with autumn foliage, and winterwith bare trees) conditions. Emotion measures included surface facial electromyography (EMG) activity in the corrugator supercilii and zygomaticus major muscle regions, skin conductance, and self-reported mood state on the Profile of Mood States Depression–Dejection Subscale. Results: Light intensity was a more salient cue than season in determining emotional reactions among SAD participants. Relative to controls, SAD participants displayed more corrugator activity, more frequent significant skin conductance responses (SCR), greater SCR magnitude, and more self-reported depressed mood in response to overcast stimuli and less corrugator activity, lower SCR magnitude, and less self-reported depressed mood in response to sunny stimuli. Limitations: Study limitations include the single, as opposed to repeated, assessment and the lack of a nonseasonal depression group. Conclusions: These findings suggest that extreme emotional reactivity to light-relevant stimuli may be a correlate of winter depression; and future work should examine its potential onset or maintenance significance

Cognitive-behavioral therapy, light therapy, and their combination in treating seasonal affective disorder

Background: The need to develop supplementary or alternative treatments for seasonal affective disorder (SAD) is underscored by the significant minority (47%) of SAD patients that is refractory to light therapy, the persistence of residual symptoms despite light treatment, and poor long-term compliance with light use. Because preliminary studies suggest that cognitive and behavioral factors are involved in SAD, cognitive-behavioral therapy (CBT) warrants investigation as a possible treatment option. Methods: We piloted a 6-week randomized clinical trial to compare a standard light therapy protocol; a novel, SAD-tailored, group CBT intervention; and their combination in ameliorating and remitting a current SAD episode and as prophylaxis against episode recurrence. Depressive symptom severity and remission rates were assessed at post-treatment and at a 1-year follow-up visit to examine long-term treatment durability. Results: CBT, light therapy, and their combination all demonstrated significant reductions in depressive symptoms on two different outcome measures. Remission rates varied by measure, but did not reach statistical significance. During the subsequent winter, CBT, particularly in combination with light therapy, appeared to improve long-term outcome regarding symptom severity, remission rates, and relapse rates. No CBT-treated participant, with or without light, experienced a full SAD relapse compared to over 60% of those treated with light alone. Limitations: These results should be viewed as preliminary and are limited by the small sample size (n=23) and lack of a control group. Conclusions: The nearly half of SAD patients who do not remit with light alone may benefit from CBT as an adjunct or alternative treatment, especially as a prophylaxis against episode recurrence

MANOVA comparing individuals that did and did not use LT.

*<p><i>p</i><.05.</p

Demographic variables compared between those that did and did not use LT.

*<p><i>p</i><.05.</p

Comparison of motivation, credibility, and depression symptom scale scores between those reporting use vs. non-use of light therapy (<i>M, SD</i>).

<p>*<i>p</i><.05. Each measure has a different scale and minimum/maximum values, and is only compared here between groups defined by self-reported use vs. non-use of light therapy. Use: Individuals who reported using LT. Non Use: Individuals reporting no use of LT in the previous winter.</p