Adolescents with autism show typical fMRI repetition suppression, but atypical surprise response

Contains fulltext : 195734.pdf (publisher's version ) (Closed access)Recent theoretical frameworks have hypothesized that autism spectrum disorder (ASD) may be marked by an altered balance between sensory inputs and prior knowledge - the so-called hypoprior hypothesis. Yet evidence regarding such an altered balance is mixed. Here, we aimed to test this hypothesis within the domain of visual perception, by examining how neural activity in the visual system was modulated by stimulus repetition and stimulus expectation in healthy and ASD participants. We presented 22 adolescents with ASD and 22 typically developing (TD) adolescents with pairs of object stimuli, while measuring brain activity using functional magnetic resonance imaging (fMRI). Stimulus pairs could be stimulus repetitions or not and could be expected or not. We examined neural activity in early (V1) and object-selective (LOC) visual cortex. Both ASD and TD individuals showed robust and equal repetition suppression in LOC. By contrast, ASD and TD groups showed a different response to expected versus unexpected stimuli, specifically in V1. Thereby, our results suggest that while the more automatic modulation of activity by repetition is unaffected in ASD, there is some evidence that the balance between sensory evidence and prior knowledge may indeed be altered in early visual cortex of ASD.10 p

No evidence for altered up- and downregulation of brain activity in visual cortex during illusory shape perception in autism

Autism spectrum disorder (ASD) may be marked by an altered balance between sensory input and prior expectations. Because many illusions rely on integrating sensory input with prior information such as spatial context, individuals with ASD may therefore be less susceptible to visual illusions than typically developing (TD) individuals. Yet empirical evidence on the matter is rather divergent, varying depending on the type of illusion, study procedure, and population. Visual illusions lead to neural activity alterations in the visual system. In the so-called Kanizsa illusion, these are likely caused by top-down feedback to V1. Here we tested the hypothesis that a reduced susceptibility to illusions in ASD would manifest as diminished modulation of V1 activity by illusions, using functional magnetic resonance imaging (fMRI). We presented 22 adolescents with ASD and 22 age-, gender-, and intelligence-matched TD controls with displays that consisted of three circular inducers. These either formed an illusory triangle (Kanizsa illusion) or not. We identified regions in primary visual cortex (V1) that corresponded to (the visual field locations of) the illusory triangle and its inducers, and recorded their visual response. Previous research in healthy volunteers has shown a specific pattern of up- and down-regulation in regions of V1 that process the shape and inducers, respectively. Here, we replicated this pattern of up- and downregulation in V1, in both the TD and ASD groups, with no differences between groups. This suggests that illusory shape processing in primary visual cortex is equally present in ASD, suggesting unimpaired processing of spatial context

Risk factors, prevalence, and course of severe fatigue after breast cancer treatment: a meta-analysis involving 12 327 breast cancer survivors

Contains fulltext : 166361.pdf (publisher's version ) (Closed access)BACKGROUND: This meta-analysis aimed to (i) examine demographic, disease-related, and treatment-related risk factors, (ii) estimate the prevalence, and (iii) describe the course of severe fatigue following breast cancer (BC) treatment. METHODS: PubMed, PsycINFO, Cochrane, CINAHL, and Web of Science were systematically searched from inception up to 23 November 2015. Risk factors and prevalence rates were analyzed with inverse variance random-effects analyses. Heterogeneity was studied with sensitivity analyses. RESULTS: Twenty-seven studies were included (N = 12 327). Breast cancer survivors (BCS) with a partner were at lower risk for severe fatigue than survivors without a partner [risk ratio (RR) 0.96, 95% confidence interval (CI) 0.93-0.98]. Survivors with stage II or III cancer, and survivors treated with chemotherapy were at higher risk for severe fatigue than survivors with stage 0 or I cancer and without chemotherapy (RR respectively 1.18, 95% CI 1.08-1.28; 1.12, 95% CI 1.06-1.19). Survivors treated with surgery, radiotherapy, and chemotherapy, and survivors with this combination plus hormone therapy were at higher risk than survivors with other treatment combinations (RR respectively 1.18, 95% CI 1.05-1.33; 1.38, 95% CI 1.15-1.66). Survivors treated with surgery and surgery plus radiotherapy were at lower risk than survivors with additional treatments (RR respectively 0.83, 95% CI 0.70-0.98; 0.87, 95% CI 0.78-0.96). Hormone and targeted therapy were no significant risk factors. The pooled prevalence of severe fatigue was 26.9% (95% CI 23.2-31.0), but this should be interpreted with caution because of high heterogeneity. A relatively large decrease in the prevalence of severe fatigue seemed to occur in the first half year after treatment completion. CONCLUSIONS: Approximately one in four BCS suffer from severe fatigue. Risk factors of severe fatigue were higher disease stages, chemotherapy and receiving the combination of surgery, radiotherapy, and chemotherapy, both with and without hormone therapy. Having a partner, receiving only surgery, and surgery plus radiotherapy decreased the risk

Postural orthostatic tachycardia is not a useful diagnostic marker for chronic fatigue syndrome

Item does not contain fulltextBACKGROUND: Postural orthostatic tachycardia syndrome (POTS) is considered a diagnostic marker for chronic fatigue syndrome (CFS). OBJECTIVES: The aims of this study were to (i) compare POTS prevalence in a CFS cohort with fatigued patients not meeting CFS criteria, and (ii) assess activity, impairment and response to cognitive behavioural therapy (CBT) in CFS patients with POTS (POTS-CFS) and without POTS (non-POTS-CFS). METHODS: Prospective cohort study at the Radboud University Medical Centre in the Netherlands. Between June 2013 and December 2014, 863 consecutive patients with persistent fatigue were screened. Patients underwent an active standing test, filled out questionnaires and wore an activity-sensing device for a period of 12 days. RESULTS: A total of 419 patients with CFS and 341 non-CFS fatigued patients were included in the study. POTS prevalence in adult patients with CFS was 5.7% vs. 6.9% in non-CFS adults (P = 0.54). In adolescents, prevalence rates were 18.2% and 17.4%, respectively (P = 0.93). Adult patients with POTS-CFS were younger (30 +/- 12 vs. 40 +/- 13 years, P = 0.001) and had a higher supine heart rate (71 +/- 11 vs. 65 +/- 9 beats per min, P = 0.009) compared with non-POTS-CFS patients. Severity and activity patterns did not differ between groups. In patients with CFS, criteria for Systemic Exertion Intolerance Disease (SEID) were met in 76% of adults and 67% of adolescents. In these patients with CFS fulfilling the SEID criteria, the prevalence of POTS was not different from that in the overall CFS population. POTS-CFS adolescents had less clinically significant improvement after CBT than non-POTS-CFS adolescents (58% vs. 88%, P = 0.017). CONCLUSION: In adults with CFS, the prevalence of POTS was low, was not different from the rate in non-CFS fatigued patients and was not related to disease severity or treatment outcome. In POTS-CFS adolescents, CBT was less successful than in non-POTS-CFS patients. The evaluation of POTS appears to be of limited value for the diagnosis of CFS

Prefrontal structure varies as a function of pain symptoms in chronic fatigue syndrome

Contains fulltext : 163005.pdf (publisher's version ) (Closed access)Background: Chronic fatigue syndrome (CFS) is characterized by severe fatigue persisting for ≥6 months and leading to considerable impairment in daily functioning. Neuroimaging studies of patients with CFS have revealed alterations in prefrontal brain morphology. However, it remains to be determined whether these alterations are specific for fatigue or whether they relate to other common CFS symptoms (e.g., chronic pain, lower psychomotor speed, and reduced physical activity). Methods: We used magnetic resonance imaging to quantify gray matter volume (GMV) and the N-acetylaspartate and N-acetylaspartylglutamate/creatine ratio (NAA/Cr) in a group of 89 women with CFS. Building on previous reports, we tested whether GMV and NAA/Cr in the dorsolateral prefrontal cortex are associated with fatigue severity, pain, psychomotor speed, and physical activity, while controlling for depressive symptoms. We also considered GMV and NAA/Cr differences between patients with CFS and 26 sex-, age-, and education-matched healthy controls. Results: The presence of pain symptoms was the main predictor of both GMV and NAA/Cr in the left dorsolateral prefrontal cortex of patients with CFS. More pain was associated with reduced GMVs and NAA/Cr, over and above the effects of fatigue, depressive symptoms, physical activity, and psychomotor speed. In contrast to previous reports and despite a large representative sample, global GMV did not differ between the CFS and healthy control groups. Conclusions: CFS, as diagnosed by Centers for Disease Control and Prevention criteria, is not a clinical entity reliably associated with reduced GMV. Individual variation in the presence of pain, rather than fatigue, is associated with neuronal alterations in the dorsolateral prefrontal cortex of patients with CFS.8 p

Körperliche Aktivität,Immunsystem und Krebs

BACKGROUND: Chronic fatigue syndrome (CFS) is characterized by profound and disabling fatigue with no known somatic explanation. Cognitive behavioral therapy (CBT) has proven to be a successful intervention leading to a reduction in fatigue and disability. Based on previous neuroimaging findings, it has been suggested that central neural mechanisms may underlie CFS symptoms and play a role in the change brought on by CBT. In this randomized controlled trial we aim to further investigate the neural mechanisms that underlie fatigue in CFS and their change by CBT. METHODS/DESIGN: We will conduct a randomized controlled trial in which we collect anatomical and functional magnetic resonance imaging (MRI) measures from female CFS patients before and after CBT (N = 60) or waiting list (N = 30) and compare these with measures from age and education matched healthy controls (N = 30). By including a large treatment group we will also be able to compare patients that benefit from CBT with those that do not. In addition, to further investigate the role of endocrine and immune biomarkers in CFS, we will determine cortisol and cytokine concentrations in blood, hair and/or saliva. DISCUSSION: This project creates an unique opportunity to enhance our understanding of CFS symptoms and its change by CBT in terms of neuroanatomical, neurofunctional, endocrinological and immunological mechanisms and can help to further improve future treatments strategies. TRIAL REGISTRATION: Dutch Trial Register #15852. Registered 9 December 2013 ( http://www.trialregister.nl/trialreg/admin/rctview.asp?TC=4311 )