Augmentation of Positive Valence System–Focused Cognitive Behavioral Therapy by Inaudible High-Frequency Sounds for Anhedonia : A Trial Protocol for a Pilot Study

Importance Recent conceptualizations in Research Domain Criteria have indicated that anhedonia, 1 of 2 core symptoms of depression, which can be treatment resistant, is associated with deficits in the positive valence system, and inaudible high-frequency sound therapy has been shown to enhance reward-related brain circuitry. Hence, cognitive behavioral therapy focusing on the positive valence system enhanced with sound therapy could have a synergistic effect on anhedonia.Objective To test the augmentation effect of inaudible high-frequency sounds on the efficacy of positive valence system–focused cognitive behavioral therapy to treat anhedonia.Design, Setting, and Participants In this individual-level allocation, exploratory, single-center randomized superiority pilot trial, patients, therapists, and evaluators will be masked to intervention or placebo assignment. The trial will take place at a national psychiatric referral hospital in Tokyo, Japan, among 44 adult patients with clinically significant anhedonia and moderate to severe depression. Outcomes will be analyzed following the intent-to-treat principle using a repeated-measures mixed model.Intervention The intervention group will participate in 8 weekly sessions of positive valence system–focused cognitive behavioral therapy with in-session exposure to an inaudible high-frequency sound; the comparison group will undergo cognitive behavioral therapy with in-session exposure to a placebo sound.Main Outcomes and Measures The primary outcome is anhedonia assessed using the self-reported Snaith-Hamilton Pleasure Scale. The secondary outcome is anhedonia assessed using the clinician-administered version of the Snaith-Hamilton Pleasure Scale.Discussion Recruitment for this study began in May 2018, and the projected date of final allocation is January 2020. A total of 21 eligible patients were registered for participation as of May 30, 2019. To date, treatments for depression do not guarantee clinically successful outcomes. This pilot trial will provide preliminary evidence of the augmentation effect of high-frequency inaudible sounds on cognitive behavioral therapy for anhedonia. Overall, exposure to an inaudible high-frequency sounds does not require attentional or cognitive effort from either patients or therapists; therefore, results from a future confirmative trial could indicate that cognitive behavioral therapy can be augmented in an effortless manner

Multicenter questionnaire survey for sporadic inclusion body myositis in Japan

Background: Sporadic inclusion body myositis (sIBM) is the most prevalent acquired muscle disease in the elderly. sIBM is an intractable and progressive disease of unknown cause and without effective treatment. The etiology of sIBM is still unknown; however, genetic factors, aging, lifestyles, and environmental factors may be involved. The purpose of this study is to elucidate the cross-sectional profile of patients affected by sIBM in Japan. Methods: We surveyed patient data for 146 cases diagnosed at a number of centers across Japan. We also issued a questionnaire for 67 patients and direct caregivers to further elucidate the natural history of the disease. Results: The mean age at the onset was 63.4 ± 9.2 years. The mean length of time from the onset to diagnosis was 55.52 ± 49.72 months, suggesting that there is a difficulty in diagnosing this disease with long-term consequences because of late treatment. 73 % described the psychological/mental aspect of the disease. The most popular primary caregiver was the patient’s spouse and 57 % patients mentioned that they were having problems managing the finances. Conclusions: Through these surveys, we described the cross-sectional profiles of sIBM in Japan. Many patients described psychological/mental and financial anxiety because of the aged profile of sIBM patients. The profiles of sIBM patients are similar to those in Western countries

The updated retrospective questionnaire study of sporadic inclusion body myositis in Japan

Background: Sporadic inclusion body myositis (sIBM) is the most prevalent muscle disease in elderly people, affecting the daily activities. sIBM is progressive with unknown cause and without effective treatment. In 2015, sIBM was classified as an intractable disease by the Japanese government, and the treatment cost was partly covered by the government. This study aimed to examine the changes in the number of patients with sIBM over the last 10 years and to elucidate the cross-sectional profile of Japanese patients with sIBM. Methods: The number of sIBM patients was estimated through a reply-paid postcard questionnaire for attending physicians. Only patients diagnosed as “definite” or “probable” sIBM by clinical and biopsy sIBM criteria were included in this study (Lancet Neurol 6:620-631, 2007, Neuromuscul Disord 23:1044-1055, 2013). Additionally, a registered selfadministered questionnaire was also sent to 106 patients who agreed to reply via their attending physician, between November 2016 and March 2017. Results: The number of patients diagnosed with sIBM for each 5-year period was 286 and 384 in 2011 and 2016, respectively. Inability to stand-up, cane-dependent gait, inability to open a plastic bottle, choking on food ingestion, and being wheelchair-bound should be included as sIBM milestones. Eight patients were positive for anti-hepatitis C virus antibody; three of them were administered interferon before sIBM onset. Steroids were administered to 33 patients (31.1%) and intravenous immunoglobulin to 46 patients (43.4%). From 2016 to 2017, total of 70 patients applied for the designated incurable disease medical expenses subsidy program. Although the treatment cost was partly covered by the government, many patients expressed psychological/mental and financial anxieties. Conclusions: We determined the cross-sectional profile of Japanese patients with sIBM. Continuous support and prospective surveys are warranted

Functional network activity during errorless and trial-and-error color-name association learning

Introduction In cognitive rehabilitation, errorless (EL) and trial-and-error (T&E) learning are well-known methods, but their neural mechanisms are not well known. In this study, we investigated functional magnetic resonance imaging data for healthy adults during EL and T&E learning. Methods Participants memorized color-name associations in both methods using Japanese traditional colors which were unfamiliar to study participants. A functional network analysis was conducted by applying graph theory. We focused on two major cognitive networks: the default mode network (DMN) and the fronto-parietal network (FPN). Also, we used "within-network connectivity" and "between-network connectivity" graph metrics. The former represents the functional connectivity strength of a subnetwork, namely the within-DMN connectivity and within-FPN connectivity, while the latter represents the number of links between the DMN and FPN. Results The within-DMN connectivity in T&E learning was significantly higher than in EL learning. The difference between the memory scores of EL and T&E learning weakly correlated with the between-network connectivity differences between both learning tasks. Conclusions Our results suggest that within-DMN connectivity is important in T&E learning and that the learning benefit differences between EL and T&E approaches potentially relate to the functional integration strength between the DMN and FPN

日本人の化粧に対する意識 ―女性の化粧義務の解消に向けて―

現代の日本社会では、「化粧は女性の身だしなみ」といわれ、職場などで女性にのみ化粧が課されることがある。女性に対してのみ課される「身だしな み」や服装規定は、化粧だけに限らない。仕事場で、女性のみヒールの高い靴を履かされたり、眼鏡をかけることを禁止されたりすることもある。これらの規定は、健康被害を生み、職務に支障をきたしうるものであり、世界的に、このような女性に対する理不尽な服装規定を廃止する動きが広がっているが、日本ではいまだに、「仕方がないこと」として許容する人も少なくない。化粧については、日本人女性も楽しみで行う人もいるが、女性だからしなければならないという義務感にかられてのみ化粧を行う人も少なくない。逆に、男性が化粧することに対して否定的な人もいる。男女問わず化粧をしたい人がし、したくない人に強要しない社会にするためには、人々のジェンダーステレオタイプをなくしていかなければならない。本稿では、化粧行動の歴史や化粧に対する意識についての研究を紹介しつつ、ジェンダーステレオタイプにとらわれない寛容な社会を築くために考えるべきことを議論する。In Japanese society today, it is often said that makeup is an essential part of personal grooming for women, and some workplaces require women and only women to wear makeup. Dress codes and rules of personal grooming that apply only to women involve more than just makeup. In some workplaces, women are required to wear high heels or are prohibited from wearing glasses. These rules can have negative health effects or hamper employees’ ability to work, and although there is a growing global movement to abolish such unfair dress codes for women, there are still many in Japan who consider them unavoidable and thus tolerate them. While many Japanese women wear makeup because they enjoy it, some use makeup simply because they feel it is mandatoryforwomen.Conversely, some people are also opposed to men using makeup. In order to create a society where people decide their makeup use as they wish regardless of their gender, we need to eliminate gender stereotypes. This paper presents research on the history of makeup‒related behavior and perceptions of makeup, as well as discussing what needs to be considered to build a tolerant society that is not dominated by gender stereotypes

In situ investigation of the photocatalytic decomposition of NO on the Ti-HMS under flow and closed reaction systems

Mesoporous materials such as Ti-HMS, prepared at ambient temperature, were studied both under continuous flow and closed reaction systems for the photocatalytic decomposition of NO. The results indicate Ti-HMS to be a good photocatalyst with a continuous reactivity under prolonged irradiation. The direct decomposition of NO into N2, O2, and N2O at 275 K with a high selectivity for N2 and O2 in a closed system is noteworthy. In situ photoluminescence and EXAFS investigations show that the Ti exists in a tetrahedral coordination and is highly dispersed within the mesoporous material. The TPD studies, before and after the photocatalytic investigations, clearly indicate that NO molecules cannot be adsorb strongly on the surface of Ti-HMS photocatalysts, in contrast to the powdered TiO2 photocatalysts, where strong NO adsorption species have been observed. It is likely that the charge transfer excited state of the tetrahedrally coordinated titanium oxide species plays a significant role in the direct decomposition of NO