The premenstrual syndrome: psychophysiologic concomitants of perceived stress and low back pain

The effects of experimentally induced and personally relevant stressors on low back EMG activity during 3 phases of the menstrual cycle in women with the premenstrual syndrome (PMS) and premenstrual low back pain were examined. Thirty-nine women reporting either PMS and premenstrual severe low back pain (group 1), PMS with premenstrual moderate low back pain (group 2), or those reporting neither condition (group 3) participated. During each of 3 menstrual phase-specific assessment sessions, participants were exposed to a neutral stimulus, an experimentally induced stressor, and 2 personally relevant stressors in a randomized order. Concomitant monitoring of low back EMG activity and heart interbeat interval was undertaken. Results indicated that participants in group 1 evidenced greater EMG changes in response to personal stressors compared to the neutral stimulus and experimentally induced stress during the premenstrual phase. EMG activity in response to personal stress was also significantly higher during the premenstrual phase than during the menstrual and intermenstrual phases for group 1, and higher than EMG changes evidenced by groups 2 and 3 during the same phase. Group 2, while not reporting as severe premenstrual back pain as did group 1, reported moderate levels of back pain and evidenced greater physiological reactivity to a personal stressor than did group 3. The findings highlight the link between personally relevant stressors and concomitant physiologic responsivity and the role that this arousal may play in the maintenance and exacerbation of premenstrual low back pain.     

Cognitive functioning in school-aged children with vertically acquired HIV infection being treated with highly active antiretroviral therapy (HAART)

In today's era of highly active antiretroviral therapy (HAART), few children with HIV-1 infection experience severe central nervous system (CNS) manifestations indicative of encephalopathy. However, little is known about the neurocognitive strengths and weaknesses of HIV-infected children treated with HAART. This cross-sectional study is the first to systematically investigate the relation between cognitive functioning and medical markers in HIV-infected children and adolescents treated with HAART with varying levels of computed tomography (CT) brain scan abnormalities. The Wechsler Intelligence Scale for Children-Third Edition was administered to 41 vertically infected children (mean age = 11.2 years) treated with HAART for at least 1 year. Other procedures at the time of testing included CT brain scans and collection of CD4 cell counts and plasma HIV-1 RNA PCR. Although global cognitive functioning among participants was in the Average range, children with minimal to moderate CT brain scan abnormalities scored significantly lower than children with normal scans on composite measures of cognitive functioning and five specific subtests, especially tasks involving executive functions. Furthermore, children with worse immune status (CD4+ counts ≤ 500) scored lower on subtests measuring processing speed. Viral load was unrelated to cognitive test scores. Thus, children with HIV being treated with HAART remain at risk for developing CNS disease. Findings emphasize the importance of conducting neuropsychological assessments in this population, particularly for children with cortical atrophy and absolute CD4+ cell counts ≤ 500.