Changes in slow and fast alpha bands in subjects submitted to different amounts of functional electrostimulation

OBJECTIVE: To examine the changes in slow (8-10Hz) and fast (10-12Hz) alpha bands of EEG in three groups of subjects submitted to different amounts of functional electrostimulation (FES). Our hypothesis is that different amounts of electrostimulation may cause different patterns of activation in the sensorimotor cortex. In particular, we expect to see an increase in alpha power due to habituation effects. We examine the two bands comprised by alpha rhythm (i.e., slow and fast alpha), since these two sub-rhythms are related to distinct aspects: general energy demands and specific motor aspects, respectively. METHODS: The sample was composed of 27 students, both sexes, aging between 25 and 40 years old. The subjects were randomly distributed in three groups: control (n=9), G24 (n=9) and G36 (n=9). A FES equipment (Neuro Compact-2462) was used to stimulate the right index finger extension. Simultaneously, the electroencephalographic signal was acquired. We investigated the absolute power in slow and fast alpha bands in the sensorimotor cortex. RESULTS: The G36 indicated a significant increasing in absolute power values in lower and higher alpha components, respectively, when compared with the control group. Particularly, in the following regions: pre-motor cortex and primary motor cortex. DISCUSSION: FES seems to promote cortical adaptations that are similar to those observed when someone learns a procedural task. FES application in the G36 was more effective in promoting such neural changes. The lower and higher components of alpha rhythms behave differently in their topographical distribution during FES application. These results suggest a somatotopic organization in primary motor cortex which can be represented by the fast alpha component.     

Suicide in late life. Review and commentary

Increasing attention has been directed to recent increases in suicide rates for children, adolescents, and young adults. Nevertheless, persons 65 years and older continue to commit suicide at a higher rate than any other age group in the United States. In this paper various aspects of suicide are examined by analyzing recent trends among young and elderly populations, cohort suicide rates, and future projection of the number of suicides in late life. Data are derived from US death certificates. Consideration of the epidemiologic data and projections may be helpful both to those interested in public policy and to clinicians serving the elderly.     

The new DSM-5 diagnosis of mild neurocognitive disorder and its relation to research in mild cognitive impairment

The Diagnostic Statistical Manual-5 (DSM-5) has included a category named the neurocognitive disorder which was formally known in DSM-IV as ‘dementia, delirium, amnestic, and other cognitive disorders’. The DSM-5 distinguishes between ‘mild’ and ‘major’ neurocognitive disorders. Major neurocognitive disorder replaces the DSM-IV's term ‘dementia or other debilitating conditions’. A pivotal addition is ‘mild neurocognitive disorder (mNCD)’ defined by a noticeable decrement in cognitive functioning that goes beyond normal changes seen in aging. It is a disorder that may progress to dementia – importantly, it may not.

Presently, our understanding of mNCD is derived from research on mild cognitive impairment (MCI). Whereas there is currently no clear treatment for mNCD, many experimental therapies now and into the future will focus upon secondary prevention, namely decreasing the risk of progression to major NCD. In this article, we will focus on mNCD by reviewing the relevant literature on MCI. We will review the research on the incidence and prevalence of MCI, conversion rates from MCI to dementia, risk factors for conversion of MCI to dementia, comorbidity of MCI with other neuropsychiatric disorders (NPS), and the development of treatment strategies for neuropsychiatric disorders in MCI.

The presence of NPS is common among individuals with MCI and is an important risk for progression to dementia. However, there has been little research on effective treatments for NPS in MCI. Clinicians and investigators must determine if the treatment of the NPS in mNCD will improve quality of life and help reduce the progression of the cognitive impairment.     

A retrospective cohort study comparing non-fatal self-harm emergency department visits between Canadian veterans living in Ontario and matched civilians

Abstract

This was a retrospective cohort study linking provincial administrative databases to compare rates of non-fatal self-harm between CAF and RCMP veterans living in Ontario and age-matched civilians. This study included male veterans who registered for provincial health insurance between 2002 and 2013. A civilian comparator group was matched 4:1 on age and sex. Self-harm emergency department (ED) visits were identified from provincial ED admission records until death or December 31, 2015. Multivariable Poisson regression compared the risk of self-harm. Analyses adjusted for age, geography, income, rurality, and major physical and mental comorbidities. In total, 9514 male veterans and 38,042 age- and sex-matched civilians were included. Overall, 0.55% of veterans had at least one non-fatal self-harm ED visit, compared with 0.81% of civilians. The rate of ED self-harm visits was 40% lower in the veteran population, compared to the civilian population (RR?=?0.60; 95% CI?=?0.41–0.87). In both groups, psychosocial and physical comorbidities, and death by suicide were more common in those who self-harmed than those who did not. A better understanding of why veterans have a lower rate of self-harm emergency department visits and how it is related to the number of completed suicides is an important area for future consideration.     

Primary sarcomas of the pancreas: A review of 253 patients from the National Cancer Data Base

Introduction

Primary sarcomas of the pancreas are rare, and the limited data regarding their presentation, oncologic profile, and survival have been derived from small case series.

Social outcomes related to age of onset among psychiatric disorders

Analyses are presented that examine the impact of a diagnosis of affective disorder, anxiety disorder, and substance abuse before and after age 20 on multiple measures of education, socioeconomic and employment status, childbearing, marital status, and instability in a random sample (N = 3,000) of community respondents from the Piedmont Health Survey. Results indicate that all categories are associated with social outcomes regardless of age of onset, particularly for marital and family outcomes. For socioeconomic outcomes, the correlates of anxiety disorder are more pervasive, and the effects of a substance abuse diagnosis are stronger for early onset.     

Utilizing psychoanalytic psychotherapy in the treatment of substance abusers

The traditional treatment of substance abuse based on the medical disease model has neglected psychological approaches to substance abuse, partly influenced by misconceptions regarding therapy. Other forms of treatment such as Cognitive‐Behavioural, Motivation Enhancement, and Transtheoretical Models have also been recently utilized. While these approaches have been effective for many individuals, they are not typically guided by a psychodynamic understanding of the individual nor do they address the interpersonal factors that influence psychotherapy. Psychoanalytic therapies do address these issues, although they have been an underutilized form of psychological treatment. The scope of this paper addresses how psychoanalytic models, that are not necessarily incompatible with other approaches may be utilized. Wurmser's Conflict Model and Khantzian's Self and Ego Deficit Model are discussed, and clinical case examples are provided to elucidate the application of psychoanalytic psychotherapy in practice. Copyright © 2002 John Wiley & Sons, Ltd.