Posts Tagged Stress

[WEB SITE] UC study explores how low risk stress reduction treatments may benefit epilepsy patients

Patients with epilepsy face many challenges, but perhaps the most difficult of all is the unpredictability of seizure occurrence. One of the most commonly reported triggers for seizures is stress.

A recent review article in the European journal Seizure, by researchers at University of Cincinnati Epilepsy Center at the UC Gardner Neuroscience Institute, looks at the stress-seizure relationship and how adopting stress reduction techniques may provide benefit as a low risk form of treatment.

The relationship between stress and seizures has been well documented over the last 50 years. It has been noted that stress can not only increase seizure susceptibility and in rare cases a form of reflex epilepsy, but also increase the risk of the development of epilepsy, especially when stressors are severe, prolonged, or experienced early in life.

“Studies to date have looked at the relationship from many angles,” says Michael Privitera, MD, director of the UC Epilepsy Center and professor in the Department of Neurology and Rehabilitation Medicine at the UC College of Medicine. “The earliest studies from the 1980s were primarily diaries of patients who described experiencing more seizures on ‘high-stress days’ than on ‘low-stress days.'”

Privitera and Heather McKee, MD, an assistant professor in the Department of Neurology and Rehabilitation Medicine, looked at 21 studies from the 1980s to present–from patients who kept diaries of stress levels and correlation of seizure frequency, to tracking seizures after major life events, to fMRI studies that looked at responses to stressful verbal/auditory stimuli.

“Most all [of these studies] show increases in seizure frequency after high-stress events. Studies have also followed populations who have collectively experienced stressful events, such as the effects of war, trauma or natural disaster, or the death of a loved one,” says Privitera. All of which found increased seizure risk during such a time of stress.

For example, a 2002 study evaluated the occurrence of epileptic seizures during the war in Croatia in the early 1990s. Children from war-affected areas had epileptic seizures more often than children not affected by the war. Additionally, the 10-year follow up showed that patients who had their first epileptic seizure during a time of stress were more likely to have controlled epilepsy or even be off medication years later.

“Stress is a subjective and highly individualized state of mental or emotional strain. Although it’s quite clear that stress is an important and common seizure precipitant, it remains difficult to obtain objective conclusions about a direct causal factor for individual epilepsy patients,” says McKee.

Another aspect of the stress-seizure relationship is the finding by UC researchers that there were higher anxiety levels in patients with epilepsy who report stress as a seizure precipitant. The researchers suggest patients who believe stress is a seizure trigger may want to talk with their health care provider about screening for anxiety.

“Any patient reporting stress as a seizure trigger should be screened for a treatable mood disorder, especially considering that mood disorders are so common within this population,” adds McKee.

The researchers report that while some small prospective trials using general stress reduction methods have shown promise in improving outcomes in people with epilepsy, large-scale, randomized, controlled trials are needed to convince both patients and providers that stress reduction methods should be standard adjunctive treatments for people with epilepsy.

“What I think some of these studies point to is that efforts toward stress reduction techniques, though somewhat inconsistent, have shown promise in reducing seizure frequency. We need future research to establish evidence-based treatments and clarify biological mechanisms of the stress-seizure relationship,” says Privitera.

Overall, he says, recommending stress reduction methods to patients with epilepsy “could improve overall quality of life and reduce seizure frequency at little to no risk.”

Some low risk stress reduction techniques may include controlled deep breathing, relaxation or mindfulness therapy, as well as exercise, or establishing routines.

Source: UC study explores how low risk stress reduction treatments may benefit epilepsy patients

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[WEB SITE] Life after stroke: Tips for recovering communication skills – Medical News Today

Every year in the United States, more than 795,000 people have a stroke, according to the Centers for Disease Control and Prevention. Furthermore, the United Kingdom’s Stroke Association note that 1 in 3 people will experience communication problems after a stroke.
[stroke]
Stroke can lead to ongoing communication problems, but recovery is often possible.

Unfortunately, we often judge people on how well they communicate. From the outside, a person who has difficulty speaking may appear to have difficulty thinking, too, but this is not necessarily true.

For a person who has had a stroke, the ability to think and communicate depends on the part, or parts, of the brain that have been affected.

Having a stroke can be a frightening and frustrating experience. Not being able to tell people what is going on in the aftermath can extend the trauma.

Friends and family members, for their part, can also find themselves tongue-tied. They may feel embarrassed, lost for words, or they may think that this is no longer the person they once knew.

Post-stroke rehabilitation can help people to regain some or all of their skills. Speech therapists specialize in communication, but nonspecialists can also play a key role.

It is important for friends and relatives to understand that what a person expresses on the outside, after a stroke, is not necessarily what is going on in their head. They should also remember that, although a person faces new challenges after experiencing a stroke, they are still the same person.

This article will offer some tips from people who have “been there” that can give us the necessary skills for helping someone get back to communicating after a stroke.

How does a stroke affect communication?

A stroke is a brain injury that results from bleeding or a blockage in the brain. The effects can be sudden or gradual, and the damage may impact various aspects of mental and physical health.

These include:

  • Motor skills
  • The senses, including reactions to pain
  • Language
  • Thinking and memory
  • Emotions.

A stroke can affect a person’s use of language in a variety of ways.

Not only can the processing of language be impaired, but paralysis or physical weakness in the face, tongue, or throat muscles could make it hard to swallow, control breathing, and form sounds.

The type and extent of communication problems will depend on the form of stroke and what kind of injury has occurred. The damage and resulting levels of ability will also vary.

The Stroke Association describe three conditions that affect communication after a stroke: aphasia, dysarthria, and dyspraxia. A person may experience one or a combination of these.

Aphasia

Aphasia, or dysphasia, results from damage to one of the “language control centers” in the brain. While it influences communication, it does not impact intelligence. It may affect just one type of communication – for example, reading, listening or speaking, or a combination.

Fast facts about stroke

  • Stroke can lead to paralysis or weakness on one side of the body
  • There may be difficulty with thinking, awareness, attention, learning, judgment, and memory
  • It can be hard to understand or form speech
  • Mood and emotions can be affected.

Learn more about stroke

Damage to a part of the brain known as Wernicke’s area can lead to receptive aphasia.

This makes it difficult to understand long and complex sentences, especially if there is background noise, or if more than one person is talking. The person may feel as if others are speaking in a foreign language. Their own speech may also become incoherent.

If there is damage to Broca’s area, expressive aphasia can result.

The person can understand others, but they will be unable to explain themselves. They can think the words, but they cannot speak them or put them together in order to make coherent, grammatically correct sentences.

A person with expressive aphasia may be able to make sounds or say short words or parts of sentences, but they may miss out important words or use the wrong word. They might have the word “on the tip of the tongue,” but not be able to get it out.

It may seem to the speaker that they are talking normally, but to a listener, it can sound like nonsense. Listeners may believe that the speaker is confused when they are not. They just cannot get the ideas across.

Damage that affects multiple areas of the brain can lead to mixed, or global, aphasia with challenges in all aspects of communication. The person may no longer use language to convey thought.

Dysarthria and dyspraxia

Dysarthria and dyspraxia relate to the physical production of speech sounds.

A person with dysarthria can find the words, but they cannot form them because of a physical problem, such as muscular weakness. This may cause the words to come out slurred or in short bursts. This slurring does not necessarily reflect the person’s state of mind. It is likely that only their ability to communicate is limited.

Dyspraxia involves difficulty with movement and coordination, so that the muscles needed for speech sounds may not work properly or in the correct order. This, too, can affect speech.

Other changes

Other changes that can make it hard to contribute to conversations include:

  • A loss of voice tone, normally used to express emotions
  • Fixed facial expression
  • Problems understanding humor
  • Inability to take turns in conversation.

These can make the person appear depressed, even if they are not.

Some people are aware that they are experiencing these changes. If so, letting others know what the problem is can help to combat the issue.

However, a person with anosognosia will be unable to recognize that anything is wrong, due to a lack of insight resulting from damage to the brain. This can hinder recovery.

Further problems

Depending on the damage that has occurred, vision and hearing problems can also affect communication and writing ability.

Tiredness is a common result of stroke. Conversation might also be tiring, because it demands so much effort.

After a stroke, stress and personality changes can occur. Stress can exacerbate communication problems, especially if the person becomes impatient with themselves, or if others become impatient.

Mood changes, due to the stroke’s effect on the brain, can further add to the strain.

What does a speech therapist do?

Speech therapy is a key part of rehabilitation after a stroke.

A speech therapist will help people with swallowing; this can be severely impaired, and it has an impact on language production.

[speech therapy]
Speech therapy can involve practicing forming words.

Language practice activities that speech therapists may use include intensive exercises in:

  • Repeating words
  • Following directions
  • Reading and writing.

Examples of more extensive practice are:

  • Conversational coaching
  • Rehearsing speech
  • Developing prompts to help people remember specific words
  • Working out ways to get around language disabilities, such as using symbols and sign language.

Communication technology has expanded the range of ways to practice and improve communication. An example of this is pressing a key to activate a voice simulator.

Some tips from people with first-hand experience

Medical News Today asked two men, Peter Cline and Geoff, about their experience in regaining communication skills after a stroke. Peter, an engineer, had a stroke at the age of 59 when he was just starting a holiday in Tasmania. Geoff, who ran his own business until his retirement, was living in Spain when he became ill.

Both men have worked hard to regain their communication skills.

We asked what advice they would give people in order to help them communicate with someone following a stroke.

They gave us this list of dos:

[singing group]
Songs help some people to relax and communicate.
  • Do look directly at the person when you are speaking to them
  • Do speak slowly and clearly, but use a normal tone of voice
  • Do use short sentences and stick to one topic at a time
  • Do ensure there is no background noise
  • Do reassure the person that you understand their frustration
  • Do write things down, if it will help
  • Do find out about the person’s employment, interests and passions – now and before the stroke – and try to relate to these
  • Do give people a chance to say what they want to say, without jumping in or correcting them.

They also gave us some don’ts:

  • Don’t finish the person’s sentences for them
  • Don’t speak too fast
  • Don’t push them too much
  • Don’t speak to the person while they are driving, for example, because they cannot concentrate
  • Don’t assume that because the person is having difficulty understanding, they must be stupid
  • Don’t “talk down” to the person, or speak to them as if they are a child
  • Don’t keep “rabbiting.”

Geoff told MNT that he feels his communication skills “go up and down.” It becomes harder for him to communicate when he is tired, and when there are more than two people in the conversation.

Both Geoff and Peter have made remarkable progress in their communication skills, and they each offered some words of encouragement for people who have had a stroke.

Geoff’s advice is:

“Take time to recover, and, when communicating, take time to explain, and don’t let yourself feel rushed.”

Peter says:

  • Persevere and don’t give up. Things will gradually improve but not as quickly as you want them to
  • Expect peaks and troughs in your recovery
  • Enjoy relaxing with something you are familiar with, for example, old films, music, or whatever your “comforter” is.

Peter explains that after a stroke, an individual can feel as if they are inside a bubble. “It helps if you can get someone to understand that,” he says.

Activities that can help

Friends and family can engage in regular practice activities to help someone recover their communication skills after a stroke.

It may be helpful to arrange regular slots for communication practice, at a time when the person will not be tired.

Here are some activities for sharing, depending on individual styles and taste:

[photo album and conversation]
A photo album can be useful for prompting conversation.
  • Songs, especially if the person was a keen singer before. Some people can sing after a stroke, even if they cannot speak, because singing and speaking use different parts of the brain
  • Card games that involve the person saying the name of the card
  • A photo album, to share and discuss the people and events in the pictures
  • A personal file, with information about the person’s life, jobs, and family, in order to provide topics of conversation and nonverbal clues when access to key words is difficult
  • A diary, with records of visits, events, and conversations. Friends and family can be encouraged to write in it, to help the person track their progress
  • News stories to read in advance and discuss during the session.

If an important conversation is coming up – with the insurance company or hospital, for example – these slots can be a good place to prepare.

Other tips for self-help

If a person has difficulty expressing a word or idea, encouraging them to write or draw what they mean can help. Some people can spell a word, even if they cannot say it.

Strategies that people have used to practice alone include:

  • Rehearsing speech sounds, such as vowels and consonants
  • Using children’s books to practicing reading and writing
  • Reciting poems or nursery rhymes
  • Saying the names of famous sports personalities
  • Watching the news, and copying how the newsreader speaks
  • Persevering in conversation with friends or family, however difficult it is

It is important for friends and family to continue to treat the person as an intelligent adult, and to be aware that while their ability to communicate has changed, their identity has not. They are still who they are, with interests, skills, and a past.

In addition, everyone is different, and the effects of stroke vary. For this reason, there will not be a “one-size-fits-all” solution.

Full recovery is not always possible, but patience, help, support, and practice can go a long way in helping people to regain their communication skills after a stroke.

Source: Life after stroke: Tips for recovering communication skills – Medical News Today

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[WEB SITE] 6 Things That Can Trigger a Seizure Even If You Don’t Have Epilepsy

Harrison Ford has played a hero in the movies, but in real life, he gives that distinction to his 26-year-old daughter, Georgia. Earlier this month, the actor revealed that Georgia has epilepsy, and that it took years for her to get the proper treatment. “I admire her perseverance, her talent, her strength,” he told the Daily News.Epilepsy isn’t always easy to identify. The disorder typically isn’t diagnosed until a person has had two or more “unprovoked” seizures—that is, seizures that don’t have a clear trigger, explains Vikram Rao, MD, PhD, an assistant professor of neurology at the University of California, San Francisco.It turns out there are multiple things that can trigger a seizure, which is essentially a surge of electrical activity in the brain. And just because you have one, that doesn’t mean you’ve got epilepsy. But you should always get checked out by a doctor afterwards, says Dr. Rao.Here, six things that are known to trigger seizures even in people who don’t have a neurological condition—and what to do when a seizure strikes.

Stress

Seizures triggered by stress look similar to epileptic seizures, mainly because they can have the same symptoms—numbness, confusion, convulsions, and more. But there are differences in the brain electrical activity between the two types. In fact, research suggests that somewhere between 5% and 20% of people with epilepsy may be misdiagnosed and, in fact, suffering from seizures provoked by anxiety or underlying trauma.RELATED: 25 Surprising Ways Stress Affects Your Health

Low blood sugar

Your brain is a huge consumer of glucose, says Dr. Rao. When your blood sugar levels drop too low—a state called hypoglycemia—your brain has trouble functioning normally and the result could be a seizure. Since hypoglycemia is a potential a side effect of diabetes medications, diabetics may be at a higher risk for this type of seizure.

Heatstroke

You already know that playing soccer for hours on a scorching-hot day can be dangerous. In that kind of heat (and under that kind of exertion), people can have trouble cooling themselves down. Once your internal thermostat reaches about 104 degrees Fahrenheit, you risk damaging your organs, including your brain: “The brain doesn’t function as well at higher temperatures,” says Dr. Rao. Once heat illness sets in, the brain can misfire, possibly triggering a seizure.

Alcohol Withdrawal

An estimated 2 million people may experience alcohol withdrawalevery year, according to a 2004 study in the journal American Family Physician. People can develop a tolerance to (or dependence on) alcohol, and the wiring in their brains can reflect that. So when some people quit cold turkey, it leaves their brains in a new, altered state that can set them up for a seizure, usually within 48 hours after their last drink, says Dr. Rao.

Certain medications

Antidepressants like bupropion (a.k.a. Wellbutrin and Zyban) have been associated with seizures in certain studies. And some antibiotics, like penicillins and quinolones, and pain medications like tramadol (sold under the brand name Ultram) might increase the risk of seizures too.

Sleep deprivation

Too-little sleep is a powerful trigger for seizures, says Dr. Rao. (He’s seen seizures in college students who’ve stayed up for days in a row cramming for an exam.) “No one knows the exact reason behind this,” says Dr. Rao, “but sleep is restorative. We spend one-third of our lives sleeping, so we know it’s important.”RELATED: 30 Sleep Hacks for Your Most Restful Night Ever

What to do if someone has a seizure

Oftentimes, less is more. Rule number one: Keep the person safe. That means making sure she doesn’t accidentally hurt herself, either on a nearby sharp object or by falling down the stairs.As Anto Bagić, MD, PhD, the chief of the epilepsy division at the University of Pittsburgh Medical Center puts it: “There’s no ‘heroic’ measure necessary.” Don’t try to restrain the person (she might panic and lash out even more aggressively) and do not put anything in her mouth (she might choke on it). Besides, it’s a myth that people can swallow their tongue during a seizure.Either give her some space or, if necessary, guide her to a safer area, Dr. Bagić explains. If she’s lying on the floor, gently turn her on her side so that her saliva doesn’t block her airway.Most seizures resolve themselves within five minutes, so if it goes on for longer than that, you should call 911, says Dr. Bagić. More often, however, the person will regain consciousness after a few minutes—and when she does, stay calm.“When people are coming back [from a seizure], that’s when they’re at their most vulnerable,” says Dr. Bagić. “It can be scary if the first thing they see is people staring at them or panicking.”Another key point: Stay with the person until you’re sure that she’s completely recovered. Do all that, and it’ll be heroic enough.

Source: 6 Things That Can Trigger a Seizure Even If You Don’t Have Epilepsy – women health benefits

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[WEB SITE] Five Meaningful Ways to Love the Caregiver in Your Life

Meaningful Ways to Love the Caregiver in Your Life

More than 65 million people, 29% of the U.S. population, provide care for a chronically ill, disabled, or aged family member or friend during any given year and spend an average of 20 hours per week providing care.”

-National Alliance for Caregiving in collaboration with AARP; 2009

Caregivers experience a level of stress that is often misunderstood. Long-term caregivers may suffer deep emotional upset, and burnout with little relief.  The caregivers of traumatic brain injury survivors are people who have been called to walk an extraordinary caregiving journey, often without warning or preparation.

How can we help? Are there practical ways to incorporate the “It takes a village” philosophy into the lives of caregivers that you know? The answer is yes, with a little work and a lot of heart, you can assist those who are in a constant caregiving role.

As a caregiver who often feels lonely and overwhelmed, I’d like to offer some practical solutions that have been helpful to me.

1. Get Specific

Instead of saying, “Let me know what I can do to help,” come up with something you can do, and present it. This is something we are all guilty of doing from time to time. As someone who has been in the throes of caregiving for four years, I find it’s most helpful when someone designs a specific plan and sets it into motion.

For example, “I’d like to prepare dinner for your family once a month. You pick a day, and we will make it happen.” Or, “Let’s plan on my giving you a break, the second Wednesday of every month from 4-7.” This helps the caregiver to see that a break is in sight and set up activities of her own.

It’s important to remember that long-term caregiving may make someone feel as if her resources have been depleted, making it more difficult to reach out. When someone offers something specific that will help in a concrete way, it eases part of the burden for the caregiver involved.

2. Offer Clear Praise

Avoid saying things like, “All things considered; you are doing a good job.” Or, “You are doing the best that you can.” Instead go for specific, genuine praise that doesn’t leave room for questions about what the words you are saying might mean. For example, “I know it’s been a challenging four years, you are handling it so well.” Or a simple,  “I just want to let you know I care about you.” Build the caregiver up, recognizing that their bucket may feel pretty empty at times, and they need a reserve to refill it.

Once, after an unexpected hospitalization, a dear friend looked at me and said with tears in her eyes, “You are my hero.” I knew that her sentiments were genuine. For the next several days, when I felt defeated, I focused on her praise. It not only lifted my spirit but also made me work harder in my role as a caregiver.  Genuine praise is the wind in a caregiver’s sail.

3. Practice Compassion

The caregiver is often pulled in many directions from sun-up to sundown. After spending a month with us, my thirty-year-old nephew said to me, “I don’t know how you do it.”
“Do what?” I asked.
His response: “Life.”

From afar it looks easier than it is. After a time, caregivers pick up on the fact that they can sound like complainers, so instead they often hold things in. Holding in feelings can result in growing frustration. People who offer compassionate understanding when I am overwhelmed allow me to vent in healthy ways.

When a caregiver comes to you and is comfortable enough to share her frustration, please stop, look, and listen. In other words, take time to take in what her reality may look and feel like from her perspective. People often put caregivers on a pedestal, but they get grouchy, groggy and Grinch-like too. Acknowledging the difficulties they face allows them to get to the next step. Denial is unhealthy for everyone, but when faced with continual strain, it is important to have reality checks and friends with whom you can honestly share your feelings.

4. Recognize the Importance of Human Touch

If your finances allow it, consider the gift of massage for a caregiver. Recently, I gave myself this gift and was struck with how much better it made me feel. The massage had barely started, and I could feel the sadness and tension in my entire body. I told myself to relax and let the nurturing take place. Within a few minutes, while lying on the massage table, I began to weep. I was then overcome with such deep sadness, that sobs began to erupt. The therapist’s touch had released a trigger in my body to let some of the pain inside come to the outside. My reaction was not uncommon in this setting. Often, just providing someone a safe place is all that person needs to have the release occur. Caregivers often get in a cycle of not making space for self-care; sometimes a gift is the nudge they need to break away for an hour or so.

5. Less Judgment, More Lovement

I have shared this phrase before in my posts and blogs, but it bears repeating. The caregiver’s life is demanding. We are presented with challenging scenarios, which are new to us. We have to make the best decisions we can in a given set of circumstances. And we make mistakes.

We must decide on things like when and if we should call an ambulance. We have to be the voice for a person who often resents our having to take that role on for them, and we also have to find our own lives in the mix of fully assisting someone else.

Most caregivers I know deal with some level of anxiety, guilt, and frustration that resulted from their caregiving role. At the end of the day, they do need more love, because they are required to give more love away.

These are just a few ways to help caregivers be the best they can be.

Source: Five Meaningful Ways to Love the Caregiver in Your Life

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[WEB site] First trial of Cognition Kit wearables demonstrates effectiveness in measuring mental health

The neuroscience company Cambridge Cognition Holdings PLC, which develops near patient technologies for the assessment of brain health, has announced results from a new technology feasibility study. The results demonstrate for the first time that consumer grade wearables such as the Apple Watch® and Microsoft Band can be used to accurately measure clinically relevant cognitive performance in everyday life using the Company’s new Cognition Kit software.

Mental health conditions are among the leading causes of disability worldwide. With more than 450 million people living with mental illnesses, the cost of treatment and care to global economies will double by 2030 to over $6 trillion (Source: World Health Organization).

Current methods of brain health assessment rely on infrequent snapshots to characterise impairment and recovery. Such sparse sampling will often miss clinically significant changes, which can impact on a patient’s quality of life and limit the ability to accurately measure the effect of intervention and treatment.

Cognition Kit is a wearable software platform developed under a joint venture between Cambridge Cognition and London research agency Ctrl Group to address this growing need. The technology will enable doctors, scientists and patients to better understand and manage day-to-day brain health by measuring the key biological and psychological factors affecting mental performance accurately in real time.

The new study shows for the first time that wearable consumer devices can be used clinically to measure cognitive performance accurately when programmed with the Cognition Kit software.

During the study participants wore a wearable device to monitor their levels of stress and physiological activity using built-in sensors of heart rate, galvanic skin response and skin temperature.

Throughout each day, subjects completed game-like micro tests of cognition on the device to measure attention, memory, mood and reaction speed.

After each cognitive game, subjects reported how they felt by selecting one of six faces to convey their current mood. On June 24th, the day of the EU referendum results in the UK, the researchers observed a significant drop in the general mood of the British participants in the study.

The 30 million data points recorded demonstrate distinct patterns of performance within and across days, allowing a rich picture of a subject’s cognitive health to emerge. Cognition Kit thus has the potential to revolutionise brain health treatment at all stages – from patient assessments during the development of disease-modifying interventions to monitoring of patient health.

With drug development companies increasingly being required to demonstrate clinical outcomes-based value of treatments in patients, this Cognition Kit study provides evidence that new technologies could transform healthcare and medical research in a wearable health industry estimated to be worth $2 billion (Source: Soreon Research Wearable Healthcare Report 2014).

Cambridge Cognition is in discussion with a number of pharmaceutical partners following significant early interest boosted by the results of the study and expects to sign the first Cognition Kit contracts in the near future.

Francesca Cormack, PhD, Director of Research and Innovation, Cambridge Cognition commented

”This proof of concept study demonstrates for the first time that these consumer devices are enabling the rapid and accurate collection of largescale scientific datasets. This not only allows dramatically more detailed knowledge of moment-by-moment brain function but also opens up new possibilities to develop machine learning algorithms that will enable earlier detection and intervention in brain disorders.”

Ben Fehnert, Co-founder of Ctrl Group and Director of Cognition Kit commented

”Simple, regular interaction with peoples own phones and wearable devices is key to helping understand daily and longer term fluctuations in cognitive function. This study is the first demonstration of how Cognition Kit software can build a rich picture of brain health using peoples own devices during their daily lives.”

About Cognition Kit

Cognition Kit is a joint venture between Cambridge Cognition and Ctrl Group formed in 2016 to develop digital health tools on mobile and wearable devices. Cognition Kit software takes research out of the lab and into daily life, enabling doctors, scientists and the public to better understand and manage day-to-day brain health.

Source: First trial of Cognition Kit wearables demonstrates effectiveness in measuring mental health

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[ARTICLE] When neutral turns significant: brain dynamics of rapidly formed associations between neutral stimuli and emotional contexts – Full Text

Abstract

The ability to associate neutral stimuli with motivationally relevant outcomes is an important survival strategy. In this study, we used event-related potentials (ERPs) to investigate brain dynamics of associative emotional learning when participants were confronted with multiple heterogeneous information. Participants viewed 144 different objects in the context of 144 different emotional and neutral background scenes. During each trial, neutral objects were shown in isolation and then paired with the background scene. All pairings were presented twice to compare ERPs in response to neutral objects before and after single association. After single pairing, neutral objects previously encoded in the context of emotional scenes evoked a larger P100 over occipital electrodes compared to objects that were previously paired with neutral scenes. Likewise, larger late positive potentials (LPPs) were observed over parieto-occipital electrodes (450–750 ms) for objects previously associated with emotional relative to neutral contexts. The LPP – but not P100 – enhancement was also related to subjective object/context binding. Taken together, our ERP data provide evidence for fast emotional associative learning, as reflected by heightened perceptual and sustained elaborative processing for neutral information previously encountered in emotional contexts. These findings could assist in understanding binding mechanisms in stress and anxiety, as well as in addiction and eating-related disorders.

Introduction

One important survival strategy is to perceive fluctuating changes that occur in contiguous environments in order to readjust the momentary motivational relevance of incoming information. This ability allows developing flexible and adaptive responses based on the history of contingencies encountered by the individual (Miskovic & Keil, 2012). In this sense, it has been observed that a previously neutral stimulus (conditioned stimulus; CS+) continuously associated with an aversive event (unconditioned stimulus; UCS) acquires motivational relevance, compared to a neutral stimulus (CS−) unpaired with a UCS or associated with a non-emotional UCS, a process called associative learning. Traditionally, a large number of pairings between few and/or simple CS+ and a strongly aversive UCS have been used in learning paradigms to generate strong associations (Lissek et al., 2006). However, rather than single, unambiguous and/or isolated CS/UCS pairings, we are constantly confronted with multiple different events that imply associations between neutral and moderately relevant stimuli. Thus, the use of paradigms involving ‘weak’ ambiguous situations (e.g. less salient UCS, multiple complex pairings and/or few contingencies CS/UCS) would provide a better understanding of the underpinnings of associative learning (Lissek et al., 2006; Beckers et al., 2013; Steinberg et al., 2013b; Hur et al., in press). In the present study, we investigated the role of UCS heterogeneity on the formation of associations using electrophysiological correlates of associative learning for multiple neutral events paired with multiple emotional contingencies (emotional scenes).

Recent studies from Junghöfer and colleagues (e.g. Pastor et al., 2015; see Steinberg et al., 2013b, for review) used the so-called MultiCS conditioning, in which multiple CSs+ (e.g. pictures of different faces) were associated with emotionally relevant UCSs (e.g. aversive and appetitive sounds, electric shocks), while other CSs− remained unpaired or were associated with neutral events. Brain activation was measured using electro- and magnetoencephalography (EEG, MEG) during these conditioning procedures. After multiple pairings, CSs+ compared to CSs− evoked enhanced neural activity at prefrontal and sensory cortical regions during earlier (< 300 ms; Bröckelmann et al., 2011; Steinberg et al., 2012, 2013a; Rehbein et al., 2014, 2015) and later stages of processing (> 300 ms; Pastor et al., 2015), irrespective of contingency awareness. These results suggest the existence of a rather automatic learning mechanism that rapidly transfers the emotional properties of the UCS to CSs, leading to a facilitated perceptual and a more elaborated processing of the CS+.

Nevertheless, these studies have only used highly salient UCS. Therefore, it is unclear whether such associative learning processes also occur in the presence of less intense emotional events – i.e., reproducing daily interactions – or whether the formation of associations is exclusively facilitated in survival-specific contexts (Öhman & Mineka, 2001). It is also unclear whether the acquired motivational significance leading to neural response enhancement for emotion-associated stimuli occurs rapidly after one single pairing (e.g. Morel et al., 2012; Rehbein et al., 2014), or whether more than one repetition is needed to form such associations (e.g. Steinberg et al., 2012). While most of the electrophysiological conditioning studies have used aversive cues as UCS (see Miskovic & Keil, 2012, for review), it has recently been observed that pleasant information can also serve as effective, intrinsically motivating UCSs (Schacht et al., 2012; Steinberg et al., 2013a; Blechert et al., 2016; see Martin-Soelch et al., 2007, for neuroimaging findings). Both aversive and appetitive conditioning processes likely not only contribute to various disorders, such as trauma- and stress-related disorders, but also to substance abuse and eating-related disorders (e.g. Martin-Soelch et al., 2007; Pape & Pare, 2010). Thus, more evidence regarding the effect of valence on associative conditioning is needed.

In the present study, we therefore investigated brain dynamics of associative emotional learning when participants viewed neutral objects in the context of different emotionally arousing (both pleasant and unpleasant) and neutral background scenes. Object and scene presentation occurred always in the same order; first objects were presented in isolation (CS) and then a picture scene was added as background (see Fig. 1). Pairings were presented in two consecutive blocks, allowing to compare the processing of CS+ objects – paired with emotional scenes – and CS− objects – paired with neutral scenes, before (first block) and after single pairing (second block). Based on previous EEG and MEG conditioning studies (see Miskovic & Keil, 2012, for review), we predicted enhanced processing of neutral cues previously paired with emotional contexts, irrespective of valence, relative to cues previously paired with neutral contexts at different stages of processing. Because both perceptual and sustained elaborative processing have been found to be enhanced for stimuli associated with CS+, we predicted enhanced positivity for the CS+ compared with the CS− at (a) earlier (P100) and (b) later stages of processing [late positive potential (LPP)].

Figure 1. Schematic view of the stimulus presentation during the first and the second associative learning blocks. When an object was seen during the first block, the object/background association has not yet taken place, and when the object was seen in the second block, object and background scene have been associated once. [Correction added on 19 Aug 2016, after original online publication: Figure 1 has been corrected.]

Continue —> When neutral turns significant: brain dynamics of rapidly formed associations between neutral stimuli and emotional contexts – Ventura-Bort – 2016 – European Journal of Neuroscience – Wiley Online Library

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[WEB SITE] How stress increases seizures for patients with epilepsy – Medical News Today

It is well known that stress can increase the frequency and severity of seizures for patients with epilepsy. Now, researchers have shed light on why this is, and they may have even found a way to stop it.

Researchers have shed light on why stress increases seizure frequency for patients with epilepsy.

Published in the journal Science Signaling, the researchers reveal how epilepsy alters the way brain reacts to stress to cause seizures.

Epilepsy is a neurological disorder characterized by recurrent seizures, which are sudden surges of electrical activity in the brain.

According to the Epilepsy Foundation, around 1.3-2.8 million people in the United States have epilepsy. Each year, around 48 in every 100,000 Americans develop the condition.

Stress and anxiety are well-established triggers for seizures among people with epilepsy, and studies have shown that reducing stress may lower seizure risk for those with the condition.

While neurologists recommend that patients with epilepsy avoid stressful situations as a way of avoiding stress-induced seizures, it is not always possible to do so, highlighting the need for a therapeutic alternative.

However, because scientists have been unclear about how stress causes seizures, such a treatment has proven difficult to find.

Now, Michael O. Poulter, Ph.D., of the University of Western Ontario in Canada, and colleagues believe they may have moved a step closer to fulfilling this need.

Stress-induced seizures caused by increased activity in piriform cortex

For their study, the researchers focused on analyzing the activity of corticotropin-releasing factor (CRF) in the brains of rats with and without epilepsy.

CRF is a neurotransmitter – a chemical that enables communication between nerve cells – that regulates the behavioral response to stress.

The researchers assessed how CRF affected the piriform cortex of the rodents, which is a region of the brain in which seizures are known to occur among humans with epilepsy.

Among rats without epilepsy, the researchers found that CRF reduced activity in the piriform cortex of the brain. Among rats with epilepsy, however, they found CRF did the opposite, increasing activity in the piriform cortex.

“When we used CRF on the epileptic brain, the polarity of the effect flipped; it went from inhibiting the piriform cortex to exciting it,” explains Poulter. “At that point we became excited, and decided to explore exactly why this was happening.”

On further investigation, the team found that CRF altered neuronal signaling in the brains of rats with epilepsy.

Specifically, they found that CRF activated a protein called regulator of G protein signaling protein type 2 (RGS2), which changed communication between nerve cells in the piriform cortex to increase the occurrence of seizures.

The researchers say their findings suggest it may be possible to prevent stress-induced seizures in patients with epilepsy by blocking CRF.

“We are very excited about this possibility for treating epilepsy patients.”

Michael O. Poulter, Ph.D.

Furthermore, the researchers say their findings may have implications for other neurological disorders, such as depression and schizophrenia; these conditions might trigger neurochemical processes that increase severity of symptoms.

Learn how a derivative of cannabis could help treat childhood epilepsy.

Source: How stress increases seizures for patients with epilepsy – Medical News Today

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[VIDEO] Seizures and Stress: What it Means, How to Block the Connection – YouTube

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[ARTICLE] Can emotional stress trigger the onset of epilepsy?

Highlights

  • Onset of epilepsy after a stressful life event
  • More than half of the patients reported a death of a loved one as a triggering factor.
  • Medial temporal lobe epilepsy is overrepresented.
  • The average age at onset is quite late, around age 30, even in the presence of brain lesions.
  • Contrary to patients with psychogenic nonepileptic seizures, no sexual abuse is reported.

Abstract

Objective: The aim of this study was to investigate the potential role of an acute adverse stress as “trigger” for the onset of epilepsy.

Methods: Among 4618 consecutive patients, twenty-two reported a major life event within three months before the onset of epilepsy.

Results: All patients had focal epilepsy except one with idiopathic generalized epilepsy. The temporal lobe was involved in 90% of patients with focal epilepsy. More precisely, 13 patients (62% of patients with focal epilepsy) had medial temporal lobe epilepsy (MTLE), two had lateral temporal lobe epilepsy, four had temporoparietooccipital junction epilepsy, and two patients had central lobe epilepsy. The mean age and the median age at onset of epilepsy for patients with MTLE were both 38 years (range: 9.5–65 years). Ten patients had right and three had left MTLE. Among patients with focal epilepsy, MRI was abnormal in 7 (33%) with hippocampal sclerosis in four, periventricular nodular heterotopia in two, and complex cortical dysgenesis in one. The mean age at onset of epilepsy for patients with brain lesions was 26 years (range: 9.5–49). Twelve patients (54%) reported a death as a triggering factor for the onset of their epilepsy. Seven patients (32%) reported that a relationship of trust had been broken. Three patients (14%) had been subjects of violence. No patient reported sexual abuse as a triggering factor.

Conclusion: This study provides evidence that some patients (5/1000 patients) began their seizures in the wake of significant life events. The average age at onset of epilepsy is quite late, around age 30, even in the presence of brain lesions. These patients are emotionally and affectively more prone to have consequences of a stressful life event. The recognition and management of such situations may bring significant relief with improvement of the control of epilepsy.

via Can emotional stress trigger the onset of epilepsy?.

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[ARTICLE] Impact of sleep duration on seizure frequency in adults with epilepsy: A sleep diary study

Highlights

•We studied the effect of partial sleep deprivation on seizure occurrence.

•Adults with epilepsy recorded 237 seizures and sleep and wake periods for 1 month.

•Sleep time was not different between preseizure and seizure-free periods.

•Napping, sleepiness, fatigue, and insomnia symptoms were commonly reported.

•Small degrees of sleep loss were not associated with seizures in our sample.

Abstract

Background

Prolonged sleep deprivation activates epileptiform EEG abnormalities and seizures in people with epilepsy. Few studies have addressed the effect of chronic partial sleep deprivation on seizure occurrence in populations with epilepsy. We tested the primary hypothesis that partial sleep deprivation over 24- and 72-hour periods increases seizure occurrence in adults with epilepsy.

Methods

Forty-four subjects completed a series of self-reported instruments, as well as 1-month sleep and seizure diaries, to characterize their sleep and quality of life. Diaries were used to determine the relationship between seizure occurrence and total sleep time 24 and 72 h before seizure occurrence using random effects models and a logistic regression model fit by generalized estimating equations.

Results

A total of 237 seizures were recorded during 1295 diary days, representing 5.5 ± 7.0 (mean ± SD) seizures per month. Random effects models for 24- and 72-hour total sleep times showed no clinically or statistically significant differences in the total sleep time between preseizure periods and seizure-free periods. The average 24-hour total sleep time during preseizure 24-hour periods was 8 min shorter than that during seizure-free periods (p = 0.51). The average 72-hour total sleep time during preseizure periods was 20 min longer than that during seizure-free periods (p = 0.86). The presence of triggers was a significant predictor of seizure occurrence, with stress/anxiety noted most often as a trigger. Mean total sleep time was 9 h, and subjects took an average of 12 ± 10 naps per month, having a mean duration of 1.9 ± 1.2 h. Daytime sleepiness, fatigue, and insomnia symptoms were commonly reported.

Conclusions

Small degrees of sleep loss were not associated with seizure occurrence in our sample of adults with epilepsy. Our results also include valuable observations of the altered sleep times and frequent napping habits of adults with refractory epilepsy and the potential contribution of these habits to quality of life and seizure control.

via Impact of sleep duration on seizure frequency in adults with epilepsy: A sleep diary study – Epilepsy & Behavior.

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