Jacqueline Schmidt Rio-Valle

Neuropsychological consequences of alcohol and drug abuse on different components of executive functions

Several studies have shown alterations in different components of executive functioning in users of different drugs, including cannabis, cocaine and heroin. However, it is difficult to establish a specific association between the use of each of these drugs and executive alterations, since most drug abusers are polysubstance abusers, and alcohol is a ubiquitous confounding factor. Moreover, in order to study the association between consumption of different drugs and executive functioning, the patterns of quantity and duration of drugs used must be considered, given the association between these parameters and the executive functioning alteration degree. Based on the multicomponent approach to executive functions, the aims of the present study were: (i) to analyse the differential contribution of alcohol versus cocaine, heroin and cannabis use on executive functions performance; and (ii) to analyse the contribution made by the severity of the different drugs used (quantity and duration patterns) on these functions in a sample of polysubstance abusers that requested treatment for cannabis-, cocaine- or heroin-related problems. We administered measures of fluency, working memory, analogical reasoning, interference, cognitive flexibility, decision-making and self-regulation to two groups: 60 substance-dependent individuals (SDIs) and 30 healthy control individuals (HCIs). SDIs had significantly poorer performance than HCIs across all of the executive domains assessed. Results from hierarchical regression models showed the existence of common correlates of the use of alcohol, cannabis and cocaine on verbal fluency and decision-making; common correlates of quantity of cannabis and cocaine use on verbal working memory and analogical reasoning; common correlates of duration of cocaine and heroin use on shifting; and specific effects of duration of cocaine use on inhibition measures. These findings indicate that alcohol abuse is negatively associated with fluency and decision-making deficits, whereas the different drugs motivating treatment have both generalized and specific deleterious effects on different executive components.

BMI Predicts Emotion‐Driven Impulsivity and Cognitive Inflexibility in Adolescents With Excess Weight

Adolescent obesity is increasingly viewed as a brain‐related dysfunction, whereby reward‐driven urges for pleasurable foods “hijack” response selection systems, such that behavioral control progressively shifts from impulsivity to compulsivity. In this study, we aimed to examine the link between personality factors (sensitivity to reward (SR) and punishment (SP), BMI, and outcome measures of impulsivity vs. flexibility in—otherwise healthy—excessive weight adolescents. Sixty‐three adolescents (aged 12–17) classified as obese (n = 26), overweight (n = 16), or normal weight (n = 21) participated in the study. We used psychometric assessments of the SR and SP motivational systems, impulsivity (using the UPPS‐P scale), and neurocognitive measures with discriminant validity to dissociate inhibition vs. flexibility deficits (using the process‐approach version of the Stroop test). We tested the relative contribution of age, SR/SP, and BMI on estimates of impulsivity and inhibition vs. switching performance using multistep hierarchical regression models. BMI significantly predicted elevations in emotion‐driven impulsivity (positive and negative urgency) and inferior flexibility performance in adolescents with excess weight—exceeding the predictive capacity of SR and SP. SR was the main predictor of elevations in sensation seeking and lack of premeditation. These findings demonstrate that increases in BMI are specifically associated with elevations in emotion‐driven impulsivity and cognitive inflexibility, supporting a dimensional path in which adolescents with excess weight increase their proneness to overindulge when under strong affective states, and their difficulties to switch or reverse habitual behavioral patterns.

Brain Structural Correlates of Reward Sensitivity and Impulsivity in Adolescents with Normal and Excess Weight

Introduction Neuroscience evidence suggests that adolescent obesity is linked to brain dysfunctions associated with enhanced reward and somatosensory processing and reduced impulse control during food processing. Comparatively less is known about the role of more stable brain structural measures and their link to personality traits and neuropsychological factors on the presentation of adolescent obesity. Here we aimed to investigate regional brain anatomy in adolescents with excess weight vs. lean controls. We also aimed to contrast the associations between brain structure and personality and cognitive measures in both groups. Methods Fifty-two adolescents (16 with normal weight and 36 with excess weight) were scanned using magnetic resonance imaging and completed the Sensitivity to Punishment and Sensitivity to Reward Questionnaire (SPSRQ), the UPPS-P scale, and the Stroop task. Voxel-based morphometry (VBM) was used to assess possible between-group differences in regional gray matter (GM) and to measure the putative differences in the way reward and punishment sensitivity, impulsivity and inhibitory control relate to regional GM volumes, which were analyzed using both region of interest (ROI) and whole brain analyses. The ROIs included areas involved in reward/somatosensory processing (striatum, somatosensory cortices) and motivation/impulse control (hippocampus, prefrontal cortex). Results Excess weight adolescents showed increased GM volume in the right hippocampus. Voxel-wise volumes of the second somatosensory cortex (SII) were correlated with reward sensitivity and positive urgency in lean controls, but this association was missed in excess weight adolescents. Moreover, Stroop performance correlated with dorsolateral prefrontal cortex volumes in controls but not in excess weight adolescents. Conclusion Adolescents with excess weight have structural abnormalities in brain regions associated with somatosensory processing and motivation.

Effects of a multicomponent behavioral intervention on impulsivity and cognitive deficits in adolescents with excess weight.

The aim of this study was to explore the effects of a multidisciplinary behavioral intervention including cognitive behavioral therapy, structured physical activity, and dietary counseling on impulsive personality and cognitive skills and subsequent BMI loss in excess weight adolescents. Forty-two adolescents with excess weight (14 males and 28 females, range 12–17 years), as defined by the International Obesity Task Force Criteria, participated in our study. We used a longitudinal observational design with two assessments: before and after treatment. We collected baseline measures of impulsive personality (UPPS-P scale), cognitive performance (letter number sequencing, Stroop and Iowa gambling task), and biometric parameters. After 12 weeks of intervention, parallel measures were used to determine whether treatment-induced changes in impulsivity and cognition predicted changes in BMI. BMI showed a statistically significant reduction after treatment [from mean (SD) 29.36 (4.51) to 27.31 (4.41), Cohen’s d=0.5]. Greater reductions in negative urgency (negative-emotion-driven impulsivity) and greater improvement in cognitive inhibitory control skills were associated with greater reductions in BMI. Because the design was correlational and lacked a control group, future studies should clarify whether these associations reflect a causal effect or just overlapping improvements associated with a third variable (e.g. increases in attention procurement or motivation).

Dysfunctional involvement of emotion and reward brain regions on social decision making in excess weight adolescents

Obese adolescents suffer negative social experiences, but no studies have examined whether obesity is associated with dysfunction of the social brain or whether social brain abnormalities relate to disadvantageous traits and social decisions. We aimed at mapping functional activation differences in the brain circuitry of social decision making in adolescents with excess versus normal weight, and at examining whether these separate patterns correlate with reward/punishment sensitivity, disordered eating features, and behavioral decisions. In this fMRI study, 80 adolescents aged 12 to 18 years old were classified in two groups based on age adjusted body mass index (BMI) percentiles: normal weight (n = 44, BMI percentiles 5th–84th) and excess weight (n = 36, BMI percentile ≥ 85th). Participants were scanned while performing a social decision‐making task (ultimatum game) in which they chose to “accept” or “reject” offers to split monetary stakes made by another peer. Offers varied in fairness (Fair vs. Unfair) but in all cases “accepting” meant both players win the money, whereas “rejecting” meant both lose it. We showed that adolescents with excess weight compared to controls display significantly decreased activation of anterior insula, anterior cingulate, and midbrain during decisions about Unfair versus Fair offers. Moreover, excess weight subjects show lower sensitivity to reward and more maturity fears, which correlate with insula activation. Indeed, blunted insula activation accounted for the relationship between maturity fears and acceptance of unfair offers. Excess weight adolescents have diminished activation of brain regions essential for affective tracking of social decision making, which accounts for the association between maturity fears and social decisions. Hum Brain Mapp, 36:–237, 2015.

Decreased insular and increased midbrain activations during decision-making under risk in adolescents with excess weight

Functional magnetic resonance imaging (fMRI) was used to explore the brain substrates of decisions under risk in excess weight adolescents. Decreased activations of the brain regions signaling risk (orbitofrontal cortex [OFC], insula) were expected during anticipation of higher rewards and increased activations of the brain regions involved in reward processing (OFC, striatum) were expected after reward receipt in excess weight adolescents compared to normal weight controls.

The Effect of Exercise Training on Mediators of Inflammation in Breast Cancer Survivors: A Systematic Review with Meta-analysis

Several sources of evidence indicate that exercise during and after breast cancer could positively modulate the tumor microenvironment. This meta-analysis aimed to determine the effects of exercise training on mediators of inflammation in breast cancer survivors. We searched for randomized controlled trials published from January 1990 to March 2014. An inverse variance method of meta-analysis was performed using a random effects model in the presence of statistical heterogeneity. Eight high-quality trials (n = 478) were included. Exercise improved the serum concentrations of IL6 [weighted mean difference (WMD) = −0.55 pg/mL; 95% confidence interval (CI), −1.02 to −0.09], TNFα (WMD = −0.64 pg/mL; 95% CI, −1.21 to −0.06), IL8 (MD = −0.49 pg/mL; 95% CI, −0.89 to −0.09), and IL2 (WMD = 1.03 pg/mL; 95% CI, 0.40 to 1.67). No significant differences were found in the serum concentrations of C-reactive protein (WMD = −0.15; 95% CI, −0.56 to 0.25) or IL10 (WMD = 0.41; 95% CI, −0.18 to 1.02). Exercise training positively modulates chronic low-grade inflammation in women with breast cancer, which may impact upon carcinogenic mechanisms and the tumor microenvironment. These findings align with the other positive effects of exercise for breast cancer survivors, reinforcing the appropriateness of exercise prescription in this population. Cancer Epidemiol Biomarkers Prev; 25(7); 1009–17. ©2016 AACR.

The insulin-like growth factor system is modulated by exercise in breast cancer survivors: a systematic review and meta-analysis

BackgroundInsulin-like growth factors (IGF´s) play a crucial role in controlling cancer cell proliferation, differentiation and apoptosis. Exercise has been postulated as an effective intervention in improving cancer-related outcomes and survival, although its effects on IGF´s are not well understood. This meta-analysis aimed to determine the effects of exercise in modulating IGF´s system in breast cancer survivors.MethodsDatabases of PuMed, EMBASE, Cochrane Central Register of Controlled Trials, EMBASE, ClinicalTrials.gov, SPORTDiscus, LILACS and Scopus were systematically searched up to November 2014. Effect estimates were calculated through a random-effects model of meta-analysis according to the DerSimonian and Laird method. Heterogeneity was evaluated with the I2 test. Risk of bias and methodological quality were evaluated using the PEDro score.ResultsFive randomized controlled trials (n = 235) were included. Most women were post-menopausal. High-quality and low risk of bias were found (mean PEDro score = 6.2 ± 1). Exercise resulted in significant improvements on IGF-I, IGF-II, IGFBP-I, IGFBP-3, Insulin and Insulin resistance (P < 0.05). Non-significant differences were found for Glucose. Aerobic exercise improved IGF-I, IGFBP-3 and Insulin. No evidence of publication bias was detected by Egger´s test (p = 0.12).ConclusionsExercise improved IGF´s in breast cancer survivors. These findings provide novel insight regarding the molecular effects of exercise on tumoral microenvironment, apoptosis and survival in breast cancer survivors.

The Effects of Body Composition, Dietary Intake, and Physical Activity on Calcaneus Quantitative Ultrasound in Spanish Young Adults

Identifying modifiable factors that influence bone gain during early adulthood in order to maximize peak bone mass (PBM) is a potential primary strategy in the prevention of osteoporosis in later life. The present study examined the relationships between body composition, dietary intake and physical activity (PA), and bone health measured by quantitative ultrasound (QUS) at the right calcaneus. The study population consisted of 781 Spanish men and women (age 19.1 ± 3.6). Body composition, dietary intake, PA, and bone strength were assessed. Calcaneus QUS was significantly correlated with age, height, weight, body mass index, lean mass, fat mass, protein intake, and moderate and high PA. No significant correlation between calcium intake and broadband ultrasound attenuation (BUA, dB/MHz) was detected. Linear regression analyses revealed that independent variables accounted for 18.8% of the total variance of calcaneus BUA (p = .000). Lean mass and high PA were significant predictors of BUA variance in young adults (p = .000 and p = .045, respectively). Results indicate that lifestyle choices and their consequences during early adulthood could influence bone mass, particularly PA and lean mass. Furthermore, this study provides novel data about bone mass as indicated by the QUS measurements at the time of PBM acquisition.

Exercise training, inflammatory cytokines, and other markers of low-grade inflammation in breast cancer survivors: A systematic review and meta-analysis.

121 Background: Low-grade inflammation, characterized by high cytokine activity, plays a crucial role in tumorigenesis. Further, cytokines and other inflammatory biomarkers are closely implicated in tumor growth, angiogenesis, and metastasis. This metaanalysis of randomized controlled trials estimates the effects of exercise training in the control of the serum levels of cytokines and other inflammatory markers in breast cancer survivors. METHODS PRISMA statement and the Cochrane Handbook were followed. We searched MEDLINE, CENTRAL, EMBASE, Scopus and DARE database to retrieve randomized controlled trials published between 1980- March 2014 providing effect estimates of exercise interventions in the serum levels of cytokines, such as interleukin (IL) -2, IL-6, IL-8, tumoral necrosis factor alpha (TNF-α) and C-reactive protein (CRP) in breast cancer survivors. An Inverse of variance (IV) fixed-effects model was conducted in absence of heterogeneity (I2<50%); otherwise a random-effects model was selected. Mean Differences (MD) were calculated to estimate differences between groups (p<0.05 with 95% Confidence interval). Heterogeneity was measured with the Chi2 test (p<0.10) and I2 statistics. RESULTS A total of 15 studies were included (n=1,447; mean age= 51.6 years old). Exercise interventions resulted in positive effects for CRP (MD= 0.37, 95%CI, 0.04 to 0.71; p= 0.03; I2=15%), IL-2 (MD= -6.04, 85%CI, -11.41 to -0.67; p=0.03; I2=0%), IL-10 (-22.90, 95%CI, -41.27 to -4.53; p=0.001, I2=0%) and waist circumference as indicator of body composition (MD= -1.12, 95%CI, -2.06 to -0.18; p=0.02; I2=45%). Non-significant differences were observed for IL-6 and TNF-α. There was no evidence of publication bias. CONCLUSIONS These findings suggest that exercise training improves the systemic pro-inflammatory profile in breast cancer survivors and consequently the immunological responses and the carcinogenic processes related to tumoral environment. The effects observed for IL-10 provide a novel focus of evidence for the role of exercise as an effective anti-inflammatory intervention in cancer survivors.