Arts & Sciences Brown School McKelvey School of Engineering School of Medicine Weekly Publications

WashU weekly Neuroscience publications

“Donor activation focused rehabilitation approach to hand closing nerve transfer surgery in individuals with cervical level spinal cord injury” (2022) Spinal Cord Series and Cases

Donor activation focused rehabilitation approach to hand closing nerve transfer surgery in individuals with cervical level spinal cord injury
(2022) Spinal Cord Series and Cases, 8 (1), art. no. 47, . 

Kahn, L.C.a , Evans, A.G.b c , Hill, E.J.R.c , Fox, I.K.c

a Milliken Hand Rehabilitation Center, Department of Occupational Therapy, Washington University, St. Louis, MO 63110, United States
b School of Medicine, Meharry Medical College, Nashville, TN 37208, United States
c Division of Plastic and Reconstructive Surgery, Washington University School of Medicine, St. Louis, MO 63110, United States

Abstract
Study design: Case Series. Objectives: To describe the donor activation focused rehabilitation approach (DAFRA) in the setting of the hand closing nerve transfers in cervical spinal cord injury (SCI) so that therapists may apply it to treatment of individuals undergoing this procedure. Setting: United States of America—Academic Level 1 Trauma Center. Methods: We reviewed the records of individuals with cervical SCI who underwent nerve transfer to restore hand closing and post-surgery DAFRA therapy at our institution. The three post-surgery phases of DAFRA included (1) early phase (0–12 months) education, limb preparation, and donor activation exercises, (2) middle phase (12–24 months) volitional recipient muscle activation and (3) late phase (18 + months) strengthening and incorporation of motion in activities of daily living. Results: Subtle gains in hand closing were first observed at a mean of 8.4 months after hand closing nerve transfer surgery. Remarkable improvements including discontinuation of assistive devices, independence with feeding and urinary function, and measurable grip were observed. Function continued to improve slowly for one to two more years. Conclusions: A deliberate, slow-paced (monthly for >2 years post-surgery) and incremental therapy program—DAFRA—can be used to improve outcomes after nerve transfer to restore hand closing in cervical SCI. Sponsorship: This work was made possible by funding from the Craig H. Neilsen Foundation Spinal Cord Injury Research on the Translation Spectrum (SCIRTS) Grant: Nerve Transfers to Restore Hand Function in Cervical Spinal Cord Injury (PI: Ida Fox). © 2022, The Author(s), under exclusive licence to International Spinal Cord Society.

Document Type: Article
Publication Stage: Final
Source: Scopus

“Prevalence of stressful life events and associations with symptoms of depression, anxiety, and post-traumatic stress disorder among people entering care for HIV in Cameroon” (2022) Journal of Affective Disorders

Prevalence of stressful life events and associations with symptoms of depression, anxiety, and post-traumatic stress disorder among people entering care for HIV in Cameroon
(2022) Journal of Affective Disorders, 308, pp. 421-431. 

Filiatreau, L.M.a b c , Ebasone, P.V.d , Dzudie, A.d , Ajeh, R.d , Pence, B.W.e , Wainberg, M.f , Nash, D.g , Yotebieng, M.h , Anastos, K.h i , Pefura-Yone, E.j , Nsame, D.k , Parcesepe, A.M.c l

a Washington University in St. Louis, School of Medicine, Department of Psychiatry, St. Louis, MO, United States
b Washington University in St. Louis, Brown School, International Center for Child Health and Development, St. Louis, MO, United States
c University of North Carolina at Chapel Hill, Carolina Population Center, Chapel Hill, NC, United States
d Clinical Research Education Networking and Consultancy, Yaounde, Cameroon
e University of North Carolina at Chapel Hill, Gillings School of Global Public Health, Department of Epidemiology, Chapel Hill, NC, United States
f Columbia University, Department of Psychiatry, New York, NY, United States
g City University of New York, Institute of Implementation Science in Population Health, New York, NY, United States
h Albert Einstein College of Medicine, Department of Medicine, Bronx, NY, United States
i Albert Einstein College of Medicine, Department of Epidemiology & Population Health, Bronx, NY, United States
j Jamot Hospital, Yaounde, Cameroon
k Bamenda Regional Hospital, Bamenda, Cameroon
l University of North Carolina at Chapel Hill, Gillings School of Global Public Health, Department of Maternal and Child Health, Chapel Hill, NC, United States

Abstract
Background: Exposure to stressors increases the risk of mental health disorders. People living with HIV (PLWH) are particularly affected by poor mental health which can contribute to adverse HIV treatment outcomes. Methods: We estimated the prevalence of recent stressful life events (modified Life Events Survey) among a cohort of PLWH entering HIV care at three public health care facilities in Cameroon and quantified the association of seven types of stressful life events with symptoms of depression (Patient Health Questionnaire-9 scores>9), anxiety (General Anxiety Disorder-7 scores>9), and PTSD (PTSD Checklist for DSM-5 scores>30) using separate log-binomial regression models. Results: Of 426 PLWH enrolling in care, a majority were women (59%), in relationships (58%), and aged 21 to 39 years (58%). Recent death of a family member (39%) and severe illness of a family member (34%) were the most commonly reported stressful life events. In multivariable analyses, more stressful life event types, a negative relationship change, death or illness of a friend/family member, experience of violence, work-related difficulties, and feeling unsafe in one’s neighborhood were independently associated with at least one of the mental health outcomes assessed. The greatest magnitude of association was observed between work-related difficulties and PTSD (adjusted prevalence ratio: 3.1; 95% confidence interval: 2.0–4.8). Limitations: Given the design of our study, findings are subject to recall and social desirability bias. Conclusions: Stressful life events were common among this population of PLWH entering care in Cameroon. Evidence-based interventions that improve coping, stress management, and mental health are needed. © 2022 Elsevier B.V.

Author Keywords
Anxiety;  Cameroon;  Depression;  HIV;  PTSD;  Stressful life events

Funding details
National Institute of Mental HealthNIMHK01 MH114721
National Institute of Allergy and Infectious DiseasesNIAIDP30 AI050410
National Institute on Minority Health and Health DisparitiesNIMHDT37 MD014218, U01AI096299
Eunice Kennedy Shriver National Institute of Child Health and Human DevelopmentNICHDP2C HD050924
Center for AIDS Research, University of North Carolina at Chapel HillUNC CFAR
Carolina Population Center, University of North Carolina at Chapel HillCPC

Document Type: Article
Publication Stage: Final
Source: Scopus

“SOD1 mediates lysosome-to-mitochondria communication and its dysregulation by amyloid-β oligomers” (2022) Neurobiology of Disease

SOD1 mediates lysosome-to-mitochondria communication and its dysregulation by amyloid-β oligomers
(2022) Neurobiology of Disease, 169, art. no. 105737, . 

Norambuena, A.a , Sun, X.a , Wallrabe, H.a , Cao, R.a d , Sun, N.f , Pardo, E.a , Shivange, N.a , Wang, D.B.a , Post, L.A.c e , Ferris, H.A.c e , Hu, S.f , Periasamy, A.a d , Bloom, G.S.a b c

a Department of Biology, University of Virginia, Charlottesville, VA 22904, United States
b Department of Cell Biology, University of Virginia, Charlottesville, VA 22904, United States
c Department of Neuroscience, University of Virginia, Charlottesville, VA 22904, United States
d W.M. Keck Center for Cellular Imaging, University of Virginia, Charlottesville, VA 22904, United States
e Division of Endocrinology & Metabolism, School of Medicine, University of Virginia, Charlottesville, VA 22904, United States
f Department of Biomedical Engineering, Washington University in St. Louis, St. Louis, MO, United States

Abstract
Altered mitochondrial DNA (mtDNA) occurs in neurodegenerative disorders like Alzheimer’s disease (AD); how mtDNA synthesis is linked to neurodegeneration is poorly understood. We previously discovered Nutrient-induced Mitochondrial Activity (NiMA), an inter-organelle signaling pathway where nutrient-stimulated lysosomal mTORC1 activity regulates mtDNA replication in neurons by a mechanism sensitive to amyloid-β oligomers (AβOs), a primary factor in AD pathogenesis (Norambuena et al., 2018). Using 5-ethynyl-2′-deoxyuridine (EdU) incorporation into mtDNA of cultured neurons, along with photoacoustic and mitochondrial metabolic imaging of cultured neurons and mouse brains, we show these effects being mediated by mTORC1-catalyzed T40 phosphorylation of superoxide dismutase 1 (SOD1). Mechanistically, tau, another key factor in AD pathogenesis and other tauopathies, reduced the lysosomal content of the tuberous sclerosis complex (TSC), thereby increasing NiMA and suppressing SOD1 activity and mtDNA synthesis. AβOs inhibited these actions. Dysregulation of mtDNA synthesis was observed in fibroblasts derived from tuberous sclerosis (TS) patients, who lack functional TSC and elevated SOD1 activity was also observed in human AD brain. Together, these findings imply that tau and SOD1 couple nutrient availability to mtDNA replication, linking mitochondrial dysfunction to AD. © 2022 The Authors

Author Keywords
Alzheimer’s disease;  Amino acids;  Insulin;  mTOR;  Tau

Funding details
17–5
OD016446
National Institutes of HealthNIH
National Institute on AgingNIAR01AG067048
Alzheimer’s AssociationAAZEN-16-363266
Cure Alzheimer’s FundCAF
University of VirginiaUV
Geological Survey of BelgiumGSBRF1 AG051085

Document Type: Article
Publication Stage: Final
Source: Scopus

“Neurocircuitry of treatment in anxiety disorders” (2022) Biomarkers in Neuropsychiatry

Neurocircuitry of treatment in anxiety disorders
(2022) Biomarkers in Neuropsychiatry, 6, art. no. 100052, . 

Baumel, W.T.a , Lu, L.b c , Huang, X.b c , Drysdale, A.T.d , Sweeny, J.A.a b , Gong, Q.b c , Sylvester, C.M.d , Strawn, J.R.a

a Department of Psychiatry & Behavioral Neuroscience, College of Medicine, University of Cincinnati, Cincinnati, OH, United States
b Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, China
c Psychoradiology Research Unit of Chinese Academy of Medical Sciences, West China Hospital of Sichuan University, Sichuan, Chengdu, China
d Department of Psychiatry, School of Medicine, Washington University in St. Louis, St. Louis, MO, United States

Abstract
Background: Understanding how treatments change neurobiology is critical to developing predictors of treatment response. This is especially true for anxiety disorders—the most common psychiatric disorders across the lifespan. With this in mind, we examined neurofunctional predictors of treatment response and neurofunctional changes associated with treatment across anxiety disorders. Methods: PubMed/Medline was searched for prospective treatment studies that included parallel examinations of functional activation or connectivity (both task-based and resting state) in adults and youth with panic disorder and generalized, separation, and/or social anxiety disorders published before April 30, 2021. All studies examining baseline predictors or changes related to pharmacologic and psychotherapeutic treatment of DSM-IV and DSM-5 anxiety disorders were included. Demographic, clinical, and treatment data as well as neurofunctional outcomes were extracted and summarized. Results: Twenty-nine studies examined changes in functional activation and/or connectivity (56 treatment arms) related to treatment and twenty-three examined neurofunctional predictors of treatment response. Predictors of treatment response and treatment-related neurofunctional changes were frequently observed within amygdala-prefrontal circuits. However, immense heterogeneity and few replication studies preclude a cohesive neurofunctional treatment response model across anxiety disorders. Conclusions: The extant literature describing neurofunctional aspects of treatment response in anxiety disorders is best viewed as a partially constructed scaffold on which to build a clinically translatable set of robust neuroimaging biomarkers that can be used to guide treatment and to select from available treatment. The construction of this understanding will require harmonization of analytic and task approaches, larger samples, and replication of component studies. © 2022 The Authors

Author Keywords
Anxiety/Anxiety disorders;  biological markers;  CBT/cognitive behavior;  neuroimaging;  Pharmacotherapy;  therapy;  treatment

Funding details
National Institutes of HealthNIHK23 MH109983, R01 HD098757, R01 MH122389, R25 MH112473
National Institute of Mental HealthNIMH
National Institute of Environmental Health SciencesNIEHS
Eunice Kennedy Shriver National Institute of Child Health and Human DevelopmentNICHD

Document Type: Review
Publication Stage: Final
Source: Scopus

“Sleep behavior and chronotype before and throughout pregnancy” (2022) Sleep Medicine

Sleep behavior and chronotype before and throughout pregnancy
(2022) Sleep Medicine, 94, pp. 54-62. 

Zhao, P.a , Bedrick, B.S.a , Brown, K.E.a , McCarthy, R.a , Chubiz, J.E.a , Ju, Y.-E.S.a , Raghuraman, N.a , Fay, J.C.b , Jungheim, E.S.c , Herzog, E.D.a , England, S.K.a

a Washington University, St. Louis, United States
b University of Rochester, United States
c Northwestern University, United States

Abstract
Study objective: To compare sleep behavior before and during pregnancy. Methods: In this prospective cohort study, healthy women were followed from pre-pregnancy until delivery. At pre-pregnancy and each trimester, participants completed validated questionnaires of chronotype and sleep quality and timing, including the Munich ChronoType Questionnaire, Epworth Sleepiness Scale, and Pittsburgh Sleep Quality Index. The primary outcomes were sleep period start and end times, sleep duration, sleep midpoint, and social jetlag, compared between pre-pregnancy and each trimester. Wrist actigraphy was used to measure the same outcomes in a subset of participants. Results: Eighty-six women were included in analysis of questionnaires. Of these, 37 provided complete actigraphy data. Questionnaire and actigraphy data indicate that participants had less social jetlag during pregnancy than before pregnancy. Sleep period start times were earlier on both work and free days in the first and second trimesters than pre-pregnancy, and returned to pre-pregnancy times by the third trimester. Actigraphy data revealed that, compared to pre-pregnancy, participants had longer sleep periods in all trimesters on work days and in the first trimester on free days. Sleep surveys revealed that participants had poorer sleep quality in the first and third trimesters and more sleepiness in the first trimester than pre-pregnancy. Conclusion: The first trimester of pregnancy is characterized by earlier sleep period start time, longer sleep duration, and poorer sleep quality than pre-pregnancy. Sleep quality temporarily improves in the second trimester, and sleep period start time returns to pre-pregnancy time by the third trimester. Study rationale: Multiple parameters of sleep have been studied in the context of pregnancy and pregnancy outcomes, but rarely in comparison to pre-pregnancy or longitudinally through pregnancy. Study impact: Actigraphy and questionnaire data reveal sleep timing and quality change throughout pregnancy. These data on sleep changes in healthy pregnancy can be used as a baseline to identify sleep-related risk factors throughout pregnancy. © 2022 Elsevier B.V.

Author Keywords
Actigraphy;  Chronotype;  Circadian;  Pregnancy;  Reproduction;  Sleep behavior;  Sleep surveys;  Survey

Funding details
National Institutes of HealthNIHK23NS089922, UL1RR024992 Sub-Award KL2TR000450
March of Dimes FoundationMDF
National Center for Advancing Translational SciencesNCATS
Institute of Clinical and Translational SciencesICTSUL1TR000448

Document Type: Article
Publication Stage: Final
Source: Scopus

“Restless legs syndrome is associated with long-COVID in women” (2022) Journal of Clinical Sleep Medicine: JCSM: Official Oublication of the American Academy of Sleep Medicine

Restless legs syndrome is associated with long-COVID in women
(2022) Journal of Clinical Sleep Medicine: JCSM: Official Oublication of the American Academy of Sleep Medicine, 18 (5), pp. 1413-1418. Cited 1 time.

Weinstock, L.B.a , Brook, J.B.b , Walters, A.S.c , Goris, A.d , Afrin, L.B.e , Molderings, G.J.f

a Departments of Medicine, Missouri Baptist Medical Center and Washington University School of Medicine, St. Louis, MO, United States
b Biostatistics, Private Practice, Truckee, CA, United States
c Division of Sleep Medicine, Vanderbilt University School of Medicine, Nashville, TN, United States
d Infection Prevention and Control and Clinical Quality, Missouri Baptist Medical Center, St. Louis, MO, United States
e Department of Mast Cell Studies, Hematology/Oncology, AIM Center for Personalized Medicine, Purchase, NY, United States
f Institute of Human Genetics, University Hospital Bonn, Bonn, Germany

Abstract
STUDY OBJECTIVES: Sleep disturbance is common in long-COVID (LC). Restless legs syndrome (RLS) is characterized by sleep disturbance and has been reported after viral infections. Therefore, we evaluated RLS symptoms cross-sectionally in individuals with LC at both current and pre-coronavirus disease 2019 (pre-COVID-19) time points. METHODS: Adults on LC-focused Facebook pages were recruited for an online assessment of symptoms before COVID-19 infection and during their present LC state in a cross-sectional manner. The LC group documented baseline symptoms retrospectively. Questions were included about the presence/severity of RLS symptoms and assessments of fatigue, quality of life, and sleep apnea. A control group was recruited and included individuals ≥ 18 years of age who never had overt symptoms of COVID-19. Pregnancy was an exclusion criterion for both groups. RESULTS: There were 136 participants with LC (89.7% females, age 46.9 ± 12.9 years) and 136 controls (65.4% females, age 49.2 ± 15.5). RLS prevalence in females with LC was 5.7% pre-COVID-19 and 14.8% post-COVID-19 (P < .01) vs 6.7% in control females. Severity of RLS was moderate in both groups. Logistic regression predicting post-COVID-19 RLS among females with LC failed to find significant effects of hospitalization, sleep apnea, neuropathic pain severity, or use of antihistamines and antidepressants. CONCLUSIONS: The baseline prevalence of RLS in females with LC was similar to the general population group as well as to patients in epidemiological studies. The prevalence significantly increased in the LC state. Postinfectious immunological mechanisms may be at play in the production for RLS symptoms. CITATION: Weinstock LB, Brook JB, Walters AS, Goris A, Afrin LB, Molderings GJ. Restless legs syndrome is associated with long-COVID in women. J Clin Sleep Med. 2022;18(5):1413-1418. © 2022 American Academy of Sleep Medicine.

Author Keywords
COVID-19;  fatigue;  long-COVID;  long-haul-COVID;  restless legs syndrome

Document Type: Article
Publication Stage: Final
Source: Scopus

“Oxygen Metabolic Stress and White Matter Injury in Patients with Cerebral Small Vessel Disease” (2022) Stroke

Oxygen Metabolic Stress and White Matter Injury in Patients with Cerebral Small Vessel Disease
(2022) Stroke, 53 (5), pp. 1570-1579. Cited 1 time.

Kang, P.a , Ying, C.c , Chen, Y.a , Ford, A.L.a b , An, H.a b c , Lee, J.-M.a b c

a Department of Neurology, Washington University School of Medicine, United States
b Mallinckrodt Institute of Radiology, Washington University School of Medicine, United States
c Department of Biomedical Engineering, Washington University, United States

Abstract
Background: Chronic hypoxia-ischemia is a putative mechanism underlying the development of white matter hyperintensities (WMH) and microstructural disruption in cerebral small vessel disease. WMH fall primarily within deep white matter (WM) watershed regions. We hypothesized that elevated oxygen extraction fraction (OEF), a signature of hypoxia-ischemia, would be detected in the watershed where WMH density is highest. We further hypothesized that OEF would be elevated in regions immediately surrounding WMH, at the leading edge of growth. Methods: In this cross-sectional study conducted from 2016 to 2019 at an academic medical center in St Louis, MO, participants (age >50) with a range of cerebrovascular risk factors underwent brain magnetic resonance imaging using pseudocontinuous arterial spin labeling, asymmetric spin echo, fluid-attenuated inversion recovery and diffusion tensor imaging to measure cerebral blood flow (CBF), OEF, WMH, and WM integrity, respectively. We defined the physiologic watershed as a region where CBF was below the 10th percentile of mean WM CBF in a young healthy cohort. We conducted linear regression to evaluate the relationship between CBF and OEF with structural and microstructural WM injury defined by fluid-attenuated inversion recovery WMH and diffusion tensor imaging, respectively. We conducted ANOVA to determine if OEF was increased in proximity to WMH lesions. Results: In a cohort of 42 participants (age 50-80), the physiologic watershed region spatially overlapped with regions of highest WMH lesion density. As CBF decreased and OEF increased, WMH density increased. Elevated watershed OEF was associated with greater WMH burden and microstructural disruption, after adjusting for vascular risk factors. In contrast, WM and watershed CBF were not associated with WMH burden or microstructural disruption. Moreover, OEF progressively increased while CBF decreased, in concentric contours approaching WMH lesions. Conclusions: Chronic hypoxia-ischemia in the watershed region may contribute to cerebral small vessel disease pathogenesis and development of WMH. Watershed OEF may hold promise as an imaging biomarker to identify individuals at risk for cerebral small vessel disease progression. © 2022 Lippincott Williams and Wilkins. All rights reserved.

Author Keywords
cerebral small vessel diseases;  dementia;  ischemia;  leukoaraiosis;  magnetic resonance imaging

Funding details
National Institutes of HealthNIHKL2 TR002346
American Academy of NeurologyAAN1P30NS098577, 1R011NS082561, R01HL129241, R01NS085419, RF1NS116565, U24 NS107230
National Center for Advancing Translational SciencesNCATS

Document Type: Article
Publication Stage: Final
Source: Scopus

“Molecular and neural basis of pleasant touch sensation” (2022) Science

Molecular and neural basis of pleasant touch sensation
(2022) Science, 376 (6592), pp. 483-491. 

Liu, B.a , Qiao, L.a , Liu, K.a , Liu, J.a , Piccinni-Ash, T.J.a , Chen, Z.-F.a b

a Center for the Study of Itch and Sensory Disorders, Department of Anesthesiology, Washington University, School of Medicine, St. Louis, MO 63110, United States
b Department of Medicine, Psychiatry, and Developmental Biology, Washington University, School of Medicine, St. Louis, MO 63110, United States

Abstract
Pleasant touch provides emotional and psychological support that helps mitigate social isolation and stress. However, the underlying mechanisms remain poorly understood. Using a pleasant touch-conditioned place preference (PT-CPP) test, we show that genetic ablation of spinal excitatory interneurons expressing prokineticin receptor 2 (PROKR2), or its ligand PROK2 in sensory neurons, abolishes PT-CPP without impairing pain and itch behaviors in mice. Mutant mice display profound impairments in stress response and prosocial behaviors. Moreover, PROKR2 neurons respond most vigorously to gentle stroking and encode reward value. Collectively, we identify PROK2 as a long-sought neuropeptide that encodes and transmits pleasant touch to spinal PROKR2 neurons. These findings may have important implications for elucidating mechanisms by which pleasant touch deprivation contributes to social avoidance behavior and mental disorders. Copyright © 2022 The Authors

Funding details
National Institutes of HealthNIH1R01AR056318-06, R01NS094344

Document Type: Article
Publication Stage: Final
Source: Scopus

“Early Expression of MMP-9 Predicts Recovery of Tibialis Anterior after Sciatic Nerve Crush Injury” (2022) Plastic and Reconstructive Surgery – Global Open

Early Expression of MMP-9 Predicts Recovery of Tibialis Anterior after Sciatic Nerve Crush Injury
(2022) Plastic and Reconstructive Surgery – Global Open, 10 (4), p. E4260. 

Brogan, D.M.a , Dy, C.J.a , Wever, J.a , Lee, T.a , Achilefu, S.b

a Department of Orthopaedic Surgery, Washington University in St. Louis, St. Louis, MO, United States
b Department of Radiology, Washington University in St. Louis, St. Louis, MO, United States

Abstract
Background: The purpose of this study was to assess the expression of molecular markers and epineural blood flow after differing degrees of nerve injury to identify potential tools to predict nerve recovery in a rat sciatic nerve model. Methods: A total of 72 rats were divided into nine groups. Each group was subjected to one of three crush injuries, created by applying one of three vascular clamps for 30 seconds. Vascularity was assessed with laser Doppler flowmetry before and after crush, and at nonsurvival surgery. Nonsurvival surgeries were performed 6 hours, 2 weeks, or 6 weeks later with nerve conduction studies and muscle strength testing. Expression of matrix metalloproteinase 9 (MMP-9) and matrix metalloproteinase 2 (MMP-2) in each nerve was quantified using with enzyme linked immunosorbent analysis. Results: Persistent hyperemia was noted in the zone of injury compared with baseline at 2 weeks and 6 weeks in the groups that displayed incomplete recovery. Expression of MMP-9 at 6 hours increased with increasing severity of crush and was inversely related to tibialis anterior muscle force recovery. The ratio of MMP-9:MMP-2 expression correlated well with recovery of compound nerve action potential amplitude at 6 weeks. Conclusions: Resolution of nerve hyperemia may correlate with nerve recovery from trauma, but early measures of nerve blood flow after injury are not prognostic of recovery. Ratio of MMP-9:MMP-2 expression 6 hours after injury correlates with recovery of compound nerve action potential at 6 weeks, while MMP-9 expression alone predicts tibialis anterior recovery. These findings together suggest that increased MMP-9 expression is a potentially useful marker of more severe nerve injury. © 2022 Lippincott Williams and Wilkins. All rights reserved.

Funding details
American Foundation for Surgery of the HandAFSH

Document Type: Article
Publication Stage: Final
Source: Scopus

“Impact of the COVID-19 Pandemic on Psychosocial Health of Persons With Spinal Cord Injury: Investigation of Experiences and Needed Resources” (2022) Topics in Spinal Cord Injury Rehabilitation

Impact of the COVID-19 Pandemic on Psychosocial Health of Persons With Spinal Cord Injury: Investigation of Experiences and Needed Resources
(2022) Topics in Spinal Cord Injury Rehabilitation, 28 (2), pp. 185-195. 

Morgan, K., Heeb, R., Walker, K., Tucker, S., Hollingsworth, H.

Program in Occupational Therapy, Washington University School of Medicine in St. Louis, St. Louis, MO, United States

Abstract
Background: Emerging evidence suggests that the COVID-19 pandemic has been accompanied by increased rates of depression and social isolation. However, we do not yet understand how the COVID-19 pandemic has affected the psychosocial health of people with spinal cord injury (PwSCI), a population that is already at risk of experiencing mental health conditions. Objectives: The aims of the study were to (1) examine the impact of the pandemic on the psychosocial health of PwSCI and (2) investigate the experiences of PwSCI and resources they reported needing during the peak of the pandemic. Methods: A cross-sectional survey with closed- and open-ended questions was administered to 51 PwSCI. Participants were included if they had an SCI, were 18 years or older, lived in St. Louis, Missouri, and surrounding areas, and understood English. Results: Canonical correlation showed a significant association between financial security, food insecurity, and personal assistance service use and adverse psychosocial health outcomes (p < .001). Participants reported interest in resources related to COVID-19 precautions for wheelchair users as well as home exercise programming and financial assistance with utilities. Finally, qualitative analysis revealed four major themes: (1) mental health during the pandemic, (2) financial concerns and reduced access to personal assistance services, (3) feelings of social isolation prior to the pandemic, and (4) local and national authorities’ handling of the pandemic. Conclusion: PwSCI are impacted by the COVID-19 pandemic and reported a variety of resource needs. These findings may inform service providers, support systems, and organizations to better support PwSCI during times of crisis. © 2022 American Spinal Injury Association.

Author Keywords
health resources;  mental health;  pandemics;  spinal cord injuries

Document Type: Article
Publication Stage: Final
Source: Scopus

“Examining the factor structure and discriminative utility of the Infant Behavior Questionnaire–Revised in infant siblings of autistic children” (2022) Child Development

Examining the factor structure and discriminative utility of the Infant Behavior Questionnaire–Revised in infant siblings of autistic children
(2022) Child Development, . 

Sung, S.a , Fenoglio, A.a , Wolff, J.J.a , Schultz, R.T.b , Botteron, K.N.c , Dager, S.R.d , Estes, A.M.d , Hazlett, H.C.e , Zwaigenbaum, L.f , Piven, J.e , Elison, J.T.a , Piven, J.g , Hazlett, H.C.g , Chappell, C.g , Dager, S.g , Estes, A.g , Shaw, D.g , Botteron, K.g , McKinstry, R.g , Constantino, J.g , Pruett, J.g , Schultz, R.g , Pandey, J.g , Zwaigenbaum, L.g , Elison, J.T.g , Wolff, J.J.g , Evans, A.C.g , Collins, D.L.g , Pike, G.B.g , Fonov, V.g , Kostopoulos, P.g , Das, S.g , MacIntyre, L.g , Gerig, G.g , Styner, M.g , Gu, H.g , for the IBIS Networkg

a University of Minnesota, Minneapolis, MN, United States
b Children’s Hospital of Philadelphia, Philadelphia, PA, United States
c Washington University School of Medicine, Saint Louis, MO, United States
d University of Washington, Seattle, WA, United States
e University of North Carolina—Chapel Hill, Chapel Hill, NC, United States
f University of Alberta, Edmonton, AB, United States

Abstract
Using the Infant Behavior Questionnaire–Revised in a longitudinal sample of infant siblings of autistic children (HR; n = 427, 171 female, 83.4% White) and a comparison group of low-risk controls (LR, n = 200, 86 female, 81.5% White), collected between 2007 and 2017, this study identified an invariant factor structure of temperament traits across groups at 6 and 12 months. Second, after partitioning the groups by familial risk and diagnostic outcome at 24 months, results reveal an endophenotypic pattern of Positive Emotionality at both 6 and 12 months, (HR-autism spectrum disorder [ASD] < HR-no-ASD < LR). Third, increased ‘Duration of Orienting’ at 12 months was associated with lower scores on the 24-month developmental outcomes in HR infants. These findings may augment efforts for early identification of ASD. © 2022 The Authors. Child Development published by Wiley Periodicals LLC on behalf of Society for Research in Child Development.

Funding details
National Institutes of HealthNIHR01 HD055741
Autism SpeaksAS
Simons FoundationSF140209
Intellectual and Developmental Disabilities Research CenterIDDRCHD079124, HD083091, HD087011, HD86984, R01 MH104324, R01 MH116961

Document Type: Article
Publication Stage: Article in Press
Source: Scopus

“The tic in TikTok and (where) all systems go: Mass social media induced illness and Munchausen’s by internet as explanatory models for social media associated abnormal illness behavior” (2022) Clinical Child Psychology and Psychiatry

The tic in TikTok and (where) all systems go: Mass social media induced illness and Munchausen’s by internet as explanatory models for social media associated abnormal illness behavior
(2022) Clinical Child Psychology and Psychiatry, . 

Giedinghagen, A.

Department of Psychiatry, Division of Child and Adolescent Psychiatry, Washington University in St Louis School of Medicine, St Louis, MO, United States

Abstract
This paper explores the recent phenomenon of adolescents presenting en masse (both online and in clinical settings) with symptoms seemingly acquired from viewing illness-related content posted by social media influencers. The most frequently reproduced illnesses have included Dissociative Identity Disorder (DID) and Tourette Syndrome. It discusses evidence that the recent spate of new-onset, severe tics are a form of Mass Psychogenic Illness facilitated by social media networks (a phenomenon labeled Mass Social Media Induced Illness). It then suggests that many of those self-diagnosed with DID may be manifesting a similar, technologically-facilitated conversion phenomenon. It then explores another explanatory model: that these simulacra of DID and Tourette Syndrome may also arise via a mechanism more closely resembling social media facilitated Factitious Disorder. Similar presentations, of individuals falsifying cancer, have previously been labeled Munchausen’s by Internet. It then proposes an overarching construct, Social Media Associated Abnormal Illness Behavior (SMAAIB), that is agnostic regarding phenomenology. Within this framework, it explores the ways in which de-commodifying attention, connection and care (measured once in appointments and admissions, now in ‘likes’ and ‘shares’) and obtaining a full picture of the patient’s psychological, sociological and cultural grounding can offer deeper understanding and ultimately a path to wellness. © The Author(s) 2022.

Author Keywords
conversion disorder;  dissociative identity disorder;  Factitious disorder;  internet;  mass social media induced illness;  Munchausen’s by internet;  social media;  TikTok

Document Type: Article
Publication Stage: Article in Press
Source: Scopus

“Understanding Everyday Events: Predictive-Looking Errors Drive Memory Updating” (2022) Psychological Science

Understanding Everyday Events: Predictive-Looking Errors Drive Memory Updating
(2022) Psychological Science, . 

Wahlheim, C.N.a , Eisenberg, M.L.b , Stawarczyk, D.b c , Zacks, J.M.b

a Department of Psychology, University of North Carolina at Greensboro, United States
b Department of Psychological and Brain Sciences, Washington University in St. Louis, United States
c Department of Psychology, Psychology and Neuroscience of Cognition Research Unit, University of Liège, Belgium

Abstract
Memory-guided predictions can improve event comprehension by guiding attention and the eyes to the location where an actor is about to perform an action. But when events change, viewers may experience predictive-looking errors and need to update their memories. In two experiments (Ns = 38 and 98), we examined the consequences of mnemonic predictive-looking errors for comprehending and remembering event changes. University students watched movies of everyday activities with actions that were repeated exactly and actions that were repeated with changed features—for example, an actor reached for a paper towel on one occasion and a dish towel on the next. Memory guidance led to predictive-looking errors that were associated with better memory for subsequently changed event features. These results indicate that retrieving recent event features can guide predictions during unfolding events and that error signals derived from mismatches between mnemonic predictions and actual events contribute to new learning. © The Author(s) 2022.

Author Keywords
action observation;  event cognition;  memory updating;  mnemonic prediction error;  open data;  open materials;  predictive looking

Document Type: Article
Publication Stage: Article in Press
Source: Scopus

“Developmental pathways from preschool temper tantrums to later psychopathology” (2022) Development and Psychopathology

Developmental pathways from preschool temper tantrums to later psychopathology
(2022) Development and Psychopathology, . 

Hoyniak, C.P.a , Donohue, M.R.a , Quiñones-Camacho, L.E.a , Vogel, A.C.a , Perino, M.T.a , Hennefield, L.a , Tillman, R.a , Barch, D.M.a b c d , Luby, J.L.a

a Department of Psychiatry, Washington University, School of Medicine, St. Louis, MO, United States
b Program in Neuroscience, Washington University, St. Louis, MO, United States
c Department of Psychological and Brain Sciences, Washington University, St. Louis, MO, United States
d Department of Radiology, Washington University, School of Medicine, St. Louis, MO, United States

Abstract
Temper tantrums are sudden, overt negative emotional displays that are disproportionate to the eliciting event. Research supports that severe temper tantrums during the preschool period are associated with preschool psychopathology, but few studies have identified which characteristics of preschool tantrums are predictive of distal psychopathological outcomes in later childhood and adolescence. To examine this question, we used a prospective, longitudinal dataset enriched for early psychopathology. Participants (N = 299) included 3-to 6-year-old children (47.8% female) assessed for tantrums and early childhood psychopathology using diagnostic interviews and then continually assessed using diagnostic interviews over 10 subsequent time points throughout childhood and adolescence. We identified two unique groupings of tantrum behaviors: aggression towards others/objects (e.g., hitting others) and aggression towards self (e.g., hitting self). While both types of tantrum behaviors were associated with early childhood psychopathology severity, tantrum behaviors characterized by aggression towards self were more predictive of later psychopathology. Children displaying high levels of both types of tantrum behaviors had more severe externalizing problems during early childhood and more severe depression and oppositional defiant disorder across childhood and adolescence. Findings suggest that tantrum behaviors characterized by aggression towards self are particularly predictive of later psychopathology. © The Author(s), 2022. Published by Cambridge University Press.

Author Keywords
aggression;  early childhood;  longitudinal course;  self-injurious behaviors;  temper tantrums

Funding details
National Institutes of HealthNIHK23 MH127305-01, K23MH125023-01, K99HD105002, R01 MH064769-06A1, T32 MH100019

Document Type: Article
Publication Stage: Article in Press
Source: Scopus

“Sex-Specific Patterns of Body Mass Index Relationship with White Matter Connectivity” (2022) Journal of Alzheimer’s Disease

Sex-Specific Patterns of Body Mass Index Relationship with White Matter Connectivity
(2022) Journal of Alzheimer’s Disease, 86 (4), pp. 1831-1848. 

Rahmani, F.a , Wang, Q.a , Mckay, N.S.a , Keefe, S.a , Hantler, N.a , Hornbeck, R.a , Wang, Y.a , Hassenstab, J.a , Schindler, S.a b , Xiong, C.a , Morris, J.C.a b c , Benzinger, T.L.S.a c , Raji, C.A.a b

a Mallinckrodt Institute of Radiology, Division of Neuroradiology, Washington University in St. Louis, St. Louis, MO, United States
b Department of Neurology, Washington University in St. Louis, St. Louis, MO, United States
c Charles F. and Joanne Knight Alzheimer Disease Research Center (Knight ADRC), Washington University, St. Louis, MO, United States

Abstract
Background: Obesity is an increasingly recognized modifiable risk factor for Alzheimer’s disease (AD). Increased body mass index (BMI) is related to distinct changes in white matter (WM) fiber density and connectivity. Objective: We investigated whether sex differentially affects the relationship between BMI and WM structural connectivity. Methods: A cross-sectional sample of 231 cognitively normal participants were enrolled from the Knight Alzheimer Disease Research Center. Connectome analyses were done with diffusion data reconstructed using q-space diffeomorphic reconstruction to obtain the spin distribution function and tracts were selected using a deterministic fiber tracking algorithm. Results: We identified an inverse relationship between higher BMI and lower connectivity in the associational fibers of the temporal lobe in overweight and obese men. Normal to overweight women showed a significant positive association between BMI and connectivity in a wide array of WM fibers, an association that reversed in obese and morbidly obese women. Interaction analyses revealed that with increasing BMI, women showed higher WM connectivity in the bilateral frontoparietal and parahippocampal parts of the cingulum, while men showed lower connectivity in right sided corticostriatal and corticopontine tracts. Subgroup analyses demonstrated comparable results in participants with and without positron emission tomography or cerebrospinal fluid evidence of brain amyloidosis, indicating that the relationship between BMI and structural connectivity in men and women is independent of AD biomarker status. Conclusion: BMI influences structural connectivity of WM differently in men and women across BMI categories and this relationship does not vary as a function of preclinical AD. © 2022 The authors.

Author Keywords
Aging;  Alzheimer’s disease;  body mass index;  connectome;  diffusion magnetic resonance imaging;  white matter

Funding details
National Institutes of HealthNIH1RF1AG072637-01, EB009352, K23AG053426, P01AG 026276, P01AG003991, P30AG0 66444, P30NS098577, R01AG054567-01A1, UL1TR000448
Radiological Society of North AmericaRSNA
Foundation for Barnes-Jewish HospitalFBJH
Washington University School of Medicine in St. LouisWUSM

Document Type: Article
Publication Stage: Final
Source: Scopus

“Consideration of sex and gender in Alzheimer’s disease and related disorders from a global perspective” (2022) Alzheimer’s and Dementia

Consideration of sex and gender in Alzheimer’s disease and related disorders from a global perspective
(2022) Alzheimer’s and Dementia, . 

Mielke, M.M.a b , Aggarwal, N.T.c d , Vila-Castelar, C.e , Agarwal, P.d f , Arenaza-Urquijo, E.M.g h i , Brett, B.j , Brugulat-Serrat, A.g h i k , DuBose, L.E.l , Eikelboom, W.S.m , Flatt, J.n , Foldi, N.S.o p , Franzen, S.m , Gilsanz, P.q , Li, W.r , McManus, A.J.s , van Lent, D.M.t u v , Milani, S.A.w , Shaaban, C.E.x , Stites, S.D.y , Sundermann, E.z , Suryadevara, V.aa , Trani, J.-F.ab , Turner, A.D.ac , Vonk, J.M.J.ad ae , Quiroz, Y.T.e af , Babulal, G.M.ag ah ai , for the Diversity and Disparity Professional Interest Area Sex and Gender Special Interest Groupaj

a Division of Epidemiology, Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN, United States
b Department of Neurology, Mayo Clinic, Rochester, MN, United States
c Department of Neurological Sciences, Rush University Medical Center, Chicago, IL, United States
d Rush Alzheimer’s Disease Center, Rush University Medical Center, Chicago, IL, United States
e Department of Psychiatry, Harvard Medical School, Massachusetts General Hospital, Massachusetts, Boston, United States
f Department of Internal Medicine, Rush University Medical Center, Chicago, IL, United States
g Barcelonaβeta Brain Research Center (BBRC), Pasqual Maragall Foundation, Barcelona, Spain
h IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
i CIBER Fragilidad y Envejecimiento Saludable (CIBERFES), Madrid, Spain
j Department of Neurosurgery, Medical College of Wisconsin, Wisconsin, Milwaukee, United States
k Atlantic Fellow for Equity in Brain Health, The University of California San Francisco, San Francisco, CA, United States
l Department of Medicine, Division of Geriatrics, University of Colorado Anschutz Medical Campus, Aurora, CO, United States
m Department of Neurology, Erasmus MC University Medical Center, Rotterdam, Netherlands
n Social and Behavioral Health Program, School of Public Health, University of Nevada, Las Vegas, Las Vegas, NV, United States
o Department of Psychology, Queens College and The Graduate Center, City University of New York, New York, United States
p Department of Psychiatry, New York University Long Island School of Medicine, New York, United States
q Kaiser Permanente Division of Research, Oakland, CA, United States
r Department of Clinical and Diagnostic Sciences, University of Alabama at Birmingham, Birmingham, AL, United States
s Department of Neurology, Massachusetts General Hospital, Boston, MA, United States
t UT Health San Antonio, Glenn Biggs Institute for Alzheimer’s and Neurodegenerative diseases, San Antonio, TX, United States
u Framingham Heart Study, Framingham, MA, United States
v Department of Neurology, Boston University School of Medicine, Boston, MA, United States
w Division of Geriatrics & Palliative Medicine, Department of Internal Medicine, University of Texas Medical Branch, Galveston, TX, United States
x Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, United States
y Department of Psychiatry, Perlman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States
z Department of Psychiatry, University of California, San Diego, CA, United States
aa Department of Orthopedic Surgery, Rush University Medical Center, Chicago, IL, United States
ab Department of Public Health, Washington University in St. Louis, St. Louis, MO, United States
ac Department of Psychiatry & Behavioral Sciences, University of Miami Miller School of Medicine, Miami, FL, United States
ad Taub Institute for Research on Alzheimer’s Disease and the Aging Brain, College of Physicians and Surgeons, Columbia University, New York, NY, United States
ae Julius Center for Health Sciences and Primary Care, Department of Epidemiology, University Medical Center Utrecht and Utrecht University, Utrecht, Netherlands
af Grupo de Neurociencias de Antioquia of Universidad de Antioquia, Medellin, Columbia, United States
ag Department of Neurology, Washington University in St. Louis, St. Louis, MS, United States
ah Department of Clinical Research and Leadership, The George Washington University School of Medicine and Health Sciences, Washington, DC, United States
ai Department of Psychology, Faculty of Humanities, University of Johannesburg, Johannesburg, South Africa

Abstract
Sex or gender differences in the risk of Alzheimer’s disease and related dementias (ADRD) differ by world region, suggesting that there are potentially modifiable risk factors for intervention. However, few epidemiological or clinical ADRD studies examine sex differences; even fewer evaluate gender in the context of ADRD risk. The goals of this perspective are to: (1) provide definitions of gender, biologic sex, and sexual orientation. and the limitations of examining these as binary variables; (2) provide an overview of what is known with regard to sex and gender differences in the risk, prevention, and diagnosis of ADRD; and (3) discuss these sex and gender differences from a global, worldwide perspective. Identifying drivers of sex and gender differences in ADRD throughout the world is a first step in developing interventions unique to each geographical and sociocultural area to reduce these inequities and to ultimately reduce global ADRD risk. Highlights: The burden of dementia is unevenly distributed geographically and by sex and gender. Scientific advances in genetics and biomarkers challenge beliefs that sex is binary. Discrimination against women and sex and gender minority (SGM) populations contributes to cognitive decline. Sociocultural factors lead to gender inequities in Alzheimer’s disease and related dementias (ADRD) worldwide. © 2022 The Authors. Alzheimer’s & Dementia published by Wiley Periodicals LLC on behalf of Alzheimer’s Association.

Author Keywords
Alzheimer’s;  ethnicity;  gender;  global health;  risk factors, sex;  sociocultural factors

Funding details
5R01AG066823, K23 AG073528, K23AG065442, K99AG066934, P30AG024832, P30AG059301, R01 AG054671
K12HD052023
09150161810017
National Institutes of HealthNIH
National Institute on AgingNIAF32AG071273, P30AG010161, P30AG072975, R01AG062637, R01AG067428, R01AG068183, R01AG073627, R01AG074302, R03 AG 67062, RF1 AG55151, T32AG000279, T32AG055381, U54 AG44170
National Institute of General Medical SciencesNIGMSSC3GM122662
National Institute of Allergy and Infectious DiseasesNIAID
National Institute of Neurological Disorders and StrokeNINDSDP5OD019833, L30NS113158
Alzheimer’s AssociationAA2019‐AARGD‐644788, AARF 2019A005859, AARF‐17‐528934, AARG‐21‐852512
Massachusetts General HospitalMGHWE.15‐2018‐05
BrightFocus FoundationBFFA2021142S
Nederlandse Organisatie voor Wetenschappelijk OnderzoekNWO

Document Type: Article
Publication Stage: Article in Press
Source: Scopus

“New insight into the neural mechanisms of migraine in adolescents: Relationships with sleep” (2022) Headache

New insight into the neural mechanisms of migraine in adolescents: Relationships with sleep
(2022) Headache, . 

Nahman-Averbuch, H.a b c , Schneider, V.J., IIb d e , Lee, G.R.f g , Peugh, J.L.b h , Hershey, A.D.c h i , Powers, S.W.b c h , de Zambotti, M.j , Coghill, R.C.b c h , King, C.D.b c h

a Division of Clinical and Translational Research and Washington University Pain Center, Department of Anesthesiology, Washington University School of Medicine, St. Louis, MO, United States
b Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, United States
c Pediatric Pain Research Center, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, United States
d Center for Pain Research and Behavioral Health, University of Florida, Gainesville, FL, United States
e Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, United States
f Department of Radiology, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, United States
g Department of Radiology, University of Cincinnati College of Medicine, Cincinnati, OH, United States
h Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, United States
i Division of Neurology, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, United States
j Center for Health Sciences, SRI International, Menlo Park, CA, United States

Abstract
Objective: This case-control study examines if measures of subjective and objective (actigraphic) sleep difficulties mediate alterations in amygdalar connectivity in adolescents with migraine compared to healthy adolescents. Background: Adolescents with migraine have different functional connectivity of the amygdala compared to individuals without migraine. Sleep is often disturbed in adolescents with migraine, and could contribute to the alterations in functional connectivity. Methods: Twenty adolescents with migraine and 20 healthy controls were recruited from Cincinnati Children’s Hospital. Participants completed surveys about their headaches and overall sleep quality, sleep hygiene, and perceived sleep difficulties (Insomnia Severity Scale [ISI]); completed wrist-worn actigraphy; and underwent a magnetic resonance imaging scan. Results: Adolescents with migraine differed from healthy controls only in perceived difficulty in sleep initiation and maintenance (ISI: 8.5 ± 4.7 and 4.5 ± 3.7 [mean ± standard deviation], −4.00 [95% confidence: −6.7 to −1.3], p = 0.005) and had greater functional connectivity between the amygdala and the posterior cingulate cortex, precuneus, dorsolateral prefrontal, sensorimotor, and the occipital cortexes. The differences in functional connectivity of the amygdala were not mediated by the subjective/objective sleep measures (ISI/wake minutes after sleep onset). Conclusions: Adolescents with migraine have greater connectivity between the amygdala and areas involved in sensory, affective, and cognitive aspects of pain. These alterations may not be due to higher levels of sleep difficulties in adolescents with migraine, suggesting that both amygdala and sleep alterations may play an independent role in migraine pathophysiology. This advances the understanding of the mechanisms underlying pediatric migraine and can potentially advance migraine management. © 2022 American Headache Society.

Author Keywords
actigraphy;  amygdala;  functional magnetic resonance imaging;  insomnia;  migraine;  sleep

Document Type: Article
Publication Stage: Article in Press
Source: Scopus

“Earlier bedtimes and more sleep displace sedentary behavior but not moderate-to-vigorous physical activity in adolescents” (2022) Sleep Health

Earlier bedtimes and more sleep displace sedentary behavior but not moderate-to-vigorous physical activity in adolescents
(2022) Sleep Health, . 

Krietsch, K.N.a b c , Duraccio, K.M.a d , Zhang, N.e , Saelens, B.E.f , Howarth, T.a , Combs, A.g , Beebe, D.W.a h

a Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, United States
b Department of Psychology, St. Louis Children’s Hospital, St. Louis, MO, United States
c Department of Clinical Pediatrics, Washington University, St. Louis, MO, United States
d Department of Psychology, Brigham Young University, Provo, UT, United States
e Division of Biostatistics and Epidemiology, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, United States
f Seattle Children’s Research Institute and Departments of Pediatrics and Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, United States
g Department of Psychology, University of Cincinnati College of Arts and Sciences, Cincinnati, OH, United States
h Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, United States

Abstract
Objectives: Correlational models suggest increased cardiometabolic risk when sleep replaces moderate-to-vigorous (but not sedentary or light) physical activity. This study tested which activity ranges are impacted by experimentally altering adolescents’ bedtime. Method: Adolescents completed a 3-week within-subjects crossover experiment with 5 nights of late bedtimes and 5 nights early bedtimes (6.5- and 9.5-hours sleep opportunity, respectively). Experimental condition order was randomized. Waketimes were held constant throughout to mimic school start times. Sleep and physical activity occurred in the natural environments, with lab appointments following each 5-day condition. Waist-worn accelerometers measured physical activity and sedentary behavior. Wrist-worn actigraphs confirmed sleep condition adherence. Wilcoxon tests and linear mixed effects models compared waking activity levels between conditions and across time. Results: Ninety healthy adolescents (14-17 years) completed the study. When in the early (vs. late) bedtime condition, adolescents fell asleep 1.96 hours earlier (SD = 1.08, d = 1.82, p < .0001) and slept 1.49 hours more (SD = 1.01, d = 1.74, p < .0001). They spent 1.68 and 0.32 fewer hours in sedentary behavior (SD = 1.67, d = 1.0, p < .0001) and light physical activity (SD = 0.87, d = 0.37, p = .0005), respectively. This pattern was reflected in increased proportion of waking hours spent in sedentary and light activity. Absolute and proportion of moderate-to-vigorous physical activity did not differ between conditions (d = 0.02, p = .89; d = 0.14, p = .05, respectively). Conclusions: Inducing earlier bedtimes (allowing for healthy sleep opportunity) did not affect moderate-to-vigorous physical activity. Alternatively, later bedtimes (allowing for ≤ 6.5 hours of sleep opportunity, mimicking common adolescent school night sleep) increased sedentary behavior. Results are reassuring for the benefits of earlier bedtimes. © 2022 National Sleep Foundation

Author Keywords
health promotion;  moderate to vigorous physical activity;  obesity;  pediatric;  sedentary activity;  Sleep duration

Funding details
National Institutes of HealthNIHR01 HL120879, T32 DK063929

Document Type: Article
Publication Stage: Article in Press
Source: Scopus

“Understanding Associations Between Race/Ethnicity, Experiences of Discrimination, and Psychotic-like Experiences in Middle Childhood” (2022) Journal of the American Academy of Child and Adolescent Psychiatry

Understanding Associations Between Race/Ethnicity, Experiences of Discrimination, and Psychotic-like Experiences in Middle Childhood
(2022) Journal of the American Academy of Child and Adolescent Psychiatry, . 

Karcher, N.R.a , Klaunig, M.J.b c , Elsayed, N.M.d , Taylor, R.L.d , Jay, S.Y.b , Schiffman, J.b c

a Washington University School of Medicine, Missouri, St. Louis
b University of Maryland, Baltimore
c University of California, Irvine
d Washington University in St. Louis, Missouri

Abstract
Objective: The present study aimed to examine factors that may account for race/ethnicity differences in psychotic-like experiences (PLEs) in a middle childhood sample, including evidence for experiences of discrimination as a psychosocial mediator of these differences. Method: In a sample of 9- to 10-year-olds (N = 10,839) from the Adolescent Brain Cognitive Development Study, we compared PLEs across racial/ethnic groups. We also examined whether experiences of discrimination indirectly linked racial/ethnic identity and PLEs and whether social support moderated this indirect association. Results: Differences between racial/ethnic groups were found in the endorsement of PLEs, such that Black and Hispanic participants endorsed higher levels of PLEs compared with Asian, multiracial/multiethnic, and White participants. These differences were accounted for in part by experiences of discrimination, an indirect effect that was in turn attenuated by increased social support. Conclusion: This is the first study to suggest that the experience of discrimination may indirectly link the association between racial/ethnic differences and endorsement of PLEs using the Prodromal Questionnaire–Brief Child Version and additionally that social support may act as a moderator of this mediation. Results provide evidence that social inequities such as racial discrimination may contribute to increases in PLEs. These findings shed further light on the links between structural racism and mental health inequities for people in minoritized groups. © 2022 American Academy of Child and Adolescent Psychiatry

Author Keywords
ABCD Study;  ethnicity;  experiences of discrimination;  psychotic-like experiences;  race

Funding details
National Science FoundationNSFDGE-1745038
National Institutes of HealthNIHU01DA041022, U01DA041025, U01DA041028, U01DA041048, U01DA041089, U01DA041093, U01DA041106, U01DA041117, U01DA041120, U01DA041134, U01DA041148, U01DA041156, U01DA041174, U24DA041123, U24DA041147
National Institute of Mental HealthNIMHK23MH121792-01, L30 MH120574-01
Substance Abuse and Mental Health Services AdministrationSAMHSAR01 MH112545-03, SM081092-01, U01 MH124639-01

Document Type: Article
Publication Stage: Article in Press
Source: Scopus