BACKGROUND Negative urgency, defined as impulsive risk-taking during extreme negative emotional states, is the most important impulsivity-related trait for alcohol-related problems and alcohol dependence. However, how negative urgency imparts risk for alcohol-related problems is not yet well understood. Therefore, the goal of the current study was to examine how negative urgency relates to separable aspects of the emotional experience and alcohol-seeking behaviors. METHODS A total of 34 (19 women) community-dwelling, alcohol-using adults aged 21–32 (mean age=24.86, SD=3.40, 74.3% Caucasian) completed two counterbalanced intravenous alcohol self-administration sessions: one during a neutral mood condition and one during a negative mood condition. RESULTS Negative urgency was associated with 1) greater mood change following negative mood induction (F=4.38, df=15, p=.002, η2=0.87), but was unrelated to changes in craving or cortisol release in response to mood induction; 2) greater alcohol craving prior to and after an alcohol prime (F=3.27, p=.02, η2=0.86), but only in the negative and not the neutral mood condition; and 3) higher peak BrAC (F=2.13, df=42, p=.02, η2=0.48), continuing to increase intoxication level over a longer period (F=3.77, df=42, p<.001, η2=0.62), and more alcohol seeking (F=21.73, df=22, p<.001, η2=0.94) throughout the negative session. Negative urgency was associated with overall lower cortisol release. CONCLUSIONS These results highlight the importance of assessing behavioral indicators of negative urgency under mood condition, and suggest that negative urgency may amplify alcohol self-administration through increased negative emotional reactivity to mood events and increased alcohol craving after initial alcohol exposure, leading to maintenance of alcohol related behavior.

Background Although negative mood has long been implicated in differences in alcohol seeking by men and women, little research has used precise, well-controlled laboratory experiments to examine how negative mood affects alcohol seeking behaviors. Methods A total of 34 (19 Women) community-dwelling, alcohol using adults aged 21–32 (mean age=24.86, SD=3.40, 74.3% Caucasian; Alcohol Use Disorder Identification Test [AUDIT]= 10.1, SD= 3.4) completed two counter-balanced intravenous alcohol self-administration sessions: one under negative mood and one under neutral mood. Fourteen individuals (9 women; mean age=25.00, SD=2.77) participated in an alcohol “liking” experiment (i.e., free access drinking) and 20 individuals (10 women; mean age=24.77, SD=3.73) participated in an alcohol “wanting” experiment, in which gaining access to alcohol required progressively effortful work. There was no significant difference between men and women on the AUDIT (t(34)=−0.38, p=.71). Results Priming with negative mood induction caused a significant decrease in self-reported mood (mean change=−1.90, t(39)=−6.81, p<.001), as intended. In free access, negative mood was associated with a significantly increased peak breath alcohol concentration (BrAC; F=9.41, p=.01), with a trend toward a greater effect in men than in women (F=2.67, p=.13). Negative mood also had a significant effect on peak BrAC achieved in the progressive work paradigm (F=5.28, p=.04), with a significantly stronger effect in men (F=5.35, p=.03) than women; men also trended toward more consistent work for alcohol across both neutral and negative sessions. Conclusions These preliminary findings demonstrate a gender-specific response on how mood affects alcohol seeking and suggest gender-specific interventions to prevent mood-based alcohol consumption.

The Auditory Steady-State Response (ASSR) in the electroencephalogram (EEG) is usually reduced in schizophrenia (SZ), particularly to 40 Hz stimulation. The gamma frequency ASSR deficit has been attributed to N-methyl-D-aspartate receptor (NMDAR) hypofunction. We tested whether the NMDAR antagonist, phencyclidine (PCP), produced similar ASSR deficits in rats. EEG was recorded from awake rats via intracranial electrodes overlaying the auditory cortex and at the vertex of the skull. ASSRs to click trains were recorded at 10, 20, 30, 40, 50, and 55 Hz and measured by ASSR Mean Power (MP) and Phase Locking Factor (PLF). In Experiment 1, the effect of different subcutaneous doses of PCP (1.0, 2.5 and 4.0 mg/kg) on the ASSR in 12 rats was assessed. In Experiment 2, ASSRs were compared in PCP treated rats and control rats at baseline, after acute injection (5 mg/kg), following two weeks of subchronic, continuous administration (5 mg/kg/day), and one week after drug cessation. Acute administration of PCP increased PLF and MP at frequencies of stimulation below 50 Hz, and decreased responses at higher frequencies at the auditory cortex site. Acute administration had a less pronounced effect at the vertex site, with a reduction of either PLF or MP observed at frequencies above 20 Hz. Acute effects increased in magnitude with higher doses of PCP. Consistent effects were not observed after subchronic PCP administration. These data indicate that acute administration of PCP, a NMDAR antagonist, produces an increase in ASSR synchrony and power at low frequencies of stimulation and a reduction of high frequency (> 40 Hz) ASSR activity in rats. Subchronic, continuous administration of PCP, on the other hand, has little impact on ASSRs. Thus, while ASSRs are highly sensitive to NMDAR antagonists, their translational utility as a cross-species biomarker for NMDAR hypofunction in SZ and other disorders may be dependent on dose and schedule.

Seven neuropsychology journals that publish on topics relevant to clinical neuropsychology were examined for their experimental rigor according to the standards of the American Academy of Neurology (AAN) in their Clinical Practice Guidelines. By using a keyword approach on topics relevant to forensic neuropsychology, all articles that reported empirical findings from 2003 through 2008 were identified. Each study was rated by AAN classification criteria that ranged from a level I classification (prospective, most rigorous, and independent) to level IV (least rigorous). The typical forensic neuropsychological study averaged a class III ranking. Few studies were based on large sample sizes or utilized a reported masking or blind technique with regards to subject selection and how diagnostic criteria were met and/or data analyzed. While the authors for the average study reported a university affiliation, few reported explicit Institutional Review Board statements. Considerable variability across these seven journals with regards to conflict of interest (COI) disclosure policies was observed and only a few studies reported explicit statements about funding or COI issues. These observations suggest that neuropsychological research on forensic topics currently has many limitations and that future research needs to address these issues.

Background: Cardiac risk stratification and coronary angiography are routinely performed as part of kidney and liver transplant candidacy evaluation. There are limited data on the outcomes of surgical coronary revascularization in this patient population. We investigated outcomes in patients with end stage renal or hepatic disease undergoing coronary artery bypass grafting (CABG) to attain kidney or liver transplant candidacy.Methods: Retrospective analysis of all patients who underwent isolated CABG at our institution between 2010 and 2016. Patients were divided into two cohorts: Pre-transplant (those undergoing surgery to attain renal or hepatic transplant candidacy) and Non-transplant (all others). Baseline characteristics and postoperative outcomes were compared between groups.Results: A total of 1801 patients were included: 28 in Pre-transplant (n=22 kidney, n=7 liver) and 1773 in Non-transplant. Major adverse postoperative outcomes were significantly greater in Pre-transplant compared to Non-transplant: 30-day mortality (14.3% vs. 2.8%, p=0.009), neurologic events (17.9% vs. 4.8%, p=0.011), re-intubation (21.4% vs. 5.8%, p=0.005) and total postoperative ventilation (5.2 vs. 5.0 hours, p=0.0124). One-and five-year mortality in Pretransplant was 17.9% and 53.6%, respectively. Of the Pre-transplant cohort, three patients (10.7%) underwent organ transplantation (all kidneys) at a mean 436 days after CABG. No patients received liver transplantation. Conclusions:Outcomes following CABG in the pre-kidney and pre-liver transplant population are poor. Despite surgical revascularization, the vast majority of patients do not ultimately undergo transplantation. Revascularization strategies and optimal management in this high-risk population warrants further study.