Stressful experiences modulate neuro-circuitry function, and the temporal trajectory of these alterations, elapsing from early disturbances to late recovery, heavily influences resilience and vulnerability to stress. Such effects of stress may depend on processes that are engaged during resting-state, through active recollection of past experiences and anticipation of future events, all known to involve the default mode network (DMN). By inducing social stress and acquiring resting-state functional magnetic resonance imaging (fMRI) before stress, immediately following it, and 2 h later, we expanded the time-window for examining the trajectory of the stress response. Throughout the study repeated cortisol samplings and self-reports of stress levels were obtained from 51 healthy young males. Post-stress alterations were investigated by whole brain resting-state functional connectivity (rsFC) of two central hubs of the DMN: the posterior cingulate cortex (PCC) and hippocampus. Results indicate a ’recovery’ pattern of DMN connectivity, in which all alterations, ascribed to the intervening stress, returned to pre-stress levels. The only exception to this pattern was a stress-induced rise in amygdala-hippocampal connectivity, which was sustained for as long as 2 h following stress induction. Furthermore, this sustained enhancement of limbic connectivity was inversely correlated to individual stress-induced cortisol responsiveness (AUCi) and characterized only the group lacking such increased cortisol (i.e., non-responders). Our observations provide evidence of a prolonged post-stress response profile, characterized by both the comprehensive balance of most DMN functional connections and the distinct time and cortisol dependent ascent of intra-limbic connectivity. These novel insights into neuro-endocrine relations are another milestone in the ongoing search for individual markers in stress-related psychopathologies.
Objective To assess the efficacy and safety of a remote electrical neuromodulation (REN) device for the acute treatment of migraine. Background There is a significant unmet need for novel effective well‐tolerated acute migraine treatments. REN is a novel acute migraine treatment that stimulates upper arm peripheral nerves to induce conditioned pain modulation – an endogenous analgesic mechanism in which conditioning stimulation inhibits pain in remote body regions. A recent pilot study showed that REN can significantly reduce headache. We have conducted a randomized, double‐blind, sham‐controlled study to further evaluate the efficacy and safety of REN for the acute treatment of migraine. Methods This was a randomized, double‐blind, sham‐controlled, multicenter study conducted at 7 sites in the United States and 5 sites in Israel. Two hundred and fifty‐two adults meeting the International Classification of Headache Disorders criteria for migraine with 2‐8 migraine headaches per month were randomized in a 1:1 ratio to active or sham stimulation. A smartphone‐controlled wireless device was applied for 30‐45 minutes on the upper arm within 1 hour of attack onset; electrical stimulation was at a perceptible but non‐painful intensity level. Migraine pain levels were recorded at baseline, 2, and 48 hours post‐treatment. Most bothersome symptoms (MBS) were also recorded. The primary efficacy endpoint was the proportion of participants achieving pain relief at 2 hours post‐treatment (improvement from severe or moderate pain to mild or none, or from mild pain to none). Relief of MBS and pain‐free at 2 hours were key secondary endpoints. Results Active stimulation was more effective than sham stimulation in achieving pain relief (66.7% [66/99] vs 38.8% [40/103]; therapeutic gain of 27.9% [CI95%, 15.6‐40.2]; P < .0001), pain‐free (37.4% vs 18.4%, P = .003), and MBS relief (46.3% vs 22.2%, P = .0008) at 2 hours post‐treatment. The pain relief and pain‐free superiority of the active treatment was sustained 48 hours post‐treatment. The incidence of device‐related adverse events was low and similar between treatment groups (4.8% [6/126] vs 2.4% [3/126], P = .499). Conclusions REN provides superior clinically meaningful relief of migraine pain and MBS compared to placebo, offering a safe and effective non‐pharmacological alternative for acute migraine treatment.
Recent theoretical and empirical work has highlighted the role of domain-general, large-scale brain networks in generating emotional experiences. These networks are hypothesized to process aspects of emotional experiences that are not unique to a specific emotional category (e.g., Bsadness,^Bhappiness^), but rather that generalize across categories. In this article, we examined the dynamic interactions (i.e., changing cohesiveness) between specific domain-general networks across time while participants experienced various instances of sadness, fear, and anger. We used a novel method for probing the network connectivity dynamics between two salience networks and three amygdala-based networks. We hypothesized, and found, that the functional connectivity between these networks covaried with the intensity of different emotional experiences. Stronger connectivity between the dorsal salience network and the medial amygdala network was associated with more intense ratings of emotional experience across six different instances of the three emotion categories examined. Also, stronger connectivity between the dorsal salience network and the ventrolateral amygdala network was associated with more intense ratings of emotional experience across five out of the six different instances. Our findings demonstrate that a variety of emotional experiences are associated with dynamic interactions of domain-general neural systems. Cogn Affect Behav Neurosci (2016) 16:709-723 DOI 10.3758/s13415-016-0425-4 Gal Raz and Alexandra Touroutoglou contributed equally to this work and share first authorship. (Barrett, 2006(Barrett, , 2012Barrett & Satpute, 2013;Lindquist, Wager, Kober, Bliss-Moreau, & Barrett, 2012;Touroutoglou, Lindquist, Dickerson, & Barrett, 2015;Wilson-Mendenhall, Barrett, & Barsalou, 2015). Situating recent meta-analytic evidence on brain basis of emotion within a growing systems neuroscience literature reveals that the regions involved in emotion are distributed across multiple, anatomically constrained Bresting-state^networks that contribute to many psychological phenomena (Barrett & Satpute, 2013;Kober et al., 2008;. Specific regions that had initially been shown to be more active for one emotion category than for others in meta-analytic data (e.g., more active for fear than for sadness or disgust; Fusar-Poli et al., 2009;Vytal & Hamann, 2010) were not replicated in a more comprehensive metaanalysis , but instead operate in large-scale networks that are not specific to any given emotion category (Touroutoglou et al., 2015), or even to the domain of emotion (Anderson, 2015). These networks support more domain-general functions, such as executive function, affiliation, salience detection, and so forth, and thus contribute to constructing emotional experiences (as well as other kinds of experiences; Barrett & Satpute, 2013;. When regional or network patterns emerge for one emotion category versus another, this is because that category of emotional experiences tends to draw more on certain domain-general func...
Glucose monitoring devices represent an exciting frontier in diabetes research. Great efforts have been dedicated to the development of non-invasive glucose monitoring devices, which may considerably improve the quality of life for people suffering from diabetes and facilitate their compliance for glucose monitoring. This manuscript reviews past, current and emerging non-invasive glucose monitoring techniques and devices and presents the major challenges they face. Poor glucose specificity and sensitivity, physiological time lag, calibration process and human factors perspective are discussed. Since incorporating user requirements into device development may potentially increase user acceptance and improve patient safety and device effectiveness, special attention is given to usability, user experience and applicability for home use, thus extending previous published reviews. The main conclusion is that a favorable non-invasive glucose monitoring device must overcome the combination of accuracy, usability and applicability challenges. Improving the assessment of device usability and acceptance may shed light on primary user concerns and may thus offer a meaningful step forward in the commercialization of non-invasive glucose monitoring devices.
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