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Revue Medicale de Liege Feb 2023Affective instability is a common phenomenon in adults. It may be the expression of underlying organic or psychiatric conditions. This is a potentially disabling symptom...
Affective instability is a common phenomenon in adults. It may be the expression of underlying organic or psychiatric conditions. This is a potentially disabling symptom for the individual, which can cause psychological distress and even consequences in daily life functioning. This article is intended for any healthcare professional and aims to clarify the assessment and diagnostic approach to a patient with mood swings.
Topics: Adult; Humans; Mood Disorders; Affect
PubMed: 36799329
DOI: No ID Found -
Frontiers in Cellular Neuroscience 2021Bipolar disorder (BD) is a mood disorder that affects millions worldwide and is associated with severe mood swings between mania and depression. The mood stabilizers... (Review)
Review
Bipolar disorder (BD) is a mood disorder that affects millions worldwide and is associated with severe mood swings between mania and depression. The mood stabilizers valproate (VPA) and lithium (Li) are among the main drugs that are used to treat BD patients. However, these drugs are not effective for all patients and cause serious side effects. Therefore, better drugs are needed to treat BD patients. The main barrier to developing new drugs is the lack of knowledge about the therapeutic mechanism of currently available drugs. Several hypotheses have been proposed for the mechanism of action of mood stabilizers. However, it is still not known how they act to alleviate both mania and depression. The pathology of BD is characterized by mitochondrial dysfunction, oxidative stress, and abnormalities in calcium signaling. A deficiency in the unfolded protein response (UPR) pathway may be a shared mechanism that leads to these cellular dysfunctions. This is supported by reported abnormalities in the UPR pathway in lymphoblasts from BD patients. Additionally, studies have demonstrated that mood stabilizers alter the expression of several UPR target genes in mouse and human neuronal cells. In this review, we outline a new perspective wherein mood stabilizers exert their therapeutic mechanism by activating the UPR. Furthermore, we discuss UPR abnormalities in BD patients and suggest future research directions to resolve discrepancies in the literature.
PubMed: 34531727
DOI: 10.3389/fncel.2021.735622 -
Frontiers in Psychiatry 2022Psychiatric traits have been associated with intracerebral hemorrhage (ICH) in observational studies, although their causal relationships remain uncertain. We used...
BACKGROUND
Psychiatric traits have been associated with intracerebral hemorrhage (ICH) in observational studies, although their causal relationships remain uncertain. We used Mendelian randomization analyses to infer causality between psychiatric traits and ICH.
METHODS
We collected data from genome-wide association studies of ICH ( = 361,194) and eight psychiatric traits among Europeans, including mood swings ( = 451,619), major depressive disorder ( = 480,359), attention-deficit/hyperactivity disorder ( = 53,293), anxiety ( = 459,560), insomnia ( = 462,341), schizophrenia ( = 77,096), neuroticism ( = 374,323), and bipolar disorder ( = 51,710). We performed a series of bidirectional two-sample Mendelian randomization and related sensitivity analyses. A Bonferroni corrected threshold of < 0.00625 (0.05/8) was considered to be significant, and < 0.05 was considered suggestive of evidence for a potential association.
RESULTS
Mendelian randomization analyses revealed suggestive positive causality of mood swings on ICH (odds ratio = 1.006, 95% confidence interval = 1.001-1.012, = 0.046), and the result was consistent after sensitivity analysis. However, major depressive disorder ( = 0.415), attention-deficit/hyperactivity disorder ( = 0.456), anxiety ( = 0.664), insomnia ( = 0.699), schizophrenia ( = 0.799), neuroticism ( = 0.140), and bipolar disorder ( = 0.443) are not significantly associated with the incidence of ICH. In the reverse Mendelian randomization analyses, no causal effects of ICH on mood swings ( = 0.565), major depressive disorder ( = 0.630), attention-deficit/hyperactivity disorder ( = 0.346), anxiety ( = 0.266), insomnia ( = 0.102), schizophrenia ( = 0.463), neuroticism ( = 0.261), or bipolar disorder ( = 0.985) were found.
CONCLUSION
Our study revealed that mood swings are suggestively causal of ICH and increase the risk of ICH. These results suggest the clinical significance of controlling mood swings for ICH prevention.
PubMed: 36684013
DOI: 10.3389/fpsyt.2022.1049432 -
Frontiers in Bioengineering and... 2021Fall-induced injuries can stem from a disruption in the postural control system and place a financial burden on the healthcare system. Most gait research focused on...
Fall-induced injuries can stem from a disruption in the postural control system and place a financial burden on the healthcare system. Most gait research focused on lower extremities and neglected the contribution of arm swing, which have been shown to affect the movement of the center of mass when walking. This study evaluated the effect of arm swing on postural control and stability during regular and rocky surface walking. Fifteen healthy young adults (age = 23.4 ± 2.8) walked on these two surfaces with three arm motions (normal, held, and active) using the CAREN Extended-System (Motek Medical, Amsterdam, NL). Mean, standard deviation and maximal values of trunk linear and angular velocity were calculated in all three axes. Moreover, step length, time and width mean and coefficient of variation as well as margin of stability mean and standard deviation were calculated. Active arm swing increased trunk linear and angular velocity variability and peak values compared to normal and held arm conditions. Active arm swing also increased participants' step length and step time, as well as the variability of margin of stability. Similarly, rocky surface walking increased trunk kinematics variability and peak values compared to regular surface walking. Furthermore, rocky surface increased the average step width while reducing the average step time. Though this surface type increased the coefficient of variation of all spatiotemporal parameters, rocky surface also led to increased margin of stability mean and variation. The spatiotemporal adaptations showed the use of "cautious" gait to mitigate the destabilizing effects of both the active arm swing and rocky surface walking and, ultimately, maintain dynamic stability.
PubMed: 34926413
DOI: 10.3389/fbioe.2021.645581 -
Journal of Sports Science & Medicine Sep 2022In the last decades, indoor volleyball has experienced significant rule changes and a high player specialization in both sexes. Different spike attack arm swing...
In the last decades, indoor volleyball has experienced significant rule changes and a high player specialization in both sexes. Different spike attack arm swing techniques have developed which might affect performance and risk of injury. While a variety of arm swing techniques was already shown in world class beach volleyball players, it is unclear if this is also true for world class indoor volleyball. Therefore, the purpose of this study was to assess the spike attack arm swing techniques of Olympic volleyball winners and finalists (1984-2021) and to investigate possible differences between sex, playing position, scoring system, and compared to beach volleyball. Eighty-two male (M) and 85 female (F) players were assessed from video recordings from ten competitions. Five different arm swing techniques in the cocking phase (Straight, Bow-and-arrow high, Bow-and-arrow low, Snap, Circular) were classified by two experts. The most frequent technique for both sexes was the Circular (M = 40.2%; F = 38.8%), followed by Snap (M = 28.0%; F = 23.5%), Bow-and-arrow low (M = 20.7%; F = 21.2%), Bow-and-arrow high (M = 7.3% F = 11.8%), and Straight (M = 3.7%; F = 4.7%). Bow-and-arrow high and Straight techniques were significantly less used than other techniques in both sexes. There were no significant differences (p > 0.05) in arm swing techniques between sexes, playing positions, and scoring system but significant differences (p < 0.001) to beach volleyball. Although most volleyball textbooks only describe the Bow-and-arrow techniques, most of the world class indoor volleyball players used Circular and Snap arm swing techniques. Reasons for that could be the implicit knowledge of players (and coaches) regarding increased performance (ball speed) and injury prevention. Based on these results we suggest to critically revise arm swing technique training especially for young players and players with shoulder problems.
Topics: Arm; Female; Humans; Male; Shoulder; Video Recording; Volleyball
PubMed: 36157399
DOI: 10.52082/jssm.2022.465 -
Journal of Biomechanics Jan 2022Motor variability is a fundamental feature of gait. Altered arm swing and lower limb asymmetry (LLA) may be contributing factors having been shown to affect the...
Motor variability is a fundamental feature of gait. Altered arm swing and lower limb asymmetry (LLA) may be contributing factors having been shown to affect the magnitude and dynamics of variability in spatiotemporal and trunk motion. However, the effects on lower limb joints remain unclear. Full-body kinematics of 15 healthy young adults were recorded during treadmill walking using the Computer-Assisted Rehabilitation Environment system. Participants completed six trials, combining three arm swing (AS) amplitude (normal, active, held) and two LLA (symmetrical, asymmetrical) conditions. The mean standard deviation (meanSD), maximum Lyapunov exponent (λ), detrended fluctuation analysis scaling exponent of range of motion (DFAα), and sample entropy (SaEn) were computed for tridimensional trunk, pelvis, and lower limb joint angles, and compared using repeated-measures ANOVAs. Relative to normal AS, active AS increased meanSD of all joint angles, λ of frontal plane hip and ankle angles, and SaEn of sagittal plane ankle angles. Active AS, however, did not affect λ or SaEn of trunk or pelvis angles. LLA increased meanSD of sagittal plane joint angles, λ of Euclidean norm trunk angle and of lower limb joint angles, and SaEn of ankle dorsiflexion/ plantarflexion, but decreased SaEn of tridimensional trunk angles and hip rotation in the slower moving leg. Alterations in lower limb variability with active AS and LLA suggest that young adults actively exploit their lower limb redundancies to maintain gait. This appears to preserve trunk stability and regularity during active AS but not during LLA.
Topics: Ankle Joint; Biomechanical Phenomena; Gait; Humans; Lower Extremity; Walking; Young Adult
PubMed: 34749161
DOI: 10.1016/j.jbiomech.2021.110855 -
Journal of Neurotrauma Mar 2024Naturally occurring life stages in women are associated with changes in the milieu of endogenous ovarian hormones. Women of childbearing age may be exposed to exogenous... (Review)
Review
Naturally occurring life stages in women are associated with changes in the milieu of endogenous ovarian hormones. Women of childbearing age may be exposed to exogenous ovarian hormone(s) because of their use of varying combinations of estrogen and progesterone hormones-containing oral contraceptives (OC; also known as "the pill"). If women have central nervous system (CNS) injury such as spinal cord injury (SCI) and traumatic brain injury (TBI) during their childbearing age, they are likely to retain their reproductive capabilities and may use OC. Many deleterious side effects of long-term OC use have been reported, such as aberrant blood clotting and endothelial dysfunction that consequently increase the risk of myocardial infarction, venous thromboembolism, and ischemic brain injury. Although controversial, studies have suggested that OC use is associated with neuropsychiatric ramifications, including uncontrollable mood swings and poorer cognitive performance. Our understanding about how the combination of endogenous hormones and OC-conferred exogenous hormones affect outcomes after CNS injuries remains limited. Therefore, understanding the impact of OC use on CNS injury outcomes needs further investigation to reveal underlying mechanisms, promote reporting in clinical or epidemiological studies, and raise awareness of possible compounded consequences. The goal of the current review is to discuss the impacts of CNS injury on endogenous ovarian hormones and vice-versa, as well as the putative consequences of exogenous ovarian hormones (OC) on the CNS to identify potential gaps in our knowledge to consider for future laboratory, epidemiological, and clinical studies.
Topics: Female; Humans; Hormonal Contraception; Trauma, Nervous System; Central Nervous System; Brain Injuries, Traumatic; Estrogens
PubMed: 37975282
DOI: 10.1089/neu.2023.0219 -
L'Encephale Dec 2020Interictal psychosis (IIP) refers to psychosis that occurs in clear consciousness in persons with epilepsy (PWE) with temporal onset not during or immediately following...
Interictal psychosis (IIP) refers to psychosis that occurs in clear consciousness in persons with epilepsy (PWE) with temporal onset not during or immediately following a seizure. The pooled prevalence estimate of psychosis in PWE is 5.6%. PWE and schizophrenia have very high mortality, and more than one in four persons with both disorders die between the age of 25 and 50years. IIP can manifest in brief or chronic forms. The chronic forms of IIP may closely resemble schizophrenia. However, some authors have described the typical presence of persecutory and religious delusions, sudden mood swings and the preservation of affect, as well as rarity of negative symptoms and catatonic states, but these differences remain controversial. Typically, IIP starts after many years of active temporal lobe epilepsy. Several epilepsy-related variables are considered pathogenically relevant in IIP including epilepsy type and seizure characteristics. Risk factors for developing IIP are family history of psychosis, learning disability, early age of onset of epilepsy, unilateral or bilateral hippocampal sclerosis, history of status epilepticus, history of febrile seizures, and poorly controlled temporal lobe epilepsy. In patients with epilepsy and psychosis, structural imaging studies have shown several relevant changes leading to conflicting findings. Altered neuronal plasticity and excitability have been described in epilepsy and psychotic disorders. Neuropathological data suggest that IIP are not the result of classic epileptic pathology of the temporal lobe. Forced normalization (FN) and alternating psychosis refer to patients with poorly controlled epilepsy (focal or generalized) who have had psychotic episodes associated with remission of their seizures and disappearance of epileptiform activity on their EEGs. FN mainly occurs in temporal lobe epilepsy when patients have frequent seizures that are abruptly terminated triggered by an antiepileptic drug, vagus nerve stimulation or epilepsy surgery. Treatment is based on withdrawal of the responsible drug, and by transient use of antipsychotics for acute symptomatic control on a case-by-case basis. FN is an entity whose pathophysiology remains uncertain. Antiepileptic drugs (AEDs) may sometimes induce psychotic symptoms and psychosis could be a direct effect of the AEDs. IIP has been reported more frequently following the initiation of zonisamide, topiramate, and levetiracetam when compared with other antiepileptic drugs. However, AEDs do not appear to be the only determinant of IIP. The management of IIP requires a multidisciplinary approach with early involvement of a liaison psychiatrist associated with a neurologist. IIP are underdiagnosed and mistreated. Existing recommendations are extrapolated from those established for the treatment of schizophrenia with some additional guidance from expert opinions. A two-step procedure, not necessarily consecutive, is suggested. The first step requires reevaluation of the antiepileptic treatment. The second step requires initiation of atypical neuroleptics. Antipsychotic drugs should be selected with consideration of the balance between pharmacological profiles, efficacy, and adverse effects. Regarding pharmacokinetic interactions, AEDs with inducing properties reduce the blood levels of all antipsychotics. It is important to consider implications of combining neuroleptics and AEDs with a similar spectrum of side effects. Regarding the duration of treatment, IIP episodes are more likely to be recurrent than in primary schizophrenia. In practice, atypical neuroleptics with few motor side effects such as risperidone can be used as first choice, given the low propensity for drug-drug interactions and the low seizure risk, with the added suggestion to start low and go slow. Clozapine could be prescribed in selected cases.
Topics: Adult; Anticonvulsants; Antipsychotic Agents; Epilepsy; Humans; Middle Aged; Psychotic Disorders; Seizures
PubMed: 32594995
DOI: 10.1016/j.encep.2020.04.014 -
Mathematical Biosciences and... Feb 2022Serotonin, dopamine and norepinephrine are monoamine neurotransmitters that modulate our mood state. Hence, imbalances in the levels of these neurotransmitters have been...
Serotonin, dopamine and norepinephrine are monoamine neurotransmitters that modulate our mood state. Hence, imbalances in the levels of these neurotransmitters have been linked to the incidence of several psychiatric disorders. Here, a mathematical model written in terms of ordinary differential equations is proposed to represent the interaction of these three neurotransmitters. It is analytically and numerically shown that this model can experience a Hopf bifurcation. Thus, by varying a parameter value, the neurotransmitter levels can change from a steady state to an oscillatory behavior, which may be at least a partial explanation of the mood swings observed in depressed people.
Topics: Dopamine; Humans; Models, Theoretical; Neurotransmitter Agents; Serotonin; Systems Analysis
PubMed: 35341287
DOI: 10.3934/mbe.2022187