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L'Encephale Dec 2022What is mood? Despite its crucial place in psychiatric nosography and cognitive science, it is still difficult to delimit its conceptual ground. The distinction between...
What is mood? Despite its crucial place in psychiatric nosography and cognitive science, it is still difficult to delimit its conceptual ground. The distinction between emotion and mood is ambiguous: mood is often presented as an affective state that is more prolonged and less intense than emotion, or as an affective polarity distinguishing high and low mood swinging around a baseline. However, these definitions do not match the clinical reality of mood disorders such as unipolar depression and bipolar disorder, and do not allow us to understand the effect of mood on behaviour, perception and cognition. In this paper, we propose a multidimensional and computational theory of mood inspired by contemporary hypotheses in theoretical neuroscience and philosophy of emotion. After suggesting an operational distinction between emotion and mood, we show how a succession of emotions can cumulatively generate congruent mood over time, making mood an emerging state from emotion. We then present how mood determines mental and behavioral states when interacting with the environment, constituting a dispositional state of emotion, perception, belief, and action. Using this theoretical framework, we propose a computational representation of the emerging and dispositional dimensions of mood by formalizing mood as a layer of third-order Bayesian beliefs encoding the precision of emotion, and regulated by prediction errors associated with interoceptive predictions. Finally, we show how this theoretical framework sheds light on the processes involved in mood disorders, the emergence of mood congruent beliefs, or the mechanisms of antidepressant treatments in clinical psychiatry.
Topics: Humans; Bayes Theorem; Affect; Emotions; Mood Disorders; Bipolar Disorder
PubMed: 35987716
DOI: 10.1016/j.encep.2022.02.002 -
Neurologia I Neurochirurgia Polska 2021Parkinsonism is usually designated a movement disorder. However, cognitive impairment comprises a major part of many parkinsonian syndromes, and inversely correlates... (Review)
Review
Parkinsonism is usually designated a movement disorder. However, cognitive impairment comprises a major part of many parkinsonian syndromes, and inversely correlates with quality of life. Parkinsonian features are largely attributed to subcortical dopaminergic dysfunction, although other brain regions and neurotransmitters also contribute. This is illustrated by phenotypic differences among different parkinsonian syndromes. Slowed processing speed and executive dysfunction are generally expected in parkinsonian patients, but additional cognitive features can suggest specific pathological substrates, e.g. apraxia in corticobasal degeneration. Similarly, motor symptoms generally include combinations of bradykinesia, rigidity, rest tremor, and postural instability, although nuanced differences and associated clinical features often help differentiate between parkinsonian syndromes. Human gait requires complex synchronisation at every level of the nervous system, yet occurs with minimal conscious effort on behalf of the walker. Deviations from the normal gait pattern can result from otherwise unnoticeable insults to the body, both intrinsic and extrinsic to the nervous system. Gait is almost always abnormal in parkinsonism, ranging from subtle arm swing asymmetry to discrete episodes of gait freezing. Moreover, one's cognitive state can directly affect one's quality of gait. The notion that a gait profile could in fact be a disease-specific biomarker is an area of great research interest. This review focuses on the manifestations of, and correlations between, cognitive and gait impairment in common parkinsonian conditions, and provides guidance for a clinical approach to assessing them.
Topics: Cognition; Corticobasal Degeneration; Gait; Humans; Parkinsonian Disorders; Quality of Life
PubMed: 34817060
DOI: 10.5603/PJNNS.a2021.0084 -
Frontiers in Neuroscience 2023Bipolar disorder (BD) is characterized by extreme mood swings ranging from manic/hypomanic to depressive episodes. The severity, duration, and frequency of these... (Review)
Review
Bipolar disorder (BD) is characterized by extreme mood swings ranging from manic/hypomanic to depressive episodes. The severity, duration, and frequency of these episodes can vary widely between individuals, significantly impacting quality of life. Individuals with BD spend almost half their lives experiencing mood symptoms, especially depression, as well as associated clinical dimensions such as anhedonia, fatigue, suicidality, anxiety, and neurovegetative symptoms. Persistent mood symptoms have been associated with premature mortality, accelerated aging, and elevated prevalence of treatment-resistant depression. Recent efforts have expanded our understanding of the neurobiology of BD and the downstream targets that may help track clinical outcomes and drug development. However, as a polygenic disorder, the neurobiology of BD is complex and involves biological changes in several organelles and downstream targets (pre-, post-, and extra-synaptic), including mitochondrial dysfunction, oxidative stress, altered monoaminergic and glutamatergic systems, lower neurotrophic factor levels, and changes in immune-inflammatory systems. The field has thus moved toward identifying more precise neurobiological targets that, in turn, may help develop personalized approaches and more reliable biomarkers for treatment prediction. Diverse pharmacological and non-pharmacological approaches targeting neurobiological pathways other than neurotransmission have also been tested in mood disorders. This article reviews different neurobiological targets and pathophysiological findings in non-canonical pathways in BD that may offer opportunities to support drug development and identify new, clinically relevant biological mechanisms. These include: neuroinflammation; mitochondrial function; calcium channels; oxidative stress; the glycogen synthase kinase-3 (GSK3) pathway; protein kinase C (PKC); brain-derived neurotrophic factor (BDNF); histone deacetylase (HDAC); and the purinergic signaling pathway.
PubMed: 37592949
DOI: 10.3389/fnins.2023.1228455 -
Clinical Nutrition ESPEN Aug 2022Symptoms associated with menopause could be a public health issue in the world, characterized by a permanent cessation of menstruation due to lack of ovarian follicular... (Randomized Controlled Trial)
Randomized Controlled Trial
BACKGROUND & AIMS
Symptoms associated with menopause could be a public health issue in the world, characterized by a permanent cessation of menstruation due to lack of ovarian follicular activity 12 months after menopause. It leads to mood swings, sleep disturbances and hot flashes. Modification of lifestyle and proper nutrition program are involved in improving mood and sleep quality. Thus, the aim of present study was to evaluate the effect of probiotics on mood and sleep quality (primary outcomes), quality of life, satisfaction with the intervention and side effects (secondary outcomes) in postmenopausal women.
METHODS
This triple-blind randomized controlled trial was conducted on 66 postmenopausal women aged 45-55 years in Behbahan city-Iran in 2020-2021. Women were randomly assigned to the intervention and control groups. Intervention group received 100 g of yogurt containing probiotics and control group received 100 g of ordinary yogurt daily after lunch for 6 weeks. Before the intervention and 6 weeks after the intervention, the participants completed the Pittsburgh sleep quality scale, DASS-21 (Depression, Anxiety, and Stress Scale-21 items), and the menopause quality of life (MENQOL) questionnaire. Independent t-test, Mann-Whitney U and ANCOVA tests were used for data analysis.
RESULTS
There was no statistically significant difference between the two groups in terms of socio-demographic characteristics and baseline values. Six weeks after the intervention, based on ANCOVA test and by adjusting the baseline score, the mean anxiety score (adjusted mean difference (AMD): -0.56, 95% confidence interval (95% CI): -0.01 to -1.12; P = 0.044), mean stress score (AMD: -0.76, 95% CI: -0.01 to -1.52; P = 0.046) and mean quality of life score (AMD: -4.86, 95% CI: 3.06 to -6.66; P < 0.001) in the group receiving probiotic yogurt were significantly lower than those in the control group. However, in terms of mean scores of depression and sleep quality, there was no statistically significant difference between the two groups.
CONCLUSION
The results of this study suggest the effects of consuming probiotic yogurt on improving anxiety, stress and quality of life in postmenopausal women. However, further studies are needed to obtain a definite conclusion in this regard.
TRIAL REGISTRATION
Iranian Registry of Clinical Trials (IRCT): IRCT20120718010324N57; Date of registration: 30/06/2020. URL: https://en.irct.ir/user/trial/47177/view; Date of first registration: 21/07/2020.
Topics: Female; Humans; Iran; Postmenopause; Probiotics; Quality of Life; Sleep Quality
PubMed: 35871917
DOI: 10.1016/j.clnesp.2022.06.005 -
Handbook of Clinical Neurology 2022Sleep disorders are prevalent in heart failure and include insomnia, poor sleep architecture, periodic limb movements and periodic breathing, and encompass both... (Review)
Review
Sleep disorders are prevalent in heart failure and include insomnia, poor sleep architecture, periodic limb movements and periodic breathing, and encompass both obstructive (OSA) and central sleep apnea (CSA). Polysomnographic studies show excess light sleep and poor sleep efficiency particularly in those with heart failure. Multiple studies of consecutive patients with heart failure show that about 50% of patients suffer from either OSA or CSA. While asleep, acute pathological consequences of apneas and hypopneas include altered blood gases, sleep fragmentation, and large negative swings in intrathoracic pressure. These pathological consequences are qualitatively similar in both types of sleep apnea, though worse in OSA than CSA. Sleep apnea results in oxidative stress, inflammation, and endothelial dysfunction, best documented in OSA. Multiple studies show that both OSA and CSA are associated with excess hospital readmissions and premature mortality. However, no randomized controlled trial (RCT) has been reported for OSA, but sensitivity analysis of two randomized controlled trials has concluded that use of positive airway pressure devices is associated with excess mortality in patients with heart failure and CSA. Phrenic nerve stimulation has shown improvement in sleep apnea events and daytime sleepiness; however, no randomized controlled trials have demonstrated improvement in survival in patients with heart failure. The correct identification and treatment of heart failure patients with sleep and breathing disorders could affect the long-term outcomes of these patients.
Topics: Heart Failure; Humans; Sleep; Sleep Apnea Syndromes; Sleep Apnea, Central; Sleep Apnea, Obstructive
PubMed: 36031310
DOI: 10.1016/B978-0-323-91532-8.00009-4 -
Cureus Aug 2022Bipolar disorder (BD) is a mood disorder characterized by severe mood swings and or periods of depression. This study examined the role that practicing yoga has on the... (Review)
Review
Bipolar disorder (BD) is a mood disorder characterized by severe mood swings and or periods of depression. This study examined the role that practicing yoga has on the symptoms of BD. One of the main goals was to identify if patients with BD believe that yoga is a viable treatment option. Six research databases were searched using the keywords "yoga" AND "therapy" AND "BD" AND "bipolar depression." Articles published in 2005 and later were included in the search. After duplicates were removed, and inclusion and exclusion criteria were applied, five articles were analyzed and included in this literature review. Results of this review indicate that yoga has been shown to be associated with both benefits and risks for the treatment of BD. Studies have shown that yoga might relieve some symptoms of BD and depression. However, due to the lack of research on the impact of yoga on BD and the small number of studies included in this review, results should be approached with caution. Overall, yoga was well-tolerated in the studies reviewed in this article. Yoga may relieve the symptoms of depression. Future research should analyze the long-term impact of yoga on bipolar depression. Yoga instructional standards should also be considered.
PubMed: 36072189
DOI: 10.7759/cureus.27688 -
Praxis Apr 2022The non-medical use of image- and performance-enhancing drugs (IPEDs) is widespread in the fitness and bodybuilding scene. The reasons for IPED use are often hedonistic...
The non-medical use of image- and performance-enhancing drugs (IPEDs) is widespread in the fitness and bodybuilding scene. The reasons for IPED use are often hedonistic in nature and they are used in so-called "cycles" over several weeks. The most common side effects are: testicular atrophy, acne, hypersexuality, hypertension, gynecomastia, lipid metabolism disorders, mood swings, hair loss, and policythemia. Common consequences following IPED use are: decreased libido, oligo- or azoospermia, and erectile dysfunction. To reduce undesirable side effects and consequences, IPED users often take medications for self-treatment; occasionally IPED users also mention such medications and ask for them in the general medical practice.
Topics: Exercise; Humans; Male; Performance-Enhancing Substances
PubMed: 35473328
DOI: 10.1024/1661-8157/a003874 -
Current Pharmaceutical Design 2023Multiple sclerosis (MS) is a central nervous system (CNS) immune-mediated disease that mainly strikes young adults and leaves them disabled. MS is an autoimmune illness... (Review)
Review
Multiple sclerosis (MS) is a central nervous system (CNS) immune-mediated disease that mainly strikes young adults and leaves them disabled. MS is an autoimmune illness that causes the immune system to attack the brain and spinal cord. The myelin sheaths, which insulate the nerve fibers, are harmed by our own immune cells, and this interferes with brain signal transmission. Numbness, tingling, mood swings, memory problems, exhaustion, agony, vision problems, and/or paralysis are just a few of the symptoms. Despite technological advancements and significant research efforts in recent years, diagnosing MS can still be difficult. Each patient's MS is distinct due to a heterogeneous and complex pathophysiology with diverse types of disease courses. There is a pressing need to identify markers that will allow for more rapid and accurate diagnosis and prognosis assessments to choose the best course of treatment for each MS patient. The cerebrospinal fluid (CSF) is an excellent source of particular indicators associated with MS pathology. CSF contains molecules that represent pathological processes such as inflammation, cellular damage, and loss of blood-brain barrier integrity. Oligoclonal bands, neurofilaments, MS-specific miRNA, lncRNA, IgG-index, and anti-aquaporin 4 antibodies are all clinically utilised indicators for CSF in MS diagnosis. In recent years, a slew of new possible biomarkers have been presented. In this review, we look at what we know about CSF molecular markers and how they can aid in the diagnosis and differentiation of different MS forms and treatment options, and monitoring and predicting disease progression, therapy response, and consequences during such opportunistic infections.
Topics: Young Adult; Humans; Multiple Sclerosis; Prognosis; Biomarkers; Oligoclonal Bands; Disease Progression; Early Diagnosis
PubMed: 37921136
DOI: 10.2174/0113816128247471231018053737 -
BMC Psychiatry Jun 2023Bipolar disorder (BD) is characterized by intensive mood fluctuations. While hormones imbalance plays important role in the mood swings, it is unknown whether peripheral...
BACKGROUND
Bipolar disorder (BD) is characterized by intensive mood fluctuations. While hormones imbalance plays important role in the mood swings, it is unknown whether peripheral hormones profiles could differentiate the manic and depressive mood episodes in BD. In this study, we investigated the changes of various hormones and inflammatory markers across distinct mood episodes of BD in a large clinical study to provide mood episode-specific peripheral biomarkers for BD.
METHODS
A total of 8332 BD patients (n = 2679 depressive episode; n = 5653 manic episode) were included. All patients were in acute state of mood episodes and need hospitalization. A panel of blood tests were performed for levels of sex hormones (serum levels of testosterone, estradiol, and progesterone), stress hormones (adrenocorticotropic hormone and cortisol), and an inflammation marker (C-reactive protein, CRP). A receiver operating characteristic (ROC) curve was used to analyze the discriminatory potential of the biomarkers for mood episodes.
RESULTS
In overall comparison between mood episodes, the BD patients expressed higher levels of testosterone, estradiol, progesterone, and CRP (P < 0.001) and lower adrenocorticotropic hormone (ACTH) level (P < 0.001) during manic episode. The episode-specific changes of testosterone, ACTH, and CRP levels remained between the two groups (P < 0.001) after correction for the confounding factors including age, sex, BMI, occupation, marital status, tobacco use, alcohol consumption, psychotic symptoms, and age at onset. Furthermore, we found a sex- and age-specific impact of combined biomarkers in mood episodes in male BD patients aged ≥ 45 years (AUC = 0.70, 95% CI, 0.634-0.747), not in females.
CONCLUSIONS
While both hormone and inflammatory change is independently associated with mood episodes, we found that the combination of sex hormones, stress hormones and CRP could be more effective to differentiate the manic and depressive episode. The biological signatures of mood episodes in BD patients may be sex- and age-specific. Our findings not only provide mood episode-related biological markers, but also better support for targeted intervention in BD treatments.
Topics: Female; Humans; Male; Bipolar Disorder; Mania; Progesterone; Hydrocortisone; Biomarkers; Adrenocorticotropic Hormone; Testosterone; Estradiol
PubMed: 37340368
DOI: 10.1186/s12888-023-04846-1 -
BJPsych Open Apr 2024Many studies have found an association between mood-disorder-related traits and endometriosis and adenomyosis. However, the cause-effect relationship remains unclear.
BACKGROUND
Many studies have found an association between mood-disorder-related traits and endometriosis and adenomyosis. However, the cause-effect relationship remains unclear.
AIMS
We conducted Mendelian randomisation analyses to evaluate any causal relationship between mood disorders and endometriosis as well as different sites of endometriosis.
METHOD
Summary-level statistics for mood-disorder-related traits and endometriosis (8288 cases, 68 969 controls) in European populations were derived from large-scale data-sets of genome-wide association studies. A two-sample Mendelian randomisation was performed using the inverse-variance weighted and weight median methods. Further sensitivity analyses, including heterogeneity, pleiotropy and leave-one-out analyses, were conducted to test the consistency of the results.
RESULTS
Genetically determined mood swings (odds ratio = 2.557, 95% CI: 1.192-5.483, = 0.016) and major depression (odds ratio = 1.233, 95% CI: 1.019-1.493, = 0.031) were causally associated with an increased risk of endometriosis. Mood swings (odds ratio = 4.238, 95% CI: 1.194-15.048, = 0.025) and major depression (odds ratio = 1.512, 95% CI: 1.052-2.173, = 0.025) were also causally associated with the risk of adenomyosis. Sensitivity analyses confirmed the reliability of the results.
CONCLUSIONS
Our results suggest that mood-disorder-related traits increase the risk of endometriosis and adenomyosis. This study provides new insights into the potential pathogenesis of endometriosis and adenomyosis, and highlights the importance of preventing endometriosis and adenomyosis in patients with mood-disorder-related traits.
PubMed: 38622955
DOI: 10.1192/bjo.2024.46