Simultaneous rTMS and psychotherapy in major depressive disorder: Clinical outcomes and predictors from a large naturalistic study

Publication date: Available online 11 November 2017
Source:Brain Stimulation
Author(s): Lana Donse, Frank Padberg, Alexander T. Sack, A. John Rush, Martijn Arns
BackgroundRepetitive transcranial magnetic stimulation (rTMS) is considered an efficacious non-invasive neuromodulation treatment for major depressive disorder (MDD). However, little is known about the clinical outcome of combined rTMS and psychotherapy (rTMS + PT). Through common neurobiological brain mechanisms, rTMS + PT may exert enhanced antidepressant effects compared to the respective monotherapies.ObjectiveThe current naturalistic study aimed to evaluate feasibility and clinical outcome of rTMS + PT in a large group of MDD patients. The second aim was to identify clinical predictors of response and remission.MethodsA total of 196 patients with MDD were treated with at least 10 sessions of simultaneous rTMS and PT. rTMS was applied over the DLPFC, either 10 Hz left or 1 Hz right. Psychotherapy was based on principles of cognitive behavioral therapy (CBT). Symptoms were measured using the BDI each fifth session until end of treatment and at 6-month follow-up. Comparisons were made between responders and non-responders, as well as between the 10 Hz and 1 Hz protocol. Additionally, baseline variables and early BDI change were evaluated as predictors of response/remission.Major findings and conclusions1) Combining rTMS and PT resulted in a 66% response and a 56% remission rate at the end of treatment with 60% sustained remission at follow-up. Compared to previous findings in RCTs, these rates are relatively high; 2) No differences were found between the 10 Hz and 1 Hz TMS regarding clinical outcome; 3) Clinical baseline variables were not predictive of treatment outcomes; 4) Early symptom improvement (at session 10) was highly predictive of response, and may therefore be used to guide rTMS + PT continuation; 5) Based on the current findings in a large naturalistic study, future studies employing a more standardized method are warranted to draw solid conclusions on the unique effect of rTMS + PT.



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Masthead

Publication date: November–December 2017
Source:Brain Stimulation, Volume 10, Issue 6





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Editorial Board

Publication date: November–December 2017
Source:Brain Stimulation, Volume 10, Issue 6





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Table of Contents

Publication date: November–December 2017
Source:Brain Stimulation, Volume 10, Issue 6





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Safety of repeated sessions of transcranial direct current stimulation: A systematic review

Publication date: Available online 31 October 2017
Source:Brain Stimulation
Author(s): Stevan Nikolin, Christina Huggins, Donel Martin, Angelo Alonzo, Colleen K. Loo
BackgroundRepeated sessions of transcranial direct current stimulation (tDCS) are increasingly used for therapeutic applications. However, adverse events (AEs) associated with repeated sessions have not been comprehensively evaluated.ObjectiveThe aim of this study was therefore to evaluate the safety of repeated sessions of tDCS, examining AE risk relative to tDCS exposure. Further, to identify whether certain participant populations are particularly at risk from tDCS.MethodsA systematic review and meta-analysis included sham-controlled studies (up to June 2017) involving two or more tDCS sessions, spaced not more than a day apart. Data was extracted on AEs reported, total tDCS exposure (cumulative charge), and diagnostic groups (Healthy, Pain Disorder, Stroke, Neurocognitive Disorder, Neuropsychiatric Disorder, and Other). Univariate simple linear meta-regression analyses examined AE likelihood, comparing active and sham tDCS, with increasing exposure. Rates of AEs were compared for diagnostic groups.Results158 studies (total 4130 participants) met inclusion criteria and were included for quantitative analyses. The incidence of AEs (examined per session, by proportion of participants, and by the number of studies reporting AEs) did not increase with higher levels of tDCS exposure. Furthermore, AE rates were not found to be greater for any diagnostic group.ConclusionsLittle evidence was found to suggest that repeated sessions of active tDCS pose increased risk to participants compared to sham tDCS within the limits of parameters used to date. Increased risks associated with greater levels of exposure to tDCS, or rare and under-reported AEs, however, cannot be ruled out.



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Information for Authors

Publication date: November–December 2017
Source:Brain Stimulation, Volume 10, Issue 6





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Responders to rTMS for depression show increased fronto-midline theta and theta connectivity compared to non-responders

Publication date: Available online 27 October 2017
Source:Brain Stimulation
Author(s): N.W. Bailey, K.E. Hoy, N.C. Rogasch, R.H. Thomson, S. McQueen, D. Elliot, C.M. Sullivan, B.D. Fulcher, Z.J. Daskalakis, P.B. Fitzgerald
BackgroundRepetitive transcranial magnetic stimulation (rTMS) is an effective treatment for depression, but only some individuals respond. Predicting response could reduce patient and clinical burden. Neural activity related to working memory (WM) has been related to mood improvements, so may represent a biomarker for response prediction.Primary hypothesesWe expected higher theta and alpha activity in responders compared to non-responders to rTMS.MethodsFifty patients with treatment resistant depression and twenty controls performed a WM task while electroencephalography (EEG) was recorded. Patients underwent 5–8 weeks of rTMS treatment, repeating the EEG at week 1 (W1). Of the 39 participants with valid WM-related EEG data from baseline and W1, 10 were responders. Comparisons between responders and non-responders were made at baseline and W1 for measures of theta (4–8 Hz), upper alpha (10–12.5 Hz), and gamma (30–45 Hz) power, connectivity, and theta-gamma coupling. The control group's measures were compared to the depression group's baseline measures separately.ResultsResponders showed higher levels of WM-related fronto-midline theta power and theta connectivity compared to non-responders at baseline and W1. Responder's fronto-midline theta power and connectivity was similar to controls. Responders also showed an increase in gamma connectivity from baseline to W1, with a concurrent improvement in mood and WM reaction times. An unbiased combination of all measures provided mean sensitivity of 0.90 at predicting responders and specificity of 0.92 in a predictive machine learning algorithm.ConclusionBaseline and W1 fronto-midline theta power and theta connectivity show good potential for predicting response to rTMS treatment for depression.



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Electroconvulsive therapy, depression, the immune system and inflammation: A systematic review

Publication date: Available online 19 October 2017
Source:Brain Stimulation
Author(s): Antoine Yrondi, Marie Sporer, Patrice Péran, Laurent Schmitt, Christophe Arbus, Anne Sauvaget
BackgroundThe management and treatment of major depressive disorder are major public health challenges, the lifetime prevalence of this illness being 4.4%–20% in the general population. Major depressive disorder and treatment resistant depression appear to be, in part, related to a dysfunction of the immune response. Among the treatments for depression ECT occupies an important place. The underlying cerebral mechanisms of ECT remain unclear.Objectives/HypothesisThe aim of this review is to survey the potential actions of ECT on the immuno-inflammatory cascade activated during depression.MethodsA systematic search of the literature was carried out, using the bibliographic search engines PubMed and Embase. The search covered articles published up until october 2017.The following MESH terms were used: Electroconvulsive therapy AND (inflammation OR immune OR immunology).ResultsOur review shows that there is an acute immuno-inflammatory response immediately following an ECT session. There is an acute stress reaction. Studies show an increase in the plasma levels of cortisol and of interleukins 1 and 6. However, at the end of the course of treatment, ECT produces, in the long term, a fall in the plasma level of cortisol, a reduction in the levels of TNF alpha and interleukin 6.LimitationsOne of the limitations of this review is that a large number of studies are relatively old, with small sample sizes and methodological bias.ConclusionAdvances in knowledge of the immuno-inflammatory component of depression seem to be paving the way towards models to explain the mechanism of action of ECT.



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Stochastic resonance in the human vestibular system – Noise-induced facilitation of vestibulospinal reflexes

Publication date: Available online 31 October 2017
Source:Brain Stimulation
Author(s): M. Wuehr, J.C. Boerner, C. Pradhan, J. Decker, K. Jahn, T. Brandt, R. Schniepp
BackgroundThere is strong evidence that the presence of noise can enhance information processing in sensory systems via stochastic resonance (SR).ObjectivesTo examine the presence of SR in human vestibulospinal reflex function.MethodsHealthy subjects were stimulated with 1 Hz sinusoidal GVS of varying amplitudes (0–1.9 mA). Coherence between GVS input and stimulation-induced motion responses was determined and psychometric function fits were subsequently used to determine individual vestibulospinal reflex thresholds. This procedure was repeated with additional application of imperceptible white noise GVS (nGVS).ResultsnGVS significantly facilitated the detectability of weak subthreshold vestibular inputs (p < 0.001) and thereby effectively lowered the vestibulospinal threshold in 90% of participants (p < 0.001, mean reduction: 17.5 ± 14.6%).ConclusionThis finding provides evidence for the presence of SR-dynamics in the human vestibular system and gives a functional explanation for previously observed ameliorating effects of low-intensity vestibular noise stimulation on balance control in healthy subjects and patients with vestibular hypofunction.



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Simultaneous aerobic exercise and rTMS: Feasibility of combining therapeutic modalities to treat depression

Publication date: Available online 31 October 2017
Source:Brain Stimulation
Author(s): Ryan E. Ross, Catherine J. VanDerwerker, Jennifer H. Newton, Mark S. George, E. Baron Short, Gregory L. Sahlem, A.J. Manett, James B. Fox, Chris M. Gregory




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Sensory percepts induced by microwire array and DBS microstimulation in human sensory thalamus

Publication date: Available online 27 October 2017
Source:Brain Stimulation
Author(s): Brandon D. Swan, Lynne B. Gasperson, Max O. Krucoff, Warren M. Grill, Dennis A. Turner
BackgroundMicrostimulation in human sensory thalamus (ventrocaudal, VC) results in focal sensory percepts in the hand and arm which may provide an alternative target site (to somatosensory cortex) for the input of prosthetic sensory information. Sensory feedback to facilitate motor function may require simultaneous or timed responses across separate digits to recreate perceptions of slip as well as encoding of intensity variations in pressure or touch.ObjectivesTo determine the feasibility of evoking sensory percepts on separate digits with variable intensity through either a microwire array or deep brain stimulation (DBS) electrode, recreating "natural" and scalable percepts relating to the arm and hand.MethodsWe compared microstimulation within ventrocaudal sensory thalamus through either a 16-channel microwire array (∼400 kΩ per channel) or a 4-channel DBS electrode (∼1.2 kΩ per contact) for percept location, size, intensity, and quality sensation, during thalamic DBS electrode placement in patients with essential tremor.ResultsPercepts in small hand or finger regions were evoked by microstimulation through individual microwires and in 5/6 patients sensation on different digits could be perceived from stimulation through separate microwires. Microstimulation through DBS electrode contacts evoked sensations over larger areas in 5/5 patients, and the apparent intensity of the perceived response could be modulated with stimulation amplitude. The perceived naturalness of the sensation depended both on the pattern of stimulation as well as intensity of the stimulation.ConclusionsProducing consistent evoked perceptions across separate digits within sensory thalamus is a feasible concept and a compact alternative to somatosensory cortex microstimulation for prosthetic sensory feedback. This approach will require a multi-element low impedance electrode with a sufficient stimulation range to evoke variable intensities of perception and a predictable spread of contacts to engage separate digits.



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TLR8 activation and inhibition by guanosine analogs in RNA: importance of functional groups and chain length

Publication date: Available online 11 November 2017
Source:Bioorganic & Medicinal Chemistry
Author(s): Tiannan Hu, Scott R. Suter, Madeline M. Mumbleau, Peter A. Beal
Toll-like receptor 8 (TLR8) is an important component of the human innate immune system that recognizes single stranded RNA (ssRNA). Recent x-ray crystal structures of TLR8 bound to ssRNA revealed a previously unrecognized binding site for a 5'-UpG-3' dinucleotide. Here we use an atomic mutagenesis strategy coupled with a cellular TLR8 activation assay to probe the importance of specific functional groups present on the guanine base in RNA-mediated receptor agonism and antagonism. Results from RNA analogs containing 7-deazaguanosine, 2-aminopurine and inosine confirm the importance of guanine N7, O6 and N2, respectively, in TLR8 activation. Nevertheless, these RNAs each retained TLR8 antagonism activity. RNA containing 7-deaza-8-azainosine (7d8aI) was prepared from a novel phosphoramidite and found to be a weaker TLR8 activator than guanosine-containing RNA. However, 7d8aI-containing RNA also retained TLR8 antagonism activity indicating that removal of multiple TLR8 H-bonding sites on guanine is insufficient for blocking TLR8 antagonism by guanine-containing RNA. We also identified an oligoribonucleotide length dependence on both TLR8 activation and antagonism. These studies extend our understanding of the effects of nucleobase modification on immune stimulation and will inform the design of novel RNA-based therapeutics.

Graphical abstract

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Defining the Role of Free Flaps in Partial Breast Reconstruction

J reconstr Microsurg
DOI: 10.1055/s-0037-1607363

Background Free flaps have a well-established role in breast reconstruction after mastectomy; however, their role in partial breast reconstruction remains poorly defined. We reviewed our experience with partial breast reconstruction to better understand indications for free tissue transfer. Methods A retrospective review was performed of all patients undergoing partial breast reconstruction at our center between February 2009 and October 2015. We evaluated the characteristics of patients who underwent volume displacement procedures versus volume replacement procedures and free versus pedicled flap reconstruction. Results There were 78 partial breast reconstructions, with 52 reductions/tissue rearrangements (displacement group) and 26 flaps (replacement group). Bra cup size and body mass index (BMI) were significantly smaller in the replacement group. Fifteen pedicled and 11 free flaps were performed. Most pedicled flaps (80.0%) were used for lateral or upper pole defects. Most free flaps (72.7%) were used for medial and inferior defects or when there was inadequate donor tissue for a pedicled flap. Complications included hematoma, cellulitis, and one aborted pedicled flap. Conclusion Free and pedicled flaps are useful for partial breast reconstruction, particularly in breast cancer patients with small breasts undergoing breast-conserving treatment (BCT). Flap selection depends on defect size, location, and donor tissue availability. Medial defects are difficult to reconstruct using pedicled flaps due to arc of rotation and intervening breast tissue. Free tissue transfer can overcome these obstacles. Confirming negative margins before flap reconstruction ensures harvest of adequate volume and avoids later re-operation. Judicious use of free flaps for oncoplastic reconstruction expands the possibility for breast conservation.
[...]

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Recent advances in melanoma research via “omics” platforms

Publication date: Available online 11 November 2017
Source:Journal of Proteomics
Author(s): Carmen Rodríguez-Cerdeira, Alberto Molares-Vila, Miguel Carnero-Gregorio, Alberte Corbalán-Rivas
Melanoma has a high mortality rate and metastatic melanoma is highly resistant to conventional therapies. "Omics" fields such as proteomics and microRNA and exosome studies have provided new knowledge to complement the information generated by genomic studies. This work aimed to review the current status of biomarker discovery for melanoma through multi-"omics" platforms. A few sets of novel microRNAs and proteins are described, some of them with important implications in suppressing melanoma at different stages. Upregulation of genes involved in angiogenesis, immunosuppressive factors, modification of stroma, capture of melanoma cells in lymph nodes and factors responsible for tumour cell recruitment have been identified in exosomes, among molecules with other functions. A remarkable series of proteins involved in epithelial-mesenchymal/mesenchymal-epithelial transitions, inflammation, motility, proliferation and progression processes, centrosome amplification, aneuploidy, inhibition of CD8+ effector T-cells, and metastasis in general were identified. Genomic and protein-protein interactions or metabolome levels were not analysed.Proteomics tools such as Orbitrap shotgun mass spectrometry or deep mining proteomic analysis utilizing high-resolution reversed phase nanoseparation in combination with mass spectrometry are also discussed. The application of these tools together with bioinformatics approaches applied to the clinical setting will enable the implementation of personalized medicine in the near future.

Graphical abstract

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CaMKIIα expression in a mouse model of NMDAR hypofunction schizophrenia: putative roles for IGF-1R and TLR4

Publication date: Available online 11 November 2017
Source:Brain Research Bulletin
Author(s): O.M. Ogundele, C.C. Lee
Schizophrenia (SCZ) is a neuropsychiatric disorder that is linked to social behavioral deficits and other negative symptoms associated with hippocampal synaptic dysfunction. Synaptic mechanism of schizophrenia is characterized by loss of hippocampal N-Methyl-D-Aspartate Receptor (NMDAR) activity (NMDAR hypofunction) and dendritic spines. Previous studies show that genetic deletion of hippocampal synaptic regulatory calcium-calmodulin dependent kinase II alpha (CaMKIIα) cause synaptic and behavioral defects associated with schizophrenia in mice. Although CaMKIIα is involved in modulation of NMDAR activity, it is equally linked to inflammatory and neurotropin signaling in neurons. Based on these propositions, we speculate that non-neurotransmitter upstream receptors associated with neurotropic and inflammatory signaling activities of CaMKIIα may alter its synaptic function. Besides, how these receptors (i.e. inflammatory and neurotropic receptors) alter CaMKIIα function (phosphorylation) relative to hippocampal NMDAR activity in schizophrenia is poorly understood. Here, we examined the relationship between toll-like receptor (TLR4; inflammatory), insulin-like growth factor receptor 1 (IGF-1R; neurotropic) and CaMKIIα expression in the hippocampus of behaviorally deficient schizophrenic mice after we induced schizophrenia through NMDAR inhibition.Schizophrenia was induced in WT (C57BL/6) mice through intraperitoneal administration of 30mg/Kg ketamine (NMDAR antagonist) for 5days (WT/SCZ). Five days after the last ketamine treatment, wild type schizophrenic mice show deficiencies in sociability and social novelty behavior. Furthermore, there was a significant decrease in hippocampal CaMKIIα (p <0.001) and IGF-1R (p <0.001) expression when assessed through immunoblotting and confocal immunofluorescence microscopy. Additionally, WT schizophrenic mice show an increased percentage of phosphorylated CaMKIIα in addition to upregulated TLR4 signaling (TLR4, NF-κB, and MAPK/ErK) in the hippocampus. To ascertain the functional link between TLR4, IGF-1R and CaMKIIα relative to NMDAR hypofunction in schizophrenia, we created hippocampal-specific TLR4 knockdown mouse using AAV-driven Cre-lox technique (TLR4 KD). Subsequently, we inhibited NMDAR function in TLR4 KD mice in an attempt to induce schizophrenia (TLR4 KD SCZ). Interestingly, IGF-1R and CaMKIIα expressions were preserved in the TLR4 KD hippocampus after attenuation of NMDAR function. Furthermore, TLR4 KD SCZ mice showed no prominent defects in sociability and social novelty behavior when compared with the control (WT).Our results show that a sustained IGF-1R expression may preserve the synaptic activity of CaMKIIα while TLR4 signaling ablates hippocampal CaMKIIα expression in NMDAR hypofunction schizophrenia. Together, we infer that IGF-1R depletion and increased TLR4 signaling are non-neurotransmitter pro-schizophrenic cues that can reduce synaptic CaMKIIα activity in a pharmacologic mouse model of schizophrenia.



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Sarcopenia in Peripheral Arterial Disease: Prevalence and Impact on Functional Status

Publication date: Available online 11 November 2017
Source:Archives of Physical Medicine and Rehabilitation
Author(s): Odessa Addison, Steven J. Prior, Rishi Kundi, Monica C. Serra, Leslie I. Katzel, Andrew W. Gardner, Alice S. Ryan
ObjectivesTo determine the prevalence of sarcopenia in older men with peripheral arterial disease (PAD) and to compare to a subset of the group to age, race, sex, and body mass index (BMI)-matched non-PAD control counterparts. We also sought to compare the functional status of those with PAD with and without sarcopenia.DesignCohort study.SettingA Veterans Affairs medical center.ParticipantsSedentary, community dwelling men age 50+ years with a confirmed diagnosis of PAD (N=108; 44% black; BMI 27.8 ± 0.4 kg/m²; ABI:0.62 ± 0.01; mean ±SEM).InterventionsNot applicable.Main OutcomesDual-energy x-ray absorptiometry scans were used to assess appendicular lean mass (ALM) and determine the prevalence of sarcopenia by ALM/height² (ALM/ht²). Treadmill tests were used to determine claudication onset time (COT), peak walking time (PWT), and claudication recovery time (CRT). Six-minute walk distance (6MWD) was also measured.ResultsSarcopenia prevalence in our PAD cohort was 25%. The PAD subset (N=42) matched with control counterparts for race, sex, age, and BMI had higher prevalence rates compared with their non-PAD counter parts (23.8% vs 2.4%, P<0.05). Individuals with sarcopenia (N=28) had lower 6MWD (p<0.05; 326± 18.8 vs 380 ± 9.7 meters) and higher CRT (p<0.05; 592 ± 98 vs 395 ± 29 seconds) compared to individuals with PAD but without sarcopenia (N=80). There was no difference in COT or PWT between the PAD groups.ConclusionsMen with PAD demonstrate a high prevalence of sarcopenia. Those with sarcopenia and PAD demonstrate decreased mobility function.



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Pain Neurophysiology Education and Therapeutic Exercise for Patients With Chronic Low Back Pain: A Single-Blind Randomized Controlled Trial.

Publication date: Available online 11 November 2017
Source:Archives of Physical Medicine and Rehabilitation
Author(s): Bodes Pardo Gema., Lluch Girbés Enrique., Roussel Nathalie A., Gallego Izquierdo Tomás., Jiménez Penick Virginia., Pecos Martín Daniel.
AimTo assess the effect of a pain neurophysiology education program plus therapeutic exercise for patients with chronic low back pain (CLBP).DesignSingle-blind randomized controlled trial.SettingPrivate clinic (Clínica Bonn) and Alcalá de Henares University, Madrid, Spain.Participants56 patients with CLBP for 6 months or more.InterventionParticipants were randomized to receive either a therapeutic exercise (TE) program consisting of motor control, stretching, and aerobic exercises (TE group, n=28) or the same therapeutic exercise program in addition to a pain neurophysiology education program (PNE+TE group, n=28), conducted in two 30 to 50 minute sessions in groups of 4 to 6 participants.Main outcomes measuresThe primary outcome was pain intensity rated on the Numeric Pain Rating Scale which was completed immediately following treatment and at a 1-month and 3-month follow-up. Secondary outcome measures were pressure pain threshold, finger-to-floor distance, Roland-Morris Disability Questionnaire, Pain Catastrophizing Scale, Tampa Scale for Kinesiophobia, and the Patient Global Impression of Change.ResultsAt the 3-month follow-up, a large change in pain intensity (-2.2 (-2.93,-1.28), p<0.001; d=1.37) was observed for the PNE+TE group, and a moderate effect size was observed for the secondary outcome measures.ConclusionCombining pain neurophysiology education plus therapeutic exercise resulted in significantly better results for participants with CLBP, with a large effect size, compared to therapeutic exercise alone.



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A systematic review on the effect of serious games and wearable technology used in rehabilitation of patients with traumatic bone and soft tissue injuries

Publication date: Available online 11 November 2017
Source:Archives of Physical Medicine and Rehabilitation
Author(s): Henriëtte A.W. Meijer, Maurits Graafland, J. Carel Goslings, Marlies P. Schijven
ObjectiveTo determine the effects on functional outcomes and treatment adherence of wearable technology and serious games (i.e., interactive computer applications with specific purposes useful in the 'real world') currently applied in physical rehabilitation of patients after traumatic bone and soft tissue injuries.Data SourcesPubMed, Embase, the Cochrane Library and CINAHL were searched without publication date restrictions for the terms 'wearable', 'serious game', 'videogame' or 'mobile application', and 'rehabilitation', 'exercise therapy' or 'physiotherapy'.Study SelectionThe search yielded 2704 eligible articles, which were screened by two independent reviewers. Studies comparing a serious game to standard therapy were included.Data ExtractionMethodology and results of the studies were critically appraised in conformity with PRISMA guidelines.Data SynthesisTwelve articles were included, all of which tested 'off-the-shelf' games. No studies on 'wearable-controlled' games, or games specifically developed for rehabilitation could be included. Medical conditions included post-operative rehabilitation and acute traumatic injuries. All studies were of low to moderate quality. Only two studies found beneficial effects of serious games over conventional therapy. One of three studies reporting pain scores found beneficial effects of a serious game compared to physiotherapy. One out of five trials reporting treatment adherence found a statistically significant advantage in the game-group compared to conventional physiotherapy. Due to heterogeneity in study design and outcome measures, pooling of data was not possible.ConclusionsSerious games seem a safe alternative or addition to conventional physiotherapy after traumatic bone and soft tissue injury. Future research should determine their validity and effectiveness in rehabilitation therapy, next to their cost-effectiveness and effect on treatment adherence.



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Electrophysiological correlates of performance monitoring under social observation in patients with social anxiety disorder and healthy controls

Publication date: Available online 11 November 2017
Source:Biological Psychology
Author(s): Rolf Voegler, Jutta Peterburs, Hannah Lemke, Sebastian Ocklenburg, Roman Liepelt, Thomas Straube
Previous research suggests that electrophysiological correlates of performance monitoring, in particular the error-related negativity (ERN), vary according to psychopathology and context factors. The present study examined the effect of social context on behavioral and electrophysiological correlates of performance monitoring in healthy adult subjects and in patients with social anxiety disorder (SAD). Participants performed two runs of a Go/NoGo flanker task in different social conditions: in the observation condition, they were observed by a confederate while performing the task, whereas there was no observation in the control condition. Behavioral data showed that accuracy and response times were not modulated by social observation and also did not systematically differ between groups. Post-error slowing was more pronounced in patients, independent of observation condition. ERN amplitudes were generally increased under social observation as compared to the control condition regardless of group (patients, controls). No effects of social context or group were found for PE, NoGo-N2, and NoGo-P3. Exploratory analysis revealed a late sustained parietal negativity to errors in patients as compared to controls. Taken together, the present findings emphasize the importance of social context for the processes underlying performance monitoring. However, the notion of altered error monitoring reflected in an altered ERN in SAD is not supported by our data.



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Atmospheric-pressure chemical purification of detonation-synthesized nanodiamond by using perchloric acid: Intensive parametric study to control sp3/sp2carbon ratio

Publication date: Available online 12 November 2017
Source:Diamond and Related Materials
Author(s): Seung Pyo Hong, Sang Wook Ha, Seung Whan Lee
Controlled- and high-sp³/sp² carbon ratio of the detonation-synthesized nanodiamond (DND) may play a very important role in many applications. Here, we demonstrated an atmospheric-pressure process of chemical purification using perchloric acid (HClO4) and intensively studied the control parameters including the reaction temperature, DND loading amount, and processing time. The sp³/sp² carbon ratio was characterized using UV-Raman spectroscopy (325nm) and is evaluated based on the intensity ratio (IDia/IG) of the diamond peak and G band peak at 1325cm⁻¹ and 1590cm⁻¹, respectively. Through the combination of control parameters, we successfully controlled the intensity ratio of IDia/IG at the range from 0.28 to 1.5 and achieved 15.5% higher than compared with commercial DND. In addition, we also investigated the electrical conductivity of DND vs. intensity ratio of IDia/IG and the results show that lower intensity ratio of IDia/IG have higher electrical conductivity because of non-diamond carbon.

Graphical abstract

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