Predictors of fatigue in obstructive sleep apnea.

Posted on March 3, 2012 by Maurice Preter MD

Sleep Breath. 2008 Nov;12(4):397-9. Epub 2008 May 31.
Predictors of fatigue in obstructive sleep apnea.
Mills PJ, Kim JH, Bardwell W, Hong S, Dimsdale JE.
Source

Department of Psychiatry, University of California, San Diego, La Jolla, CA, USA. pmills@ucsd.edu
Abstract
OBJECTIVE:

The objective of this study was to determine potential inflammatory predictors of fatigue in obstructive sleep apnea (OSA).
MATERIALS AND METHODS:

Fifty-six women and men untreated OSA patients had their sleep monitored with polysomnography. Fatigue was assessed by the Multidimensional Fatigue Symptom Inventory-Short Form. Depressed mood was assessed by the Center for Epidemiologic Studies-Depression Scale. Blood was drawn to assess circulating levels of Interleukin-6 (IL-6) and soluble tumor necrosis factor receptor I (sTNF-RI). Age, gender, body mass index (BMI), blood pressure, OSA severity, depressed mood, and inflammatory biomarkers were entered into a hierarchical multiple linear regression analysis predicting self-reported fatigue.
RESULTS:

Approximately 42% of the patients reported significant amounts of fatigue. Higher BMI (p = 0.014), greater depressed mood (p = 0.004), and higher sTNF-RI levels (p = 0.033) were independent predictors of fatigue in the final model (full model R2 = .571; p = .003). Age, gender, blood pressure and apnea severity were unrelated to fatigue.
CONCLUSION:

The findings suggest that in addition to depressed mood, fatigue in OSA may be associated with increased body weight and elevated levels of the proinflammatory cytokine receptor sTNF-RI. The findings support a linkage between the widely reported fatigue in OSA and a sleep-related component of inflammation.

PMID:
18516635
[PubMed – indexed for MEDLINE]
PMCID:
PMC2633300

Free PMC Article

Posted in Aging, Psychiatry/Neurology |

Omega-3 DHA and EPA for cognition, behavior, and mood: clinical findings and structural-functional synergies with cell membrane phospholipids.

Posted on March 3, 2012 by Maurice Preter MD

Altern Med Rev. 2007 Sep;12(3):207-27.
Omega-3 DHA and EPA for cognition, behavior, and mood: clinical findings and structural-functional synergies with cell membrane phospholipids.
Kidd PM.
Source

University of California, Berkeley, California, USA.
Abstract

The omega-3 fatty acids docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA) are orthomolecular, conditionally essential nutrients that enhance quality of life and lower the risk of premature death. They function exclusively via cell membranes, in which they are anchored by phospholipid molecules. DHA is proven essential to pre- and postnatal brain development, whereas EPA seems more influential on behavior and mood. Both DHA and EPA generate neuroprotective metabolites. In double-blind, randomized, controlled trials, DHA and EPA combinations have been shown to benefit attention deficit/hyperactivity disorder (AD/HD), autism, dyspraxia, dyslexia, and aggression. For the affective disorders, meta-analyses confirm benefits in major depressive disorder (MDD) and bipolar disorder, with promising results in schizophrenia and initial benefit for borderline personality disorder. Accelerated cognitive decline and mild cognitive impairment (MCI) correlate with lowered tissue levels of DHA/EPA, and supplementation has improved cognitive function. Huntington disease has responded to EPA. Omega-3 phospholipid supplements that combine DHA/EPA and phospholipids into the same molecule have shown marked promise in early clinical trials. Phosphatidylserine with DHA/EPA attached (Omega-3 PS) has been shown to alleviate AD/HD symptoms. Krill omega-3 phospholipids, containing mostly phosphatidylcholine (PC) with DHA/EPA attached, markedly outperformed conventional fish oil DHA/EPA triglycerides in double-blind trials for premenstrual syndrome/dysmenorrhea and for normalizing blood lipid profiles. Krill omega-3 phospholipids demonstrated anti-inflammatory activity, lowering C-reactive protein (CRP) levels in a double-blind trial. Utilizing DHA and EPA together with phospholipids and membrane antioxidants to achieve a triple cell membrane synergy may further diversify their currently wide range of clinical applications.

PMID:
18072818
[PubMed – indexed for MEDLINE]

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Substance P at the nexus of mind and body in chronic inflammation and affective disorders.

Posted on March 3, 2012 by Maurice Preter MD

Reductionistic but still of interest.

Psychol Bull. 2007 Nov;133(6):1007-37.
Substance P at the nexus of mind and body in chronic inflammation and affective disorders.
Rosenkranz MA.
Source

Department of Psychology, University of Wisconsin-Madison, WI 53705, USA. marosenk@wisc.edu
Abstract

For decades, research has demonstrated that chronic diseases characterized by dysregulation of inflammation are particularly susceptible to exacerbation by stress and emotion. Likewise, rates of depression and anxiety are overrepresented in individuals suffering from chronic inflammatory disease. In recent years, substance P has been implicated in both the pathophysiology of inflammatory disease and the pathophysiology of depression and anxiety by 2 parallel fields of study. This review integrates the literature from these 2 parallel fields and examines the possibility that substance P dysregulation may be a point of convergence underlying the overlap of chronic inflammatory disease and mood and anxiety disorders. First, the involvement of substance P in peripheral inflammation and in the immune events associated with chronic inflammatory disease is discussed, with a focus on inflammatory bowel disease and asthma. Next, the function of substance P in the communication of peripheral inflammation to the brain is considered. Finally, to complete the bidirectional loop of brain-immune interactions, substance P expression in anxiety and depression as well as its potential role in the neural regulation of peripheral inflammation is reviewed.

PMID:
17967092
[PubMed – indexed for MEDLINE]

Posted in Uncategorized | Tagged |

Mood-worsening with high-pollen-counts and seasonality: a preliminary report.

Posted on March 3, 2012 by Maurice Preter MD

J Affect Disord. 2007 Aug;101(1-3):269-74. Epub 2007 Jan 12.
Mood-worsening with high-pollen-counts and seasonality: a preliminary report.
Guzman A, Tonelli LH, Roberts D, Stiller JW, Jackson MA, Soriano JJ, Yousufi S, Rohan KJ, Komarow H, Postolache TT.
Source

Mood and Anxiety Program, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD, USA. aguzman@psych.umaryland.edu
Abstract
BACKGROUND:

Because aeroallergens produce inflammation in the respiratory airways, and inflammation triggers depression in vulnerable individuals, we hypothesized that mood sensitivity to pollen, the most seasonal aeroallergen, will be associated with a greater seasonality of mood. Since pollen is absent during winter, we specifically predicted that mood sensitivity to tree pollen will predict non-winter SAD but not winter SAD.
METHODS:

A convenience sample of African and African American college students who lived in the Washington DC metropolitan area for at least the past 3 years completed the Seasonal Pattern Assessment Questionnaire (SPAQ), from which the Global Seasonality Score (GSS) was calculated, a diagnosis of cumulative SAD (syndromal or subsyndromal SAD) was derived, a seasonal pattern (winter vs non-winter) identified, and self-reported mood changes during high pollen counts obtained. A Mann-Whitney test was used to compare GSS between participants with vs without mood worsening during high pollen counts. The capability of mood worsening with high pollen counts, gender, ethnicity, and age to predict non-winter SAD was analyzed with logistic regressions.
RESULTS:

GSS was greater (z=5.232, p<0.001) in those who reported mood worsening with high pollen counts. Mood sensitivity to pollen predicted non-winter SAD (p=0.017), but not winter SAD.
LIMITATIONS:

The SPAQ is not a definitive tool to assess seasonality, and self-reported mood worsening with high pollen counts relies on recollection. No direct measures of depression scores or pollen counts were collected. The non-winter SAD concept has not been previously established.
CONCLUSIONS:

Our study, which should be considered preliminary in light of its limitations, suggests that self-reported mood-worsening with high pollen count is associated with a greater seasonality of mood, and predicts SAD of non-winter type.

PMID:
17222915
[PubMed – indexed for MEDLINE]
PMCID:
PMC1949487

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Posted in Psychiatry/Neurology |

A study on symptom profiles of late-life depression: the influence of vascular, degenerative and inflammatory risk-indicators. Naarding P, Schoevers RA, Janzing JG, Jonker C, Koudstaal PJ, Beekman AT. Source

Posted on March 3, 2012 by Maurice Preter MD

J Affect Disord. 2005 Oct;88(2):155-62.
A study on symptom profiles of late-life depression: the influence of vascular, degenerative and inflammatory risk-indicators.
Naarding P, Schoevers RA, Janzing JG, Jonker C, Koudstaal PJ, Beekman AT.
Source

Spatie, Center for Mental Health, PO box 926, 7300 BD Apeldoorn and Department of Psychiatry, University Medical Center St. Radboud, Nijmegen, The Netherlands. p.naarding@spatie.nl
Abstract
BACKGROUND:

If specific symptom profiles of depressive disorders in the elderly are related to a specific etiology, this could have implications for everyday clinical practice. We hypothesized that a “motivational” profile, with symptoms such as psychomotor change, loss of interest and loss of energy, could clinically separate patients with predominantly vascular or degenerative risk indicators from patients with inflammatory risk indicators.
METHODS:

A total of 4051 subjects participated in a study on mental health problems in community-dwelling elderly. Information on psychiatric symptoms, demographic and medical status, previous history and family history was obtained. We distinguished three subgroups according to predominant somatic risk-indicators; vascular, degenerative and inflammatory groups.
RESULTS:

Motivational symptoms were associated with vascular or degenerative risk-indicators for depression; psychomotor change with both indicators; loss of energy with vascular, though also with the inflammatory indicator, and thinking/concentration disturbance with the degenerative indicator. The so-called mood symptoms of depression, especially thoughts of death, were more strongly related with the inflammatory risk-indicator. Melancholic symptoms like appetite and sleep disturbances were more strongly associated with the inflammatory risk-indicator.
LIMITATIONS:

Etiological classification was not confirmed by additional investigations such as laboratory findings or MRI brain scans.
CONCLUSION:

This study showed that in patients with a late-life depression specific symptoms of the depressive disorder may reflect the predominant underlying pathogenic mechanism.

PMID:
16098601
[PubMed – indexed for MEDLINE]

Posted in Aging | Tagged |