Category Archives: adults

A Virtual Reality Shopping Environment Could Help Evaluate Cognitive Deficits or Decline in Adults

New research published in the Journal of Medical Internet Research, uses a novel virtual reality shopping task called “VStore” to measure cognition, which asks participants to take part in tests designed to mirror the real world. Researchers hope that it will be able to test for age-related cognitive deficits and future cognitive decline.

In the ‘VStore’, participants “go to the shops” to navigate a shopping scenario as a way of assessing functional cognition, as well as the thinking and processing skills needed to accomplish complex everyday activities. The immersive environment (a virtual shop) mirrored actiities encountered in everyday life and meant that participants were better able to engage brain structures that are associated with spatial navigation, such as the hippocampus and entorhinal cortex, both of which can be affected in the early stages of Alzheimer disease.

The trial recruited 142 healthy individuals aged 20-79 years. Each participant was asked to “go to the shops,” first verbally recalling a list of 12 items, before being assessed for the amount of time it took to collect the items, as well as select the corresponding items on a virtual self-checkout machine, pay, and order coffee.

Cognition tests, such as those used to measure the deficits present in several neuropsychiatric disorders including Alzheimer’s disease, schizophrenia, and depression, are traditionally time-consuming and onerous. Vstore—the technology that the researchers used in this study—is designed to overcome these limitations to provide a more accurate, engaging, and cost-effective process to explore a person’s cognitive health.

Researchers were able to establish that Vstore effectively engages a range of key neuropsychological functions simultaneously, suggesting that the functional tasks embedded in virtual reality may engage a greater range of cognitive domains than standard assessments.

Reference:
Lilla Alexandra Porffy, Mitul A. Mehta, Joel Patchitt, Celia Boussebaa, Jack Brett, Teresa D’Oliveira, Elias Mouchlianitis, Sukhi S. Shergill. A Novel Virtual Reality Assessment of Functional Cognition (VStore): Validation Study (Preprint)Journal of Medical Internet Research, 2021; DOI: 10.2196/27641

Non-Invasive Vagus Nerve Stimulation for Treatment of Posttraumatic Stress Disorder

A Vagus Nerve Stimulation(nVNS) device called gammaCore™, this week has received a Breakthrough Designation from the U.S. Food and Drug Administration (FDA) for the treatment of posttraumatic stress disorder (PTSD) after showing a reduction of symptoms of PTSD by 31% when compared to sham treatment.

The Breakthrough Device Designation was supported, in part, by research from an Emory-Georgia Tech team led by J. Douglas Bremner, M.D., in the Departments of Psychiatry and Radiology at the Emory University School of Medicine, and Omer T. Inan, Ph.D., from the School of Electrical and Computer Engineering and the Coulter Department of Biomedical Engineering at the Georgia Institute of Technology in Atlanta, Georgia. Their research, built upon a strong mechanistic rationale and animal studies, shows nVNS blocks sympathetic and inflammatory responses to memories of traumatic events in patients with PTSD, modulates brain responses to traumatic memory, and reduces symptoms of PTSD by 31% when compared to a sham stimulation.

The Breakthrough Devices Program is a voluntary program for certain medical devices and device-led combination products for more effective treatment or diagnosis of life-threatening or irreversibly debilitating diseases or conditions.

The goal of the Breakthrough Devices Program is to provide patients and health care providers with timely access to critical medical devices by speeding up their development, assessment, and review, while preserving the statutory standards for premarket approval, 510(k) clearance, and De Novo marketing authorization, consistent with the FDA’s mission to protect and promote public health.

Why PTSD?

PTSD is a highly prevalent and disabling disorder with limited approved treatment options. According to the U.S. Department of Veterans Affairs National Center for PTSD, approximately 15 million adults in the U.S. experience PTSD each year. In the Military and Veterans Administration alone, PTSD is reported to affect between 10-20% of veterans who served in each Operations Iraqi Freedom (OIF) and Enduring Freedom (OEF), the Gulf War (Desert Storm), and the Vietnam War. More than half of all patients with PTSD report severely impaired quality of life in areas including mood, social and family relationships, leisure activities, sense of well-being and life satisfaction.

According to one of the investigators, Dr. Douglas Bremner commented, “Current treatments for PTSD involving medication and psychotherapy have limitations due to limited efficacy, possible side effects, and the unwillingness of many PTSD patients to engage in therapies that involve reliving traumatic memories. gammaCore represents a new class of treatment separate from medication or psychotherapy that is safe, relatively free of side effects, and does not involve costly and invasive procedures for implantation, like previous VNS devices approved by the FDA for treatment of refractory depression.”

Gammacore device has been previously approved by the FDA for: (Source: https://www.gammacore.com/)

Migraine – Clinically proven to treat and prevent migraines in users ages 12 and up. Help reduce migraines days without additional drugs.

Cluster Headache – The only clinically proven device to treat and prevent cluster headache attacks, while providing fast, reliable relief for those suffering with cluster headache.

Hemicrania Continua (HC) & Paroxysmal Hemicrania (PH) – 1st and ONLY device for HC and PH treatment, proven to reduce pain severity or headache frequency.

COVID-19 – Emergency Use Authorization to treat users with known or suspected COVID-19 and experiencing reduced airflow.

Sources:

FDA
Fact sheet for healthcare workers

Instructions for use of gammaCore

gammaCore™ Press release

Social media use shown to be linked to depression in adults

Data shows that individuals over age 35 were mostly likely to be negatively affected by highly visual apps, such as TikTok and Snapchat.

A number of recent studies have focused on adolescents and young adults being negatively affected by frequent use of social media. Symptoms of diminished well-being and greater levels of anxiety and depression were commonly reported. A research question asked if these same symptoms might apply to older consumers of social media.

To investigate this question, data from multiple waves of an ongoing 50-state US survey as used. The surveys, conducted from May 2020 through May 2021, were initially focused on learning more about how adults were coping during the Covid-19 pandemic. Over time, researchers increasingly became interested in whether social media use might be linked to changes in mental health.

The survey initially asked people who were not expressing depressed feelings about their social media use, with subsequent queries to see if the people who were using certain kinds of social media were more likely to be depressed. The research does not prove social media causes depression. Indeed, it is possible that people already prone to feeling sad were more likely to log on to such sites.

Compared to adults who did not use social media, “people who were using Facebook, people who were using TikTok, and people who were using Snapchat were substantially more likely to come back and tell us they felt depressed the next time they filled out the survey,” reported Roy H Perlis, MD, a professor of psychiatry at Harvard Medical School and Massachusetts General Hospital.

The research also found age differences in how certain platforms impacted mental health. Depressive symptoms were more commonly reported among Facebook users under age 35 than older adults. The opposite was true for users of Snapchat and TikTok more depressive symptoms were reported among people over age 35.

The reasons for such findings were unclear. It could be that because Snapchat and TikTok are more visual mediums, perhaps affecting older adults differently. Or it could suggest that a person is out of sync with his or her peers. Perlis said more research is needed to interpret the results appropriately. Ultimately, experts recommend remaining mindful of time spent on social media.

The authors concluded that  “Among survey respondents who did not report depressive symptoms initially, social media use was associated with greater likelihood of subsequent increase in depressive symptoms after adjustment for sociodemographic features and news sources. These data cannot elucidate the nature of this association, but suggest the need for further study to understand how social media use may factor into depression among adults.”

Mitch Prinstein, PhD, chief science officer for the American Psychological Association commenting on this research pointed out that “Our brains were not built for this kind of social interaction. And social media is kind of hijacking the need for social interaction with something very artificial and insufficient,” he said. “Social media is the empty calories of social interaction.”

Sources:

Perils RH, Green J, Simonsson M, et al. Association Between Social Media Use and Self-reported Symptoms of Depression in US Adults. JAMA Netw Open. 2021;4(11):e2136113. doi:10.1001/jamanetworkopen.2021.36113

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