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Background and Purpose: Lesioned brains of patients with stroke may change through the course of recovery; however, little is known about their evolution in the chronic phase. Here, we aimed to quantify the extent of lesion volume change and brain atrophy in the chronic poststroke brain using magnetic resonance imaging., Methods: Optimized T1-weighted scans were collected more than once (time between visits=2 months to 6 years) in 56 patients (age=36-90 years; time poststroke=3 months to 20 years). Volumetric changes attributable to lesion growth and atrophy were quantified with automated procedures. We looked at how volumetric changes related to time between visits, using nonparametric statistics, after controlling for age, time poststroke, and brain and lesion size at the earlier time., Results: Lesions expanded more in patients who had longer time-intervals between their imaging sessions (partial rank correlation ρ=0.56; P<0.001). The median rate of lesion growth was 1.59 cm(3) per year. Across patients, the whole-brain atrophy rate was 0.95% per year, with accelerated atrophy in the ipsilesional hemisphere., Conclusions: We show gradual lesion expansion many years after stroke, beyond that expected by normal aging and after controlling for other variables. Future studies need to understand how structural reorganization enables long-term recovery even when the brain is shrinking.

Purpose of Review: Functional neuro-imaging studies of aphasic stroke offer the potential for a better understanding of the neuronal mechanisms that sustain language recovery. Conclusions, however, have been hampered by a set of unexpected challenges related to experimental design and interpretation. In this review of studies published between January 2004 and February 2005, we discuss imaging studies of speech production and comprehension in patients with aphasia after left hemisphere stroke., Recent Findings: Studies of speech production suggest that recovery depends on slowly evolving activation changes in the left hemisphere. In contrast, right hemisphere activation changes have been interpreted in terms of transcallosal disinhibition that do not reflect recovery because they occur early after stroke, in areas homologous to the lesion, and do not appear to correlate with the level of recovery. There have been few studies of auditory speech comprehension, but unlike speech production, recovery of speech comprehension appears to depend on both left and right temporal lobe activation., Summary: Together, recent studies provide a deeper appreciation of how the neuronal mechanisms of recovery depend on the task, the lesion site, the time from insult and the distinction between neuronal reorganization that does and does not sustain recovery. Although many more studies of aphasic stroke are required with larger patient numbers and more focal lesion sites, we also argue that clinical diagnosis and treatment requires a better understanding of the normal variability in functional anatomy and the many neuronal pathways that are available to sustain each type of language task.

Background and Purpose: Evidence now exists for a pathogenic role for neutrophils in acute cerebral ischemia. We have studied the patterns and temporal profile of cerebral neutrophil recruitment to areas of acute ischemic stroke (IS) and have attempted to correlate this with neurological status and outcome., Methods: Patients with cortical middle cerebral artery (MCA) IS were recruited within 24 hours of clinical onset. Neutrophil recruitment was studied using indium-111 (111In) troponolate-labeled neutrophils, planar imaging, and single-photon emission computed tomography (SPECT). Volume of brain infarction was calculated from concurrent computed tomography (CT). Hematoxylin and eosin sections were obtained postmortem (n=2). Outcome was measured using Barthel, Rankin, and National Institute of Health Stroke (NIHSS) scales., Results: Fifteen patients were studied. Significant 111In-neutrophil recruitment to ipsilateral hemisphere, as measured by asymmetry index (AI), was demonstrated within 24 hours of onset in 9 patients; this response was heterogenous between patients and on repeated measurement attenuated over time. Histologically, recruitment was confirmed within intravascular, intramural, and intraparenchymal compartments. Interindividual heterogeneity in neutrophil response did not correlate with infarct volume or outcome. In an exploratory analysis, neutrophil accumulation appeared to correlate significantly with infarct expansion (Spearman rho=0.66; P=0.03, n=12)., Conclusions: Neutrophils recruit to areas of ischemic brain within 24 hours of symptom onset. This recruitment attenuates over time and is confirmed histologically. While neutrophil accumulation may be associated with either the magnitude or the rate of infarct growth, these results require confirmation in future studies.

Background and Purpose: The increase in fractional anisotropy (FA) in acute stroke has yet to be explained. Using an engineering methodology known as pq diagrams, we sought to explain the increase in FA by describing changes in the total magnitude of the diffusion tensor (L) as well as the isotropic (p) and anisotropic (q) components., Methods: Diffusion tensor imaging was performed in 10 patients with stroke <27 hours old. The diffusion tensor was decomposed into the p and q components and plotted to describe the diffusion trajectories. FA was also calculated and compared., Results: There was significant and consistent reduction in p, q, and L (p: mean, -50.0%; range, -36.6% to -64.5%; q: mean, -50.8%; range, -30.8% to -72.8%; L: mean, -50.3%; range, -37.0% to -65.1%). There were inconsistent changes in FA (mean, -0.5%; range, -44.9% to +45.0%). Five patients had elevated FA due to proportionately higher loss of L than q., Conclusions: Changes in FA only occur when there is a change in the ratio of q/L. Acute elevation of FA occurred in the context of a larger reduction in L than q. The elevation in FA occurs in the context of a reduction in the anisotropic tensor and therefore is a consequence of ratio-metric measurement. This appears to clarify the reported increase in FA in terms of alterations in the shape of the apparent diffusion tensor. pq diagrams appear to offer improved resolution of acute diffusion changes in ischemia.

Vasodilator-stimulated phosphoprotein (VASP) is highly expressed in vascular endothelial cells, where it has been implicated in cellular reorganization during angiogenesis, as well as in endothelial retraction and changes in vessel permeability. However, the cellular functions of VASP are not known. In this study, we have expressed wild-type and mutant forms of VASP in endothelial cells to determine in what aspects of cytoskeletal behavior this protein participates. Expression of wild-type VASP induces marked membrane ruffling and formation of prominent stress fibers in bovine aortic endothelial cells. Deletion of the proline-rich domain of VASP abolishes its ability to bind profilin but does not affect ruffling or stress fiber formation. Further deletions reveal a sequence within the carboxy-terminal domain that is responsible for in vivo bundle formation. Ruffling occurs only on the expression of forms of VASP that possess bundling activity and the capacity to bind zyxin/vinculin-derived peptide. The ability of distinct subdomains within VASP to bind adhesion proteins and induce F-actin bundling in vivo suggests that this protein could function in the aggregation and tethering of actin filaments during the formation of endothelial cell-substrate and cell-cell contacts. These data provide a mechanism whereby VASP can influence endothelial migration and organization during capillary formation and modulate vascular permeability via effects on endothelial cell contractility.

Objective: In daily life, we must dynamically and flexibly deploy strategies to regulate our emotions, which depends on awareness of emotions and internal bodily signals. Variability in emotion-regulation strategy use may predict fewer negative emotions, especially when people pay more attention to their bodily states-or have greater "interoceptive attention" (IA). Using experience sampling, this study aimed to test whether IA predicts variability in strategy use and whether this variability and IA together predict negative affect., Methods: University student participants ( n = 203; 165 females; Mage = 20.68, SD age = 1.84) completed trait questionnaires and reported state levels of IA, emotional awareness, negative affect, and emotion-regulation strategies, seven times daily for 1 week., Results: State IA significantly predicted between-strategy variability, which was mediated by emotional awareness (indirect effect = 0.002, 95% confidence interval = <0.001-0.003). Between-strategy variability was associated with lower negative affect, particularly when individuals had higher state IA (simple slope = -0.83, t = -5.87, p < .001) versus lower IA (simple slope = -0.31, t = -2.62, p = .009)., Conclusions: IA appears to facilitate adaptative emotion regulation and help alleviate negative affect. Findings underscore the key roles of IA and emotion-regulation flexibility in mental health., (Copyright © 2024 by the American Psychosomatic Society.)

Individuals with chronic conditions are susceptible to stress-related health complications. Left unattended, chronic stress exacerbates inflammation, diminishes quality of life (QOL), and increases all-cause mortality. Here, we suggest a theoretical framework promoting the use of mindfulness-based interventions (MBIs) in patients with chronic conditions and a conceptual model of how MBIs may influence stress and QOL., (Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.)

Background: Individuals with the behavioral variant of frontotemporal dementia (bvFTD) exhibit various levels of abulia, disinhibition, impaired judgment, and decline in executive function. Empirical evidence has shown that individuals with bvFTD also often exhibit difficulty using honorific speech, which expresses respect to another party or addressee., Objective: To analyze differences in the ability to use honorific speech among individuals with bvFTD, individuals with dementia of the Alzheimer type (AD dementia), and individuals with normal cognition (NC)., Method: A total of 53 native Korean speakers (13 bvFTD, 20 AD dementia, and 20 NC) completed an experimental honorific speech task (HST) that involved both expressive and receptive tasks. We analyzed the number of correct responses and error patterns separately for an expressive task and for a receptive task., Results: The bvFTD group had significantly fewer correct responses on the HST compared with the AD dementia and NC groups. The bvFTD group exhibited more misjudgment errors in identifying nonhonorific speech as honorific speech in the expressive task, and significantly longer response times in the receptive task, than the AD dementia and NC groups. Significant associations were identified between HST scores and cortical atrophy in the temporal and frontotemporal lobes., Conclusion: A decline in the ability to use honorific speech may be a diagnosable behavioral and psychiatric symptom for bvFTD in Korean-speaking individuals. This decline in individuals with bvFTD could be attributed to multiple factors, including social manners (politeness) and impaired social language use ability (pragmatics)., Competing Interests: The authors declare no conflicts of interest., (Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.)

Abstract: Substance use disorders (SUDs) are characterized by a recurrent and maladaptive use of drugs and/or alcohol. Cognitive behavioral therapies (CBTs) comprise different types of interventions: traditional CBT and the more recent "third wave" behavior therapies, such as acceptance and commitment therapy (ACT), dialectical behavior therapy (DBT), mindfulness-based cognitive therapy (MBCT), and schema therapy (ST). We searched English-language articles published between 2014 and present. This review includes randomized controlled trials (RCTs), quasi-RCTs, pilot studies, and reviews of CBTs for SUDs available on PubMed. Results seem to indicate that CBT and MBCT are effective interventions for SUDs; however, the studies showed a high degree of heterogeneity, so no exhaustive conclusions could be outlined at this time. ACT and DBT in SUD management are limited to few studies and results are therefore inconclusive., (Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.)

Kinesiophobia is an excessive, irrational, debilitating fear of physical movement and activity caused by a sense of vulnerability to pain or re-injury, which can have a direct impact on physical functioning and mental well-being of patients. This paper aims to provide reliable support for future in-depth research on kinesiophobia through scientometrics and historical review. Studies on kinesiophobia published from 2002 to 2022 were retrieved from the Web of Science Core Collection. CiteSpace and VOSviewer were used to conduct bibliometric analysis of the included studies and map knowledge domains. Keywords were manually clustered, and the results were analyzed and summarized in combination with a literature review. A total of 4157 original research articles and reviews were included. Research on kinesiophobia is developing steadily and has received more attention from scholars in recent years. There are regional differences in the distribution of research. Chronic pain is the focus of research in this field. A multidisciplinary model of pain neuroscience education combined with physical therapy based on cognitive-behavioral therapy and the introduction and development of virtual reality may be the frontier of research. There is a large space for the study of kinesiophobia. In the future, to improve regional academic exchanges and cooperation, more attention should be given to the clinical applicability and translation of scientific work, which will be conducive to improving the quality of life and physical and mental health outcomes of kinesiophobia patients., Competing Interests: The authors have no conflicts of interest to disclose., (Copyright © 2023 the Author(s). Published by Wolters Kluwer Health, Inc.)

Initiating and maintaining behavior change is key to the prevention and treatment of most preventable chronic medical and psychiatric illnesses. The cultivation of mindfulness, involving acceptance and nonjudgment of present-moment experience, often results in transformative health behavior change. Neural systems involved in motivation and learning have an important role to play. A theoretical model of mindfulness that integrates these mechanisms with the cognitive, emotional, and self-related processes commonly described, while applying an integrated model to health behavior change, is needed. This integrative review (1) defines mindfulness and describes the mindfulness-based intervention movement, (2) synthesizes the neuroscience of mindfulness and integrates motivation and learning mechanisms within a mindful self-regulation model for understanding the complex effects of mindfulness on behavior change, and (3) synthesizes current clinical research evaluating the effects of mindfulness-based interventions targeting health behaviors relevant to psychiatric care. The review provides insight into the limitations of current research and proposes potential mechanisms to be tested in future research and targeted in clinical practice to enhance the impact of mindfulness on behavior change. [ABSTRACT FROM AUTHOR]