Examinando por Autor "Montoro, Casandra I."
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Ítem Aberrant Cerebral Blood Flow Responses during Cognition: Implications for the Understanding of Cognitive Deficits in Fibromyalgia(American Psychological Association, 2015) Montoro, Casandra I.; Duschek, Stefan; Muñoz, Cristina; Fernández, María José; Reyes del Paso, Gustavo A.Objective: There is ample evidence for cognitive deficits in fibromyalgia syndrome (FMS). The present study investigated cerebral blood flow responses during arithmetic processing in FMS patients and its relationship with performance. The influence of clinical factors on performance and blood flow responses were also analyzed. Method: Forty-five FMS patients and 32 matched healthy controls completed a mental arithmetic task while cerebral blood flow velocities in the middle (MCA) and anterior (ACA) cerebral arteries were measured bilaterally using functional transcranial Doppler sonography (fTCD). Results: Patients′ cognitive processing speeds were slower versus healthy controls. In contrast to patients, healthy controls showed a pronounced early blood flow response (during seconds 4–6 after the warning signal) in all assessed arteries. MCA blood flow modulation during this period was correlated with task performance. This early blood flow response component was markedly less pronounced in FMS patients in both MCAs. Furthermore, patients displayed an aberrant pattern of lateralization, with right hemispheric dominance especially observed in the ACA. Severity of clinical pain in FMS patients was correlated with cognitive performance and cerebral blood flow responses. Conclusions: Cognitive impairment in FMS is associated with alterations in cerebral blood flow responses during cognitive processing. These results suggest a potential physiological pathway through which psychosocial and clinical factors may affect cognition. (PsycInfo Database Record (c) 2022 APA, all rights reserved)Ítem Breath-holding during exhalation as a simple manipulation to reduce pain perception.(Oxford University Press, 2015) Reyes del Paso, Gustavo A.; Muñoz, Cristina; Montoro, Casandra I.Objective: Baroreceptor stimulation yields antinociceptive effects. In this study, baroreceptors were stimulated by a respiratory maneuver, with the effect of this manipulation on pain perception subsequently measured. Methods: Thirty-eight healthy participants were instructed to inhale slowly (control condition) and to hold the air in lungs after a deep inhalation (experimental condition). It was expected that breath-holding would increases blood pressure (BP) and thus stimulate the baroreceptors, which in turn would reduce pain perception. Pain was induced by pressure algometry on the nail of the left-index finger, at three different pressure intensities, and quantified by visual analogue scales. Heart rate (HR) and BP were continuously recorded. Results: Pain perception was lower when pain pressure was administered during the breath-holding phase versus the slow inhalation phase, regardless of the pressure intensity. During breath-holding, a rapid increase in BP and decrease in HR were observed, demonstrating activation of the baroreceptor reflex. Conclusion: Pain perception is reduced when painful stimulation is applied during breath-holding immediately following a deep inhalation. These results suggest that a simple and easy-to-perform respiratory maneuver could be used to reduce acute pain perception.Ítem Cerebral blood flow modulations during cognitive control in major depressive disorder.(Elsevier, 2018) Hoffman, Alexandra; Montoro, Casandra I.; Reyes del Paso, Gustavo A.; Duschek, StefanBackground: This study investigated cerebral blood flow modulations during proactive and reactive cognitive control in major depressive disorder (MDD). Proactive control refers to preparatory processes during anticipation of a behaviorally relevant event; reactive control is activated after such an event to ensure goal attainment. Methods: Using functional transcranial Doppler sonography, blood flow velocities in the middle cerebral arteries of both hemispheres were recorded in 40 MDD patients and 40 healthy controls during a precued Stroop task. The font color of color words, which appeared 5 s after an acoustic warning signal, had to be indicated while ignoring word meaning. Results: Patients, as compared to controls, exhibited smaller bilateral blood flow increases during task preparation and larger increases after color word presentation. Response time was longer in patients irrespective of the match or mismatch between font color and word meaning. The blood flow increase after word presentation correlated positively with response time. Limitations: Potential effects of psychotropic medication on cognition and cerebral blood flow could not be controlled. Conclusions: The study revealed evidence of reduced cortical activity during proactive and elevated activity that occurs during reactive control in MDD. Deficient implementation of proactive control in MDD may lead to increased reliance on reactive control. The association between the blood flow increase after color word presentation and poorer performance indicates that deficient response preparation cannot be compensated for by reactive strategies. The findings are clinically relevant, as they may contribute to our understanding of the mechanisms relevant to cognitive impairments in MDD.Ítem Cerebral blood flow variability in fibromyalgia syndrome: Relationships with emotional, clinical and functional variables(Plos, 2018) Montoro, Casandra I.; Duschek, Stefan; Schuepbach, Daniel; Gandarillas, Miguel A.; Reyes del Paso, Gustavo A.Objective: This study analyzed variability in cerebral blood flow velocity (CBFV) and its association with emotional, clinical and functional variables and medication use in fibromyalgia syndrome (FMS). Methods: Using transcranial Doppler sonography, CBFV were bilaterally recorded in the anterior (ACA) and middle (MCA) cerebral arteries of 44 FMS patients and 31 healthy individuals during a 5-min resting period. Participants also completed questionnaires assessing pain, fatigue, insomnia, anxiety, depression and health-related quality of life (HRQoL). Results: Fast Fourier transformation revealed a spectral profile with four components: (1) a first very low frequency (VLF) component with the highest amplitude at 0.0024 Hz; (2) a second VLF component around 0.01-to-0.025 Hz; (3) a low frequency (LF) component from 0.075-to-0.11 Hz; and (4) a high frequency (HF) component with the lowest amplitude from 0.25-to-0.35 Hz. Compared to controls, FMS patients exhibited lower LF and HF CBFV variability in the MCAs (p < .005) and right ACA (p = .03), but higher variability at the first right MCA (p = .04) and left ACA (p = .005) VLF components. Emotional, clinical and functional variables were inversely related to LF and HF CBFV variability (r≥-.24, p≤.05). However, associations for the first VLF component were positive (r≥.28, p≤.05). While patients´ medication use was associated with lower CBFV variability, comorbid depression and anxiety disorders were unrelated to variability. Conclusions: Lower CBFV variability in the LF and HF ranges were observed in FMS, suggesting impaired coordination of cerebral regulatory systems. CBFV variability was differentially associated with clinical variables as a function of time-scale, with short-term variability being related to better clinical outcomes. CBFV variability analysis may be a promising tool to characterize FMS pathology and it impact on facets of HRQoL.Ítem Personality and fibromyalgia: relationships with clinical, emotional, and functional variables.(Elsevier, 2015) Montoro, Casandra I.; Reyes del Paso, Gustavo A.This study evaluates H.J. Eysenck’s three personality dimensions (neuroticism, extraversion, and psychoticism) in patients with fibromyalgia (FMS) compared with healthy controls (HC), and analyzes their association with clinical, emotional and functional variables and pain coping strategies. Ninety-two FMS patients and 65 HC completed the abbreviated EPQR, in addition to instruments measuring clinical pain, fatigue, sleep, anxiety, depression, health related quality of live (HRQL) and pain coping strategies. Results showed: (1) FMS patients exhibited greater levels of neuroticism and psychoticism but not extroversion, in comparison with HC; (2) group differences in all measured variables remained when the three personality dimensions were entered as covariates; (3) while in HC neuroticism was positively associated with pain, anxiety, depression, catastrophizing strategy scores, and lower HRQL, in FMS patients associations were sparse and lower in magnitude; (4) in FMS patients extroversion was associated with lower pain, anxiety, and depression, and higher mental HRQL; and (5) psychoticism was associated with lower anxiety in the FMS group and greater catastrophizing in HC. Data suggest that neuroticism only plays a minor role in clinical manifestations of FMS. However, extraversion appears to exert a protective influence in FMS, as it is associated with better health outcomes in several domains.Ítem Variability in cerebral blood flow velocity at rest and during mental stress in healthy individuals: Associations with cardiovascular parameters and cognitive performance.(Elsevier, 2018) Montoro, Casandra I.; Duschek, Stefan; Reyes del Paso, Gustavo A.This study analyzed variability in cerebral blood flow velocity (CBFV) and possible underlying physiological mechanisms during rest and a mental arithmetic task. Blood flow velocities were bilaterally recorded by transcranial Doppler sonography in the anterior and middle cerebral arteries of 43 participants. Electrocardiography, continuous blood pressure (BP) and respiratory recordings were additionally obtained. Fast Fourier transformation revealed a spectral profile with two main components in CBFV, one in the very low frequency (VLF, 0.01–0.025 Hz), and the other in the low frequency band (LF, 0.075–0.11 Hz). During the task, CBFV variability decreased. While heart rate variability and respiration had only weak impacts, BP variability was closely associated with CBFV variability. LF CBFV variability correlated negatively with task performance. The findings indicate a connection between peripheral and cerebral hemodynamics, presumably mediated by the passive pressure-flow relationship and neural mechanisms. LF CBFV variability may constitute a suitable marker of mental effort load.