Objective We aimed to investigate the improvement in sleep quantity and quality when clonidine was used in children and adolescents with insomnia. We also examined how sociodemographic characteristics such as age, sex, underlying psychological problems, and levels of depression and anxiety affected the effect of clonidine.Methods We retrospectively reviewed outpatients aged 6 to 24 who took clonidine due to insomnia from September 2019 to September 2021 at the Department of Psychiatry at Eunpyeong St. Mary’s Hospital of Catholic University. We used the Pittsburgh Sleep Quality Index (PSQI), Children’s Depression Inventory (CDI), and State-Trait Anxiety Inventory (STAI) for our study.Results A total of 62 participants were included in our study (34 females, mean age 13.94±4.94 years). After using clonidine, there was a significant decrease in PSQI components 1, 2, and 5, especially PSQI component 2. There was a greater decrease in sleep latency when clonidine was used in females, those aged between 13 and 24, those with mood/anxiety disorder or attention-deficit/hyperactivity disorder, those whose sleep latency exceeded 60 minutes at baseline, and those who used clonidine for more than 14 days. Those with higher STAI-Trait scores and CDI scores at baseline showed less improvement in total PSQI scores.Conclusion Considering that there are currently no Food and Drug Administration-approved sleep drugs for children and adolescents and no apparent difference in efficacy and safety among sleep drugs, we demonstrated that treatment with clonidine might be a good approach to improve sleep quality and quantity for children and adolescents.
Objective: This research measures the regional GMV (rGMV) of the cerebellum, attention, Executive Function (EF) and we aimed to identify their correlation and sex differences in children and adolescents. Methods: Subjects comprised 114 children (male = 62, female = 52, 12.44 ± 2.99 years old) from South Korea. Participants were divided into three groups by age (age 6−9, 10−13, and 14−17). The Stroop Color and Word Test (SCWT), Wisconsin Card Sorting Test (WCST), and Advanced Test of Attention (ATA) were used to estimate executive function. Magnetic resonance imaging (MRI) images were analyzed with Regional Voxel-Based Morphometry Analysis. Results: The correlations between cerebellar rGMV and SCWT, WCST, and ATA subcategories showed difference by age and sex. In 6−9 age group, girls showed more overall correlations with cerebellar regions than boys, in WCST Categories Completed and ATA results. In age 10−13 group, more regions of cerebellum corresponded to SCWT subcategories in girls. Nevertheless, more correlation between cerebellar rGMV, WCST subcategories and some ATA subtests were observed in boys in the same age group. In the adolescent group, aged 14−17, boys showed more correlation with cerebellar rGMV, while girls showed little correlation. Conclusion: This study highlights that sex-different cerebellum maturation in adolescence might be correlated with EF and attention. These results provides evidence that cerebellum modulates higher cognitive functioning during child development.
Objective To explore risk factors for dry mouth and examine the clinical utility of the heart rate variability (HRV) test in the prediction of dry mouth.Methods Every outpatient, who underwent tests for both unstimulated salivary flow and HRV, was retrospectively reviewed. After excluding seven subjects, the demographics and clinical factors in 70 total patients were collected. Based on objective salivary flow rates, patients were classified into normal (≥0.2 mL/min) or hyposalivation groups (<0.2 mL/min), and inter-group comparisons were performed with a two-tailed statistical significance of 0.05.Results Patients with subjective dry mouth were significantly more likely to show hyposalivation. Advanced age, female sex, and current use of psychotropic medications were identified as risk factors for dry mouth. However, dry mouth was not associated with any HRV parameters.Conclusion HRV test did not demonstrate a clinical utility in predicting dry mouth. Because subjective dry mouth is significantly associated with objective hyposalivation, a simple probing question would be useful for early recognition of dry mouth. Clinical attention is required for patients meeting criteria of older age, female, and/or using psychotropic prescriptions. Prompt management of hyposalivation may improve quality of life and clinical outcome by enhanced treatment adherence.
BACKGROUND The world health organization announced the inclusion of gaming disorder (GD) as one of disease despite some concerns. However, video gaming was associated with the enhancement of cognitive function. Moreover, despite the comparable extensive video gaming, pro-gamers did not show any negative symptoms that the individuals with GD reported. It is important to understand the association between extensive video gaming and alterations in brain regions more objectively. OBJECTIVE This study aimed to systematically explore the association between extensive video gaming and the changes in cognitive function by focusing on pro-gamers and individuals with GD. METHODS Literatures for pro-gamers and individuals with GD were searched in PubMed and Web of Science by using search terms (e.g., “pro-gamers” and “(Internet) gaming disorder”). While literatures for pro-gamers were searched without the date restriction, literatures for individuals with GD were included in search results when they were published since 2013. The selection of articles was conducted by following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. RESULTS By following the PRISMA guidelines, 1903 records with unique titles were identified. Through the screening process of titles and abstracts, 86 full-text articles were accessed to determine the eligibility. A total of 18 studies were included in this systematic review. Among included 18 studies, six studies included pro-gamers as participants, one study included both pro-gamers and individuals with GD, and eleven studies included individuals with GD. Pro-gamers showed structural and functional alterations in brain regions (e.g. the left cingulate cortex, insula subregions and the prefrontal regions). Cognitive function (e.g., attention and sensori-motor function) and the cognitive control improved in pro-gamers. Individuals with GD showed structural and functional alterations in brain regions (e.g., the striatum, the orbitofrontal cortex and amygdala) that were associated with impaired cognitive control and the higher level of the craving. They also showed increased cortical thickness in the middle temporal cortex which indicated the acquisition of better skills. Moreover, it was suggested that factors (e.g., the gaming expertise, the duration or the severity of GD and the level of self-control) seemed to modulate the association of the extensive VG playing with the changes in cognitive function. CONCLUSIONS Although limited studies that included pro-gamers and/or individuals who reported to show symptoms of GD for more than one year were identified, this review contributed to the objective understanding of the association between the extensive VG playing and the changes in cognitive function. Conducting studies in a longitudinal design or with various comparison groups in the future would be helpful to deepen the understanding of the association.
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