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Background: The capacity to change attention from one area to another depending on the many environmental circumstances present is a crucial aspect of selective attention and is strictly correlated to reaction time. The cholinergic system of the basal forebrain is crucial for attentive abilities. Several inputs, particularly orexin neurons, whose cell bodies are found in the postero-lateral hypothalamus, can activate the cholinergic system. The aim of this study was to investigate if high frequencies rTMS at dorsolateral prefrontal cortex (DLPFC) in highly trained volleyball players can change Orexin-A levels, attention and reaction time. This study was a double-blinded (participant and evaluator) matched-pair experimental design. Twenty right-handed female volleyball players were recruited for the study (age 24.6 ± 2.7 years; height 177.0 ± 5.5 cm; body mass 67.5 ± 6.5 kg; BMI 21.5 ± 1.2). Results: The main finding of this study was that 10 Hz rTMS to the DLPFC seems to increase Orexin-A salivary levels and the percentage of correct answers, while decreasing RT. After rTMS, the athletes show an increase in the percentage of correct answers immediately after the end of stimulation, and also after 15 and 30 min. Moreover, the athletes show decreases in reaction time after the end of stimulation and after 15 and 30 min to the end of stimulation, while no differences were found at the end of stimulation. Finally, the athletes show significant increases in Orexin-A salivary levels after stimulation with a peak after 30’ of the end. Conclusion: The results of our study seem to indicate that there is a relationship between salivary Orexin-A levels and RT. These results could provide useful tools for modulating sports training; in fact, if confirmed, they could lead coaches to offer their athletes rTMS sessions appropriately integrated with training. In fact, alternating attention is a mental flexibility that enables people to change their point of focus and switch between tasks requiring various levels of cognition.

We evaluated the impact of weight loss (WL) using a Mediterranean diet and mild-to-moderate–intensity aerobic exercise program, on clinical status of obese, symptomatic patients with hypertrophic cardiomyopathy (HCM). Compared with nonresponders, responders showed a significant reduction of left atrial diameter, left atrial volume index (LAVI), E/Eʹaverage, pulmonary artery systolic pressure (PASP), and a significant increase in Vo2max(%) and peak workload. Body mass index changes correlated with reduction in left atrial diameter, LAVI, E/Eʹaverage, PASP, and increase of Vo2max(mL/Kg/min), Vo2max(%), peak workload. Mediterranean diet and aerobic exercise is associated with clinical-hemodynamic improvement in obese symptomatic HCM patients.

Weight gain in schizophrenia patients is becoming a major concern as second generation antipsychotics (SGAs) have been associated with considerable increase in weight. The mechanisms by which they produce this side effect are not known. The orexins, are a family of hypothalamic neuropeptides that are selectively expressed in neurons of “feeding area” (lateral hypothalamus and perifornical area). They arise from the precursor peptide prepro-orexin by proteolytic processing and act through two closely related G-protein-coupled receptors, the orexin 1 (OX1R) and orexin 2 receptors (OX2R). Despite the small number of orexin cells, orexin axons are distributed throughout the brain. The orexins modulate feeding behavior, some metabolic processes and arousal. Fos expression is induced in orexin neurons by SGAs that cause significant weight gain but not by those SGAs with low weight gain liability. Moreover, in the same paradigm, amphetamine also activated orexin neurons. Clozapine markedly increased fos expression in orexin neurons that innervate the PFC whereas amphetamine had a weak effect. These findings suggest that it is likely that changes in the activity of afferents or hormonal signals to these orexin neurons determine the differential response. One study has pointed that the same effect on fos-induction by olanzapine was reversed by Zonisamide, an anti-epilepsy drug. It is suggested that the receptors targeted by SGAs may be present on orexin neurons or on their afferents and play a role in induction of weight gain.

Schizophrenia is a chronic and disabling mental illness affecting millions of people worldwide. A greater proportion of people with schizophrenia tends to be overweight. Antipsychotic medications have been considered the primary risk factor for obesity in schizophrenia, although the mechanisms by which they increase weight and produce metabolic disturbances are unclear. Several lines of research indicate that leptin could be a good candidate involved in pathways linking antipsychotic treatment and weight gain. Leptin is a circulating hormone released by adipocytes in response to increased fat deposition to regulate body weight, acting through receptors in the hypothalamus. In this work, we reviewed preclinical, clinical, and genetic data in order to infer the potential role played by leptin in antipsychotic-induced weight gain considering two main hypotheses: (1) leptin is an epiphenomenon of weight gain; (2) leptin is a consequence of antipsychotic-induced “leptin-resistance status,” causing weight gain.