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Introduction Type III home sleep apnea tests have become increasingly popular due to reduced cost and convenience. However, previous research has reported limitations in their diagnostic accuracy. In this study, we assessed which individuals would benefit the most from a Type II home-PSG study when the only information available to clinicians were answers to subjective questionnaires. Methods We analyzed responses to a custom sleep survey from 510 participants (age 46.2±12.4; 229 females). We entered 13 outcomes to a principal component analysis (PCA). These included age, body mass index (BMI), Epworth sleepiness scale (ESS) scores, sex, questions about snoring, subjective hours of sleep, satisfaction with own sleep, movement symptoms, problems falling asleep, staying asleep and waking up early. Based on the correlations between the original outcomes, the PCA extracted 3 factors that were interpreted as 3 different phenotypes: I) insomnia (e.g., sleep initiation and maintenance complaints, satisfaction with sleep, lower subjective sleep duration); ii) OSA (e.g., bed partner snoring complaints, snoring self-awareness, sleepiness, respiratory complaints); iii) movement disorder (e.g., movements, female, lower age, higher BMI). We then computed the pre-test probability of OSA (factor 2 scores >80%) and conducted a series of ROC analyses to assess specificity of the AHI in the same patient from both Type II and a simulated Type III (with EEG channels removed), RDI, and ORP metrics. Results The AUC values assessing the ability to predict 80% pre-test probability of OSA were: AHI Type II (0.734), AHI Type III (0.672), RDI (0.729), ORPNREM (0.622) and ORPTRT (0.543). The clinically used cut-off of 15 for the AHI Type II correctly classified 83% of patients with 47% probability of false positives, while the same cut-off for Type III correctly classified 43% of patients with 33% probability of false positives. Conclusion AHI Type II tests had the highest sensitivity in detecting OSA despite someone having >80% pretest probability. This may be due to the characterization of hypopneas, respiratory effort related arousals, and total sleep time versus total recording time. These analyses indicate the superiority of Type II studies and indices that involve EEG signals to accurately detect OSA in patients with high pretest probability. Support (if any)

Introduction The diagnosis of insomnia is currently based on subjective complaints. Previous research has demonstrated limited benefits of polysomnography in improving diagnostic accuracy with no evident differences in sleep macro-architecture and traditional indices of sleep quality. In this study, we aimed to assess the ability of a novel index of sleep quality, the Odds Ratio Product (ORP), to correctly identify individuals with insomnia, based on subjective complaints. Methods We analyzed responses to a custom sleep survey from 510 participants (age 46.2±12.4; 229 females). We entered 13 outcomes to a principal component analysis (PCA). These included age, body mass index (BMI), Epworth Sleepiness Scale (ESS) scores, sex, questions about snoring, subjective hours of sleep, satisfaction with own sleep, movement symptoms, problems falling asleep, staying asleep and waking up early. Based on the correlations between the original outcomes, the PCA extracted 3 factors that were interpreted as 3 different phenotypes: 1) insomnia (e.g., sleep initiation and maintenance complaints, satisfaction with sleep, lower subjective sleep duration); 2) OSA (e.g., bed partner snoring complaints, snoring self-awareness, sleepiness, respiratory complaints); 3) movement disorder (e.g., movements, female, lower age, higher BMI). We then computed the pre-test probability of insomnia (factor 1 scores >80%) and conducted a series of ROC analyses to assess specificity of PSG indices traditionally used to evaluate the presence of insomnia, and of ORP metrics. Results The AUC values assessing the ability of ORP metrics to predict 80% pre-test probability of insomnia were: ORPwake (0.592, 95% CI 0.499-0.685), ORPNREM (0.465, 95% CI 0.362-0.558), ORPREM (0.542, 95% CI 0.447-0.636), and ORPTRT (0.567, 95% CI 0.475-0.659). When looking at traditional indices like total sleep time (TST), wake after sleep onset (WASO), and number of awakenings, the AUC values were 0.471 (95% CI 0.385-0.556), 0.612 (95% CI 0.528-0.697) and 0.509 (95% CI 0.421-0.597), respectively. Conclusion WASO, ORPwake and ORPTRT have the highest sensitivity to detect insomnia in participants with >80% pretest probability measured by subjective complaints. These analyses indicate the value of EEG metrics of sleep quality to correctly identify individuals with insomnia and the need to investigate both sleep and wake states. Support (if any)

Introduction Recent research has highlighted differences in sleep quality for comorbid insomnia and obstructive sleep apnea (COMISA). We investigated how COMISA affects objective sleep quality measured with odds ratio product (ORP) compared to individuals without insomnia or moderate to severe OSA. Methods 410 participants (age 46.4±12.3; 174 females) recorded their sleep with in-home PSG using the Cerebra Sleep System and completed questionnaires. Sleep quality was measured using ORP derived from micro-analyzing frontal EEG channels. On the questionnaires, participants reported whether they experienced insomnia symptoms at least three times a week. Participants were classified as having no diagnosis if their RDI on the home PSG was < 15 and no insomnia symptoms. They were classified as insomnia only if they reported at least one insomnia symptom with an RDI < 15. They were classified as OSA only if they had an RDI ≥15 and reported no insomnia symptoms. Finally, they were classified as COMISA if they had an RDI ≥15 and reported at least one insomnia symptom. All analyses controlled for age and were corrected for multiple comparisons. Results 113(27.6%) patients were classified as having no diagnosis, 109(26.6%) as insomnia only, 83(20.2%) as OSA only, and 105(25.6%) as COMISA. There was a significant effect of diagnosis on ORPNREM (F3,405= 6.042, p Conclusion Participants with no diagnosis had the lowest ORP indicative of better sleep quality than participants with evidence of sleep disorders. Having COMISA may have greater impacts on sleep quality than insomnia symptoms alone. OSA severity was the only predictor of poor sleep quality when looking at ORPNREM. Yet both OSA severity and insomnia symptoms were associated with higher ORPTRT indicating that individuals with COMISA may show alterations of sleep quality in different states throughout the night. Support (if any)

Introduction Objective markers of insomnia have remained largely elusive. Odds ratio product (ORP; a marker of objective sleep quality), is currently being investigated for a potential role in assisting in insomnia diagnosis. Recent research has shown how patients with insomnia may present with hyperarousal and may be identified by looking at ORP architecture. In the current study, we aimed to investigate how ORP architecture, and specifically time spent in the lowest two (deep sleep) and last decile (full wakefulness) of ORP, relate to the number of insomnia symptoms. Methods 403 participants (age 46.3±12.3, range 18-79, 172 females) recorded their sleep with in-home PSG using the Cerebra Sleep System and completed sleep questionnaires. Sleep quality was measured using the odds ratio product (ORP) derived from micro-analyzing frontal EEG channels. On the questionnaires, participants reported whether they experienced any of the following insomnia symptoms at least three times a week: trouble falling asleep, trouble staying asleep, and waking up too early. Statistical analyses included number of insomnia symptoms as a dependent variable in a multiple linear regression, time spent in the lowest two deciles of ORP and the highest decile of ORP as independent variables, and age as a covariate in a separate model. Results 60 participants reported 1 symptom of insomnia, 82 reported 2 symptoms, and 68 reported 3 symptoms. The full model was significant (F2,399=4.675, p=0.010, R=0.228, R2 adj=0.052) and indicated that time spent in the highest decile of ORP was the only significant predictor of number of insomnia symptoms (t399=2.321, p=0.021, β=0.131) after controlling for age. Time spent in the lowest two deciles of ORP (deep sleep) was not a significant predictor (p >0.05). Conclusion Time in the highest ORP decile, indicative of full wakefulness, is positively associated with insomnia symptoms after controlling for age. Individuals reporting more insomnia symptoms spent more time in full wakefulness. Time spent in deep sleep was not associated with insomnia symptoms. This may indicate hyperarousal and low sleep drive in participants with subjective insomnia complaints, which is consistent with insomnia etiology. Support (if any)

Objective: To investigate the sex and gender differences in the impact of the isolation period implemented in response to the COVID-19 pandemic on individuals' sleep quality, empathy, and mood. Design: Data were collected between March 23 and June 7, 2020 on a sample of volunteers in the Canadian population. Six hundred and thirty-eight volunteers completed an online survey (~30 min). Main Outcome and Measures: We first examined biological sex, gender, and sexual identity differences (both components of the ampler concept of gender) in sleep, empathy, and mood disturbances. Then, we assessed changes in sleep and mood over the course of the isolation period and tested for significant relationships between sleep variables, mood, and empathy. Results: We analyzed complete data for 573 participants (112 males and 459 females, 2 undisclosed, mean ± SD age = 25.9 ± 10.5 years, mean ± SD education = 16.2 ± 2.9 years). As compared to males, female participants reported lower quality of sleep, lower sleep efficiency, and greater symptoms of insomnia, anxiety, depression, and trauma. In addition, females reported higher scores than males on the IRI empathy scale and all its subcomponents. Similar results were found when stratifying by gender. Sleep and mood disturbances increased over the course of the isolation period in the whole sample. The most significant predictors of poor quality of sleep and insomnia were depression, anxiety, and trauma scores, especially in females; higher empathy trait was associated with higher depression, anxiety, and trauma scores, perhaps indicating a more positive role of fear and anxiety responses to the pandemic crisis. Significance and Conclusions: Sex and gender differences seem to play a role in the individuals' psychological and behavioral reactions to the COVID-19 pandemic. These differences need to be considered in planning targeted psychological interventions.

ObjectiveTo test the hypothesis that aerobic exercise is associated with improvements in cognition and cerebrovascular regulation, we enrolled 206 healthy low-active middle-aged and older adults (mean ± SD age 65.9 ± 6.4 years) in a supervised 6-month aerobic exercise intervention and assessed them before and after the intervention.MethodsThe study is a quasi-experimental single group pre/postintervention study. Neuropsychological tests were used to assess cognition before and after the intervention. Transcranial Doppler ultrasound was used to measure cerebral blood flow velocity. Cerebrovascular regulation was assessed at rest, during euoxic hypercapnia, and in response to submaximal exercise. Multiple linear regression was used to examine the association between changes in cognition and changes in cerebrovascular function.ResultsThe intervention was associated with improvements in some cognitive domains, cardiorespiratory fitness, and cerebrovascular regulation. Changes in executive functions were negatively associated with changes in cerebrovascular resistance index (CVRi) during submaximal exercise (β = −0.205,p= 0.013), while fluency improvements were positively associated with changes in CVRi during hypercapnia (β = 0.106,p =0.03).ConclusionThe 6-month aerobic exercise intervention was associated with improvements in some cognitive domains and cerebrovascular regulation. Secondary analyses showed a novel association between changes in cognition and changes in cerebrovascular regulation during euoxic hypercapnia and in response to submaximal exercise.

To determine the relationship between sleep spindle characteristics (density, power and frequency), executive functioning and cognitive decline in older adults, we studied a convenience subsample of healthy middle-aged and older participants of the Brain in Motion study. Participants underwent a single night of unattended in-home polysomnography with neurocognitive testing carried out shortly afterwards. Spectral analysis of the EEG was performed to derive spindle characteristics in both central and frontal derivations during non-rapid eye movement (NREM) Stage 2 and 3. Multiple linear regressions were used to examine associations between spindle characteristics and cognitive outcomes, with age, body mass index (BMI), periodic limb movements index (PLMI) and apnea hypopnea index (AHI) as covariates. NREM Stage 2 total spindle density was significantly associated with executive functioning (central: β = .363, p = .016; frontal: β = .408, p = .004). NREM Stage 2 fast spindle density was associated with executive functioning (central: β = .351, p = .022; frontal: β = .380, p = .009) and Montreal Cognitive Assessment score (MoCA, central: β = .285, p = .037; frontal: β = .279, p = .032). NREM Stage 2 spindle frequency was also associated with MoCA score (central: β = .337, p = .013). Greater spindle density and fast spindle density were associated with better executive functioning and less cognitive decline in our study population. Our cross-sectional design cannot infer causality. Longitudinal studies will be required to assess the ability of spindle characteristics to predict future cognitive status.

Background Sleep disturbances have been shown to be associated with the presence of the apolipoprotein (APOE) ɛ4 allele, the well-known genetic risk factor for late-onset sporadic Alzheimer's disease (AD). Objective This study quantifies the effects of a six-month aerobic exercise intervention on objective and subjective sleep quality in middle-aged to older individuals including those at increased genetic risk for late-onset sporadic Alzheimer's disease (AD), who carry the apolipoprotein (APOE) ɛ4 risk allele. Methods 199 sedentary men and women without significant cognitive impairments were enrolled in the Brain in Motion study, a quasi-experimental single group pre-test/post-test study with no control group. Participants completed a six-month aerobic exercise intervention and consented to genetic testing. Genotyping of APOE confirmed that 54 individuals were carriers of the ɛ4 allele. Participants' subjective quality of sleep was assessed with the Pittsburgh Sleep Quality Index (PSQI) pre- and post-intervention. A convenience sample of participants (n = 29, APOE ɛ4+ = 7) consented to undergo two nights of in-home polysomnography (PSG) pre- and post intervention. Sleep architecture and respiratory variables were assessed. Results The six-month aerobic exercise intervention significantly improved participants' total PSQI score, sleep efficiency, and sleep latency in the full sample (n = 199). PSG results showed that total sleep time and sleep onset latency significantly improved over the course of the exercise intervention only in individuals who carried the APOE ɛ4 allele. These results are, however, exploratory and need to be carefully interpreted due to the rather small number of APOE ɛ4+ in the PSG subgroup. Conclusions The six-month aerobic exercise intervention significantly improved participants' sleep quality with beneficial effects on PSG shown in individuals at increased genetic risk for late-onset sporadic AD.

The ability to experience emotional empathy is critical for vicariously sharing the emotional state of others. This important empathic skill is significantly affected by sleep deprivation and poor sleep quality. Here, we provide the very first evidence that experienced paramedics have a significantly reduced emotional empathy as compared to non-paramedic individuals and paramedic trainees, and that such effect is caused by their poor quality of sleep. Future research building on our findings could potentially lead to an improvement of work conditions, shifts schedules, and resiliency training for paramedics, which would ultimately benefit all users of emergency medical services.

To investigate the relative importance of isolated thoracic perfusion (ITP) in the multidisciplinary palliative treatment of progressive malignant pleural mesothelioma (MPM) patients.Fifty-two MPM patients with progressive disease after systemic chemotherapy with cisplatin and pemetrexed were submitted to 112 ITP using mitomycin C (25 mg/m2) and cisplatin (70 mg/m2) between 2000 and 2017. Isolation of the chest was achieved by insertion of stop-flow balloon catheters via femoral or iliac access. Primary endpoints were adverse events, tumor response rate, progression-free survival (PFS) and overall survival (OS) from initial ITP.Median interval-time from MPM diagnosis was 9 months. There were no perfusion-related postoperative deaths. The main procedure-related complication was persistent leakage of lymphatic fluid from the incision in less than 10% of ITP. No severe perfusion-related toxicity was reported, with grade 3 haematological toxicity and platinum-induced neurotoxicity in less than 8% of the patients. Following initial ITP, overall tumor response rate was 25%, median PFS was 7 months (IQR 5-10.5), and median OS was 16 months (IQR 12.5-21). After the last ITP, 14 patients received further therapies, including targeted therapy with cetuximab or bevacizumab. Non-epithelioid histology, stage III, and ECOG performance status 3 pre-ITP were prognostic factors with a significant influence on OS. Median OS, calculated from the diagnosis of MPM, was 26.5 months (IQR 22.5-28).ITP is safe, tolerable, and useful but its inclusion in the multidisciplinary palliative treatment of progressive MPM patients should be investigated in a larger multicentre controlled study.

Background: Sleep disturbances have been shown to be associated with the presence of the apolipoprotein (APOE) ɛ4 allele, the well-known genetic risk factor for late-onset sporadic Alzheimer’s disease (AD). Objective: This study quantifies the effects of a six-month aerobic exercise intervention on objective and subjective sleep quality in middle-aged to older individuals including those at increased genetic risk for late-onset sporadic Alzheimer’s disease (AD), who carry the apolipoprotein (APOE) ɛ4 risk allele. Methods: 199 sedentary men and women without significant cognitive impairments were enrolled in the Brain in Motion study, a quasi-experimental single group pre-test/post-test study with no control group. Participants completed a six-month aerobic exercise intervention and consented to genetic testing. Genotyping of APOE confirmed that 54 individuals were carriers of the ɛ4 allele. Participants’ subjective quality of sleep was assessed with the Pittsburgh Sleep Quality Index (PSQI) pre- and post-intervention. A convenience sample of participants (n = 29, APOE ɛ4+ = 7) consented to undergo two nights of in-home polysomnography (PSG) pre- and post intervention. Sleep architecture and respiratory variables were assessed. Results: The six-month aerobic exercise intervention significantly improved participants’ total PSQI score, sleep efficiency, and sleep latency in the full sample (n = 199). PSG results showed that total sleep time and sleep onset latency significantly improved over the course of the exercise intervention only in individuals who carried the APOE ɛ4 allele. These results are, however, exploratory and need to be carefully interpreted due to the rather small number of APOE ɛ4+ in the PSG subgroup. Conclusions: The six-month aerobic exercise intervention significantly improved participants’ sleep quality with beneficial effects on PSG shown in individuals at increased genetic risk for late-onset sporadic AD.

The human ability to vicariously share someone else's emotions (i.e., emotional empathy) relies on an extended neural network including regions in the anterior cingulate and insular cortex. Here, we tested the hypothesis that good sleep quality is associated with increased activation in the brain areas underlying emotional empathy. To this aim, we assessed subjective sleep quality in a large sample of healthy young volunteers, and asked participants to complete a computerized emotional empathy task. Then, we asked 16 participants to complete the same task while undergoing functional Magnetic Resonance Imaging (fMRI). After confirming the behavioral relationship between quality of sleep and emotional empathy in the large sample, we conducted a Region of Interest (ROI) analysis on selected ROIs involved in emotional empathy, and measured Blood Oxygen Level Dependent (BOLD) signal change in participants who performed the emotional empathy task in the MRI scanner; additionally, we assessed how the BOLD signal in different brain areas temporally correlated with performance throughout the task (i.e., task-based functional connectivity). We found increased BOLD signal change in a selective region within the left insula for individuals with better subjective sleep quality. These findings provide the very first evidence that individuals' sleep quality relates to emotional empathic responses through increased neural activation of a specific area within the insular cortex.

Pelvic Melanoma relapse occurs in 15% of patients with loco regional metastases, and 25% of cases do not respond to new target-therapy and/or immunotherapy. Melphalan hypoxic pelvic perfusion may, therefore, be an option for these non-responsive patients. Overall median survival time (MST), stratified for variables, including BRAF V600E mutation and eligibility for treatments with new immunotherapy drugs, was retrospectively assessed in 41 patients with pelvic melanoma loco regional metastases. They had received a total of 175 treatments with Melphalan hypoxic perfusion and cytoreductive excision. Among the 41 patients, 22 (53.7%) patients exhibited a wild-type BRAF genotype, 11 of which were not eligible for immunotherapy. The first treatment resulted in a 97.5% response-rate in the full cohort and a 100% response-rate in the 22 wild-type BRAF patients. MST was 18 months in the full sample, 20 months for the 22 wild-type BRAF patients and 21 months for the 11 wild-type BRAF patients not eligible for immunotherapy. Melphalan hypoxic perfusion is a potentially effective treatment for patients with pelvic melanoma loco regional metastases that requires confirmation in a larger multicenter study.

Trait neuroticism is suggested to be related to measures of volume and function of the hippocampus, a brain structure located in the medial temporal lobe that is critical for human navigation and orientation. In this study, we assessed whether measures of trait neuroticism and self-concept are correlated with the human ability to orient by means of cognitive maps (i.e. mental representations of an environment that include landmarks and their spatial relationships). After controlling for gender differences, which are well-known in spatial orientation abilities, we found that measures of neuroticism (i.e. negative affect, emotional stability) and self-concept (i.e. self-esteem) were correlated with individual differences in the rate at which cognitive maps were formed; the same measures were generally unrelated to the ability to make use of cognitive maps, as well as the ability to orient using visual path integration. The relationships (and lack thereof) between personality traits and the spatial orientation skills, as reported in the present study, are consistent with specific neural correlates underlying these factors, and may have important implications for treatment of disorders related to them.

Aging is associated with decline in white matter (WM) microstructure, decreased cognitive functioning, and increased risk of Alzheimer’s disease and related dementias . Recent research has identified aerobic physical exercise as a promising intervention for increasing white matter microstructure in aging, with the aim of increasing cognitive abilities, and protecting against neurodegenerative processes . However, the degree to which white matter microstructure can be protected or improved with exercise remains incompletely understood. Here, a sub-group of 25 healthy, sedentary participants (aged 57 to 86 years; M = 67.1; SD = 7.9; 11 female, 14 male) from the larger Brain in Motion Study (Tyndall et al ., 2013) underwent diffusion tensor imaging (DTI) before and after a six-month aerobic exercise intervention. DTI data were analysed with FSL’s Tract-Based Spatial Statistics (TBSS) to determine whether WM microstructure improved, as defined by increased fractional anisotropy (FA) and/or decreased mean diffusivity (MD), after the aerobic exercise intervention. Neither FA nor MD of the cerebral WM were significantly correlated with either age or cardiovascular fitness at baseline. Whole-brain WM mean FA decreased over the intervention while mean MD showed no significant change. Longitudinal TBSS analyses revealed decreased FA in the left uncinate fasciculus , left anterior corona radiata , left inferior fronto-occipital fasciculus, and left anterior thalamic radiation. MD increased in the left forceps major, left inferior longitudinal fasciculus , and left superior longitudinal fasciculus . Results indicate that six months of aerobic exercise in healthy, sedentary older adults was not associated with improvements in FA or MD measures of cerebral WM microstructure.

Abstract. Sleep loss is known to severely disturb individuals’ mood and emotion processing. Here, we tested the hypothesis that quality of sleep is predictive of individuals’ performance on a task evaluating emotional empathy. We tested 34 healthy undergraduate students [19 males, mean (SD) age = 21.82 (3.26) years; mean (SD) education = 14.98 (1.91) years] recruited through the University of Calgary research participation system. We collected objective (actigraphy) and subjective (questionnaires and self-reports) sleep measures to characterize individuals’ sleep quality, and asked participants to solve a computerized emotional empathy task. We first performed a dimensionality reduction analysis on the sleep-related measures, which resulted in six principal components, and then ran a stepwise multiple regression analysis to investigate the sleep measures that best predicted participants’ scores on the emotional empathy task. We found that subjective sleep quality, together with sleep phase, best predicted participants’ empathic sensitivity to negative images while they explicitly evaluated the emotions of others (i.e., direct component of emotional empathy). Also, subjective sleep quality resulted to be the best predictor of participants’ arousal state in response to negative images, which is an implicit manifestation of their empathic experience (i.e., indirect component of emotional empathy). In both cases, lower subjective sleep quality was associated with lower empathic sensitivity to negative stimuli. Finally, sleep duration best predicted average empathic responses to stimuli of all valences, with shorter sleep durations associated with lower average empathic responses. Our findings provide evidence of a significant relationship between individuals’ quality of sleep and their ability to share the emotions experienced by others. These findings may have important implications for individuals employed in professions requiring social interaction and empathic experience coupled with schedules that interfere with nighttime sleep.

The ability to spatially orient is one of the most complex cognitive skills. It relies on the processing of different spatial information available in the environment, leading to the use of different cognitive strategies useful for orientation. The neural mechanisms underlying such a complex phenomenon include networks that require the proper functioning of a variety of cortical and subcortical regions. Here, we review the basic behavioral and neural mechanism responsible for the ability to orient in spatial surroundings, as well as its development (and lack of) in children.

The aim of this study is to evaluate the empathic ability and its functional brain correlates in post-traumatic stress disorder subjects (PTSD). Seven PTSD subjects and ten healthy controls, all present in the L'Aquila area during the earthquake of the April 2009, underwent fMRI during which they performed a modified version of the Multifaceted Empathy Test. PTSD patients showed impairments in implicit and explicit emotional empathy, but not in cognitive empathy. Brain responses during cognitive empathy showed an increased activation in patients compared to controls in the right medial frontal gyrus and the left inferior frontal gyrus. During implicit emotional empathy responses patients with PTSD, compared to controls, exhibited greater neural activity in the left pallidum and right insula; instead the control group showed an increased activation in right inferior frontal gyrus. Finally, in the explicit emotional empathy responses the PTSD group showed a reduced neural activity in the left insula and the left inferior frontal gyrus. The behavioral deficit limited to the emotional empathy dimension, accompanied by different patterns of activation in empathy related brain structures, represent a first piece of evidence of a dissociation between emotional and cognitive empathy in PTSD patients. The present findings support the idea that empathy is a multidimensional process, with different facets depending on distinct anatomical substrates.

Previous studies have shown that sleep loss has a detrimental effect on the ability of the individuals to process emotional information. In this study, we tested the hypothesis that this negative effect extends to the ability of experiencing emotions while observing other individuals, i.e. emotional empathy. To test this hypothesis, we assessed emotional empathy in 37 healthy volunteers who were assigned randomly to one of three experimental groups: one group was tested before and after a night of total sleep deprivation (sleep deprivation group), a second group was tested before and after a usual night of sleep spent at home (sleep group) and the third group was tested twice during the same day (day group). Emotional empathy was assessed by using two parallel versions of a computerized test measuring direct (i.e. explicit evaluation of empathic concern) and indirect (i.e. the observer's reported physiological arousal) emotional empathy. The results revealed that the post measurements of both direct and indirect emotional empathy of participants in the sleep deprivation group were significantly lower than those of the sleep and day groups; post measurement scores of participants in the day and sleep groups did not differ significantly for either direct or indirect emotional empathy. These data are consistent with previous studies showing the negative effect of sleep deprivation on the processing of emotional information, and extend these effects to emotional empathy. The findings reported in our study are relevant to healthy individuals with poor sleep habits, as well as clinical populations suffering from sleep disturbances.

Wie bereits in ► Kap. 1 beschrieben, kann die Induktionschemotherapie Anderungen auslosen, welche die Erfolgsaussichten einer anschliesenden Operation bzw. Strahlentherapie erhohen. Die Beckenperfusion kann als Induktionschemotherapie fur die Behandlung von Rektumkarzinomen vornehmlich bei Lokalrezidiven, aber auch bei bestimmten Patienten mit fortgeschrittenen Primartumoren eingesetzt werden.