Publications by authors named "Peter A Hall"

95 Publications

Examining the relationships among adolescent health behaviours, prefrontal function, and academic achievement using fNIRS.

Dev Cogn Neurosci 2021 08 1;50:100983. Epub 2021 Jul 1.

School of Public Health Sciences, University of Waterloo, Waterloo, ON, Canada; Department of Psychology, University of Waterloo, Waterloo, ON, Canada; Centre for Bioengineering and Biotechnology, University of Waterloo, Waterloo, Canada. Electronic address:

Several adolescent health behaviours have been hypothesized to improve academic performance via their beneficial impact on cognitive control and functional aspects of the prefrontal cortex (PFC). The primary objective of this study is to examine the association between lifestyle behaviours and academic performance in a sample of adolescents, and to examine the extent to which activity within the PFC and behavioural indices of inhibition may mediate this relationship. Sixty-seven adolescents underwent two study sessions five days apart. Sleep and physical activity were measured using wrist-mounted accelerometry; eating habits, substance use and academic achievement were measured by self-report. Prefrontal function was quantified by Multi-Source Interference Task (MSIT) performance, and task-related activity via functional near-infrared spectroscopy (fNIRS). Higher levels of physical activity predicted higher MSIT accuracy scores (β = .321, ρ = 0.019) as well as greater activation within the right dlPFC (b = .008, SE = .004, ρ = .0322). Frequency of fast-food consumption and substance use were negatively associated with MSIT accuracy scores (β = -0.307, ρ = .023) and Math grades (b = -3.702, SE = 1.563, ρ = .022), respectively. Overall, the results of this study highlight the importance of lifestyle behaviours as predictors of prefrontal function and academic achievement in youth.
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http://dx.doi.org/10.1016/j.dcn.2021.100983DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8280512PMC
August 2021

Morphometry of the Lateral Orbitofrontal Cortex is Associated With Eating Dispositions in Early Adolescence: Findings From a Large Population-Based Study.

Soc Cogn Affect Neurosci 2021 Jul 3. Epub 2021 Jul 3.

Department of Psychology, University of Waterloo, Waterloo, Canada.

Early adolescence is a critical period for eating behavior as children gain autonomy around food choice and peer influences increase in potency. From a neurodevelopmental perspective, significant structural changes take place in the prefrontal cortex during this time, including the orbitofrontal cortex (OFC), which is involved in socially contextualized decision making. We examined morphological features of the OFC in relation to food choice in a sample of 10,309 early adolescent children from the ABCD study. Structural parameters of the OFC and insula were examined for relationships with two important aspects of food choice: limiting consumption of fast/fried food and maximizing consumption of nutritious foods. Raw, partially and fully adjusted models were evaluated. Findings revealed that larger surface area of the lateral OFC was associated with higher odds of limiting fast/fried food consumption in raw (OR=1.07, CI:1.02,1.12, p=.002, pFDR=.012), partially adjusted (OR=1.11, CI:1.03,1.19, p=.004, pFDR=.024), and fully adjusted models (OR=1.11, CI:1.03,1.19, p=.006, pFDR=.036). In contrast, larger insula volume was associated with lower odds of maximizing healthy foods in raw (OR=0.94, CI:.91,0.97, p <.001, pFDR=.003) and partially adjusted (OR=0.93, CI: 0.88-0.98, p=.008, pFDR=.048) models. These findings refine understanding of the OFC as a network node implicated in socially mediated eating behavior.
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http://dx.doi.org/10.1093/scan/nsab084DOI Listing
July 2021

An examination of the prospective association between physical activity and academic achievement in youth at the population level.

PLoS One 2021 11;16(6):e0253142. Epub 2021 Jun 11.

School of Public Health and Health Systems, University of Waterloo, Waterloo, Ontario, Canada.

Exercise has significant benefits for brain health and this may have downstream learning benefits for youth. However existing studies looking at links between physical activity and academic achievement are limited by relatively small sample sizes and/or cross-sectional designs. The objective of this study is to determine the direction and magnitude of the association between physical activity and academic achievement in a large prospective sample of adolescents. Linear mixed models with random intercepts and multinomial ordinal generalized estimating equations were employed to analyze the prospective relationship between measures of physical activity and academic achievement from the COMPASS study (N = 9,898 linked participant data cases from year 2 (2013-2014) to year 4 (2015-2016)). The linear relationships between minutes of moderate to vigorous physical activity and academic achievement (English: r = -.047, p < .000; Math: r = -.026, p = .008) as well as meeting the national physical activity guidelines and academic achievement (English: est = -.052, p = .004; Math: est = -.052, p = .028) were negative and trivial in magnitude. Organized sport participation showed slight positive associations with academic achievement indices, but these were also of trivial magnitude. In conclusion, the relationship between physical activity and academic achievement was effectively null in this population sample. Advocacy for physical activity programming for adolescent populations may best be undertaken with reference to lack of net academic achievement cost, rather than presence of benefit, or simply with reference to the many other physical and mental health benefits for youth.
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http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0253142PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8195429PMC
June 2021

Biobehavioral Aspects of the COVID-19 Pandemic: A Review.

Psychosom Med 2021 05;83(4):309-321

From the School of Public Health Sciences (Hall, Fong, Oremus, Sakib, Butt, Jandu, Morita) and Department of Psychology (Hall, Fong), University of Waterloo, Waterloo, Ontario, Canada; Department of Psychology and Neuroscience (Sheeran), University of North Carolina at Chapel Hill, Chapel Hill, North Carolina; Ontario Institute for Cancer Research (Fong), Toronto, Ontario, Canada; Department of Psychology (Cheah), University of Maryland, Baltimore County, Baltimore, Maryland; Department of Physical Therapy, Faculty of Medicine (Liu-Ambrose), University of British Columbia, Vancouver, Canada; School of Biomedical Engineering, Science and Health Systems (Ayaz) and Department of Psychology, College of Arts and Sciences (Ayaz), Drexel University; and Department of Family and Community Health (Ayaz), University of Pennsylvania, Philadelphia, Pennsylvania.

Objective: This review highlights the scope and significance of the coronavirus disease 2019 (COVID-19) pandemic with a focus on biobehavioral aspects and critical avenues for research.

Methods: A narrative review of the published research literature was undertaken, highlighting major empirical findings emerging during the first and second waves of the COVID-19 pandemic.

Results: Interactions among biological, behavioral, and societal processes were prominent across all regions of the globe during the first year of the COVID-19 emergency. Affective, cognitive, behavioral, socioeconomic, and technological factors all played a significant role in the spread of infection, response precautions, and outcomes of mitigation efforts. Affective symptoms, suicidality, and cognitive dysfunction have been widely described consequences of the infection, the economic fallout, and the necessary public health mitigation measures themselves. The impact of COVID-19 may be especially serious for those living with severe mental illness and/or chronic medical diseases, given the confluence of several adverse factors in a manner that appears to have syndemic potential.

Conclusions: The COVID-19 pandemic has made clear that biological and behavioral factors interact with societal processes in the infectious disease context. Empirical research examining mechanistic pathways from infection and recovery to immunological, behavioral, and emotional outcomes is critical. Examination of how emotional and behavioral factors relate to the pandemic-both as causes and as effects-can provide valuable insights that can improve management of the current pandemic and future pandemics to come.
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http://dx.doi.org/10.1097/PSY.0000000000000932DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8115744PMC
May 2021

Effects of prefrontal theta burst stimulation on neuronal activity and subsequent eating behavior: an interleaved rTMS and fNIRS study.

Soc Cogn Affect Neurosci 2021 Feb 22. Epub 2021 Feb 22.

School of Public Health & Health Systems, University of Waterloo, Ontario, Canada.

The dorsolateral prefrontal cortex (dlPFC) and dorsomedial prefrontal cortex (dmPFC) are important nodes for self-control and decision-making, but through separable processes (cognitive control versus evaluative processing). This study aimed to examine the effects of excitatory brain stimulation (intermittent theta-burst stimulation; iTBS) targeting the dlPFC and dmPFC on food choice. iTBS was hypothesized to decrease consumption of appetitive snack foods, via enhanced interference control for dlPFC stimulation and reduced delay discounting for dmPFC stimulation. Using a single-blinded, between-subjects design, participants (N = 43) were randomly assigned to of the three conditions: 1) iTBS targeting the left dlPFC, 2) iTBS targeting bilateral dmPFC, or 3) sham. Participants then completed two cognitive tasks (delay discounting (DD) and Flanker), followed by a taste test. fNIRS imaging revealed increases in medial PFC activity were evident in the dmPFC stimulation group during the DD task; likewise, a neural efficiency effect was observed in the dlPFC stimulation group during the Flanker. Gender significantly moderated consumption during the taste test, with females in the dmPFC showing paradoxical increases in food consumption compared to sham. Findings are consistent with possible amplification of positive evaluative processing in the presence of dietary restraint, vis-à-vis excitation of the mPFC.
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http://dx.doi.org/10.1093/scan/nsab023DOI Listing
February 2021

Correction: Considerations for an Individual-Level Population Notification System for Pandemic Response: A Review and Prototype.

J Med Internet Res 2020 Jun 22;22(6):e21634. Epub 2020 Jun 22.

School of Public Health and Health Systems, University of Waterloo, Waterloo, ON, Canada.

[This corrects the article DOI: 10.2196/19930.].
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http://dx.doi.org/10.2196/21634DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7381056PMC
June 2020

Considerations for an Individual-Level Population Notification System for Pandemic Response: A Review and Prototype.

J Med Internet Res 2020 06 5;22(6):e19930. Epub 2020 Jun 5.

School of Public Health and Health Systems, University of Waterloo, Waterloo, ON, Canada.

The outbreak of the coronavirus disease (COVID-19), caused by severe acute respiratory syndrome coronavirus 2, spread worldwide after its emergence in China. Whether rich or poor, all nations are struggling to cope with this new global health crisis. The speed of the threat's emergence and the quick response required from public health authorities and the public itself makes evident the need for a major reform in pandemic surveillance and notification systems. The development and implementation of a graded, individual-level pandemic notification system could be an effective tool to combat future threats of epidemics. This paper describes a prototype model of such a notification system and its potential advantages and challenges for implementation. Similar to other emergency alerts, this system would include a number of threat levels (level 1-5) with a higher level indicating increasing severity and intensity of safety measures (eg, level 1: general hygiene, level 2: enhanced hygiene, level 3: physical distancing, level 4: shelter in place, and level 5: lockdown). The notifications would be transmitted to cellular devices via text message (for lower threat levels) or push notification (for higher threat levels). The notification system would allow the public to be informed about the threat level in real time and act accordingly in an organized manner. New Zealand and the United Kingdom have recently launched similar alert systems designed to coordinate the ongoing COVID-19 pandemic response more efficiently. Implementing such a system, however, faces multiple challenges. Extensive preparation and coordination among all levels of government and relevant sectors are required. Additionally, such systems may be effective primarily in countries where there exists at least moderate trust in government. Advance and ongoing public education about the nature of the system and its steps would be an essential part of the system, such that all members of the public understand the meaning of each step in advance, similar to what has been established in systems for other emergency responses. This educational component is of utmost importance to minimize adverse public reaction and unintended consequences. The use of mass media and local communities could be considered where mobile phone penetration is low. The implementation of such a notification system would be more challenging in developing countries for several reasons, including inadequate technology, limited use of data plans, high population density, poverty, mistrust in government, and tendency to ignore or failure to understand the warning messages. Despite the challenges, an individual-level pandemic notification system could provide added benefits by giving an additional route for notification that would be complementary to existing platforms.
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http://dx.doi.org/10.2196/19930DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7279045PMC
June 2020

Quantifying Cortical Resilience in Experimental, Clinical, and Epidemiological Studies: A Conceptually Grounded Method Using Noninvasive Brain Stimulation.

Psychosom Med 2020 04;82(3):281-286

From the Prevention Neuroscience Laboratory, Faculty of Applied Health Sciences (Hall, Sakib), University of Waterloo, Waterloo; Department of Psychology (Erickson), University of Pittsburgh, Pittsburgh, Pennsylvania; Department of Psychology, Brain and Mind Institute (Lowe), Western University, London, Ontario, Canada.

Objective: Cortical resilience can be defined as the ability of the cortex of the human brain to rebound efficiently from perturbation. This concept is important in both research and clinical practice contexts. However, no direct measure of cortical resilience exists. Inhibitory variants of repetitive transcranial magnetic stimulation, such as continuous theta burst stimulation, provide a standardized method for inducing a perturbation; when coupled with the assessment of recovery rate from the perturbation, such a paradigm might provide a standardized measure of cortical resilience. This article describes a standardized method for quantifying cortical resilience using theta burst stimulation protocols.

Methods: A descriptive overview of a method for assessing cortical resilience is presented. Links are drawn between critical facets of the resilience construct and the protocol described.

Results: The Cortical Challenge and Recovery Test (CCaRT) method makes use of existing stimulation parameters and cognitive testing paradigms to provide a flexible and conceptually meaningful measure of cortical resilience.

Conclusions: The CCaRT paradigm is potentially useful in research and contexts where cortical resilience is to be measured. The CCaRT paradigm has applicability to epidemiological studies and laboratory experimentation as well as diagnostic practice and clinical trial outcome measures.
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http://dx.doi.org/10.1097/PSY.0000000000000785DOI Listing
April 2020

Long noncoding RNA BHLHE40-AS1 promotes early breast cancer progression through modulating IL-6/STAT3 signaling.

J Cell Biochem 2020 07 7;121(7):3465-3478. Epub 2020 Jan 7.

Department of Biomedical Sciences, Cancer Research Center, University at Albany-SUNY, Rensselaer, New York.

Ductal carcinoma in situ (DCIS) is a nonobligate precursor to invasive breast cancer. Only a small percentage of DCIS cases are predicted to progress; however, there is no method to determine which DCIS lesions will remain innocuous from those that will become invasive disease. Therefore, DCIS is treated aggressively creating a current state of overdiagnosis and overtreatment. There is a critical need to identify functional determinants of progression of DCIS to invasive ductal carcinoma (IDC). Interrogating biopsies from five patients with contiguous DCIS and IDC lesions, we have shown that expression of the long noncoding RNA BHLHE40-AS1 increases with disease progression. BHLHE40-AS1 expression supports DCIS cell proliferation, motility, and invasive potential. Mechanistically, BHLHE40-AS1 modulates interleukin (IL)-6/signal transducer and activator of transcription 3 (STAT3) activity and a proinflammatory cytokine signature, in part through interaction with interleukin enhancer-binding factor 3. These data suggest that BHLHE40-AS1 supports early breast cancer progression by engaging STAT3 signaling, creating an immune-permissive microenvironment.
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http://dx.doi.org/10.1002/jcb.29621DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7263938PMC
July 2020

What mediates exercise effects on dietary choice? Clues from the brain stimulation literature.

Authors:
Peter A Hall

Int J Obes (Lond) 2019 08 12;43(8):1650-1651. Epub 2019 Jun 12.

Prevention Neuroscience Laboratory, School of Public Health & Health Systems, University of Waterloo, Waterloo, Ontario, N2L 3G1, Canada.

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http://dx.doi.org/10.1038/s41366-019-0395-zDOI Listing
August 2019

Contextual cues as modifiers of cTBS effects on indulgent eating.

Brain Stimul 2019 Sep - Oct;12(5):1253-1260. Epub 2019 May 6.

Prevention Neuroscience Laboratory, School of Public Health & Health Systems, University of Waterloo, Waterloo, Ontario, N2L 3G1, Canada. Electronic address:

Background: Prior studies have found that continuous theta burst stimulation (cTBS) targeting the left dlPFC results in reliable increases in consumption of calorie-dense food items. However, it is not known to what extent such effects are modified by cues in the immediate eating environment. Tempting environments (i.e., those saturated with appetitive eating cues) may lead to more reliance on cognitive control networks involving the dlPFC, thereby enhancing cTBS effects on indulgent eating.

Objective/hypothesis: The objective was to examine the extent to which cTBS effects on indulgent eating would be modified by contextual cues. It was hypothesized that cTBS effects would be stronger in the presence of facilitating cues.

Methods: Using a single-blinded between-subjects factorial design, 107 TMS-naïve adults were randomly assigned to one of four conditions: 1) active cTBS + facilitating cues, 2) sham cTBS + facilitating cues, 3) active cTBS + inhibiting cues, 4) sham cTBS + inhibiting cues. Following stimulation participants completed a flanker paradigm and a taste test during which quantity consumed was assessed surreptitiously.

Results: Findings revealed a significant interaction between stimulation and cue type (F(1,102) = 6.235, p = .014), such that cTBS resulted in increased food consumption (compared to sham) in the presence of the facilitating cue but not in the presence of the inhibiting cue. Moderated mediational analyses showed selective mediation of cTBS effects on consumption through cTBS attenuation of flanker interference scores.

Conclusions: The effects of cTBS on indulgent eating are strengthened in the presence of facilitating cues. Methodologically speaking, facilitating cues may be a functional prerequisite for exploring cTBS effects on eating in the laboratory. Substantively, the findings also suggest that facilitating cues in the eating environment may amplify counter-intentional food indulgence in everyday life via cognitive control failure.
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http://dx.doi.org/10.1016/j.brs.2019.05.003DOI Listing
January 2020

The Prefrontal Cortex and Obesity: A Health Neuroscience Perspective.

Trends Cogn Sci 2019 04 26;23(4):349-361. Epub 2019 Feb 26.

School of Public Health and Health Systems, University of Waterloo, Waterloo, Ontario N2L 3G1, Canada.

In the modern obesogenic environment, limiting calorie-dense food consumption is partially dependent on the capacity of individuals to override visceral reactions to hyperpalatable and rewarding food cues. In the current review, we employ a health neuroscience framework to outline: (i) how individual variations in prefrontal cortical structure and functionality, and by extension, executive functions, may predispose an individual to the overconsumption of appetitive calorie-dense foods via differences in dietary self-regulation; (ii) how obesity may result in changes to cortical structure and functionality; and (iii) how the relationship between the structure and function of the prefrontal cortex and obesity may be best described as reciprocal in nature.
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http://dx.doi.org/10.1016/j.tics.2019.01.005DOI Listing
April 2019

Sleep and cognitive function in chronic stroke: a comparative cross-sectional study.

Sleep 2019 05;42(5)

University of British Columbia, Faculty of Medicine, Aging, Mobility and Cognitive Neuroscience Laboratory, Djavad Mowafaghian Centre for Brain Health and Centre for Hip Health and Mobility, Vancouver, BC, Canada.

Poor sleep is common following stroke, limits stroke recovery, and can contribute to further cognitive decline post-stroke. However, it is unclear what aspects of sleep are different in older adults with stroke compared with those without, and whether the relationship between sleep and cognitive function differs by stroke history. We investigated whether older adults with stroke experience poorer sleep quality than older adults without stroke, and whether poor sleep quality attenuates cognitive performance among older adults with a history of stroke. Thirty-five age- and sex-matched older adults with stroke (age: 69.86 ± 1.13 years; 51.43% female) and without stroke (age: 69.83 ± 1.12; 51.43% female) were compared with respect to sleep quality using the MotionWatch8 (MW8) and Pittsburgh Sleep Quality Index (PSQI). Cognitive performance was indexed using the Alzheimer's Disease Assessment Scale Plus (ADAS-Cog Plus). Additionally, we examined whether poor sleep quality is associated with poorer cognitive performance among older adults with stroke. Older adults with stroke had longer MW8 measured sleep duration (27.82 ± 12.17 min; p = 0.03) and greater fragmentation (6.44 ± 2.24; p < 0.01), but did not differ in PSQI from their nonstroke peers. There was a significant group x sleep quality interaction for fragmentation (β = 0.02; p < 0.01) and efficiency (β = -0.03; p = 0.02) on ADAS-Cog Plus performance, whereby differences in cognitive performance between older adults with and without stroke were accentuated in the presence of poor sleep quality. Older adults with stroke have poorer sleep quality than their nonstroke counterparts, and older adults with stroke and poor sleep quality experience larger deficits in cognitive performance. Clinical Trial Registration: Vitality: Promoting Cognitive Function in Older Adults With Chronic Stroke (Vitality); https://clinicaltrials.gov/ct2/show/NCT01916486; NCT01916486.
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http://dx.doi.org/10.1093/sleep/zsz040DOI Listing
May 2019

Reproducibility and sources of interindividual variability in the responsiveness to prefrontal continuous theta burst stimulation (cTBS).

Neurosci Lett 2018 11 26;687:280-284. Epub 2018 Sep 26.

Prevention Neuroscience Lab, School of Public Health and Health Systems, University of Waterloo, Waterloo, ON, N2L 3G1, Canada. Electronic address:

Despite the increasing use of continuous theta burst (cTBS) protocols targeting the prefrontal cortex in clinical and research settings, very little is known regarding the interindividual factors that influence the magnitude and duration of cTBS aftereffects. The few existing studies have predominantly focussed on motor and corticospinal excitability, and the applicability of such findings to prefrontal modulation remains unclear. The current investigation aggregated published data from our laboratory to (1) assess the reproducibility of the effects of cTBS targeting the left dorsolateral prefrontal cortex (dlPFC) on executive function task performance, and (2) determine which factors are associated with individual differences in cTBS responsivity. Data from 76 healthy young adult female participants aged 19-26 (M = 20.6; SD = 1.6) were included in the analyses. Significant attenuations in executive function task performance from baseline were observed following active cTBS. However, these effects were not totally universal in that cTBS-induced attenuation of executive functions was observed in 61.8% of participants (i.e., responders). In addition, baseline task performance was a significant predictor of the magnitude of the cTBS-induced change in task performance in that cTBS effect was larger for individuals with higher baseline executive control abilities than those with lower abilities. Together, these data provide a quantitative estimate of the degree to which healthy participants may vary in the responsiveness to prefrontal cTBS, and potential moderating factors.
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http://dx.doi.org/10.1016/j.neulet.2018.09.039DOI Listing
November 2018

Cravings, currents and cadavers: What is the magnitude of tDCS effects on food craving outcomes?

Nutr Neurosci 2020 06 28;23(6):490-493. Epub 2018 Aug 28.

Brain and Mind Institute, Western University, Canada.

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http://dx.doi.org/10.1080/1028415X.2018.1513678DOI Listing
June 2020

Time Perspective and All-Cause Mortality: Evidence From the English Longitudinal Study of Ageing.

Ann Behav Med 2019 03;53(5):486-492

Institute of Applied Health Sciences, University of Aberdeen, Aberdeen, UK.

Background: Long-term future thinking has been associated with a range of favorable health behaviors. However, it is currently unclear whether this translates into an effect on morbidity and mortality.

Purpose: The goal of this study was to study the relationship between time perspective and all-cause mortality and to examine the role of health behavior in explaining this association.

Methods: Participants (N = 9,949) aged 50 and over from the English Longitudinal Study of Ageing, a representative cohort of older English adults, estimated the length of their time horizon for financial planning (time perspective). Two thousand ninety-two deaths were recorded over a 9-year follow-up period (2002/2003-2012). Smoking, physical activity, and alcohol consumption were examined as factors that may underlie the time perspective-mortality link.

Results: Our prospective survival analyses showed that those who tend to plan for longer periods experienced a significantly reduced risk of all-cause mortality (HR = 0.83; 95% confidence interval [CI]: [0.80, 0.87], p < .001 per 1 SD increase in future time perspective). This association remained after adjusting for baseline socioeconomic status and health (HR = 0.92; 95% CI: [0.88, 0.97], p < .001). The link between time perspective and mortality was observed across the gradient of financial circumstances and did not appear to be due to reverse causality. Healthy behavior among the more future orientated explained 34% of the link between time perspective and mortality.

Conclusions: Using a simply administered indicator of time perspective, this study suggests that a future-orientated time perspective may be an important predictor of reduced risk of death.
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http://dx.doi.org/10.1093/abm/kay046DOI Listing
March 2019

Neuroimaging, neuromodulation, and population health: the neuroscience of chronic disease prevention.

Ann N Y Acad Sci 2018 09 4;1428(1):240-256. Epub 2018 Jun 4.

Department of Psychology, Ohio State University, Columbus, Ohio.

Preventable chronic diseases are the leading cause of death in the majority of countries throughout the world, and this trend will continue for the foreseeable future. The potential to offset the social, economic, and personal burdens associated with such conditions depends on our ability to influence people's thought processes, decisions, and behaviors, all of which can be understood with reference to the brain itself. Within the health neuroscience framework, the brain can be viewed as a predictor, mediator, moderator, or outcome in relation to health-related phenomena. This review explores examples of each of these, with specific reference to the primary prevention (i.e., prevention of initial onset) of chronic diseases. Within the topic of primary prevention, we touch on several cross-cutting themes (persuasive communications, delay discounting of rewards, and self-control), and place a special focus on obesity as a disorder influenced by both eating behavior and exercise habits.
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http://dx.doi.org/10.1111/nyas.13868DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6175225PMC
September 2018

The neurocognitive mechanisms underlying food cravings and snack food consumption. A combined continuous theta burst stimulation (cTBS) and EEG study.

Neuroimage 2018 08 6;177:45-58. Epub 2018 May 6.

Prevention Neuroscience Lab, School of Public Health and Health Systems, University of Waterloo, Waterloo, ON, N2L 3G1, Canada. Electronic address:

Regulation of food cravings is thought to be critical for modulating eating behavior, yet we do not fully understand the mechanisms by which cognitive control operates in the eating context. The current study combined rTMS and EEG paradigms to examine the causal role of the left dorsolateral prefrontal cortex (dlPFC) in modulating visceral and behavioral responses to high calorie foods, and the mediational mechanisms underlying this relation. 28 right-handed female participants received both active and sham continuous theta burst stimulation (cTBS; a rTMS variant used to decrease cortical activity) targeting the left dlPFC in a counterbalanced order. Prior to and following each stimulation session participants completed a flanker and food-cue presentation (high and low calorie food) task. Following cTBS participants had the opportunity to consume both high and low calorie foods during a taste test. Findings revealed a reliable effect of cTBS on food consumption, such that participants selectively ingested significantly more calories from appetitive calorie dense snack foods following active relative to sham cTBS; this effect did not translate to control (low calorie) food consumption. In addition, attenuation of dlPFC activity resulted in the significant increase in N2 amplitude and P3b latency to incongruent flanker trials, and the selective significant increase in the P3a amplitude to and P3a amplitude bias for high calorie food stimuli. Results from the parallel mediation analysis revealed that only the indirect effect of flanker task performance was significant; the indirect effects of stimulation induced changes in the P3 bias for high calorie foods, the urge to consume high calorie foods, and the general liking ratings for high calorie foods were not significant. These findings confirm the causal role of the left dlPFC in the modulation of calorie dense food consumption via inhibitory control capacity.
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http://dx.doi.org/10.1016/j.neuroimage.2018.05.013DOI Listing
August 2018

Effects of left dlPFC modulation on social cognitive processes following food sampling.

Appetite 2018 07 27;126:73-79. Epub 2018 Mar 27.

Western University and Parkwood Institute-Mental Health, Canada.

Background: The dorsolateral prefrontal cortex (dlPFC) plays a central role in the inhibition of eating, but also the modulation of conscious thought processes that might precede, accompany or follow initial food tasting. The latter might be particularly important to the extent that post-tasting cognitions may drive prolonged eating beyond the satiety point. However, we know very little about the effect of the dlPFC on conation following initial food sampling. This investigation compared the effects of dlPFC attenuation using repetitive transcranial magnetic stimulation (rTMS) on social cognition following (Study 1) and prior to (Study 2) a food consumption opportunity.

Methods: In Study 1, participants (N = 21; M = 21 years) were randomized to active or sham continuous theta-burst stimulation (cTBS; an inhibitory variant of rTMS) targeting the left dlPFC followed by an interference task. Participants subsequently completed measures of attitudes, norms and perceived control following a mock taste test. In Study 2, a second sample of right handed participants (N = 37; M = 21 years) were assigned to active or sham cTBS, followed by an interference task and two measures of attitudes (implicit and explicit), both assessed prior to the same taste test paradigm.

Results: In Study 1, findings revealed a reliable effect of cTBS on post-tasting attitudes (t(1,19) = 3.055, p = .007; d = 1.34), such that attitudes towards calorie dense snack foods were significantly more positive following active stimulation than following sham stimulation. Similar effects were found for social norms (t(1,19) = 3.024, p = .007, d = 1.31) and perceived control (t(1,20) = 19.247, p < .001, d = 0.50). In Study 2, no effects of cTBS were observed on pre-consumption attitudes, despite reliable effects on interference scores and subsequent consumption.

Conclusions: The left dlPFC may selectively modulate facilitative social cognition following initial food sampling (but not pre-consumption).
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http://dx.doi.org/10.1016/j.appet.2018.03.022DOI Listing
July 2018

Study protocol for Vitality: a proof-of-concept randomised controlled trial of exercise training or complex mental and social activities to promote cognition in adults with chronic stroke.

BMJ Open 2018 03 17;8(3):e021490. Epub 2018 Mar 17.

Department of Physical Therapy, University of British Columbia, Vancouver, British Columbia, Canada.

Introduction: Cerebrovascular disease-such as stroke-is the second most common cause of dementia (ie, vascular dementia). Specifically, a stroke increases one's risk for dementia by a factor of two. Thus, stroke survivors represent a target population in need of intervention strategies to promote cognitive function and prevent dementia. The current standard of care in stroke rehabilitation does not adequately address the significant cognitive consequences of stroke, especially for those who are in the chronic phase (ie, >12 months since an index stroke). Two potential intervention strategies are: (1) exercise training and (2) cognitive and social enrichment activities.

Methods And Analysis: The aim of this proof-of-concept randomised controlled trial is to determine whether a 6-month targeted exercise training programme or a 6-month cognitive and social enrichment programme can efficaciously and efficiently improve cognitive function in older adults with chronic stroke compared with a 6-month stretch and tone programme (ie, control). The primary measurement periods will be baseline, month 6 (postintervention) and month 12 (6-month follow-up). The primary outcome measure will be performance on the Alzheimer's Disease Assessment Scale-Cognitive-Plus (ADAS-Cog-Plus), a global measure of cognitive performance using multidimensional item response theory to summarise scores from the 13-item ADAS-Cog and other standard cognitive assessments. The primary analysis will compare changes in ADAS-Cog-Plus performance from baseline to month 6. Proof-of-concept outcomes relating to intervention feasibility will be analysed descriptively. The economic evaluation will examine the incremental costs and health outcome benefits generated by both interventions versus the control.

Ethics And Dissemination: Ethical approval has been obtained from the University of British Columbia's Clinical Research Ethics Board (H13-00715, 26 July 2013). Any modifications to the protocol will require a formal amendment to the protocol and approval by the Research Ethics Board. Outcomes of this randomised controlled trial and the statistical code to generate those outcomes will be disseminated through publication in peer-reviewed journals as well as conference presentations.

Trial Registration Number: NCT01916486.
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http://dx.doi.org/10.1136/bmjopen-2018-021490DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5875626PMC
March 2018

The effects of theta burst stimulation (TBS) targeting the prefrontal cortex on executive functioning: A systematic review and meta-analysis.

Neuropsychologia 2018 03 10;111:344-359. Epub 2018 Feb 10.

Prevention Neuroscience Lab, School of Public Health and Health Systems, University of Waterloo, Waterloo, ON, Canada N2L 3G1. Electronic address:

Theta burst stimulation (TBS) is a highly efficient repetitive transcranial magnetic stimulation (rTMS) variant employed in experimental and clinical treatment paradigms. Despite widespread usage of TBS targeting the prefrontal cortex (PFC), there has been no systematic review of the evidence linking TBS protocols to changes in task performance on common measures of prefrontal function in general, and executive functions specifically. A systematic review of the literature was conducted using PsycINFO, PubMed, Web of Science and Scopus databases to identify articles examining the effects of TBS targeting the PFC on executive function task performance. Both the up-regulating (intermittent theta burst stimulation; iTBS) and down-regulating (continuous theta burst stimulation; cTBS) variants of TBS were considered. 32 (29 cTBS; 8 iTBS) studies met the inclusion criteria. Participants (n = 759; 51.41% female) were primarily young adults (M = 26), with one study examining the effects of cTBS and iTBS in older adults. Results from individual studies were converted to Hedge's g and random-effects models were used to estimate the overall effect size for each protocol. Age, biological sex, and control methodology were examined as potential moderators of the cTBS effect on executive function test performance. Findings indicated a- reliable attentuating effect of cTBS on executive function task performance (g = -.244, Z = -5.920, p < .001); this effect was relatively uniform across included studies (Q= 24.178, p = .838, I = 0). Although no significant moderators of the cTBS effect were identified, laterality sub analyses indicated that the magnitude of the effect was significantly higher (M = .213, Z = 2.546, p = .011) for left-sided (g = -.358, Z = -5.816, p < .001) relative to right-sided (g = -.145, Z = -2.552, p = .011) PFC stimulation. A systematic review of iTBS studies revealed variability in reliability of effects though most were in the theorized direction. TBS protocols appear to be effective in modulating prefrontal cortical excitability in previously theorized directions.
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http://dx.doi.org/10.1016/j.neuropsychologia.2018.02.004DOI Listing
March 2018

The politics of social status: economic and cultural roots of the populist right.

Br J Sociol 2017 Nov;68 Suppl 1:S57-S84

Harvard University.

This paper explores the factors that have recently increased support for candidates and causes of the populist right across the developed democracies, especially among a core group of working-class men. In the context of debates about whether the key causal factors are economic or cultural, we contend that an effective analysis must rest on understanding how economic and cultural developments interact to generate support for populism. We suggest that one way to do so is to see status anxiety as a proximate factor inducing support for populism, and economic and cultural developments as factors that combine to precipitate such anxiety. Using cross-national survey data from 20 developed democracies, we assess the viability of this approach. We show that lower levels of subjective social status are associated with support for right populist parties, identify a set of economic and cultural developments likely to have depressed the social status of men without a college education, and show that the relative social status of those men has declined since 1987 in many of the developed democracies. We conclude that status effects provide one pathway through which economic and cultural developments may combine to increase support for the populist right.
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http://dx.doi.org/10.1111/1468-4446.12319DOI Listing
November 2017

Frontal alpha asymmetry and aerobic exercise: are changes due to cardiovascular demand or bilateral rhythmic movement?

Biol Psychol 2018 02 2;132:9-16. Epub 2017 Nov 2.

University of Waterloo, Kinesiology, 200 University Avenue West, B.C. Matthews Hall, N2L 3G1, Canada.

The left and right prefrontal cortices are linked to networks that control approach and withdrawal motivation, respectively. The relationship between activity in the left and right prefrontal activity is used to assess brain states and specifically their link to motivational behaviours and tendencies. The most common measure used in this context is called the frontal alpha asymmetry (FAA), which compares alpha (8-13Hz) power at each region. Interestingly, research shows that FAA is influenced by aerobic exercise by increasing relative left prefrontal cortex activity. In turn this effect may be beneficial for individuals with mood disorders that are associated with abnormal motivational tendencies. However, it is unknown whether changes in FAA after exercise are due to cardiovascular demands of activity or simply the movement required for the exercise. Therefore, this study aimed to investigate the influence of aerobic exercise and 'no intensity' bilateral movement cycling on FAA in young healthy adults. Results showed aerobic exercise caused a significant increase in FAA scores 22-38min after exercise. However, movement did not lead to a significant change in FAA. This suggests there is an intensity required for physical activity to evoke a change in FAA.
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http://dx.doi.org/10.1016/j.biopsycho.2017.10.011DOI Listing
February 2018

Brain Stimulation Effects on Food Cravings and Consumption: An Update on Lowe et al. (2017) and a Response to Generoso et al. (2017).

Psychosom Med 2017 09;79(7):839-842

Faculty of Applied Health Sciences, University of Waterloo, Waterloo, Ontario, Canada;School of Public Health and Health Systems, University of Waterloo, Waterloo, Ontario, Canada;Faculty of Medicine, University of Toronto.

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http://dx.doi.org/10.1097/PSY.0000000000000504DOI Listing
September 2017

The neurocognitive consequences of sleep restriction: A meta-analytic review.

Neurosci Biobehav Rev 2017 Sep 28;80:586-604. Epub 2017 Jul 28.

School of Public Health and Health Systems, University of Waterloo, Waterloo, ON, N2L 3G1, Canada.

The current meta-analytic review evaluated the effects of experimentally manipulated sleep restriction on neurocognitive functioning. Random-effects models were employed to estimate the overall effect size and the differential effect size across cognitive domains. Age, time of day, age-adjusted sleep deficit, cumulative days of restricted sleep, sleep latency, subjective sleepiness, and biological sex were examined as potential moderators of the effect. Based on a sample of 61 studies, from 71 different populations, findings revealed a significant negative effect of sleep restriction on cognitive processing across cognitive domains (g=-0.383, p<0.001). This effect held for executive functioning (g=-0.324, p<0.001), sustained attention (g=-0.409, p<0.001), and long-term memory (g=-0.192, p=0.002). There was insufficient evidence to detect an effect within the domains of attention, multitask, impulsive decision-making or intelligence. Age group, time of day, cumulative days of restricted sleep, sleep latency, subjective sleepiness, and biological sex were all significant moderators of the overall effect. In conclusion, the current meta-analysis is the first comprehensive review to provide evidence that short-term sleep restriction significantly impairs waking neurocognitive functioning.
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http://dx.doi.org/10.1016/j.neubiorev.2017.07.010DOI Listing
September 2017

Larger Lateral Prefrontal Cortex Volume Predicts Better Exercise Adherence Among Older Women: Evidence From Two Exercise Training Studies.

J Gerontol A Biol Sci Med Sci 2017 Jun;72(6):804-810

Djavad Mowafaghian Centre for Brain Health and.

Background: Recent research has suggested an important role of lateral prefrontal cortex (lPFC) in consistent implementation of positive health behaviors and avoidance of negative health behaviors.

Methods: We examined whether gray matter volume in the lPFC prospectively predicts exercise class attendance among older women (n = 122) who underwent either a 52-week or 26-week exercise training intervention. Structural magnetic resonance imaging determined gray matter volume at baseline.

Results: Independent of intracranial volume, age, education, body composition, mobility, depressive symptoms, and general cognitive functioning, larger lPFC volume predicted greater exercise class attendance (all p values < .05). Follow-up whole-brain analyses further confirmed that regions in the lPFC-especially the left middle frontal gyrus (p < .005)-predicted future exercise adherence as well as identified other regions, especially in the insula and temporal cortex, that predicted exercise adherence.

Conclusions: These findings suggest that sustained engagement in exercise training might rely in part on functions of the lPFC and that lPFC volume might be a reasonable proxy for such functions.
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http://dx.doi.org/10.1093/gerona/glx043DOI Listing
June 2017

Non-invasive brain stimulation for food cravings, consumption, and disorders of eating: A review of methods, findings and controversies.

Appetite 2018 05 11;124:78-88. Epub 2017 Mar 11.

Division of Geriatric Psychiatry at Western University and Parkwood Institute-Mental Health, London, Ontario, Canada.

Objective: To describe the state of the human research literature pertaining to the use of non-invasive brain stimulation (NIBS) procedures for modulating food cravings, food consumption, and treating disorders of eating (i.e., obesity, bulimia nervosa, and anorexia nervosa).

Methods: A narrative review of methods, empirical findings, and current areas of controversy. Both single-session experimental and multi-session therapeutic modalities are considered, separately for repetitive transcranial magnetic stimulation (rTMS) and transcranial direct current stimulation (tDCS) technologies.

Results: Single-session studies involving NIBS report more consistent effects of rTMS than tDCS, but this advantage is more clear in relation to food cravings than actual food consumption. Multisession therapeutic approaches have been applied to both obesity and eating disorders. With respect to obesity, the three published (tDCS) and one ongoing trial (rTMS) have yielded promising though very preliminary findings. Application of multi-session NIBS (predominantly rTMS) to eating disorders has also yielded promising but ultimately inconclusive results, both in relation to bulimia nervosa and binge eating disorder. Findings regarding excitatory NIBS in the context of anorexia are more controversial, with evidence of improvement in affective functioning, but a trend of iatrogenic weight loss.

Conclusions: Excitatory NIBS-particularly rTMS-can reliably reduce food cravings in single and multi-session format. For multi-session treatment of clinical conditions, more studies are needed for both rTMS and tDCS, particularly in relation to obesity, bulimia, and binge eating disorder. Application of NIBS for anorexia is less clear at this point, and excitatory NIBS may be contraindicated on theoretical and empirical grounds.
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http://dx.doi.org/10.1016/j.appet.2017.03.006DOI Listing
May 2018

The Neurobiology of Health Communication.

Psychosom Med 2017 05;79(4):376-378

From the University of Waterloo (Hall), Waterloo, Canada; and University of Pittsburgh (Erickson, Gianaros), Pittsburgh, Pennsylvania.

This issue of Psychosomatic Medicine describes findings from an innovative study by Kang et al that used neuroimaging methods to quantify neural responses to health communications. Findings indicated that sedentary individuals who hold self-transcendent values show attenuated limbic threat responses to communications about the benefits of physical activity. Furthermore, participants who were instructed to articulate such values showed some evidence of additional blunting of the same neural response. In this editorial, we provide context for the interpretation of these findings within the existing research using the brain-as-predictor approach, and other recent trends within biobehavioral medicine involving the use of neuroscience methods in the service of health behavior change.
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http://dx.doi.org/10.1097/PSY.0000000000000457DOI Listing
May 2017

An exploration of exercise-induced cognitive enhancement and transfer effects to dietary self-control.

Brain Cogn 2016 12 23;110:102-111. Epub 2016 Apr 23.

School of Public Health & Health Systems, University of Waterloo, Waterloo, Ontario, Canada; Department of Kinesiology, University of Waterloo, Waterloo, Ontario, Canada. Electronic address:

The primary objective of this study was to examine the effects of aerobic exercise on executive function, specifically inhibitory control, and the transfer to self-control in the dietary domain. It was hypothesized that exercise would enhance inhibitory control, and that this enhancement would facilitate self-control in a laboratory taste test paradigm. Using a crossover design, 51 participants completed counterbalanced sessions of both moderate exercise (experimental condition) and minimal effort walking (control condition) using a treadmill; the intersession interval was 7days. Prior to each exercise bout participants completed a Stroop task. Following each bout participants completed a second Stoop task, as well as a bogus taste test involving three appetitive calorie dense snack foods and two control foods; the amount of each food type consumed during the taste test was covertly measured. Results revealed that moderate exercise significantly improved performance on the Stroop task, and also reduced food consumption during the taste test for appetitive calorie dense snack foods; there was no exercise effect on control food consumption. Exercise-induced gains in Stroop performance mediated the effects of moderate exercise on appetitive snack food consumption. Together these findings provide evidence that a bout of a moderate aerobic exercise can enhance inhibitory control, and support for cross-domain transfer effects to dietary self-control.
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http://dx.doi.org/10.1016/j.bandc.2016.04.008DOI Listing
December 2016
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