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- Feasibility and acceptability of an exergame intervention for schizophreniaPublication . Campos, Carlos; Mesquita, Filipa; Marques, António; Trigueiro, Maria João; Orvalho, Verónica; Rocha, NunoObjectives To evaluate the feasibility and acceptability of an exergame intervention as a tool to promote physical activity in outpatients with schizophrenia. Design Feasibility/Acceptability Study and Quasi-Experimental Trial. Method Sixteen outpatients with schizophrenia received treatment as usual and they all completed an 8-week exergame intervention using Microsoft Kinect® (20 min sessions, biweekly). Participants completed pre and post treatment assessments regarding functional mobility (Timed Up and Go Test), functional fitness performance (Senior Fitness Test), motor neurological soft signs (Brief Motor Scale), hand grip strength (digital dynamometer), static balance (force plate), speed of processing (Trail Making Test), schizophrenia-related symptoms (Positive and Negative Syndrome Scale) and functioning (Personal and Social Performance Scale). The EG group completed an acceptability questionnaire after the intervention. Results Attrition rate was 18.75% and 69.23% of the participants completed the intervention within the proposed schedule. Baseline clinical traits were not related to game performance indicators. Over 90% of the participants rated the intervention as satisfactory and interactive. Most participants (76.9%) agreed that this intervention promotes healthier lifestyles and is an acceptable alternative to perform physical activity. Repeated-measures MANOVA analyses found no significant multivariate effects for combined outcomes. Conclusion This study established the feasibility and acceptability of an exergame intervention for outpatients with schizophrenia. The intervention proved to be an appealing alternative to physical activity. Future trials should include larger sample sizes, explore patients' adherence to home-based exergames and consider greater intervention dosage (length, session duration, and/or frequency) in order to achieve potential effects.
- An unobtrusive stress detection software: Protocol design to assess the reliability of video plethysmographyPublication . Ferreira, Simão; Rodrigues, Matilde; Campos, Carlos; Rocha, NunoSoftware solutions for stress detection have been emerging. Existing solutions still largely rely on supervised learning methods, requiring extremely large sets of labeled data for each situation. Stress assessment using video plethysmography is a recent method that needs further investigation. The room lighting conditions and the person’s movement have been identified as the main barriers to the software progression. Thus, it is necessary to build a laboratory pilot that will take into account these difficulties. We present an in-depth protocol on how to assess the reliability of a video facial recognition software on collecting physiological data (heart rate and blinking).
- Análise do padrão motor em pessoas com diagnóstico de esquizofrenia: uma abordagem em tempo realPublication . Sá, Fátima; Marques, António; Campos, Carlos; Trigueiro, Maria João; Rocha, NunoAs alterações motoras são consistentemente observadas na esquizofrenia, embora estudos nesta área com recurso a ferramentas válidas de análise cinemática do movimento sejam ainda escassos (Kent et al., 2012; Putzhammer & Klein, 2006; Walther & Strik, 2012). Verificar se os indivíduos com esquizofrenia apresentam alterações na coordenação motora, comparativamente com indivíduos sem diagnóstico, bem como analisar se a presença dos sinais neurológicos subtis (SNS) motores se encontra correlacionada com o funcionamento executivo e psicopatológico na esquizofrenia. Participaram 29 indivíduos (13 com diagnóstico de esquizofrenia e 16 sem diagnóstico) equivalentes em termos de idade, género, escolaridade e índice de massa corporal. Para a recolha de dados utilizou-se a Positive and Negative Sindrome Scale (PANSS), o subteste do Vocabulário (WAIS-III edição), o teste da fluência verbal, a Brief Motor Scale (BMS) e o sistema de parametrização do movimento em tempo real – Biostage. Encontraram-se alterações na coordenação motora nos indivíduos com esquizofrenia, recrutando estes um padrão motor menos desenvolvido e com menor individualização das componentes, comparativamente com os indivíduos sem a perturbação. Verificou-se também que o grupo de pessoas com esquizofrenia é caracterizado por uma alta prevalência dos SNS motores (média BMS = 6,01), estabelecendo este domínio uma relação boa com o desempenho verbal (rho Spearman=-0,62) e uma relação forte e positiva com todos os domínios psicopatológicos da PANSS (rho Spearman=0,74). A compreensão da existência das alterações motoras como parte intrínseca da esquizofrenia é fundamental, permitindo o desenvolvimento de práticas mais efetivas na área da saúde e reabilitação.
- Kinematic parameters of throwing performance in patients with schizophrenia using a markerless motion capture systemPublication . Sá, Fátima; Marques, António; Rocha, Nuno; Trigueiro, Maria João; Campos, Carlos; Schröder, JohannesMotor dysfunction is consistently reported but understudied in schizophrenia. It has been hypothesized that this abnormality may reflect a neuro-developmental disorder underlying this illness. The main goal of this study was to analyze movement patterns used by participants with schizophrenia and healthy controls during overarm throwing performance, using a markerless motion capture system. Thirteen schizophrenia patients and 16 healthy control patients performed the overarm throwing task in a markerless motion capture system. Participants were also examined for the presence of motor neurological soft signs (mNSS) using the Brief Motor Scale. Schizophrenia patients demonstrated a less developed movement pattern with low individualization of components compared to healthy controls. The schizophrenia group also displayed a higher incidence of mNSS. The presence of a less mature movement pattern can be an indicator of neuro-immaturity and a marker for atypical neurological development in schizophrenia. Our findings support the understanding of motor dysfunction as an intrinsic part of the disorder of schizophrenia.
- Attachment Dimensions and Spatial Navigation in Female College Students: The Role of Comfort With Closeness and Confidence in OthersPublication . Rocha, Nuno; Lemos, Andreia; Campos, Carlos; Rocha, Susana; Yamamoto, Tetsuya; Machado, Sérgio; Murillo-Rodriguez, EricThere is preliminary evidence suggesting that hippocampal functioning is associated with attachment style. However, it is unknown if attachment is also associated with hippocampal-related cognitive function such as spatial learning and recall. This study aims to verify if attachment dimensions are associated with spatial learning and recall. Sixty-five female participants were recruited and were evaluated using the Adult Attachment Scale-R and tested on a virtual maze navigation task (VMT) at one moment (exploratory trial + 3 trials) and 24 h later (3 trials). There was a significant Moment × Trial × Close-Depend interaction for the outcome time, F(2,126) = 3.807, p = 0.025, with post hoc analysis indicating that the High Close-Depend group displayed significant improvements between Trial 1 and Trial 3 in the post-test assessment. Conversely, the Low Close-Depend group displayed significant improvements between Trial 1and Trial 3 but on the pre-test assessment. Furthermore, the Low Close-Depend group presented significant better performance in pre-test Trial 3 in comparison to the High Close-Depend group. Thereby, it seems that low comfort with proximity and trust in others is associated with reduced spatial recall, although spatial learning performance was actually superior in these participants. It is possible that reduced exposure to social interaction and meaningful relationships may be reduced in the Low Close-Depend group, leading to modifications in hippocampal function and, ultimately, reduced spatial recall. Oppositely, participants in the High Close-Depend group may not display typical spatial learning in the proposed task as they are more willing to freely explore the presented environment.
- Refining the link between psychopathy, antisocial behavior, and empathy: a meta-analytical approach across different conceptual frameworksPublication . Campos, Carlos; Pasion, Rita; Azeredo, Andreia; Eduarda, Ramião; Mazer, Prune; Machado, Inês; Barbosa, FernandoThe current meta-analysis included 431 records (N= 123,414) to comprehensively explore the complex interaction between psychopathy, antisocial behavior, and empathy. First, empathy domains (cognitive and affective) were used to provide critical insights for distinguishing antisocial behavior from psychopathy. Cognitive empathy was more impaired in antisocial groups (gcognitive= -.40; gaffective= -.11), while high psychopathy samples displayed larger deficits in affective empathy (gaffective= -.44; gcognitive= -.23), although this dissociation was not clear in correlational analyses. Secondly, the specific associations between empathy domains and psychopathy dimensions were evaluated. Psychopathy traits closely related to antisocial behavior were mildly associated with both empathy domains (r= -.07 to -.14). Callous-affective traits were largely associated with affective empathy (r= -.32 to -.35) and moderately correlated to cognitive empathy (r= -.26). Diverging results were found for the interpersonal dimension, as boldness-adaptive manifestations were unrelated to cognitive empathy (r= .05), while non-adaptive interpersonal traits were negatively associated with both empathy domains (rcognitive= -.14; raffective= -.25). Overall, these findings suggest that: (1) psychopathy and antisocial behavior display distinct empathic profiles; (2) psychopathy dimensions are differentially associated with cognitive and affective empathy; (3) the interaction between interpersonal traits and empathic processes is different across the conceptual models of psychopathy.
- Aerobic exercise reduces anxiety symptoms and improves fitness in patients with panic disorderPublication . Lamego, Murilo Khede; Lattari, Eduardo; Sá Filho, Alberto Souza de; Paes, Flávia; Mascarenhas Jr., Jarbas; Maranhão Neto, Geraldo; Oliveira, Aldair José de; Campos, Carlos; Rocha, Nuno; Nardi, Antonio E.; Machado, SergioTo investigate the effects of a regularly repeated aerobic exercise series on anxiety and maximum oxygen consumption (VO2max) in Panic Disorder patients. METHODS: Ten previously sedentary female subjects diagnosed with Panic Disorder performed 36 sessions of aerobic exercise (at 70 to 75% of VO2max), 3 times per week during 12 weeks. A cardiopulmonary evaluation (ergospirometry test) was used to set the intensity of training as well as to establish baseline and post-training VO2max parameters. The assessment of anxiety symptoms was performed at baseline, at the end of the 6th and 12th weeks, using the Trait Anxiety Inventory (STAI-T) and State Anxiety Inventory (STAI-S), and the Subjective Units of Distress Scale (SUDS) questionnaires. One-way ANOVA for repeated measurements (at 3 moments: Baseline, 6th week (mid-training) and 12th week (post-training) was used to compare the evolution of the questionnaires; the Bonferroni post hoc test was applied to identify differences between moments. A dependent t-test was performed for measures of VO2max. RESULTS: Compared to baseline, (a) STAI-T showed significant anxiety reductions at mid- and post-training moments; (b) STAI-S and SUDS recorded anxiety reductions only at Post-training; (c) VO2max showed a significant improvement at Post-training. CONCLUSION: This protocol promoted beneficial effects on cardiorespiratory fitness and anxiety levels of Panic Disorder patients.
- Dissociating self reported interoceptive accuracy and attention: Evidence from a Portuguese community samplePublication . Campos, Carlos; Rocha, Nuno; Barbosa, FernandoThe 2x2 factorial model has been recently proposed as a promising framework to measure individual differences in interoception. The first factor addresses which domain is being measured (interoceptive accuracy vs. attention), while the second distinguishes how it is being measured (self-report beliefs vs. objective performance). The current study examined the association between self-reported interoceptive accuracy and attention. We hypothesized no linear association between these constructs, although a quadratic U-shaped association was expected. Furthermore, alexithymia should be differentially related to interoceptive accuracy and attention. An online community sample (*n *= 515) completed the Interoceptive Accuracy Scale (IAS), the Body Perception Questionnaire (BPQ) *ndexing self-reported interoceptive attention, and the Toronto Alexithymia Scale (TAS). Pearson correlations, Steiger’s Z-test, polynomial regression analysis, and two-lines testing were used for statistical analysis. IAS was positively correlated with BPQ, r = .204, p < .001. In the polynomial regression analysis, the linear model indicated a positive association between IAS and BPQ (4.2%), but the quadratic term explained an additional 12.7% of the variance. Two-lines testing indicated a U-shaped association between self-report interoceptive accuracy and attention. IAS was negatively correlated with TAS, r = -.291, p < .001, while there was no significant association between BPQ and TAS, r = -.030, p = .500, as these correlations were statistically different. These results suggest that interoceptive accuracy and attention can be dissociated using self-report measures and may display a quadratic U-shaped association, providing further evidence for the 2x2 factorial model. Future studies should explore the non-linear relationship between interoceptive accuracy and attention using alternative questionnaires and performance-based measures.
- Allostatic interoception in frontotemporal dementia: A scoping review protocolPublication . Carneiro, Fábio; Hazelton, Jessica L.; Campos, Carlos; Ibáñez, Agustín; Ferreira-Santos, FernandoFrontotemporal dementia (FTD) encompasses a spectrum of disorders characterized by distinct behavioral, cognitive, and motor symptoms. Deficits in interoception and allostasis have garnered attention, considering the involvement of the allostatic-interoceptive network in FTD, their contribution to canonical social cognitive and affective deficits, and the identification of whole-body biomarkers related to autonomic and allostatic processes. Traditionally, interoception has been defined as the perception of visceral signals, yet contemporary understandings broaden this to encompass both the representation and regulation of the physiological state across bodily tissues. Consequently, interoceptive deficits in FTD extend beyond classical viscerosensory paradigms to include pain, temperature, autonomic, metabolic, immune, and neuroendocrine phenomena. Allostasis involves the prospective regulation of energy balance, as well as the anticipation and adaptive response to homeostatic challenges. These repeated challenges result in physiological consequences measurable by markers of allostatic load, spanning various bodily systems. Despite emerging evidence highlighting dysfunction in interoception and allostasis in FTD, the literature remains fragmented, lacking cohesive reviews addressing the diverse mechanisms comprehensively. Thus, this scoping review examines the reciprocal interaction between brain and bodily physiology (interoception) and the physiological responses to environmental demands (allostatic load) in FTD. Following the principles outlined in the PRISMA statement, we will systematically search and screen quantitative primary research studies on patients with FTD, utilizing interoceptive or allostatic metrics. By synthesizing the existing literature, we aim to identify active research areas, delineate primary deficits across physiological systems, uncover syndrome-specific patterns of dysfunction, and identify the most promising and understudied domains in this field.
- Neuroplastic Changes Following Social Cognition Training in Schizophrenia: A Systematic ReviewPublication . Campos, Carlos; Santos, Susana; Gagen, Emily; Machado, Sérgio; Rocha, Susana; Kurtz, Matthew M; Rocha, NunoSocial cognitive impairment is a key feature of schizophrenia and social cognition training (SCT) is a promising tool to address these deficits. Neurobiological dysfunction in schizophrenia has been widely researched, but neuronal changes induced by SCT have been scarcely explored. This review aims to assess the neuroplastic effects of SCT in patients with schizophrenia spectrum disorders. PubMed and Web of Science databases were searched for clinical trials testing the effects of SCT in functional and structural brain measurements of adult patients with schizophrenia or schizoaffective disorders. A total of 11 studies were included: five used fMRI, two used EEG and ERP, one used ERP only, two used MEG and one study used MRI. Data extracting and processing regarding sociodemographic and clinical variables, intervention characteristics, neuroimaging procedures, neuroplastic findings, effect sizes and study quality criteria was completed by two raters. Results indicate a wide range of structural and functional changes in numerous regions and circuits of the social brain, including early perceptual areas, the limbic system and prefrontal regions. Despite the small number of trials currently available, evidence suggests that SCT is associated with neuroplastic changes in the social brain and concomitant improvements in social cognitive performance. There is a lack of extensive knowledge about the neural mechanisms that underlie social cognitive enhancement after treatment, but the reported findings may shed light on the neural substrates of social cognitive impairment in schizophrenia and how improved treatment procedures can be developed and applied.