Recent stressful life events (SLE) are a risk factor for psychosis, but limited research has explored how SLEs affect individuals at clinical high risk (CHR) for psychosis. The current study investigated the longitudinal effects of SLEs on functioning and symptom severity in CHR individuals, where we hypothesized CHR would report more SLEs than healthy controls (HC), and SLEs would be associated with poorer outcomes.

The study used longitudinal data from the EU-GEI High Risk study. Data from 331 CHR participants were analyzed to examine the effects of SLEs on changes in functioning, positive and negative symptoms over a 2-year follow-up. We compared the prevalence of SLEs between CHR and HCs, and between CHR who did (CHR-T) and did not (CHR-NT) transition to psychosis.

CHR reported 1.44 more SLEs than HC (p < 0.001), but there was no difference in SLEs between CHR-T and CHR-NT at baseline. Recent SLEs were associated with poorer functioning and more severe positive and negative symptoms in CHR individuals (all p < 0.01) but did not reveal a significant interaction with time.

CHR individuals who had experienced recent SLEs exhibited poorer functioning and more severe symptoms. However, as the interaction between SLEs and time was not significant, this suggests SLEs did not contribute to a worsening of symptoms and functioning over the study period. SLEs could be a key risk factor to becoming CHR for psychosis, however further work is required to inform when early intervention strategies mitigating against the effects of stress are most effective.

Contrast-induced encephalopathy (CIE) is an adverse event associated with diagnostic and therapeutic endovascular procedures. Decades of animal and human research support a mechanistic role for pathological blood-brain barrier dysfunction (BBBd). Here, we describe an institutional case series and review the literature supporting a mechanistic role for BBBd in CIE.

A literature review was conducted by searching MEDLINE, Web of Science, Embase, CINAHL and Cochrane databases from inception to January 31, 2022. We searched our institutional neurovascular database for cases of CIE following endovascular treatment of cerebrovascular disease during a 6-month period. Informed consent was obtained in all cases.

Review of the literature revealed risk factors for BBBd and CIE, including microvascular disease, pathological neuroinflammation, severe procedural hypertension, iodinated contrast load and altered cerebral blood flow dynamics. In our institutional series, 6 of 52 (11.5%) of patients undergoing therapeutic neuroendovascular procedures developed CIE during the study period. Four patients were treated for ischemic stroke and two patients for recurrent cerebral aneurysms. Mechanical stenting or thrombectomy were utilized in all cases.

In this institutional case series and literature review of animal and human data, we identified numerous shared risk factors for CIE and BBBd, including microvascular disease, increased procedure length, large contrast volumes, severe intraoperative hypertension and use of mechanical devices that may induce iatrogenic endothelial injury.

Obstructive sleep apnea (OSA) is a sleep disorder with no widely accepted pharmacological therapy. Cannabinoids have been suggested to reduce OSA severity in small human studies. The purpose of this retrospective cohort study was to explore the association of self-reported cannabis use on OSA severity and sleep parameters in a large cohort of adults undergoing in-laboratory polysomnography.

Sleep and medication data were collected for all consecutive adults who completed diagnostic polysomnography at Sunnybrook Health Sciences Centre from 2010 to 2022. Multivariable linear regression models were employed that adjusted for age, sex, and BMI (minimally adjusted model), as well as medication and comorbidity data (maximally adjusted model). An exploratory subgroup analysis was additionally run in patients with moderate to severe OSA.

Of 6,958 individuals (mean age 54.7 ± 16.3, BMI 29.1 ± 6.8, 51.0% female), 71 reported cannabis use. In our minimally adjusted models, cannabis use predicted a reduced respiratory disturbance index (RDI) (β: −4.8 [95% CI: −9.4, −0.2]; p = 0.042); this association became nonsignificant in the fully adjusted models. In an exploratory analysis of patients with moderate to severe OSA (n = 613), cannabis use (n = 7) predicted increased stage N3 sleep (β: 33.5 [95% CI: 15.6, 51.4]; p < 0.001) and decreased REM sleep (β: 16.0 [95% CI: 0.3, 31.7]; p = 0.046).

Self-reported cannabis use was not associated with OSA severity after adjusting for confounders. In an exploratory subgroup analysis of patients with moderate to severe OSA, cannabis use impacted sleep architecture. Future studies should further explore these findings.

Psychotic experiences (PEs) and social isolation (SI) seem related during early stages of psychosis, but the temporal dynamics between the two are not clear. Literature so far suggests a self-perpetuating cycle wherein momentary increases in PEs lead to social withdrawal, which, subsequently, triggers PEs at a next point in time, especially when SI is associated with increased distress. The current study investigated the daily-life temporal associations between SI and PEs, as well as the role of SI-related and general affective distress in individuals at clinical high risk (CHR) for psychosis.

We used experience sampling methodology in a sample of 137 CHR participants. We analyzed the association between SI, PEs, and distress using time-lagged linear mixed-effects models.

SI did not predict next-moment fluctuations in PEs, or vice versa. Furthermore, although SI-related distress was not predictive of subsequent PEs, general affective distress during SI was a robust predictor of next-moment PEs.

Our results suggest that SI and PEs are not directly related on a moment-to-moment level, but a negative emotional state when alone does contribute to the risk of PEs. These findings highlight the role of affective wellbeing during early-stage psychosis development.

Accurate processing of facial displays of emotion is critical for effective communication. A robust literature has documented impairment in the ability to recognize facial affect in people with traumatic brain injury (TBI), but research is scarce about memory for facial affect. Disruptions in recognizing and remembering the emotions of others can undermine relationship quality and may result in psychosocial dysfunction. Importantly, the extant literature indicates that facial affect recognition dissociates from other cognitive abilities such that it is likely a distinct neuronal process. Thus, explicit measurement of affect recognition and memory for emotions may be critical for implementing and refining rehabilitation interventions. The present study examined the relationship between recognition and memory for emotions using a novel computerized task and explored its associations with other cognitive abilities.

Participants were adults who were neurologically healthy (n = 31) or had a history of moderate to severe TBI (n = 26). The battery included the novel Assessment of Facial Affect Recognition and Memory (AFARM), Cambridge Face Memory Test (face memory without emotion), Wechsler Test of Adult Reading, Rey Auditory Verbal Learning Test, Judgment of Line Orientation, Oral Symbol Digit Modalities, Digit Span, FAS, Animal Fluency, and the Affect Intensity Measure (experienced emotion). Spearman correlations examined the relationship of AFARM performance with the test battery. Logistic regression models examined whether immediate-delay (ID-EM) and long-delay face emotion-memory (LD-EM) accounted for unique variance in group membership beyond recognition accuracy of facial affect and memory for faces.

AFARM demonstrated relationships with neuropsychological and mood variables in the expected directions across and within groups, with the strongest associations observed for memory for verbal information (rs = .51 to .58) and processing speed (rs = .48 to .57). Consistent with traditional list-learning tests, ID- and LD-EM were highly correlated (r = .85). Experienced affect intensity was inversely associated with ID-EM (r = -.29) and LD-EM (r = -.38) but not with recognition accuracy (r = -.10). Logistic regression examining ID-EM was significant, χ2(3) = 26.05, p < .001, Nagelkerke R2 = .49. ID-EM accounted for unique variance in group status (p = .006; OR = 0.65) after accounting for recognition accuracy and face memory. Similarly, the model examining LD-EM was significant χ2(3) = 27.70, p < .001, Nagelkerke R2 = .43; LD-EM was significant after accounting for other variables (p = .017; OR = 0.69).

The findings are consistent with the hypothesis that memory for emotions represents a unique component of social cognition that is separate from recognition. Accuracy in identifying emotions, face recognition memory, and memory for emotions are strongly related but not wholly redundant processes. Consistent with prior literature, subjective experience of emotion had substantial effects on objective performance tasks, indicating that an individual's intense experience of their own emotions can disrupt sensitivity to the emotions of others. Future research should assess the extent to which memory for emotions relates to psychosocial outcomes such as the quality and quantity of interpersonal relationships.