Decision-Making and Management of Self-Care in Persons with Traumatic Spinal Cord Injuries: A Preliminary Study

Patients and physicians understand the importance of self-care following spinal cord injury (SCI), yet many individuals with SCI do not adhere to recommended self-care activities despite logistical supports. Neurobehavioral determinants of SCI self-care behavior, such as impulsivity, are not widely studied, yet understanding them could inform efforts to improve SCI self-care. We explored associations between impulsivity and self-care in an observational study of 35 US adults age 18 - 50 who had traumatic SCI with paraplegia at least six months before assessment. The primary outcome measure was self-reported self-care. In LASSO regression models that included all neurobehavioral measures and demographics as predictors of self-care, dispositional measures of greater impulsivity (negative urgency, lack of premeditation, lack of perseverance), and reduced mindfulness were associated with reduced self-care. Outcome (magnitude) sensitivity, a latent decision-making parameter derived from computationally modeling successive choices in a gambling task, was also associated with self-care behavior. These results are preliminary;more research is needed to demonstrate the utility of these findings in clinical settings. Information about associations between impulsivity and poor self-care in people with SCI could guide the development of interventions to improve SCI self-care and help patients with elevated risks related to self-care and secondary health conditions.

Electro-acupuncture Treatment for Internet Addiction: Evidence of Normalization of Impulse Control Disorder in Adolescents

Objective： To observe the impacts of electro-acupuncture（EA） and psychological intervention（PI） on impulsive behavior among internet addiction（IA） adolescents. Methods： Thirty-two IA adolescents were allocated to either EA（16 cases） or PI（16 cases） group by a randomized digital table. Subjects in the EA group received EA treatment and subjects in the PI group received cognition and behavior therapy. All adolescents underwent 45-d intervention. Sixteen healthy volunteers were recruited into a control group. Barratt Impulsiveness Scale（BIS-11） scores, Young＇s Internet Addiction Test（IAT） as well as the ratio of brain N-acetyl aspartate（NAA） to creatine（NAA/Cr） and choline（Cho） to creatine（Cho/Cr） were recorded by magnetic resonance spectroscopy before and after intervention respectively. Results： The IAT scores and BIS-11 total scores in both EA and PI group were remarkably decreased after treatment（P〈0.05）, while EA group showed more significant decrease in certain BIS-11 sub-factors（P〈0.05）. Both NAA/Cr and Cho/Cr were significantly improved in EA group after treatment（P〈0.05）; however, there were no significant changes of NAA/Cr or Cho/Cr in PI group after treatment（P〉0.05）. Conclusions： Both EA and PI had significantly positive effect on IA adolescents, especially in the aspects of psychological experiences and behavioral expressions, EA might have an advantage over PI in terms of impulsivity control and brain neuron protection. The mechanism underlying this advantage might be related to the increased NAA and Cho levels in prefrontal and anterior cingulate cortices.