Dr. Kathleen  Thomas  Md image

Dr. Kathleen Thomas Md

206 Bergen Ave Suite 202
Kearny NJ 07032
201 467-7500
Medical School: Other - Unknown
Accepts Medicare: No
Participates In eRX: No
Participates In PQRS: No
Participates In EHR: No
License #: 25MA03743600
NPI: 1417031873
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Long-term consequences of childhood maltreatment: Altered amygdala functional connectivity. - Development and psychopathology
Childhood maltreatment is a serious individual, familial, and societal threat that compromises healthy development and is associated with lasting alterations to emotion perception, processing, and regulation (Cicchetti & Curtis, 2005; Pollak, Cicchetti, Hornung, & Reed, 2000; Pollak & Tolley-Schell, 2003). Individuals with a history of maltreatment show altered structural and functional brain development in both frontal and limbic structures (Hart & Rubia, 2012). In particular, previous research has identified hyperactive amygdala responsivity associated with childhood maltreatment (e.g., Dannlowski et al., 2012). However, less is known about the impact of maltreatment on the relationship between the amygdala and other brain regions. The present study employed an emotion processing functional magnetic resonance imaging task to examine task-based activation and functional connectivity in adults who experienced maltreatment as children. The sample included adults with a history of substantiated childhood maltreatment (n = 33) and comparison adults (n = 38) who were well matched on demographic variables, all of whom have been studied prospectively since childhood. The maltreated group exhibited greater activation than comparison participants in the prefrontal cortex and basal ganglia. In addition, maltreated adults showed increased amygdala connectivity with the hippocampus and prefrontal cortex. The results suggest that the intense early stress of childhood maltreatment is associated with lasting alterations to frontolimbic circuitry.
Functional and Anatomic Consequences of Diabetic Pregnancy on Memory in Ten-Year-Old Children. - Journal of developmental and behavioral pediatrics : JDBP
Pregnancies complicated by diabetes mellitus impair offspring memory functions during infancy and early childhood. The purpose of this study was to investigate the long-term consequences of such pregnancies on memory and memory-related brain regions in 10-year-old children.Nineteen children of diabetic mothers (CDMs) and 35 children of nondiabetic mothers participated in this 10-year follow-up study. Memory performance was assessed using a continuous recognition memory task during which children made old/new judgments in response to pictures of concrete and abstract objects presented after different lags or delays. In addition, the volume of the hippocampal formation (HF) was measured using high-resolution structural images.At 10 years of age, recognition memory performance of CDMs did not differ from children of nondiabetic mothers. Similarly, the volume of the HF did not differ between groups. However, the size of the HF in CDMs predicted the time those children needed to provide accurate responses in the continuous recognition memory task.CDMs do not show memory impairments by 10 years of age, despite evidence for such impairments early in life. However, subtle differences in underlying neural processes may still be present. These results have important implications for long-term cognitive development of CDMs.
Adolescent drinking and brain morphometry: A co-twin control analysis. - Developmental cognitive neuroscience
Developmental changes in structure and functioning are thought to make the adolescent brain particularly sensitive to the negative effects of alcohol. Although alcohol use disorders are relatively rare in adolescence, the initiation of alcohol use, including problematic use, becomes increasingly prevalent during this period. The present study examined associations between normative drinking (alcohol initiation, binge drinking, intoxication) and brain morphometry in a sample of 96 adolescent monozygotic twins. A priori regions of interest included 11 subcortical and 20 cortical structures implicated in the existing empirical literature as associated with normative alcohol use in adolescence. In addition, co-twin control analyses were used to disentangle risk for alcohol use from consequences of alcohol exposure on the developing brain. Results indicated significant associations reflecting preexisting vulnerability toward problematic alcohol use, including reduced volume of the amygdala, increased volume of the cerebellum, and reduced cortical volume and thickness in several frontal and temporal regions, including the superior and middle frontal gyri, pars triangularis, and middle and inferior temporal gyri. Results also indicated some associations consistent with a neurotoxic effect of alcohol exposure, including reduced volume of the ventral diencephalon and the middle temporal gyrus.Copyright © 2015 The Authors. Published by Elsevier Ltd.. All rights reserved.
Impaired Bottom-Up Effective Connectivity Between Amygdala and Subgenual Anterior Cingulate Cortex in Unmedicated Adolescents with Major Depression: Results from a Dynamic Causal Modeling Analysis. - Brain connectivity
Major depressive disorder (MDD) is a significant contributor to lifetime disability and frequently emerges in adolescence, yet little is known about the neural mechanisms of MDD in adolescents. Dynamic causal modeling (DCM) analysis is an innovative tool that can shed light on neural network abnormalities. A DCM analysis was conducted to test several frontolimbic effective connectivity models in 27 adolescents with MDD and 21 healthy adolescents. The best neural model for each person was identified using Bayesian model selection. The findings revealed that the two adolescent groups fit similar optimal neural models. The best across-groups model was then used to infer upon both within-group and between-group tests of intrinsic and modulation parameters of the network connections. First, for model validation, within-group tests revealed robust evidence for bottom-up connectivity, but less evidence for strong top-down connectivity in both groups. Second, we tested for differences between groups on the validated parameters of the best model. This revealed that adolescents with MDD had significantly weaker bottom-up connectivity in one pathway, from amygdala to sgACC (p=0.008), than healthy controls. This study provides the first examination of effective connectivity using DCM within neural circuitry implicated in emotion processing in adolescents with MDD. These findings aid in advancing understanding the neurobiology of early-onset MDD during adolescence and have implications for future research investigating how effective connectivity changes across contexts, with development, over the course of the disease, and after intervention.
Brain activation in response to overt and covert fear and happy faces in women with borderline personality disorder. - Brain imaging and behavior
Borderline personality disorder (BPD) is a serious condition involving emotion dysregulation. Past research has identified BPD-associated differences within fronto-limbic circuitry during conditions of processing negative emotion. Functional magnetic resonance imaging (fMRI) paradigms that incorporate overt and covert (masked) presentations of emotional stimuli can provide complementary information about neural systems underlying emotion processing (e.g., both slow [overt] and fast [covert; automatic] processing pathways). This study examined brain activation during processing of overt and covert presentations of emotional faces in 12 women with BPD and 12 age-matched healthy controls. To assess a range of emotional valence and arousal, we examined responses to fear, happy and neutral expressions. All participants underwent an fMRI scanning session in which participants passively viewed emotional faces. Scanning sessions consisted of 5 runs including: (1) Overt Fear (OF) versus Neutral (N), (2) Covert Fear (CF) versus Covert Neutral (CN), (3) Overt Happy (OH) versus N, (4) Covert Happy (CH) versus CN, and (5) N versus fixation. We compared whole-brain activation between groups for each run. In response to overt fear, BPD patients showed greater activation both in left amygdala and in several frontal cortical regions. There were no significant differences in brain activation in response to overt happy faces. In response to covert fear and covert happy stimuli, the BPD group also showed greater activation than controls in several regions including frontal and temporal cortical regions, as well as cerebellum and thalamus. These findings add to prior reports suggesting increased amygdala activation in BPD, but we found this only in the overt fear versus fixation condition. In this sample, BPD patients showed hyper-activation, rather than hypo-activation, of cortical regulatory regions during overt fear. Enhanced cortical recruitment in response to covert fear and happy faces in BPD could reflect a more extended response system in which stimuli that typically only activate automatic pathways are additionally tapping into cortical regulatory systems. The observation of this pattern both in response to fear and in response to happy presentations suggests that the effect of arousal may be as or more impactful than the effect of emotional valence.
Hot executive function following moderate-to-late preterm birth: altered delay discounting at 4 years of age. - Developmental science
Interest in monitoring long-term neurodevelopmental outcomes of children born moderate-to-late preterm (32-36 weeks gestation) is increasing. Moderate-to-late preterm birth has a negative impact on academic achievement, which may relate to differential development of executive function (EF). Prior studies reporting deficits in EF in preterm children have almost exclusively assessed EF in affectively neutral contexts in high-risk preterm children (< 32 weeks gestation). Disrupted function in motivational or emotionally charged contexts (hot EF) following preterm birth remains uninvestigated, despite evidence that preterm children show differential development of neural circuitry subserving hot EF, including reduced orbitofrontal cortex volume. The present study is the first to examine whether low-risk, healthy children born moderate-to-late preterm exhibit impairments in the development of hot EF. Preterm children at age 4.5 years were less likely to choose larger, delayed rewards across all levels of reward magnitude on a delay discounting task using tangible rewards, but performed more similarly to their full-term peers on a delay aversion task involving abstract rewards and on measures of cool EF. The relationship between gestational age at birth and selection of delayed rewards extended across the entire gestational age range of the sample (32-42 weeks), and remained significant after controlling for intelligence and processing speed. Results imply that there is not a finite cut-off point at which children are spared from potential long-term neurodevelopmental effects of PT birth. Further investigation of reward processing and hot EF in individuals with a history of PT birth is warranted given the susceptibility of prefrontal cortex development to early environmental variations.© 2015 John Wiley & Sons Ltd.
Pre-Practice Hydration Status and the Effects of Hydration Regimen on Collegiate Division III Male Athletes. - Journal of sports science & medicine
Pre-practice euhydration is key in the prevention of heat related injuries. The pre-practice hydration status of male National Collegiate Athletic Association (NCAA)-Division III athletes and the effects of a direct hydration regimen have yet to be investigated therefore; the aim of the study was 1) to analyze the pre-practice hydration status of current NCAA-DIII male athletes and 2) assess the impact of a directed intervention on pre-practice hydration status. The study was divided into baseline, pre and post intervention phases. For baseline, hydration status through urine specific gravity (USG) and anthropometric indices were measured prior to morning practice. Following baseline, pre-intervention commenced and participants were assigned to either control (CON) or experimental (EXP) groups. The CON and EXP group participants were instructed to maintain normal hydration and diet schedules and record fluid intake for seven days leading to post-intervention. The EXP group participants were asked to consume an additional 23.9 fl oz (~ 750 ml) per day for one week (7 days) leading to post-intervention. After 7 days the same measures were taken. At baseline, the majority of the participants were hypohydrated. Following the intervention, the EXP group participants consumed significantly more fluids than the participants in the CON group (3277.91 ± 1360. 23 ml vs 1931.54 ± 881.81 ml; p < 0.05). A-two-way repeated measure ANOVA revealed a non-significant time or treatment effect for USG or body mass but did demonstrate a significant USG interaction. In addition, an independent t-test examining absolute changes in USG demonstrated a significant difference between groups in which the EXP group improved hydration status and the CON group did not (-0.02 ± 0.006 vs 0.001 ± 0.005 ml; p < 0.05). In addition, there was no significant (p >0.05) difference in the regression slopes or intercepts between the CON and EXP groups when expressed as daily fluid intake per kg body (ml·kg(-1)) and change in USG from pre-intervention to post-intervention. Most of the participants were hypohydrated at baseline/pre-intervention and the direct hydration intervention improved post-intervention hydration status but only to a small extent. Key pointsThe majority of NCAA-DIII male athletes whom we assessed prior to practice through the use of USG appeared to be hypohydrated.The hydration intervention of adding 24.9 fl oz (~750ml) per day to an athlete's daily fluid intake led to a significant increase in fluid consumption but resulted in only small improvements in USG.The only small improvement in hydration status following the intervention may be a result of an intervention volume that is too small or an under-reporting of fluid consumption.
Autism and families' financial burden: the association with health insurance coverage. - American journal on intellectual and developmental disabilities
We examined the relationship between family financial burden and children's health insurance coverage in families (n  =  316) raising children with autism spectrum disorders (ASD), using pooled 2000-2009 Medical Expenditure Panel Survey data. Measures of family financial burden included any out-of-pocket spending in the previous year, and spending as a percentage of families' income. Families spent an average of $9.70 per $1,000 of income on their child's health care costs. Families raising children with private insurance were more than 5 times as likely to have any out-of-pocket spending compared to publicly insured children. The most common out-of-pocket expenditure types were medications, outpatient services, and dental care. This study provides evidence of the relative inadequacy of private insurance in meeting the needs of children with ASD.
FKBP5 moderation of depressive symptoms in peer victimized, post-institutionalized children. - Psychoneuroendocrinology
The purpose of this study was to examine whether FKBP5 rs1360780 moderates relations between different forms of life stress/adversity (early institutional rearing and peer victimization) and depressive symptoms in adolescents. As reported previously, PI youth were at risk for being victimized by peers. Here, victimization was associated with elevated depressive symptoms. While FKBP5 did not moderate the association between early life adversity and depressive symptoms for either sex, it moderated the association between current adversity and depressive symptoms for victimized girls carrying the minor allele. Consistent with a differential susceptibility model, girls with the minor allele exhibited more depressive symptoms at higher levels of victimization, but fewer depressive symptoms at lower levels of victimization. Interestingly, boys with the CC genotype had higher rates of depressive symptoms compared to girls with the CC genotype in the context of heightened victimization.Copyright © 2014 Elsevier Ltd. All rights reserved.
Duration of early adversity and structural brain development in post-institutionalized adolescents. - NeuroImage
For children reared in institutions for orphaned or abandoned children, multiple aspects of the early environment deviate from species-typical experiences, which may lead to alterations in neurobehavioral development. Although the effects of early deprivation and early life stress have been studied extensively in animal models, less is known about implications for human brain development. This structural neuroimaging study examined the long-term neural correlates of early adverse rearing environments in a large sample of 12-14 year old children (N = 110) who were internationally adopted from institutional care as young children (median age at adoption = 12 months) relative to a same age, comparison group reared with their biological families in the United States. History of institutional rearing was associated with broad changes in cortical volume even after controlling for variability in head size. Results suggested that prefrontal cortex was especially susceptible to early adversity, with significant reductions in volume (driven primarily by differences in surface area rather than cortical thickness) in post-institutionalized youth. Hippocampal volumes showed an association with duration of institutional care, with later-adopted children showing the smallest volumes relative to non-adopted controls. Larger amygdala volumes were not detected in this sample of post-institutionalized children. These data suggest that this temporally discrete period of early deprivation is associated with persisting alterations in brain morphology even years after exposure. Furthermore, these alterations are not completely ameliorated by subsequent environmental enrichment by early adolescence.Copyright © 2014 Elsevier Inc. All rights reserved.

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