Hasil untuk "Neurosciences. Biological psychiatry. Neuropsychiatry"

Thibaut Burg, Ludo Van Den Bosch

Abstract Amyotrophic lateral sclerosis (ALS) is a devastating neurodegenerative disease affecting the adult motor system, with no effective treatments available. Despite extensive research efforts, the exact pathological cascade leading to progressive motor neuron degeneration remains elusive. Recent evidence highlights significant modifications in lipid metabolism during ALS progression, even before the onset of motor symptoms. Glycerophospholipids, the primary components of cellular membranes, are frequently altered in ALS patients and models. These lipids not only play a structural role in membranes, but also contribute to cellular metabolism, signaling pathways, and cell type-specific processes such as neuronal transmission and muscle contraction. In this review, we discuss glycerophospholipid physiological functions in the motor system and review recent studies demonstrating their alterations and the possible underlying pathological mechanisms in ALS. Furthermore, we discuss challenges emerging from studying lipid alterations in neurodegeneration and evaluate the therapeutic potential of glycerophospholipids.

Guoguang Lv, Shiyu Zhang, Ting Zhang et al.

A 71 year-old male was diagnosed of epidermoid cyst located in diploe and cerebellum. The skull part was found firstly and kept steady for more than 5 years. The cerebellar part was found nearby when dizziness and vomit happened. The patient has gone through a traumatic brain injury 4 decades ago. All lesions were resected totally. Interestingly the dura mater was confirmed intact without any leakage into subdural space. Imaging and pathological materials are collected completely. Conclusion: We report a case that EC was found in both skull and cerebellum whereas the dural mater was intact. Epidermoid cell migration or infiltration are possible explanations. Gross total resection is advanced for better clinical outcome.

Xudong Wen, Pan Long, Pan Long

A. Ghenim, D. Brahim, I. Yaich et al.

Introduction Internet use can become uncontrollable, leading to physical and psychological suffering and what is known as cyberaddiction. Objectives To assess the frequency of cyberaddiction in a population of young doctors. Methods We conducted a cross-sectional, descriptive study of a population of young doctors. We collected socio-professional and medical data using a Google Forms self-questionnaire. The Young scale was recommended for screening for cyberaddiction. A score ≥5 indicates Internet addiction. The Hospital Anxiety and Depression Scale (HAD) was adopted to reveal anxiety-depressive disorders. Results A total of 45 physicians responded to our survey. The mean age was 29.93±4.8 years. The sex ratio (M/F) was 0.3. Participants were single in 69% of cases. Residents represented 64% of the population. Physicians were family medicine residents in 11% of cases. The mean Young’s score was 3.13±1.97/8. Cyberaddiction was noted in 24% of cases. A definite anxiety-depressive disorder was found in 6.7% and 13.3% of cases respectively. Internet addiction was significantly associated with female gender (p<0.05) and a positive HAD (A) score (p=0.03). Conclusions According to the results of our study, cyberaddiction is common among medical staff. A preventive strategy is needed to counter the harmful effects of this addiction. Disclosure of Interest None Declared

Benjamin Boecking, Eva Stoettner, Petra Brueggemann et al.

BackgroundAmongst “third-wave” cognitive behavioural therapies, schema therapy demonstrates encouraging efficacy across various mental health conditions. Within this field, clinical interest has begun to converge on the “schema-mode-model” – a conceptualization framework for affective, cognitive and behavioral states that guide individuals’ perceptions and behaviours at a given point in time. Schema mode expressions in patients with chronic tinnitus are as-yet unexamined.MethodsThe present study reports self-report data from N = 696 patients with chronic tinnitus who completed the Schema Mode- and Tinnitus Handicap Inventories alongside measures of perceived stress, anxiety and depression. The Schema Mode Inventory assesses so-called maladaptive “parent”, “child” and “coping” modes. Parent modes can be understood as self-states which are characterized by self-critical and hostile beliefs; child modes are characterized by biographically unmet emotional needs; and coping modes by inflexible attempts to regulate emotion and stabilize one’s sense of self. Descriptive, correlational and mediation analyses investigated schema mode expressions (1) in patients with chronic tinnitus, (2) as compared to published reference values from a healthy control sample, (3) in their relation to other psychological constructs, and (4) regarding their potential role in driving tinnitus-related distress.ResultsPatients reported mild-to-moderate levels of emotional distress. Compared to healthy controls, patients showed (1) high relative expressions of child-, detachment and compliant coping modes and (2) a conspicuously low relative expression of the ‘punitive parent’ mode. Correlational patterns suggested strong associations of (1) parent as well as angry child modes with perceived stress and anxiety, (2) the vulnerable child mode with all measured constructs and (3) emotional distress with - intrapersonally - emotional detachment as well as - interpersonally - alleged compliance. Mediation analyses demonstrated that tinnitus-related distress was driven by significant interactions between child and coping modes.ConclusionsThe study provides initial clinical evidence for the relevance and applicability of schema-mode based formulation and treatment planning in patients with chronic tinnitus.

S. Pérez Oliveira, J. Castilla Silgado, C. Painous et al.

Kai-Liang Wang, Ji-Ping Li, Yong-Zhi Shan et al.

Jesper Duemose Nielsen, Oula Puonti, Rong Xue et al.

Generating realistic volume conductor models for forward calculations in electroencephalography (EEG) is not trivial and several factors contribute to the accuracy of such models, two of which are its anatomical accuracy and the accuracy with which electrode positions are known. Here, we investigate effects of anatomical accuracy by comparing forward solutions from SimNIBS, a tool which allows state-of-the-art anatomical modeling, with well-established pipelines in MNE-Python and FieldTrip. We also compare different ways of specifying electrode locations when digitized positions are not available such as transformation of measured positions from standard space and transformation of a manufacturer layout.Substantial effects of anatomical accuracy were seen throughout the entire brain both in terms of field topography and magnitude with SimNIBS generally being more accurate than the pipelines in MNE-Python and FieldTrip. Topographic and magnitude effects were particularly pronounced for MNE-Python which uses a three-layer boundary element method (BEM) model. We attribute these mainly to the coarse representation of the anatomy used in this model, in particular differences in skull and cerebrospinal fluid (CSF). Effects of electrode specification method were evident in occipital and posterior areas when using a transformed manufacturer layout whereas transforming measured positions from standard space generally resulted in smaller errors.We suggest modeling the anatomy of the volume conductor as accurately possible and we hope to facilitate this by making it easy to export simulations from SimNIBS to MNE-Python and FieldTrip for further analysis. Likewise, if digitized electrode positions are not available, a set of measured positions on a standard head template may be preferable to those specified by the manufacturer.

D. Dovbysh, M. Bebchuk, I. Kopytina et al.

Introduction Parents today can be important members of a multi-professional team, helping children with mental illness. The well-being of the parents is an important factor in successfully helping the child and willingness to cooperate with specialists. Objectives To investigate the experiences of parents undergoing family psychotherapy on an outpatient basis and during a child’s hospitalization. Methods 86 parents who applied for family therapy on an outpatient basis and 80 parents (main group) of hospitalized children took part in the study. Participants were offered the following questionnaires: Beck Hopelessness Scale, modified scales of the Dembo-Rubinstein, GAD-7, PHQ-9, Quality of Life Enjoyment and Satisfaction Questionnaire. The study was conducted from 04/01/2021 to 04/14/2021. Results The main group significantly differs from the outpatient group in the following parameters (according to the t-test): the level of depression (M=18,34 and M=11,61 respectively) and anxiety (M=12,07 and M=7,96 respectively), the quality of life in the sphere of emotional well-being, social sphere, activity and free time, as well as the happiness self-assessment scales. The results on the scales of depression and hopelessness are inversely significantly associated with the willingness of parents to participate in family psychotherapy (r=-0,74, p=0,01) visit the child (r=-0,58, p=0,05), and regularly contact a doctor (r=-0,61, p=0,05). Conclusions Depending on the well-being of family members and the tasks facing the family, family assistance may differ depending on the stage of treatment of the child. Disclosure No significant relationships.

Ahmed Hassab Errasoul, Mohammed A. Alarabi

Abstract Background Despite its superiority over other drugs for psychosis, clozapine remains underused and is associated with many clinical challenges, including difficulties in predicting therapeutic serum levels (350-600 ng/mL). We found no large or recent study that investigated the determinants of serum clozapine levels in Middle Eastern patients. Therefore, we investigated the association between clozapine dose and serum level, and the clinical predictors of the clozapine serum level, in Middle Eastern patients. Methods This cross-sectional study included 94 patients of Middle Eastern ethnicity who attended the Clozapine Clinic in King Saud University Medical City in Riyadh, Saudi Arabia. We used a single measure of the serum clozapine level, which was collected 12 h after the last oral dose of clozapine under steady-state conditions. Results The average clozapine dose and serum level were 400 mg/daily and 705 ng/mL, respectively. The majority of patients (59.8%) had serum levels higher than 600 ng/mL. Clozapine dose and serum level were positively correlated (r s [94] = 0.32, p = 0.002). We generated a predictive model of the serum clozapine level, which revealed that the daily dose, smoking status, use of fluvoxamine or lamotrigine, and body mass index (BMI) predicted 43.6% of the variance in the serum level (p < 0.001). Using this model, we calculated that patients with a BMI of 25 kg/m2 would require a clozapine dose between 50 to 275 mg/daily if they were non-smokers, and a dose of 200 to 450 mg/daily if they were smokers, in order to reach a serum clozapine level between 350 to 600 ng/mL. Patients with higher BMI and those receiving fluvoxamine would require lower doses. Conclusions This was a naturalistic study of the clozapine dose-level relationship and the clinical predictors of the serum clozapine level in a sample of Middle Eastern patients. The ratios of clozapine level to dose in our patients more closely resembled those reported in Asian samples than in European samples. These findings do not reduce the value of individualised therapeutic drug monitoring, but may assist clinicians when prescribing clozapine to Middle Eastern patients. Further psychopharmacological studies are needed on this demographic population.

Xinyu Gao, Xinyu Gao, Xinyu Gao et al.

Accumulating evidence suggested that overweight and smoking often co-exist. However, current neuroimaging researches have almost always studied smoking or overweight status separately. Here we sought to investigate the neurobiological mechanisms of this comorbid association, by detecting spontaneous brain activity changes associated with smoking and weight status separately and collectively. We used 2 × 2 factorial design and included the following four groups: overweight/normal-weight smokers (n = 34/n = 30) and overweight/normal-weight non-smokers (n = 22/n = 24). The spontaneous brain activity among the four groups was comparable using an amplitude of low-frequency fluctuation (ALFF) method based on resting-state fMRI (rs-fMRI). Furthermore, correlation analyses between brain activity changes, smoking severity and BMI values were performed. A main effect of smoking was discovered in the default mode network (DMN) and visual network related brain regions. Moreover, overweight people had high ALFF value in the brain regions associated with reward and executive control. More importantly, smoking and overweight both affected brain activity of the middle temporal gyrus (MTG), but the effect was opposite. And the brain activity of MTG was negatively correlated with smoking years, pack year and BMI value. These results suggest that smoking and overweight not only affect spontaneous brain activity alone, but also paradoxically affect spontaneous brain activity in the MTG. This suggests that we need to control for weight as a variable when studying spontaneous brain activity in smokers. Besides, this interaction may provide a neurological explanation for the comorbidity of overweight and smoking and a target for the treatment of comorbid populations.

Surekha Dabla, Areca Wangnoo, Neeraj Kumar et al.

Federico Mucci

Life goes on. Despite a pandemic not yet eradicated, despite the (increasingly global) connotations of one (of the many) ongoing war conflicts, life continues to go on. And so it must be, as in fact it has always been since the beginning of known human history. Not only humanity, finding itself on its knees in front of natural disasters or severe conflicts, has always managed to recover but has even been able to exploit them to overcome its previous limitations or, in certain cases, to make them a source of inspiration both for itself and the studies of nature. If on the one hand the transcending of preexisting limits means identifying answers to questions, on the other it implies raising other doubts. If we consider Medicine as a daily practice of a science, the aforementioned observation becomes tremendously concrete by imagining a common act such as the administration of a drug: how many possible side effects could occur while waiting for the desired therapeutic effects to occur? If this is perhaps the most recurring of the different questions, there exists another one, no less common and still unsolved, subject of debate amongst clinicians: the placebo effect. The importance of placebo is evident in its controversy, being it widely used in the most authoritative research studies to describe “controls” and, contemporary, being formally "discouraged" from its use in daily clinical practice. Undeniably, its relevance acquires an even more significant impact when involved in the field of neuroscience and, in particular, in the practice of psychiatry. The present issue of Clinical Neuropsychiatry proudly begins with an editorial written by Fabrizio Benedetti (pp.69-72), who has dedicated over 30 years of career to an in-depth and unprecedented study of the placebo effect. Starting from the apparently simple question “Drugs and placebos: what’s the difference?”, Benedetti presents an exhaustive albeit concise dissertation aimed at disentangling some of the several questions about the controversy, the clinical importance and the concrete results related to placebo especially regarding neuroscientific field in an extraordinarily clear and linear way. The current issue of Clinical Neuropsychiatry proceeds in presenting a retrospective case-study of Gatta and colleagues (pp-72-84) that aims at providing an epidemiological– clinical analysis of the population of children and adolescents admitted to an Italian Child Neuropsychiatry Unit (CNU) during a five-year period. The need for such an investigation appears immediately evident, in spite of an overall increase in CNU hospitalizations that has almost doubled over the past ten years. Since the most frequent and recurrent reasons for hospitalization in minors appear to be self-injurious and suicidal behaviors, healthcare workers should be adequately trained while, at the same time, diagnostic-therapeutic protocols for psychiatric emergencies should be implemented (or developed) to manage psychiatric acute conditions in the developmental age. Although suicide remains one of the most frequent causes of death in adolescence, it affects all age groups and indeed represents the most dangerous psychiatric emergency, by definition. Therefore, it becomes sadly natural to consider the suicidal risk during the COVID-19 pandemic can be considered as "an emergency within an emergency". After two years, during which hundreds of scientific papers about the impact and the consequences of the COVID-19 on mental health have been published, Barberis et colleagues (pp. 84-97) take together the available literature and provide a systematic review aimed at describe the current state of the art of suicidal behaviours during the ongoing pandemic. There is no doubt that the ongoing pandemic has negatively affected (and worsened) almost all maladaptive behaviors. During these two years, scholars have also been speculating on how and to what extent seclusion, isolation and social distancing mesaures may have influenced behaviors and personality traits across the different pandemic waves. Recently, Joaquim and colleagues (pp.

Federico Mucci

Thanks to the works of distinguished philosophers and thinkers, there is no doubt that since ancient times, humanity has begun to focus on important questions and elaborate complex hypotheses regarding the concepts of free will and freedom of choice. Apparently, the questions seem to change over time, as they are expressed in different forms both in the ancient epics (such as the "Epic of Gilgamesh") and in modern and recent academic studies of quantum physics or neuroscience. However, the question if "mankind is truly free and able to choose freely?" remains constant throughout millennia and, in all probability, seems to be destined to remain unanswered and generate further speculation in the future. In a certain sense, the answers that were provided over the centuries also seem to provide a portrait of the many societies (and their relative vices as well as virtues) that have followed one to another. Starting from the results obtained after at least a decade intensively devoted to the study of the effects of the Internet, social networks and new technologies on psychopathology, Donatella Marazziti (2022) (pp. 277-279) attempts to provide answers to the aforementioned questions in the brilliant editorial that opens this autumn issue of Clinical Neuropsychiatry. However, if it is true that it is not the truth that sets us free but the doubt, Professor Marazziti is able to boldly hit this goal by inviting readers and colleagues to answer further questions that, sharply, reflect the current society in which we are living (or surviving). After all – according to a very personal opinion of mine that is dictated by the current historical moment – I fear that we cannot feel completely sure that we are able to distinguish whether we are actually living or surviving. Unfortunately, we are facing both with a conflict that, needless to deny, concerns us, a strictly related economic recession, and with the COVID-19 pandemic that (despite superhuman efforts) only seems to be slowly diminishing. On the other hand, if the intensive care units are now no longer overcrowded with pneumonia cases, a new epidemic has already presented itself to forcefully knock on the doors of family doctors and specialists, namely the cognitive deficits related to COVID-19. Sachdev and Shabbir (2022) (pp. 328-334), recognizing the importance of this new clinical burden, present a careful review of the literature aimed at shedding more light on the association between COVID-19 infection and the development of cognitive deficits, as well as at providing further points of speculation to better understand the underlying etiology and pathogenesis of this clinical consequence. Researching the etiological cause and describing the development of pathology is difficult, however it is no less simple to identify a treatment and understand the response mechanisms. For biological processes that still partly continue to be elusive, even the placebo and nocebo effects are able to elicit concrete and easily identifiable responses in humans. Fabrizio Benedetti, the undisputed leader in the field of research on the placebo effect, and his coworkers (2022) (pp. 298-306) present a study conducted on 378 healthy adults (whose prenatal maternal plasma cortisol level was measured during the three trimesters of pregnancy) aimed determining whether prenatal hyperactivity of hypothalamus-pitui tary-adrenal system (HPA) might influence nocebo effect in adults while, at the same time, at underlying the importance of clinicians-patients communication in perceiving symptoms such as pain. Abnormal and prolonged responses of the hypothalamus-pituitary-adrenal axis appear to be closely linked also with another symptomatic dimension that is transversal to numerous psychic disorders, that is rumination. Rumination may be defined as repetitive and unwanted past-centered negative thinking and described as a dynamic process that fluctuates over time (within hours and/or days). Although rumination is an extremely widespread and represented symptom, its investigation is usually conducted by the means of experiencing sampling methodology (ESM), a technique with measurements in everyday life.

Shuangxi Chen, Bing He, Guijuan Zhou et al.

Abstract Background and Purpose Enhanced remyelination of the regenerated axons results in functional re‐innervation and improved functional motor recovery after brachial plexus root avulsion (BPRA). The neural cell adhesion molecule L1 (L1CAM, L1) regulates myelination and promotes regeneration after acute injury in the nervous system. Berberine (BBR) can exert neuroprotective roles against the lesion. Herein, we investigated whether berberine (BBR) can affect the expression of L1 and enhance the axonal remyelination in rats following BPRA. Methods The surgical procedures were performed to build the rat brachial plexus avulsion and re‐implantation model, and then, the rats were treated with BBR. After the rehabilitation for 12 weeks, the musculocutaneous nerves were collected for quantitative real‐time PCR, Western blot analysis, and histochemical and immunofluorescence staining. Results We observed that, BBR treatment ameliorated the abnormal musculocutaneous nerve fibers morphology, up‐regulated the L1 expression, increased the myelination‐related genes, decreased the differentiated‐associated genes, and up‐regulated the phosphorylation of ERK. Conclusion These results suggest that BBR may enhance L1 expression and promote axonal remyelination after spinal root avulsion.

Keane Lim, Sara-Ann Lee, Amy E. Pinkham et al.

Background: Converging evidence has indicated that deficits in social cognition may manifest as poor functioning; therefore, social cognition has emerged as an important research area and treatment target. However, few studies have examined the psychometrics of multiple social cognition measures in an Asian population. This study aims to evaluate the psychometrics of measures indexing the four core social cognition domains. Methods: Schizophrenia outpatients (n = 116) and healthy controls (n = 73) completed a battery of nine social cognitive measures, twice, four weeks apart. Psychometric properties were examined via test-retest reliability, internal consistency, utility as a repeated measure, time administration, and tolerability. Logistic regression was performed to identify psychometrically sound tasks that best discriminated case-control status. PCA was conducted to explore social cognition dimensional structure. Results: The Bell Lysaker Emotion Recognition Task (BLERT), Penn Emotion Recognition Task (ER40), and The Awareness of Social Inference Test, branch III (TASIT-3) showed strongest psychometrics. The Ambiguous Intentions and Hostility Questionnaire, Hostility Bias subscale (AIHQ-HB) showed slightly weaker properties, requiring further evaluation. The Hinting task, Mini Profile of Nonverbal Sensitivity (MiniPONS), Relationships Across Domains (RAD), Internal Personal and Situational Attributions Questionnaire (IPSAQ), and Mayer-Salovey-Caruso Emotional Intelligence Test (MSCEIT) showed poorer psychometrics in our sample. PCA revealed a two-factor solution comprising social cognition skills and attributional style/bias. Conclusion: Here, we examined the psychometric properties of a comprehensive social cognition battery based on the SCOPE study in an Asian schizophrenia population. Continued evaluation and standardization of social cognitive measures are needed to refine our understanding of this construct in schizophrenia. Keywords: Schizophrenia, Social cognition, Psychometric

Mário João Fartaria, Tobias Kober, Cristina Granziera et al.

Purpose: The goals of this study were to assess the performance of a novel lesion segmentation tool for longitudinal analyses, as well as to validate the generated lesion progression map between two time points using conventional and non-conventional MR sequences. Material and methods: The lesion segmentation approach was evaluated with (LeMan-PV) and without (LeMan) the partial volume framework using “conventional” and “non-conventional” MR imaging in a two-year follow-up prospective study of 32 early RRMS patients. Manual segmentations of new, enlarged, shrunken, and stable lesions were used to evaluate the performance of the method variants. The true positive rate was estimated for those lesion evolutions in both white matter and cortex. The number of false positives was compared with two strategies for longitudinal analyses. New lesion tissue volume estimation was evaluated using Bland-Altman plots. Wilcoxon signed-rank test was used to evaluate the different setups. Results: The best median of the true positive rate was obtained using LeMan-PV with non-conventional sequences (P < .05): 87%, 87%, 100%, 83%, for new, enlarged, shrunken, and stable WM lesions, and 50%, 60%, 50%, 80%, for new, enlarged, shrunken, and stable cortical lesions, respectively. Most of the missed lesions were below the mean lesion size in each category. Lesion progression maps presented a median of 0 false positives (range:0–9) and the partial volume framework improved the volume estimation of new lesion tissue. Conclusion: LeMan-PV exhibited the best performance in the detection of new, enlarged, shrunken and stable WM lesions. The method showed lower performance in the detection of cortical lesions, likely due to their low occurrence, small size and low contrast with respect to surrounding tissues. The proposed lesion progression map might be useful in clinical trials or clinical routine. Keywords: Cortical lesions, Multiple sclerosis, Longitudinal analysis, Lesion segmentation, Non-conventional MRI

Prof. Dr. A. Meyer-Lindenberg

Павличенко, А.В.

Несоблюдение режима терапии антидепрессантами является одной из самых частных причин обострений при рекуррентных депрессиях. Анализ литературы, посвященной несоблюдению режима приема антидепрессантов и исходам, свидетельствует о том, что некомплаентные пациенты имеют повышенный риск рецидива болезни, повторных госпитализаций, увеличения тяжести эпизода, снижения уровня респонса и ремиссии. Ухудшение клинических характеристик может привести к росту финансовых затрат на оказание помощи данной категории больных. Негативное отношение пациентов к лечению, а также побочные эффекты и переносимость антидепрессантов являются основными факторами, влияющими на приверженность терапии. Кроме того, с учетом всех характеристик конкретных антидепрессантов (эффективность, безопасность, стоимость) наилучшим выбором при лечении депрессий средней и тяжелой степени является назначение сертралина. В настоящее время назрела необ ходимость в разработке более эффективных программ интервенций, направленных на улучшение комплаентности больных с депрессиями. Для этих целей следует привлекать не только врачей, но и медицинских сестер, а также распространять среди пациентов научно популярную печатную продукцию о депрессиях.

A. Arntz, Adam S. Radomsky, I. Engelhard