Gaia Sampogna, Isabella Berardelli, Umberto Albert
et al.
Abstract Background According to international guidelines, lithium treatment represents the gold standard for the appropriate management of persons with bipolar disorder. However, prescription rates in ordinary practice are not in line with clinical guidelines’ suggestions. Clinicians prefer to use drugs other than lithium, considering its low therapeutic window, the need for regular lab tests and its side effects profile. Based on these premises, a Delphi-method study focused on highly-debated aspects of lithium treatment in bipolar disorder has been promoted with the aim to reach a consensus among an expert panel of Italian psychiatrists. Methods The Delphi method is a structured technique aimed to obtain a consensus from repeated rounds of questionnaires where opinion/agreement among experts are important. A Steering Committee of experts has developed a 24-items questionnaire exploring: (1) the use of lithium as first choice for treating different phases of bipolar disorder; (2) the side effect and tolerability profile of lithium treatment as hampering factors for its use in clinical practice; (3) the lithium prescribing in special target population, such as adolescents, elderly patients, and pregnant women. Results The questionnaire was delivered to a panel of 100 Italian psychiatrists, experts in the field of managing people with bipolar disorders. An almost complete positive consensus was reached for statements dealing with the use of lithium treatment as first choice in the management of patients with bipolar disorder, and as the first choice for preventing manic/hypomanic and depressive episodes. Conclusions Current clinical guidelines and scientific evidence support the use of lithium as first choice treatment in patients with bipolar disorder. However, over the last decades a downward tendency in lithium’s prescription has been registered worldwide. The present Delphi study confirmed the “good clinical reasons” for supporting lithium prescription in clinical practice. Our findings should be used to develop clinical practice guidelines and reduce the discrepancy between international guidelines and ordinary care.
Neurosciences. Biological psychiatry. Neuropsychiatry, Neurophysiology and neuropsychology
Abstract The rapid development of face forgery technology has raised concerns among researchers about information security. To mitigate the malicious abuse of the technology, deepfake detection has proven to be an effective countermeasure. However, existing methods only provide a true-false and binary classification, and they lack research on uncertainty estimation, which leads to the predictive reliability being unknown. The model uncertainty reflects its understanding of knowledge. Even when faced with unseen deepfake content, a detector without awareness of its cognitive limitations may still output incorrect predictions with high confidence. The detector assigns extremely high probabilities to samples, which is referred to a phenomenon known as overconfidence. In this paper, we introduce the novel concept of deepfake detection calibration, which focuses on aligning predicted probability with actual distribution to alleviate the overconfidence and estimate the uncertainty. Specifically, we introduce an innovative calibration method called packed-ensembles (PE), which divides a detector into multiple subnetworks. PE allows each subnetwork to focus on different forgery traces, resulting in reliable predictions without incurring additional computational costs. Comprehensive experiments demonstrate that our method effectively mitigates the overconfidence in deepfake detection while maintaining generalization, and significantly enhances detection reliability.
Electronic computers. Computer science, Neurophysiology and neuropsychology
In this narrative review, we explore the differences in processing speed (PS) impairments among three epilepsy conditions; Temporal Lobe Epilepsy (TLE), Frontal Lobe Epilepsy (FLE) and Genetic Generalized Epilepsy (GGE) with a focus on Juvenile Myoclonic Epilepsy (JME). Despite the large body of research focusing on cognition in epilepsy, the intricacies of PS impairments in the epilepsy syndromes have not been fully explored. We investigate the cognitive profiles with focus on PS associated with each of the three conditions, and the neuropsychological methods employed. Furthermore, we evaluate PS in epilepsy within the theoretical frameworks of PS, such as the Relative Consequence Model, the Limited Time Mechanism Model, and the Neural Noise Hypothesis. We find the main challenge of PS research in epilepsy is the inconsistency of assessment methods utilized in different studies. Furthermore, PS impairments are not isolated but rather interconnected to other cognitive domains. Thus, future studies need to standardize PS assessment tools, and incorporate innovative solutions such as technology and neuroimaging techniques to further enhance our understanding of PS impairments in epilepsy.
Neurology. Diseases of the nervous system, Neurophysiology and neuropsychology
Eoin P. Donnellan, Kathleen M. Gorman, Amre Shahwan
et al.
KBG syndrome is characterised by developmental delay, dental (macrodontia of upper central incisors), craniofacial and skeletal anomalies. Since the identification of variants in the gene (ANKRD11) responsible for KBG syndrome, wider phenotypes are emerging. While there is phenotypic variability within many features of KBG syndrome, epilepsy is not usually markedly severe and movement disorders largely undocumented. Here we describe a novel early onset phenotype of dyskinetic epileptic encephalopathy in a male, who presented during infancy with a florid hyperkinetic movement disorder and developmental regression. Initially he had epileptic spasms and tonic seizures, and EEGs revealed a modified hypsarrhythmia. The epilepsy phenotype evolved to Lennox-Gastaut syndrome with seizures resistant to multiple anti-seizure therapies and the movement disorder evolved to choreoathetosis of limbs and head with oro-lingual dyskinesias. Previous extensive neurometabolic and imaging investigations, including panel-based exome sequencing were unremarkable. Later trio exome sequencing identified a de novo pathogenic heterozygous frameshift deletion of ANKRD11 (c.6792delC; p.Ala2265Profs*72). Review of the literature did not identify any individuals with such a hyperkinetic movement disorder presentation in combination with early-onset epileptic encephalopathy. This report expands the phenotype of ANKRD11-related KBG syndrome to include epileptic dyskinetic encephalopathy.
Neurology. Diseases of the nervous system, Neurophysiology and neuropsychology
Renée C. Waters, Hunter M. Worth, Betsy Vasquez
et al.
Early life adversity (ELA) increases the risk of developing neuropsychiatric illnesses such as anxiety disorders. However, the mechanisms connecting these negative early life experiences to illness later in life remain unclear. In rodents, plasticity mechanisms, specifically adult neurogenesis in the ventral hippocampus, have been shown to be altered by ELA and important for buffering against detrimental stress-induced outcomes. The current study sought to explore whether adult neurogenesis contributes to ELA-induced changes in avoidance behavior. Using the GFAP-TK transgenic model, which allows for the inhibition of adult neurogenesis, and CD1 littermate controls, we subjected mice to an ELA paradigm of maternal separation and early weaning (MSEW) or control rearing. We found that mice with intact adult neurogenesis showed no behavioral changes in response to MSEW. After reducing adult neurogenesis, however, male mice previously subjected to MSEW had an unexpected decrease in avoidance behavior. This finding was not observed in female mice, suggesting that a sex difference exists in the role of adult-born neurons in buffering against ELA-induced changes in behavior. Taken together with the existing literature on ELA and avoidance behavior, this work suggests that strain differences exist in susceptibility to ELA and that adult-born neurons may play a role in regulating adaptive behavior.
Neurosciences. Biological psychiatry. Neuropsychiatry, Neurology. Diseases of the nervous system
Siavash Khodaparast, Hassan Abdi, Vahid Bakhshalipour
et al.
Aim and Background: Sleep is one of the important elements in circadian cycles that is associated with the restoration of physical and mental strength and has a great impact on quality of life. Sports activities are among the interfering factors in improving the quality of sleep and quality of life; Therefore, this study was conducted with the aim of the effect of aerobic exercise on improving the mental quality of sleep and quality of life of the elderly.
Methods and Materials: This is a quasi-experimental study and the subjects of this study were 40 elderly people in 1399. For data analysis, a researcher-made demographic questionnaire was used and the standard questionnaires for measuring Petersburg quality of sleep (PSQI) and quality of life (SF-36) were used. An appropriate training protocol was used for the intervention and data were analyzed. Shapiro-Wilk, dependent parametric t-test and non-parametric Wilcoxon tests were used and statistical calculations were used by SPSS software.
Findings: After aerobic exercise, the average score of sleep quality decreased from 8.1 to 6, ie 26% improvement in sleep quality and the average score of quality of life increased from 78.63 to 81.73, ie 4% improvement in quality of life was observed (p≤ 0.05).
Conclusions: It seems that the intervention has a significant effect on the studied variables and sports activities improve the level of sleep quality and quality of life of the elderly.
The objective of this paper is to compare and contrast FMD and FS, and highlight important differences in etiology and the clinical approach towards these two entities. While patients with FMD often experience abnormal movements on a daily basis, FS is characterized by paroxysmal events. Both patient populations share psychiatric and environmental comorbidities, but patients with FS may have increased anxiety and neuroticism and a higher percentage of childhood trauma. Functional MRI scans have demonstrated impaired executive control over motor behavior in both groups. FMD responds well to multidisciplinary rehabilitation-oriented treatment, while psychotherapy remains the mainstay of treatment for FS. For practicing clinicians, recognizing commonalities and differences in patients with FMD and FS is important to develop the most appropriate treatment plan.
Neurology. Diseases of the nervous system, Neurophysiology and neuropsychology
Stress has been shown to disturb the balance of human intestinal microbiota and subsequently causes mental health problems like anxiety and depression. Our previous study showed that ingesting the probiotic strain, Lactobacillus (L.) plantarum P-8, for 12 weeks could alleviate stress and anxiety of stressed adults. The current study was a follow-up work aiming to investigate the functional role of the gut metagenomes in the observed beneficial effects. The fecal metagenomes of the probiotic (n = 43) and placebo (n = 36) receivers were analyzed in depth. The gut microbiomes of the placebo group at weeks 0 and 12 showed a significantly greater Aitchison distance (P < 0.001) compared with the probiotic group. Meanwhile, the Shannon diversity index of the placebo group (P < 0.05) but not the probiotic group decreased significantly at week 12. Additionally, significantly more species-level genome bins (SGBs) of Bifidobacterium adolescentis, Bifidobacterium longum, and Fecalibacterium prausnitzii (P < 0.01) were identified in the fecal metagenomes of the probiotic group, while the abundances of SGBs representing the species Roseburia faecis and Fusicatenibacter saccharivorans decreased significantly (P < 0.05). Furthermore, the 12-week probiotic supplementation enhanced the diversity of neurotransmitter-synthesizing/consuming SGBs and the levels of some predicted microbial neuroactive metabolites (e.g., short-chain fatty acids, gamma-aminobutyric acid, arachidonic acid, and sphingomyelin). Our results showed a potential link between probiotic-induced gut microbiota modulation and stress/anxiety alleviation in stressed adults, supporting that the gut-brain axis was involved in relieving stress-related symptoms. The beneficial effect relied not only on microbial diversity changes but more importantly gut metagenome modulations at the SGB and functional gene levels.
Neurosciences. Biological psychiatry. Neuropsychiatry, Neurology. Diseases of the nervous system
Extensive studies have demonstrated that face processing ability develops gradually during development until adolescence. However, the underlying mechanism is unclear. One hypothesis is that children and adults represent faces in qualitatively different fashions with different group templates. An alternative hypothesis emphasizes the development as a quantitative change with a decrease of variation in representations. To test these hypotheses, we used between-participant correlation to measure activation pattern similarity both within and between late-childhood children and adults. We found that activation patterns for faces in the fusiform face area and occipital face area were less similar within the children group than within the adults group, indicating children had a greater variation in representing faces. Interestingly, the activation pattern similarity of children to their own group template was not significantly larger than that to adults’ template, suggesting children and adults shared a template in representing faces. Further, the decrease in representation variance was likely a general principle in the ventral visual cortex, as a similar result was observed in a scene-selective region when perceiving scenes. Taken together, our study provides evidence that development of object representation may result from a homogenization process that shifts from greater variance in late-childhood to homogeneity in adults.
Manganese is an essential element that is ubiquitously present in our diet and water supply. It is a cofactor for several critical physiological processes. Elevated blood levels of Manganese secondary to SLC30A10 gene mutation presents distinctly with dystonia, polycythemia, chronic liver disease and a characteristic high T1 signal in basal ganglia on brain MRI. The primary treatment for this condition is chelation along with iron therapy. We report a previously healthy boy with compound heterozygous SLC30A10 gene mutations who had a unique clinical presentation with prominent seizures, polycythemia, and characteristic T1 hyperintensity in basal ganglia. Seizures have not been previously reported to be associated with this specific mutation.
Neurology. Diseases of the nervous system, Neurophysiology and neuropsychology
Cong-Qi Du,1 Yong-Yi Yang,2 Jing Chen,1 Lei Feng,3 Wen-Qin Lin1 1Reproductive Medicine Center, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, People’s Republic of China; 2Department of Gynaecology, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, People’s Republic of China; 3Information Center, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, People’s Republic of ChinaCorrespondence: Wen-Qin LinThe First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou 310003, People’s Republic of ChinaEmail wzlwq70@126.comBackground: The effects of sleep duration on semen quality have been documented in many epidemiological studies. However, the association between sleep quality and semen parameters and reproductive hormones is still unclear.Patients Enrollment and Methods: We conducted a cross-sectional study among 970 outpatients from the Reproductive Medicine Center in Zhejiang, China between October 2017 and July 2019. All participants delivered a semen sample, underwent a physical examination, and answered a questionnaire to provide the following information: demographics, life habits, and sleep habits. Sleep quality was measured using the Pittsburgh Sleep Quality Index (PSQI). We first divided the patients into two groups according to sleep quality (good sleep: PQSI < 5 and poor sleep: PSQI ≥ 5). Then, we analyzed routine sperm parameters (semen volume, sperm total motility, progressive motility, sperm concentration, total sperm number, and normal sperm morphology) and reproductive hormones (follicle-stimulating hormone, luteinizing hormone, estrogen, testosterone, and prolactin) of each group. Finally, we used multivariate linear regression analysis and Spearman correlation coefficients to examine the relationship between sleep quality (discrete variable or dichotomous variable) and sperm parameters, reproductive hormones.Results: A negative correlation was found between the general PSQI scores and several semen parameters: total motility (r= −0.187979, p< 0.001), progressive motility (r= −0.192902, p< 0.001), concentration (r= −0.167063, p< 0.001), total sperm number (r= −0.160008, p< 0.001), and normal sperm morphology (r= −0.124511, p< 0.001). However, there was no significant correlation between the semen volume, all reproductive hormones and the general PSQI scores. After adjusting for confounders, men with poor sleep had lower total motility (β= −9.287; 95% CI, −12.050, −6.523), progressive motility (β= −8.853; 95% CI, −11.526, −6.180), concentration (log scale, β= −0.131; 95% CI, −0.181, −0.082), total sperm number (log scale, β= −0.137; 95% CI, −0.189, −0.084), and normal sperm morphology (β= −1.195; 95% CI, −1.844, −0.547), but semen volume and all reproductive hormones were not markedly altered.Conclusion: Poor sleep quality might be related to impaired semen quality, but we found no evidence that poor sleep quality affects reproductive hormones.Keywords: sleep quality, fertility, male reproduction, sperm quality, PSQI
Andrea Manzotti, Francesco Cerritelli, Jorge E. Esteves
et al.
Preterm birth is a significant risk factor for a range of long-term health problems and developmental disabilities. Though touch plays a central role in many perinatal care strategies, the neurobiological basis of these approaches is seldom considered. C-Tactile afferents (CTs) are a class of unmyelinated nerve fibre activated by low force, dynamic touch. Consistent with an interoceptive function, touch specifically targeted to activate CTs activates posterior insular cortex and has been reported to reduce autonomic arousal. The present study compared the effect of 5 min of CT optimal velocity stroking touch to 5 min of static touch on the heart-rate and oxygen saturation levels of preterm infants between 28- & 37-weeks gestational age. CT touch produced a significant decrease in infants’ heart-rates and increase in their blood oxygenation levels, which sustained throughout a 5-min post-touch period. In contrast, there was no significant change in heart-rate or blood oxygenation levels of infants receiving static touch. These findings provide support for the hypothesis that CTs signal the affective quality of nurturing touch, providing a neurobiological substrate for the apparent beneficial effects of neonatal tactile interventions and offering insight for their optimisation. Keywords: Preterm, Infant, Affective, Touch, C-tactile, Heart-rate
Variability of neural signaling is an important index of healthy brain functioning, as is signal complexity, which relates to information processing capacity. Alterations in variability and complexity may underlie certain brain dysfunctions. Here, resting-state fMRI was used to examine variability and complexity in children and adolescents with and without autism spectrum disorder (ASD). Variability was measured using the mean square successive difference (MSSD) of the time series, and complexity was assessed using sample entropy. A categorical approach was implemented to determine if the brain measures differed between diagnostic groups (ASD and controls). A dimensional approach was used to examine the continuum of relationships between each brain measure and behavioral severity, age, IQ, and the global efficiency (GE) of each participant’s structural connectome, which reflects the structural capacity for information processing. Using the categorical approach, no significant group differences were found for neither MSSD nor entropy. The dimensional approach revealed significant positive correlations between each brain measure, GE, and age. Negative correlations were observed between each brain measure and the severity of ASD behaviors across all participants. These results reveal the nature of variability and complexity of BOLD signals in children and adolescents with and without ASD. Keywords: Brain-behavior relationships, Mean square successive difference, Partial least squares, Resting-state fMRI, Sample entropy
Aim and Background: The aim of this study was the evaluation of the effectiveness of group cognitive behavioral therapy (CBT) on the reduction of adjustment disorder in elderly individuals. Methods and Materials: This was a semi-experimental and empirical study. The statistical population consisted of elderly individuals referring to daily rehabilitation centers and the Institute of Jahan Didegan in Tehran, Iran, for treatment and promotion of their psychological status. Subjects were selected via simple random and convenience sampling method. First, the Critical Life Event Inventory (CIEI) and Mini-Mental State Examination (MMSE) were completed through clinical interviews. Then, by performing the Bell Adjustment Inventory (BDI), those with adjustment disorder were identified based on the Diagnostic and Statistical Manual of Mental Disorders-5th Edition (DSM-V) criteria. Among the individuals with adjustment disorder, 30 elderly individuals were selected randomly and divided into 2 groups (N = 15 in each) of cognitive-behavior therapy (experimental) and control (waiting list). Finally, the posttest and 1-month fallow-up were conducted for both groups. Findings: ANOVA and Tukey test results revealed that there was a significant difference between the mean posttest and follow-up scores of the cognitive-behavioral therapy group on the reduction of adjustment disorder in elderly individuals (P = 0.001). Conclusions: CBT was effective on reducing adjustment disorder in elderly individuals.
Aim and Background: Sensorimotor difficulties, including abnormalities in muscle tone, gross and fine motor skills, balance, and motor coordination, are common co-occurring symptoms in children with autism spectrum disorders (ASD) and influence different aspects of their lives. The purpose of this study was to identify the effectiveness of sensorimotor exercises on improvement of motor functioning and ASD symptoms. Methods and Materials: In this quasi-experimental study, from among autistic children in Tehran, 2 autistic children were selected through non-random convenience sampling technique to participate in the study. Data were collected using multiple baseline design, and through the Lincoln-Oseretsky Motor Development Scale and Gilliam Autism Rating Scale (GARS). After observation of a relatively stable baseline, the 7-part intervention plan, including body awareness, motor programming, bilateral motor integration, balance skills, fine motor coordination, functional vision skills, and oral-motor skills, was implemented. The data were analyzed using visual analysis, effect size, and inferential statistics including t-test. Findings: Results of t-test, effect size and visual analysis revealed a significant difference between baseline and treatment conditions. The mean scores of motor skills increased and mean scores of stereotypic behaviors decreased (P < 0.05). Conclusions: The findings indicate that motor performance and stereotypic behaviors of children with ASD improved with sensorimotor exercises. However, no significant changes were observed in the social interaction and communication skills of the children.
Nicola Mammarella, Beth Fairfield, Alberto Di Domenico
Memory for repeated items improves when presentations are spaced during study. Here, two experiments assessed the so-called spacing effect on a yes–no recognition memory task using affective and neutral words. In Experiment 1, a group of participants was asked to orient their attention to semantic features of target words (deep semantic analysis) that were consecutively repeated or spaced, while another group was engaged in a graphemic shallow analysis of words (Experiment 2). The depth of word processing approach was meant to highlight the role of repetition priming mechanisms in the generation of spacing effects. We found that spacing effects occurred for both affective and neutral words (Experiment 1). However, following shallow analysis of words, the spacing effect was reduced for both affective and neutral words (Experiment 2). No differences were detected in terms of positive versus negative words. These results suggest that spaced learning operates when the to-be-remembered material is also affectively charged and that, under certain circumstances, it may enhance recognition memory as affective connotation does.
<p>Abstract</p> <p>Background</p> <p>Extracellular-signal regulated kinase (ERK1/2) is activated by nerve damage and its activation precedes survival and proliferation of Schwann cells. In contrast, activation of caspase 3, a cysteine protease, is considered as a marker for apoptosis in Schwann cells. In the present study, axonal outgrowth, activation of ERK1/2 by phosphorylation (p-ERK 1/2 ) and immunoreactivity of cleaved caspase 3 were examined after immediate, delayed, or no repair of transected rat sciatic nerves.</p> <p>Results</p> <p>Axonal outgrowth, detected by neurofilament staining, was longer after immediate repair than after either the delayed or no repair conditions. Immediate repair also showed a higher expression of p-ERK 1/2 and a lower number of cleaved caspase 3 stained Schwann cells than after delayed nerve repair. If the transected nerve was not repaired a lower level of p-ERK 1/2 was found than in either the immediate or delayed repair conditions. Axonal outgrowth correlated to p-ERK 1/2, but not clearly with cleaved caspase 3. Contact with regenerating axons affected Schwann cells with respect to p-ERK 1/2 and cleaved caspase 3 after immediate nerve repair only.</p> <p>Conclusion</p> <p>The decreased regenerative capacity that has historically been observed after delayed nerve repair may be related to impaired activation of Schwann cells and increased Schwann cell death. Outgrowing axons influence ERK 1/2 activation and apoptosis of Schwann cells.</p>
Neurosciences. Biological psychiatry. Neuropsychiatry, Neurophysiology and neuropsychology
Kobayashi Maori, Teramoto Wataru, Hidaka Souta
et al.
<p>Abstract</p> <p>Background</p> <p>After a prolonged exposure to a paired presentation of different types of signals (e.g., color and motion), one of the signals (color) becomes a driver for the other signal (motion). This phenomenon, which is known as contingent motion aftereffect, indicates that the brain can establish new neural representations even in the adult's brain. However, contingent motion aftereffect has been reported only in visual or auditory domain. Here, we demonstrate that a visual motion aftereffect can be contingent on a specific sound.</p> <p>Results</p> <p>Dynamic random dots moving in an alternating right or left direction were presented to the participants. Each direction of motion was accompanied by an auditory tone of a unique and specific frequency. After a 3-minutes exposure, the tones began to exert marked influence on the visual motion perception, and the percentage of dots required to trigger motion perception systematically changed depending on the tones. Furthermore, this effect lasted for at least 2 days.</p> <p>Conclusions</p> <p>These results indicate that a new neural representation can be rapidly established between auditory and visual modalities.</p>
Neurosciences. Biological psychiatry. Neuropsychiatry, Neurophysiology and neuropsychology