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Abstract
Obsessive-compulsive disorder (OCD) affects 1%-3% of children worldwide and has a profound impact on quality of life for patients and families. Although our understanding of the underlying etiology remains limited, data from neuroimaging and genetic studies as well as the efficacy of serotonergic medications suggest the disorder is associated with the fundamental alterations in the function of cortico-striato-thalamocortical circuits. Significant delays to diagnosis are common, ultimately leading to more severe functional impairment with long-term developmental consequences. The clinical assessment requires a detailed history of specific OCD symptoms as well as psychiatric and medical comorbidities. Standardized assessment tools may aid in evaluating and tracking symptom severity and both individual and family functioning. In the majority of children, an interdisciplinary approach that combines cognitive behavioral therapy with a serotonin reuptake inhibitor leads to meaningful symptom improvement, although some patients experience a chronic, episodic course. There are limited data to guide the management of treatment-refractory illness in children, although atypical antipsychotics and glutamate-modulating agents may be used cautiously as augmenting agents. This review outlines a clinical approach to the diagnosis and management of OCD, highlighting associated challenges, and limitations to our current knowledge.
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Affiliation(s)
- Clara Westwell-Roper
- Department of Psychiatry, Faculty of Medicine, University of British Columbia, Vancouver, Canada
| | - S Evelyn Stewart
- Department of Psychiatry, Faculty of Medicine, University of British Columbia, Vancouver, Canada.,BC Children's Hospital Research Institute, Vancouver, Canada.,BC Mental Health and Substance Use Research Institute, Vancouver, Canada
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102
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Chuang WC, Yeh CB, Wang SC, Pan PY, Shyu JF, Liu YP, Gau SSF, Lu RB. Potential Negative Effects of Dextromethorphan as an Add-On Therapy to Methylphenidate in Children With ADHD. Front Psychiatry 2019; 10:437. [PMID: 31333511 PMCID: PMC6620613 DOI: 10.3389/fpsyt.2019.00437] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2018] [Accepted: 06/03/2019] [Indexed: 12/28/2022] Open
Abstract
Objectives: Methylphenidate (MPH) is highly effective in controlling the symptoms of attention-deficit/hyperactivity disorder (ADHD), but some children with ADHD either do not respond to, or do not tolerate, treatment. Dextromethorphan (DM) is a neuroprotective agent which has been used in the treatment of neuropsychiatric disorders. This clinical trial had examined the effect of DM on the use of MPH in the children with ADHD. Methods: This randomized double-blind clinical trial had evaluated 44 male outpatients, aged between 6 and 12 years, with a diagnosis of ADHD. The study subjects were randomly assigned into one of the two groups: receiving MPH alone (15-60 mg per day) or MPH plus DM (30-60 mg per day) for 8 weeks. Assessments, comprising the Chinese version of the Child Behavior Checklist (CBCL-C) scale and the Swanson, Nolan and Pelham Questionnaire (SNAP)-IV rating tests conducted by parents and the serum cytokines measured by microarray and enzyme-linked immunosorband assay (ELISA), were compared between groups at baseline and at 8 weeks after the medication was started. Results: There were a significant decrease at the mean scores of both CBCL-C and SNAP-IV scales after 8 weeks of treatment, but no significant differences between MPH and MPH+DM groups. Compared with the MPH-only group, the mean scores of some psychometric parameters reported on the CBCL-C and SNAP-IV scales regarding time effects as well as the attention problems on the CBCL-C scale regarding group effect were significantly higher in the DM+MPH group. Although there were no significant differences in the levels of various serum cytokines between groups, the subjects in the DM-MPH group had relatively fewer and lower levels of adverse effects. Significant interactions were found between the withdrawn/depression item reported on the CBCL-C scale and tumor necrosis factor α (ခTNF-α) (p = 0.027), as well as between thought problems item on the CBCL-C and TNF-α (p = 0.028) in subjects who had received DM+MPH treatment. Conclusion: Following the trial, DM+MPH was not superior to MPH alone for the treatment of children with ADHD, yet DM may potentially have negative effects on ADHD symptoms when combined with MPH. Clinical Trial Registration: Clinicaltrials.gov, trial number: NCT01787136.
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Affiliation(s)
- Wei-Chen Chuang
- Department of Psychiatry, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.,Department of Psychiatry, Tri-Service General Hospital, Songshan Branch, Taipei, Taiwan
| | - Chin-Bin Yeh
- Department of Psychiatry, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Sheng-Chiang Wang
- Department of Psychiatry, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.,Department of Psychiatry, Tri-Service General Hospital, Songshan Branch, Taipei, Taiwan
| | - Pei-Yin Pan
- Department of Psychiatry, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Jia-Fwu Shyu
- Department of Psychiatry, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.,Department of Biology & Anatomy, National Defense Medical Center, Taipei, Taiwan
| | - Yia-Ping Liu
- Department of Psychiatry, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.,Department of Physiology, National Defense Medical Center, Taipei, Taiwan
| | - Susan Shur-Fen Gau
- Department of Psychiatry, National Taiwan University Hospital and College of Medicine, Taipei, Taiwan
| | - Ru-Band Lu
- Institute of Behavioral Medicine, College of Medicine and Hospital, National Cheng Kung University, Tainan, Taiwan.,Addiction Research Center, National Cheng Kung University, Tainan, Taiwan.,Center for Neuropsychiatric Research, National Health Research Institutes, Miaoli, Taiwan
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103
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Al-Alawi M, Al Sinawi H, Rashid R. In the Realm of Psychoneuroimmunology: The Role of Celecoxib as an Add-On Treatment for Bipolar Mania. MOLECULAR NEUROPSYCHIATRY 2018; 4:164-167. [PMID: 30643790 PMCID: PMC6323359 DOI: 10.1159/000494700] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/12/2018] [Accepted: 10/16/2018] [Indexed: 12/25/2022]
Abstract
Bipolar affective disorder (BPAD) is a chronic debilitating psychiatric illness seriously affecting the quality of patients' life. The available treatment is effective in about half of those suffering from the illness. The neurobiological basis of the disorder is not fully unraveled. With such lacunae, attempts have been made to decipher the underlying neuroimmunological process of the illness as is the case with other mental disorders. As a result, some inflammatory processes have been implicated in the etiology of BPAD, as described in this communication. Subsequently, the role of anti-inflammatory agents such as celecoxib was investigated by treating different phases of BPAD. Given the promising outcomes of several trials and reviews, celecoxib has gained momentum and has been recommended as an adjunctive treatment by some guidelines for treating resistant BPAD cases. This brief communication highlights some of the caveats in the randomized trials using celecoxib as an add-on treatment in bipolar mania specifically, which need to be addressed in future work.
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Affiliation(s)
- Mohammed Al-Alawi
- Oman Medical Specialty Board, Muscat, Oman
- Department of Behavioral Medicine, Sultan Qaboos University Hospital, Muscat, Oman
| | - Hamed Al Sinawi
- Oman Medical Specialty Board, Muscat, Oman
- Department of Behavioral Medicine, Sultan Qaboos University Hospital, Muscat, Oman
| | - Roshe Rashid
- Department of Behavioral Medicine, Sultan Qaboos University Hospital, Muscat, Oman
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104
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Carvalho KMB, Ronca DB, Michels N, Huybrechts I, Cuenca-Garcia M, Marcos A, Molnár D, Dallongeville J, Manios Y, Schaan BD, Moreno L, de Henauw S, Carvalho LA. Does the Mediterranean Diet Protect against Stress-Induced Inflammatory Activation in European Adolescents? The HELENA Study. Nutrients 2018; 10:E1770. [PMID: 30445703 PMCID: PMC6266959 DOI: 10.3390/nu10111770] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2018] [Revised: 11/01/2018] [Accepted: 11/10/2018] [Indexed: 12/12/2022] Open
Abstract
Stress increases inflammation but whether adherence to Mediterranean diet counteracts this association and how early can these effects be observed is not well known. We tested whether (1) cortisol is associated to inflammation, (2) cortisol is associated to the adolescent Mediterranean diet score (aMDS), (3) aMDS lessens inflammation, (4) aMDS associates with cortisol levels and inflammation. Two hundred and forty-two adolescents (137 females; 12.5⁻17.5 years old) provided salivary cortisol, blood and 2-day 24-h dietary recall from which aMDS was derived. Cortisol levels were associated with increased tumor necrosis factor (TNF-α B = 11.887, p = 0.001) when adjusted for age, gender, parental education and body mass index (BMI). Moreover, cortisol levels were inversely associated to adherence to the Mediterranean Diet (B = -1.023, p = 0.002). Adolescents with higher adherence to aMDS had lower levels of interleukins (IL) IL-1, IL-2, IL-6 and TNF-α, compared to those who did not adhere. The association between cortisol and TNF-α was no longer significant when aMDS was included in the model (B = 6.118, p = 0.139). In addition, comparing lower and higher aMDS groups, the association between cortisol and TNF-α was only observed in those with lower aMDS adherence. Our study suggests that adherence to the Mediterranean Diet may counteract the effect of stress on inflammatory biomarkers which may contribute to decreasing the risk of future mental health.
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Affiliation(s)
- Kenia M B Carvalho
- Graduate Program in Human Nutrition, University of Brasília, Brasília 70910-900, Brazil.
| | - Débora B Ronca
- Graduate Program in Human Nutrition, University of Brasília, Brasília 70910-900, Brazil.
| | - Nathalie Michels
- Department of Public Health, Faculty of Medicine and Health Sciences, Ghent University, 9000 Ghent, Belgium.
| | - Inge Huybrechts
- Department of Public Health, Faculty of Medicine and Health Sciences, Ghent University, 9000 Ghent, Belgium.
- International Agency for Research on Cancer, 69372 Lyon, France.
| | - Magdalena Cuenca-Garcia
- Department of Medical Physiology, School of Medicine, University of Granada, 18071 Granada, Spain.
| | - Ascensión Marcos
- ICTAN-CSIC Spanish National Research Council, 28040 Madrid, Spain.
| | - Dénes Molnár
- Department of Paediatrics, Medical School, University of Pécs, 7623 Pécs, Hungary.
| | | | - Yannis Manios
- Department of Nutrition and Dietetics, Harokopio University, 17671 Athens, Greece.
| | - Beatriz D Schaan
- Graduate Program in Medical-Sciences, Endocrinology, Federal University of Rio Grande do Sul, Porto Alegre 90035-003, Brazil.
| | - Luis Moreno
- GENUD (Growth, Exercise, Nutrition and Development) Research Group, 50013 Zaragoza, Spain.
| | - Stefaan de Henauw
- Department of Public Health, Faculty of Medicine and Health Sciences, Ghent University, 9000 Ghent, Belgium.
| | - Livia A Carvalho
- Department of Clinical Pharmacology, William Harvey Research Institute, Barts and The London Hospital, Queen Mary University of London, London E1 4NS, UK.
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105
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Cespedes JC, Liu M, Harbuzariu A, Nti A, Onyekaba J, Cespedes HW, Bharti PK, Solomon W, Anyaoha P, Krishna S, Adjei A, Botchway F, Ford B, Stiles JK. Neuregulin in Health and Disease. INTERNATIONAL JOURNAL OF BRAIN DISORDERS AND TREATMENT 2018; 4:024. [PMID: 31032468 PMCID: PMC6483402 DOI: 10.23937/2469-5866/1410024] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Affiliation(s)
- Juan Carlos Cespedes
- Department of Microbiology, Biochemistry and Immunology, Morehouse School of Medicine, USA
| | - Mingli Liu
- Department of Microbiology, Biochemistry and Immunology, Morehouse School of Medicine, USA
| | - Adriana Harbuzariu
- Department of Microbiology, Biochemistry and Immunology, Morehouse School of Medicine, USA
| | - Annette Nti
- Department of Microbiology, Biochemistry and Immunology, Morehouse School of Medicine, USA
| | - John Onyekaba
- Department of Microbiology, Biochemistry and Immunology, Morehouse School of Medicine, USA
| | - Hanna Watson Cespedes
- Department of Microbiology, Biochemistry and Immunology, Morehouse School of Medicine, USA
| | | | - Wesley Solomon
- Department of Microbiology, Biochemistry and Immunology, Morehouse School of Medicine, USA
| | - Precious Anyaoha
- Department of Microbiology, Biochemistry and Immunology, Morehouse School of Medicine, USA
| | - Sri Krishna
- ICMR-National Institute for Research in Tribal Health, India
| | - Andrew Adjei
- Department of Pathology, Korle-Bu Teaching Hospital, University of Ghana Medical School, Ghana
| | - Felix Botchway
- Department of Pathology, Korle-Bu Teaching Hospital, University of Ghana Medical School, Ghana
| | - Byron Ford
- Division of Biomedical Sciences, University of California-Riverside School of Medicine, USA
| | - Jonathan K Stiles
- Department of Microbiology, Biochemistry and Immunology, Morehouse School of Medicine, USA
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106
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Sandgren AM, Brummer RJ. ADHD-originating in the gut? The emergence of a new explanatory model. Med Hypotheses 2018; 120:135-145. [DOI: 10.1016/j.mehy.2018.08.022] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2017] [Accepted: 08/25/2018] [Indexed: 12/12/2022]
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107
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Miguel PM, Deniz BF, Deckmann I, Confortim HD, Diaz R, Laureano DP, Silveira PP, Pereira LO. Prefrontal cortex dysfunction in hypoxic-ischaemic encephalopathy contributes to executive function impairments in rats: Potential contribution for attention-deficit/hyperactivity disorder. World J Biol Psychiatry 2018; 19:547-560. [PMID: 28105895 DOI: 10.1080/15622975.2016.1273551] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
OBJECTIVES The attention-deficit/hyperactivity disorder (ADHD) compromises the quality of life of individuals including adaptation to the social environment. ADHD aetiology includes perinatal conditions such as hypoxic-ischaemic events; preclinical studies have demonstrated attentional deficits and impulsive-hyperactive outcomes after neonatal hypoxic and/or ischaemic intervention, but data are missing to understand this relationship. Thus, the aim of this study was to evaluate executive function (EF) and impulsivity, and tissue integrity and dopaminergic function in the prefrontal cortex (PFC) of rats submitted to hypoxia-ischaemia (HI). METHODS At postnatal day (PND) 7, male Wistar rats were divided into control (n = 10) and HI groups (n = 11) and the HI procedure was conducted. At PND60, the animals were tested in the attentional set-shifting (ASS) task to EF and in the tolerance to delay of reward for assessment of impulsivity. After, morphological analysis and the dopaminergic system were evaluated in the PFC. RESULTS Animals subjected to HI had impairments in EF evidenced by a behavioural inflexibility that was correlated to PFC atrophy. Moreover, HI animals presented reduced D2 receptors in the ipsilateral side of ischaemia in the PFC. CONCLUSIONS Animals submitted to HI presented impaired EF associated with tissue atrophy and dopaminergic disturbance in the PFC.
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Affiliation(s)
- Patrícia Maidana Miguel
- a Programa de Pós-Graduação em Neurociências, Instituto de Ciências Básicas da Saúde (ICBS) , Universidade Federal do Rio Grande do Sul , Porto Alegre , RS , Brazil.,b Departamento de Ciências Morfológicas, ICBS , Universidade Federal do Rio Grande do Sul , Porto Alegre , RS , Brazil
| | - Bruna Ferrary Deniz
- a Programa de Pós-Graduação em Neurociências, Instituto de Ciências Básicas da Saúde (ICBS) , Universidade Federal do Rio Grande do Sul , Porto Alegre , RS , Brazil.,b Departamento de Ciências Morfológicas, ICBS , Universidade Federal do Rio Grande do Sul , Porto Alegre , RS , Brazil
| | - Iohanna Deckmann
- b Departamento de Ciências Morfológicas, ICBS , Universidade Federal do Rio Grande do Sul , Porto Alegre , RS , Brazil
| | - Heloísa Deola Confortim
- a Programa de Pós-Graduação em Neurociências, Instituto de Ciências Básicas da Saúde (ICBS) , Universidade Federal do Rio Grande do Sul , Porto Alegre , RS , Brazil.,b Departamento de Ciências Morfológicas, ICBS , Universidade Federal do Rio Grande do Sul , Porto Alegre , RS , Brazil
| | - Ramiro Diaz
- a Programa de Pós-Graduação em Neurociências, Instituto de Ciências Básicas da Saúde (ICBS) , Universidade Federal do Rio Grande do Sul , Porto Alegre , RS , Brazil.,b Departamento de Ciências Morfológicas, ICBS , Universidade Federal do Rio Grande do Sul , Porto Alegre , RS , Brazil
| | - Daniela Pereira Laureano
- a Programa de Pós-Graduação em Neurociências, Instituto de Ciências Básicas da Saúde (ICBS) , Universidade Federal do Rio Grande do Sul , Porto Alegre , RS , Brazil
| | - Patrícia Pelufo Silveira
- a Programa de Pós-Graduação em Neurociências, Instituto de Ciências Básicas da Saúde (ICBS) , Universidade Federal do Rio Grande do Sul , Porto Alegre , RS , Brazil.,c Programa de Pós-Graduação em Saúde da Criança e do Adolescente, Faculdade de Medicina , Universidade Federal do Rio Grande do Sul , Porto Alegre , RS , Brazil.,d Ludmer Centre for Neuroinformatics and Mental Health , Douglas Mental Health University Institute, McGill University , Montreal , QC , Canada
| | - Lenir Orlandi Pereira
- a Programa de Pós-Graduação em Neurociências, Instituto de Ciências Básicas da Saúde (ICBS) , Universidade Federal do Rio Grande do Sul , Porto Alegre , RS , Brazil.,b Departamento de Ciências Morfológicas, ICBS , Universidade Federal do Rio Grande do Sul , Porto Alegre , RS , Brazil
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108
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Castellheim A, Lundström S, Molin M, Kuja-Halkola R, Gillberg C, Gillberg C. The role of general anesthesia on traits of neurodevelopmental disorders in a Swedish cohort of twins. J Child Psychol Psychiatry 2018; 59:966-972. [PMID: 29465765 DOI: 10.1111/jcpp.12885] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/24/2018] [Indexed: 12/21/2022]
Abstract
BACKGROUND The role of general anesthetics as a risk factor for possible neurodevelopmental disorders (NDDs) in humans is unresolved. The investigation of the role of anesthetics in the development of postgeneral anesthesia (anesthesia onward) NDDs has proven to be complicated, partly because of the inherent confounding in clinical cohort studies, and partly by the fact that anesthetics are only one part in the complex process of anesthesia-surgery. METHODS Utilizing the Swedish databases Child and Adolescent Twins Study in Sweden (CATSS) and National Patient Register (NPR), we investigated twins discordant for anesthesia, born between 1997 and 2004 for traits of NDDs. We identified 68 twin pairs discordant for anesthesia and explored traits of Attention-Deficit/Hyperactivity Disorder (ADHD), Learning Disability (LD), and Autism Spectrum Disorder (ASD) in them while simultaneously taking congenital abnormalities and systemic disorders (CSDs) into account. We analyzed the possible effect of anesthesia on neurodevelopmental problems, and we analyzed the within-pair differences using conditional linear regression. RESULTS Twins with a recorded episode of anesthesia had higher traits of NDDs than twins without; similarly twins with CSDs had higher mean scores on all traits than twins without CSDs. The within-pair analyses suggested that exposure to anesthesia was associated with higher scores of ADHD (regression coefficient 1.02 and 95% confidence intervals: 0.27-1.78) in monozygotic (MZ) twins discordant for anesthesia. This effect remained when adjusting for congenital abnormalities. DISCUSSION Our finding that traits of ADHD were slightly associated with anesthesia in a genetically sensitive design is in need of replication and warrants further investigation. Future studies should aim to elucidate mechanisms behind this possible association (e.g. anesthetics doses, age at exposure, exposure duration).
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Affiliation(s)
- Albert Castellheim
- Department of Anesthesiology and Intensive Care, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Sebastian Lundström
- Gillberg Neuropsychiatry Centre, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Centre for Ethics, Law, and Mental Health, Institute of Neuroscience and Physiology, University of Gothenburg, Gothenburg, Sweden
| | | | - Ralf Kuja-Halkola
- Department of Medical Epidemiology and Biostatistics, Karolinska Institute, Stockholm, Sweden
| | - Carina Gillberg
- Gillberg Neuropsychiatry Centre, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Christopher Gillberg
- Gillberg Neuropsychiatry Centre, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
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109
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Freed RD, Mehra LM, Laor D, Patel M, Alonso CM, Kim-Schulze S, Gabbay V. Anhedonia as a clinical correlate of inflammation in adolescents across psychiatric conditions. World J Biol Psychiatry 2018; 20:712-722. [PMID: 29843560 PMCID: PMC6377856 DOI: 10.1080/15622975.2018.1482000] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
Objectives: Peripheral inflammation has been associated with multiple psychiatric disorders, particularly with depression. However, findings remain inconsistent and unreproducible, most likely due to the disorder's heterogeneity in phenotypic presentation. Therefore, in the present study, in an effort to account for inter-individual differences in symptom severity, we utilised a dimensional approach to assess the relationships between a broad panel of inflammatory cytokines and key psychiatric symptoms (i.e. depression, anhedonia, anxiety, fatigue and suicidality) in adolescents across psychiatric disorders. We hypothesised that only anhedonia (reflecting deficits of reward function) will be associated with inflammation.Methods: Participants were 54 psychotropic medication-free adolescents with diverse psychiatric conditions and 22 healthy control (HC) adolescents, aged 12-20. We measured 41 cytokines after in vitro lipopolysaccharide stimulation. Mann-Whitney U and Spearman correlation tests examined group comparison and associations, respectively, while accounting for multiple comparisons and confounds, including depression severity adolescent.Results: There were no group differences in cytokine levels. However, as hypothesised, within the psychiatric group, only anhedonia was associated with 19 cytokines, including haematopoietic growth factors, chemokines, pro-inflammatory cytokines, and anti-inflammatory cytokines.Conclusions: Our findings suggest that general inflammation may induce reward dysfunction, which plays a salient role across psychiatric conditions, rather than be specific to one categorical psychiatric disorder.
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Affiliation(s)
- Rachel D. Freed
- Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Pl, New York, NY
| | - Lushna M. Mehra
- Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Pl, New York, NY
| | - Daniel Laor
- Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Pl, New York, NY
| | - Manishkumar Patel
- Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Pl, New York, NY
| | - Carmen M. Alonso
- Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Pl, New York, NY
| | | | - Vilma Gabbay
- Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Pl, New York, NY,Nathan S. Kline Institute for Psychiatric Research, 140 Old Orangeburg Rd, Orangeburg, NY
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110
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Grant JE, Chamberlain SR. Salivary Inflammatory Markers in Trichotillomania: A Pilot Study. Neuropsychobiology 2018; 76:182-186. [PMID: 29920483 PMCID: PMC6098693 DOI: 10.1159/000489865] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2018] [Accepted: 05/06/2018] [Indexed: 11/19/2022]
Abstract
BACKGROUND Immune dysregulation has been hypothesized to be important in the development and pathophysiology of compulsive disorders such as obsessive compulsive disorder (OCD), which has a high comorbid overlap with trichotillomania (both are OC-related disorders). The role of inflammation in the pathophysiology of trichotillomania has garnered little research to date. METHODS Individuals with trichotillomania provided saliva sample for analysis of inflammatory cytokines. Additionally, these participants were examined on a variety of demographic variables (including body mass index [BMI], previously found to relate to inflammation) along with clinical measures (symptom severity, functioning, and comorbidity). RESULTS Thirty-one participants, mean age of 24.7 (±10.2) years, 27 (87.1%) females were -included. The mean score on the Massachusetts General Hospital Hair Pulling Scale was 15.7 (±4.2), reflective of moderate symptom severity. Compared to normative data, the mean inflammatory marker levels in the trichotillomania sample had the following Z scores: interleukin-1β (IL-1β) Z = -0.26, IL-6 Z = -0.39, IL-8 Z = -0.32, and tumor necrosis factor-α Z = -0.83. Levels of inflammatory markers did not correlate significantly with BMI, depressive mood, symptom severity, or disability. CONCLUSIONS The relatively low level of inflammatory saliva cytokines observed in the current study (negative z scores versus normative data with medium effect sizes) indicates that evaluation of blood inflammatory levels in trichotillomania versus matched controls would be valuable in future work. If a hypoinflammatory state is confirmed -using blood samples, this would differentiate trichotillomania from other mental disorders (such as OCD, schizophrenia, and depression), which have typically been linked with high inflammatory measures in the literature, at least in some cases.
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Affiliation(s)
- Jon E. Grant
- Department of Psychiatry and Behavioral Neuroscience, University of Chicago, Chicago, Illinois, USA,*Jon E. Grant, JD, MD, MPH, Department of Psychiatry and Behavioral Neuroscience, University of Chicago, Pritzker School of Medicine, 5841 S. Maryland Avenue, MC 3077, Chicago, IL 60637 (USA), E-Mail
| | - Samuel R. Chamberlain
- Department of Psychiatry, University of Cambridge, Cambridge and Peterborough NHS Foundation Trust, Cambridge, United Kingdom
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111
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Cytokine, chemokine and BDNF levels in medication-free pediatric patients with obsessive-compulsive disorder. Eur Child Adolesc Psychiatry 2018; 27:977-984. [PMID: 29302747 DOI: 10.1007/s00787-017-1099-3] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2017] [Accepted: 12/11/2017] [Indexed: 12/16/2022]
Abstract
The aim of this study was to investigate whether the serum levels of IL-12, IL-17, TGFβ, TNF-alpha, sTNFR1, sTNFR2, IL-1β, CCL3, CCL24, CXCL8, and BDNF are associated with obsessive-compulsive disorder (OCD) in medication-free children. A total of 44 (22 boys/22 girls) medication-free children with OCD and 40 (23 boys/17 girls) healthy controls were included in this study. The severity of the OCD symptoms were assessed by the Children's Yale-Brown Obsessive-Compulsive Scale and the Maudsley Obsessive-Compulsive Inventory. The Children's Depression Inventory and the Screen for Child Anxiety-Related Emotional Disorders were applied to the children in order to determine depression and anxiety levels. IL-17, IL-12, TGF β, TNF-alpha, sTNFR1, sTNFR2, IL-1β, CCL3, CCL24, CXCL8, and BDNF levels were measured by enzyme-linked immunosorbent assay. Multivariate analysis of covariance (MANCOVA) revealed a significant main effect on both groups for the levels of serum cytokine, chemokine, and BDNF, an effect that was independent of severities of depression and anxiety [Pillai's Trace V = 0.371, F (11, 70) = 3.756, p < 0.001, hp2 = 0.187]. Analysis of covariance (ANCOVA) indicated that serum TNF-alpha levels were significantly higher in the OCD group than in the control group (p < 0.001). In contrast, serum IL-12 levels were significantly lower in the OCD group than in the control group (p = 0.014). These findings suggest that TNF-alpha and IL-12 may play a role in the pathophysiology of OCD in children. The causal relationship between these proinflammatory cytokines and pediatric OCD requires further investigation.
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112
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Thurgur H, Pinteaux E. Microglia in the Neurovascular Unit: Blood-Brain Barrier-microglia Interactions After Central Nervous System Disorders. Neuroscience 2018; 405:55-67. [PMID: 31007172 DOI: 10.1016/j.neuroscience.2018.06.046] [Citation(s) in RCA: 117] [Impact Index Per Article: 19.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2018] [Revised: 06/26/2018] [Accepted: 06/27/2018] [Indexed: 12/11/2022]
Abstract
Over the past few decades, microglial cells have been regarded as the main executor of inflammation after acute and chronic central nervous system (CNS) disorders, responding rapidly to exogenous stimuli during acute trauma or infections, or signals released by cells undergoing cell death during conditions such as stroke, Alzheimer's disease (AD) and Parkinson's disease (PD). Barriers of the nervous system, and in particular the blood-brain barrier (BBB), play a key role in the normal physiological and cognitive functions of the brain. Being at the interface between the central and peripheral compartment, the BBB is regarded as a sensor of homeostasis, and any disruption within the brain or the systemic compartment triggers BBB dysfunction and neuroinflammation, both contributing to the pathogenesis of cerebrovascular disease. This involves a dynamic response mediated by all components of the neurovascular unit (NVU), and ongoing research suggests that BBB-microglia interaction is critical to dictate the microglial response to NVU injury. The present review aims to give an up-to-date account of the emerging critical role of BBB-microglia interactions during neuroinflammation, and how these could be targeted for the therapeutic treatment of major central inflammatory disease.
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Affiliation(s)
- Hannah Thurgur
- Faculty of Biology, Medicine and Health, AV Hill Building, The University of Manchester, United Kingdom
| | - Emmanuel Pinteaux
- Faculty of Biology, Medicine and Health, AV Hill Building, The University of Manchester, United Kingdom.
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113
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Ghassabian A, Sundaram R, Chahal N, McLain AC, Bell EM, Lawrence DA, Gilman SE, Yeung EH. Concentrations of immune marker in newborn dried blood spots and early childhood development: Results from the Upstate KIDS Study. Paediatr Perinat Epidemiol 2018; 32:337-345. [PMID: 29972605 PMCID: PMC6763275 DOI: 10.1111/ppe.12485] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
BACKGROUND Evidence shows cytokine dysregulation in children with developmental disabilities. The association between immune activity during the perinatal period and child development is less clear. METHODS We examined the relationship between newborn concentrations of immune markers and child development. Within Upstate KIDS, a population-based birth cohort (2008-2010, upstate New York), we assayed immune markers, which are postulated to have neuro-modulatory effects, in newborn dried blood spots (NDBS, n = 3038). Mothers completed the Ages & Stages Questionnaire© (ASQ) for their children repeatedly through age 36 months. At 30 and 36 months, mothers also reported whether their children received any developmental services. We used generalised linear mixed models adjusted for maternal and child characteristics to test associations. RESULTS Sixteen immune markers were associated with failing ASQ in unadjusted models. After full adjustment (for gestational age, mode of delivery, parity, pregnancy smoking, etc.), we observed that higher levels of 4 markers, including platelet-derived growth factor-AA (PDGF-AA, OR 0.77, 95% CI 0.67, 0.89), plasminogen activator inhibitor-1 (OR 0.80, 95% CI 0.68, 0.94), stromal cell derived factor-1 (OR 0.85, 95% CI 0.73, 0.98), and macrophage inflammatory protein-1beta (OR 0.87, 95% CI 0.77, 0.98) were associated with lower odds of ASQ failure. The associations did not exist if correction for multiple comparisons was performed, except for PDGF-AA. Analyses with developmental service use revealed similar null findings. CONCLUSIONS Immune marker concentrations in NDBS may not be associated with developmental delay in the general population. Newborn concentrations of growth factor PDGF-AA may be protective of developmental delay in childhood.
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Affiliation(s)
- Akhgar Ghassabian
- Departments of Pediatrics, Environmental Medicine, and
Population Health, New York University School of Medicine, New York, NY,Epidemiology Branch, Division of Intramural Population
Health Research, Eunice Kennedy Shriver National Institute of Child
Health and Human Development, National Institutes of Health, Bethesda, MD
| | - Rajeshwari Sundaram
- Biostatistics and Bioinformatics Branch, Division of
Intramural Population Health Research, Eunice Kennedy Shriver
National Institute of Child Health and Human Development, National Institutes of
Health, Bethesda, MD
| | - Nikhita Chahal
- Epidemiology Branch, Division of Intramural Population
Health Research, Eunice Kennedy Shriver National Institute of Child
Health and Human Development, National Institutes of Health, Bethesda, MD
| | - Alexander C McLain
- Department of Epidemiology and Biostatistics, Arnold
School of Public Health, University of South Carolina, SC
| | - Erin M. Bell
- Department of Environmental Health Sciences,Department of Epidemiology and Biostatistics, University
at Albany School of Public Health, Albany, NY
| | - David A Lawrence
- Department of Environmental Health Sciences,Wadsworth Center, New York State Department of Health,
Albany, NY
| | - Stephen E. Gilman
- Health Behavior Branch, Division of Intramural Population
Health Research, Eunice Kennedy Shriver National Institute of Child
Health and Human Development, National Institutes of Health, Bethesda, MD,Department of Mental Health, The Johns Hopkins Bloomberg
School of Public Health, Baltimore, MD
| | - Edwina H Yeung
- Epidemiology Branch, Division of Intramural Population
Health Research, Eunice Kennedy Shriver National Institute of Child
Health and Human Development, National Institutes of Health, Bethesda, MD
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114
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Avcil S. Evaluation of the neutrophil/lymphocyte ratio, platelet/lymphocyte ratio, and mean platelet volume as inflammatory markers in children with attention-deficit hyperactivity disorder. Psychiatry Clin Neurosci 2018; 72:522-530. [PMID: 29607599 DOI: 10.1111/pcn.12659] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2018] [Revised: 03/08/2018] [Accepted: 03/23/2018] [Indexed: 12/14/2022]
Abstract
AIM The neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR), monocyte/lymphocyte ratio (MLR), and mean platelet volume (MPV) have recently been used as indicators of a systemic inflammatory response. The aim of this study was to investigate the relations of the NLR, PLR, MLR, and MPV with attention-deficit hyperactivity disorder (ADHD). METHODS The study group consisting of 82 children diagnosed with ADHD was compared with a healthy control (HC) group of 70 age-, sex-, and body-mass-index-matched subjects. The NLR, PLR, MLR, and MPV were measured according to the complete blood count. RESULTS The NLR, PLR, MLR, MPV, and neutrophil count of the ADHD group were significantly higher than those of the HC group. The lymphocyte counts of the patients were significantly lower than those of the HC group. CONCLUSION Inflammation might play a role in the etiopathogenesis of ADHD. The NLR, PLR, MLR, and MPV may be potential inflammation markers for ADHD in children.
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Affiliation(s)
- Sibelnur Avcil
- Department of Child and Adolescent Psychiatry, Adnan Menderes University Faculty of Medicine, Aydın, Turkey
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115
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Rodrigues-Amorim D, Rivera-Baltanás T, Spuch C, Caruncho HJ, González-Fernandez Á, Olivares JM, Agís-Balboa RC. Cytokines dysregulation in schizophrenia: A systematic review of psychoneuroimmune relationship. Schizophr Res 2018; 197:19-33. [PMID: 29239785 DOI: 10.1016/j.schres.2017.11.023] [Citation(s) in RCA: 69] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2017] [Revised: 11/15/2017] [Accepted: 11/18/2017] [Indexed: 02/07/2023]
Abstract
INTRODUCTION Schizophrenia is a multifactorial psychiatric disease with complex interactions among the brain and the immune system. A psycho-immune relationship underling schizophrenia is supported by several studies and integrates a specific area of knowledge - psychoneuroimmunology. METHODS A systematic review was performed by 2009 Preferred Reporting Items (PRISMA) recommendations. Based on the inclusion/exclusion criteria, publications with relevant information (evaluated by the Joanna Briggs Institute Critical Appraisals tools to quality assessment) were included. RESULTS In this review, we considered the inflammatory activity promoted by cytokine alterations in schizophrenia aetiology, which reflects the systemic comprehension of this disease in opposition to the traditional approach focused solely on the brain. We focus on the analysis of several specific outcomes, such as proinflammatory cytokines, sample sort, laboratory techniques, diagnosis scales and results of each publication. CONCLUSION This systematic review confirms the existence of cytokines abnormalities in schizophrenia disease. Immune imbalances such as increased levels of some cytokines (either at protein level or at mRNA expression), cytokine mRNAs, as well as cytokine gene polymorphisms have been reported with a large support in schizophrenia. These findings provide a strong evidence of a concomitant process of inflammatory activity in schizophrenia illness course.
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Affiliation(s)
- Daniela Rodrigues-Amorim
- Psychiatric Diseases Research Group, Galicia Sur Health Research Institute (IISGS), Complexo Hospitalario Universitario de Vigo (CHUVI), SERGAS, CIBERSAM, Spain
| | - Tania Rivera-Baltanás
- Psychiatric Diseases Research Group, Galicia Sur Health Research Institute (IISGS), Complexo Hospitalario Universitario de Vigo (CHUVI), SERGAS, CIBERSAM, Spain
| | - Carlos Spuch
- Neurology Research Group, Galicia Sur Health Research Institute (IISGS), Complexo Hospitalario Universitario de Vigo (CHUVI), SERGAS, CIBERSAM, Spain
| | - Hector J Caruncho
- Division of Medical Sciences, University of Victoria, Victoria, BC V8P 5C2, Canada
| | - África González-Fernandez
- Immunology, Biomedical Research Center (CINBIO) (Centro Singular de Investigación de Galicia), Galicia-Sur Health Research Institute (IISGS), University Campus, University of Vigo, Vigo, Spain
| | - Jose M Olivares
- Psychiatric Diseases Research Group, Galicia Sur Health Research Institute (IISGS), Complexo Hospitalario Universitario de Vigo (CHUVI), SERGAS, CIBERSAM, Spain
| | - Roberto C Agís-Balboa
- Psychiatric Diseases Research Group, Galicia Sur Health Research Institute (IISGS), Complexo Hospitalario Universitario de Vigo (CHUVI), SERGAS, CIBERSAM, Spain.
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116
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Conti P, Caraffa A, Ronconi G, Conti CM, Kritas SK, Mastrangelo F, Tettamanti L, Theoharides TC. Impact of mast cells in depression disorder: inhibitory effect of IL-37 (new frontiers). Immunol Res 2018; 66:323-331. [DOI: 10.1007/s12026-018-9004-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/18/2023]
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117
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Neavin DR, Joyce J, Swintak C. Treatment of Major Depressive Disorder in Pediatric Populations. Diseases 2018; 6:diseases6020048. [PMID: 29866991 PMCID: PMC6023496 DOI: 10.3390/diseases6020048] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2018] [Revised: 05/28/2018] [Accepted: 05/31/2018] [Indexed: 12/12/2022] Open
Abstract
Major depressive disorder (MDD) is a severe illness that afflicts about 16.6% of people over their lifetime. MDD is highly correlated with suicidality, and often first presents in adolescence. Unfortunately, many pediatric patients suffering from MDD go undiagnosed, and current evidence-based treatment options in the U.S. are limited to psychotherapy and two selective serotonin reuptake inhibitors approved by the United States Food and Drug Administration. Molecular mechanisms have been shown to play a role in MDD pathogenesis, progression, and response to medication, yet few studies have explored the role of these pathways in pediatric MDD. In this review, we outline the gravity and importance of MDD in pediatric patients, some challenges in diagnosis and treatment, current treatments available for pediatric patients, and research to investigate differences between pediatric and adult MDD. We hope that this review will provide an outline of the current understanding and treatment of MDD in pediatric patients, and provide thoughtful insights for future work that could advance our understanding of MDD in pediatric populations, and also identify new therapeutic strategies.
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Affiliation(s)
- Drew R Neavin
- Department of Molecular Pharmacology and Experimental Therapeutics, Mayo Clinic Graduate School of Biomedical Sciences, Mayo Clinic, Rochester, MN 55902, USA.
| | - Jeremiah Joyce
- Mayo Clinic School of Medicine, Mayo Clinic, Rochester, MN 55902, USA.
| | - Cosima Swintak
- Department of Psychiatry, College of Medicine, Rochester, MN 55902, USA.
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118
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Bennabi M, Gaman A, Delorme R, Boukouaci W, Manier C, Scheid I, Si Mohammed N, Bengoufa D, Charron D, Krishnamoorthy R, Leboyer M, Tamouza R. HLA-class II haplotypes and Autism Spectrum Disorders. Sci Rep 2018; 8:7639. [PMID: 29769579 PMCID: PMC5955937 DOI: 10.1038/s41598-018-25974-9] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2018] [Accepted: 04/26/2018] [Indexed: 02/06/2023] Open
Abstract
Infections and autoimmunity are associated with autism spectrum disorders (ASD), with both strongly influenced by the genetic regulation of the human leukocyte antigen (HLA) system. The relationship between ASD and the HLA genetic diversity requires further investigation. Using a case control design, the distribution of HLA class II-DRB1 and DQB1 alleles, genotypes and haplotypes were investigated in ASD patients, versus healthy controls (HC). ASD patients meeting DSM-IV TR criteria and HC (474 and 350 respectively) were genotyped at medium resolution using a Luminex-based SSO technology. Comparisons of genotypes, allele frequencies associated with a haplotype analysis were performed. Results indicate: (i) the HLA-DRB1 *11-DQB1*07 haplotype was more prevalent in ASD patients, versus HC (Pc = 0.001), partially replicating previous data and possibly linking to gastro-intestinal (GI)-related pro-inflammatory processes, given that this haplotype associates with pediatric celiac disorders; (ii) the HLA-DRB1 *17-DQB1*02 haplotype was higher in HC, versus ASD patients (Pc = 0.002), indicating that this is a protective haplotype. Using the Autism Diagnostic Interview to assess clinical dimensions, higher scores on social (Pc = 0.006) and non-verbal functioning (Pc = 0.004) associated with the DRB1 *11 DQB1*07 haplotype. Our results support HLA involvement in ASD, with possible relevance to GI and gut-brain axis dysregulation.
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Affiliation(s)
- Meriem Bennabi
- INSERM, U1160, Hôpital Saint Louis, Paris, France.,INSERM, U955, Psychiatrie Translationnelle, Créteil, France.,Fondation FondaMental, Créteil, France
| | - Alexandru Gaman
- INSERM, U955, Psychiatrie Translationnelle, Créteil, France.,Fondation FondaMental, Créteil, France
| | - Richard Delorme
- Fondation FondaMental, Créteil, France.,DHU Protect, AP-HP, Service de psychiatrie de l'enfant et de l'adolescent, Hôpital Robert Debré, Paris, France.,Département de génétique humaine et fonctions cognitives, Institut Pasteur, Paris, France.,Université Paris Diderot, Sorbonne Paris-Cité, Paris, France
| | | | | | - Isabelle Scheid
- INSERM, U955, Psychiatrie Translationnelle, Créteil, France.,Fondation FondaMental, Créteil, France
| | | | - Djaouida Bengoufa
- Laboratoire Jean Dausset and LabEx Transplantex, Hôpital Saint Louis, Paris, France
| | - Dominique Charron
- INSERM, U1160, Hôpital Saint Louis, Paris, France.,Université Paris Diderot, Sorbonne Paris-Cité, Paris, France.,Laboratoire Jean Dausset and LabEx Transplantex, Hôpital Saint Louis, Paris, France
| | - Rajagopal Krishnamoorthy
- INSERM, U955, Psychiatrie Translationnelle, Créteil, France.,Fondation FondaMental, Créteil, France
| | - Marion Leboyer
- INSERM, U955, Psychiatrie Translationnelle, Créteil, France.,Fondation FondaMental, Créteil, France.,DHU PePSY, AP-HP, Pôle de Psychiatrie, Hôpitaux Universitaires Henri Mondor, Créteil, France.,Université Paris-Est-Créteil, Faculté de médecine, Créteil, France
| | - Ryad Tamouza
- INSERM, U1160, Hôpital Saint Louis, Paris, France. .,INSERM, U955, Psychiatrie Translationnelle, Créteil, France. .,Fondation FondaMental, Créteil, France. .,Université Paris Diderot, Sorbonne Paris-Cité, Paris, France. .,Laboratoire Jean Dausset and LabEx Transplantex, Hôpital Saint Louis, Paris, France. .,DHU PePSY, AP-HP, Pôle de Psychiatrie, Hôpitaux Universitaires Henri Mondor, Créteil, France.
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119
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Bustan Y, Drapisz A, Ben Dor DH, Avrahami M, Schwartz-Lifshitz M, Weizman A, Barzilay R. Elevated neutrophil to lymphocyte ratio in non-affective psychotic adolescent inpatients: Evidence for early association between inflammation and psychosis. Psychiatry Res 2018; 262:149-153. [PMID: 29448179 DOI: 10.1016/j.psychres.2018.02.002] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2017] [Revised: 01/17/2018] [Accepted: 02/01/2018] [Indexed: 12/12/2022]
Abstract
Accumulating data suggest an association between inflammation and schizophrenia and related psychosis. While several studies have established this immune-psychosis association in adult schizophrenia patients, there is very limited data associating inflammation with acute psychosis in children and adolescents. The ratio between neutrophils and lymphocyte, computed from routine blood counts, has been shown to correlate with traditional markers of inflammation, and is therefore considered a proxy-marker for inflammation. Here we report elevated neutrophil to lymphocyte ratio and total leukocyte count in psychotic adolescent inpatients (n = 81, mean age 14.7 years, 52% males) compared to non-psychotic adolescent inpatient (n = 285, mean age 15.9 years, 58% males), in a population of adolescent inpatients with no affective symptomatology. The elevated neutrophil to lymphocyte ratio remained significant after controlling for confounders such as age, BMI, smoking and antipsychotic medication. In a subset of psychotic adolescent inpatients (n = 20, mean duration between blood test 157 days), we found significant decrease in neutrophil to lymphocyte ratio at clinical remission compared with the acute psychotic state. The results suggest that psychosis is associated with peripheral markers of inflammation early in the course of psychiatric pathology, and that inflammation may represent a state that accompanies psychosis and decreases during clinical remission.
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Affiliation(s)
- Yael Bustan
- Child & Adolescent Division, Geha Mental Health Center, Sackler Faculty of Medicine, Tel Aviv University, Israel
| | - Adi Drapisz
- Child & Adolescent Division, Geha Mental Health Center, Sackler Faculty of Medicine, Tel Aviv University, Israel
| | - David H Ben Dor
- Child & Adolescent Division, Geha Mental Health Center, Sackler Faculty of Medicine, Tel Aviv University, Israel
| | - Matan Avrahami
- Child & Adolescent Division, Geha Mental Health Center, Sackler Faculty of Medicine, Tel Aviv University, Israel
| | - Maya Schwartz-Lifshitz
- Child & Adolescent Division, Geha Mental Health Center, Sackler Faculty of Medicine, Tel Aviv University, Israel
| | - Abraham Weizman
- Child & Adolescent Division, Geha Mental Health Center, Sackler Faculty of Medicine, Tel Aviv University, Israel
| | - Ran Barzilay
- Child & Adolescent Division, Geha Mental Health Center, Sackler Faculty of Medicine, Tel Aviv University, Israel; Lifespan Brain Institute, Children's Hospital of Philadelphia and Penn Medicine; the Department of Child and Adolescent Psychiatry and Behavioral Sciences, CHOP, Philadelphia, PA, United States.
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120
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Jiang HY, Zhou YY, Zhou GL, Li YC, Yuan J, Li XH, Ruan B. Gut microbiota profiles in treatment-naïve children with attention deficit hyperactivity disorder. Behav Brain Res 2018; 347:408-413. [PMID: 29580894 DOI: 10.1016/j.bbr.2018.03.036] [Citation(s) in RCA: 86] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2017] [Revised: 03/05/2018] [Accepted: 03/22/2018] [Indexed: 01/10/2023]
Abstract
BACKGROUNDS Although increasing evidence suggests a role for the gut microbiota in neurodevelopment, the actual structure and composition of microbiota in children with attention-deficit/hyperactivity disorder (ADHD) remain unclear. METHODS Thus, the present study aimed to define the characteristics of gut microbiota in treatment-naive children with ADHD and to assess their relationship with the severity of ADHD symptoms. High-throughput pyrosequencing was used to investigate the microbiota composition in fecal matter from 51 children with ADHD and 32 healthy controls (HC). RESULTS An operational taxonomical unit (OTU)-level analysis revealed a significant decrease in the fractional representation of Faecalibacterium in children with ADHD compared to HC. In individuals with ADHD, the abundance of Faecalibacterium was negatively associated with parental reports of ADHD symptoms. However, there was no significant difference in alpha diversity between the ADHD and control groups. CONCLUSIONS This present findings support the involvement of microbiota alteration in psychiatric diseases and Faecalibacterium may represent a potential novel marker of gut microbiota in ADHD. Future studies are needed to validate these findings and to elucidate the temporal and causal relationships between these variables.
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Affiliation(s)
- Hai-Yin Jiang
- State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang, 310003, China
| | - Yuan-Yue Zhou
- Department of Child Psychiatry, Hangzhou Seventh People's Hospital, Hangzhou, Zhejiang, 310013, China
| | - Guo-Ling Zhou
- Department of Child Psychiatry, Hangzhou Seventh People's Hospital, Hangzhou, Zhejiang, 310013, China
| | - Yu-Chuan Li
- State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang, 310003, China
| | - Jing Yuan
- Department of Liver Diseases, The Third People's Hospital of Shenzhen, Shenzhen, Guangdong, 518000, China
| | - Xiao-He Li
- Department of Liver Diseases, The Third People's Hospital of Shenzhen, Shenzhen, Guangdong, 518000, China
| | - Bing Ruan
- State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang, 310003, China.
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121
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Abstract
Gestational inflammation may contribute to brain abnormalities associated with childhood neuropsychiatric disorders. Limited knowledge exists regarding the associations of maternal cytokine levels during pregnancy with offspring neurocognitive development. We assayed the concentrations of five cytokines (interleukin (IL)-6, IL-1β, IL-8, tumor necrosis factor alpha (TNF-α), and IL-10) up to four times in the 2nd and 3rd trimesters of pregnancy using stored prenatal sera from 1366 participants in the New England Family Study (enrollment 1959-1966). Intelligence (IQ), academic achievement, and neuropsychological functioning of singleton offspring were assessed at age 7 years using standardized tests. We used linear mixed models with random effects to estimate the cumulative exposure to each cytokine during 2nd and 3rd trimesters, and then related cumulative cytokine exposure to a wide range of offspring neurocognitive outcomes. We found that children of women with higher levels of the pro-inflammatory cytokine, TNF-α, in the 2nd and 3rd trimesters had lower IQ (B = -2.51, 99% CI: -4.84,-0.18), higher problem scores in visual-motor maturity (B = 0.12, 99% CI: 0.001,0.24), and lower Draw-a-Person test scores (B = -1.28, 99% CI: -2.49,-0.07). Higher gestational levels of IL-8, another pro-inflammatory molecule, were associated with better Draw-a-Person test scores and tactile finger recognition scores. Other cytokines were not associated with our outcome of interest. The opposing directions of associations observed between TNF-α and IL-8 with childhood outcomes suggest pleiotropic effects of gestational inflammation across the domains of neurocognitive functioning. Although the path to psychopathological disturbances in children is no doubt multifactorial, our findings point to a potential role for immune processes in the neurocognitive development of children.
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122
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Cohen-Cymberknoh M, Tanny T, Breuer O, Blau H, Mussaffi H, Kadosh D, Gartner S, Salinas A, Bentur L, Nir V, Gur M, Reiter J, Shoseyov D, Kerem E, Berger I. Attention deficit hyperactivity disorder symptoms in patients with cystic fibrosis. J Cyst Fibros 2018; 17:281-285. [DOI: 10.1016/j.jcf.2017.11.020] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2017] [Revised: 11/29/2017] [Accepted: 11/30/2017] [Indexed: 02/05/2023]
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123
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Calaprice D, Tona J, Murphy TK. Treatment of Pediatric Acute-Onset Neuropsychiatric Disorder in a Large Survey Population. J Child Adolesc Psychopharmacol 2018; 28:92-103. [PMID: 28832181 PMCID: PMC5826468 DOI: 10.1089/cap.2017.0101] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
OBJECTIVE The goal of this study was to investigate treatment histories and outcomes in a large community sample of youth with Pediatric Acute-onset Neuropsychiatric Syndrome (PANS), and, where appropriate, to examine the impact of immune deficiency on treatment outcomes. METHODS A comprehensive internet-based survey was completed by parents or guardians of youth who had received physician diagnoses of PANS, or by young adults (age 18+) who had themselves been diagnosed by a physician (N = 698). Data regarding the treatment histories of these patients, including the variety of medical and psychological treatments employed and the caregiver- or self-reported response to each, are presented. RESULTS The PANS patients in this study had commonly been treated with antibiotic (N = 675), anti-inflammatory (N = 437), and/or psychotropic therapy (N = 378). Response to antibiotic treatment was best when treatment was relatively aggressive, with broad-spectrum antibiotics and courses of >30 days generally producing the best results (i.e., up to 52% of patients achieving a "very effective" response). For immune-deficient patients (caregiver-reported laboratory studies below normal limits; N = 108), use of broad-spectrum antibiotics appeared to be particularly desirable. Anti-inflammatory therapies, including over-the-counter medications such as ibuprofen, were at least "somewhat effective" for most patients. Intravenous immunoglobulin (IVIG) had been used to treat PANS in 193 (28%) of the patients and was at least "somewhat effective" for 89%, although for 18% of these, the effect was not sustained. The highest rate of sustained response to IVIG treatment was seen in immune-deficient patients who received doses of at least 0.8 g/kg IVIG on a regular basis. Psychotropic medications, most commonly SSRIs (38% reported a trial), were commonly employed, but were often ineffective (e.g., 44% found SSRIs "somewhat" to "very effective"). Many patients (N = 473) had received some form of psychotherapy with some benefit, with cognitive behavioral therapy found to be at least somewhat effective in a majority of those treated with this modality. CONCLUSION Among the PANS patients represented in this study, relatively aggressive treatment courses targeted at eradicating infection and modulating the inflammatory response appeared to provide the best caregiver-reported therapeutic results, and to be generally well tolerated. Given its relative efficacy and tolerability, treatment targeting the inflammatory response may represent an underutilized approach in this population. The results of this study should be considered in light of the limitations inherent in a self-selected and administered online survey.
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Affiliation(s)
| | - Janice Tona
- Department of Rehabilitation Science, University at Buffalo, Buffalo, New York
| | - Tanya K. Murphy
- Department of Pediatrics, University of South Florida, St. Petersburg, Florida.,Department of Psychiatry, University of South Florida, St. Petersburg, Florida
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Kosidou K, Dalman C, Widman L, Arver S, Lee BK, Magnusson C, Gardner RM. Maternal Polycystic Ovary Syndrome and Risk for Attention-Deficit/Hyperactivity Disorder in the Offspring. Biol Psychiatry 2017; 82:651-659. [PMID: 27889187 DOI: 10.1016/j.biopsych.2016.09.022] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2016] [Revised: 09/09/2016] [Accepted: 09/21/2016] [Indexed: 12/16/2022]
Abstract
BACKGROUND Attention-deficit/hyperactivity disorder (ADHD) is the most common childhood neurodevelopmental disorder, and boys are two to three times more likely to develop ADHD. Maternal polycystic ovary syndrome (PCOS), a common metabolic disorder associated with excess circulating androgens, has been associated with increased risk for autism spectrum disorder in the offspring. In this study, we aimed to investigate whether maternal PCOS increases the risk for ADHD in the offspring. METHODS We conducted a matched case-control study using health and population data registers for all children born in Sweden from 1984 to 2008. Maternal PCOS was defined by ICD-coded register diagnosis. The outcome of ADHD was defined as an ICD-coded register diagnosis of ADHD and/or registered prescription of medications to treat ADHD. A total of 58,912 ADHD cases (68.8% male) were identified and matched to 499,998 unaffected controls by sex and birth month and year. RESULTS Maternal PCOS increased the odds of offspring ADHD by 42% after adjustment for confounders (odds ratio [OR], 1.42; 95% confidence interval [CI], 1.26-1.58). Exclusion of ADHD cases with comorbid autism spectrum disorder attenuated but did not explain the relationship (OR, 1.34; 95% CI, 1.18-1.52). The risk was somewhat elevated for ADHD with comorbid autism spectrum disorder (OR, 1.76; 95% CI, 1.37-2.26). The risk for ADHD was higher among obese mothers with PCOS (OR, 1.68; 95% CI, 1.31-2.17) and was highest among obese mothers with PCOS and other features of metabolic syndrome (OR, 2.59; 95% CI, 1.02-6.58). CONCLUSIONS This study provides evidence that maternal PCOS may subtly influence the neurodevelopment of the offspring, resulting in increased risk for neurodevelopmental disorders such as ADHD.
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Affiliation(s)
- Kyriaki Kosidou
- Centre for Epidemiology and Community Medicine, Stockholm County Council, Karolinska Institutet, Stockholm, Sweden; Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden
| | - Christina Dalman
- Centre for Epidemiology and Community Medicine, Stockholm County Council, Karolinska Institutet, Stockholm, Sweden; Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden
| | - Linnea Widman
- Centre for Epidemiology and Community Medicine, Stockholm County Council, Karolinska Institutet, Stockholm, Sweden; Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden
| | - Stefan Arver
- Division of Public Health Epidemiology, and Department of Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Brian K Lee
- Department of Epidemiology and Biostatistics, Drexel University School of Public Health, Philadelphia, Pennsylvania; A.J. Drexel Autism Institute, Philadelphia, Pennsylvania
| | - Cecilia Magnusson
- Centre for Epidemiology and Community Medicine, Stockholm County Council, Karolinska Institutet, Stockholm, Sweden; Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden
| | - Renee M Gardner
- Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden.
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125
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Poddighe D. Letter to Editor regarding "Improvement of psychiatric symptoms in youth following resolution of sinusitis". Int J Pediatr Otorhinolaryngol 2017; 101:259-260. [PMID: 28781195 DOI: 10.1016/j.ijporl.2017.07.046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2017] [Accepted: 07/30/2017] [Indexed: 10/19/2022]
Affiliation(s)
- Dimitri Poddighe
- Department of Pediatrics, ASST Melegnano e Martesana, Milano, Italy; Department of Pediatrics, University of Pavia, Italy.
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126
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Spindola LM, Pan PM, Moretti PN, Ota VK, Santoro ML, Cogo-Moreira H, Gadelha A, Salum G, Manfro GG, Mari JJ, Brentani H, Grassi-Oliveira R, Brietzke E, Miguel EC, Rohde LA, Sato JR, Bressan RA, Belangero SI. Gene expression in blood of children and adolescents: Mediation between childhood maltreatment and major depressive disorder. J Psychiatr Res 2017; 92:24-30. [PMID: 28384542 DOI: 10.1016/j.jpsychires.2017.03.015] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2017] [Revised: 02/27/2017] [Accepted: 03/20/2017] [Indexed: 12/14/2022]
Abstract
Investigating major depressive disorder (MDD) in childhood and adolescence can help reveal the relative contributions of genetic and environmental factors to MDD, since early stages of disease have less influence of illness exposure. Thus, we investigated the mRNA expression of 12 genes related to the hypothalamic-pituitary-adrenal (HPA) axis, inflammation, neurodevelopment and neurotransmission in the blood of children and adolescents with MDD and tested whether a history of childhood maltreatment (CM) affects MDD through gene expression. Whole-blood mRNA levels of 12 genes were compared among 20 children and adolescents with MDD diagnosis (MDD group), 49 participants without MDD diagnosis but with high levels of depressive symptoms (DS group), and 61 healthy controls (HC group). The differentially expressed genes were inserted in a mediation model in which CM, MDD, and gene expression were, respectively, the independent variable, outcome, and intermediary variable. NR3C1, TNF, TNFR1 and IL1B were expressed at significantly lower levels in the MDD group than in the other groups. CM history did not exert a significant direct effect on MDD. However, an indirect effect of the aggregate expression of the 4 genes mediated the relationship between CM and MDD. In the largest study investigating gene expression in children with MDD, we demonstrated that NR3C1, TNF, TNFR1 and IL1B expression levels are related to MDD and conjunctly mediate the effect of CM history on the risk of developing MDD. This supports a role of glucocorticoids and inflammation as potential effectors of environmental stress in MDD.
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MESH Headings
- Adolescent
- Child
- Child Abuse/psychology
- Cohort Studies
- Depressive Disorder, Major/blood
- Depressive Disorder, Major/physiopathology
- Female
- Gene Expression/physiology
- Genetic Testing
- Humans
- Hypothalamo-Hypophyseal System/metabolism
- Interleukin-1beta/genetics
- Interleukin-1beta/metabolism
- Male
- Models, Biological
- Peptide Fragments/genetics
- Peptide Fragments/metabolism
- Pituitary-Adrenal System/metabolism
- RNA, Messenger/metabolism
- Receptors, Glucocorticoid/genetics
- Receptors, Glucocorticoid/metabolism
- Receptors, Tumor Necrosis Factor, Type I/genetics
- Receptors, Tumor Necrosis Factor, Type I/metabolism
- Residence Characteristics
- Tumor Necrosis Factor-alpha/genetics
- Tumor Necrosis Factor-alpha/metabolism
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Affiliation(s)
- Leticia Maria Spindola
- Genetics Division, Department of Morphology and Genetics, Universidade Federal de Sao Paulo (UNIFESP), Brazil; LiNC - Interdisciplinary Laboratory of Clinical Neurosciences, UNIFESP, Brazil; National Institute of Developmental Psychiatry for Children and Adolescents (INPD), Brazil; Department of Psychiatry, UNIFESP, Brazil
| | - Pedro Mario Pan
- LiNC - Interdisciplinary Laboratory of Clinical Neurosciences, UNIFESP, Brazil; National Institute of Developmental Psychiatry for Children and Adolescents (INPD), Brazil; Department of Psychiatry, UNIFESP, Brazil
| | - Patricia Natalia Moretti
- Genetics Division, Department of Morphology and Genetics, Universidade Federal de Sao Paulo (UNIFESP), Brazil; LiNC - Interdisciplinary Laboratory of Clinical Neurosciences, UNIFESP, Brazil; National Institute of Developmental Psychiatry for Children and Adolescents (INPD), Brazil; Department of Psychiatry, UNIFESP, Brazil
| | - Vanessa Kiyomi Ota
- Genetics Division, Department of Morphology and Genetics, Universidade Federal de Sao Paulo (UNIFESP), Brazil; LiNC - Interdisciplinary Laboratory of Clinical Neurosciences, UNIFESP, Brazil; National Institute of Developmental Psychiatry for Children and Adolescents (INPD), Brazil; Department of Psychiatry, UNIFESP, Brazil
| | - Marcos Leite Santoro
- Genetics Division, Department of Morphology and Genetics, Universidade Federal de Sao Paulo (UNIFESP), Brazil; LiNC - Interdisciplinary Laboratory of Clinical Neurosciences, UNIFESP, Brazil; National Institute of Developmental Psychiatry for Children and Adolescents (INPD), Brazil
| | - Hugo Cogo-Moreira
- LiNC - Interdisciplinary Laboratory of Clinical Neurosciences, UNIFESP, Brazil; National Institute of Developmental Psychiatry for Children and Adolescents (INPD), Brazil; Department of Psychiatry, UNIFESP, Brazil
| | - Ary Gadelha
- LiNC - Interdisciplinary Laboratory of Clinical Neurosciences, UNIFESP, Brazil; National Institute of Developmental Psychiatry for Children and Adolescents (INPD), Brazil; Department of Psychiatry, UNIFESP, Brazil
| | - Giovanni Salum
- National Institute of Developmental Psychiatry for Children and Adolescents (INPD), Brazil; Department of Psychiatry, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Brazil
| | - Gisele Gus Manfro
- National Institute of Developmental Psychiatry for Children and Adolescents (INPD), Brazil; Department of Psychiatry, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Brazil
| | - Jair Jesus Mari
- LiNC - Interdisciplinary Laboratory of Clinical Neurosciences, UNIFESP, Brazil; National Institute of Developmental Psychiatry for Children and Adolescents (INPD), Brazil; Department of Psychiatry, UNIFESP, Brazil
| | - Helena Brentani
- National Institute of Developmental Psychiatry for Children and Adolescents (INPD), Brazil; Department & Institute of Psychiatry, Faculdade de Medicina da Universidade de São Paulo, Brazil
| | - Rodrigo Grassi-Oliveira
- Post-Graduation Program in Psychology, Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Brazil; Developmental Cognitive Neuroscience Lab, PUCRS, Brazil
| | | | - Euripedes Constantino Miguel
- National Institute of Developmental Psychiatry for Children and Adolescents (INPD), Brazil; Department & Institute of Psychiatry, Faculdade de Medicina da Universidade de São Paulo, Brazil
| | - Luis Augusto Rohde
- National Institute of Developmental Psychiatry for Children and Adolescents (INPD), Brazil; Department of Psychiatry, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Brazil
| | - João Ricardo Sato
- National Institute of Developmental Psychiatry for Children and Adolescents (INPD), Brazil; Center of Mathematics, Computation and Cognition, Universidade Federal do ABC, Brazil
| | - Rodrigo Affonseca Bressan
- LiNC - Interdisciplinary Laboratory of Clinical Neurosciences, UNIFESP, Brazil; National Institute of Developmental Psychiatry for Children and Adolescents (INPD), Brazil; Department of Psychiatry, UNIFESP, Brazil
| | - Sintia Iole Belangero
- Genetics Division, Department of Morphology and Genetics, Universidade Federal de Sao Paulo (UNIFESP), Brazil; LiNC - Interdisciplinary Laboratory of Clinical Neurosciences, UNIFESP, Brazil; National Institute of Developmental Psychiatry for Children and Adolescents (INPD), Brazil; Department of Psychiatry, UNIFESP, Brazil.
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127
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Allred EN, Dammann O, Fichorova RN, Hooper SR, Hunter SJ, Joseph RM, Kuban K, Leviton A, O'Shea TM, Scott MN. Systemic Inflammation during the First Postnatal Month and the Risk of Attention Deficit Hyperactivity Disorder Characteristics among 10 year-old Children Born Extremely Preterm. J Neuroimmune Pharmacol 2017; 12:531-543. [PMID: 28405874 PMCID: PMC6508968 DOI: 10.1007/s11481-017-9742-9] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2017] [Accepted: 03/23/2017] [Indexed: 01/19/2023]
Abstract
Although multiple sources link inflammation with attention difficulties, the only human study that evaluated the relationship between systemic inflammation and attention problems assessed attention at age 2 years. Parent and/or teacher completion of the Childhood Symptom Inventory-4 (CSI-4) provided information about characteristics that screen for attention deficit hyperactive disorder (ADHD) among 793 10-year-old children born before the 28th week of gestation who had an IQ ≥ 70. The concentrations of 27 proteins in blood spots obtained during the first postnatal month were measured. 151 children with ADHD behaviors were identified by parent report, while 128 children were identified by teacher report. Top-quartile concentrations of IL-6R, TNF-α, IL-8, VEGF, VEFG-R1, and VEGF-R2 on multiple days were associated with increased risk of ADHD symptoms as assessed by a teacher. Some of this increased risk was modulated by top-quartile concentrations of IL-6R, RANTES, EPO, NT-4, BDNF, bFGF, IGF-1, PIGF, Ang-1, and Ang-2. Systemic inflammation during the first postnatal month among children born extremely preterm appears to increase the risk of teacher-identified ADHD characteristics, and high concentrations of proteins with neurotrophic properties appear capable of modulating this increased risk.
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Affiliation(s)
- Elizabeth N Allred
- Boston Children's Hospital and Harvard Medical School, 300 Longwood Avenue, Boston, MA, 02115-5724, USA
| | - Olaf Dammann
- Tufts University School of Medicine, Boston, MA, 02111, USA
| | - Raina N Fichorova
- Brigham and Women's Hospital and Harvard Medical School, Boston, MA, 02115, USA
| | - Stephen R Hooper
- University of North Carolina School of Medicine, Chapel Hill, NC, USA
| | - Scott J Hunter
- The University of Chicago Medicine Comer Children's Hospital, Chicago, IL, USA
| | | | - Karl Kuban
- Boston Medical Center and Boston University School of Medicine, Boston, MA, USA
| | - Alan Leviton
- Boston Children's Hospital and Harvard Medical School, 300 Longwood Avenue, Boston, MA, 02115-5724, USA.
| | | | - Megan N Scott
- The University of Chicago Medicine Comer Children's Hospital, Chicago, IL, USA
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128
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Leviton A, Hunter SJ, Scott MN, Hooper SR, Joseph RM, O'Shea TM, Allred EN, Kuban K. Observer variability identifying attention deficit/hyperactivity disorder in 10-year-old children born extremely preterm. Acta Paediatr 2017; 106:1317-1322. [PMID: 28390106 DOI: 10.1111/apa.13869] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
AIM A DSM-5 diagnosis of attention deficit/hyperactive disorder (ADHD) requires that symptoms be present in two settings. We wanted to see how teachers and parents compare on their assessments. METHODS We evaluated how well Child Symptom Inventory-4 (CSI-4) reports from 871 parents and 634 teachers of 10-year-old children born before the 28th week of gestation provided information about indicators of school dysfunction. RESULTS Kappa values for parent and teacher agreement of any ADHD were at best fair to poor (<0.41). Nevertheless, ADHD identified by each alone provided a moderate amount of information about such indicators of school dysfunction as grade repetition. Only occasionally did agreement provide more information than provided by only one reporter. Mother's social class and intelligence level did not discriminate between parents who did and did not agree with the teacher. CONCLUSION ADHD identified by a single observer can provide appreciable information about a range of the child's functions needed for success in school and, therefore, should not be discounted when another observer does not consider the child to have ADHD symptoms.
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Affiliation(s)
- Alan Leviton
- Boston Children's Hospital; Harvard Medical School; Boston MA USA
| | - Scott J. Hunter
- The University of Chicago Medicine Comer Children's Hospital; Chicago IL USA
| | - Megan N. Scott
- The University of Chicago Medicine Comer Children's Hospital; Chicago IL USA
| | | | | | | | | | - Karl Kuban
- Boston Medical Center; Boston University School of Medicine; Boston MA USA
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129
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Mousavi SY, Khezri R, Karkhaneh-Yousefi MA, Mohammadinejad P, Gholamian F, Mohammadi MR, Zeinoddini A, Akhondzadeh S. A Randomized, Double-Blind Placebo-Controlled Trial on Effectiveness and Safety of Celecoxib Adjunctive Therapy in Adolescents with Acute Bipolar Mania. J Child Adolesc Psychopharmacol 2017; 27:494-500. [PMID: 28409660 DOI: 10.1089/cap.2016.0207] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
OBJECTIVE Recent studies have focused on the role of inflammatory cascades as one of the possible etiologic factors of bipolar disorder. We hypothesize that celecoxib, through its anti-inflammatory properties, may have a therapeutic role in acute bipolar mania. PATIENTS AND METHODS Forty-two adolescent inpatients with the diagnosis of acute bipolar mania participated in a parallel, randomized, double-blind controlled trial, and 40 patients underwent an 8-week treatment with either celecoxib (100 mg twice daily) or placebo as an adjunctive treatment to lithium and risperidone. Patients were evaluated using Young Mania Rating Scale (YMRS) at baseline and weeks 2, 4, and 8. The primary outcome measure was to assess the efficacy of celecoxib compared with placebo in improving mania symptoms. RESULT General linear model repeated measures showed significant effect for time × treatment interaction on YMRS scores [F (2.54, 96.56) = 3.21, p = 0.03]. Significantly greater improvement was observed in YMRS scores in the celecoxib group compared with the placebo group from baseline YMRS score at week 8 (p = 0.04). Although a 35% greater response to treatment (considering a Clinical Global Impressions-Improvement score of ≤2, very much/much improved) was observed in the celecoxib group compared with the placebo group, the difference did not reach the statistical significance level (p = 0.09). No serious adverse event was reported. CONCLUSIONS Celecoxib may be an effective adjuvant therapy in treatment of manic episodes (without psychotic features) of adolescents with bipolar mood disorder. The mood-stabilizing role of this drug might be mediated through its action on inflammatory cascades.
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Affiliation(s)
- Seyed Yaser Mousavi
- Psychiatric Research Center, Roozbeh Hospital, Tehran University of Medical Sciences , Tehran, Iran
| | - Rasoul Khezri
- Psychiatric Research Center, Roozbeh Hospital, Tehran University of Medical Sciences , Tehran, Iran
| | | | - Payam Mohammadinejad
- Psychiatric Research Center, Roozbeh Hospital, Tehran University of Medical Sciences , Tehran, Iran
| | - Faezeh Gholamian
- Psychiatric Research Center, Roozbeh Hospital, Tehran University of Medical Sciences , Tehran, Iran
| | - Mohammad Reza Mohammadi
- Psychiatric Research Center, Roozbeh Hospital, Tehran University of Medical Sciences , Tehran, Iran
| | - Atefeh Zeinoddini
- Psychiatric Research Center, Roozbeh Hospital, Tehran University of Medical Sciences , Tehran, Iran
| | - Shahin Akhondzadeh
- Psychiatric Research Center, Roozbeh Hospital, Tehran University of Medical Sciences , Tehran, Iran
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130
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Wang Q, Dong X, Wang Y, Liu M, Sun A, Li N, lin Y, Geng Z, Jin Y, Li X. Adolescent escitalopram prevents the effects of maternal separation on depression‐ and anxiety‐like behaviours and regulates the levels of inflammatory cytokines in adult male mice. Int J Dev Neurosci 2017; 62:37-45. [PMID: 28778811 DOI: 10.1016/j.ijdevneu.2017.07.007] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2017] [Revised: 07/25/2017] [Accepted: 07/31/2017] [Indexed: 01/26/2023] Open
Affiliation(s)
- Qi Wang
- Department of PsychiatryThe First Hospital of China Medical UniversityShenyangLiaoning ProvinceChina
| | - Xiaomei Dong
- Department of PsychiatryThe First Hospital of China Medical UniversityShenyangLiaoning ProvinceChina
| | - Yan Wang
- Department of PsychiatryThe First Hospital of China Medical UniversityShenyangLiaoning ProvinceChina
| | - Mengxi Liu
- Department of PsychiatryThe First Hospital of China Medical UniversityShenyangLiaoning ProvinceChina
| | - Anji Sun
- Department of PsychiatryThe First Hospital of China Medical UniversityShenyangLiaoning ProvinceChina
| | - Nannan Li
- Department of PsychiatryThe First Hospital of China Medical UniversityShenyangLiaoning ProvinceChina
| | - Yiwei lin
- Department of PsychiatryThe First Hospital of China Medical UniversityShenyangLiaoning ProvinceChina
| | - Zhongli Geng
- Department of PsychiatryThe First Hospital of China Medical UniversityShenyangLiaoning ProvinceChina
| | - Ye Jin
- Department of PsychiatryThe First Hospital of China Medical UniversityShenyangLiaoning ProvinceChina
| | - Xiaobai Li
- Department of PsychiatryThe First Hospital of China Medical UniversityShenyangLiaoning ProvinceChina
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131
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Chen VCH, Hsu TC, Chen LJ, Chou HC, Weng JC, Tzang BS. Effects of taurine on resting-state fMRI activity in spontaneously hypertensive rats. PLoS One 2017; 12:e0181122. [PMID: 28700674 PMCID: PMC5507323 DOI: 10.1371/journal.pone.0181122] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2017] [Accepted: 06/26/2017] [Indexed: 11/18/2022] Open
Abstract
Attention deficit hyperactivity disorder (ADHD) is a global behavior illness among children and adults. To investigate the effects of taurine on resting-state fMRI activity in ADHD, a spontaneously hypertensive rat (SHR) animal model was adopted. Significantly decreased serum C-reactive protein (CRP) was detected in rats of Wistar Kyoto (WKY) high-taurine group and significantly decreased interleukin (IL)-1β and CRP were detected in rats of SHR low-taurine and high-taurine groups. Moreover, significantly higher horizontal locomotion was detected in rats of WKY low-taurine and SHR low-taurine groups than in those of controls. In contrast, significantly lower horizontal locomotion was detected in rats of the SHR high-taurine group than in those of the SHR control group. Additionally, significantly lower functional connectivity (FC) and mean amplitude of low-frequency fluctuation (mALFF) in the bilateral hippocampus in rats of WKY high-taurine and SHR high-taurine groups was detected. Notably, the mALFF in rats of the SHR low-taurine and high-taurine groups was significantly lower than in those of the SHR control group. These findings suggest that the administration of a high-dose taurine probably improves hyperactive behavior in SHR rats by ameliorating the inflammatory cytokines and modulating brain functional signals in SHR rats.
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Affiliation(s)
- Vincent Chin-Hung Chen
- Department of Psychiatry, Chang Gung University, Taoyuan, Taiwan
- Department of Psychiatry, Chiayi Chang Gung Memorial Hospital, Chiayi, Taiwan
| | - Tsai-Ching Hsu
- Institute of Biochemistry, Microbiology and Immunology, Chung Shan Medical University, Taichung, Taiwan
- Clinical Laboratory, Chung Shan Medical University Hospital, Taichung, Taiwan
| | - Li-Jeng Chen
- Institute of Biochemistry, Microbiology and Immunology, Chung Shan Medical University, Taichung, Taiwan
| | - Hong-Chun Chou
- Department of Medical Imaging and Radiological Sciences, Chung Shan Medical University, Taichung, Taiwan
| | - Jun-Cheng Weng
- Department of Medical Imaging and Radiological Sciences, Chung Shan Medical University, Taichung, Taiwan
- Department of Medical Imaging and Radiological Sciences, Chang Gung University, Taoyuan, Taiwan
- * E-mail: (JCW); (BST)
| | - Bor-Show Tzang
- Institute of Biochemistry, Microbiology and Immunology, Chung Shan Medical University, Taichung, Taiwan
- Clinical Laboratory, Chung Shan Medical University Hospital, Taichung, Taiwan
- Department of Biochemistry, School of Medicine, Chung Shan Medical University, Taichung, Taiwan
- * E-mail: (JCW); (BST)
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132
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Belem da Silva CT, de Abreu Costa M, Kapczinski F, de Aguiar BW, Salum GA, Manfro GG. Inflammation and internalizing disorders in adolescents. Prog Neuropsychopharmacol Biol Psychiatry 2017; 77:133-137. [PMID: 28385493 DOI: 10.1016/j.pnpbp.2017.03.023] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2016] [Revised: 03/26/2017] [Accepted: 03/30/2017] [Indexed: 12/28/2022]
Abstract
Serum inflammatory markers have been studied in adults with anxiety and depression, but little is known about cytokine levels in young adolescents with emotional disorders. The objective of this study is to compare serum levels of interleukin-6 (IL-6) and interleukin-10 (IL-10) between adolescents with internalizing disorders and adolescents from the same community without internalizing disorders. A total of 134 non-medicated subjects (n=76 with internalizing disorders) were recruited from a larger sample of 2457 individuals. Serum levels of IL-6 and IL-10 were quantified and psychiatric diagnosis was evaluated using structured clinical interviews. Adolescents with internalizing disorders presented significantly higher levels of IL-6 as compared to youngsters without internalizing disorders. Differences between groups in IL-10 levels were not statistically significant. This study points out that IL-6 levels may be associated with internalizing disorders in youths and suggests that inflammation might be an early biomarker of emotional distress. High levels of cytokines may adversely affect general health in the long-term, which raise broader issues in terms of public health if results are replicated.
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Affiliation(s)
| | - Marianna de Abreu Costa
- Federal University of Rio Grande do Sul (UFRGS), Brazil; Hospital de Clínicas de Porto Alegre (HCPA), Brazil
| | - Flávio Kapczinski
- Federal University of Rio Grande do Sul (UFRGS), Brazil; Hospital de Clínicas de Porto Alegre (HCPA), Brazil; Laboratório de Psiquiatria Molecular, Instituto Nacional de Ciência e Tecnologia - Translacional em Medicina (INCT), Brazil
| | - Bianca Wollenhaupt de Aguiar
- Federal University of Rio Grande do Sul (UFRGS), Brazil; Hospital de Clínicas de Porto Alegre (HCPA), Brazil; Laboratório de Psiquiatria Molecular, Instituto Nacional de Ciência e Tecnologia - Translacional em Medicina (INCT), Brazil
| | - Giovanni Abrahão Salum
- Federal University of Rio Grande do Sul (UFRGS), Brazil; Hospital de Clínicas de Porto Alegre (HCPA), Brazil
| | - Gisele Gus Manfro
- Federal University of Rio Grande do Sul (UFRGS), Brazil; Hospital de Clínicas de Porto Alegre (HCPA), Brazil
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Miłkowska P, Popko K, Demkow U, Wolańczyk T. Pro-Inflammatory Cytokines in Psychiatric Disorders in Children and Adolescents: A Review. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2017. [PMID: 28456928 DOI: 10.1007/5584_2017_24] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/28/2024]
Abstract
Cytokines are a large group of small proteins which play a significant role in cell signaling and regulate a variety of processes in organisms, including proliferation and differentiation of many cells, mediation in defense reactions and regulation of hematopoiesis. Cytokines can be divided into those with pro- and those with anti-inflammatory properties. In the group of pro-inflammatory cytokines the most important are: IL-1 beta, IL-6, TNF-alpha, and IFN-gamma. Pro-inflammatory cytokines might be involved in the pathophysiology of many psychiatric conditions in adults, but their role in children and adolescents is less clear. The aim of this article is to demonstrate the patterns of pro-inflammatory cytokines in children and adolescents.
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Affiliation(s)
- Paulina Miłkowska
- Department of Child Psychiatry, Warsaw Medical University, 63A Zwirki i Wigury Street, 02-091, Warsaw, Poland.
| | - Katarzyna Popko
- Department of Laboratory Diagnostics and Clinical Immunology of Developmental Age, Warsaw Medical University, 63A Zwirki i Wigury Street, 02-091, Warsaw, Poland
| | - Urszula Demkow
- Department of Laboratory Diagnostics and Clinical Immunology of Developmental Age, Warsaw Medical University, 63A Zwirki i Wigury Street, 02-091, Warsaw, Poland
| | - Tomasz Wolańczyk
- Department of Child Psychiatry, Warsaw Medical University, 63A Zwirki i Wigury Street, 02-091, Warsaw, Poland
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134
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Kichev A, Eede P, Gressens P, Thornton C, Hagberg H. Implicating Receptor Activator of NF-κB (RANK)/RANK Ligand Signalling in Microglial Responses to Toll-Like Receptor Stimuli. Dev Neurosci 2017; 39:192-206. [PMID: 28402971 DOI: 10.1159/000464244] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2016] [Accepted: 02/16/2017] [Indexed: 01/08/2023] Open
Abstract
Inflammation in the perinatal brain caused by maternal or intrauterine fetal infection is now well established as an important contributor to the development of perinatal brain injury. Exposure to inflammatory products can impair perinatal brain development and act as a risk factor for neurological dysfunction, cognitive disorders, cerebral palsy, or preterm birth. Pre-exposure to inflammation significantly exacerbates brain injury caused by hypoxic/ischaemic insult. Tumour necrosis factor (TNF) is a family of cytokines largely involved in inflammation signalling. In our previous study, we identified the importance of TNF-related apoptosis-inducing ligand (TRAIL) signalling in the development of perinatal brain injury. We observed a significant increase in the expression levels of a soluble decoy receptor for TRAIL, osteoprotegerin (OPG). Besides TRAIL, OPG is able to bind the receptor activator of the NF-κB (RANK) ligand (RANKL) and inhibit its signalling. The function of the RANK/RANKL/OPG system in the brain has not come under much scrutiny. The aim of this research study was to elucidate the role of RANK, RANKL, and OPG in microglial responses to the proinflammatory stimuli lipopolysaccharide (LPS) and polyinosinic-polycytidylic acid (Poly I:C). Here, we show that RANK signalling is important for regulating the activation of the BV2 microglial cell line. We found that LPS treatment causes a significant decrease in the expression of RANK in the BV2 cell line while significantly increasing the expression of OPG, Toll-like receptor (TLR)3, and the adaptor proteins MyD88 and TRIF. We found that pretreatment of BV2 cells with RANKL for 24 h before the LPS or Poly I:C exposure decreases the expression of inflammatory markers such as inducible nitric oxide synthase and cyclooxygenase. This is accompanied by a decreased expression of the TLR adaptor proteins MyD88 and TRIF, which we observed after RANKL treatment. Similar results were obtained in our experiments with primary mouse microglia. Using recently developed CRISPR/Cas9 technology, we generated a BV2 cell line lacking RANK (RANK-/- BV2). We showed that most effects of RANKL pretreatment were abolished, thereby proving the specificity of this effect. Taken together, these findings suggest that RANK signalling is important for modulating the inflammatory activation of microglial cells to a moderate level, and that RANK attenuates TLR3/TLR4 signalling.
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Affiliation(s)
- Anton Kichev
- Centre for the Developing Brain, Perinatal Brain Injury Group, Kings College London, London, UK
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Ritter ML, Guo W, Samuels JF, Wang Y, Nestadt PS, Krasnow J, Greenberg BD, Fyer AJ, McCracken JT, Geller DA, Murphy DL, Knowles JA, Grados MA, Riddle MA, Rasmussen SA, McLaughlin NC, Nurmi EL, Askland KD, Cullen B, Piacentini J, Pauls DL, Bienvenu J, Stewart E, Goes FS, Maher B, Pulver AE, Mattheisen M, Qian J, Nestadt G, Shugart YY. Genome Wide Association Study (GWAS) between Attention Deficit Hyperactivity Disorder (ADHD) and Obsessive Compulsive Disorder (OCD). Front Mol Neurosci 2017; 10:83. [PMID: 28386217 PMCID: PMC5362635 DOI: 10.3389/fnmol.2017.00083] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2016] [Accepted: 03/09/2017] [Indexed: 11/13/2022] Open
Abstract
Objective: The aim of this study was to identify any potential genetic overlap between attention deficit hyperactivity disorder (ADHD) and obsessive compulsive disorder (OCD). We hypothesized that since these disorders share a sub-phenotype, they may share common risk alleles. In this manuscript, we report the overlap found between these two disorders. Methods: A meta-analysis was conducted between ADHD and OCD, and polygenic risk scores (PRS) were calculated for both disorders. In addition, a protein-protein analysis was completed in order to examine the interactions between proteins; p-values for the protein-protein interaction analysis was calculated using permutation. Conclusion: None of the single nucleotide polymorphisms (SNPs) reached genome wide significance and there was little evidence of genetic overlap between ADHD and OCD.
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Affiliation(s)
- McKenzie L. Ritter
- Unit on Statistical Genomics, National Institute of Mental Health, National Institutes of Health (NIH)Bethesda, MD, USA
| | - Wei Guo
- Unit on Statistical Genomics, National Institute of Mental Health, National Institutes of Health (NIH)Bethesda, MD, USA
| | - Jack F. Samuels
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of MedicineBaltimore, MD, USA
| | - Ying Wang
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of MedicineBaltimore, MD, USA
| | - Paul S. Nestadt
- Department of Mental Health, Johns Hopkins University Bloomberg School of Public HealthBaltimore, MD, USA
| | - Janice Krasnow
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of MedicineBaltimore, MD, USA
| | - Benjamin D. Greenberg
- Department of Psychiatry, Faculty of Medicine, University of TorontoToronto, ON, Canada
| | - Abby J. Fyer
- New York State Psychiatric Institute, College of Physicians and Surgeons at Columbia UniversityNew York, NY, USA
| | - James T. McCracken
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles School of MedicineLos Angeles, CA, USA
| | - Daniel A. Geller
- Department of Psychiatry, Massachusetts General Hospital and Harvard Medical SchoolBoston, MA, USA
| | - Dennis L. Murphy
- Laboratory of Clinical Science, National Institute of Mental HealthBethesda, MD, USA
| | - James A. Knowles
- Department of Psychiatry and Behavioral Sciences, Keck School of Medicine at the University of Southern CaliforniaLos Angeles, CA, USA
| | - Marco A. Grados
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of MedicineBaltimore, MD, USA
| | - Mark A. Riddle
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of MedicineBaltimore, MD, USA
| | - Steven A. Rasmussen
- Department of Psychiatry, Faculty of Medicine, University of TorontoToronto, ON, Canada
| | - Nicole C. McLaughlin
- Department of Psychiatry, Faculty of Medicine, University of TorontoToronto, ON, Canada
| | - Erika L. Nurmi
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles School of MedicineLos Angeles, CA, USA
| | - Kathleen D. Askland
- Department of Psychiatry, Faculty of Medicine, University of TorontoToronto, ON, Canada
| | - Bernadette Cullen
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of MedicineBaltimore, MD, USA
| | - John Piacentini
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles School of MedicineLos Angeles, CA, USA
| | - David L. Pauls
- Department of Psychiatry, Massachusetts General Hospital and Harvard Medical SchoolBoston, MA, USA
| | - Joseph Bienvenu
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of MedicineBaltimore, MD, USA
| | - Evelyn Stewart
- Department of Psychiatry, University of British ColumbiaVancouver, BC, Canada
| | - Fernando S. Goes
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of MedicineBaltimore, MD, USA
| | - Brion Maher
- Department of Mental Health, Johns Hopkins University Bloomberg School of Public HealthBaltimore, MD, USA
| | - Ann E. Pulver
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of MedicineBaltimore, MD, USA
| | - Manuel Mattheisen
- Department of Biomedicine and Center for Integrated Sequencing (iSEQ), Aarhus UniversityAarhus, Denmark
- Department of Biostatistics, Harvard School of Public HealthBoston, MA, USA
- Department of Genomic Mathematics, University of BonnBonn, Germany
| | - Ji Qian
- State Key Laboratory of Genetic Engineering, Life Science Institutes, Fudan UniversityShanghai, China
| | - Gerald Nestadt
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of MedicineBaltimore, MD, USA
| | - Yin Yao Shugart
- Unit on Statistical Genomics, National Institute of Mental Health, National Institutes of Health (NIH)Bethesda, MD, USA
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Joseph RM, Korzeniewski SJ, Allred EN, O'Shea TM, Heeren T, Frazier JA, Ware J, Hirtz D, Leviton A, Kuban K. Extremely low gestational age and very low birthweight for gestational age are risk factors for autism spectrum disorder in a large cohort study of 10-year-old children born at 23-27 weeks' gestation. Am J Obstet Gynecol 2017; 216:304.e1-304.e16. [PMID: 27847193 PMCID: PMC5334372 DOI: 10.1016/j.ajog.2016.11.1009] [Citation(s) in RCA: 56] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2016] [Revised: 10/21/2016] [Accepted: 11/06/2016] [Indexed: 12/11/2022]
Abstract
BACKGROUND No prospective cohort study of high-risk children has used rigorous exposure assessment and optimal diagnostic procedures to examine the perinatal antecedents of autism spectrum disorder separately among those with and without cognitive impairment. OBJECTIVE We sought to identify perinatal factors associated with increased risk for autism spectrum disorder with and without intellectual disability (intelligence quotient <70) in children born extremely preterm. STUDY DESIGN This prospective multicenter (14 institutions in 5 states) birth cohort study included children born at 23-27 weeks' gestation in 2002 through 2004 who were evaluated for autism spectrum disorder and intellectual disability at age 10 years. Pregnancy information was obtained from medical records and by structured maternal interview. Cervical-vaginal "infection" refers to maternal report of bacterial infection (n = 4), bacterial vaginosis (n = 30), yeast infection (n = 62), mixed infection (n = 4), or other/unspecified infection (n = 43; eg, chlamydia, trichomonas, or herpes). We do not know the extent to which infection per se was confirmed by microbial colonization. We use the terms "fetal growth restriction" and "small for gestational age" interchangeably in light of the ongoing challenge to discern pathologically from constitutionally small newborns. Severe fetal growth restriction was defined as a birthweight Z-score for gestational age at delivery <-2 (ie, ≥2 SD below the median birthweight in a referent sample that excluded pregnancies delivered for preeclampsia or fetal indications). Participants were classified into 4 groups based on whether or not they met rigorous diagnostic criteria for autism spectrum disorder and intellectual disability (autism spectrum disorder+/intellectual disability-, autism spectrum disorder+/intellectual disability+, autism spectrum disorder-/intellectual disability+, and autism spectrum disorder-/intellectual disability-). Temporally ordered multinomial logistic regression models were used to examine the information conveyed by perinatal factors about increased risk for autism spectrum disorder and/or intellectual disability (autism spectrum disorder+/intellectual disability-, autism spectrum disorder+/intellectual disability+, and autism spectrum disorder-/intellectual disability+). RESULTS In all, 889 of 966 (92%) children recruited were assessed at age 10 years, of whom 857 (96%) were assessed for autism spectrum disorder; of these, 840 (98%) children were assessed for intellectual disability. Autism spectrum disorder+/intellectual disability- was diagnosed in 3.2% (27/840), autism spectrum disorder+/intellectual disability+ in 3.8% (32/840), and autism spectrum disorder-/intellectual disability+ in 8.5% (71/840). Maternal report of presumed cervical-vaginal infection during pregnancy was associated with increased risk of autism spectrum disorder+/intellectual disability+ (odds ratio, 2.7; 95% confidence interval, 1.2-6.4). The lowest gestational age category (23-24 weeks) was associated with increased risk of autism spectrum disorder+/intellectual disability+ (odds ratio, 2.9; 95% confidence interval, 1.3-6.6) and autism spectrum disorder+/intellectual disability- (odds ratio, 4.4; 95% confidence interval, 1.7-11). Severe fetal growth restriction was strongly associated with increased risk for autism spectrum disorder+/intellectual disability- (odds ratio, 9.9; 95% confidence interval, 3.3-30), whereas peripartum maternal fever was uniquely associated with increased risk of autism spectrum disorder-/intellectual disability+ (odds ratio, 2.9; 95% confidence interval, 1.2-6.7). CONCLUSION Our study confirms that low gestational age is associated with increased risk for autism spectrum disorder irrespective of intellectual ability, whereas severe fetal growth restriction is strongly associated with autism spectrum disorder without intellectual disability. Maternal report of cervical-vaginal infection is associated with increased risk of autism spectrum disorder with intellectual disability, and peripartum maternal fever is associated with increased risk for intellectual disability without autism spectrum disorder.
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Affiliation(s)
- Robert M. Joseph
- Department of Anatomy and Neurobiology, Boston University School of Medicine, Boston, MA, USA
| | - Steven J. Korzeniewski
- Department of Obstetrics and Gynecology, Wayne State University School of Medicine, Detroit, MI, USA
- Department of Epidemiology & Biostatistics, Michigan State University, East Lansing, MI, USA
| | - Elizabeth N. Allred
- Boston Children's Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - T. Michael O'Shea
- Department of Pediatrics, University of North Carolina, Chapel Hill NC, USA
| | - Tim Heeren
- Department of Biostatistics, Boston University School of Public Health, Boston, MA, USA
| | - Jean A. Frazier
- University of Massachusetts Memorial Health Care and University of Massachusetts Medical School, Worcester, MA, USA
| | - Janice Ware
- Boston Children's Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - Deborah Hirtz
- Department of Pediatrics, Boston Medical Center, Boston, MA, USA
- The University of Vermont Medical Center, Burlington, VT, USA
| | - Alan Leviton
- Boston Children's Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - Karl Kuban
- Department of Pediatrics, Boston Medical Center, Boston, MA, USA
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Masi A, Glozier N, Dale R, Guastella AJ. The Immune System, Cytokines, and Biomarkers in Autism Spectrum Disorder. Neurosci Bull 2017; 33:194-204. [PMID: 28238116 PMCID: PMC5360854 DOI: 10.1007/s12264-017-0103-8] [Citation(s) in RCA: 151] [Impact Index Per Article: 21.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2016] [Accepted: 01/22/2017] [Indexed: 12/24/2022] Open
Abstract
Autism Spectrum Disorder (ASD) is a pervasive neurodevelopmental condition characterized by variable impairments in communication and social interaction as well as restricted interests and repetitive behaviors. Heterogeneity of presentation is a hallmark. Investigations of immune system problems in ASD, including aberrations in cytokine profiles and signaling, have been increasing in recent times and are the subject of ongoing interest. With the aim of establishing whether cytokines have utility as potential biomarkers that may define a subgroup of ASD, or function as an objective measure of response to treatment, this review summarizes the role of the immune system, discusses the relationship between the immune system, the brain, and behavior, and presents previously-identified immune system abnormalities in ASD, specifically addressing the role of cytokines in these aberrations. The roles and identification of biomarkers are also addressed, particularly with respect to cytokine profiles in ASD.
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Affiliation(s)
- Anne Masi
- Autism Clinic for Translational Research, Brain and Mind Centre, Central Clinical School, Sydney Medical School, University of Sydney, Sydney, New South Wales, 2050, Australia
| | - Nicholas Glozier
- Autism Clinic for Translational Research, Brain and Mind Centre, Central Clinical School, Sydney Medical School, University of Sydney, Sydney, New South Wales, 2050, Australia
| | - Russell Dale
- Childrens Hospital at Westmead Clinical School, University of Sydney, Sydney, New South Wales, 2145, Australia
| | - Adam J Guastella
- Autism Clinic for Translational Research, Brain and Mind Centre, Central Clinical School, Sydney Medical School, University of Sydney, Sydney, New South Wales, 2050, Australia.
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Guloksuz SA, Abali O, Aktas Cetin E, Bilgic Gazioglu S, Deniz G, Yildirim A, Kawikova I, Guloksuz S, Leckman JF. Elevated plasma concentrations of S100 calcium-binding protein B and tumor necrosis factor alpha in children with autism spectrum disorders. ACTA ACUST UNITED AC 2017; 39:195-200. [PMID: 28099628 PMCID: PMC7111377 DOI: 10.1590/1516-4446-2015-1843] [Citation(s) in RCA: 43] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2015] [Accepted: 09/18/2016] [Indexed: 02/08/2023]
Abstract
Objective: To investigate plasma concentrations of S100B (a calcium-binding protein derived primarily from the glia) and inflammatory cytokines in children with autism and the relationship between S100B and cytokine concentrations. Methods: Plasma levels of S100B, tumor necrosis factor alpha (TNF-α), interferon gamma, interleukin (IL)-1β, IL-4, IL-6, IL-10, and IL-17A were measured in 40 unmedicated children with autism and 35 normally developing healthy children. The severity of autism was assessed using the Childhood Autism Rating Scale (CARS). Results: Concentrations of both S100B and TNF-α were higher in children with autism before and after adjusting for a priori-selected confounders (age, sex, and body mass index). S100B concentrations were higher in children with severe autism compared to children with mild-moderate autism. However, this association remained as a trend after adjusting for confounders. S100B concentrations correlated positively with TNF-α concentrations. Conclusion: Our findings showing an increase in peripheral concentrations of S100B and TNF-α provide limited support to the hypothesis about the roles of altered immune function and S100B in autism spectrum disorder (ASD). Studies of larger numbers of well-characterized individuals with ASD are needed to clarify the potential role of the immune system in the pathophysiology of this disorder.
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Affiliation(s)
| | - Osman Abali
- Department of Child and Adolescent Psychiatry, Istanbul University School of Medicine, Istanbul, Turkey
| | - Esin Aktas Cetin
- Department of Immunology, Institute of Experimental Medicine (DETAE), Istanbul University, Istanbul, Turkey
| | - Sema Bilgic Gazioglu
- Department of Immunology, Institute of Experimental Medicine (DETAE), Istanbul University, Istanbul, Turkey
| | - Gunnur Deniz
- Department of Immunology, Institute of Experimental Medicine (DETAE), Istanbul University, Istanbul, Turkey
| | | | - Ivana Kawikova
- Department of Pediatrics, School of Medicine, Yale University, New Haven, CT, USA
| | - Sinan Guloksuz
- Department of Psychiatry, School of Medicine, Yale University, New Haven, CT, USA.,Department of Psychiatry and Neuropsychology, South Limburg Mental Health Research and Teaching Network, European Graduate School of Neuroscience (EURON), School for Mental Health and Neuroscience (MHeNS), Maastricht University, Maastricht, The Netherlands
| | - James F Leckman
- Child Study Center, School of Medicine, Yale University, New Haven, CT, USA
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Medical comorbidities in children and adolescents with autism spectrum disorders and attention deficit hyperactivity disorders: a systematic review. Eur Child Adolesc Psychiatry 2017; 26:1093-1103. [PMID: 28674760 PMCID: PMC5591355 DOI: 10.1007/s00787-017-1020-0] [Citation(s) in RCA: 133] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2016] [Accepted: 06/20/2017] [Indexed: 01/19/2023]
Abstract
Somatic disorders occur more often in adult psychiatric patients than in the general adult population. However, in child and adolescent psychiatry this association is unclear, mainly due to a lack of integration of existing data. To address this issue, we here present a systematic review on medical comorbidity in the two major developmental disorders autism spectrum disorder (ASD) and attention deficit hyperactivity disorder (ADHD) and formulate clinical recommendations. The literature was searched using the PubMed and PsycINFO databases (2000-1 May 2016) with the keywords "[((child and adolescent) AND (Autism OR Attention Deficit Hyperactivity Disorder* OR ADHD)) AND ("Cardiovascular Diseases" [Mesh] OR "Endocrine System Diseases" [Mesh] OR "Immune System Diseases" [Mesh] OR "Neurobehavioral Manifestations" [Mesh] OR "Gastrointestinal Disorders" [Mesh] OR Somatic OR Autoimmune disease OR Nervous system disease OR Infection OR Infectious disease)]. Two raters independently assessed the quality of the eligible studies. The initial search identified 5278 articles. Based on inclusion and exclusion criteria 104 papers were selected and subsequently subjected to a quality control. This quality was assessed according to a standardized and validated set of criteria and yielded 29 studies for inclusion. This thorough literature search provides an overview of relevant articles on medical comorbidity in ADHD and/or ASD, and shows that medical disorders in these children and adolescents appear to be widespread. Those who work with children with ASD and/or ADHD should be well aware of this and actively promote routine medical assessment. Additionally, case-control studies and population-based studies are needed to provide reliable prevalence estimates. Future studies should furthermore focus on a broader evaluation of medical disorders in children and adolescents with ADHD and/or ASD to improve treatment algorithm in this vulnerable group.
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140
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Improvement of psychiatric symptoms in youth following resolution of sinusitis. Int J Pediatr Otorhinolaryngol 2017; 92:38-44. [PMID: 28012531 DOI: 10.1016/j.ijporl.2016.10.034] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2016] [Revised: 10/25/2016] [Accepted: 10/26/2016] [Indexed: 11/20/2022]
Abstract
INTRODUCTION Accumulating evidence supports a role for inflammation in psychiatric illness, and the onset or exacerbation of psychiatric symptoms may follow non-CNS infections. Here, we provide the first detailed description of obsessive-compulsive and related psychiatric symptoms arising concurrently with sinusitis. METHODS We reviewed the charts of 150 consecutive patients evaluated in our Pediatric Acute-onset Neuropsychiatric Syndromes clinic for documented sinusitis as defined by the American Academy of Pediatrics guidelines. Sinusitis treatments, sinonasal imaging, and neuropsychiatric symptoms before, during, and after sinusitis onset were noted. Patients were included in the final review if they had a clear diagnosis of isolated sinusitis (without concurrent illness and/or immunodeficiency), and were evaluated during an episode of sinusitis. RESULTS 10/150 (6.6%) patients had isolated sinusitis at the time of their neuropsychiatric deterioration. Eight patients received antibiotics to treat sinusitis, three of whom also received sinus surgery. Neuropsychiatric symptoms improved in all eight patients concurrent with resolution of sinusitis per parent report and clinician assessment. One patient did not follow through with recommended sinus surgery or antibiotics and her psychiatric symptoms persisted. One patient was lost to follow-up. CONCLUSIONS Improvement of psychiatric symptoms correlated with resolution of sinus disease in this retrospective study. Identification, treatment, and resolution of underlying infections, including sinusitis, may have the potential to change the trajectory of some neuropsychiatric illnesses. Randomized clinical trials are needed.
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Miłkowska P, Popko K, Demkow U, Wolańczyk T. Pro-inflammatory Cytokines in Psychiatric Disorders in Children and Adolescents: A Review. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2017; 1021:73-80. [PMID: 28405892 DOI: 10.1007/5584_2017_32] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Cytokines are a large group of small proteins which play a significant role in cell signaling and regulate a variety of processes in organisms, including proliferation and differentiation of many cells, mediation in defense reactions and regulation of hematopoiesis. Cytokines can be divided into those with pro- and those with anti-inflammatory properties. In the group of pro-inflammatory cytokines the most important are: IL-1 beta, IL-6, TNF-alpha, and IFN-gamma. Pro-inflammatory cytokines might be involved in the pathophysiology of many psychiatric conditions in adults, but their role in children and adolescents is less clear. The aim of this article is to demonstrate the patterns of pro-inflammatory cytokines in children and adolescents.
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Affiliation(s)
- Paulina Miłkowska
- Department of Child Psychiatry, Warsaw Medical University, 63A Zwirki i Wigury Street, 02-091, Warsaw, Poland.
| | - Katarzyna Popko
- Department of Laboratory Diagnostics and Clinical Immunology of Developmental Age, Warsaw Medical University, 63A Zwirki i Wigury Street, 02-091, Warsaw, Poland
| | - Urszula Demkow
- Department of Laboratory Diagnostics and Clinical Immunology of Developmental Age, Warsaw Medical University, 63A Zwirki i Wigury Street, 02-091, Warsaw, Poland
| | - Tomasz Wolańczyk
- Department of Child Psychiatry, Warsaw Medical University, 63A Zwirki i Wigury Street, 02-091, Warsaw, Poland
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Donfrancesco R, Nativio P, Borrelli E, Giua E, Andriola E, Villa MP, DI Trani M. Serum cytokines in pediatric neuropsychiatric syndromes: focus on Attention Deficit Hyperactivity Disorder. Minerva Pediatr (Torino) 2016; 73:398-404. [PMID: 28006890 DOI: 10.23736/s2724-5276.16.04642-9] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
BACKGROUND Inflammation may represent a common underlying mechanism in a wide range of diseases, including neuropsychiatric disorders. Cytokine involvement has been investigated in some studies on patients with childhood neuropsychiatric diseases. The aim of this study was to determine whether cytokines are involved in ADHD to provide a rationale for immune-based therapeutic strategies in this disorder. METHODS Sixty children were studied: 34 consecutive drug-naïve children with ADHD (30 males and 4 females; mean age of 10.10 years, SD=2.43 age) and 26 healthy control children (22 males and 4 females; mean age of 10.70 years, SD=1.81). All cytokines but IL-2 (IL4-IL6-IL10- IL17-TNFA and IFNG) were studied by ELISAs; IL-2 was instead studied by means of paired anti-cytokine Abs and cytokine standards obtained from PharMingen. RESULTS Data reveal higher IL-6 and IL-10 levels in ADHD patients than in the control group (P=0.03). No differences emerged between the two groups for the other cytokines. CONCLUSIONS Our study showed an imbalance between pro- and anti-inflammatory cytokines that may play a pivotal role in the pathogenesis of ADHD.
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Affiliation(s)
| | - Paola Nativio
- Department of Molecular Medicine, Sapienza University, Rome, Italy
| | | | - Eleonora Giua
- Faculty of Medicine and Psychology, Sapienza University, Rome, Italy
| | | | - Maria P Villa
- NESMOS Department, S. Andrea Hospital, Sapienza University, Rome, Italy
| | - Michela DI Trani
- Department of Dynamic and Clinical Psychology, and Health Studies, Sapienza University, Rome, Italy -
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Microglial Dysregulation in OCD, Tourette Syndrome, and PANDAS. J Immunol Res 2016; 2016:8606057. [PMID: 28053994 PMCID: PMC5174185 DOI: 10.1155/2016/8606057] [Citation(s) in RCA: 60] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2016] [Accepted: 11/15/2016] [Indexed: 02/07/2023] Open
Abstract
There is accumulating evidence that immune dysregulation contributes to the pathophysiology of obsessive-compulsive disorder (OCD), Tourette syndrome, and Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections (PANDAS). The mechanistic details of this pathophysiology, however, remain unclear. Here we focus on one particular component of the immune system: microglia, the brain's resident immune cells. The role of microglia in neurodegenerative diseases has been understood in terms of classic, inflammatory activation, which may be both a consequence and a cause of neuronal damage. In OCD and Tourette syndrome, which are not characterized by frank neural degeneration, the potential role of microglial dysregulation is much less clear. Here we review the evidence for a neuroinflammatory etiology and microglial dysregulation in OCD, Tourette syndrome, and PANDAS. We also explore new hypotheses as to the potential contributions of microglial abnormalities to pathophysiology, beyond neuroinflammation, including failures in neuroprotection, lack of support for neuronal survival, and abnormalities in synaptic pruning. Recent advances in neuroimaging and animal model work are creating new opportunities to elucidate these issues.
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Mental Health Comorbidities in Pediatric Chronic Pain: A Narrative Review of Epidemiology, Models, Neurobiological Mechanisms and Treatment. CHILDREN-BASEL 2016; 3:children3040040. [PMID: 27918444 PMCID: PMC5184815 DOI: 10.3390/children3040040] [Citation(s) in RCA: 84] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/15/2016] [Revised: 11/15/2016] [Accepted: 11/21/2016] [Indexed: 12/12/2022]
Abstract
Chronic pain during childhood and adolescence can lead to persistent pain problems and mental health disorders into adulthood. Posttraumatic stress disorders and depressive and anxiety disorders are mental health conditions that co-occur at high rates in both adolescent and adult samples, and are linked to heightened impairment and disability. Comorbid chronic pain and psychopathology has been explained by the presence of shared neurobiology and mutually maintaining cognitive-affective and behavioral factors that lead to the development and/or maintenance of both conditions. Particularly within the pediatric chronic pain population, these factors are embedded within the broader context of the parent-child relationship. In this review, we will explore the epidemiology of, and current working models explaining, these comorbidities. Particular emphasis will be made on shared neurobiological mechanisms, given that the majority of previous research to date has centered on cognitive, affective, and behavioral mechanisms. Parental contributions to co-occurring chronic pain and psychopathology in childhood and adolescence will be discussed. Moreover, we will review current treatment recommendations and future directions for both research and practice. We argue that the integration of biological and behavioral approaches will be critical to sufficiently address why these comorbidities exist and how they can best be targeted in treatment.
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Ceylan ME, Evrensel A, Noyan CO, Dönmez A. Tolosa-Hunt syndrome and comorbidity of obsessive compulsive disorder and aortic aneurysm. BMJ Case Rep 2016; 2016:bcr-2016-216727. [PMID: 27872048 DOI: 10.1136/bcr-2016-216727] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Affiliation(s)
| | - Alper Evrensel
- Department of Psychiatry, Üsküdar University, Istanbul, Turkey
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146
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Garcia-Delgar B, Morer A, Luber MJ, Coffey BJ. Obsessive-Compulsive Disorder, Tics, and Autoinflammatory Diseases: Beyond PANDAS. J Child Adolesc Psychopharmacol 2016; 26:847-850. [PMID: 27854543 PMCID: PMC6445174 DOI: 10.1089/cap.2016.29118.bjc] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Affiliation(s)
- Blanca Garcia-Delgar
- Department of Child and Adolescent Psychiatry and Psychology, Institute of Neurosciences, Hospital Clínic, Barcelona, Spain
| | - Astrid Morer
- Department of Child and Adolescent Psychiatry and Psychology, Institute of Neurosciences, Hospital Clínic, Barcelona, Spain.,Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.,Centro de Investigación en Red de Salud Mental (CIBERSAM), Instituto Carlos III, Madrid, Spain
| | - Maxwell J. Luber
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Barbara J. Coffey
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, New York
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147
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Şimşek Ş, Yıldırım V, Çim A, Kaya S. Serum IL-4 and IL-10 Levels Correlate with the Symptoms of the Drug-Naive Adolescents with First Episode, Early Onset Schizophrenia. J Child Adolesc Psychopharmacol 2016; 26:721-726. [PMID: 27384868 DOI: 10.1089/cap.2015.0220] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
OBJECTIVE In this study, it was aimed to understand the underlying possible immunopathogenesis of first episode, early onset schizophrenia (EOS) through profiling the T helper 1 (Th1) cell cytokines TNF-α, IFN-γ, and IL-2, Th2 cell cytokines IL-4 and IL-10, Th17 cell cytokine IL-17A, and inflammatory cytokine IL-6. METHODS The study included a total of 30 children, admitted to child psychiatry outpatient clinic aged between 10 and 17 years of age, who had not received prior therapy and were diagnosed with psychosis according to the Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM-IV) as the patient group, and 26 age- and gender-matched children as the control group. Structured psychiatric interviews (K-SADS-PL and PANSS) were conducted with all participants. The BD Cytokine Bead Array Human Th1/Th2/Th17 Cytokine Kit is used for the measurement of serum cytokines, for example, IL-2, IL-4, IL-6, IL-10, IL-17A, TNF-α, and IFN-γ. RESULTS There was no significant difference between groups in terms of IL-2, IL-4, IL-6, IL-10, IL-17A, TNF-α, and IFN-γ levels (p > 0.05). However, there was a significant correlation between IL-10 and IL-4 with negative symptoms of EOS (r = -0.65, p = 0.02 and r = 0.67, p = 0.02, respectively). CONCLUSION IL4 and IL-10 levels have a relationship with negative symptoms of disease. Therefore, this study might suggest that immunological processes might have a role in the disease pathophysiology.
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Affiliation(s)
- Şeref Şimşek
- 1 Department of Child Psychiatry, Dicle University Medical School , Diyarbakır, Turkey
| | - Veli Yıldırım
- 2 Department of Child Psychiatry, Mersin University Medical School , Mersin, Turkey
| | - Abdullah Çim
- 3 Department of Medical Genetics, Dicle University Medical School , Diyarbakır, Turkey
| | - Savaş Kaya
- 4 Department of Immunology, Dicle University Medical School , Diyarbakır, Turkey
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148
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Amitai M, Taler M, Carmel M, Michaelovsky E, Eilat T, Yablonski M, Orpaz N, Chen A, Apter A, Weizman A, Fennig S. The Relationship Between Plasma Cytokine Levels and Response to Selective Serotonin Reuptake Inhibitor Treatment in Children and Adolescents with Depression and/or Anxiety Disorders. J Child Adolesc Psychopharmacol 2016; 26:727-732. [PMID: 26771135 DOI: 10.1089/cap.2015.0147] [Citation(s) in RCA: 56] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE In adults there is growing evidence that antidepressant (AD) treatment results in a decline in inflammatory cytokines. This is the first report, to our knowledge, of the relationship between response to selective serotonin reuptake inhibitor (SSRI) treatment for anxiety and/or depression and cytokine levels in children and adolescents. METHODS Forty-one patients who met Diagnostic and Statistical Manual for Mental Disorders, 4th ed. (DSM-IV) criteria for major depressive disorder (MDD) or anxiety disorders participated in study. Their ages ranged from 9 to 18 (14.12 ± 2.30) years. The patients were treated with fluoxetine for 8 weeks. Plasma concentrations of tumor necrosis factor (TNF)-α, interleukin (IL)-6, and IL-1β were measured by enzyme linked immunosorbent assays (ELISA) before and after fluoxetine treatment. Clinical response was measured with several scales, including the Children's Depression Rating Scale-Revised (CDRS-R), the Beck Depression Inventory (BDI), and the Screen for Child Anxiety Related Emotional Disorders (SCARED) Results: The overall response rate was 56%. Antidepressant treatment significantly reduced TNF-α levels (p = 0.037), with no significant changes in the levels of IL-6 and IL-1β. All three proinflammatory cytokines were significantly (p < 0.05) higher in SSRI-refractory than in SSRI-responsive patients. CONCLUSIONS Higher levels of TNF-α, IL-6, and IL-1β might predict nonresponse to fluoxetine treatment in children.
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Affiliation(s)
- Maya Amitai
- 1 Department of Psychological Medicine, Schneider Children's Medical Center of Israel , Petach Tikva, Israel .,2 Sackler Faculty of Medicine, Tel Aviv University , Tel Aviv, Israel .,3 The Ruhman Family Laboratory for Research on the Neurobiology of Stress, Department of Neurobiology, Weizmann Institute of Science , Rehovot, Israel
| | - Michal Taler
- 2 Sackler Faculty of Medicine, Tel Aviv University , Tel Aviv, Israel .,4 Felsenstein Medical Research Center , Petach Tikva, Israel
| | - Miri Carmel
- 2 Sackler Faculty of Medicine, Tel Aviv University , Tel Aviv, Israel .,4 Felsenstein Medical Research Center , Petach Tikva, Israel
| | - Elena Michaelovsky
- 2 Sackler Faculty of Medicine, Tel Aviv University , Tel Aviv, Israel .,4 Felsenstein Medical Research Center , Petach Tikva, Israel
| | - Tamar Eilat
- 1 Department of Psychological Medicine, Schneider Children's Medical Center of Israel , Petach Tikva, Israel
| | - Maya Yablonski
- 5 The Gonda Multidisciplinary Brain Research Center, Bar-Ilan University , Ramat-Gan, Israel
| | - Naama Orpaz
- 6 Schneider Children's Medical Center of Israel , Petach Tikva, Israel
| | - Alon Chen
- 3 The Ruhman Family Laboratory for Research on the Neurobiology of Stress, Department of Neurobiology, Weizmann Institute of Science , Rehovot, Israel .,7 Department of Stress Neurobiology and Neurogenetics, Max-Planck Institute of Psychiatry , Munich, Germany
| | - Alan Apter
- 1 Department of Psychological Medicine, Schneider Children's Medical Center of Israel , Petach Tikva, Israel .,2 Sackler Faculty of Medicine, Tel Aviv University , Tel Aviv, Israel
| | - Abraham Weizman
- 2 Sackler Faculty of Medicine, Tel Aviv University , Tel Aviv, Israel .,4 Felsenstein Medical Research Center , Petach Tikva, Israel .,8 Research Unit, Geha Mental Health Center , Petach Tikva, Israel
| | - Silvana Fennig
- 1 Department of Psychological Medicine, Schneider Children's Medical Center of Israel , Petach Tikva, Israel .,2 Sackler Faculty of Medicine, Tel Aviv University , Tel Aviv, Israel
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149
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Guan SSA, Bower JE, Almeida DM, Cole SW, Dahl RE, Irwin MR, Seeman TE, McDade T, Fuligni AJ. Parental support buffers the association of depressive symptoms with cortisol and C-reactive protein during adolescence. Brain Behav Immun 2016; 57:134-143. [PMID: 26995316 PMCID: PMC5010993 DOI: 10.1016/j.bbi.2016.03.007] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2015] [Revised: 03/09/2016] [Accepted: 03/10/2016] [Indexed: 01/02/2023] Open
Abstract
Social experiences can affect the relationship between depression and physical health. The current study examined how social support from parents and friends may moderate the association of depressive symptoms with hypothalamic-pituitary-adrenal (HPA) axis activity and C-reactive protein among adolescents (N=316, Mage=16.40, SD=.74; 57% female) from diverse ethnic backgrounds (23.1% Asian, 29.1% European, 41.8% Latino, and 6.0% other backgrounds). Results indicated that parent support, but not friend support, moderated the link between depressive symptoms and both total daily cortisol output (a measure HPA activity) and C-reactive protein (a marker of inflammation). These patterns did not differ by ethnicity. Overall, the study highlights the continued, and perhaps accumulated, importance of parents during adolescence despite increasing needs for autonomy from and exploration outside of the family unit.
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150
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Frick L, Rapanelli M, Abbasi E, Ohtsu H, Pittenger C. Histamine regulation of microglia: Gene-environment interaction in the regulation of central nervous system inflammation. Brain Behav Immun 2016; 57:326-337. [PMID: 27381299 PMCID: PMC5012904 DOI: 10.1016/j.bbi.2016.07.002] [Citation(s) in RCA: 57] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2016] [Revised: 06/08/2016] [Accepted: 07/02/2016] [Indexed: 01/24/2023] Open
Abstract
Microglia mediate neuroinflammation and regulate brain development and homeostasis. Microglial abnormalities are implicated in a range of neuropsychiatric pathology, including Tourette syndrome (TS) and autism. Histamine (HA) is both a neurotransmitter and an immune modulator. HA deficiency has been implicated as a rare cause of TS and may contribute to other neuropsychiatric conditions. In vitro studies suggest that HA can regulate microglia, but this has never been explored in vivo. We used immunohistochemistry to examine the effects of HA deficiency in histidine decarboxylase (Hdc) knockout mice and of HA receptor stimulation in wild-type animals. We find HA to regulate microglia in vivo, via the H4 receptor. Chronic HA deficiency in Hdc knockout mice reduces ramifications of microglia in the striatum and (at trend level) in the hypothalamus, but not elsewhere in the brain. Depletion of histaminergic neurons in the hypothalamus has a similar effect. Microglia expressing IGF-1 are particularly reduced, However, the microglial response to challenge with lipopolysacchariade (LPS) is potentiated in Hdc knockout mice. Genetic abnormalities in histaminergic signaling may produce a vulnerability to inflammatory challenge, setting the state for pathogenically dysregulated neuroimmune responses.
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Affiliation(s)
- Luciana Frick
- Department of Psychiatry, Yale University, New Haven, CT
| | | | - Eeman Abbasi
- Department of Psychiatry, Yale University, New Haven, CT
| | - Hiroshi Ohtsu
- Tohoku University, Graduate School of Engineering, Sendai, Janpan
| | - Christopher Pittenger
- Department of Psychiatry, Yale University, New Haven, CT, United States; Department of Psychology, Yale University, New Haven, CT, United States; Child Study Center, Yale University, New Haven, CT, United States; Interdepartmental Neuroscience Program, Yale University, New Haven, CT, United States.
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