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Zalsman G. How else can inflammation kill you? Eur Neuropsychopharmacol 2023; 67:1-3. [PMID: 36459952 PMCID: PMC9707409 DOI: 10.1016/j.euroneuro.2022.11.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Revised: 11/02/2022] [Accepted: 11/04/2022] [Indexed: 11/30/2022]
Affiliation(s)
- Gil Zalsman
- Geha Mental Health Center and Psychiatry Department, Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel; Division of Molecular Imaging and Neuropathology, Department of Psychiatry, Columbia University, New York, NY, United States.
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2
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Vuscan ME, Faludi C, Rusu SI, Vica ML, Balici S, Siserman CV, Coman HG, Matei HV. Determinants of Suicide Ideation in the Romanian Population. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:10384. [PMID: 36012016 PMCID: PMC9408719 DOI: 10.3390/ijerph191610384] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Revised: 08/12/2022] [Accepted: 08/18/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Suicide ideation and behaviors are directly linked to the risk of death by suicide. In Romania, as well as worldwide, increased suicide rates were observed in the recent past, more so in the context of the COVID-19 pandemic. The purpose of this study was to investigate the influence of psychosocial factors, quality of life (QOL), and loneliness dimensions and adverse life antecedents on suicide ideation (SI) and prolonged sadness (PS). METHODS This cross-sectional quantitative research study used a CATI data gathering method to investigate 1102 randomly selected individuals over 18 years of age regarding various determinants of SI and PS. Data were collected in June 2021. Descriptive, inferential, and multivariate statistics were used for data analysis. RESULTS SI was negatively correlated with all the assessed psychosocial factors, more significantly with family relationships, wealth, health, social relationships, and affective life. Stronger correlations were observed when investigating the state of prolonged sadness, sex, and affective lives along with health and income, which were more influential. SI was negatively correlated with QOL and positively correlated with adverse life events and total loneliness scores. Lesser educated youngsters with reduced overall happiness and a history of depression, self-harm, and trauma were at greater risk of developing SI. CONCLUSIONS This is the first national study exploring the suicide ideation and prolonged sadness in relation to psychosocial factors, quality of life, and adverse life events. These results have important implications for suicide prevention programs, which should be designed in accordance with similar studies.
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Affiliation(s)
- Mihaela Elvira Vuscan
- Department of Cellular and Molecular Biology, Iuliu Haṭieganu University of Medicine and Pharmacy, 400349 Cluj-Napoca, Romania
- Legal Medicine Institute, 400006 Cluj-Napoca, Romania
| | - Cristina Faludi
- Department of Social Work, “Babeṣ Bolyai” University, 400604 Cluj-Napoca, Romania
| | - Sergiu Ionica Rusu
- Doctoral School of Sociology, “Babeṣ Bolyai” University, 400604 Cluj-Napoca, Romania
| | - Mihaela Laura Vica
- Department of Cellular and Molecular Biology, Iuliu Haṭieganu University of Medicine and Pharmacy, 400349 Cluj-Napoca, Romania
- Legal Medicine Institute, 400006 Cluj-Napoca, Romania
| | - Stefana Balici
- Department of Cellular and Molecular Biology, Iuliu Haṭieganu University of Medicine and Pharmacy, 400349 Cluj-Napoca, Romania
| | - Costel Vasile Siserman
- Legal Medicine Institute, 400006 Cluj-Napoca, Romania
- Department of Legal Medicine, Iuliu Haṭieganu University of Medicine and Pharmacy, 400349 Cluj-Napoca, Romania
| | - Horia George Coman
- Department of Medical Psychology, Iuliu Haṭieganu University of Medicine and Pharmacy, 400349 Cluj-Napoca, Romania
| | - Horea Vladi Matei
- Department of Cellular and Molecular Biology, Iuliu Haṭieganu University of Medicine and Pharmacy, 400349 Cluj-Napoca, Romania
- Legal Medicine Institute, 400006 Cluj-Napoca, Romania
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3
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Goldstein Ferber S, Shoval G, Zalsman G, Weller A. Does COVID-19 related symptomatology indicate a transdiagnostic neuropsychiatric disorder? - Multidisciplinary implications. World J Psychiatry 2022; 12:1004-1015. [PMID: 36158308 PMCID: PMC9476837 DOI: 10.5498/wjp.v12.i8.1004] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Revised: 04/28/2022] [Accepted: 07/25/2022] [Indexed: 02/05/2023] Open
Abstract
The clinical presentation that emerges from the extensive coronavirus disease 2019 (COVID-19) mental health literature suggests high correlations among many conventional psychiatric diagnoses. Arguments against the use of multiple comorbidities for a single patient have been published long before the pandemic. Concurrently, diagnostic recommendations for use of transdiagnostic considerations for improved treatment have been also published in recent years. In this review, we pose the question of whether a transdiagnostic mental health disease, including psychiatric and neuropsychiatric symptomology, has emerged since the onset of the pandemic. There are many attempts to identify a syndrome related to the pandemic, but none of the validated scales is able to capture the entire psychiatric and neuropsychiatric clinical presentation in infected and non-infected individuals. These scales also only marginally touch the issue of etiology and prevalence. We suggest a working hypothesis termed Complex Stress Reaction Syndrome (CSRS) representing a global psychiatric reaction to the pandemic situation in the general population (Type A) and a neuropsychiatric reaction in infected individuals (Type B) which relates to neurocognitive and psychiatric features which are part (excluding systemic and metabolic dysfunctions) of the syndrome termed in the literature as long COVID. We base our propositions on multidisciplinary scientific data regarding mental health during the global pandemic situation and the effects of viral infection reviewed from Google Scholar and PubMed between February 1, 2022 and March 10, 2022. Search in-clusion criteria were "mental health", "COVID-19" and "Long COVID", English language and human studies only. We suggest that this more comprehensive way of understanding COVID-19 complex mental health reactions may promote better prevention and treatment and serve to guide implementation of recommended administrative regulations that were recently published by the World Psychiatric Association. This review may serve as a call for an international investigation of our working hypothesis.
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Affiliation(s)
- Sari Goldstein Ferber
- Department of Psychology and Gonda Brain Research Center, Bar Ilan University, Ramat Gan 5317000, Israel
| | - Gal Shoval
- Department of Psychiatry, Tel Aviv University, Tel Aviv 6997801, Israel
- Department of Neuroscience, Princeton University, Princeton, NJ 08544, United States
| | - Gil Zalsman
- Department of Psychiatry, Tel Aviv University, Tel Aviv 6997801, Israel
- Department of Psychiatry, Columbia University, New York, NY 10032, United States
| | - Aron Weller
- Department of Psychology and Gonda Brain Research Center, Bar Ilan University, Ramat Gan 5317000, Israel
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4
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Characteristics of patients treated for suicidal behavior during the pandemic in a psychiatric emergency department in a Spanish province. REVISTA DE PSIQUIATRIA Y SALUD MENTAL 2022. [DOI: 10.1016/j.rpsm.2022.03.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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5
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Bednarova A, Hlavacova N, Pecenak J. Analysis of Motives and Factors Connected to Suicidal Behavior in Patients Hospitalized in a Psychiatric Department. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19106283. [PMID: 35627820 PMCID: PMC9141087 DOI: 10.3390/ijerph19106283] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Revised: 05/15/2022] [Accepted: 05/20/2022] [Indexed: 11/30/2022]
Abstract
(1) Background: This study aimed to investigate the motives and factors connected to suicidal behavior in 121 hospitalized patients with intentional self-harm (diagnosis X 60-81 according to the ICD-10); (2) Methods: Suicidal behavior of the patient was assessed from data obtained by psychiatric examinations and by the Columbia Suicide Severity Rating Scale. Analysis of data to identify the patients’ reason and motives behind suicidal behavior in a group of patients with a suicide attempt (SA, n = 80) and patients with Non-Suicidal Self-Injurious Behavior (NSSIB, n = 41) was carried out; (3) Results: Results showed that patients with affective disorder have a 19-times higher rate of SA against other diagnoses. Patients with personality disorders have a 32-times higher rate of NSSIB than patients with other diagnoses. Living alone and the absence of social support increased the likelihood of SA. Qualitative data analysis of patients’ statements showed different themes in the justification of motives for suicidal behavior between SA and NSSIB cases. Significant differences were shown for non-communicated reasons, loneliness, social problems, extortion, and distress; (4) Conclusions: The evaluation of patients’ verbal statements by qualitative analysis during the psychiatric examination should be considered in clinical practice. It should be considered to include self-poisoning in the criteria of the Non-suicidal Self-Injury diagnostic categories.
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Affiliation(s)
- Aneta Bednarova
- 2nd Department of Psychiatry, Faculty of Medicine, University Hospital of L. Pasteur Kosice, Pavol Jozef Safarik University, 04011 Kosice, Slovakia;
| | - Natasa Hlavacova
- Institute of Experimental Endocrinology, Biomedical Research Center, Slovak Academy of Sciences, 84505 Bratislava, Slovakia
- Correspondence:
| | - Jan Pecenak
- Department of Psychiatry, Faculty of Medicine, University Hospital Bratislava, Comenius University, 81369 Bratislava, Slovakia;
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Pérez V, Elices M, Vilagut G, Vieta E, Blanch J, Laborda-Serrano E, Prat B, Colom F, Palao D, Alonso J. Suicide-related thoughts and behavior and suicide death trends during the COVID-19 in the general population of Catalonia, Spain. Eur Neuropsychopharmacol 2022; 56:4-12. [PMID: 34875491 PMCID: PMC8603035 DOI: 10.1016/j.euroneuro.2021.11.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Revised: 11/09/2021] [Accepted: 11/11/2021] [Indexed: 12/31/2022]
Abstract
The COVID-19 pandemic is expected to increase suicidal behavior. However, data available to date are inconsistent. This study examines suicidal thoughts and behaviors and suicide trends in 2020 relative to 2019 as an approximation to the impact of the pandemic on suicidal behavior and death in the general population of Catalonia, Spain. Data on suicide-related thoughts and behaviors (STBs) and suicidal mortality were obtained from the Catalonia Suicide Risk Code (CSRC) register and the regional police, respectively. We compared the monthly crude incidence of STBs and suicide mortality rates of 2020 with those of 2019. Joinpoint regression analysis was used to assess changes in trends over time during the studied period. In 2020, 4,263 consultations for STBs and 555 suicide deaths were registered in Catalonia (approx. 7.5 million inhabitants). Compared to 2019, in 2020 STBs rates decreased an average of 6.3% (incidence rate ratio, IRR=0.94, 95% CI 0,90-0,98) and overall suicide death rates increased 1.2% (IRR=1.01, 95% CI 0.90-1.13). Joinpoint regression results showed a substantial decrease in STBs rates with a monthly percent change (MPC) of -22.1 (95% CI: -41.1, 2.9) from January-April 2020, followed by a similar increase from April-July 2020 (MPC=24.7, 95% CI: -5.9, 65.2). The most restrictive measures implemented in response to the COVID-19 pandemic reduced consultations for STBs, suggesting that the "stay at home" message may have discouraged people from contacting mental health services. STBs and mortality should continue to be monitored in 2021 and beyond to understand better the mid-to-long term impact of COVID-19 on suicide trends.
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Affiliation(s)
- V Pérez
- Institut de Neuropsiquiatria i Addiccions (INAD), Parc de Salut Mar, Universitat Autònoma de Barcelona (UAB), Barcelona, Spain; Institut Hospital del Mar d'Investigacions Mèdiques, (IMIM), Parce de Salut Mar, Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain
| | - M Elices
- Institut Hospital del Mar d'Investigacions Mèdiques, (IMIM), Parce de Salut Mar, Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain.
| | - G Vilagut
- Institut Hospital del Mar d'Investigacions Mèdiques, (IMIM), Parce de Salut Mar, Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - E Vieta
- Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain; Hospital Clinic, Institute of Neuroscience, University of Barcelona, IDIBAPS, Barcelona, Spain
| | - J Blanch
- Hospital Clinic, Institute of Neuroscience, University of Barcelona, IDIBAPS, Barcelona, Spain; Master Plan on Mental Health and Addictions, Ministry of Health, Catalan Government, Spain
| | | | - B Prat
- Master Plan on Mental Health and Addictions, Ministry of Health, Catalan Government, Spain
| | - F Colom
- Institut de Neuropsiquiatria i Addiccions (INAD), Parc de Salut Mar, Universitat Autònoma de Barcelona (UAB), Barcelona, Spain; Institut Hospital del Mar d'Investigacions Mèdiques, (IMIM), Parce de Salut Mar, Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain
| | - D Palao
- Department of Mental Health, Parc Taulí-University Hospital; Unitat Mixta de Neurociència Traslacional I3PT, Department of Psychiatry and Forensic Medicine, Autonomous University of Barcelona; CIBERSAM, Spain
| | - J Alonso
- Institut Hospital del Mar d'Investigacions Mèdiques, (IMIM), Parce de Salut Mar, Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain; Department of Experimental and Health Sciences, Pompeu Fabra University, Barcelona, Spain
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McPherson P, Sall S, Santos A, Thompson W, Dwyer DS. Catalytic Reaction Model of Suicide. Front Psychiatry 2022; 13:817224. [PMID: 35356712 PMCID: PMC8959568 DOI: 10.3389/fpsyt.2022.817224] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Accepted: 02/07/2022] [Indexed: 12/20/2022] Open
Abstract
Suicide is a devastating outcome of unresolved issues that affect mental health, general wellbeing and socioeconomic stress. The biology of suicidal behavior is still poorly understood, although progress has been made. Suicidal behavior runs in families and genetic studies have provided initial glimpses into potential genes that contribute to suicide risk. Here, we attempt to unify the biology and behavioral dimensions into a model that can guide research in this area. The proposed model envisions suicidal behavior as a catalytic reaction that may result in suicide depending on the conditions, analogously to enzyme catalysis of chemical reactions. A wide array of substrates or reactants, such as hopelessness, depression, debilitating illnesses and diminished motivation can mobilize suicidal thoughts and behaviors (STBs), which can then catalyze the final step/act of suicide. Here, we focus on three biological substrates in particular: threat assessment, motivation to engage in life and impulsivity. Genetic risk factors can affect each of these processes and tilt the balance toward suicidal behavior when existential crises (real or perceived) emerge such as loss of a loved one, sudden changes in social status or serious health issues. Although suicide is a uniquely human behavior, many of the fundamental biological processes are evolutionarily conserved. Insights from animal models may help to shape our understanding of suicidal behavior in man. By examining counterparts of the major biological processes in other organisms, new ideas about the role of genetic risk factors may emerge along with possible therapeutic interventions or preventive measures.
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Affiliation(s)
- Pamela McPherson
- Department of Psychiatry and Behavioral Medicine, Shreveport, LA, United States
| | - Saveen Sall
- Department of Psychiatry and Behavioral Medicine, Shreveport, LA, United States
| | - Aurianna Santos
- Department of Psychiatry and Behavioral Medicine, Shreveport, LA, United States
| | - Willie Thompson
- Department of Psychiatry and Behavioral Medicine, Shreveport, LA, United States
| | - Donard S Dwyer
- Department of Psychiatry and Behavioral Medicine, Shreveport, LA, United States.,Department of Pharmacology, Toxicology and Neuroscience, LSU Health Shreveport, Shreveport, LA, United States
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8
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Pompili M. Can we expect a rise in suicide rates after the Covid-19 pandemic outbreak? Eur Neuropsychopharmacol 2021; 52:1-2. [PMID: 34120055 PMCID: PMC8164342 DOI: 10.1016/j.euroneuro.2021.05.011] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Revised: 05/15/2021] [Accepted: 05/22/2021] [Indexed: 11/24/2022]
Affiliation(s)
- Maurizio Pompili
- Department of Neurosciences, Mental Health and Sensory Organs, Faculty of Medicine and Psychology, Suicide Prevention Centre, Sant'Andrea Hospital, Sapienza University of Rome, Rome, Italy.
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9
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Courtet P, Olié E. Suicide in the COVID-19 pandemic: What we learnt and great expectations. Eur Neuropsychopharmacol 2021; 50:118-120. [PMID: 34246052 DOI: 10.1016/j.euroneuro.2021.06.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Revised: 06/07/2021] [Accepted: 06/09/2021] [Indexed: 11/27/2022]
Affiliation(s)
- Ph Courtet
- Department of Emergency Psychiatry and Acute Care, Lapeyronie Hospital, CHU Montpellier, Montpellier, France; IGF, Univ. Montpellier, CNRS, INSERM, Montpellier, France; FondaMental Foundation, Créteil, France.
| | - E Olié
- Department of Emergency Psychiatry and Acute Care, Lapeyronie Hospital, CHU Montpellier, Montpellier, France; IGF, Univ. Montpellier, CNRS, INSERM, Montpellier, France; FondaMental Foundation, Créteil, France
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10
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Jardon V, Colin S, Lamotte A, Correia F, Debien C. [Management of suicidal crises and suicidal individuals]. REVUE DE L'INFIRMIÈRE 2021; 70:24-28. [PMID: 33832725 DOI: 10.1016/j.revinf.2021.02.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Knowing how to assess the suicidal risk of people in crisis, knowing how to orient them, welcome them, treat them and look after them are the keys to these multidisciplinary health care.
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Affiliation(s)
- Vincent Jardon
- Hôpital Michel-Fontan 1 et 2, rue André-Verhaeghe, CHRU de Lille, 59037 Lille cedex, France.
| | - Sandrine Colin
- Hôpital Michel-Fontan 1 et 2, rue André-Verhaeghe, CHRU de Lille, 59037 Lille cedex, France
| | - Alexia Lamotte
- Hôpital Michel-Fontan 1 et 2, rue André-Verhaeghe, CHRU de Lille, 59037 Lille cedex, France
| | - Fanny Correia
- Hôpital Michel-Fontan 1 et 2, rue André-Verhaeghe, CHRU de Lille, 59037 Lille cedex, France
| | - Christophe Debien
- Hôpital Michel-Fontan 1 et 2, rue André-Verhaeghe, CHRU de Lille, 59037 Lille cedex, France; Centre national de ressources et de résilience (CN2R), 103, boulevard de la Liberté, 59000 Lille, France
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Goldstein Ferber S, Shoval G, Zalsman G, Mikulincer M, Weller A. Between Action and Emotional Survival During the COVID-19 era: Sensorimotor Pathways as Control Systems of Transdiagnostic Anxiety-Related Intolerance to Uncertainty. Front Psychiatry 2021; 12:680403. [PMID: 34393847 PMCID: PMC8358206 DOI: 10.3389/fpsyt.2021.680403] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2021] [Accepted: 06/16/2021] [Indexed: 12/29/2022] Open
Abstract
Objectives: The COVID-19 pandemic and aligned social and physical distancing regulations increase the sense of uncertainty, intensifying the risk for psychopathology globally. Anxiety disorders are associated with intolerance to uncertainty. In this review we describe brain circuits and sensorimotor pathways involved in human reactions to uncertainty. We present the healthy mode of coping with uncertainty and discuss deviations from this mode. Methods: Literature search of PubMed and Google Scholar. Results: As manifestation of anxiety disorders includes peripheral reactions and negative cognitions, we suggest an integrative model of threat cognitions modulated by sensorimotor regions: "The Sensorimotor-Cognitive-Integration-Circuit." The model emphasizes autonomic nervous system coupling with the cortex, addressing peripheral anxious reactions to uncertainty, pathways connecting cortical regions and cost-reward evaluation circuits to sensorimotor regions, filtered by the amygdala and basal ganglia. Of special interest are the ascending and descending tracts for sensory-motor crosstalk in healthy and pathological conditions. We include arguments regarding uncertainty in anxiety reactions to the pandemic and derive from our model treatment suggestions which are supported by scientific evidence. Our model is based on systematic control theories and emphasizes the role of goal conflict regulation in health and pathology. We also address anxiety reactions as a spectrum ranging from healthy to pathological coping with uncertainty, and present this spectrum as a transdiagnostic entity in accordance with recent claims and models. Conclusions: The human need for controllability and predictability suggests that anxiety disorders reactive to the pandemic's uncertainties reflect pathological disorganization of top-down bottom-up signaling and neural noise resulting from non-pathological human needs for coherence in life.
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Affiliation(s)
- Sari Goldstein Ferber
- Psychology Department and Gonda Brain Research Center, Bar-Ilan University, Ramat Gan, Israel
| | - Gal Shoval
- Geha Mental Health Center, Petah Tiqva, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Princeton Neuroscience Institute, Princeton University, Princeton, NJ, United States
| | - Gil Zalsman
- Geha Mental Health Center, Petah Tiqva, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Division of Molecular Imaging and Neuropathology, Department of Psychiatry, Columbia University and New York State Psychiatric Institute, New York, NY, United States
| | - Mario Mikulincer
- Interdisciplinary Center (IDC) Herzliya, Baruch Ivcher School of Psychology, Herzliya, Israel
| | - Aron Weller
- Psychology Department and Gonda Brain Research Center, Bar-Ilan University, Ramat Gan, Israel
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