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Soto-Angona Ó, Fortea A, Fortea L, Martínez-Ramírez M, Santamarina E, López FJG, Knudsen GM, Ona G. Do classic psychedelics increase the risk of seizures? A scoping review. Eur Neuropsychopharmacol 2024; 85:35-42. [PMID: 38917636 DOI: 10.1016/j.euroneuro.2024.05.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Revised: 04/27/2024] [Accepted: 05/01/2024] [Indexed: 06/27/2024]
Abstract
Seizures are a concerning adverse event frequently associated with the use of psychedelics, and hence, studies involving these substances tend to exclude patients with past history of epilepsy. This is especially relevant because epileptic seizures are markedly increased in the population suffering from mental disorders, and psychedelic assisted therapy is being researched as a promising treatment for several of them. To determine the extent of the current literature on the relationship between classic psychedelics and seizures, a scoping review was performed using the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews). The search was conducted in PubMed, Web of Science, Google scholar, LILACS and Scielo, and both animal and human models were included. A total of 16 publications on humans, and 11 on animals, were found. The results are heterogeneous, but globally suggest that psychedelics may not increase the risk of seizures in healthy individuals or animals in the absence of other drugs. However, concomitant use of other substances or drugs, such as kambo or lithium, could increase the risk of seizures. Additionally, these conclusions are drawn from data lacking sufficient external validity, so they should be interpreted with caution. Future paths for research and a summary on possible neurobiological underpinnings that might clarify the relationship between classical psychedelics and seizures are also provided.
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Affiliation(s)
- Óscar Soto-Angona
- Sociedad Española de Medicina Psicodélica (SEMPsi), Barcelona, Spain; Department of Psychiatry and Forensic Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain; Parc Sanitari Sant Joan de Déu, Barcelona, Spain; Fundació Sant Joan de Déu, Institut de Recerca Sant Joan de Déu, Barcelona, Spain
| | - Adriana Fortea
- Sociedad Española de Medicina Psicodélica (SEMPsi), Barcelona, Spain; Department of Psychiatry and Psychology, Institute of Neuroscience, Hospital Clinic of Barcelona, Barcelona, Spain; Fundació Clínic per a la Recerca Biomèdica-Institut d'Investigacions Biomèdiques August Pi I Sunyer, Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Spain
| | - Lydia Fortea
- Fundació Clínic per a la Recerca Biomèdica-Institut d'Investigacions Biomèdiques August Pi I Sunyer, Barcelona, Spain; Department of Medicine, University of Barcelona, Institute of Neuroscience, Barcelona, Spain
| | - María Martínez-Ramírez
- Sociedad Española de Medicina Psicodélica (SEMPsi), Barcelona, Spain; Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Catalonia, Spain
| | - Estevo Santamarina
- Epilepsy Unit. Department of Neurology, Hospital Universitari Vall d'Hebron, Barcelona, Catalonia, Spain
| | | | - Gite Moos Knudsen
- Neurobiology Research Unit, Rigshospitalet and Dept. Clinical Medicine, University of Copenhagen, Denmark
| | - Genís Ona
- Sociedad Española de Medicina Psicodélica (SEMPsi), Barcelona, Spain; Fundació Sant Joan de Déu, Institut de Recerca Sant Joan de Déu, Barcelona, Spain; Universitat Rovira i Virgili, Medical Anthropology Research Center (MARC), Department of Anthropology, Philosophy and Social Work, Tarragona, Catalonia, Spain.
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2
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Saleki K, Alijanizadeh P, Javanmehr N, Rezaei N. The role of Toll-like receptors in neuropsychiatric disorders: Immunopathology, treatment, and management. Med Res Rev 2024; 44:1267-1325. [PMID: 38226452 DOI: 10.1002/med.22012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Revised: 10/20/2023] [Accepted: 12/20/2023] [Indexed: 01/17/2024]
Abstract
Neuropsychiatric disorders denote a broad range of illnesses involving neurology and psychiatry. These disorders include depressive disorders, anxiety, schizophrenia, bipolar disorder, attention deficit hyperactivity disorder, autism spectrum disorders, headaches, and epilepsy. In addition to their main neuropathology that lies in the central nervous system (CNS), lately, studies have highlighted the role of immunity and neuroinflammation in neuropsychiatric disorders. Toll-like receptors (TLRs) are innate receptors that act as a bridge between the innate and adaptive immune systems via adaptor proteins (e.g., MYD88) and downstream elements; TLRs are classified into 13 families that are involved in normal function and illnesses of the CNS. TLRs expression affects the course of neuropsychiatric disorders, and is influenced during their pharmacotherapy; For example, the expression of multiple TLRs is normalized during the major depressive disorder pharmacotherapy. Here, the role of TLRs in neuroimmunology, treatment, and management of neuropsychiatric disorders is discussed. We recommend longitudinal studies to comparatively assess the cell-type-specific expression of TLRs during treatment, illness progression, and remission. Also, further research should explore molecular insights into TLRs regulation and related pathways.
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Affiliation(s)
- Kiarash Saleki
- Student Research Committee, Babol University of Medical Sciences, Babol, Iran
- USERN Office, Babol University of Medical Sciences, Babol, Iran
- Department of e-Learning, Virtual School of Medical Education and Management, Shahid Beheshti University of Medical Sciences (SBMU), Tehran, Iran
| | - Parsa Alijanizadeh
- Student Research Committee, Babol University of Medical Sciences, Babol, Iran
- USERN Office, Babol University of Medical Sciences, Babol, Iran
| | - Nima Javanmehr
- Student Research Committee, Babol University of Medical Sciences, Babol, Iran
- USERN Office, Babol University of Medical Sciences, Babol, Iran
| | - Nima Rezaei
- Research Center for Immunodeficiencies, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran
- Department of Immunology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
- Network of Immunity in Infection, Malignancy and Autoimmunity (NIIMA), Universal Scientific Education and Research Network (USERN), Tehran, Iran
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3
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Wiggins JL, Ureña Rosario A, MacNeill LA, Krogh‐Jespersen S, Briggs‐Gowan M, Smith JD, Wakschlag LS. Prevalence, stability, and predictive utility of the Multidimensional Assessment of Preschoolers Scales clinically optimized irritability score: Pragmatic early assessment of mental disorder risk. Int J Methods Psychiatr Res 2023; 32:e1991. [PMID: 37728118 PMCID: PMC10654826 DOI: 10.1002/mpr.1991] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Revised: 08/11/2023] [Accepted: 08/17/2023] [Indexed: 09/21/2023] Open
Abstract
OBJECTIVES Characterizing the scope and import of early childhood irritability is essential for real-world actualization of this reliable indicator of transdiagnostic mental health risk. Thus, we utilize pragmatic assessment to establish prevalence, stability, and predictive utility of clinically significant early childhood irritability. METHODS Data included two independent, diverse community samples of preschool age children (N = 1857; N = 1490), with a subset enriched for risk (N = 425) assessed longitudinally from early childhood through preadolescence (∼4-9 years old). A validated, brief (2-item) scale pragmatically assessed clinically significant irritability. In the longitudinal subsample, clinical interviews assessed internalizing/externalizing disorders. RESULTS One in five preschool-age children had clinically significant irritability, which was independently replicated. Irritability was highly stable through preadolescence. Children with versus without clinically significant early childhood irritability had greater odds of early onset, persistent internalizing/externalizing disorders. The pragmatic assessment effectively screened out low-risk children and identified 2/3 of children with early-onset, persistent psychopathology. CONCLUSIONS Clinically significant early childhood irritability prevalence is akin to the pediatric obesity epidemic and may warrant similar universal screening/intervention. Also, irritability's stability demonstrates the common guidance "they'll grow out of it" to be false. Finally, pragmatic irritability assessment has transdiagnostic predictive power and addresses a need for feasible measures to flag risk.
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Affiliation(s)
- Jillian Lee Wiggins
- Department of PsychologySan Diego State UniversitySan DiegoCaliforniaUSA
- San Diego State University/University of California, San Diego Joint Doctoral Program in Clinical PsychologySan DiegoCaliforniaUSA
| | - Ana Ureña Rosario
- Department of PsychologySan Diego State UniversitySan DiegoCaliforniaUSA
| | - Leigha A. MacNeill
- Department of Medical Social SciencesFeinberg School of MedicineNorthwestern UniversityChicagoIllinoisUSA
- Institute for Innovations in Developmental SciencesNorthwestern UniversityEvanstonIllinoisUSA
| | - Sheila Krogh‐Jespersen
- Institute for Innovations in Developmental SciencesNorthwestern UniversityEvanstonIllinoisUSA
| | | | - Justin D. Smith
- Department of Population Health SciencesUniversity of UtahSalt Lake CityUtahUSA
| | - Lauren S. Wakschlag
- Department of Medical Social SciencesFeinberg School of MedicineNorthwestern UniversityChicagoIllinoisUSA
- Institute for Innovations in Developmental SciencesNorthwestern UniversityEvanstonIllinoisUSA
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4
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Basu I, Yousefi A, Crocker B, Zelmann R, Paulk AC, Peled N, Ellard KK, Weisholtz DS, Cosgrove GR, Deckersbach T, Eden UT, Eskandar EN, Dougherty DD, Cash SS, Widge AS. Closed-loop enhancement and neural decoding of cognitive control in humans. Nat Biomed Eng 2023; 7:576-588. [PMID: 34725508 PMCID: PMC9056584 DOI: 10.1038/s41551-021-00804-y] [Citation(s) in RCA: 20] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Accepted: 09/02/2021] [Indexed: 12/20/2022]
Abstract
Deficits in cognitive control-that is, in the ability to withhold a default pre-potent response in favour of a more adaptive choice-are common in depression, anxiety, addiction and other mental disorders. Here we report proof-of-concept evidence that, in participants undergoing intracranial epilepsy monitoring, closed-loop direct stimulation of the internal capsule or striatum, especially the dorsal sites, enhances the participants' cognitive control during a conflict task. We also show that closed-loop stimulation upon the detection of lapses in cognitive control produced larger behavioural changes than open-loop stimulation, and that task performance for single trials can be directly decoded from the activity of a small number of electrodes via neural features that are compatible with existing closed-loop brain implants. Closed-loop enhancement of cognitive control might remediate underlying cognitive deficits and aid the treatment of severe mental disorders.
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Affiliation(s)
- Ishita Basu
- Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Ali Yousefi
- Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
- Departments of Computer Science and Neuroscience, Worcester Polytechnic Institute, Worcester, MA, USA
| | - Britni Crocker
- Department of Neurology, Massachusetts General Hospital, Boston, MA, USA
| | - Rina Zelmann
- Department of Neurology, Massachusetts General Hospital, Boston, MA, USA
| | - Angelique C Paulk
- Department of Neurology, Massachusetts General Hospital, Boston, MA, USA
| | - Noam Peled
- Department of Radiology, MGH/HST Martinos Center for Biomedical Imaging and Harvard Medical School, Boston, MA, USA
| | - Kristen K Ellard
- Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | | | - G Rees Cosgrove
- Department of Neurological Surgery, Brigham & Womens Hospital, Boston, MA, USA
| | - Thilo Deckersbach
- Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Uri T Eden
- Department of Mathematics and Statistics, Boston University, Boston, MA, USA
| | - Emad N Eskandar
- Department of Neurological Surgery, Massachusetts General Hospital, Boston, MA, USA
- Department of Neurological Surgery, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Darin D Dougherty
- Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Sydney S Cash
- Department of Neurology, Massachusetts General Hospital, Boston, MA, USA
| | - Alik S Widge
- Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA.
- Department of Psychiatry, University of Minnesota, Minneapolis, MN, USA.
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5
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Leijdesdorff SMJ, Huijs CEM, Klaassen RMC, Popma A, van Amelsvoort TAMJ, Evers SMAA. Burden of mental health problems: quality of life and cost-of-illness in youth consulting Dutch walk-in youth health centres. J Ment Health 2023; 32:150-157. [PMID: 33086874 DOI: 10.1080/09638237.2020.1836555] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
BACKGROUND Little is known about the burden of (sub-threshold) mental health problems in youth. AIM To examine the burden of mental health problems in terms of health-related quality of life (HRQoL) and cost-of-illness, for first visitors of the Dutch youth walk-in centres (@ease). METHOD A bottom-up, prevalence-based burden of disease study from a societal perspective. HRQoL was assessed through the EuroQoL (EQ-5D-5L), and cost-of-illness via items about truancy and health care utilization. RESULTS Participants (N = 80) showed a decreased HRQoL compared to the general population of Dutch youth. In the three months prior to their 1st attendance, participants skipped on average 4.11 days of school and had 1.03 health care visits, leading to total costs of €512.64 per person. Females had significantly higher health care costs and lower HRQoL. Health care use was lower in those not speaking the Dutch language. Living alone was a significant predictor of truancy (costs), and therefore total costs. CONCLUSIONS Mental health problems in youth consulting @ease have a considerable impact on the individual's HRQoL, and an economic impact on society, yet almost 75% is not receiving care. A lack of interventions in this critical period in life may have major lifelong consequences.
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Affiliation(s)
- S M J Leijdesdorff
- Department of Psychiatry and Neuropsychology, Mental Health and Neuroscience (MNeNS) Maastricht University, Maastricht, The Netherlands
| | - C E M Huijs
- Department of Health Services Research, Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, The Netherlands
| | - R M C Klaassen
- Department of Child and Adolescent Psychiatry, Duivendrecht, The Netherlands
| | - A Popma
- Department of Child and Adolescent Psychiatry, Duivendrecht, The Netherlands.,Department of Child and Adolescent Psychiatry, Amsterdam University Medical Center, Amsterdam, The Netherlands
| | - T A M J van Amelsvoort
- Department of Psychiatry and Neuropsychology, Mental Health and Neuroscience (MNeNS) Maastricht University, Maastricht, The Netherlands
| | - S M A A Evers
- Department of Health Services Research, Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, The Netherlands.,Trimbos Institute Centre for Economic Evaluation and Machine Learning, Utrecht, the Netherlands
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6
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Ona G, Kohek M, Bouso JC. The illusion of knowledge in the emerging field of psychedelic research. NEW IDEAS IN PSYCHOLOGY 2022. [DOI: 10.1016/j.newideapsych.2022.100967] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
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7
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Ona G, Berrada A, Bouso JC. Communalistic use of psychoactive plants as a bridge between traditional healing practices and Western medicine: A new path for the Global Mental Health movement. Transcult Psychiatry 2022; 59:638-651. [PMID: 34665080 DOI: 10.1177/13634615211038416] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
The Global Mental Health (GMH) movement aims to provide urgently needed treatment to those with mental illness, especially in low- and middle-income countries. Due to the complexity of providing mental health services to people from various cultures, there is much debate among GMH advocates regarding the best way to proceed. While biomedical interventions offer some degree of help, complementary approaches should focus on the social/community aspects. Many cultures conduct traditional rituals involving the communal use of psychoactive plants. We propose that these practices should be respected, protected, and promoted as valuable tools with regard to mental health care at the community level. The traditional use of psychoactive plants promotes community engagement and participation, and they are relatively affordable. Furthermore, the worldviews and meaning-making systems of local population are respected. The medical systems surrounding the use of psychoactive plants can be explained in biomedical terms, and many recently published clinical trials have demonstrated their therapeutic potential. Psychoactive plants and associated rituals offer potential benefits as complementary aspects of mental health services. They should be considered as such by international practitioners and advocates of the GMH movement.
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Affiliation(s)
- Genís Ona
- ICEERS - International Center for Ethnobotanical Education, Research, and Service, Barcelona, Spain.,Department of Anthropology, Philosophy and Social Work, Medical Anthropology Research Center (MARC), 16777Universitat Rovira i Virgili, Tarragona, Spain
| | - Ali Berrada
- Unidad de Medicina Interna, 16548Hospital del Mar, Barcelona, Spain
| | - José Carlos Bouso
- ICEERS - International Center for Ethnobotanical Education, Research, and Service, Barcelona, Spain.,Department of Anthropology, Philosophy and Social Work, Medical Anthropology Research Center (MARC), 16777Universitat Rovira i Virgili, Tarragona, Spain
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8
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Ross A, Paulk AC, Cash SS, Widge AS, Basu I. Neural mass model-based study of frontal-temporal theta oscillations in human subjects during the performance of a cognitive control task. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2022; 2022:2937-2940. [PMID: 36086466 PMCID: PMC9974231 DOI: 10.1109/embc48229.2022.9871719] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
Cognitive control, the ability to rapidly shift one's attention and behavioral strategy in response to environmental changes, is often compromised across psychiatric disorders. One of the well-validated behavioral paradigms for tapping into the cognitive control circuits is a cognitive interference task, where subjects must suppress a natural response to follow a less intuitive rule. Slower response times on these tasks indicate difficulty exerting control to overcome response conflict. Conflict evokes robust electrophysiological signatures, such as theta (4-8 Hz) oscillations in the prefrontal cortex (PFC). However, the underlying neural mechanisms of conflict-evoked theta oscillations in the PFC are not clear. The objective of this work is to use a neural mass model (NMM) to find feasible cortical networks generating theta oscillations during conflict processing in human subjects. We used intracranial EEG (iEEG) recorded from dorsolateral PFC (dIPFC) and lateral temporal lobe (LTL) of human subjects with intractable epilepsy undergoing invasive monitoring, while they performed a multi-source interference task (MSIT). We used a dynamic causal modeling (DCM) framework to simulate dIPFC-LTL theta using a Jansen-Rit NMM. We found significant evidence for an LTL input into the dlPFC during the initial 500 ms of conflict processing compared to a bidirectional connection between the dlPFC and LTL. We conclude that a neural mass modeling framework can be used to elucidate candidate mechanisms of neural oscillations underlying conflict resolution in human subjects. Clinical Relevance- This can be used to find feasible target mechanisms for designing therapy in patients with compromised cognitive control. This framework can also be expanded to serve as an in-silico test bed for designing and testing neuromodulatory interventions such as electrical stimulation for improving cognitive control in mood/anxiety disorders.
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Affiliation(s)
| | | | - Sydney S Cash
- Massachusetts General Hospital, Boston, Massachusetts
| | | | - Ishita Basu
- University of Cincinnati, Cincinnati, Ohio 45267
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9
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Singh M, Dwibedy SLL, Biswal SR, Muthuswamy S, Kumar A, Kumar S. Circular RNA: A novel and potential regulator in pathophysiology of schizophrenia. Metab Brain Dis 2022; 37:1309-1316. [PMID: 35435609 DOI: 10.1007/s11011-022-00978-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Accepted: 03/31/2022] [Indexed: 12/11/2022]
Abstract
Circular RNAs (CircRNAs) are a sub-class of non-coding RNA, which are covalently closed at the ends through a non-canonical process called, backsplicing from the precursor linear RNAs. These molecules are involved in several biological phenomena including regulation of gene expression, synaptic plasticity, and cognition. Several studies have shown that circRNA are present abundantly inside the mammalian brain and they are believed to be associated with the development of neurons and neuronal functions. It is also evident that alterations in intracellular and extracellular levels of circRNAs are linked with various neurological and neuropsychiatric disorders including schizophrenia (SZ). Detailed studies of circRNAs are required to decode the molecular mechanism behind the onset of SZ and the related biological activities during disease progression. This can help unravel their role in this neurobehavioral disorder and develop effective therapeutics against the disease. The present review mainly focuses on the expression and activities of the circRNAs in the post-mortem brain, peripheral blood, and exosomes. It also gives an insight into the role of circRNA interaction with RNA binding proteins (RBPs) and nucleotide modification and their therapeutic potential in the context of schizophrenia.
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Affiliation(s)
- Mandakini Singh
- Department of Life Science, National Institute of Technology (NIT) Rourkela, Odisha, 769008, India
| | | | - Smruti Rekha Biswal
- Department of Life Science, National Institute of Technology (NIT) Rourkela, Odisha, 769008, India
| | - Srinivasan Muthuswamy
- Department of Life Science, National Institute of Technology (NIT) Rourkela, Odisha, 769008, India
| | - Ajay Kumar
- Department of Zoology, Institute of Science, Banaras Hindu University, Uttar Pradesh, Varanasi, 221005, India
| | - Santosh Kumar
- Department of Life Science, National Institute of Technology (NIT) Rourkela, Odisha, 769008, India.
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10
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Mintz D. Recovery from Childhood Psychiatric Treatment: Addressing the Meaning of Medications. Psychodyn Psychiatry 2022; 50:131-148. [PMID: 35235407 DOI: 10.1521/pdps.2022.50.1.131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Medications exert effects not only through biological mechanisms but also through the meanings that they carry. While positive effects (e.g., the placebo effect) are broadly recognized, psychiatry is often less attuned to the negative effects that are mediated through the meaning of medications. These negative effects may be especially pronounced when noxious meanings and countertherapeutic aspects of medications are incorporated into the unfolding development of a child and not countered by psychotherapeutic experiences that allow iatrogenic meanings to be placed in context. In this paper, psychosocial mechanisms, by which medications may cause harm, are explored. These include adverse effects on identity, impaired agency, impaired affective competence, and negative effects on the patient's relationship with care. When such harm has occurred at the level of meaning, it is best addressed at the level of meaning. Examples of psychotherapeutic work with young adults is offered to demonstrate the process of reworking developmental harm related to the meaning of medications.
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Affiliation(s)
- David Mintz
- Director of Psychiatric Education/Associate Director of Training/Team Leader, Austen Riggs Center
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11
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Kieling C, Salum GA, Pan PM, Bressan RA. Youth mental health services: the right time for a global reach. World Psychiatry 2022; 21:86-87. [PMID: 35015362 PMCID: PMC8751574 DOI: 10.1002/wps.20933] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Affiliation(s)
- Christian Kieling
- Department of Psychiatry, School of Medicine, Universidade Federal do Rio Grande do Sul, and Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
| | - Giovanni A Salum
- Department of Psychiatry, School of Medicine, Universidade Federal do Rio Grande do Sul, and Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
| | - Pedro M Pan
- Department of Psychiatry, Universidade Federal de São Paulo, São Paulo, Brazil
- Instituto Ame Sua Mente, São Paulo, Brazil
| | - Rodrigo A Bressan
- Department of Psychiatry, Universidade Federal de São Paulo, São Paulo, Brazil
- Instituto Ame Sua Mente, São Paulo, Brazil
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12
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Krogh-Jespersen S, MacNeill LA, Anderson EL, Stroup HE, Harriott EM, Gut E, Blum A, Fareedi E, Fredian KM, Wert SL, Wakschlag LS, Norton ES. Disruption Leads to Methodological and Analytic Innovation in Developmental Sciences: Recommendations for Remote Administration and Dealing With Messy Data. Front Psychol 2022; 12:732312. [PMID: 35058833 PMCID: PMC8764157 DOI: 10.3389/fpsyg.2021.732312] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Accepted: 11/22/2021] [Indexed: 12/19/2022] Open
Abstract
The COVID-19 pandemic has impacted data collection for longitudinal studies in developmental sciences to an immeasurable extent. Restrictions on conducting in-person standardized assessments have led to disruptive innovation, in which novel methods are applied to increase participant engagement. Here, we focus on remote administration of behavioral assessment. We argue that these innovations in remote assessment should become part of the new standard protocol in developmental sciences to facilitate data collection in populations that may be hard to reach or engage due to burdensome requirements (e.g., multiple in-person assessments). We present a series of adaptations to developmental assessments (e.g., Mullen) and a detailed discussion of data analytic approaches to be applied in the less-than-ideal circumstances encountered during the pandemic-related shutdown (i.e., missing or messy data). Ultimately, these remote approaches actually strengthen the ability to gain insight into developmental populations and foster pragmatic innovation that should result in enduring change.
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Affiliation(s)
- Sheila Krogh-Jespersen
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
- Institute for Innovations in Developmental Sciences, Northwestern University, Chicago, IL, United States
| | - Leigha A. MacNeill
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
- Institute for Innovations in Developmental Sciences, Northwestern University, Chicago, IL, United States
| | - Erica L. Anderson
- Institute for Innovations in Developmental Sciences, Northwestern University, Chicago, IL, United States
| | - Hannah E. Stroup
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
- Institute for Innovations in Developmental Sciences, Northwestern University, Chicago, IL, United States
| | - Emily M. Harriott
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
- Institute for Innovations in Developmental Sciences, Northwestern University, Chicago, IL, United States
| | - Ewa Gut
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
- Institute for Innovations in Developmental Sciences, Northwestern University, Chicago, IL, United States
| | - Abigail Blum
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
- Institute for Innovations in Developmental Sciences, Northwestern University, Chicago, IL, United States
| | - Elveena Fareedi
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
- Institute for Innovations in Developmental Sciences, Northwestern University, Chicago, IL, United States
| | - Kaitlyn M. Fredian
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
- Institute for Innovations in Developmental Sciences, Northwestern University, Chicago, IL, United States
| | - Stephanie L. Wert
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
- Institute for Innovations in Developmental Sciences, Northwestern University, Chicago, IL, United States
| | - Lauren S. Wakschlag
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
- Institute for Innovations in Developmental Sciences, Northwestern University, Chicago, IL, United States
| | - Elizabeth S. Norton
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
- Institute for Innovations in Developmental Sciences, Northwestern University, Chicago, IL, United States
- Department of Communication Sciences and Disorders, Northwestern University, Evanston, IL, United States
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13
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Widge AS, Ellard KK, Paulk AC, Basu I, Yousefi A, Zorowitz S, Gilmour A, Afzal A, Deckersbach T, Cash SS, Kramer MA, Eden UT, Dougherty DD, Eskandar EN. Treating Refractory Mental Illness With Closed-Loop Brain Stimulation: Progress Towards a Patient-Specific Transdiagnostic Approach. FOCUS (AMERICAN PSYCHIATRIC PUBLISHING) 2022; 20:137-151. [PMID: 35746936 PMCID: PMC9063604 DOI: 10.1176/appi.focus.20102] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/29/2015] [Accepted: 07/25/2016] [Indexed: 01/03/2023]
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14
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Chronic mild stress paradigm as a rat model of depression: facts, artifacts, and future perspectives. Psychopharmacology (Berl) 2022; 239:663-693. [PMID: 35072761 PMCID: PMC8785013 DOI: 10.1007/s00213-021-05982-w] [Citation(s) in RCA: 47] [Impact Index Per Article: 23.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Accepted: 09/15/2021] [Indexed: 02/06/2023]
Abstract
RATIONALE The chronic mild stress (CMS) paradigm was first described almost 40 years ago and has become a widely used model in the search for antidepressant drugs for major depression disorder (MDD). It has resulted in the publication of almost 1700 studies in rats alone. Under the original CMS procedure, the expression of an anhedonic response, a key symptom of depression, was seen as an essential feature of both the model and a depressive state. The prolonged exposure of rodents to unpredictable/uncontrollable mild stressors leads to a reduction in the intake of palatable liquids, behavioral despair, locomotor inhibition, anxiety-like changes, and vegetative (somatic) abnormalities. Many of the CMS studies do not report these patterns of behaviors, and they often fail to include consistent molecular, neuroanatomical, and physiological phenotypes of CMS-exposed animals. OBJECTIVES To critically review the CMS studies in rats so that conceptual and methodological flaws can be avoided in future studies. RESULTS Analysis of the literature supports the validity of the CMS model and its impact on the field. However, further improvements could be achieved by (i) the stratification of animals into 'resilient' and 'susceptible' cohorts within the CMS animals, (ii) the use of more refined protocols in the sucrose test to mitigate physiological and physical artifacts, and (iii) the systematic evaluation of the non-specific effects of CMS and implementation of appropriate adjustments within the behavioral tests. CONCLUSIONS We propose methodological revisions and the use of more advanced behavioral tests to refine the rat CMS paradigm, which offers a valuable tool for developing new antidepressant medications.
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15
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Natale NR, Kent M, Fox N, Vavra D, Lambert K. Neurobiological effects of a probiotic-supplemented diet in chronically stressed male Long-Evans rats: Evidence of enhanced resilience. IBRO Neurosci Rep 2021; 11:207-215. [PMID: 34849506 PMCID: PMC8607205 DOI: 10.1016/j.ibneur.2021.10.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Revised: 10/25/2021] [Accepted: 10/28/2021] [Indexed: 12/15/2022] Open
Abstract
Probiotics that regulate the microbiome-gut-brain axis and provide mental health benefits to the host are referred to as psychobiotics. Preclinical studies have demonstrated psychobiotic effects on early life stress-induced anxiety- and depression-related behavior in rodents; however, the specific mechanisms remain ill-defined. In the current study, we investigated the effects of probiotic supplementation on neurobiological responses to chronic stress in adult male Long-Evans rats. Twenty-four rats were randomly assigned to probiotic (PB) or vehicle control (VEH) groups, then to either chronic unpredictable stress (CUS) or no-stress control (CON) conditions within each group (n = 6/subgroup). We hypothesized that PB supplementation would reduce markers of anxiety and enhance emotional resilience, especially in the CUS animals. In the cognitive uncertainty task, a nonsignificant trend was observed indicating that the PB-supplemented animals spent more time oriented toward the food reward than VEH animals. In the open-field task, CUS-PB animals spent more time in the center of the arena than CUS-VEH animals, an effect not observed between the two CON groups. In the swim task, the PB animals, regardless of stress assignment, exhibited increased floating, suggesting a conserved response in a challenging context. Focusing on the endocrine measures, higher dehydroepiandrosterone (DHEA)-to-corticosterone fecal metabolite ratios, a correlate of emotional resilience, were observed in PB animals. Further, PB animals exhibited reduced microglia immunoreactivity in the basolateral amygdala, possibly indicating a neuroprotective effect of PB supplements in this rodent model. These results provide evidence that PB supplementation interacts with stress exposure to influence adaptive responses associated with endocrine, neural, and behavioral indices of anxiety.
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Affiliation(s)
- Nick R. Natale
- Dept of Psychology, University of Richmond, VA 23173, USA
| | - Molly Kent
- Dept of Biology, Virginia Military Institute, Lexington, VA 24450, USA
| | - Nathan Fox
- Dept of Psychology, University of Richmond, VA 23173, USA
| | - Dylan Vavra
- Dept of Psychology, University of Richmond, VA 23173, USA
| | - Kelly Lambert
- Dept of Psychology, University of Richmond, VA 23173, USA
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16
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Conradt E, Crowell SE, Cicchetti D. Using Development and Psychopathology Principles to Inform the Research Domain Criteria (RDoC) Framework. Dev Psychopathol 2021; 33:1521-1525. [PMID: 35480855 PMCID: PMC9037759 DOI: 10.1017/s0954579421000985] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
AbstractIn 2010, the Research Domain Criteria (RDoC) were developed to advance our understanding of the pathophysiology of mental illness across multiple levels of analysis, ranging from cells to circuits to self-report instruments. Several conceptual RDoC-informed manuscripts have highlighted the importance of studying how developmental processes give rise to psychopathology. However, there are few empirical studies that integrate the RDoC framework with development and psychopathology principles. This special issue was developed to fill this empirical gap. In this introduction to the special issue, we describe how the developmental psychopathology field predates and informs the RDoC framework. We highlight three important ways in which developmental psychopathology and the RDoC framework can mutually inform one another, leading to novel discoveries to identify, prevent, and treat mental health problems across the life span.
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Affiliation(s)
| | - Sheila E Crowell
- University of Utah, Departments of Psychology, Psychiatry, OB/GYN
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17
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Leijdesdorff S, Klaassen R, Wairata DJ, Rosema S, van Amelsvoort T, Popma A. Barriers and facilitators on the pathway to mental health care among 12-25 year olds. Int J Qual Stud Health Well-being 2021; 16:1963110. [PMID: 34448440 PMCID: PMC8405110 DOI: 10.1080/17482631.2021.1963110] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/29/2021] [Indexed: 12/16/2022] Open
Abstract
PURPOSE The mismatch between the number of young people that require mental health care and who actually receive it, questions access to care. This study aims to gain in-depth understanding of barriers and facilitators in the pathway to mental health care among 12 to 25 year olds as experienced by visitors of youth walk-in centres of the Dutch @ease Foundation. METHODS Open interviews were conducted to explore participants' experiences and attitudes towards mental health care. Following inductive thematic analysis, barriers and facilitators in participants' pathways towards care were described. RESULTS Fifteen participants were included, heterogenic with regard to age, sex and nationality. Three main themes in the process of seeking help were 'attitudes towards mental health problems and seeking help', 'entrance to care' and 'in care itself'. A fourth theme consisted of suggestions for improvement. CONCLUSION Negative attitudes towards mental health problems make young people to only seek help when problems begin to escalate. The lack of knowledge about mental health problems, treatment options and costs asks for more awareness and clear information. Updates about waiting lists and alternative options, informal settings with walk-in options and personalized care are feasible and crucial improvements to decrease the individual and societal burden.
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Affiliation(s)
- Sophie Leijdesdorff
- Department of Psychiatry and Neuropsychology, Mental Health and Neuroscience (MHeNS) Maastricht University, Maastricht, The Netherlands
| | - Rianne Klaassen
- Academic Child and Adolescent Psychiatry, Levvel, Amsterdam, The Netherlands
| | - Di-Jon Wairata
- Department of Psychiatry and Neuropsychology, Mental Health and Neuroscience (MHeNS) Maastricht University, Maastricht, The Netherlands
| | - Stefanie Rosema
- Academic Child and Adolescent Psychiatry, Levvel, Amsterdam, The Netherlands
| | - Therese van Amelsvoort
- Department of Psychiatry and Neuropsychology, Mental Health and Neuroscience (MHeNS) Maastricht University, Maastricht, The Netherlands
| | - Arne Popma
- Academic Child and Adolescent Psychiatry, Levvel, Amsterdam, The Netherlands
- Department of Child and Adolescent Psychiatry, Amsterdam University Medical Centers, Amsterdam, The Netherlands
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18
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Protocol for a systematic review on the role of the gut microbiome in paediatric neurological disorders. Acta Neuropsychiatr 2021; 33:211-216. [PMID: 33818352 DOI: 10.1017/neu.2021.8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
INTRODUCTION The gut-brain axis refers to the bidirectional communication that occurs between the intestinal tract and central nervous system (CNS). Through a series of neural, immune, endocrine, and metabolic signalling pathways, commensal microbiota are able to influence CNS development and neurological function. Alterations in gut microbiota have been implicated in various neuropathologies. The purpose of this review is to evaluate and summarise existing literature assessing the role of specific bacterial taxa on the development of neurodevelopmental, neuropsychiatric, and neurodegenerative pathologies of childhood. We will also discuss microbiota-based therapies dietary interventions and their efficacy. METHODS AND ANALYSIS We will search PubMed, Cochrane Library, and OVID electronic databases for articles published between January 1980 and February 2021. A search method involving two rounds of reviewing the literature using a three-step method in each round will be performed. Two researchers will be selected, and screen titles and abstracts independently. The full text of selected articles will be assessed against inclusion criteria. Data will be extracted and evaluated using the appropriate Critical Appraisal Skills Programme (CASP) checklist. ETHICS AND DISSEMINATION Findings from this study will be shared across relevant paediatric neurology and gastroenterology societies and submitted for peer review. This study did not require institutional ethics approval.
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19
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Wolfers T, Rokicki J, Alnæs D, Berthet P, Agartz I, Kia SM, Kaufmann T, Zabihi M, Moberget T, Melle I, Beckmann CF, Andreassen OA, Marquand AF, Westlye LT. Replicating extensive brain structural heterogeneity in individuals with schizophrenia and bipolar disorder. Hum Brain Mapp 2021; 42:2546-2555. [PMID: 33638594 PMCID: PMC8090780 DOI: 10.1002/hbm.25386] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Revised: 01/22/2021] [Accepted: 02/12/2021] [Indexed: 12/17/2022] Open
Abstract
Identifying brain processes involved in the risk and development of mental disorders is a major aim. We recently reported substantial interindividual heterogeneity in brain structural aberrations among patients with schizophrenia and bipolar disorder. Estimating the normative range of voxel-based morphometry (VBM) data among healthy individuals using a Gaussian process regression (GPR) enables us to map individual deviations from the healthy range in unseen datasets. Here, we aim to replicate our previous results in two independent samples of patients with schizophrenia (n1 = 94; n2 = 105), bipolar disorder (n1 = 116; n2 = 61), and healthy individuals (n1 = 400; n2 = 312). In line with previous findings with exception of the cerebellum our results revealed robust group level differences between patients and healthy individuals, yet only a small proportion of patients with schizophrenia or bipolar disorder exhibited extreme negative deviations from normality in the same brain regions. These direct replications support that group level-differences in brain structure disguise considerable individual differences in brain aberrations, with important implications for the interpretation and generalization of group-level brain imaging findings to the individual with a mental disorder.
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Affiliation(s)
- Thomas Wolfers
- Department of PsychologyUniversity of OsloOsloNorway
- Division of Mental Health and Addiction, Norwegian Center for Mental Disorders Research (NORMENT)University of Oslo and Oslo University HospitalOsloNorway
- Donders Center for Cognitive Neuroimaging, Donders Institute for Brain, Cognition, and BehaviorRadboud UniversityNijmegenThe Netherlands
| | - Jaroslav Rokicki
- Department of PsychologyUniversity of OsloOsloNorway
- Division of Mental Health and Addiction, Norwegian Center for Mental Disorders Research (NORMENT)University of Oslo and Oslo University HospitalOsloNorway
| | - Dag Alnæs
- Department of PsychologyUniversity of OsloOsloNorway
- Division of Mental Health and Addiction, Norwegian Center for Mental Disorders Research (NORMENT)University of Oslo and Oslo University HospitalOsloNorway
| | - Pierre Berthet
- Department of PsychologyUniversity of OsloOsloNorway
- Division of Mental Health and Addiction, Norwegian Center for Mental Disorders Research (NORMENT)University of Oslo and Oslo University HospitalOsloNorway
| | - Ingrid Agartz
- Division of Mental Health and Addiction, Norwegian Center for Mental Disorders Research (NORMENT)University of Oslo and Oslo University HospitalOsloNorway
- KG Jebsen Center for Neurodevelopmental DisordersUniversity of OsloOsloNorway
- Department of Psychiatric ResearchDiakonhjemmet HospitalOsloNorway
- Department of Clinical NeuroscienceCenter for Psychiatric ResearchStockholmSweden
| | - Seyed Mostafa Kia
- Donders Center for Cognitive Neuroimaging, Donders Institute for Brain, Cognition, and BehaviorRadboud UniversityNijmegenThe Netherlands
| | - Tobias Kaufmann
- Division of Mental Health and Addiction, Norwegian Center for Mental Disorders Research (NORMENT)University of Oslo and Oslo University HospitalOsloNorway
| | - Mariam Zabihi
- Donders Center for Cognitive Neuroimaging, Donders Institute for Brain, Cognition, and BehaviorRadboud UniversityNijmegenThe Netherlands
| | - Torgeir Moberget
- Department of PsychologyUniversity of OsloOsloNorway
- Division of Mental Health and Addiction, Norwegian Center for Mental Disorders Research (NORMENT)University of Oslo and Oslo University HospitalOsloNorway
| | - Ingrid Melle
- Division of Mental Health and Addiction, Norwegian Center for Mental Disorders Research (NORMENT)University of Oslo and Oslo University HospitalOsloNorway
| | - Christian F. Beckmann
- Donders Center for Cognitive Neuroimaging, Donders Institute for Brain, Cognition, and BehaviorRadboud UniversityNijmegenThe Netherlands
- Department of Cognitive NeuroscienceRadboud University Medical CenterNijmegenThe Netherlands
| | - Ole A. Andreassen
- Division of Mental Health and Addiction, Norwegian Center for Mental Disorders Research (NORMENT)University of Oslo and Oslo University HospitalOsloNorway
- KG Jebsen Center for Neurodevelopmental DisordersUniversity of OsloOsloNorway
| | - Andre F. Marquand
- Donders Center for Cognitive Neuroimaging, Donders Institute for Brain, Cognition, and BehaviorRadboud UniversityNijmegenThe Netherlands
- Department of Cognitive NeuroscienceRadboud University Medical CenterNijmegenThe Netherlands
- Department of Neuroimaging, Center for Neuroimaging SciencesInstitute of Psychiatry, King's College LondonLondonUK
| | - Lars T. Westlye
- Department of PsychologyUniversity of OsloOsloNorway
- Division of Mental Health and Addiction, Norwegian Center for Mental Disorders Research (NORMENT)University of Oslo and Oslo University HospitalOsloNorway
- KG Jebsen Center for Neurodevelopmental DisordersUniversity of OsloOsloNorway
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20
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Oña G, Bouso JC. Therapeutic Potential of Natural Psychoactive Drugs for Central Nervous System Disorders: A Perspective from Polypharmacology. Curr Med Chem 2021; 28:53-68. [PMID: 31830883 DOI: 10.2174/0929867326666191212103330] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2019] [Revised: 10/01/2019] [Accepted: 10/02/2019] [Indexed: 11/22/2022]
Abstract
In the drug development, the formation of highly selective ligands has been unsuccessful in the treatment of central nervous system disorders. Multi-target ligands, from the polypharmacology paradigm, are being proposed as treatments for these complex disorders, since they offer enhanced efficacy and a strong safety profile. Natural products are the best examples of multi-target compounds, so they are of high interest within this paradigm. Additionally, recent research on psychoactive drugs of natural origin, such as ayahuasca and cannabis, has demonstrated the promising therapeutic potential for the treatment of some psychiatric and neurological disorders. In this text, we describe how research on psychoactive drugs can be effectively combined with the polypharmacology paradigm, providing ayahuasca and cannabis research as examples. The advantages and disadvantages are also discussed.
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Affiliation(s)
- Genís Oña
- International Center for Ethnobotanical Education, Research and Service (ICEERS), Barcelona, Spain
| | - José Carlos Bouso
- International Center for Ethnobotanical Education, Research and Service (ICEERS), Barcelona, Spain
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21
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Tanuma M, Kasai A, Bando K, Kotoku N, Harada K, Minoshima M, Higashino K, Kimishima A, Arai M, Ago Y, Seiriki K, Kikuchi K, Kawata S, Fujita K, Hashimoto H. Direct visualization of an antidepressant analog using surface-enhanced Raman scattering in the brain. JCI Insight 2020; 5:133348. [PMID: 32125287 DOI: 10.1172/jci.insight.133348] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2019] [Accepted: 02/19/2020] [Indexed: 12/18/2022] Open
Abstract
Detailed spatial information of low-molecular weight compound distribution, especially in the brain, is crucial to understanding their mechanism of actions. Imaging techniques that can directly visualize drugs in the brain at a high resolution will complement existing tools for drug distribution analysis. Here, we performed surface-enhanced Raman scattering (SERS) imaging using a bioorthogonal alkyne tag to visualize drugs directly in situ at a high resolution. Focusing on the selective serotonin reuptake inhibitor S-citalopram (S-Cit), which possesses a nitrile group, we substituted an alkynyl group into its structure and synthesized alkynylated S-Cit (Alk-S-Cit). The brain transitivity and the serotonin reuptake inhibition of Alk-S-Cit were not significantly different as compared with S-Cit. Alk-S-Cit was visualized in the coronal mouse brain section using SERS imaging with silver nanoparticles. Furthermore, SERS imaging combined with fluorescence microscopy allowed Alk-S-Cit to be visualized in the adjacent neuronal membranes, as well as in the brain vessel and parenchyma. Therefore, our multimodal imaging technique is an effective method for detecting low-molecular weight compounds in their original tissue environment and can potentially offer additional information regarding the precise spatial distribution of such drugs.
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Affiliation(s)
- Masato Tanuma
- Laboratory of Molecular Neuropharmacology, Graduate School of Pharmaceutical Sciences, and
| | - Atsushi Kasai
- Laboratory of Molecular Neuropharmacology, Graduate School of Pharmaceutical Sciences, and
| | - Kazuki Bando
- Department of Applied Physics, Graduate School of Engineering, Osaka University, Suita, Osaka, Japan.,Serendip Research, Osaka, Osaka, Japan
| | - Naoyuki Kotoku
- Chemical Biology Laboratory, College of Pharmaceutical Sciences, Ritsumeikan University, Kusatsu, Shiga, Japan
| | - Kazuo Harada
- Department of Legal Medicine, Graduate School of Medicine.,Laboratory of Applied Environmental Biology, Graduate School of Pharmaceutical Sciences
| | | | - Kosuke Higashino
- Laboratory of Molecular Neuropharmacology, Graduate School of Pharmaceutical Sciences, and
| | - Atsushi Kimishima
- Laboratory of Natural Products Chemistry, Graduate School of Pharmaceutical Sciences
| | - Masayoshi Arai
- Laboratory of Natural Products Chemistry, Graduate School of Pharmaceutical Sciences
| | - Yukio Ago
- Laboratory of Molecular Neuropharmacology, Graduate School of Pharmaceutical Sciences, and.,Laboratory of Biopharmaceutics, Graduate School of Pharmaceutical Sciences
| | - Kaoru Seiriki
- Laboratory of Molecular Neuropharmacology, Graduate School of Pharmaceutical Sciences, and.,Institute for Transdisciplinary Graduate Degree Programs
| | - Kazuya Kikuchi
- Laboratory of Chemical Biology, Graduate School of Engineering.,Immunology Frontier Research Center, and
| | - Satoshi Kawata
- Department of Applied Physics, Graduate School of Engineering, Osaka University, Suita, Osaka, Japan.,Serendip Research, Osaka, Osaka, Japan
| | - Katsumasa Fujita
- Department of Applied Physics, Graduate School of Engineering, Osaka University, Suita, Osaka, Japan.,Institute for Open and Transdisciplinary Research Initiatives, Osaka University, Suita, Osaka, Japan.,Advanced Photonics and Biosensing Open Innovation Laboratory, AIST-Osaka University, Suita, Osaka, Japan
| | - Hitoshi Hashimoto
- Laboratory of Molecular Neuropharmacology, Graduate School of Pharmaceutical Sciences, and.,Institute for Open and Transdisciplinary Research Initiatives, Osaka University, Suita, Osaka, Japan.,Molecular Research Center for Children's Mental Development, United Graduate School of Child Development, Osaka University, Kanazawa University, Hamamatsu University School of Medicine, Chiba University and University of Fukui, Suita, Osaka, Japan.,Institute for Datability Science and.,Department of Molecular Pharmaceutical Sciences, Graduate School of Medicine, Osaka University, Suita, Osaka, Japan
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22
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Henderson TA, van Lierop MJ, McLean M, Uszler JM, Thornton JF, Siow YH, Pavel DG, Cardaci J, Cohen P. Functional Neuroimaging in Psychiatry-Aiding in Diagnosis and Guiding Treatment. What the American Psychiatric Association Does Not Know. Front Psychiatry 2020; 11:276. [PMID: 32351416 PMCID: PMC7176045 DOI: 10.3389/fpsyt.2020.00276] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2020] [Accepted: 03/23/2020] [Indexed: 12/12/2022] Open
Abstract
While early efforts in psychiatry were focused on uncovering the neurobiological basis of psychiatric symptoms, they made little progress due to limited ability to observe the living brain. Today, we know a great deal about the workings of the brain; yet, none of this neurobiological awareness has translated into the practice of psychiatry. The categorical system which dominates psychiatric diagnosis and thinking fails to match up to the real world of genetics, sophisticated psychological testing, and neuroimaging. Nevertheless, the American Psychiatric Association (APA) recently published a position paper stating that neuroimaging provided no benefit to the diagnosis and treatment of psychiatric disorders. Using the diagnosis of depression as a model, we illustrate how setting aside the unrealistic expectation of a pathognomonic "fingerprint" for categorical diagnoses, we can avoid missing the biological and, therefore, treatable contributors to psychopathology which can and are visualized using functional neuroimaging. Infection, toxicity, inflammation, gut-brain dysregulation, and traumatic brain injury can all induce psychiatric manifestations which masquerade as depression and other psychiatric disorders. We review these and provide illustrative clinical examples. We further describe situations for which single photon emission computed tomography (SPECT) and positron emission tomography (PET) functional neuroimaging already meet or exceed the criteria set forth by the APA to define a neuroimaging biomarker, including the differential diagnosis of Alzheimer's disease and other dementias, the differential diagnosis of ADHD, and the evaluation of traumatic brain injury. The limitations, both real and perceived, of SPECT and PET functional neuroimaging in the field of psychiatry are also elaborated. An important overarching concept for diagnostic imaging in all its forms, including functional neuroimaging, is that imaging allows a clinician to eliminate possibilities, narrow the differential diagnosis, and tailor the treatment plan. This progression is central to any medical diagnostic process.
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Affiliation(s)
- Theodore A Henderson
- The Synaptic Space, Inc., Denver, CO, United States.,Neuro-Luminance, Inc., Denver, CO, United States.,Dr. Theodore Henderson, Inc., Denver, CO, United States.,International Society of Applied Neuroimaging, Denver, CO, United States
| | - Muriel J van Lierop
- International Society of Applied Neuroimaging, Denver, CO, United States.,Private Practice, Toronto, ON, Canada
| | - Mary McLean
- International Society of Applied Neuroimaging, Denver, CO, United States.,Private Practice, Toronto, ON, Canada
| | - John Michael Uszler
- International Society of Applied Neuroimaging, Denver, CO, United States.,Nuclear Medicine, Providence St. John's Health Center, Santa Monica, CA, United States.,Molecular and Medical Pharmacology, University of California, Los Angeles, Los Angeles, CA, United States
| | - John F Thornton
- International Society of Applied Neuroimaging, Denver, CO, United States.,Rossiter-Thornton Associates, Toronto, ON, Canada
| | - Yin-Hui Siow
- International Society of Applied Neuroimaging, Denver, CO, United States.,Nuclear Medicine, Southlake Regional Health Centre, Newmarket, ON, Canada
| | - Dan G Pavel
- International Society of Applied Neuroimaging, Denver, CO, United States.,PathFinder Brain SPECT, Deerfield, IL, United States
| | - Joe Cardaci
- International Society of Applied Neuroimaging, Denver, CO, United States.,Fremantle-School of Medicine, University of Notre Dame, Fremantle, WA, Australia.,Diagnostic Nuclear Medicine, Hollywood Private Hospital, Nedlands, WA, Australia.,Consultant Physician, Perth, WA, Australia
| | - Phil Cohen
- International Society of Applied Neuroimaging, Denver, CO, United States.,Nuclear Medicine, Lions Gate Hospital, Vancouver, BC, Canada.,Radiology, University of British Columbia, Vancouver, BC, Canada
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23
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Wolfers T, Beckmann CF, Hoogman M, Buitelaar JK, Franke B, Marquand AF. Individual differences v. the average patient: mapping the heterogeneity in ADHD using normative models. Psychol Med 2020; 50:314-323. [PMID: 30782224 PMCID: PMC7083555 DOI: 10.1017/s0033291719000084] [Citation(s) in RCA: 91] [Impact Index Per Article: 22.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2018] [Revised: 01/04/2019] [Accepted: 01/08/2019] [Indexed: 12/26/2022]
Abstract
BACKGROUND The present paper presents a fundamentally novel approach to model individual differences of persons with the same biologically heterogeneous mental disorder. Unlike prevalent case-control analyses, that assume a clear distinction between patient and control groups and thereby introducing the concept of an 'average patient', we describe each patient's biology individually, gaining insights into the different facets that characterize persistent attention-deficit/hyperactivity disorder (ADHD). METHODS Using a normative modeling approach, we mapped inter-individual differences in reference to normative structural brain changes across the lifespan to examine the degree to which case-control analyses disguise differences between individuals. RESULTS At the level of the individual, deviations from the normative model were frequent in persistent ADHD. However, the overlap of more than 2% between participants with ADHD was only observed in few brain loci. On average, participants with ADHD showed significantly reduced gray matter in the cerebellum and hippocampus compared to healthy individuals. While the case-control differences were in line with the literature on ADHD, individuals with ADHD only marginally reflected these group differences. CONCLUSIONS Case-control comparisons, disguise inter-individual differences in brain biology in individuals with persistent ADHD. The present results show that the 'average ADHD patient' has limited informative value, providing the first evidence for the necessity to explore different biological facets of ADHD at the level of the individual and practical means to achieve this end.
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Affiliation(s)
- Thomas Wolfers
- Department of Human Genetics, Donders Institute for Brain, Cognition and Behavior, Radboud University Medical Center, Nijmegen, The Netherlands
- Donders Centre for Cognitive Neuroimaging, Donders Institute for Brain, Cognition and Behavior, Radboud University, Nijmegen, The Netherlands
| | - Christian F. Beckmann
- Donders Centre for Cognitive Neuroimaging, Donders Institute for Brain, Cognition and Behavior, Radboud University, Nijmegen, The Netherlands
- Department of Cognitive Neuroscience, Donders Institute for Brain, Cognition and Behavior, Radboud University Medical Center, Nijmegen, The Netherlands
- Centre for Functional MRI of the Brain (FMRIB), University of Oxford, Oxford, UK
| | - Martine Hoogman
- Department of Human Genetics, Donders Institute for Brain, Cognition and Behavior, Radboud University Medical Center, Nijmegen, The Netherlands
- Donders Centre for Cognitive Neuroimaging, Donders Institute for Brain, Cognition and Behavior, Radboud University, Nijmegen, The Netherlands
| | - Jan K. Buitelaar
- Department of Cognitive Neuroscience, Donders Institute for Brain, Cognition and Behavior, Radboud University Medical Center, Nijmegen, The Netherlands
- Karakter Child and Adolescent Psychiatry University Center, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Barbara Franke
- Department of Human Genetics, Donders Institute for Brain, Cognition and Behavior, Radboud University Medical Center, Nijmegen, The Netherlands
- Department of Psychiatry, Donders Institute for Brain, Cognition and Behavior, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Andre F. Marquand
- Donders Centre for Cognitive Neuroimaging, Donders Institute for Brain, Cognition and Behavior, Radboud University, Nijmegen, The Netherlands
- Department of Cognitive Neuroscience, Donders Institute for Brain, Cognition and Behavior, Radboud University Medical Center, Nijmegen, The Netherlands
- Department of Neuroimaging, Institute of Psychiatry, King's College London, London, UK
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24
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Effects of biomedical messages and expert-recommended messages on reducing mental health-related stigma: a randomised controlled trial. Epidemiol Psychiatr Sci 2019; 29:e74. [PMID: 31753045 PMCID: PMC8061129 DOI: 10.1017/s2045796019000714] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
AIMS Mental health-related stigma is a major challenge associated with the huge mental health treatment gap. It has remained unclear what kind of educational content is effective in reducing the stigma. Whether biomedical messages (BMM) about mental illness are effective or harmful in decreasing stigma is controversial. To investigate whether BMM can improve practically useful knowledge of mental illness, comparably to recommended messages (RCM) advocated by experts, of types such as 'recovery-oriented', 'social inclusion/human rights' and 'high prevalence of mental illnesses' through a randomised controlled trial (RCT). METHOD This study is an individual-level RCT with a parallel-group design over 1 year, conducted in Tokyo, Japan. A total of 179 participants (males n = 80, mean age = 21.9 years and s.d. = 7.8) were recruited in high schools and universities, and through a commercial internet advertisement in June and July 2017, without any indication that the study appertained to mental health. Participants were allocated to the BMM and RCM groups. They underwent a 10-min intervention, and completed self-report questionnaires during baseline, post-test, 1-month follow-up and 1-year follow-up surveys. The primary outcome measures were practically useful knowledge of mental illness at the post-test survey using the Mental Illness and Disorder Understanding Scale (MIDUS). Analysis was conducted in October 2018. RESULTS Both groups demonstrated improved MIDUS score in the post-test survey, and showed similar intervention effects (F(1, 177) = 160.5, p < 0.001, η2 = 0.48). The effect of the interventions continued until the 1-year follow-up survey (B [95% CI] = -2.56 [-4.27, -0.85], p < 0.01), and showed no difference between groups. The reported adverse effect that BMM increase stigma was not confirmed. CONCLUSIONS BMM may have a positive impact on stigma, comparable to RCM. These findings may encourage reconsideration of the content of messages about mental health, as it is indicated that combining BMM and RCM might contribute to an effective anti-stigma programme.
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25
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Mintz D. Recovery from Childhood Psychiatric Treatment: Addressing the Meaning of Medications. Psychodyn Psychiatry 2019; 47:235-256. [PMID: 31448987 DOI: 10.1521/pdps.2019.47.3.235] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Medications exert effects not only through biological mechanisms but also through the meanings that they carry. While positive effects (e.g., the placebo effect) are broadly recognized, psychiatry is often less attuned to the negative effects that are mediated through the meaning of medications. These negative effects may be especially pronounced when noxious meanings and countertherapeutic aspects of medications are incorporated into the unfolding development of a child and not countered by psychotherapeutic experiences that allow iatrogenic meanings to be placed in context. In this paper, psychosocial mechanisms, by which medications may cause harm, are explored. These include adverse effects on identity, impaired agency, impaired affective competence, and negative effects on the patient's relationship with care. When such harm has occurred at the level of meaning, it is best addressed at the level of meaning. Examples of psychotherapeutic work with young adults is offered to demonstrate the process of reworking developmental harm related to the meaning of medications.
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Affiliation(s)
- David Mintz
- Director of Psychiatric Education/Associate Director of Training/Team Leader, Austen Riggs Center
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26
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Provenza NR, Paulk AC, Peled N, Restrepo MI, Cash SS, Dougherty DD, Eskandar EN, Borton DA, Widge AS. Decoding task engagement from distributed network electrophysiology in humans. J Neural Eng 2019; 16:056015. [PMID: 31419211 PMCID: PMC6765221 DOI: 10.1088/1741-2552/ab2c58] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
OBJECTIVE Here, our objective was to develop a binary decoder to detect task engagement in humans during two distinct, conflict-based behavioral tasks. Effortful, goal-directed decision-making requires the coordinated action of multiple cognitive processes, including attention, working memory and action selection. That type of mental effort is often dysfunctional in mental disorders, e.g. when a patient attempts to overcome a depression or anxiety-driven habit but feels unable. If the onset of engagement in this type of focused mental activity could be reliably detected, decisional function might be augmented, e.g. through neurostimulation. However, there are no known algorithms for detecting task engagement with rapid time resolution. APPROACH We defined a new network measure, fixed canonical correlation (FCCA), specifically suited for neural decoding applications. We extracted FCCA features from local field potential recordings in human volunteers to give a temporally continuous estimate of mental effort, defined by engagement in experimental conflict tasks. MAIN RESULTS Using a small number of features per participant, we accurately decoded and distinguished task engagement from other mental activities. Further, the decoder distinguished between engagement in two different conflict-based tasks within seconds of their onset. SIGNIFICANCE These results demonstrate that network-level brain activity can detect specific types of mental efforts. This could form the basis of a responsive intervention strategy for decision-making deficits.
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Affiliation(s)
- Nicole R Provenza
- Brown University School of Engineering, Providence, RI, United States of America
- Charles Stark Draper Laboratory, Cambridge, MA, United States of America
| | - Angelique C Paulk
- Massachusetts General Hospital Neurosurgery Research, Boston, MA, United States of America
- Massachusetts General Hospital Neurology, Boston, MA, United States of America
| | - Noam Peled
- MGH/HST Martinos Center for Biomedical Imaging, Charlestown, MA, United States of America
| | - Maria I Restrepo
- Center for Computation and Visualization, Brown University, Providence, RI 02912, United States of America
| | - Sydney S Cash
- Massachusetts General Hospital Neurology, Boston, MA, United States of America
| | - Darin D Dougherty
- Massachusetts General Hospital Psychiatry, Boston, MA, United States of America
| | - Emad N Eskandar
- Massachusetts General Hospital Neurosurgery Research, Boston, MA, United States of America
- Present affiliation: Chair, Department of Neurological Surgery, Montefiore Medical Center, New York, NY, United States of America
| | - David A Borton
- Brown University School of Engineering, Providence, RI, United States of America
- Carney Institute for Brain Science, Providence, RI, United States of America
- Department of Veterans Affairs, Providence Medical Center, Center for Neurorestoration and Neurotechnology, Providence, RI, United States of America
| | - Alik S Widge
- Massachusetts General Hospital Psychiatry, Boston, MA, United States of America
- Present affiliation: Department of Psychiatry, University of Minnesota, Minneapolis, MN, United States of America
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27
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Grunwald LM, Stock R, Haag K, Buckenmaier S, Eberle MC, Wildgruber D, Storchak H, Kriebel M, Weißgraeber S, Mathew L, Singh Y, Loos M, Li KW, Kraushaar U, Fallgatter AJ, Volkmer H. Comparative characterization of human induced pluripotent stem cells (hiPSC) derived from patients with schizophrenia and autism. Transl Psychiatry 2019; 9:179. [PMID: 31358727 PMCID: PMC6663940 DOI: 10.1038/s41398-019-0517-3] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2018] [Accepted: 06/01/2019] [Indexed: 12/12/2022] Open
Abstract
Human induced pluripotent stem cells (hiPSC) provide an attractive tool to study disease mechanisms of neurodevelopmental disorders such as schizophrenia. A pertinent problem is the development of hiPSC-based assays to discriminate schizophrenia (SZ) from autism spectrum disorder (ASD) models. Healthy control individuals as well as patients with SZ and ASD were examined by a panel of diagnostic tests. Subsequently, skin biopsies were taken for the generation, differentiation, and testing of hiPSC-derived neurons from all individuals. SZ and ASD neurons share a reduced capacity for cortical differentiation as shown by quantitative analysis of the synaptic marker PSD95 and neurite outgrowth. By contrast, pattern analysis of calcium signals turned out to discriminate among healthy control, schizophrenia, and autism samples. Schizophrenia neurons displayed decreased peak frequency accompanied by increased peak areas, while autism neurons showed a slight decrease in peak amplitudes. For further analysis of the schizophrenia phenotype, transcriptome analyses revealed a clear discrimination among schizophrenia, autism, and healthy controls based on differentially expressed genes. However, considerable differences were still evident among schizophrenia patients under inspection. For one individual with schizophrenia, expression analysis revealed deregulation of genes associated with the major histocompatibility complex class II (MHC class II) presentation pathway. Interestingly, antipsychotic treatment of healthy control neurons also increased MHC class II expression. In conclusion, transcriptome analysis combined with pattern analysis of calcium signals appeared as a tool to discriminate between SZ and ASD phenotypes in vitro.
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Affiliation(s)
- Lena-Marie Grunwald
- 0000 0000 9457 1306grid.461765.7Department Molecular Biology, NMI Natural and Medical Sciences Institute at the University of Tübingen, Markwiesenstr. 55, 72770 Reutlingen, Germany
| | - Ricarda Stock
- 0000 0000 9457 1306grid.461765.7Department Molecular Biology, NMI Natural and Medical Sciences Institute at the University of Tübingen, Markwiesenstr. 55, 72770 Reutlingen, Germany
| | - Kathrina Haag
- 0000 0000 9457 1306grid.461765.7Department Molecular Biology, NMI Natural and Medical Sciences Institute at the University of Tübingen, Markwiesenstr. 55, 72770 Reutlingen, Germany
| | - Sandra Buckenmaier
- 0000 0000 9457 1306grid.461765.7Department Cell Physiology, NMI Natural and Medical Sciences Institute at the University of Tübingen, Markwiesenstr. 55, 72770 Reutlingen, Germany
| | - Mark-Christian Eberle
- 0000 0001 2190 1447grid.10392.39Department of Psychiatry, University of Tübingen, Osianderstrasse 24, 72076 Tübingen, Germany
| | - Dirk Wildgruber
- 0000 0001 2190 1447grid.10392.39Department of Psychiatry, University of Tübingen, Osianderstrasse 24, 72076 Tübingen, Germany
| | - Helena Storchak
- 0000 0001 2190 1447grid.10392.39Department of Psychiatry, University of Tübingen, Osianderstrasse 24, 72076 Tübingen, Germany
| | - Martin Kriebel
- 0000 0000 9457 1306grid.461765.7Department Molecular Biology, NMI Natural and Medical Sciences Institute at the University of Tübingen, Markwiesenstr. 55, 72770 Reutlingen, Germany
| | - Stephanie Weißgraeber
- 0000 0004 6008 5552grid.498061.2CeGaT GmbH - Center for Genomics and Transcriptomics, Paul-Ehrlich-Str. 23, 72076 Tübingen, Germany
| | - Lisha Mathew
- 0000 0004 6008 5552grid.498061.2CeGaT GmbH - Center for Genomics and Transcriptomics, Paul-Ehrlich-Str. 23, 72076 Tübingen, Germany
| | - Yasmin Singh
- 0000 0004 6008 5552grid.498061.2CeGaT GmbH - Center for Genomics and Transcriptomics, Paul-Ehrlich-Str. 23, 72076 Tübingen, Germany
| | - Maarten Loos
- grid.426096.fSylics (Synaptologics BV), PO Box 71033, 1008 BA Amsterdam, The Netherlands
| | - Ka Wan Li
- grid.484519.5Department of Molecular and Cellular Neurobiology, Center for Neurogenomics and Cognitive Research, Amsterdam Neuroscience, Vrije Universiteit, Amsterdam, The Netherlands
| | - Udo Kraushaar
- 0000 0000 9457 1306grid.461765.7Department Cell Physiology, NMI Natural and Medical Sciences Institute at the University of Tübingen, Markwiesenstr. 55, 72770 Reutlingen, Germany
| | - Andreas J. Fallgatter
- 0000 0001 2190 1447grid.10392.39Department of Psychiatry, University of Tübingen, Osianderstrasse 24, 72076 Tübingen, Germany
| | - Hansjürgen Volkmer
- Department Molecular Biology, NMI Natural and Medical Sciences Institute at the University of Tübingen, Markwiesenstr. 55, 72770, Reutlingen, Germany.
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28
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Wakschlag LS, Roberts MY, Flynn RM, Smith JD, Krogh-Jespersen S, Kaat AJ, Gray L, Walkup J, Marino BS, Norton ES, Davis MM. Future Directions for Early Childhood Prevention of Mental Disorders: A Road Map to Mental Health, Earlier. JOURNAL OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY : THE OFFICIAL JOURNAL FOR THE SOCIETY OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY, AMERICAN PSYCHOLOGICAL ASSOCIATION, DIVISION 53 2019; 48:539-554. [PMID: 30916591 PMCID: PMC6750224 DOI: 10.1080/15374416.2018.1561296] [Citation(s) in RCA: 72] [Impact Index Per Article: 14.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Mental disorders are the predominant chronic diseases of youth, with substantial life span morbidity and mortality. A wealth of evidence demonstrates that the neurodevelopmental roots of common mental health problems are present in early childhood. Unfortunately, this has not been translated to systematic strategies for improving population-level mental health at this most malleable neurodevelopmental period. We lay out a translational Mental Health, Earlier road map as a key future direction for prevention of mental disorder. This paradigm shift aims to reduce population attributable risk of mental disorder emanating from early life, by preventing, attenuating, or delaying onset/course of chronic psychopathology via the promotion of self-regulation in early childhood within large-scale health care delivery systems. The Earlier Pillar rests on a "science of when to worry" that (a) optimizes clinical assessment methods for characterizing probabilistic clinical risk beginning in infancy via deliberate incorporation of neurodevelopmental heterogeneity, and (b) universal primary-care-based screening targeting patterns of dysregulated irritability as a robust transdiagnostic marker of vulnerability to life span mental health problems. The core of the Healthier Pillar is provision of low-intensity selective intervention promoting self-regulation for young children with developmentally atypical patterns of irritability within an implementation science framework in pediatric primary care to ensure highest population impact and sustainability. These Mental Health, Earlier strategies hold much promise for transforming clinical outlooks and ensuring young children's mental health and well-being in a manner that reverberates throughout the life span.
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Affiliation(s)
- Lauren S. Wakschlag
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University
- Institute for Innovations in Developmental Sciences, Northwestern University
| | - Megan Y. Roberts
- Institute for Innovations in Developmental Sciences, Northwestern University
- Department of Communication Sciences and Disorders, School of Communication, Northwestern University
| | - Rachel M. Flynn
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University
- Institute for Innovations in Developmental Sciences, Northwestern University
| | - Justin D. Smith
- Institute for Innovations in Developmental Sciences, Northwestern University
- Department of Psychiatry and Behavioral Sciences, Feinberg School of Medicine, Northwestern University
| | - Sheila Krogh-Jespersen
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University
- Institute for Innovations in Developmental Sciences, Northwestern University
| | - Aaron J. Kaat
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University
- Institute for Innovations in Developmental Sciences, Northwestern University
| | - Larry Gray
- Institute for Innovations in Developmental Sciences, Northwestern University
- Department of Pediatrics, Feinberg School of Medicine, Northwestern University
- Ann & Robert H. Lurie Children’s Hospital of Chicago
| | - John Walkup
- Institute for Innovations in Developmental Sciences, Northwestern University
- Department of Psychiatry and Behavioral Sciences, Feinberg School of Medicine, Northwestern University
- Ann & Robert H. Lurie Children’s Hospital of Chicago
| | - Bradley S. Marino
- Institute for Innovations in Developmental Sciences, Northwestern University
- Department of Pediatrics, Feinberg School of Medicine, Northwestern University
- Ann & Robert H. Lurie Children’s Hospital of Chicago
| | - Elizabeth S. Norton
- Institute for Innovations in Developmental Sciences, Northwestern University
- Department of Communication Sciences and Disorders, School of Communication, Northwestern University
| | - Matthew M. Davis
- Institute for Innovations in Developmental Sciences, Northwestern University
- Department of Pediatrics, Feinberg School of Medicine, Northwestern University
- Ann & Robert H. Lurie Children’s Hospital of Chicago
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29
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Provenza NR, Matteson ER, Allawala AB, Barrios-Anderson A, Sheth SA, Viswanathan A, McIngvale E, Storch EA, Frank MJ, McLaughlin NCR, Cohn JF, Goodman WK, Borton DA. The Case for Adaptive Neuromodulation to Treat Severe Intractable Mental Disorders. Front Neurosci 2019; 13:152. [PMID: 30890909 PMCID: PMC6412779 DOI: 10.3389/fnins.2019.00152] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2018] [Accepted: 02/11/2019] [Indexed: 12/20/2022] Open
Abstract
Mental disorders are a leading cause of disability worldwide, and available treatments have limited efficacy for severe cases unresponsive to conventional therapies. Neurosurgical interventions, such as lesioning procedures, have shown success in treating refractory cases of mental illness, but may have irreversible side effects. Neuromodulation therapies, specifically Deep Brain Stimulation (DBS), may offer similar therapeutic benefits using a reversible (explantable) and adjustable platform. Early DBS trials have been promising, however, pivotal clinical trials have failed to date. These failures may be attributed to targeting, patient selection, or the “open-loop” nature of DBS, where stimulation parameters are chosen ad hoc during infrequent visits to the clinician’s office that take place weeks to months apart. Further, the tonic continuous stimulation fails to address the dynamic nature of mental illness; symptoms often fluctuate over minutes to days. Additionally, stimulation-based interventions can cause undesirable effects if applied when not needed. A responsive, adaptive DBS (aDBS) system may improve efficacy by titrating stimulation parameters in response to neural signatures (i.e., biomarkers) related to symptoms and side effects. Here, we present rationale for the development of a responsive DBS system for treatment of refractory mental illness, detail a strategic approach for identification of electrophysiological and behavioral biomarkers of mental illness, and discuss opportunities for future technological developments that may harness aDBS to deliver improved therapy.
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Affiliation(s)
- Nicole R Provenza
- Brown University School of Engineering, Providence, RI, United States.,Charles Stark Draper Laboratory, Cambridge, MA, United States
| | - Evan R Matteson
- Brown University School of Engineering, Providence, RI, United States
| | - Anusha B Allawala
- Brown University School of Engineering, Providence, RI, United States
| | - Adriel Barrios-Anderson
- Psychiatric Neurosurgery Program at Butler Hospital, The Warren Alpert Medical School of Brown University, Providence, RI, United States
| | - Sameer A Sheth
- Department of Neurosurgery, Baylor College of Medicine, Houston, TX, United States
| | - Ashwin Viswanathan
- Department of Neurosurgery, Baylor College of Medicine, Houston, TX, United States
| | - Elizabeth McIngvale
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, United States
| | - Eric A Storch
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, United States
| | - Michael J Frank
- Department of Cognitive, Linguistic, and Psychological Sciences, Brown University, Providence, RI, United States.,Department of Psychology, University of Pittsburgh, Pittsburgh, PA, United States
| | - Nicole C R McLaughlin
- Psychiatric Neurosurgery Program at Butler Hospital, The Warren Alpert Medical School of Brown University, Providence, RI, United States
| | - Jeffrey F Cohn
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA, United States
| | - Wayne K Goodman
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, United States
| | - David A Borton
- Brown University School of Engineering, Providence, RI, United States.,Carney Institute for Brain Science, Brown University, Providence, RI, United States.,Department of Veterans Affairs, Providence Medical Center, Center for Neurorestoration and Neurotechnology, Providence, RI, United States
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30
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Yao G, Niu W, Zhu X, He M, Kong L, Chen S, Zhang L, Cheng Z. hsa_circRNA_104597: a novel potential diagnostic and therapeutic biomarker for schizophrenia. Biomark Med 2019; 13:331-340. [PMID: 30781971 DOI: 10.2217/bmm-2018-0447] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Aim: To assess whether expression of circular RNAs (circRNAs) in peripheral blood mononuclear cells can serve as a biomarker for diagnosis and/or therapeutic response in people living with schizophrenia (SZ). Materials & methods: Differentially expressed circRNAs were screened via microarray in nine individuals living with SZ and nine healthy controls, then quantified using real-time quantitative reverse transcription PCR in SZ (n = 102) and healthy control (n = 103) groups. CircRNAs were re-assessed twice in 30 randomly selected individuals living with SZ after 4- and 8-week antipsychotic treatments. Results: Five circRNAs were differentially expressed between groups. Only hsa_circRNA_104597, which was downregulated in the SZ group, was significantly upregulated after 8-week treatment. Conclusion: Dysregulation of hsa_circRNA_104597 may serve as a novel potential diagnostic and therapeutic biomarker for SZ.
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Affiliation(s)
- Gaofeng Yao
- Department of Psychology, The Affiliated Wuxi Mental Health Center of Nanjing Medical University, Wuxi, PR China.,Prevention & Treatment Center for Psychological Diseases, No. 904 Hospital of the Chinese People's Liberation Army, Changzhou, PR China
| | - Wei Niu
- Department of Rehabilitation, No. 904 Hospital of Chinese People's Liberation Army, Changzhou, PR China
| | - Xiaoli Zhu
- Prevention & Treatment Center for Psychological Diseases, No. 904 Hospital of the Chinese People's Liberation Army, Changzhou, PR China
| | - Mingjun He
- Prevention & Treatment Center for Psychological Diseases, No. 904 Hospital of the Chinese People's Liberation Army, Changzhou, PR China
| | - Lingming Kong
- Prevention & Treatment Center for Psychological Diseases, No. 904 Hospital of the Chinese People's Liberation Army, Changzhou, PR China
| | - Shengdong Chen
- Department of Neurology, No. 904 Hospital of Chinese People's Liberation Army, Changzhou, PR China
| | - Liyi Zhang
- Prevention & Treatment Center for Psychological Diseases, No. 904 Hospital of the Chinese People's Liberation Army, Changzhou, PR China
| | - Zaohuo Cheng
- Department of Psychology, The Affiliated Wuxi Mental Health Center of Nanjing Medical University, Wuxi, PR China
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31
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Cha J, Ide JS, Bowman FD, Simpson HB, Posner J, Steinglass JE. Abnormal reward circuitry in anorexia nervosa: A longitudinal, multimodal MRI study. Hum Brain Mapp 2018; 37:3835-3846. [PMID: 27273474 DOI: 10.1002/hbm.23279] [Citation(s) in RCA: 73] [Impact Index Per Article: 12.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2016] [Revised: 04/18/2016] [Accepted: 05/20/2016] [Indexed: 12/15/2022] Open
Abstract
Anorexia nervosa (AN) is a debilitating illness and existing interventions are only modestly effective. This study aimed to determine whether AN pathophysiology is associated with altered connections within fronto-accumbal circuitry subserving reward processing. Diffusion and resting-state functional MRI scans were collected in female inpatients with AN (n = 22) and healthy controls (HC; n = 18) between the ages of 16 and 25 years. Individuals with AN were scanned during the acute, underweight phase of the illness and again following inpatient weight restoration. HC were scanned twice over the same timeframe. Based on univariate and multivariate analyses of fronto-accumbal circuitry, underweight individuals with AN were found to have increased structural connectivity (diffusion probabilistic tractography), increased white matter anisotropy (tract-based spatial statistics), increased functional connectivity (seed-based correlation in resting-state fMRI), and altered effective connectivity (spectral dynamic causal modeling). Following weight restoration, fronto-accumbal structural connectivity continued to be abnormally increased bilaterally with large (partial η2 = 0.387; right NAcc-OFC) and moderate (partial η2 = 0.197; left NAcc-OFC) effect sizes. Increased structural connectivity within fronto-accumbal circuitry in the underweight state correlated with severity of eating disorder symptoms. Taken together, the findings from this longitudinal, multimodal neuroimaging study offer converging evidence of atypical fronto-accumbal circuitry in AN. Hum Brain Mapp 37:3835-3846, 2016. © 2016 Wiley Periodicals, Inc.
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Affiliation(s)
- Jiook Cha
- Department of Psychiatry, Columbia University Medical Center, New York, New York. .,Division of Child and Adolescent Psychiatry, New York State Psychiatric Institute, New York, New York.
| | - Jaime S Ide
- Department of Biomedical Engineering, Stony Brook University, Stony Brook, New York
| | - F Dubois Bowman
- Department of Biostatistics, Mailman School of Public Health, College of Physicians and Surgeons, Columbia University, New York, New York
| | - Helen B Simpson
- Department of Psychiatry, Columbia University Medical Center, New York, New York.,Division of Clinical Therapeutics, New York State Psychiatric Institute, New York, New York
| | - Jonathan Posner
- Department of Psychiatry, Columbia University Medical Center, New York, New York.,Division of Child and Adolescent Psychiatry, New York State Psychiatric Institute, New York, New York
| | - Joanna E Steinglass
- Department of Psychiatry, Columbia University Medical Center, New York, New York. .,Division of Clinical Therapeutics, New York State Psychiatric Institute, New York, New York.
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32
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Widge AS, Ellard KK, Paulk AC, Basu I, Yousefi A, Zorowitz S, Gilmour A, Afzal A, Deckersbach T, Cash SS, Kramer MA, Eden UT, Dougherty DD, Eskandar EN. Treating refractory mental illness with closed-loop brain stimulation: Progress towards a patient-specific transdiagnostic approach. Exp Neurol 2017; 287:461-472. [PMID: 27485972 DOI: 10.1016/j.expneurol.2016.07.021] [Citation(s) in RCA: 79] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2015] [Accepted: 07/25/2016] [Indexed: 12/24/2022]
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33
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Gallo EF, Posner J. Moving towards causality in attention-deficit hyperactivity disorder: overview of neural and genetic mechanisms. Lancet Psychiatry 2016; 3:555-67. [PMID: 27183902 PMCID: PMC4893880 DOI: 10.1016/s2215-0366(16)00096-1] [Citation(s) in RCA: 116] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2016] [Revised: 03/04/2016] [Accepted: 03/04/2016] [Indexed: 12/17/2022]
Abstract
Attention-deficit hyperactivity disorder (ADHD) is a neurodevelopmental disorder characterised by developmentally inappropriate levels of inattention and hyperactivity or impulsivity. The heterogeneity of its clinical manifestations and the differential responses to treatment and varied prognoses have long suggested myriad underlying causes. Over the past decade, clinical and basic research efforts have uncovered many behavioural and neurobiological alterations associated with ADHD, from genes to higher order neural networks. Here, we review the neurobiology of ADHD by focusing on neural circuits implicated in the disorder and discuss how abnormalities in circuitry relate to symptom presentation and treatment. We summarise the literature on genetic variants that are potentially related to the development of ADHD, and how these, in turn, might affect circuit function and relevant behaviours. Whether these underlying neurobiological factors are causally related to symptom presentation remains unresolved. Therefore, we assess efforts aimed at disentangling issues of causality, and showcase the shifting research landscape towards endophenotype refinement in clinical and preclinical settings. Furthermore, we review approaches being developed to understand the neurobiological underpinnings of this complex disorder, including the use of animal models, neuromodulation, and pharmacoimaging studies.
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Affiliation(s)
- Eduardo F Gallo
- Columbia University and New York State Psychiatric Institute, New York, NY, USA.
| | - Jonathan Posner
- Columbia University and New York State Psychiatric Institute, New York, NY, USA
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34
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Zbukvic IC, Ganella DE, Perry CJ, Madsen HB, Bye CR, Lawrence AJ, Kim JH. Role of Dopamine 2 Receptor in Impaired Drug-Cue Extinction in Adolescent Rats. Cereb Cortex 2016; 26:2895-904. [PMID: 26946126 PMCID: PMC4869820 DOI: 10.1093/cercor/bhw051] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Adolescent drug users display resistance to treatment such as cue exposure therapy (CET), as well as increased liability to relapse. The basis of CET is extinction learning, which involves dopamine signaling in the medial prefrontal cortex (mPFC). This system undergoes dramatic alterations during adolescence. Therefore, we investigated extinction of a cocaine-associated cue in adolescent and adult rats. While cocaine self-administration and lever-alone extinction were not different between the two ages, we observed that cue extinction reduced cue-induced reinstatement in adult but not adolescent rats. Infusion of the selective dopamine 2 receptor (D2R)-like agonist quinpirole into the infralimbic cortex (IL) of the mPFC prior to cue extinction significantly reduced cue-induced reinstatement in adolescents. This effect was replicated by acute systemic treatment with the atypical antipsychotic aripiprazole (Abilify), a partial D2R-like agonist. These data suggest that adolescents may be more susceptible to relapse due to a deficit in cue extinction learning, and highlight the significance of D2R signaling in the IL for cue extinction during adolescence. These findings inspire new tactics for improving adolescent CET, with aripiprazole representing an exciting potential pharmacological adjunct for behavioral therapy.
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Affiliation(s)
- Isabel C. Zbukvic
- Behavioral Neuroscience Division, The Florey Institute of Neuroscience and Mental Health, Parkville, VIC 3051, Australia
- The Florey Department of Neuroscience and Mental Health, University of Melbourne, Parkville, VIC 3010, Australia
| | - Despina E. Ganella
- Behavioral Neuroscience Division, The Florey Institute of Neuroscience and Mental Health, Parkville, VIC 3051, Australia
- The Florey Department of Neuroscience and Mental Health, University of Melbourne, Parkville, VIC 3010, Australia
| | - Christina J. Perry
- Behavioral Neuroscience Division, The Florey Institute of Neuroscience and Mental Health, Parkville, VIC 3051, Australia
- The Florey Department of Neuroscience and Mental Health, University of Melbourne, Parkville, VIC 3010, Australia
| | - Heather B. Madsen
- Behavioral Neuroscience Division, The Florey Institute of Neuroscience and Mental Health, Parkville, VIC 3051, Australia
- The Florey Department of Neuroscience and Mental Health, University of Melbourne, Parkville, VIC 3010, Australia
| | - Christopher R. Bye
- Behavioral Neuroscience Division, The Florey Institute of Neuroscience and Mental Health, Parkville, VIC 3051, Australia
- The Florey Department of Neuroscience and Mental Health, University of Melbourne, Parkville, VIC 3010, Australia
| | - Andrew J. Lawrence
- Behavioral Neuroscience Division, The Florey Institute of Neuroscience and Mental Health, Parkville, VIC 3051, Australia
- The Florey Department of Neuroscience and Mental Health, University of Melbourne, Parkville, VIC 3010, Australia
| | - Jee Hyun Kim
- Behavioral Neuroscience Division, The Florey Institute of Neuroscience and Mental Health, Parkville, VIC 3051, Australia
- The Florey Department of Neuroscience and Mental Health, University of Melbourne, Parkville, VIC 3010, Australia
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The relevance of cytochrome P450 polymorphism in forensic medicine and akathisia-related violence and suicide. J Forensic Leg Med 2016; 41:65-71. [PMID: 27138119 DOI: 10.1016/j.jflm.2016.04.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2015] [Revised: 03/04/2016] [Accepted: 04/01/2016] [Indexed: 11/22/2022]
Abstract
Adverse drug reactions and interactions are among the major causes of death in the United States. Antidepressants have been reported as causing suicide and homicide and share the class attribute of frequently producing akathisia, a state of severe restlessness associated with thoughts of death and violence. Medical examiners can now identify some pharmacogenetic interactions that cause drugs, deemed safe for most, to be lethal to others. Such deaths do not yet include medication-induced, akathisia-related suicides and homicides. An extrapyramidal side effect, akathisia is a manifestation of drug toxicity whose causes lie, inter alia, in drugs, doses, and co-prescribed medications that inhibit and compete for metabolizing enzymes, which may themselves be defective. In this paper, we report our investigation into adverse drug reactions/interactions in three persons who committed homicide, two also intending suicide, while on antidepressants prescribed for stressful life events. Their histories of medication use, adverse reactions and reasons for changes in medications are presented. DNA samples were screened for variants in the cytochrome P450 gene family; that produce drug metabolizing enzymes. All three cases exhibit genotype-based diminished metabolic capability that, in combination with their enzyme inhibiting/competing medications, decreased metabolism further and are the likely cause of these catastrophic events.
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Wakschlag LS, Estabrook R, Petitclerc A, Henry D, Burns JL, Perlman SB, Voss JL, Pine DS, Leibenluft E, Briggs-Gowan ML. Clinical Implications of a Dimensional Approach: The Normal:Abnormal Spectrum of Early Irritability. J Am Acad Child Adolesc Psychiatry 2015; 54:626-34. [PMID: 26210331 PMCID: PMC4515952 DOI: 10.1016/j.jaac.2015.05.016] [Citation(s) in RCA: 136] [Impact Index Per Article: 15.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2014] [Revised: 04/23/2015] [Accepted: 06/08/2015] [Indexed: 12/23/2022]
Abstract
OBJECTIVE The importance of dimensional approaches is widely recognized, but an empirical base for clinical application is lacking. This is particularly true for irritability, a dimensional phenotype that cuts across many areas of psychopathology and manifests early in life. We examine longitudinal, dimensional patterns of irritability and their clinical import in early childhood. METHOD Irritability was assessed longitudinally over an average of 16 months in a clinically enriched, diverse community sample of preschoolers (N = 497; mean = 4.2 years; SD = 0.8). Using the Temper Loss scale of the Multidimensional Assessment Profile of Disruptive Behavior (MAP-DB) as a developmentally sensitive indicator of early childhood irritability, we examined its convergent/divergent, clinical, and incremental predictive validity, and modeled its linear and nonlinear associations with clinical risk. RESULTS The Temper Loss scale demonstrated convergent and divergent validity to child and maternal factors. In multivariate analyses, Temper Loss predicted mood (separation anxiety disorder [SAD], generalized anxiety disorder [GAD], and depression/dysthymia), disruptive (oppositional defiant disorder [ODD], attention-deficit/hyperactivity disorder [ADHD], and conduct disorder [CD]) symptoms. Preschoolers with even mildly elevated Temper Loss scale scores showed substantially increased risk of symptoms and disorders. For ODD, GAD, SAD, and depression, increases in Temper Loss scale scores at the higher end of the dimension had a greater impact on symptoms relative to increases at the lower end. Temper Loss scale scores also showed incremental validity over DSM-IV disorders in predicting subsequent impairment. Finally, accounting for the substantial heterogeneity in longitudinal patterns of Temper Loss significantly improved prediction of mood and disruptive symptoms. CONCLUSION Dimensional, longitudinal characterization of irritability informs clinical prediction. A vital next step will be empirically generating parameters for the incorporation of dimensional information into clinical decision-making with reasonable certainty.
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Affiliation(s)
- Lauren S Wakschlag
- Department of Medical Social Sciences and the Institute for Policy Research, Northwestern University, IL.
| | | | | | - David Henry
- Institute for Health Research and Policy, University of Illinois at Chicago
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Nichols SR, Briggs-Gowan M, Estabrook R, Burns J, Kestler J, Berman G, Henry D, Wakschlag L. Punishment Insensitivity in Early Childhood: A Developmental, Dimensional Approach. JOURNAL OF ABNORMAL CHILD PSYCHOLOGY 2015; 43:1011-23. [PMID: 25425187 PMCID: PMC4446258 DOI: 10.1007/s10802-014-9950-1] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Impairment in learning from punishment ("punishment insensitivity") is an established feature of severe antisocial behavior in adults and youth but it has not been well studied as a developmental phenomenon. In early childhood, differentiating a normal: abnormal spectrum of punishment insensitivity is key for distinguishing normative misbehavior from atypical manifestations. This study employed a novel measure, the Multidimensional Assessment Profile of Disruptive Behavior (MAP-DB), to examine the distribution, dimensionality, and external validity of punishment insensitivity in a large, demographically diverse community sample of preschoolers (3-5 years) recruited from pediatric clinics (N = 1,855). Caregivers completed surveys from which a seven-item Punishment Insensitivity scale was derived. Findings indicated that Punishment Insensitivity behaviors are relatively common in young children, with at least 50 % of preschoolers exhibiting them sometimes. Item response theory analyses revealed a Punishment Insensitivity spectrum. Items varied along a severity continuum: most items needed to occur "Often" in order to be severe and behaviors that were qualitatively atypical or intense were more severe. Although there were item-level differences across sociodemographic groups, these were small. Construct, convergent, and divergent validity were demonstrated via association to low concern for others and noncompliance, motivational regulation, and a disruptive family context. Incremental clinical utility was demonstrated in relation to impairment. Early childhood punishment insensitivity varies along a severity continuum and is atypical when it predominates. Implications for understanding the phenomenology of emergent disruptive behavior are discussed.
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Affiliation(s)
- Sara R. Nichols
- Department of Medical Social Sciences, Northwestern University, Chicago, IL
| | | | - Ryne Estabrook
- Department of Medical Social Sciences, Northwestern University, Chicago, IL
| | - James Burns
- Department of Medical Social Sciences, Northwestern University, Chicago, IL
| | - Jacqueline Kestler
- Department of Medical Social Sciences, Northwestern University, Chicago, IL
| | - Grace Berman
- Department of Medical Social Sciences, Northwestern University, Chicago, IL
| | - David Henry
- Institute for Health Research and Policy, University of Illinois at Chicago, Chicago, IL
| | - Lauren Wakschlag
- Department of Medical Social Sciences, Northwestern University, Chicago, IL
- Institute for Policy Research, Northwestern University, Evanston, IL
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Quantification of the Serotonin 1A Receptor Using PET: Identification of a Potential Biomarker of Major Depression in Males. Neuropsychopharmacology 2015; 40:1692-9. [PMID: 25578798 PMCID: PMC4915251 DOI: 10.1038/npp.2015.15] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2014] [Revised: 11/13/2014] [Accepted: 12/09/2014] [Indexed: 01/26/2023]
Abstract
Multiple lines of research have implicated the serotonin 1A (5-HT1A) receptor in major depressive disorder (MDD). Despite this, quantification of 5-HT1A is yet to yield a clinically relevant MDD biomarker. One reason may be that reported sex differences in the serotonergic system confound the comparison between diagnostic groups. Therefore, this study sought to determine whether differences in 5-HT1A binding between depressed and control subjects are affected by sex. Using positron emission tomography (PET), serotonin 1A binding was quantified in 50 patients with MDD (34 female, 16 male) and 57 healthy controls (32 female, 25 male). The subjects' 5-HT1A density (BPF, equal to the product of the density of available receptors and tracer affinity), was determined by using the PET tracer [carbonyl-C-11]-WAY-100635, a selective 5-HT1A antagonist. Results indicated that male MDD subjects had a 67.0% higher BPF across 13 brain regions compared with male controls (df=103, p<0.0001). The greatest difference between MDD subjects and controls was in the raphe (132%, p=0.000). Furthermore, by using a threshold, male controls can be distinguished from depressed males with high sensitivity and specificity (both >80%). In females, the separation between diagnostic groups yields much lower sensitivity and specificity. This data therefore suggests a specific biosignature for MDD in males. Identification of such a biosignature could provide a deeper understanding of depression pathology, help identify those at highest risk, and aid in the development of new therapies. Further, these findings suggest that combining male and female cohorts may not be optimal for some MDD studies.
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Wood PL, Unfried G, Whitehead W, Phillipps A, Wood JA. Dysfunctional plasmalogen dynamics in the plasma and platelets of patients with schizophrenia. Schizophr Res 2015; 161:506-10. [PMID: 25497441 DOI: 10.1016/j.schres.2014.11.032] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2014] [Revised: 11/19/2014] [Accepted: 11/24/2014] [Indexed: 10/24/2022]
Abstract
BACKGROUND Based upon the concept of a prodromal risk syndrome for first psychosis, intense efforts are being applied to define potential biomarkers of disease onset in schizophrenia. One such tentative biomarker may be plasmalogens, complex structural glycerophospholipids that serve multiple functions in all cells. METHODS To further investigate this possibility, we undertook a lipidomics analysis of choline and ethanolamine plasmalogens in the plasma and platelets of 23 patients with schizophrenia and 27 age-matched controls. RESULTS Plasma levels of both choline and ethanolamine plasmalogens were decreased by 23 to 45% in patients with schizophrenia. In platelets, from patients with schizophrenia, ethanolamine plasmalogens also were decreased while choline plasmalogen levels were increased. Levels of docosahexaenoic acid (DHA) were decreased by approximately 30% both in plasma and platelets. CONCLUSIONS Our results suggest that alterations in lipid transport or lipid remodeling/metabolism of plasmalogens are present in schizophrenia and that changes in the steady-state levels of these complex lipid pools may be involved in altered neuronal function.
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Affiliation(s)
- Paul L Wood
- DeBusk College of Osteopathic Medicine, Lincoln Memorial University, 6965 Cumberland Gap Parkway, Harrogate, TN 37752, United States.
| | - Greg Unfried
- Southwestern Behavioral Healthcare, 415 Mulberry St., Evansville, IN 47713, United States
| | - Willard Whitehead
- Southwestern Behavioral Healthcare, 415 Mulberry St., Evansville, IN 47713, United States
| | - Aaron Phillipps
- DeBusk College of Osteopathic Medicine, Lincoln Memorial University, 6965 Cumberland Gap Parkway, Harrogate, TN 37752, United States
| | - Julie A Wood
- Southwestern Behavioral Healthcare, 415 Mulberry St., Evansville, IN 47713, United States
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Féger J, Hirsch E. In search of innovative therapeutics for neuropsychiatric disorders: The case of neurodegenerative diseases. ANNALES PHARMACEUTIQUES FRANÇAISES 2015; 73:3-12. [DOI: 10.1016/j.pharma.2014.10.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2014] [Accepted: 10/02/2014] [Indexed: 10/24/2022]
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Dietrich-Muszalska A. Oxidative Stress in Schizophrenia. OXIDATIVE STRESS IN APPLIED BASIC RESEARCH AND CLINICAL PRACTICE 2015. [DOI: 10.1007/978-1-4939-0440-2_2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/11/2023]
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Decreased centrality of subcortical regions during the transition to adolescence: a functional connectivity study. Neuroimage 2014; 104:44-51. [PMID: 25290886 DOI: 10.1016/j.neuroimage.2014.09.063] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2014] [Revised: 09/25/2014] [Accepted: 09/26/2014] [Indexed: 12/18/2022] Open
Abstract
Investigations of brain maturation processes are a key step to understand the cognitive and emotional changes of adolescence. Although structural imaging findings have delineated clear brain developmental trajectories for typically developing individuals, less is known about the functional changes of this sensitive development period. Developmental changes, such as abstract thought, complex reasoning, and emotional and inhibitory control, have been associated with more prominent cortical control. The aim of this study is to assess brain networks connectivity changes in a large sample of 7- to 15-year-old subjects, testing the hypothesis that cortical regions will present an increasing relevance in commanding the global network. Functional magnetic resonance imaging (fMRI) data were collected in a sample of 447 typically developing children from a Brazilian community sample who were submitted to a resting state acquisition protocol. The fMRI data were used to build a functional weighted graph from which eigenvector centrality (EVC) was extracted. For each brain region (a node of the graph), the age-dependent effect on EVC was statistically tested and the developmental trajectories were estimated using polynomial functions. Our findings show that angular gyrus become more central during this maturation period, while the caudate; cerebellar tonsils, pyramis, thalamus; fusiform, parahippocampal and inferior semilunar lobe become less central. In conclusion, we report a novel finding of an increasing centrality of the angular gyrus during the transition to adolescence, with a decreasing centrality of many subcortical and cerebellar regions.
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Strauss KA, Markx S, Georgi B, Paul SM, Jinks RN, Hoshi T, McDonald A, First MB, Liu W, Benkert AR, Heaps AD, Tian Y, Chakravarti A, Bucan M, Puffenberger EG. A population-based study of KCNH7 p.Arg394His and bipolar spectrum disorder. Hum Mol Genet 2014; 23:6395-406. [PMID: 24986916 PMCID: PMC4222358 DOI: 10.1093/hmg/ddu335] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
We conducted blinded psychiatric assessments of 26 Amish subjects (52 ± 11 years) from four families with prevalent bipolar spectrum disorder, identified 10 potentially pathogenic alleles by exome sequencing, tested association of these alleles with clinical diagnoses in the larger Amish Study of Major Affective Disorder (ASMAD) cohort, and studied mutant potassium channels in neurons. Fourteen of 26 Amish had bipolar spectrum disorder. The only candidate allele shared among them was rs78247304, a non-synonymous variant of KCNH7 (c.1181G>A, p.Arg394His). KCNH7 c.1181G>A and nine other potentially pathogenic variants were subsequently tested within the ASMAD cohort, which consisted of 340 subjects grouped into controls subjects and affected subjects from overlapping clinical categories (bipolar 1 disorder, bipolar spectrum disorder and any major affective disorder). KCNH7 c.1181G>A had the highest enrichment among individuals with bipolar spectrum disorder (χ2 = 7.3) and the strongest family-based association with bipolar 1 (P = 0.021), bipolar spectrum (P = 0.031) and any major affective disorder (P = 0.016). In vitro, the p.Arg394His substitution allowed normal expression, trafficking, assembly and localization of HERG3/Kv11.3 channels, but altered the steady-state voltage dependence and kinetics of activation in neuronal cells. Although our genome-wide statistical results do not alone prove association, cumulative evidence from multiple independent sources (parallel genome-wide study cohorts, pharmacological studies of HERG-type potassium channels, electrophysiological data) implicates neuronal HERG3/Kv11.3 potassium channels in the pathophysiology of bipolar spectrum disorder. Such a finding, if corroborated by future studies, has implications for mental health services among the Amish, as well as development of drugs that specifically target HERG3/Kv11.3.
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Affiliation(s)
- Kevin A Strauss
- Clinic for Special Children, Strasburg, PA, USA, Franklin & Marshall College, Lancaster, PA, USA, Lancaster General Hospital, Lancaster, PA, USA,
| | - Sander Markx
- Department of Psychiatry, Columbia University, New York, New York, USA
| | | | - Steven M Paul
- Departments of Neuroscience, Psychiatry and Pharmacology, Weill Cornell Medical College of Cornell University, New York, New York, USA
| | - Robert N Jinks
- Biological Foundations of Behavior Program, Franklin & Marshall College, Lancaster, PA, USA and
| | - Toshinori Hoshi
- Department of Physiology, University of Pennsylvania, Philadelphia, PA, USA
| | - Ann McDonald
- Department of Psychiatry, Columbia University, New York, New York, USA
| | - Michael B First
- Department of Psychiatry, Columbia University, New York, New York, USA
| | - Wencheng Liu
- Departments of Neuroscience, Psychiatry and Pharmacology, Weill Cornell Medical College of Cornell University, New York, New York, USA
| | - Abigail R Benkert
- Clinic for Special Children, Strasburg, PA, USA, Biological Foundations of Behavior Program, Franklin & Marshall College, Lancaster, PA, USA and
| | | | - Yutao Tian
- Department of Physiology, University of Pennsylvania, Philadelphia, PA, USA
| | - Aravinda Chakravarti
- Center for Complex Disease Genomics, McKusick-Nathans Institute of Genetic Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Maja Bucan
- Department of Genetics, Perelman School of Medicine and
| | - Erik G Puffenberger
- Clinic for Special Children, Strasburg, PA, USA, Franklin & Marshall College, Lancaster, PA, USA
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Chung JY, Insel TR. Mind the gap: neuroscience literacy and the next generation of psychiatrists. ACADEMIC PSYCHIATRY : THE JOURNAL OF THE AMERICAN ASSOCIATION OF DIRECTORS OF PSYCHIATRIC RESIDENCY TRAINING AND THE ASSOCIATION FOR ACADEMIC PSYCHIATRY 2014; 38:121-123. [PMID: 24619911 DOI: 10.1007/s40596-014-0054-6] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/28/2013] [Accepted: 11/25/2013] [Indexed: 06/03/2023]
Abstract
The National Institute of Mental Health seeks to address the gap between modern neuroscience and psychiatric training. The authors describe a two-pronged approach: first, to identify and support trainees in clinical neuroscience and second, to promote neuroscience literacy in psychiatric residency programs.
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Affiliation(s)
- Joyce Y Chung
- National Institute of Mental Health, Bethesda, MD, USA,
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Tadayonnejad R, Ajilore O. Brain network dysfunction in late-life depression: a literature review. J Geriatr Psychiatry Neurol 2014; 27:5-12. [PMID: 24381233 DOI: 10.1177/0891988713516539] [Citation(s) in RCA: 88] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
As a common psychiatric disorder in the growing geriatric population, late-life depression (LLD) has a negative impact on the cognitive, affective, and somatic domains of the lives of the elderly individuals. Accumulating evidence from the structural and functional imaging studies on LLD supports a "network dysfunction model" rather than a "lesion pathology model" for understanding the underlying biological mechanism in this mental disorder. In this work, we used network dysfunction model as a conceptual framework for reviewing recent neuroimaging findings in LLD. Our focus was on 4 major neurocircuits that have been shown to be involved in LLD: default mood network, cognitive control network, affective/frontolimbic network, and corticostriatal circuits. Findings of LLD-related gray and white matter structural abnormalities and resting-state and task-based functional changes were discussed for each network separately. We extended our review by summarizing the latest works that apply graph theory-based network analysis techniques for testing alterations in whole-brain network properties associated with LLD.
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Affiliation(s)
- Reza Tadayonnejad
- Department of Psychiatry, University of Illinois at Chicago, Chicago, IL, USA
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Salum GA, Desousa DA, do Rosário MC, Pine DS, Manfro GG. Pediatric anxiety disorders: from neuroscience to evidence-based clinical practice. BRAZILIAN JOURNAL OF PSYCHIATRY 2014; 35 Suppl 1:S03-21. [PMID: 24142122 DOI: 10.1590/1516-4446-2013-s108] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
The objective of this narrative review of the literature is to describe the epidemiology, etiology, pathophysiology, diagnosis, and treatment of pediatric anxiety disorders. We aim to guide clinicians in understanding the biology of anxiety disorders and to provide general guidelines for the proper diagnoses and treatment of these conditions early in life. Anxiety disorders are prevalent, associated with a number of negative life outcomes, and currently under-recognized and under-treated. The etiology involves both genes and environmental influences modifying the neural substrate in a complex interplay. Research on pathophysiology is still in its infancy, but some brain regions, such as the amygdala and the prefrontal cortex, have been implicated in fear and anxiety. Current practice is to establish diagnosis based purely on clinical features, derived from clinical interviews with the child, parents, and teachers. Treatment is effective using medication, cognitive behavioral therapy, or a combination of both. An introduction to the neuroscience behind anxiety disorders combined with an evidence-based approach may help clinicians to understand these disorders and treat them properly in childhood.
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Affiliation(s)
- Giovanni Abrahão Salum
- Universidade Federal do Rio Grande do Sul, Anxiety Disorders Outpatient Program for Child and Adolescent Psychiatry, Hospital de Clínicas de Porto Alegre, Porto AlegreRS, Brazil
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Oldham MA, Ciraulo DA. Bright light therapy for depression: a review of its effects on chronobiology and the autonomic nervous system. Chronobiol Int 2014; 31:305-19. [PMID: 24397276 DOI: 10.3109/07420528.2013.833935] [Citation(s) in RCA: 72] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Bright light therapy (BLT) is considered among the first-line treatments for seasonal affective disorder (SAD), yet a growing body of literature supports its use in other neuropsychiatric conditions including non-seasonal depression. Despite evidence of its antidepressant efficacy, clinical use of BLT remains highly variable internationally. In this article, we explore the autonomic effects of BLT and suggest that such effects may play a role in its antidepressant and chronotherapeutic properties. After providing a brief introduction on the clinical application of BLT, we review the chronobiological effects of BLT on depression and on the autonomic nervous system in depressed and non-depressed individuals with an emphasis on non-seasonal depression. Such a theory of autonomic modulation via BLT could serve to integrate aspects of recent work centered on alleviating allostatic load, the polyvagal theory, the neurovisceral integration model and emerging evidence on the roles of glutamate and gamma-hydroxybutyric acid (GABA).
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Affiliation(s)
- Mark A Oldham
- Department of Psychiatry, Boston University Medical Center , Boston, MA , USA
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Ebel J, Beuter S, Wuchter J, Kriebel M, Volkmer H. Organisation and Control of Neuronal Connectivity and Myelination by Cell Adhesion Molecule Neurofascin. ADVANCES IN NEUROBIOLOGY 2014; 8:231-47. [DOI: 10.1007/978-1-4614-8090-7_10] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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50
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Problems and solutions to filling the drying drug pipeline for psychiatric disorders: a report from the inaugural 2012 CINP Think Tank. Int J Neuropsychopharmacol 2014; 17:137-48. [PMID: 24063634 DOI: 10.1017/s1461145713001077] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
The inaugural Collegium Internationale Neuro-Psychopharmacologicum (CINP) Think Tank, a small open meeting sponsored by the CINP, discussed impediments to developing new drugs for psychiatric disorders and approaches to overcome these impediments. Whilst neuropsycharmacology has a rich pharmacopeia (current treatments benefiting many individuals), issues of treatment resistance, sub-optimal response and unwanted side effects remain problematic. Many scientific, economic and social issues are impeding the development of drugs (e.g. higher risk of failure, placebo effects, problematic regulatory environments, pressures imposed by patent protection, downward pressure on reimbursements and financial, legal and social risk aversion). A consensus of the meeting was that efforts to understanding the core pathophysiology of psychiatric disorders are fundamental to increasing the chance of developing new drugs. However, findings from disorders such as Huntington's chorea, have shown that knowing the cause of a disorder may not reveal new drug targets. By contrast, clinically useful biomarkers that define target populations for new drugs and models that allow findings to be accurately translated from animals to humans will increase the likelihood of developing new drugs. In addition, a greater accent on experimental medicine, creative clinical investigations and improved communication between preclinical neuropsychopharmacologists, clinicians committed to neuropsychopharmacological research, industry and the regulators would also be a driver to the development of new treatments. Finally, it was agreed that the CINP must continue its role as a conduit facilitating vibrant interactions between industry and academia as such communications are a central component in identifying new drug targets, developing new drugs and transitioning new drugs into the clinic.
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