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Dular L, Špiclin Ž. Analysis of Brain Age Gap across Subject Cohorts and Prediction Model Architectures. Biomedicines 2024; 12:2139. [PMID: 39335651 PMCID: PMC11428686 DOI: 10.3390/biomedicines12092139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2024] [Revised: 09/12/2024] [Accepted: 09/16/2024] [Indexed: 09/30/2024] Open
Abstract
Background: Brain age prediction from brain MRI scans and the resulting brain age gap (BAG)-the difference between predicted brain age and chronological age-is a general biomarker for a variety of neurological, psychiatric, and other diseases or disorders. Methods: This study examined the differences in BAG values derived from T1-weighted scans using five state-of-the-art deep learning model architectures previously used in the brain age literature: 2D/3D VGG, RelationNet, ResNet, and SFCN. The models were evaluated on healthy controls and cohorts with sleep apnea, diabetes, multiple sclerosis, Parkinson's disease, mild cognitive impairment, and Alzheimer's disease, employing rigorous statistical analysis, including repeated model training and linear mixed-effects models. Results: All five models consistently identified a statistically significant positive BAG for diabetes (ranging from 0.79 years with RelationNet to 2.13 years with SFCN), multiple sclerosis (2.67 years with 3D VGG to 4.24 years with 2D VGG), mild cognitive impairment (2.13 years with 2D VGG to 2.59 years with 3D VGG), and Alzheimer's dementia (5.54 years with ResNet to 6.48 years with SFCN). For Parkinson's disease, a statistically significant BAG increase was observed in all models except ResNet (1.30 years with 2D VGG to 2.59 years with 3D VGG). For sleep apnea, a statistically significant BAG increase was only detected with the SFCN model (1.59 years). Additionally, we observed a trend of decreasing BAG with increasing chronological age, which was more pronounced in diseased cohorts, particularly those with the largest BAG, such as multiple sclerosis (-0.34 to -0.2), mild cognitive impairment (-0.37 to -0.26), and Alzheimer's dementia (-0.66 to -0.47), compared to healthy controls (-0.18 to -0.1). Conclusions: Consistent with previous research, Alzheimer's dementia and multiple sclerosis exhibited the largest BAG across all models, with SFCN predicting the highest BAG overall. The negative BAG trend suggests a complex interplay of survival bias, disease progression, adaptation, and therapy that influences brain age prediction across the age spectrum.
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Affiliation(s)
| | - Žiga Špiclin
- University of Ljubljana, Faculty of Electrical Engineering, Tržaška cesta 25, 1000 Ljubljana, Slovenia
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Kaddoura R, Faraji H, Othman M, Abu Hijleh A, Loney T, Goswami N, Benamer HTS. Exploring Factors Associated with Falls in Multiple Sclerosis: Insights from a Scoping Review. Clin Interv Aging 2024; 19:923-938. [PMID: 38803468 PMCID: PMC11129740 DOI: 10.2147/cia.s460475] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2024] [Accepted: 04/17/2024] [Indexed: 05/29/2024] Open
Abstract
Multiple sclerosis (MS) is a chronic inflammatory condition that causes demyelination of the central nervous system accompanied by a wide range of symptoms. The high prevalence of falls among patients diagnosed with MS within the initial six months highlights the importance of this issue. The objective of this study is to identify factors associated with falls in MS patients in order to increase awareness and reduce the risk of falls. This scoping review used specific Mesh terms to formulate the literature search around falls and MS using Medline, Google Scholar, Scopus, and Embase search engines. English papers published between 2012 and 2022, studies with a clear definition of falls, McDonald's diagnostic criteria for MS, and those with Expanded Disability Status Scale (EDSS) or Patient Determined Disease Steps (PDDS) scores were included. Critical data from the selected articles were extracted and classified according to the different factors associated with falls in MS patients. Eighteen articles were included in this review. The most important factors associated with falls in MS patients identified were the severity and progression of the disease, mobility and balance problems, bladder dysfunction, fear of falling, fatigue, and cognitive dysfunction. In conclusion, this scoping review yielded the most common factors associated with falls in patients with MS. Study findings can be used to develop future interventions focusing on improving mobility, proprioception, and balance to decrease fall risk and injury amongst MS patients.
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Affiliation(s)
- Rachid Kaddoura
- College of Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, United Arab Emirates
| | - Hanan Faraji
- College of Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, United Arab Emirates
| | - Malek Othman
- College of Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, United Arab Emirates
| | - Amin Abu Hijleh
- College of Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, United Arab Emirates
| | - Tom Loney
- Department of Basic Sciences, College of Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, United Arab Emirates
| | - Nandu Goswami
- Division of Physiology and Pathophysiology, Medical University of Graz, Graz, Austria
- Center for Space and Aviation Health, College of Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, United Arab Emirates
| | - Hani T S Benamer
- Department of Clinical Sciences, College of Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, United Arab Emirates
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Majmasanaye M, Mehrpooya M, Amiri H, Eshraghi A. Discovering the Potential Value of Coenzyme Q10 as an Adjuvant Treatment in Patients With Depression. J Clin Psychopharmacol 2024; 44:232-239. [PMID: 38684047 DOI: 10.1097/jcp.0000000000001845] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/02/2024]
Abstract
PURPOSE/BACKGROUND Depressive disorder or mental cold is the most common mental disorder, and depression exists all over the world and in all countries and cultures. The results of several studies have shown that using compounds with antioxidant properties has been fruitful in patients with depression. Coenzyme Q10 (CoQ10) is a fat-soluble antioxidant and exerts its antioxidant effect by directly neutralizing free radicals or reducing tocopherol and preventing the inhibition of mitochondrial activity because of oxidative stress. This study aimed to investigate the effects of oral CoQ10 in patients with depression as an adjunctive treatment. METHODS/PROCEDURES Sixty-nine patients with moderate and severe depression were randomly divided into 2 CoQ10 groups (36) and placebo (33). The first group of patients received CoQ10 supplements at a dose of 200 mg daily for 8 weeks along with standard interventions and treatments for depression, and the second group received standard treatments for depression along with a placebo. The change in the score of Montgomery-Åsberg Depression Rating Scale depression scale was evaluated 4 and 8 weeks after the intervention. Also, at baseline and 8 weeks later at the end of the study, serum levels of total antioxidant capacity, total thiol groups, nitric oxide, malondialdehyde, and interleukin 6 were assessed. FINDINGS/RESULTS The changes in the depression score at the end of the study showed that, in the group receiving the CoQ10 supplement after 8 weeks, there was a reduction in depression symptoms, which was statistically significant compared with before the start of the study Meanwhile, no significant changes were observed in the patients of the placebo group in terms of symptom reduction. Compared with baseline and the placebo condition, serum levels of nitric oxide and total thiol groups significantly decreased and increased, respectively. Also, no statistically significant changes were observed for interleukin 6, malondialdehyde, and total antioxidant capacity. IMPLICATIONS/CONCLUSIONS A dose of 200 mg of CoQ10 supplement daily for 8 weeks can reduce depression and fatigue, as well as improve the quality of life of patients with depression. In addition, CoQ10 can significantly improve inflammation and oxidative stress status in patients with depression.
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Affiliation(s)
- Mahnam Majmasanaye
- From the School of Pharmacy, Iran University of Medical Sciences, Tehran, Iran
| | - Maryam Mehrpooya
- Department of Clinical Pharmacy, School of Pharmacy, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Hasan Amiri
- Department of Emergency Medicine, School of Medicine, Emergency Medicine Management Research Center, Hazrate Rasoul General Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - Azadeh Eshraghi
- Emergency Medicine Management Research Center, Health Management Research Institute, Iran University of Medical Sciences, Tehran, Iran
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Kwon S, Han KD, Jung JH, Cho EB, Chung YH, Park J, Choi HL, Jeon HJ, Shin DW, Min JH. Risk of depression and anxiety in multiple sclerosis and neuromyelitis optica spectrum disorder: A nationwide cohort study in South Korea. Mult Scler 2024; 30:714-725. [PMID: 38561953 DOI: 10.1177/13524585241237093] [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] [Indexed: 04/04/2024]
Abstract
BACKGROUND We investigated the risks of depression/anxiety in patients with multiple sclerosis (pwMS) or patients with neuromyelitis optica spectrum disorder (pwNMOSD). OBJECTIVES MS/NMOSD cohorts were collected from Korean National Health Insurance Service, using the International Classification of Diseases-10th and information on Rare Intractable Disease program. Patients who were younger than 20 years, had a previous depression/anxiety, or died in the index year were excluded. METHODS Hazard ratios (HRs) of depression/anxiety in pwMS and pwNMOSD from controls matched 1:5 for age, sex, hypertension, diabetes, and dyslipidemia were calculated using Cox regressions with a 1-year lag period and estimated over time. RESULTS During a mean follow-up of 4.1 years, adjusted hazard ratios (aHR) for depression were 3.25 (95% confidence interval (CI) = 2.59-4.07) in MS and 2.17 (1.70-2.76) in NMOSD, and aHRs for anxiety were 1.83 (1.49-2.23) in MS and 1.56 (1.26-1.91) in NMOSD. The risks of anxiety/depression did not differ between MS and NMOSD and were highest in the second year after diagnosis of MS/NMOSD. The relative risk of depression was higher in younger pwMS/pwNMOSD, and the relative risk of anxiety was higher in pwMS who was male, had low income, or lived in a non-urban area. CONCLUSION The risk of depression and anxiety was increased in pwMS/pwNMOSD.
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Affiliation(s)
- Soonwook Kwon
- Department of Neurology, Inha University Hospital, Inha University College of Medicine, Incheon, South Korea
| | - Kyung-Do Han
- Department of Statistics and Actuarial Science, Soongsil University, Seoul, South Korea
| | - Jin Hyung Jung
- Department of Biostatistics, The Catholic University of Korea, Seoul, South Korea
| | - Eun Bin Cho
- Department of Neurology, Gyeongsang Institute of Health Science, Gyeongsang National University, Jinju, South Korea
- Department of Neurology, Gyeongsang National University Changwon Hospital, Changwon, South Korea
| | - Yeon Hak Chung
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Junhee Park
- Department of Family Medicine and Supportive Care Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Hea Lim Choi
- Department of Family Medicine and Supportive Care Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
- Department of Clinical Research Design and Evaluation, Samsung Advanced Institute for Health Sciences & Technology, Sungkyunkwan University, Seoul, South Korea
| | - Hong Jin Jeon
- Department of Clinical Research Design and Evaluation, Samsung Advanced Institute for Health Sciences & Technology, Sungkyunkwan University, Seoul, South Korea
- Depression Center, Department of Psychiatry, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Dong Wook Shin
- Department of Family Medicine and Supportive Care Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
- Department of Clinical Research Design and Evaluation and Department of Digital Health, Samsung Advanced Institute for Health Sciences & Technology, Sungkyunkwan University, Seoul, South Korea
| | - Ju-Hong Min
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
- Neuroscience Center, Samsung Medical Center, Seoul, South Korea
- Department of Health Sciences and Technology, Samsung Advanced Institute for Health Sciences & Technology, Sungkyunkwan University, Seoul, South KoreaYeon Hak Chung is currently affiliated to Department of Neurology, Korea University Guro Hospital, Korea University College of Medicine, Seoul, South Korea
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Kampaite A, Gustafsson R, York EN, Foley P, MacDougall NJJ, Bastin ME, Chandran S, Waldman AD, Meijboom R. Brain connectivity changes underlying depression and fatigue in relapsing-remitting multiple sclerosis: A systematic review. PLoS One 2024; 19:e0299634. [PMID: 38551913 PMCID: PMC10980255 DOI: 10.1371/journal.pone.0299634] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Accepted: 02/13/2024] [Indexed: 04/01/2024] Open
Abstract
Multiple Sclerosis (MS) is an autoimmune disease affecting the central nervous system, characterised by neuroinflammation and neurodegeneration. Fatigue and depression are common, debilitating, and intertwined symptoms in people with relapsing-remitting MS (pwRRMS). An increased understanding of brain changes and mechanisms underlying fatigue and depression in RRMS could lead to more effective interventions and enhancement of quality of life. To elucidate the relationship between depression and fatigue and brain connectivity in pwRRMS we conducted a systematic review. Searched databases were PubMed, Web-of-Science and Scopus. Inclusion criteria were: studied participants with RRMS (n ≥ 20; ≥ 18 years old) and differentiated between MS subtypes; published between 2001-01-01 and 2023-01-18; used fatigue and depression assessments validated for MS; included brain structural, functional magnetic resonance imaging (fMRI) or diffusion MRI (dMRI). Sixty studies met the criteria: 18 dMRI (15 fatigue, 5 depression) and 22 fMRI (20 fatigue, 5 depression) studies. The literature was heterogeneous; half of studies reported no correlation between brain connectivity measures and fatigue or depression. Positive findings showed that abnormal cortico-limbic structural and functional connectivity was associated with depression. Fatigue was linked to connectivity measures in cortico-thalamic-basal-ganglial networks. Additionally, both depression and fatigue were related to altered cingulum structural connectivity, and functional connectivity involving thalamus, cerebellum, frontal lobe, ventral tegmental area, striatum, default mode and attention networks, and supramarginal, precentral, and postcentral gyri. Qualitative analysis suggests structural and functional connectivity changes, possibly due to axonal and/or myelin loss, in the cortico-thalamic-basal-ganglial and cortico-limbic network may underlie fatigue and depression in pwRRMS, respectively, but the overall results were inconclusive, possibly explained by heterogeneity and limited number of studies. This highlights the need for further studies including advanced MRI to detect more subtle brain changes in association with depression and fatigue. Future studies using optimised imaging protocols and validated depression and fatigue measures are required to clarify the substrates underlying these symptoms in pwRRMS.
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Affiliation(s)
- Agniete Kampaite
- Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, United Kingdom
- Edinburgh Imaging, Edinburgh Imaging Facility, University of Edinburgh, Edinburgh, United Kingdom
| | - Rebecka Gustafsson
- Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, United Kingdom
| | - Elizabeth N. York
- Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, United Kingdom
- Edinburgh Imaging, Edinburgh Imaging Facility, University of Edinburgh, Edinburgh, United Kingdom
- Anne Rowling Regenerative Neurology Clinic, University of Edinburgh, Edinburgh, United Kingdom
| | - Peter Foley
- Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, United Kingdom
- Anne Rowling Regenerative Neurology Clinic, University of Edinburgh, Edinburgh, United Kingdom
| | - Niall J. J. MacDougall
- Anne Rowling Regenerative Neurology Clinic, University of Edinburgh, Edinburgh, United Kingdom
- Department of Neurology, Institute of Neurological Sciences, Queen Elizabeth University Hospital, Glasgow, United Kingdom
| | - Mark E. Bastin
- Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, United Kingdom
- Edinburgh Imaging, Edinburgh Imaging Facility, University of Edinburgh, Edinburgh, United Kingdom
| | - Siddharthan Chandran
- Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, United Kingdom
- Anne Rowling Regenerative Neurology Clinic, University of Edinburgh, Edinburgh, United Kingdom
- UK Dementia Research Institute, University of Edinburgh, Edinburgh, United Kingdom
| | - Adam D. Waldman
- Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, United Kingdom
- Edinburgh Imaging, Edinburgh Imaging Facility, University of Edinburgh, Edinburgh, United Kingdom
| | - Rozanna Meijboom
- Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, United Kingdom
- Edinburgh Imaging, Edinburgh Imaging Facility, University of Edinburgh, Edinburgh, United Kingdom
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Dziedzic A, Saluk J. Probiotics and Commensal Gut Microbiota as the Effective Alternative Therapy for Multiple Sclerosis Patients Treatment. Int J Mol Sci 2022; 23:ijms232214478. [PMID: 36430954 PMCID: PMC9699268 DOI: 10.3390/ijms232214478] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2022] [Revised: 11/17/2022] [Accepted: 11/18/2022] [Indexed: 11/23/2022] Open
Abstract
The gut-brain axis (GBA) refers to the multifactorial interactions between the intestine microflora and the nervous, immune, and endocrine systems, connecting brain activity and gut functions. Alterations of the GBA have been revealed in people with multiple sclerosis (MS), suggesting a potential role in disease pathogenesis and making it a promising therapeutic target. Whilst research in this field is still in its infancy, a number of studies revealed that MS patients are more likely to exhibit modified microbiota, altered levels of short-chain fatty acids, and enhanced intestinal permeability. Both clinical and preclinical trials in patients with MS and animal models revealed that the administration of probiotic bacteria might improve cognitive, motor, and mental behaviors by modulation of GBA molecular pathways. According to the newest data, supplementation with probiotics may be associated with slower disability progression, reduced depressive symptoms, and improvements in general health in patients with MS. Herein, we give an overview of how probiotics supplementation may have a beneficial effect on the course of MS and its animal model. Hence, interference with the composition of the MS patient's intestinal microbiota may, in the future, be a grip point for the development of diagnostic tools and personalized microbiota-based adjuvant therapy.
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Cathomas F, Holt LM, Parise EM, Liu J, Murrough JW, Casaccia P, Nestler EJ, Russo SJ. Beyond the neuron: Role of non-neuronal cells in stress disorders. Neuron 2022; 110:1116-1138. [PMID: 35182484 PMCID: PMC8989648 DOI: 10.1016/j.neuron.2022.01.033] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Revised: 12/15/2021] [Accepted: 01/24/2022] [Indexed: 12/11/2022]
Abstract
Stress disorders are leading causes of disease burden in the U.S. and worldwide, yet available therapies are fully effective in less than half of all individuals with these disorders. Although to date, much of the focus has been on neuron-intrinsic mechanisms, emerging evidence suggests that chronic stress can affect a wide range of cell types in the brain and periphery, which are linked to maladaptive behavioral outcomes. Here, we synthesize emerging literature and discuss mechanisms of how non-neuronal cells in limbic regions of brain interface at synapses, the neurovascular unit, and other sites of intercellular communication to mediate the deleterious, or adaptive (i.e., pro-resilient), effects of chronic stress in rodent models and in human stress-related disorders. We believe that such an approach may one day allow us to adopt a holistic "whole body" approach to stress disorder research, which could lead to more precise diagnostic tests and personalized treatment strategies. Stress is a major risk factor for many psychiatric disorders. Cathomas et al. review new insight into how non-neuronal cells mediate the deleterious effects, as well as the adaptive, protective effects, of stress in rodent models and human stress-related disorders.
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Affiliation(s)
- Flurin Cathomas
- Nash Family Department of Neuroscience, Icahn School of Medicine at Mount Sinai, New York, NY, USA; Friedman Brain Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Leanne M Holt
- Nash Family Department of Neuroscience, Icahn School of Medicine at Mount Sinai, New York, NY, USA; Friedman Brain Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Eric M Parise
- Nash Family Department of Neuroscience, Icahn School of Medicine at Mount Sinai, New York, NY, USA; Friedman Brain Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Jia Liu
- Neuroscience Initiative, Advanced Science Research Center, Program in Biology and Biochemistry at The Graduate Center of The City University of New York, New York, NY, USA
| | - James W Murrough
- Nash Family Department of Neuroscience, Icahn School of Medicine at Mount Sinai, New York, NY, USA; Friedman Brain Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA; Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Patrizia Casaccia
- Nash Family Department of Neuroscience, Icahn School of Medicine at Mount Sinai, New York, NY, USA; Friedman Brain Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA; Neuroscience Initiative, Advanced Science Research Center, Program in Biology and Biochemistry at The Graduate Center of The City University of New York, New York, NY, USA
| | - Eric J Nestler
- Nash Family Department of Neuroscience, Icahn School of Medicine at Mount Sinai, New York, NY, USA; Friedman Brain Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA; Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Scott J Russo
- Nash Family Department of Neuroscience, Icahn School of Medicine at Mount Sinai, New York, NY, USA; Friedman Brain Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA; Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
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Cuomo-Haymour N, Sigrist H, Ineichen C, Russo G, Nüesch U, Gantenbein F, Kulic L, Knuesel I, Bergamini G, Pryce CR. Evidence for Effects of Extracellular Vesicles on Physical, Inflammatory, Transcriptome and Reward Behaviour Status in Mice. Int J Mol Sci 2022; 23:ijms23031028. [PMID: 35162951 PMCID: PMC8835024 DOI: 10.3390/ijms23031028] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2021] [Revised: 01/05/2022] [Accepted: 01/11/2022] [Indexed: 02/01/2023] Open
Abstract
Immune-inflammatory activation impacts extracellular vesicles (EVs), including their miRNA cargo. There is evidence for changes in the EV miRNome in inflammation-associated neuropsychiatric disorders. This mouse study investigated: (1) effects of systemic lipopolysaccharide (LPS) and chronic social stress (CSS) on plasma EV miRNome; and (2) physiological, transcriptional, and behavioural effects of peripheral or central delivered LPS-activated EVs in recipient mice. LPS or CSS effects on the plasma EV miRNome were assessed by using microRNA sequencing. Recipient mice received plasma EVs isolated from LPS-treated or SAL-treated donor mice or vehicle only, either intravenously or into the nucleus accumbens (NAc), on three consecutive days. Bodyweight, spleen or NAc transcriptome and reward (sucrose) motivation were assessed. LPS and CSS increased the expression of 122 and decreased expression of 20 plasma EV miRNAs, respectively. Peripheral LPS-EVs reduced bodyweight, and both LPS-EVs and SAL-EVs increased spleen expression of immune-relevant genes. NAc-infused LPS-EVs increased the expression of 10 immune-inflammatory genes. Whereas motivation increased similarly across test days in all groups, the effect of test days was more pronounced in mice that received peripheral or central LPS-EVs compared with other groups. This study provides causal evidence that increased EV levels impact physiological and behavioural processes and are of potential relevance to neuropsychiatric disorders.
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Affiliation(s)
- Nagiua Cuomo-Haymour
- Preclinical Laboratory for Translational Research into Affective Disorders, Department of Psychiatry, Psychotherapy and Psychosomatics Psychiatric Hospital, University of Zurich, 8008 Zurich, Switzerland; (N.C.-H.); (H.S.); (C.I.); (G.B.)
- Neuroscience Center Zurich, 8057 Zurich, Switzerland
| | - Hannes Sigrist
- Preclinical Laboratory for Translational Research into Affective Disorders, Department of Psychiatry, Psychotherapy and Psychosomatics Psychiatric Hospital, University of Zurich, 8008 Zurich, Switzerland; (N.C.-H.); (H.S.); (C.I.); (G.B.)
| | - Christian Ineichen
- Preclinical Laboratory for Translational Research into Affective Disorders, Department of Psychiatry, Psychotherapy and Psychosomatics Psychiatric Hospital, University of Zurich, 8008 Zurich, Switzerland; (N.C.-H.); (H.S.); (C.I.); (G.B.)
| | - Giancarlo Russo
- Functional Genomics Centre Zurich, University of Zurich and Swiss Federal Institute of Technology Zurich, 8057 Zurich, Switzerland;
| | - Ursina Nüesch
- Paediatric Immunology, University Children’s Hospital Zurich, 8032 Zurich, Switzerland;
| | - Felix Gantenbein
- Zurich Integrative Rodent Physiology, University of Zurich, 8057 Zurich, Switzerland;
| | - Luka Kulic
- Roche Pharmaceutical Research and Early Development, Roche Innovation Center Basel, 4070 Basel, Switzerland; (L.K.); (I.K.)
| | - Irene Knuesel
- Roche Pharmaceutical Research and Early Development, Roche Innovation Center Basel, 4070 Basel, Switzerland; (L.K.); (I.K.)
| | - Giorgio Bergamini
- Preclinical Laboratory for Translational Research into Affective Disorders, Department of Psychiatry, Psychotherapy and Psychosomatics Psychiatric Hospital, University of Zurich, 8008 Zurich, Switzerland; (N.C.-H.); (H.S.); (C.I.); (G.B.)
| | - Christopher Robert Pryce
- Preclinical Laboratory for Translational Research into Affective Disorders, Department of Psychiatry, Psychotherapy and Psychosomatics Psychiatric Hospital, University of Zurich, 8008 Zurich, Switzerland; (N.C.-H.); (H.S.); (C.I.); (G.B.)
- Neuroscience Center Zurich, 8057 Zurich, Switzerland
- Correspondence: ; Tel.: +41-(0)44-634-89-21
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9
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Crouch TA, Reas HE, Quach CM, Erickson TM. Does depression in multiple sclerosis mediate effects of cognitive functioning on quality of life? Qual Life Res 2021; 31:497-506. [PMID: 34228241 DOI: 10.1007/s11136-021-02927-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/23/2021] [Indexed: 10/20/2022]
Abstract
PURPOSE Patients with multiple sclerosis (MS) are at significant risk for decreased quality of life (QoL), in part due to factors such as cognitive impairment and depression. However, objective versus subjective assessments of cognitive functioning may differentially predict QoL, and it remains unknown whether they each impact QoL through levels of depression. The aims of the present study included (1) testing the effects of cognitive impairment on MS-related QoL via depression symptoms and (2) examining whether perceived and objective cognitive functioning differentially predict QoL through depression. METHODS Patients formally diagnosed with MS (N = 128) participated in cognitive assessment (Brief International Cognitive Assessment for Multiple Sclerosis) and completed self-report measures of perceived cognitive functioning (perceived deficits questionnaire), depression (Hospital Anxiety and Depression Scale), and MS-related QoL (functional assessment of multiple sclerosis). RESULTS Mediational hypotheses were tested by regression and structural equation modeling. As hypothesized, both perceived and objective cognitive functioning independently predicted lower QoL controlling for the effects of depression (p < 0.001). Consistent with hypotheses, depression mediated effects of both perceived (95% CI [0.31, 0.68]) and objective cognitive functioning (95% CI [0.09, 6.96]) on QoL when tested in separate models. However, when both predictors were modeled simultaneously, depression only mediated the effects of perceived (not objective) cognitive functioning (95% CI for standardized effect [0.10, 0.61]). CONCLUSIONS This study, thus, suggests the need to conceptualize different pathways by which objective and subjective cognitive impairment may shape QoL in the lives of individuals with MS.
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Affiliation(s)
- Tara A Crouch
- Sleep Medicine, Puget Sound VA Health Care System, 1660 S. Columbian Way, Seattle, WA, 98108, USA.
| | - Hannah E Reas
- Sleep Medicine, Puget Sound VA Health Care System, 1660 S. Columbian Way, Seattle, WA, 98108, USA
| | - Christina M Quach
- Department of Clinical Psychology, Seattle Pacific University, 3307 3rd Ave. W., Suite 107, Seattle, WA, 98119, USA
| | - Thane M Erickson
- Department of Clinical Psychology, Seattle Pacific University, 3307 3rd Ave. W., Suite 107, Seattle, WA, 98119, USA.
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10
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Kane A, Thompson NR, Sullivan AB. Assessment of Computer Assisted Rehabilitation Environment (CAREN) System Use and Mood in Patients with Multiple Sclerosis. Int J MS Care 2021; 24:63-66. [DOI: 10.7224/1537-2073.2020-131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Abstract
Background: Depression is a common comorbidity in patients with multiple sclerosis (MS) and is associated with decreased quality of life. Identifying treatments that aid psychological and physical rehabilitation in patients with MS provides valuable information for interdisciplinary teams.
Methods: Seventy-five adults with MS who completed the Patient Health Questionnaire-9 (PHQ-9) and Patient-Reported Outcomes Measurement Information System (PROMIS) Global Health scale during routine physical therapy appointments where the (CAREN) system was used were studied. Data were retrospective and collected via patient-reported outcomes. Group comparisons used two-sample t tests or Mann-Whitney U tests for continuous variables and Fisher exact tests for categorical variables. To examine self-reported depression, mean ± SD baseline scores were computed and stratified by number of CAREN sessions.
Results: Patients with five or more sessions seemed to have lower baseline PHQ-9 and PROMIS Mental Health scores; however, no significant differences were found at the univariate level. There were no statistically significant differences in follow-up scores for the outcome measures.
Conclusions: Current research evaluating the rehabilitation of patients with MS using the CAREN system is scarce. This pilot study is important to inform prospective studies exploring use of the CAREN system for psychological rehabilitation. Patients with five or more CAREN sessions had lower baseline PHQ-9 scores, which may suggest that mood plays a role in the selection of patients for CAREN system use. This study shows that mood is not affected by the CAREN system. More specific research needs to be completed with a more robust sample.
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Affiliation(s)
- Alexa Kane
- From the Mellen Center for Multiple Sclerosis (AK, ABS), Department of Qualitative Health Sciences (NRT), and Neurological Institute Center for Outcomes Research and Evaluation (NRT), Cleveland Clinic, Cleveland, OH, USA
| | - Nicolas R. Thompson
- From the Mellen Center for Multiple Sclerosis (AK, ABS), Department of Qualitative Health Sciences (NRT), and Neurological Institute Center for Outcomes Research and Evaluation (NRT), Cleveland Clinic, Cleveland, OH, USA
| | - Amy B. Sullivan
- From the Mellen Center for Multiple Sclerosis (AK, ABS), Department of Qualitative Health Sciences (NRT), and Neurological Institute Center for Outcomes Research and Evaluation (NRT), Cleveland Clinic, Cleveland, OH, USA
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Raimo S, Santangelo G, Trojano L. The emotional disorders associated with multiple sclerosis. HANDBOOK OF CLINICAL NEUROLOGY 2021; 183:197-220. [PMID: 34389118 DOI: 10.1016/b978-0-12-822290-4.00009-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Multiple sclerosis (MS) is associated with a high prevalence of emotional and mood disorders. Emotional disorders may worsen during illness progression and affect the quality of life of patients and their families. MS is often associated with depression, with an increased risk of suicide, poor adherence to treatment, decreased functional status, and quality of life. The diagnosis and treatment of emotional and mood disorders in these patients is often challenging since several symptoms of these disorders overlap with those of MS. Other prevalent emotional disorders in MS include bipolar disorder, anxiety disorders, emotional blunting (apathy), and pseudobulbar affect. Early recognition and treatment of these comorbidities could contribute to the reduction of disability and even to decreased mortality. The aim of this chapter is to provide an up-to-date review of mood and emotional disorders that are often associated with MS, focusing on their epidemiology, clinical features, pathogenesis, assessment, and treatment. The interplay between the psychosocial impact of the chronic disability and the demyelinating structural lesions of the brain in precipitating emotional and mood disorders is discussed, as well as its implications for diagnosis and treatment.
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Affiliation(s)
- Simona Raimo
- Department of Psychology, University of Campania "Luigi Vanvitelli", Caserta, Italy.
| | - Gabriella Santangelo
- Department of Psychology, University of Campania "Luigi Vanvitelli", Caserta, Italy
| | - Luigi Trojano
- Department of Psychology, University of Campania "Luigi Vanvitelli", Caserta, Italy
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12
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Oxidative Damage of Blood Platelets Correlates with the Degree of Psychophysical Disability in Secondary Progressive Multiple Sclerosis. OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2020; 2020:2868014. [PMID: 32655763 PMCID: PMC7317616 DOI: 10.1155/2020/2868014] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Revised: 05/22/2020] [Accepted: 05/30/2020] [Indexed: 12/11/2022]
Abstract
The results of past research studies show that platelets are one of the main sources of reactive oxygen species (ROS) and reactive nitrogen species (RNS) to be found in the course of many pathological states. The aim of this study was to determine the level of oxidative/nitrative stress biomarkers in blood platelets obtained from multiple sclerosis (MS) patients (n = 110) and to verify their correlation with the clinical parameters of the psychophysical disability of patients. The mitochondrial metabolism of platelets was assessed by measuring the intracellular production of ROS using the fluorescence method with DCFH-DA dye and by identification of changes in the mitochondrial membrane potential of platelets using the JC-1 dye. Moreover, we measured the mRNA expression for the gene encoding the cytochrome c oxidase subunit I (MTCO-1) and glyceraldehyde 3-phosphate dehydrogenase (GAPDH) in platelets and megakaryocytes using the RT-qPCR method, as well as the concentration of NADPH oxidase (NOX-1) by the ELISA method. Our results proved an increased level of oxidative/nitrative damage of proteins (carbonyl groups, 3-nitrotyrosine) (p < 0.0001) and decreased level of -SH in MS (p < 0.0001) and also a pronounced correlation between these biomarkers and parameters assessed by the Expanded Disability Status Scale and the Beck's Depression Inventory. The application of fluorescence methods showed mitochondrial membrane potential disruption (p < 0.001) and higher production of ROS in platelets from MS compared to control (p < 0.0001). Our research has also confirmed the impairment of red-ox metabolism in MS, which was achieved by increasing the relative mRNA expression in platelets for the genes studied (2-fold increase for the MTCO-1 gene and 1.5-fold increase in GAPDH gene, p < 0.05), as well as the augmented concentration of NOX-1 compared to control (p < 0.0001). Our results indicate that the oxidative/nitrative damage of platelets is implicated in the pathophysiology of MS, which reflects the status of the disease.
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Cognitive Fatigability is Independent of Subjective Cognitive Fatigue and Mood in Multiple Sclerosis. Cogn Behav Neurol 2020; 33:113-121. [PMID: 32496296 DOI: 10.1097/wnn.0000000000000228] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Sustained cognitive testing is used to detect cognitive fatigability and is often considered a substitute for subjective cognitive fatigue (CF). However, the relationship between cognitive fatigability and subjective CF in people with multiple sclerosis (PwMS) remains undetermined. OBJECTIVE To explore potential associations between fatigability induced by sustained cognitive testing and subjective CF in PwMS. METHODS We gave 120 PwMS and 60 demographically matched, healthy individuals the Beck Depression Inventory-FastScreen (BDI-FS) to measure mood and the Modified Fatigue Impact Scale to measure CF. In addition, we used the Quotient ADHD Test, a sustained attention test, to measure cognitive fatigability. We also explored potential correlations between the individuals' performance on the sustained attention test and thalamic volume using recent MRI scans. RESULTS Forty-one (34.2%) of the PwMS exhibited cognitive fatigability. These 41 were found to be significantly older (P=0.006), had been diagnosed with the disease for longer (P=0.03), had higher scores (P<0.001) on the Expanded Disability Status Scale, and had reduced thalamic volume (P=0.04) compared with the 79 (65.8%) PwMS not exhibiting cognitive fatigability. The PwMS exhibiting cognitive fatigability scored similarly on the BDI-FS (P=0.21) and self-reported similar rates of CF (P=0.62) as the PwMS not exhibiting cognitive fatigability. CONCLUSION Cognitive fatigability induced by sustained cognitive testing is not an accurate clinical alternative to subjective CF. This study provides evidence to support cognitive fatigability and CF in PwMS as two distinct concepts.
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14
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Vorobeychik G, Black D, Cooper P, Cox A. Multiple sclerosis and related challenges to young women's health: Canadian expert review. Neurodegener Dis Manag 2020; 10:1-13. [PMID: 32372725 DOI: 10.2217/nmt-2020-0010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
Multiple sclerosis (MS) is among the most common chronic neurological diseases, with a highly variable degree of disability during its long-term course. The majority of patients develop significant permanent disability later in life. MS is often diagnosed in women of childbearing age, with a 3:1 ratio of young women to young men with MS. Comorbidities such as depression, anxiety, migraines and reproductive, urological and bowel issues are common and negatively impact patients' quality of life. The objective of this supplement is to review the most common comorbidities occurring in young women with MS, and to propose a multidisciplinary, holistic approach to management.
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Affiliation(s)
- Galina Vorobeychik
- Department of Medicine, University of British Columbia, Vancouver, BC V5Z 1M9.,Fraser Health Multiple Sclerosis Clinic, Burnaby Hospital, Burnaby, BC V5G 2X6
| | - Denise Black
- Seine River Medical Centre, Winnipeg, MB R2N 0A5
| | - Paul Cooper
- Department of Clinical Neurological Sciences, Western University, London, ON N6A 3K7.,Schulich School of Medicine & Dentistry, London, ON N6A 5C1
| | - Ashley Cox
- Department of Urology, Dalhousie University, Halifax, NS B3H 1Y6
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15
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Impellizzeri F, Leonardi S, Latella D, Maggio MG, Foti Cuzzola M, Russo M, Sessa E, Bramanti P, De Luca R, Calabrò RS. An integrative cognitive rehabilitation using neurologic music therapy in multiple sclerosis: A pilot study. Medicine (Baltimore) 2020; 99:e18866. [PMID: 31977888 PMCID: PMC7004652 DOI: 10.1097/md.0000000000018866] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2019] [Revised: 11/06/2019] [Accepted: 12/04/2019] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Multiple sclerosis (MS) is a demyelinating disease, affecting both the sensorimotor and cognitive systems. The typical pattern of cognitive impairment includes reduced speed of information processing, decreased phonological and semantic speech fluency, deficits in verbal and visual episodic memory, as well as attention and executive dysfunctions. We aimed to investigate the influence of the neurologic music therapy (NMT) on mood, motivation, emotion status, and cognitive functions in patients with MS. METHODS Thirty patients with MS were randomly divided in 2 groups: the control group (CG) undergoing conventional cognitive rehabilitation (CCR), 6 times a week for 8 weeks, and the experimental group (EG) undergoing CCR 3 times a week for 8 weeks plus NMT techniques, performed 3 times a week for 8 weeks. All the participants were submitted to the same amount of treatment. Each patient was evaluated before (baseline: T0) and immediately after the end of each training (T1). MAIN OUTCOMES MEASURES We used as main outcome measure: the brief repeatable battery of neuropsychological test to assess various cognitive abilities; and the multiple sclerosis quality of life-54 (MSQoL-54). RESULTS Both the groups benefit from 8 weeks of CR. In particular, the EG got better results in cognitive function, with regard to selective reminding test long term storage (P < .000), long term retrieval (P = .007), and delayed recall of the 10/36 spatial recall test (P = .001), as compared with the CG. Moreover, the improvement in emotional status, motivation, mood and quality of life (with regard to the mental component; P < .000) was more evident in the EG. CONCLUSIONS NMT could be considered a complementary approach to enhance CCR in patients affected by MS.
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Affiliation(s)
- Federica Impellizzeri
- Istituto di Ricovero e Cura a Carattere Scientifico Centro Neurolesi “Bonino Pulejo”, Messina
| | - Simona Leonardi
- Istituto di Ricovero e Cura a Carattere Scientifico Centro Neurolesi “Bonino Pulejo”, Messina
| | - Dèsiréè Latella
- Istituto di Ricovero e Cura a Carattere Scientifico Centro Neurolesi “Bonino Pulejo”, Messina
| | - Maria Grazia Maggio
- Istituto di Ricovero e Cura a Carattere Scientifico Centro Neurolesi “Bonino Pulejo”, Messina
| | - Marilena Foti Cuzzola
- Istituto di Ricovero e Cura a Carattere Scientifico Centro Neurolesi “Bonino Pulejo”, Messina
| | - Margherita Russo
- Great Metropolitan Hospital – Bianchi-Melacrino-Morelli-, Reggio Calabria, Italy
| | - Edoardo Sessa
- Istituto di Ricovero e Cura a Carattere Scientifico Centro Neurolesi “Bonino Pulejo”, Messina
| | - Placido Bramanti
- Istituto di Ricovero e Cura a Carattere Scientifico Centro Neurolesi “Bonino Pulejo”, Messina
| | - Rosaria De Luca
- Istituto di Ricovero e Cura a Carattere Scientifico Centro Neurolesi “Bonino Pulejo”, Messina
| | - Rocco Salvatore Calabrò
- Istituto di Ricovero e Cura a Carattere Scientifico Centro Neurolesi “Bonino Pulejo”, Messina
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16
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Ratajska A, Zurawski J, Healy B, Glanz BI. Computerized Cognitive Behavioral Therapy for Treatment of Depression in Multiple Sclerosis: A Narrative Review of Current Findings and Future Directions. Int J MS Care 2019; 21:113-123. [PMID: 31191176 DOI: 10.7224/1537-2073.2017-094] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Depression is common in multiple sclerosis (MS), affecting up to 50% of patients at some point in their lifetime. Although the rate of depression in MS is higher than that in the general population and that in patients with other chronic medical conditions, depression in MS is underdiagnosed and undertreated. Antidepressant agents are used empirically in the management of MS-related depression, but evidence specifically demonstrating the efficacy of these medications in patients with MS is sparse. Considerable work suggests that psychological interventions such as cognitive behavioral therapy (CBT) may be effective in the management of depression in MS. Recently there has been an expansion of computerized adaptations of CBT, allowing patients to complete therapy sessions remotely via online programs. This article reviews our current understanding of depression in MS and the role of CBT in its management, focusing on recent developments in computerized formats for CBT. Four computerized CBT programs that have been previously tested in patients with MS are described: Deprexis, MoodGYM, Beating the Blues, and MS Invigor8. We conclude that despite challenges inherent to computerized CBT interventions, such platforms have the potential to positively affect mental health care delivery to the MS patient population.
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17
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Pereira GM, Soares NM, Souza ARD, Becker J, Finkelsztejn A, Almeida RMMD. Basal cortisol levels and the relationship with clinical symptoms in multiple sclerosis: a systematic review. ARQUIVOS DE NEURO-PSIQUIATRIA 2018; 76:622-634. [DOI: 10.1590/0004-282x20180091] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/15/2018] [Accepted: 06/06/2018] [Indexed: 01/06/2023]
Abstract
ABSTRACT Multiple sclerosis (MS) is a demyelinating, progressive and neurodegenerative disease. A disturbance on the hypothalamic-pituitary-adrenal axis can be observed in patients with MS, showing altered cortisol levels. We aimed to identify basal cortisol levels and verify the relationship with clinical symptoms in patients with MS. A systematic search was conducted in the databases: Pubmed, Web of Science and SCOPUS. Both higher and lower cortisol levels were associated with MS. Higher cortisol levels were associated with depression and anxiety, while lower levels were associated with depression, fatigue and urinary dysfunction. Higher cortisol levels may be associated with the progression and severity of MS.
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18
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Medina-Rodriguez EM, Lowell JA, Worthen RJ, Syed SA, Beurel E. Involvement of Innate and Adaptive Immune Systems Alterations in the Pathophysiology and Treatment of Depression. Front Neurosci 2018; 12:547. [PMID: 30174579 PMCID: PMC6107705 DOI: 10.3389/fnins.2018.00547] [Citation(s) in RCA: 59] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2018] [Accepted: 07/20/2018] [Indexed: 12/19/2022] Open
Abstract
Major depressive disorder (MDD) is a prevalent and debilitating disorder, often fatal. Treatment options are few and often do not provide immediate relief to the patients. The increasing involvement of inflammation in the pathology of MDD has provided new potential therapeutic avenues. Cytokine levels are elevated in the blood and cerebrospinal fluid of MDD patients whereas immune cells often exhibit an immunosuppressed phenotype in MDD patients. Blocking cytokine actions in patients exhibiting MDD show some antidepressant efficacy. However, the role of cytokines, and the immune response in MDD patients remain to be determined. We reviewed here the roles of the innate and adaptive immune systems in MDD, as well as potential mechanisms whereby the immune response might be regulated in MDD.
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Affiliation(s)
- Eva M Medina-Rodriguez
- Department of Psychiatry and Behavioral Sciences, Miller School of Medicine, University of Miami, Miami, FL, United States
| | - Jeffrey A Lowell
- Department of Psychiatry and Behavioral Sciences, Miller School of Medicine, University of Miami, Miami, FL, United States
| | - Ryan J Worthen
- Department of Psychiatry and Behavioral Sciences, Miller School of Medicine, University of Miami, Miami, FL, United States
| | - Shariful A Syed
- Department of Psychiatry and Behavioral Sciences, Miller School of Medicine, University of Miami, Miami, FL, United States
| | - Eléonore Beurel
- Department of Psychiatry and Behavioral Sciences, Miller School of Medicine, University of Miami, Miami, FL, United States.,Department of Biochemistry and Molecular Biology, Miller School of Medicine, University of Miami, Miami, FL, United States
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19
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Bakirtzis C, Ioannidis P, Messinis L, Nasios G, Konstantinopoulou E, Papathanasopoulos P, Grigoriadis N. The Rationale for Monitoring Cognitive Function in Multiple Sclerosis: Practical Issues for Clinicians. Open Neurol J 2018; 12:31-40. [PMID: 30008964 PMCID: PMC6008981 DOI: 10.2174/1874205x01812010031] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2018] [Revised: 04/14/2018] [Accepted: 05/07/2018] [Indexed: 11/22/2022] Open
Abstract
About half of patients with multiple sclerosis exhibit cognitive impairment which negatively affects their quality of life. The assessment of cognitive function in routine clinical practice is still undervalued, although various tools have been proposed for this reason. In this article, we describe the potential benefits of implementing cognitive assessment tools in routine follow -ups of MS patients. Early detection of changes in cognitive performance may provide evidence of disease activity, could unmask depression or medication side-effects and provide suitable candidates for cognitive rehabilitation. Since apathy and cognitive deficiencies are common presenting symptoms in Progressive Multifocal Leukoencephalopathy, we discuss the utility of frequent monitoring of mental status in multiple sclerosis patients at increased risk. In addition, we propose a relevant algorithm aiming to incorporate a systematic evaluation of cognitive function in every day clinical practice in multiple sclerosis.
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Affiliation(s)
- Christos Bakirtzis
- The Multiple Sclerosis Center, 2nd Department of Neurology, AHEPA University Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Panagiotis Ioannidis
- The Multiple Sclerosis Center, 2nd Department of Neurology, AHEPA University Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Lambros Messinis
- Department of Neurology, Neuropsychology Section, University of Patras Medical School, Patras, Greece
| | - Grigorios Nasios
- Department of Speech and Language Therapy, Higher Educational Institute of Epirus, Ioannina, Greece
| | - Elina Konstantinopoulou
- Lab of Cognitive Neuroscience, School of Psychology, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | | | - Nikolaos Grigoriadis
- The Multiple Sclerosis Center, 2nd Department of Neurology, AHEPA University Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
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20
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Peripheral Inflammatory Markers Contributing to Comorbidities in Autism. Behav Sci (Basel) 2016; 6:bs6040029. [PMID: 27983615 PMCID: PMC5197942 DOI: 10.3390/bs6040029] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2016] [Revised: 12/08/2016] [Accepted: 12/09/2016] [Indexed: 11/17/2022] Open
Abstract
This study evaluates the contribution of peripheral biomarkers to comorbidities and clinical findings in autism. Seventeen autistic children and age-matched typically developing (AMTD), between three to nine years old were evaluated. The diagnostic followed the Diagnostic and Statistical Manual of Mental Disorders 4th Edition (DMS-IV) and the Childhood Autism Rating Scale (CARS) was applied to classify the severity. Cytokine profile was evaluated in plasma using a sandwich type ELISA. Paraclinical events included electroencephalography (EEG) record. Statistical analysis was done to explore significant differences in cytokine profile between autism and AMTD groups and respect clinical and paraclinical parameters. Significant differences were found to IL-1β, IL-6, IL-17, IL-12p40, and IL-12p70 cytokines in individuals with autism compared with AMTD (p < 0.05). All autistic patients showed interictalepileptiform activity at EEG, however, only 37.5% suffered epilepsy. There was not a regional focalization of the abnormalities that were detectable with EEG in autistic patients with history of epilepsy. A higher IL-6 level was observed in patients without history of epilepsy with interictalepileptiform activity in the frontal brain region, p < 0.05. In conclusion, peripheral inflammatory markers might be useful as potential biomarkers to predict comorbidities in autism as well as reinforce and aid informed decision-making related to EEG findings in children with Autism spectrum disorders (ASD).
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CCL19 as a Chemokine Risk Factor for Posttreatment Lyme Disease Syndrome: a Prospective Clinical Cohort Study. CLINICAL AND VACCINE IMMUNOLOGY : CVI 2016; 23:757-66. [PMID: 27358211 DOI: 10.1128/cvi.00071-16] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/12/2016] [Accepted: 06/22/2016] [Indexed: 12/31/2022]
Abstract
Approximately 10% to 20% of patients optimally treated for early Lyme disease develop persistent symptoms of unknown pathophysiology termed posttreatment Lyme disease syndrome (PTLDS). The objective of this study was to investigate associations between PTLDS and immune mediator levels during acute illness and at several time points following treatment. Seventy-six participants with physician-documented erythema migrans and 26 healthy controls with no history of Lyme disease were enrolled. Sixty-four cytokines, chemokines, and inflammatory markers were measured at each visit for a total of 6 visits over 1 year. An operationalized definition of PTLDS incorporating symptoms and functional impact was applied at 6 months and 1 year following treatment completion, and clinical outcome groups were defined as the return-to-health, symptoms-only, and PTLDS groups. Significance analysis of microarrays identified 7 of the 64 immune mediators to be differentially regulated by group. Generalized logit regressions controlling for potential confounders identified posttreatment levels of the T-cell chemokine CCL19 to be independently associated with clinical outcome group. Receiver operating characteristic analysis identified a CCL19 cutoff of >111.67 pg/ml at 1 month following treatment completion to be 82% sensitive and 83% specific for later PTLDS. We speculate that persistently elevated CCL19 levels among participants with PTLDS may reflect ongoing, immune-driven reactions at sites distal to secondary lymphoid tissue. Our findings suggest the relevance of CCL19 both during acute infection and as an immunologic risk factor for PTLDS during the posttreatment phase. Identification of a potential biomarker predictor for PTLDS provides the opportunity to better understand its pathophysiology and to develop early interventions in the context of appropriate and specific clinical information.
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22
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Théaudin M, Romero K, Feinstein A. In multiple sclerosis anxiety, not depression, is related to gender. Mult Scler 2015; 22:239-44. [DOI: 10.1177/1352458515588582] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2015] [Accepted: 04/11/2015] [Indexed: 01/21/2023]
Abstract
Background: There is a high prevalence of depressive and anxiety disorders in multiple sclerosis (MS), a disease 2.5 times more frequent in females. Contrary to the general population, in whom studies have demonstrated higher rates of depression and anxiety in females, little is known about the impact of gender on psychiatric sequelae in MS patients. Objectives: We conducted a retrospective study to try to clarify this uncertainty. Methods: Demographic, illness-related and behavioral variables were obtained from a neuropsychiatric database of 896 patients with a confirmed diagnosis of MS. Symptoms of depression and anxiety were obtained with the Hospital Anxiety and Depression Scale (HADS). Gender comparisons were undertaken and predictors of depression and anxiety sought with a linear regression analysis. Results: HADS data were available for 711 of 896 (79.35%) patients. Notable gender differences included a higher frequency of primary progressive MS in males ( p = 0.002), higher HADS anxiety scores in females ( p < 0.001), but no differences in HADS depression scores. Conclusion: In MS, gender influences the frequency of anxiety only. This suggests that the etiological factors underpinning anxiety and depression in MS are not only different from one another, but also in the case of depression, different from those observed in general population samples.
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Affiliation(s)
- Marie Théaudin
- Sunnybrook Health Sciences Centre, Canada/MS Clinic Saint Michael’s Hospital, Canada
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23
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Melnikov MV, Pashchekov МV, Boyко AN. Psychoneuroimmunology and multiple sclerosis. Zh Nevrol Psikhiatr Im S S Korsakova 2015; 115:8-15. [DOI: 10.17116/jnevro2015115228-15] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
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Altered cytokine and BDNF levels in autism spectrum disorder. Neurotox Res 2013; 24:491-501. [PMID: 23604965 DOI: 10.1007/s12640-013-9393-4] [Citation(s) in RCA: 110] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2012] [Revised: 04/09/2013] [Accepted: 04/10/2013] [Indexed: 01/08/2023]
Abstract
The contribution of neuroimmune functioning and brain-derived neurotrophic factor (BDNF) to functional dysregulation in autism spectrum disorder was assessed in 29 patients under treatment in two specialized centers of Basilicata (Chiaromonte and Matera), Southern Italy, through analysis of serum levels of cytokines and BDNF. Elevated levels of the pro-inflammatory cytokine, including interleukin-1, interleukin-6, interleukin-12, interleukin-23, tumor necrosis factor-α and BDNF were observed, regardless of age and gender. Comparisons were made with age- and gender-related healthy controls. The present findings reinforce current notions regarding immunoexcitotoxic mechanisms contributing to the pathophysiology of autistic disorder.
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25
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Morphostructural MRI abnormalities related to neuropsychiatric disorders associated to multiple sclerosis. Mult Scler Int 2013; 2013:102454. [PMID: 23691320 PMCID: PMC3654321 DOI: 10.1155/2013/102454] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2013] [Accepted: 03/27/2013] [Indexed: 11/17/2022] Open
Abstract
Multiple Sclerosis associated neuropsychiatric disorders include major depression (MD), obsessive-compulsive disorder (OCD), bipolar affective disorder, euphoria, pseudobulbar affect, psychosis, and personality change. Magnetic Resonance Imaging (MRI) studies focused mainly on identifying morphostructural correlates of MD; only a few anecdotal cases on OCD associated to MS (OCD-MS), euphoria, pseudobulbar affect, psychosis, personality change, and one research article on MRI abnormalities in OCD-MS have been published. Therefore, in the present review we will report mainly on neuroimaging abnormalities found in MS patients with MD and OCD. All together, the studies on MD associated to MS suggest that, in this disease, depression is linked to a damage involving mainly frontotemporal regions either with discrete lesions (with those visible in T1 weighted images playing a more significant role) or subtle normal appearing white matter abnormalities. Hippocampal atrophy, as well, seems to be involved in MS related depression. It is conceivable that grey matter pathology (i.e., global and regional atrophy, cortical lesions), which occurs early in the course of disease, may involve several areas including the dorsolateral prefrontal cortex, the orbitofrontal cortex, and the anterior cingulate cortex whose disruption is currently thought to explain late-life depression. Further MRI studies are necessary to better elucidate OCD pathogenesis in MS.
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26
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Harald B, Gordon P. Meta-review of depressive subtyping models. J Affect Disord 2012; 139:126-40. [PMID: 21885128 DOI: 10.1016/j.jad.2011.07.015] [Citation(s) in RCA: 212] [Impact Index Per Article: 17.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2011] [Revised: 05/11/2011] [Accepted: 07/15/2011] [Indexed: 10/17/2022]
Abstract
BACKGROUND Increasing dissatisfaction with the non-specificity of major depression has led many to propose more specific depressive subtyping models. The present meta-review seeks to map dominant depressive subtype models, and highlight definitions and overlaps. METHODS A database search in Medline and EMBASE of proposed depressive subtypes, and limited to reviews published between 2000 and 2011, was undertaken. Of the more than four thousand reviews, 754 were judged as potentially relevant and provided the base for the present selective meta-review. RESULTS Fifteen subtype models were identified. The subtypes could be divided into five molar categories of (1) symptom-based subtypes, such as melancholia, psychotic depression, atypical depression and anxious depression, (2) aetiologically-based subtypes, exemplified by adjustment disorders, early trauma depression, reproductive depression, perinatal depression, organic depression and drug-induced depression, (3) time of onset-based subtypes, as illustrated by early and late onset depression, as well as seasonal affective disorder, (4) gender-based (e.g. female) depression, and (5) treatment resistant depression. An overview considering definition, bio-psycho-social correlates and the evidence base of treatment options for each subtype is provided. LIMITATIONS Despite the large data base, this meta-review is nevertheless narrative focused. CONCLUSIONS Subtyping depression is a promising attempt to overcome the non-specificity of many diagnostic constructs such as major depression, both in relation to their intrinsic non-specificity and failure to provide treatment-specific information. If a subtyping model is to be advanced it would need, however, to demonstrate differential impacts of causes and treatments.
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Fischer A, Heesen C, Gold SM. Biological outcome measurements for behavioral interventions in multiple sclerosis. Ther Adv Neurol Disord 2011; 4:217-29. [PMID: 21765872 DOI: 10.1177/1756285611405252] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
Behavioral interventions including exercise, stress management, patient education, psychotherapy and multidisciplinary neurorehabilitation in general are receiving increasing recognition in multiple sclerosis (MS) clinical practice and research. Most scientific evaluations of these approaches have focused on psychosocial outcome measures such as quality of life, fatigue or depression. However, it is becoming increasingly clear that neuropsychiatric symptoms of MS are at least partially mediated by biological processes such as inflammation, neuroendocrine dysfunction or regional brain damage. Thus, successful treatment of these symptoms with behavioral approaches could potentially also affect the underlying biology. Rigidly designed scientific studies are needed to explore the potential of such interventions to affect MS pathology and biological pathways linked to psychological and neuropsychiatric symptoms of MS. Such studies need to carefully select outcome measures on the behavioral level that are likely to be influenced by the specific intervention strategy and should include biomarkers with evidence for an association with the outcome parameter in question. In this overview, we illustrate how biological and psychological outcome parameters can be combined to evaluate behavioral interventions. We focus on two areas of interest as potential targets for behavioral interventions: depression and fatigue.
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Affiliation(s)
- Anja Fischer
- Institute for Neuroimmunology and Clinical Multiple Sclerosis Research (inims), University Hospital Hamburg, Eppendorf, Germany
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Loftis JM, Choi D, Hoffman W, Huckans MS. Methamphetamine causes persistent immune dysregulation: a cross-species, translational report. Neurotox Res 2011; 20:59-68. [PMID: 20953917 PMCID: PMC3081419 DOI: 10.1007/s12640-010-9223-x] [Citation(s) in RCA: 82] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2010] [Revised: 09/10/2010] [Accepted: 09/27/2010] [Indexed: 10/18/2022]
Abstract
Methamphetamine (MA) dependence causes serious cognitive impairments that can persist during abstinence and negatively affect recovery outcomes. Evidence suggests that immune factors, such as cytokines, chemokines, and cellular adhesion molecules, contribute to MA-induced immune dysfunction, neuronal injury, and persistent cognitive impairments, yet the role of MA-induced brain inflammation remains unclear. To address this question, we used a cross-species, translational approach. Thirty-two male C57BL/6J mice were administered MA (1 mg/kg) or saline subcutaneously for seven consecutive days. Mice were euthanized at 72 h or 3 weeks after the last drug dose, and blood and brain samples were collected. In addition, 20 adults in remission from MA dependence and 20 non-dependent controls completed neuropsychological assessments and a blood draw. Multiplex assays were used to measure cytokine, chemokine, and intercellular adhesion molecule (ICAM-1) expression in mouse and human samples. A number of significant MA-induced changes in neuroimmune factors were observed. Of particular interest were the chemokine monocyte chemoattractant protein 1 (MCP-1) and the cellular adhesion molecule ICAM-1, which were similarly increased in the plasma of MA exposed mice as well as humans. In human participants, MA-induced changes in the cytokine and chemokine milieu were accompanied by increased cognitive impairments. Mice showing MA-induced changes in peripheral immune molecule expression also had significant brain-region specific changes in pro-inflammatory cytokines, chemokines, and ICAM-1. This cross-species, translational study suggests that chronic CNS immune dysregulation may in part contribute to the longlasting neuropsychiatric consequences of MA dependence.
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Affiliation(s)
- Jennifer M Loftis
- Research & Development Service, Portland VA Medical Center, 3710 SW U.S. Veterans Hospital Rd., R&D 16, Portland, OR 97239, USA.
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Kinsbourne M. The Immune system's moderating response to inflammation relieves autistic behavior: response to Peter Good. Neuropsychol Rev 2011; 21:68-9. [PMID: 21240676 DOI: 10.1007/s11065-011-9158-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2011] [Accepted: 01/06/2011] [Indexed: 11/26/2022]
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Barwick FH, Arnett PA. Relationship between global cognitive decline and depressive symptoms in multiple sclerosis. Clin Neuropsychol 2011; 25:193-209. [PMID: 21246447 DOI: 10.1080/13854046.2010.538435] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Cognitive impairment and depressed mood are common symptoms in multiple sclerosis (MS), which significantly impact patients' role functioning and quality of life. Cross-sectional studies indicate a modest association between cognitive impairment and depressive symptoms in MS. Longitudinal studies show inconsistent results but provide some data indicating a relationship between increasing global cognitive decline and increasing depressive symptoms over time. Establishing whether such a relationship exists represents an important first step in understanding the temporal nature of that relationship along with any treatment implications. The current study investigated this relationship by using the adjusted difference between a demographic estimate of premorbid intellectual functioning (Barona) and a performance measure of current intellectual functioning (Shipley Institute of Living) to capture long-term global cognitive decline in MS patients. Degree of global cognitive decline was then related to a self-report measure of mood, evaluative, and vegetative depression symptoms (Chicago Multiscale Depression Inventory). Global cognitive decline accounted for 5% of the variance in mood-evaluative symptoms but none of the variance in vegetative symptoms. When groups experiencing moderate, mild, and no global cognitive decline were compared on depression symptom subscales, MS patients experiencing moderate cognitive decline reported significantly higher mood and evaluative, but not vegetative, depressive symptoms than MS patients with stable cognitive functioning.
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Affiliation(s)
- Fiona H Barwick
- Psychology Department, The Pennsylvania State University, University Park, PA 16802, USA.
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Paparrigopoulos T, Ferentinos P, Kouzoupis A, Koutsis G, Papadimitriou GN. The neuropsychiatry of multiple sclerosis: focus on disorders of mood, affect and behaviour. Int Rev Psychiatry 2010; 22:14-21. [PMID: 20233111 DOI: 10.3109/09540261003589323] [Citation(s) in RCA: 102] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Neuropsychiatric symptoms are common in multiple sclerosis (MS). They include two broad categories of disturbances: abnormalities in cognition, and abnormalities of mood, affect and behaviour. The present review deals with the epidemiology, clinical features, etiology and treatment of disturbances included in the second category, i.e., major depression, fatigue and sleep disorders, bipolar disorder, euphoria, pathological laughing and crying, anxiety, psychosis and personality changes. Major depression is one of the most common neuropsychiatric disorders in MS with an approximate 50% lifetime prevalence rate. Early recognition and management of depression in MS is of major importance because it is a key predictor of morbidity, mortality, quality of life, possibly physical outcome and disease exacerbations, adherence to immunomodulatory treatments and suicide risk in MS patients, as well as of the caregiver's distress and quality of life. The etiopathogenesis of neuropsychiatric disorders in MS has been incompletely investigated. It is postulated that a complex interplay of biological, disease-related, behavioural and psychosocial factors contribute to the pathophysiology of most of them. Management of neuropsychiatric symptoms in MS is often effective, although commonly based on evidence provided by case studies and uncontrolled trials. A comprehensive biopsychosocial neuropsychiatric approach is essential for the optimal care of patients with MS.
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Affiliation(s)
- Thomas Paparrigopoulos
- First Department of Psychiatry, Athens University Medical School, 115 28, Athens, Greece.
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Trecker CC, Kozubal DE, Quigg M, Hammond E, Krishnan C, Sim PA, Kaplin AI. Quality care in transverse myelitis: a responsive protocol. J Child Neurol 2009; 24:577-83. [PMID: 19211922 DOI: 10.1177/0883073808325655] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
This study was conducted to aid in the development of a multidisciplinary care center for patients with transverse myelitis. We surveyed the parents of 20 children diagnosed with transverse myelitis between the ages of 0.5 and 21 years to understand their experiences in navigating the health care system. We analyzed acute care events and long-term follow-up in relation to patient satisfaction. Results showed satisfactory ratings in the vicinity of 50% in key areas such as the articulation of a treatment plan. A significant disparity was found in the patients' desire for specialty care and their ability to procure such care. In all, 90% of patients expressed a desire to consult with a psychiatrist, but only 25% were successful in making a visit, a 64% deficit; 70% of respondents also desired to see a gastroenterologist, with only 25% actually doing so, leaving a 43% gap. Recommendations and patient opinions regarding the creation of a collaborative care environment are noted. Research with a larger sample will further elucidate the needs in transverse myelitis patient care.
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Zaffaroni M, Marino F, Bombelli R, Rasini E, Monti M, Ferrari M, Ghezzi A, Comi G, Lecchini S, Cosentino M. Therapy with interferon-beta modulates endogenous catecholamines in lymphocytes of patients with multiple sclerosis. Exp Neurol 2008; 214:315-21. [PMID: 18824168 DOI: 10.1016/j.expneurol.2008.08.015] [Citation(s) in RCA: 43] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2008] [Revised: 08/14/2008] [Accepted: 08/29/2008] [Indexed: 01/20/2023]
Abstract
OBJECTIVE To investigate the endogenous dopaminergic/adrenergic system of lymphocytes in multiple sclerosis (MS) patients during treatment with interferon (IFN)-beta. METHODS Patients with relapsing-remitting MS undergoing IFN-beta treatment were prospectively studied during the first year of treatment. Circulating lymphocytes were obtained at baseline and after 1, 3, 6 and 12 months of treatment and assayed for catecholamine (CA) production and mRNA expression of tyrosine hydroxylase (TH, the rate-limiting enzyme in the synthesis of CA), beta(2)-adrenoceptors (AR) and D2, D3 and D5 dopaminergic receptors (DR). RESULTS In cells from patients treated with IFN-beta for 12 months the production of CA hugely increased and was less sensitive to IFN-gamma-induced inhibition. Expression of mRNA for TH, beta(2)-AR and DRD5 was already enhanced after 1 month and further increased up to 6-12 months of treatment. On the contrary, DRD2 mRNA progressively decreased and DRD3 mRNA did not significantly change over the whole study period. CONCLUSIONS In MS patients IFN-beta treatment enhances the ability of lymphocytes to produce CA, and induces extensive modifications of both beta(2)-AR and DR-operated pathways. The clinical relevance of these effects deserves consideration.
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Affiliation(s)
- Mauro Zaffaroni
- Multiple Sclerosis Center, Hospital S. Antonio Abate, Gallarate, VA, Italy
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