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Parsaei M, Hasehmi SM, Seyedmirzaei H, Cattarinussi G, Sambataro F, Brambilla P, Delvecchio G. Microstructural white matter alterations associated with social anxiety disorders: A systematic review. J Affect Disord 2024; 350:78-88. [PMID: 38220105 DOI: 10.1016/j.jad.2024.01.118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Revised: 12/04/2023] [Accepted: 01/09/2024] [Indexed: 01/16/2024]
Abstract
BACKGROUND Social anxiety disorder (SAD) is a psychiatric condition characterized by impaired social functioning that negatively impacts individuals' quality of life. Previous neuroimaging studies have revealed morphological and functional changes in various brain regions associated with SAD. Recent advances in diffusion tensor imaging (DTI) and diffusion-weighted imaging (DWI) have enabled the investigation of microstructural white matter (WM) alterations in SAD. This study aims to provide an overview of DTI/DWI studies exploring WM microstructure changes in SAD. METHODS A systematic search on PubMed, Scopus, Web of Science, and PsycINFO was conducted for relevant records on July 8, 2023. An exploratory meta-analysis was also performed. RESULTS Eight studies were reviewed. Consistent findings indicated reduced fractional anisotropy and increased diffusivity measures in different WM tracts in SAD patients compared to healthy controls. These alterations were mostly observed within regions of the fronto-limbic network, like uncinate fasciculus (UF) and superior and inferior longitudinal fasciculi (SLF and ILF). Finally, our exploratory meta-analysis on four studies utilizing a voxel-wise analytic approach yielded no significant differences between SAD patients and controls. LIMITATIONS Limited number of studies, small sample sizes, and heterogeneity in analysis methods. CONCLUSIONS Patients with SAD exhibited altered WM integrity, particularly in the UF, SLF, and ILF, compared to healthy controls. However, due to the limited number of included studies, our meta-analysis yielded no significant differences between SAD patients and controls. Therefore, future research is crucial to unravel the link between altered WM structure and the involvement of other limbic and cortical structures in SAD pathogenesis.
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Affiliation(s)
- Mohammadamin Parsaei
- Maternal, Fetal & Neonatal Research Center, Family Health Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Homa Seyedmirzaei
- School of Medicine, Tehran University of Medical Sciences, Tehran, Iran; Interdisciplinary Neuroscience Research Program Tehran University of Medical Sciences, Tehran, Iran
| | - Giulia Cattarinussi
- Department of Neuroscience (DNS), Padua Neuroscience Center, University of Padova, Padua, Italy; Padua Neuroscience Center, University of Padova, Padua, Italy
| | - Fabio Sambataro
- Department of Neuroscience (DNS), Padua Neuroscience Center, University of Padova, Padua, Italy; Padua Neuroscience Center, University of Padova, Padua, Italy
| | - Paolo Brambilla
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy; Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Giuseppe Delvecchio
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
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Parsaei M, Arvin A, Taebi M, Seyedmirzaei H, Cattarinussi G, Sambataro F, Pigoni A, Brambilla P, Delvecchio G. Machine Learning for prediction of violent behaviors in schizophrenia spectrum disorders: a systematic review. Front Psychiatry 2024; 15:1384828. [PMID: 38577400 PMCID: PMC10991827 DOI: 10.3389/fpsyt.2024.1384828] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2024] [Accepted: 03/08/2024] [Indexed: 04/06/2024] Open
Abstract
Background Schizophrenia spectrum disorders (SSD) can be associated with an increased risk of violent behavior (VB), which can harm patients, others, and properties. Prediction of VB could help reduce the SSD burden on patients and healthcare systems. Some recent studies have used machine learning (ML) algorithms to identify SSD patients at risk of VB. In this article, we aimed to review studies that used ML to predict VB in SSD patients and discuss the most successful ML methods and predictors of VB. Methods We performed a systematic search in PubMed, Web of Sciences, Embase, and PsycINFO on September 30, 2023, to identify studies on the application of ML in predicting VB in SSD patients. Results We included 18 studies with data from 11,733 patients diagnosed with SSD. Different ML models demonstrated mixed performance with an area under the receiver operating characteristic curve of 0.56-0.95 and an accuracy of 50.27-90.67% in predicting violence among SSD patients. Our comparative analysis demonstrated a superior performance for the gradient boosting model, compared to other ML models in predicting VB among SSD patients. Various sociodemographic, clinical, metabolic, and neuroimaging features were associated with VB, with age and olanzapine equivalent dose at the time of discharge being the most frequently identified factors. Conclusion ML models demonstrated varied VB prediction performance in SSD patients, with gradient boosting outperforming. Further research is warranted for clinical applications of ML methods in this field.
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Affiliation(s)
- Mohammadamin Parsaei
- Maternal, Fetal & Neonatal Research Center, Family Health Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Alireza Arvin
- Center for Orthopedic Trans-disciplinary Applied Research (COTAR), Tehran University of Medical Sciences, Tehran, Iran
| | - Morvarid Taebi
- Center for Orthopedic Trans-disciplinary Applied Research (COTAR), Tehran University of Medical Sciences, Tehran, Iran
| | - Homa Seyedmirzaei
- Sports Medicine Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Giulia Cattarinussi
- Department of Neuroscience (DNS), Padua Neuroscience Center, University of Padova, Padua, Italy
- Padua Neuroscience Center, University of Padova, Padua, Italy
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, Kings College London, London, United Kingdom
| | - Fabio Sambataro
- Department of Neuroscience (DNS), Padua Neuroscience Center, University of Padova, Padua, Italy
- Padua Neuroscience Center, University of Padova, Padua, Italy
| | - Alessandro Pigoni
- Social and Affective Neuroscience Group, MoMiLab, Institutions, Markets, Technologies (IMT) School for Advanced Studies Lucca, Lucca, Italy
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - Paolo Brambilla
- Social and Affective Neuroscience Group, MoMiLab, Institutions, Markets, Technologies (IMT) School for Advanced Studies Lucca, Lucca, Italy
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
- Department of Neurosciences and Mental Health, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Giuseppe Delvecchio
- Department of Neurosciences and Mental Health, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
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Pigoni A, Delvecchio G, Turtulici N, Madonna D, Pietrini P, Cecchetti L, Brambilla P. Machine learning and the prediction of suicide in psychiatric populations: a systematic review. Transl Psychiatry 2024; 14:140. [PMID: 38461283 PMCID: PMC10925059 DOI: 10.1038/s41398-024-02852-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Revised: 02/22/2024] [Accepted: 02/22/2024] [Indexed: 03/11/2024] Open
Abstract
Machine learning (ML) has emerged as a promising tool to enhance suicidal prediction. However, as many large-sample studies mixed psychiatric and non-psychiatric populations, a formal psychiatric diagnosis emerged as a strong predictor of suicidal risk, overshadowing more subtle risk factors specific to distinct populations. To overcome this limitation, we conducted a systematic review of ML studies evaluating suicidal behaviors exclusively in psychiatric clinical populations. A systematic literature search was performed from inception through November 17, 2022 on PubMed, EMBASE, and Scopus following the PRISMA guidelines. Original research using ML techniques to assess the risk of suicide or predict suicide attempts in the psychiatric population were included. An assessment for bias risk was performed using the transparent reporting of a multivariable prediction model for individual prognosis or diagnosis (TRIPOD) guidelines. About 1032 studies were retrieved, and 81 satisfied the inclusion criteria and were included for qualitative synthesis. Clinical and demographic features were the most frequently employed and random forest, support vector machine, and convolutional neural network performed better in terms of accuracy than other algorithms when directly compared. Despite heterogeneity in procedures, most studies reported an accuracy of 70% or greater based on features such as previous attempts, severity of the disorder, and pharmacological treatments. Although the evidence reported is promising, ML algorithms for suicidal prediction still present limitations, including the lack of neurobiological and imaging data and the lack of external validation samples. Overcoming these issues may lead to the development of models to adopt in clinical practice. Further research is warranted to boost a field that holds the potential to critically impact suicide mortality.
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Affiliation(s)
- Alessandro Pigoni
- Social and Affective Neuroscience Group, MoMiLab, IMT School for Advanced Studies Lucca, Lucca, Italy
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - Giuseppe Delvecchio
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - Nunzio Turtulici
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - Domenico Madonna
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - Pietro Pietrini
- MoMiLab, IMT School for Advanced Studies Lucca, Lucca, Italy
| | - Luca Cecchetti
- Social and Affective Neuroscience Group, MoMiLab, IMT School for Advanced Studies Lucca, Lucca, Italy
| | - Paolo Brambilla
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy.
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy.
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Maggioni E, Pigoni A, Fontana E, Delvecchio G, Bonivento C, Bianchi V, Mauri M, Bellina M, Girometti R, Agarwal N, Nobile M, Brambilla P. Right frontal cingulate cortex mediates the effect of prenatal complications on youth internalizing behaviors. Mol Psychiatry 2024:10.1038/s41380-024-02475-y. [PMID: 38378927 DOI: 10.1038/s41380-024-02475-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Revised: 01/26/2024] [Accepted: 01/31/2024] [Indexed: 02/22/2024]
Abstract
Prenatal and perinatal complications represent well-known risk factors for the future development of psychiatric disorders. Such influence might become manifested during childhood and adolescence, as key periods for brain and behavioral changes. Internalizing and externalizing behaviors in adolescence have been associated with the risk of psychiatric onset later in life. Both brain morphology and behavior seem to be affected by obstetric complications, but a clear link among these three aspects is missing. Here, we aimed at analyzing the association between prenatal and perinatal complications, behavioral issues, and brain volumes in a group of children and adolescents. Eighty-two children and adolescents with emotional-behavioral problems underwent clinical and 3 T brain magnetic resonance imaging (MRI) assessments. The former included information on behavior, through the Child Behavior Checklist/6-18 (CBCL/6-18), and on the occurrence of obstetric complications. The relationships between clinical and gray matter volume (GMV) measures were investigated through multiple generalized linear models and mediation models. We found a mutual link between prenatal complications, GMV alterations in the frontal gyrus, and withdrawn problems. Specifically, complications during pregnancy were associated with higher CBCL/6-18 withdrawn scores and GMV reductions in the right superior frontal gyrus and anterior cingulate cortex. Finally, a mediation effect of these GMV measures on the association between prenatal complications and the withdrawn dimension was identified. Our findings suggest a key role of obstetric complications in affecting brain structure and behavior. For the first time, a mediator role of frontal GMV in the relationship between prenatal complications and internalizing symptoms was suggested. Once replicated on independent cohorts, this evidence will have relevant implications for planning preventive interventions.
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Affiliation(s)
- Eleonora Maggioni
- Department of Electronics Information and Bioengineering, Politecnico di Milano, Milano, Italy
| | - Alessandro Pigoni
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
- Social and Affective Neuroscience Group, MoMiLab, IMT School for Advanced Studies Lucca, Lucca, Italy
| | - Elisa Fontana
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - Giuseppe Delvecchio
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | | | - Valentina Bianchi
- Child and Adolescent Psychiatry Unit, Scientific Institute IRCCS "Eugenio Medea", Bosisio Parini (Lc), Italy
| | - Maddalena Mauri
- Child and Adolescent Psychiatry Unit, Scientific Institute IRCCS "Eugenio Medea", Bosisio Parini (Lc), Italy
| | - Monica Bellina
- Child and Adolescent Psychiatry Unit, Scientific Institute IRCCS "Eugenio Medea", Bosisio Parini (Lc), Italy
| | - Rossano Girometti
- Institute of Radiology, Department of Medicine (DMED), University of Udine, Udine, Italy
- University Hospital S. Maria Della Misericordia, Azienda Sanitaria Universitaria Friuli Centrale (ASUFC), Udine, Italy
| | - Nivedita Agarwal
- Neuroimaging Unit, Scientific Institute IRCCS "Eugenio Medea", Bosisio Parini (Lc), Italy
| | - Maria Nobile
- Child and Adolescent Psychiatry Unit, Scientific Institute IRCCS "Eugenio Medea", Bosisio Parini (Lc), Italy
| | - Paolo Brambilla
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy.
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Dusi N, Esposito CM, Delvecchio G, Prunas C, Brambilla P. Case report and systematic review of cerebellar vermis alterations in psychosis. Int Clin Psychopharmacol 2024:00004850-990000000-00123. [PMID: 38266159 DOI: 10.1097/yic.0000000000000535] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/26/2024]
Abstract
INTRODUCTION Cerebellar alterations, including both volumetric changes in the cerebellar vermis and dysfunctions of the corticocerebellar connections, have been documented in psychotic disorders. Starting from the clinical observation of a bipolar patient with cerebellar hypoplasia, the purpose of this review is to summarize the data in the literature about the association between hypoplasia of the cerebellar vermis and psychotic disorders [schizophrenia (SCZ) and bipolar disorder (BD)]. METHODS A bibliographic search on PubMed has been conducted, and 18 articles were finally included in the review: five used patients with BD, 12 patients with SCZ and one subject at psychotic risk. RESULTS For SCZ patients and subjects at psychotic risk, the results of most of the reviewed studies seem to suggest a gray matter volume reduction coupled with an increase in white matter volumes in the cerebellar vermis, compared to healthy controls. Instead, the results of the studies on BD patients are more heterogeneous with evidence showing a reduction, no difference or even an increase in cerebellar vermis volume compared to healthy controls. CONCLUSIONS From the results of the reviewed studies, a possible correlation emerged between cerebellar vermis hypoplasia and psychotic disorders, especially SCZ, ultimately supporting the hypothesis of psychotic disorders as neurodevelopmental disorders.
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Affiliation(s)
- Nicola Dusi
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan
| | | | - Giuseppe Delvecchio
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan
| | - Cecilia Prunas
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan
| | - Paolo Brambilla
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan
- Department of Pathophisiology and Transplantation, University of Milan, Milan, Italy
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Videtta G, Squarcina L, Prunas C, Brambilla P, Delvecchio G. White matter integrity and medication response to antidepressants in major depressive disorder: a review of the literature. Front Psychiatry 2024; 14:1335706. [PMID: 38361831 PMCID: PMC10867229 DOI: 10.3389/fpsyt.2023.1335706] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Accepted: 12/27/2023] [Indexed: 02/17/2024] Open
Abstract
Major Depressive Disorder (MDD) is a severe psychiatric disorder characterized by selective impairments in mood regulation, cognition and behavior. Although it is well-known that antidepressants can effectively treat moderate to severe depression, the biochemical effects of these medications on white matter (WM) integrity are still unclear. Therefore, the aim of the study is to review the main scientific evidence on the differences in WM integrity in responders and non-responders to antidepressant medications. A record search was performed on three datasets (PubMed, Scopus and Web of Science) and ten records matched our inclusion criteria. Overall, the reviewed studies highlighted a good efficacy of antidepressants in MDD treatment. Furthermore, there were differences in WM integrity between responders and non-responders, mainly localized in cingulate cortices, hippocampus and corpus callosum, where the former group showed higher fractional anisotropy and lower axial diffusivity values. Modifications in WM integrity might be partially explained by branching and proliferation as well as neurogenesis of axonal fibers mediated by antidepressants, which in turn may have positively affected brain metabolism and increase the quantity of the serotonergic neurotransmitter within synaptic clefts. However, the reviewed studies suffer from some limitations, including the heterogeneity in treatment duration, antidepressant administration, medical posology, and psychiatric comorbidities. Therefore, future studies are needed to reduce confounding effects of antidepressant medications and to adopt longitudinal and multimodal approaches in order to better characterize the differences in WM integrity between responders and non-responders.
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Affiliation(s)
- Giovanni Videtta
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
| | - Letizia Squarcina
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - Cecilia Prunas
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Paolo Brambilla
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Giuseppe Delvecchio
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
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Cattarinussi G, Pouya P, Grimaldi DA, Dini MZ, Sambataro F, Brambilla P, Delvecchio G. Cortical alterations in relatives of patients with bipolar disorder: A review of magnetic resonance imaging studies. J Affect Disord 2024; 345:234-243. [PMID: 37865341 DOI: 10.1016/j.jad.2023.10.097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Revised: 09/11/2023] [Accepted: 10/15/2023] [Indexed: 10/23/2023]
Abstract
INTRODUCTION Bipolar disorder (BD) is a severe mental disorder characterized by high heritability rates. Widespread brain cortical alterations have been reported in BD patients, mostly involving the frontal, temporal and parietal regions. Importantly, also unaffected relatives of BD patients (BD-RELs) present abnormalities in cortical measures, which are not influenced by disease-related factors, such as medication use and illness duration. Here, we collected all available evidence on cortical measures in BD-RELs to further our knowledge on the potential cortical alterations associated with the vulnerability and the resilience to BD. METHODS A search on PubMed, Web of Science and Scopus was performed to identify neuroimaging studies exploring cortical alterations in BD-RELs, including cortical thickness (CT), surface area (SA), gyrification (GI) and cortical complexity. Eleven studies were included. Of these, five assessed CT, five examined CT and SA and one explored CT, SA and GI. RESULTS Overall, a heterogeneous pattern of cortical alterations emerged. The areas more consistently linked with genetic liability for BD were the prefrontal and sensorimotor regions. Mixed evidence was reported in the temporal and cingulate areas. LIMITATIONS The small sample size and the heterogeneity in terms of methodologies and the characteristics of the participants limit the generalizability of our results. CONCLUSIONS Our findings suggest that the genetic liability for BD is related to reduced CT in the prefrontal cortex, which might be a marker of risk for BD, and increased CT within the sensorimotor cortex, which could represent a marker of resilience.
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Affiliation(s)
- Giulia Cattarinussi
- Department of Neuroscience (DNS), Padua Neuroscience Center, University of Padova, Padua, Italy; Padua Neuroscience Center, University of Padova, Padua, Italy
| | - Parnia Pouya
- Research Center for Evidence-Based Medicine, Health Management and Safety Promotion Research Institute, Tabriz University of Medical Sciences, Tabriz, Iran; Iranian EBM Center: A Joanna Briggs Institute Affiliated Group, Iran; Student Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran
| | | | - Mahta Zare Dini
- Research Center for Evidence-Based Medicine, Health Management and Safety Promotion Research Institute, Tabriz University of Medical Sciences, Tabriz, Iran; Iranian EBM Center: A Joanna Briggs Institute Affiliated Group, Iran; Student Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Fabio Sambataro
- Department of Neuroscience (DNS), Padua Neuroscience Center, University of Padova, Padua, Italy; Padua Neuroscience Center, University of Padova, Padua, Italy
| | - Paolo Brambilla
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy; Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - Giuseppe Delvecchio
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy.
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Bracco L, Dusi N, Moltrasio C, Brambilla P, Delvecchio G. Structural and functional brain imaging after treatment with selective-serotonin reuptake-inhibitors in obsessive-compulsive disorder: A mini review. J Affect Disord 2024; 345:141-148. [PMID: 37820957 DOI: 10.1016/j.jad.2023.10.034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Revised: 10/02/2023] [Accepted: 10/08/2023] [Indexed: 10/13/2023]
Abstract
BACKGROUND Obsessive-compulsive disorder (OCD) is a psychiatric disorder whose etiopathogenesis, according to various neuroimaging studies, seems to be linked to selective dysfunctions in regions within the cortico-striatal-thalamo-cortical circuit. Selective Serotonin Reuptake Inhibitors (SSRIs) are the first-line therapy for OCD but their neurobiological effects on the brain is only partially understood. Therefore, the aim of this review is to highlight structural and functional brain imaging modifications induced by SSRIs treatment. METHODS A literature search on PubMed, Psych-Info and Embase database was performed. Studies including patients with OCD that analyzed the effect of SSRIs through structural and functional Magnetic Resonance Imaging were selected. Seven relevant studies were considered eligible for the present review. RESULTS Overall, the results of the reviewed studies showed that SSRIs treatment seems to normalize structural, in terms of the white matter and gray matter volumes, and functional activity alterations observed in OCD patients, especially in regions within the prefrontal cortex and striatum. LIMITATIONS The poor design of the studies, the small and heterogeneous samples, differences in age, gender, illness course, comorbidities, treatment protocols and the different magnetic fields used make it difficult to generalize the results. CONCLUSIONS From the available evidence it emerged that SSRIs treatment has proven to be effective in normalizing brain structural and functional alterations observed in OCD patients. However, future neuroimaging investigations should focus on long-term effects of drugs on brain structure and function in OCD patients through longitudinal approaches in order to identify more effective treatments for these patients.
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Affiliation(s)
- L Bracco
- Department of Pathophysiology and Transplantation, University of Milan, 20122 Milan, Italy
| | - N Dusi
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
| | - C Moltrasio
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - P Brambilla
- Department of Pathophysiology and Transplantation, University of Milan, 20122 Milan, Italy; Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - G Delvecchio
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
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Rezaei S, Gharepapagh E, Rashidi F, Cattarinussi G, Sanjari Moghaddam H, Di Camillo F, Schiena G, Sambataro F, Brambilla P, Delvecchio G. Machine learning applied to functional magnetic resonance imaging in anxiety disorders. J Affect Disord 2023; 342:54-62. [PMID: 37683943 DOI: 10.1016/j.jad.2023.09.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Revised: 08/21/2023] [Accepted: 09/05/2023] [Indexed: 09/10/2023]
Abstract
BACKGROUND Brain functional abnormalities have been commonly reported in anxiety disorders, including generalized anxiety disorder, social anxiety disorder, panic disorder, agoraphobia, and specific phobias. The role of functional abnormalities in the discrimination of these disorders can be tested with machine learning (ML) techniques. Here, we aim to provide a comprehensive overview of ML studies exploring the potential discriminating role of functional brain alterations identified by functional magnetic resonance imaging (fMRI) in anxiety disorders. METHODS We conducted a search on PubMed, Web of Science, and Scopus of ML investigations using fMRI as features in patients with anxiety disorders. A total of 12 studies (resting-state fMRI n = 5, task-based fMRI n = 6, resting-state and task-based fMRI n=1) met our inclusion criteria. RESULTS Overall, the studies showed that, regardless of the classifiers, alterations in functional connectivity and aberrant neural activation involving the amygdala, anterior cingulate cortex, hippocampus, insula, orbitofrontal cortex, temporal pole, cerebellum, default mode network, dorsal attention network, sensory network, and affective network were able to discriminate patients with anxiety from controls, with accuracies spanning from 36 % to 94 %. LIMITATIONS The small sample size, different ML approaches and heterogeneity in the selection of regions included in the multivariate pattern analyses limit the conclusions of the present review. CONCLUSIONS ML methods using fMRI as features can distinguish patients with anxiety disorders from healthy controls, indicating that these techniques could be used as a helpful tool for the diagnosis and the development of more targeted treatments for these disorders.
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Affiliation(s)
- Sahar Rezaei
- Connective Tissue Diseases Research Center, Tabriz University of Medical Sciences, Tabriz, Iran; Department of Nuclear Medicine, Medical School, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Esmaeil Gharepapagh
- Connective Tissue Diseases Research Center, Tabriz University of Medical Sciences, Tabriz, Iran; Department of Nuclear Medicine, Medical School, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Fatemeh Rashidi
- Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Giulia Cattarinussi
- Department of Neuroscience (DNS), University of Padova, Padua, Italy; Padova Neuroscience Center, University of Padova, Padua, Italy
| | | | - Fabio Di Camillo
- Department of Neuroscience (DNS), University of Padova, Padua, Italy
| | - Giandomenico Schiena
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Fabio Sambataro
- Department of Neuroscience (DNS), University of Padova, Padua, Italy; Padova Neuroscience Center, University of Padova, Padua, Italy
| | - Paolo Brambilla
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy; Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Giuseppe Delvecchio
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
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Shafie M, Shahmohamadi E, Cattarinussi G, Sanjari Moghaddam H, Akhondzadeh S, Sambataro F, Moltrasio C, Delvecchio G. Resting-state functional magnetic resonance imaging alterations in borderline personality disorder: A systematic review. J Affect Disord 2023; 341:335-345. [PMID: 37673288 DOI: 10.1016/j.jad.2023.09.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Revised: 08/24/2023] [Accepted: 09/01/2023] [Indexed: 09/08/2023]
Abstract
BACKGROUND Borderline personality disorder (BPD) is a severe psychiatric disorder characterized by emotion dysregulation, impulsivity, and interpersonal disturbances. Several structural and functional neuroimaging abnormalities have been described in BPD. In particular, resting-state functional magnetic resonance imaging (rs-fMRI) studies have recently suggested various connectivity alterations within and between large-scale brain networks in BPD. This review aimed at providing an updated summary of the evidence reported by the available rs-fMRI studies in BPD individuals. METHODS A search on PubMed, Scopus, and Web of Science was performed to identify rs-fMRI alterations in BPD. A total of 15 studies met our inclusion criteria. RESULTS Overall, aberrant resting-state functional connectivity (rs-FC) within and between default mode network (DMN), salience network (SN), and central executive network (CEN) were observed in BPD compared to healthy controls, as well as selective functional impairments in bilateral amygdala, anterior and posterior cingulate cortex, hippocampus, and prefrontal cortex. LIMITATIONS The observational design, small sample size, prevalence of females, high rates of concurrent comorbidities and medications, and heterogeneity across imaging methodologies limit the generalizability of the results. CONCLUSIONS The identification of altered patterns of rs-FC within and between selective brain networks, including DMN, SN, and CEN, could further our knowledge of the clinical symptoms of BPD, and therefore, future studies with multimodal methodologies and longitudinal designs are warranted to further explore the neural correlates of this disorder.
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Affiliation(s)
- Mahan Shafie
- School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Giulia Cattarinussi
- Department of Neuroscience (DNS), Padua Neuroscience Center, University of Padova, Padua, Italy; Padua Neuroscience Center, University of Padova, Padua, Italy
| | - Hossein Sanjari Moghaddam
- School of Medicine, Tehran University of Medical Sciences, Tehran, Iran; Psychiatry and Psychology Research Center, Roozbeh Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Shahin Akhondzadeh
- Psychiatry and Psychology Research Center, Roozbeh Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Fabio Sambataro
- Department of Neuroscience (DNS), Padua Neuroscience Center, University of Padova, Padua, Italy; Padua Neuroscience Center, University of Padova, Padua, Italy
| | - Chiara Moltrasio
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Giuseppe Delvecchio
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
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Parsaei M, Taghavizanjani F, Cattarinussi G, Moghaddam HS, Di Camillo F, Akhondzadeh S, Sambataro F, Brambilla P, Delvecchio G. Classification of suicidality by training supervised machine learning models with brain MRI findings: A systematic review. J Affect Disord 2023; 340:766-791. [PMID: 37567348 DOI: 10.1016/j.jad.2023.08.034] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Revised: 07/03/2023] [Accepted: 08/04/2023] [Indexed: 08/13/2023]
Abstract
BACKGROUND Suicide is a global public health issue causing around 700,000 deaths worldwide each year. Therefore, identifying suicidal thoughts and behaviors in patients can help lower the suicide-related mortality rate. This review aimed to investigate the feasibility of suicidality identification by applying supervised Machine Learning (ML) methods to Magnetic Resonance Imaging (MRI) data. METHODS We conducted a systematic search on PubMed, Scopus, and Web of Science to identify studies examining suicidality by applying ML methods to MRI features. Also, the Prediction Model Risk of Bias Assessment Tool (PROBAST) was employed for the quality assessment. RESULTS 23 studies met the inclusion criteria. Of these, 20 developed prediction models without external validation and 3 developed prediction models with external validation. The performance of ML models varied among the reviewed studies, with the highest reported values of accuracies and Area Under the Curve (AUC) ranging from 51.7 % to 100 % and 0.52 to 1, respectively. Over half of the studies that reported accuracy (12/21) or AUC (13/16) achieved values of ≥0.8. Our comparative analysis indicated that deep learning exhibited the highest predictive performance compared to other ML models. The most commonly identified discriminative imaging features were resting-state functional connectivity and grey matter volume within prefrontal-limbic structures. LIMITATIONS Small sample sizes, lack of external validation, heterogeneous study designs, and ML model development. CONCLUSIONS Most of the studies developed ML models capable of ML-based suicide identification, although ML models' predictive performance varied across the reviewed studies. Thus, further well-designed is necessary to uncover the true potential of different ML models in this field.
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Affiliation(s)
| | | | - Giulia Cattarinussi
- Department of Neuroscience (DNS), University of Padova, Padua, Italy; Padua Neuroscience Center, University of Padova, Padua, Italy
| | - Hossein Sanjari Moghaddam
- School of Medicine, Tehran University of Medical Science, Tehran, Iran; Psychiatry and Psychology Research Center, Roozbeh Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Fabio Di Camillo
- Department of Neuroscience (DNS), University of Padova, Padua, Italy
| | - Shahin Akhondzadeh
- Psychiatry and Psychology Research Center, Roozbeh Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Fabio Sambataro
- Department of Neuroscience (DNS), University of Padova, Padua, Italy; Padua Neuroscience Center, University of Padova, Padua, Italy
| | - Paolo Brambilla
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy; Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Giuseppe Delvecchio
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
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De Maria L, Delvecchio G, Sponselli S, Cafaro F, Caputi A, Giannelli G, Stefanizzi P, Bianchi FP, Stufano A, Tafuri S, Lovreglio P, Boffetta P, Vimercati L. SARS-CoV-2 Infections, Re-Infections and Clinical Characteristics: A Two-Year Retrospective Study in a Large University Hospital Cohort of Vaccinated Healthcare Workers. J Clin Med 2023; 12:6800. [PMID: 37959268 PMCID: PMC10647276 DOI: 10.3390/jcm12216800] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Revised: 10/23/2023] [Accepted: 10/26/2023] [Indexed: 11/15/2023] Open
Abstract
At the University Hospital of Bari, during the first year after the start of the mandatory vaccination campaign with BNT162b2 mRNA COVID-19 vaccine, the preliminary results of an observational study showed a significant prevalence of SARS-CoV-2 breakthrough infections (BIs) among healthcare workers (HCWs), but no hospitalization or deaths. In the present study, we extended the observation period (January 2021-January 2023) with the aim of determining the incidence, characteristics and clinical course of SARS-CoV-2 BIs among 6213 HCWs. All HCWs were regularly monitored and screened. To allow return to work after BI, the protocol required one negative nasopharyngeal swab test followed by a medical examination certifying complete clinical recovery. We observed an overall incidence rate of SARS-CoV-2 BIs of 20.2%. Females were most affected, especially in the nurse group compared with doctors and other HCWs (p < 0.0001). Cardiovascular diseases were the most frequent comorbidity (n = 140; 11.4%). The source of infection was non-occupational in 52.4% of cases. Most cases (96.9%) showed minor symptoms and only two cases of hospitalization (one in intensive care unit), 13 cases of re-infection and no deaths were recorded. Our results confirm that SARS-CoV-2 infection can break vaccination protection but the clinical course is favorable.
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Affiliation(s)
- Luigi De Maria
- Interdisciplinary Department of Medicine, University of Bari, 70124 Bari, Italy; (L.D.M.); (G.D.); (S.S.); (F.C.); (G.G.); (P.S.); (A.S.); (S.T.); (P.L.); (L.V.)
| | - Giuseppe Delvecchio
- Interdisciplinary Department of Medicine, University of Bari, 70124 Bari, Italy; (L.D.M.); (G.D.); (S.S.); (F.C.); (G.G.); (P.S.); (A.S.); (S.T.); (P.L.); (L.V.)
| | - Stefania Sponselli
- Interdisciplinary Department of Medicine, University of Bari, 70124 Bari, Italy; (L.D.M.); (G.D.); (S.S.); (F.C.); (G.G.); (P.S.); (A.S.); (S.T.); (P.L.); (L.V.)
| | - Francesco Cafaro
- Interdisciplinary Department of Medicine, University of Bari, 70124 Bari, Italy; (L.D.M.); (G.D.); (S.S.); (F.C.); (G.G.); (P.S.); (A.S.); (S.T.); (P.L.); (L.V.)
| | - Antonio Caputi
- Interdisciplinary Department of Medicine, University of Bari, 70124 Bari, Italy; (L.D.M.); (G.D.); (S.S.); (F.C.); (G.G.); (P.S.); (A.S.); (S.T.); (P.L.); (L.V.)
| | - Gianmarco Giannelli
- Interdisciplinary Department of Medicine, University of Bari, 70124 Bari, Italy; (L.D.M.); (G.D.); (S.S.); (F.C.); (G.G.); (P.S.); (A.S.); (S.T.); (P.L.); (L.V.)
| | - Pasquale Stefanizzi
- Interdisciplinary Department of Medicine, University of Bari, 70124 Bari, Italy; (L.D.M.); (G.D.); (S.S.); (F.C.); (G.G.); (P.S.); (A.S.); (S.T.); (P.L.); (L.V.)
| | | | - Angela Stufano
- Interdisciplinary Department of Medicine, University of Bari, 70124 Bari, Italy; (L.D.M.); (G.D.); (S.S.); (F.C.); (G.G.); (P.S.); (A.S.); (S.T.); (P.L.); (L.V.)
| | - Silvio Tafuri
- Interdisciplinary Department of Medicine, University of Bari, 70124 Bari, Italy; (L.D.M.); (G.D.); (S.S.); (F.C.); (G.G.); (P.S.); (A.S.); (S.T.); (P.L.); (L.V.)
| | - Piero Lovreglio
- Interdisciplinary Department of Medicine, University of Bari, 70124 Bari, Italy; (L.D.M.); (G.D.); (S.S.); (F.C.); (G.G.); (P.S.); (A.S.); (S.T.); (P.L.); (L.V.)
| | - Paolo Boffetta
- Stony Brook Cancer Center, Stony Brook University, Stony Brook, NY 11794, USA;
- Department of Medical and Surgical Sciences, University of Bologna, 40138 Bologna, Italy
| | - Luigi Vimercati
- Interdisciplinary Department of Medicine, University of Bari, 70124 Bari, Italy; (L.D.M.); (G.D.); (S.S.); (F.C.); (G.G.); (P.S.); (A.S.); (S.T.); (P.L.); (L.V.)
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Vimercati L, Cavone D, Negrisolo O, Pentimone F, De Maria L, Caputi A, Sponselli S, Delvecchio G, Cafaro F, Chellini E, Binazzi A, Di Marzio D, Mensi C, Consonni D, Migliore E, Brentisci C, Martini A, Negro C, D'Agostin F, Grappasonni I, Pascucci C, Benfatto L, Malacarne D, Casotto V, Comiati V, Storchi C, Mangone L, Murano S, Rossin L, Tallarigo F, Vitale F, Verardo M, Eccher S, Madeo G, Staniscia T, Carrozza F, Cozzi I, Romeo E, Pelullo P, Labianca M, Melis M, Cascone G, Ferri GM, Serio G. Mesothelioma Risk Among Maritime Workers According to Job Title: Data From the Italian Mesothelioma Register (ReNaM). Med Lav 2023; 114:e2023038. [PMID: 37878258 PMCID: PMC10627101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Accepted: 07/12/2023] [Indexed: 10/26/2023]
Abstract
The study describes the 466 cases of malignant mesotheliomas (MM) collected by the National Mesothelioma Register (ReNaM) in Italy in the period 1993-2018 relating to subjects with exclusive asbestos exposure in merchant or military navy. The cases among maritime workers represent 1.8% of the total cases with defined exposure registred in the ReNaM, of which 212 cases (45.4%) among merchant maritime workers and 254 cases (54.5%) among navy. The distribution by site of mesothelioma showed 453 (97.2%) MM cases of the pleura, 11 (2.3%) of the peritoneum and 2 (0.4%) of the tunica vaginalis of the testis. With regard to occupational exposure, it was classified as certain in 318 (68.2%) cases, probable in 69 (14.8%) cases and possible in 79 (16.9%) cases. Among the 23 classified jobs, the highest percentages of certain exposures are among naval engineers, motor mechanics, machine captains and sailors. Machine crew accounted for 49.3% of the cases, deck crew for 27.6%. All cases began exposure on board between 1926 and 1988. Seamen were exposed to asbestos while at sea by virtue of living onboard ships and from continual release of asbestos fibers due to the motion of a vessel. Epidemiological surveillance through the ReNaM has allowed us to verify among cases in the maritime, navy and merchant marine sectors, that in the past, subjects were exposed regardless of the ship's department where have provided service therefore all these cases must be considered as occupational diseases.
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Affiliation(s)
- Luigi Vimercati
- Section of Occupational Medicine "B. Ramazzini", Department of Interdisciplinary Medicine, Regional Oper-ating Center of Puglia (COR Puglia), University of Bari, 70125 Bari, Italy.
| | - Domenica Cavone
- Section of Occupational Medicine "B. Ramazzini", Department of Interdisciplinary Medicine, Regional Oper-ating Center of Puglia (COR Puglia), University of Bari, 70125 Bari, Italy.
| | - Omero Negrisolo
- Environmental Prevention Technician former Judicial Police Officer Padua .
| | - Floriana Pentimone
- Section of Occupational Medicine "B. Ramazzini", Department of Interdisciplinary Medicine, Regional Oper-ating Center of Puglia (COR Puglia), University of Bari, 70125 Bari, Italy.
| | - Luigi De Maria
- Section of Occupational Medicine "B. Ramazzini", Department of Interdisciplinary Medicine, Regional Oper-ating Center of Puglia (COR Puglia), University of Bari, 70125 Bari, Italy.
| | - Antonio Caputi
- Section of Occupational Medicine "B. Ramazzini", Department of Interdisciplinary Medicine, Regional Oper-ating Center of Puglia (COR Puglia), University of Bari, 70125 Bari, Italy.
| | - Stefania Sponselli
- Section of Occupational Medicine "B. Ramazzini", Department of Interdisciplinary Medicine, Regional Oper-ating Center of Puglia (COR Puglia), University of Bari, 70125 Bari, Italy.
| | - Giuseppe Delvecchio
- Section of Occupational Medicine "B. Ramazzini", Department of Interdisciplinary Medicine, Regional Oper-ating Center of Puglia (COR Puglia), University of Bari, 70125 Bari, Italy.
| | - Francesco Cafaro
- Section of Occupational Medicine "B. Ramazzini", Department of Interdisciplinary Medicine, Regional Oper-ating Center of Puglia (COR Puglia), University of Bari, 70125 Bari, Italy.
| | | | - Alessandra Binazzi
- Occupational and Environmental Medicine, Epidemiology and Hygiene Department, Italian Workers' Compensation Authority (INAIL), 00143 Rome, Italy.
| | - Davide Di Marzio
- Occupational and Environmental Medicine, Epidemiology and Hygiene Department, Italian Workers' Compensation Authority (INAIL), 00143 Rome, Italy.
| | - Carolina Mensi
- Epidemiology Unit, Regional Operating Center of Lombardia (COR Lombardia), Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, 20122 Milano, Italy.
| | - Dario Consonni
- Epidemiology Unit, Regional Operating Center of Lombardia (COR Lombardia), Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, 20122 Milano, Italy.
| | - Enrica Migliore
- Unit of Cancer Epidemiology, Regional Operating Center of Piemonte (COR Piemonte), University of Torino and CPO-Piemonte, 10126 Torino, Italy.
| | - Carol Brentisci
- Unit of Cancer Epidemiology, Regional Operating Center of Piemonte (COR Piemonte), University of Torino and CPO-Piemonte, 10126 Torino, Italy.
| | - Andrea Martini
- Prevention and Clinical Network, Institute for Cancer Research, Regional Operating Center of Toscana (COR Toscana), 50139 Firenze, Italy.
| | - Corrado Negro
- Clinical Unit of Occupational Medicine, Regional Operating Center of Friuli-Venezia Giulia (COR Friu-li-Venezia Giulia), University of Trieste-Trieste General Hospitals, 34123 Trieste, Italy.
| | - Flavia D'Agostin
- Clinical Unit of Occupational Medicine, Regional Operating Center of Friuli-Venezia Giulia (COR Friu-li-Venezia Giulia), University of Trieste-Trieste General Hospitals, 34123 Trieste, Italy.
| | - Iolanda Grappasonni
- Regional Operating Center of Marche (COR Marche), School of Medicinal and Health Products Sciences, University of Camerino, 62032 Camerino, Italy.
| | - Cristiana Pascucci
- Regional Operating Center of Marche (COR Marche), School of Medicinal and Health Products Sciences, University of Camerino, 62032 Camerino, Italy.
| | - Lucia Benfatto
- Regional Operating Center of Liguria (COR Liguria Regional Operating Center of Liguria (COR Liguria), Clinical Epidemiology Unit, IRCCS Ospedale Policlinico San Martino, 16132 Genova, Italy.
| | - Davide Malacarne
- Regional Operating Center of Liguria (COR Liguria Regional Operating Center of Liguria (COR Liguria), Clinical Epidemiology Unit, IRCCS Ospedale Policlinico San Martino, 16132 Genova, Italy.
| | - Veronica Casotto
- Azienda Zero, Epidemiological Department, Regional Operating Center of Veneto (COR Veneto), Veneto Region, 35131 Padova, Italy.
| | - Vera Comiati
- Azienda Zero, Epidemiological Department, Regional Operating Center of Veneto (COR Veneto), Veneto Region, 35131 Padova, Italy.
| | - Cinzia Storchi
- Epidemiology Unit, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy.
| | - Lucia Mangone
- Epidemiology Unit, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy .
| | - Stefano Murano
- Occupational Medicine Unit, Alto Adige Health Authority, Regional Operating Center of Autonomous Province of Bolzano (COR A.P. of Bolzano), 39100 Bolzano, Italy.
| | - Lucia Rossin
- Occupational Medicine Unit, Alto Adige Health Authority, Regional Operating Center of Autonomous Province of Bolzano (COR A.P. of Bolzano), 39100 Bolzano, Italy.
| | - Federico Tallarigo
- Public Health Unit, Regional Operating Center of Calabria (COR Calabria), 88900 Crotone, Italy.
| | - Filomena Vitale
- Public Health Unit, Regional Operating Center of Calabria (COR Calabria), 88900 Crotone, Italy.
| | - Marina Verardo
- Valle d'Aosta Health Local Unit, Regional Operating Center of Valle d'Aosta (COR Valle d'Aosta), 11100 Aosta, Italy.
| | - Silvia Eccher
- Hygiene and Occupational Medicine, Provincial Unit of Health, Regional Operating Center o Autono-mous Province of Trento (COR A.P. of Trento), 38100 Trento, Italy.
| | - Gabriella Madeo
- Center of Umbria (COR Umbria), Servizio Prevenzione, Sanità Veterinaria e Sicurezza Alimen-tare-Regione Umbria, 06126 Perugia, Italy.
| | - Tommaso Staniscia
- COR Abruzzo, Abruzzo Regional Health Agency (ASR), Pescara, Italy; 65121 Pescara, Italy.
| | - Francesco Carrozza
- Oncology Unit, Cardarelli Hospital, Regional Operating Center of Molise (COR Molise), 86100 Campo-basso, Italy.
| | - Ilaria Cozzi
- Regional Operating Center of Lazio (COR Lazio), Department of Epidemiology, Epidemiology Lazio Re-gional Health Service, ASL Roma 1, 00147 Roma, Italy.
| | - Elisa Romeo
- Regional Operating Center of Lazio (COR Lazio), Department of Epidemiology, Epidemiology Lazio Re-gional Health Service, ASL Roma 1, 00147 Roma, Italy.
| | - Paola Pelullo
- Department of Experimental Medicine, "Luigi Vanvitelli" University, Regional Operating Center of Campania (COR Campania), 80138 Napoli, Italy.
| | - Michele Labianca
- Epidemiologic Regional Center, Regional Operating Center of Basilicata (COR Basilicata), 85100 Poten-za, Italy.
| | - Massimo Melis
- Regional Epidemiological Center, Regional Operating Center of Sardegna (COR Sardegna), 09125 Ca-gliari, Italy.
| | - Giuseppe Cascone
- Regional Operating Center of Sicilia (COR Sicilia), 97100 Ragusa, Italy; ASP Ragusa Dipartimento di Prevenzione Medica .
| | | | - Gabriella Serio
- Department of Emergency and Organ Transplantation (DETO), Pathological Anatomy Section, Univer-sity of Bari Aldo Moro, Bari, Italy.
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Tesic I, Pigoni A, Moltrasio C, Brambilla P, Delvecchio G. How does feeling pain look like in depression: A review of functional neuroimaging studies. J Affect Disord 2023; 339:400-411. [PMID: 37459979 DOI: 10.1016/j.jad.2023.07.083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Revised: 07/13/2023] [Accepted: 07/14/2023] [Indexed: 07/23/2023]
Abstract
INTRODUCTION Major Depression Disorder (MDD) and pain appear to be reciprocal risk factors and sharing common neuroanatomical pathways and biological substrates. However, the role of MDD on pain processing remains still unclear. Therefore, this review aims to focus on the effect of depression on pain anticipation, and perception, before and after treatment, through functional magnetic resonance imaging (fMRI). METHODS A bibliographic search was conducted on PubMed, Scopus and Web of Science, looking for fMRI studies exploring pain processing in MDD patients. RESULTS Amongst the 602 studies retrieved, 12 met the inclusion criteria. In terms of pain perception, studies evidenced that MDD patients generally presented increased activation in brain regions within the prefrontal cortex, insula and in the limbic system (such as amygdala, hippocampus) and occipital cortex. The studies investigating the effect of antidepressant treatment evidenced a reduced activation in areas such as insula, anterior cingulate, and prefrontal cortices. In terms of pain anticipation, contrasting results were evidenced in MDD patients, which presented both increased and decreased activity in the prefrontal cortex, the insula and the temporal lobe, alongside with increased activity in the anterior cingulate cortex, the frontal gyrus and occipital lobes. LIMITATIONS The small number of included studies, the heterogeneous approaches of the studies might limit the conclusions of this review. CONCLUSIONS Acute pain processing in MDD patients seems to involve numerous and different brain areas. However, more specific fMRI studies with a more homogeneous population and rigorous approach should be conducted to better highlight the effect of depression on pain processing.
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Affiliation(s)
- Isidora Tesic
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - Alessandro Pigoni
- Social and Affective Neuroscience Group, MoMiLab, IMT School for Advanced Studies Lucca, Lucca, Italy; Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Chiara Moltrasio
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Paolo Brambilla
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy; Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
| | - Giuseppe Delvecchio
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
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Valizadeh P, Cattarinussi G, Sambataro F, Brambilla P, Delvecchio G. Neuroimaging alterations associated with medication use in early-onset bipolar disorder: An updated review. J Affect Disord 2023; 339:984-997. [PMID: 37481130 DOI: 10.1016/j.jad.2023.07.098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Revised: 07/11/2023] [Accepted: 07/18/2023] [Indexed: 07/24/2023]
Abstract
BACKGROUND Pediatric bipolar disorder (PBD) is a severe disorder characterized by mood fluctuations starting at a young age. Several neuroimaging studies revealed a specific biological signature of PBD involving alterations in the amygdala and prefrontal regions. Considering the growing concerns regarding the effects of PBD treatments on developing brains, this review aims to provide an overview of the studies investigating the effect of mood stabilizers, antipsychotics, and anticonvulsants on neuroimaging findings in PBD. METHODS We searched PubMed, Scopus, and Web of Science to identify all structural magnetic resonance imaging (sMRI), functional magnetic resonance imaging (fMRI), and diffusion tensor imaging (DTI) studies exploring the effects of medications on neuroimaging findings in PBD. A total of 18 studies met our inclusion criteria (fMRI n = 11, sMRI n = 6, DTI n = 1). RESULTS Although the findings varied highly across the studies, some investigations consistently indicated that medications primarily affect the prefrontal cortex and the amygdala. Moreover, despite some exceptions, the reported medication effects predominantly lean towards structural and functional normalization. LIMITATIONS The reviewed studies differ in methods, medications, and fMRI paradigms. Furthermore, most studies used observational approaches with small sample sizes, minimizing the statistical power. CONCLUSIONS Evidence suggests the potential of antipsychotics and mood stabilizers to modulate the neuroimaging findings in PBD patients, mostly normalizing brain structure and function in key mood-regulating regions.
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Affiliation(s)
- Parya Valizadeh
- School of Medicine, Tehran University of Medical Science, Tehran, Iran; Neuroscience Research Group (NRG), Universal Scientific Education and Research Network (USERN), Tehran, Iran
| | - Giulia Cattarinussi
- Department of Neuroscience (DNS), Padua Neuroscience Center, University of Padova, Padua, Italy; Padua Neuroscience Center, University of Padova, Padua, Italy
| | - Fabio Sambataro
- Department of Neuroscience (DNS), Padua Neuroscience Center, University of Padova, Padua, Italy; Padua Neuroscience Center, University of Padova, Padua, Italy
| | - Paolo Brambilla
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy; Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Giuseppe Delvecchio
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
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Oliva A, Ferracini SM, Amoia R, Giardinieri G, Moltrasio C, Brambilla P, Delvecchio G. The association between anger rumination and emotional dysregulation in borderline personality disorder: A review. J Affect Disord 2023; 338:546-553. [PMID: 37348655 DOI: 10.1016/j.jad.2023.06.036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Revised: 06/06/2023] [Accepted: 06/19/2023] [Indexed: 06/24/2023]
Abstract
INTRODUCTION Borderline Personality Disorder (BPD) is characterized by impulsiveness, interpersonal difficulties, emotional instability and dysfunctional cognitive processes. In addition to these symptoms, anger rumination is a cognitive mechanism often prominent in BPD patients and it has been found to be associated with maladaptive outcomes, such as increasing anger feelings, aggressive and impulsive behaviors. In this context, the aim of our review is to synthesize results on the relationship between emotional dysregulation and anger rumination in BPD with the final goal to get more information about possible psychotherapeutic methods in the treatment of BPD. METHODS A comprehensive search on BPD and anger rumination was performed on PubMed, Embase and Scopus. The search identified 8 articles meeting our inclusion criteria. RESULTS Most of the studies reported a correlation between BPD emotional instability and dyscontrolled behaviors, anger and depressive rumination. Specifically, from the reviewed studies, it emerged that the tendency to use dysfunctional cognitive strategies, such as anger rumination, predicted aggressive behavior above and beyond emotion dysregulation, ultimately suggesting that anger rumination mediates the relationship between emotional dysregulation and aggression proneness. LIMITATIONS The cross-sectional design and the inclusion of subjects without a definite diagnosis of BPD (e.g., university students), may have decreased the generalizability of the results to the clinical populations and limited the possibility to explore the effect of anger rumination over time in BPD. CONCLUSIONS From the reviewed studies emerged that the identification of anger rumination as a proximal process with respect to BPD may have the potential to expand and support psychotherapeutic treatment.
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Affiliation(s)
- Anna Oliva
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - Serena Mazzoleni Ferracini
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - Roberto Amoia
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - Giulia Giardinieri
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - Chiara Moltrasio
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - Paolo Brambilla
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy; Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy.
| | - Giuseppe Delvecchio
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
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Videtta G, Squarcina L, Rossetti MG, Brambilla P, Delvecchio G, Bellani M. White matter modifications of corpus callosum in bipolar disorder: A DTI tractography review. J Affect Disord 2023; 338:220-227. [PMID: 37301293 DOI: 10.1016/j.jad.2023.06.012] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Revised: 05/08/2023] [Accepted: 06/04/2023] [Indexed: 06/12/2023]
Abstract
BACKGROUND The recent widespread use of diffusion tensor imaging (DTI) tractography allowed researchers to investigate the diffusivity modifications and neuroanatomical changes of white matter (WM) fascicles in major psychiatric disorders, including bipolar disorder (BD). In BD, corpus callosum (CC) seems to have a crucial role in explaining the pathophysiology and cognitive impairment of this psychiatric disorder. This review aims to provide an overview on the latest results emerging from studies that investigated neuroanatomical changes of CC in BD using DTI tractography. METHODS Bibliographic research was conducted on PubMed, Scopus and Web of Science datasets until March 2022. Ten studies fulfilled our inclusion criteria. RESULTS From the reviewed DTI tractography studies a significant decrease of fractional anisotropy emerged in the genu, body and splenium of CC of BD patients compared to controls. This finding is coupled with reduction of fiber density and modification in fiber tract length. Finally, an increase of radial and mean diffusivity in forceps minor and in the entire CC was also reported. LIMITATIONS Small sample size, heterogeneity in terms of methodological (diffusion gradient) and clinical (lifetime comorbidity, BD status, pharmacological treatments) characteristics. CONCLUSIONS Overall, these findings suggest the presence of structural modifications in CC in BD patients, which may in turn explain the cognitive impairments often observed in this psychiatric disorder, especially in executive processing, motor control and visual memory. Finally, structural modifications may suggest an impairment in the amount of functional information and a morphological impact within those brain regions connected by CC.
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Affiliation(s)
- Giovanni Videtta
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
| | - Letizia Squarcina
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - Maria Gloria Rossetti
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - Paolo Brambilla
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy; Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - Giuseppe Delvecchio
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy.
| | - Marcella Bellani
- Section of Psychiatry, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
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Argote M, Sescousse G, Brunelin J, Baudin G, Schaub MP, Rabin R, Schnell T, Ringen PA, Andreassen OA, Addington JM, Brambilla P, Delvecchio G, Bechdolf A, Wobrock T, Schneider-Axmann T, Herzig D, Mohr C, Vila-Badia R, Rodie JU, Mallet J, Ricci V, Martinotti G, Knížková K, Rodriguez M, Cookey J, Tibbo P, Scheffler F, Asmal L, Garcia-Rizo C, Amoretti S, Huber C, Thibeau H, Kline E, Fakra E, Jardri R, Nourredine M, Rolland B. Association between cannabis use and symptom dimensions in schizophrenia spectrum disorders: an individual participant data meta-analysis on 3053 individuals. EClinicalMedicine 2023; 64:102199. [PMID: 37731936 PMCID: PMC10507201 DOI: 10.1016/j.eclinm.2023.102199] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Revised: 08/14/2023] [Accepted: 08/18/2023] [Indexed: 09/22/2023] Open
Abstract
Background The association between cannabis use and positive symptoms in schizophrenia spectrum disorders is well documented, especially via meta-analyses. Yet, findings are inconsistent regarding negative symptoms, while other dimensions such as disorganization, depression, and excitement, have not been investigated. In addition, meta-analyses use aggregated data discarding important confounding variables which is a source of bias. Methods PubMed, ScienceDirect and PsycINFO were used to search for publications from inception to September 27, 2022. We contacted the authors of relevant studies to extract raw datasets and perform an Individual Participant Data meta-analysis (IPDMA). Inclusion criteria were: psychopathology of individuals with schizophrenia spectrum disorders assessed by the Positive and Negative Syndrome Scale (PANSS); cannabis-users had to either have a diagnosis of cannabis use disorder or use cannabis at least twice a week. The main outcomes were the PANSS subscores extracted via the 3-factor (positive, negative and general) and 5-factor (positive, negative, disorganization, depression, excitement) structures. Preregistration is accessible via Prospero: ID CRD42022329172. Findings Among the 1149 identified studies, 65 were eligible and 21 datasets were shared, totaling 3677 IPD and 3053 complete cases. The adjusted multivariate analysis revealed that relative to non-use, cannabis use was associated with higher severity of positive dimension (3-factor: Adjusted Mean Difference, aMD = 0.34, 95% Confidence Interval, CI = [0.03; 0.66]; 5-factor: aMD = 0.38, 95% CI = [0.08; 0.63]), lower severity of negative dimension (3-factor: aMD = -0.49, 95% CI [-0.90; -0.09]; 5-factor: aMD = -0.50, 95% CI = [-0.91; -0.08]), higher severity of excitement dimension (aMD = 0.16, 95% CI = [0.03; 0.28]). No association was found between cannabis use and disorganization (aMD = -0.13, 95% CI = [-0.42; 0.17]) or depression (aMD = -0.14, 95% CI = [-0.34; 0.06]). Interpretation No causal relationship can be inferred from the current results. The findings could be in favor of both a detrimental and beneficial effect of cannabis on positive and negative symptoms, respectively. Longitudinal designs are needed to understand the role of cannabis is this association. The reported effect sizes are small and CIs are wide, the interpretation of findings should be taken with caution. Funding This research did not receive any specific grant or funding. Primary financial support for authors was provided by Le Vinatier Psychiatric Hospital.
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Affiliation(s)
- Mathilde Argote
- PSYR, CNRL, INSERM U1028, CNRS UMR5292, UCBL1, Bron, France
- Université Claude Bernard Lyon 1, Lyon, France
- Centre Hospitalier Le Vinatier, Bron, France
| | - Guillaume Sescousse
- PSYR, CNRL, INSERM U1028, CNRS UMR5292, UCBL1, Bron, France
- Université Claude Bernard Lyon 1, Lyon, France
- Centre Hospitalier Le Vinatier, Bron, France
| | - Jérôme Brunelin
- PSYR, CNRL, INSERM U1028, CNRS UMR5292, UCBL1, Bron, France
- Université Claude Bernard Lyon 1, Lyon, France
- Centre Hospitalier Le Vinatier, Bron, France
| | - Grégoire Baudin
- Laboratoire de Psychopathologie et Processus de Santé, Université Paris Cité, F-92100, France
| | - Michael Patrick Schaub
- Swiss Research Institute for Public Health and Addiction ISGF, University of Zurich, Zurich, Switzerland
| | - Rachel Rabin
- Department of Psychiatry, McGill University, Montreal, Canada
| | - Thomas Schnell
- Medical School Hamburg, University of Applied Sciences and Medical University, Hamburg, Germany
| | - Petter Andreas Ringen
- NORMENT Centre, Division of Mental Health and Addiction, Oslo University Hospital and University of Oslo, Oslo, Norway
| | - Ole Andreas Andreassen
- NORMENT Centre, Division of Mental Health and Addiction, Oslo University Hospital and University of Oslo, Oslo, Norway
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | | | - Paolo Brambilla
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - Giuseppe Delvecchio
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Andreas Bechdolf
- Department of Psychiatry, Psychotherapy und Psychosomatic, Vivantes Klinikum am Urban und Vivantes Klinikum im Friedrichshain, Berlin, Germany
- Department of Psychiatry and Psychotherapy, CCM, Charite-Universitätsmedizin Berlin, Berlin, Germany
| | - Thomas Wobrock
- Centre for Mental Health, County Hospitals Darmstadt-Dieburg, Groß-Umstadt, Germany
- Department of Psychiatry and Psychotherapy, Georg-August University Göttingen, Germany
| | - Thomas Schneider-Axmann
- Department of Psychiatry and Psychotherapy, Ludwig Maximillian University Munich, Munich, Germany
| | - Daniela Herzig
- Clienia Littenheid AG, Psychiatrische Tagesklinik Frauenfeld, 8500, Frauenfeld, Switzerland
- Department of Experimental Psychology, University of Bristol, Bristol, UK
- Université de Lausanne, Institute of Psychology (IP), Lausanne, Switzerland
| | - Christine Mohr
- Department of Experimental Psychology, University of Bristol, Bristol, UK
- Université de Lausanne, Institute of Psychology (IP), Lausanne, Switzerland
| | - Regina Vila-Badia
- Etiopathogenesis and Treatment of Severe Mental Disorders (MERITT), Institut de Recerca Sant Joan de Déu, Spain
- Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Spain
| | - Judith Usall Rodie
- Etiopathogenesis and Treatment of Severe Mental Disorders (MERITT), Institut de Recerca Sant Joan de Déu, Spain
- Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Spain
| | - Jasmina Mallet
- Université Paris Cité, INSERM UMR1266, Institute of Psychiatry and Neuroscience of Paris France, France
- AP-HP, Department of Psychiatry, Louis Mourier Hospital, Colombes, France
| | - Valerio Ricci
- Department of Neuroscience, San Luigi Gonzaga University Hospital, 10043, Orbassano, Italy
| | - Giovanni Martinotti
- Department of Neuroscience, Imaging, Clinical Sciences, University of Chieti-Pescara, Italy
| | - Karolína Knížková
- National Institute of Mental Health, Klecany, Czech Republic
- Department of Psychiatry, First Faculty of Medicine, Charles University, Prague, Czech Republic
- General University Hospital in Prague, Czech Republic
| | - Mabel Rodriguez
- National Institute of Mental Health, Klecany, Czech Republic
| | - Jacob Cookey
- Department of Psychiatry, QEII Health Sciences Centre, Dalhousie University, Halifax, Nova Scotia, Canada
- Nova Scotia Early Psychosis Program, Nova Scotia Health Authority (Central Zone), Halifax, Nova Scotia, Canada
| | - Philip Tibbo
- Department of Psychiatry, QEII Health Sciences Centre, Dalhousie University, Halifax, Nova Scotia, Canada
- Nova Scotia Early Psychosis Program, Nova Scotia Health Authority (Central Zone), Halifax, Nova Scotia, Canada
| | - Freda Scheffler
- Neuroscience Institute, University of Cape Town, Cape Town, South Africa
- Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
| | - Laila Asmal
- Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Clemente Garcia-Rizo
- Barcelona Clinic Schizophrenia Unit, Neuroscience Institute, Hospital Clínic of Barcelona, IDIBAPS, CIBERSAM, University of Barcelona, Barcelona, Spain
| | - Silvia Amoretti
- Psychiatric Genetics Unit, Vall d’Hebron Research Institute (VHIR), Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Barcelona, Spain
| | - Christian Huber
- Universitäre Psychiatrische Kliniken (UPK) Basel, Universität Basel, Wilhelm Klein-Str. 27, 4002 Basel, Switzerland
| | - Heather Thibeau
- Boston Medical Center, Department of Psychiatry, 801 Massachusetts Avenue, 4th Floor, Boston, MA, 02118, United States of America
| | - Emily Kline
- Boston Medical Center, Department of Psychiatry, 801 Massachusetts Avenue, 4th Floor, Boston, MA, 02118, United States of America
- Department of Psychiatry, Boston University School of Medicine, 801 Massachusetts Avenue, 4th Floor, Boston, MA, 02118, United States of America
| | - Eric Fakra
- PSYR, CNRL, INSERM U1028, CNRS UMR5292, UCBL1, Bron, France
- Pôle Universitaire de Psychiatrie, CHU Saint-Etienne, Saint-Etienne, France
| | - Renaud Jardri
- Lille University, Inserm U1172-LilNcog-Lille Neuroscience & Cognition, Plasticity and Subjectivity Team, F-59000, Lille, France
- CHU Lille, Fontan Hospital, Child & Adolescent Psychiatry Department & CURE Research Platform, Lille, France
| | - Mikail Nourredine
- Université Claude Bernard Lyon 1, Lyon, France
- Service de biostatistique, Hospices Civils de Lyon, Lyon, France
- Service hospitalo-universitaire de pharmacotoxicologie, Hospices Civils de Lyon, Lyon, France
| | - Benjamin Rolland
- PSYR, CNRL, INSERM U1028, CNRS UMR5292, UCBL1, Bron, France
- Université Claude Bernard Lyon 1, Lyon, France
- Centre Hospitalier Le Vinatier, Bron, France
- Service Universitaire d’Addictologie de Lyon (SUAL), HCL, CH Le Vinatier, Lyon, France
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Vimercati L, Cavone D, De Maria L, Caputi A, Pentimone F, Sponselli S, Delvecchio G, Chellini E, Binazzi A, Di Marzio D, Mensi C, Consonni D, Migliore E, Mirabelli D, Angelini A, Martini A, Negro C, D'Agostin F, Grappasonni I, Pascucci C, Benfatto L, Malacarne D, Casotto V, Comiati V, Storchi C, Mangone L, Murano S, Rossin L, Tallarigo F, Vitale F, Verardo M, Eccher S, Madeo G, Staniscia T, Carrozza F, Cozzi I, Romeo E, Pelullo P, Labianca M, Melis M, Cascone G, Marinaccio A, Ferri GM, Serio G. Mesothelioma Risk among Construction Workers According to Job Title: Data from the Italian Mesothelioma Register. Med Lav 2023; 114:e2023025. [PMID: 37309879 DOI: 10.23749/mdl.v114i3.14538] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Accepted: 04/13/2023] [Indexed: 06/14/2023]
Abstract
BACKGROUND An increased risk of mesothelioma has been reported in various countries for construction workers. The Italian National Mesothelioma Registry, from 1993 to 2018, reported exposure exclusively in the construction sector in 2310 cases. We describe the characteristics of these cases according to job title. METHODS We converted into 18 groups the original jobs (N=338) as reported by ISTAT codes ('ATECO 91'). The exposure level was attributed at certain, probable and possible in accordance with the qualitative classification of exposure as reported in the Registry guidelines. Descriptive analysis by jobs highlights the total number of subjects for each single job and certain exposure, in descending order, insulator, plumbing, carpenter, mechanic, bricklayer, electrician, machine operator, plasterer, building contractor, painter and labourer. RESULTS The cases grow for plumbing in the incidence periods 1993-2018, while, as expected, it decreases for insulator. Within each period considered the most numerous cases are always among bricklayers and labourers, these data confirm the prevalence of non-specialised "interchangeable" jobs in Italian construction sector in the past. CONCLUSIONS Despite the 1992 ban, the construction sector still presents an occupational health prevention challenge, circumstances of exposure to asbestos may still occur due to incomplete compliance with prevention and protection measures.
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Affiliation(s)
- Luigi Vimercati
- Section of Occupational Medicine "B. Ramazzini", Department of Interdisciplinary Medicine, Regional Op-erating Center of Puglia (COR Puglia), University of Bari, 70125 Bari, Italy.
| | - Domenica Cavone
- Section of Occupational Medicine "B. Ramazzini", Department of Interdisciplinary Medicine, Regional Oper-ating Center of Puglia (COR Puglia), University of Bari, 70125 Bari, Italy.
| | - Luigi De Maria
- Section of Occupational Medicine "B. Ramazzini", Department of Interdisciplinary Medicine, Regional Oper-ating Center of Puglia (COR Puglia), University of Bari, 70125 Bari, Italy.
| | - Antonio Caputi
- Section of Occupational Medicine "B. Ramazzini", Department of Interdisciplinary Medicine, Regional Oper-ating Center of Puglia (COR Puglia), University of Bari, 70125 Bari, Italy.
| | - Floriana Pentimone
- Section of Occupational Medicine "B. Ramazzini", Department of Interdisciplinary Medicine, Regional Oper-ating Center of Puglia (COR Puglia), University of Bari, 70125 Bari, Italy.
| | - Stefania Sponselli
- Section of Occupational Medicine "B. Ramazzini", Department of Interdisciplinary Medicine, Regional Oper-ating Center of Puglia (COR Puglia), University of Bari, 70125 Bari, Italy.
| | - Giuseppe Delvecchio
- Section of Occupational Medicine "B. Ramazzini", Department of Interdisciplinary Medicine, Regional Oper-ating Center of Puglia (COR Puglia), University of Bari, 70125 Bari, Italy.
| | | | - Alessandra Binazzi
- Occupational and Environmental Medicine, Epidemiology and Hygiene Department, Italian Workers' Com-pensation Authority (INAIL), 00143 Rome, Italy.
| | - Davide Di Marzio
- Occupational and Environmental Medicine, Epidemiology and Hygiene Department, Italian Workers' Com-pensation Authority (INAIL), 00143 Rome, Italy.
| | - Carolina Mensi
- Epidemiology Unit, Regional Operating Center of Lombardia (COR Lombardia), Fondazione IRCCS Ca' Gran-da Ospedale Maggiore Policlinico, 20122 Milano, Italy.
| | - Dario Consonni
- Epidemiology Unit, Regional Operating Center of Lombardia (COR Lombardia), Fondazione IRCCS Ca' Gran-da Ospedale Maggiore Policlinico, 20122 Milano, Italy.
| | - Enrica Migliore
- Unit of Cancer Epidemiology, Regional Operating Center of Piemonte (COR Piemonte), University of Torino and CPO-Piemonte, 10124 Torino, Italy.
| | - Dario Mirabelli
- Unit of Cancer Epidemiology, Regional Operating Center of Piemonte (COR Piemonte), University of Torino and CPO-Piemonte, 10124 Torino, Italy.
| | - Alessia Angelini
- Prevention and Clinical Network, Institute for Cancer Research, Regional Operating Center of Toscana (COR Toscana), 50139 Firenze, Italy.
| | - Andrea Martini
- Prevention and Clinical Network, Institute for Cancer Research, Regional Operating Center of Toscana (COR Toscana), 50139 Firenze, Italy.
| | - Corrado Negro
- Clinical Unit of Occupational Medicine, Regional Operating Center of Friuli-Venezia Giulia (COR Friuli-Venezia Giulia), University of Trieste-Trieste General Hospitals, 34123 Trieste, Italy .
| | - Flavia D'Agostin
- Clinical Unit of Occupational Medicine, Regional Operating Center of Friuli-Venezia Giulia (COR Friuli-Venezia Giulia), University of Trieste-Trieste General Hospitals, 34123 Trieste, Italy .
| | - Iolanda Grappasonni
- Regional Operating Center of Marche (COR Marche), School of Medicinal and Health Products Sciences, Uni-versity of Camerino, 62032 Camerino, Italy.
| | - Cristiana Pascucci
- Regional Operating Center of Marche (COR Marche), School of Medicinal and Health Products Sciences, Uni-versity of Camerino, 62032 Camerino, Italy.
| | - Lucia Benfatto
- Regional Operating Center of Liguria (COR Liguria Regional Operating Center of Liguria (COR Liguria), Clinical Epidemiology Unit, IRCCS Ospedale Policlinico San Martino, 16132 Genova, Italy.
| | - Davide Malacarne
- Regional Operating Center of Liguria (COR Liguria Regional Operating Center of Liguria (COR Liguria), Clinical Epidemiology Unit, IRCCS Ospedale Policlinico San Martino, 16132 Genova, Italy.
| | - Veronica Casotto
- Azienda Zero, Epidemiological Department, Regional Operating Center of Veneto (COR Veneto), Veneto Re-gion, 35131 Padova, Italy.
| | - Vera Comiati
- Azienda Zero, Epidemiological Department, Regional Operating Center of Veneto (COR Veneto), Veneto Re-gion, 35131 Padova, Italy.
| | - Cinzia Storchi
- Health Local Unit, Public Health Department, Regional Operating Center of Emilia-Romagna (COR Emi-lia-Romagna), 42020 Reggio Emilia, Italy, Epidemiology Unit, AUSL-IRCCS di Reggio Emilia, Italy.
| | - Lucia Mangone
- Health Local Unit, Public Health Department, Regional Operating Center of Emilia-Romagna (COR Emi-lia-Romagna), 42020 Reggio Emilia, Italy, Epidemiology Unit, AUSL-IRCCS di Reggio Emilia, Italy.
| | - Stefano Murano
- Occupational Medicine Unit, Alto Adige Health Authority, Regional Operating Center of Autonomous Province of Bolzano (COR A.P. of Bolzano), 39100 Bolzano, Italy.
| | - Lucia Rossin
- Occupational Medicine Unit, Alto Adige Health Authority, Regional Operating Center of Autonomous Province of Bolzano (COR A.P. of Bolzano), 39100 Bolzano, Italy.
| | - Federico Tallarigo
- Public Health Unit, Regional Operating Center of Calabria (COR Calabria), 88900 Crotone, Italy.
| | - Filomena Vitale
- Public Health Unit, Regional Operating Center of Calabria (COR Calabria), 88900 Crotone, Italy.
| | - Marina Verardo
- Valle d'Aosta Health Local Unit, Regional Operating Center of Valle d'Aosta (COR Valle d'Aosta), 11100 Aosta, Italy.
| | - Silvia Eccher
- Hygiene and Occupational Medicine, Provincial Unit of Health, Regional Operating Center o Autonomous Province of Trento (COR A.P. of Trento), 38100 Trento, Italy.
| | - Gabriella Madeo
- Center of Umbria (COR Umbria), Servizio Prevenzione, Sanità Veterinaria e Sicurezza Alimentare-Regione Umbria, 06126 Perugia, Italy.
| | - Tommaso Staniscia
- Occupational Medicine Unit, Health Local Unit, Regional Operating Center of Abruzzo (COR Abruzzo), 65121 Pescara, Italy.
| | - Francesco Carrozza
- Oncology Unit, Cardarelli Hospital, Regional Operating Center of Molise (COR Molise), 86100 Campobasso, It-aly.
| | - Ilaria Cozzi
- Regional Operating Center of Lazio (COR Lazio), Department of Epidemiology, Epidemiology Lazio Regional Health Service, ASL Roma 1, 00147 Roma, Italy.
| | - Elisa Romeo
- Regional Operating Center of Lazio (COR Lazio), Department of Epidemiology, Epidemiology Lazio Regional Health Service, ASL Roma 1, 00147 Roma, Italy.
| | - Paola Pelullo
- Department of Experimental Medicine, "Luigi Vanvitelli" University, Regional Operating Center of Campania (COR Campania), 80138 Napoli, Italy.
| | - Michele Labianca
- Epidemiologic Regional Center, Regional Operating Center of Basilicata (COR Basilicata), 85100 Potenza, Italy.
| | - Massimo Melis
- Regional Epidemiological Center, Regional Operating Center of Sardegna (COR Sardegna), 09125 Cagliari, Ita-ly.
| | - Giuseppe Cascone
- Cancer Registry ASP Ragusa and Sicilia Regional Epidemiological Observatory, Regional Operating Center of Sicilia (COR Sicilia), 97100 Ragusa, Italy.
| | - Alessandro Marinaccio
- Occupational and Environmental Medicine, Epidemiology and Hygiene Department, Italian Workers' Com-pensation Authority (INAIL), 00143 Rome, Italy.
| | | | - Gabriella Serio
- Department of Emergency and Organ Transplantation (DETO), Pathological Anatomy Section, University of Bari Aldo Moro, Bari, Italy.
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Sponselli S, De Maria L, Caputi A, Stefanizzi P, Bianchi FP, Delvecchio G, Foti C, Romita P, Ambrogio F, Zagaria S, Giannelli G, Tafuri S, Vimercati L. Infection Control among Healthcare Workers and Management of a Scabies Outbreak in a Large Italian University Hospital. J Clin Med 2023; 12:jcm12113830. [PMID: 37298025 DOI: 10.3390/jcm12113830] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Revised: 05/25/2023] [Accepted: 06/01/2023] [Indexed: 06/12/2023] Open
Abstract
This retrospective observational study describes the results of an ad-hoc designated prevention protocol aimed at containing the spread of the scabies infestation among healthcare workers (HCWs) of a large University Hospital in Italy. The outbreak started on October 2022 and a preventive protocol was set up thanks to a multidisciplinary approach. HCWs at high scabies risk were defined as subjects working in Operative Units with a scabies prevalence higher than 2%, close contacts of a confirmed case of scabies, or HCWs with signs and symptoms of the disease. All cases at high scabies risk underwent a dermatological examination, and the infested HCWs were suspended from work until definitive healing. Mass drug administration was established for all HCWs working in Operative Units with a scabies prevalence higher than 2%. Until March 2023, out of 183 screening dermatological examinations, 21 (11.5%) were diagnostic for scabies. Between 11 October 2022 (date of the first diagnosed scabies case) and 6 March 2023 (the end of incubation period related to the last case detected), the frequency of scabies was 0.35% (21 scabies cases/6000 HCWs). The duration of the outbreak in our hospital was 14.7 weeks. Statistical analysis shows a significant association between scabies and being a nurse and having an allergy to dust mites. We obtained a low frequency of scabies infection, limiting the duration of the outbreak and the related economic burden.
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Affiliation(s)
- Stefania Sponselli
- Interdisciplinary Department of Medicine, University of Bari, 70124 Bari, Italy
| | - Luigi De Maria
- Interdisciplinary Department of Medicine, University of Bari, 70124 Bari, Italy
| | - Antonio Caputi
- Interdisciplinary Department of Medicine, University of Bari, 70124 Bari, Italy
| | - Pasquale Stefanizzi
- Interdisciplinary Department of Medicine, University of Bari, 70124 Bari, Italy
| | | | - Giuseppe Delvecchio
- Interdisciplinary Department of Medicine, University of Bari, 70124 Bari, Italy
| | - Caterina Foti
- Department of Biomedical Science and Human Oncology, University of Bari, 70124 Bari, Italy
| | - Paolo Romita
- Department of Biomedical Science and Human Oncology, University of Bari, 70124 Bari, Italy
| | - Francesca Ambrogio
- Department of Biomedical Science and Human Oncology, University of Bari, 70124 Bari, Italy
| | - Silvia Zagaria
- Interdisciplinary Department of Medicine, University of Bari, 70124 Bari, Italy
| | - Gianmarco Giannelli
- Interdisciplinary Department of Medicine, University of Bari, 70124 Bari, Italy
| | - Silvio Tafuri
- Interdisciplinary Department of Medicine, University of Bari, 70124 Bari, Italy
| | - Luigi Vimercati
- Interdisciplinary Department of Medicine, University of Bari, 70124 Bari, Italy
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Shamabadi A, Karimi H, Cattarinussi G, Moghaddam HS, Akhondzadeh S, Sambataro F, Schiena G, Delvecchio G. Neuroimaging Correlates of Treatment Response to Transcranial Magnetic Stimulation in Bipolar Depression: A Systematic Review. Brain Sci 2023; 13:brainsci13050801. [PMID: 37239273 DOI: 10.3390/brainsci13050801] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Revised: 05/10/2023] [Accepted: 05/10/2023] [Indexed: 05/28/2023] Open
Abstract
Transcranial magnetic stimulation (TMS) has become a promising strategy for bipolar disorder (BD). This study reviews neuroimaging findings, indicating functional, structural, and metabolic brain changes associated with TMS in BD. Web of Science, Embase, Medline, and Google Scholar were searched without any restrictions for studies investigating neuroimaging biomarkers, through structural magnetic resonance imaging (MRI), diffusion tensor imaging (DTI), functional MRI (fMRI), magnetic resonance spectroscopy (MRS), positron emission tomography (PET), and single photon emission computed tomography (SPECT), in association with response to TMS in patients with BD. Eleven studies were included (fMRI = 4, MRI = 1, PET = 3, SPECT = 2, and MRS = 1). Important fMRI predictors of response to repetitive TMS (rTMS) included higher connectivity of emotion regulation and executive control regions. Prominent MRI predictors included lower ventromedial prefrontal cortex connectivity and lower superior frontal and caudal middle frontal volumes. SPECT studies found hypoconnectivity of the uncus/parahippocampal cortex and right thalamus in non-responders. The post-rTMS changes using fMRI mostly showed increased connectivity among the areas neighboring the coil. Increased blood perfusion was reported post-rTMS in PET and SPECT studies. Treatment response comparison between unipolar depression and BD revealed almost equal responses. Neuroimaging evidence suggests various correlates of response to rTMS in BD, which needs to be further replicated in future studies.
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Affiliation(s)
- Ahmad Shamabadi
- Psychiatric Research Center, Roozbeh Psychiatric Hospital, Tehran University of Medical Sciences, Tehran M9HV+R6Q, Iran
- School of Medicine, Tehran University of Medical Sciences, Tehran P94V+8MF, Iran
| | - Hanie Karimi
- Psychiatric Research Center, Roozbeh Psychiatric Hospital, Tehran University of Medical Sciences, Tehran M9HV+R6Q, Iran
- School of Medicine, Tehran University of Medical Sciences, Tehran P94V+8MF, Iran
| | - Giulia Cattarinussi
- Department of Neuroscience (DNS), Padua Neuroscience Center, University of Padova, 35131 Padua, Italy
| | - Hossein Sanjari Moghaddam
- Psychiatric Research Center, Roozbeh Psychiatric Hospital, Tehran University of Medical Sciences, Tehran M9HV+R6Q, Iran
| | - Shahin Akhondzadeh
- Psychiatric Research Center, Roozbeh Psychiatric Hospital, Tehran University of Medical Sciences, Tehran M9HV+R6Q, Iran
| | - Fabio Sambataro
- Department of Neuroscience (DNS), Padua Neuroscience Center, University of Padova, 35131 Padua, Italy
| | - Giandomenico Schiena
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy
| | - Giuseppe Delvecchio
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy
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22
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Enrico P, Delvecchio G, Turtulici N, Aronica R, Pigoni A, Squarcina L, Villa FM, Perlini C, Rossetti MG, Bellani M, Lasalvia A, Bonetto C, Scocco P, D'Agostino A, Torresani S, Imbesi M, Bellini F, Veronese A, Bocchio-Chiavetto L, Gennarelli M, Balestrieri M, Colombo GI, Finardi A, Ruggeri M, Furlan R, Brambilla P. Identification of an inflammation-associated psychosis onset subgroup by applying unsupervised machine learning to whole-blood expression levels of immune gene transcripts. Journal of Affective Disorders Reports 2023. [DOI: 10.1016/j.jadr.2023.100540] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/03/2023] Open
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23
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Seyedmirzaei H, Katebian S, Pourkand D, Cattarinussi G, Sambataro F, Brambilla P, Delvecchio G. Effects of COVID-19 pandemic on depression in patients with schizophrenia: A mini-review of the current evidence. J Affect Disord 2023; 332:143-149. [PMID: 37003432 PMCID: PMC10063456 DOI: 10.1016/j.jad.2023.03.087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Revised: 03/14/2023] [Accepted: 03/20/2023] [Indexed: 04/03/2023]
Abstract
BACKGROUND Since the emergence of COVID-19, there have been concerns about the psychological effects of the pandemic on people's mental health around the world. People with psychotic disorders like schizophrenia (SCZ) may be more prone to develop mood disorders during the lockdowns due to their limited access to healthcare, reduced social support, and probable cognitive impairment. METHODS We conducted a systematic search on PubMed and Scopus to explore the effects of the pandemic on depressive symptoms in individuals with SCZ. A total of 12 studies were included. RESULTS Overall, studies suggested higher depression rates in patients with SCZ compared to healthy controls. Isolation due to the COVID-19 infection emerged as a risk factor for the development of depressive symptoms. However, results regarding the longitudinal changes of depression in SCZ patients during the lockdowns were inconsistent. LIMITATIONS The small sample sizes of studies, different depression scales and stages of the lockdowns, as well as the different government policies and restriction levels across the countries limit the conclusions of the present review. CONCLUSIONS Our review suggests an increased probability of depression in patients with SCZ during the pandemic. Identifying the risk factors for developing depression in this population helps find new, suitable approaches to address patients' needs and lower the adverse psychological effects of the pandemic.
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Affiliation(s)
- Homa Seyedmirzaei
- School of Medicine, Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | - Saba Katebian
- School of Medicine, Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | - Donya Pourkand
- School of Medicine, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Giulia Cattarinussi
- Department of Neuroscience (DNS), University of Padova, Padua, Italy; Padova Neuroscience Center, University of Padova, Padua, Italy
| | - Fabio Sambataro
- Department of Neuroscience (DNS), University of Padova, Padua, Italy; Padova Neuroscience Center, University of Padova, Padua, Italy
| | - Paolo Brambilla
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy; Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Giuseppe Delvecchio
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy.
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24
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Massalha Y, Maggioni E, Callari A, Brambilla P, Delvecchio G. A review of resting-state fMRI correlations with executive functions and social cognition in bipolar disorder. J Affect Disord 2023; 334:337-351. [PMID: 37003435 DOI: 10.1016/j.jad.2023.03.084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Revised: 03/20/2023] [Accepted: 03/25/2023] [Indexed: 04/03/2023]
Abstract
BACKGROUND Deficits in executive functions (EF) and social cognition (SC) are often observed in bipolar disorder (BD), leading to a severe impairment in engaging a functional interaction with the others and the surrounding environment. Therefore, in recent years, resting-state functional magnetic resonance imaging (rs-fMRI) studies on BD tried to identify the neural underpinnings of these cognitive domains by exploring the association between the intrinsic functional connectivity (FC) and the scores in clinical scales evaluating these domains. METHODS A bibliographic search on PubMed and Scopus of studies evaluating the correlations between rs-fMRI findings and EF and/or SC in BD was conducted until March 2022. Ten studies met the inclusion criteria. RESULTS Overall, the results of the reviewed studies showed that BD patients had FC deficits compared to healthy controls (HC) in selective resting-state networks involved in EF and SC, which include the default mode network, especially the link between medial prefrontal cortex and posterior cingulate cortex, and the sensory-motor network. Finally, it also emerged the predominant role of alterations in prefrontal connections in explaining the cognitive deficits in BD patients. LIMITATIONS The heterogeneity of the reviewed studies, in terms of cognitive domains explored and neuroimaging acquisitions, limited the comparability of the findings. CONCLUSIONS rs-fMRI studies could help deepen the brain network alterations underlying EF and SC deficits in BD, pointing the attention on the neuronal underpinning of cognition, whose knowledge may lead to the development of new neurobiological-based approaches to improve the quality of life of these patients.
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Affiliation(s)
- Yara Massalha
- Department of Pathophysiology and Transplantation, University of Milan, 20122 Milan, Italy
| | - Eleonora Maggioni
- Department of Electronics, Information and Bioengineering, Politecnico di Milano, 20122 Milan, Italy
| | - Antonio Callari
- Fondazione IRCCS Ca' Granda-Ospedale Maggiore Policlinico, Department of Neurosciences and Mental Health, 20122 Milan, Italy
| | - Paolo Brambilla
- Department of Pathophysiology and Transplantation, University of Milan, 20122 Milan, Italy; Fondazione IRCCS Ca' Granda-Ospedale Maggiore Policlinico, Department of Neurosciences and Mental Health, 20122 Milan, Italy
| | - Giuseppe Delvecchio
- Fondazione IRCCS Ca' Granda-Ospedale Maggiore Policlinico, Department of Neurosciences and Mental Health, 20122 Milan, Italy.
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25
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Kennedy KG, Mio M, Goldstein BI, Brambilla P, Delvecchio G. Systematic review and meta-analysis of retinal microvascular caliber in bipolar disorder, major depressive disorder, and schizophrenia. J Affect Disord 2023; 331:342-351. [PMID: 36958491 DOI: 10.1016/j.jad.2023.03.040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Revised: 03/06/2023] [Accepted: 03/09/2023] [Indexed: 03/25/2023]
Abstract
BACKGROUND Individuals with a severe mental illness (SMI), such as bipolar disorder (BD), major depressive disorder (MDD), and schizophrenia (SZ), have increased rates of cardiovascular and cerebrovascular disease. Interestingly, it has been reported that retinal microvessels, a proxy cerebrovascular measure, non-invasively assessed via retinal imaging, predict future cardiovascular disease, with some studies also showing anomalous retinal microvascular caliber in SMI. Therefore, this review and meta-analysis evaluated whether retinal microvascular caliber differs between individuals with SMI vs controls and summarized current findings. METHODS A systematic literature search for retinal microvascular caliber and SMI was conducted in Embase and MEDLINE. Studies needed to be published in English before 2022 December 1st and examine retinal microvascular caliber in individuals diagnosed with a SMI. Finally, a meta-analysis of arteriolar and venular caliber in SMI case-controlled studies was also conducted. RESULTS The search yielded 65 unique articles, 11 were included in the review and 6 in the meta-analysis. The meta-analysis found that the SMI group had significantly wider venules than controls (SMD = -0.53; 95 % CI = 0.24, 0.81; p = 0.0004) but not arterioles (SMD = 0.07; 95 % CI = -0.29, 0.44; p = 0.70). Additionally, the systematic review found that poorer retinal microvascular health is associated with greater illness severity. LIMITATIONS Large heterogeneity of findings and small sample size. CONCLUSION This systematic review and meta-analysis found that SMI, specifically SZ, is associated with wider retinal venules. Retinal imaging, a fast, cost-effective, and non-invasive assay of cerebrovascular health, may provide insight into the pathophysiological processes of SMI. However, future longitudinal studies investigating these findings are warranted.
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Affiliation(s)
- Kody G Kennedy
- Centre for Youth Bipolar Disorder, Centre for Addictions and Mental Health, Toronto, Canada; Department of Pharmacology, University of Toronto, Toronto, Canada
| | - Megan Mio
- Centre for Youth Bipolar Disorder, Centre for Addictions and Mental Health, Toronto, Canada; Department of Pharmacology, University of Toronto, Toronto, Canada
| | - Benjamin I Goldstein
- Centre for Youth Bipolar Disorder, Centre for Addictions and Mental Health, Toronto, Canada; Department of Pharmacology, University of Toronto, Toronto, Canada
| | - Paolo Brambilla
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy; Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - Giuseppe Delvecchio
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
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26
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De Maria L, Sponselli S, Caputi A, Delvecchio G, Giannelli G, Pipoli A, Cafaro F, Zagaria S, Cavone D, Sardone R, Vimercati L. Indoor Radon Concentration Levels in Healthcare Settings: The Results of an Environmental Monitoring in a Large Italian University Hospital. Int J Environ Res Public Health 2023; 20:4685. [PMID: 36981594 PMCID: PMC10048382 DOI: 10.3390/ijerph20064685] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Revised: 03/03/2023] [Accepted: 03/04/2023] [Indexed: 06/18/2023]
Abstract
The aim of the study is to determine the radon concentrations in the University Hospital of Bari, Apulia Region, Southern Italy. The monitoring took place from 2017 to 2018 for a total of 402 days and included 3492 premises. Radon environmental sampling was performed with passive dosimeters of the CR-39 type. The highest mean concentration was found in basement rooms (118.9 Bq/m3), followed by ground-floor rooms (88.2 Bq/m3), first-floor rooms (78.1 Bq/m3), second-floor rooms (66.7 Bq/m3), and third-floor rooms (68.9 Bq/m3). An average radon concentration lower than the WHO recommended level of 100 Bq/m3 was detected in 73.5% of monitored environments, while only 0.9% exceeded the reference level of 300 Bq/m3 set by the national law (Legislative Decree 101/2020). The frequency of environments in which radon concentrations exceed 300 Bq/m3 is significantly higher in the basement (p-value < 0.001). As for a previous preliminary investigation in the same hospital conducted on a much smaller number of premises (n = 401), most of the monitored environments had radon concentrations lower than the reference levels set by the new national law, and the risk to the healthcare workers' health derived from occupational exposure to radon could be considered acceptable.
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Affiliation(s)
- Luigi De Maria
- Interdisciplinary Department of Medicine, University of Bari, 70124 Bari, Italy
| | - Stefania Sponselli
- Interdisciplinary Department of Medicine, University of Bari, 70124 Bari, Italy
| | - Antonio Caputi
- Interdisciplinary Department of Medicine, University of Bari, 70124 Bari, Italy
| | - Giuseppe Delvecchio
- Interdisciplinary Department of Medicine, University of Bari, 70124 Bari, Italy
| | - Gianmarco Giannelli
- Interdisciplinary Department of Medicine, University of Bari, 70124 Bari, Italy
| | - Antonella Pipoli
- Interdisciplinary Department of Medicine, University of Bari, 70124 Bari, Italy
| | - Francesco Cafaro
- Interdisciplinary Department of Medicine, University of Bari, 70124 Bari, Italy
| | - Silvia Zagaria
- Interdisciplinary Department of Medicine, University of Bari, 70124 Bari, Italy
| | - Domenica Cavone
- Interdisciplinary Department of Medicine, University of Bari, 70124 Bari, Italy
| | - Rodolfo Sardone
- Unit of Data Sciences and Technology Innovation for Population Health, National Institute of Gastroenterology “Saverio de Bellis”, Research Hospital, Castellana Grotte, 70013 Bari, Italy
- Unit of Epidemiology and Statistics, Local Healthcare Authority of Taranto, 74121 Taranto, Italy
| | - Luigi Vimercati
- Interdisciplinary Department of Medicine, University of Bari, 70124 Bari, Italy
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27
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Enrico P, Delvecchio G, Turtulici N, Aronica R, Pigoni A, Squarcina L, Villa FM, Perlini C, Rossetti MG, Bellani M, Lasalvia A, Bonetto C, Scocco P, D'Agostino A, Torresani S, Imbesi M, Bellini F, Veronese A, Bocchio-Chiavetto L, Gennarelli M, Balestrieri M, Colombo GI, Finardi A, Ruggeri M, Furlan R, Brambilla P. A machine learning approach on whole blood immunomarkers to identify an inflammation-associated psychosis onset subgroup. Mol Psychiatry 2023; 28:1190-1200. [PMID: 36604602 DOI: 10.1038/s41380-022-01911-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Revised: 11/29/2022] [Accepted: 12/07/2022] [Indexed: 01/07/2023]
Abstract
Psychosis onset is a transdiagnostic event that leads to a range of psychiatric disorders, which are currently diagnosed through clinical observation. The integration of multimodal biological data could reveal different subtypes of psychosis onset to target for the personalization of care. In this study, we tested the existence of subgroups of patients affected by first-episode psychosis (FEP) with a possible immunopathogenic basis. To do this, we designed a data-driven unsupervised machine learning model to cluster a sample of 127 FEP patients and 117 healthy controls (HC), based on the peripheral blood expression levels of 12 psychosis-related immune gene transcripts. To validate the model, we applied a resampling strategy based on the half-splitting of the total sample with random allocation of the cases. Further, we performed a post-hoc univariate analysis to verify the clinical, cognitive, and structural brain correlates of the subgroups identified. The model identified and validated two distinct clusters: 1) a FEP cluster characterized by the high expression of inflammatory and immune-activating genes (IL1B, CCR7, IL12A and CXCR3); 2) a cluster consisting of an equal number of FEP and HC subjects, which did not show a relative over or under expression of any immune marker (balanced subgroup). None of the subgroups was related to specific symptoms dimensions or longitudinal diagnosis of affective vs non-affective psychosis. FEP patients included in the balanced immune subgroup showed a thinning of the left supramarginal and superiorfrontal cortex (FDR-adjusted p-values < 0.05). Our results demonstrated the existence of a FEP patients' subgroup identified by a multivariate pattern of immunomarkers involved in inflammatory activation. This evidence may pave the way to sample stratification in clinical studies aiming to develop diagnostic tools and therapies targeting specific immunopathogenic pathways of psychosis.
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Affiliation(s)
- Paolo Enrico
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy.,Department of Psychiatry and Psychotherapy, Ludwig-Maximilian-University, Munich, Germany
| | - Giuseppe Delvecchio
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - Nunzio Turtulici
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - Rosario Aronica
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - Alessandro Pigoni
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy.,Social and Affective Neuroscience Group, MoMiLab, IMT School for Advanced Studies Lucca, Lucca, Italy
| | - Letizia Squarcina
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - Filippo M Villa
- Child Psychopathology Unit, Scientific Institute, IRCCS Eugenio Medea, Bosisio Parini, Lecco, Italy
| | - Cinzia Perlini
- Department of Neurosciences, Biomedicine and Movement Sciences, Section of Clinical Psychology, University of Verona, Verona, Italy.,USD Clinical Psychology, Azienda Ospedaliera Universitaria Integrata (AOUI) of Verona, Verona, Italy
| | - Maria G Rossetti
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - Marcella Bellani
- Department of Neurosciences, Biomedicine and Movement Sciences, Section of Psychiatry, University of Verona, Verona, Italy.,UOC of Psychiatry, Azienda Ospedaliera Universitaria Integrata (AOUI) of Verona, Verona, Italy
| | - Antonio Lasalvia
- Department of Neurosciences, Biomedicine and Movement Sciences, Section of Psychiatry, University of Verona, Verona, Italy
| | - Chiara Bonetto
- Department of Neurosciences, Biomedicine and Movement Sciences, Section of Psychiatry, University of Verona, Verona, Italy
| | - Paolo Scocco
- Department of Mental Health, AULSS 6 Euganea, Padua, Italy
| | - Armando D'Agostino
- Department of Health Sciences, San Paolo University Hospital, University of Milan, Milano, Milan, Italy
| | - Stefano Torresani
- Department of Psychiatry, ULSS, Bolzano Suedtiroler Sanitaetbetrieb- Azienda Sanitaria dell'Alto Adige, Bolzano, Italy
| | | | | | | | - Luisella Bocchio-Chiavetto
- Faculty of Psychology, eCampus University, Novedrate, Como, Italy.,Genetics Unit, IRCCS Istituto Centro San Giovanni di Dio, Fatebenefratelli, Brescia, Italy
| | - Massimo Gennarelli
- Genetics Unit, IRCCS Istituto Centro San Giovanni di Dio, Fatebenefratelli, Brescia, Italy.,Department of Molecular and Translational Medicine, University of Brescia, Brescia, Italy
| | | | - Gualtiero I Colombo
- Centro Cardiologico Monzino IRCCS, Immunology and Functional Genomics Unit, Milan, Italy
| | - Annamaria Finardi
- Clinical Neuroimmunology Unit, Institute of Experimental Neurology, IRCCS Ospedale San Raffaele, Milano, Italy
| | - Mirella Ruggeri
- Department of Neurosciences, Biomedicine and Movement Sciences, Section of Psychiatry, University of Verona, Verona, Italy.,UOC of Psychiatry, Azienda Ospedaliera Universitaria Integrata (AOUI) of Verona, Verona, Italy
| | - Roberto Furlan
- Clinical Neuroimmunology Unit, Institute of Experimental Neurology, IRCCS Ospedale San Raffaele, Milano, Italy
| | - Paolo Brambilla
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy. .,Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy.
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28
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Zito S, Nosari G, Pigoni A, Moltrasio C, Delvecchio G. Association between testosterone levels and mood disorders: A minireview. J Affect Disord 2023; 330:48-56. [PMID: 36841309 DOI: 10.1016/j.jad.2023.02.108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Revised: 02/17/2023] [Accepted: 02/20/2023] [Indexed: 02/27/2023]
Abstract
BACKGROUND Although many studies reported the neuropsychiatric involvement of testosterone (T) levels in the development of mood disorders, its role in this disabling disorder is still not well understood. Therefore, in this review, we aim to summarize the current literature exploring serum testosterone levels in both major depressive disorder (MDD) and bipolar disorder (BD), with particular attention given to the possible causal relationship between pathological mood alterations and T levels. METHODS We selected 9 original studies from a bibliographic search on PubMed, excluding studies on hormonal therapy and other psychiatric disorders other than mood disorders. RESULTS The results reported by the reviewed studies were conflicting especially with regards to the presence of dysfunctional levels of T in patients with BD. Specifically, while MDD was found to be associated with low levels of T compared to healthy controls (HC), in BD the results were highly heterogeneous, with a mixed picture of reduced, increased or no difference in T levels in BD patients compared to HC. LIMITATIONS Studies were highly heterogeneous in terms of samples employed, psychometric scales used for assessing depressive symptoms, T assay methods and therapeutic regimens. CONCLUSIONS Overall, T levels were shown to be reduced in both MDD and BD patients, ultimately suggesting that T could be useful as a biomarker in mood disorders and provide guidance for future research.
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Affiliation(s)
- Silvana Zito
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Guido Nosari
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy; Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - Alessandro Pigoni
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Chiara Moltrasio
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Giuseppe Delvecchio
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
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29
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Villa FM, Crippa A, Rosi E, Nobile M, Brambilla P, Delvecchio G. ADHD and eating disorders in childhood and adolescence: An updated minireview. J Affect Disord 2023; 321:265-271. [PMID: 36356347 DOI: 10.1016/j.jad.2022.10.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Revised: 10/12/2022] [Accepted: 10/17/2022] [Indexed: 11/09/2022]
Abstract
INTRODUCTION Attention-deficit/hyperactivity disorder (ADHD) is one of the most common neurodevelopmental disorders with overactivity, inattention, and impulsivity as core characteristics. Recent studies suggest that 20 % of children with ADHD also develop eating disorders (EDs), including anorexia nervosa, bulimia nervosa and binge eating disorder. However, little is still known about the association between ADHD and EDs through childhood and adolescence. Therefore, in the present work, we aimed at summarizing the studies investigating ADHD and EDs in childhood and adolescence over the last 10 years. METHODS A bibliographic search on PubMed was performed and only studies that considered participants with a clinical diagnosis of ADHD, patients with an additional diagnosis of EDs and patients under 18 years old were included. A total of 7 studies were retrieved and included in the review. RESULTS The majority of the reviewed studies (N = 5) found an association between ADHD and EDs, while the remaining, which focused on EDs symptomatology, reported either lower ED symptoms in ADHD sample or no association between ADHD and EDs. LIMITATIONS the majority of studies were cross-sectional and therefore did not allow to explore the longitudinal casual relation between ADHD and EDs in the developmental age range considered. CONCLUSIONS This review suggests that children and adolescents with ADHD should be monitored for EDs. However, more work is still needed to better understand the clinical implications of the comorbidity between ADHD and EDs and its prospective impact on the life of children and adolescents with ADHD.
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Affiliation(s)
- F M Villa
- Child Psychopathology Unit, Scientific Institute, IRCCS E. Medea, 23842 Bosisio Parini, Italy
| | - A Crippa
- Child Psychopathology Unit, Scientific Institute, IRCCS E. Medea, 23842 Bosisio Parini, Italy
| | - E Rosi
- Child Psychopathology Unit, Scientific Institute, IRCCS E. Medea, 23842 Bosisio Parini, Italy
| | - M Nobile
- Child Psychopathology Unit, Scientific Institute, IRCCS E. Medea, 23842 Bosisio Parini, Italy
| | - P Brambilla
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy; Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy.
| | - G Delvecchio
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
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De Maria L, Sponselli S, Caputi A, Stefanizzi P, Pipoli A, Giannelli G, Delvecchio G, Tafuri S, Inchingolo F, Migliore G, Bianchi FP, Boffetta P, Vimercati L. SARS-CoV-2 Breakthrough Infections in Health Care Workers: An Italian Retrospective Cohort Study on Characteristics, Clinical Course and Outcomes. J Clin Med 2023; 12:jcm12020628. [PMID: 36675555 PMCID: PMC9864312 DOI: 10.3390/jcm12020628] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Revised: 01/03/2023] [Accepted: 01/10/2023] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND The aim of this study was to determine the characteristics, clinical course and outcomes of COVID-19 breakthrough infections (BIs) among healthcare workers (HCWs) of an Italian University Hospital. METHODS A retrospective observational study was conducted on 6111 HCWs, from January 2021 to February 2022. The study population was offered the full vaccination with BNT162b2 mRNA COVID-19 vaccine. To allow return to work after BI, the protocol required one negative nasopharyngeal RT-PCR swab followed by a medical examination to assess the HCW's health status. Laboratory tests, instrumental tests and specialist evaluations were carried out if necessary. RESULTS The cases of BIs observed numbered 582 (9.7%). The frequency of BIs was significantly higher in females than in males (67% vs. 33%; p = 0.03), and in nurses than in all other professional categories (p = 0.001). A total of 88% of the HCWs affected by BI were still symptomatic after the negative swab. None of the instrumental tests carried out showed any new findings of pathological significance. All cases showed progressive disappearance of symptoms, such that no cases of long COVID and no hospitalization or deaths were recorded. CONCLUSIONS Our results confirm that SARS-CoV-2 infections occur even after a full vaccination course; however, the clinical course is favorable and severe outcomes are reduced.
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Affiliation(s)
- Luigi De Maria
- Interdisciplinary Department of Medicine, University of Bari, 70124 Bari, Italy
| | - Stefania Sponselli
- Interdisciplinary Department of Medicine, University of Bari, 70124 Bari, Italy
| | - Antonio Caputi
- Interdisciplinary Department of Medicine, University of Bari, 70124 Bari, Italy
- Correspondence: (A.C.); (L.V.); Tel.: +39-08-0547-8256 (L.V.)
| | - Pasquale Stefanizzi
- Interdisciplinary Department of Medicine, University of Bari, 70124 Bari, Italy
| | - Antonella Pipoli
- Interdisciplinary Department of Medicine, University of Bari, 70124 Bari, Italy
| | - Gianmarco Giannelli
- Interdisciplinary Department of Medicine, University of Bari, 70124 Bari, Italy
| | - Giuseppe Delvecchio
- Interdisciplinary Department of Medicine, University of Bari, 70124 Bari, Italy
| | - Silvio Tafuri
- Interdisciplinary Department of Medicine, University of Bari, 70124 Bari, Italy
| | | | - Giovanni Migliore
- General Direction, Policlinico Regional Hospital of Bari, 70124 Bari, Italy
| | | | - Paolo Boffetta
- Stony Brook Cancer Center, Stony Brook University, Stony Brook, NY 11794, USA
- Department of Medical and Surgical Sciences, University of Bologna, 40138 Bologna, Italy
| | - Luigi Vimercati
- Interdisciplinary Department of Medicine, University of Bari, 70124 Bari, Italy
- Correspondence: (A.C.); (L.V.); Tel.: +39-08-0547-8256 (L.V.)
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Aronica R, Enrico P, Squarcina L, Brambilla P, Delvecchio G. Association between Diffusion Tensor Imaging, inflammation and immunological alterations in unipolar and bipolar depression: A review. Neurosci Biobehav Rev 2022; 143:104922. [PMID: 36272579 DOI: 10.1016/j.neubiorev.2022.104922] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Revised: 09/23/2022] [Accepted: 10/17/2022] [Indexed: 11/06/2022]
Abstract
Major Depressive Disorder (MDD) and Bipolar Disorder Depression (BDD) are common psychiatric illnesses characterized by structural and functional brain alterations and signs of neuroinflammation. In line with the neuroinflammatory pathogenesis of depressive syndromes, recent studies have demonstrated how white matter (WM) microstructural impairments detected by Diffusion Tensor Imaging, are correlated to peripheral immunomarkers in depressed patients. In this context, we performed a comprehensive systematic search on PubMed, Medline and Scopus of the original studies published till June 2022, exploring the association between immunomarkers and WM alteration patterns in patients affected by MDD or BDD. Overall, the studies included in this review showed a consistent association between blood proinflammatory and counter-regulatory immunomarkers, including regulatory T cells and natural killer cells markers, as well as measures of demyelination and dysmyelination in both MDD and BDD patients. These pathogenetic insights could outline an integrated clinical perspective to affective disorders, helping psychiatrists to develop novel biotype-to-phenotype models of depression and opening the way to tailored approaches in treatments.
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Affiliation(s)
- Rosario Aronica
- Department of Pathophysiology and Transplantation, University of Milan, 20122 Milan, Italy; Fondazione IRCCS Ca' Granda-Ospedale Maggiore Policlinico, Department of Neurosciences and Mental Health, 20122 Milan, Italy
| | - Paolo Enrico
- Department of Pathophysiology and Transplantation, University of Milan, 20122 Milan, Italy; Fondazione IRCCS Ca' Granda-Ospedale Maggiore Policlinico, Department of Neurosciences and Mental Health, 20122 Milan, Italy
| | - Letizia Squarcina
- Department of Pathophysiology and Transplantation, University of Milan, 20122 Milan, Italy
| | - Paolo Brambilla
- Department of Pathophysiology and Transplantation, University of Milan, 20122 Milan, Italy; Fondazione IRCCS Ca' Granda-Ospedale Maggiore Policlinico, Department of Neurosciences and Mental Health, 20122 Milan, Italy
| | - Giuseppe Delvecchio
- Fondazione IRCCS Ca' Granda-Ospedale Maggiore Policlinico, Department of Neurosciences and Mental Health, 20122 Milan, Italy.
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Delvecchio G, Gritti D, Squarcina L, Brambilla P. Neurovascular alterations in bipolar disorder: A review of perfusion weighted magnetic resonance imaging studies. J Affect Disord 2022; 316:254-272. [PMID: 35940377 DOI: 10.1016/j.jad.2022.07.059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Revised: 07/08/2022] [Accepted: 07/22/2022] [Indexed: 11/19/2022]
Abstract
BACKGROUND Bipolar Disorder (BD) is a severe chronic psychiatric disorder whose aetiology is still largely unknown. However, increasing literature reported the involvement of neurovascular factors in the pathophysiology of BD, suggesting that a measure of Cerebral Blood Flow (CBF) could be an important biomarker of the illness. Therefore, since, to date, Magnetic Resonance Perfusion Weighted Imaging (PWI) techniques, such as Dynamic Susceptibility Contrast (DSC) and Arterial Spin Labelling (ASL), are the most common approaches that allow non-invasive in-vivo perfusion measurements,this review aims to summarize the results from all PWI studies that evaluated the CBF in BD. METHODS A bibliographic search in PubMed up until May 2021 was performed. 16 PWI studies that used DSC or ASL sequences met our inclusion criteria. RESULTS Overall, the results supported the presence of hyper-perfusion in the cingulate cortex and fronto-temporal regions, as well as the presence of hypo-perfusion in the cerebellum in BD, compared with both healthy controls and patients with unipolar depression. CBF changes after cognitive and aerobic training, as well as in relation with other physiological, clinical, and neurocognitive variables were also reported. LIMITATIONS The heterogeneity across the studies, in terms of experimental designs, sample selection, and methodological approach employed, limited the studies' comparison. CONCLUSIONS These findings showed CBF alterations in the cingulate cortex, fronto-temporal regions, and cerebellum in BD, suggesting that CBF may be an important pathophysiological marker of BD that merits further investigation to clarify the extent of neurovascular alterations.
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Affiliation(s)
- Giuseppe Delvecchio
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy.
| | - Davide Gritti
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - Letizia Squarcina
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - Paolo Brambilla
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy; Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
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Cattarinussi G, Bellani M, Maggioni E, Sambataro F, Brambilla P, Delvecchio G. Resting-state functional connectivity and spontaneous brain activity in early-onset bipolar disorder: A review of functional Magnetic Resonance Imaging studies. J Affect Disord 2022; 311:463-471. [PMID: 35580695 DOI: 10.1016/j.jad.2022.05.055] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Revised: 05/04/2022] [Accepted: 05/10/2022] [Indexed: 10/18/2022]
Abstract
BACKGROUND Early-onset bipolar disorder (BD) is a complex psychiatric illness characterized by mood swings, irritability and functional impairments. To improve our understanding of the pathophysiology of the disorder, we collected the existing resting-state functional Magnetic Resonance Imaging (rs-fMRI) studies exploring resting-state functional connectivity (rs-FC) and spontaneous activity alterations in children and adolescents with BD. METHODS A search on PubMed, Web of Science and Scopus was conducted to identify all the relevant rs-fMRI investigations conducted in early-onset BD. A total of 14 studies employing different methodological approaches to explore rs-FC and spontaneous activity in early-onset BD were included (independent component analysis, n = 1; seed-based analysis, n = 7; amplitude of low frequency fluctuations analysis, n = 2; regional homogeneity analysis, n = 4). RESULTS Overall, the studies showed abnormalities within the Default Mode Network (DMN) and between the DMN and the Salience Network (SN). Moreover, widespread alterations in rs-FC and spontaneous brain activity within and between cortico-limbic structures, involving primarily the occipital and frontal lobes, amygdala, hippocampus, insula, thalamus and striatum were also reported. LIMITATIONS The small sample sizes, the use of medications, the presence of comorbidities and the heterogeneity in methods hamper the integration of the study findings. CONCLUSIONS Early-onset BD seems to be characterized by selective rs-FC and spontaneous activity dysfunctions in DMN and SN as well as in the cortico-limbic and cortico-striatal circuits, which could explain the emotive and cognitive deficits observed in this disabling psychiatric illness.
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Affiliation(s)
- Giulia Cattarinussi
- Department of Neuroscience (DNS), University of Padova, Padua, Italy; Padua Neuroscience Center, University of Padova, Padua, Italy
| | - Marcella Bellani
- Section of Psychiatry, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Eleonora Maggioni
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy; Department of Electronics Information and Bioengineering, Politecnico di Milano, Milano, Italy
| | - Fabio Sambataro
- Department of Neuroscience (DNS), University of Padova, Padua, Italy; Padua Neuroscience Center, University of Padova, Padua, Italy
| | - Paolo Brambilla
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy; Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - Giuseppe Delvecchio
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
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Cattarinussi G, Delvecchio G, Sambataro F, Brambilla P. The effect of polygenic risk scores for major depressive disorder, bipolar disorder and schizophrenia on morphological brain measures: A systematic review of the evidence. J Affect Disord 2022; 310:213-222. [PMID: 35533776 DOI: 10.1016/j.jad.2022.05.007] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2021] [Revised: 04/27/2022] [Accepted: 05/04/2022] [Indexed: 01/26/2023]
Abstract
BACKGROUND Major depressive disorder (MDD), bipolar disorder (BD) and schizophrenia (SCZ) share clinical features and genetic bases. Magnetic Resonance Imaging (MRI) studies assessing the effect of polygenic risk score (PRS) for psychiatric disorders on brain structure show heterogeneous results. Therefore, we provided an overview of the existing evidence on the association between PRS for MDD, BD and SCZ and MRI abnormalities in clinical and healthy populations. METHODS A search on PubMed, Web of Science and Scopus was performed to identify the studies exploring the effect of PRS for MDD, BD and SCZ on MRI measures. A total of 25 studies were included (N = 13 on healthy individuals and N = 12 on clinical populations). RESULTS Both in affected and unaffected individuals, PRS for BD and SCZ showed either positive or negative correlations with cortical thickness (CT), mostly involving fronto-temporal areas, whereas PRS for MDD was associated with cortical alterations in prefrontal regions in healthy subjects. LIMITATIONS The heterogeneity in the methods limits the conclusions of this review. CONCLUSIONS Overall the evidence on the effect of PRS for MDD, BD and SCZ on brain is considerably heterogeneous and far to be conclusive. However, from the results emerged that PRS for MDD, BD and SCZ were associated with widespread cortical abnormalities in all the populations explored, suggesting that genetic risk for MDD, BD and SCZ might affect neurodevelopmental processes, resulting in cortical alterations that transcend diagnostic boundaries and seem to be independent from the clinical status.
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Affiliation(s)
- Giulia Cattarinussi
- Department of Neuroscience (DNS), University of Padova, Padua, Italy; Padua Neuroscience Center, University of Padova, Padua, Italy
| | - Giuseppe Delvecchio
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
| | - Fabio Sambataro
- Department of Neuroscience (DNS), University of Padova, Padua, Italy; Padua Neuroscience Center, University of Padova, Padua, Italy
| | - Paolo Brambilla
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy; Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
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Caletti E, Massimo C, Magliocca S, Moltrasio C, Brambilla P, Delvecchio G. The role of the acceptance and commitment therapy in the treatment of social anxiety: An updated scoping review. J Affect Disord 2022; 310:174-182. [PMID: 35537544 DOI: 10.1016/j.jad.2022.05.008] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Revised: 04/27/2022] [Accepted: 05/04/2022] [Indexed: 12/01/2022]
Abstract
BACKGROUND Social Anxiety Disorder (SAD) or Social Phobia is characterized by fear and anxiety of social circumstances that negatively impact an individual's occupational and relational life. There are several treatment options for this disorder ranging from pharmacological therapy to psychotherapies. In particular, the Acceptance and Commitment Therapy (ACT), a form of cognitive-behavioral therapy that practices acceptance and awareness strategies with behavior change strategies in order to increase an individual's mental flexibility, has been found to be effective. In this review, we aimed to provide an overview of recent studies that examined ACT's efficacy in SAD, also taking into consideration the comparison with traditional Cognitive-behavioral Therapy (CBT) interventions. METHODS A bibliographic search on PubMed, EMBASE and Scopus was conducted from inception to the 3rd of February 2022 of all studies investigating the effect of ACT in SAD individuals without any comorbidity. Among the articles retrieved, 11 met the inclusion criteria. RESULTS From the reviewed studies, ACT may be considered a promising treatment of social phobia by improving attentional bias, awareness, emotion regulation, and safety/avoidance behaviors; however, the results have not yet demonstrated a valid alternative to the CBT. LIMITATIONS Only four studies considered a follow-up evaluation, which is paramount to exploring the effectiveness of ACT and several studies have a very small sample size. Concerning the review itself we only considered original English articles and we did not measure the risk of publication bias and the risk of bias between studies. CONCLUSIONS The results of this study suggest that ACT can be a promising treatment for improving selective psychological problems often observed in SAD. However, larger longitudinal studies further exploring the effectiveness of the behavioral and cognitive "third-wave" psychotherapies, based mainly on acceptance of SAD, are necessary.
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Affiliation(s)
- Elisabetta Caletti
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - Chiara Massimo
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - Sara Magliocca
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy; Department of Psychology, University of Milan-Bicocca, Milan, Italy
| | - Chiara Moltrasio
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - Paolo Brambilla
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy; Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - Giuseppe Delvecchio
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy.
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Cellini P, Pigoni A, Delvecchio G, Moltrasio C, Brambilla P. Machine learning in the prediction of postpartum depression: A review. J Affect Disord 2022; 309:350-357. [PMID: 35460742 DOI: 10.1016/j.jad.2022.04.093] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Revised: 03/29/2022] [Accepted: 04/13/2022] [Indexed: 02/06/2023]
Abstract
BACKGROUND Current screening options in the setting of postpartum depression (PPD) are firmly rooted in self-report symptom-based tools. The implementation of the modern machine learning (ML) approaches might, in this context, represent a way to refine patient screening by precisely identifying possible PPD predictors and, subsequently, a population at risk of developing the disease, in an effort to lower its morbidity, mortality and its economic burden. METHODS We performed a bibliographic search on PubMed and Embase looking for studies aimed at the identification of PPD predictors using ML techniques. RESULTS Among the 482 articles retrieved, 11 met the inclusion criteria. The most used algorithm was the support vector machine. Notably, all studies reached an area under the curve above 0.7, ultimately suggesting that the prediction of PPD could be feasible. Variables obtained from sociodemographic and clinical aspects (psychiatric and gynecological factors) seem to be the most reliable. Only three studies employed biological variables, in the form of blood, genetic and epigenetic predictors, while no study employed imaging techniques. LIMITATIONS The literature on PPD prediction via ML techniques is currently scarce, with most studies employing different variables selection and ML algorithms, ultimately reducing the generalizability of the results. CONCLUSIONS The identification of a population at risk of developing PPD might be feasible with current technology and clinical knowledge. Further studies are necessary to clarify how such an approach could be implemented into clinical practice.
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Affiliation(s)
- Paolo Cellini
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - Alessandro Pigoni
- Social and Affective Neuroscience Group, MoMiLab, IMT School for Advanced Studies Lucca, Lucca, Italy; Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - Giuseppe Delvecchio
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy.
| | - Chiara Moltrasio
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - Paolo Brambilla
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy; Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
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Boscutti A, Cereda G, Lazzaretti M, Enrico P, Fiorentini A, Prunas C, Callari A, Fontana E, Delvecchio G, Brambilla P. Successful clozapine rechallenge after myopericarditis: a case report. Int Clin Psychopharmacol 2022; 37:179-181. [PMID: 35661661 PMCID: PMC10885862 DOI: 10.1097/yic.0000000000000407] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Clozapine-induced myocarditis and pericarditis are uncommon adverse effects of clozapine treatment. However, in most cases, they lead to clozapine discontinuation. Here, we describe a case of successful clozapine rechallenge after clozapine-induced myopericarditis. The patient, a 31-year-old male with treatment-resistant schizophrenia (TRS), developed dyspnea on exertion and chest pain on day 19 after the start of clozapine titration. An electrocardiogram (ECG) showed widespread, mild, convex ST interval elevation. While troponin levels were mildly elevated, the echocardiogram was unremarkable. A myopericarditis diagnosis was formulated, and clozapine was stopped, with a progressive resolution of clinical, laboratory and ECG abnormalities. After 6 months, a rechallenge with clozapine was attempted. A very slow titration scheme was adopted, along with close monitoring of clinical, laboratory and ECG parameters. Clozapine target dose was reached without the occurrence of any abnormality. Given the unique role of clozapine in the management of TRS, clozapine rechallenge may be considered after pericarditis, even with troponin levels elevation. Further studies are needed to update current clinical guidelines.
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Affiliation(s)
- Andrea Boscutti
- Department of Pathophysiology and Transplantation, University of Milan and
| | - Guido Cereda
- Department of Pathophysiology and Transplantation, University of Milan and
| | - Matteo Lazzaretti
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda-Ospedale Maggiore Policlinico, Milan, Italy
| | - Paolo Enrico
- Department of Pathophysiology and Transplantation, University of Milan and
| | - Alessio Fiorentini
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda-Ospedale Maggiore Policlinico, Milan, Italy
| | - Cecilia Prunas
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda-Ospedale Maggiore Policlinico, Milan, Italy
| | - Antonio Callari
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda-Ospedale Maggiore Policlinico, Milan, Italy
| | - Elisa Fontana
- Department of Pathophysiology and Transplantation, University of Milan and
| | - Giuseppe Delvecchio
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda-Ospedale Maggiore Policlinico, Milan, Italy
| | - Paolo Brambilla
- Department of Pathophysiology and Transplantation, University of Milan and
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda-Ospedale Maggiore Policlinico, Milan, Italy
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Cattarinussi G, Delvecchio G, Moltrasio C, Ferro A, Sambataro F, Brambilla P. Effects of pharmacological treatments on neuroimaging findings in borderline personality disorder: A review of FDG-PET and fNIRS studies. J Affect Disord 2022; 308:314-321. [PMID: 35429522 DOI: 10.1016/j.jad.2022.04.050] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Revised: 03/23/2022] [Accepted: 04/10/2022] [Indexed: 01/18/2023]
Abstract
BACKGROUND Borderline personality disorder (BPD) is a serious mental condition characterized by instability in identity, interpersonal relationships, emotion regulation and impulsivity. These symptoms seem to be associated to specific brain alterations, which have been largely investigated. In particular, positron emission tomography (PET) and functional near-infrared spectroscopy (fNIRS) have demonstrated abnormalities in brain metabolism and hemodynamics in BPD, specifically in the fronto-limbic system. However, the role of medications on brain metabolism and hemodynamics in BPD is still largely unknown. METHODS We conducted a search on PubMed, Scopus and Web of Science of PET and fNIRS studies exploring the effect of medications on brain metabolism and hemodynamics in BPD. A total of 10 studies met the inclusion criteria. RESULTS Overall, PET studies showed an effect of psychotropic agents on brain metabolism, especially in frontal and temporal areas. Also, higher metabolic rates in frontal areas were found to correlate with clinical improvements. In contrast, fNIRS investigations reported an inconclusive or absent effects on brain hemodynamics in BPD patients. LIMITATIONS The small sample size, the elevated percentage of women, the heterogeneity in pharmacological agents and the presence of comorbidities limit the conclusions of the present review. CONCLUSIONS Serotoninergic agents and second-generation antipsychotics produce changes in frontal and temporal metabolism in BPD, which appear to correlate with clinical improvements. Differently, brain hemodynamics do not seem to be significantly affected by the most commonly prescribed drugs in BPD, suggesting that the therapeutic actions of medications are not mediated by changes in neural hemodynamics.
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Affiliation(s)
- Giulia Cattarinussi
- Department of Neuroscience (DNS), Padua Neuroscience Center, University of Padova, Padua, Italy
| | - Giuseppe Delvecchio
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
| | - Chiara Moltrasio
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Adele Ferro
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Fabio Sambataro
- Department of Neuroscience (DNS), Padua Neuroscience Center, University of Padova, Padua, Italy
| | - Paolo Brambilla
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy; Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
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Piani MC, Maggioni E, Delvecchio G, Brambilla P. Sustained attention alterations in major depressive disorder: A review of fMRI studies employing Go/No-Go and CPT tasks. J Affect Disord 2022; 303:98-113. [PMID: 35139418 DOI: 10.1016/j.jad.2022.02.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2021] [Revised: 12/23/2021] [Accepted: 02/04/2022] [Indexed: 10/19/2022]
Abstract
BACKGROUND Major depressive disorder (MDD) is a severe psychiatric condition characterized by selective cognitive dysfunctions. In this regard, functional Magnetic Resonance Imaging (fMRI) studies showed, both at resting state and during tasks, alterations in the brain functional networks involved in cognitive processes in MDD patients compared to controls. Among those, it seems that the attention network may have a role in the disease pathophysiology. Therefore, in this review we aim at summarizing the current fMRI evidence investigating sustained attention in MDD patients. METHODS We conducted a search on PubMed on case-control studies on MDD employing fMRI acquisitions during Go/No-Go and continuous performance tasks. A total of 12 studies have been included in the review. RESULTS Overall, the majority of fMRI studies reported quantitative alterations in the response to attentive tasks in selective brain regions, including the prefrontal cortex, the cingulate cortex, the temporal and parietal lobes, the insula and the precuneus, which are key nodes of the attention, the executive, and the default mode networks. LIMITATIONS The heterogeneity in the study designs, fMRI acquisition techniques and processing methods have limited the generalizability of the results. CONCLUSIONS The results from the included studies showed the presence of alterations in the activation patterns of regions involved in sustained attention in MDD, which are in line with current evidence and seemed to explain some of the key symptoms of depression. However, given the paucity and heterogeneity of studies available, it may be worthwhile to continue investigating the attentional domain in MDD with ad-hoc study designs to retrieve more robust evidence.
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Affiliation(s)
- Maria Chiara Piani
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milano 20122, Italy
| | - Eleonora Maggioni
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milano 20122, Italy
| | - Giuseppe Delvecchio
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milano 20122, Italy.
| | - Paolo Brambilla
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milano 20122, Italy; Department of Pathophysiology and Transplantation, University of Milan, Italy
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Madonna D, Enrico P, Ciappolino V, Boscutti A, Colombo E, Turtulici N, Cantù F, Cereda G, Delvecchio G, De Falco S, Chierichetti M, Savioli M, Grasselli G, Brambilla P. Factors Associated With Severity of Delirium Complicating COVID-19 in Intensive Care Units. Front Neurol 2022; 13:774953. [PMID: 35401416 PMCID: PMC8987982 DOI: 10.3389/fneur.2022.774953] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Accepted: 02/07/2022] [Indexed: 12/12/2022] Open
Abstract
The clinical outcome of the disease provoked by the SARS-CoV-2 infection, COVID-19, is largely due to the development of interstitial pneumonia accompanied by an Acute Respiratory Distress Syndrome (ARDS), often requiring ventilatory support therapy in Intensive Care Units (ICUs). Current epidemiologic evidence is demonstrating that the COVID-19 prognosis is significantly influenced by its acute complications. Among these, delirium figures as one of the most frequent and severe, especially in the emergency setting, where it shows a significantly negative prognostic impact. In this regard, the aim of our study is to identify clinical severity factors of delirium complicating COVID-19 related-ARDS. We performed a comparative and correlation analysis using demographics, comorbidities, multisystemic and delirium severity scores and anti-delirium therapy in two cohorts of ARDS patients with delirium, respectively, due to COVID-19 (n = 40) or other medical conditions (n = 39). Our results indicate that delirium in COVID-19-related ARDS is more severe since its onset despite a relatively less severe systemic condition at the point of ICU admission and required higher dosages of antipsychotic and non-benzodiazepinic sedative therapy respect to non-COVID patients. Finally, the correlation analysis showed a direct association between the male gender and maximum dosage of anti-delirium medications needed within the COVID-19 group, which was taken as a surrogate of delirium severity. Overall, our results seem to indicate that pathogenetic factors specifically associated to severe COVID-19 are responsible for the high severity of delirium, paving the way for future research focused on the mechanisms of the cognitive alterations associated with COVID-19.
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Affiliation(s)
- Domenico Madonna
- Department of Neurosciences and Mental Health, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Paolo Enrico
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - Valentina Ciappolino
- Department of Neurosciences and Mental Health, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Andrea Boscutti
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - Elisa Colombo
- Department of Neurosciences and Mental Health, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Nunzio Turtulici
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - Filippo Cantù
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - Guido Cereda
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - Giuseppe Delvecchio
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - Stefano De Falco
- Department of Anesthesia, Intensive Care and Emergency, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Ca' Granda-Ospedale Maggiore Policlinico, Milan, Italy
| | - Monica Chierichetti
- Department of Anesthesia, Intensive Care and Emergency, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Ca' Granda-Ospedale Maggiore Policlinico, Milan, Italy
| | - Monica Savioli
- Department of Anesthesia, Intensive Care and Emergency, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Ca' Granda-Ospedale Maggiore Policlinico, Milan, Italy
| | - Giacomo Grasselli
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
- Department of Anesthesia, Intensive Care and Emergency, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Ca' Granda-Ospedale Maggiore Policlinico, Milan, Italy
| | - Paolo Brambilla
- Department of Neurosciences and Mental Health, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
- *Correspondence: Paolo Brambilla
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Boscutti A, Pigoni A, Delvecchio G, Lazzaretti M, Mandolini GM, Girardi P, Ferro A, Sala M, Abbiati V, Cappucciati M, Bellani M, Perlini C, Rossetti MG, Balestrieri M, Damante G, Bonivento C, Rossi R, Finos L, Serretti A, Brambilla P. The Influence of 5-HTTLPR, BDNF Rs6265 and COMT Rs4680 Polymorphisms on Impulsivity in Bipolar Disorder: The Role of Gender. Genes (Basel) 2022; 13:genes13030482. [PMID: 35328036 PMCID: PMC8954186 DOI: 10.3390/genes13030482] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Revised: 02/28/2022] [Accepted: 03/02/2022] [Indexed: 02/04/2023] Open
Abstract
Impulsivity has been proposed as an endophenotype for bipolar disorder (BD); moreover, impulsivity levels have been shown to carry prognostic significance and to be quality-of-life predictors. To date, reports about the genetic determinants of impulsivity in mood disorders are limited, with no studies on BD individuals. Individuals with BD and healthy controls (HC) were recruited in the context of an observational, multisite study (GECOBIP). Subjects were genotyped for three candidate single-nucleotide polymorphisms (SNPs) (5-HTTLPR, COMT rs4680, BDNF rs6265); impulsivity was measured through the Italian version of the Barratt Impulsiveness Scale (BIS-11). A mixed-effects regression model was built, with BIS scores as dependent variables, genotypes of the three polymorphisms as fixed effects, and centers of enrollment as random effect. Compared to HC, scores for all BIS factors were higher among subjects with euthymic BD (adjusted β for Total BIS score: 5.35, p < 0.001). No significant interaction effect was evident between disease status (HC vs. BD) and SNP status for any polymorphism. Considering the whole sample, BDNF Met/Met homozygosis was associated with lower BIS scores across all three factors (adjusted β for Total BIS score: −10.2, p < 0.001). A significant 5-HTTLPR x gender interaction was found for the SS genotype, associated with higher BIS scores in females only (adjusted β for Total BIS score: 12.0, p = 0.001). Finally, COMT polymorphism status was not significantly associated with BIS scores. In conclusion, BD diagnosis did not influence the effect on impulsivity scores for any of the three SNPs considered. Only one SNP—the BDNF rs6265 Met/Met homozygosis—was independently associated with lower impulsivity scores. The 5-HTTLPR SS genotype was associated with higher impulsivity scores in females only. Further studies adopting genome-wide screening in larger samples are needed to define the genetic basis of impulsivity in BD.
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Affiliation(s)
- Andrea Boscutti
- Department of Pathophysiology and Transplantation, University of Milan, 20122 Milan, Italy;
| | - Alessandro Pigoni
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca’ Granda-Ospedale Maggiore Policlinico, 20122 Milan, Italy; (A.P.); (G.D.); (M.L.); (G.M.M.); (A.F.); (M.G.R.)
- Social and Affective Neuroscience Group, MoMiLab, IMT School for Advanced Studies Lucca, 55100 Lucca, Italy
| | - Giuseppe Delvecchio
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca’ Granda-Ospedale Maggiore Policlinico, 20122 Milan, Italy; (A.P.); (G.D.); (M.L.); (G.M.M.); (A.F.); (M.G.R.)
| | - Matteo Lazzaretti
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca’ Granda-Ospedale Maggiore Policlinico, 20122 Milan, Italy; (A.P.); (G.D.); (M.L.); (G.M.M.); (A.F.); (M.G.R.)
| | - Gian Mario Mandolini
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca’ Granda-Ospedale Maggiore Policlinico, 20122 Milan, Italy; (A.P.); (G.D.); (M.L.); (G.M.M.); (A.F.); (M.G.R.)
| | - Paolo Girardi
- Department of Developmental Psychology and Socialization, University of Padua, 35131 Padua, Italy; (P.G.); (L.F.)
| | - Adele Ferro
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca’ Granda-Ospedale Maggiore Policlinico, 20122 Milan, Italy; (A.P.); (G.D.); (M.L.); (G.M.M.); (A.F.); (M.G.R.)
| | - Michela Sala
- Mental Health Department, Azienda Sanitaria Locale Alessandria, 15121 Alessandria, Italy;
| | - Vera Abbiati
- Department of Brain and Behavioral Sciences, University of Pavia, 27100 Pavia, Italy;
| | - Marco Cappucciati
- Department of Mental Health and Substance Abuse, Azienda Sanitaria Locale Piacenza, 29121 Piacenza, Italy;
| | - Marcella Bellani
- Section of Psychiatry, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, 37134 Verona, Italy;
| | - Cinzia Perlini
- Section of Clinical Psychology, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, 37134 Verona, Italy;
| | - Maria Gloria Rossetti
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca’ Granda-Ospedale Maggiore Policlinico, 20122 Milan, Italy; (A.P.); (G.D.); (M.L.); (G.M.M.); (A.F.); (M.G.R.)
- Section of Psychiatry, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, 37134 Verona, Italy;
| | - Matteo Balestrieri
- Psychiatry Unit, Department of Medicine, University of Udine, 33100 Udine, Italy;
| | - Giuseppe Damante
- Department of Medicine (DAME), University of Udine, 33100 Udine, Italy;
| | - Carolina Bonivento
- IRCCS “E. Medea”, Polo Friuli-Venezia Giulia, San Vito al Tagliamento, 33078 Pordenone, Italy;
| | - Roberta Rossi
- Psychiatry Unit, IRCCS Istituto Centro San Giovanni di Dio FBF, 25125 Brescia, Italy;
| | - Livio Finos
- Department of Developmental Psychology and Socialization, University of Padua, 35131 Padua, Italy; (P.G.); (L.F.)
| | - Alessandro Serretti
- Department of Biomedical and NeuroMotor Sciences, University of Bologna, 40123 Bologna, Italy;
| | - Paolo Brambilla
- Department of Pathophysiology and Transplantation, University of Milan, 20122 Milan, Italy;
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca’ Granda-Ospedale Maggiore Policlinico, 20122 Milan, Italy; (A.P.); (G.D.); (M.L.); (G.M.M.); (A.F.); (M.G.R.)
- Correspondence:
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Tassi E, Boscutti A, Mandolini GM, Moltrasio C, Delvecchio G, Brambilla P. A scoping review of near infrared spectroscopy studies employing a verbal fluency task in bipolar disorder. J Affect Disord 2022; 298:604-617. [PMID: 34780861 DOI: 10.1016/j.jad.2021.11.019] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Revised: 11/02/2021] [Accepted: 11/07/2021] [Indexed: 11/27/2022]
Abstract
BACKGROUND Deficits in cognitive functioning, including attention, memory, and executive functions, along with impairments in language production, are present in patients with bipolar disorder (BD) patients during mood phases, but also during euthymia.Verbal fluency tasks (VFTs), being able to evaluate integrity of a wide range of cognitive domains and represent, can be used to screen for these disturbances. Neuroimaging studies, including Near-InfraRed Spectroscopy (NIRS), have repeatedly showed widespread alterations in the prefrontal and temporal cortex during the performance of VFTs in BD patients. This review aims to summarize the results of NIRS studies that evaluated hemodynamic responses associated with the VFTs in prefrontal and temporal regions in BD patients. METHODS We performed a scoping review of studies evaluating VFT-induced activation in prefrontal and temporal regions in BD patients, and the relationship between NIRS data and various clinical variables. RESULTS 15 studies met the inclusion criteria. In BD patients, compared to healthy controls, NIRS studies showed hypoactivation of the dorsolateral prefrontal cortex, ventrolateral prefrontal cortex and anterior temporal regions. Moreover, clinical variables, such as depressive and social adaptation scores, were negatively correlated with hemodynamic responses in prefrontal and temporal regions, while a positive correlation were reported for measures of manic symptoms and impulsivity. LIMITATIONS The heterogeneity of the studies in terms of methodology, study design and clinical characteristics of the samples limited the comparability of the findings. CONCLUSIONS Given its non-invasiveness, good time-resolution and no need of posturalconstraint, NIRS technique could represent a useful tool for the evaluation of prefrontal and temporal haemodynamic correlates of cognitive performances in BD patients.
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Affiliation(s)
- Emma Tassi
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda-Ospedale Maggiore Policlinico, via F. Sforza 35, Milan 20122, Italy
| | - Andrea Boscutti
- Department of Pathophysiology and Transplantation, University of Milan, Milan 20122, Italy
| | - Gian Mario Mandolini
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda-Ospedale Maggiore Policlinico, via F. Sforza 35, Milan 20122, Italy
| | - Chiara Moltrasio
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda-Ospedale Maggiore Policlinico, via F. Sforza 35, Milan 20122, Italy
| | - Giuseppe Delvecchio
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda-Ospedale Maggiore Policlinico, via F. Sforza 35, Milan 20122, Italy.
| | - Paolo Brambilla
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda-Ospedale Maggiore Policlinico, via F. Sforza 35, Milan 20122, Italy; Department of Pathophysiology and Transplantation, University of Milan, Milan 20122, Italy
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Cantù F, Schiena G, Sciortino D, Di Consoli L, Delvecchio G, Maggioni E, Brambilla P. Use of 30-Hz Accelerated iTBS in Drug-Resistant Unipolar and Bipolar Depression in a Public Healthcare Setting: A Case Series. Front Psychiatry 2022; 12:798847. [PMID: 35095614 PMCID: PMC8790145 DOI: 10.3389/fpsyt.2021.798847] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Accepted: 12/20/2021] [Indexed: 11/16/2022] Open
Abstract
Background: Depressive episodes, especially when resistant to pharmacotherapy, are a hard challenge to face for clinicians and a leading cause of disability worldwide. Neuromodulation has emerged as a potential therapeutic option for treatment-resistant depression (TRD), in particular transcranial magnetic stimulation (TMS). In this article, we present a case series of six patients who received TMS with an accelerated intermittent theta-burst stimulation (iTBS) protocol in a public healthcare setting. Methods: We enrolled a total number of six participants, affected by a treatment-resistant depressive episode, in either Major Depressive Disorder (MDD) or Bipolar Disorder (BD). Patients underwent an accelerated iTBS protocol, targeted to the left dorsolateral prefrontal cortex (DLPFC), 3-week-long, with a total of 6 days of overall stimulation. On each stimulation day, the participants received 3 iTBS sessions, with a 15-min pause between them. Patients were assessed by the Hamilton Rating Scale for Depression (HAM-D), the Montgomery-Asberg Depression Rating Scale (MADRS), the Hamilton Rating Scale for Anxiety (HAM-A), and the Mania Rating Scale (MRS). At baseline (T0), at the end of the second week (T1), and at the end of the cycle of stimulation (T2). Results: The rANOVA (repeated Analysis of Variance) statistics showed no significant effect of time on the rating scale scores, with a slight decrease in MADRS scores and a very slight increase in HAM-A and HAM-D scores. No manic symptoms emerged during the entire protocol. Conclusions: Although accelerated iTBS might be considered a less time-consuming strategy for TMS administration, useful in a public healthcare setting, our results in a real-word six-patient population with TRD did not show a significant effect. Further studies on wider samples are needed to fully elucidate the potential of accelerated iTBS protocols in treatment-resistant depression.
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Affiliation(s)
- Filippo Cantù
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - Giandomenico Schiena
- Department of Neurosciences and Mental Health, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Domenico Sciortino
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - Lorena Di Consoli
- Department of Neurosciences and Mental Health, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Giuseppe Delvecchio
- Department of Neurosciences and Mental Health, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Eleonora Maggioni
- Department of Neurosciences and Mental Health, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Paolo Brambilla
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
- Department of Neurosciences and Mental Health, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
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Ching CRK, Hibar DP, Gurholt TP, Nunes A, Thomopoulos SI, Abé C, Agartz I, Brouwer RM, Cannon DM, de Zwarte SMC, Eyler LT, Favre P, Hajek T, Haukvik UK, Houenou J, Landén M, Lett TA, McDonald C, Nabulsi L, Patel Y, Pauling ME, Paus T, Radua J, Soeiro‐de‐Souza MG, Tronchin G, van Haren NEM, Vieta E, Walter H, Zeng L, Alda M, Almeida J, Alnæs D, Alonso‐Lana S, Altimus C, Bauer M, Baune BT, Bearden CE, Bellani M, Benedetti F, Berk M, Bilderbeck AC, Blumberg HP, Bøen E, Bollettini I, del Mar Bonnin C, Brambilla P, Canales‐Rodríguez EJ, Caseras X, Dandash O, Dannlowski U, Delvecchio G, Díaz‐Zuluaga AM, Dima D, Duchesnay É, Elvsåshagen T, Fears SC, Frangou S, Fullerton JM, Glahn DC, Goikolea JM, Green MJ, Grotegerd D, Gruber O, Haarman BCM, Henry C, Howells FM, Ives‐Deliperi V, Jansen A, Kircher TTJ, Knöchel C, Kramer B, Lafer B, López‐Jaramillo C, Machado‐Vieira R, MacIntosh BJ, Melloni EMT, Mitchell PB, Nenadic I, Nery F, Nugent AC, Oertel V, Ophoff RA, Ota M, Overs BJ, Pham DL, Phillips ML, Pineda‐Zapata JA, Poletti S, Polosan M, Pomarol‐Clotet E, Pouchon A, Quidé Y, Rive MM, Roberts G, Ruhe HG, Salvador R, Sarró S, Satterthwaite TD, Schene AH, Sim K, Soares JC, Stäblein M, Stein DJ, Tamnes CK, Thomaidis GV, Upegui CV, Veltman DJ, Wessa M, Westlye LT, Whalley HC, Wolf DH, Wu M, Yatham LN, Zarate CA, Thompson PM, Andreassen OA. What we learn about bipolar disorder from large-scale neuroimaging: Findings and future directions from the ENIGMA Bipolar Disorder Working Group. Hum Brain Mapp 2022; 43:56-82. [PMID: 32725849 PMCID: PMC8675426 DOI: 10.1002/hbm.25098] [Citation(s) in RCA: 24] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Revised: 05/31/2020] [Accepted: 06/04/2020] [Indexed: 12/17/2022] Open
Abstract
MRI-derived brain measures offer a link between genes, the environment and behavior and have been widely studied in bipolar disorder (BD). However, many neuroimaging studies of BD have been underpowered, leading to varied results and uncertainty regarding effects. The Enhancing Neuro Imaging Genetics through Meta-Analysis (ENIGMA) Bipolar Disorder Working Group was formed in 2012 to empower discoveries, generate consensus findings and inform future hypothesis-driven studies of BD. Through this effort, over 150 researchers from 20 countries and 55 institutions pool data and resources to produce the largest neuroimaging studies of BD ever conducted. The ENIGMA Bipolar Disorder Working Group applies standardized processing and analysis techniques to empower large-scale meta- and mega-analyses of multimodal brain MRI and improve the replicability of studies relating brain variation to clinical and genetic data. Initial BD Working Group studies reveal widespread patterns of lower cortical thickness, subcortical volume and disrupted white matter integrity associated with BD. Findings also include mapping brain alterations of common medications like lithium, symptom patterns and clinical risk profiles and have provided further insights into the pathophysiological mechanisms of BD. Here we discuss key findings from the BD working group, its ongoing projects and future directions for large-scale, collaborative studies of mental illness.
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Affiliation(s)
- Christopher R. K. Ching
- Imaging Genetics Center, Mark and Mary Stevens Neuroimaging and Informatics Institute, Keck School of MedicineUniversity of Southern CaliforniaLos AngelesCaliforniaUSA
| | | | - Tiril P. Gurholt
- Norwegian Centre for Mental Disorders Research (NORMENT), Institute of Clinical Medicine, University of OsloOsloNorway
- Division of Mental Health and Addicition, Oslo University HospitalOsloNorway
| | - Abraham Nunes
- Department of PsychiatryDalhousie UniversityHalifaxNova ScotiaCanada
- Faculty of Computer ScienceDalhousie UniversityHalifaxNova ScotiaCanada
| | - Sophia I. Thomopoulos
- Imaging Genetics Center, Mark and Mary Stevens Neuroimaging and Informatics Institute, Keck School of MedicineUniversity of Southern CaliforniaLos AngelesCaliforniaUSA
| | - Christoph Abé
- Faculty of Computer ScienceDalhousie UniversityHalifaxNova ScotiaCanada
- Department of Clinical NeuroscienceKarolinska InstitutetStockholmSweden
| | - Ingrid Agartz
- Norwegian Centre for Mental Disorders Research (NORMENT), Institute of Clinical Medicine, University of OsloOsloNorway
- Department of Psychiatric ResearchDiakonhjemmet HospitalOsloNorway
- Center for Psychiatric Research, Department of Clinical NeuroscienceKarolinska InstitutetStockholmSweden
| | - Rachel M. Brouwer
- Department of Psychiatry, University Medical Center Utrecht Brain Center, University Medical Center UtrechtUtrecht UniversityUtrechtThe Netherlands
| | - Dara M. Cannon
- Centre for Neuroimaging & Cognitive Genomics (NICOG), Clinical Neuroimaging Laboratory, NCBES Galway Neuroscience Centre, College of Medicine Nursing and Health SciencesNational University of Ireland GalwayGalwayIreland
| | - Sonja M. C. de Zwarte
- Department of Psychiatry, University Medical Center Utrecht Brain Center, University Medical Center UtrechtUtrecht UniversityUtrechtThe Netherlands
| | - Lisa T. Eyler
- Department of PsychiatryUniversity of CaliforniaLa JollaCaliforniaUSA
- Desert‐Pacific MIRECCVA San Diego HealthcareSan DiegoCaliforniaUSA
| | - Pauline Favre
- INSERM U955, team 15 “Translational Neuro‐Psychiatry”CréteilFrance
- Neurospin, CEA Paris‐Saclay, team UNIACTGif‐sur‐YvetteFrance
| | - Tomas Hajek
- Division of Mental Health and Addicition, Oslo University HospitalOsloNorway
- National Institute of Mental HealthKlecanyCzech Republic
| | - Unn K. Haukvik
- Division of Mental Health and Addicition, Oslo University HospitalOsloNorway
- Norwegian Centre for Mental Disorders Research (NORMENT)Oslo University HospitalOsloNorway
| | - Josselin Houenou
- INSERM U955, team 15 “Translational Neuro‐Psychiatry”CréteilFrance
- Neurospin, CEA Paris‐Saclay, team UNIACTGif‐sur‐YvetteFrance
- APHPMondor University Hospitals, DMU IMPACTCréteilFrance
| | - Mikael Landén
- Department of Neuroscience and PhysiologyUniversity of GothenburgGothenburgSweden
- Department of Medical Epidemiology and BiostatisticsKarolinska InstitutetStockholmSweden
| | - Tristram A. Lett
- Department for Psychiatry and PsychotherapyCharité Universitätsmedizin BerlinBerlinGermany
- Department of Neurology with Experimental NeurologyCharité Universitätsmedizin BerlinBerlinGermany
| | - Colm McDonald
- Department of Psychiatry, University Medical Center Utrecht Brain Center, University Medical Center UtrechtUtrecht UniversityUtrechtThe Netherlands
| | - Leila Nabulsi
- Imaging Genetics Center, Mark and Mary Stevens Neuroimaging and Informatics Institute, Keck School of MedicineUniversity of Southern CaliforniaLos AngelesCaliforniaUSA
- Department of Psychiatry, University Medical Center Utrecht Brain Center, University Medical Center UtrechtUtrecht UniversityUtrechtThe Netherlands
| | - Yash Patel
- Bloorview Research InstituteHolland Bloorview Kids Rehabilitation HospitalTorontoOntarioCanada
| | - Melissa E. Pauling
- Desert‐Pacific MIRECCVA San Diego HealthcareSan DiegoCaliforniaUSA
- INSERM U955, team 15 “Translational Neuro‐Psychiatry”CréteilFrance
| | - Tomas Paus
- Bloorview Research InstituteHolland Bloorview Kids Rehabilitation HospitalTorontoOntarioCanada
- Departments of Psychology and PsychiatryUniversity of TorontoTorontoOntarioCanada
| | - Joaquim Radua
- Department of Psychiatric ResearchDiakonhjemmet HospitalOsloNorway
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS)Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM)BarcelonaSpain
- Early Psychosis: Interventions and Clinical‐detection (EPIC) lab, Department of Psychosis StudiesInstitute of Psychiatry, Psychology and Neuroscience, King's College LondonLondonUK
- Stockholm Health Care ServicesStockholm County CouncilStockholmSweden
| | - Marcio G. Soeiro‐de‐Souza
- Mood Disorders Unit (GRUDA), Hospital das Clinicas HCFMUSP, Faculdade de MedicinaUniversidade de São PauloSão PauloSPBrazil
| | - Giulia Tronchin
- Department of Psychiatry, University Medical Center Utrecht Brain Center, University Medical Center UtrechtUtrecht UniversityUtrechtThe Netherlands
| | - Neeltje E. M. van Haren
- Department of Child and Adolescent Psychiatry/PsychologyErasmus Medical CenterRotterdamThe Netherlands
| | - Eduard Vieta
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS)Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM)BarcelonaSpain
- Barcelona Bipolar Disorders and Depressive Unit, Hospital Clinic, Institute of NeurosciencesUniversity of BarcelonaBarcelonaSpain
| | - Henrik Walter
- Department for Psychiatry and PsychotherapyCharité Universitätsmedizin BerlinBerlinGermany
| | - Ling‐Li Zeng
- Imaging Genetics Center, Mark and Mary Stevens Neuroimaging and Informatics Institute, Keck School of MedicineUniversity of Southern CaliforniaLos AngelesCaliforniaUSA
- College of Intelligence Science and TechnologyNational University of Defense TechnologyChangshaChina
| | - Martin Alda
- Division of Mental Health and Addicition, Oslo University HospitalOsloNorway
| | - Jorge Almeida
- Dell Medical SchoolThe University of Texas at AustinAustinTexasUSA
| | - Dag Alnæs
- Norwegian Centre for Mental Disorders Research (NORMENT), Institute of Clinical Medicine, University of OsloOsloNorway
| | - Silvia Alonso‐Lana
- FIDMAG Germanes Hospitalàries Research FoundationBarcelonaSpain
- CIBERSAMMadridSpain
| | - Cara Altimus
- Milken Institute Center for Strategic PhilanthropyWashingtonDistrict of ColumbiaUSA
| | - Michael Bauer
- Department of Psychiatry and Psychotherapy, Medical FacultyTechnische Universität DresdenDresdenGermany
| | - Bernhard T. Baune
- Department of PsychiatryUniversity of MünsterMünsterGermany
- Department of PsychiatryThe University of MelbourneMelbourneVictoriaAustralia
- The Florey Institute of Neuroscience and Mental HealthThe University of MelbourneMelbourneVictoriaAustralia
| | - Carrie E. Bearden
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human BehaviorUniversity of CaliforniaLos AngelesCaliforniaUSA
- Department of PsychologyUniversity of CaliforniaLos AngelesCaliforniaUSA
| | - Marcella Bellani
- Section of Psychiatry, Department of Neurosciences, Biomedicine and Movement SciencesUniversity of VeronaVeronaItaly
| | - Francesco Benedetti
- Vita‐Salute San Raffaele UniversityMilanItaly
- Division of Neuroscience, Psychiatry and Psychobiology UnitIRCCS San Raffaele Scientific InstituteMilanItaly
| | - Michael Berk
- Department of Pathophysiology and TransplantationUniversity of MilanMilanItaly
- IMPACT Institute – The Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Barwon HealthDeakin UniversityGeelongVictoriaAustralia
| | - Amy C. Bilderbeck
- The National Centre of Excellence in Youth Mental Health, Centre for Youth Mental Health, Florey Institute for Neuroscience and Mental Health and the Department of Psychiatry, The University of MelbourneOrygenMelbourneVictoriaAustralia
- P1vital LtdWallingfordUK
| | | | - Erlend Bøen
- Mood Disorders Research ProgramYale School of MedicineNew HavenConnecticutUSA
| | - Irene Bollettini
- Division of Neuroscience, Psychiatry and Psychobiology UnitIRCCS San Raffaele Scientific InstituteMilanItaly
| | - Caterina del Mar Bonnin
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS)Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM)BarcelonaSpain
- Barcelona Bipolar Disorders and Depressive Unit, Hospital Clinic, Institute of NeurosciencesUniversity of BarcelonaBarcelonaSpain
| | - Paolo Brambilla
- Psychosomatic and CL PsychiatryOslo University HospitalOsloNorway
- Department of Neurosciences and Mental HealthFondazione IRCCS Ca' Granda Ospedale Maggiore PoliclinicoMilanItaly
| | - Erick J. Canales‐Rodríguez
- FIDMAG Germanes Hospitalàries Research FoundationBarcelonaSpain
- CIBERSAMMadridSpain
- Department of RadiologyCentre Hospitalier Universitaire Vaudois (CHUV)LausanneSwitzerland
- Signal Processing Lab (LTS5), École Polytechnique Fédérale de LausanneLausanneSwitzerland
| | - Xavier Caseras
- MRC Centre for Neuropsychiatric Genetics and GenomicsCardiff UniversityCardiffUK
| | - Orwa Dandash
- Melbourne Neuropsychiatry Centre, Department of PsychiatryUniversity of Melbourne and Melbourne HealthMelbourneVictoriaAustralia
- Brain, Mind and Society Research Hub, Turner Institute for Brain and Mental Health, School of Psychological SciencesMonash UniversityClaytonVictoriaAustralia
| | - Udo Dannlowski
- Department of PsychiatryUniversity of MünsterMünsterGermany
| | | | - Ana M. Díaz‐Zuluaga
- Research Group in Psychiatry GIPSI, Department of PsychiatryFaculty of Medicine, Universidad de AntioquiaMedellínColombia
| | - Danai Dima
- Department of Psychology, School of Social Sciences and ArtsCity, University of LondonLondonUK
- Department of Neuroimaging, Institute of Psychiatry, Psychology & NeuroscienceKing's College LondonLondonUK
| | | | - Torbjørn Elvsåshagen
- Norwegian Centre for Mental Disorders Research (NORMENT)Oslo University HospitalOsloNorway
- Department of NeurologyOslo University HospitalOsloNorway
- Institute of Clinical MedicineUniversity of OsloOsloNorway
| | - Scott C. Fears
- Center for Neurobehavioral GeneticsLos AngelesCaliforniaUSA
- Greater Los Angeles Veterans AdministrationLos AngelesCaliforniaUSA
| | - Sophia Frangou
- Centre for Brain HealthUniversity of British ColumbiaVancouverBritish ColumbiaCanada
- Department of PsychiatryIcahn School of Medicine at Mount SinaiNew YorkNew YorkUSA
| | - Janice M. Fullerton
- Neuroscience Research AustraliaRandwickNew South WalesAustralia
- School of Medical SciencesUniversity of New South WalesSydneyNew South WalesAustralia
| | - David C. Glahn
- Department of PsychiatryBoston Children's Hospital and Harvard Medical SchoolBostonMassachusettsUSA
| | - Jose M. Goikolea
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS)Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM)BarcelonaSpain
- Barcelona Bipolar Disorders and Depressive Unit, Hospital Clinic, Institute of NeurosciencesUniversity of BarcelonaBarcelonaSpain
| | - Melissa J. Green
- Neuroscience Research AustraliaRandwickNew South WalesAustralia
- School of PsychiatryUniversity of New South WalesSydneyNew South WalesAustralia
| | | | - Oliver Gruber
- Department of General PsychiatryHeidelberg UniversityHeidelbergGermany
| | - Bartholomeus C. M. Haarman
- Department of Psychiatry, University Medical Center GroningenUniversity of GroningenGroningenThe Netherlands
| | - Chantal Henry
- Department of PsychiatryService Hospitalo‐Universitaire, GHU Paris Psychiatrie & NeurosciencesParisFrance
- Université de ParisParisFrance
| | - Fleur M. Howells
- Neuroscience InstituteUniversity of Cape TownCape TownSouth Africa
- Department of Psychiatry and Mental HealthUniversity of Cape TownCape TownSouth Africa
| | | | - Andreas Jansen
- Core‐Facility Brainimaging, Faculty of MedicineUniversity of MarburgMarburgGermany
- Department of Psychiatry and PsychotherapyPhilipps‐University MarburgMarburgGermany
| | - Tilo T. J. Kircher
- Department of Psychiatry and PsychotherapyPhilipps‐University MarburgMarburgGermany
| | - Christian Knöchel
- Department of Psychiatry, Psychosomatic Medicine and PsychotherapyGoethe University FrankfurtFrankfurtGermany
| | - Bernd Kramer
- Department of General PsychiatryHeidelberg UniversityHeidelbergGermany
| | - Beny Lafer
- Laboratory of Psychiatric Neuroimaging (LIM‐21), Departamento e Instituto de PsiquiatriaHospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de São PauloSão PauloSPBrazil
| | - Carlos López‐Jaramillo
- Research Group in Psychiatry GIPSI, Department of PsychiatryFaculty of Medicine, Universidad de AntioquiaMedellínColombia
- Mood Disorders ProgramHospital Universitario Trastorno del ÁnimoMedellínColombia
| | - Rodrigo Machado‐Vieira
- Experimental Therapeutics and Molecular Pathophysiology Program, Department of PsychiatryUTHealth, University of TexasHoustonTexasUSA
| | - Bradley J. MacIntosh
- Hurvitz Brain SciencesSunnybrook Research InstituteTorontoOntarioCanada
- Department of Medical BiophysicsUniversity of TorontoTorontoOntarioCanada
| | - Elisa M. T. Melloni
- Vita‐Salute San Raffaele UniversityMilanItaly
- Division of Neuroscience, Psychiatry and Psychobiology UnitIRCCS San Raffaele Scientific InstituteMilanItaly
| | - Philip B. Mitchell
- School of PsychiatryUniversity of New South WalesSydneyNew South WalesAustralia
| | - Igor Nenadic
- Department of Psychiatry and PsychotherapyPhilipps‐University MarburgMarburgGermany
| | - Fabiano Nery
- University of CincinnatiCincinnatiOhioUSA
- Universidade de São PauloSão PauloSPBrazil
| | | | - Viola Oertel
- Department of Psychiatry, Psychosomatic Medicine and PsychotherapyGoethe University FrankfurtFrankfurtGermany
| | - Roel A. Ophoff
- UCLA Center for Neurobehavioral GeneticsLos AngelesCaliforniaUSA
- Department of PsychiatryErasmus Medical Center, Erasmus UniversityRotterdamThe Netherlands
| | - Miho Ota
- Department of Mental Disorder ResearchNational Institute of Neuroscience, National Center of Neurology and PsychiatryTokyoJapan
| | | | - Daniel L. Pham
- Milken Institute Center for Strategic PhilanthropyWashingtonDistrict of ColumbiaUSA
| | - Mary L. Phillips
- Department of PsychiatryUniversity of PittsburghPittsburghPennsylvaniaUSA
| | | | - Sara Poletti
- Vita‐Salute San Raffaele UniversityMilanItaly
- Division of Neuroscience, Psychiatry and Psychobiology UnitIRCCS San Raffaele Scientific InstituteMilanItaly
| | - Mircea Polosan
- University of Grenoble AlpesCHU Grenoble AlpesGrenobleFrance
- INSERM U1216 ‐ Grenoble Institut des NeurosciencesLa TroncheFrance
| | - Edith Pomarol‐Clotet
- FIDMAG Germanes Hospitalàries Research FoundationBarcelonaSpain
- CIBERSAMMadridSpain
| | - Arnaud Pouchon
- University of Grenoble AlpesCHU Grenoble AlpesGrenobleFrance
| | - Yann Quidé
- Neuroscience Research AustraliaRandwickNew South WalesAustralia
- School of PsychiatryUniversity of New South WalesSydneyNew South WalesAustralia
| | - Maria M. Rive
- Department of PsychiatryAmsterdam UMC, location AMCAmsterdamThe Netherlands
| | - Gloria Roberts
- School of PsychiatryUniversity of New South WalesSydneyNew South WalesAustralia
| | - Henricus G. Ruhe
- Department of PsychiatryRadboud University Medical CenterNijmegenThe Netherlands
- Donders Institute for Brain, Cognition and BehaviorRadboud UniversityNijmegenThe Netherlands
| | - Raymond Salvador
- FIDMAG Germanes Hospitalàries Research FoundationBarcelonaSpain
- CIBERSAMMadridSpain
| | - Salvador Sarró
- FIDMAG Germanes Hospitalàries Research FoundationBarcelonaSpain
- CIBERSAMMadridSpain
| | - Theodore D. Satterthwaite
- Department of PsychiatryUniversity of Pennsylvania Perelman School of MedicinePhiladelphiaPennsylvaniaUSA
| | - Aart H. Schene
- Department of PsychiatryRadboud University Medical CenterNijmegenThe Netherlands
| | - Kang Sim
- West Region, Institute of Mental HealthSingaporeSingapore
- Yong Loo Lin School of MedicineNational University of SingaporeSingaporeSingapore
| | - Jair C. Soares
- Center of Excellent on Mood DisordersUTHealth HoustonHoustonTexasUSA
- Department of Psychiatry and Behavioral SciencesUTHealth HoustonHoustonTexasUSA
| | - Michael Stäblein
- Department of Psychiatry, Psychosomatic Medicine and PsychotherapyGoethe University FrankfurtFrankfurtGermany
| | - Dan J. Stein
- Neuroscience InstituteUniversity of Cape TownCape TownSouth Africa
- Department of Psychiatry and Mental HealthUniversity of Cape TownCape TownSouth Africa
- SAMRC Unit on Risk & Resilience in Mental DisordersUniversity of Cape TownCape TownSouth Africa
| | - Christian K. Tamnes
- Norwegian Centre for Mental Disorders Research (NORMENT), Institute of Clinical Medicine, University of OsloOsloNorway
- Department of Psychiatric ResearchDiakonhjemmet HospitalOsloNorway
- PROMENTA Research Center, Department of PsychologyUniversity of OsloOsloNorway
| | - Georgios V. Thomaidis
- Papanikolaou General HospitalThessalonikiGreece
- Laboratory of Mechanics and MaterialsSchool of Engineering, Aristotle UniversityThessalonikiGreece
| | - Cristian Vargas Upegui
- Research Group in Psychiatry GIPSI, Department of PsychiatryFaculty of Medicine, Universidad de AntioquiaMedellínColombia
| | - Dick J. Veltman
- Department of PsychiatryAmsterdam UMCAmsterdamThe Netherlands
| | - Michèle Wessa
- Department of Neuropsychology and Clinical PsychologyJohannes Gutenberg‐University MainzMainzGermany
| | - Lars T. Westlye
- Department of PsychologyUniversity of OsloOsloNorway
- Norwegian Centre for Mental Disorders Research (NORMENT), Department of Mental Health and AddictionOslo University HospitalOsloNorway
| | | | - Daniel H. Wolf
- Department of PsychiatryUniversity of Pennsylvania Perelman School of MedicinePhiladelphiaPennsylvaniaUSA
| | - Mon‐Ju Wu
- Department of Psychiatry and Behavioral SciencesUTHealth HoustonHoustonTexasUSA
| | - Lakshmi N. Yatham
- Department of PsychiatryUniversity of British ColumbiaVancouverBritish ColumbiaCanada
| | - Carlos A. Zarate
- Chief Experimental Therapeutics & Pathophysiology BranchBethesdaMarylandUSA
- Intramural Research ProgramNational Institute of Mental HealthBethesdaMarylandUSA
| | - Paul M. Thompson
- Imaging Genetics Center, Mark and Mary Stevens Neuroimaging and Informatics Institute, Keck School of MedicineUniversity of Southern CaliforniaLos AngelesCaliforniaUSA
| | - Ole A. Andreassen
- Norwegian Centre for Mental Disorders Research (NORMENT), Institute of Clinical Medicine, University of OsloOsloNorway
- Division of Mental Health and Addicition, Oslo University HospitalOsloNorway
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Bergamelli E, Del Fabro L, Delvecchio G, D’Agostino A, Brambilla P. Correction to: The Impact of Lithium on Brain Function in Bipolar Disorder: An Updated Review of Functional Magnetic Resonance Imaging Studies. CNS Drugs 2022; 36:1241. [PMID: 36205837 PMCID: PMC9653305 DOI: 10.1007/s40263-022-00962-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Emilio Bergamelli
- Department of Mental Health and Addiction, ASST Santi Paolo e Carlo, San Paolo Hospital, Milan, Italy ,Department of Health Sciences, University of Milan, Milan, Italy
| | - Lorenzo Del Fabro
- Department of Pathophysiology and Transplantation, University of Milan, via F. Sforza 35, 20122 Milan, Italy ,Department of Neurosciences and Mental Health, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Giuseppe Delvecchio
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
| | - Armando D’Agostino
- Department of Mental Health and Addiction, ASST Santi Paolo e Carlo, San Paolo Hospital, Milan, Italy ,Department of Health Sciences, University of Milan, Milan, Italy
| | - Paolo Brambilla
- Department of Pathophysiology and Transplantation, University of Milan, via F. Sforza 35, 20122 Milan, Italy ,Department of Neurosciences and Mental Health, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
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Dusi N, Bracco L, Bressi C, Delvecchio G, Brambilla P. Imaging associations of self-injurious behaviours amongst patients with Borderline Personality Disorder: A mini-review. J Affect Disord 2021; 295:781-787. [PMID: 34517252 DOI: 10.1016/j.jad.2021.08.074] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Revised: 07/07/2021] [Accepted: 08/25/2021] [Indexed: 11/15/2022]
Abstract
BACKGROUND Borderline Personality Disorder (BPD) is a severe and disabling psychiatric syndrome, frequently associated with self-injurious behaviours (SIB). In recent years, functional magnetic resonance imaging (fMRI) investigations have tried to identify alterations associated with SIB amongst BPD patients, in order to better delineate possible neurobiological underpinnings of these manifestations. In this mini-review, we aimed at summarizing fMRI studies exploring patterns of neural activation associated with SIB in BPD patients. METHODS Literature searches on PubMed, Psych-Info and Embase databases were performed for all fMRI studies including adult patients with BPD and SIB undergoing different tasks, including painful or thermic stimulation, affective stimulation through the presentation of picturesor the recollection of personal memories as well as tasks that evaluate sustained attention and impulsivity, and reward processing. Thirteen relevant papers were considered eligible for the present review. RESULTS Patients with BPD and SIB, compared to HC, showed prefrontal, nucleus accumbens overactivation and amygdala deactivation during pain stimulation. During negative affective stimulation, BPD patients showed a hyperactivation of the amygdala and a hypoactivation of the orbitofrontal cortex (OFC), which was also found to be enhanced during a gambling task and during a recalling of aversive memories. In contrast, during cognitive tasks with negative affective interference, BPD patients showed hypoactivation of OFC, anterior cingulated cortex, and basal ganglia. LIMITATIONS The limited number of studies and the heterogeneity regarding the fMRI tasks employed allowed only suggestive conclusions. CONCLUSIONS The reviewed fMRI studies highlighted that BPD patients with a history of SIB showed altered brain activity, compared to HC, in regions involved in inhibitory cognitive processes and affect regulation, which may in turn, explain the overwhelming emotional experiences eliciting SIB in these patients.
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Affiliation(s)
- N Dusi
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - L Bracco
- Department of Pathophysiology and Transplantation, University of Milan, 20122 Milan, Italy
| | - C Bressi
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - G Delvecchio
- Department of Pathophysiology and Transplantation, University of Milan, 20122 Milan, Italy.
| | - P Brambilla
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy; Department of Pathophysiology and Transplantation, University of Milan, 20122 Milan, Italy
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Cereda G, Ciappolino V, Boscutti A, Cantù F, Enrico P, Oldani L, Delvecchio G, Brambilla P. Zinc as a Neuroprotective Nutrient for COVID-19-Related Neuropsychiatric Manifestations: A Literature Review. Adv Nutr 2021; 13:66-79. [PMID: 34634109 PMCID: PMC8524565 DOI: 10.1093/advances/nmab110] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Revised: 05/25/2021] [Accepted: 09/10/2021] [Indexed: 12/12/2022] Open
Abstract
The outbreak of the pandemic associated with Severe Acute Respiratory Syndrome coronavirus 2 (SARS-CoV-2) led researchers to find new potential treatments, including nonpharmacological molecules such as zinc (Zn2+). Specifically, the use of Zn2+ as a therapy for SARS-CoV-2 infection is based on several findings: 1) the possible role of the anti-inflammatory activity of Zn2+ on the aberrant inflammatory response triggered by COronaVIrus Disease 19 (COVID-19), 2) properties of Zn2+ in modulating the competitive balance between the host and the invading pathogens, and 3) the antiviral activity of Zn2+ on a number of pathogens, including coronaviruses. Furthermore, Zn2+ has been found to play a central role in regulating brain functioning and many disorders have been associated with Zn2+ deficiency, including neurodegenerative diseases, psychiatric disorders, and brain injuries. Within this context, we carried out a narrative review to provide an overview of the evidence relating to the effects of Zn2+ on the immune and nervous systems, and the therapeutic use of such micronutrients in both neurological and infective disorders, with the final goal of elucidating the possible use of Zn2+ as a preventive or therapeutic intervention in COVID-19. Overall, the results from the available evidence showed that, owing to its neuroprotective properties, Zn2+ supplementation could be effective not only on COVID-19-related symptoms but also on virus replication, as well as on COVID-19-related inflammation and neurological damage. However, further clinical trials evaluating the efficacy of Zn2+ as a nonpharmacological treatment of COVID-19 are required to achieve an overall improvement in outcome and prognosis.
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Affiliation(s)
- Guido Cereda
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - Valentina Ciappolino
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda-Ospedale Maggiore Policlinico, Milan, Italy
| | - Andrea Boscutti
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - Filippo Cantù
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - Paolo Enrico
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - Lucio Oldani
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda-Ospedale Maggiore Policlinico, Milan, Italy
| | - Giuseppe Delvecchio
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
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Schiena G, Franco G, Boscutti A, Delvecchio G, Maggioni E, Brambilla P. Connectivity changes in major depressive disorder after rTMS: a review of functional and structural connectivity data. Epidemiol Psychiatr Sci 2021; 30:e59. [PMCID: PMC8444152 DOI: 10.1017/s2045796021000482] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Aims In the search for effective therapeutic strategies for depression, repetitive transcranial magnetic stimulation (rTMS) emerged as a non-invasive, promising treatment. This is because the antidepressant effect of rTMS might be related to neuronal plasticity mechanisms possibly reverting connectivity alterations often observed in depression. Therefore, in this review, we aimed at providing an overview of the findings reported by studies investigating functional and structural connectivity changes after rTMS in depression. Methods A bibliographic search was conducted on PubMed, including studies that used unilateral, excitatory (⩾10 Hz) rTMS treatment targeted on the left dorsolateral prefrontal cortex (DLPFC) in unipolar depressed patients. Results The majority of the results showed significant TMS-induced changes in functional connectivity (FC) between areas important for emotion regulation, including the DLPFC and the subgenual anterior cingulate cortex, and among regions that are part of the major resting-state networks, such as the Default Mode Network, the Salience Networks and the Central Executive Network. Finally, in diffusion tensor imaging studies, it has been reported that rTMS appeared to increase fractional anisotropy in the frontal lobe. Limitations The small sample size, the heterogeneity of the rTMS stimulation parameters, the concomitant use of psychotropic drugs might have limited the generalisability of the results. Conclusions Overall, rTMS treatment induces structural and FC changes in brain regions and networks implicated in the pathogenesis of unipolar depression. However, whether these changes underlie the antidepressant effect of rTMS still needs to be clarified.
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Affiliation(s)
- G. Schiena
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - G. Franco
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - A. Boscutti
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - G. Delvecchio
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
- Author for correspondence: G. Delvecchio, E-mail:
| | - E. Maggioni
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - P. Brambilla
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
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Gritti D, Delvecchio G, Ferro A, Bressi C, Brambilla P. Neuroinflammation in Major Depressive Disorder: A Review of PET Imaging Studies Examining the 18-kDa Translocator Protein. J Affect Disord 2021; 292:642-651. [PMID: 34153835 DOI: 10.1016/j.jad.2021.06.001] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Revised: 05/27/2021] [Accepted: 06/01/2021] [Indexed: 11/19/2022]
Abstract
BACKGROUND Major Depressive Disorder (MDD) is a severe psychiatric disorder whose pathological mechanisms are largely unknown. In the field of immuno-psychiatry, several evidences suggested a prominent role of inflammation in MDD not only in peripheral immune system but also in the brain. To date, brain inflammation is traceable in vivo with Positron Emission Tomography (PET), through the quantification of the expression of 18-kda Translocator Protein (TSPO) by active microglia. In this context, this review aimed to summarize the results of all in vivo PET imaging studies that evaluated microglia activation in MDD. METHODS A bibliographic search in PubMed up to June 2020 was performed. A total of 9 studies that used first and second generation TSPO radiotracers met our inclusion criteria. RESULTS Overall the results suggested the presence of TSPO upregulation in MDD, especially in anterior cingulate cortex, prefrontal cortex, hippocampal formation and insula. Notably, from a therapeutic point of view, results suggested that the symptoms amelioration, caused by both antidepressant medication and cognitive behavioural therapy, may be accompanied by reduced inflammatory status in the brain. Finally, a positive effect of the anti-inflammatory treatment with a cyclooxygenase inhibitor has also been observed. LIMITATIONS The heterogeneity across the studies in experimental designs, sample selection and methods limited the studies comparison. CONCLUSIONS These findings supported the presence of neuroinflammation in MDD, suggesting that microgliosis may be an important pathophysiological mechanism that merits further investigation as a potential target for novel treatment strategies.
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Affiliation(s)
- Davide Gritti
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - Giuseppe Delvecchio
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy.
| | - Adele Ferro
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - Cinzia Bressi
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - Paolo Brambilla
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy; Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
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Boscutti A, Delvecchio G, Pigoni A, Cereda G, Ciappolino V, Bellani M, Fusar-Poli P, Brambilla P. Olfactory and gustatory dysfunctions in SARS-CoV-2 infection: A systematic review. Brain Behav Immun Health 2021; 15:100268. [PMID: 34027497 PMCID: PMC8129998 DOI: 10.1016/j.bbih.2021.100268] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2021] [Revised: 05/06/2021] [Accepted: 05/09/2021] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Among Coronavirus Disease 2019 (COVID-19) manifestations, Olfactory (OD) and Gustatory (GD) Dysfunctions (OGD) have drawn considerable attention, becoming a sort of hallmark of the disease. Many have speculated on the pathogenesis and clinical characteristics of these disturbances; however, no definite answers have been produced on the topic. With this systematic review, we aimed to collect all the available evidence regarding the prevalence of OGD, the timing of their onset and their resolution, their rate of recovery and their role as diagnostic and prognostic tools for Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infection. METHODS A systematic review comprising all the observational studies that reported the prevalence and/or the longitudinal trajectories of OGD in COVID-19 patients, as self-reported by patients or measured through objective psychophysical tests. RESULTS After the selection process, 155 studies were included, with a total of 70,920 patients and 105,291 not-infected individuals. Prevalence reports were extremely variable across studies, with wide ranges for OD (0%-98%) and GD (0-89%) prevalence. OGD occurred early during the disease course and only rarely preceded other symptoms; out of 30 studies with a follow-up time of at least 20 days, only in 5 studies OGD fully resolved in more than 90% of patients. OGD had low sensitivity and high specificity for SARS-CoV-2 infection; accuracy of OD and GD for infection identification was higher than 80% in 10 out of 33 studies and in 8 out of 22 studies considered, respectively. 28 out of 30 studies that studied the association between OGD and disease severity found how OGD were associated with lower rates of severe pneumonia, hospitalization and mortality. CONCLUSIONS OGD seem to be highly prevalent in SARS-CoV-2 infection. They occur early, concomitantly with other symptoms and often persist after recovery, in some cases for months; whether a full recovery eventually occurs in all cases is not clear yet. OGD are good predictors of SARS-CoV-2 infection and are associated with a milder disease course.
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Affiliation(s)
- A. Boscutti
- Department of Pathophysiology and Transplantation, University of Milan, 20122, Milan, Italy
| | - G. Delvecchio
- Department of Pathophysiology and Transplantation, University of Milan, 20122, Milan, Italy
| | - A. Pigoni
- Social and Affective Neuroscience Group, MoMiLab, IMT School for Advanced Studies Lucca, Lucca, Italy
| | - G. Cereda
- Department of Pathophysiology and Transplantation, University of Milan, 20122, Milan, Italy
| | - V. Ciappolino
- Fondazione IRCCS Ca' Granda-Ospedale Maggiore Policlinico, Department of Neurosciences and Mental Health, 20122, Milan, Italy
| | - M. Bellani
- Department of Neurosciences, Biomedicine and Movement Sciences, Section of Psychiatry and Clinical Psychology, University of Verona, Verona, Italy
- UOC Psychiatry, Azienda Ospedaliera Universitaria Integrata, Verona (AOUI), Italy
| | - P. Fusar-Poli
- Early Psychosis: Interventions and Clinical-detection (EPIC) Lab, Department of Psychosis Studies, UK
- OASIS Service, South London and Maudsley NHS Foundation Trust, London, UK
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - P. Brambilla
- Department of Pathophysiology and Transplantation, University of Milan, 20122, Milan, Italy
- Fondazione IRCCS Ca' Granda-Ospedale Maggiore Policlinico, Department of Neurosciences and Mental Health, 20122, Milan, Italy
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