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Rufino KA, Goli P, Patriquin MA, Kosten TR, Nielsen DA, Salas R. Val/Met BDNF as a genetic risk for a false sense of security in post-discharge suicide risk. J Affect Disord 2024; 354:98-103. [PMID: 38447916 DOI: 10.1016/j.jad.2024.03.001] [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: 11/15/2023] [Revised: 02/14/2024] [Accepted: 03/03/2024] [Indexed: 03/08/2024]
Abstract
BACKGROUND The time after discharge from psychiatric inpatient care is one of the most dangerous periods in terms of suicide risk. Predicting who is at higher risk could help with resource allocation to assure patients at high risk of suicide attempts are most closely followed. We previously showed that inpatients who improve their suicide ideation levels faster while in inpatient treatment are the ones with highest rates of post-discharge suicide. Here, we studied the possible genetic underpinnings associated with such risk. METHOD We recorded the slope of suicide ideation recovery of 710 psychiatric inpatients from which we studied two genetic variants likely associated with suicide risk: The serotonin transporter variant 5-HTTLPR, and the BDNF gene variant Val66Met. RESULTS We found that inpatients carrying the BDNF Met variant (hypothesized as conferring higher suicide risk) improved their suicide ideation scores faster than Val/Val carrying inpatients. No significant association was found for 5-HTTLPR. LIMITATIONS The present sample was genetically homogenous, and future research should replicate these findings on a more diverse sample. CONCLUSIONS In conclusion, we found a paradoxical result: Carrying the BDNF Met variant allows inpatients to improve faster, which was shown to confer higher risk at the post-discharge period. This may explain some inconsistencies in the literature in terms of the role of BDNF in suicide ideation and attempts.
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Affiliation(s)
- K A Rufino
- The Menninger Clinic, Houston, TX, USA; Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, USA; Department of Social Sciences, The University of Houston Downtown, Houston, TX, USA
| | - P Goli
- Rice University, Houston, TX, USA
| | - M A Patriquin
- The Menninger Clinic, Houston, TX, USA; Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, USA; Michael E DeBakey VA Medical Center, Houston, TX, USA
| | - T R Kosten
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, USA; Michael E DeBakey VA Medical Center, Houston, TX, USA; Department of Neuroscience, Baylor College of Medicine, Houston, TX, USA
| | - D A Nielsen
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, USA; Michael E DeBakey VA Medical Center, Houston, TX, USA
| | - R Salas
- The Menninger Clinic, Houston, TX, USA; Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, USA; Department of Neuroscience, Baylor College of Medicine, Houston, TX, USA; Center for Translational Research on Inflammatory Diseases, Michael E DeBakey VA Medical Center, Houston, TX, USA.
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Ambrosi E, Curtis KN, Goli P, Patriquin MA, Arciniegas DB, Simonetti A, Spalletta G, Salas R. Resting-State Functional Connectivity of the Anterior Cingulate Cortex Among Persons With Mood Disorders and Suicidal Behaviors. J Neuropsychiatry Clin Neurosci 2023; 36:143-150. [PMID: 37981779 DOI: 10.1176/appi.neuropsych.20220203] [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] [Indexed: 11/21/2023]
Abstract
OBJECTIVE To assess whether anterior cingulate cortex (ACC) abnormalities contribute to suicide risk in major depressive disorder and bipolar disorder, the investigators compared resting-state functional connectivity (rsFC) of ACC subdivisions between individuals with major depressive or bipolar disorder with and without a lifetime history of suicidal behavior. METHODS Forty-two inpatients with and 26 inpatients without a history of suicidal behavior (SB+ and SB-, respectively) associated with major depressive or bipolar disorder and 40 healthy control (HC) participants underwent rsFC neuroimaging. RsFC of the subgenual, perigenual, rostral, dorsal, and caudal subdivisions of the ACC was calculated. Possible confounders, such as psychosis and severity of depression, were controlled for, seed-to-voxel and post hoc region of interest (ROI)-to-ROI analyses were performed, and the accuracy of rsFC in classifying suicidal behavior was studied. RESULTS Compared with individuals in the SB- and HC groups, patients in the SB+ group had higher rsFC between the left rostral and right dorsal ACC seeds and visual cortex clusters. Conversely, rsFC between the left rostral and right dorsal ACC seeds and cingulate and frontal clusters was lower in the SB+ group than in the HC group. Left rostral ACC to left Brodmann's area 18 connectivity showed up to 75% discriminative accuracy in distinguishing SB+ from SB- patients. CONCLUSIONS A history of suicidal behavior among individuals with major depressive disorder or bipolar disorder was associated with altered rsFC of the rostral and caudal ACC, regions involved in conflict detection and error monitoring. Replication of these findings is needed to further explore the involvement of the ACC in the neurobiology of suicidal behavior and suicidal ideation.
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Affiliation(s)
- Elisa Ambrosi
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston (all authors); Center for Translational Research on Inflammatory Diseases, Michael E. DeBakey Veterans Affairs Medical Center, Houston (Curtis, Salas); Department of Neuroscience, Rice University, Houston (Goli); Department of Research, Menninger Clinic, Houston (Patriquin, Salas); Department of Psychiatry and Behavioral Sciences, University of New Mexico School of Medicine, Albuquerque (Arciniegas); Fondazione Policlinico Universitario Agostino Gemelli, Scientific Institute for Research, Hospitalization and Healthcare, Rome (Simonetti); Department of Clinical and Behavioral Neurology, Santa Lucia Foundation, Scientific Institute for Research, Hospitalization and Healthcare, Rome (Spalletta)
| | - Kaylah N Curtis
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston (all authors); Center for Translational Research on Inflammatory Diseases, Michael E. DeBakey Veterans Affairs Medical Center, Houston (Curtis, Salas); Department of Neuroscience, Rice University, Houston (Goli); Department of Research, Menninger Clinic, Houston (Patriquin, Salas); Department of Psychiatry and Behavioral Sciences, University of New Mexico School of Medicine, Albuquerque (Arciniegas); Fondazione Policlinico Universitario Agostino Gemelli, Scientific Institute for Research, Hospitalization and Healthcare, Rome (Simonetti); Department of Clinical and Behavioral Neurology, Santa Lucia Foundation, Scientific Institute for Research, Hospitalization and Healthcare, Rome (Spalletta)
| | - Puneetha Goli
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston (all authors); Center for Translational Research on Inflammatory Diseases, Michael E. DeBakey Veterans Affairs Medical Center, Houston (Curtis, Salas); Department of Neuroscience, Rice University, Houston (Goli); Department of Research, Menninger Clinic, Houston (Patriquin, Salas); Department of Psychiatry and Behavioral Sciences, University of New Mexico School of Medicine, Albuquerque (Arciniegas); Fondazione Policlinico Universitario Agostino Gemelli, Scientific Institute for Research, Hospitalization and Healthcare, Rome (Simonetti); Department of Clinical and Behavioral Neurology, Santa Lucia Foundation, Scientific Institute for Research, Hospitalization and Healthcare, Rome (Spalletta)
| | - Michelle A Patriquin
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston (all authors); Center for Translational Research on Inflammatory Diseases, Michael E. DeBakey Veterans Affairs Medical Center, Houston (Curtis, Salas); Department of Neuroscience, Rice University, Houston (Goli); Department of Research, Menninger Clinic, Houston (Patriquin, Salas); Department of Psychiatry and Behavioral Sciences, University of New Mexico School of Medicine, Albuquerque (Arciniegas); Fondazione Policlinico Universitario Agostino Gemelli, Scientific Institute for Research, Hospitalization and Healthcare, Rome (Simonetti); Department of Clinical and Behavioral Neurology, Santa Lucia Foundation, Scientific Institute for Research, Hospitalization and Healthcare, Rome (Spalletta)
| | - David B Arciniegas
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston (all authors); Center for Translational Research on Inflammatory Diseases, Michael E. DeBakey Veterans Affairs Medical Center, Houston (Curtis, Salas); Department of Neuroscience, Rice University, Houston (Goli); Department of Research, Menninger Clinic, Houston (Patriquin, Salas); Department of Psychiatry and Behavioral Sciences, University of New Mexico School of Medicine, Albuquerque (Arciniegas); Fondazione Policlinico Universitario Agostino Gemelli, Scientific Institute for Research, Hospitalization and Healthcare, Rome (Simonetti); Department of Clinical and Behavioral Neurology, Santa Lucia Foundation, Scientific Institute for Research, Hospitalization and Healthcare, Rome (Spalletta)
| | - Alessio Simonetti
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston (all authors); Center for Translational Research on Inflammatory Diseases, Michael E. DeBakey Veterans Affairs Medical Center, Houston (Curtis, Salas); Department of Neuroscience, Rice University, Houston (Goli); Department of Research, Menninger Clinic, Houston (Patriquin, Salas); Department of Psychiatry and Behavioral Sciences, University of New Mexico School of Medicine, Albuquerque (Arciniegas); Fondazione Policlinico Universitario Agostino Gemelli, Scientific Institute for Research, Hospitalization and Healthcare, Rome (Simonetti); Department of Clinical and Behavioral Neurology, Santa Lucia Foundation, Scientific Institute for Research, Hospitalization and Healthcare, Rome (Spalletta)
| | - Gianfranco Spalletta
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston (all authors); Center for Translational Research on Inflammatory Diseases, Michael E. DeBakey Veterans Affairs Medical Center, Houston (Curtis, Salas); Department of Neuroscience, Rice University, Houston (Goli); Department of Research, Menninger Clinic, Houston (Patriquin, Salas); Department of Psychiatry and Behavioral Sciences, University of New Mexico School of Medicine, Albuquerque (Arciniegas); Fondazione Policlinico Universitario Agostino Gemelli, Scientific Institute for Research, Hospitalization and Healthcare, Rome (Simonetti); Department of Clinical and Behavioral Neurology, Santa Lucia Foundation, Scientific Institute for Research, Hospitalization and Healthcare, Rome (Spalletta)
| | - Ramiro Salas
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston (all authors); Center for Translational Research on Inflammatory Diseases, Michael E. DeBakey Veterans Affairs Medical Center, Houston (Curtis, Salas); Department of Neuroscience, Rice University, Houston (Goli); Department of Research, Menninger Clinic, Houston (Patriquin, Salas); Department of Psychiatry and Behavioral Sciences, University of New Mexico School of Medicine, Albuquerque (Arciniegas); Fondazione Policlinico Universitario Agostino Gemelli, Scientific Institute for Research, Hospitalization and Healthcare, Rome (Simonetti); Department of Clinical and Behavioral Neurology, Santa Lucia Foundation, Scientific Institute for Research, Hospitalization and Healthcare, Rome (Spalletta)
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Moosvi AM, Dono A, Bellman A, Ballester L, Goli P, Esquenazi Y. TERT Immunohistochemistry Expression as a Surrogate of TERT Promoter Mutations in Infiltrating Gliomas. Am J Clin Pathol 2021. [DOI: 10.1093/ajcp/aqab191.303] [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] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Introduction/Objective
Genomic alterations are critical for the diagnosis of infiltrating gliomas. Mutations in the telomerase reverse transcriptase promoter (TERTp) are sufficient for a diagnosis of glioblastoma in some cases, independent of histologic features. Although DNA sequencing is the preferred method for evaluating TERTp mutations, there are limitations with regards to turn-around-time, accessibility, and cost. In this study, we evaluated the efficacy of using TERT immunohistochemistry (IHC) as a surrogate marker for the identification of TERTp mutations in infiltrating gliomas.
Methods/Case Report
The study cohort consisted of 31 infiltrating gliomas diagnosed following the 2016 WHO classification of CNS tumors by a board-certified neuropathologist. Each case was evaluated by immunohistochemistry (anti-TERT monoclonal antibody) and with a targeted next-generation sequencing (NGS) panel. A systemic literature search was conducted to examine reports of TERT antibody as a surrogate marker of TERTp mutations. TERTp mutation detected by sequencing was considered the gold standard.
Results (if a Case Study enter NA)
TERT immunohistochemistry demonstrated a sensitivity of 61.1% and specificity of 69.2%. Cases were divided into IDH-WT and IDH-mutant infiltrating gliomas. Among the IDH-WT group, 84% contained the TERTp mutation with a sensitivity of 62.5% and specificity of 33.3% for the TERTp IHC. IDH-mutant gliomas showed a 16.2% TERTp mutation rate, and immunohistochemistry had a sensitivity of 50% and 80% specificity. The probability of TERT immunohistochemistry in diagnosing TERTp mutations exhibited a poor likelihood ratio for both the positive and negative test. Literature review included 5 studies with an overall sensitivity and specificity remaining consistently low (<80%), with 2 of these studies evaluating CNS related tumors giving rise to similar diagnostic performance.
Conclusion
TERT IHC has suboptimal sensitivity and specificity for identifying TERTp mutations in IDH-WT and IDH- mutant infiltrating gliomas.
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Affiliation(s)
- A M Moosvi
- Department of Pathology & Laboratory Medicine, The University of Texas Health Science Center - Houston, Sugar Land, Texas, UNITED STATES
| | - A Dono
- Department of Pathology & Laboratory Medicine, The University of Texas Health Science Center - Houston, Sugar Land, Texas, UNITED STATES
| | - A Bellman
- Department of Pathology & Laboratory Medicine, The University of Texas Health Science Center - Houston, Sugar Land, Texas, UNITED STATES
| | - L Ballester
- Department of Pathology & Laboratory Medicine, The University of Texas Health Science Center - Houston, Sugar Land, Texas, UNITED STATES
| | - P Goli
- Rice University, Houston, Texas, UNITED STATES
| | - Y Esquenazi
- Vivian L. Smith Department of Neurosurgery, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, Texas, UNITED STATES
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