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Pan Q, Lv T, Xu H, Fang H, Li M, Zhu J, Wang Y, Fan X, Xu P, Wang X, Wang Q, Matsumoto H, Wang M. Gut pathobiome mediates behavioral and developmental disorders in biotoxin-exposed amphibians. Environ Sci Ecotechnol 2024; 21:100415. [PMID: 38577706 PMCID: PMC10992726 DOI: 10.1016/j.ese.2024.100415] [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] [Subscribe] [Scholar Register] [Received: 09/24/2023] [Revised: 03/15/2024] [Accepted: 03/16/2024] [Indexed: 04/06/2024]
Abstract
Emerging evidence suggests a link between alterations in the gut microbiome and adverse health outcomes in the hosts exposed to environmental pollutants. Yet, the causal relationships and underlying mechanisms remain largely undefined. Here we show that exposure to biotoxins can affect gut pathobiome assembly in amphibians, which in turn triggers the toxicity of exogenous pollutants. We used Xenopus laevis as a model in this study. Tadpoles exposed to tropolone demonstrated notable developmental impairments and increased locomotor activity, with a reduction in total length by 4.37%-22.48% and an increase in swimming speed by 49.96%-84.83%. Fusobacterium and Cetobacterium are predominant taxa in the gut pathobiome of tropolone-exposed tadpoles. The tropolone-induced developmental and behavioral disorders in the host were mediated by assembly of the gut pathobiome, leading to transcriptome reprogramming. This study not only advances our understanding of the intricate interactions between environmental pollutants, the gut pathobiome, and host health but also emphasizes the potential of the gut pathobiome in mediating the toxicological effects of environmental contaminants.
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Affiliation(s)
- Qianqian Pan
- Ministry of Agricultural and Rural Affairs Laboratory of Molecular Biology of Crop Pathogens and Insects, Zhejiang University, Hangzhou, 310058, China
- Institute of Pesticide and Environmental Toxicology, College of Agriculture and Biotechnology, Zhejiang University, Hangzhou, 310058, China
| | - Tianxing Lv
- Ministry of Agricultural and Rural Affairs Laboratory of Molecular Biology of Crop Pathogens and Insects, Zhejiang University, Hangzhou, 310058, China
- Institute of Pesticide and Environmental Toxicology, College of Agriculture and Biotechnology, Zhejiang University, Hangzhou, 310058, China
| | - Haorong Xu
- Ministry of Agricultural and Rural Affairs Laboratory of Molecular Biology of Crop Pathogens and Insects, Zhejiang University, Hangzhou, 310058, China
- Institute of Pesticide and Environmental Toxicology, College of Agriculture and Biotechnology, Zhejiang University, Hangzhou, 310058, China
| | - Hongda Fang
- Ministry of Agricultural and Rural Affairs Laboratory of Molecular Biology of Crop Pathogens and Insects, Zhejiang University, Hangzhou, 310058, China
- Institute of Pesticide and Environmental Toxicology, College of Agriculture and Biotechnology, Zhejiang University, Hangzhou, 310058, China
| | - Meng Li
- Institute of Pesticide and Environmental Toxicology, College of Agriculture and Biotechnology, Zhejiang University, Hangzhou, 310058, China
| | - Jiaping Zhu
- Institute of Pesticide and Environmental Toxicology, College of Agriculture and Biotechnology, Zhejiang University, Hangzhou, 310058, China
| | - Yue Wang
- Ministry of Agricultural and Rural Affairs Laboratory of Molecular Biology of Crop Pathogens and Insects, Zhejiang University, Hangzhou, 310058, China
- Institute of Pesticide and Environmental Toxicology, College of Agriculture and Biotechnology, Zhejiang University, Hangzhou, 310058, China
| | - Xiaoyan Fan
- Ministry of Agricultural and Rural Affairs Laboratory of Molecular Biology of Crop Pathogens and Insects, Zhejiang University, Hangzhou, 310058, China
- Institute of Pesticide and Environmental Toxicology, College of Agriculture and Biotechnology, Zhejiang University, Hangzhou, 310058, China
| | - Ping Xu
- Institution of Tea Science, Zhejiang University, Hangzhou, 310058, China
| | - Xiuguo Wang
- The Tobacco Research Institute, Chinese Academy of Agricultural Sciences, Qingdao, 266101, China
| | - Qiangwei Wang
- Ministry of Agricultural and Rural Affairs Laboratory of Molecular Biology of Crop Pathogens and Insects, Zhejiang University, Hangzhou, 310058, China
- Institute of Pesticide and Environmental Toxicology, College of Agriculture and Biotechnology, Zhejiang University, Hangzhou, 310058, China
| | - Haruna Matsumoto
- Ministry of Agricultural and Rural Affairs Laboratory of Molecular Biology of Crop Pathogens and Insects, Zhejiang University, Hangzhou, 310058, China
- Institute of Pesticide and Environmental Toxicology, College of Agriculture and Biotechnology, Zhejiang University, Hangzhou, 310058, China
| | - Mengcen Wang
- Ministry of Agricultural and Rural Affairs Laboratory of Molecular Biology of Crop Pathogens and Insects, Zhejiang University, Hangzhou, 310058, China
- Institute of Pesticide and Environmental Toxicology, College of Agriculture and Biotechnology, Zhejiang University, Hangzhou, 310058, China
- Global Education Program for AgriScience Frontiers, Graduate School of Agriculture, Hokkaido University, Sapporo, Japan
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Wang T, Sun R, Sindelar JL, Chen X. Occupational differences in the effects of retirement on hospitalizations for mental illness among female workers: Evidence from administrative data in China. Econ Hum Biol 2024; 53:101367. [PMID: 38340649 DOI: 10.1016/j.ehb.2024.101367] [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] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/30/2022] [Revised: 01/24/2024] [Accepted: 02/01/2024] [Indexed: 02/12/2024]
Abstract
Retirement, a major transition in the life course, may affect many aspects of retirees' well-being, including health and health care utilization. Leveraging differential statutory retirement age (SRA) by occupation for China's urban female workers, we provide some of the first evidence on the causal effect of retirement on hospitalizations attributable to mental illness and its heterogeneity. To address endogeneity in retirement decisions, we take advantage of exogeneity of the differing SRA cut-offs for blue-collar (age 50) and white-collar (age 55) female urban employees. We apply a Fuzzy Regression Discontinuity Design (RDD) around the SRA cut-offs using nationally representative hospital inpatient claims data that cover these workers. We show that blue-collar females incur more hospitalizations for mental illness after retirement, while no similar change is found for white-collar females. Conditional on blue-collar females being hospitalized, probabilities of overall and ER admissions due to mental illness increase by 2.3 and 1.2 percentage points upon retirement, respectively. The effects are primarily driven by patients within the categories of schizophrenia, schizotypal and delusional disorders; and neurotic, stress-related and somatoform disorders. Moreover, the 'Donut' RDD estimates suggest that pent-up demand at retirement unlikely dominates our findings for blue-collar females. Rather, our results lend support to their worsening mental health at retirement. These findings suggest that occupational differences in mental illness and related health care utilization at retirement should be considered when optimizing retirement policy schemes.
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Affiliation(s)
- Tianyu Wang
- School of Labor and Human Resources, Renmin University of China, China
| | - Ruochen Sun
- Wharton School of Business, University of Pennsylvania, USA
| | | | - Xi Chen
- Yale School of Public Health, Yale University, USA.
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Zhu DT, Zhong A, Ho WJ, Tamang S. Disaggregating Asian-American Mortality in Drug-Related Overdoses and Behavioral Disorders: A Cross-Sectional Study. J Racial Ethn Health Disparities 2024:10.1007/s40615-024-01983-5. [PMID: 38530623 DOI: 10.1007/s40615-024-01983-5] [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: 12/07/2023] [Revised: 02/25/2024] [Accepted: 03/17/2024] [Indexed: 03/28/2024]
Abstract
Asian Americans have been historically underrepresented in the national drug overdose discourse due to their lower substance use and overdose rates compared to other racial/ethnic groups. However, aggregated analyses fail to capture the vast diversity among Asian-American subgroups, obscuring critical disparities. We conducted a cross-sectional study between 2018 and 2021 examining Asian-American individuals within the CDC WONDER database with drug overdoses as the underlying cause of death (n = 3195; ICD-10 codes X40-X44, X60-X64, X85, and Y10-Y14) or psychoactive substance-related mental and behavioral disorders as one of multiple causes of death (n = 15,513; ICD-10 codes F10-F19). Proportional mortality ratios were calculated, comparing disaggregated Asian-American subgroups to the reference group (Asian Americans as a single aggregate group). Z-tests identified significant differences between subgroups. Compared to the reference group (0.99%), drug overdose deaths were less prevalent among Japanese (0.46%; p < 0.001), Chinese (0.47%; p < 0.001), and Filipino (0.82%; p < 0.001) subgroups, contrasting with a higher prevalence among Asian Indian (1.20%; p < 0.001), Vietnamese (1.35%; p < 0.001), Korean (1.36%; p < 0.001), and other Asian (1.79%; p < 0.001) subgroups. Similarly, compared to the reference group (4.80%), deaths from mental and behavioral disorders were less prevalent among Chinese (3.18%; p < 0.001), Filipino (4.52%; p < 0.001), and Asian Indian (4.56%; p < 0.001) subgroups, while more prevalent among Korean (5.60%; p < 0.001), Vietnamese (5.64%; p < 0.001), Japanese (5.81%; p < 0.001), and other Asian (6.14%; p < 0.001) subgroups. Disaggregated data also revealed substantial geographical variations in these deaths obscured by aggregated analyses. Our findings revealed pronounced intra-racial disparities, underscoring the importance of data disaggregation to inform targeted clinical and public health interventions.
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Affiliation(s)
- David T Zhu
- Medical Scientist Training Program, School of Medicine, Virginia Commonwealth University, 1201 E Marshall St, Richmond, VA, 23298, USA.
| | | | - Winnie J Ho
- Yale School of Public Health, New Haven, CT, USA
| | - Suzanne Tamang
- Department of Medicine, Stanford University School of Medicine, Stanford, CA, USA
- Department of Veterans Affairs, Program Evaluation Resource Center, Office of Mental Health and Suicide Prevention, Menlo Park, CA, USA
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Cuoco S, Blundo C, Ricci M, Cappiello A, Bisogno R, Carotenuto I, Avallone AR, Erro R, Pellecchia MT, Amboni M, Barone P, Picillo M. Psychometric properties of the Caregiver's inventory neuropsychological diagnosis dementia (CINDD) in mild cognitive impairment and dementia. J Neural Transm (Vienna) 2024; 131:173-180. [PMID: 38200268 PMCID: PMC10791830 DOI: 10.1007/s00702-023-02728-0] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Accepted: 12/12/2023] [Indexed: 01/12/2024]
Abstract
OBJECTIVES The Caregiver's Inventory Neuropsychological Diagnosis Dementia (CINDD) is an easy tool designed to quantify cognitive, behavioural and functional deficits of patients with cognitive impairment. Aim of the present study was to analyse the psychometric properties of the CINDD in Mild Cognitive Impairment (MCI) and Dementia (D). DESIGN, SETTING AND PARTICIPANTS The CINDD, composed by 9 sub-domains, was administered to fifty-six caregivers of patients with different types of dementia (D) and 44 caregivers of patients with MCI. All patients underwent an extensive neuropsychological assessment, the Neuropsychiatric Inventory (NPI) and functional autonomy scales. The reliability, convergent construct validity and possible cut-off of CINND were measured by Cronbach's alpha (α), Pearson's correlation and ROC analysis, respectively. RESULTS The D and MCI patients differed only for age (p=0.006). The internal consistency of CINDD was high (α= 0.969). The α-value for each CINDD domain was considered acceptable, except the mood domain (α=0.209). The CINDD total score correlated with cognitive screening tests; each domain of the CINDD correlated with the corresponding score from either tests or NPI (p<0.05), except for visuo-spatial perception skills and apathy. A screening cut-off equal to 59, can be used discriminate D from MCI (Sensitivity=0.70, Specificity=0.57). CONCLUSION The CINDD is a feasible, accurate and reliable tool for the assessment of cognitive and behavioural difficulties in patients with different degree of cognitive impairment. It may be used to quantify and monitor caregiver-reported ecological data in both clinical and research settings.
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Affiliation(s)
- Sofia Cuoco
- Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", Neuroscience section, Center for Neurodegenerative Diseases (CEMAND), University of Salerno, Via Allende, Baronissi, 84081, Salerno, Italy
| | - Carlo Blundo
- Department of Neuroscience, Center of Cognitive Disorders and Dementia, San Camillo Hospital, Rome, Italy
| | - Monica Ricci
- Department of Neuroscience, Center of Cognitive Disorders and Dementia, San Camillo Hospital, Rome, Italy
| | - Arianna Cappiello
- Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", Neuroscience section, Center for Neurodegenerative Diseases (CEMAND), University of Salerno, Via Allende, Baronissi, 84081, Salerno, Italy
| | - Rossella Bisogno
- Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", Neuroscience section, Center for Neurodegenerative Diseases (CEMAND), University of Salerno, Via Allende, Baronissi, 84081, Salerno, Italy
| | - Immacolata Carotenuto
- Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", Neuroscience section, Center for Neurodegenerative Diseases (CEMAND), University of Salerno, Via Allende, Baronissi, 84081, Salerno, Italy
| | - Anna Rosa Avallone
- Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", Neuroscience section, Center for Neurodegenerative Diseases (CEMAND), University of Salerno, Via Allende, Baronissi, 84081, Salerno, Italy
| | - Roberto Erro
- Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", Neuroscience section, Center for Neurodegenerative Diseases (CEMAND), University of Salerno, Via Allende, Baronissi, 84081, Salerno, Italy
| | - Maria Teresa Pellecchia
- Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", Neuroscience section, Center for Neurodegenerative Diseases (CEMAND), University of Salerno, Via Allende, Baronissi, 84081, Salerno, Italy
| | - Marianna Amboni
- Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", Neuroscience section, Center for Neurodegenerative Diseases (CEMAND), University of Salerno, Via Allende, Baronissi, 84081, Salerno, Italy
- IDC Hermitage-Capodimonte, Naples, Italy
| | - Paolo Barone
- Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", Neuroscience section, Center for Neurodegenerative Diseases (CEMAND), University of Salerno, Via Allende, Baronissi, 84081, Salerno, Italy
| | - Marina Picillo
- Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", Neuroscience section, Center for Neurodegenerative Diseases (CEMAND), University of Salerno, Via Allende, Baronissi, 84081, Salerno, Italy.
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Baba A. Neural networks from biological to artificial and vice versa. Biosystems 2024; 235:105110. [PMID: 38176518 DOI: 10.1016/j.biosystems.2023.105110] [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] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Revised: 12/22/2023] [Accepted: 12/22/2023] [Indexed: 01/06/2024]
Abstract
In this paper, we examine how deep learning can be utilized to investigate neural health and the difficulties in interpreting neurological analyses within algorithmic models. The key contribution of this paper is the investigation of the impact of a dead neuron on the performance of artificial neural networks (ANNs). Therefore, we conduct several tests using different training algorithms and activation functions to identify the precise influence of the training process on neighboring neurons and the overall performance of the ANN in such cases. The aim is to assess the potential application of the findings in the biological domain, the expected results may have significant implications for the development of effective treatment strategies for neurological disorders. Successive training phases that incorporate visual and acoustic data derived from past social and familial experiences could be suggested to achieve this goal. Finally, we explore the conceptual analogy between the Adam optimizer and the learning process of the brain by delving into the specifics of both systems while acknowledging their fundamental differences.
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Affiliation(s)
- Abdullatif Baba
- Kuwait College of Science and Technology, Computer Science and Engineering Department, Kuwait; University of Turkish Aeronautical Association, Computer Engineering Department, Ankara, Turkey.
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Jacus JP, Brunet-Jarrige MC, Cuervo-Lombard CV. [Restraint in geriatrics: France's backwardness]. Encephale 2023:S0013-7006(23)00175-6. [PMID: 37985256 DOI: 10.1016/j.encep.2023.08.010] [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] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Revised: 07/08/2023] [Accepted: 08/23/2023] [Indexed: 11/22/2023]
Abstract
In the absence of legal provisions, passive physical restraint methods in geriatrics were defined at the start of this century, accompanied by recommendations relating to their use. Despite the frequency of these measures of restraint, there are few French publications on this subject. It seems that this practice varies according to the geriatric establishments and prevails in hospital more than in nursing home. The most widespread method is the dual barrier on the bed, as well as in hospital than in nursing home. To this should be added restraint provided by the premises themselves, intended to secure access to a facility, found in 90% of residences for the dependent elderly, and also medication. Passive physical restraint, mainly implemented to prevent falls, has however clearly shown its deleterious effects, particularly in the USA where it is thought to be responsible for 1/1000 deaths in nursing homes, although when it is absent there appears to be no increased risk of falls. Medication-based restraint is more readily used to sedate in case of disruptive behaviors (agitation, aggressiveness) although no clear data is available to date. Restraint provided by the premises themselves, used preventively in case of wandering and straying, is nevertheless a deprivation of freedom, and seems to concern the majority of geriatric facilities today. In the absence of legislation to regulate these practices, the present authors discuss the need for ethical reflection before the implementation of measures of restraint, whatever their nature, and they propose certain ideas on possible methods for passive physical restraint: raising awareness among caregivers and family members who often call for these measures, the existence of alternative measures, and the delaying of implementation as long as possible and/or sequentially.
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Affiliation(s)
- Jean-Pierre Jacus
- Laboratoire cliniques pathologique et interculturelle (LCPI), EA 4591, université Jean-Jaurès, Toulouse, France.
| | - Marie-Christine Brunet-Jarrige
- Laboratoire cliniques pathologique et interculturelle (LCPI), EA 4591, université Jean-Jaurès, Toulouse, France; EHPAD Jallier, Carbonne, France
| | - Christine-Vanessa Cuervo-Lombard
- Centre d'études et de recherches en psychopathologie et psychologie de la santé (CERPPS), EA7411, université Jean-Jaurès, Toulouse, France
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Sawada A, Sifrim D, Fujiwara Y. Esophageal Reflux Hypersensitivity: A Comprehensive Review. Gut Liver 2023; 17:831-842. [PMID: 36588526 PMCID: PMC10651372 DOI: 10.5009/gnl220373] [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: 08/24/2022] [Revised: 10/01/2022] [Accepted: 10/18/2022] [Indexed: 01/03/2023] Open
Abstract
Reflux hypersensitivity (RH) is one of the phenotypes of gastroesophageal reflux disease. The latest Rome IV defines RH as a condition with typical reflux symptoms and positive reflux-symptom association despite normal acid exposure. Subsequently, the Lyon consensus proposed detailed cutoff values for the criteria on the basis of experts' consensus. Rome IV brought a clear-cut perspective into the pathophysiology of gastroesophageal reflux disease and the importance of esophageal hypersensitivity. This perspective can be supported by the fact that other functional gastrointestinal disorders such as irritable bowel syndrome and functional dyspepsia often overlap with RH. Although several possible pathophysiological mechanisms of esophageal hypersensitivity have been identified, there is still unmet medical needs in terms of treatment for this condition. This review summarizes the current knowledge regarding RH.
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Affiliation(s)
- Akinari Sawada
- Department of Gastroenterology, Osaka Metropolitan University Graduate School of Medicine, Osaka, Japan
| | - Daniel Sifrim
- Wingate Institute of Neurogastroenterology, Blizard Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Yasuhiro Fujiwara
- Department of Gastroenterology, Osaka Metropolitan University Graduate School of Medicine, Osaka, Japan
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Morin A, Carle G, Ponchel A, Fernández-Eulate G, Nadjar Y. Psychiatric burden in a cohort of adults with Niemann Pick type C disease: from psychotic symptoms to frontal lobe behavioral disorders. Orphanet J Rare Dis 2023; 18:298. [PMID: 37740198 PMCID: PMC10517467 DOI: 10.1186/s13023-023-02851-x] [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] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Accepted: 08/03/2023] [Indexed: 09/24/2023] Open
Abstract
OBJECTIVES To describe Niemann-Pick type C (NP-C) behavioral symptoms (focusing on psychotic symptoms) and its relation to frontal lobe functioning. METHODS We retrospectively reviewed medical charts of NP-C-patients followed in the Lysosomal Diseases reference center in Paris Pitié-Salpêtrière. We collected demographic data, psychiatric clinical manifestations, psychometric scales, and extended neuropsychological data including executive and behavioral frontal lobe functions evaluations. RESULTS Nineteen patients were included in the study with ten of them having experienced at least one acute psychotic episode, being inaugural for six of them. Most of the patients suffered from behavioral (15/17) and cognitive disorders (18/19) (including executive dysfunction (11/12), apathy (13/17), impaired social cognition (11/13) and stereotyped behaviors (5/10). For five patients, quality of life was significantly impaired by these abnormal behaviors. Concerning frontal neuropsychological evaluation, Facial emotion recognition was by far the most performed neuropsychological test (n = 8) and the score was always abnormal. It is noteworthy that psychotic symptoms were often drug resistant (8/9) and that Miglustat was associated with a better control of psychotic symptoms. CONCLUSIONS We report a high frequency of psychiatric symptoms in NP-C encompassing acute psychotic manifestations, often presenting early in the course of the disease with atypical features. We also report disabling behavioral manifestations related to frontal dysfunction.
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Affiliation(s)
- A Morin
- Department of Neurology, Rouen University Hospital, University of Rouen, 76000, Rouen, France.
- Department of Psychiatry, Rouvray Hospital, University of Rouen, 76000, Rouen, France.
| | - G Carle
- Saint-Exupery Private Clinic, Toulouse, France
| | - A Ponchel
- GHU Paris Psychiatrie & Neurosciences, Paris, France
| | - G Fernández-Eulate
- Neuro-Metabolism Unit, Neurology Department, Reference Center for Lysosomal Diseases, Pitié-Salpêtrière University Hospital, APHP, Paris, France
- Institut Necker-Enfants Malades, INSERM U1151, BioSPC (ED562), Université Paris Cité, Paris, France
| | - Y Nadjar
- Neuro-Metabolism Unit, Neurology Department, Reference Center for Lysosomal Diseases, Pitié-Salpêtrière University Hospital, APHP, Paris, France
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Panda PK, Ramachandran A, Kumar V, Sharawat IK. Sensory processing abilities and their impact on disease severity in children with attention-deficit hyperactivity disorder. J Neurosci Rural Pract 2023; 14:509-515. [PMID: 37692805 PMCID: PMC10483208 DOI: 10.25259/jnrp_22_2023] [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: 01/08/2023] [Accepted: 07/10/2023] [Indexed: 09/12/2023] Open
Abstract
Objectives Although several studies have shown sensory processing abnormalities in pediatric subjects with attention-deficit hyperactivity disorder (ADHD), there is significant heterogeneity among their results. Materials and Methods This study was performed to compare the sensory processing abilities of children and adolescents with and without ADHD aged 6-15 years and to correlate the sensory processing problems in these patients, with the symptom profile and severity of ADHD. While child sensory profile-2 (SP-2) was used to assess, the sensory processing abilities of ADHD patients, revised Connor's parent rating scale revised, Malin's intelligence scale for Indian children, grade level assessment device, and child behavior checklist were used to assess ADHD symptom severity, intelligence, learning, and behavioral problems, respectively. Results A total of 66 ADHD patients enrolled (60 boys), 22 (28%), 7 (9%), and 49 (63%) cases were the ADHD-hyperactive-impulsive (ADHD-HI), ADHD-inattentive, and ADHD-combined (ADHD-C) types, respectively, and 33 typically developing controls. The ADHD patients had a significantly low raw score on most of the factors, sections, and response patterns of SP-2 (P < 0.05), but only four and one ADHD patients had auditory and visual processing scores outside the normal clinical range. There was a trend toward higher scores in the children with ADHD-C and ADHD-HI subtypes. There was a moderate negative correlation between hyperactivity/impulsivity T-score and auditory processing scores in the SP (P < 0.05, r = -0.43). We observed a negative correlation, although weak, between visual processing scores and hyperactivity/impulsivity and a positive correlation between the severity of conduct disorder-related problems, oppositional defiant problems, anxiety problems, and auditory as well as tactile processing scores (P < 0.05). In the quadrant score summary, the scores for all four types, that is, sensory sensitivity, low registration, sensation avoiding, and sensation seeking, were significantly more in the ADHD group, as compared to healthy controls. Conclusion Sensory processing abilities in ADHD children differ from that of typically developing children when objectively assessed, although most of the ADHD children had scores in the clinically normal range. The sensory processing profile also has an impact on the severity and comorbidity profile of ADHD patients.
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Affiliation(s)
- Prateek Kumar Panda
- Division of Pediatric Neurology, Department of Pediatrics, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Aparna Ramachandran
- Department of Neurology, IQRAA International Hospital and Research Centre, Kozhikode, Kerala, India
| | - Vinod Kumar
- Division of Pediatric Neurology, Department of Pediatrics, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Indar Kumar Sharawat
- Division of Pediatric Neurology, Department of Pediatrics, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
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He F, Liu R, Tian G, Qi Y, Wang T. Ecotoxicological evaluation of oxidative stress-mediated neurotoxic effects, genetic toxicity, behavioral disorders, and the corresponding mechanisms induced by fluorene-contaminated soil targeted to earthworm (Eisenia fetida) brain. Sci Total Environ 2023; 871:162014. [PMID: 36740067 DOI: 10.1016/j.scitotenv.2023.162014] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [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: 12/22/2022] [Revised: 01/29/2023] [Accepted: 01/30/2023] [Indexed: 06/18/2023]
Abstract
Fluorene is a commonly identified PAH pollutant in soil and exhibits various worrisome hazardous effects to soil organisms. Currently, the toxicity profiles of fluorene on earthworm brain are rare, and the mechanisms and their corresponding pathways involved in fluorene-triggered neurotoxicity, genotoxicity, and behavior changes have not been reported hitherto. Herein, earthworm (Eisenia fetida) brain was chosen as targeted receptor to explore the neurotoxic effects, genetic toxicity, behavioral disorders, and related mechanisms caused by fluorene-induced oxidative stress pathways. The results showed excess fluorene initiated the release of excessive quantities of ROS in earthworm brain, which have caused oxidative stress and accompanied by serious oxidative effects, including LPO (lipid peroxidation) and DNA injury. To minimize the damage effects, the antioxidant defense mechanisms (antioxidant enzymes and non-enzymatic antioxidants) were activated, and entailed a decrease of the antioxidant capacity in E. fetida brain, which, in turn, causes further ROS-induced ROS release. Exposure of fluorene induced the abnormal mRNA expression of genes relevant to oxidative stress (e.g., GST, SOD, CAT, GPx, MT, and Hsp70) and neurotoxicity (e.g., H02, C04, D06, and E08) in E. fetida brain. Specifically, fluorene can bind directly to AChE, destroying the conformation of this protein, and even affecting its physiological functions. This occurrence caused the inhibition of AChE activity and excess ACh accumulation at the nicotinic post-synaptic membrane, finally triggering neurotoxicity by activation of pathways related to oxidative stress. Moreover, the avoidance responses and burrowing behavior were obviously disturbed by oxidative stress-induced neurotoxicity after exposure to fluorene. The results form IBR suggested more severe poisoning effects to E. fetida brain initiated by high-dose and long-term exposure of fluorene. Among, oxidative stress injury and genotoxic potential are more sensitive endpoint than others. Collectively, fluorene stress can provoke potential neurotoxicity, genotoxicity, and behavioral disturbances targeted to E. fetida brain through the ROS-mediated pathways involving oxidative stress. These findings are of great significance to estimate the detrimental effects of fluorene and the corresponding mechanisms on soil eco-safety.
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Affiliation(s)
- Falin He
- School of Environmental Science and Engineering, Shandong University, China-America CRC for Environment & Health, 72# Jimo Binhai Road, Qingdao, Shandong 266237, PR China
| | - Rutao Liu
- School of Environmental Science and Engineering, Shandong University, China-America CRC for Environment & Health, 72# Jimo Binhai Road, Qingdao, Shandong 266237, PR China.
| | - Guang Tian
- School of Environmental Science and Engineering, Shandong University, China-America CRC for Environment & Health, 72# Jimo Binhai Road, Qingdao, Shandong 266237, PR China
| | - Yuntao Qi
- School of Environmental Science and Engineering, Shandong University, China-America CRC for Environment & Health, 72# Jimo Binhai Road, Qingdao, Shandong 266237, PR China
| | - Tingting Wang
- School of Environmental Science and Engineering, Shandong University, China-America CRC for Environment & Health, 72# Jimo Binhai Road, Qingdao, Shandong 266237, PR China
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Hajizadeh Moghaddam A, Alizadeh S, Nejadi M, Mokhtari Sangdehi SR, Zare M, Ranjbar M. Nano-hesperetin ameliorates 6-hydroxydopamine-induced behavioral deficits and oxidative damage by up-regulating gene expression of antioxidant enzymes. Avicenna J Phytomed 2023; 13:290-301. [PMID: 37655004 PMCID: PMC10465877 DOI: 10.22038/ajp.2022.21532] [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] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Accepted: 10/23/2022] [Indexed: 09/02/2023]
Abstract
Objective Hesperetin (Hst) has shown several pharmacological effects. The efficacy of Hst is highly restricted in vivo due mainly to poor bioavailability. This investigation was intended to compare the influence of Hst and nano-Hst treatment on 6-hydroxydopamine (6-OHDA)-induced behavioral deficits and oxidative stress in rats. Materials and Methods Forty-two Wistar male rats were equally assigned to 6 groups: control, 6-OHDA, Hst5, Hst10, nano-Hst5, and nano-Hst10. Treatment with Hst and nano-Hst was initiated 1 day after the intrastriatal injection of 6-OHDA and continued for 28 days. Behavioral deficits were evaluated using apomorphine-induced rotation test (AIRT), narrow beam test (NBT) and novel object recognition test (NORT), and the hippocampus and striatum were used to evaluate oxidative stress-related parameters. Results The rats injected only with 6-OHDA showed learning and memory deficits but Hst and nano-Hst treatments improved it (p<0.001). Compared to the control group, a marked promotion in Malondialdehyde (MDA) levels along with a marked reduction in activities and gene expression of antioxidant enzymes and reduced glutathione (GSH) levels in the hippocampus and striatum were observed in the 6-OHDA group (p<0.01). However, administration of Hst and nano-Hst remarkably diminished MDA levels (p<0.01), and significantly increased the activities (p<0.01) and gene expression of antioxidant enzymes (p<0.05) and GSH levels (p<0.01) compared to the 6-OHDA group. In most parameters, nano-Hst has shown better therapeutic effects than Hst. Conclusion Our findings reveal that Hst can be considered as a potential candidate for the treatment of neurodegenerative diseases and that nano-Hst may have better bioavailability.
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Affiliation(s)
| | - Sara Alizadeh
- Department of Animal Sciences, Faculty of Basic Sciences, University of Mazandaran, Babolsar, Iran
| | - Monireh Nejadi
- Department of Animal Sciences, Faculty of Basic Sciences, University of Mazandaran, Babolsar, Iran
| | | | - Mahboobeh Zare
- Faculty of Herbs, Amol University of Special Modern Technologies, Amol, Iran
| | - Mojtaba Ranjbar
- Faculty of Biotechnology, Amol University of Special Modern Technologies, Amol, Iran
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Panda PK, Ramachandran A, Tomar A, Elwadhi A, Kumar V, Sharawat IK. Prevalence, nature, and severity of the psychiatric comorbidities and their impact on quality of life in adolescents with Juvenile myoclonic epilepsy. Epilepsy Behav 2023; 142:109216. [PMID: 37088064 DOI: 10.1016/j.yebeh.2023.109216] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2023] [Revised: 04/02/2023] [Accepted: 04/04/2023] [Indexed: 04/25/2023]
Abstract
INTRODUCTION Adults with Juvenile myoclonic epilepsy (JME) are at increased risk for psychiatric comorbidities, personality traits, and abnormality in executive function. But studies on adolescents and their impact on quality of life are scarce in the literature. MATERIALS AND METHODS This cross-sectional study was performed between August 2019 and October 2022 to compare the prevalence of psychiatric comorbidities in adolescents with JME and age and gender-matched healthy controls. After completing DSM-5 Structured Clinical Interview (SCID-5) initially in all patients, we measured the severity of individual psychiatric problems like anxiety, depression, and somatic symptoms by using an appropriate psychometric scale. We also measured both groups' intelligence quotient (IQ), executive function, and quality of life. RESULTS One hundred patients with JME (14.3 ± 2.5 years, 48 boys) and 100 controls were enrolled. Psychiatric disorders were observed in 46% of JME and 6% of controls (p < 0.01). Psychiatric comorbidities noted in the patients with JME were: somatic symptom and related disorders(n = 14), anxiety (n = 13), adjustment disorders (n = 12), depression (n = 11), oppositional defiant disorder (n = 6), conduct disorder (n = 5), anorexia nervosa (n = 3), narcissistic (n = 3), histrionic (n = 1), substance-related disorder (n = 1), borderline (n = 2) and antisocial personality disorder (n = 2). The prevalence of depressive disorders, anxiety disorders, adjustment disorders, somatic symptoms, related disorders, and any personality disorder was significantly more in the JME group (p < 0.01 for all). Female gender, higher Epilepsy Stigma Scale score, and lower Epilepsy Outcome Expectancy Scale were significantly associated with depressive disorders (p = 0.04, 0.03, 0.03 respectively). Similarly, for anxiety, only female gender and lower Epilepsy Outcome Expectancy Scale were significant associated factors (p = 0.03, 0.02 respectively). CONCLUSIONS Psychiatric disorders like anxiety, depression, and personality disorders are more frequent in adolescents with JME than in controls.
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Affiliation(s)
- Prateek Kumar Panda
- Pediatric Neurology Division, Department of Pediatrics, All India Institute of Medical Sciences, Rishikesh, Uttarakhand 249203, India
| | - Aparna Ramachandran
- Department of Neurology, IQRAA International Hospital and Research Centre, Kozhikode, Kerala 673009, India
| | - Apurva Tomar
- Pediatric Neurology Division, Department of Pediatrics, All India Institute of Medical Sciences, Rishikesh, Uttarakhand 249203, India
| | - Aman Elwadhi
- Pediatric Neurology Division, Department of Pediatrics, All India Institute of Medical Sciences, Rishikesh, Uttarakhand 249203, India
| | - Vinod Kumar
- Department of Pediatrics, All India Institute of Medical Sciences, Rishikesh, Uttarakhand 249203, India
| | - Indar Kumar Sharawat
- Pediatric Neurology Division, Department of Pediatrics, All India Institute of Medical Sciences, Rishikesh, Uttarakhand 249203, India.
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Barreto Meichtry L, Silva da Silva G, Londero L, Munir Mustafa Dahleh M, Cardoso Bortolotto V, Machado Araujo S, Aparecida Musachio E, Trivisiol da Silva D, Emanuelli T, Ricardo Sigal Carriço M, Roehrs R, Petri Guerra G, Prigol M. Exposure to trans fat during the developmental period ofDrosophila melanogasteralters the composition of fatty acids in the head and induces depression-like behavior. Neuroscience 2023; 519:10-22. [PMID: 36933760 DOI: 10.1016/j.neuroscience.2023.03.015] [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: 07/14/2022] [Revised: 03/02/2023] [Accepted: 03/13/2023] [Indexed: 03/18/2023]
Abstract
Given the importance of understanding the disorders caused by trans fatty acids (TFAs), this study sought to add different concentrations hydrogenated vegetable fat (HVF) to the diet of Drosophila melanogaster during the developmental period and evaluate the effects on neurobehavioral parameters. Longevity, hatching rate, and behavioral functions were assessed, such as negative geotaxis, forced swimming, light/dark, mating, and aggressiveness. The fatty acids (FAs) present in the heads of the flies were quantified as well as serotonin (5HT) and dopamine (DA) levels. Our findings showed that flies that received HVF at all concentrations during development showed reduced longevity and hatching rates, in addition to increased depression-like, anxious-like, anhedonia-like, and aggressive behaviors. As for the biochemical parameters, there was a more significant presence of TFA in flies exposed to HVF at all concentrations evaluated and lower 5HT and DA levels. This study shows that HVF during the developmental phase can cause neurological changes and consequently induce behavioral disorders, thereby highlighting the importance of the type of FA offered in the early stages of life.
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Affiliation(s)
- Luana Barreto Meichtry
- Laboratório de Avaliações Farmacológicas e Toxicológicas Aplicadas às Moléculas Bioativas - LaftamBio Pampa - Universidade Federal do Pampa - Campus Itaqui - Rua Luiz Joaquim de Sá Britto, Promorar, Itaqui, Rio Grande do Sul, Brazil, CEP 97650-000
| | - Guilherme Silva da Silva
- Laboratório de Avaliações Farmacológicas e Toxicológicas Aplicadas às Moléculas Bioativas - LaftamBio Pampa - Universidade Federal do Pampa - Campus Itaqui - Rua Luiz Joaquim de Sá Britto, Promorar, Itaqui, Rio Grande do Sul, Brazil, CEP 97650-000
| | - Larissa Londero
- Laboratório de Avaliações Farmacológicas e Toxicológicas Aplicadas às Moléculas Bioativas - LaftamBio Pampa - Universidade Federal do Pampa - Campus Itaqui - Rua Luiz Joaquim de Sá Britto, Promorar, Itaqui, Rio Grande do Sul, Brazil, CEP 97650-000
| | - Mustafa Munir Mustafa Dahleh
- Laboratório de Avaliações Farmacológicas e Toxicológicas Aplicadas às Moléculas Bioativas - LaftamBio Pampa - Universidade Federal do Pampa - Campus Itaqui - Rua Luiz Joaquim de Sá Britto, Promorar, Itaqui, Rio Grande do Sul, Brazil, CEP 97650-000
| | - Vandreza Cardoso Bortolotto
- Laboratório de Avaliações Farmacológicas e Toxicológicas Aplicadas às Moléculas Bioativas - LaftamBio Pampa - Universidade Federal do Pampa - Campus Itaqui - Rua Luiz Joaquim de Sá Britto, Promorar, Itaqui, Rio Grande do Sul, Brazil, CEP 97650-000
| | - Stífani Machado Araujo
- Laboratório de Avaliações Farmacológicas e Toxicológicas Aplicadas às Moléculas Bioativas - LaftamBio Pampa - Universidade Federal do Pampa - Campus Itaqui - Rua Luiz Joaquim de Sá Britto, Promorar, Itaqui, Rio Grande do Sul, Brazil, CEP 97650-000
| | - Elize Aparecida Musachio
- Laboratório de Avaliações Farmacológicas e Toxicológicas Aplicadas às Moléculas Bioativas - LaftamBio Pampa - Universidade Federal do Pampa - Campus Itaqui - Rua Luiz Joaquim de Sá Britto, Promorar, Itaqui, Rio Grande do Sul, Brazil, CEP 97650-000
| | - Dariane Trivisiol da Silva
- Departamento de Tecnologia e Ciência dos Alimentos, Centro de Ciências Rurais Universidade Federal de Santa Maria, Santa Maria, RS, Brazil, CEP 97105-900
| | - Tatiana Emanuelli
- Departamento de Tecnologia e Ciência dos Alimentos, Centro de Ciências Rurais Universidade Federal de Santa Maria, Santa Maria, RS, Brazil, CEP 97105-900
| | - Murilo Ricardo Sigal Carriço
- Universidade Federal do Pampa - Campus Uruguaiana, Programa de Pós-Graduação em Bioquímica (PPGBioq), BR-472 Km 7, Uruguaiana, Brazil, CEP 97501-970
| | - Rafael Roehrs
- Universidade Federal do Pampa - Campus Uruguaiana, Programa de Pós-Graduação em Bioquímica (PPGBioq), BR-472 Km 7, Uruguaiana, Brazil, CEP 97501-970
| | - Gustavo Petri Guerra
- Laboratório de Avaliações Farmacológicas e Toxicológicas Aplicadas às Moléculas Bioativas - LaftamBio Pampa - Universidade Federal do Pampa - Campus Itaqui - Rua Luiz Joaquim de Sá Britto, Promorar, Itaqui, Rio Grande do Sul, Brazil, CEP 97650-000
| | - Marina Prigol
- Laboratório de Avaliações Farmacológicas e Toxicológicas Aplicadas às Moléculas Bioativas - LaftamBio Pampa - Universidade Federal do Pampa - Campus Itaqui - Rua Luiz Joaquim de Sá Britto, Promorar, Itaqui, Rio Grande do Sul, Brazil, CEP 97650-000.
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Papageorgiou L, Kalospyrou E, Papakonstantinou E, Diakou I, Pierouli K, Dragoumani K, Bacopoulou F, Chrousos GP, Exarchos TP, Vlamos P, Eliopoulos E, Vlachakis D. DRDs and Brain-Derived Neurotrophic Factor Share a Common Therapeutic Ground: A Novel Bioinformatic Approach Sheds New Light Toward Pharmacological Treatment of Cognitive and Behavioral Disorders. Adv Exp Med Biol 2023; 1424:97-115. [PMID: 37486484 DOI: 10.1007/978-3-031-31982-2_11] [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] [Indexed: 07/25/2023]
Abstract
Cognitive and behavioral disorders are subgroups of mental health disorders. Both cognitive and behavioral disorders can occur in people of different ages, genders, and social backgrounds, and they can cause serious physical, mental, or social problems. The risk factors for these diseases are numerous, with a range from genetic and epigenetic factors to physical factors. In most cases, the appearance of such a disorder in an individual is a combination of his genetic profile and environmental stimuli. To date, researchers have not been able to identify the specific causes of these disorders, and as such, there is urgent need for innovative study approaches. The aim of the present study was to identify the genetic factors which seem to be more directly responsible for the occurrence of a cognitive and/or behavioral disorder. More specifically, through bioinformatics tools and software as well as analytical methods such as systemic data and text mining, semantic analysis, and scoring functions, we extracted the most relevant single nucleotide polymorphisms (SNPs) and genes connected to these disorders. All the extracted SNPs were filtered, annotated, classified, and evaluated in order to create the "genomic grammar" of these diseases. The identified SNPs guided the search for top suspected genetic factors, dopamine receptors D and neurotrophic factor BDNF, for which regulatory networks were built. The identification of the "genomic grammar" and underlying factors connected to cognitive and behavioral disorders can aid in the successful disease profiling and the establishment of novel pharmacological targets and provide the basis for personalized medicine, which takes into account the patient's genetic background as well as epigenetic factors.
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Affiliation(s)
- Louis Papageorgiou
- Department of Biotechnology, Laboratory of Genetics, School of Applied Biology and Biotechnology, Agricultural University of Athens, Athens, Greece
| | - Efstathia Kalospyrou
- Department of Biotechnology, Laboratory of Genetics, School of Applied Biology and Biotechnology, Agricultural University of Athens, Athens, Greece
| | - Eleni Papakonstantinou
- Department of Biotechnology, Laboratory of Genetics, School of Applied Biology and Biotechnology, Agricultural University of Athens, Athens, Greece
| | - Io Diakou
- Department of Biotechnology, Laboratory of Genetics, School of Applied Biology and Biotechnology, Agricultural University of Athens, Athens, Greece
| | - Katerina Pierouli
- Department of Biotechnology, Laboratory of Genetics, School of Applied Biology and Biotechnology, Agricultural University of Athens, Athens, Greece
| | - Konstantina Dragoumani
- Department of Biotechnology, Laboratory of Genetics, School of Applied Biology and Biotechnology, Agricultural University of Athens, Athens, Greece
| | - Flora Bacopoulou
- University Research Institute of Maternal and Child Health & Precision Medicine, National and Kapodistrian University of Athens, "Aghia Sophia" Children's Hospital, Athens, Greece
| | - George P Chrousos
- University Research Institute of Maternal and Child Health & Precision Medicine, National and Kapodistrian University of Athens, "Aghia Sophia" Children's Hospital, Athens, Greece
| | - Themis P Exarchos
- Department of Informatics, Bioinformatics & Human Electrophysiology Laboratory, Ionian University, Corfu, Greece
| | - Panagiotis Vlamos
- Department of Informatics, Bioinformatics & Human Electrophysiology Laboratory, Ionian University, Corfu, Greece
| | - Elias Eliopoulos
- Department of Biotechnology, Laboratory of Genetics, School of Applied Biology and Biotechnology, Agricultural University of Athens, Athens, Greece
| | - Dimitrios Vlachakis
- Department of Biotechnology, Laboratory of Genetics, School of Applied Biology and Biotechnology, Agricultural University of Athens, Athens, Greece.
- University Research Institute of Maternal and Child Health & Precision Medicine, National and Kapodistrian University of Athens, "Aghia Sophia" Children's Hospital, Athens, Greece.
- Division of Endocrinology and Metabolism, Center of Clinical, Experimental Surgery and Translational Research, Biomedical Research Foundation of the Academy of Athens, Athens, Greece.
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15
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Kanungo S, Beenen KT. Role of Psychologists in Pediatric Metabolic Disorders. Pediatr Clin North Am 2022; 69:1003-1016. [PMID: 36207093 DOI: 10.1016/j.pcl.2022.05.012] [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] [Indexed: 12/31/2022]
Abstract
Metabolic disorders or inborn errors of metabolism (IEMs) can have a wide range of neurodevelopmental and behavioral presentations. These can vary with age and/or management or stressors from common childhood/intercurrent illnesses/procedures/interventions. Collaborative care models such as multidisciplinary metabolic clinics or colocated models with behavioral health clinics and metabolic clinics in the same location can be valuable resources in improving long-term outcomes in patients with IEM. Psychologists' expertise using behavioral interventions, screening, or adaptive/cognitive measures can help with diagnosis, treatment adherence, school performance, family support, community resources, transition to adolescence and young adulthood using health belief concepts to improve outcomes.
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Affiliation(s)
- Shibani Kanungo
- Department of Pediatric and Adolescent Medicine, Western Michigan University Homer Stryker MD School of Medicine, 1000 Oakland Drive, Kalamazoo MI 49008, USA; Department of Medical Ethics, Humanities and Law, Western Michigan University Homer Stryker MD School of Medicine, 1000 Oakland Drive, Kalamazoo MI 49008, USA.
| | - Katherine T Beenen
- Department of Pediatric and Adolescent Medicine, Western Michigan University Homer Stryker MD School of Medicine, 1000 Oakland Drive, Kalamazoo MI 49008, USA
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Ishihara Y, Honda T, Ishihara N, Namba K, Taketoshi M, Tominaga Y, Tsuji M, Vogel CFA, Yamazaki T, Itoh K, Tominaga T. A CCR5 antagonist, maraviroc, alleviates neural circuit dysfunction and behavioral disorders induced by prenatal valproate exposure. J Neuroinflammation 2022; 19:195. [PMID: 35906621 DOI: 10.1186/s12974-022-02559-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Accepted: 07/22/2022] [Indexed: 02/02/2023] Open
Abstract
BACKGROUND Valproic acid (VPA) is a clinically used antiepileptic drug, but it is associated with a significant risk of a low verbal intelligence quotient (IQ) score, attention-deficit hyperactivity disorder and autism spectrum disorder in children when it is administered during pregnancy. Prenatal VPA exposure has been reported to affect neurogenesis and neuronal migration and differentiation. In addition, growing evidence has shown that microglia and brain immune cells are activated by VPA treatment. However, the role of VPA-activated microglia remains unclear. METHODS Pregnant female mice received sodium valproate on E11.5. A microglial activation inhibitor, minocycline or a CCR5 antagonist, maraviroc was dissolved in drinking water and administered to dams from P1 to P21. Measurement of microglial activity, evaluation of neural circuit function and expression analysis were performed on P10. Behavioral tests were performed in the order of open field test, Y-maze test, social affiliation test and marble burying test from the age of 6 weeks. RESULTS Prenatal exposure of mice to VPA induced microglial activation and neural circuit dysfunction in the CA1 region of the hippocampus during the early postnatal periods and post-developmental defects in working memory and social interaction and repetitive behaviors. Minocycline, a microglial activation inhibitor, clearly suppressed the above effects, suggesting that microglia elicit neural dysfunction and behavioral disorders. Next-generation sequencing analysis revealed that the expression of a chemokine, C-C motif chemokine ligand 3 (CCL3), was upregulated in the hippocampi of VPA-treated mice. CCL3 expression increased in microglia during the early postnatal periods via an epigenetic mechanism. The CCR5 antagonist maraviroc significantly suppressed neural circuit dysfunction and post-developmental behavioral disorders induced by prenatal VPA exposure. CONCLUSION These findings suggest that microglial CCL3 might act during development to contribute to VPA-induced post-developmental behavioral abnormalities. CCR5-targeting compounds such as maraviroc might alleviate behavioral disorders when administered early.
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Zhang M, Gao X, Yang Z, Wen M, Huang H, Zheng R, Wang W, Wei Y, Cheng J, Han S, Zhang Y. Shared gray matter alterations in subtypes of addiction: a voxel-wise meta-analysis. Psychopharmacology (Berl) 2021; 238:2365-2379. [PMID: 34313804 DOI: 10.1007/s00213-021-05920-w] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [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: 01/06/2021] [Accepted: 07/05/2021] [Indexed: 12/26/2022]
Abstract
BACKGROUND Numerous studies based on voxel-based morphometry (VBM) have revealed gray matter (GM) alterations in multiple brain regions for addiction. However, findings are poorly replicated, and it remains elusive whether distinct diagnoses of addiction are underpinned by shared abnormalities. Our aim was to conduct a quantitative meta-analysis of structural neuroimaging studies investigating GM abnormalities in two main categories of addiction: substance use disorders (SUD) and behavioral addictions (BA). METHOD A systematic database search was conducted in several databases from Jan 1, 2010, to Oct 23, 2020, to identify eligible VBM studies. Meta-analysis was performed with the seed-based d mapping software package to compare alternations between individuals with addiction-related disorders and healthy controls (HC). RESULTS A total of 59 VBM studies including 2096 individuals with addiction-related disorders and 2637 HC met the inclusion criteria. Individuals with addiction-related disorders showed shared GM volume decrease in bilateral prefrontal cortex, bilateral insula, bilateral rolandic operculum, left superior temporal gyrus, and right Heschl gyrus and GM increase in right lingual gyrus and right fusiform gyrus comparing with HC (p < 0.005). Subgroup analysis found heterogeneity between SUD and BA mainly in left inferior occipital gyrus and right striatum (p < 0.005). Meta-regression revealed that GM atrophy in right anterior cingulate (r = 0.541, p = 0.03 (uncorrected)) and left inferior frontal gyrus (r = 0.595, p = 0.015) were positively correlated with higher impulsivity. CONCLUSIONS This meta-analysis identified a concordance across subtypes of addiction in terms of the brain structural changes in prefrontal and insula areas, which may relate to higher impulsivity observed across addiction diagnoses. This concordance provides an organizing model that emphasizes the importance of shared neural substrates in addiction.
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Affiliation(s)
- Mengzhe Zhang
- Department of MRI, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Xinyu Gao
- Department of MRI, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Zhengui Yang
- Department of MRI, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Mengmeng Wen
- Department of MRI, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Huiyu Huang
- Department of MRI, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Ruiping Zheng
- Department of MRI, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Weijian Wang
- Department of MRI, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Yarui Wei
- Department of MRI, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Jingliang Cheng
- Department of MRI, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.
| | - Shaoqiang Han
- Department of MRI, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.
| | - Yong Zhang
- Department of MRI, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.
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Özgen Y, Güngör M, Kutlu M, Kara B. Clinical and electrophysiological predictors of behavioral disorders in patients with benign childhood epilepsy with centrotemporal spikes. Epilepsy Behav 2021; 121:108037. [PMID: 34058495 DOI: 10.1016/j.yebeh.2021.108037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Revised: 05/02/2021] [Accepted: 05/02/2021] [Indexed: 11/22/2022]
Abstract
PURPOSE Long-term seizure and developmental outcomes of benign childhood epilepsy with centrotemporal spikes (BECTS) are thought to be good. Studies have shown that behavioral disorders may accompany BECTS. We aimed to investigate the frequency of behavioral disorders in patients with BECTS and evaluate their relationship to epilepsy features. METHODS Data for 41 patients with BECTS followed up at our clinic between December 2019 and June 2020 were analyzed. Behavioral disorders and intelligence were evaluated by the Turgay Diagnostic and Statistical Manual of Mental Disorders 4th Edition - Disruptive Behaviour Disorders Rating Scale and Wechsler Intelligence Scale for Children Revised, respectively. Patients with a diagnosis of BECTS were divided into 2 groups: children with a behavioral disorder and children without a behavioral disorder. Demographic characteristics, clinical and electroencephalography (EEG) findings, and intelligence level were compared between the two groups. RESULTS Twelve of the patients (29%) were classified as having attention-deficit/hyperactivity disorder (ADHD) and 2 (5%) were classified as having oppositional defiant disorder (ODD). The age at seizure onset was earlier in patients with behavioral disorders (p = 0.023). Bilateral interictal epileptic discharges (IEDs) were more common in children with behavioral disorders than children without behavioral disorders (p = 0.039). The most preferred antiseizure medication was carbamazepine, followed by levetiracetam and valproic acid. The intelligence score of the patients with BECTS was in the normal range in both groups. The total, verbal, and performance scores were lower in patients with a behavioral disorder than in patients without a behavioral disorder, but there was no statistically significant difference between the two groups. CONCLUSION Behavioral disorders may be present in approximately one-third of patients with BECTS. Early onset of seizures and the presence of bilateral IEDs may be risk factors for behavioral disorders in children with BECTS.
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Seguella L, Pesce M, Capuano R, Casano F, Pesce M, Corpetti C, Vincenzi M, Maftei D, Lattanzi R, Del Re A, Sarnelli G, Gulbransen BD, Esposito G. High-fat diet impairs duodenal barrier function and elicits glia-dependent changes along the gut-brain axis that are required for anxiogenic and depressive-like behaviors. J Neuroinflammation 2021; 18:115. [PMID: 33993886 DOI: 10.1186/s12974-021-02164-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Accepted: 04/30/2021] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Mood and metabolic disorders are interrelated and may share common pathological processes. Autonomic neurons link the brain with the gastrointestinal tract and constitute a likely pathway for peripheral metabolic challenges to affect behaviors controlled by the brain. The activities of neurons along these pathways are regulated by glia, which exhibit phenotypic shifts in response to changes in their microenvironment. How glial changes might contribute to the behavioral effects of consuming a high-fat diet (HFD) is uncertain. Here, we tested the hypothesis that anxiogenic and depressive-like behaviors driven by consuming a HFD involve compromised duodenal barrier integrity and subsequent phenotypic changes to glia and neurons along the gut-brain axis. METHODS C57Bl/6 male mice were exposed to a standard diet or HFD for 20 weeks. Bodyweight was monitored weekly and correlated with mucosa histological damage and duodenal expression of tight junction proteins ZO-1 and occludin at 0, 6, and 20 weeks. The expression of GFAP, TLR-4, BDNF, and DCX were investigated in duodenal myenteric plexus, nodose ganglia, and dentate gyrus of the hippocampus at the same time points. Dendritic spine number was measured in cultured neurons isolated from duodenal myenteric plexuses and hippocampi at weeks 0, 6, and 20. Depressive and anxiety behaviors were also assessed by tail suspension, forced swimming, and open field tests. RESULTS HFD mice exhibited duodenal mucosa damage with marked infiltration of immune cells and decreased expression of ZO-1 and occludin that coincided with increasing body weight. Glial expression of GFAP and TLR4 increased in parallel in the duodenal myenteric plexuses, nodose ganglia, and hippocampus in a time-dependent manner. Glial changes were associated with a progressive decrease in BDNF, and DCX expression, fewer neuronal dendritic spines, and anxiogenic/depressive symptoms in HFD-treated mice. Fluorocitrate (FC), a glial metabolic poison, abolished these effects both in the enteric and central nervous systems and prevented behavioral alterations at week 20. CONCLUSIONS HFD impairs duodenal barrier integrity and produces behavioral changes consistent with depressive and anxiety phenotypes. HFD-driven changes in both peripheral and central nervous systems are glial-dependent, suggesting a potential glial role in the alteration of the gut-brain signaling that occurs during metabolic disorders and psychiatric co-morbidity.
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Amirkhosravi L, Khaksari M, Sheibani V, Shahrokhi N, Ebrahimi MN, Amiresmaili S, Salmani N. Improved spatial memory, neurobehavioral outcomes, and neuroprotective effect after progesterone administration in ovariectomized rats with traumatic brain injury: Role of RU486 progesterone receptor antagonist. Iran J Basic Med Sci 2021; 24:349-359. [PMID: 33995946 PMCID: PMC8087858 DOI: 10.22038/ijbms.2021.50973.11591] [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] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/05/2020] [Accepted: 12/22/2020] [Indexed: 12/27/2022]
Abstract
OBJECTIVES The contribution of classic progesterone receptors (PR) in interceding the neuroprotective efficacy of progesterone (P4) on the prevention of brain edema and long-time behavioral disturbances was assessed in traumatic brain injury (TBI). MATERIALS AND METHODS Female Wistar rats were ovariectomized and apportioned into 6 groups: sham, TBI, oil, P4, vehicle, and RU486. P4 or oil was injected following TBI. The antagonist of PR (RU486) or DMSO was administered before TBI. The brain edema and destruction of the blood-brain barrier (BBB) were determined. Intracranial pressure (ICP), cerebral perfusion pressure (CPP), and beam walk (BW) task were evaluated previously and at various times post-trauma. Long-time locomotor and cognitive consequences were measured one day before and on days 3, 7, 14, and 21 after the trauma. RESULTS RU486 eliminated the inhibitory effects of P4 on brain edema and BBB leakage (P<0.05, P<0.001, respectively). RU486 inhibited the decremental effect of P4 on ICP as well as the increasing effect of P4 on CPP (P<0.001) after TBI. Also, RU486 inhibited the effect of P4 on the increase in traversal time and reduction in vestibulomotor score in the BW task (P<0.001). TBI induced motor, cognitive, and anxiety-like disorders, which lasted for 3 weeks after TBI; but, P4 prevented these cognitive and behavioral abnormalities (P<0.05), and RU486 opposed this P4 effect (P<0.001). CONCLUSION The classic progesterone receptors have neuroprotective effects and prevent long-time behavioral and memory deficiency after brain trauma.
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Affiliation(s)
- Ladan Amirkhosravi
- Neuroscience Research and Physiology Research Centers, Kerman University of Medical Sciences, Kerman, Iran
- Endocrinology and Metabolism Research Center, Institute of Basic and Clinical Physiology Sciences, Kerman University of Medical Sciences, Kerman, Iran
| | - Mohammad Khaksari
- Endocrinology and Metabolism Research Center, Institute of Basic and Clinical Physiology Sciences, Kerman University of Medical Sciences, Kerman, Iran
| | - Vahid Sheibani
- Neuroscience Research Center, Kerman University of Medical Sciences, Kerman, Iran
| | - Nader Shahrokhi
- Physiology Research Centers, Institute of Basic and Clinical Physiology Sciences, Kerman University of Medical Sciences, Kerman, Iran
| | - Mohammad Navid Ebrahimi
- Neuroscience Research and Physiology Research Centers, Kerman University of Medical Sciences, Kerman, Iran
| | | | - Neda Salmani
- Department of Psychology, Genetic Institute, Islamic Azad University- Zarand Branch, Kerman, Iran
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Hoshikawa Y, Hoshino S, Kawami N, Iwakiri K. Prevalence of behavioral disorders in patients with vonoprazan-refractory reflux symptoms. J Gastroenterol 2021; 56:117-124. [PMID: 33247348 DOI: 10.1007/s00535-020-01751-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [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: 07/21/2020] [Accepted: 11/12/2020] [Indexed: 02/04/2023]
Abstract
BACKGROUND Behavioral disorders, such as supragastric belching (SGB) and rumination syndrome (RS), which may be treated by cognitive behavioral therapy, are common in patients with reflux symptoms refractory to proton pump inhibitors (PPI). Vonoprazan (VPZ) has been used as a new type of acid inhibitor in Japan since 2015. We herein investigated the prevalence of behavioral disorders in patients with VPZ-refractory reflux symptoms and attempted to identify predictive factors. METHODS We retrospectively analyzed esophagogastroduodenograms, high-resolution manometry, and 24-h multiluminal impedance pH-metry (MIIpH) in patients with VPZ-refractory reflux symptoms (heartburn or regurgitation) receiving 20 mg VPZ who underwent these tests at our hospital between January 2015 and April 2020. Patients were divided as follows: non-erosive reflux disease with pathological esophageal acid exposure (NERD), functional heartburn (FH), reflux hypersensitivity (RH), excessive (> 13 per day) SGB, and possible RS based on MIIpH parameters. RESULTS Among 49 patients, 6 (12.2%) had SGB, 4 (8.2%) possible RS, 29 (59.2%) FH, 9 (18.4%) RH, and 1 (2%) NERD. Possible RS patients had more postprandial non-acid reflux events than FH patients (p < 0.05). The multivariate logistic regression analysis did not identify any predictive factors with statistical significance. CONCLUSION More than 20% patients with VPZ-refractory reflux symptoms had behavioral disorders. The use of HRM and MIIpH may be clinically relevant for a better diagnosis and more specific treatment.
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Affiliation(s)
- Yoshimasa Hoshikawa
- Department of Gastroenterology, Nippon Medical School, Graduate School of Medicine, 1-1-5, Sendagi, Bunkyo-ku, Tokyo, 113-8603, Japan
| | - Shintaro Hoshino
- Department of Gastroenterology, Nippon Medical School, Graduate School of Medicine, 1-1-5, Sendagi, Bunkyo-ku, Tokyo, 113-8603, Japan
| | - Noriyuki Kawami
- Department of Gastroenterology, Nippon Medical School, Graduate School of Medicine, 1-1-5, Sendagi, Bunkyo-ku, Tokyo, 113-8603, Japan
| | - Katsuhiko Iwakiri
- Department of Gastroenterology, Nippon Medical School, Graduate School of Medicine, 1-1-5, Sendagi, Bunkyo-ku, Tokyo, 113-8603, Japan.
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Nissinen NM, Gissler M, Sarkola T, Kahila H, Autti-Rämö I, Koponen AM. Completed secondary education among youth with prenatal substance exposure: A longitudinal register-based matched cohort study. J Adolesc 2020; 86:15-27. [PMID: 33264707 DOI: 10.1016/j.adolescence.2020.11.006] [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: 04/02/2020] [Revised: 11/10/2020] [Accepted: 11/11/2020] [Indexed: 11/28/2022]
Abstract
INTRODUCTION The dual impact of prenatal substance exposure (i.e. alcohol/drugs) and adverse postnatal caregiving environment on offspring secondary education completion is an understudied research area. The aim was to investigate the influence of childhood adversities, out-of-home care, and offspring's mental and/or behavioural disorders on secondary education completion among prenatally exposed offspring in comparison to matched unexposed offspring. METHODS This is a longitudinal register-based matched cohort study in Finland including offspring with a history of prenatal substance exposure and a matched unexposed cohort. The study sample included 283 exposed and 820 unexposed offspring aged 18-23 years. RESULTS The results showed a time lag in secondary education completion and lower educational attainment overall among exposed compared with unexposed (37.8% vs. 51.0%, respectively). The results from the multivariate logistic regression models showed that the differences in the secondary education completion between exposed and unexposed were diminished in the presence of covariates. A cumulative childhood adversity score and out-of-home care were not associated with secondary education completion in the multivariate models, whereas the different domains of offspring's mental and/or behavioural disorders including psychiatric disorders (AOR 0.65, 95% CI 0.45-0.96), neuropsychological disorders (AOR 0.35, 95% CI 0.23-0.54) and dual psychiatric and neuropsychological disorder (AOR 0.29, 95% CI 0.18-0.48) showed an independent negative effect on secondary education completion. CONCLUSIONS Inferior educational outcomes may not be directly linked with prenatal substance exposure but may rather reflect the extent of evolving offspring's mental and/or behavioural disorders over time influenced by childhood adversities.
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Affiliation(s)
- Niina-Maria Nissinen
- Folkhälsan Research Center, Helsinki, Finland; Tampere University, Faculty of Social Sciences, Health Sciences Unit, Tampere, Finland.
| | - Mika Gissler
- THL Finnish Institute for Health and Welfare, Information Services Department, Helsinki, Finland; Karolinska Institute, Department of Neurobiology, Care Sciences and Society, Stockholm, Sweden; University of Turku, Research Centre for Child Psychiatry, Turku, Finland
| | - Taisto Sarkola
- Children's Hospital, University of Helsinki, And Helsinki University Hospital, Helsinki, Finland; Minerva Foundation Institute for Medical Research, Helsinki, Finland
| | - Hanna Kahila
- Department of Obstetrics and Gynecology, University of Helsinki, And Helsinki University Central Hospital, Helsinki, Finland
| | - Ilona Autti-Rämö
- Council for Choices in Health Care in Finland, Department for Steering of Healthcare and Social Welfare, Ministry of Social Affairs and Health, Helsinki, Finland; University of Helsinki, Children's Hospital, Division of Child Neurology, Helsinki, Finland
| | - Anne M Koponen
- Folkhälsan Research Center, Helsinki, Finland; University of Helsinki, Department of Public Health, Helsinki, Finland
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Cavalcante MB, Cavalcante CTDMB, Sarno M, Barini R, Kwak-Kim J. Maternal immune responses and obstetrical outcomes of pregnant women with COVID-19 and possible health risks of offspring. J Reprod Immunol 2020; 143:103250. [PMID: 33249335 PMCID: PMC7676367 DOI: 10.1016/j.jri.2020.103250] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [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: 09/12/2020] [Revised: 10/30/2020] [Accepted: 11/16/2020] [Indexed: 12/23/2022]
Abstract
Pregnant women with COVID-19 have proinflammatory immune responses. Maternal COVID-19 is associated with increased risk of preterm birth, IUGR and LBW. Vascular malperfusion, inflammation and thrombosis are major placental pathologies. Placental pathologies may progress even in asymptomatic COVID-19 cases. COVID-19 may increase long-term offspring risk for non-communicable disease.
Coronavirus disease 2019 (COVID-19) pandemic has spread rapidly across the world. The vast majority of patients with COVID-19 manifest mild to moderate symptoms but may progress to severe cases or even mortalities. Young adults of reproductive age are the most affected population by SARS-CoV-2 infection. However, there is no consensus yet if pregnancy contributes to the severity of COVID-19. Initial studies of pregnant women have found that COVID-19 significantly increases the risk of preterm birth, intrauterine growth restriction, and low birth weight, which have been associated with non-communicable diseases in offspring. Besides, maternal viral infections with or without vertical transmission have been allied with neurological and behavioral disorders of the offspring. In this review, obstetrical outcomes of women with COVID-19 and possible risks for their offspring are discussed by reviewing maternal immune responses to COVID-19 based on the current evidence. Structural and systemic follow-up of offspring who are exposed to SARS-CoV-2 in-utero is suggested.
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Affiliation(s)
- Marcelo Borges Cavalcante
- Department of Obstetrics and Gynecology, Fortaleza University (UNIFOR), Fortaleza, CE, 60.811-905, Brazil; CONCEPTUS - Reproductive Medicine, Fortaleza, CE, 60.170-240, Brazil.
| | | | - Manoel Sarno
- Department of Obstetrics and Gynecology, Federal University of Bahia (UFBA), Salvador, BA, 40.026-010, Brazil; Harris Birthright Research Center for Fetal Medicine, "'King's College Hospital and Department of Fetal Medicine, University College, London, United Kingdom
| | - Ricardo Barini
- Department of Obstetrics and Gynecology, Campinas University (UNICAMP), Campinas, SP, 13.083-887, Brazil
| | - Joanne Kwak-Kim
- Reproductive Medicine and Immunology, Obstetrics and Gynecology, Clinical Sciences Department, Chicago Medical School, Rosalind Franklin University of Medicine and Science, Vernon Hills, IL, 60061, USA
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Boutoleau-Bretonnière C, Pouclet-Courtemanche H, Gillet A, Bernard A, Deruet AL, Gouraud I, Lamy E, Mazoué A, Rocher L, Bretonnière C, El Haj M. Impact of Confinement on the Burden of Caregivers of Patients with the Behavioral Variant of Frontotemporal Dementia and Alzheimer Disease during the COVID-19 Crisis in France. Dement Geriatr Cogn Dis Extra 2020; 10:127-134. [PMID: 34191932 PMCID: PMC7705930 DOI: 10.1159/000511416] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [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: 09/07/2020] [Accepted: 09/07/2020] [Indexed: 11/19/2022] Open
Abstract
Introduction The clinical presentation of the behavioral variant of frontotemporal dementia (bvFTD) differs from that of Alzheimer disease (AD), with major impairments in behavioral functions in bvFTD and cognitive impairment in AD. Both behavioral disturbances in bvFTD and cognitive impairment in AD contribute to caregiver burden. Objective To investigate the impact of home confinement during the COVID-19 crisis on the burden of caregivers of bvFTD or AD patients. Methods During the COVID-19 lockdown in France, neurologists and neuropsychologists from the Memory Center of Nantes Hospital conducted teleconsultations for 38 AD patients and 38 bvFTD patients as well as for their caregivers. During these consultations, caregivers were invited to rate the change in their burden during home confinement. They were also invited to rate behavioral or emotional changes in the patients during, compared with before, the confinement. Results Twenty-two bvFTD caregivers and 14 AD caregivers experienced an increase in burden. For bvFTD caregivers, this increased burden occurred regardless of behavioral changes, while AD caregivers experienced an increased burden related to changes in patients' neuropsychiatric symptoms. Among the whole cohort, 2 factors were associated with increased caregiver burden: behavioral change and bvFTD. Conclusion The results demonstrate that during home confinement in the COVID-19 crisis, neuropsychiatric symptoms were the core factor that impacted caregiver burden in different ways depending on the disease.
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Affiliation(s)
- Claire Boutoleau-Bretonnière
- CHU Nantes, Inserm CIC04, Nantes, France.,Service de Neurologie, Centre Mémoire de Ressources et Recherche, CHU Nantes, Nantes, France
| | - Hélène Pouclet-Courtemanche
- CHU Nantes, Inserm CIC04, Nantes, France.,Service de Neurologie, Centre Mémoire de Ressources et Recherche, CHU Nantes, Nantes, France
| | | | - Amélie Bernard
- CHU Nantes, Inserm CIC04, Nantes, France.,Service de Neurologie, Centre Mémoire de Ressources et Recherche, CHU Nantes, Nantes, France
| | - Anne-Laure Deruet
- CHU Nantes, Inserm CIC04, Nantes, France.,Service de Neurologie, Centre Mémoire de Ressources et Recherche, CHU Nantes, Nantes, France
| | - Inès Gouraud
- CHU Nantes, Inserm CIC04, Nantes, France.,Service de Neurologie, Centre Mémoire de Ressources et Recherche, CHU Nantes, Nantes, France
| | - Estelle Lamy
- CHU Nantes, Inserm CIC04, Nantes, France.,Service de Neurologie, Centre Mémoire de Ressources et Recherche, CHU Nantes, Nantes, France
| | - Aurélien Mazoué
- Service de Neurologie, Centre Mémoire de Ressources et Recherche, CHU Nantes, Nantes, France
| | - Laëtitia Rocher
- CHU Nantes, Inserm CIC04, Nantes, France.,Service de Neurologie, Centre Mémoire de Ressources et Recherche, CHU Nantes, Nantes, France.,Laboratoire de Psychologie des Pays de la Loire (LPPL - EA 4638), Universités d'Angers et Nantes, Nantes, France
| | | | - Mohamad El Haj
- Laboratoire de Psychologie des Pays de la Loire (LPPL - EA 4638), Universités d'Angers et Nantes, Nantes, France.,Unité de Gériatrie, Centre Hospitalier de Tourcoing, Tourcoing, France.,Institut Universitaire de France, Paris, France
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25
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Lengyel A, Pinti É, Pikó H, Jávorszky E, David D, Tihanyi M, Gönczi É, Kiss E, Tóth Z, Tory K, Fekete G, Haltrich I. Clinical and genetic findings in Hungarian pediatric patients carrying chromosome 16p copy number variants and a review of the literature. Eur J Med Genet 2020; 63:104027. [PMID: 32758661 DOI: 10.1016/j.ejmg.2020.104027] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [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: 01/07/2020] [Revised: 07/10/2020] [Accepted: 07/25/2020] [Indexed: 11/27/2022]
Abstract
The short arm of chromosome 16 (16p) is enriched for segmental duplications, making it susceptible to recurrent, reciprocal rearrangements implicated in the etiology of several phenotypes, including intellectual disability, speech disorders, developmental coordination disorder, autism spectrum disorders, attention deficit hyperactivity disorders, obesity and congenital skeletal disorders. In our clinical study 73 patients were analyzed by chromosomal microarray, and results were confirmed by fluorescence in situ hybridization or polymerase chain reaction. All patients underwent detailed clinical evaluation, with special emphasis on behavioral symptoms. 16p rearrangements were identified in 10 individuals. We found six pathogenic deletions and duplications of the recurrent regions within 16p11.2: one patient had a deletion of the distal 16p11.2 region associated with obesity, while four individuals had duplications, and one patient a deletion of the proximal 16p11.2 region. The other four patients carried 16p variations as second-site genomic alterations, acting as possible modifying genetic factors. We present the phenotypic and genotypic results of our patients and discuss our findings in relation to the available literature.
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Affiliation(s)
- Anna Lengyel
- II Department of Pediatrics, Semmelweis University, Budapest, Hungary.
| | - Éva Pinti
- II Department of Pediatrics, Semmelweis University, Budapest, Hungary
| | - Henriett Pikó
- I Department of Internal Medicine, Semmelweis University, Budapest, Hungary
| | - Eszter Jávorszky
- I Department of Pediatrics, Semmelweis University, Budapest, Hungary
| | - Dezső David
- Department of Human Genetics, National Health Institute Dr. Ricardo Jorge, Lisbon, Portugal
| | - Mariann Tihanyi
- Department of Genetics, Zala County Hospital, Zalaegerszeg, Hungary
| | - Éva Gönczi
- II Department of Pediatrics, Semmelweis University, Budapest, Hungary
| | - Eszter Kiss
- II Department of Pediatrics, Semmelweis University, Budapest, Hungary
| | - Zsuzsa Tóth
- II Department of Pediatrics, Semmelweis University, Budapest, Hungary
| | - Kálmán Tory
- I Department of Pediatrics, Semmelweis University, Budapest, Hungary
| | - György Fekete
- II Department of Pediatrics, Semmelweis University, Budapest, Hungary
| | - Irén Haltrich
- II Department of Pediatrics, Semmelweis University, Budapest, Hungary
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Abadie V, Hamiaux P, Ragot S, Legendre M, Malecot G, Burtin A, Attie-Bitach T, Lyonnet S, Bilan F, Gilbert-Dussardier B, Vaivre-Douret L. Should autism spectrum disorder be considered part of CHARGE syndrome? A cross-sectional study of 46 patients. Orphanet J Rare Dis 2020; 15:136. [PMID: 32493418 DOI: 10.1186/s13023-020-01421-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2019] [Accepted: 05/25/2020] [Indexed: 11/15/2022] Open
Abstract
Background Behavioral problems are an important issue for people with CHARGE syndrome. The similarity of their behavioral traits with those of people with autism raises questions. In a large national cross-sectional study, we used specific standardized tools for diagnosing autism (Autism Diagnostic Interview-Revised and Diagnostic and Statistical Manual of Mental Disorders, 5th edition, DSM-5) and evaluating behavioral disorders (Developmental Behavior Checklist-Parents, DBC-P) to investigate a series of individuals with CHARGE syndrome, defined by Verloes’s criteria. We evaluated their adaptive functioning level and sensory particularities and extracted several data items from medical files to assess as potential risk factors for autism and/or behavioral disorders. Results We investigated 64 individuals with CHARGE syndrome (35 females; mean age 10.7 years, SD 7.1 years). Among 46 participants with complete results for the Autism Diagnostic Interview-Revised (ADI-R), 13 (28%) had a diagnosis of autism according to the ADI-R, and 25 (54%) had a diagnosis of autism spectrum disorder (ASD) according to the DSM-5 criteria. The frequency of autistic traits in the entire group was a continuum. We did not identify any risk factor for ASD but found a negative correlation between the ADI-R score and adaptive functioning level. Among 48 participants with data for the DBC-P, 26 (55%) had behavioral disorders, which were more frequent in patients with radiological brain anomalies, impaired adaptive functioning, later independent walking, and more sensory particularities. Conclusions ASD should be considered to be an independent risk requiring early screening and management in children born with CHARGE syndrome.
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Mondo E, Barone M, Soverini M, D'Amico F, Cocchi M, Petrulli C, Mattioli M, Marliani G, Candela M, Accorsi P. Gut microbiome structure and adrenocortical activity in dogs with aggressive and phobic behavioral disorders. Heliyon 2020; 6:e03311. [PMID: 32021942 PMCID: PMC6994854 DOI: 10.1016/j.heliyon.2020.e03311] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2019] [Revised: 09/20/2019] [Accepted: 01/24/2020] [Indexed: 12/18/2022] Open
Abstract
Accompanying human beings since the Paleolithic period, dogs has been recently regarded as a reliable model for the study of the gut microbiome connections with health and disease. In order to provide some glimpses on the connections between the gut microbiome layout and host behavior, we profiled the phylogenetic composition and structure of the canine gut microbiome of dogs with aggressive (n = 11), phobic (n = 13) and normal behavior (n = 18). Hormones' determination was made through Radio Immuno-Assay (RIA), and next generation sequencing of the V3-V4 gene region of the bacterial 16S rRNA was employed to determine gut microbiome composition. Our results did not evidence any significant differences of hormonal levels between the three groups. According to our findings, aggressive behavioral disorder was found to be characterized by a peculiar gut microbiome structure, with high biodiversity and enrichment in generally subdominant bacterial genera (i.e. Catenibacterium and Megamonas). On the other hand, phobic dogs were enriched in Lactobacillus, a bacterial genus with known probiotic and psychobiotic properties. Although further studies are needed to validate our findings, our work supports the intriguing opportunity that different behavioral phenotypes in dogs may be associated with peculiar gut microbiome layouts, suggesting possible connections between the gut microbiome and the central nervous system and indicating the possible adoption of probiotic interventions aimed at restoring a balanced host-symbiont interplay for mitigating behavioral disorders.
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Affiliation(s)
- E. Mondo
- Department of Medical Veterinary Science, University of Bologna, Ozzano Emilia, Italy
| | - M. Barone
- Unit of Holobiont Microbiome and Microbiome Engineering (HolobioME), Department of Pharmacy and Biotechnology, University of Bologna, Italy
| | - M. Soverini
- Unit of Holobiont Microbiome and Microbiome Engineering (HolobioME), Department of Pharmacy and Biotechnology, University of Bologna, Italy
| | - F. D'Amico
- Unit of Holobiont Microbiome and Microbiome Engineering (HolobioME), Department of Pharmacy and Biotechnology, University of Bologna, Italy
| | - M. Cocchi
- Department of Medical Veterinary Science, University of Bologna, Ozzano Emilia, Italy
| | - C. Petrulli
- Department of Medical Veterinary Science, University of Bologna, Ozzano Emilia, Italy
| | - M. Mattioli
- Department of Medical Veterinary Science, University of Bologna, Ozzano Emilia, Italy
| | - G. Marliani
- Department of Medical Veterinary Science, University of Bologna, Ozzano Emilia, Italy
| | - M. Candela
- Unit of Holobiont Microbiome and Microbiome Engineering (HolobioME), Department of Pharmacy and Biotechnology, University of Bologna, Italy
| | - P.A. Accorsi
- Department of Medical Veterinary Science, University of Bologna, Ozzano Emilia, Italy
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Derevensky JL, Hayman V, Lynette Gilbeau. Behavioral Addictions: Excessive Gambling, Gaming, Internet, and Smartphone Use Among Children and Adolescents. Pediatr Clin North Am 2019; 66:1163-1182. [PMID: 31679605 DOI: 10.1016/j.pcl.2019.08.008] [Citation(s) in RCA: 53] [Impact Index Per Article: 10.6] [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] [Indexed: 12/26/2022]
Abstract
The introduction of behavioral addictions is a relatively new concept in psychiatry. It was not until 2010 that the term behavioral addictions was added to the official classification of psychiatric diagnoses in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. Gambling, typically thought to be an adult behavior, has become commonplace among adolescents. Although technological advances have made accessing information and communication easier, excessive use of the Internet and smartphones can result in multiple mental and physical health issues. Gambling disorders, gaming disorders, Internet use disorder, and excessive smartphone use often begin during childhood and adolescence.
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Affiliation(s)
- Jeffrey L Derevensky
- International Centre for Youth Gambling Problems and High-Risk Behaviors, McGill University, 3724 McTavish Street, Montreal, Quebec H3A 1Y2, Canada.
| | - Victoria Hayman
- International Centre for Youth Gambling Problems and High-Risk Behaviors, McGill University, 3724 McTavish Street, Montreal, Quebec H3A 1Y2, Canada
| | - Lynette Gilbeau
- International Centre for Youth Gambling Problems and High-Risk Behaviors, McGill University, 3724 McTavish Street, Montreal, Quebec H3A 1Y2, Canada
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Liao C, de Molliens MP, Schneebeli ST, Brewer M, Song G, Chatenet D, Braas KM, May V, Li J. Targeting the PAC1 Receptor for Neurological and Metabolic Disorders. Curr Top Med Chem 2019; 19:1399-1417. [PMID: 31284862 PMCID: PMC6761004 DOI: 10.2174/1568026619666190709092647] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [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: 12/04/2018] [Revised: 12/23/2018] [Accepted: 12/26/2018] [Indexed: 12/16/2022]
Abstract
The pituitary adenylate cyclase-activating polypeptide (PACAP)-selective PAC1 receptor (PAC1R, ADCYAP1R1) is a member of the vasoactive intestinal peptide (VIP)/secretin/glucagon family of G protein-coupled receptors (GPCRs). PAC1R has been shown to play crucial roles in the central and peripheral nervous systems. The activation of PAC1R initiates diverse downstream signal transduction pathways, including adenylyl cyclase, phospholipase C, MEK/ERK, and Akt pathways that regulate a number of physiological systems to maintain functional homeostasis. Accordingly, at times of tissue injury or insult, PACAP/PAC1R activation of these pathways can be trophic to blunt or delay apoptotic events and enhance cell survival. Enhancing PAC1R signaling under these conditions has the potential to mitigate cellular damages associated with cerebrovascular trauma (including stroke), neurodegeneration (such as Parkinson's and Alzheimer's disease), or peripheral organ insults. Conversely, maladaptive PACAP/PAC1R signaling has been implicated in a number of disorders, including stressrelated psychopathologies (i.e., depression, posttraumatic stress disorder, and related abnormalities), chronic pain and migraine, and metabolic diseases; abrogating PAC1R signaling under these pathological conditions represent opportunities for therapeutic intervention. Given the diverse PAC1R-mediated biological activities, the receptor has emerged as a relevant pharmaceutical target. In this review, we first describe the current knowledge regarding the molecular structure, dynamics, and function of PAC1R. Then, we discuss the roles of PACAP and PAC1R in the activation of a variety of signaling cascades related to the physiology and diseases of the nervous system. Lastly, we examine current drug design and development of peptides and small molecules targeting PAC1R based on a number of structure- activity relationship studies and key pharmacophore elements. At present, the rational design of PAC1R-selective peptide or small-molecule therapeutics is largely hindered by the lack of structural information regarding PAC1R activation mechanisms, the PACAP-PAC1R interface, and the core segments involved in receptor activation. Understanding the molecular basis governing the PACAP interactions with its different cognate receptors will undoubtedly provide a basis for the development and/or refinement of receptor-selective therapeutics.
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Affiliation(s)
- Chenyi Liao
- Department of Chemistry, University of Vermont, Burlington, VT 05405, United States
| | | | - Severin T Schneebeli
- Department of Chemistry, University of Vermont, Burlington, VT 05405, United States
| | - Matthias Brewer
- Department of Chemistry, University of Vermont, Burlington, VT 05405, United States
| | - Gaojie Song
- Shanghai Key Laboratory of Regulatory Biology, Institute of Biomedical Sciences and School of Life Sciences, East China Normal University, Shanghai, 200241, China
| | - David Chatenet
- INRS - Institut Armand-Frappier, 531 boul. des Prairies, Laval, QC H7V 1B7, Canada
| | - Karen M Braas
- Department of Neurological Sciences, University of Vermont, Larner College of Medicine, 149 Beaumont Avenue, Burlington, VT 05405, United States
| | - Victor May
- Department of Neurological Sciences, University of Vermont, Larner College of Medicine, 149 Beaumont Avenue, Burlington, VT 05405, United States
| | - Jianing Li
- Department of Chemistry, University of Vermont, Burlington, VT 05405, United States
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Graham L, Gossell-Williams M, Tapper J, Melbourne-Chambers R. Sleep disorders and behavioral disorders in Jamaican children with epilepsy: A case-control study. Epilepsy Behav 2019; 99:106477. [PMID: 31425974 DOI: 10.1016/j.yebeh.2019.106477] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [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: 05/22/2019] [Revised: 07/23/2019] [Accepted: 07/31/2019] [Indexed: 10/26/2022]
Abstract
Children with epilepsy (CWE) are more likely to have sleep and behavioral disorders. With differences in reports, the aim was to evaluate sleep and behavior in Jamaican CWE and determine any association with epilepsy-related variables. Children with epilepsy were identified along with age and gender-matched controls from the University Hospital of the West Indies and the Bustamante Hospital for Children. Written informed consent was obtained followed by the completion of questionnaires assessing sleep, behavior, and background of both cases and controls. Parents of 61 children (26 cases and 35 controls) participated in the study. There was no difference in sleep scores or frequency of sleep disorders between cases and controls (p > 0.05). Children with epilepsy had worse scores than controls in peer problems (3.85 vs 2.32, p < 0.01), internal problems (7.42 vs 4.71, p < 0.01), and total behavioral problem (16.27 vs 12.09, p < 0.01). When compared with controls, CWE had a higher frequency of abnormal peer problems (66% vs 32%, p < 0.05) and emotional problems score (42% vs 15%, p < 0.05). Children with learning difficulty were three times more likely to have abnormal behavioral score Odds Ratio (OR) = 3.818, p < 0.05). Jamaican CWE have similar sleep scores to their healthy peers but have a higher frequency of peer and emotional problems.
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Affiliation(s)
- Leohrandra Graham
- Department of Basic Medical Sciences, Faculty of Medical Sciences, University of the West Indies, Mona, Kingston, Jamaica.
| | - Maxine Gossell-Williams
- Department of Basic Medical Sciences, Faculty of Medical Sciences, University of the West Indies, Mona, Kingston, Jamaica
| | - Judy Tapper
- Department of Child and Adolescent Health, Faculty of Medical Sciences, University of the West Indies, Mona, Kingston, Jamaica; Neurology Department, Bustamante Hospital for Children, Kingston, Jamaica
| | - Roxanne Melbourne-Chambers
- Department of Child and Adolescent Health, Faculty of Medical Sciences, University of the West Indies, Mona, Kingston, Jamaica; Paediatric Neurology Department, University Hospital of the West Indies, Kingston, Jamaica
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Galal YS, Emadeldin M, Mwafy MA. Prevalence and correlates of bullying and victimization among school students in rural Egypt. J Egypt Public Health Assoc 2019; 94:18. [PMID: 32813138 PMCID: PMC7364771 DOI: 10.1186/s42506-019-0019-4] [Citation(s) in RCA: 5] [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: 12/18/2018] [Accepted: 05/23/2019] [Indexed: 06/10/2023]
Abstract
OBJECTIVES Knowledge on risk factors of bullying and victimization among school students is crucial for the implementation of preventive measures. This study was conducted to determine the prevalence and correlates of school bullying and victimization and their association with behavioral disorders among preparatory and secondary school students in rural Egypt. STUDY DESIGN Cross-sectional METHODS: A total of 476 students from two mixed public schools in rural Egypt (one preparatory and one secondary) were enrolled. A pretested self-administered questionnaire was used to collect sociodemographic characteristics and correlates of bullying and victimization including personal and social, family, school, and community factors. Frequency of bullying and victimization was measured using the short version aggression and victimization scale. The Strengths and Difficulties Questionnaire (SDQ) was used for screening behavioral problems. RESULTS Prevalence of bullying behavior was high (77.8%) among the studied group, of those 9.5% were unique bullies, 10.5% were unique victims, and 57.8% were bully-victims. On multivariate logistic regression analysis, failure in previous scholastic years (OR = 11.1, 95% CI 1.1-101.4, P = 0.033), witnessing family members using weapons (OR = 6.1, 95% CI 1.1-34.0, P = 0.038), male gender (OR = 2.3, 95% CI 1.1-5.0, P = 0.027), and mothers' education (university or higher) (OR = 0.1, 95% CI 0.02-0.7, P = 0.017) remained the significant predictors for bullying. However, only having a drug addict friend (OR 2.5, 95% CI 1.1-5.4, P = 0.025) was the significant predictor for victimization. The independent predictors for being bully-victims in order of importance were exposure to physical violence in the street (OR = 5.1, 95% CI 1.2-22.7, P = 0.031), male gender (OR = 3.2, 95% CI 1.8-5.6, P < 0.001), witnessing fights (OR = 3.1, 95% CI 1.7-5.7, P < 0.001) and insulting words (OR = 2.5, 95% CI 1.3-4.7, P = 0.007) among family members, exposure to insulting words in the street (OR = 2.1, 95% CI 1.2-3.7, P = 0.010), watching violent movies (OR = 2.0, 95% CI 1.2-3.4, P = 0.008), and younger age (OR = 0.7, 95% CI 0.6-0.8, P < 0.001). The self-reported SDQ revealed that the conduct problems scale scored significantly higher among bully-victims (2.8 ± 1.7 vs. 2.3 ± 1.6, P = 0.004). CONCLUSIONS Prevalence of bullying behavior was high among rural adolescent school students. Establishment of a bullying prevention committee at school including all school personnel for addressing different factors associated with bullying behavior is recommended. Further follow-up and psychiatric assessment of students for predicting those prone to behavioral abnormalities are also recommended.
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Affiliation(s)
- Yasmine Samir Galal
- Department of Public Health and Community Medicine, Faculty of Medicine, Cairo University, 31 Mohamed Hassan El-Gamal Street, 6th Zone, Nasr City, Cairo 11759 Egypt
| | - Maha Emadeldin
- Department of Psychiatry, Faculty of Medicine, Beni-Suef University, 9/5, 216 Degla Street, Maadi, Cairo 111342 Egypt
| | - Maha Abdelrahman Mwafy
- Department of Family Medicine, Faculty of Medicine, Cairo University, 94 American University Housing Fifth Settlement, Orman, Giza 651 Egypt
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Kaiser BN, Ticao C, Anoje C, Minto J, Boglosa J, Kohrt BA. Adapting culturally appropriate mental health screening tools for use among conflict-affected and other vulnerable adolescents in Nigeria. Glob Ment Health (Camb) 2019; 6:e10. [PMID: 31258924 PMCID: PMC6582460 DOI: 10.1017/gmh.2019.8] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [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: 12/16/2018] [Revised: 04/19/2019] [Accepted: 05/13/2019] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND The Boko Haram insurgency has brought turmoil and instability to Nigeria, generating a large number of internally displaced people and adding to the country's 17.5 million orphans and vulnerable children. Recently, steps have been taken to improve the mental healthcare infrastructure in Nigeria, including revamping national policies and initiating training of primary care providers in mental healthcare. In order for these efforts to succeed, they require means for community-based detection and linkage to care. A major gap preventing such efforts is the shortage of culturally appropriate, valid screening tools for identifying emotional and behavioral disorders among adolescents. In particular, studies have not conducted simultaneous validation of screening tools in multiple languages, to support screening and detection efforts in linguistically diverse populations. We aim to culturally adapt screening tools for emotional and behavioral disorders for use among adolescents in Nigeria, in order to facilitate future validation studies. METHODS We used a rigorous mixed-method process to culturally adapt the Depression Self Rating Scale, Child PTSD Symptom Scale, and Disruptive Behavior Disorders Rating Scale. We employed expert translations, focus group discussions (N = 24), and piloting with cognitive interviewing (N = 24) to achieve semantic, content, technical, and criterion equivalence of screening tool items. RESULTS We identified and adapted items that were conceptually difficult for adolescents to understand, conceptually non-equivalent across languages, considered unacceptable to discuss, or stigmatizing. Findings regarding problematic items largely align with existing literature regarding cross-cultural adaptation. CONCLUSIONS Culturally adapting screening tools represents a vital first step toward improving community case detection.
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Affiliation(s)
- B. N. Kaiser
- Department of Anthropology, University of California San Diego, La Jolla, CA, USA
- Duke Global Health Institute, Duke University, Durham, NC, USA
| | | | - C. Anoje
- Catholic Relief Services, Abuja, Nigeria
| | | | | | - B. A. Kohrt
- Department of Psychiatry and Behavioral Sciences, George Washington University, Washington, DC, USA
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Hempel A, Frost M, Agarwal N. Language and behavioral outcomes of treatment with pulse-dose prednisone for electrical status epilepticus in sleep (ESES). Epilepsy Behav 2019; 94:93-99. [PMID: 30897536 DOI: 10.1016/j.yebeh.2019.02.016] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [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: 12/04/2018] [Revised: 02/17/2019] [Accepted: 02/17/2019] [Indexed: 12/29/2022]
Abstract
Few studies have examined treatment response in electrical status epilepticus in sleep (ESES), and fewer still have evaluated the effect of corticosteroid treatment employing a pulse-dose regimen. The aim of this study was to examine the effectiveness of pulse-dose prednisone in treating language and behavioral disturbances that often accompany ESES. The sample included 17 patients age 5 to 10 years at time of baseline electroencephalogram (EEG) and neuropsychological assessments. For all patients, focal, multifocal, or generalized spike and wave activity occupied greater than 50% of the nonrapid eye movement (REM) sleep record. Patients were seen for follow-up EEG recording and neuropsychological testing with an average of 10 months following initiation of pulse-dose prednisone. Improvement in language or behavior was examined in relation to resolution of ESES on EEG, age at seizure onset and treatment, duration of ESES, duration of treatment, lesional versus nonlesional epilepsy, history of language or behavioral regression, seizure control at follow-up, and intelligence quotient (IQ). With the exception of a greater likelihood of patients with low IQ to demonstrate improvement in language or behavior, improvement was seen in most patients, irrespective of ESES or other factors.
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Affiliation(s)
- Ann Hempel
- Minnesota Epilepsy Group, P.A., St. Paul, Minnesota, USA.
| | - Michael Frost
- Minnesota Epilepsy Group, P.A., St. Paul, Minnesota, USA; Children's Hospitals and Clinics of Minnesota, St. Paul, Minnesota, USA
| | - Nitin Agarwal
- Minnesota Epilepsy Group, P.A., St. Paul, Minnesota, USA; Children's Hospitals and Clinics of Minnesota, St. Paul, Minnesota, USA
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Matta GS, Peddisetty RP. Impact of Etiology on Efficacy of Oral Triclofos in Recording Pediatric Electroencephalography: A Tertiary Care Center Study. J Neurosci Rural Pract 2019; 10:234-237. [PMID: 31001010 PMCID: PMC6454965 DOI: 10.4103/jnrp.jnrp_280_18] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Background and Objectives: Oral triclofos is a frequently used sedative in pediatric age to record sleep Electroencephalography (EEG). This study is aimed to assess efficacy, safety profile, need for second dose, and rescheduling of oral triclofos in relation to etiology. Materials and Methods: This is a retrospective study done enrolling all children aged 6 months to 5 years referred for EEG over 1 year. After a trial for natural sleep, the first dose of oral triclofos was given. If a child does not sleep after an hour, the second dose was given and rescheduled if does not sleep even with the second dose. Age, sex, diagnosis, sleep latency, sleep duration, adverse effects, EEG findings, patients needing second dose, and rescheduling were noted. Descriptive statistics and Chi-square test were used to analyze data. Results: A total of 384 children required oral triclofos. The common etiologies for sleep study were atypical febrile seizures, hypoxic-ischemic encephalopathy (HIE) sequelae, and behavioral disorders such as autism and attention-deficit hyperactive disorder (ADHD). Including the second dose, we were able to successfully record sleep EEG in 372 (96.8%) patients. Rescheduling was required in 3.2% of patients. Mean sleep-onset latency was 36 min and mean sleep duration was 84 min. Single dose was sufficient in 329 (85.6%) and the second dose in 55 (14.4%). Thirty (38.5%) children of HIE sequelae (P < 0.001) required the second dose followed by behavioral disorders (29.1%, P = 0.03). Irritability, vomiting, and dizziness were common side effects which resolved spontaneously. Conclusions: Oral triclofos was effective as sedative for recording EEG. Children with HIE sequelae and behavioral disorders such as autism/ADHD more commonly required second dosing and rescheduling.
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Affiliation(s)
- Gopi Srikanth Matta
- Department of Neurology, Niloufer Children's Hospital, Hyderabad, Telangana, India
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DeLisi M, Drury AJ, Elbert MJ. Do behavioral disorders render gang status spurious? New insights. Int J Law Psychiatry 2019; 62:117-124. [PMID: 30616846 DOI: 10.1016/j.ijlp.2018.12.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [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: 10/30/2018] [Revised: 12/04/2018] [Accepted: 12/10/2018] [Indexed: 06/09/2023]
Abstract
In community and correctional settings, gang status is a robust predictor of offending, unfortunately relatively few studies have considered behavioral disorders of offenders and whether these disorders mediate the gang-offending relationship. Drawing on a near population of correctional clients on federal supervised release, negative binomial regression and ROC-AUC models found that gang variables were rendered insignificant or were generally weak classifiers of severe offending once behavioral disorders were specified. The only exception was security threat group status that was robustly associated with prison misconduct. Gang researchers should consider behavioral disorders and other psychopathology of gang members to inform theory and research.
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Affiliation(s)
- Matt DeLisi
- Iowa State University, 203A East Hall, 510 Farm House Lane, Ames, IA 50011, United States.
| | - Alan J Drury
- United States Probation and Pretrial Services, Southern District of Iowa, 110 East Court Avenue, Des Moines, IA 50309, United States.
| | - Michael J Elbert
- United States Probation and Pretrial Services, Southern District of Iowa, 110 East Court Avenue, Des Moines, IA 50309, United States.
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Marciano RC, Cardoso MGF, Vasconcelos MA, Paula JJ, Pinho NC, Oliveira AC, Oliveira EA, Lima EM. Behavioral disorders and impairment of quality of life in children and adolescents with lower urinary tract dysfunction. J Pediatr Urol 2018; 14:568.e1-568.e7. [PMID: 30190220 DOI: 10.1016/j.jpurol.2018.07.017] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [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: 02/07/2018] [Accepted: 07/21/2018] [Indexed: 10/28/2022]
Abstract
BACKGROUND Lower urinary tract dysfunction (LUTD) is a broad term describing the full spectrum of disorders in any of the stages of bladder function-storage or voiding LUTD is a clinical condition associated with emotional and behavioral disorders in children. This cross-sectional study aimed to investigate the association of emotional and behavioral symptoms and their impact on the quality of life (QoL) in children and adolescents with LUTD. METHODS Eighty-eight patients and their parents enrolled in an interdisciplinary program for children and adolescents with LUTD were included in the analysis. Child Behavior Checklist (CBCL) was used to estimate the prevalence of behavioral and emotional problems through the assessment of 14 items. Pediatric Quality of Life Inventory (versions for parents and children) was applied in the versions for parents and children to evaluate the QoL. The Pediatric Quality of Life Inventory-PedsQL, version 4.0-was applied separately for parents and patients. The association of clinical variables and aspects related to QoL of patients were evaluated through non-parametric correlations (Spearman) and multiple linear regression analysis. RESULTS According to CBCL's clinical scores, 56% of the patients showed total behavioral problems, 55% internalizing, and 38% externalizing. When comparing the conditions of LUTD and the CBCL scores, patients with voiding postponement had the lowest rates of total problems (P = 0.036). Children and adolescents with LUTD who also had enuresis showed a higher frequency of externalizing problems (P = 0.001), especially aggressive behavior (P = 0.013). Scores of patients with LUTD were significantly lower in all domains of QoL than normative data. Presence of behavioral problems was associated with worse QoL in all evaluated aspects. The total QoL was most influenced by the CBCL school competence scale according to the regression model analysis. CONCLUSIONS The study findings suggest the relevance of evaluation of behavioral and social repercussions of LUTD to improve the multidisciplinary approach for this condition in pediatric population.
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Affiliation(s)
- R C Marciano
- Department of Psychiatry, School of Medicine, Hospital Das Clínicas, Federal University of Minas Gerais, Belo Horizonte, MG, Brazil
| | - M G F Cardoso
- Department of Psychology, School of Medicine, Hospital Das Clínicas, Federal University of Minas Gerais, Belo Horizonte, MG, Brazil
| | - M A Vasconcelos
- Division of Pediatric Nephrourology, School of Medicine, Hospital Das Clínicas, Federal University of Minas Gerais, Belo Horizonte, MG, Brazil
| | - J J Paula
- Division of Pediatric Nephrourology, School of Medicine, Hospital Das Clínicas, Federal University of Minas Gerais, Belo Horizonte, MG, Brazil
| | - N C Pinho
- Division of Pediatric Nephrourology, School of Medicine, Hospital Das Clínicas, Federal University of Minas Gerais, Belo Horizonte, MG, Brazil
| | - A C Oliveira
- Division of Pediatric Nephrourology, School of Medicine, Hospital Das Clínicas, Federal University of Minas Gerais, Belo Horizonte, MG, Brazil
| | - E A Oliveira
- Division of Pediatric Nephrourology, School of Medicine, Hospital Das Clínicas, Federal University of Minas Gerais, Belo Horizonte, MG, Brazil.
| | - E M Lima
- Division of Pediatric Nephrourology, School of Medicine, Hospital Das Clínicas, Federal University of Minas Gerais, Belo Horizonte, MG, Brazil
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Mitrasinovic S, Zhang M, Appelboom G, Sussman E, Moore JM, Hancock SL, Adler JR, Kondziolka D, Steinberg GK, Chang SD. Milestones in stereotactic radiosurgery for the central nervous system. J Clin Neurosci 2018; 59:12-19. [PMID: 30595165 DOI: 10.1016/j.jocn.2018.09.029] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [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: 08/12/2018] [Accepted: 09/26/2018] [Indexed: 10/28/2022]
Abstract
INTRODUCTION Since Lars Leksell developed the first stereotactic radiosurgery (SRS) device in 1951, there has been growth in the technologies available and clinical indications for SRS. This expansion has been reflected in the medical literature, which is built upon key articles and institutions that have significantly impacted SRS applications. Our aim was to identify these prominent works and provide an educational tool for training and further inquiry. METHOD A list of search phrases relating to central nervous system applications of stereotactic radiosurgery was compiled. A topic search was performed using PubMed and Scopus databases. The journal, year of publication, authors, treatment technology, clinical subject, study design and level of evidence for each article were documented. Influence was proposed by citation count and rate. RESULTS Our search identified a total of 10,211 articles with the top 10 publications overall on the study of SRS spanning 443-1313 total citations. Four articles reported on randomized controlled trials, all of which evaluated intracranial metastases. The most prominent subtopics included SRS for arteriovenous malformation, glioblastoma, and acoustic neuroma. Greatest representation by treatment modality included Gamma Knife, LINAC, and TomoTherapy. CONCLUSIONS This systematic reporting of the influential literature on SRS for intracranial and spinal pathologies underscores the technology's rapid and wide reaching clinical applications. Moreover the findings provide an academic guide to future health practitioners and engineers in their study of SRS for neurosurgery.
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Affiliation(s)
- Stefan Mitrasinovic
- Department of Neurosurgery, Stanford University School of Medicine, Stanford Health Care and Stanford Children's Health, Stanford Neuroscience Health Center, 213 Quarry Road, Palo Alto, CA 94304-5979, United States
| | - Michael Zhang
- Department of Neurosurgery, Stanford University School of Medicine, Stanford Health Care and Stanford Children's Health, Stanford Neuroscience Health Center, 213 Quarry Road, Palo Alto, CA 94304-5979, United States
| | - Geoff Appelboom
- Department of Neurosurgery, Stanford University School of Medicine, Stanford Health Care and Stanford Children's Health, Stanford Neuroscience Health Center, 213 Quarry Road, Palo Alto, CA 94304-5979, United States.
| | - Eric Sussman
- Department of Neurosurgery, Stanford University School of Medicine, Stanford Health Care and Stanford Children's Health, Stanford Neuroscience Health Center, 213 Quarry Road, Palo Alto, CA 94304-5979, United States
| | - Justin M Moore
- Division of Neurosurgery, Beth Israel Deaconess Medical Center, 110 Francis Street, Lowry Suite 3B, Boston, MA 02215-5501, United States
| | - Steven L Hancock
- Department of Radiation Oncology, Stanford University School of Medicine, Stanford Health Care and Stanford Children's Health, Stanford Cancer Center, MC 5847, 875 Blake Wilbur Dr, Stanford, CA 94305-5847, United States
| | - John R Adler
- Department of Neurosurgery, Stanford University School of Medicine, Stanford Health Care and Stanford Children's Health, Stanford Neuroscience Health Center, 213 Quarry Road, Palo Alto, CA 94304-5979, United States
| | - Douglas Kondziolka
- Department of Neurosurgery, NYU Langone Medical Center, 530 First Avenue, Suite 8R, New York, NY 10016, United States
| | - Gary K Steinberg
- Department of Neurosurgery, Stanford University School of Medicine, Stanford Health Care and Stanford Children's Health, Stanford Neuroscience Health Center, 213 Quarry Road, Palo Alto, CA 94304-5979, United States
| | - Steven D Chang
- Department of Neurosurgery, Stanford University School of Medicine, Stanford Health Care and Stanford Children's Health, Stanford Neuroscience Health Center, 213 Quarry Road, Palo Alto, CA 94304-5979, United States
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Horowitz-Kraus T, Woodburn M, Rajagopal A, Versace AL, Kowatch RA, Bertocci MA, Bebko G, Almeida JRC, Perlman SB, Travis MJ, Gill MK, Bonar L, Schirda C, Diwadkar VA, Sunshine JL, Birmaher B, Axelson D, Gerry Taylor H, Horwitz SM, Frazier T, Eugene Arnold L, Fristad MA, Youngstrom EA, Findling RL, Phillips ML, Holland SK. Decreased functional connectivity in the fronto-parietal network in children with mood disorders compared to children with dyslexia during rest: An fMRI study. Neuroimage Clin 2018; 18:582-590. [PMID: 29845006 PMCID: PMC5964829 DOI: 10.1016/j.nicl.2018.02.034] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/29/2017] [Revised: 02/13/2018] [Accepted: 02/28/2018] [Indexed: 11/17/2022]
Abstract
Background The DSM-5 separates the diagnostic criteria for mood and behavioral disorders. Both types of disorders share neurocognitive deficits of executive function and reading difficulties in childhood. Children with dyslexia also have executive function deficits, revealing a role of executive function circuitry in reading. The aim of the current study is to determine whether there is a significant relationship of functional connectivity within the fronto-parietal and cingulo-opercular cognitive control networks to reading measures for children with mood disorders, behavioral disorders, dyslexia, and healthy controls (HC). Method Behavioral reading measures of phonological awareness, decoding, and orthography were collected. Resting state fMRI data were collected, preprocessed, and then analyzed for functional connectivity. Differences in the reading measures were tested for significance among the groups. Global efficiency (GE) measures were also tested for correlation with reading measures in 40 children with various disorders and 17 HCs. Results Significant differences were found between the four groups on all reading measures. Relative to HCs and children with mood disorders or behavior disorders, children with dyslexia as a primary diagnosis scored significantly lower on all three reading measures. Children with mood disorders scored significantly lower than controls on a test of phonological awareness. Phonological awareness deficits correlated with reduced resting state functional connectivity MRI (rsfcMRI) in the cingulo-opercular network for children with dyslexia. A significant difference was also found in fronto-parietal global efficiency in children with mood disorders relative to the other three groups. We also found a significant difference in cingulo-opercular global efficiency in children with mood disorders relative to the Dyslexia and Control groups. However, none of these differences correlate significantly with reading measures. Conclusions/significance Reading difficulties involve abnormalities in different cognitive control networks in children with dyslexia compared to children with mood disorders. Findings of the current study suggest increased functional connectivity of one cognitive control network may compensate for reduced functional connectivity in the other network in children with mood disorders. These findings provide guidance to clinical professionals for design of interventions tailored for children suffering from reading difficulties originating from different pathologies.
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Affiliation(s)
- Tzipi Horowitz-Kraus
- Cincinnati Children's Hospital Medical Center, University of Cincinnati, United States; Educational Neuroimaging Center, Faculty of Education in Science and Technology, Technion, Israel.
| | - Mackenzie Woodburn
- Cincinnati Children's Hospital Medical Center, University of Cincinnati, United States
| | - Akila Rajagopal
- Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center, University of Pittsburgh, United States
| | - Amelia L Versace
- Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center, University of Pittsburgh, United States
| | - Robert A Kowatch
- The Research Institute at Nationwide Children's Hospital, United States; Department of Psychiatry and Behavioral Health, Wexner Medical Center, Ohio State University, United States
| | - Michele A Bertocci
- Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center, University of Pittsburgh, United States
| | - Genna Bebko
- Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center, University of Pittsburgh, United States
| | - Jorge R C Almeida
- Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center, University of Pittsburgh, United States
| | - Susan B Perlman
- Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center, University of Pittsburgh, United States
| | - Michael J Travis
- Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center, University of Pittsburgh, United States
| | - Mary Kay Gill
- Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center, University of Pittsburgh, United States
| | - Lisa Bonar
- Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center, University of Pittsburgh, United States
| | - Claudiu Schirda
- Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center, University of Pittsburgh, United States
| | - Vaibhav A Diwadkar
- Department of Psychiatry and Behavioral Neuroscience, Wayne State University, United States
| | - Jeffrey L Sunshine
- Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center, University of Pittsburgh, United States
| | - Boris Birmaher
- Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center, University of Pittsburgh, United States
| | - David Axelson
- Department of Psychiatry and Behavioral Health, Wexner Medical Center, Ohio State University, United States
| | - H Gerry Taylor
- University Hospitals Cleveland Medical Center, Case Western Reserve University, United States
| | - Sarah M Horwitz
- Department of Child Psychiatry, New York University School of Medicine, United States
| | - Thomas Frazier
- Department of Psychiatry and Behavioral Health, Wexner Medical Center, Ohio State University, United States
| | - L Eugene Arnold
- Department of Psychiatry and Behavioral Health, Wexner Medical Center, Ohio State University, United States
| | - Mary A Fristad
- Department of Psychiatry and Behavioral Health, Wexner Medical Center, Ohio State University, United States
| | - Eric A Youngstrom
- Department of Psychology, University of North Carolina at Chapel Hill, United States
| | - Robert L Findling
- University Hospitals Cleveland Medical Center, Case Western Reserve University, United States; Department of Psychiatry, Johns Hopkins University, United States
| | - Mary L Phillips
- Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center, University of Pittsburgh, United States
| | - Scott K Holland
- Cincinnati Children's Hospital Medical Center, University of Cincinnati, United States
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Jaïdi Y, Nonnonhou V, Kanagaratnam L, Bertholon LA, Badr S, Noël V, Novella JL, Mahmoudi R. Reduction of the Anticholinergic Burden Makes It Possible to Decrease Behavioral and Psychological Symptoms of Dementia. Am J Geriatr Psychiatry 2018; 26:280-8. [PMID: 28890165 DOI: 10.1016/j.jagp.2017.08.005] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2017] [Revised: 08/04/2017] [Accepted: 08/07/2017] [Indexed: 12/16/2022]
Abstract
OBJECTIVE The aim of this study was to evaluate the impact of a reduction of the anticholinergic burden (AB) on the frequency and severity of behavioral and psychological symptoms of dementia (BPSD) and their repercussions on the care team (occupational disruptiveness). METHODS In this prospective, single-center study in an acute care unit for Alzheimer disease (AD) and related disorders, 125 elderly subjects (mean age: 84.4 years) with dementia presented with BPSD. The reduction of the AB was evaluated by the Anticholinergic Cognitive Burden Scale. BPSD were evaluated with the Neuropsychiatric Inventory-Nursing Home Version (NPI-NH). The effect of the reduction of the AB on the BPSD was studied using logistic regression adjusting for the variables of the comprehensive geriatric assessment. RESULTS Seventy-one subjects (56.8%) presenting with probable AD, 32 (25.6%) mixed dementia (AD and vascular), 17 (13.6%) vascular dementia, and 5 (4.0%) Lewy body dementia were included. Reducing the AB by at least 20% enabled a significant decrease in the frequency × severity scores of the NPI-NH (adjusted odds ratio: 3.5; 95% confidence interval: 1.6-7.9) and of the occupational disruptiveness score (adjusted odds ratio: 9.9; 95% confidence interval: 3.6-27.3). CONCLUSION AB reduction in elderly subjects with dementia makes is possible to reduce BPSD and caregiver burden. Recourse to treatments involving an AB must be avoided as much as possible in these patients, and preferential use of nonpharmacologic treatment management plans is encouraged.
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Barnett ER, Boucher EA, Daviss WB, Elwyn G. Supporting Shared Decision-making for Children's Complex Behavioral Problems: Development and User Testing of an Option Grid™ Decision Aid. Community Ment Health J 2018; 54:7-16. [PMID: 28401416 DOI: 10.1007/s10597-017-0136-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [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: 09/19/2016] [Accepted: 03/25/2017] [Indexed: 11/25/2022]
Abstract
There is a lack of research to guide collaborative treatment decision-making for children who have complex behavioral problems, despite the extensive use of mental health services in this population. We developed and pilot-tested a one-page Option Grid™ patient decision aid to facilitate shared decision-making for these situations. An editorial team of parents, child psychiatrists, researchers, and other stakeholders developed the scope and structure of the decision aid. Researchers included information about a carefully chosen number of psychosocial and pharmacological treatment options, using descriptions based on the best available evidence. Using semi-structured qualitative interviews (n = 18), we conducted user testing with four parents and four clinical prescribers and field testing with four parents, four clinical prescribers, and two clinic administrators. The researchers coded and synthesized the interview responses using mixed inductive and deductive methods. Parents, clinicians, and administrators felt the Option Grid had significant value, although they reported that additional training and other support would be required in order to successfully implement the Option Grid and achieve shared decision-making in clinical practice.
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Affiliation(s)
- Erin R Barnett
- Department of Psychiatry, Geisel School of Medicine at Dartmouth, Dartmouth Trauma Interventions Research Center, Dartmouth-Hitchcock Medical Center, One Medical Center Drive, Lebanon, NH, 03756, USA.
| | - Elizabeth A Boucher
- Center for Program Design and Evaluation at Dartmouth, 21 Lafayette #373, Lebanon, NH, 03756, USA
| | - William B Daviss
- Department of Psychiatry, Dartmouth-Hitchcock Psychiatric Associates, Geisel School of Medicine at Dartmouth, One Medical Center Drive, Lebanon, NH, 03756, USA
| | - Glyn Elwyn
- The Dartmouth Institute for Health Policy and Clinical Practice, One Medical Center Drive, Lebanon, NH, 03756, USA
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Trojano L, Papagno C. Cognitive and behavioral disorders in Parkinson's disease: an update. II: behavioral disorders. Neurol Sci 2017; 39:53-61. [PMID: 29038946 DOI: 10.1007/s10072-017-3155-7] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [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: 08/18/2017] [Accepted: 10/10/2017] [Indexed: 12/11/2022]
Abstract
Patients with Parkinson's disease (PD) can experience several behavioral symptoms, such as apathy, agitation, hypersexuality, stereotypic movements, pathological gambling, abuse of antiparkinsonian drugs, and REM sleep behavioral disorders. Psychoses and hallucinations, depression and anxiety disorders, and difficulties in recognizing and experiencing emotions also impair behavior and can cause severe psychosocial problems in patients with PD. Symptoms can be present since early stages of the disease, sometimes even before the appearance of classical motor symptoms, likely in relation to dopamine depletion in basal ganglia and/or to dysfunctions of other neurotrasmitter systems, and others can develop later, in some cases in relation to dopaminergic treatment. In this paper, we review recent literature, with particular attention to the last 5 years, on the main behavioral and emotional disturbances described in PD patients as well as the hypothesized neurofunctional substrate of such impairments. Finally, we provide some suggestions on the most suitable instruments to check and assess PD-associated behavioral defects over time.
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Affiliation(s)
- Luigi Trojano
- Department of Psychology, University of Campania 'Luigi Vanvitelli', Viale Ellittico 31, 81100, Caserta, Italy.
- ICS Maugeri, IRCCS, Telese Terme, Italy.
| | - Costanza Papagno
- CIMeC, University of Trento, Trento, Italy.
- Department of Psychology, University of Milano-Bicocca, Piazza dell'Ateneo 1, 02100, Milan, Italy.
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Bertozzi G, Sessa F, Albano GD, Sani G, Maglietta F, Roshan MHK, Volti GL, Bernardini R, Avola R, Pomara C, Salerno M. The Role of Anabolic Androgenic Steroids in Disruption of the Physiological Function in Discrete Areas of the Central Nervous System. Mol Neurobiol 2017; 55:5548-5556. [PMID: 28971285 PMCID: PMC5994209 DOI: 10.1007/s12035-017-0774-1] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [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: 07/18/2017] [Accepted: 09/12/2017] [Indexed: 12/12/2022]
Abstract
Anabolic-androgenic steroids (AAS) abuse is often associated with a wide spectrum of adverse effects. These drugs are frequently abused by adolescents and athletes for esthetic purposes, as well as for improvement of their endurance and performances. In this literature review, we evaluated the correlation between AAS and anxiety or aggression. Two pathways are thought to be involved in AAS-induced behavioral disorders. Direct pathway via the amygdalo-fugal pathway, which connects the central nucleus of the amygdala to the brainstem, is involved in cognitive-emotive and homeostatic processes. The latter is modified by chronic AAS use, which subsequently leads to increased anxiety. Indirect pathways via the serotonergic, dopaminergic, and glutamatergic signals which are modified by AAS abuse in latero-anterior hypothalamus and can mediate the aggressive behavior. In conclusion, the molecular mechanisms underlying the behavioral alterations following AAS abuse is unclear and remains ambiguous as additional long-term studies aimed to understand the precise mechanisms are required.
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Affiliation(s)
- Giuseppe Bertozzi
- Department of Clinical and Experimental Medicine, Section of Forensic Pathology, University of Foggia, Ospedale Colonnello D'Avanzo, Foggia, Italy
| | - Francesco Sessa
- Department of Clinical and Experimental Medicine, Section of Forensic Pathology, University of Foggia, Ospedale Colonnello D'Avanzo, Foggia, Italy
| | - Giuseppe Davide Albano
- Department of Clinical and Experimental Medicine, Section of Forensic Pathology, University of Foggia, Ospedale Colonnello D'Avanzo, Foggia, Italy
| | - Gabriele Sani
- NESMOS Department (Neurosciences, Mental Health, and Sensory Organs), Sapienza University of Rome, School of Medicine and Psychology, Sant'Andrea Hospital, Rome, Italy
- Centro Lucio Bini, Rome, Italy
| | - Francesca Maglietta
- Department of Clinical and Experimental Medicine, Section of Forensic Pathology, University of Foggia, Ospedale Colonnello D'Avanzo, Foggia, Italy
| | - Mohsin H K Roshan
- Department of Anatomy, School of Medicine, University of Malta, Msida, Malta
| | - Giovanni Li Volti
- Department of Biomedical and Biotechnological Sciences, University of Catania, Catania, Italy
| | - Renato Bernardini
- Department of Biomedical and Biotechnological Sciences, University of Catania, Catania, Italy
| | - Roberto Avola
- Department of Biomedical and Biotechnological Sciences, University of Catania, Catania, Italy
| | - Cristoforo Pomara
- Department of Clinical and Experimental Medicine, Section of Forensic Pathology, University of Foggia, Ospedale Colonnello D'Avanzo, Foggia, Italy.
- Department of Anatomy, School of Medicine, University of Malta, Msida, Malta.
- D'Avanzo Hospital, 71122, Foggia, Italy.
| | - Monica Salerno
- Department of Clinical and Experimental Medicine, Section of Forensic Pathology, University of Foggia, Ospedale Colonnello D'Avanzo, Foggia, Italy
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Malazonia A, Zerekidze T, Giorgadze E, Chkheidze N, Asatiani K. Melatonin Level Variations with Different Behavioural Risk Factors in Obese Female Patients. Open Access Maced J Med Sci 2017; 5:613-617. [PMID: 28932301 PMCID: PMC5591590 DOI: 10.3889/oamjms.2017.063] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [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: 04/19/2017] [Revised: 05/17/2017] [Accepted: 05/19/2017] [Indexed: 01/16/2023] Open
Abstract
AIM: The role of behavioural factors and sleep duration and quality is important in the pathogenesis of obesity. The aim of our study was to evaluate the effects of behavioural risk factors on melatonin secretion in women. SUBJECTS AND METHODS: In total, 120 female patients were enrolled in the study and divided into two groups according to the body mass index. Detailed history, anthropometric measurements, urine and blood samples were evaluated for each patient. RESULTS: Two groups significantly differed in weight, BMI, and waist circumference, and were 94.2 ± 14.9 kg, 33.4 ± 5.23 kg/m2 and 99.2 ± 12.6 cm for the study group and 56.0 ± 5.2 kg, 20.0 ± 1.8 kg/m2 and 60.1 ± 10.4 cm for the control group, respectively, sleep disruptions were detected in 48 patients from study group, with mean score 6.76 ± 3.6, and only 10 patients were detected in the control group, with mean score 4.42 ± 1.68. Eating disturbances were revealed in 66 patients from the study group and 21 patients from the control group. Melatonin levels were 17% higher in the study group, compared to control group. CONCLUSION: Higher melatonin levels in patients with obesity and concomitant behavioural impairments may be due to its protective effect to fight free radicals and to induce vasodilatation. Further studies are needed to confirm our finding.
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Affiliation(s)
- Ana Malazonia
- Tbilisi State University - Department of Endocrinology, Lubliana str. 2/6, Tbilisi 0159, Georgia
| | - Tamar Zerekidze
- Tbilisi State University - Department of Endocrinology, Lubliana str. 2/6, Tbilisi 0159, Georgia
| | - Elen Giorgadze
- Tbilisi State University - Department of Endocrinology, Lubliana str. 2/6, Tbilisi 0159, Georgia
| | - Natia Chkheidze
- Tbilisi State University - Department of Endocrinology, Lubliana str. 2/6, Tbilisi 0159, Georgia
| | - Ketevan Asatiani
- Tbilisi State University - Department of Endocrinology, Lubliana str. 2/6, Tbilisi 0159, Georgia
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Kamimura-Nishimura K, Froehlich T, Chirdkiatgumchai V, Adams R, Fredstrom B, Manning P. Autism spectrum disorders and their treatment with psychotropic medications in a nationally representative outpatient sample: 1994-2009. Ann Epidemiol 2017; 27:448-453.e1. [PMID: 28789776 DOI: 10.1016/j.annepidem.2017.06.001] [Citation(s) in RCA: 9] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2016] [Revised: 04/12/2017] [Accepted: 06/20/2017] [Indexed: 01/19/2023]
Abstract
PURPOSE No prior studies have assessed change in health care provider-coded rates of Autism spectrum disorder (ASD) diagnoses over time, and few have investigated sociodemographic factors associated with having an ASD diagnosis, having behavioral conditions comorbid with ASD, or using psychotropic medications for this group. METHODS We used data from the 1994-2009 National (Hospital) Ambulatory Medical Care Surveys for children aged 2-18 years (n = 158,488). RESULTS Rates of visits with coded-ASD per 100 outpatient medical visits increased from 0.04% to 0.82% from 1994 to 2009. Factors associated with an ASD diagnosis included male gender, lack of private insurance, white race, and later study period. The most frequent comorbid behavioral diagnoses were ADHD, anxiety, disruptive behavior, and mood disorders. Older age was linked to an increased likelihood of having a comorbid behavioral diagnosis and using psychotropic medications. Geographic region was also associated with having a comorbid behavioral diagnosis, and psychotropic use was linked to have a behavioral comorbidity. Comorbidities with the highest rates of psychotropic use were ADHD, mood, and anxiety disorders. CONCLUSIONS Pediatric outpatient visits with an ASD diagnosis have increased dramatically from 1994 to 2009. Further study is needed to determine the reasons for the observed sociodemographic disparities in ASD diagnosis.
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Affiliation(s)
- Kelly Kamimura-Nishimura
- Division of Developmental and Behavioral Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH.
| | - Tanya Froehlich
- Division of Developmental and Behavioral Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH
| | | | - Ryan Adams
- Division of Developmental and Behavioral Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH
| | - Bridget Fredstrom
- Division of Developmental and Behavioral Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH
| | - Patty Manning
- Division of Developmental and Behavioral Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH
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Karimzadeh M, Rostami M, Teymouri R, Moazzen Z, Tahmasebi S. The association between parental mental health and behavioral disorders in pre-school children. Electron Physician 2017; 9:4497-4502. [PMID: 28848622 PMCID: PMC5557127 DOI: 10.19082/4497] [Citation(s) in RCA: 9] [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: 07/02/2016] [Accepted: 01/25/2017] [Indexed: 11/20/2022] Open
Abstract
Background and Aim Behavioral disorders among children reflect psychological problems of parents, as mental illness of either parent would increase the likelihood of mental disorder in the child. In view of the negative relationship between parents’ and children’s illness, the current study intended to determine the correlation between mental health of parents and behavioral disorders of pre-school children. Methods The present descriptive-correlational research studied 80 children registered at pre-school centers in Pardis Township, Tehran, Iran during 2014–2015 using convenience sampling. The research tools included General Health Questionnaire (GHQ) and Preschool Behavior Questionnaire (PBQ). The resulted data were analyzed using Pearson Product-moment Correlation Coefficient and regression analysis in SPSS 21. Results The research results showed that there was a significant positive correlation between all dimensions of mental health of parents with general behavioral disorders (p<0.001). The results of the regression analysis showed that parents’ depression was the first and the only predictive variable of behavioral disorders in children with 26.8% predictive strength. Conclusion Given the strong relationship between children’s behavioral disorders and parents’ general health, and the significant role of parents’ depression in children’s behavioral disorders, it seems necessary to take measures to decrease the impact of parents’ disorders on children.
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Affiliation(s)
- Mansoureh Karimzadeh
- Ph.D. Assistant Professor, Pediatric Neurorehabilitation Research Center, Department of Preschool Education, School of Educational Science and Social Welfare, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Mohammad Rostami
- Ph.D. Student, Department of Counseling, School of Behavioral Science, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Robab Teymouri
- Ph.D. of Linguistics, Research Expert, Pediatric Neurorehabilitation Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Zahra Moazzen
- M.Sc., Department of Preschool Education, School of Educational Science and Social Welfare, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Siyamak Tahmasebi
- Ph.D., Assistant Professor, Department of Preschool Education, School of Educational Science and Social Welfare, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
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Horowitz-Kraus T, Holland SK, Versace AL, Bertocci MA, Bebko G, Almeida JRC, Perlman SB, Travis MJ, Gill MK, Bonar L, Schirda C, Sunshine JL, Birmaher B, Taylor G, Diwadkar VA, Horwitz SM, Axelson D, Frazier T, Arnold EL, Fristad MA, Youngstrom EA, Findling RL, Phillips ML. Reading related white matter structures in adolescents are influenced more by dysregulation of emotion than behavior. Neuroimage Clin 2017; 15:732-740. [PMID: 28702350 PMCID: PMC5491458 DOI: 10.1016/j.nicl.2017.06.020] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [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: 12/02/2016] [Revised: 05/18/2017] [Accepted: 06/16/2017] [Indexed: 11/21/2022]
Abstract
Mood disorders and behavioral are broad psychiatric diagnostic categories that have different symptoms and neurobiological mechanisms, but share some neurocognitive similarities, one of which is an elevated risk for reading deficit. Our aim was to determine the influence of mood versus behavioral dysregulation on reading ability and neural correlates supporting these skills in youth, using diffusion tensor imaging in 11- to 17-year-old children and youths with mood disorders or behavioral disorders and age-matched healthy controls. The three groups differed only in phonological processing and passage comprehension. Youth with mood disorders scored higher on the phonological test but had lower comprehension scores than children with behavioral disorders and controls; control participants scored the highest. Correlations between fractional anisotropy and phonological processing in the left Arcuate Fasciculus showed a significant difference between groups and were strongest in behavioral disorders, intermediate in mood disorders, and lowest in controls. Correlations between these measures in the left Inferior Longitudinal Fasciculus were significantly greater than in controls for mood but not for behavioral disorders. Youth with mood disorders share a deficit in the executive-limbic pathway (Arcuate Fasciculus) with behavioral-disordered youth, suggesting reduced capacity for engaging frontal regions for phonological processing or passage comprehension tasks and increased reliance on the ventral tract (e.g., the Inferior Longitudinal Fasciculus). The low passage comprehension scores in mood disorder may result from engaging the left hemisphere. Neural pathways for reading differ mainly in executive-limbic circuitry. This new insight may aid clinicians in providing appropriate intervention for each disorder.
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Affiliation(s)
- Tzipi Horowitz-Kraus
- Cincinnati Children's Hospital Medical Center, University of Cincinnati, United States; Educational Neuroimaging Center, Faculty of Education in Science and Technology, Technion, Haifa, Israel.
| | - Scott K Holland
- Cincinnati Children's Hospital Medical Center, University of Cincinnati, United States
| | - Amelia L Versace
- Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center, University of Pittsburgh, United States
| | - Michele A Bertocci
- Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center, University of Pittsburgh, United States
| | - Genna Bebko
- Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center, University of Pittsburgh, United States
| | - Jorge R C Almeida
- Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center, University of Pittsburgh, United States
| | - Susan B Perlman
- Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center, University of Pittsburgh, United States
| | - Michael J Travis
- Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center, University of Pittsburgh, United States
| | - Mary Kay Gill
- Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center, University of Pittsburgh, United States
| | - Lisa Bonar
- Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center, University of Pittsburgh, United States
| | - Claudiu Schirda
- Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center, University of Pittsburgh, United States
| | - Jeffrey L Sunshine
- Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center, University of Pittsburgh, United States
| | - Boris Birmaher
- Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center, University of Pittsburgh, United States
| | - Gerry Taylor
- University Hospitals Case Medical Center, Case Western Reserve University, United States
| | - Vaibhav A Diwadkar
- Department of Psychiatry and Behavioral Neuroscience, Wayne State University, United States
| | - Sarah M Horwitz
- Department of Child Psychiatry, New York University School of Medicine, United States
| | - David Axelson
- Department of Psychiatry and Behavioral Health, Wexner Medical Center, Ohio State University, United States
| | - Thomas Frazier
- Department of Psychiatry and Behavioral Health, Wexner Medical Center, Ohio State University, United States
| | - Eugene L Arnold
- Department of Psychiatry and Behavioral Health, Wexner Medical Center, Ohio State University, United States
| | - Mary A Fristad
- Department of Psychiatry and Behavioral Health, Wexner Medical Center, Ohio State University, United States
| | - Eric A Youngstrom
- Department of Psychology, University of North Carolina at Chapel Hill, United States
| | - Robert L Findling
- University Hospitals Case Medical Center, Case Western Reserve University, United States; Department of Psychiatry, Johns Hopkins University, United States
| | - Mary L Phillips
- Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center, University of Pittsburgh, United States
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Viel JF, Rouget F, Warembourg C, Monfort C, Limon G, Cordier S, Chevrier C. Behavioural disorders in 6-year-old children and pyrethroid insecticide exposure: the PELAGIE mother-child cohort. Occup Environ Med 2017; 74:275-281. [PMID: 28250046 DOI: 10.1136/oemed-2016-104035] [Citation(s) in RCA: 69] [Impact Index Per Article: 9.9] [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: 08/22/2016] [Revised: 12/21/2016] [Accepted: 01/03/2017] [Indexed: 02/01/2023]
Abstract
OBJECTIVE The potential impact of environmental exposure to pyrethroid insecticides on child neurodevelopment has only just started to receive attention despite their widespread use. We investigated the associations between prenatal and childhood exposure to pyrethroid insecticides and behavioural skills in 6-year-olds. METHODS The PELAGIE cohort enrolled 3421 pregnant women from Brittany, France between 2002 and 2006. 428 mothers were randomly selected for the study when their children turned 6, and 287 (67%) agreed to participate. Children's behaviour was assessed using the Strengths and Difficulties Questionnaire (SDQ). Three subscales (prosocial behaviour, internalising disorders and externalising disorders) were considered. Five pyrethroid metabolites were measured in maternal and child urine samples collected between 6 and 19 gestational weeks and at 6 years of age, respectively. Logistic regression and reverse-scale Cox regression models were used to estimate the associations between SDQ scores and urinary pyrethroid metabolite concentrations, adjusting for organophosphate metabolite concentrations and potential confounders. RESULTS Increased prenatal cis-3-(2,2-dichlorovinyl)-2,2-dimethylcyclopropane carboxylic acid (DCCA) concentrations were associated with internalising difficulties (Cox p value=0.05). For childhood 3-phenoxybenzoic acid (PBA) concentrations, a positive association was observed with externalising difficulties (Cox p value=0.04) and high ORs were found for abnormal or borderline social behaviour (OR 2.93, 95% CI 1.27 to 6.78, and OR 1.91, 95% CI 0.80 to 4.57, for the intermediate and highest metabolite categories, respectively). High childhood trans-DCCA concentrations were associated with reduced externalising disorders (Cox p value=0.03). CONCLUSIONS The present study suggests that exposure to certain pyrethroids, at environmental levels, may negatively affect neurobehavioral development by 6 years of age.
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Affiliation(s)
- Jean-François Viel
- INSERM-IRSET no. 1085, Epidemiological Research on Environment, Reproduction and Development, University of Rennes 1, Rennes, France.,Department of Epidemiology and Public Health, University Hospital, Rennes, France
| | - Florence Rouget
- INSERM-IRSET no. 1085, Epidemiological Research on Environment, Reproduction and Development, University of Rennes 1, Rennes, France.,Department of Pediatrics, University Hospital, Rennes, France
| | - Charline Warembourg
- INSERM-IRSET no. 1085, Epidemiological Research on Environment, Reproduction and Development, University of Rennes 1, Rennes, France
| | - Christine Monfort
- INSERM-IRSET no. 1085, Epidemiological Research on Environment, Reproduction and Development, University of Rennes 1, Rennes, France
| | | | - Sylvaine Cordier
- INSERM-IRSET no. 1085, Epidemiological Research on Environment, Reproduction and Development, University of Rennes 1, Rennes, France
| | - Cécile Chevrier
- INSERM-IRSET no. 1085, Epidemiological Research on Environment, Reproduction and Development, University of Rennes 1, Rennes, France
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Pickles A, Sharp H, Hellier J, Hill J. Prenatal anxiety, maternal stroking in infancy, and symptoms of emotional and behavioral disorders at 3.5 years. Eur Child Adolesc Psychiatry 2017; 26:325-34. [PMID: 27464490 DOI: 10.1007/s00787-016-0886-6] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/30/2015] [Accepted: 06/28/2016] [Indexed: 12/27/2022]
Abstract
Animal findings of long-term effects of maternal behaviors mediated via altered GR gene expression will, if translated into humans, have far reaching implications for our understanding of child and adolescent psychopathology. We have previously shown that mothers' self-reported stroking of their infants modifies associations between prenatal depression and anxiety and child outcomes at 29 weeks and 2.5 years. Here, we examine whether the effect of early maternal stroking is evident at 3.5 years, and in a much larger sample than in previous publications. A general population sample of 1233 first-time mothers completed anxiety measures at 20 weeks gestation, 865 reported on infant stroking at 9 weeks, and 813 on child symptoms at 3.5 years. Maternal stroking moderated the association between pregnancy-specific anxiety and internalizing (p = 0.010) and externalizing (p = 0.004) scores, such that an effect of PSA to increase symptoms was markedly reduced for mothers who reported high levels of stroking. There was no effect of maternal stroking on general anxiety. The findings confirm the previously reported effect of maternal stroking, and in a much larger sample. They indicate that there are long-term effects of early maternal stroking, modifying associations between prenatal anxiety and child emotional and behavioral symptoms.
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Abstract
BACKGROUND Antiretroviral therapy (ART) in HIV pregnant women has led to a dramatic decrease in the rate of HIV mother-to-child transmission but this benefit is counterbalanced with adverse effects related to in utero and neonatal exposure to ART. In 2013, some parents described neurodevelopmental disorders in their children. METHODS A standardized letter was sent to the 133 women who delivered in Nantes hospital from 01/01/2003 to 31/12/2012 (167 births). RESULTS Response rate was 33%. Over a 10-year period, 7 children had behavioral disorders and/or cognitive/developmental delay, 1 child had developmental delay + growth retardation and 2 experienced cancer. CONCLUSIONS We found a significant association between neurodevelopmental disorders, preterm birth and exposure to 3 nucleoside reverse transcriptase inhibitors (NRTIs). Further studies are needed and long-term follow-up into adulthood should continue.
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Affiliation(s)
| | | | - Elise Launay
- Department of Pediatrics, Hotel-Dieu Hospital, Nantes, France
| | - François Raffi
- Department of Infectious Diseases, Hotel-Dieu Hospital, Nantes, France
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Sheldrick RC, Breuer DJ, Hassan R, Chan K, Polk DE, Benneyan J. A system dynamics model of clinical decision thresholds for the detection of developmental- behavioral disorders. Implement Sci 2016; 11:156. [PMID: 27884203 PMCID: PMC5123221 DOI: 10.1186/s13012-016-0517-0] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [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: 01/27/2016] [Accepted: 10/27/2016] [Indexed: 12/18/2022] Open
Abstract
Background Clinical decision-making has been conceptualized as a sequence of two separate processes: assessment of patients’ functioning and application of a decision threshold to determine whether the evidence is sufficient to justify a given decision. A range of factors, including use of evidence-based screening instruments, has the potential to influence either or both processes. However, implementation studies seldom specify or assess the mechanism by which screening is hypothesized to influence clinical decision-making, thus limiting their ability to address unexpected findings regarding clinicians’ behavior. Building on prior theory and empirical evidence, we created a system dynamics (SD) model of how physicians’ clinical decisions are influenced by their assessments of patients and by factors that may influence decision thresholds, such as knowledge of past patient outcomes. Using developmental-behavioral disorders as a case example, we then explore how referral decisions may be influenced by changes in context. Specifically, we compare predictions from the SD model to published implementation trials of evidence-based screening to understand physicians’ management of positive screening results and changes in referral rates. We also conduct virtual experiments regarding the influence of a variety of interventions that may influence physicians’ thresholds, including improved access to co-located mental health care and improved feedback systems regarding patient outcomes. Results Results of the SD model were consistent with recent implementation trials. For example, the SD model suggests that if screening improves physicians’ accuracy of assessment without also influencing decision thresholds, then a significant proportion of children with positive screens will not be referred and the effect of screening implementation on referral rates will be modest—results that are consistent with a large proportion of published screening trials. Consistent with prior theory, virtual experiments suggest that physicians’ decision thresholds can be influenced and detection of disabilities improved by increasing access to referral sources and enhancing feedback regarding false negative cases. Conclusions The SD model of clinical decision-making offers a theoretically based framework to improve understanding of physicians’ behavior and the results of screening implementation trials. The SD model is also useful for initial testing of hypothesized strategies to increase detection of under-identified medical conditions. Electronic supplementary material The online version of this article (doi:10.1186/s13012-016-0517-0) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- R Christopher Sheldrick
- Department of Pediatrics, Tufts Medical Center, 800 Washington Street #854, Boston, MA, 02111, USA.
| | - Dominic J Breuer
- Healthcare Systems Engineering Institute, Northeastern University, 360 Huntington Ave, Boston, MA, 02115, USA
| | - Razan Hassan
- Healthcare Systems Engineering Institute, Northeastern University, 360 Huntington Ave, Boston, MA, 02115, USA
| | - Kee Chan
- Department of Health Policy and Administration, University of Illinois, Chicago, School of Public Health, 1603 West Taylor Street, Chicago, IL, USA
| | - Deborah E Polk
- Dental Public Health and Information Management, University of Pittsburg, 381 Salk Hall, Pittsburgh, PA, 15261, USA
| | - James Benneyan
- Healthcare Systems Engineering Institute, Northeastern University, 360 Huntington Ave, Boston, MA, 02115, USA
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