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Another Perspective on Huntington's Disease: Disease Burden in Family Members and Pre-Manifest HD When Compared to Genotype-Negative Participants from ENROLL-HD. Brain Sci 2021; 11:brainsci11121621. [PMID: 34942923 PMCID: PMC8699274 DOI: 10.3390/brainsci11121621] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Revised: 12/02/2021] [Accepted: 12/07/2021] [Indexed: 11/17/2022] Open
Abstract
Background: In addition to the effects on patients suffering from motor-manifest Huntington’s disease (HD), this fatal disease is devasting to people who are at risk, premanifest mutation-carriers, and especially to whole families. There is a huge burden on people in the environment of affected HD patients, and a need for further research to identify at-risk caregivers. The aim of our research was to investigate a large cohort of family members, in comparison with genotype negative and premanifest HD in order to evaluate particular cohorts more closely. Methods: We used the ENROLL-HD global registry study to compare motoric, cognitive, functional, and psychiatric manifestation in family members, premanifest HD, and genotype negative participant as controls. Cross-sectional data were analyzed using ANCOVA-analyses in IBM SPSS Statistics V.28. Results: Of N = 21,116 participants from the global registry study, n = 5174 participants had a premanifest motor-phenotype, n = 2358 were identified as family controls, and n = 2640 with a negative HD genotype. Analysis of variance revealed more motoric, cognitive, and psychiatric impairments in premanifest HD (all p < 0.001). Self-reported psychiatric assessments revealed a significantly higher score for depression in family controls (p < 0.001) when compared to genotype negative (p < 0.001) and premanifest HD patients (p < 0.05). Family controls had significantly less cognitive capacities within the cognitive test battery when compared to genotype negative participants. Conclusions: Within the largest cohort of HD patients and families, several impairments of motoric, functional, cognitive, and psychiatric components can be confirmed in a large cohort of premanifest HD, potentially due to prodromal HD pathology. HD family controls suffered from higher self-reported depression and less cognitive capacities, which were potentially due to loaded or stressful situations. This research aims to sensitize investigators to be aware of caregiver burdens caused by HD and encourage support with socio-medical care and targeted psychological interventions. In particular, further surveys and variables are necessary in order to implement them within the database so as to identify at-risk caregivers.
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Vaccarino AL, Kalali AH, Blier P, Gilbert Evans S, Engelhardt N, Foster JA, Frey BN, Greist JH, Kobak KA, Lam RW, MacQueen G, Milev R, Müller DJ, Parikh SV, Placenza FM, Rizvi SJ, Rotzinger S, Sheehan DV, Sills T, Soares CN, Turecki G, Uher R, Williams JBW, Kennedy SH, Evans KR. THE DEPRESSION INVENTORY DEVELOPMENT SCALE: Assessment of Psychometric Properties Using Classical and Modern Measurement Theory in a CAN-BIND Trial. INNOVATIONS IN CLINICAL NEUROSCIENCE 2020; 17:30-40. [PMID: 33520402 PMCID: PMC7839654] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Objective: The goal of the Depression Inventory Development (DID) project is to develop a comprehensive and psychometrically sound rating scale for major depressive disorder (MDD) that reflects current diagnostic criteria and conceptualizations of depression. We report here the evaluation of the current DID item bank using Classical Test Theory (CTT), Item Response Theory (IRT) and Rasch Measurement Theory (RMT). Methods: The present study was part of a larger multisite, open-label study conducted by the Canadian Biomarker Integration Network in Depression (ClinicalTrials.gov: NCT01655706). Trained raters administered the 32 DID items at each of two visits (MDD: baseline, n=211 and Week 8, n=177; healthy participants: baseline, n=112 and Week 8, n=104). The DID's "grid" structure operationalizes intensity and frequency of each item, with clear symptom definitions and a structured interview guide, with the current iteration assessing symptoms related to anhedonia, cognition, fatigue, general malaise, motivation, anxiety, negative thinking, pain, and appetite. Participants were also administered the Montgomery- Åsberg Depression Rating Scale (MADRS) and Quick Inventory of Depressive Symptomatology-Self-Report (QIDS-SR) that allowed DID items to be evaluated against existing "benchmark" items. CTT was used to assess data quality/reliability (i.e., missing data, skewness, scoring frequency, internal consistency), IRT to assess individual item performance by modelling an item's ability to discriminate levels of depressive severity (as assessed by the MADRS), and RMT to assess how the items perform together as a scale to capture a range of depressive severity (item targeting). These analyses together provided empirical evidence to base decisions on which DID items to remove, modify, or advance. Results: Of the 32 DID items evaluated, eight items were identified by CTT as problematic, displaying low variability in the range of responses, floor effects, and/or skewness; and four items were identified by IRT to show poor discriminative properties that would limit their clinical utility. Five additional items were deemed to be redundant. The remaining 15 DID items all fit the Rasch model, with person and item difficulty estimates indicating satisfactory item targeting, with lower precision in participants with mild levels of depression. These 15 DID items also showed good internal consistency (alpha=0.95 and inter-item correlations ranging from r=0.49 to r=0.84) and all items were sensitive to change following antidepressant treatment (baseline vs. Week 8). RMT revealed problematic item targeting for the MADRS and QIDSSR, including an absence of MADRS items targeting participants with mild/moderate depression and an absence of QIDS-SR items targeting participants with mild or severe depression. Conclusion: The present study applied CTT, IRT, and RMT to assess the measurement properties of the DID items and identify those that should be advanced, modified, or removed. Of the 32 items evaluated, 15 items showed good measurement properties. These items (along with previously evaluated items) will provide the basis for validation of a penultimate DID scale assessing anhedonia, cognitive slowing, concentration, executive function, recent memory, drive, emotional fatigue, guilt, self-esteem, hopelessness, tension, rumination, irritability, reduced appetite, insomnia, sadness, worry, suicidality, and depressed mood. The strategies adopted by the DID process provide a framework for rating scale development and validation.
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Affiliation(s)
- Anthony L Vaccarino
- Drs. Vaccarino, Evans and Gilbert Evans are with Indoc Research in Toronto, Ontario, Canada
- Dr Kalali is with the International Society for CNS Drug Development in San Diego, California
- Dr. Blier is with the Departments of Psychiatry and Cellular & Molecular Medicine at the University of Ottawa Institute of Mental Health Research in Ottawa, Ontario, Canada
- Dr. Engelhardt is with Intra-Cellular Therapies in New York, New York
- Dr. Foster is with Department of Psychiatry & Behavioural Neurosciences at McMaster University in Hamilton, Ontario, Canada
- Dr. Frey is with the Department of Psychiatry and Behavioural Neurosciences at McMaster University and Mood Disorders Program and Women's Health Concerns Clinic, St. Joseph's Healthcare in Hamilton, Ontario, Canada
- Dr. Greist is with the Department of Psychiatry at the University of Wisconsin School of Medicine and Public Health in Madison, Wisconsin
- Dr. Kobak is with the Center for Telepsychology in Madison, Wisconsin
- Dr. Lam is with the Department of Psychiatry at the University of British Columbia in Vancouver, British Columbia, Canada
- Dr. MacQueen is with Mathison Centre for Mental Health Research and Education at the Department of Psychiatry, University of Calgary in Calgary, Alberta, Canada
- Dr. Milev is with the Department of Psychiatry and the Department of Psychology, and Centre for Neuroscience Studies at Queen's University in Kingston, Ontario, Canada
- Dr. Müller is with the Centre for Addiction and Mental Health and the Department of Psychiatry at the University of Toronto in Toronto, Ontario, Canada. Parikh is with the Department of Psychiatry at the University of Michigan in Ann Arbor, Michigan
- Dr. Placenza is with the Department of Psychiatry at the Krembil Research Centre, University Health Network, University of Toronto in Toronto, Ontario, Canada
- Dr. Rizvi is with Arthur Sommer Rotenberg Program for Suicide and Depression Studies at St. Michael's Hospital in Toronto, Ontario, Canada
- Dr. Rotzinger is with St. Michael's Hospital (Unity Health Toronto) and Department of Psychiatry at the University of Toronto in Toronto, Ontario, Canada
- Dr. Sheehan is with the University of South Florida College of Medicine in Tampa, Florida
- Dr. Sills was with OCBN in Toronto, Ontario, Canada
- Dr. Soares is with the Department of Psychiatry at Queen's University and Providence Care Hospital in Kingston, Ontario, Canada
- Dr. Turecki is with the Department of Psychiatry at McGill University in Montreal, Quebec, Canada
- Dr. Uher is with the Department of Psychiatry at Dalhousie University in Halifax, Nova Scotia, Canada
- Dr. Williams is with the Departments of Psychiatry and Neurology at Columbia University in New York, New York
- Dr. Kennedy is with the Department of Psychiatry at the University of Toronto and Centre for Depression and Suicide, St. Michael's Hospital in Toronto, Ontario, Canada
| | - Amir H Kalali
- Drs. Vaccarino, Evans and Gilbert Evans are with Indoc Research in Toronto, Ontario, Canada
- Dr Kalali is with the International Society for CNS Drug Development in San Diego, California
- Dr. Blier is with the Departments of Psychiatry and Cellular & Molecular Medicine at the University of Ottawa Institute of Mental Health Research in Ottawa, Ontario, Canada
- Dr. Engelhardt is with Intra-Cellular Therapies in New York, New York
- Dr. Foster is with Department of Psychiatry & Behavioural Neurosciences at McMaster University in Hamilton, Ontario, Canada
- Dr. Frey is with the Department of Psychiatry and Behavioural Neurosciences at McMaster University and Mood Disorders Program and Women's Health Concerns Clinic, St. Joseph's Healthcare in Hamilton, Ontario, Canada
- Dr. Greist is with the Department of Psychiatry at the University of Wisconsin School of Medicine and Public Health in Madison, Wisconsin
- Dr. Kobak is with the Center for Telepsychology in Madison, Wisconsin
- Dr. Lam is with the Department of Psychiatry at the University of British Columbia in Vancouver, British Columbia, Canada
- Dr. MacQueen is with Mathison Centre for Mental Health Research and Education at the Department of Psychiatry, University of Calgary in Calgary, Alberta, Canada
- Dr. Milev is with the Department of Psychiatry and the Department of Psychology, and Centre for Neuroscience Studies at Queen's University in Kingston, Ontario, Canada
- Dr. Müller is with the Centre for Addiction and Mental Health and the Department of Psychiatry at the University of Toronto in Toronto, Ontario, Canada. Parikh is with the Department of Psychiatry at the University of Michigan in Ann Arbor, Michigan
- Dr. Placenza is with the Department of Psychiatry at the Krembil Research Centre, University Health Network, University of Toronto in Toronto, Ontario, Canada
- Dr. Rizvi is with Arthur Sommer Rotenberg Program for Suicide and Depression Studies at St. Michael's Hospital in Toronto, Ontario, Canada
- Dr. Rotzinger is with St. Michael's Hospital (Unity Health Toronto) and Department of Psychiatry at the University of Toronto in Toronto, Ontario, Canada
- Dr. Sheehan is with the University of South Florida College of Medicine in Tampa, Florida
- Dr. Sills was with OCBN in Toronto, Ontario, Canada
- Dr. Soares is with the Department of Psychiatry at Queen's University and Providence Care Hospital in Kingston, Ontario, Canada
- Dr. Turecki is with the Department of Psychiatry at McGill University in Montreal, Quebec, Canada
- Dr. Uher is with the Department of Psychiatry at Dalhousie University in Halifax, Nova Scotia, Canada
- Dr. Williams is with the Departments of Psychiatry and Neurology at Columbia University in New York, New York
- Dr. Kennedy is with the Department of Psychiatry at the University of Toronto and Centre for Depression and Suicide, St. Michael's Hospital in Toronto, Ontario, Canada
| | - Pierre Blier
- Drs. Vaccarino, Evans and Gilbert Evans are with Indoc Research in Toronto, Ontario, Canada
- Dr Kalali is with the International Society for CNS Drug Development in San Diego, California
- Dr. Blier is with the Departments of Psychiatry and Cellular & Molecular Medicine at the University of Ottawa Institute of Mental Health Research in Ottawa, Ontario, Canada
- Dr. Engelhardt is with Intra-Cellular Therapies in New York, New York
- Dr. Foster is with Department of Psychiatry & Behavioural Neurosciences at McMaster University in Hamilton, Ontario, Canada
- Dr. Frey is with the Department of Psychiatry and Behavioural Neurosciences at McMaster University and Mood Disorders Program and Women's Health Concerns Clinic, St. Joseph's Healthcare in Hamilton, Ontario, Canada
- Dr. Greist is with the Department of Psychiatry at the University of Wisconsin School of Medicine and Public Health in Madison, Wisconsin
- Dr. Kobak is with the Center for Telepsychology in Madison, Wisconsin
- Dr. Lam is with the Department of Psychiatry at the University of British Columbia in Vancouver, British Columbia, Canada
- Dr. MacQueen is with Mathison Centre for Mental Health Research and Education at the Department of Psychiatry, University of Calgary in Calgary, Alberta, Canada
- Dr. Milev is with the Department of Psychiatry and the Department of Psychology, and Centre for Neuroscience Studies at Queen's University in Kingston, Ontario, Canada
- Dr. Müller is with the Centre for Addiction and Mental Health and the Department of Psychiatry at the University of Toronto in Toronto, Ontario, Canada. Parikh is with the Department of Psychiatry at the University of Michigan in Ann Arbor, Michigan
- Dr. Placenza is with the Department of Psychiatry at the Krembil Research Centre, University Health Network, University of Toronto in Toronto, Ontario, Canada
- Dr. Rizvi is with Arthur Sommer Rotenberg Program for Suicide and Depression Studies at St. Michael's Hospital in Toronto, Ontario, Canada
- Dr. Rotzinger is with St. Michael's Hospital (Unity Health Toronto) and Department of Psychiatry at the University of Toronto in Toronto, Ontario, Canada
- Dr. Sheehan is with the University of South Florida College of Medicine in Tampa, Florida
- Dr. Sills was with OCBN in Toronto, Ontario, Canada
- Dr. Soares is with the Department of Psychiatry at Queen's University and Providence Care Hospital in Kingston, Ontario, Canada
- Dr. Turecki is with the Department of Psychiatry at McGill University in Montreal, Quebec, Canada
- Dr. Uher is with the Department of Psychiatry at Dalhousie University in Halifax, Nova Scotia, Canada
- Dr. Williams is with the Departments of Psychiatry and Neurology at Columbia University in New York, New York
- Dr. Kennedy is with the Department of Psychiatry at the University of Toronto and Centre for Depression and Suicide, St. Michael's Hospital in Toronto, Ontario, Canada
| | - Susan Gilbert Evans
- Drs. Vaccarino, Evans and Gilbert Evans are with Indoc Research in Toronto, Ontario, Canada
- Dr Kalali is with the International Society for CNS Drug Development in San Diego, California
- Dr. Blier is with the Departments of Psychiatry and Cellular & Molecular Medicine at the University of Ottawa Institute of Mental Health Research in Ottawa, Ontario, Canada
- Dr. Engelhardt is with Intra-Cellular Therapies in New York, New York
- Dr. Foster is with Department of Psychiatry & Behavioural Neurosciences at McMaster University in Hamilton, Ontario, Canada
- Dr. Frey is with the Department of Psychiatry and Behavioural Neurosciences at McMaster University and Mood Disorders Program and Women's Health Concerns Clinic, St. Joseph's Healthcare in Hamilton, Ontario, Canada
- Dr. Greist is with the Department of Psychiatry at the University of Wisconsin School of Medicine and Public Health in Madison, Wisconsin
- Dr. Kobak is with the Center for Telepsychology in Madison, Wisconsin
- Dr. Lam is with the Department of Psychiatry at the University of British Columbia in Vancouver, British Columbia, Canada
- Dr. MacQueen is with Mathison Centre for Mental Health Research and Education at the Department of Psychiatry, University of Calgary in Calgary, Alberta, Canada
- Dr. Milev is with the Department of Psychiatry and the Department of Psychology, and Centre for Neuroscience Studies at Queen's University in Kingston, Ontario, Canada
- Dr. Müller is with the Centre for Addiction and Mental Health and the Department of Psychiatry at the University of Toronto in Toronto, Ontario, Canada. Parikh is with the Department of Psychiatry at the University of Michigan in Ann Arbor, Michigan
- Dr. Placenza is with the Department of Psychiatry at the Krembil Research Centre, University Health Network, University of Toronto in Toronto, Ontario, Canada
- Dr. Rizvi is with Arthur Sommer Rotenberg Program for Suicide and Depression Studies at St. Michael's Hospital in Toronto, Ontario, Canada
- Dr. Rotzinger is with St. Michael's Hospital (Unity Health Toronto) and Department of Psychiatry at the University of Toronto in Toronto, Ontario, Canada
- Dr. Sheehan is with the University of South Florida College of Medicine in Tampa, Florida
- Dr. Sills was with OCBN in Toronto, Ontario, Canada
- Dr. Soares is with the Department of Psychiatry at Queen's University and Providence Care Hospital in Kingston, Ontario, Canada
- Dr. Turecki is with the Department of Psychiatry at McGill University in Montreal, Quebec, Canada
- Dr. Uher is with the Department of Psychiatry at Dalhousie University in Halifax, Nova Scotia, Canada
- Dr. Williams is with the Departments of Psychiatry and Neurology at Columbia University in New York, New York
- Dr. Kennedy is with the Department of Psychiatry at the University of Toronto and Centre for Depression and Suicide, St. Michael's Hospital in Toronto, Ontario, Canada
| | - Nina Engelhardt
- Drs. Vaccarino, Evans and Gilbert Evans are with Indoc Research in Toronto, Ontario, Canada
- Dr Kalali is with the International Society for CNS Drug Development in San Diego, California
- Dr. Blier is with the Departments of Psychiatry and Cellular & Molecular Medicine at the University of Ottawa Institute of Mental Health Research in Ottawa, Ontario, Canada
- Dr. Engelhardt is with Intra-Cellular Therapies in New York, New York
- Dr. Foster is with Department of Psychiatry & Behavioural Neurosciences at McMaster University in Hamilton, Ontario, Canada
- Dr. Frey is with the Department of Psychiatry and Behavioural Neurosciences at McMaster University and Mood Disorders Program and Women's Health Concerns Clinic, St. Joseph's Healthcare in Hamilton, Ontario, Canada
- Dr. Greist is with the Department of Psychiatry at the University of Wisconsin School of Medicine and Public Health in Madison, Wisconsin
- Dr. Kobak is with the Center for Telepsychology in Madison, Wisconsin
- Dr. Lam is with the Department of Psychiatry at the University of British Columbia in Vancouver, British Columbia, Canada
- Dr. MacQueen is with Mathison Centre for Mental Health Research and Education at the Department of Psychiatry, University of Calgary in Calgary, Alberta, Canada
- Dr. Milev is with the Department of Psychiatry and the Department of Psychology, and Centre for Neuroscience Studies at Queen's University in Kingston, Ontario, Canada
- Dr. Müller is with the Centre for Addiction and Mental Health and the Department of Psychiatry at the University of Toronto in Toronto, Ontario, Canada. Parikh is with the Department of Psychiatry at the University of Michigan in Ann Arbor, Michigan
- Dr. Placenza is with the Department of Psychiatry at the Krembil Research Centre, University Health Network, University of Toronto in Toronto, Ontario, Canada
- Dr. Rizvi is with Arthur Sommer Rotenberg Program for Suicide and Depression Studies at St. Michael's Hospital in Toronto, Ontario, Canada
- Dr. Rotzinger is with St. Michael's Hospital (Unity Health Toronto) and Department of Psychiatry at the University of Toronto in Toronto, Ontario, Canada
- Dr. Sheehan is with the University of South Florida College of Medicine in Tampa, Florida
- Dr. Sills was with OCBN in Toronto, Ontario, Canada
- Dr. Soares is with the Department of Psychiatry at Queen's University and Providence Care Hospital in Kingston, Ontario, Canada
- Dr. Turecki is with the Department of Psychiatry at McGill University in Montreal, Quebec, Canada
- Dr. Uher is with the Department of Psychiatry at Dalhousie University in Halifax, Nova Scotia, Canada
- Dr. Williams is with the Departments of Psychiatry and Neurology at Columbia University in New York, New York
- Dr. Kennedy is with the Department of Psychiatry at the University of Toronto and Centre for Depression and Suicide, St. Michael's Hospital in Toronto, Ontario, Canada
| | - Jane A Foster
- Drs. Vaccarino, Evans and Gilbert Evans are with Indoc Research in Toronto, Ontario, Canada
- Dr Kalali is with the International Society for CNS Drug Development in San Diego, California
- Dr. Blier is with the Departments of Psychiatry and Cellular & Molecular Medicine at the University of Ottawa Institute of Mental Health Research in Ottawa, Ontario, Canada
- Dr. Engelhardt is with Intra-Cellular Therapies in New York, New York
- Dr. Foster is with Department of Psychiatry & Behavioural Neurosciences at McMaster University in Hamilton, Ontario, Canada
- Dr. Frey is with the Department of Psychiatry and Behavioural Neurosciences at McMaster University and Mood Disorders Program and Women's Health Concerns Clinic, St. Joseph's Healthcare in Hamilton, Ontario, Canada
- Dr. Greist is with the Department of Psychiatry at the University of Wisconsin School of Medicine and Public Health in Madison, Wisconsin
- Dr. Kobak is with the Center for Telepsychology in Madison, Wisconsin
- Dr. Lam is with the Department of Psychiatry at the University of British Columbia in Vancouver, British Columbia, Canada
- Dr. MacQueen is with Mathison Centre for Mental Health Research and Education at the Department of Psychiatry, University of Calgary in Calgary, Alberta, Canada
- Dr. Milev is with the Department of Psychiatry and the Department of Psychology, and Centre for Neuroscience Studies at Queen's University in Kingston, Ontario, Canada
- Dr. Müller is with the Centre for Addiction and Mental Health and the Department of Psychiatry at the University of Toronto in Toronto, Ontario, Canada. Parikh is with the Department of Psychiatry at the University of Michigan in Ann Arbor, Michigan
- Dr. Placenza is with the Department of Psychiatry at the Krembil Research Centre, University Health Network, University of Toronto in Toronto, Ontario, Canada
- Dr. Rizvi is with Arthur Sommer Rotenberg Program for Suicide and Depression Studies at St. Michael's Hospital in Toronto, Ontario, Canada
- Dr. Rotzinger is with St. Michael's Hospital (Unity Health Toronto) and Department of Psychiatry at the University of Toronto in Toronto, Ontario, Canada
- Dr. Sheehan is with the University of South Florida College of Medicine in Tampa, Florida
- Dr. Sills was with OCBN in Toronto, Ontario, Canada
- Dr. Soares is with the Department of Psychiatry at Queen's University and Providence Care Hospital in Kingston, Ontario, Canada
- Dr. Turecki is with the Department of Psychiatry at McGill University in Montreal, Quebec, Canada
- Dr. Uher is with the Department of Psychiatry at Dalhousie University in Halifax, Nova Scotia, Canada
- Dr. Williams is with the Departments of Psychiatry and Neurology at Columbia University in New York, New York
- Dr. Kennedy is with the Department of Psychiatry at the University of Toronto and Centre for Depression and Suicide, St. Michael's Hospital in Toronto, Ontario, Canada
| | - Benicio N Frey
- Drs. Vaccarino, Evans and Gilbert Evans are with Indoc Research in Toronto, Ontario, Canada
- Dr Kalali is with the International Society for CNS Drug Development in San Diego, California
- Dr. Blier is with the Departments of Psychiatry and Cellular & Molecular Medicine at the University of Ottawa Institute of Mental Health Research in Ottawa, Ontario, Canada
- Dr. Engelhardt is with Intra-Cellular Therapies in New York, New York
- Dr. Foster is with Department of Psychiatry & Behavioural Neurosciences at McMaster University in Hamilton, Ontario, Canada
- Dr. Frey is with the Department of Psychiatry and Behavioural Neurosciences at McMaster University and Mood Disorders Program and Women's Health Concerns Clinic, St. Joseph's Healthcare in Hamilton, Ontario, Canada
- Dr. Greist is with the Department of Psychiatry at the University of Wisconsin School of Medicine and Public Health in Madison, Wisconsin
- Dr. Kobak is with the Center for Telepsychology in Madison, Wisconsin
- Dr. Lam is with the Department of Psychiatry at the University of British Columbia in Vancouver, British Columbia, Canada
- Dr. MacQueen is with Mathison Centre for Mental Health Research and Education at the Department of Psychiatry, University of Calgary in Calgary, Alberta, Canada
- Dr. Milev is with the Department of Psychiatry and the Department of Psychology, and Centre for Neuroscience Studies at Queen's University in Kingston, Ontario, Canada
- Dr. Müller is with the Centre for Addiction and Mental Health and the Department of Psychiatry at the University of Toronto in Toronto, Ontario, Canada. Parikh is with the Department of Psychiatry at the University of Michigan in Ann Arbor, Michigan
- Dr. Placenza is with the Department of Psychiatry at the Krembil Research Centre, University Health Network, University of Toronto in Toronto, Ontario, Canada
- Dr. Rizvi is with Arthur Sommer Rotenberg Program for Suicide and Depression Studies at St. Michael's Hospital in Toronto, Ontario, Canada
- Dr. Rotzinger is with St. Michael's Hospital (Unity Health Toronto) and Department of Psychiatry at the University of Toronto in Toronto, Ontario, Canada
- Dr. Sheehan is with the University of South Florida College of Medicine in Tampa, Florida
- Dr. Sills was with OCBN in Toronto, Ontario, Canada
- Dr. Soares is with the Department of Psychiatry at Queen's University and Providence Care Hospital in Kingston, Ontario, Canada
- Dr. Turecki is with the Department of Psychiatry at McGill University in Montreal, Quebec, Canada
- Dr. Uher is with the Department of Psychiatry at Dalhousie University in Halifax, Nova Scotia, Canada
- Dr. Williams is with the Departments of Psychiatry and Neurology at Columbia University in New York, New York
- Dr. Kennedy is with the Department of Psychiatry at the University of Toronto and Centre for Depression and Suicide, St. Michael's Hospital in Toronto, Ontario, Canada
| | - John H Greist
- Drs. Vaccarino, Evans and Gilbert Evans are with Indoc Research in Toronto, Ontario, Canada
- Dr Kalali is with the International Society for CNS Drug Development in San Diego, California
- Dr. Blier is with the Departments of Psychiatry and Cellular & Molecular Medicine at the University of Ottawa Institute of Mental Health Research in Ottawa, Ontario, Canada
- Dr. Engelhardt is with Intra-Cellular Therapies in New York, New York
- Dr. Foster is with Department of Psychiatry & Behavioural Neurosciences at McMaster University in Hamilton, Ontario, Canada
- Dr. Frey is with the Department of Psychiatry and Behavioural Neurosciences at McMaster University and Mood Disorders Program and Women's Health Concerns Clinic, St. Joseph's Healthcare in Hamilton, Ontario, Canada
- Dr. Greist is with the Department of Psychiatry at the University of Wisconsin School of Medicine and Public Health in Madison, Wisconsin
- Dr. Kobak is with the Center for Telepsychology in Madison, Wisconsin
- Dr. Lam is with the Department of Psychiatry at the University of British Columbia in Vancouver, British Columbia, Canada
- Dr. MacQueen is with Mathison Centre for Mental Health Research and Education at the Department of Psychiatry, University of Calgary in Calgary, Alberta, Canada
- Dr. Milev is with the Department of Psychiatry and the Department of Psychology, and Centre for Neuroscience Studies at Queen's University in Kingston, Ontario, Canada
- Dr. Müller is with the Centre for Addiction and Mental Health and the Department of Psychiatry at the University of Toronto in Toronto, Ontario, Canada. Parikh is with the Department of Psychiatry at the University of Michigan in Ann Arbor, Michigan
- Dr. Placenza is with the Department of Psychiatry at the Krembil Research Centre, University Health Network, University of Toronto in Toronto, Ontario, Canada
- Dr. Rizvi is with Arthur Sommer Rotenberg Program for Suicide and Depression Studies at St. Michael's Hospital in Toronto, Ontario, Canada
- Dr. Rotzinger is with St. Michael's Hospital (Unity Health Toronto) and Department of Psychiatry at the University of Toronto in Toronto, Ontario, Canada
- Dr. Sheehan is with the University of South Florida College of Medicine in Tampa, Florida
- Dr. Sills was with OCBN in Toronto, Ontario, Canada
- Dr. Soares is with the Department of Psychiatry at Queen's University and Providence Care Hospital in Kingston, Ontario, Canada
- Dr. Turecki is with the Department of Psychiatry at McGill University in Montreal, Quebec, Canada
- Dr. Uher is with the Department of Psychiatry at Dalhousie University in Halifax, Nova Scotia, Canada
- Dr. Williams is with the Departments of Psychiatry and Neurology at Columbia University in New York, New York
- Dr. Kennedy is with the Department of Psychiatry at the University of Toronto and Centre for Depression and Suicide, St. Michael's Hospital in Toronto, Ontario, Canada
| | - Kenneth A Kobak
- Drs. Vaccarino, Evans and Gilbert Evans are with Indoc Research in Toronto, Ontario, Canada
- Dr Kalali is with the International Society for CNS Drug Development in San Diego, California
- Dr. Blier is with the Departments of Psychiatry and Cellular & Molecular Medicine at the University of Ottawa Institute of Mental Health Research in Ottawa, Ontario, Canada
- Dr. Engelhardt is with Intra-Cellular Therapies in New York, New York
- Dr. Foster is with Department of Psychiatry & Behavioural Neurosciences at McMaster University in Hamilton, Ontario, Canada
- Dr. Frey is with the Department of Psychiatry and Behavioural Neurosciences at McMaster University and Mood Disorders Program and Women's Health Concerns Clinic, St. Joseph's Healthcare in Hamilton, Ontario, Canada
- Dr. Greist is with the Department of Psychiatry at the University of Wisconsin School of Medicine and Public Health in Madison, Wisconsin
- Dr. Kobak is with the Center for Telepsychology in Madison, Wisconsin
- Dr. Lam is with the Department of Psychiatry at the University of British Columbia in Vancouver, British Columbia, Canada
- Dr. MacQueen is with Mathison Centre for Mental Health Research and Education at the Department of Psychiatry, University of Calgary in Calgary, Alberta, Canada
- Dr. Milev is with the Department of Psychiatry and the Department of Psychology, and Centre for Neuroscience Studies at Queen's University in Kingston, Ontario, Canada
- Dr. Müller is with the Centre for Addiction and Mental Health and the Department of Psychiatry at the University of Toronto in Toronto, Ontario, Canada. Parikh is with the Department of Psychiatry at the University of Michigan in Ann Arbor, Michigan
- Dr. Placenza is with the Department of Psychiatry at the Krembil Research Centre, University Health Network, University of Toronto in Toronto, Ontario, Canada
- Dr. Rizvi is with Arthur Sommer Rotenberg Program for Suicide and Depression Studies at St. Michael's Hospital in Toronto, Ontario, Canada
- Dr. Rotzinger is with St. Michael's Hospital (Unity Health Toronto) and Department of Psychiatry at the University of Toronto in Toronto, Ontario, Canada
- Dr. Sheehan is with the University of South Florida College of Medicine in Tampa, Florida
- Dr. Sills was with OCBN in Toronto, Ontario, Canada
- Dr. Soares is with the Department of Psychiatry at Queen's University and Providence Care Hospital in Kingston, Ontario, Canada
- Dr. Turecki is with the Department of Psychiatry at McGill University in Montreal, Quebec, Canada
- Dr. Uher is with the Department of Psychiatry at Dalhousie University in Halifax, Nova Scotia, Canada
- Dr. Williams is with the Departments of Psychiatry and Neurology at Columbia University in New York, New York
- Dr. Kennedy is with the Department of Psychiatry at the University of Toronto and Centre for Depression and Suicide, St. Michael's Hospital in Toronto, Ontario, Canada
| | - Raymond W Lam
- Drs. Vaccarino, Evans and Gilbert Evans are with Indoc Research in Toronto, Ontario, Canada
- Dr Kalali is with the International Society for CNS Drug Development in San Diego, California
- Dr. Blier is with the Departments of Psychiatry and Cellular & Molecular Medicine at the University of Ottawa Institute of Mental Health Research in Ottawa, Ontario, Canada
- Dr. Engelhardt is with Intra-Cellular Therapies in New York, New York
- Dr. Foster is with Department of Psychiatry & Behavioural Neurosciences at McMaster University in Hamilton, Ontario, Canada
- Dr. Frey is with the Department of Psychiatry and Behavioural Neurosciences at McMaster University and Mood Disorders Program and Women's Health Concerns Clinic, St. Joseph's Healthcare in Hamilton, Ontario, Canada
- Dr. Greist is with the Department of Psychiatry at the University of Wisconsin School of Medicine and Public Health in Madison, Wisconsin
- Dr. Kobak is with the Center for Telepsychology in Madison, Wisconsin
- Dr. Lam is with the Department of Psychiatry at the University of British Columbia in Vancouver, British Columbia, Canada
- Dr. MacQueen is with Mathison Centre for Mental Health Research and Education at the Department of Psychiatry, University of Calgary in Calgary, Alberta, Canada
- Dr. Milev is with the Department of Psychiatry and the Department of Psychology, and Centre for Neuroscience Studies at Queen's University in Kingston, Ontario, Canada
- Dr. Müller is with the Centre for Addiction and Mental Health and the Department of Psychiatry at the University of Toronto in Toronto, Ontario, Canada. Parikh is with the Department of Psychiatry at the University of Michigan in Ann Arbor, Michigan
- Dr. Placenza is with the Department of Psychiatry at the Krembil Research Centre, University Health Network, University of Toronto in Toronto, Ontario, Canada
- Dr. Rizvi is with Arthur Sommer Rotenberg Program for Suicide and Depression Studies at St. Michael's Hospital in Toronto, Ontario, Canada
- Dr. Rotzinger is with St. Michael's Hospital (Unity Health Toronto) and Department of Psychiatry at the University of Toronto in Toronto, Ontario, Canada
- Dr. Sheehan is with the University of South Florida College of Medicine in Tampa, Florida
- Dr. Sills was with OCBN in Toronto, Ontario, Canada
- Dr. Soares is with the Department of Psychiatry at Queen's University and Providence Care Hospital in Kingston, Ontario, Canada
- Dr. Turecki is with the Department of Psychiatry at McGill University in Montreal, Quebec, Canada
- Dr. Uher is with the Department of Psychiatry at Dalhousie University in Halifax, Nova Scotia, Canada
- Dr. Williams is with the Departments of Psychiatry and Neurology at Columbia University in New York, New York
- Dr. Kennedy is with the Department of Psychiatry at the University of Toronto and Centre for Depression and Suicide, St. Michael's Hospital in Toronto, Ontario, Canada
| | - Glenda MacQueen
- Drs. Vaccarino, Evans and Gilbert Evans are with Indoc Research in Toronto, Ontario, Canada
- Dr Kalali is with the International Society for CNS Drug Development in San Diego, California
- Dr. Blier is with the Departments of Psychiatry and Cellular & Molecular Medicine at the University of Ottawa Institute of Mental Health Research in Ottawa, Ontario, Canada
- Dr. Engelhardt is with Intra-Cellular Therapies in New York, New York
- Dr. Foster is with Department of Psychiatry & Behavioural Neurosciences at McMaster University in Hamilton, Ontario, Canada
- Dr. Frey is with the Department of Psychiatry and Behavioural Neurosciences at McMaster University and Mood Disorders Program and Women's Health Concerns Clinic, St. Joseph's Healthcare in Hamilton, Ontario, Canada
- Dr. Greist is with the Department of Psychiatry at the University of Wisconsin School of Medicine and Public Health in Madison, Wisconsin
- Dr. Kobak is with the Center for Telepsychology in Madison, Wisconsin
- Dr. Lam is with the Department of Psychiatry at the University of British Columbia in Vancouver, British Columbia, Canada
- Dr. MacQueen is with Mathison Centre for Mental Health Research and Education at the Department of Psychiatry, University of Calgary in Calgary, Alberta, Canada
- Dr. Milev is with the Department of Psychiatry and the Department of Psychology, and Centre for Neuroscience Studies at Queen's University in Kingston, Ontario, Canada
- Dr. Müller is with the Centre for Addiction and Mental Health and the Department of Psychiatry at the University of Toronto in Toronto, Ontario, Canada. Parikh is with the Department of Psychiatry at the University of Michigan in Ann Arbor, Michigan
- Dr. Placenza is with the Department of Psychiatry at the Krembil Research Centre, University Health Network, University of Toronto in Toronto, Ontario, Canada
- Dr. Rizvi is with Arthur Sommer Rotenberg Program for Suicide and Depression Studies at St. Michael's Hospital in Toronto, Ontario, Canada
- Dr. Rotzinger is with St. Michael's Hospital (Unity Health Toronto) and Department of Psychiatry at the University of Toronto in Toronto, Ontario, Canada
- Dr. Sheehan is with the University of South Florida College of Medicine in Tampa, Florida
- Dr. Sills was with OCBN in Toronto, Ontario, Canada
- Dr. Soares is with the Department of Psychiatry at Queen's University and Providence Care Hospital in Kingston, Ontario, Canada
- Dr. Turecki is with the Department of Psychiatry at McGill University in Montreal, Quebec, Canada
- Dr. Uher is with the Department of Psychiatry at Dalhousie University in Halifax, Nova Scotia, Canada
- Dr. Williams is with the Departments of Psychiatry and Neurology at Columbia University in New York, New York
- Dr. Kennedy is with the Department of Psychiatry at the University of Toronto and Centre for Depression and Suicide, St. Michael's Hospital in Toronto, Ontario, Canada
| | - Roumen Milev
- Drs. Vaccarino, Evans and Gilbert Evans are with Indoc Research in Toronto, Ontario, Canada
- Dr Kalali is with the International Society for CNS Drug Development in San Diego, California
- Dr. Blier is with the Departments of Psychiatry and Cellular & Molecular Medicine at the University of Ottawa Institute of Mental Health Research in Ottawa, Ontario, Canada
- Dr. Engelhardt is with Intra-Cellular Therapies in New York, New York
- Dr. Foster is with Department of Psychiatry & Behavioural Neurosciences at McMaster University in Hamilton, Ontario, Canada
- Dr. Frey is with the Department of Psychiatry and Behavioural Neurosciences at McMaster University and Mood Disorders Program and Women's Health Concerns Clinic, St. Joseph's Healthcare in Hamilton, Ontario, Canada
- Dr. Greist is with the Department of Psychiatry at the University of Wisconsin School of Medicine and Public Health in Madison, Wisconsin
- Dr. Kobak is with the Center for Telepsychology in Madison, Wisconsin
- Dr. Lam is with the Department of Psychiatry at the University of British Columbia in Vancouver, British Columbia, Canada
- Dr. MacQueen is with Mathison Centre for Mental Health Research and Education at the Department of Psychiatry, University of Calgary in Calgary, Alberta, Canada
- Dr. Milev is with the Department of Psychiatry and the Department of Psychology, and Centre for Neuroscience Studies at Queen's University in Kingston, Ontario, Canada
- Dr. Müller is with the Centre for Addiction and Mental Health and the Department of Psychiatry at the University of Toronto in Toronto, Ontario, Canada. Parikh is with the Department of Psychiatry at the University of Michigan in Ann Arbor, Michigan
- Dr. Placenza is with the Department of Psychiatry at the Krembil Research Centre, University Health Network, University of Toronto in Toronto, Ontario, Canada
- Dr. Rizvi is with Arthur Sommer Rotenberg Program for Suicide and Depression Studies at St. Michael's Hospital in Toronto, Ontario, Canada
- Dr. Rotzinger is with St. Michael's Hospital (Unity Health Toronto) and Department of Psychiatry at the University of Toronto in Toronto, Ontario, Canada
- Dr. Sheehan is with the University of South Florida College of Medicine in Tampa, Florida
- Dr. Sills was with OCBN in Toronto, Ontario, Canada
- Dr. Soares is with the Department of Psychiatry at Queen's University and Providence Care Hospital in Kingston, Ontario, Canada
- Dr. Turecki is with the Department of Psychiatry at McGill University in Montreal, Quebec, Canada
- Dr. Uher is with the Department of Psychiatry at Dalhousie University in Halifax, Nova Scotia, Canada
- Dr. Williams is with the Departments of Psychiatry and Neurology at Columbia University in New York, New York
- Dr. Kennedy is with the Department of Psychiatry at the University of Toronto and Centre for Depression and Suicide, St. Michael's Hospital in Toronto, Ontario, Canada
| | - Daniel J Müller
- Drs. Vaccarino, Evans and Gilbert Evans are with Indoc Research in Toronto, Ontario, Canada
- Dr Kalali is with the International Society for CNS Drug Development in San Diego, California
- Dr. Blier is with the Departments of Psychiatry and Cellular & Molecular Medicine at the University of Ottawa Institute of Mental Health Research in Ottawa, Ontario, Canada
- Dr. Engelhardt is with Intra-Cellular Therapies in New York, New York
- Dr. Foster is with Department of Psychiatry & Behavioural Neurosciences at McMaster University in Hamilton, Ontario, Canada
- Dr. Frey is with the Department of Psychiatry and Behavioural Neurosciences at McMaster University and Mood Disorders Program and Women's Health Concerns Clinic, St. Joseph's Healthcare in Hamilton, Ontario, Canada
- Dr. Greist is with the Department of Psychiatry at the University of Wisconsin School of Medicine and Public Health in Madison, Wisconsin
- Dr. Kobak is with the Center for Telepsychology in Madison, Wisconsin
- Dr. Lam is with the Department of Psychiatry at the University of British Columbia in Vancouver, British Columbia, Canada
- Dr. MacQueen is with Mathison Centre for Mental Health Research and Education at the Department of Psychiatry, University of Calgary in Calgary, Alberta, Canada
- Dr. Milev is with the Department of Psychiatry and the Department of Psychology, and Centre for Neuroscience Studies at Queen's University in Kingston, Ontario, Canada
- Dr. Müller is with the Centre for Addiction and Mental Health and the Department of Psychiatry at the University of Toronto in Toronto, Ontario, Canada. Parikh is with the Department of Psychiatry at the University of Michigan in Ann Arbor, Michigan
- Dr. Placenza is with the Department of Psychiatry at the Krembil Research Centre, University Health Network, University of Toronto in Toronto, Ontario, Canada
- Dr. Rizvi is with Arthur Sommer Rotenberg Program for Suicide and Depression Studies at St. Michael's Hospital in Toronto, Ontario, Canada
- Dr. Rotzinger is with St. Michael's Hospital (Unity Health Toronto) and Department of Psychiatry at the University of Toronto in Toronto, Ontario, Canada
- Dr. Sheehan is with the University of South Florida College of Medicine in Tampa, Florida
- Dr. Sills was with OCBN in Toronto, Ontario, Canada
- Dr. Soares is with the Department of Psychiatry at Queen's University and Providence Care Hospital in Kingston, Ontario, Canada
- Dr. Turecki is with the Department of Psychiatry at McGill University in Montreal, Quebec, Canada
- Dr. Uher is with the Department of Psychiatry at Dalhousie University in Halifax, Nova Scotia, Canada
- Dr. Williams is with the Departments of Psychiatry and Neurology at Columbia University in New York, New York
- Dr. Kennedy is with the Department of Psychiatry at the University of Toronto and Centre for Depression and Suicide, St. Michael's Hospital in Toronto, Ontario, Canada
| | - Sagar V Parikh
- Drs. Vaccarino, Evans and Gilbert Evans are with Indoc Research in Toronto, Ontario, Canada
- Dr Kalali is with the International Society for CNS Drug Development in San Diego, California
- Dr. Blier is with the Departments of Psychiatry and Cellular & Molecular Medicine at the University of Ottawa Institute of Mental Health Research in Ottawa, Ontario, Canada
- Dr. Engelhardt is with Intra-Cellular Therapies in New York, New York
- Dr. Foster is with Department of Psychiatry & Behavioural Neurosciences at McMaster University in Hamilton, Ontario, Canada
- Dr. Frey is with the Department of Psychiatry and Behavioural Neurosciences at McMaster University and Mood Disorders Program and Women's Health Concerns Clinic, St. Joseph's Healthcare in Hamilton, Ontario, Canada
- Dr. Greist is with the Department of Psychiatry at the University of Wisconsin School of Medicine and Public Health in Madison, Wisconsin
- Dr. Kobak is with the Center for Telepsychology in Madison, Wisconsin
- Dr. Lam is with the Department of Psychiatry at the University of British Columbia in Vancouver, British Columbia, Canada
- Dr. MacQueen is with Mathison Centre for Mental Health Research and Education at the Department of Psychiatry, University of Calgary in Calgary, Alberta, Canada
- Dr. Milev is with the Department of Psychiatry and the Department of Psychology, and Centre for Neuroscience Studies at Queen's University in Kingston, Ontario, Canada
- Dr. Müller is with the Centre for Addiction and Mental Health and the Department of Psychiatry at the University of Toronto in Toronto, Ontario, Canada. Parikh is with the Department of Psychiatry at the University of Michigan in Ann Arbor, Michigan
- Dr. Placenza is with the Department of Psychiatry at the Krembil Research Centre, University Health Network, University of Toronto in Toronto, Ontario, Canada
- Dr. Rizvi is with Arthur Sommer Rotenberg Program for Suicide and Depression Studies at St. Michael's Hospital in Toronto, Ontario, Canada
- Dr. Rotzinger is with St. Michael's Hospital (Unity Health Toronto) and Department of Psychiatry at the University of Toronto in Toronto, Ontario, Canada
- Dr. Sheehan is with the University of South Florida College of Medicine in Tampa, Florida
- Dr. Sills was with OCBN in Toronto, Ontario, Canada
- Dr. Soares is with the Department of Psychiatry at Queen's University and Providence Care Hospital in Kingston, Ontario, Canada
- Dr. Turecki is with the Department of Psychiatry at McGill University in Montreal, Quebec, Canada
- Dr. Uher is with the Department of Psychiatry at Dalhousie University in Halifax, Nova Scotia, Canada
- Dr. Williams is with the Departments of Psychiatry and Neurology at Columbia University in New York, New York
- Dr. Kennedy is with the Department of Psychiatry at the University of Toronto and Centre for Depression and Suicide, St. Michael's Hospital in Toronto, Ontario, Canada
| | - Franca M Placenza
- Drs. Vaccarino, Evans and Gilbert Evans are with Indoc Research in Toronto, Ontario, Canada
- Dr Kalali is with the International Society for CNS Drug Development in San Diego, California
- Dr. Blier is with the Departments of Psychiatry and Cellular & Molecular Medicine at the University of Ottawa Institute of Mental Health Research in Ottawa, Ontario, Canada
- Dr. Engelhardt is with Intra-Cellular Therapies in New York, New York
- Dr. Foster is with Department of Psychiatry & Behavioural Neurosciences at McMaster University in Hamilton, Ontario, Canada
- Dr. Frey is with the Department of Psychiatry and Behavioural Neurosciences at McMaster University and Mood Disorders Program and Women's Health Concerns Clinic, St. Joseph's Healthcare in Hamilton, Ontario, Canada
- Dr. Greist is with the Department of Psychiatry at the University of Wisconsin School of Medicine and Public Health in Madison, Wisconsin
- Dr. Kobak is with the Center for Telepsychology in Madison, Wisconsin
- Dr. Lam is with the Department of Psychiatry at the University of British Columbia in Vancouver, British Columbia, Canada
- Dr. MacQueen is with Mathison Centre for Mental Health Research and Education at the Department of Psychiatry, University of Calgary in Calgary, Alberta, Canada
- Dr. Milev is with the Department of Psychiatry and the Department of Psychology, and Centre for Neuroscience Studies at Queen's University in Kingston, Ontario, Canada
- Dr. Müller is with the Centre for Addiction and Mental Health and the Department of Psychiatry at the University of Toronto in Toronto, Ontario, Canada. Parikh is with the Department of Psychiatry at the University of Michigan in Ann Arbor, Michigan
- Dr. Placenza is with the Department of Psychiatry at the Krembil Research Centre, University Health Network, University of Toronto in Toronto, Ontario, Canada
- Dr. Rizvi is with Arthur Sommer Rotenberg Program for Suicide and Depression Studies at St. Michael's Hospital in Toronto, Ontario, Canada
- Dr. Rotzinger is with St. Michael's Hospital (Unity Health Toronto) and Department of Psychiatry at the University of Toronto in Toronto, Ontario, Canada
- Dr. Sheehan is with the University of South Florida College of Medicine in Tampa, Florida
- Dr. Sills was with OCBN in Toronto, Ontario, Canada
- Dr. Soares is with the Department of Psychiatry at Queen's University and Providence Care Hospital in Kingston, Ontario, Canada
- Dr. Turecki is with the Department of Psychiatry at McGill University in Montreal, Quebec, Canada
- Dr. Uher is with the Department of Psychiatry at Dalhousie University in Halifax, Nova Scotia, Canada
- Dr. Williams is with the Departments of Psychiatry and Neurology at Columbia University in New York, New York
- Dr. Kennedy is with the Department of Psychiatry at the University of Toronto and Centre for Depression and Suicide, St. Michael's Hospital in Toronto, Ontario, Canada
| | - Sakina J Rizvi
- Drs. Vaccarino, Evans and Gilbert Evans are with Indoc Research in Toronto, Ontario, Canada
- Dr Kalali is with the International Society for CNS Drug Development in San Diego, California
- Dr. Blier is with the Departments of Psychiatry and Cellular & Molecular Medicine at the University of Ottawa Institute of Mental Health Research in Ottawa, Ontario, Canada
- Dr. Engelhardt is with Intra-Cellular Therapies in New York, New York
- Dr. Foster is with Department of Psychiatry & Behavioural Neurosciences at McMaster University in Hamilton, Ontario, Canada
- Dr. Frey is with the Department of Psychiatry and Behavioural Neurosciences at McMaster University and Mood Disorders Program and Women's Health Concerns Clinic, St. Joseph's Healthcare in Hamilton, Ontario, Canada
- Dr. Greist is with the Department of Psychiatry at the University of Wisconsin School of Medicine and Public Health in Madison, Wisconsin
- Dr. Kobak is with the Center for Telepsychology in Madison, Wisconsin
- Dr. Lam is with the Department of Psychiatry at the University of British Columbia in Vancouver, British Columbia, Canada
- Dr. MacQueen is with Mathison Centre for Mental Health Research and Education at the Department of Psychiatry, University of Calgary in Calgary, Alberta, Canada
- Dr. Milev is with the Department of Psychiatry and the Department of Psychology, and Centre for Neuroscience Studies at Queen's University in Kingston, Ontario, Canada
- Dr. Müller is with the Centre for Addiction and Mental Health and the Department of Psychiatry at the University of Toronto in Toronto, Ontario, Canada. Parikh is with the Department of Psychiatry at the University of Michigan in Ann Arbor, Michigan
- Dr. Placenza is with the Department of Psychiatry at the Krembil Research Centre, University Health Network, University of Toronto in Toronto, Ontario, Canada
- Dr. Rizvi is with Arthur Sommer Rotenberg Program for Suicide and Depression Studies at St. Michael's Hospital in Toronto, Ontario, Canada
- Dr. Rotzinger is with St. Michael's Hospital (Unity Health Toronto) and Department of Psychiatry at the University of Toronto in Toronto, Ontario, Canada
- Dr. Sheehan is with the University of South Florida College of Medicine in Tampa, Florida
- Dr. Sills was with OCBN in Toronto, Ontario, Canada
- Dr. Soares is with the Department of Psychiatry at Queen's University and Providence Care Hospital in Kingston, Ontario, Canada
- Dr. Turecki is with the Department of Psychiatry at McGill University in Montreal, Quebec, Canada
- Dr. Uher is with the Department of Psychiatry at Dalhousie University in Halifax, Nova Scotia, Canada
- Dr. Williams is with the Departments of Psychiatry and Neurology at Columbia University in New York, New York
- Dr. Kennedy is with the Department of Psychiatry at the University of Toronto and Centre for Depression and Suicide, St. Michael's Hospital in Toronto, Ontario, Canada
| | - Susan Rotzinger
- Drs. Vaccarino, Evans and Gilbert Evans are with Indoc Research in Toronto, Ontario, Canada
- Dr Kalali is with the International Society for CNS Drug Development in San Diego, California
- Dr. Blier is with the Departments of Psychiatry and Cellular & Molecular Medicine at the University of Ottawa Institute of Mental Health Research in Ottawa, Ontario, Canada
- Dr. Engelhardt is with Intra-Cellular Therapies in New York, New York
- Dr. Foster is with Department of Psychiatry & Behavioural Neurosciences at McMaster University in Hamilton, Ontario, Canada
- Dr. Frey is with the Department of Psychiatry and Behavioural Neurosciences at McMaster University and Mood Disorders Program and Women's Health Concerns Clinic, St. Joseph's Healthcare in Hamilton, Ontario, Canada
- Dr. Greist is with the Department of Psychiatry at the University of Wisconsin School of Medicine and Public Health in Madison, Wisconsin
- Dr. Kobak is with the Center for Telepsychology in Madison, Wisconsin
- Dr. Lam is with the Department of Psychiatry at the University of British Columbia in Vancouver, British Columbia, Canada
- Dr. MacQueen is with Mathison Centre for Mental Health Research and Education at the Department of Psychiatry, University of Calgary in Calgary, Alberta, Canada
- Dr. Milev is with the Department of Psychiatry and the Department of Psychology, and Centre for Neuroscience Studies at Queen's University in Kingston, Ontario, Canada
- Dr. Müller is with the Centre for Addiction and Mental Health and the Department of Psychiatry at the University of Toronto in Toronto, Ontario, Canada. Parikh is with the Department of Psychiatry at the University of Michigan in Ann Arbor, Michigan
- Dr. Placenza is with the Department of Psychiatry at the Krembil Research Centre, University Health Network, University of Toronto in Toronto, Ontario, Canada
- Dr. Rizvi is with Arthur Sommer Rotenberg Program for Suicide and Depression Studies at St. Michael's Hospital in Toronto, Ontario, Canada
- Dr. Rotzinger is with St. Michael's Hospital (Unity Health Toronto) and Department of Psychiatry at the University of Toronto in Toronto, Ontario, Canada
- Dr. Sheehan is with the University of South Florida College of Medicine in Tampa, Florida
- Dr. Sills was with OCBN in Toronto, Ontario, Canada
- Dr. Soares is with the Department of Psychiatry at Queen's University and Providence Care Hospital in Kingston, Ontario, Canada
- Dr. Turecki is with the Department of Psychiatry at McGill University in Montreal, Quebec, Canada
- Dr. Uher is with the Department of Psychiatry at Dalhousie University in Halifax, Nova Scotia, Canada
- Dr. Williams is with the Departments of Psychiatry and Neurology at Columbia University in New York, New York
- Dr. Kennedy is with the Department of Psychiatry at the University of Toronto and Centre for Depression and Suicide, St. Michael's Hospital in Toronto, Ontario, Canada
| | - David V Sheehan
- Drs. Vaccarino, Evans and Gilbert Evans are with Indoc Research in Toronto, Ontario, Canada
- Dr Kalali is with the International Society for CNS Drug Development in San Diego, California
- Dr. Blier is with the Departments of Psychiatry and Cellular & Molecular Medicine at the University of Ottawa Institute of Mental Health Research in Ottawa, Ontario, Canada
- Dr. Engelhardt is with Intra-Cellular Therapies in New York, New York
- Dr. Foster is with Department of Psychiatry & Behavioural Neurosciences at McMaster University in Hamilton, Ontario, Canada
- Dr. Frey is with the Department of Psychiatry and Behavioural Neurosciences at McMaster University and Mood Disorders Program and Women's Health Concerns Clinic, St. Joseph's Healthcare in Hamilton, Ontario, Canada
- Dr. Greist is with the Department of Psychiatry at the University of Wisconsin School of Medicine and Public Health in Madison, Wisconsin
- Dr. Kobak is with the Center for Telepsychology in Madison, Wisconsin
- Dr. Lam is with the Department of Psychiatry at the University of British Columbia in Vancouver, British Columbia, Canada
- Dr. MacQueen is with Mathison Centre for Mental Health Research and Education at the Department of Psychiatry, University of Calgary in Calgary, Alberta, Canada
- Dr. Milev is with the Department of Psychiatry and the Department of Psychology, and Centre for Neuroscience Studies at Queen's University in Kingston, Ontario, Canada
- Dr. Müller is with the Centre for Addiction and Mental Health and the Department of Psychiatry at the University of Toronto in Toronto, Ontario, Canada. Parikh is with the Department of Psychiatry at the University of Michigan in Ann Arbor, Michigan
- Dr. Placenza is with the Department of Psychiatry at the Krembil Research Centre, University Health Network, University of Toronto in Toronto, Ontario, Canada
- Dr. Rizvi is with Arthur Sommer Rotenberg Program for Suicide and Depression Studies at St. Michael's Hospital in Toronto, Ontario, Canada
- Dr. Rotzinger is with St. Michael's Hospital (Unity Health Toronto) and Department of Psychiatry at the University of Toronto in Toronto, Ontario, Canada
- Dr. Sheehan is with the University of South Florida College of Medicine in Tampa, Florida
- Dr. Sills was with OCBN in Toronto, Ontario, Canada
- Dr. Soares is with the Department of Psychiatry at Queen's University and Providence Care Hospital in Kingston, Ontario, Canada
- Dr. Turecki is with the Department of Psychiatry at McGill University in Montreal, Quebec, Canada
- Dr. Uher is with the Department of Psychiatry at Dalhousie University in Halifax, Nova Scotia, Canada
- Dr. Williams is with the Departments of Psychiatry and Neurology at Columbia University in New York, New York
- Dr. Kennedy is with the Department of Psychiatry at the University of Toronto and Centre for Depression and Suicide, St. Michael's Hospital in Toronto, Ontario, Canada
| | - Terrence Sills
- Drs. Vaccarino, Evans and Gilbert Evans are with Indoc Research in Toronto, Ontario, Canada
- Dr Kalali is with the International Society for CNS Drug Development in San Diego, California
- Dr. Blier is with the Departments of Psychiatry and Cellular & Molecular Medicine at the University of Ottawa Institute of Mental Health Research in Ottawa, Ontario, Canada
- Dr. Engelhardt is with Intra-Cellular Therapies in New York, New York
- Dr. Foster is with Department of Psychiatry & Behavioural Neurosciences at McMaster University in Hamilton, Ontario, Canada
- Dr. Frey is with the Department of Psychiatry and Behavioural Neurosciences at McMaster University and Mood Disorders Program and Women's Health Concerns Clinic, St. Joseph's Healthcare in Hamilton, Ontario, Canada
- Dr. Greist is with the Department of Psychiatry at the University of Wisconsin School of Medicine and Public Health in Madison, Wisconsin
- Dr. Kobak is with the Center for Telepsychology in Madison, Wisconsin
- Dr. Lam is with the Department of Psychiatry at the University of British Columbia in Vancouver, British Columbia, Canada
- Dr. MacQueen is with Mathison Centre for Mental Health Research and Education at the Department of Psychiatry, University of Calgary in Calgary, Alberta, Canada
- Dr. Milev is with the Department of Psychiatry and the Department of Psychology, and Centre for Neuroscience Studies at Queen's University in Kingston, Ontario, Canada
- Dr. Müller is with the Centre for Addiction and Mental Health and the Department of Psychiatry at the University of Toronto in Toronto, Ontario, Canada. Parikh is with the Department of Psychiatry at the University of Michigan in Ann Arbor, Michigan
- Dr. Placenza is with the Department of Psychiatry at the Krembil Research Centre, University Health Network, University of Toronto in Toronto, Ontario, Canada
- Dr. Rizvi is with Arthur Sommer Rotenberg Program for Suicide and Depression Studies at St. Michael's Hospital in Toronto, Ontario, Canada
- Dr. Rotzinger is with St. Michael's Hospital (Unity Health Toronto) and Department of Psychiatry at the University of Toronto in Toronto, Ontario, Canada
- Dr. Sheehan is with the University of South Florida College of Medicine in Tampa, Florida
- Dr. Sills was with OCBN in Toronto, Ontario, Canada
- Dr. Soares is with the Department of Psychiatry at Queen's University and Providence Care Hospital in Kingston, Ontario, Canada
- Dr. Turecki is with the Department of Psychiatry at McGill University in Montreal, Quebec, Canada
- Dr. Uher is with the Department of Psychiatry at Dalhousie University in Halifax, Nova Scotia, Canada
- Dr. Williams is with the Departments of Psychiatry and Neurology at Columbia University in New York, New York
- Dr. Kennedy is with the Department of Psychiatry at the University of Toronto and Centre for Depression and Suicide, St. Michael's Hospital in Toronto, Ontario, Canada
| | - Claudio N Soares
- Drs. Vaccarino, Evans and Gilbert Evans are with Indoc Research in Toronto, Ontario, Canada
- Dr Kalali is with the International Society for CNS Drug Development in San Diego, California
- Dr. Blier is with the Departments of Psychiatry and Cellular & Molecular Medicine at the University of Ottawa Institute of Mental Health Research in Ottawa, Ontario, Canada
- Dr. Engelhardt is with Intra-Cellular Therapies in New York, New York
- Dr. Foster is with Department of Psychiatry & Behavioural Neurosciences at McMaster University in Hamilton, Ontario, Canada
- Dr. Frey is with the Department of Psychiatry and Behavioural Neurosciences at McMaster University and Mood Disorders Program and Women's Health Concerns Clinic, St. Joseph's Healthcare in Hamilton, Ontario, Canada
- Dr. Greist is with the Department of Psychiatry at the University of Wisconsin School of Medicine and Public Health in Madison, Wisconsin
- Dr. Kobak is with the Center for Telepsychology in Madison, Wisconsin
- Dr. Lam is with the Department of Psychiatry at the University of British Columbia in Vancouver, British Columbia, Canada
- Dr. MacQueen is with Mathison Centre for Mental Health Research and Education at the Department of Psychiatry, University of Calgary in Calgary, Alberta, Canada
- Dr. Milev is with the Department of Psychiatry and the Department of Psychology, and Centre for Neuroscience Studies at Queen's University in Kingston, Ontario, Canada
- Dr. Müller is with the Centre for Addiction and Mental Health and the Department of Psychiatry at the University of Toronto in Toronto, Ontario, Canada. Parikh is with the Department of Psychiatry at the University of Michigan in Ann Arbor, Michigan
- Dr. Placenza is with the Department of Psychiatry at the Krembil Research Centre, University Health Network, University of Toronto in Toronto, Ontario, Canada
- Dr. Rizvi is with Arthur Sommer Rotenberg Program for Suicide and Depression Studies at St. Michael's Hospital in Toronto, Ontario, Canada
- Dr. Rotzinger is with St. Michael's Hospital (Unity Health Toronto) and Department of Psychiatry at the University of Toronto in Toronto, Ontario, Canada
- Dr. Sheehan is with the University of South Florida College of Medicine in Tampa, Florida
- Dr. Sills was with OCBN in Toronto, Ontario, Canada
- Dr. Soares is with the Department of Psychiatry at Queen's University and Providence Care Hospital in Kingston, Ontario, Canada
- Dr. Turecki is with the Department of Psychiatry at McGill University in Montreal, Quebec, Canada
- Dr. Uher is with the Department of Psychiatry at Dalhousie University in Halifax, Nova Scotia, Canada
- Dr. Williams is with the Departments of Psychiatry and Neurology at Columbia University in New York, New York
- Dr. Kennedy is with the Department of Psychiatry at the University of Toronto and Centre for Depression and Suicide, St. Michael's Hospital in Toronto, Ontario, Canada
| | - Gustavo Turecki
- Drs. Vaccarino, Evans and Gilbert Evans are with Indoc Research in Toronto, Ontario, Canada
- Dr Kalali is with the International Society for CNS Drug Development in San Diego, California
- Dr. Blier is with the Departments of Psychiatry and Cellular & Molecular Medicine at the University of Ottawa Institute of Mental Health Research in Ottawa, Ontario, Canada
- Dr. Engelhardt is with Intra-Cellular Therapies in New York, New York
- Dr. Foster is with Department of Psychiatry & Behavioural Neurosciences at McMaster University in Hamilton, Ontario, Canada
- Dr. Frey is with the Department of Psychiatry and Behavioural Neurosciences at McMaster University and Mood Disorders Program and Women's Health Concerns Clinic, St. Joseph's Healthcare in Hamilton, Ontario, Canada
- Dr. Greist is with the Department of Psychiatry at the University of Wisconsin School of Medicine and Public Health in Madison, Wisconsin
- Dr. Kobak is with the Center for Telepsychology in Madison, Wisconsin
- Dr. Lam is with the Department of Psychiatry at the University of British Columbia in Vancouver, British Columbia, Canada
- Dr. MacQueen is with Mathison Centre for Mental Health Research and Education at the Department of Psychiatry, University of Calgary in Calgary, Alberta, Canada
- Dr. Milev is with the Department of Psychiatry and the Department of Psychology, and Centre for Neuroscience Studies at Queen's University in Kingston, Ontario, Canada
- Dr. Müller is with the Centre for Addiction and Mental Health and the Department of Psychiatry at the University of Toronto in Toronto, Ontario, Canada. Parikh is with the Department of Psychiatry at the University of Michigan in Ann Arbor, Michigan
- Dr. Placenza is with the Department of Psychiatry at the Krembil Research Centre, University Health Network, University of Toronto in Toronto, Ontario, Canada
- Dr. Rizvi is with Arthur Sommer Rotenberg Program for Suicide and Depression Studies at St. Michael's Hospital in Toronto, Ontario, Canada
- Dr. Rotzinger is with St. Michael's Hospital (Unity Health Toronto) and Department of Psychiatry at the University of Toronto in Toronto, Ontario, Canada
- Dr. Sheehan is with the University of South Florida College of Medicine in Tampa, Florida
- Dr. Sills was with OCBN in Toronto, Ontario, Canada
- Dr. Soares is with the Department of Psychiatry at Queen's University and Providence Care Hospital in Kingston, Ontario, Canada
- Dr. Turecki is with the Department of Psychiatry at McGill University in Montreal, Quebec, Canada
- Dr. Uher is with the Department of Psychiatry at Dalhousie University in Halifax, Nova Scotia, Canada
- Dr. Williams is with the Departments of Psychiatry and Neurology at Columbia University in New York, New York
- Dr. Kennedy is with the Department of Psychiatry at the University of Toronto and Centre for Depression and Suicide, St. Michael's Hospital in Toronto, Ontario, Canada
| | - Rudolph Uher
- Drs. Vaccarino, Evans and Gilbert Evans are with Indoc Research in Toronto, Ontario, Canada
- Dr Kalali is with the International Society for CNS Drug Development in San Diego, California
- Dr. Blier is with the Departments of Psychiatry and Cellular & Molecular Medicine at the University of Ottawa Institute of Mental Health Research in Ottawa, Ontario, Canada
- Dr. Engelhardt is with Intra-Cellular Therapies in New York, New York
- Dr. Foster is with Department of Psychiatry & Behavioural Neurosciences at McMaster University in Hamilton, Ontario, Canada
- Dr. Frey is with the Department of Psychiatry and Behavioural Neurosciences at McMaster University and Mood Disorders Program and Women's Health Concerns Clinic, St. Joseph's Healthcare in Hamilton, Ontario, Canada
- Dr. Greist is with the Department of Psychiatry at the University of Wisconsin School of Medicine and Public Health in Madison, Wisconsin
- Dr. Kobak is with the Center for Telepsychology in Madison, Wisconsin
- Dr. Lam is with the Department of Psychiatry at the University of British Columbia in Vancouver, British Columbia, Canada
- Dr. MacQueen is with Mathison Centre for Mental Health Research and Education at the Department of Psychiatry, University of Calgary in Calgary, Alberta, Canada
- Dr. Milev is with the Department of Psychiatry and the Department of Psychology, and Centre for Neuroscience Studies at Queen's University in Kingston, Ontario, Canada
- Dr. Müller is with the Centre for Addiction and Mental Health and the Department of Psychiatry at the University of Toronto in Toronto, Ontario, Canada. Parikh is with the Department of Psychiatry at the University of Michigan in Ann Arbor, Michigan
- Dr. Placenza is with the Department of Psychiatry at the Krembil Research Centre, University Health Network, University of Toronto in Toronto, Ontario, Canada
- Dr. Rizvi is with Arthur Sommer Rotenberg Program for Suicide and Depression Studies at St. Michael's Hospital in Toronto, Ontario, Canada
- Dr. Rotzinger is with St. Michael's Hospital (Unity Health Toronto) and Department of Psychiatry at the University of Toronto in Toronto, Ontario, Canada
- Dr. Sheehan is with the University of South Florida College of Medicine in Tampa, Florida
- Dr. Sills was with OCBN in Toronto, Ontario, Canada
- Dr. Soares is with the Department of Psychiatry at Queen's University and Providence Care Hospital in Kingston, Ontario, Canada
- Dr. Turecki is with the Department of Psychiatry at McGill University in Montreal, Quebec, Canada
- Dr. Uher is with the Department of Psychiatry at Dalhousie University in Halifax, Nova Scotia, Canada
- Dr. Williams is with the Departments of Psychiatry and Neurology at Columbia University in New York, New York
- Dr. Kennedy is with the Department of Psychiatry at the University of Toronto and Centre for Depression and Suicide, St. Michael's Hospital in Toronto, Ontario, Canada
| | - Janet B W Williams
- Drs. Vaccarino, Evans and Gilbert Evans are with Indoc Research in Toronto, Ontario, Canada
- Dr Kalali is with the International Society for CNS Drug Development in San Diego, California
- Dr. Blier is with the Departments of Psychiatry and Cellular & Molecular Medicine at the University of Ottawa Institute of Mental Health Research in Ottawa, Ontario, Canada
- Dr. Engelhardt is with Intra-Cellular Therapies in New York, New York
- Dr. Foster is with Department of Psychiatry & Behavioural Neurosciences at McMaster University in Hamilton, Ontario, Canada
- Dr. Frey is with the Department of Psychiatry and Behavioural Neurosciences at McMaster University and Mood Disorders Program and Women's Health Concerns Clinic, St. Joseph's Healthcare in Hamilton, Ontario, Canada
- Dr. Greist is with the Department of Psychiatry at the University of Wisconsin School of Medicine and Public Health in Madison, Wisconsin
- Dr. Kobak is with the Center for Telepsychology in Madison, Wisconsin
- Dr. Lam is with the Department of Psychiatry at the University of British Columbia in Vancouver, British Columbia, Canada
- Dr. MacQueen is with Mathison Centre for Mental Health Research and Education at the Department of Psychiatry, University of Calgary in Calgary, Alberta, Canada
- Dr. Milev is with the Department of Psychiatry and the Department of Psychology, and Centre for Neuroscience Studies at Queen's University in Kingston, Ontario, Canada
- Dr. Müller is with the Centre for Addiction and Mental Health and the Department of Psychiatry at the University of Toronto in Toronto, Ontario, Canada. Parikh is with the Department of Psychiatry at the University of Michigan in Ann Arbor, Michigan
- Dr. Placenza is with the Department of Psychiatry at the Krembil Research Centre, University Health Network, University of Toronto in Toronto, Ontario, Canada
- Dr. Rizvi is with Arthur Sommer Rotenberg Program for Suicide and Depression Studies at St. Michael's Hospital in Toronto, Ontario, Canada
- Dr. Rotzinger is with St. Michael's Hospital (Unity Health Toronto) and Department of Psychiatry at the University of Toronto in Toronto, Ontario, Canada
- Dr. Sheehan is with the University of South Florida College of Medicine in Tampa, Florida
- Dr. Sills was with OCBN in Toronto, Ontario, Canada
- Dr. Soares is with the Department of Psychiatry at Queen's University and Providence Care Hospital in Kingston, Ontario, Canada
- Dr. Turecki is with the Department of Psychiatry at McGill University in Montreal, Quebec, Canada
- Dr. Uher is with the Department of Psychiatry at Dalhousie University in Halifax, Nova Scotia, Canada
- Dr. Williams is with the Departments of Psychiatry and Neurology at Columbia University in New York, New York
- Dr. Kennedy is with the Department of Psychiatry at the University of Toronto and Centre for Depression and Suicide, St. Michael's Hospital in Toronto, Ontario, Canada
| | - Sidney H Kennedy
- Drs. Vaccarino, Evans and Gilbert Evans are with Indoc Research in Toronto, Ontario, Canada
- Dr Kalali is with the International Society for CNS Drug Development in San Diego, California
- Dr. Blier is with the Departments of Psychiatry and Cellular & Molecular Medicine at the University of Ottawa Institute of Mental Health Research in Ottawa, Ontario, Canada
- Dr. Engelhardt is with Intra-Cellular Therapies in New York, New York
- Dr. Foster is with Department of Psychiatry & Behavioural Neurosciences at McMaster University in Hamilton, Ontario, Canada
- Dr. Frey is with the Department of Psychiatry and Behavioural Neurosciences at McMaster University and Mood Disorders Program and Women's Health Concerns Clinic, St. Joseph's Healthcare in Hamilton, Ontario, Canada
- Dr. Greist is with the Department of Psychiatry at the University of Wisconsin School of Medicine and Public Health in Madison, Wisconsin
- Dr. Kobak is with the Center for Telepsychology in Madison, Wisconsin
- Dr. Lam is with the Department of Psychiatry at the University of British Columbia in Vancouver, British Columbia, Canada
- Dr. MacQueen is with Mathison Centre for Mental Health Research and Education at the Department of Psychiatry, University of Calgary in Calgary, Alberta, Canada
- Dr. Milev is with the Department of Psychiatry and the Department of Psychology, and Centre for Neuroscience Studies at Queen's University in Kingston, Ontario, Canada
- Dr. Müller is with the Centre for Addiction and Mental Health and the Department of Psychiatry at the University of Toronto in Toronto, Ontario, Canada. Parikh is with the Department of Psychiatry at the University of Michigan in Ann Arbor, Michigan
- Dr. Placenza is with the Department of Psychiatry at the Krembil Research Centre, University Health Network, University of Toronto in Toronto, Ontario, Canada
- Dr. Rizvi is with Arthur Sommer Rotenberg Program for Suicide and Depression Studies at St. Michael's Hospital in Toronto, Ontario, Canada
- Dr. Rotzinger is with St. Michael's Hospital (Unity Health Toronto) and Department of Psychiatry at the University of Toronto in Toronto, Ontario, Canada
- Dr. Sheehan is with the University of South Florida College of Medicine in Tampa, Florida
- Dr. Sills was with OCBN in Toronto, Ontario, Canada
- Dr. Soares is with the Department of Psychiatry at Queen's University and Providence Care Hospital in Kingston, Ontario, Canada
- Dr. Turecki is with the Department of Psychiatry at McGill University in Montreal, Quebec, Canada
- Dr. Uher is with the Department of Psychiatry at Dalhousie University in Halifax, Nova Scotia, Canada
- Dr. Williams is with the Departments of Psychiatry and Neurology at Columbia University in New York, New York
- Dr. Kennedy is with the Department of Psychiatry at the University of Toronto and Centre for Depression and Suicide, St. Michael's Hospital in Toronto, Ontario, Canada
| | - Kenneth R Evans
- Drs. Vaccarino, Evans and Gilbert Evans are with Indoc Research in Toronto, Ontario, Canada
- Dr Kalali is with the International Society for CNS Drug Development in San Diego, California
- Dr. Blier is with the Departments of Psychiatry and Cellular & Molecular Medicine at the University of Ottawa Institute of Mental Health Research in Ottawa, Ontario, Canada
- Dr. Engelhardt is with Intra-Cellular Therapies in New York, New York
- Dr. Foster is with Department of Psychiatry & Behavioural Neurosciences at McMaster University in Hamilton, Ontario, Canada
- Dr. Frey is with the Department of Psychiatry and Behavioural Neurosciences at McMaster University and Mood Disorders Program and Women's Health Concerns Clinic, St. Joseph's Healthcare in Hamilton, Ontario, Canada
- Dr. Greist is with the Department of Psychiatry at the University of Wisconsin School of Medicine and Public Health in Madison, Wisconsin
- Dr. Kobak is with the Center for Telepsychology in Madison, Wisconsin
- Dr. Lam is with the Department of Psychiatry at the University of British Columbia in Vancouver, British Columbia, Canada
- Dr. MacQueen is with Mathison Centre for Mental Health Research and Education at the Department of Psychiatry, University of Calgary in Calgary, Alberta, Canada
- Dr. Milev is with the Department of Psychiatry and the Department of Psychology, and Centre for Neuroscience Studies at Queen's University in Kingston, Ontario, Canada
- Dr. Müller is with the Centre for Addiction and Mental Health and the Department of Psychiatry at the University of Toronto in Toronto, Ontario, Canada. Parikh is with the Department of Psychiatry at the University of Michigan in Ann Arbor, Michigan
- Dr. Placenza is with the Department of Psychiatry at the Krembil Research Centre, University Health Network, University of Toronto in Toronto, Ontario, Canada
- Dr. Rizvi is with Arthur Sommer Rotenberg Program for Suicide and Depression Studies at St. Michael's Hospital in Toronto, Ontario, Canada
- Dr. Rotzinger is with St. Michael's Hospital (Unity Health Toronto) and Department of Psychiatry at the University of Toronto in Toronto, Ontario, Canada
- Dr. Sheehan is with the University of South Florida College of Medicine in Tampa, Florida
- Dr. Sills was with OCBN in Toronto, Ontario, Canada
- Dr. Soares is with the Department of Psychiatry at Queen's University and Providence Care Hospital in Kingston, Ontario, Canada
- Dr. Turecki is with the Department of Psychiatry at McGill University in Montreal, Quebec, Canada
- Dr. Uher is with the Department of Psychiatry at Dalhousie University in Halifax, Nova Scotia, Canada
- Dr. Williams is with the Departments of Psychiatry and Neurology at Columbia University in New York, New York
- Dr. Kennedy is with the Department of Psychiatry at the University of Toronto and Centre for Depression and Suicide, St. Michael's Hospital in Toronto, Ontario, Canada
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Zarotti N, Dale M, Eccles F, Simpson J. Psychological Interventions for People with Huntington's Disease: A Call to Arms. J Huntingtons Dis 2020; 9:231-243. [PMID: 32894248 PMCID: PMC7683059 DOI: 10.3233/jhd-200418] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
BACKGROUND Although Huntington's disease (HD) can cause a wide range of psychological difficulties, no review has ever been carried out on the range of psychological interventions adopted with this population. OBJECTIVE To scope the literature on psychological interventions for psychological difficulties in people affected by HD. METHODS A systematic scoping review was performed across MEDLINE, PsycINFO, CINAHL, Academic Search Ultimate, and Cochrane Library up to 1 March 2020. RESULTS From an initial return of 1579 citations, a total of nine papers were considered eligible for review. These included a qualitative investigation, three case studies, two case series, two uncontrolled pretest-posttest designs, and only one randomised control trial (RCT). Despite the wide range of psychological difficulties which can be experienced by people affected by the HD gene expansion, the adopted interventions only accounted for five main psychological outcomes (anxiety, apathy, depression, irritability, and coping). Further discussion and suggestions for future research are provided for each outcome. CONCLUSION The current literature on psychological interventions in people affected by HD is extremely limited both in terms of methods and addressed clinical outcomes. Consequently, no conclusions can be offered yet as to which psychological therapy may help this population. As further more comprehensive research is urgently needed for this group, the ultimate aim of the present review is to act as a call to arms for HD researchers worldwide to help shed light on the most effective way to translate psychological theory into practice for the benefit of people affected by HD.
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Affiliation(s)
- Nicolò Zarotti
- Division of Health Research, Faculty of Health and Medicine, Lancaster University, Lancaster, UK
| | - Maria Dale
- Adult Mental Health Psychology, Leicestershire Partnership NHS Trust, Leicester, UK
| | - Fiona Eccles
- Division of Health Research, Faculty of Health and Medicine, Lancaster University, Lancaster, UK
| | - Jane Simpson
- Division of Health Research, Faculty of Health and Medicine, Lancaster University, Lancaster, UK
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Cognitive Control, Learning, and Clinical Motor Ratings Are Most Highly Associated with Basal Ganglia Brain Volumes in the Premanifest Huntington's Disease Phenotype. J Int Neuropsychol Soc 2017; 23:159-170. [PMID: 28205498 PMCID: PMC5803794 DOI: 10.1017/s1355617716001132] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
OBJECTIVES Huntington's disease (HD) is a debilitating genetic disorder characterized by motor, cognitive and psychiatric abnormalities associated with neuropathological decline. HD pathology is the result of an extended chain of CAG (cytosine, adenine, guanine) trinucleotide repetitions in the HTT gene. Clinical diagnosis of HD requires the presence of an otherwise unexplained extrapyramidal movement disorder in a participant at risk for HD. Over the past 15 years, evidence has shown that cognitive, psychiatric, and subtle motor dysfunction is evident decades before traditional motor diagnosis. This study examines the relationships among subcortical brain volumes and measures of emerging disease phenotype in prodromal HD, before clinical diagnosis. METHODS The dataset includes 34 cognitive, motor, psychiatric, and functional variables and five subcortical brain volumes from 984 prodromal HD individuals enrolled in the PREDICT HD study. Using cluster analyses, seven distinct clusters encompassing cognitive, motor, psychiatric, and functional domains were identified. Individual cluster scores were then regressed against the subcortical brain volumetric measurements. RESULTS Accounting for site and genetic burden (the interaction of age and CAG repeat length) smaller caudate and putamen volumes were related to clusters reflecting motor symptom severity, cognitive control, and verbal learning. CONCLUSIONS Variable reduction of the HD phenotype using cluster analysis revealed biologically related domains of HD and are suitable for future research with this population. Our cognitive control cluster scores show sensitivity to changes in basal ganglia both within and outside the striatum that may not be captured by examining only motor scores. (JINS, 2017, 23, 159-170).
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Vaccarino AL, Evans KR, Kalali AH, Kennedy SH, Engelhardt N, Frey BN, Greist JH, Kobak KA, Lam RW, MacQueen G, Milev R, Placenza FM, Ravindran AV, Sheehan DV, Sills T, Williams JBW. The Depression Inventory Development Workgroup: A Collaborative, Empirically Driven Initiative to Develop a New Assessment Tool for Major Depressive Disorder. INNOVATIONS IN CLINICAL NEUROSCIENCE 2016; 13:20-31. [PMID: 27974997 PMCID: PMC5141593] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
The Depression Inventory Development project is an initiative of the International Society for CNS Drug Development whose goal is to develop a comprehensive and psychometrically sound measurement tool to be utilized as a primary endpoint in clinical trials for major depressive disorder. Using an iterative process between field testing and psychometric analysis and drawing upon expertise of international researchers in depression, the Depression Inventory Development team has established an empirically driven and collaborative protocol for the creation of items to assess symptoms in major depressive disorder. Depression-relevant symptom clusters were identified based on expert clinical and patient input. In addition, as an aid for symptom identification and item construction, the psychometric properties of existing clinical scales (assessing depression and related indications) were evaluated using blinded datasets from pharmaceutical antidepressant drug trials. A series of field tests in patients with major depressive disorder provided the team with data to inform the iterative process of scale development. We report here an overview of the Depression Inventory Development initiative, including results of the third iteration of items assessing symptoms related to anhedonia, cognition, fatigue, general malaise, motivation, anxiety, negative thinking, pain and appetite. The strategies adopted from the Depression Inventory Development program, as an empirically driven and collaborative process for scale development, have provided the foundation to develop and validate measurement tools in other therapeutic areas as well.
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Affiliation(s)
- Anthony L Vaccarino
- Dr. Vaccarino is with Indoc Research, Toronto, Ontario, Canada; Dr. Evans is with Indoc Research, Toronto, Ontario, Canada, and Department of Pathology and Molecular Medicine, Queen's University, Kingston, Ontario, Canada; Dr. Kalali is with Quintiles Inc, San Diego, California, USA, and Department of Psychiatry, University of California, San Diego, California, USA; Drs. Kennedy and Placenza are with University Health Network, Toronto, Ontario, Canada; Dr. Engelhardt is with Cronos Clinical Consulting Services, Lambertville, New Jersey, USA; Dr. Frey is with Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada, and Mood Disorders Program and Women's Health Concerns Clinic, St. Joseph's Healthcare, Hamilton, Ontario, Canada; Dr. Greist is with Department of Psychiatry, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA; Dr. Kobak is with Center for Telepsychology, Madison, Wisconsin, USA; Dr. Lam is with Department of Psychiatry, University of British Columbia, Vancouver, British Columbia, Canada; Dr. MacQueen is with Mathison Centre for Mental Health Research and Education, Department of Psychiatry, University of Calgary, Calgary, Alberta, Canada; Dr. Milev is with Department of Psychiatry, Queen's University, Kingston, Ontario, Canada; Dr. Ravindran is with Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada, and Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Dr. Sheehan is with Department of Psychiatry and Behavioral Health, University of South Florida College of Medicine, Tampa, Florida, USA; Dr. Sills was with OCBN, Toronto, Ontario, Canada; Dr. Williams is with Columbia University, New York, New York, USA, and Medavante Inc., Trenton, New Jersey, USA
| | - Kenneth R Evans
- Dr. Vaccarino is with Indoc Research, Toronto, Ontario, Canada; Dr. Evans is with Indoc Research, Toronto, Ontario, Canada, and Department of Pathology and Molecular Medicine, Queen's University, Kingston, Ontario, Canada; Dr. Kalali is with Quintiles Inc, San Diego, California, USA, and Department of Psychiatry, University of California, San Diego, California, USA; Drs. Kennedy and Placenza are with University Health Network, Toronto, Ontario, Canada; Dr. Engelhardt is with Cronos Clinical Consulting Services, Lambertville, New Jersey, USA; Dr. Frey is with Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada, and Mood Disorders Program and Women's Health Concerns Clinic, St. Joseph's Healthcare, Hamilton, Ontario, Canada; Dr. Greist is with Department of Psychiatry, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA; Dr. Kobak is with Center for Telepsychology, Madison, Wisconsin, USA; Dr. Lam is with Department of Psychiatry, University of British Columbia, Vancouver, British Columbia, Canada; Dr. MacQueen is with Mathison Centre for Mental Health Research and Education, Department of Psychiatry, University of Calgary, Calgary, Alberta, Canada; Dr. Milev is with Department of Psychiatry, Queen's University, Kingston, Ontario, Canada; Dr. Ravindran is with Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada, and Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Dr. Sheehan is with Department of Psychiatry and Behavioral Health, University of South Florida College of Medicine, Tampa, Florida, USA; Dr. Sills was with OCBN, Toronto, Ontario, Canada; Dr. Williams is with Columbia University, New York, New York, USA, and Medavante Inc., Trenton, New Jersey, USA
| | - Amir H Kalali
- Dr. Vaccarino is with Indoc Research, Toronto, Ontario, Canada; Dr. Evans is with Indoc Research, Toronto, Ontario, Canada, and Department of Pathology and Molecular Medicine, Queen's University, Kingston, Ontario, Canada; Dr. Kalali is with Quintiles Inc, San Diego, California, USA, and Department of Psychiatry, University of California, San Diego, California, USA; Drs. Kennedy and Placenza are with University Health Network, Toronto, Ontario, Canada; Dr. Engelhardt is with Cronos Clinical Consulting Services, Lambertville, New Jersey, USA; Dr. Frey is with Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada, and Mood Disorders Program and Women's Health Concerns Clinic, St. Joseph's Healthcare, Hamilton, Ontario, Canada; Dr. Greist is with Department of Psychiatry, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA; Dr. Kobak is with Center for Telepsychology, Madison, Wisconsin, USA; Dr. Lam is with Department of Psychiatry, University of British Columbia, Vancouver, British Columbia, Canada; Dr. MacQueen is with Mathison Centre for Mental Health Research and Education, Department of Psychiatry, University of Calgary, Calgary, Alberta, Canada; Dr. Milev is with Department of Psychiatry, Queen's University, Kingston, Ontario, Canada; Dr. Ravindran is with Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada, and Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Dr. Sheehan is with Department of Psychiatry and Behavioral Health, University of South Florida College of Medicine, Tampa, Florida, USA; Dr. Sills was with OCBN, Toronto, Ontario, Canada; Dr. Williams is with Columbia University, New York, New York, USA, and Medavante Inc., Trenton, New Jersey, USA
| | - Sidney H Kennedy
- Dr. Vaccarino is with Indoc Research, Toronto, Ontario, Canada; Dr. Evans is with Indoc Research, Toronto, Ontario, Canada, and Department of Pathology and Molecular Medicine, Queen's University, Kingston, Ontario, Canada; Dr. Kalali is with Quintiles Inc, San Diego, California, USA, and Department of Psychiatry, University of California, San Diego, California, USA; Drs. Kennedy and Placenza are with University Health Network, Toronto, Ontario, Canada; Dr. Engelhardt is with Cronos Clinical Consulting Services, Lambertville, New Jersey, USA; Dr. Frey is with Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada, and Mood Disorders Program and Women's Health Concerns Clinic, St. Joseph's Healthcare, Hamilton, Ontario, Canada; Dr. Greist is with Department of Psychiatry, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA; Dr. Kobak is with Center for Telepsychology, Madison, Wisconsin, USA; Dr. Lam is with Department of Psychiatry, University of British Columbia, Vancouver, British Columbia, Canada; Dr. MacQueen is with Mathison Centre for Mental Health Research and Education, Department of Psychiatry, University of Calgary, Calgary, Alberta, Canada; Dr. Milev is with Department of Psychiatry, Queen's University, Kingston, Ontario, Canada; Dr. Ravindran is with Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada, and Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Dr. Sheehan is with Department of Psychiatry and Behavioral Health, University of South Florida College of Medicine, Tampa, Florida, USA; Dr. Sills was with OCBN, Toronto, Ontario, Canada; Dr. Williams is with Columbia University, New York, New York, USA, and Medavante Inc., Trenton, New Jersey, USA
| | - Nina Engelhardt
- Dr. Vaccarino is with Indoc Research, Toronto, Ontario, Canada; Dr. Evans is with Indoc Research, Toronto, Ontario, Canada, and Department of Pathology and Molecular Medicine, Queen's University, Kingston, Ontario, Canada; Dr. Kalali is with Quintiles Inc, San Diego, California, USA, and Department of Psychiatry, University of California, San Diego, California, USA; Drs. Kennedy and Placenza are with University Health Network, Toronto, Ontario, Canada; Dr. Engelhardt is with Cronos Clinical Consulting Services, Lambertville, New Jersey, USA; Dr. Frey is with Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada, and Mood Disorders Program and Women's Health Concerns Clinic, St. Joseph's Healthcare, Hamilton, Ontario, Canada; Dr. Greist is with Department of Psychiatry, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA; Dr. Kobak is with Center for Telepsychology, Madison, Wisconsin, USA; Dr. Lam is with Department of Psychiatry, University of British Columbia, Vancouver, British Columbia, Canada; Dr. MacQueen is with Mathison Centre for Mental Health Research and Education, Department of Psychiatry, University of Calgary, Calgary, Alberta, Canada; Dr. Milev is with Department of Psychiatry, Queen's University, Kingston, Ontario, Canada; Dr. Ravindran is with Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada, and Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Dr. Sheehan is with Department of Psychiatry and Behavioral Health, University of South Florida College of Medicine, Tampa, Florida, USA; Dr. Sills was with OCBN, Toronto, Ontario, Canada; Dr. Williams is with Columbia University, New York, New York, USA, and Medavante Inc., Trenton, New Jersey, USA
| | - Benicio N Frey
- Dr. Vaccarino is with Indoc Research, Toronto, Ontario, Canada; Dr. Evans is with Indoc Research, Toronto, Ontario, Canada, and Department of Pathology and Molecular Medicine, Queen's University, Kingston, Ontario, Canada; Dr. Kalali is with Quintiles Inc, San Diego, California, USA, and Department of Psychiatry, University of California, San Diego, California, USA; Drs. Kennedy and Placenza are with University Health Network, Toronto, Ontario, Canada; Dr. Engelhardt is with Cronos Clinical Consulting Services, Lambertville, New Jersey, USA; Dr. Frey is with Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada, and Mood Disorders Program and Women's Health Concerns Clinic, St. Joseph's Healthcare, Hamilton, Ontario, Canada; Dr. Greist is with Department of Psychiatry, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA; Dr. Kobak is with Center for Telepsychology, Madison, Wisconsin, USA; Dr. Lam is with Department of Psychiatry, University of British Columbia, Vancouver, British Columbia, Canada; Dr. MacQueen is with Mathison Centre for Mental Health Research and Education, Department of Psychiatry, University of Calgary, Calgary, Alberta, Canada; Dr. Milev is with Department of Psychiatry, Queen's University, Kingston, Ontario, Canada; Dr. Ravindran is with Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada, and Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Dr. Sheehan is with Department of Psychiatry and Behavioral Health, University of South Florida College of Medicine, Tampa, Florida, USA; Dr. Sills was with OCBN, Toronto, Ontario, Canada; Dr. Williams is with Columbia University, New York, New York, USA, and Medavante Inc., Trenton, New Jersey, USA
| | - John H Greist
- Dr. Vaccarino is with Indoc Research, Toronto, Ontario, Canada; Dr. Evans is with Indoc Research, Toronto, Ontario, Canada, and Department of Pathology and Molecular Medicine, Queen's University, Kingston, Ontario, Canada; Dr. Kalali is with Quintiles Inc, San Diego, California, USA, and Department of Psychiatry, University of California, San Diego, California, USA; Drs. Kennedy and Placenza are with University Health Network, Toronto, Ontario, Canada; Dr. Engelhardt is with Cronos Clinical Consulting Services, Lambertville, New Jersey, USA; Dr. Frey is with Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada, and Mood Disorders Program and Women's Health Concerns Clinic, St. Joseph's Healthcare, Hamilton, Ontario, Canada; Dr. Greist is with Department of Psychiatry, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA; Dr. Kobak is with Center for Telepsychology, Madison, Wisconsin, USA; Dr. Lam is with Department of Psychiatry, University of British Columbia, Vancouver, British Columbia, Canada; Dr. MacQueen is with Mathison Centre for Mental Health Research and Education, Department of Psychiatry, University of Calgary, Calgary, Alberta, Canada; Dr. Milev is with Department of Psychiatry, Queen's University, Kingston, Ontario, Canada; Dr. Ravindran is with Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada, and Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Dr. Sheehan is with Department of Psychiatry and Behavioral Health, University of South Florida College of Medicine, Tampa, Florida, USA; Dr. Sills was with OCBN, Toronto, Ontario, Canada; Dr. Williams is with Columbia University, New York, New York, USA, and Medavante Inc., Trenton, New Jersey, USA
| | - Kenneth A Kobak
- Dr. Vaccarino is with Indoc Research, Toronto, Ontario, Canada; Dr. Evans is with Indoc Research, Toronto, Ontario, Canada, and Department of Pathology and Molecular Medicine, Queen's University, Kingston, Ontario, Canada; Dr. Kalali is with Quintiles Inc, San Diego, California, USA, and Department of Psychiatry, University of California, San Diego, California, USA; Drs. Kennedy and Placenza are with University Health Network, Toronto, Ontario, Canada; Dr. Engelhardt is with Cronos Clinical Consulting Services, Lambertville, New Jersey, USA; Dr. Frey is with Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada, and Mood Disorders Program and Women's Health Concerns Clinic, St. Joseph's Healthcare, Hamilton, Ontario, Canada; Dr. Greist is with Department of Psychiatry, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA; Dr. Kobak is with Center for Telepsychology, Madison, Wisconsin, USA; Dr. Lam is with Department of Psychiatry, University of British Columbia, Vancouver, British Columbia, Canada; Dr. MacQueen is with Mathison Centre for Mental Health Research and Education, Department of Psychiatry, University of Calgary, Calgary, Alberta, Canada; Dr. Milev is with Department of Psychiatry, Queen's University, Kingston, Ontario, Canada; Dr. Ravindran is with Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada, and Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Dr. Sheehan is with Department of Psychiatry and Behavioral Health, University of South Florida College of Medicine, Tampa, Florida, USA; Dr. Sills was with OCBN, Toronto, Ontario, Canada; Dr. Williams is with Columbia University, New York, New York, USA, and Medavante Inc., Trenton, New Jersey, USA
| | - Raymond W Lam
- Dr. Vaccarino is with Indoc Research, Toronto, Ontario, Canada; Dr. Evans is with Indoc Research, Toronto, Ontario, Canada, and Department of Pathology and Molecular Medicine, Queen's University, Kingston, Ontario, Canada; Dr. Kalali is with Quintiles Inc, San Diego, California, USA, and Department of Psychiatry, University of California, San Diego, California, USA; Drs. Kennedy and Placenza are with University Health Network, Toronto, Ontario, Canada; Dr. Engelhardt is with Cronos Clinical Consulting Services, Lambertville, New Jersey, USA; Dr. Frey is with Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada, and Mood Disorders Program and Women's Health Concerns Clinic, St. Joseph's Healthcare, Hamilton, Ontario, Canada; Dr. Greist is with Department of Psychiatry, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA; Dr. Kobak is with Center for Telepsychology, Madison, Wisconsin, USA; Dr. Lam is with Department of Psychiatry, University of British Columbia, Vancouver, British Columbia, Canada; Dr. MacQueen is with Mathison Centre for Mental Health Research and Education, Department of Psychiatry, University of Calgary, Calgary, Alberta, Canada; Dr. Milev is with Department of Psychiatry, Queen's University, Kingston, Ontario, Canada; Dr. Ravindran is with Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada, and Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Dr. Sheehan is with Department of Psychiatry and Behavioral Health, University of South Florida College of Medicine, Tampa, Florida, USA; Dr. Sills was with OCBN, Toronto, Ontario, Canada; Dr. Williams is with Columbia University, New York, New York, USA, and Medavante Inc., Trenton, New Jersey, USA
| | - Glenda MacQueen
- Dr. Vaccarino is with Indoc Research, Toronto, Ontario, Canada; Dr. Evans is with Indoc Research, Toronto, Ontario, Canada, and Department of Pathology and Molecular Medicine, Queen's University, Kingston, Ontario, Canada; Dr. Kalali is with Quintiles Inc, San Diego, California, USA, and Department of Psychiatry, University of California, San Diego, California, USA; Drs. Kennedy and Placenza are with University Health Network, Toronto, Ontario, Canada; Dr. Engelhardt is with Cronos Clinical Consulting Services, Lambertville, New Jersey, USA; Dr. Frey is with Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada, and Mood Disorders Program and Women's Health Concerns Clinic, St. Joseph's Healthcare, Hamilton, Ontario, Canada; Dr. Greist is with Department of Psychiatry, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA; Dr. Kobak is with Center for Telepsychology, Madison, Wisconsin, USA; Dr. Lam is with Department of Psychiatry, University of British Columbia, Vancouver, British Columbia, Canada; Dr. MacQueen is with Mathison Centre for Mental Health Research and Education, Department of Psychiatry, University of Calgary, Calgary, Alberta, Canada; Dr. Milev is with Department of Psychiatry, Queen's University, Kingston, Ontario, Canada; Dr. Ravindran is with Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada, and Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Dr. Sheehan is with Department of Psychiatry and Behavioral Health, University of South Florida College of Medicine, Tampa, Florida, USA; Dr. Sills was with OCBN, Toronto, Ontario, Canada; Dr. Williams is with Columbia University, New York, New York, USA, and Medavante Inc., Trenton, New Jersey, USA
| | - Roumen Milev
- Dr. Vaccarino is with Indoc Research, Toronto, Ontario, Canada; Dr. Evans is with Indoc Research, Toronto, Ontario, Canada, and Department of Pathology and Molecular Medicine, Queen's University, Kingston, Ontario, Canada; Dr. Kalali is with Quintiles Inc, San Diego, California, USA, and Department of Psychiatry, University of California, San Diego, California, USA; Drs. Kennedy and Placenza are with University Health Network, Toronto, Ontario, Canada; Dr. Engelhardt is with Cronos Clinical Consulting Services, Lambertville, New Jersey, USA; Dr. Frey is with Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada, and Mood Disorders Program and Women's Health Concerns Clinic, St. Joseph's Healthcare, Hamilton, Ontario, Canada; Dr. Greist is with Department of Psychiatry, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA; Dr. Kobak is with Center for Telepsychology, Madison, Wisconsin, USA; Dr. Lam is with Department of Psychiatry, University of British Columbia, Vancouver, British Columbia, Canada; Dr. MacQueen is with Mathison Centre for Mental Health Research and Education, Department of Psychiatry, University of Calgary, Calgary, Alberta, Canada; Dr. Milev is with Department of Psychiatry, Queen's University, Kingston, Ontario, Canada; Dr. Ravindran is with Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada, and Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Dr. Sheehan is with Department of Psychiatry and Behavioral Health, University of South Florida College of Medicine, Tampa, Florida, USA; Dr. Sills was with OCBN, Toronto, Ontario, Canada; Dr. Williams is with Columbia University, New York, New York, USA, and Medavante Inc., Trenton, New Jersey, USA
| | - Franca M Placenza
- Dr. Vaccarino is with Indoc Research, Toronto, Ontario, Canada; Dr. Evans is with Indoc Research, Toronto, Ontario, Canada, and Department of Pathology and Molecular Medicine, Queen's University, Kingston, Ontario, Canada; Dr. Kalali is with Quintiles Inc, San Diego, California, USA, and Department of Psychiatry, University of California, San Diego, California, USA; Drs. Kennedy and Placenza are with University Health Network, Toronto, Ontario, Canada; Dr. Engelhardt is with Cronos Clinical Consulting Services, Lambertville, New Jersey, USA; Dr. Frey is with Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada, and Mood Disorders Program and Women's Health Concerns Clinic, St. Joseph's Healthcare, Hamilton, Ontario, Canada; Dr. Greist is with Department of Psychiatry, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA; Dr. Kobak is with Center for Telepsychology, Madison, Wisconsin, USA; Dr. Lam is with Department of Psychiatry, University of British Columbia, Vancouver, British Columbia, Canada; Dr. MacQueen is with Mathison Centre for Mental Health Research and Education, Department of Psychiatry, University of Calgary, Calgary, Alberta, Canada; Dr. Milev is with Department of Psychiatry, Queen's University, Kingston, Ontario, Canada; Dr. Ravindran is with Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada, and Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Dr. Sheehan is with Department of Psychiatry and Behavioral Health, University of South Florida College of Medicine, Tampa, Florida, USA; Dr. Sills was with OCBN, Toronto, Ontario, Canada; Dr. Williams is with Columbia University, New York, New York, USA, and Medavante Inc., Trenton, New Jersey, USA
| | - Arun V Ravindran
- Dr. Vaccarino is with Indoc Research, Toronto, Ontario, Canada; Dr. Evans is with Indoc Research, Toronto, Ontario, Canada, and Department of Pathology and Molecular Medicine, Queen's University, Kingston, Ontario, Canada; Dr. Kalali is with Quintiles Inc, San Diego, California, USA, and Department of Psychiatry, University of California, San Diego, California, USA; Drs. Kennedy and Placenza are with University Health Network, Toronto, Ontario, Canada; Dr. Engelhardt is with Cronos Clinical Consulting Services, Lambertville, New Jersey, USA; Dr. Frey is with Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada, and Mood Disorders Program and Women's Health Concerns Clinic, St. Joseph's Healthcare, Hamilton, Ontario, Canada; Dr. Greist is with Department of Psychiatry, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA; Dr. Kobak is with Center for Telepsychology, Madison, Wisconsin, USA; Dr. Lam is with Department of Psychiatry, University of British Columbia, Vancouver, British Columbia, Canada; Dr. MacQueen is with Mathison Centre for Mental Health Research and Education, Department of Psychiatry, University of Calgary, Calgary, Alberta, Canada; Dr. Milev is with Department of Psychiatry, Queen's University, Kingston, Ontario, Canada; Dr. Ravindran is with Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada, and Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Dr. Sheehan is with Department of Psychiatry and Behavioral Health, University of South Florida College of Medicine, Tampa, Florida, USA; Dr. Sills was with OCBN, Toronto, Ontario, Canada; Dr. Williams is with Columbia University, New York, New York, USA, and Medavante Inc., Trenton, New Jersey, USA
| | - David V Sheehan
- Dr. Vaccarino is with Indoc Research, Toronto, Ontario, Canada; Dr. Evans is with Indoc Research, Toronto, Ontario, Canada, and Department of Pathology and Molecular Medicine, Queen's University, Kingston, Ontario, Canada; Dr. Kalali is with Quintiles Inc, San Diego, California, USA, and Department of Psychiatry, University of California, San Diego, California, USA; Drs. Kennedy and Placenza are with University Health Network, Toronto, Ontario, Canada; Dr. Engelhardt is with Cronos Clinical Consulting Services, Lambertville, New Jersey, USA; Dr. Frey is with Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada, and Mood Disorders Program and Women's Health Concerns Clinic, St. Joseph's Healthcare, Hamilton, Ontario, Canada; Dr. Greist is with Department of Psychiatry, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA; Dr. Kobak is with Center for Telepsychology, Madison, Wisconsin, USA; Dr. Lam is with Department of Psychiatry, University of British Columbia, Vancouver, British Columbia, Canada; Dr. MacQueen is with Mathison Centre for Mental Health Research and Education, Department of Psychiatry, University of Calgary, Calgary, Alberta, Canada; Dr. Milev is with Department of Psychiatry, Queen's University, Kingston, Ontario, Canada; Dr. Ravindran is with Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada, and Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Dr. Sheehan is with Department of Psychiatry and Behavioral Health, University of South Florida College of Medicine, Tampa, Florida, USA; Dr. Sills was with OCBN, Toronto, Ontario, Canada; Dr. Williams is with Columbia University, New York, New York, USA, and Medavante Inc., Trenton, New Jersey, USA
| | - Terrence Sills
- Dr. Vaccarino is with Indoc Research, Toronto, Ontario, Canada; Dr. Evans is with Indoc Research, Toronto, Ontario, Canada, and Department of Pathology and Molecular Medicine, Queen's University, Kingston, Ontario, Canada; Dr. Kalali is with Quintiles Inc, San Diego, California, USA, and Department of Psychiatry, University of California, San Diego, California, USA; Drs. Kennedy and Placenza are with University Health Network, Toronto, Ontario, Canada; Dr. Engelhardt is with Cronos Clinical Consulting Services, Lambertville, New Jersey, USA; Dr. Frey is with Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada, and Mood Disorders Program and Women's Health Concerns Clinic, St. Joseph's Healthcare, Hamilton, Ontario, Canada; Dr. Greist is with Department of Psychiatry, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA; Dr. Kobak is with Center for Telepsychology, Madison, Wisconsin, USA; Dr. Lam is with Department of Psychiatry, University of British Columbia, Vancouver, British Columbia, Canada; Dr. MacQueen is with Mathison Centre for Mental Health Research and Education, Department of Psychiatry, University of Calgary, Calgary, Alberta, Canada; Dr. Milev is with Department of Psychiatry, Queen's University, Kingston, Ontario, Canada; Dr. Ravindran is with Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada, and Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Dr. Sheehan is with Department of Psychiatry and Behavioral Health, University of South Florida College of Medicine, Tampa, Florida, USA; Dr. Sills was with OCBN, Toronto, Ontario, Canada; Dr. Williams is with Columbia University, New York, New York, USA, and Medavante Inc., Trenton, New Jersey, USA
| | - Janet B W Williams
- Dr. Vaccarino is with Indoc Research, Toronto, Ontario, Canada; Dr. Evans is with Indoc Research, Toronto, Ontario, Canada, and Department of Pathology and Molecular Medicine, Queen's University, Kingston, Ontario, Canada; Dr. Kalali is with Quintiles Inc, San Diego, California, USA, and Department of Psychiatry, University of California, San Diego, California, USA; Drs. Kennedy and Placenza are with University Health Network, Toronto, Ontario, Canada; Dr. Engelhardt is with Cronos Clinical Consulting Services, Lambertville, New Jersey, USA; Dr. Frey is with Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada, and Mood Disorders Program and Women's Health Concerns Clinic, St. Joseph's Healthcare, Hamilton, Ontario, Canada; Dr. Greist is with Department of Psychiatry, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA; Dr. Kobak is with Center for Telepsychology, Madison, Wisconsin, USA; Dr. Lam is with Department of Psychiatry, University of British Columbia, Vancouver, British Columbia, Canada; Dr. MacQueen is with Mathison Centre for Mental Health Research and Education, Department of Psychiatry, University of Calgary, Calgary, Alberta, Canada; Dr. Milev is with Department of Psychiatry, Queen's University, Kingston, Ontario, Canada; Dr. Ravindran is with Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada, and Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Dr. Sheehan is with Department of Psychiatry and Behavioral Health, University of South Florida College of Medicine, Tampa, Florida, USA; Dr. Sills was with OCBN, Toronto, Ontario, Canada; Dr. Williams is with Columbia University, New York, New York, USA, and Medavante Inc., Trenton, New Jersey, USA
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Bayram-Weston Z, Stone TC, Giles P, Elliston L, Janghra N, Higgs GV, Holmans PA, Dunnett SB, Brooks SP, Jones L. Similar striatal gene expression profiles in the striatum of the YAC128 and HdhQ150 mouse models of Huntington's disease are not reflected in mutant Huntingtin inclusion prevalence. BMC Genomics 2015; 16:1079. [PMID: 26691352 PMCID: PMC4687121 DOI: 10.1186/s12864-015-2251-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2015] [Accepted: 11/27/2015] [Indexed: 11/24/2022] Open
Abstract
Background The YAC128 model of Huntington’s disease (HD) shows substantial deficits in motor, learning and memory tasks and alterations in its transcriptional profile. We examined the changes in the transcriptional profile in the YAC128 mouse model of HD at 6, 12 and 18 months and compared these with those seen in other models and human HD caudate. Results Differential gene expression by genotype showed that genes related to neuronal function, projection outgrowth and cell adhesion were altered in expression. A Time-course ANOVA revealed that genes downregulated with increased age in wild-type striata were likely to be downregulated in the YAC128 striata. There was a substantial overlap of concordant gene expression changes in the YAC128 striata compared with those in human HD brain. Changes in gene expression over time showed fewer striatal YAC128 RNAs altered in abundance than in the HdhQ150 striata but there was a very marked overlap in transcriptional changes at all time points. Despite the similarities in striatal expression changes at 18 months the HdhQ150 mice showed widespread mHTT and ubiquitin positive inclusion staining in the striatum whereas this was absent in the YAC128 striatum. Conclusions The gene expression changes in YAC128 striata show a very closely matched profile to that of HdhQ150 striata and are already significantly different between genotypes by six months of age, implying that the temporal molecular gene expression profiles of these models match very closely, despite differences in the prevalence of brain inclusion formation between the models. The YAC128 gene expression changes appear to correlate well with gene expression differences caused by ageing. A relatively small number of genes showed significant differences in expression between the striata of the two models and these could explain some of the phenotypic differences between the models. Electronic supplementary material The online version of this article (doi:10.1186/s12864-015-2251-4) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Zubeyde Bayram-Weston
- Brain Research Group, School of Bioscience, Cardiff University, Cardiff, CF10 4AX, UK.
| | - Timothy C Stone
- MRC Centre for Neuropsychiatric Genetics and Genomics, School of Medicine, Cardiff University, Cardiff, CF24 4HQ, UK.
| | - Peter Giles
- MRC Centre for Neuropsychiatric Genetics and Genomics, School of Medicine, Cardiff University, Cardiff, CF24 4HQ, UK.
| | - Linda Elliston
- MRC Centre for Neuropsychiatric Genetics and Genomics, School of Medicine, Cardiff University, Cardiff, CF24 4HQ, UK.
| | - Nari Janghra
- Brain Research Group, School of Bioscience, Cardiff University, Cardiff, CF10 4AX, UK.
| | - Gemma V Higgs
- Brain Research Group, School of Bioscience, Cardiff University, Cardiff, CF10 4AX, UK.
| | - Peter A Holmans
- MRC Centre for Neuropsychiatric Genetics and Genomics, School of Medicine, Cardiff University, Cardiff, CF24 4HQ, UK.
| | - Stephen B Dunnett
- Brain Research Group, School of Bioscience, Cardiff University, Cardiff, CF10 4AX, UK.
| | - Simon P Brooks
- Brain Research Group, School of Bioscience, Cardiff University, Cardiff, CF10 4AX, UK.
| | - Lesley Jones
- MRC Centre for Neuropsychiatric Genetics and Genomics, School of Medicine, Cardiff University, Cardiff, CF24 4HQ, UK.
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Abstract
In this review, we explore the similarities and differences in the behavioural neurobiology found in the mouse models of Huntington's disease (HD) and the human disease state. The review is organised with a comparative focus on the functional domains of motor control, cognition and behavioural disturbance (akin to psychiatric disturbance in people) and how our knowledge of the underlying physiological changes that are manifest in the HD mouse lines correspond to those seen in the HD clinical population. The review is framed in terms of functional circuitry and neurotransmitter systems and how abnormalities in these systems impact on the behavioural readouts across the mouse lines and how these may correspond to the deficits observed in people. In addition, interpretational issues associated with the data from animal studies are discussed.
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Affiliation(s)
- Simon P Brooks
- Brain Repair Group, Division of Neuroscience, Cardiff University School of Bioscience, Museum Avenue, Cardiff, Wales, UK,
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Kuljis D, Schroeder AM, Kudo T, Loh DH, Willison DL, Colwell CS. Sleep and circadian dysfunction in neurodegenerative disorders: insights from a mouse model of Huntington's disease. MINERVA PNEUMOLOGICA 2012; 51:93-106. [PMID: 23687390 PMCID: PMC3655901] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Sleep disorders are common in patients with neurogenerative diseases and manifest early in the disease process. Among a number of possible mechanisms underlying the sleep disturbances, there is evidence that dysfunction in the circadian system is a contributing factor. Focusing on a mouse model of Huntington's disease has enabled us to determine that at the onset of symptoms, spontaneous electrical activity of neurons within the central clock is disrupted even though the molecular clockwork is still functional. These findings suggest that the fundamental deficit contributing to disordered sleep is reduced SCN output. The mechanism underlying this deficit is not yet known, but mitochondrial dysfunction and oxidative stress are likely involved. Disruption of circadian output from the SCN would be expected to have wide ranging impact on the body including SCN regulated brain regions and the heart. In fact, there is a great deal of overlap in the non-motor symptoms experienced by HD patients and the consequences of circadian disruption. This raises the possibility that the disordered sleep and circadian function experienced by HD patients may be an integral part of the disease. Furthermore, we speculate that circadian dysfunction may accelerate the pathology underlying HD. If these hypotheses are correct, we should focus on treating circadian misalignment and sleep disruptions early in disease progression.
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Affiliation(s)
- Dika Kuljis
- Laboratory of Circadian and Sleep Medicine, Department of Psychiatry and Biobehavioral Sciences, University of California Los Angeles, Los Angeles, CA 90024, United States
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10
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Effect of enhanced voluntary physical exercise on brain levels of monoamines in Huntington disease mice. PLOS CURRENTS 2011; 3:RRN1281. [PMID: 22266953 PMCID: PMC3208413 DOI: 10.1371/currents.rrn1281] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 11/04/2011] [Indexed: 01/15/2023]
Abstract
Using the R6/1 mouse model of Huntington disease (HD), we have recently shown that voluntary physical activity was able to correct the depressive-like behaviours exhibited by the HD animals at a pre-motor symptomatic stage of the disease. Using the high performance liquid chromatography system, we have now evaluated the effect of exercise on monoamine metabolism in HD mice. We found that serotonin and its metabolite as well as dopamine and noradrenaline were reduced across several brain regions in female R6/1 animals. Our data also suggest that some of these neurochemical deficits were modulated by physical activity, in a genotype-region dependent manner. These newly identified changes could account for some of the behavioural effects of exercise previously reported in HD mice.
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11
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Abstract
Cognition has been well characterized in the various stages of Huntington disease (HD) as well as in the prodrome before the motor diagnosis is given. Although the clinical diagnosis of HD relies on the manifestation of motor abnormalities, the associated impairments have been growing in prominence for several reasons. First, research to understand the most debilitating aspects of HD has suggested that cognitive and behavioral changes place the greatest burden on families, are most highly associated with functional decline, and can be predictive of institutionalization. Second, cognitive impairments are evident at least 15 years prior to the time at which motor diagnosis is given. Finally, cognitive decline is associated with biological markers such as brain atrophy, circulating levels of brain-derived neurotrophic factors, and insulin-like growth factor 1. Efforts are now underway to develop valid and reliable measures of cognition in the prodrome as well as in all stages of HD so that clinical trials can be conducted using cognitive outcomes.
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Affiliation(s)
- Jane S Paulsen
- Departments of Psychiatry, Neurology, Neurosciences, and Psychology, The University of Iowa Roy J. and Lucille A. Carver College of Medicine, Research, Iowa City, IA, 52242-1000, USA.
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12
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Vaccarino AL, Sills T, Anderson KE, Endicott J, Giuliano J, Guttman M, Ho AK, Kupchak P, Paulsen JS, Warner JH, Williams J, Evans K. Assessment of Day-to-Day Functioning in Prodromal and Early Huntington Disease. PLOS CURRENTS 2011; 3:RRN1262. [PMID: 21927718 PMCID: PMC3172089 DOI: 10.1371/currents.rrn1262] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 09/13/2011] [Indexed: 11/30/2022]
Abstract
The Functional Rating Scale Taskforce for pre-Huntington Disease (FuRST-pHD) is a multinational, multidisciplinary initiative with the goal of developing a data-driven, comprehensive, psychometrically sound, rating scale for assessing symptoms and functional ability in prodromal and early Huntington disease (HD) gene expansion carriers. The process involves input from numerous sources to identify relevant symptom domains, including HD individuals, caregivers, and experts from a variety of fields, as well as knowledge gained from the analysis of data from ongoing large-scale studies in HD using existing clinical scales. This is an iterative process in which an ongoing series of field tests in prodromal (prHD) and early HD individuals provides the team with data on which to make decisions regarding which questions should undergo further development or testing and which should be excluded. We report here the development and assessment of the first iteration of interview questions aimed to assess functional impact in day-to-day activities in prHD and early HD individuals.
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Affiliation(s)
- Anthony L Vaccarino
- Research Methods, Ontario Cancer Biomarker Network, Toronto, Ontario, Canada; Department of Psychiatry and Department of Neurology, University of Maryland, School of Medicine, Baltimore, MD USA; Department of Psychiatry, Columbia University College of Physicians and Surgeons, New York, New York; CHDI Foundation, Inc.; Division of Neurology, Department of Medicine, University of Toronto, Toronto, Ontario Canada; School of Psychology and Clinical Language Sciences, University of Reading, U.K.; Department of Psychiatry, The University of Iowa Carver College of Medicine, Iowa City, IA, USA; Department of Biostatistics, CHDI Foundation, Princeton NJ USA and College of Nursing, The University of Iowa, Iowa City, IA
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