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Widegren E, Frick MA, Hoppe JM, Weis J, Möller S, Fällmar D, Mårtensson J, Brocki K, Gingnell M, Frick A. The influence of anterior cingulate GABA+ and glutamate on emotion regulation and reactivity in adolescents and adults. Dev Psychobiol 2024; 66:e22492. [PMID: 38643360 DOI: 10.1002/dev.22492] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Revised: 03/05/2024] [Accepted: 04/07/2024] [Indexed: 04/22/2024]
Abstract
During adolescence, emotion regulation and reactivity are still developing and are in many ways qualitatively different from adulthood. However, the neurobiological processes underpinning these differences remain poorly understood, including the role of maturing neurotransmitter systems. We combined magnetic resonance spectroscopy in the dorsal anterior cingulate cortex (dACC) and self-reported emotion regulation and reactivity in a sample of typically developed adolescents (n = 37; 13-16 years) and adults (n = 39; 30-40 years), and found that adolescents had higher levels of glutamate to total creatine (tCr) ratio in the dACC than adults. A glutamate Í age group interaction indicated a differential relation between dACC glutamate levels and emotion regulation in adolescents and adults, and within-group follow-up analyses showed that higher levels of glutamate/tCr were related to worse emotion regulation skills in adolescents. We found no age-group differences in gamma-aminobutyric acid+macromolecules (GABA+) levels; however, emotion reactivity was positively related to GABA+/tCr in the adult group, but not in the adolescent group. The results demonstrate that there are developmental changes in the concentration of glutamate, but not GABA+, within the dACC from adolescence to adulthood, in accordance with previous findings indicating earlier maturation of the GABA-ergic than the glutamatergic system. Functionally, glutamate and GABA+ are positively related to emotion regulation and reactivity, respectively, in the mature brain. In the adolescent brain, however, glutamate is negatively related to emotion regulation, and GABA+ is not related to emotion reactivity. The findings are consistent with synaptic pruning of glutamatergic synapses from adolescence to adulthood and highlight the importance of brain maturational processes underlying age-related differences in emotion processing.
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Affiliation(s)
- Ebba Widegren
- Department of Medical Sciences, Psychiatry, Uppsala University, Uppsala, Sweden
| | - Matilda A Frick
- Department of Medical Sciences, Child and Adolescent Psychiatry, Uppsala University, Uppsala, Sweden
- Department of Psychology, Stockholm University, Stockholm, Sweden
| | - Johanna Motilla Hoppe
- Department of Medical Sciences, Psychiatry, Uppsala University, Uppsala, Sweden
- Department of Psychology, Uppsala University, Uppsala, Sweden
| | - Jan Weis
- Department of Medical Physics, Uppsala University Hospital, Uppsala, Sweden
| | - Stefan Möller
- Department of Psychology, Lund University, Lund, Sweden
| | - David Fällmar
- Department of Surgical Sciences, Neuroradiology, Uppsala University Hospital, Uppsala, Sweden
| | - Johanna Mårtensson
- Department of Medical Physics, Uppsala University Hospital, Uppsala, Sweden
| | - Karin Brocki
- Department of Psychology, Uppsala University, Uppsala, Sweden
| | - Malin Gingnell
- Department of Medical Sciences, Psychiatry, Uppsala University, Uppsala, Sweden
| | - Andreas Frick
- Department of Medical Sciences, Psychiatry, Uppsala University, Uppsala, Sweden
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Cervin M, Martí Valls C, Möller S, Frick A, Björkstrand J, Watson D. A Psychometric Evaluation of the Expanded Version of the Inventory of Depression and Anxiety Symptoms (IDAS-II) in Children and Adolescents. Assessment 2024; 31:588-601. [PMID: 37177831 PMCID: PMC10903129 DOI: 10.1177/10731911231170841] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/15/2023]
Abstract
The expanded version of the Inventory of Depression and Anxiety Symptoms (IDAS-II) is a self-report measure of 18 empirically derived internalizing symptom dimensions. The measure has shown good psychometric properties in adults but has never been evaluated in children and adolescents. A Swedish version of the IDAS-II was administered to 633 children and adolescents (Mage =16.6 [SD = 2.0]) and 203 adults (Mage = 35.4 [SD = 12.1]). The model/data fit of the 18-factor structure was excellent in both samples and measurement invariance across age groups was supported. All scales showed good to excellent internal consistency and psychometric properties replicated in the younger youth sample (< 16 years). Among youth, good convergent validity was established for all scales and divergent validity for most scales. The IDAS-II was better at identifying youth with current mental health problems than an internationally recommended scale of internalizing symptoms. In conclusion, the IDAS-II shows promise as a measure of internalizing symptoms in youth.
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Mascherpa M, Pegoire C, Meroni A, Minopoli M, Thilaganathan B, Frick A, Bhide A. Prenatal prediction of adverse outcome using different charts and definitions of fetal growth restriction. Ultrasound Obstet Gynecol 2023. [PMID: 38145554 DOI: 10.1002/uog.27568] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Revised: 12/03/2023] [Accepted: 12/09/2023] [Indexed: 12/27/2023]
Abstract
OBJECTIVE Fetal growth assessment by ultrasound aims to identify small babies that are at higher risk of perinatal morbidity and mortality. The current study explores if the association between suboptimal fetal growth and adverse perinatal outcome varies with different definitions of fetal growth restriction and weight charts/standards. METHODS This was a retrospective cohort study of 17261 singleton non-anomalous pregnancies from 24+0 weeks' gestation at a tertiary referral hospital. Estimated fetal weight (EFW) and Doppler indices were converted into gestational age specific centiles using a growth reference standard (Intergrowth-21) and various reference charts (Hadlock, Fetal Medicine Foundation [FMF] and Swedish). Test characteristics were assessed using definitions of FGR according to the International Society of Ultrasound in Obstetrics and Gynecology (ISUOG), Society of Maternal and Fetal Medicine (SMFM) and Swedish criteria. Adverse perinatal outcome was defined as perinatal death, admission to the neonatal intensive care (NICU) at term, 5' Apgar score < 7, and therapeutic cooling for neonatal encephalopathy. The association between FGR according to different definitions and adverse perinatal outcome was compared. Multivariate logistic regression was used to investigate the strength of the associations between ultrasound parameters and adverse perinatal outcome. Ultrasound parameters were also tested for correlation. RESULTS Intergrowth-21 (IG-21), Hadlock and FMF fetal size references classified 1.47%, 3.55% and 4.5% fetuses respectively as FGR using the ISUOG definition and 2.87%, 8.82% and 10.6% fetuses respectively using the SMFM definition. The sensitivity of each of the definition/chart combinations for adverse perinatal outcome varied from 4.4% (ISUOG definition with IG-21 charts) to 13.2% (SMFM definition with FMF charts). The concomitant specificity also varied from 89.4% (SMFM definition with FMF charts) to 98.6% (ISUOG definition with IG-21 charts). ISUOG and Swedish criteria showed the highest specificity, positive predictive value, and positive likelihood ratio in detecting adverse outcomes irrespective of which fetal size reference charts/standards were used. Conversely, the SMFM definition had the highest sensitivity across all investigated growth charts. Low estimated fetal weight, elevated uterine artery mean PI, abnormal umbilical artery PI and abnormal cerebro-placental ratio were all significantly associated with adverse perinatal outcome and there was positive correlation between the covariates. Multivariate logistic regression showed that uterine artery Doppler mean PI and smallness (EFW below the 5th centile) were the only parameters to be consistently associated with adverse outcome irrespective of definitions or fetal size growth charts used. CONCLUSIONS The prevalence of FGR is variable based on the specific definition as well as the fetal size reference chart used to diagnose FGR. Irrespective of the method of classification, the sensitivity for the identification of adverse perinatal outcome remains low. Estimated fetal weight, uterine artery and fetal Dopplers are all significant predictors of adverse perinatal outcome. As these indices are correlated to each other, a prediction algorithm is advocated to overcome the limitations of using them in isolation. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- M Mascherpa
- Fetal Medicine Unit, St George's University Hospitals NHS Foundation Trust, London, UK
- Department of Medicine and Surgery, Obstetrics and Gynaecology Unit, Università degli Studi di Brescia, Brescia, Italy
| | - C Pegoire
- Fetal Medicine Unit, St George's University Hospitals NHS Foundation Trust, London, UK
| | - A Meroni
- Fetal Medicine Unit, St George's University Hospitals NHS Foundation Trust, London, UK
- Department of Medicine and Surgery, Obstetrics and Gynaecology Unit, Università degli Studi di Pavia, Pavia, Italy
| | - M Minopoli
- Fetal Medicine Unit, St George's University Hospitals NHS Foundation Trust, London, UK
- Department of Medicine and Surgery, Obstetrics and Gynaecology Unit, Università degli Study di Parma, Parma, Italy
| | - B Thilaganathan
- Fetal Medicine Unit, St George's University Hospitals NHS Foundation Trust, London, UK
| | - A Frick
- Fetal Medicine Unit, St George's University Hospitals NHS Foundation Trust, London, UK
| | - A Bhide
- Fetal Medicine Unit, St George's University Hospitals NHS Foundation Trust, London, UK
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Bhaskaran AA, Gauvrit T, Vyas Y, Bony G, Ginger M, Frick A. Endogenous noise of neocortical neurons correlates with atypical sensory response variability in the Fmr1 -/y mouse model of autism. Nat Commun 2023; 14:7905. [PMID: 38036566 PMCID: PMC10689491 DOI: 10.1038/s41467-023-43777-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Accepted: 11/20/2023] [Indexed: 12/02/2023] Open
Abstract
Excessive neural variability of sensory responses is a hallmark of atypical sensory processing in autistic individuals with cascading effects on other core autism symptoms but unknown neurobiological substrate. Here, by recording neocortical single neuron activity in a well-established mouse model of Fragile X syndrome and autism, we characterized atypical sensory processing and probed the role of endogenous noise sources in exaggerated response variability in males. The analysis of sensory stimulus evoked activity and spontaneous dynamics, as well as neuronal features, reveals a complex cellular and network phenotype. Neocortical sensory information processing is more variable and temporally imprecise. Increased trial-by-trial and inter-neuronal response variability is strongly related to key endogenous noise features, and may give rise to behavioural sensory responsiveness variability in autism. We provide a novel preclinical framework for understanding the sources of endogenous noise and its contribution to core autism symptoms, and for testing the functional consequences for mechanism-based manipulation of noise.
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Affiliation(s)
- Arjun A Bhaskaran
- INSERM, U1215 Neurocentre Magendie, 33077, Bordeaux, France
- University of Bordeaux, 33000, Bordeaux, France
- Department of Psychiatry, Djavad Mowafaghian Centre for Brain Health, University of British Columbia, Vancouver, BC, Canada
| | - Théo Gauvrit
- INSERM, U1215 Neurocentre Magendie, 33077, Bordeaux, France
- University of Bordeaux, 33000, Bordeaux, France
| | - Yukti Vyas
- INSERM, U1215 Neurocentre Magendie, 33077, Bordeaux, France
- University of Bordeaux, 33000, Bordeaux, France
| | - Guillaume Bony
- INSERM, U1215 Neurocentre Magendie, 33077, Bordeaux, France
- University of Bordeaux, 33000, Bordeaux, France
| | - Melanie Ginger
- INSERM, U1215 Neurocentre Magendie, 33077, Bordeaux, France
- University of Bordeaux, 33000, Bordeaux, France
| | - Andreas Frick
- INSERM, U1215 Neurocentre Magendie, 33077, Bordeaux, France.
- University of Bordeaux, 33000, Bordeaux, France.
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Florén Lind S, Stam F, Zelleroth S, Frick A, Grönbladh A. Acute low dose caffeine affects behavior profile and activity, an examination of male rats with high or low anxiety-like behavior. Behav Brain Res 2023; 455:114678. [PMID: 37739228 DOI: 10.1016/j.bbr.2023.114678] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Revised: 09/01/2023] [Accepted: 09/17/2023] [Indexed: 09/24/2023]
Abstract
Anxiety disorders affect up to one third of the population. Caffeine, an adenosine receptor antagonist, is thought to have a dose-dependent effect on anxiety. We recently showed that a high dose of caffeine (50 mg/kg) differentially affected anxiety-like behavior in rats with high or low baseline anxiety-like behavior, replicating findings using relatively high doses in human patient samples. It is not known if low doses of caffeine have similar effects. The elevated plus maze (EPM) was used to categorize male Wistar rats (13 weeks of age) into groups of high or low anxiety-like behavior. Behavior was evaluated using the multivariate concentric square field (MCSF) test and the EPM after a low 10 mg/kg dose of caffeine. Multivariate data analysis demonstrated that caffeine decreased the differences between the high and low anxiety group, whereas the separation remained for the high and low control groups. For the caffeine treated rats, univariate statistics showed an increase in parameters regarding activity in the EPM and duration in the slope of the MCSF. Regarding risk-taking, shelter-seeking, and exploratory behavior, caffeine did not affect the groups differently. In conclusion, these results demonstrate increased activity in the caffeine-treated rats, together with a potentially anxiolytic effect and increased impulsivity that did not differ between the baseline anxiety groups. In contrast to high caffeine doses, a low dose does not generally affect rats with high anxiety at baseline differently than rats with low anxiety-like behavior. Further studies are warranted to fully elucidate the effects of caffeine in anxiety.
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Affiliation(s)
- Sara Florén Lind
- The Beijer Laboratory, Department of Pharmaceutical Biosciences, Neuropharmacology and Addiction Research, SE-751 24, Uppsala University, Uppsala, Sweden.
| | - Frida Stam
- The Beijer Laboratory, Department of Pharmaceutical Biosciences, Neuropharmacology and Addiction Research, SE-751 24, Uppsala University, Uppsala, Sweden
| | - Sofia Zelleroth
- The Beijer Laboratory, Department of Pharmaceutical Biosciences, Neuropharmacology and Addiction Research, SE-751 24, Uppsala University, Uppsala, Sweden
| | - Andreas Frick
- The Beijer Laboratory, Department of Medical Sciences, Psychiatry, SE-751 24, Uppsala University, Uppsala, Sweden
| | - Alfhild Grönbladh
- The Beijer Laboratory, Department of Pharmaceutical Biosciences, Neuropharmacology and Addiction Research, SE-751 24, Uppsala University, Uppsala, Sweden
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Bengtsson J, Frick A, Gingnell M. Blinding integrity of dorsomedial prefrontal intermittent theta burst stimulation in depression. Int J Clin Health Psychol 2023; 23:100390. [PMID: 37223390 PMCID: PMC10200834 DOI: 10.1016/j.ijchp.2023.100390] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Accepted: 05/05/2023] [Indexed: 05/25/2023] Open
Abstract
Background The antidepressant effect of repetitive transcranial magnetic stimulation (rTMS) is partly placebo, making blinding integrity important. Blinding of high-frequency rTMS and intermittent theta burst stimulation (iTBS) has been reported as successful at study end. However, blinding integrity at study start is rarely reported. The aim of this study was to investigate blinding integrity during a treatment course of iTBS over the dorsomedial prefrontal cortex (DMPFC) in depression. Methods Forty-nine patients with depression from a double-blind-designed randomized controlled trial (NCT02905604) were included. Patients received either active or sham iTBS over the DMPFC with a placebo coil. The sham group received iTBS-synchronized transcutaneous electrical nerve stimulation. Results After one session, 74% of participants were able to correctly guess their treatment allocation. This was above chance level (p = 0.001). The percentage dropped to 64% and 56% after the fifth and last sessions. Belonging to the active group influenced the choice to guess "active" (odds ratio: 11.7, 95% CI 2.5-53.7). A higher treatment intensity of the sham treatment increased the probability to guess "active", but pain did not influence the choice. Conclusions Blinding integrity in iTBS trials must be investigated at study start to avoid uncontrolled confounding. Better sham methods are needed.
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Affiliation(s)
- Johan Bengtsson
- Department of Medical Sciences, Uppsala University, Akademiska Sjukhuset, Entrance 10, 3rd Floor, Uppsala 75185, Sweden
| | - Andreas Frick
- Department of Medical Sciences, Uppsala University, Akademiska Sjukhuset, Entrance 10, 3rd Floor, Uppsala 75185, Sweden
| | - Malin Gingnell
- Department of Medical Sciences, Uppsala University, Akademiska Sjukhuset, Entrance 10, 3rd Floor, Uppsala 75185, Sweden
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Jonasson M, Frick A, Fazio P, Hjorth O, Danfors T, Axelsson J, Appel L, Furmark T, Varrone A, Lubberink M. Striatal dopamine transporter and receptor availability correlate with relative cerebral blood flow measured with [ 11C]PE2I, [ 18F]FE-PE2I and [ 11C]raclopride PET in healthy individuals. J Cereb Blood Flow Metab 2023; 43:1206-1215. [PMID: 36912083 PMCID: PMC10291448 DOI: 10.1177/0271678x231160881] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Revised: 12/14/2022] [Accepted: 12/26/2022] [Indexed: 03/14/2023]
Abstract
The aim of this retrospective study was to investigate relationships between relative cerebral blood flow and striatal dopamine transporter and dopamine D2/3 availability in healthy subjects. The data comprised dynamic PET scans with two dopamine transporter tracers [11C]PE2I (n = 20) and [18F]FE-PE2I (n = 20) and the D2/3 tracer [11C]raclopride (n = 18). Subjects with a [11C]PE2I scan also underwent a dynamic scan with the serotonin transporter tracer [11C]DASB. Binding potential (BPND) and relative tracer delivery (R1) values were calculated on regional and voxel-level. Striatal R1 and BPND values were correlated, using either an MRI-based volume of interest (VOI) or an isocontour VOI based on the parametric BPND image. An inter-tracer comparison between [11C]PE2I BPND and [11C]DASB R1 was done on a VOI-level and simulations were performed to investigate whether the constraints of the modeling could cause correlation of the parameters. A positive association was found between BPND and R1 for all three dopamine tracers. A similar correlation was found for the inter-tracer correlation between [11C]PE2I BPND and [11C]DASB R1. Simulations showed that this relationship was not caused by cross-correlation between parameters in the kinetic model. In conclusion, these results suggest an association between resting-state striatal dopamine function and relative blood flow in healthy subjects.
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Affiliation(s)
- My Jonasson
- Department of Surgical Sciences, Nuclear Medicine and PET, Uppsala University, Uppsala, Sweden
- Medical Physics, Uppsala University Hospital, Uppsala, Sweden
| | - Andreas Frick
- Department of Medical Sciences, Psychiatry, Uppsala University, Uppsala, Sweden
| | - Patrik Fazio
- Department of Clinical Neuroscience, Centre for Psychiatry Research, Karolinska Institutet, Stockholm, Sweden
| | - Olof Hjorth
- Department of Psychology, Uppsala University, Uppsala, Sweden
| | - Torsten Danfors
- Department of Surgical Sciences, Nuclear Medicine and PET, Uppsala University, Uppsala, Sweden
- Medical Imaging Centre, Uppsala University Hospital, Uppsala, Sweden
| | - Jan Axelsson
- Department of Radiation Sciences, Radiation Physics, Umeå University, Umeå, Sweden
| | - Lieuwe Appel
- Department of Surgical Sciences, Nuclear Medicine and PET, Uppsala University, Uppsala, Sweden
- Medical Imaging Centre, Uppsala University Hospital, Uppsala, Sweden
| | - Tomas Furmark
- Department of Psychology, Uppsala University, Uppsala, Sweden
| | - Andrea Varrone
- Department of Clinical Neuroscience, Centre for Psychiatry Research, Karolinska Institutet, Stockholm, Sweden
| | - Mark Lubberink
- Department of Surgical Sciences, Nuclear Medicine and PET, Uppsala University, Uppsala, Sweden
- Medical Physics, Uppsala University Hospital, Uppsala, Sweden
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Lind SF, Stam F, Zelleroth S, Meurling E, Frick A, Grönbladh A. Acute caffeine differently affects risk-taking and the expression of BDNF and of adenosine and opioid receptors in rats with high or low anxiety-like behavior. Pharmacol Biochem Behav 2023:173573. [PMID: 37302662 DOI: 10.1016/j.pbb.2023.173573] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Revised: 06/01/2023] [Accepted: 06/02/2023] [Indexed: 06/13/2023]
Abstract
Anxiety disorders are common psychiatric conditions with a partially elucidated neurobiology. Caffeine, an unspecific adenosine receptor antagonist, is a common psychostimulant with anxiogenic effects in sensitive individuals. High doses of caffeine produce anxiety-like behavior in rats but it is not known if this is specific for rats with high baseline anxiety-like behavior. Thus, the aim of this study was to investigate general behavior, risk-taking, and anxiety-like behavior, as well as mRNA expression (adenosine A2A and A1, dopamine D2, and, μ, κ, δ opioid, receptors, BDNF, c-fos, IGF-1) in amygdala, caudate putamen, frontal cortex, hippocampus, hypothalamus, after an acute dose of caffeine. Untreated rats were screened using the elevated plus maze (EPM), giving each rat a score on anxiety-like behavior based on their time spent in the open arms, and categorized into a high or low anxiety-like behavior group accordingly. Three weeks after categorization, the rats were treated with 50 mg/kg caffeine and their behavior profile was studied in the multivariate concentric square field (MCSF) test, and one week later in the EPM. qPCR was performed on selected genes and corticosterone plasma levels were measured using ELISA. The results demonstrated that the high anxiety-like behavior rats treated with caffeine spent less time in risk areas of the MCSF and resituated towards the sheltered areas, a behavior accompanied by lower mRNA expression of adenosine A2A receptors in caudate putamen and increased BDNF expression in hippocampus. These results support the hypothesis that caffeine affects individuals differently depending on their baseline anxiety-like behavior, possibly involving adenosine receptors. This highlights the importance of adenosine receptors as a possible drug target for anxiety disorders, although further research is needed to fully elucidate the neurobiological mechanisms of caffeine on anxiety disorders.
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Affiliation(s)
- Sara Florén Lind
- The Beijer Laboratory, Department of Pharmaceutical Biosciences, Neuropharmacology and Addiction Research, SE-751 24, Uppsala University, Uppsala, Sweden.
| | - Frida Stam
- The Beijer Laboratory, Department of Pharmaceutical Biosciences, Neuropharmacology and Addiction Research, SE-751 24, Uppsala University, Uppsala, Sweden.
| | - Sofia Zelleroth
- The Beijer Laboratory, Department of Pharmaceutical Biosciences, Neuropharmacology and Addiction Research, SE-751 24, Uppsala University, Uppsala, Sweden.
| | - Evelina Meurling
- The Beijer Laboratory, Department of Pharmaceutical Biosciences, Neuropharmacology and Addiction Research, SE-751 24, Uppsala University, Uppsala, Sweden
| | - Andreas Frick
- The Beijer Laboratory, Department of Medical Sciences, Psychiatry, SE-751 24, Uppsala University, Uppsala, Sweden.
| | - Alfhild Grönbladh
- The Beijer Laboratory, Department of Pharmaceutical Biosciences, Neuropharmacology and Addiction Research, SE-751 24, Uppsala University, Uppsala, Sweden.
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Wlad M, Frick A, Engman J, Hjorth O, Hoppe JM, Faria V, Wahlstedt K, Björkstrand J, Månsson KN, Hultberg S, Alaie I, Rosén J, Fredrikson M, Furmark T, Gingnell M. Dorsal anterior cingulate cortex activity during cognitive challenge in social anxiety disorder. Behav Brain Res 2023; 442:114304. [PMID: 36681164 DOI: 10.1016/j.bbr.2023.114304] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Revised: 01/16/2023] [Accepted: 01/17/2023] [Indexed: 01/19/2023]
Abstract
BACKGROUND Social anxiety disorder (SAD) is associated with aberrant emotional information processing while little is known about non-emotional cognitive processing biases. The dorsal anterior cingulate cortex (dACC) has been implicated in SAD neuropathology and is activated both by emotional and non-affective cognitive challenges like the Multisource Interference Task (MSIT). METHODS Here, we used fMRI to compare dACC activity and test performance during MSIT in 69 SAD patients and 38 healthy controls. In addition to patient-control comparisons, we examined whether neural activity in the dACC correlated with social anxiety, trait anxiety or depression levels. RESULTS The MSIT activated the dACC as expected but with no differences in task performance or neural reactivity between SAD patients and controls. There were no significant correlations between dACC activity and social or trait anxiety symptom severity. In patients, there was a significant negative correlation between dACC activity and depressive symptoms. CONCLUSIONS In absence of affective challenge, we found no disorder-related cognitive profile in SAD patients since neither MSIT task performance nor dACC neural activity deviated in patients relative to controls.
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Affiliation(s)
- Magdalena Wlad
- Department of Medical Sciences, Uppsala University, Uppsala, Sweden.
| | - Andreas Frick
- Department of Medical Sciences, Uppsala University, Uppsala, Sweden.
| | - Jonas Engman
- Department of Psychology, Uppsala University, Uppsala, Sweden.
| | - Olof Hjorth
- Department of Psychology, Uppsala University, Uppsala, Sweden.
| | - Johanna M Hoppe
- Department of Medical Sciences, Uppsala University, Uppsala, Sweden.
| | - Vanda Faria
- Department of Psychology, Uppsala University, Uppsala, Sweden; Brain and Eye Pain Imaging Lab, Pain and Affective Neuroscience Center, Department of Anesthesiology, Critical Care and Pain Medicine, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA; Department of Otorhinolaryngology, Smell & Taste Clinic, TU Dresden, Dresden, Germany.
| | - Kurt Wahlstedt
- Department of Psychology, Uppsala University, Uppsala, Sweden.
| | | | - Kristoffer Nt Månsson
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.
| | - Sara Hultberg
- Department of Psychology, Uppsala University, Uppsala, Sweden.
| | - Iman Alaie
- Department of Medical Sciences, Uppsala University, Uppsala, Sweden; Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.
| | - Jörgen Rosén
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.
| | - Mats Fredrikson
- Department of Psychology, Uppsala University, Uppsala, Sweden.
| | - Tomas Furmark
- Department of Psychology, Uppsala University, Uppsala, Sweden.
| | - Malin Gingnell
- Department of Medical Sciences, Uppsala University, Uppsala, Sweden; Department of Psychology, Uppsala University, Uppsala, Sweden.
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10
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Tarchi L, Damiani S, Vittori PLT, Frick A, Castellini G, Politi P, Fusar-Poli P, Ricca V. Progressive Voxel-Wise Homotopic Connectivity from childhood to adulthood: Age-related functional asymmetry in resting-state functional magnetic resonance imaging. Dev Psychobiol 2023; 65:e22366. [PMID: 36811370 DOI: 10.1002/dev.22366] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2021] [Revised: 10/11/2022] [Accepted: 09/21/2022] [Indexed: 01/12/2023]
Abstract
Homotopic connectivity during resting state has been proposed as a risk marker for neurologic and psychiatric conditions, but a precise characterization of its trajectory through development is currently lacking. Voxel-Mirrored Homotopic Connectivity (VMHC) was evaluated in a sample of 85 neurotypical individuals aged 7-18 years. VMHC associations with age, handedness, sex, and motion were explored at the voxel-wise level. VMHC correlates were also explored within 14 functional networks. Primary and secondary outcomes were repeated in a sample of 107 adults aged 21-50 years. In adults, VMHC was negatively correlated with age only in the posterior insula (false discovery rate p < .05, >30-voxel clusters), while a distributed effect among the medial axis was observed in minors. Four out of 14 considered networks showed significant negative correlations between VMHC and age in minors (basal ganglia r = -.280, p = .010; anterior salience r = -.245, p = .024; language r = -.222, p = .041; primary visual r = -.257, p = .017), but not adults. In minors, a positive effect of motion on VMHC was observed only in the putamen. Sex did not significantly influence age effects on VMHC. The current study showed a specific decrease in VMHC for minors as a function of age, but not adults, supporting the notion that interhemispheric interactions can shape late neurodevelopment.
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Affiliation(s)
- Livio Tarchi
- Psychiatry Unit, Department of Health Sciences, University of Florence, Florence, Italy
| | - Stefano Damiani
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | | | - Andreas Frick
- Department of Medical Sciences, Psychiatry, Uppsala University, Uppsala, Sweden
| | - Giovanni Castellini
- Psychiatry Unit, Department of Health Sciences, University of Florence, Florence, Italy
| | - Pierluigi Politi
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - Paolo Fusar-Poli
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy.,Early Psychosis: Interventions and Clinical-detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.,OASIS Service, South London and Maudsley NHS Foundation Trust, London, UK
| | - Valdo Ricca
- Psychiatry Unit, Department of Health Sciences, University of Florence, Florence, Italy
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11
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Wallmichrath J, Schöpfer D, Frick A, Weiss M, Baumeister RGH. Investigations on the donor limb after harvest of lymphatic vessels for lymphedema surgery. J Vasc Surg Venous Lymphat Disord 2023; 11:167-176. [PMID: 35952954 DOI: 10.1016/j.jvsv.2022.06.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2022] [Revised: 06/06/2022] [Accepted: 06/30/2022] [Indexed: 10/15/2022]
Abstract
OBJECTIVE Microsurgical lymphatic vessel transplantation is one of the well-established therapies for lymphedema. Lymphatic vessels are harvested from a healthy thigh and transplanted into lymphedematous limbs to create a lymphatic bypass. Its benefit on lymphatic drainage has already been proven. However, to the best of our knowledge, the effect on the lymphatic function of the donor site has not yet been studied. Our aim was to evaluate the long-term postoperative lymphatic function in the donor site by clinical and scintigraphic examinations and a patient questionnaire. METHODS A consecutive series of 25 women (mean age, 57.2 years) who had undergone follow-up after lymph vessel transplantation to treat secondary lymphedema of the arm comprised the study group. Lymphatic vessel function of the donor site was evaluated by circumferential measurements of the limb and, in nine cases, by lymphatic scintigraphy. Additionally, a questionnaire was used to assess the patients' pre- and postoperative complaints for the donor limb and quality of life. Separately, the medical records of 100 patients who had undergone lymphatic harvest and been followed up were reviewed for documented signs of lymphatic function of the donor limb. RESULTS The lymphatic grafts were harvested from the thigh (left, n = 9; right, n = 16) and transplanted to bridge the region of lymphatic obstruction in the axilla. The mean follow-up period was 4.5 years after surgery. None of the patients had shown significant changes in the circumference of the donor limb or pathologic findings via lymphatic scintigraphy. None of the patients had reported any impairment in the donor leg or showed symptoms of postoperative lymphedema or erysipelas. CONCLUSIONS Our results have shown that harvesting lymphatic vessels from the thigh for lymphatic vessel transplantation is possible without significant donor site morbidity.
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Affiliation(s)
- Jens Wallmichrath
- Division of Hand, Plastic Surgery and Aesthetic Surgery, University Hospital, Ludwig Maximilian University of Munich, Munich, Germany.
| | - Dominik Schöpfer
- Division of Hand, Plastic Surgery and Aesthetic Surgery, University Hospital, Ludwig Maximilian University of Munich, Munich, Germany
| | - Andreas Frick
- Division of Hand, Plastic Surgery and Aesthetic Surgery, University Hospital, Ludwig Maximilian University of Munich, Munich, Germany
| | - Mayo Weiss
- Department of Nuclear Medicine, University Hospital, Ludwig Maximilian University of Munich, Munich, Germany
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12
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Guath M, Kleberg JL, Weis J, Widegren E, Frick M, Möller S, Klevebrant L, Karlsson B, Fällmar D, Mårtensson J, Pine DS, Brocki K, Gingnell M, Frick A. Pupil dilation during negative prediction errors is related to brain choline concentration and depressive symptoms in adolescents. Behav Brain Res 2023; 436:114060. [DOI: 10.1016/j.bbr.2022.114060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Revised: 08/10/2022] [Accepted: 08/14/2022] [Indexed: 10/15/2022]
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13
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Hoppe JM, Vegelius J, Gingnell M, Björkstrand J, Frick A. Internet-delivered approach-avoidance conflict task shows temporal stability and relation to trait anxiety. Learning and Motivation 2022. [DOI: 10.1016/j.lmot.2022.101848] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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14
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Hjorth O, Frick A, Gingnell M, Engman J, Björkstrand J, Faria V, Alaie I, Carlbring P, Andersson G, Jonasson M, Lubberink M, Antoni G, Reis M, Wahlstedt K, Fredrikson M, Furmark T. Serotonin and dopamine transporter availability in social anxiety disorder after combined treatment with escitalopram and cognitive-behavioral therapy. Transl Psychiatry 2022; 12:436. [PMID: 36202797 PMCID: PMC9537299 DOI: 10.1038/s41398-022-02187-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Revised: 09/08/2022] [Accepted: 09/13/2022] [Indexed: 11/15/2022] Open
Abstract
Selective serotonin reuptake inhibitors (SSRIs) and internet-based cognitive behavioral therapy (ICBT) are recommended treatments of social anxiety disorder (SAD), and often combined, but their effects on monoaminergic signaling are not well understood. In this multi-tracer positron emission tomography (PET) study, 24 patients with SAD were randomized to treatment with escitalopram+ICBT or placebo+ICBT under double-blind conditions. Before and after 9 weeks of treatment, patients were examined with positron emission tomography and the radioligands [11C]DASB and [11C]PE2I, probing the serotonin (SERT) and dopamine (DAT) transporter proteins respectively. Both treatment combinations resulted in significant improvement as measured by the Liebowitz Social Anxiety Scale (LSAS). At baseline, SERT-DAT co-expression was high and, in the putamen and thalamus, co-expression showed positive associations with symptom severity. SERT-DAT co-expression was also predictive of treatment success, but predictor-outcome associations differed in direction between the treatments. After treatment, average SERT occupancy in the SSRI + ICBT group was >80%, with positive associations between symptom improvement and occupancy in the nucleus accumbens, putamen and anterior cingulate cortex. Following placebo+ICBT, SERT binding increased in the raphe nuclei. DAT binding increased in both groups in limbic and striatal areas, but relations with symptom improvement differed, being negative for SSRI + ICBT and positive for placebo + ICBT. Thus, serotonin-dopamine transporter co-expression exerts influence on symptom severity and remission rate in the treatment of social anxiety disorder. However, the monoamine transporters are modulated in dissimilar ways when cognitive-behavioral treatment is given concomitantly with either SSRI-medication or pill placebo.
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Affiliation(s)
- Olof Hjorth
- Department of Psychology, Uppsala University, Uppsala, Sweden.
| | - Andreas Frick
- grid.8993.b0000 0004 1936 9457Department of Psychology, Uppsala University, Uppsala, Sweden ,grid.8993.b0000 0004 1936 9457The Beijer Laboratory, Department of Medical Sciences, Psychiatry, Uppsala University, Uppsala, Sweden
| | - Malin Gingnell
- grid.8993.b0000 0004 1936 9457Department of Psychology, Uppsala University, Uppsala, Sweden ,grid.8993.b0000 0004 1936 9457Department of Medical Sciences, Psychiatry, Uppsala University, Uppsala, Sweden
| | - Jonas Engman
- grid.8993.b0000 0004 1936 9457Department of Psychology, Uppsala University, Uppsala, Sweden
| | - Johannes Björkstrand
- grid.4514.40000 0001 0930 2361Department of Psychology, Lund University, Lund, Sweden
| | - Vanda Faria
- grid.38142.3c000000041936754XCenter for Pain and the Brain, Department of Anesthesiology Perioperative and Pain Medicine, Boston Children’s Hospital, Harvard Medical School, Boston, MA USA ,grid.4488.00000 0001 2111 7257Smell & Taste Clinic, Department of Otorhinolaryngology, TU Dresden, Dresden, Germany
| | - Iman Alaie
- grid.8993.b0000 0004 1936 9457Department of Medical Sciences, Child and Adolescent Psychiatry, Uppsala University, Uppsala, Sweden
| | - Per Carlbring
- grid.10548.380000 0004 1936 9377Department of Psychology, Stockholm University, Stockholm, Sweden
| | - Gerhard Andersson
- grid.4714.60000 0004 1937 0626Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden ,grid.5640.70000 0001 2162 9922Department of Behavioural Sciences and Learning, Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
| | - My Jonasson
- grid.8993.b0000 0004 1936 9457Department of Surgical Sciences, Radiology, Uppsala University, Uppsala, Sweden
| | - Mark Lubberink
- grid.8993.b0000 0004 1936 9457Department of Surgical Sciences, Radiology, Uppsala University, Uppsala, Sweden
| | - Gunnar Antoni
- grid.8993.b0000 0004 1936 9457Department of Medicinal Chemistry, Uppsala University, Uppsala, Sweden
| | - Margareta Reis
- grid.5640.70000 0001 2162 9922Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
| | - Kurt Wahlstedt
- grid.8993.b0000 0004 1936 9457Department of Psychology, Uppsala University, Uppsala, Sweden
| | - Mats Fredrikson
- grid.8993.b0000 0004 1936 9457Department of Psychology, Uppsala University, Uppsala, Sweden ,grid.4714.60000 0004 1937 0626Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Tomas Furmark
- grid.8993.b0000 0004 1936 9457Department of Psychology, Uppsala University, Uppsala, Sweden
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15
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Cervenka S, Frick A, Bodén R, Lubberink M. Application of positron emission tomography in psychiatry-methodological developments and future directions. Transl Psychiatry 2022; 12:248. [PMID: 35701411 PMCID: PMC9198063 DOI: 10.1038/s41398-022-01990-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Revised: 05/20/2022] [Accepted: 05/25/2022] [Indexed: 11/09/2022] Open
Abstract
Mental disorders represent an increasing source of disability and high costs for societies globally. Molecular imaging techniques such as positron emission tomography (PET) represent powerful tools with the potential to advance knowledge regarding disease mechanisms, allowing the development of new treatment approaches. Thus far, most PET research on pathophysiology in psychiatric disorders has focused on the monoaminergic neurotransmission systems, and although a series of discoveries have been made, the results have not led to any material changes in clinical practice. We outline areas of methodological development that can address some of the important obstacles to fruitful progress. First, we point towards new radioligands and targets that can lead to the identification of processes upstream, or parallel to disturbances in monoaminergic systems. Second, we describe the development of new methods of PET data quantification and PET systems that may facilitate research in psychiatric populations. Third, we review the application of multimodal imaging that can link molecular imaging data to other aspects of brain function, thus deepening our understanding of disease processes. Fourth, we highlight the need to develop imaging study protocols to include longitudinal and interventional paradigms, as well as frameworks to assess dimensional symptoms such that the field can move beyond cross-sectional studies within current diagnostic boundaries. Particular effort should be paid to include also the most severely ill patients. Finally, we discuss the importance of harmonizing data collection and promoting data sharing to reach the desired sample sizes needed to fully capture the phenotype of psychiatric conditions.
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Affiliation(s)
- Simon Cervenka
- Department of Medical Sciences, Psychiatry, Uppsala University, Uppsala, Sweden. .,Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet and Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden.
| | - Andreas Frick
- grid.8993.b0000 0004 1936 9457Department of Medical Sciences, Psychiatry, Uppsala University, Uppsala, Sweden
| | - Robert Bodén
- grid.8993.b0000 0004 1936 9457Department of Medical Sciences, Psychiatry, Uppsala University, Uppsala, Sweden
| | - Mark Lubberink
- grid.8993.b0000 0004 1936 9457Department of Surgical Sciences, Uppsala University, Uppsala, Sweden
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16
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Björkstrand J, Pine DS, Frick A. Evaluating an internet-delivered fear conditioning and extinction protocol using response times and affective ratings. Sci Rep 2022; 12:4014. [PMID: 35256733 PMCID: PMC8901755 DOI: 10.1038/s41598-022-07999-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Accepted: 02/23/2022] [Indexed: 12/27/2022] Open
Abstract
Pavlovian fear conditioning is widely used to study mechanisms of fear learning, but high-throughput studies are hampered by the labor-intensive nature of examining participants in the lab. To circumvent this bottle-neck, fear conditioning tasks have been developed for remote delivery. Previous studies have examined remotely delivered fear conditioning protocols using expectancy and affective ratings. Here we replicate and extend these findings using an internet-delivered version of the Screaming Lady paradigm, evaluating the effects on negative affective ratings and response time to an auditory probe during stimulus presentation. In a sample of 80 adults, we observed clear evidence of both fear acquisition and extinction using affective ratings. Response times were faster when probed early, but not later, during presentation of stimuli paired with an aversive scream. The response time findings are at odds with previous lab-based studies showing slower as opposed to faster responses to threat-predicting cues. The findings underscore the feasibility of employing remotely delivered fear conditioning paradigms with affective ratings as outcome. Findings further highlight the need for research examining optimal parameters for concurrent response time measures or alternate non-verbal indicators of conditioned responses in Pavlovian conditioning protocols.
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Affiliation(s)
| | - Daniel S Pine
- National Institute of Mental Health (NIMH), Bethesda, MD, USA
| | - Andreas Frick
- The Beijer Laboratory, Department of Neuroscience, Psychiatry, Uppsala University, Uppsala, Sweden
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17
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Gauffin H, Landtblom AM, Vigren P, Frick A, Engström M, McAllister A, Karlsson T. Similar Profile and Magnitude of Cognitive Impairments in Focal and Generalized Epilepsy: A Pilot Study. Front Neurol 2022; 12:746381. [PMID: 35095714 PMCID: PMC8790571 DOI: 10.3389/fneur.2021.746381] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Accepted: 12/14/2021] [Indexed: 11/21/2022] Open
Abstract
Introduction: Cognitive impairments in epilepsy are not well-understood. In addition, long-term emotional, interpersonal, and social consequences of the underlying disturbances are important to evaluate. Purpose: To compare cognitive function including language in young adults with focal or generalized epilepsy. In addition, quality of life and self-esteem were investigated. Patients and Methods: Young adults with no primary intellectual disability, 17 with focal epilepsy and 11 with generalized epilepsy participated and were compared to 28 healthy controls. Groups were matched on age (mean = 26 years), sex, and education. Participants were administered a battery of neuropsychological tasks and carried out self-ratings of quality of life, self-esteem, and psychological problems. Results: Similar impairments regarding cognitive function were noted in focal and generalized epilepsy. The cognitive domains tested were episodic long-term memory, executive functions, attention, working memory, visuospatial functions, and language. Both epilepsy groups had lower results compared to controls (effect sizes 0.24–1.07). The total number of convulsive seizures was predictive of episodic long-term memory function. Participants with focal epilepsy reported lower quality of life than participants with generalized epilepsy. Lowered self-esteem values were seen in both epilepsy groups and particularly in those with focal epilepsy. Along with measures of cognitive speed and depression, the total number of seizures explained more than 50% of variation in quality of life. Conclusion: Interestingly, similarities rather than differences characterized the widespread cognitive deficits that were seen in focal and generalized epilepsy, ranging from mild to moderate. These similarities were modified by quality of life and self-esteem. This study confirms the notion that epilepsy is a network disorder.
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Affiliation(s)
- Helena Gauffin
- Department of Neurology, Faculty of Medicine and Health Sciences Linköping University, Linköping, Sweden.,Department of Biomedical and Clinical Sciences, Faculty of Medicine and Health Sciences Linköping University, Linköping, Sweden
| | - Anne-Marie Landtblom
- Department of Neurology, Faculty of Medicine and Health Sciences Linköping University, Linköping, Sweden.,Department of Biomedical and Clinical Sciences, Faculty of Medicine and Health Sciences Linköping University, Linköping, Sweden.,Department of Neuroscience, Neurology, Uppsala University, Uppsala, Sweden.,Neurology Division, Clinic of Medical Specialist, Motala General Hospital, Motala, Sweden.,Center for Medical Image Science and Visualization, Linköping University, Linköping, Sweden
| | - Patrick Vigren
- Department of Neurology, Faculty of Medicine and Health Sciences Linköping University, Linköping, Sweden.,Department of Biomedical and Clinical Sciences, Faculty of Medicine and Health Sciences Linköping University, Linköping, Sweden
| | - Andreas Frick
- The Beijer Laboratory, Department of Neuroscience, Psychiatry, Uppsala University, Uppsala, Sweden
| | - Maria Engström
- Center for Medical Image Science and Visualization, Linköping University, Linköping, Sweden.,Department of Medical, Health and Caring Sciences, Linköping University, Linköping, Sweden
| | - Anita McAllister
- Division of Speech Language Pathology, Department of Clinical Science, Intervention and Technology, Karolinska Institute, Stockholm, Sweden.,Women's Health and Allied Health Professionals Theme, Medical Unit Speech and Language Pathology, Karolinska University Hospital, Stockholm, Sweden
| | - Thomas Karlsson
- Department of Neuroscience, Neurology, Uppsala University, Uppsala, Sweden.,Center for Medical Image Science and Visualization, Linköping University, Linköping, Sweden
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18
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Abstract
BACKGROUND Potentiating current antidepressant treatment is much needed. Based on animal studies, caffeine may augment the effects of currently available antidepressants. OBJECTIVE Here, we tested whether habitual caffeine consumption moderates the antidepressant effects of repetitive transcranial magnetic stimulation (rTMS) using intermittent theta-burst stimulation (iTBS). METHODS Forty patients with current depressive episodes were randomized to active iTBS (n = 19) or sham treatment (n = 21; shielded side of the coil and weak transcutaneous electrical stimulation) delivered two times per day for 10-15 weekdays. Neuronavigated stimulation was applied to the dorsomedial prefrontal cortex. Symptom improvement was measured using change in self-reported Montgomery-Åsberg Depression Rating Scale (MADRS) scores. Pretreatment habitual caffeine consumption was quantified using self-reports of number of cups of coffee and energy drinks consumed the 2 days before the treatment starts. RESULTS Habitual caffeine consumption was associated with symptom improvement following active iTBS (r = 0.51, 95% confidence interval (CI): 0.08-0.78, p = 0.025) but not following sham treatment (r = -0.02, 95% CI: -0.45 to 0.42, p = 0.938). A multiple regression analysis corroborated the findings by showing a significant caffeine consumption × treatment group interaction (β = 0.62, p = 0.043), but no main effects of treatment group (β = 0.22, p = 0.140) or caffeine consumption (β = -0.01, p = 0.948). No group differences in pretreatment symptom scores or caffeine consumption were detected (p values > 0.86). CONCLUSION Habitual caffeine consumption moderated the antidepressant effect of dorsomedial iTBS, consistent with caffeine improving antidepressant pharmacological treatments in animals. Caffeine is an antagonist of adenosine receptors and may enhance antidepressant effects through downstream dopaminergic targets.
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Affiliation(s)
- Andreas Frick
- The Beijer Laboratory, Department of Neuroscience, Psychiatry, Uppsala University, Uppsala, Sweden
| | - Jonas Persson
- Department of Neuroscience, Psychiatry, Uppsala University, Uppsala, Sweden
| | - Robert Bodén
- Department of Neuroscience, Psychiatry, Uppsala University, Uppsala, Sweden
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19
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Hjorth OR, Frick A, Gingnell M, Hoppe JM, Faria V, Hultberg S, Alaie I, Månsson KNT, Rosén J, Reis M, Wahlstedt K, Jonasson M, Lubberink M, Antoni G, Fredrikson M, Furmark T. Expectancy effects on serotonin and dopamine transporters during SSRI treatment of social anxiety disorder: a randomized clinical trial. Transl Psychiatry 2021; 11:559. [PMID: 34732695 PMCID: PMC8566580 DOI: 10.1038/s41398-021-01682-3] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Revised: 09/14/2021] [Accepted: 10/19/2021] [Indexed: 12/16/2022] Open
Abstract
It has been extensively debated whether selective serotonin reuptake inhibitors (SSRIs) are more efficacious than placebo in affective disorders, and it is not fully understood how SSRIs exert their beneficial effects. Along with serotonin transporter blockade, altered dopamine signaling and psychological factors may contribute. In this randomized clinical trial of participants with social anxiety disorder (SAD) we investigated how manipulation of verbally-induced expectancies, vital for placebo response, affect brain monoamine transporters and symptom improvement during SSRI treatment. Twenty-seven participants with SAD (17 men, 10 women), were randomized, to 9 weeks of overt or covert treatment with escitalopram 20 mg. The overt group received correct treatment information whereas the covert group was treated deceptively with escitalopram, described as an active placebo in a cover story. Before and after treatment, patients underwent positron emission tomography (PET) assessments with the [11C]DASB and [11C]PE2I radiotracers, probing brain serotonin (SERT) and dopamine (DAT) transporters. SAD symptoms were measured by the Liebowitz Social Anxiety Scale. Overt was superior to covert SSRI treatment, resulting in almost a fourfold higher rate of responders. PET results showed that SERT occupancy after treatment was unrelated to anxiety reduction and equally high in both groups. In contrast, DAT binding decreased in the right putamen, pallidum, and the left thalamus with overt SSRI treatment, and increased with covert treatment, resulting in significant group differences. DAT binding potential changes in these regions correlated negatively with symptom improvement. Findings support that the anxiolytic effects of SSRIs involve psychological factors contingent on dopaminergic neurotransmission while serotonin transporter blockade alone is insufficient for clinical response.
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Affiliation(s)
- Olof R Hjorth
- Department of Psychology, Uppsala University, Uppsala, Sweden.
| | - Andreas Frick
- Department of Psychology, Uppsala University, Uppsala, Sweden
- The Beijer Laboratory, Department of Neuroscience, Psychiatry, Uppsala University, Uppsala, Sweden
| | - Malin Gingnell
- Department of Psychology, Uppsala University, Uppsala, Sweden
- Department of Neuroscience, Psychiatry, Uppsala University, Uppsala, Sweden
| | - Johanna M Hoppe
- Department of Psychology, Uppsala University, Uppsala, Sweden
| | - Vanda Faria
- Department of Psychology, Uppsala University, Uppsala, Sweden
- Center for Pain and the Brain, Department of Anesthesiology Perioperative and Pain Medicine, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA
- Smell & Taste Clinic, Department of Otorhinolaryngology, TU Dresden, Dresden, Germany
| | - Sara Hultberg
- Department of Psychology, Uppsala University, Uppsala, Sweden
| | - Iman Alaie
- Department of Neuroscience, Child and Adolescent Psychiatry, Uppsala University, Uppsala, Sweden
| | - Kristoffer N T Månsson
- Center for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
- Center for Lifespan Psychology, Max Planck Institute for Human Development, Berlin, Germany
- Max Planck UCL Center for Computational Psychiatry and Ageing Research, Berlin/London, UK
| | - Jörgen Rosén
- Department of Psychology, Uppsala University, Uppsala, Sweden
| | - Margareta Reis
- Department of Biomedical And Clinical Sciences, Linköping University, Linköping, Sweden
- Department of Clinical Chemistry and Pharmacology, Skåne University hospital, Lund, Sweden
| | - Kurt Wahlstedt
- Department of Psychology, Uppsala University, Uppsala, Sweden
| | - My Jonasson
- Department of of Surgical Sciences/Nuclear Medicine and PET, Uppsala University, Uppsala, Sweden
| | - Mark Lubberink
- Department of of Surgical Sciences/Nuclear Medicine and PET, Uppsala University, Uppsala, Sweden
| | - Gunnar Antoni
- Department of Medicinal Chemistry, Uppsala University, Uppsala, Sweden
| | - Mats Fredrikson
- Department of Psychology, Uppsala University, Uppsala, Sweden
- Center for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Tomas Furmark
- Department of Psychology, Uppsala University, Uppsala, Sweden
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20
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Giorgione V, O'Driscoll J, Di Fabrizio C, Frick A, Cauldwell M, Khalil A, Thilaganathan B. Relationship between peripartum maternal cardiac phenotype and maternal outcome in women with hypertensive disorders of pregnancy. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.2309] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Hypertensive disorders of pregnancy (HDP) are a leading cause of maternal and neonatal morbidity worldwide.
Purpose
The aim of this study is to assess maternal cardiac function in women affected by HDP in singleton pregnancy and investigate the relationship between abnormal cardiac findings and maternal outcomes.
Methods
In this single-centre prospective longitudinal study, 190 women with a diagnosis of HDP underwent standard trans-thoracic echocardiography (TTE) in the immediate peripartum period from February 2019 to December 2020. Left ventricle morphology (LVM) and diastolic dysfunction (DD) were evaluated according to according to British Society of Echocardiography guidelines. Patients were classified into three groups according to TTE findings: (1) normal LVM and DD, (2) abnormal LVM or abnormal DD, (3) abnormal LVM and abnormal DD. Maternal indices were compared among these groups.
Results
56 (29.5%) patients affected by HDP were included in group 1, 69 (36.3%) in group 2 and 65 (34.2%) in group 3. Gestational age at delivery and birthweight centile were similar among the groups. Women in group 3 were significantly older than group 2 and group 1 (35.1±5.4 years vs 32.6±6.3 vs 33.1±5.8 years years, respectively, p=0.043). Group 2 and 3 showed a higher blood pressure in the first trimester of pregnancy compared to group 1 (mean arterial pressure: 94.3±7.2 mmHg vs 95.5±8.2 mmHg vs 91.6±8.3 mmHg, p=0.024), while no significant difference was found in body mass index among the three groups (group 1: 26.4±5.4, group 2: 28.0±6.4; group 3: 27.7±5.0, p=0.293). HDP women with LVM and DD (group 3) were more likely to be admitted to high dependency unit (35.4%) than women in group 2 and 1 (14.5% and 23.6%, respectively, p=0.019).
Conclusions
Abnormal echocardiographic findings were associated with a worse maternal cardiovascular phenotype that required a closer maternal cardiovascular monitoring in the peripartum period.
Funding Acknowledgement
Type of funding sources: Public grant(s) – EU funding. Main funding source(s): Veronica Giorgione and Carolina Di Fabrizio have received funding from European Union's Horizon 2020 research and innovation programme under the Marie Skłodowska-Curie grant agreement No 765274 (iPLACENTA project).
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Affiliation(s)
- V Giorgione
- St George's University of London, London, United Kingdom
| | - J O'Driscoll
- St George's University Hospital NHS Foundation Trust, London, United Kingdom
| | - C Di Fabrizio
- St George's University of London, London, United Kingdom
| | - A Frick
- St George's University Hospital NHS Foundation Trust, London, United Kingdom
| | - M Cauldwell
- St George's University Hospital NHS Foundation Trust, London, United Kingdom
| | - A Khalil
- St George's University of London, London, United Kingdom
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21
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Giorgione V, O'Driscoll J, Di Fabrizio C, Frick A, Cauldwell M, Khalil A, Thilaganathan B. Strain analysis by two-dimensional speckle tracking echocardiography for evaluating left ventricular systolic function in women with pre-eclampsia. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.2310] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Previous echocardiographic studies have shown that most women affected by pre-eclampsia present with mild-to moderate diastolic dysfunction and left ventricle remodelling with a preserved systolic function. These alterations appear more severe when pre-eclampsia develops before 34 weeks of gestation.
Purpose
The aim of this study is to compare left ventricular systolic (LV) function by using 2-D speckle tracking echocardiography in women with early-onset and late-onset pre-eclampsia.
Methods
In this single-centre prospective longitudinal study, 119 women with a diagnosis of pre-eclampsia underwent standard trans-thoracic echocardiography (TTE) in the immediate peripartum period from February 2019 to December 2020. LV function was assessed using two-dimensional speckle-tracking strain imaging on 4-chamber views with a frame rate of 60–90 frames/second. Strain analysis quantification was performed using a commercial software.
Results
Pre-eclampsia was diagnosed before and after 34 weeks in 37.3% (44/119) and 62.7% (74/119) of the patients, respectively. Maternal characteristics, such as maternal age, body mass index, pre-existing hypertension and nulliparity, did not show any significant difference between the two groups. Although LV remodelling/hypertrophy and diastolic dysfunction occurred more often in early-onset pre-eclampsia compared to late-onset (65.9% vs 60.8% and 59.1% vs 51.4%, respectively), this difference was not statistically significant (p=0.580 and p=0.414, respectively). Similarly, LV mass index was 80.1±16.3 in pre-eclampsia <34 and 79.1±15 >34 (p=0.715) and E/e' was 7.8±1.9 and 7.6±1.7 (p=0.424). However, global longitudinal strain (GLS) was significantly lower (−16.4±2.4 vs −17.6±2.4, p=0.030) and apical rotation was higher (11.1±5.9 vs 8.7±4.7, p=0.019) in early-onset pre-eclampsia. A positive weak correlation has been found between GLS and difference in days from pre-eclampsia diagnosis to delivery (r=0.2, p=0.002).
Conclusions
Lower GLS in women affected by early-onset pre-eclampsia compared to late-onset pre-eclampsia might be useful to detect sub-clinical LV systolic impairment. Although further studies are needed, this sensitive marker may have a role in identifying women at risk of preterm delivery and/or severe maternal morbidity in the peripartum period.
Funding Acknowledgement
Type of funding sources: Public grant(s) – EU funding. Main funding source(s): Veronica Giorgione and Carolina Di Fabrizio have received funding from the European Union's Horizon 2020 research and innovation programme under the Marie Skłodowska-Curie grant agreement No 765274 (iPLACENTA project).
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Affiliation(s)
- V Giorgione
- St George's University of London, London, United Kingdom
| | - J O'Driscoll
- St George's University Hospital NHS Foundation Trust, London, United Kingdom
| | - C Di Fabrizio
- St George's University of London, London, United Kingdom
| | - A Frick
- St George's University Hospital NHS Foundation Trust, London, United Kingdom
| | - M Cauldwell
- St George's University Hospital NHS Foundation Trust, London, United Kingdom
| | - A Khalil
- St George's University of London, London, United Kingdom
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22
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Hjorth OR, Frick A, Gingnell M, Hoppe JM, Faria V, Hultberg S, Alaie I, Månsson KNT, Wahlstedt K, Jonasson M, Lubberink M, Antoni G, Fredrikson M, Furmark T. Expression and co-expression of serotonin and dopamine transporters in social anxiety disorder: a multitracer positron emission tomography study. Mol Psychiatry 2021; 26:3970-3979. [PMID: 31822819 DOI: 10.1038/s41380-019-0618-7] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2019] [Revised: 11/20/2019] [Accepted: 11/21/2019] [Indexed: 11/09/2022]
Abstract
Serotonin and dopamine are putatively involved in the etiology and treatment of anxiety disorders, but positron emission tomography (PET) studies probing the two neurotransmitters in the same individuals are lacking. The aim of this multitracer PET study was to evaluate the regional expression and co-expression of the transporter proteins for serotonin (SERT) and dopamine (DAT) in patients with social anxiety disorder (SAD). Voxel-wise binding potentials (BPND) for SERT and DAT were determined in 27 patients with SAD and 43 age- and sex-matched healthy controls, using the radioligands [11C]DASB (3-amino-4-(2-dimethylaminomethylphenylsulfanyl)-benzonitrile) and [11C]PE2I (N-(3-iodopro-2E-enyl)-2beta-carbomethoxy-3beta-(4'-methylphenyl)nortropane). Results showed that, within transmitter systems, SAD patients exhibited higher SERT binding in the nucleus accumbens while DAT availability in the amygdala, hippocampus, and putamen correlated positively with symptom severity. At a more lenient statistical threshold, SERT and DAT BPND were also higher in other striatal and limbic regions in patients, and correlated with symptom severity, whereas no brain region showed higher binding in healthy controls. Moreover, SERT/DAT co-expression was significantly higher in SAD patients in the amygdala, nucleus accumbens, caudate, putamen, and posterior ventral thalamus, while lower co-expression was noted in the dorsomedial thalamus. Follow-up logistic regression analysis confirmed that SAD diagnosis was significantly predicted by the statistical interaction between SERT and DAT availability, in the amygdala, putamen, and dorsomedial thalamus. Thus, SAD was associated with mainly increased expression and co-expression of the transporters for serotonin and dopamine in fear and reward-related brain regions. Resultant monoamine dysregulation may underlie SAD symptomatology and constitute a target for treatment.
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Affiliation(s)
- Olof R Hjorth
- Department of Psychology, Uppsala University, Uppsala, Sweden.
| | - Andreas Frick
- Department of Psychology, Uppsala University, Uppsala, Sweden.,The Beijer Laboratory, Department of Neuroscience, Psychiatry, Uppsala University, Uppsala, Sweden.,Department of Neuroscience, Psychiatry, Uppsala University, Uppsala, Sweden
| | - Malin Gingnell
- Department of Psychology, Uppsala University, Uppsala, Sweden.,Department of Neuroscience, Psychiatry, Uppsala University, Uppsala, Sweden
| | - Johanna M Hoppe
- Department of Psychology, Uppsala University, Uppsala, Sweden
| | - Vanda Faria
- Department of Psychology, Uppsala University, Uppsala, Sweden.,Center for Pain and the Brain, Department of Anesthesiology Perioperative and Pain Medicine, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA.,Smell & Taste Clinic, Department of Otorhinolaryngology, TU Dresden, Dresden, Germany
| | - Sara Hultberg
- Department of Psychology, Uppsala University, Uppsala, Sweden
| | - Iman Alaie
- Department of Neuroscience, Child and Adolescent Psychiatry, Uppsala University, Uppsala, Sweden
| | - Kristoffer N T Månsson
- Centre for Lifespan Psychology, Max Planck Institute for Human Development, Berlin, Germany.,Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.,Max Planck UCL Centre for Computational Psychiatry and Ageing Research, Berlin, Germany
| | - Kurt Wahlstedt
- Department of Psychology, Uppsala University, Uppsala, Sweden
| | - My Jonasson
- Department of Surgical Sciences-Nuclear medicine and PET, Uppsala University, Uppsala, Sweden
| | - Mark Lubberink
- Department of Surgical Sciences-Nuclear medicine and PET, Uppsala University, Uppsala, Sweden
| | - Gunnar Antoni
- Department of Medicinal Chemistry, Uppsala University, Uppsala, Sweden
| | - Mats Fredrikson
- Department of Psychology, Uppsala University, Uppsala, Sweden.,Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Tomas Furmark
- Department of Psychology, Uppsala University, Uppsala, Sweden
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23
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Dubanet O, Ferreira Gomes Da Silva A, Frick A, Hirase H, Beyeler A, Leinekugel X. Probing the polarity of spontaneous perisomatic GABAergic synaptic transmission in the mouse CA3 circuit in vivo. Cell Rep 2021; 36:109381. [PMID: 34260906 DOI: 10.1016/j.celrep.2021.109381] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Revised: 11/18/2020] [Accepted: 06/18/2021] [Indexed: 11/27/2022] Open
Abstract
The hypothesis that reversed, excitatory GABA may be involved in various brain pathologies, including epileptogenesis, is appealing but controversial because of the technical difficulty of probing endogenous GABAergic synaptic function in vivo. We overcome this challenge by non-invasive extracellular recording of neuronal firing responses to optogenetically evoked and spontaneously occurring inhibitory perisomatic GABAergic field potentials, generated by individual parvalbumin interneurons on their target pyramidal cells. Our direct probing of GABAergic transmission suggests a rather anecdotal participation of excitatory GABA in two specific models of epileptogenesis in the mouse CA3 circuit in vivo, even though this does not preclude its expression in other brain areas or pathological conditions. Our approach allows the detection of distinct alterations of inhibition during spontaneous activity in vivo, with high sensitivity. It represents a promising tool for the investigation of excitatory GABA in different pathological conditions that may affect the hippocampal circuit.
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Affiliation(s)
- Olivier Dubanet
- University of Bordeaux, INSERM U1215, Neurocentre Magendie, 33077 Bordeaux, France
| | - Arnaldo Ferreira Gomes Da Silva
- University of Bordeaux, INSERM U1215, Neurocentre Magendie, 33077 Bordeaux, France; INMED, INSERM, Aix Marseille Univ, France
| | - Andreas Frick
- University of Bordeaux, INSERM U1215, Neurocentre Magendie, 33077 Bordeaux, France
| | - Hajime Hirase
- Center for Translational Neuromedicine, University of Copenhagen, Copenhagen, Denmark
| | - Anna Beyeler
- University of Bordeaux, INSERM U1215, Neurocentre Magendie, 33077 Bordeaux, France
| | - Xavier Leinekugel
- University of Bordeaux, INSERM U1215, Neurocentre Magendie, 33077 Bordeaux, France; INMED, INSERM, Aix Marseille Univ, France.
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24
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Kleberg JL, Högström J, Sundström K, Frick A, Serlachius E. Delayed gaze shifts away from others' eyes in children and adolescents with social anxiety disorder. J Affect Disord 2021; 278:280-287. [PMID: 32977266 DOI: 10.1016/j.jad.2020.09.022] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2020] [Revised: 09/02/2020] [Accepted: 09/08/2020] [Indexed: 02/06/2023]
Abstract
BACKGROUND Social anxiety disorder (SAD) is linked to atypical attention to other's eyes. Empirical literature about this phenomenon in childhood and adolescence is scarce. Previous studies in adults have suggested that SAD may be characterized by either rapid avoidance of eye contact, or by impaired shifting of attention away from eyes once eye contact has been established. SAD has also been linked to quick orienting towards eyes, indicating vigilant monitoring of perceived threat. METHODS In the largest eye-tracking study of youth with SAD to date, 10 to 17 year-olds with SAD (n = 88) and healthy controls (n = 62) were primed to look at either the eyes or the mouth of human faces. The latency and likelihood of a first gaze shift from, or to the eyes, was measured. RESULTS Individuals with SAD were slower to shift their gaze away from the eye region of faces than controls, but did not differ in orienting toward eyes. LIMITATIONS Participants were assessed once after the onset of SAD symptoms, meaning that the longitudinal predictive value of delayed gaze shifts from others' eyes could not be examined. CONCLUSIONS Youth with SAD may be impaired in shifting attention from other's eyes. This could contribute to the experience of eye contact as aversive, and may be a maintaining factor of childhood SAD.
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Affiliation(s)
- Johan Lundin Kleberg
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet and Stockholm Health Care Services, Region Stockholm, CAP Research Centre, Gävlegatan 22, SE-113 30 Stockholm, Sweden.
| | - Jens Högström
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet and Stockholm Health Care Services, Region Stockholm, CAP Research Centre, Gävlegatan 22, SE-113 30 Stockholm, Sweden
| | - Karin Sundström
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet and Stockholm Health Care Services, Region Stockholm, CAP Research Centre, Gävlegatan 22, SE-113 30 Stockholm, Sweden
| | - Andreas Frick
- The Beijer Laboratory, Department of Neuroscience, Uppsala University, Uppsala, Sweden
| | - Eva Serlachius
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet and Stockholm Health Care Services, Region Stockholm, CAP Research Centre, Gävlegatan 22, SE-113 30 Stockholm, Sweden
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25
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Abstract
AbstractAlthough cognitive behavioral therapy (CBT) is an established and efficient treatment for a variety of common mental disorders, a considerable number of patients do not respond to treatment or relapse after successful CBT. Recent findings and approaches from neuroscience could pave the way for clinical developments to enhance the outcome of CBT. Herein, we will present how neuroscience can offer novel perspectives to better understand (a) the biological underpinnings of CBT, (b) how we can enrich CBT with neuroscience-informed techniques (augmentation of CBT), and (c) why some patients may respond better to CBT than others (predictors of therapy outcomes), thus paving the way for more personalized and effective treatments. We will introduce some key topics and describe a selection of findings from CBT-related research using tools from neuroscience, with the hope that this will provide clinicians and clinical researchers with a brief and comprehensible overview of the field.
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26
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Del Pino I, Tocco C, Magrinelli E, Marcantoni A, Ferraguto C, Tomagra G, Bertacchi M, Alfano C, Leinekugel X, Frick A, Studer M. COUP-TFI/Nr2f1 Orchestrates Intrinsic Neuronal Activity during Development of the Somatosensory Cortex. Cereb Cortex 2020; 30:5667-5685. [DOI: 10.1093/cercor/bhaa137] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2020] [Revised: 04/17/2020] [Accepted: 04/29/2020] [Indexed: 01/19/2023] Open
Abstract
Abstract
The formation of functional cortical maps in the cerebral cortex results from a timely regulated interaction between intrinsic genetic mechanisms and electrical activity. To understand how transcriptional regulation influences network activity and neuronal excitability within the neocortex, we used mice deficient for Nr2f1 (also known as COUP-TFI), a key determinant of primary somatosensory (S1) area specification during development. We found that the cortical loss of Nr2f1 impacts on spontaneous network activity and synchronization of S1 cortex at perinatal stages. In addition, we observed alterations in the intrinsic excitability and morphological features of layer V pyramidal neurons. Accordingly, we identified distinct voltage-gated ion channels regulated by Nr2f1 that might directly influence intrinsic bioelectrical properties during critical time windows of S1 cortex specification. Altogether, our data suggest a tight link between Nr2f1 and neuronal excitability in the developmental sequence that ultimately sculpts the emergence of cortical network activity within the immature neocortex.
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Affiliation(s)
- Isabel Del Pino
- Université de Bordeaux, Inserm U1215, Neurocentre Magendie, 33077 Bordeaux, France
- Centro de Investigación Príncipe Felipe, 46012 Valencia, Spain
| | - Chiara Tocco
- Université Côte d’Azur, CNRS, Inserm, iBV, 06108 Nice, France
| | - Elia Magrinelli
- Université Côte d’Azur, CNRS, Inserm, iBV, 06108 Nice, France
- Département des Neurosciences Fondamentales, Université de Lausanne, CH-1005 Lausanne, Switzerland
| | - Andrea Marcantoni
- Dipartimento di Scienza e Tecnologia del Farmaco, Università di Torino, 10125 Torino, Italy
| | | | - Giulia Tomagra
- Dipartimento di Scienza e Tecnologia del Farmaco, Università di Torino, 10125 Torino, Italy
| | | | | | - Xavier Leinekugel
- Université de Bordeaux, Inserm U1215, Neurocentre Magendie, 33077 Bordeaux, France
| | - Andreas Frick
- Université de Bordeaux, Inserm U1215, Neurocentre Magendie, 33077 Bordeaux, France
| | - Michèle Studer
- Université Côte d’Azur, CNRS, Inserm, iBV, 06108 Nice, France
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27
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Baumeister RGH, Wallmichrath J, Weiss M, Baumeister SHC, Frick A. MICROSURGICAL LYMPHATIC VASCULAR GRAFTING AND SECONDARY LIPOSUCTION: RESULTS OF COMBINATION TREATMENT IN SECONDARY LYMPHEDEMA. Lymphology 2020. [DOI: 10.2458/lymph.4653] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Surgical treatment of lymphedema with liposuction typically requires subsequent compression therapy. Here we describe an approach where secondary arm lymphedemas are initially treated by autologous lymphatic grafting to bypass the axilla and restore lymphatic flow. In the presence of excess adipose tissue, liposuction is then performed in a second procedure. To assess outcomes, the authors evaluated 28 consecutive adult patients who had undergone secondary liposuction following lymphatic grafting. Arm volumes were measured prior to lymphatic grafting and after the secondary liposuction. The necessity for additional treatment by compression garment and manual lymphatic drainage was assessed prior to lymphatic grafting and after the secondary liposuction following the direct postoperative regimen. The mean arm volumes were reduced significantly (p<0.001) from a mean of 3417±171 (SEM) cm3 prior to lymphatic grafting to 3020±125 cm3 after reconstruction of the lymphatic vascular system and finally to 2516±104 cm3 after the secondary liposuction (SLS). All 28 adult patients underwent continuous compression and manual lymph-drainage (MLD) prior to the reconstructive surgery. All 28 patients were evaluated regarding necessity of any additional therapy more than 6 months after SLS with a median follow up period of 37 months (range, 7-160 months). 18 of 28 patients did not require any supportive therapy beyond 6 months after SLS to maintain the results. Three patients continued to utilize manual lymphatic drainage, 4 used a combination of MLD and compression therapy and 3 used elastic compression therapy (one patient only while at work). These results indicate that microsurgical restoration of lymphatic outflow followed by SLS eliminates the need for additional treatment in more than two thirds of patients.
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28
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Costache ME, Frick A, Månsson K, Engman J, Faria V, Hjorth O, Hoppe JM, Gingnell M, Frans Ö, Björkstrand J, Rosén J, Alaie I, Åhs F, Linnman C, Wahlstedt K, Tillfors M, Marteinsdottir I, Fredrikson M, Furmark T. Higher- and lower-order personality traits and cluster subtypes in social anxiety disorder. PLoS One 2020; 15:e0232187. [PMID: 32348331 PMCID: PMC7190155 DOI: 10.1371/journal.pone.0232187] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2019] [Accepted: 04/08/2020] [Indexed: 02/03/2023] Open
Abstract
Social anxiety disorder (SAD) can come in different forms, presenting problems for diagnostic classification. Here, we examined personality traits in a large sample of patients (N = 265) diagnosed with SAD in comparison to healthy controls (N = 164) by use of the Revised NEO Personality Inventory (NEO-PI-R) and Karolinska Scales of Personality (KSP). In addition, we identified subtypes of SAD based on cluster analysis of the NEO-PI-R Big Five personality dimensions. Significant group differences in personality traits between patients and controls were noted on all Big Five dimensions except agreeableness. Group differences were further noted on most lower-order facets of NEO-PI-R, and nearly all KSP variables. A logistic regression analysis showed, however, that only neuroticism and extraversion remained significant independent predictors of patient/control group when controlling for the effects of the other Big Five dimensions. Also, only neuroticism and extraversion yielded large effect sizes when SAD patients were compared to Swedish normative data for the NEO-PI-R. A two-step cluster analysis resulted in three separate clusters labelled Prototypical (33%), Introvert-Conscientious (29%), and Instable-Open (38%) SAD. Individuals in the Prototypical cluster deviated most on the Big Five dimensions and they were at the most severe end in profile analyses of social anxiety, self-rated fear during public speaking, trait anxiety, and anxiety-related KSP variables. While additional studies are needed to determine if personality subtypes in SAD differ in etiological and treatment-related factors, the present results demonstrate considerable personality heterogeneity in socially anxious individuals, further underscoring that SAD is a multidimensional disorder.
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Affiliation(s)
| | - Andreas Frick
- The Beijer Laboratory, Department of Neuroscience, Uppsala University, Uppsala, Sweden
| | - Kristoffer Månsson
- Department of Psychology, Uppsala University, Uppsala, Sweden
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, & Stockholm Health Care Services, Stockholm County Council, Stockholm, Sweden
- Max Planck UCL Centre for Computational Psychiatry and Ageing Research, Berlin, Germany and London, United Kingdom
- Center for Lifespan Psychology, Max Planck Institute for Human Development, Berlin, Germany
| | - Jonas Engman
- Department of Psychology, Uppsala University, Uppsala, Sweden
| | - Vanda Faria
- Department of Psychology, Uppsala University, Uppsala, Sweden
- Center for Pain and The Brain, Department of Anesthesiology, Harvard Medical School, Boston Children’s Hospital, Perioperative and Pain Medicine, Boston, MA, United States of America
- Department of Otorhinolaryngology, Smell & Taste Clinic, TU Dresden, Dresden, Germany
| | - Olof Hjorth
- Department of Psychology, Uppsala University, Uppsala, Sweden
| | | | - Malin Gingnell
- Department of Psychology, Uppsala University, Uppsala, Sweden
- Department of Neuroscience, Uppsala University, Uppsala, Sweden
| | - Örjan Frans
- Department of Psychology, Uppsala University, Uppsala, Sweden
| | - Johannes Björkstrand
- Department of Psychology, Uppsala University, Uppsala, Sweden
- Department of Psychology, Lund University, Lund, Sweden
| | - Jörgen Rosén
- Department of Psychology, Uppsala University, Uppsala, Sweden
| | - Iman Alaie
- Department of Psychology, Uppsala University, Uppsala, Sweden
- Department of Neuroscience, Child and Adolescent Psychiatry, Uppsala University, Uppsala, Sweden
| | - Fredrik Åhs
- Department of Psychology and Social Work, Mid Sweden University, Östersund, Sweden
| | - Clas Linnman
- Harvard Medical School, Spaulding Rehabilitation Hospital, Boston, MA, United States of America
| | - Kurt Wahlstedt
- Department of Psychology, Uppsala University, Uppsala, Sweden
| | - Maria Tillfors
- Department of Social and Psychological Studies, Karlstad University, Karlstad, Sweden
| | - Ina Marteinsdottir
- Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden
| | - Mats Fredrikson
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Tomas Furmark
- Department of Psychology, Uppsala University, Uppsala, Sweden
- * E-mail:
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29
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Giunta RE, Frank K, Moellhoff N, Braig D, Haas EM, Ahmad N, Hagen CS, Wiggenhauser PS, Frick A, Koban K, Wachtel N, Taha S, Ehrl D, Schenck TL. [The COVID-19 Pandemia and its consequences for plastic surgery and hand surgery]. HANDCHIR MIKROCHIR P 2020; 52:233-241. [PMID: 32344444 DOI: 10.1055/a-1163-9009] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
Abstract
The first case of a SARS-Cov-2 virus infection was confirmed on January 27th in Munich. For both, plastic and hand surgeons it is crucial to act responsible, minimize the transmission of the virus and aid in reasonable and adequate allocation of resources for the treatment of affected patients during this pandemia. This article aims to provide an overview over the latest developments and insights that affect plastic and hand surgeons. At the same time plastic and hand surgeons are required to participate actively in the discussion of new regulatory measures that on one hand aim to ensure a proper medical care of COVID-19 patients and on the other hand need to guarantee coverage of all other patients. Furthermore exit - strategies after the pandemia need to be discussed by our societies. Naturally, this manuscript provides insight into the current situation, which might undergo changes due to the swift progression of the pandemia.
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Affiliation(s)
- Riccardo E Giunta
- Klinikum der Ludwig-Maximilians Universität, MünchenAbteilung für Handchirurgie, Plastische und Ästhetische Chirurgie
| | - Konstantin Frank
- Klinikum der Ludwig-Maximilians Universität, MünchenAbteilung für Handchirurgie, Plastische und Ästhetische Chirurgie
| | - Nicholas Moellhoff
- Klinikum der Ludwig-Maximilians Universität, MünchenAbteilung für Handchirurgie, Plastische und Ästhetische Chirurgie
| | - David Braig
- Klinikum der Ludwig-Maximilians Universität, MünchenAbteilung für Handchirurgie, Plastische und Ästhetische Chirurgie
| | - Elisabeth M Haas
- Klinikum der Ludwig-Maximilians Universität, MünchenAbteilung für Handchirurgie, Plastische und Ästhetische Chirurgie
| | - Nura Ahmad
- Klinikum der Ludwig-Maximilians Universität, MünchenAbteilung für Handchirurgie, Plastische und Ästhetische Chirurgie
| | - Christine S Hagen
- Klinikum der Ludwig-Maximilians Universität, MünchenAbteilung für Handchirurgie, Plastische und Ästhetische Chirurgie
| | - Paul Severin Wiggenhauser
- Klinikum der Ludwig-Maximilians Universität, MünchenAbteilung für Handchirurgie, Plastische und Ästhetische Chirurgie
| | - Andreas Frick
- Klinikum der Ludwig-Maximilians Universität, MünchenAbteilung für Handchirurgie, Plastische und Ästhetische Chirurgie
| | - Konstantin Koban
- Klinikum der Ludwig-Maximilians Universität, MünchenAbteilung für Handchirurgie, Plastische und Ästhetische Chirurgie
| | - Nikolaus Wachtel
- Klinikum der Ludwig-Maximilians Universität, MünchenAbteilung für Handchirurgie, Plastische und Ästhetische Chirurgie
| | - Sara Taha
- Klinikum der Ludwig-Maximilians Universität, MünchenAbteilung für Handchirurgie, Plastische und Ästhetische Chirurgie
| | - Denis Ehrl
- Klinikum der Ludwig-Maximilians Universität, MünchenAbteilung für Handchirurgie, Plastische und Ästhetische Chirurgie
| | - Thilo L Schenck
- Klinikum der Ludwig-Maximilians Universität, MünchenAbteilung für Handchirurgie, Plastische und Ästhetische Chirurgie
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Benazzo A, Schwarz S, Schweiger T, Frick A, Moser B, Matilla J, Lang G, Taghavi S, Jaksch P, Klepetko W, Hoetzenecker K. Respiratory Failure Treated by ECLS in Previously Unscreened Patients - Is Lung Transplantation Feasible? J Heart Lung Transplant 2020. [DOI: 10.1016/j.healun.2020.01.458] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
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Hartwig M, Loor G, Bottiger B, Warnecke G, Sommer W, Frick A, Neyrinck A, Villavicencio-Theoduloz M, Drezek K, Daoud D, Wei Q, Huddleston S, Landeweer M, Toyoda Y, Kashem M, Chandrashekaran S, Machuca T, Plascencia R, Smith M, Van Raemdonck D. Effect of Time of Intraoperative Circulatory Support on Incidence of High-Grade Primary Graft Dysfunction (PGD): Multicenter Analysis on Use of Extracorporeal Life Support (ECLS) during Lung Transplantation. J Heart Lung Transplant 2020. [DOI: 10.1016/j.healun.2020.01.346] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Benazzo A, Schwarz S, Schweiger T, Frick A, Muraközy G, Lambers C, Moser B, Matilla J, Lang G, Taghavi S, Klepetko W, Hoetzenecker K, Jaksch P. Outcome of Extracorporeal Photopheresis as Add-On Therapy in Patients for Antibody-Mediated Rejection after Lung Transplantation. J Heart Lung Transplant 2020. [DOI: 10.1016/j.healun.2020.01.1303] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
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Frick A, Kifjak D, Taghavi S, Lang G, Moser B, Schwarz S, Benazzo A, Klepetko W, Jaksch P, Hoetzenecker K. Lung Transplantation for Acute Respiratory Distress Syndrome Patients: A Single Center Experience. J Heart Lung Transplant 2020. [DOI: 10.1016/j.healun.2020.01.338] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Frick A, Kostiv V, Vojtassakova D, Akolekar R, Nicolaides KH. Comparison of different methods of measuring angle of progression in prediction of labor outcome. Ultrasound Obstet Gynecol 2020; 55:391-400. [PMID: 31692170 DOI: 10.1002/uog.21913] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/01/2019] [Revised: 10/21/2019] [Accepted: 10/24/2019] [Indexed: 06/10/2023]
Abstract
OBJECTIVES First, to compare the manual sagittal and parasagittal and automated parasagittal methods of measuring the angle of progression (AoP) by transperineal ultrasound during labor, and, second, to develop models for the prediction of time to delivery and need for Cesarean section (CS) for failure to progress (FTP) in a population of patients undergoing induction of labor. METHODS This was a prospective observational study of transperineal ultrasound in a cohort of 512 women with a singleton pregnancy undergoing induction of labor. A random selection of 50 stored images was assessed for inter- and intraobserver reliability of AoP measurements using the manual sagittal and parasagittal and automated parasagittal methods. In cases of vaginal delivery, univariate linear, multiple linear and quantile regression analyses were performed to predict time to delivery. Univariate and multivariate binomial logistic regression analyses were performed to predict CS for FTP in the first stage of labor. RESULTS The intraclass correlation coefficient (ICC) for the manual parasagittal method for a single observer was 0.97 (95% CI, 0.95-0.98) and for two observers it was 0.96 (95% CI, 0.93-0.98), indicating good reliability. The ICC for the sagittal method for a single observer was 0.93 (95% CI, 0.88-0.96) and for two observers it was 0.74 (95% CI, 0.58-0.84), indicating moderate reliability for a single observer and poor reliability between two observers. Bland-Altman analysis demonstrated narrower limits of agreement for the manual parasagittal approach than for the sagittal approach for both a single and two observers. The automated parasagittal method failed to capture an image in 19% of cases. The mean difference in AoP measurements between the sagittal and manual parasagittal methods was 11°. In pregnancies resulting in vaginal delivery, 54% of the variation in time to delivery was explained in a model combining parity, epidural and syntocinon use during labor and the sonographic findings of fetal head position and AoP. In the prediction of CS for FTP in the first stage of labor, a model which combined maternal factors with the sonographic measurements of AoP and estimated fetal weight was superior to one utilizing maternal factors alone (area under the receiver-operating-characteristics curve, 0.80 vs 0.76). CONCLUSIONS First, the method of measuring AoP with the greatest reliability is the manual parasagittal technique and future research should focus on this technique. Second, over half of the variation in time to vaginal delivery can be explained by a model that combines maternal factors, pregnancy characteristics and ultrasound findings. Third, the ability of AoP to provide clinically useful prediction of CS for FTP in the first stage of labor is limited. Copyright © 2019 ISUOG. Published by John Wiley & Sons Ltd.
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Affiliation(s)
- A Frick
- Harris Birthright Research Centre for Fetal Medicine, King's College Hospital, London, UK
| | - V Kostiv
- Harris Birthright Research Centre for Fetal Medicine, King's College Hospital, London, UK
- Fetal Medicine Unit, Medway Maritime Hospital, Gillingham, UK
| | - D Vojtassakova
- Harris Birthright Research Centre for Fetal Medicine, King's College Hospital, London, UK
- Fetal Medicine Unit, Medway Maritime Hospital, Gillingham, UK
| | - R Akolekar
- Fetal Medicine Unit, Medway Maritime Hospital, Gillingham, UK
- Institute of Medical Sciences, Canterbury Christ Church University, Chatham, UK
| | - K H Nicolaides
- Harris Birthright Research Centre for Fetal Medicine, King's College Hospital, London, UK
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Kraus J, Roman R, Jurkovičová L, Mareček R, Mikl M, Brázdil M, Frick A. Social support modulates subjective and neural responses to sad mental imagery. Behav Brain Res 2020; 380:112433. [PMID: 31843658 DOI: 10.1016/j.bbr.2019.112433] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2019] [Revised: 11/16/2019] [Accepted: 12/12/2019] [Indexed: 01/10/2023]
Abstract
Mental imagery related to the recent death of a loved one is associated with intense sadness and distress. Social relations, such as with one's significant other, can regulate negative emotions and provide comfort, but the neural correlates of social comfort are largely unknown. In this functional magnetic resonance imaging study, we examined brain responses to sad mental imagery and how these are modulated by holding hands with one's romantic partner. We found that mental imagery of a recently deceased loved one was associated with increased reactivity in the dorsal striatum, medial prefrontal cortex, anterior and posterior cingulate cortex, thalamus and cerebellum. Holding hands with one's partner as compared to being alone or holding hands with a stranger provided subjective comfort and reduced neural reactivity in the dorsal striatum without affecting the vividness of the imagery. Our findings indicate an important role for the dorsal striatum in sad mental imagery and social comfort and suggest that tactile social support by one's romantic partner regulates subjective distress through other processes than mere distraction from the mental imagery.
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Affiliation(s)
- Jakub Kraus
- Faculty of Medicine, Masaryk University, Kamenice 753/5, 625 00 Brno, Czech Republic; Department of Clinical Neuroscience, Karolinska Institute, Nobels Väg 9, 171 65 Stockholm, Sweden.
| | - Robert Roman
- Centre for Neuroscience, Central European Institute of Technology, Masaryk University, Kamenice 753/5, 625 00 Brno, Czech Republic
| | - Lenka Jurkovičová
- Faculty of Medicine, Masaryk University, Kamenice 753/5, 625 00 Brno, Czech Republic
| | - Radek Mareček
- Centre for Neuroscience, Central European Institute of Technology, Masaryk University, Kamenice 753/5, 625 00 Brno, Czech Republic
| | - Michal Mikl
- Centre for Neuroscience, Central European Institute of Technology, Masaryk University, Kamenice 753/5, 625 00 Brno, Czech Republic
| | - Milan Brázdil
- Centre for Neuroscience, Central European Institute of Technology, Masaryk University, Kamenice 753/5, 625 00 Brno, Czech Republic
| | - Andreas Frick
- The Beijer Laboratory, Department of Neuroscience, Uppsala University, Husargatan 3, 752 39 Uppsala, Sweden
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Möhrle D, Fernández M, Peñagarikano O, Frick A, Allman B, Schmid S. What we can learn from a genetic rodent model about autism. Neurosci Biobehav Rev 2020; 109:29-53. [DOI: 10.1016/j.neubiorev.2019.12.015] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2019] [Revised: 10/28/2019] [Accepted: 12/10/2019] [Indexed: 12/15/2022]
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Frick A, Engman J, Alaie I, Björkstrand J, Gingnell M, Larsson EM, Eriksson E, Wahlstedt K, Fredrikson M, Furmark T. Neuroimaging, genetic, clinical, and demographic predictors of treatment response in patients with social anxiety disorder. J Affect Disord 2020; 261:230-237. [PMID: 31655378 DOI: 10.1016/j.jad.2019.10.027] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2019] [Revised: 08/30/2019] [Accepted: 10/19/2019] [Indexed: 12/18/2022]
Abstract
BACKGROUND Correct prediction of treatment response is a central goal of precision psychiatry. Here, we tested the predictive accuracy of a variety of pre-treatment patient characteristics, including clinical, demographic, molecular genetic, and neuroimaging markers, for treatment response in patients with social anxiety disorder (SAD). METHODS Forty-seven SAD patients (mean±SD age 33.9 ± 9.4 years, 24 women) were randomized and commenced 9 weeks' Internet-delivered cognitive behavior therapy (CBT) combined either with the selective serotonin reuptake inhibitor (SSRI) escitalopram (20 mg daily [10 mg first week], SSRI+CBT, n = 24) or placebo (placebo+CBT, n = 23). Treatment responders were defined from the Clinical Global Impression-Improvement scale (CGI-I ≤ 2). Before treatment, patients underwent functional magnetic resonance imaging and the Multi-Source Interference Task taxing cognitive interference. Support vector machines (SVMs) were trained to separate responders from nonresponders based on pre-treatment neural reactivity in the dorsal anterior cingulate cortex (dACC), amygdala, and occipital cortex, as well as molecular genetic, demographic, and clinical data. SVM models were tested using leave-one-subject-out cross-validation. RESULTS The best model separated treatment responders (n = 24) from nonresponders based on pre-treatment dACC reactivity (83% accuracy, P = 0.001). Responders had greater pre-treatment dACC reactivity than nonresponders especially in the SSRI+CBT group. No other variable was associated with clinical response or added predictive accuracy to the dACC SVM model. LIMITATIONS Small sample size, especially for genetic analyses. No replication or validation samples were available. CONCLUSIONS The findings demonstrate that treatment outcome predictions based on neural cingulate activity, at the individual level, outperform genetic, demographic, and clinical variables for medication-assisted Internet-delivered CBT, supporting the use of neuroimaging in precision psychiatry.
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Affiliation(s)
- Andreas Frick
- The Beijer Laboratory, Department of Neuroscience, Uppsala University, Uppsala, Sweden; Department of Psychology, Uppsala University, Uppsala, Sweden.
| | - Jonas Engman
- Department of Psychology, Uppsala University, Uppsala, Sweden
| | - Iman Alaie
- Department of Psychology, Uppsala University, Uppsala, Sweden; Department of Neuroscience, Child and Adolescent Psychiatry, Uppsala University, Uppsala, Sweden
| | - Johannes Björkstrand
- Department of Psychology, Uppsala University, Uppsala, Sweden; Department of Psychology, University of Southern Denmark, Odense, Denmark; Department of Psychology, Lund University, Lund, Sweden
| | - Malin Gingnell
- Department of Psychology, Uppsala University, Uppsala, Sweden; Department of Neuroscience, Uppsala University, Uppsala, Sweden
| | - Elna-Marie Larsson
- Department of Surgical Sciences/Radiology, Uppsala University, Uppsala, Sweden
| | - Elias Eriksson
- Department of Pharmacology, Institute of Neuroscience and Physiology at the Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Kurt Wahlstedt
- Department of Psychology, Uppsala University, Uppsala, Sweden
| | - Mats Fredrikson
- Department of Psychology, Uppsala University, Uppsala, Sweden; Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Tomas Furmark
- Department of Psychology, Uppsala University, Uppsala, Sweden
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Baumeister RGH, Wallmichrath J, Weiss M, Baumeister SHC, Frick A. Microsurgical lymphatic vascular grafting and secondary liposuction: Results of combination treatment in secondary lymphedema. Lymphology 2020; 53:38-47. [PMID: 32521129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Surgical treatment of lymphedema with liposuction typically requires subsequent compression therapy. Here we describe an approach where secondary arm lymphedemas are initially treated by autologous lymphatic grafting to bypass the axilla and restore lymphatic flow. In the presence of excess adipose tissue, liposuction is then performed in a second procedure. To assess outcomes, the authors evaluated 28 consecutive adult patients who had undergone secondary liposuction following lymphatic grafting. Arm volumes were measured prior to lymphatic grafting and after the secondary liposuction. The necessity for additional treatment by compression garment and manual lymphatic drainage was assessed prior to lymphatic grafting and after the secondary liposuction following the direct postoperative regimen. The mean arm volumes were reduced significantly (p<0.001) from a mean of 3417± 171 (SEM) cm3 prior to lymphatic grafting to 3020±125 cm3 after reconstruction of the lymphatic vascular system and finally to 2516±104 cm3 after the secondary liposuction (SLS). All 28 adult patients underwent continuous compression and manual lymph-drainage (MLD) prior to the reconstructive surgery. All 28 patients were evaluated regarding necessity of any additional therapy more than 6 months after SLS with a median follow up period of 37 months (range, 7-160 months). 18 of 28 patients did not require any supportive therapy beyond 6 months after SLS to maintain the results. Three patients continued to utilize manual lymphatic drainage, 4 used a combination of MLD and compression therapy and 3 used elastic compression therapy (one patient only while at work). These results indicate that microsurgical restoration of lymphatic outflow followed by SLS eliminates the need for additional treatment in more than two thirds of patients.
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Affiliation(s)
- R G H Baumeister
- Consultant in Lymphology and Microsurgery Chirurgische Klinik Muenchen Bogenhausen and Urologische Klinik Muenchen Planegg, Munich
| | - J Wallmichrath
- Former Head of the Division of Plastic-, Hand- and Microsurgery, Department of Surgery, Campus Grosshadern, Ludwig-Maximilians University, Munich
- Division of Hand, Plastic and Aesthetic Surgery, University Hospital, LMU Munich, Germany
| | - M Weiss
- Department of Nuclear Medicine, University Hospital, LMU Munich, Germany
| | - S H C Baumeister
- Division of Pediatric Oncology, Dana-Farber Cancer Institute, Boston Children's Hospital and Harvard Medical School, Boston, MA, USA
- Division of Pediatric Hematology-Oncology, Boston Children's Hospital and Harvard Medical School, Boston, MA, USA
| | - A Frick
- Division of Hand, Plastic and Aesthetic Surgery, University Hospital, LMU Munich, Germany
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Kraus J, Frick A, Roman R, Jurkovičová L, Mareček R, Mikl M, Brázdil M, Fredrikson M. Soothing the emotional brain: modulation of neural activity to personal emotional stimulation by social touch. Soc Cogn Affect Neurosci 2019; 14:1179-1185. [PMID: 31820813 PMCID: PMC7057286 DOI: 10.1093/scan/nsz090] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2019] [Revised: 09/26/2019] [Accepted: 10/14/2019] [Indexed: 01/10/2023] Open
Abstract
Social touch may modulate emotions, but the neurobehavioral correlates are poorly understood. Here, we investigated neural responses to a picture of a deceased close person and if neural activity and connectivity are modulated by social touch from one's romantic partner. Using functional magnetic resonance imaging, we found altered reactivity in several brain areas including the anterior cingulate cortex (ACC) and the anterior insula in response to the personal picture compared to a picture of an unfamiliar person. Hand holding with the romantic partner, compared to being alone, reduced reactivity in the ACC and cerebellum and provided subjective comfort. To separate physical touch from the emotional effect of partner presence, we evaluated hand holding with the partner relative to a stranger and found reduced reactivity in the anterior insula. Connectivity between the anterior insula and the ACC was reduced during partner touch, and the connectivity strength was negatively related to attachment security, with higher reported partner security associated with weaker connectivity. Overall, holding hands with one's partner attenuates reactivity in emotional brain areas and reduces between-region connectivity.
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Affiliation(s)
- Jakub Kraus
- Department of Clinical Neuroscience, Karolinska Institute, Stockholm, Sweden.,Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - Andreas Frick
- The Beijer Laboratory, Department of Neuroscience, Uppsala University, Uppsala, Sweden
| | - Robert Roman
- Centre for Neuroscience, Central European Institute of Technology, Masaryk University, Brno, Czech Republic
| | | | - Radek Mareček
- Centre for Neuroscience, Central European Institute of Technology, Masaryk University, Brno, Czech Republic
| | - Michal Mikl
- Centre for Neuroscience, Central European Institute of Technology, Masaryk University, Brno, Czech Republic
| | - Milan Brázdil
- Centre for Neuroscience, Central European Institute of Technology, Masaryk University, Brno, Czech Republic
| | - Mats Fredrikson
- Department of Clinical Neuroscience, Karolinska Institute, Stockholm, Sweden
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Hirche C, Engel H, Seidenstuecker K, Taeger C, Machens HG, Frick A, Harder Y. Rekonstruktive Mikrochirurgie des sekundären Lymphödems: Konsensus der Deutschsprachigen Arbeitsgemeinschaft für Mikrochirurgie der peripheren Nerven und Gefäße (DAM) zur Indikation, Diagnostik und Therapie mittels Lymphovenöser Anastomosen (LVA) und vaskularisierter Lymphknotentransplantation (VLKT). HANDCHIR MIKROCHIR P 2019; 51:424-433. [DOI: 10.1055/a-0874-2212] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
Abstract
ZusammenfassungDas sekundäre Lymphödem ist eine komplexe Erkrankung, die durch chronische Inflammation und reduzierte Immunkompetenz, Ansammlung von Lymphflüssigkeit und Proteinablagerungen sowie sekundärer Fettablagerung und Fibrosierung bei der Stadienmigration charakterisiert ist. Während die Domäne der Behandlung immer noch eine lebenslange komplexe physikalische Entstauungstherapie (KPE) ist, wird der Fokus auf chirurgische Verfahren zur physiologischen Rekonstruktion gesetzt. Die lymphovenösen Anastomosen (LVA) und die freie, vaskularisierte Lymphknotentransplantation (VLKT) sind die am verbreitetsten angewendeten, rekonstruktiven Techniken, die die Wiederherstellung oder Verbesserung der physiologischen Lymphtransportkapzität adressieren. Der vorliegende Artikel fasst die Empfehlungen eines Expertenpanels zur Diagnostik, Indikation und Therapie von LVA und VLKT bei sekundären Lymphödemen während der 40. Jahrestagung der Deutschsprachigen Arbeitsgemeinschaft für Mikrochirurgie der peripheren Nerven und Gefäße (DAM) in Lugano, Schweiz, zusammen und diskutiert sie. Das Expertengremium befasste sich mit der Diagnostik für die lymphorekonstruktive Chirurgie, einschließlich der essentiellen Anwendung der Fluoreszenz-Lymphangiographie mit Indocyaningrün (ICG) und der intraoperativen Navigation für beide Techniken sowie dem „reverse mapping“, um die Rate des Hebestellen-Lymphödems nach VLKT zu reduzieren, sowie die Verwendung von Lymphödem-spezifischen Fragebögen zur Lebensqualität. Sowohl LVA als auch VLKT werden einschließlich Tipps und Tricks zur Identifizierung funktioneller Lymphkollektoren, Ausrüstung, Anastomosenarten und Dokumentation für LVA sowie Auswahl der Spender- und Empfängerstelle, Anzahl der inkludierten Lymphknoten und Herangehensweise an spezifische Spenderstellen, wie z. B. jejunal-mesenterial für den VLKT, beschrieben. Die synchrone und sequentielle Anwendung von LVA, VLKT und/oder ablativer Liposuktion wird vor dem Hintergrund der Wirksamkeit und Morbidität diskutiert. Schließlich werden Empfehlungen zur postoperativen Behandlung und Diagnostik erörtert. Die vorliegende Konsensusarbeit adressiert eine Erhöhung des Standardisierungsgrades der Behandlung für weitere multizentrische Studien im deutschsprachigen Raum in diesem aufstrebenden Gebiet der Lymphödemtherapie.
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Affiliation(s)
- Christoph Hirche
- Klinik für Hand-, Plastische und Rekonstruktive Chirurgie, Mikrochirurgie, Schwerbrandverletztenzentrum, Klinik für Plastische und Handchirurgie an der Universität Heidelberg
| | - Holger Engel
- Klinik für Hand-, Plastische und Rekonstruktive Chirurgie, Mikrochirurgie, Schwerbrandverletztenzentrum, Klinik für Plastische und Handchirurgie an der Universität Heidelberg
- Klinik für Plastisch-rekonstruktive, Ästhetische und Handchirurgie, Klinikum Kassel
| | - Katrin Seidenstuecker
- Abteilung für Plastische Chirurgie II, Rekonstruktive Mikro- und Lymphchirurgie, Sana-Kliniken Düsseldorf, Standort Benrath
| | - Christian Taeger
- Abteilung für Plastische, Hand- und Wiederherstellungschirurgie, Universitätsklinikum Regensburg
| | - Hans-Günther Machens
- Klinik für Plastische Chirurgie und Handchirurgie, Klinikum rechts der Isar der Technischen Universität München
| | - Andreas Frick
- Abteilung für Handchirurgie, Plastische Chirurgie und Ästhetische Chirurgie Campus Innenstadt und Großhadern der Ludwig-Maximilians Universität Münche
| | - Yves Harder
- Klinik für Plastische, Rekonstruktive und Ästhetische Chirurgie, Ospedale Regionale di Lugano, Ente Ospedaliero Cantonale
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Rodó C, Suy A, Sulleiro E, Soriano-Arandes A, Maiz N, García-Ruiz I, Arévalo S, Rando A, Anton A, Vázquez Méndez É, Garrido M, Frick A, Rodrigo C, Pumarola T, Carreras E. Pregnancy outcomes after maternal Zika virus infection in a non-endemic region: prospective cohort study. Clin Microbiol Infect 2019; 25:633.e5-633.e9. [PMID: 30771526 DOI: 10.1016/j.cmi.2019.02.008] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2018] [Revised: 02/01/2019] [Accepted: 02/05/2019] [Indexed: 11/28/2022]
Abstract
OBJECTIVES The aim was to describe pregnancy outcomes after Zika virus (ZIKV) infection in a non-endemic region. METHODS According to the Spanish protocol issued after the ZIKV outbreak in Brazil in 2015, all pregnant women who had travelled to high-burden countries were screened for ZIKV. Serological and molecular tests were used to identify ZIKV-infected pregnant women. They were classified as confirmed ZIKV infection when reverse transcription (RT) PCR tested positive, or probable ZIKV infection when ZIKV immunoglobulin M and/or immunoglobulin G and ZIKV plaque reduction neutralization tests were positive. Women found positive using molecular or serological tests were prospectively followed-up with ultrasound scans and neurosonograms on a monthly basis until delivery; magnetic resonance imaging and amniotic fluid testing were performed after signed informed consent. Samples of placenta, and fetal and neonatal tissues were obtained. RESULTS Seventy-two pregnant women tested positive for ZIKV infection: ten were confirmed by RT-PCR, and 62 were probable cases based on serological tests. The prevalence of adverse perinatal outcomes was 33.3% (three out of nine, 95% CI 12.1-64.6%): two cases of congenital ZIKV syndrome (CZS) and one miscarriage, all born to women infected in the first trimester of gestation. All ZIKV-confirmed women had persistent viraemias beyond 2 weeks (median 61.50 days; IQR 35.50-80.75). Amniotic fluid testing was only positive in the two fetuses with anomalies. CONCLUSION The prevalence of perinatal adverse outcomes for women with ZIKV-confirmed infection was 33.3%. Amniocentesis for ZIKV RT-PCR is recommended when fetal abnormalities are found. Intensive prenatal and postnatal follow-up of ZIKV-infected pregnancies is advised in confirmed cases.
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Affiliation(s)
- C Rodó
- Maternal Fetal Medicine Unit, Department of Obstetrics, Hospital Universitari Vall d'Hebron, Barcelona, Universitat Autònoma de Barcelona, Barcelona, Spain.
| | - A Suy
- Maternal Fetal Medicine Unit, Department of Obstetrics, Hospital Universitari Vall d'Hebron, Barcelona, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - E Sulleiro
- Department of Microbiology, Hospital Universitari Vall d'Hebron, PROSICS Barcelona, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - A Soriano-Arandes
- Tropical Medicine and International Health Unit, Hospital Universitari Vall d'Hebron, Barcelona, PROSICS Barcelona, Universitat Autònoma de Barcelona, Barcelona, Spain; Pediatric Infectious Diseases and Immunodeficiences Unit, Hospital Universitari Vall d'Hebron, Barcelona, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - N Maiz
- Maternal Fetal Medicine Unit, Department of Obstetrics, Hospital Universitari Vall d'Hebron, Barcelona, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - I García-Ruiz
- Maternal Fetal Medicine Unit, Department of Obstetrics, Hospital Universitari Vall d'Hebron, Barcelona, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - S Arévalo
- Maternal Fetal Medicine Unit, Department of Obstetrics, Hospital Universitari Vall d'Hebron, Barcelona, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - A Rando
- Department of Microbiology, Hospital Universitari Vall d'Hebron, PROSICS Barcelona, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - A Anton
- Department of Microbiology, Hospital Universitari Vall d'Hebron, PROSICS Barcelona, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - É Vázquez Méndez
- Department of Paediatric Radiology, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - M Garrido
- Department of Pathology, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - A Frick
- Tropical Medicine and International Health Unit, Hospital Universitari Vall d'Hebron, Barcelona, PROSICS Barcelona, Universitat Autònoma de Barcelona, Barcelona, Spain; Pediatric Infectious Diseases and Immunodeficiences Unit, Hospital Universitari Vall d'Hebron, Barcelona, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - C Rodrigo
- Pediatric Infectious Diseases and Immunodeficiences Unit, Hospital Universitari Vall d'Hebron, Barcelona, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - T Pumarola
- Department of Microbiology, Hospital Universitari Vall d'Hebron, PROSICS Barcelona, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - E Carreras
- Maternal Fetal Medicine Unit, Department of Obstetrics, Hospital Universitari Vall d'Hebron, Barcelona, Universitat Autònoma de Barcelona, Barcelona, Spain
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Kraus J, Frick A, Fischer H, Howner K, Fredrikson M, Furmark T. Amygdala reactivity and connectivity during social and non-social aversive stimulation in social anxiety disorder. Psychiatry Res Neuroimaging 2018; 280:56-61. [PMID: 30165271 DOI: 10.1016/j.pscychresns.2018.08.012] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2018] [Revised: 08/18/2018] [Accepted: 08/19/2018] [Indexed: 11/21/2022]
Abstract
Social anxiety disorder (SAD) is characterized by exaggerated amygdala reactivity in response to symptom provocation, but it is unclear if such hyper-reactivity is elicited by disorder-specific challenges only or characterizes reactions to aversive stimuli in general. Here, using functional magnetic resonance imaging in 14 patients with SAD, as compared to 12 healthy controls, we found that amygdala hyper-reactivity is confined to disorder-relevant social stimulation. SAD patients displayed increased amygdala reactivity to fearful as compared to neutral facial pictures, but not in response to generally aversive but mainly non-social stimulation when compared to neutral pictorial stimuli taken from the International Affective Picture System. The increased amygdala reactivity was not mediated by an altered prefrontal inhibition among SAD patients as compared to controls, suggesting increased bottom-up processes rather than attenuated top-down control. In conclusion, the enhanced amygdala reactivity in SAD seems specific to socially relevant stimuli rather than aversive stimuli in general.
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Affiliation(s)
- Jakub Kraus
- Department of Clinical Neuroscience, Karolinska Institute, Nobels väg 9, Stockholm, Sweden; Centre for Neuroscience, Central European Institute of Technology, Masaryk University, Brno, Czech Republic; Faculty of Medicine, Masaryk University, Brno, Czech Republic.
| | - Andreas Frick
- Department of Psychology, Uppsala University, Uppsala, Sweden; Department of Psychology, Stockholm University, Stockholm, Sweden
| | - Håkan Fischer
- Department of Psychology, Stockholm University, Stockholm, Sweden
| | - Katarina Howner
- Department of Clinical Neuroscience, Karolinska Institute, Nobels väg 9, Stockholm, Sweden
| | - Mats Fredrikson
- Department of Clinical Neuroscience, Karolinska Institute, Nobels väg 9, Stockholm, Sweden; Department of Psychology, Uppsala University, Uppsala, Sweden
| | - Tomas Furmark
- Department of Psychology, Uppsala University, Uppsala, Sweden
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43
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Affiliation(s)
- Andreas Frick
- Department of Psychology, Stockholm University, Stockholm, Sweden; Department of Psychology, Uppsala University, Uppsala, Sweden.
| | - Kristoffer N T Månsson
- Department of Psychology, Stockholm University, Stockholm, Sweden; Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden; Department of Psychology, Uppsala University, Uppsala, Sweden
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44
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Hoppe JM, Frick A, Åhs F, Linnman C, Appel L, Jonasson M, Lubberink M, Långström B, Frans Ö, von Knorring L, Fredrikson M, Furmark T. Association between amygdala neurokinin-1 receptor availability and anxiety-related personality traits. Transl Psychiatry 2018; 8:168. [PMID: 30154470 PMCID: PMC6113290 DOI: 10.1038/s41398-018-0163-1] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2017] [Revised: 03/30/2018] [Accepted: 04/13/2018] [Indexed: 02/08/2023] Open
Abstract
Animal studies indicate that substance P (SP) and its preferred neurokinin-1 (NK1) receptor modulate stress and anxiety-related behavior. Alterations in the SP-NK1 system have also been observed in human anxiety disorders, yet little is known about the relation between this system and individual differences in personality traits associated with anxiety propensity and approach-avoidance behavior, including trait anxiety, neuroticism, and extraversion. Exploring this relation could provide important insights into the neurobiological underpinnings of human anxiety and the etiology of anxiety disorders, as anxious traits are associated with increased susceptibility to develop psychopathological conditions. Here we examined the relationship between central NK1 receptor availability and self-rated measures of trait anxiety, neuroticism, and extraversion. The amygdala was chosen as the primary region of interest since this structure has been suggested to mediate the effect of the SP-NK1 system on anxiety. Anxious traits and NK1 receptor availability, determined with positron emission tomography and the radiotracer [11C]GR205171, were measured in 17 healthy individuals. Voxel-wise analyses showed a significant positive correlation between bilateral amygdala NK1 receptor availability and trait anxiety, and a trend in similar direction was observed for neuroticism. Conversely, extraversion was found to be negatively associated with amygdala NK1 receptor availability. Extraversion also correlated negatively with the NK1 measure in the cuneus/precuneus and fusiform gyrus according to exploratory whole-brain analyses. In conclusion, our findings indicate that amygdala NK1 receptor availability is associated with anxiety-related personality traits in healthy subjects, consistent with a modulatory role for the SP-NK1 system in human anxiety.
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Affiliation(s)
- Johanna M. Hoppe
- 0000 0004 1936 9457grid.8993.bDepartment of Psychology, Uppsala University, Uppsala, Sweden
| | - Andreas Frick
- 0000 0004 1936 9457grid.8993.bDepartment of Psychology, Uppsala University, Uppsala, Sweden ,0000 0004 1936 9377grid.10548.38Department of Psychology, Stockholm University, Stockholm, Sweden
| | - Fredrik Åhs
- 0000 0004 1936 9457grid.8993.bDepartment of Psychology, Uppsala University, Uppsala, Sweden ,0000 0004 1937 0626grid.4714.6Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Clas Linnman
- 000000041936754Xgrid.38142.3cDepartment of Anesthesiology, Perioperative and Pain Medicine, Boston Children’s Hospital, and Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA USA
| | - Lieuwe Appel
- 0000 0004 1936 9457grid.8993.bNuclear Medicine and PET, Department of Surgical Sciences, Uppsala University, Uppsala, Sweden
| | - My Jonasson
- 0000 0004 1936 9457grid.8993.bNuclear Medicine and PET, Department of Surgical Sciences, Uppsala University, Uppsala, Sweden ,0000 0001 2351 3333grid.412354.5Medical Physics, Uppsala University Hospital, Uppsala, Sweden
| | - Mark Lubberink
- 0000 0004 1936 9457grid.8993.bNuclear Medicine and PET, Department of Surgical Sciences, Uppsala University, Uppsala, Sweden ,0000 0001 2351 3333grid.412354.5Medical Physics, Uppsala University Hospital, Uppsala, Sweden
| | - Bengt Långström
- 0000 0004 1936 9457grid.8993.bDepartment of Chemistry, Uppsala University, Uppsala, Sweden
| | - Örjan Frans
- 0000 0004 1936 9457grid.8993.bDepartment of Psychology, Uppsala University, Uppsala, Sweden
| | - Lars von Knorring
- 0000 0004 1936 9457grid.8993.bDepartment of Neuroscience, Psychiatry, Uppsala University, Uppsala, Sweden
| | - Mats Fredrikson
- 0000 0004 1936 9457grid.8993.bDepartment of Psychology, Uppsala University, Uppsala, Sweden ,0000 0004 1937 0626grid.4714.6Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Tomas Furmark
- 0000 0004 1936 9457grid.8993.bDepartment of Psychology, Uppsala University, Uppsala, Sweden
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45
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Zerbi V, Ielacqua GD, Markicevic M, Haberl MG, Ellisman MH, A-Bhaskaran A, Frick A, Rudin M, Wenderoth N. Dysfunctional Autism Risk Genes Cause Circuit-Specific Connectivity Deficits With Distinct Developmental Trajectories. Cereb Cortex 2018; 28:2495-2506. [PMID: 29901787 PMCID: PMC5998961 DOI: 10.1093/cercor/bhy046] [Citation(s) in RCA: 52] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2017] [Revised: 01/16/2018] [Accepted: 02/12/2018] [Indexed: 12/22/2022] Open
Abstract
Autism spectrum disorders (ASD) are a set of complex neurodevelopmental disorders for which there is currently no targeted therapeutic approach. It is thought that alterations of genes regulating migration and synapse formation during development affect neural circuit formation and result in aberrant connectivity within distinct circuits that underlie abnormal behaviors. However, it is unknown whether deviant developmental trajectories are circuit-specific for a given autism risk-gene. We used MRI to probe changes in functional and structural connectivity from childhood to adulthood in Fragile-X (Fmr1-/y) and contactin-associated (CNTNAP2-/-) knockout mice. Young Fmr1-/y mice (30 days postnatal) presented with a robust hypoconnectivity phenotype in corticocortico and corticostriatal circuits in areas associated with sensory information processing, which was maintained until adulthood. Conversely, only small differences in hippocampal and striatal areas were present during early postnatal development in CNTNAP2-/- mice, while major connectivity deficits in prefrontal and limbic pathways developed between adolescence and adulthood. These findings are supported by viral tracing and electron micrograph approaches and define 2 clearly distinct connectivity endophenotypes within the autism spectrum. We conclude that the genetic background of ASD strongly influences which circuits are most affected, the nature of the phenotype, and the developmental time course of the associated changes.
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Affiliation(s)
- Valerio Zerbi
- Neural Control of Movement Lab, HEST, ETH Zürich, Winterthurerstrasse 190, Zurich, Switzerland
| | - Giovanna D Ielacqua
- Institute for Biomedical Engineering, University and ETH Zurich, Wolfgang-Pauli-Str. 27, Zurich, Switzerland
| | - Marija Markicevic
- Neural Control of Movement Lab, HEST, ETH Zürich, Winterthurerstrasse 190, Zurich, Switzerland
| | - Matthias Georg Haberl
- National Center for Microscopy and Imaging Research, University of California, San Diego, La Jolla, CA, USA
| | - Mark H Ellisman
- National Center for Microscopy and Imaging Research, University of California, San Diego, La Jolla, CA, USA
- Department of Neurosciences, University of California, San Diego, La Jolla, CA, USA
| | - Arjun A-Bhaskaran
- INSERM, Neurocentre Magendie, Physiopathologie de la Plasticité Neuronale, U1215, Bordeaux, France
- University of Bordeaux, Neurocentre Magendie, Physiopathologie de la Plasticité Neuronale, Bordeaux, France
| | - Andreas Frick
- INSERM, Neurocentre Magendie, Physiopathologie de la Plasticité Neuronale, U1215, Bordeaux, France
- University of Bordeaux, Neurocentre Magendie, Physiopathologie de la Plasticité Neuronale, Bordeaux, France
| | - Markus Rudin
- Institute for Biomedical Engineering, University and ETH Zurich, Wolfgang-Pauli-Str. 27, Zurich, Switzerland
- Neuroscience Center Zurich, University and ETH Zurich, Winterthurerstrasse 190, Zurich, Switzerland
- Institute of Pharmacology and Toxicology, University of Zurich, Winterthurerstrasse 190, Zurich, Switzerland
| | - Nicole Wenderoth
- Neural Control of Movement Lab, HEST, ETH Zürich, Winterthurerstrasse 190, Zurich, Switzerland
- Neuroscience Center Zurich, University and ETH Zurich, Winterthurerstrasse 190, Zurich, Switzerland
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46
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Vos R, Van Herck A, Vanaudenaerde B, Verleden S, Van Raemdonck D, Frick A, Neyrinck A, Verleden G. A Prospective, Randomized, Placebo-controlled Trial of Pre-transplant and Prompt Post-transplant Treatment With Azithromycin to Improve Early Allograft Function and Outcome After Lung Transplantation (NCT01915082). J Heart Lung Transplant 2018. [DOI: 10.1016/j.healun.2018.01.203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022] Open
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47
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Carreno-Munoz MI, Martins F, Medrano MC, Aloisi E, Pietropaolo S, Dechaud C, Subashi E, Bony G, Ginger M, Moujahid A, Frick A, Leinekugel X. Potential Involvement of Impaired BK Ca Channel Function in Sensory Defensiveness and Some Behavioral Disturbances Induced by Unfamiliar Environment in a Mouse Model of Fragile X Syndrome. Neuropsychopharmacology 2018; 43:492-502. [PMID: 28722023 PMCID: PMC5770751 DOI: 10.1038/npp.2017.149] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2017] [Revised: 06/12/2017] [Accepted: 07/08/2017] [Indexed: 01/20/2023]
Abstract
In fragile X syndrome (FXS), sensory hypersensitivity and impaired habituation is thought to result in attention overload and various behavioral abnormalities in reaction to the excessive and remanent salience of environment features that would normally be ignored. This phenomenon, termed sensory defensiveness, has been proposed as the potential cause of hyperactivity, hyperarousal, and negative reactions to changes in routine that are often deleterious for FXS patients. However, the lack of tools for manipulating sensory hypersensitivity has not allowed the experimental testing required to evaluate the relevance of this hypothesis. Recent work has shown that BMS-204352, a BKCa channel agonist, was efficient to reverse cortical hyperexcitability and related sensory hypersensitivity in the Fmr1-KO mouse model of FXS. In the present study, we report that exposing Fmr1-KO mice to novel or unfamiliar environments resulted in multiple behavioral perturbations, such as hyperactivity, impaired nest building and excessive grooming of the back. Reversing sensory hypersensitivity with the BKCa channel agonist BMS-204352 prevented these behavioral abnormalities in Fmr1-KO mice. These results are in support of the sensory defensiveness hypothesis, and confirm BKCa as a potentially relevant molecular target for the development of drug medication against FXS/ASD.
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Affiliation(s)
- Maria Isabel Carreno-Munoz
- INSERM, Neurocentre Magendie, U1215, Bordeaux, France,University of Bordeaux, Neurocentre Magendie, U1215, Bordeaux, France,University of the Basque Country (UPV/EHU), Donostia, Spain
| | - Fabienne Martins
- INSERM, Neurocentre Magendie, U1215, Bordeaux, France,University of Bordeaux, Neurocentre Magendie, U1215, Bordeaux, France
| | - Maria Carmen Medrano
- INSERM, Neurocentre Magendie, U1215, Bordeaux, France,University of Bordeaux, Neurocentre Magendie, U1215, Bordeaux, France
| | - Elisabetta Aloisi
- INSERM, Neurocentre Magendie, U1215, Bordeaux, France,University of Bordeaux, Neurocentre Magendie, U1215, Bordeaux, France
| | - Susanna Pietropaolo
- University of Bordeaux, INCIA, Pessac, France,CNRS, INCIA, UMR 5287, Pessac, France
| | - Corentin Dechaud
- INSERM, Neurocentre Magendie, U1215, Bordeaux, France,University of Bordeaux, Neurocentre Magendie, U1215, Bordeaux, France
| | - Enejda Subashi
- INSERM, Neurocentre Magendie, U1215, Bordeaux, France,University of Bordeaux, Neurocentre Magendie, U1215, Bordeaux, France
| | - Guillaume Bony
- INSERM, Neurocentre Magendie, U1215, Bordeaux, France,University of Bordeaux, Neurocentre Magendie, U1215, Bordeaux, France
| | - Melanie Ginger
- INSERM, Neurocentre Magendie, U1215, Bordeaux, France,University of Bordeaux, Neurocentre Magendie, U1215, Bordeaux, France
| | | | - Andreas Frick
- INSERM, Neurocentre Magendie, U1215, Bordeaux, France,University of Bordeaux, Neurocentre Magendie, U1215, Bordeaux, France
| | - Xavier Leinekugel
- INSERM, Neurocentre Magendie, U1215, Bordeaux, France,University of Bordeaux, Neurocentre Magendie, U1215, Bordeaux, France,Neurocentre Magendie, INSERM U1215, Université de Bordeaux, 146 rue Leo Saignat, 33077 Bordeaux, France, Tel: +33 6 09 55 53 39, Fax: +33 5 57 57 36 69, E-mail:
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48
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Landrock S, Wallmichrath J, Baumeister RGH, Bartenstein P, Frick A, Weiss M. The clinical yield of SPECT/CT for the assessment of lymphatic transport disorders. Nuklearmedizin 2018; 52:235-43. [DOI: 10.3413/nukmed-0587-13-05] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2013] [Accepted: 09/12/2013] [Indexed: 11/20/2022]
Abstract
ZusammenfassungZiel dieser Studie war zu untersuchen, ob die zusätzliche Bildgebung mittels SPECT/CTTechnik den diagnostischen Wert der planaren Lymphszintigraphie bei Patienten mit Lymphtransportstörungen verbessern kann. Patienten, Methoden: Über einen festgelegten Zeitraum von zwei Jahren wurden 36 konsekutive Patienten (27 Frauen, 9 Männer, Alter 27–87 Jahre) in unsere Studie eingeschlossen. Zusätzlich zur planaren Lymphszintigraphie wurden weitere ergänzende SPECT/CT-Akquisitionen der betroffenen Extremitäten oder des Körperstamms durchgeführt. Insgesamt erfolgte eine prospektive Auswertung von 48 anatomischen Lymphabflussregionen mittels planarer Szintigraphie und tomographischer SPECT/CT. Ergebnisse: In 28/48 Fällen (58%) brachte die SPECT/CTBildgebung klinisch relevante Zusatzinformationen im Vergleich zur planaren Technik; darunter 27 bezüglich der exakten anatomischen Lokalisation der Transportstörungen sowie 8 Fälle, bei denen die Ausdehnung der lymphogenen Störung mittels SPECT/CT ausgedehnter beurteilt wurde als in der alleinigen planaren Szintigraphie. In 3 Fällen konnte durch die SPECT/CT differenzialdiagnostisch zwischen Lymphknoten versus Lymphozele differenziert werden. In keinem der Fälle konnten Lymphgefäße/-transplantate durch die morphologische CT-Komponente dargestellt werden. Schlussfolgerungen: Die zusätzlich zur planaren Lymphszintigraphie durchgeführte SPECT/CT präzisiert die anatomische Zuordnung lymphogen bedingter Transportstörungen und somit die Abschätzung der Ausdehnung der Pathologie. Des Weiteren löst sie Überlagerungseffekte anatomischer Strukturen durch die tomographische Akquisition auf und ermöglicht die Differenzialdiagnose von Lymphknoten versus Lymphozelen.
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49
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Frick A, Engman J, Wahlstedt K, Gingnell M, Fredrikson M, Furmark T. Anterior cingulate cortex activity as a candidate biomarker for treatment selection in social anxiety disorder. BJPsych Open 2018; 4:157-159. [PMID: 29922481 PMCID: PMC6003252 DOI: 10.1192/bjo.2018.15] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2017] [Revised: 02/26/2018] [Accepted: 03/06/2018] [Indexed: 11/23/2022] Open
Abstract
UNLABELLED We aimed to identify biomarkers to guide the decision to add selective serotonin reuptake inhibitors (SSRI) to psychological treatment for social anxiety disorder (SAD). Forty-eight patients with SAD underwent functional magnetic resonance imaging and collection of clinical and demographic variables before treatment with cognitive-behavioural therapy, combined on a double-blind basis with either escitalopram or placebo for 9 weeks. Pre-treatment neural reactivity to aversive faces in the dorsal anterior cingulate cortex (ACC), but not clinical/demographic variables, moderated clinical outcomes. Cross-validated individual-level predictions accurately identified 81% of responders/non-responders. Dorsal ACC reactivity is thus a potential biomarker for SAD treatment selection. DECLARATION OF INTEREST None.
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Affiliation(s)
- Andreas Frick
- Department of Psychology, Uppsala University, Sweden and Department of Psychology, Stockholm University, Sweden
| | - Jonas Engman
- Department of Psychology, Uppsala University, Sweden
| | | | - Malin Gingnell
- Department of Psychology, Uppsala University, Sweden and Department of Neuroscience, Uppsala University, Sweden
| | - Mats Fredrikson
- Department of Psychology, Uppsala University, Sweden and Department of Clinical Neuroscience, Karolinska Institutet, Sweden
| | - Tomas Furmark
- Department of Psychology, Uppsala University, Sweden
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50
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Jonasson M, Appel L, Danfors T, Nyholm D, Askmark H, Frick A, Engman J, Furmark T, Sörensen J, Lubberink M. Development of a clinically feasible [ 11C]PE2I PET method for differential diagnosis of parkinsonism using reduced scan duration and automated reference region extraction. Am J Nucl Med Mol Imaging 2017; 7:263-274. [PMID: 29348981 PMCID: PMC5768921] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 11/03/2017] [Accepted: 11/21/2017] [Indexed: 06/07/2023]
Abstract
[11C]PE2I is a highly selective dopamine transporter PET ligand. Parametric images based on dynamic [11C]PE2I scans, showing dopamine transporter availability (BPND) and relative cerebral blood flow (R1), can be used in differential diagnosis of parkinsonism. This work aimed to investigate a shortened scan duration and automated generation of parametric images which are two prerequisites for routine clinical application. Twelve subjects with parkinsonism and seventeen healthy controls underwent 80 min dynamic [11C]PE2I PET scans. BPND and R1 images were generated using cerebellum reference region defined on a co-registered MRI, as well as a supervised cluster analysis (SVCA)-based reference. Initial 20, 30 and 40 min of the scans were extracted and images of standardized uptake value ratio (SUVR) and R1 were computed using MRI- and SVCA-based reference. Correlation was high between striatal 80 min MRI-based BPND and 40 min SVCA-based SUVR-1 (R2=0.95). High correlation was also found between R1 values in striatal and limbic regions (R2≥0.91) whereas correlation was moderate for cortical regions (R2=0.71). The results indicate that dynamic [11C]PE2I scans can be restricted to 40 min and that SVCA can be used for automatic extraction of a reference region. These outcomes will support routine applications of [11C]PE2I PET in clinical settings.
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Affiliation(s)
- My Jonasson
- Nuclear Medicine and PET, Department of Surgical Sciences, Uppsala UniversityUppsala, Sweden
- Medical Physics, Uppsala University HospitalUppsala, Sweden
| | - Lieuwe Appel
- Nuclear Medicine and PET, Department of Surgical Sciences, Uppsala UniversityUppsala, Sweden
- PET Centre, Uppsala University HospitalUppsala, Sweden
| | - Torsten Danfors
- Nuclear Medicine and PET, Department of Surgical Sciences, Uppsala UniversityUppsala, Sweden
- PET Centre, Uppsala University HospitalUppsala, Sweden
| | - Dag Nyholm
- Neurology, Department of Neuroscience, Uppsala UniversityUppsala, Sweden
| | - Håkan Askmark
- Neurology, Department of Neuroscience, Uppsala UniversityUppsala, Sweden
| | - Andreas Frick
- Department of Psychology, Uppsala UniversityUppsala, Sweden
| | - Jonas Engman
- Department of Psychology, Uppsala UniversityUppsala, Sweden
| | - Tomas Furmark
- Department of Psychology, Uppsala UniversityUppsala, Sweden
| | - Jens Sörensen
- Nuclear Medicine and PET, Department of Surgical Sciences, Uppsala UniversityUppsala, Sweden
- PET Centre, Uppsala University HospitalUppsala, Sweden
| | - Mark Lubberink
- Nuclear Medicine and PET, Department of Surgical Sciences, Uppsala UniversityUppsala, Sweden
- Medical Physics, Uppsala University HospitalUppsala, Sweden
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