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Rodríguez-Hidalgo E, García-Alba J, Novell R, Esteba-Castillo S. The Global Deterioration Scale for Down Syndrome Population (GDS-DS): A Rating Scale to Assess the Progression of Alzheimer's Disease. Int J Environ Res Public Health 2023; 20:5096. [PMID: 36982004 PMCID: PMC10049652 DOI: 10.3390/ijerph20065096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Revised: 03/09/2023] [Accepted: 03/13/2023] [Indexed: 06/18/2023]
Abstract
The aim of this study is to adapt and validate the global deterioration scale (GDS) for the systematic tracking of Alzheimer's disease (AD) progression in a population with Down syndrome (DS). A retrospective dual-center cohort study was conducted with 83 participants with DS (46.65 ± 5.08 years) who formed the primary diagnosis (PD) group: cognitive stability (n = 48), mild cognitive impairment (n = 24), and Alzheimer's disease (n = 11). The proposed scale for adults with DS (GDS-DS) comprises six stages, from cognitive and/or behavioral stability to advanced AD. Two neuropsychologists placed the participants of the PD group in each stage of the GDS-DS according to cognitive, behavioral and daily living skills data. Inter-rater reliability in staging with the GDS-DS was excellent (ICC = 0.86; CI: 0.80-0.93), and the agreement with the diagnosis categories of the PD group ranged from substantial to excellent with κ values of 0.82 (95% CI: 0.73-0.92) and 0.85 (95% CI: 0.72, 0.99). Performance with regard to the CAMCOG-DS total score and orientation subtest of the Barcelona test for intellectual disability showed a slight progressive decline across all the GDS-DS stages. The GDS-DS scale is a sensitive tool for staging the progression of AD in the DS population, with special relevance in daily clinical practice.
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Affiliation(s)
- Emili Rodríguez-Hidalgo
- Specialized Service in Mental Health and Intellectual Disability, Institute of Health Assistance (IAS), Parc Hospitalari Martí i Julià, 17190 Girona, Spain
- Neurodevelopmental Group [Girona Biomedical Research Institute]-IDIBGI, Institute of Health Assistance (IAS), Parc Hospitalari Martí i Julià, 17190 Girona, Spain
| | - Javier García-Alba
- Research and Psychology in Education Department, Complutense University of Madrid, 28040 Madrid, Spain
| | - Ramon Novell
- Specialized Service in Mental Health and Intellectual Disability, Institute of Health Assistance (IAS), Parc Hospitalari Martí i Julià, 17190 Girona, Spain
- Neurodevelopmental Group [Girona Biomedical Research Institute]-IDIBGI, Institute of Health Assistance (IAS), Parc Hospitalari Martí i Julià, 17190 Girona, Spain
| | - Susanna Esteba-Castillo
- Specialized Service in Mental Health and Intellectual Disability, Institute of Health Assistance (IAS), Parc Hospitalari Martí i Julià, 17190 Girona, Spain
- Neurodevelopmental Group [Girona Biomedical Research Institute]-IDIBGI, Institute of Health Assistance (IAS), Parc Hospitalari Martí i Julià, 17190 Girona, Spain
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Gámez S, Cobo J, Fernández-Lafitte M, Coronas R, Parra I, Oliva JC, Àlvarez A, Esteba-Castillo S, Giménez-Palop O, Corripio R, Palao DJ, Caixàs A. An Exploratory Analysis on the 2D:4D Digit Ratio and Its Relationship with Social Responsiveness in Adults with Prader-Willi Syndrome. J Clin Med 2023; 12:jcm12031155. [PMID: 36769803 PMCID: PMC9917981 DOI: 10.3390/jcm12031155] [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: 12/27/2022] [Revised: 01/22/2023] [Accepted: 01/29/2023] [Indexed: 02/04/2023] Open
Abstract
Prader-Willi syndrome (PWS) is a genetic disorder produced by a lack of expression of paternally derived genes in the 15q11-13 region. Research has generally focused on its genetic and behavioral expression, but only a few studies have examined epigenetic influences. Prenatal testosterone or the maternal testosterone-to-estradiol ratio (MaTtEr) has been suggested to play an important role in the development of the 'social brain' during pregnancy. Some studies propose the 2D:4D digit ratio of the hand as an indirect MaTtEr measure. The relationship between social performance and MaTtEr has been studied in other neurodevelopmental conditions such as Autism Spectrum Disorder (ASD), but to our best knowledge, it has never been studied in PWS. Therefore, our study aims to clarify the possible existence of a relationship between social performance-as measured using the Social Responsiveness Scale (SRS)-and MaTtEr levels using the 2D:4D ratio. We found that, as a group, PWS individuals have shorter index and ring fingers than the control group, but no significant difference in the 2D:4D ratios. The 2D:4D ratio showed a correlation only with Restricted Interests and Repetitive Behavior Subscale, where a positive correlation only for male individuals with PWS was found. Considering only PWS with previous GH treatment during childhood/adolescence (PWS-GH), index and ring fingers did not show differences in length with the control group, but the 2D:4D ratio was significantly higher in the right or dominant hand compared to controls.
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Affiliation(s)
- Sara Gámez
- Mental Health Department, Corporació Sanitària Parc Taulí—Universitat Autònoma de Barcelona—CIBERSAM, 08202 Sabadell, Spain
| | - Jesus Cobo
- Mental Health Department, Corporació Sanitària Parc Taulí—Universitat Autònoma de Barcelona—CIBERSAM, 08202 Sabadell, Spain
- Department of Psychiatry and Forensic Medicine, Universitat Autònoma de Barcelona, 08193 Bellaterra, Spain
- Institut d’Investigació i Innovació Parc Taulí (I3PT)—CERCA, 08208 Sabadell, Spain
- Correspondence: (J.C.); (A.C.)
| | - Meritxell Fernández-Lafitte
- Mental Health Department, Corporació Sanitària Parc Taulí—Universitat Autònoma de Barcelona—CIBERSAM, 08202 Sabadell, Spain
| | - Ramón Coronas
- Mental Health Department, Corporació Sanitària Parc Taulí—Universitat Autònoma de Barcelona—CIBERSAM, 08202 Sabadell, Spain
| | - Isabel Parra
- Mental Health Department, Corporació Sanitària Parc Taulí—Universitat Autònoma de Barcelona—CIBERSAM, 08202 Sabadell, Spain
- Department of Psychiatry and Forensic Medicine, Universitat Autònoma de Barcelona, 08193 Bellaterra, Spain
- Institut d’Investigació i Innovació Parc Taulí (I3PT)—CERCA, 08208 Sabadell, Spain
| | - Joan Carles Oliva
- Statistics Unit, Fundació Parc Taulí—(I3PT)—CERCA, 08208 Sabadell, Spain
| | - Aida Àlvarez
- Department of Mental Health, Mutua Terrassa University Hospital, 08221 Terrassa, Spain
| | - Susanna Esteba-Castillo
- Specialized Mental Health and Intellectual Disability Department, Institut d’Assistència Sanitària, Parc Hospitalari Martí i Julià, 17190 Girona, Spain
- Neurodevelopment Group, Girona Biomedical Research Institute IDIBGI, Institut d’Assistència Sanitària, Parc Hospitalari Martí i Julià, 17190 Girona, Spain
| | - Olga Giménez-Palop
- Endocrinology and Nutrition Department, Hospital Universitari Parc Taulí, Corporació Sanitària Parc Taulí—Universitat Autònoma de Barcelona, 08202 Sabadell, Spain
- Department of Medicine, Universitat Autònoma de Barcelona, 08193 Bellaterra, Spain
| | - Raquel Corripio
- Pediatric Endocrine Department, Parc Taulí Hospital Universitari, Institutd’Investigació i Innovació Parc Taulí (I3PT), Universitat Autònoma de Barcelona, 08202 Sabadell, Spain
| | - Diego J. Palao
- Mental Health Department, Corporació Sanitària Parc Taulí—Universitat Autònoma de Barcelona—CIBERSAM, 08202 Sabadell, Spain
- Department of Psychiatry and Forensic Medicine, Universitat Autònoma de Barcelona, 08193 Bellaterra, Spain
- Institut d’Investigació i Innovació Parc Taulí (I3PT)—CERCA, 08208 Sabadell, Spain
| | - Assumpta Caixàs
- Endocrinology and Nutrition Department, Hospital Universitari Parc Taulí, Corporació Sanitària Parc Taulí—Universitat Autònoma de Barcelona, 08202 Sabadell, Spain
- Department of Medicine, Universitat Autònoma de Barcelona, 08193 Bellaterra, Spain
- Correspondence: (J.C.); (A.C.)
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Fernández A, Ramírez-Toraño F, Bruña R, Zuluaga P, Esteba-Castillo S, Abásolo D, Moldenhauer F, Shumbayawonda E, Maestú F, García-Alba J. Brain signal complexity in adults with Down syndrome: Potential application in the detection of mild cognitive impairment. Front Aging Neurosci 2022; 14:988540. [PMID: 36337705 PMCID: PMC9631477 DOI: 10.3389/fnagi.2022.988540] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Accepted: 09/27/2022] [Indexed: 11/13/2022] Open
Abstract
Background Down syndrome (DS) is considered the most frequent cause of early-onset Alzheimer’s disease (AD), and the typical pathophysiological signs are present in almost all individuals with DS by the age of 40. Despite of this evidence, the investigation on the pre-dementia stages in DS is scarce. In the present study we analyzed the complexity of brain oscillatory patterns and neuropsychological performance for the characterization of mild cognitive impairment (MCI) in DS. Materials and methods Lempel-Ziv complexity (LZC) values from resting-state magnetoencephalography recordings and the neuropsychological performance in 28 patients with DS [control DS group (CN-DS) (n = 14), MCI group (MCI-DS) (n = 14)] and 14 individuals with typical neurodevelopment (CN-no-DS) were analyzed. Results Lempel-Ziv complexity was lowest in the frontal region within the MCI-DS group, while the CN-DS group showed reduced values in parietal areas when compared with the CN-no-DS group. Also, the CN-no-DS group exhibited the expected pattern of significant increase of LZC as a function of age, while MCI-DS cases showed a decrease. The combination of reduced LZC values and a divergent trajectory of complexity evolution with age, allowed the discrimination of CN-DS vs. MCI-DS patients with a 92.9% of sensitivity and 85.7% of specificity. Finally, a pattern of mnestic and praxic impairment was significantly associated in MCI-DS cases with the significant reduction of LZC values in frontal and parietal regions (p = 0.01). Conclusion Brain signal complexity measured with LZC is reduced in DS and its development with age is also disrupted. The combination of both features might assist in the detection of MCI within this population.
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Affiliation(s)
- Alberto Fernández
- Department of Legal Medicine, Psychiatry and Pathology, Universidad Complutense de Madrid, Madrid, Spain
- Institute of Sanitary Investigation (IdISSC), Hospital Universitario San Carlos, Madrid, Spain
- Center for Cognitive and Computational Neuroscience, Universidad Complutense de Madrid, Madrid, Spain
| | - Federico Ramírez-Toraño
- Center for Cognitive and Computational Neuroscience, Universidad Complutense de Madrid, Madrid, Spain
- Department of Experimental Psychology, Cognitive Processes and Speech Therapy, Universidad Complutense de Madrid, Madrid, Spain
| | - Ricardo Bruña
- Center for Cognitive and Computational Neuroscience, Universidad Complutense de Madrid, Madrid, Spain
- Department of Radiology, Universidad Complutense de Madrid, Madrid, Spain
- Department of Industrial Engineering & IUNE & ITB, Universidad de La Laguna, San Cristóbal de La Laguna, Spain
| | - Pilar Zuluaga
- Statistics & Operations Research Department, Faculty of Medicine, Universidad Complutense de Madrid, Madrid, Spain
| | - Susanna Esteba-Castillo
- Neurodevelopmental Group, Girona Biomedical Research Institute-IDIBGI, Institute of Health Assistance (IAS), Parc Hospitalari Martí i Julià, Girona, Spain
| | - Daniel Abásolo
- Centre for Biomedical Engineering, School of Mechanical Engineering Sciences, University of Surrey, Guildford, United Kingdom
| | - Fernando Moldenhauer
- Adult Down Syndrome Unit, Internal Medicine Department, Health Research Institute, Hospital Universitario de La Princesa, Madrid, Spain
| | - Elizabeth Shumbayawonda
- Centre for Biomedical Engineering, School of Mechanical Engineering Sciences, University of Surrey, Guildford, United Kingdom
| | - Fernando Maestú
- Center for Cognitive and Computational Neuroscience, Universidad Complutense de Madrid, Madrid, Spain
- Department of Experimental Psychology, Cognitive Processes and Speech Therapy, Universidad Complutense de Madrid, Madrid, Spain
| | - Javier García-Alba
- Department of Research and Psychology in Education, Universidad Complutense de Madrid, Madrid, Spain
- *Correspondence: Javier García-Alba,
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Esteba-Castillo S, Garcia-Alba J, Rodríguez-Hildago E, Vaquero L, Novell R, Moldenhauer F, Castellanos MÁ. Proposed diagnostic criteria for mild cognitive impairment in Down syndrome population. J Appl Res Intellect Disabil 2021; 35:495-505. [PMID: 34693611 DOI: 10.1111/jar.12959] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2020] [Revised: 10/08/2021] [Accepted: 10/08/2021] [Indexed: 11/27/2022]
Abstract
BACKGROUND Despite presenting higher risk of dementia, mild cognitive impairment (MCI) is not well defined in Down syndrome population. OBJECTIVE We aimed to describe cognitive and neuropsychological patterns associated with MCI in Down syndrome individuals. METHOD Two groups of adults with Down syndrome (control and prodromal) were studied throughout 3 years. Two linear mixed models and a model including the variables that best predicted group membership were built. RESULTS Behavioural Regulation Index (BRI) (Behaviour Rating Inventory of Executive Function test) and the model composed of BRI, abstraction and delayed verbal memory were the variable and model best predicting group membership, respectively. CONCLUSION Suggest a diagnosis of MCI when BRI is the earliest change perceived by caregivers and this is combined with low scores in abstract thinking, and when an amnesic pattern in delayed verbal memory is observed, but adaptive skills are preserved.
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Affiliation(s)
- Susanna Esteba-Castillo
- Specialized Service in Mental Health and Intellectual Disability, Institute of Health Assistance, Girona, Spain.,Neurodevelopmental Group [Girona Biomedical Research Institute]-IDIBGI, Institute of Health Assistance (IAS), Girona, Spain
| | - Javier Garcia-Alba
- Research and Psychology in Education Department (Faculty of Education), Complutense University of Madrid, Madrid, Spain
| | - Emili Rodríguez-Hildago
- Specialized Service in Mental Health and Intellectual Disability, Institute of Health Assistance, Girona, Spain
| | - Lucía Vaquero
- Laboratory of Cognitive and Computational Neuroscience, Department of Legal Medicine, Psychiatry and Pathology (Faculty of Medicine), Complutense University of Madrid, Madrid, Spain
| | - Ramon Novell
- Specialized Service in Mental Health and Intellectual Disability, Institute of Health Assistance, Girona, Spain.,Neurodevelopmental Group [Girona Biomedical Research Institute]-IDIBGI, Institute of Health Assistance (IAS), Girona, Spain
| | - Fernando Moldenhauer
- Adults' Section of the Down syndrome Department, Internal Medicine Department, La Princesa University Hospital, Madrid, Spain
| | - Miguel Ángel Castellanos
- Department of Methodology for Behavioral Science, Complutense University of Madrid, Madrid, Spain
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Ramírez-Toraño F, García-Alba J, Bruña R, Esteba-Castillo S, Vaquero L, Pereda E, Maestú F, Fernández A. Hypersynchronized Magnetoencephalography Brain Networks in Patients with Mild Cognitive Impairment and Alzheimer's Disease in Down Syndrome. Brain Connect 2021; 11:725-733. [PMID: 33858203 DOI: 10.1089/brain.2020.0897] [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] [Indexed: 12/30/2022] Open
Abstract
Introduction: The majority of individuals with Down syndrome (DS) show signs of Alzheimer's disease (AD) neuropathology in their fourth decade. However, there is a lack of specific markers for characterizing the disease stages while considering this population's differential features. Methods: Forty-one DS individuals participated in the study, and were classified into three groups according to their clinical status: Alzheimer's disease (AD-DS), mild cognitive impairment (MCI-DS), and controls (CN-DS). We performed an exhaustive neuropsychological evaluation and assessed brain functional connectivity (FC) from magnetoencephalographic recordings. Results: Compared with CN-DS, both MCI-DS and AD-DS showed a pattern of increased FC within the high alpha band. The neuropsychological assessment showed a generalized cognitive impairment, especially affecting mnestic functions, in MCI-DS and, more pronouncedly, in AD-DS. Discussion: These findings might help to characterize the AD-continuum in DS. In addition, they support the role of the excitatory/inhibitory imbalance as a key pathophysiological factor in AD. Impact statement The pattern of functional connectivity (FC) hypersynchronization found in this study resembles the largely reported Alzheimer's disease (AD) FC evolution pattern in population with typical development. This study supports the hypothesis of the excitatory/inhibitory imbalance as a key pathophysiological factor in AD, and its conclusions could help in the characterization and prediction of Down syndrome individuals with a greater likelihood of converting to dementia.
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Affiliation(s)
- Federico Ramírez-Toraño
- Laboratory of Cognitive and Computational Neuroscience (UCM-UPM), Center for Biomedical Technology, Technical University of Madrid, Madrid, Spain.,Department of Experimental Psychology, Universidad Complutense de Madrid, Madrid, Spain
| | - Javier García-Alba
- Laboratory of Cognitive and Computational Neuroscience (UCM-UPM), Center for Biomedical Technology, Technical University of Madrid, Madrid, Spain.,Research and Psychology in Education Department, Complutense University of Madrid, Madrid, Spain
| | - Ricardo Bruña
- Laboratory of Cognitive and Computational Neuroscience (UCM-UPM), Center for Biomedical Technology, Technical University of Madrid, Madrid, Spain.,Department of Experimental Psychology, Universidad Complutense de Madrid, Madrid, Spain.,Networking Research Center on Bioengineering, Biomaterials, and Nanomedicine (CIBER-BBN), Madrid, Spain
| | - Susanna Esteba-Castillo
- Specialized Department in Mental Health and Intellectual Disability, Parc Hospitalari Martí i Julià-Institut 'd'Assistència Sanitària, Institut 'd'Assistència Sanitària (IAS), Girona, Spain
| | - Lucía Vaquero
- Laboratory of Cognitive and Computational Neuroscience (UCM-UPM), Center for Biomedical Technology, Technical University of Madrid, Madrid, Spain.,Department of Legal Medicine, Psychiatry and Pathology, Complutense University of Madrid, Spain
| | - Ernesto Pereda
- Laboratory of Cognitive and Computational Neuroscience (UCM-UPM), Center for Biomedical Technology, Technical University of Madrid, Madrid, Spain.,Electrical Engineering and Bioengineering Group, Department of Industrial Engineering and IUNE and ITB Universidad de La Laguna, Santa Cruz de Tenerife, Spain
| | - Fernando Maestú
- Laboratory of Cognitive and Computational Neuroscience (UCM-UPM), Center for Biomedical Technology, Technical University of Madrid, Madrid, Spain.,Department of Experimental Psychology, Universidad Complutense de Madrid, Madrid, Spain.,Networking Research Center on Bioengineering, Biomaterials, and Nanomedicine (CIBER-BBN), Madrid, Spain
| | - Alberto Fernández
- Laboratory of Cognitive and Computational Neuroscience (UCM-UPM), Center for Biomedical Technology, Technical University of Madrid, Madrid, Spain.,Department of Legal Medicine, Psychiatry and Pathology, Complutense University of Madrid, Spain.,Institute of Sanitary Investigation (IdISSC), San Carlos University Hospital, Madrid, Spain
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Cobo J, Coronas R, Pousa E, Oliva JC, Giménez-Palop O, Esteba-Castillo S, Novell R, Palao DJ, Caixàs A. Multidimensional Evaluation of Awareness in Prader-Willi Syndrome. J Clin Med 2021; 10:2007. [PMID: 34067179 PMCID: PMC8125854 DOI: 10.3390/jcm10092007] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2021] [Revised: 04/30/2021] [Accepted: 05/06/2021] [Indexed: 01/08/2023] Open
Abstract
There are no studies about insight or awareness of illness in patients with Prader-Willi Syndrome (PWS). The objective of this study was to explore the level of awareness of the disorder, of the need for medication, and of the social consequences of the disease, as well as of its main symptoms in PWS. We also aimed to explore relationships between awareness and sociodemographic and clinical characteristics, and to compare all data with a matched sample of patients with psychosis. Insight was assessed by an Adapted version of the Scale of Unawareness of Mental Disorder in a cross-sectional pilot study at a University Hospital. Thirty-six individuals with PWS (58.3% women) were included. Results showed that PWS patients had a good awareness of the illness and of the effects of medication, in contrast to a lack of awareness of illness' social consequences. Awareness of obesity/overweight was excellent, as was the awareness of excessive appetite. Awareness of excessive food intake was only mild. Insight correlated with age and functionality, but not with BMI. PWS patients showed a better insight into the illness but a similar awareness of the effects of the medication and of the social consequences of the disease as compared to schizophrenia-spectrum patients. This profile of insight may have relevant clinical implications.
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Affiliation(s)
- Jesús Cobo
- Mental Health Department, Corporació Sanitària Parc Taulí, Universitat Autònoma de Barcelona—CIBERSAM, 08208 Sabadell, Spain; (R.C.); (D.J.P.)
- Department of Psychiatry and Forensic Medicine, Universitat Autònoma de Barcelona, 08208 Sabadell, Spain
- Institut d’Investigació i Innovació Parc Taulí (I3PT), 08208 Sabadell, Spain; (J.-C.O.); (O.G.-P.)
- Insight Barcelona Research Group, Societat Catalana de Psiquiatria i Salut Mental, 08017 Barcelona, Spain;
| | - Ramón Coronas
- Mental Health Department, Corporació Sanitària Parc Taulí, Universitat Autònoma de Barcelona—CIBERSAM, 08208 Sabadell, Spain; (R.C.); (D.J.P.)
- Institut d’Investigació i Innovació Parc Taulí (I3PT), 08208 Sabadell, Spain; (J.-C.O.); (O.G.-P.)
| | - Esther Pousa
- Insight Barcelona Research Group, Societat Catalana de Psiquiatria i Salut Mental, 08017 Barcelona, Spain;
- Psychiatry Department, Hospital Universitari St. Pau, 08041 Barcelona, Spain
| | - Joan-Carles Oliva
- Institut d’Investigació i Innovació Parc Taulí (I3PT), 08208 Sabadell, Spain; (J.-C.O.); (O.G.-P.)
- Statistic Unit, Fundació Parc Taulí I3PT, 08208 Sabadell, Spain
| | - Olga Giménez-Palop
- Institut d’Investigació i Innovació Parc Taulí (I3PT), 08208 Sabadell, Spain; (J.-C.O.); (O.G.-P.)
- Endocrinology and Nutrition Department, Hospital Universitari Parc Taulí, Corporació Sanitària ParcTaulí—Universitat Autònoma de Barcelona, 08208 Sabadell, Spain
- Medicine Department, Universitat Autònoma de Barcelona, 08208 Sabadell, Spain
| | - Susanna Esteba-Castillo
- Specialized Service in Mental Health and Intellectual Disability, Institut Assistència Sanitària (IAS), Parc Hospitalari Martí i Julià, Salt, 17190 Girona, Spain; (S.E.-C.); (R.N.)
- Neurodevelopment Group, Girona Biomedical Research Institute—IDIBGI, Institut Assistència Sanitària (IAS), Parc Hospitalari Martí i Julià, Salt, 17190 Girona, Spain
| | - Ramon Novell
- Specialized Service in Mental Health and Intellectual Disability, Institut Assistència Sanitària (IAS), Parc Hospitalari Martí i Julià, Salt, 17190 Girona, Spain; (S.E.-C.); (R.N.)
- Neurodevelopment Group, Girona Biomedical Research Institute—IDIBGI, Institut Assistència Sanitària (IAS), Parc Hospitalari Martí i Julià, Salt, 17190 Girona, Spain
| | - Diego J. Palao
- Mental Health Department, Corporació Sanitària Parc Taulí, Universitat Autònoma de Barcelona—CIBERSAM, 08208 Sabadell, Spain; (R.C.); (D.J.P.)
- Department of Psychiatry and Forensic Medicine, Universitat Autònoma de Barcelona, 08208 Sabadell, Spain
- Institut d’Investigació i Innovació Parc Taulí (I3PT), 08208 Sabadell, Spain; (J.-C.O.); (O.G.-P.)
| | - Assumpta Caixàs
- Institut d’Investigació i Innovació Parc Taulí (I3PT), 08208 Sabadell, Spain; (J.-C.O.); (O.G.-P.)
- Endocrinology and Nutrition Department, Hospital Universitari Parc Taulí, Corporació Sanitària ParcTaulí—Universitat Autònoma de Barcelona, 08208 Sabadell, Spain
- Medicine Department, Universitat Autònoma de Barcelona, 08208 Sabadell, Spain
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García-Alba J, Rubio-Valdehita S, Sánchez MJ, García AIM, Esteba-Castillo S, Gómez-Caminero M. Cognitive training in adults with intellectual disability: pilot study applying a cognitive tele-rehabilitation program. Int J Dev Disabil 2020; 68:301-308. [PMID: 35602993 PMCID: PMC9122373 DOI: 10.1080/20473869.2020.1764242] [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] [Subscribe] [Scholar Register] [Received: 02/27/2020] [Revised: 04/29/2020] [Accepted: 04/29/2020] [Indexed: 06/15/2023]
Abstract
INTRODUCTION This pilot study analyzes the effect of a cognitive training program in adults with intellectual disability (ID). METHOD Twenty subjects (mean age 52.7 ± 9.77 years) with mild and moderate ID were divided in control and experimental group. Only the experimental group received the training program. This program was applied through the GNPT® (Guttmann, NeuroPersonalTrainer®) platform for people with ID. RESULTS The results revealed a significant improvement in the Kaufman Brief Intelligence Test-2 scores (Matrices subtest) in the experimental group [Z = 2.12; p = .03] after the intervention, indicating an enhancement in fluid ability due to effect of cognitive training program. CONCLUSION Findings provide evidence of the importance of applying these programs in a systematized way in adults with ID.
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Affiliation(s)
- Javier García-Alba
- Research and Psychology in Education Department, Complutense University of Madrid, Madrid, Spain
| | - Susana Rubio-Valdehita
- Department of Social, Work and Differential Psychology, Complutense University of Madrid, Madrid, Spain
| | - M. Julia Sánchez
- Psychology Department, Juan XXIII Roncalli Foundation, Madrid, Spain
| | - Amelia I. M. García
- Department of Social, Work and Differential Psychology, Complutense University of Madrid, Madrid, Spain
| | - Susanna Esteba-Castillo
- Specialized Department in Mental Health and Intellectual Disability, Parc Hospitalari Martí I Julia, Girona, Spain
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Novell R, Esteba-Castillo S, Rodriguez E. Efficacy and safety of a GABAergic drug (Gamalate® B6): effects on behavior and cognition in young adults with borderline-to-mild intellectual developmental disabilities and ADHD. Drugs Context 2020; 9:212601. [PMID: 32158489 PMCID: PMC7048157 DOI: 10.7573/dic.212601] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2019] [Revised: 12/12/2019] [Accepted: 12/12/2019] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND We evaluated Gamalate® B6 (GB6) in patients with borderline intellectual functioning (BIF) or mild intellectual development disability (IDD). PATIENTS AND METHODS This was a prospective phase IV observational pilot study in 30 patients who underwent neuropsychological evaluation during treatment with GB6 for 12 weeks. RESULTS In comparison with baseline, the responses were positive, with a significant improvement in hyperactivity (51.7%), irritability (35.5%), and logorrhea (50%), and no sedative effect. The Clinical Global Impressions - Severity (CGI-S) score was much improved or very much improved in 73% of cases. Reaction time was better with fewer errors, thus indicating an improvement in attentional processes. A statistically significant result was obtained for the number of movements used to solve the problem and for the total number of correctly solved problems. CONCLUSION In this pilot study, GB6 was effective and well tolerated in cases of ADHD and challenging behavior in young adults with borderline-to-mild BIF/IDD. However, given the small number of patients involved and the uncontrolled nature of the study, these results should be viewed cautiously.
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Affiliation(s)
- Ramón Novell
- Specialized Service in Mental Health and Intellectual Disability (SEMSDI), Parc Hospitalàri Martí i Julià, Instituto de Asistencia Sanitaria, Girona, Spain
| | - Susanna Esteba-Castillo
- Specialized Service in Mental Health and Intellectual Disability (SEMSDI), Parc Hospitalàri Martí i Julià, Instituto de Asistencia Sanitaria, Girona, Spain
| | - Emili Rodriguez
- Specialized Service in Mental Health and Intellectual Disability (SEMSDI), Parc Hospitalàri Martí i Julià, Instituto de Asistencia Sanitaria, Girona, Spain
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9
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García-Alba J, Ramírez-Toraño F, Esteba-Castillo S, Bruña R, Moldenhauer F, Novell R, Romero-Medina V, Maestú F, Fernández A. Neuropsychological and neurophysiological characterization of mild cognitive impairment and Alzheimer's disease in Down syndrome. Neurobiol Aging 2019; 84:70-79. [PMID: 31518951 DOI: 10.1016/j.neurobiolaging.2019.07.017] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [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: 04/08/2019] [Revised: 07/03/2019] [Accepted: 07/30/2019] [Indexed: 10/26/2022]
Abstract
Down syndrome (DS) has been considered a unique model for the investigation of Alzheimer's disease (AD) but intermediate stages in the continuum are poorly defined. Considering this, we investigated the neurophysiological (i.e., magnetoencephalography [MEG]) and neuropsychological patterns of mild cognitive impairment (MCI) and AD in middle-aged adults with DS. The sample was composed of four groups: Control-DS (n = 14, mean age 44.64 ± 3.30 years), MCI-DS (n = 14, 51.64 ± 3.95 years), AD-DS (n = 13, 53.54 ± 6.58 years), and Control-no-DS (healthy controls, n = 14, 45.21 ± 4.39 years). DS individuals were studied with neuropsychological tests and MEG, whereas the Control-no-DS group completed only the MEG session. Our results showed that the AD-DS group exhibited a significantly poorer performance as compared with the Control-DS group in all tests. Furthermore, this effect was crucially evident in AD-DS individuals when compared with the MCI-DS group in verbal and working memory abilities. In the neurophysiological domain, the Control-DS group showed a widespread increase of theta activity when compared with the Control-no-DS group. With disease progression, this increased theta was substituted by an augmented delta, accompanied with a reduction of alpha activity. Such spectral pattern-specifically observed in occipital, posterior temporal, cuneus, and precuneus regions-correlated with the performance in cognitive tests. This is the first MEG study in the field incorporating both neuropsychological and neurophysiological information, and demonstrating that this combination of markers is sensitive enough to characterize different stages along the AD continuum in DS.
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Affiliation(s)
- Javier García-Alba
- Research and Psychology in Education Department, Complutense University of Madrid, Madrid, Spain; Center for Biomedical Technology, Laboratory of Cognitive and Computational Neuroscience, Technical University of Madrid, Campus Montegancedo, Madrid, Spain.
| | - Federico Ramírez-Toraño
- Center for Biomedical Technology, Laboratory of Cognitive and Computational Neuroscience, Technical University of Madrid, Campus Montegancedo, Madrid, Spain; Department of Experimental Psychology, Complutense University of Madrid, Campus de Somosaguas, Pozuelo de Alarcón, Madrid, Spain
| | - Susanna Esteba-Castillo
- Specialized Department in Mental Health and Intellectual Disability, Parc Hospitalari Martí i Julià - Institut d'Assistència Sanitària, Institut d'Assistència Sanitària (IAS), Girona, Spain; Neurodevelopment group [Girona Biomedical Research Institute]-IDIBGI, Institute of Health Assistance (IAS), Parc Hospitalari Martí i Julià, Girona, Spain
| | - Ricardo Bruña
- Center for Biomedical Technology, Laboratory of Cognitive and Computational Neuroscience, Technical University of Madrid, Campus Montegancedo, Madrid, Spain; Department of Experimental Psychology, Complutense University of Madrid, Campus de Somosaguas, Pozuelo de Alarcón, Madrid, Spain; Networking Research Center on Bioengineering, Biomaterials and Nanomedicine (CIBER-BBN), Madrid, Spain
| | - Fernando Moldenhauer
- Internal Medicine Department, Adult Down Syndrome Unit, La Princesa University Hospital, Health Research Institute, Madrid, Spain
| | - Ramón Novell
- Specialized Department in Mental Health and Intellectual Disability, Parc Hospitalari Martí i Julià - Institut d'Assistència Sanitària, Institut d'Assistència Sanitària (IAS), Girona, Spain; Neurodevelopment group [Girona Biomedical Research Institute]-IDIBGI, Institute of Health Assistance (IAS), Parc Hospitalari Martí i Julià, Girona, Spain
| | - Verónica Romero-Medina
- Center for Biomedical Technology, Laboratory of Cognitive and Computational Neuroscience, Technical University of Madrid, Campus Montegancedo, Madrid, Spain
| | - Fernando Maestú
- Center for Biomedical Technology, Laboratory of Cognitive and Computational Neuroscience, Technical University of Madrid, Campus Montegancedo, Madrid, Spain; Department of Experimental Psychology, Complutense University of Madrid, Campus de Somosaguas, Pozuelo de Alarcón, Madrid, Spain; Networking Research Center on Bioengineering, Biomaterials and Nanomedicine (CIBER-BBN), Madrid, Spain
| | - Alberto Fernández
- Center for Biomedical Technology, Laboratory of Cognitive and Computational Neuroscience, Technical University of Madrid, Campus Montegancedo, Madrid, Spain; Department of Legal Medicine, Psychiatry and Pathology, Complutense University of Madrid, Spain, Madrid, Spain
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10
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Novell-Alsina R, Esteba-Castillo S, Caixàs A, Gabau E, Giménez-Palop O, Pujol J, Deus J, Torrents-Rodas D. Compulsions in Prader-Willi syndrome: occurrence and severity as a function of genetic subtype. Actas Esp Psiquiatr 2019; 47:79-87. [PMID: 31233206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Received: 05/01/2019] [Accepted: 05/01/2019] [Indexed: 06/09/2023]
Abstract
INTRODUCTION Compulsions are among the most typical behaviors in Prader-Willi syndrome (PWS). The most frequent causes of PWS are deletion of the genes located in the segment 15q11-q13 of the paternal allele and maternal uniparental disomy of cromosome 15. The aim of the present work was to study compulsive behavior in a sample of adults with PWS and analyze potential differences as a function of the genetic cause/subtype. MATERIAL AND METHODS In the 27 study participants, existence of type I deletion (n=7), type II deletion (n=13), and maternal disomy (n=7) was determined by means of genetic tests. The Yale-Brown Obsessive Compulsive Scale, the Compulsive Behavior Checklist, and the Repetitive Behavior Questionnaire were used to assess occurrence and severity of compulsions. RESULTS Most of the participants showed compulsive behavior, the most frequent compulsions were those of inappropriate grooming (skin picking) and order (hoarding). The occurrence of compulsions was less frequent in the maternal disomy group than in the deletion groups. Severe compulsions were more frequent in those participants with type II deletion than in the other groups. CONCLUSIONS Differences in occurrence and severity of compulsions exist as a function of PWS genetic subtype. Our results support the idea that individuals with maternal disomy are less affected by compulsive behavior. More research on the severity of compulsions as a function of deletion type should be done, as the studies conducted so far have shown contradictory results.
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Affiliation(s)
- Ramon Novell-Alsina
- Specialized Service in Mental Health and Intellectual Disability (SESM-DI), and Girona Biomedical Research Institute (IdibGi), Parc Hospitalari Martí i Julià, Institut d´Assistència Sanitària, Salt (Girona), Spain
| | - Susanna Esteba-Castillo
- Specialized Service in Mental Health and Intellectual Disability (SESM-DI), and Girona Biomedical Research Institute (IdibGi), Parc Hospitalari Martí i Julià, Institut d´Assistència Sanitària, Salt (Girona), Spain
| | - Asumpta Caixàs
- Department of Endocrinology and Nutrition, Parc Taulí Hospital Universitari, and Universitat Autònoma de Barcelona, Sabadell (Barcelona), Spain
| | - Elisabeth Gabau
- Pediatric Endocrinology Unit, Parc Taulí Hospital Universitari, Sabadell (Barcelona), Spain
| | - Olga Giménez-Palop
- Department of Endocrinology and Nutrition, Parc Taulí Hospital Universitari, and Universitat Autònoma de Barcelona, Sabadell (Barcelona), Spain
| | - Jesus Pujol
- MRI Research Unit, Department of Radiology, CIBERSAM G21, Hospital del Mar, Barcelona, Spain
| | - Joan Deus
- MRI Research Unit, Department of Radiology, CIBERSAM G21, Hospital del Mar, Barcelona, Spain Department of Health and Clinical Psychology, Universitat Autònoma de Barcelona, Bellaterra (Barcelona), Spain
| | - David Torrents-Rodas
- Specialized Service in Mental Health and Intellectual Disability (SESM-DI), and Girona Biomedical Research Institute (IdibGi), Parc Hospitalari Martí i Julià, Institut d´Assistència Sanitària, Salt (Girona), Spain Department of Psychology, Philipps-Universität Marburg, Marburg, Germany
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11
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Blanco-Hinojo L, Pujol J, Esteba-Castillo S, Martínez-Vilavella G, Giménez-Palop O, Gabau E, Casamitjana L, Deus J, Novell R, Caixàs A. Lack of response to disgusting food in the hypothalamus and related structures in Prader Willi syndrome. Neuroimage Clin 2019; 21:101662. [PMID: 30639180 PMCID: PMC6412080 DOI: 10.1016/j.nicl.2019.101662] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/18/2018] [Revised: 11/22/2018] [Accepted: 01/04/2019] [Indexed: 12/31/2022]
Abstract
Objective To investigate, based on a putative abnormal neural processing of disgusting signals in Prader Willi syndrome (PWS) patients, the brain response to visual representations of disgusting food in PWS using functional MRI (fMRI). Methods Twenty-one genetically-confirmed PWS patients, 30 age- and sex-matched and 28 BMI-matched control subjects viewed a movie depicting disgusting food-related scenes interspersed with scenes of appetizing food while fMRI was acquired. Brain activation maps were compared between groups and correlated with disgust and hunger ratings. Results At the cortical level, the response to disgusting food representations in PWS patients was qualitatively similar to that of control subjects, albeit less extensive, and engaged brain regions typically related to visually-evoked disgust, such as the anterior insula/frontal operculum, the lateral frontal cortex and visual areas. By contrast, activation was almost absent in limbic structures directly concerned with the regulation of instinctive behavior robustly activated in control subjects, such as the hypothalamus, amygdala/hippocampus and periaqueductal gray. Conclusions Our study provides novel insights into the neural substrates of appetite control in a genetically-mediated cause of obesity. The presence of significant cortical changes further indicates that PWS patients consciously process disgusting stimuli, but the virtual absence of response in deep, limbic structures suggests that disgusting signals do not adequately reach the primary brain system for the appetite control. We report an abnormal pattern of brain response to images of disgusting food in PWS. The activation demonstrated by PWS patients was restricted to the cerebral cortex. Higher subjective disgust ratings were associated with greater insula activation. In contrast, the neural response was almost absent in deep subcortical structures. Disgusting signals may not adequately reach a main brain system for appetite control.
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Affiliation(s)
- Laura Blanco-Hinojo
- MRI Research Unit, Department of Radiology, Hospital del Mar, 08003 Barcelona, Spain; Centro Investigación Biomédica en Red de Salud Mental, CIBERSAM G21, 08003 Barcelona, Spain
| | - Jesus Pujol
- MRI Research Unit, Department of Radiology, Hospital del Mar, 08003 Barcelona, Spain; Centro Investigación Biomédica en Red de Salud Mental, CIBERSAM G21, 08003 Barcelona, Spain.
| | - Susanna Esteba-Castillo
- Specialized Service in Mental Health and Intellectual Disability, Institut Assistència Sanitària (IAS), Parc Hospitalari Martí i Julià, 17190 Girona, Spain.
| | | | - Olga Giménez-Palop
- Endocrinology and Nutrition Department, Parc Taulí Hospital Universitari, Institut d'Investigació i Innovació Parc Taulí I3PT- UAB, 08208 Sabadell, Spain
| | - Elisabeth Gabau
- Clinical Genetics, Pediatrics Department, Parc Taulí Hospital Universitari, Institut d'Investigació i Innovació Parc Taulí I3PT- UAB, 08208 Sabadell, Spain.
| | - Laia Casamitjana
- Endocrinology and Nutrition Department, Parc Taulí Hospital Universitari, Institut d'Investigació i Innovació Parc Taulí I3PT- UAB, 08208 Sabadell, Spain.
| | - Joan Deus
- MRI Research Unit, Department of Radiology, Hospital del Mar, 08003 Barcelona, Spain; Department of Clinical and Health Psychology, Autonomous University of Barcelona, 08193 Barcelona, Spain.
| | - Ramón Novell
- Specialized Service in Mental Health and Intellectual Disability, Institut Assistència Sanitària (IAS), Parc Hospitalari Martí i Julià, 17190 Girona, Spain.
| | - Assumpta Caixàs
- Endocrinology and Nutrition Department, Parc Taulí Hospital Universitari, Institut d'Investigació i Innovació Parc Taulí I3PT- UAB, 08208 Sabadell, Spain
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12
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Viñas-Jornet M, Esteba-Castillo S, Baena N, Ribas-Vidal N, Ruiz A, Torrents-Rodas D, Gabau E, Vilella E, Martorell L, Armengol L, Novell R, Guitart M. High Incidence of Copy Number Variants in Adults with Intellectual Disability and Co-morbid Psychiatric Disorders. Behav Genet 2018; 48:323-336. [PMID: 29882083 PMCID: PMC6028865 DOI: 10.1007/s10519-018-9902-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2017] [Accepted: 05/10/2018] [Indexed: 01/04/2023]
Abstract
A genetic analysis of unexplained mild-moderate intellectual disability and co-morbid psychiatric or behavioural disorders is not systematically conducted in adults. A cohort of 100 adult patients affected by both phenotypes were analysed in order to identify the presence of copy number variants (CNVs) responsible for their condition identifying a yield of 12.8% of pathogenic CNVs (19% when including clinically recognizable microdeletion syndromes). Moreover, there is a detailed clinical description of an additional 11% of the patients harbouring possible pathogenic CNVs—including a 7q31 deletion (IMMP2L) in two unrelated patients and duplications in 3q29, 9p24.2p24.1 and 15q14q15.1—providing new evidence of its contribution to the phenotype. This study adds further proof of including chromosomal microarray analysis (CMA) as a mandatory test to improve the diagnosis in the adult patients in psychiatric services.
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Affiliation(s)
- Marina Viñas-Jornet
- Genetics lab, UDIAT-centre diagnostic. Parc Taulí Hospital Universitari. Institut d'Investigació i Innovació Parc Taulí I3PT. Universitat Autònoma de Barcelona, C/Parc Tauli,1, 08208, Sabadell, Barcelona, Spain.,Cellular Biology, Physiology and Immunology Department, Universitat Autònoma de Barcelona, Bellaterra, Barcelona, Spain
| | - Susanna Esteba-Castillo
- Mental Health and Intellectual Disability Specialized Service, Institut Assistència Sanitària (IAS), Parc Hospitalari Martí i Julià, Girona, Spain
| | - Neus Baena
- Genetics lab, UDIAT-centre diagnostic. Parc Taulí Hospital Universitari. Institut d'Investigació i Innovació Parc Taulí I3PT. Universitat Autònoma de Barcelona, C/Parc Tauli,1, 08208, Sabadell, Barcelona, Spain
| | - Núria Ribas-Vidal
- Mental Health and Intellectual Disability Specialized Service, Institut Assistència Sanitària (IAS), Parc Hospitalari Martí i Julià, Girona, Spain
| | - Anna Ruiz
- Genetics lab, UDIAT-centre diagnostic. Parc Taulí Hospital Universitari. Institut d'Investigació i Innovació Parc Taulí I3PT. Universitat Autònoma de Barcelona, C/Parc Tauli,1, 08208, Sabadell, Barcelona, Spain
| | - David Torrents-Rodas
- Mental Health and Intellectual Disability Specialized Service, Institut Assistència Sanitària (IAS), Parc Hospitalari Martí i Julià, Girona, Spain
| | - Elisabeth Gabau
- Pediatry-Clinical Genetics Service, Parc Taulí Hospital Universitari. Institut d'Investigació i Innovació Parc Taulí I3PT. Universitat Autònoma de Barcelona, Sabadell, Spain
| | - Elisabet Vilella
- Hospital Universitari Institut Pere Mata, IISPV, Universitat Rovira i Virgili, CIBERSAM, Reus, Spain
| | - Lourdes Martorell
- Hospital Universitari Institut Pere Mata, IISPV, Universitat Rovira i Virgili, CIBERSAM, Reus, Spain
| | - Lluís Armengol
- Research and Development Department, qGenomics Laboratory, Barcelona, Spain
| | - Ramon Novell
- Mental Health and Intellectual Disability Specialized Service, Institut Assistència Sanitària (IAS), Parc Hospitalari Martí i Julià, Girona, Spain
| | - Míriam Guitart
- Genetics lab, UDIAT-centre diagnostic. Parc Taulí Hospital Universitari. Institut d'Investigació i Innovació Parc Taulí I3PT. Universitat Autònoma de Barcelona, C/Parc Tauli,1, 08208, Sabadell, Barcelona, Spain.
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13
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Thygesen JH, Wolfe K, McQuillin A, Viñas-Jornet M, Baena N, Brison N, D'Haenens G, Esteba-Castillo S, Gabau E, Ribas-Vidal N, Ruiz A, Vermeesch J, Weyts E, Novell R, Buggenhout GV, Strydom A, Bass N, Guitart M, Vogels A. Neurodevelopmental risk copy number variants in adults with intellectual disabilities and comorbid psychiatric disorders. Br J Psychiatry 2018; 212:287-294. [PMID: 29693535 PMCID: PMC7083594 DOI: 10.1192/bjp.2017.65] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [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] [Indexed: 12/30/2022]
Abstract
BACKGROUND Copy number variants (CNVs) are established risk factors for neurodevelopmental disorders. To date the study of CNVs in psychiatric illness has focused on single disorder populations. The role of CNVs in individuals with intellectual disabilities and psychiatric comorbidities are less well characterised.AimsTo determine the type and frequency of CNVs in adults with intellectual disabilities and comorbid psychiatric disorders. METHOD A chromosomal microarray analysis of 599 adults recruited from intellectual disabilities psychiatry services at three European sites. RESULTS The yield of pathogenic CNVs was high - 13%. Focusing on established neurodevelopmental disorder risk loci we find a significantly higher frequency in individuals with intellectual disabilities and comorbid psychiatric disorder (10%) compared with healthy controls (1.2%, P<0.0001), schizophrenia (3.1%, P<0.0001) and intellectual disability/autism spectrum disorder (6.5%, P < 0.00084) populations. CONCLUSIONS In the largest sample of adults with intellectual disabilities and comorbid psychiatric disorders to date, we find a high rate of pathogenic CNVs. This has clinical implications for the use of genetic investigations in intellectual disability psychiatry.Declaration of interestNone.
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Affiliation(s)
| | - Kate Wolfe
- Division of Psychiatry, University College London, London, UK
| | | | - Marina Viñas-Jornet
- Genetics Laboratory, UDIAT-Centre Diagnostic, Hospital de Sabadell, Parc Taulí, Hospital Universitari, Institut d'Investigació i Innovació Parc Taulí I3PT, Universitat Autònoma de Barcelona, Sabadell, Spain
| | - Neus Baena
- Genetics Laboratory, UDIAT-Centre Diagnostic, Hospital de Sabadell, Parc Taulí, Hospital Universitari, Institut d'Investigació i Innovació Parc Taulí I3PT, Universitat Autònoma de Barcelona, Sabadell, Spain
| | - Nathalie Brison
- Department of Human Genetics, Centre for Human Genetics, University Hospitals Leuven, Leuven, Belgium
| | | | - Susanna Esteba-Castillo
- Mental Health and Intellectual Disability Specialized Service, Institut Assistència Sanitària (IAS), Parc Hospitalari Martí i Julià, Girona, Spain
| | - Elisabeth Gabau
- Genetics Laboratory, UDIAT-Centre Diagnostic, Hospital de Sabadell, Parc Taulí, Hospital Universitari, Institut d'Investigació i Innovació Parc Taulí I3PT, Universitat Autònoma de Barcelona, Sabadell, Spain
| | - Núria Ribas-Vidal
- Mental Health and Intellectual Disability Specialized Service, Institut Assistència Sanitària (IAS), Parc Hospitalari Martí i Julià, Girona, Spain
| | - Anna Ruiz
- Genetics Laboratory, UDIAT-Centre Diagnostic, Hospital de Sabadell, Parc Taulí, Hospital Universitari, Institut d'Investigació i Innovació Parc Taulí I3PT, Universitat Autònoma de Barcelona, Sabadell, Spain
| | - Joris Vermeesch
- Department of Human Genetics, Centre for Human Genetics, University Hospitals Leuven, Leuven, Belgium
| | - Eddy Weyts
- St Camillus Psychiatric Hospital, Bierbeek, Belgium
| | - Ramon Novell
- Mental Health and Intellectual Disability Specialized Service, Institut Assistència Sanitària (IAS), Parc Hospitalari Martí i Julià, Girona, Spain
| | - Griet Van Buggenhout
- Department of Human Genetics, Centre for Human Genetics, University Hospitals Leuven, Leuven, Belgium
| | - André Strydom
- Division of Psychiatry, University College London and Department of Forensic and Neurodevelopmental Science, Institute of Psychiatry, Psychology and Neuroscience, Kings College London, London, UK
| | - Nick Bass
- Division of Psychiatry, University College London, London, UK
| | - Miriam Guitart
- Genetics Laboratory, UDIAT-Centre Diagnostic, Hospital de Sabadell, Parc Taulí, Hospital Universitari, Institut d'Investigació i Innovació Parc Taulí I3PT, Universitat Autònoma de Barcelona, Sabadell, Spain
| | - Annick Vogels
- Department of Human Genetics, Centre for Human Genetics, University Hospitals Leuven, Leuven, Belgium,Correspondence: Annick Vogels, Department of Human Genetics, Centre for Human Genetics, University Hospitals Leuven, O&N I Herestraat 49 - Box 602, KU Leuven, 3000 Leuven, Belgium.
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14
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Fenoll R, Pujol J, Esteba-Castillo S, de Sola S, Ribas-Vidal N, García-Alba J, Sánchez-Benavides G, Martínez-Vilavella G, Deus J, Dierssen M, Novell-Alsina R, de la Torre R. Anomalous White Matter Structure and the Effect of Age in Down Syndrome Patients. J Alzheimers Dis 2018; 57:61-70. [PMID: 28222523 DOI: 10.3233/jad-161112] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
BACKGROUND Neural tissue alterations in Down syndrome are fully expressed at relatively late developmental stages. In addition, there is an early presence of neurodegenerative changes in the late life stages. OBJECTIVE The aims of this study were both to characterize white matter abnormalities in the brain of adult Down syndrome patients using diffusion tensor imaging (DTI) and to investigate whether degenerative alterations in white matter structure are detectable before dementia is clinically evident. METHODS Forty-five adult non-demented Down syndrome patients showing a wide age range (18-52 years) and a matched 45-subject control group were assessed. DTI fractional anisotropy (FA) brain maps were generated and selected cognitive tests were administered. RESULTS Compared with healthy controls, non-demented Down syndrome patients showed lower DTI FA in white matter involving the major pathways, but with more severe alterations in the frontal-subcortical circuits. White matter FA decreased with age at a similar rate in both DS and control groups. CONCLUSIONS Our results contribute to characterizing the expression of white matter structural alterations in adult Down syndrome. However, an accelerated aging effect was not demonstrated, which may suggest that the FA measurements used are not sufficiently sensitive or, alternatively, age-related white matter neurodegeneration is not obvious prior to overt clinical dementia.
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Affiliation(s)
- Raquel Fenoll
- MRI Research Unit, Department of Radiology, Hospital del Mar, Barcelona, Spain
| | - Jesus Pujol
- MRI Research Unit, Department of Radiology, Hospital del Mar, Barcelona, Spain.,Centro Investigación Biomédica en Red de Salud Mental, CIBERSAM G21, Barcelona, Spain
| | - Susanna Esteba-Castillo
- Specialized Department in Mental Health and Intellectual Disability, Institut d'Assistència Sanitària (IAS), Girona, Catalonia, Spain
| | - Susana de Sola
- Integrative Pharmacology and Neuroscience Systems Research Group, Hospital del Mar Medical Research Institute, Barcelona, Spain.,Cellular & Systems Neurobiology, Centre for Genomic Regulation (CRG), Barcelona, Spain
| | - Núria Ribas-Vidal
- Specialized Department in Mental Health and Intellectual Disability, Institut d'Assistència Sanitària (IAS), Girona, Catalonia, Spain
| | - Javier García-Alba
- Specialized Department in Mental Health and Intellectual Disability, Institut d'Assistència Sanitària (IAS), Girona, Catalonia, Spain
| | - Gonzalo Sánchez-Benavides
- Integrative Pharmacology and Neuroscience Systems Research Group, Hospital del Mar Medical Research Institute, Barcelona, Spain
| | - Gerard Martínez-Vilavella
- Integrative Pharmacology and Neuroscience Systems Research Group, Hospital del Mar Medical Research Institute, Barcelona, Spain
| | - Joan Deus
- MRI Research Unit, Department of Radiology, Hospital del Mar, Barcelona, Spain.,Department of Clinical and Health Psychology, Autonomous University of Barcelona, Spain
| | - Mara Dierssen
- Cellular & Systems Neurobiology, Centre for Genomic Regulation (CRG), Barcelona, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), Madrid, Spain
| | - Ramón Novell-Alsina
- Cellular & Systems Neurobiology, Centre for Genomic Regulation (CRG), Barcelona, Spain
| | - Rafael de la Torre
- Integrative Pharmacology and Neuroscience Systems Research Group, Hospital del Mar Medical Research Institute, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Madrid, Spain.,Department de Ciències Experimentals i de la Salut Universitat Pompeu Fabra (CEXS-UPF), Barcelona, Spain
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15
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Pujol J, Blanco-Hinojo L, Coronas R, Esteba-Castillo S, Rigla M, Martínez-Vilavella G, Deus J, Novell R, Caixàs A. Mapping the sequence of brain events in response to disgusting food. Hum Brain Mapp 2017; 39:369-380. [PMID: 29024175 DOI: 10.1002/hbm.23848] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2017] [Revised: 09/19/2017] [Accepted: 10/04/2017] [Indexed: 12/16/2022] Open
Abstract
Warning signals indicating that a food is potentially dangerous may evoke a response that is not limited to the feeling of disgust. We investigated the sequence of brain events in response to visual representations of disgusting food using a dynamic image analysis. Functional MRI was acquired in 30 healthy subjects while they were watching a movie showing disgusting food scenes interspersed with the scenes of appetizing food. Imaging analysis included the identification of the global brain response and the generation of frame-by-frame activation maps at the temporal resolution of 2 s. Robust activations were identified in brain structures conventionally associated with the experience of disgust, but our analysis also captured a variety of other brain elements showing distinct temporal evolutions. The earliest events included transient changes in the orbitofrontal cortex and visual areas, followed by a more durable engagement of the periaqueductal gray, a pivotal element in the mediation of responses to threat. A subsequent core phase was characterized by the activation of subcortical and cortical structures directly concerned not only with the emotional dimension of disgust (e.g., amygdala-hippocampus, insula), but also with the regulation of food intake (e.g., hypothalamus). In a later phase, neural excitement extended to broad cortical areas, the thalamus and cerebellum, and finally to the default mode network that signaled the progressive termination of the evoked response. The response to disgusting food representations is not limited to the emotional domain of disgust, and may sequentially involve a variety of broadly distributed brain networks. Hum Brain Mapp 39:369-380, 2018. © 2017 Wiley Periodicals, Inc.
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Affiliation(s)
- Jesus Pujol
- MRI Research Unit, Department of Radiology, Hospital del Mar, Barcelona, 08003, Spain.,Centro Investigación Biomédica en Red de Salud Mental, CIBERSAM G21, Barcelona, 08003, Spain
| | - Laura Blanco-Hinojo
- MRI Research Unit, Department of Radiology, Hospital del Mar, Barcelona, 08003, Spain.,Centro Investigación Biomédica en Red de Salud Mental, CIBERSAM G21, Barcelona, 08003, Spain
| | - Ramón Coronas
- Mental Health Center, Corporació Sanitària Parc Taulí, Sabadell, 08208, Spain
| | - Susanna Esteba-Castillo
- Specialized Service in Mental Health and Intellectual Disability, Institut Assistència Sanitària (IAS), Parc Hospitalari Martí i Julià, Girona, 17190, Spain
| | - Mercedes Rigla
- Endocrinology and Nutrition Department, Sabadell University Hospital (UAB), Corporació Sanitària Parc Taulí, Sabadell, 08208, Spain
| | | | - Joan Deus
- MRI Research Unit, Department of Radiology, Hospital del Mar, Barcelona, 08003, Spain.,Guttmann Neurorehabilitation Institute, Autonomous University of Barcelona, Barcelona, 08916, Spain.,Department of Clinical and Health Psychology, Autonomous University of Barcelona, Barcelona, 08193, Spain
| | - Ramón Novell
- Specialized Service in Mental Health and Intellectual Disability, Institut Assistència Sanitària (IAS), Parc Hospitalari Martí i Julià, Girona, 17190, Spain
| | - Assumpta Caixàs
- Endocrinology and Nutrition Department, Sabadell University Hospital (UAB), Corporació Sanitària Parc Taulí, Sabadell, 08208, Spain
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Esteba-Castillo S, Pena-Casanova J, Garcia-Alba J, Castellanos MA, Torrents-Rodas D, Rodriguez E, Deus-Yela J, Caixas A, Novell-Alsina R. [Barcelona Test for Intellectual Disability: a new instrument for the neuropsychological assessment of adults with intellectual disability]. Rev Neurol 2017; 64:433-444. [PMID: 28497439] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
INTRODUCTION Neuropsychological assessment in individuals with intellectual disability is of utmost importance in order to determine the cognitive deficits underlying brain dysfunction and limiting intellectual functioning and adaptive behavior. However, no neuropsychological batteries in Spanish language have been created and validated for this population. AIM To adapt the 'programa integrado de exploracion neuropsicologica-test Barcelona' and to validate the new version, the Barcelona Test for Intellectual Disability (TB-DI). To create normative data for its clinical use. SUBJECTS AND METHODS The original test was modified based on data from a pilot sample of 65 individuals with intellectual disability. In order to study the psychometric properties of the TB-DI, it was administered to a sample of 170 individuals with intellectual disability and to a group of 60 individuals without it. The relevant variables for stratification of normative data were determined by means of regression models. RESULTS The TB-DI was finally composed by 67 subtests grouped in eight cognitive domains and it showed good psychometric properties. Normative data were created for five groups taking into account intellectual disability level, age and acquired curricular competence. These data were organized in percentiles in a way that allows the creation of cognitive profiles in the clinical and experimental fields. CONCLUSION The TB-DI constitutes a tool of high applicability in the population with intellectual disability. It shows adequate validity and reliability, and it has good psychometric properties. The cognitive profiles obtained by the TB-DI will provide valuable information for the treatment of adult adults with mild and moderate intellectual disability.
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Affiliation(s)
| | - J Pena-Casanova
- Instituto de Investigacion Hospital del Mar, Barcelona, Espana
| | - J Garcia-Alba
- Facultad de Educacion de la Universidad Complutense de Madrid, Madrid, Espana
| | | | | | - E Rodriguez
- Institut d'Assistencia Sanitaria, Salt, Espana
| | - J Deus-Yela
- Universitat Autonoma de Barcelona, Bellaterra, Espana
- CRC-Mar Hospital del Mar, Barcelona, Espana
| | - A Caixas
- Hospital de Sabadell. Corporacio Sanitaria Parc Tauli, 08208 Sabadell, Espana
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Bueno M, Esteba-Castillo S, Novell R, Giménez-Palop O, Coronas R, Gabau E, Corripio R, Baena N, Viñas-Jornet M, Guitart M, Torrents-Rodas D, Deus J, Pujol J, Rigla M, Caixàs A. Lack of Postprandial Peak in Brain-Derived Neurotrophic Factor in Adults with Prader-Willi Syndrome. PLoS One 2016; 11:e0163468. [PMID: 27685845 PMCID: PMC5042477 DOI: 10.1371/journal.pone.0163468] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2016] [Accepted: 09/08/2016] [Indexed: 02/06/2023] Open
Abstract
Context Prader-Willi syndrome (PWS) is characterized by severe hyperphagia. Brain-derived neurotrophic factor (BDNF) and leptin are reciprocally involved in energy homeostasis. Objectives To analyze the role of BDNF and leptin in satiety in genetic subtypes of PWS. Design Experimental study. Setting University hospital. Subjects 90 adults: 30 PWS patients; 30 age-sex-BMI-matched obese controls; and 30 age-sex-matched lean controls. Interventions Subjects ingested a liquid meal after fasting ≥10 hours. Main Outcome Measures Leptin and BDNF levels in plasma extracted before ingestion and 30’, 60’, and 120’ after ingestion. Hunger, measured on a 100-point visual analogue scale before ingestion and 60’ and 120’ after ingestion. Results Fasting BDNF levels were lower in PWS than in controls (p = 0.05). Postprandially, PWS patients showed only a truncated early peak in BDNF, and their BDNF levels at 60' and 120' were lower compared with lean controls (p<0.05). Leptin was higher in PWS patients than in controls at all time points (p<0.001). PWS patients were hungrier than controls before and after eating. The probability of being hungry was associated with baseline BDNF levels: every 50-unit increment in BDNF decreased the odds of being hungry by 22% (OR: 0.78, 95%CI: 0.65–0.94). In uniparental disomy, the odds of being hungry decreased by 66% (OR: 0.34, 90%CI: 0.13–0.9). Postprandial leptin patterns did no differ among genetic subtypes. Conclusions Low baseline BDNF levels and lack of postprandial peak may contribute to persistent hunger after meals. Uniparental disomy is the genetic subtype of PWS least affected by these factors.
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Affiliation(s)
- Marta Bueno
- Department of Endocrinology and Nutrition, Hospital Universitari Arnau de Vilanova, Lleida, Spain
| | - Susanna Esteba-Castillo
- Specialized Service in Mental Health and Intellectual Disability, Institut Assistència Sanitària (IAS), Parc Hospitalari Martí i Julià, Girona, Spain
| | - Ramon Novell
- Specialized Service in Mental Health and Intellectual Disability, Institut Assistència Sanitària (IAS), Parc Hospitalari Martí i Julià, Girona, Spain
| | - Olga Giménez-Palop
- Department of Endocrinology and Nutrition, Sabadell University Hospital, Corporació Sanitària Parc Taulí, Sabadell, Spain, Autonomous University of Barcelona, Bellaterra, Spain
| | - Ramon Coronas
- Mental Health Center, Corporació Sanitària Parc Taulí, Sabadell, Spain
| | - Elisabeth Gabau
- Pediatric Endocrinology Unit, Sabadell University Hospital, Corporació Sanitària Parc Taulí, Sabadell, Spain
| | - Raquel Corripio
- Pediatric Endocrinology Unit, Sabadell University Hospital, Corporació Sanitària Parc Taulí, Sabadell, Spain
| | - Neus Baena
- Genetics Laboratory, UDIAT, Corporació Sanitària Parc Taulí, Sabadell, Spain
| | - Marina Viñas-Jornet
- Genetics Laboratory, UDIAT, Corporació Sanitària Parc Taulí, Sabadell, Spain
| | - Míriam Guitart
- Genetics Laboratory, UDIAT, Corporació Sanitària Parc Taulí, Sabadell, Spain
| | - David Torrents-Rodas
- Specialized Service in Mental Health and Intellectual Disability, Institut Assistència Sanitària (IAS), Parc Hospitalari Martí i Julià, Girona, Spain
| | - Joan Deus
- Department of Clinical and Health Psychology, Autonomous University of Barcelona, Bellaterra, Spain
- MRI Research Unit, Department of Radiology, CIBERSAM G21, Hospital del Mar, Barcelona, Spain
- Guttmann Neurorehabilitation Institute, Barcelona, Spain, Autonomous University of Barcelona, Bellaterra, Spain
| | - Jesús Pujol
- MRI Research Unit, Department of Radiology, CIBERSAM G21, Hospital del Mar, Barcelona, Spain
| | - Mercedes Rigla
- Department of Endocrinology and Nutrition, Sabadell University Hospital, Corporació Sanitària Parc Taulí, Sabadell, Spain, Autonomous University of Barcelona, Bellaterra, Spain
| | - Assumpta Caixàs
- Department of Endocrinology and Nutrition, Sabadell University Hospital, Corporació Sanitària Parc Taulí, Sabadell, Spain, Autonomous University of Barcelona, Bellaterra, Spain
- * E-mail:
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Pujol J, Blanco-Hinojo L, Esteba-Castillo S, Caixàs A, Harrison BJ, Bueno M, Deus J, Rigla M, Macià D, Llorente-Onaindia J, Novell-Alsina R. Anomalous basal ganglia connectivity and obsessive-compulsive behaviour in patients with Prader Willi syndrome. J Psychiatry Neurosci 2016; 41:261-71. [PMID: 26645739 PMCID: PMC4915935 DOI: 10.1503/jpn.140338] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND Prader Willi syndrome is a genetic disorder with a behavioural expression characterized by the presence of obsessive-compulsive phenomena ranging from elaborate obsessive eating behaviour to repetitive skin picking. Obsessive-compulsive disorder (OCD) has been recently associated with abnormal functional coupling between the frontal cortex and basal ganglia. We have tested the potential association of functional connectivity anomalies in basal ganglia circuits with obsessive-compulsive behaviour in patients with Prader Willi syndrome. METHODS We analyzed resting-state functional MRI in adult patients and healthy controls. Whole-brain functional connectivity maps were generated for the dorsal and ventral aspects of the caudate nucleus and putamen. A selected obsessive-compulsive behaviour assessment included typical OCD compulsions, self picking and obsessive eating behaviour. RESULTS We included 24 adults with Prader Willi syndrome and 29 controls in our study. Patients with Prader Willi syndrome showed abnormal functional connectivity between the prefrontal cortex and basal ganglia and within subcortical structures that correlated with the presence and severity of obsessive-compulsive behaviours. In addition, abnormally heightened functional connectivity was identified in the primary sensorimotor cortex-putamen loop, which was strongly associated with self picking. Finally, obsessive eating behaviour correlated with abnormal functional connectivity both within the basal ganglia loops and between the striatum and the hypothalamus and the amygdala. LIMITATIONS Limitations of the study include the difficulty in evaluating the nature of content of obsessions in patients with Prader Willi Syndrome and the risk of excessive head motion artifact on brain imaging. CONCLUSION Patients with Prader Willi syndrome showed broad functional connectivity anomalies combining prefrontal loop alterations characteristic of OCD with 1) enhanced coupling in the primary sensorimotor loop that correlated with the most impulsive aspects of the behaviour and 2) reduced coupling of the ventral striatum with limbic structures for basic internal homeostasis that correlated with the obsession to eat.
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Affiliation(s)
- Jesus Pujol
- Correspondence to: J. Pujol, MRI Department, CRC-Mar, Hospital del Mar, Passeig Marítim 25–29. 08003, Barcelona;
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Viñas-Jornet M, Esteba-Castillo S, Gabau E, Ribas-Vidal N, Baena N, San J, Ruiz A, Coll MD, Novell R, Guitart M. A common cognitive, psychiatric, and dysmorphic phenotype in carriers of NRXN1 deletion. Mol Genet Genomic Med 2014; 2:512-21. [PMID: 25614873 PMCID: PMC4303221 DOI: 10.1002/mgg3.105] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [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: 06/06/2014] [Revised: 08/04/2014] [Accepted: 07/16/2014] [Indexed: 12/13/2022] Open
Abstract
Deletions in the 2p16.3 region that includes the neurexin (NRXN1) gene are associated with intellectual disability and various psychiatric disorders, in particular, autism and schizophrenia. We present three unrelated patients, two adults and one child, in whom we identified an intragenic 2p16.3 deletion within the NRXN1 gene using an oligonucleotide comparative genomic hybridization array. The three patients presented dual diagnosis that consisted of mild intellectual disability and autism and bipolar disorder. Also, they all shared a dysmorphic phenotype characterized by a long face, deep set eyes, and prominent premaxilla. Genetic analysis of family members showed two inherited deletions. A comprehensive neuropsychological examination of the 2p16.3 deletion carriers revealed the same phenotype, characterized by anxiety disorder, borderline intelligence, and dysexecutive syndrome. The cognitive pattern of dysexecutive syndrome with poor working memory and reduced attention switching, mental flexibility, and verbal fluency was the same than those of the adult probands. We suggest that in addition to intellectual disability and psychiatric disease, NRXN1 deletion is a risk factor for a characteristic cognitive and dysmorphic profile. The new cognitive phenotype found in the 2p16.3 deletion carriers suggests that 2p16.3 deletions might have a wide variable expressivity instead of incomplete penetrance.
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Affiliation(s)
- Marina Viñas-Jornet
- Laboratori de Genètica, UDIAT-Centre Diagnòstic, Corporació Sanitària Parc Taulí, Institut Universitari Parc Tauli-UAB Sabadell, Spain ; Unitat de Biologia Cellular, Facultat de Biociències, Universitat Autònoma de Barcelona Bellaterra, Spain
| | - Susanna Esteba-Castillo
- Servei Especialitzat de Salut Mental i Discapacitat Intellectual, Institut Asistència Sanitària (IAS), Parc Hospitalari Martí i Julià Girona, Spain
| | - Elisabeth Gabau
- Laboratori de Genètica, UDIAT-Centre Diagnòstic, Corporació Sanitària Parc Taulí, Institut Universitari Parc Tauli-UAB Sabadell, Spain
| | - Núria Ribas-Vidal
- Servei Especialitzat de Salut Mental i Discapacitat Intellectual, Institut Asistència Sanitària (IAS), Parc Hospitalari Martí i Julià Girona, Spain
| | - Neus Baena
- Laboratori de Genètica, UDIAT-Centre Diagnòstic, Corporació Sanitària Parc Taulí, Institut Universitari Parc Tauli-UAB Sabadell, Spain
| | - Joan San
- Servei Especialitzat de Salut Mental i Discapacitat Intellectual, Institut Asistència Sanitària (IAS), Parc Hospitalari Martí i Julià Girona, Spain
| | - Anna Ruiz
- Laboratori de Genètica, UDIAT-Centre Diagnòstic, Corporació Sanitària Parc Taulí, Institut Universitari Parc Tauli-UAB Sabadell, Spain
| | - Maria Dolors Coll
- Unitat de Biologia Cellular, Facultat de Biociències, Universitat Autònoma de Barcelona Bellaterra, Spain
| | - Ramon Novell
- Servei Especialitzat de Salut Mental i Discapacitat Intellectual, Institut Asistència Sanitària (IAS), Parc Hospitalari Martí i Julià Girona, Spain
| | - Miriam Guitart
- Laboratori de Genètica, UDIAT-Centre Diagnòstic, Corporació Sanitària Parc Taulí, Institut Universitari Parc Tauli-UAB Sabadell, Spain
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20
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Esteba-Castillo S, Dalmau-Bueno A, Ribas-Vidal N, Vilà-Alsina M, Novell-Alsina R, García-Alba J. [Adaptation and validation of CAMDEX-DS (Cambridge Examination for Mental Disorders of Older People with Down's Syndrome and others with intellectual disabilities) in Spanish population with intellectual disabilities]. Rev Neurol 2013; 57:337-346. [PMID: 24081888] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
INTRODUCTION Dementia caused by Alzheimer's disease commonly affects the adult population with Down's syndrome. This population presents two characteristic clinical features: a semiologic pattern that differs from the typical Alzheimer's disease, and previous intellectual deficits that may confound the clinical diagnosis. There is a clear need to validate specific instruments adapted to Spanish population. AIM To adapt and to validate CAMDEX-DS (Cambridge Examination for Mental Disorders of Older People with Down's Syndrome and Others with Intellectual Disabilities) in Spanish population. PATIENTS AND METHODS 146 patients with intellectual disability (mild to moderate) were recruited and assessed with CAMDEX-DS, K-BIT I and DMR tests. Test-retest reliability, inter-rater concordance and validity statistic were performed between CAMDEX-DS and clinical diagnosis. This is an observational, multicenter, cross-sectional and validation study. RESULTS Test-retest and inter-rater reliability achieved kappa coefficient values of 0.92 and 0.91, respectively. Agreement (kappa index) for CAMDEX-DS on clinical diagnosis compared to other clinical criteria was high: CAMDEX-DS vs DSM-IV (kappa = 0.95; p < 0,001); CAMDEX-DS vs ICD-10 (kappa = 0.97; p < 0.001). All item-test correlations ranged between 0,31 and 0,69. Internal reliability-calculated using Chronbach's alpha scored 0.93. CONCLUSIONS The Spanish version of CAMDEX-DS is a valid instrument with high applicability for people with intellectual disability. It shows good psychometric properties. The Cambridge Cognitive Examination for Older Adults with Down's Syndrome (CAMCOG-DS) can set two key points by the level of intellectual disability on the suspicion of cognitive impairment in people with Down's syndrome.
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Benito-Cuadrado MM, Esteba-Castillo S, Böhm P, Cejudo-Bolívar J, Peña-Casanova J. Semantic verbal fluency of animals: a normative and predictive study in a Spanish population. J Clin Exp Neuropsychol 2002; 24:1117-22. [PMID: 12650236 DOI: 10.1076/jcen.24.8.1117.8376] [Citation(s) in RCA: 60] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Semantic verbal fluency is a very sensible but rather unspecific tool for the detection of neuropsychological deficits. This test is highly influenced by socio-cultural factors. Normative and predictive data for semantic verbal fluency of animals in a Spanish population are presented. The studied sample (n = 445) was stratified according to age and schooling. Statistical analysis reconfirmed a significant negative correlation (- 5.34) for age, and a significant positive correlation (5.34) for years of formal education. A predictive function for the production of names of animals during 1 min was established based on the subject's age and level of education: F(x) = 23.89 + age (- .144) + education (.39). The neuropsychological value and limitations of normative data and the predictive equation are discussed.
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Affiliation(s)
- M M Benito-Cuadrado
- Section of Behavioral Neurology & Dementia, Department of Neurology, Hospital del Mar, Institut Municipal d'Assistència Sanitària, Barcelona, Spain
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