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Deng F, Ma J. Gender Differences in Prevalence and Associated Factors of Dyslipidemia in Initial-Treatment and Drug-Naïve Schizophrenia Patients. Neuropsychiatr Dis Treat 2024; 20:957-966. [PMID: 38737771 PMCID: PMC11088862 DOI: 10.2147/ndt.s457631] [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] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/02/2024] [Accepted: 04/23/2024] [Indexed: 05/14/2024] Open
Abstract
Background Dyslipidemia is frequently comorbid with schizophrenia (SCZ), and both conditions often demonstrate significant gender differences in their clinical features. This study specifically focuses on investigating the prevalence of dyslipidemia and the factors that contribute to it in initial-treatment and drug-naïve (ITDN) SCZ patients, specifically focusing on gender differences. Methods A total of 224 male ITDN SCZ patients and 424 female ITDN SCZ patients were included in this study. Socio-demographic and general clinical data of the patients were collected, and routine biochemical parameters, such as lipid levels, fasting blood glucose, thyroid function, renal function, and blood cell counts, were measured. Patients were also assessed for psychopathology and disease severity using the Positive and Negative Syndrome Scale (PANSS) and the Clinical Global Impression Scale - Severity of Illness (CGI-SI), respectively. In addition, a lipids score was calculated for assessing the severity of dyslipidemia. Results The study revealed that the prevalence of dyslipidemia in male patients was 34.02% (83/224), whereas 33.25% (141/424) in females, indicating no statistically significant difference (χ2 = 0.04, p = 0.841). For males, the risk factors for dyslipidemia were high education levels and diastolic blood pressure (DBP), while red blood cell count (RBC) as a protective factor. Additionally, DBP was identified as a risk factor for dyslipidemia score. In females, systolic blood pressure (SBP) was identified as a risk factor for dyslipidemia, while being married and creatinine (CRE) levels were found to be protective factors. Moreover, SBP was revealed as a risk factor for dyslipidemia score. Conclusion No significant gender differences were observed in the prevalence of dyslipidemia among the ITDN SCZ patients. However, notable gender differences were identified in the factors influencing dyslipidemia and its severity within this group. These findings suggest the necessity of implementing gender-specific interventions to address the potential risk factors associated with dyslipidemia.
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Affiliation(s)
- Fang Deng
- Department of Psychiatry, Wuhan Mental Health Center, Wuhan, Hubei, People’s Republic of China
- Wuhan Hospital for Psychotherapy, Wuhan, Hubei, People’s Republic of China
| | - Jun Ma
- Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan, Hubei, People’s Republic of China
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Li X, Wei W, Wang Q, Deng W, Li M, Ma X, Zeng J, Zhao L, Guo W, Hall MH, Li T. Identify Potential Causal Relationships Between Cortical Thickness, Mismatch Negativity, Neurocognition, and Psychosocial Functioning in Drug-Naïve First-Episode Psychosis Patients. Schizophr Bull 2024:sbae026. [PMID: 38635296 DOI: 10.1093/schbul/sbae026] [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] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/19/2024]
Abstract
BACKGROUND Cortical thickness (CT) alterations, mismatch negativity (MMN) reductions, and cognitive deficits are robust findings in first-episode psychosis (FEP). However, most studies focused on medicated patients, leaving gaps in our understanding of the interrelationships between CT, MMN, neurocognition, and psychosocial functioning in unmedicated FEP. This study aimed to employ multiple mediation analysis to investigate potential pathways among these variables in unmedicated drug-naïve FEP. METHODS We enrolled 28 drug-naïve FEP and 34 age and sex-matched healthy controls. Clinical symptoms, neurocognition, psychosocial functioning, auditory duration MMN, and T1 structural magnetic resonance imaging data were collected. We measured CT in the superior temporal gyrus (STG), a primary MMN-generating region. RESULTS We found a significant negative correlation between MMN amplitude and bilateral CT of STG (CT_STG) in FEP (left: r = -.709, P < .001; right: r = -.612, P = .008). Multiple mediation models revealed that a thinner left STG cortex affected functioning through both direct (24.66%) and indirect effects (75.34%). In contrast, the effects of the right CT_STG on functioning were mainly mediated through MMN and neurocognitive pathways. CONCLUSIONS Bilateral CT_STG showed significant association with MMN, and MMN plays a mediating role between CT and cognition. Both MMN alone and its interaction with cognition mediated the effects of structural alterations on psychosocial function. The decline in overall function in FEP may stem from decreased CT_STG, leading to subsequent MMN deficits and neurocognitive dysfunction. These findings underline the crucial role of MMN in elucidating how subtle structural alterations can impact neurocognition and psychosocial function in FEP.
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Affiliation(s)
- Xiaojing Li
- Affiliated Mental Health Center and Hangzhou Seventh People's Hospital, Zhejiang University School of Medicine, Hangzhou 310058, China
- Nanhu Brain-Computer Interface Institute, Hangzhou 311100, China
- Liangzhu Laboratory, MOE Frontier Science Center for Brain Science and Brain-Machine Integration, State Key Laboratory of Brain-Machine Intelligence, Zhejiang University, 1369 West Wenyi Road, Hangzhou 311121, China
- NHC and CAMS Key Laboratory of Medical Neurobiology, Zhejiang University, Hangzhou 310058, China
| | - Wei Wei
- Affiliated Mental Health Center and Hangzhou Seventh People's Hospital, Zhejiang University School of Medicine, Hangzhou 310058, China
- Nanhu Brain-Computer Interface Institute, Hangzhou 311100, China
- Liangzhu Laboratory, MOE Frontier Science Center for Brain Science and Brain-Machine Integration, State Key Laboratory of Brain-Machine Intelligence, Zhejiang University, 1369 West Wenyi Road, Hangzhou 311121, China
- NHC and CAMS Key Laboratory of Medical Neurobiology, Zhejiang University, Hangzhou 310058, China
| | - Qiang Wang
- Mental Health Center and Psychiatric Laboratory, West China Hospital of Sichuan University, Chengdu 610041, Sichuan, China
| | - Wei Deng
- Affiliated Mental Health Center and Hangzhou Seventh People's Hospital, Zhejiang University School of Medicine, Hangzhou 310058, China
- Nanhu Brain-Computer Interface Institute, Hangzhou 311100, China
- Liangzhu Laboratory, MOE Frontier Science Center for Brain Science and Brain-Machine Integration, State Key Laboratory of Brain-Machine Intelligence, Zhejiang University, 1369 West Wenyi Road, Hangzhou 311121, China
- NHC and CAMS Key Laboratory of Medical Neurobiology, Zhejiang University, Hangzhou 310058, China
| | - Mingli Li
- Mental Health Center and Psychiatric Laboratory, West China Hospital of Sichuan University, Chengdu 610041, Sichuan, China
| | - Xiaohong Ma
- Mental Health Center and Psychiatric Laboratory, West China Hospital of Sichuan University, Chengdu 610041, Sichuan, China
| | - Jinkun Zeng
- Affiliated Mental Health Center and Hangzhou Seventh People's Hospital, Zhejiang University School of Medicine, Hangzhou 310058, China
| | - Liansheng Zhao
- Mental Health Center and Psychiatric Laboratory, West China Hospital of Sichuan University, Chengdu 610041, Sichuan, China
| | - Wanjun Guo
- Affiliated Mental Health Center and Hangzhou Seventh People's Hospital, Zhejiang University School of Medicine, Hangzhou 310058, China
- Nanhu Brain-Computer Interface Institute, Hangzhou 311100, China
- Liangzhu Laboratory, MOE Frontier Science Center for Brain Science and Brain-Machine Integration, State Key Laboratory of Brain-Machine Intelligence, Zhejiang University, 1369 West Wenyi Road, Hangzhou 311121, China
- NHC and CAMS Key Laboratory of Medical Neurobiology, Zhejiang University, Hangzhou 310058, China
| | - Mei-Hua Hall
- Psychosis Neurobiology Laboratory, McLean Hospital, Harvard Medical School, Belmont, MA, USA
| | - Tao Li
- Affiliated Mental Health Center and Hangzhou Seventh People's Hospital, Zhejiang University School of Medicine, Hangzhou 310058, China
- Nanhu Brain-Computer Interface Institute, Hangzhou 311100, China
- Liangzhu Laboratory, MOE Frontier Science Center for Brain Science and Brain-Machine Integration, State Key Laboratory of Brain-Machine Intelligence, Zhejiang University, 1369 West Wenyi Road, Hangzhou 311121, China
- NHC and CAMS Key Laboratory of Medical Neurobiology, Zhejiang University, Hangzhou 310058, China
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Cong X, Zhang T, Bian R, Li Y, Liu J, Zhang X. Prevalence and related factors of first-time suicide attempts in the past 14 days in Chinese adult patients with first-episode drug-naïve major depressive disorder. Front Psychiatry 2024; 15:1366475. [PMID: 38585486 PMCID: PMC10995384 DOI: 10.3389/fpsyt.2024.1366475] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2024] [Accepted: 03/13/2024] [Indexed: 04/09/2024] Open
Abstract
Background This study aimed to identify socio-demographic, physiologic, and psychologic related factors of the first-time suicide attempt (FSA) in the past 14 days in Chinese adult patients with first-episode drug-naïve (FEDN) major depressive disorder (MDD). Methods A total of 1718 adult patients with FEDN MDD were enrolled in this cross-sectional survey. Depression, anxiety symptoms, and suicide attempts were assessed. Additionally, biological samples were collected and measured, while Logistic regression analysis was employed to explore the risk factors for FSA in the past 14 days among FEDN MDD patients. Results Among suicide attempters, 12.11% (208 out of 1718) reported experiencing FSA in the past 14 days. Logistic regression analysis showed that the risk factors for FSA included more severe anxiety symptoms (OR=1.37, 95%CI: 1.28-1.48, p<0.001), higher levels of total cholesterol (TC) (OR=1.42, 95%CI: 1.13-1.77, p=0.003), and elevated thyroid-stimulating hormone (TSH) (OR=1.13, 95%CI: 1.03-1.25, p=0.01). The regression model exhibited good discriminatory power for FSA with an area under the curve (AUC) of 0.82. Conclusion FEDN MDD patients with more severe anxiety and higher levels of TSH and TC are more likely to develop FSA in the past 14 days. These factors are risk factors for short-term (in the past 14 days) FSA and may serve as indicators for early intervention.
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Affiliation(s)
- Xiaoyin Cong
- Department of Clinical Psychology, Jiangsu Province Hospital and The First Affiliated Hospital with Nanjing Medical University, Nanjing, China
| | - Tian Zhang
- Department of Clinical Psychology, Jiangsu Province Hospital and The First Affiliated Hospital with Nanjing Medical University, Nanjing, China
| | - Rongrong Bian
- Department of Clinical Psychology, Jiangsu Province Hospital and The First Affiliated Hospital with Nanjing Medical University, Nanjing, China
| | - Yong Li
- Department of Clinical Psychology, Jiangsu Province Hospital and The First Affiliated Hospital with Nanjing Medical University, Nanjing, China
| | - Junjun Liu
- Department of Psychiatry, Nanjing Meishan Hospital, Nanjing, China
| | - Xiangyang Zhang
- Chinese Academy of Sciences (CAS) Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China
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Wu J, Qi S, Yu W, Gao Y, Ma J. Regional Homogeneity of the Left Posterior Cingulate Gyrus May Be a Potential Imaging Biomarker of Manic Episodes in First-Episode, Drug-Naive Bipolar Disorder. Neuropsychiatr Dis Treat 2023; 19:2775-2785. [PMID: 38106358 PMCID: PMC10725752 DOI: 10.2147/ndt.s441021] [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] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Accepted: 12/07/2023] [Indexed: 12/19/2023] Open
Abstract
Introduction Abnormal brain networks with emotional response in bipolar disorder (BD). However, there have been few studies on the local consistency between manic episodes in drug-naive first-episode BD patients and healthy controls (HCs). The purpose of this study is to evaluate the utility of neural activity values analyzed by Regional Homogeneity (ReHo). Methods Thirty-seven manic episodes in first-episode, drug-naive BD patients and 37 HCs participated in resting-state functional magnetic resonance rescanning and scale estimation. Reho and receiver operating characteristic (ROC) curve methods were used to analyze the imaging data. Support vector machine (SVM) method was used to analyze ReHo in different brain regions. Results Compared to HCs, ReHo increased in the left middle temporal gyrus (MTG.L), posterior cingulate gyrus (PCG), inferior parietal gyrus, and bilateral angular gyrus, and decreased in the left dorsolateral superior frontal gyrus in target group. The ROC results showed that the ReHo value of the left PCG could discriminate the target group from the HCs, and the AUC was 0.8766. In addition, the results of the support vector machine show that the increase in ReHo value in the left PCG can effectively discriminate the patients from the controls, with accuracy, sensitivity, and specificity of 86.02%, 86.49%, and 81.08%, respectively. Conclusion The increased activity of the left PCG may contribute new evidence of participation in the pathophysiology of manic episodes in first-episode, drug-naive BD patients. The Reho value of the left posterior cingulate gyrus may be a potential neuroimaging biomarker to discriminate target group from HCs.
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Affiliation(s)
- Jiajia Wu
- Department of Psychiatry, Wuhan Mental Health Center, Wuhan, People’s Republic of China
- Wuhan Hospital for Psychotherapy, Wuhan, People’s Republic of China
| | - Shuangyu Qi
- Department of Psychiatry, Wuhan Mental Health Center, Wuhan, People’s Republic of China
- Wuhan Hospital for Psychotherapy, Wuhan, People’s Republic of China
| | - Wei Yu
- Department of Psychiatry, Xianning Bode Mental Hospital, Xianning, People’s Republic of China
| | - Yujun Gao
- Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan, People’s Republic of China
| | - Jun Ma
- Department of Psychiatry, Wuhan Mental Health Center, Wuhan, People’s Republic of China
- Wuhan Hospital for Psychotherapy, Wuhan, People’s Republic of China
- Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan, People’s Republic of China
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Toll A, Blanco-Hinojo L, Berge D, Manzano A, El Abidi K, Perez-Solà V, Mané A. Relationship between thyroid-stimulating hormone, BDNF levels, and hippocampal volume in antipsychotic-naïve first-episode psychosis patients. Front Psychiatry 2023; 14:1301714. [PMID: 38130289 PMCID: PMC10734033 DOI: 10.3389/fpsyt.2023.1301714] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Accepted: 11/17/2023] [Indexed: 12/23/2023] Open
Abstract
Introduction Thyroid hormones play an essential role in hippocampal development, a key structure in psychosis. However, the role of these hormones in first-episode psychosis (FEP) has received limited attention. It has been hypothesized that thyroid hormones could cause morphological modifications in the hippocampal structure through the upregulation of brain-derived neurotrophic factor (BDNF). In this study, we primarily aimed to determine the relationship between thyroid-stimulating hormone (TSH) levels, peripheral BDNF levels, and hippocampal volume in antipsychotic-naïve FEP patients. We also aimed to determine whether TSH levels were associated with clinical symptomatology. Materials and methods A total of 50 antipsychotic-naïve FEP patients were included in the study. At baseline, we collected fasting blood samples and registered sociodemographic and clinical variables (substance use, DUP, PANSS, GAF, and CDSS). Structural T1 MRI was performed at baseline to quantify brain volumes. No control group was used for this study. Results Of the 50 patients, more than one-third (36%) presented alterations in TSH levels, mainly elevated levels (32% of patients). The TSH levels were inversely correlated with both peripheral BDNF and hippocampal volume. On the multivariate analysis, the model that best predicted the relative hippocampal volume was a single variable model (TSH levels). No significant association was observed between TSH levels and clinical symptomatology. Discussion These results suggest that thyroid hormones could have a neuroprotective effect on the hippocampus in FEP patients, possibly through their effect by increasing BDNF concentrations, which could attenuate brain injury and neuroinflammation. Nevertheless, thyroid hormones could also affect hippocampal volume through other pathways.
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Affiliation(s)
- Alba Toll
- Institut de Salud Mental, Hospital del Mar, Barcelona, Spain
- Hospital del Mar Research Institute, Barcelona, Spain
- Centro de Investigación Biomédica en Red, Área de Salud Mental (CIBERSAM), Madrid, Spain
| | - Laura Blanco-Hinojo
- Hospital del Mar Research Institute, Barcelona, Spain
- Centro de Investigación Biomédica en Red, Área de Salud Mental (CIBERSAM), Madrid, Spain
- MRI Research Unit, Department of Radiology, Hospital del Mar, Barcelona, Spain
| | - Daniel Berge
- Institut de Salud Mental, Hospital del Mar, Barcelona, Spain
- Hospital del Mar Research Institute, Barcelona, Spain
- Centro de Investigación Biomédica en Red, Área de Salud Mental (CIBERSAM), Madrid, Spain
| | - Ana Manzano
- Institut de Salud Mental, Hospital del Mar, Barcelona, Spain
| | | | - Víctor Perez-Solà
- Institut de Salud Mental, Hospital del Mar, Barcelona, Spain
- Hospital del Mar Research Institute, Barcelona, Spain
- Centro de Investigación Biomédica en Red, Área de Salud Mental (CIBERSAM), Madrid, Spain
| | - Anna Mané
- Institut de Salud Mental, Hospital del Mar, Barcelona, Spain
- Hospital del Mar Research Institute, Barcelona, Spain
- Centro de Investigación Biomédica en Red, Área de Salud Mental (CIBERSAM), Madrid, Spain
- Department of Medicine and Life Sciences, Universitat Pompeu Fabra (UPF), Barcelona, Spain
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Chen Y, Guo Z, Wang Y, Yin H, Zhang S, Liu W. Structural and functional differences of the thalamus between drug-naïve Parkinson's disease motor subtypes. Front Neurol 2023; 14:1102927. [PMID: 37265464 PMCID: PMC10229767 DOI: 10.3389/fneur.2023.1102927] [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] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2022] [Accepted: 04/24/2023] [Indexed: 06/03/2023] Open
Abstract
Objective The thalamus is an integrative hub of motor circuits in Parkinson's disease (PD). This study aimed to investigate the alterations of structure and functional connectivity (FC) of the thalamic subregions in the tremor-dominant (TD) subtype and the postural instability and gait difficulty (PIGD) subtype in PD. Methods A total of 59 drug-naïve patients (24 TD and 35 PIGD) and 37 healthy controls were recruited. The volumes of the thalamus and the thalamic subregions were calculated using FreeSurfer. Functional connectivity (FC) analysis of the resting-state functional MRI (rsfMRI) was conducted on the thalamic subregions. Finally, the altered structure and FC were used for correlation analysis with clinical motor scores and for further motor subtypes differentiation. Results The volumes of the left posterior parietal thalamus (PPtha) in TD patients were significantly lower than those of PIGD patients. Compared with PIGD patients, TD patients exhibited higher FC between the thalamic subregions, the left middle temporal gyrus (MTG), the right dorsolateral superior frontal gyrus (SFGdl), the left middle occipital gyrus (MOG), and the right superior temporal gyrus (STG). Compared with HCs, TD patients showed higher FC between the thalamic subregions and the right SFGdl, as well as the left MOG. Compared with HCs, PIGD patients showed lower FC between the thalamic subregions and the left MTG. In addition, the altered FC was closely related to clinical symptoms and performed high-discriminative power in differentiating the motor subtypes. Conclusion Increased FC between the thalamic subregions and the sensory cortices in TD patients may indicate a better compensatory capacity for impairment of sensory information integration than that in PIGD patients. The altered FC between the thalamus and the MTG was a potential biomarker for the distinction of the PD motor subtypes.
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Yoshimura R, Okamoto N, Chibaatar E, Natsuyama T, Ikenouchi A. The Serum Brain-Derived Neurotrophic Factor Increases in Serotonin Reuptake Inhibitor Responders Patients with First-Episode, Drug-Naïve Major Depression. Biomedicines 2023; 11:biomedicines11020584. [PMID: 36831119 PMCID: PMC9953440 DOI: 10.3390/biomedicines11020584] [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: 01/11/2023] [Revised: 02/13/2023] [Accepted: 02/14/2023] [Indexed: 02/18/2023] Open
Abstract
Brain-derived neurotrophic factor (BDNF) is a growth factor synthesized in the cell bodies of neurons and glia, which affects neuronal maturation, the survival of nervous system, and synaptic plasticity. BDNF play an important role in the pathophysiology of major depression (MD). The serum BDNF levels changed over time, or with the improvement in depressive symptoms. However, the change of serum BDNF during pharmacotherapy remains obscure in MDD. In particular, the changes in serum BDNF associated with pharmacotherapy have not yet been fully elucidated. The present study aimed to compare the changes in serum BDNF concentrations in first-episode, drug-naive patients with MD treated with antidepressants between treatment-response and treatment-nonresponse groups. The study included 35 inpatients and outpatients composed of 15 males and 20 females aged 36.7 ± 6.8 years at the Department of Psychiatry of our University Hospital. All patients met the DSM-5 diagnostic criteria for MD. The antidepressants administered included paroxetine, duloxetine, and escitalopram. Severity of depressive state was assessed using the 17-item HAMD before and 8 weeks after drug administration. Responders were defined as those whose total HAMD scores at 8 weeks had decreased by 50% or more compared to those before drug administration, while non-responders were those whose total HAMD scores had decreased by less than 50%. Here we showed that serum BDNF levels were not significantly different at any point between the two groups. The responder group, but not the non-responder group, showed statistically significant changes in serum BDNF 0 and serum BDNF 8. The results suggest that the changes of serum BDNF might differ between the two groups. The measurement of serum BDNF has the potential to be a useful predictor of pharmacotherapy in patients with first-episode, drug-naïve MD.
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Zhang L, Bai A, Tang Z, Liu X, Li Y, Ma J. Incidence and factors associated of early non-response in first-treatment and drug-naïve patients with schizophrenia: a real-world study. Front Psychiatry 2023; 14:1173263. [PMID: 37181883 PMCID: PMC10172471 DOI: 10.3389/fpsyt.2023.1173263] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Accepted: 04/12/2023] [Indexed: 05/16/2023] Open
Abstract
Background Schizophrenia is a severe and persistent mental condition that causes disability. For subsequent clinical care, it is extremely practical to effectively differentiate between patients who respond to therapy quickly and those who do not. This study set out to document the prevalence and risk factors for patient early non-response. Methods The current study included 143 individuals with first-treatment and drug-naïve (FTDN) schizophrenia. Patients were classified as early non-responders based on a Positive and Negative Symptom Scale (PANSS) score reduction of less than 20% after 2 weeks of treatment, otherwise as early responders. Clinical subgroups' differences in demographic data and general clinical data were compared, and variables related to early non-response to therapy were examined. Results Two weeks later, a total of 73 patients were described as early non-responders, with an incidence of 51.05%. The early non-response subgroup had significantly higher PANSS scores, Positive symptom subscale (PSS) scores, General psychopathology subscale (GPS) scores, Clinical global impression scale - severity of illness (CGI-SI) and Fasting blood glucose (FBG) levels compared to the early-response subgroup. CGI-SI and FBG were risk factors for early non-response. Conclusion High rates of early non-response have been seen in FTDN schizophrenia patients, and risk variables for predicting early non-response include CGI-SI scores and FBG levels. However, we need more in-depth studies to confirm the generalizable range of these two parameters.
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Affiliation(s)
- Lin Zhang
- Affiliated Wuhan Mental Health Center, Tongji Medical College of Huazhong University of Science and Technology, Wuhan, China
- Department of Psychiatry, Wuhan Mental Health Center, Wuhan, China
| | - Aohan Bai
- Affiliated Wuhan Mental Health Center, Tongji Medical College of Huazhong University of Science and Technology, Wuhan, China
- Department of Psychiatry, Wuhan Mental Health Center, Wuhan, China
| | - Zhongyu Tang
- Affiliated Wuhan Mental Health Center, Tongji Medical College of Huazhong University of Science and Technology, Wuhan, China
- Department of Psychiatry, Wuhan Mental Health Center, Wuhan, China
| | - Xuebing Liu
- Affiliated Wuhan Mental Health Center, Tongji Medical College of Huazhong University of Science and Technology, Wuhan, China
- Department of Psychiatry, Wuhan Mental Health Center, Wuhan, China
| | - Yi Li
- Affiliated Wuhan Mental Health Center, Tongji Medical College of Huazhong University of Science and Technology, Wuhan, China
- Department of Psychiatry, Wuhan Mental Health Center, Wuhan, China
- Yi Li,
| | - Jun Ma
- Affiliated Wuhan Mental Health Center, Tongji Medical College of Huazhong University of Science and Technology, Wuhan, China
- Department of Psychiatry, Wuhan Mental Health Center, Wuhan, China
- *Correspondence: Jun Ma,
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Zhu Q, Zheng Y, Lang X, Fu Z, Zhang P, Jiang G, Zhang X. Prevalence and correlates of dyslipidemia in first-episode and drug-naïve major depressive disorder patients with comorbid abnormal glucose metabolism: Sex differences. Front Psychiatry 2023; 14:1101865. [PMID: 36793942 PMCID: PMC9922762 DOI: 10.3389/fpsyt.2023.1101865] [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: 11/18/2022] [Accepted: 01/16/2023] [Indexed: 02/03/2023] Open
Abstract
BACKGROUND Lipid metabolism is associated with glucose metabolism, but whether there are variations between sexes in risk factors and prevalence of abnormal lipid metabolism in major depressive disorder (MDD) patients with glucose metabolism abnormalities remains ambiguous. In the present study, the frequency and risk factors of dyslipidemia in first-episode and drug-naïve (FEDN) MDD patients with dysglycemia were examined according to sex. METHODS One thousand seven hundred and eighteen FEDN MDD patients were recruited and their demographic data, clinical data, various biochemical indicators and scale assessment scores including 17-item Hamilton Rating Scale for Depression (HAMD-17), 14-item Hamilton Anxiety Rating Scale (HAMA-14), and positive subscale of the Positive and Negative Syndrome Scale (PANSS) were collected. RESULTS The prevalence of abnormal lipid metabolism in both male and female MDD patients with abnormal glucose metabolism was higher than that in patients without abnormal glucose metabolism. Among male MDD patients with abnormal glucose metabolism, TC was positively correlated with HAMD score, TSH and TgAb levels, but negatively correlated with PANSS positive subscale scores. LDL-C was positively correlated with TSH and BMI, but negatively correlated with PANSS positive subscale scores. HDL-C was negatively correlated with TSH levels. Among females, TC was positively correlated with HAMD score, TSH, and BMI, but negatively correlated with PANSS positive subscale score. LDL-C was positively correlated with HADM score and negatively correlated with FT3 level. HDL-C was negatively correlated with TSH and BMI levels. CONCLUSION There are sex differences in the correlated factors of lipid markers in MDD patients with impaired glucose.
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Affiliation(s)
- Quanfeng Zhu
- Graduate School of Zhejiang Chinese Medical University, Hangzhou, China.,Affiliated Xiaoshan Hospital, Hangzhou Normal University, Hangzhou, China
| | - Yali Zheng
- Affiliated Xiaoshan Hospital, Hangzhou Normal University, Hangzhou, China
| | - XiaoE Lang
- Department of Psychiatry, First Hospital/First Clinical Medical College of Shanxi Medical University, Taiyuan, China
| | - Zhengchuang Fu
- Affiliated Xiaoshan Hospital, Hangzhou Normal University, Hangzhou, China
| | - Peng Zhang
- Affiliated Xiaoshan Hospital, Hangzhou Normal University, Hangzhou, China
| | - Guojun Jiang
- Affiliated Xiaoshan Hospital, Hangzhou Normal University, Hangzhou, China
| | - Xiangyang Zhang
- Chinese Academy of Sciences (CAS), Key Laboratory of Mental Health, Institute of Psychology, Beijing, China.,Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
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Seidu S, Almaqhawi A, Abdool M, Kunutsor SK, Davies MJ, Khunti K. Cardiovascular and renal outcomes of initial combination therapy with glucose-lowering agents versus a stepwise approach in newly diagnosed or treatment-naïve type 2 diabetes: A systematic review and meta-analysis. Diabetes Obes Metab 2022; 24:1469-1482. [PMID: 35434901 DOI: 10.1111/dom.14715] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Revised: 03/28/2022] [Accepted: 04/08/2022] [Indexed: 11/29/2022]
Abstract
AIM To evaluate the efficacy and safety of the initial combination therapy versus a stepwise approach in newly diagnosed type 2 diabetes (T2D) by conducting a systematic review and meta-analysis of observational cohort studies and randomized controlled trials (RCTs). METHODS Studies were identified from MEDLINE, Embase, the Cochrane Library, and through search of bibliographies to January 2022. Study-specific risk ratios (RRs) and mean differences with 95% confidence intervals (CIs) were pooled. Quality of evidence was assessed using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) system. RESULTS Eight articles including four unique RCTs (n = 5527 participants) and one observational cohort study (n = 200) that compared initial combination therapy versus stepwise therapy were included. The RR for myocardial infarction comparing initial combination therapy versus stepwise therapy was 1.21 (95% CI 0.74-2.00). Initial combination therapy reduced levels of fasting plasma glucose and glycated haemoglobin: mean differences -0.97 mmol/L (95% CI -1.41, -0.53) and -24.92 mmol/mol (95% CI -25.67, -24.27), respectively. Initial combination therapy versus stepwise therapy reduced lipid levels, blood pressure and intima media thickness, with no differences in body composition variables, neuropathy, retinopathy or adverse events. Single-study results showed that initial combination therapy reduced creatinine levels and urine albumin excretion rate. The quality of the evidence ranged from moderate to very low. CONCLUSIONS Except for improving cardiometabolic and glycaemic variables, a limited number of studies characterized by small sample sizes show that initial combination therapy for newly diagnosed T2D may be similar in efficacy and safety to stepwise therapy with respect to cardio-renal outcomes. There is a lack of sufficient evidence to recommend initial combination therapy with glucose-lowering agents in newly diagnosed T2D with the aim of preventing cardio-renal outcomes. Definitive RCTs are warranted.
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Affiliation(s)
- Samuel Seidu
- Leicester Real World Evidence Unit, Diabetes Research Centre, University of Leicester, Leicester, UK
| | - Abdullah Almaqhawi
- Department of Family and Community Medicine, College of Medicine, King Faisal University, Dammam, Saudi Arabia
| | | | - Setor K Kunutsor
- National Institute for Health Research Bristol Biomedical Research Centre, University Hospitals Bristol NHS Foundation Trust and University of Bristol, Bristol, UK
- Musculoskeletal Research Unit, Translational Health Sciences, Bristol Medical School, University of Bristol, Learning & Research Building (Level 1), Southmead Hospital, Bristol, UK
| | - Melanie J Davies
- Leicester Real World Evidence Unit, Diabetes Research Centre, University of Leicester, Leicester, UK
| | - Kamlesh Khunti
- Leicester Real World Evidence Unit, Diabetes Research Centre, University of Leicester, Leicester, UK
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11
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Garrido-Sánchez L, Gómez-Revuelta M, Ortiz-García de la Foz V, Pelayo-Terán JM, Juncal-Ruiz M, Ruiz-Veguilla M, Mayoral-Van Son J, Ayesa-Arriola R, Vázquez-Bourgon J, Crespo-Facorro B. Aripiprazole vs Risperidone Head-to-Head Effectiveness in First-Episode Non-Affective-Psychosis: A 3-Month Randomized, Flexible-Dose, Open-Label Clinical Trial. Int J Neuropsychopharmacol 2022; 25:900-911. [PMID: 35894865 PMCID: PMC9670751 DOI: 10.1093/ijnp/pyac047] [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: 04/11/2022] [Revised: 06/24/2022] [Accepted: 07/21/2022] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND Antipsychotic choice for the acute phase of a first episode of psychosis (FEP) is of the utmost importance since it may influence long-term outcome. However, head-to-head comparisons between second-generation antipsychotics remain scarce. The aim of this study was to compare the effectiveness in the short term of aripiprazole and risperidone after FEP outbreak. METHODS From February 2011 to October 2018, a prospective, randomized, open-label study was undertaken. Two hundred-sixty-six first-episode drug-naïve patients were randomly assigned to aripiprazole (n = 136) or risperidone (n = 130) and followed-up for 12 weeks. The primary effectiveness measure was all-cause treatment discontinuation. In addition, an analysis based on intention-to-treat principle was conducted to assess clinical efficacy. RESULTS The overall dropout rate at 12 weeks was small (6.39%). Effectiveness measures were similar between treatment arms as treatment discontinuation rates (χ 2 = 0,409; P = .522), and mean time to all-cause discontinuation (log rank χ 2 = -1.009; P = .316) showed no statistically significant differences. Despite no statistically significant differences between groups regarding clinical efficacy, aripiprazole required higher chlorpromazine equivalent dosage (χ 2 = 2.160; P = .032) and extended mean time (W = 8183.5; P = .008) to reach clinical response. Sex-related adverse events and rigidity were more frequent in the risperidone group, whereas sialorrhea was on the aripiprazole group. CONCLUSIONS No differences regarding effectiveness were found between aripiprazole and risperidone for the short-phase treatment of FEP. Despite the importance of efficacy during this phase, differences in side effect profiles and patient's preferences are essential factors that may lead clinical decisions for these patients. CLINICALTRIALS.GOV NCT02532491. Effectiveness of Second-Generation Antipsychotics in First Episode Psychosis Patients: 1-year Follow-up (PAFIP3_1Y).
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Affiliation(s)
| | - Marcos Gómez-Revuelta
- Correspondence: Marcos Gómez-Revuelta, MD, PhD, University Hospital Marqúes de Valdecilla, Avda. de Valdecilla, 25, 39008, Santander, Spain ()
| | - Víctor Ortiz-García de la Foz
- University Hospital Marqués de Valdecilla-IDIVAL, Department of Psychiatry, School of Medicine, University of Cantabria, Cantabria, Santander, Spain,CIBERSAM, Centro Investigación Biomédica en Red Salud Mental, Madrid, Spain
| | - José María Pelayo-Terán
- University Hospital Marqués de Valdecilla-IDIVAL, Department of Psychiatry, School of Medicine, University of Cantabria, Cantabria, Santander, Spain,CIBERSAM, Centro Investigación Biomédica en Red Salud Mental, Madrid, Spain,Servicio de Psiquiatría y Salud Mental, Hospital El Bierzo, GASBI, Servicio de Salud de Castilla y León (SACYL), Ponferrada (León), Spain
| | - María Juncal-Ruiz
- University Hospital Marqués de Valdecilla-IDIVAL, Department of Psychiatry, School of Medicine, University of Cantabria, Cantabria, Santander, Spain
| | - Miguel Ruiz-Veguilla
- University Hospital Virgen del Rocío, Department of Psychiatry, Seville, Spain,University of Seville, Seville, Spain,Instituto de Investigación Sanitaria de Sevilla, IBiS, Spain,CIBERSAM, Centro Investigación Biomédica en Red Salud Mental, Madrid, Spain
| | - Jacqueline Mayoral-Van Son
- University Hospital Virgen del Rocío, Department of Psychiatry, Seville, Spain,University of Seville, Seville, Spain,Instituto de Investigación Sanitaria de Sevilla, IBiS, Spain,CIBERSAM, Centro Investigación Biomédica en Red Salud Mental, Madrid, Spain
| | - Rosa Ayesa-Arriola
- University Hospital Marqués de Valdecilla-IDIVAL, Department of Psychiatry, School of Medicine, University of Cantabria, Cantabria, Santander, Spain,CIBERSAM, Centro Investigación Biomédica en Red Salud Mental, Madrid, Spain
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12
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Wang H, Wang K, Xue Q, Peng M, Yin L, Gu X, Leng H, Lu J, Liu H, Wang D, Xiao J, Sun Z, Li N, Dong K, Zhang Q, Zhan S, Fan C, Min B, Zhou A, Xie Y, Song H, Ye J, Liu A, Gao R, Huang L, Jiao L, Song Y, Dong H, Tian Z, Si T, Zhang X, Li X, Kamiya A, Cosci F, Gao K, Wang Y. Transcranial alternating current stimulation for treating depression: a randomized controlled trial. Brain 2022; 145:83-91. [PMID: 35353887 DOI: 10.1093/brain/awab252] [Citation(s) in RCA: 28] [Impact Index Per Article: 14.0] [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: 02/04/2021] [Revised: 05/08/2021] [Accepted: 06/15/2021] [Indexed: 11/12/2022] Open
Abstract
Treatment of depression with antidepressants is partly effective. Transcranial alternating current stimulation can provide a non-pharmacological alternative for adult patients with major depressive disorder. However, no study has used the stimulation to treat first-episode and drug-naïve patients with major depressive disorder. We used a randomized, double-blind, sham-controlled design to examine the clinical efficacy and safety of the stimulation in treating first-episode drug-naïve patients in a Chinese Han population. From 4 June 2018 to 30 December 2019, 100 patients were recruited and randomly assigned to receive 20 daily 40-min, 77.5 Hz, 15 mA, one forehead and two mastoid sessions of active or sham stimulation (n = 50 for each group) in four consecutive weeks (Week 4), and were followed for additional 4-week efficacy/safety assessment without stimulation (Week 8). The primary outcome was a remission rate defined as the 17-item Hamilton Depression Rating Scale (HDRS-17) score ≤ 7 at Week 8. Secondary analyses were response rates (defined as a reduction of ≥ 50% in the HDRS-17), changes in depressive symptoms and severity from baseline to Week 4 and Week 8, and rates of adverse events. Data were analysed in an intention-to-treat sample. Forty-nine in the active and 46 in the sham completed the study. Twenty-seven of 50 (54%) in the active treatment group and 9 of 50 (18%) in the sham group achieved remission at the end of Week 8. The remission rate was significantly higher in the active group compared to that in the sham group with a risk ratio of 1.78 (95% confidence interval, 1.29, 2.47). Compared with the sham, the active group had a significantly higher remission rate at Week 4, response rates at Weeks 4 and 8, and a larger reduction in depressive symptoms from baseline to Weeks 4 and 8. Adverse events were similar between the groups. In conclusion, the stimulation on the frontal cortex and two mastoids significantly improved symptoms in first-episode drug-naïve patients with major depressive disorder and may be considered as a non-pharmacological intervention for them in an outpatient setting.
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Affiliation(s)
- Hongxing Wang
- Division of Neuropsychiatry and Psychosomatics, Department of Neurology, Beijing Psychosomatic Disease Consultation Center, Xuanwu Hospital, National Center for Neurological Disorders, National Clinical Research Center for Geriatric Diseases, Capital Medical University, Beijing 100053, China.,Institute of Sleep and Consciousness Disorders, Center of Epilepsy, Beijing Institute for Brain Disorders, Capital Medical University, Beijing 100053, China
| | - Kun Wang
- Division of Neuropsychiatry and Psychosomatics, Department of Neurology, Beijing Psychosomatic Disease Consultation Center, Xuanwu Hospital, National Center for Neurological Disorders, National Clinical Research Center for Geriatric Diseases, Capital Medical University, Beijing 100053, China.,Department of Neurology, Beijing Puren Hospital, Beijing 100062, China
| | - Qing Xue
- Division of Neuropsychiatry and Psychosomatics, Department of Neurology, Beijing Psychosomatic Disease Consultation Center, Xuanwu Hospital, National Center for Neurological Disorders, National Clinical Research Center for Geriatric Diseases, Capital Medical University, Beijing 100053, China
| | - Mao Peng
- Division of Neuropsychiatry and Psychosomatics, Department of Neurology, Beijing Psychosomatic Disease Consultation Center, Xuanwu Hospital, National Center for Neurological Disorders, National Clinical Research Center for Geriatric Diseases, Capital Medical University, Beijing 100053, China
| | - Lu Yin
- Medical Research & Biometrics Center, Fuwai Hospital, National Center for Cardiovascular Diseases, Peking Union Medical College & Chinese Academy of Medical Sciences, Beijing, China
| | - Xuecun Gu
- Department of Neurology, Beijing Puren Hospital, Beijing 100062, China
| | - Haixia Leng
- Division of Neuropsychiatry and Psychosomatics, Department of Neurology, Beijing Psychosomatic Disease Consultation Center, Xuanwu Hospital, National Center for Neurological Disorders, National Clinical Research Center for Geriatric Diseases, Capital Medical University, Beijing 100053, China
| | - Juan Lu
- Department of Neurology, Beijing Puren Hospital, Beijing 100062, China
| | - Hongzhi Liu
- Department of Neurology, Beijing Puren Hospital, Beijing 100062, China
| | - Di Wang
- Department of Neurology, Beijing Puren Hospital, Beijing 100062, China
| | - Jin Xiao
- Department of Neurology, Beijing Puren Hospital, Beijing 100062, China
| | - Zhichao Sun
- Division of Neuropsychiatry and Psychosomatics, Department of Neurology, Beijing Psychosomatic Disease Consultation Center, Xuanwu Hospital, National Center for Neurological Disorders, National Clinical Research Center for Geriatric Diseases, Capital Medical University, Beijing 100053, China
| | - Ning Li
- Division of Neuropsychiatry and Psychosomatics, Department of Neurology, Beijing Psychosomatic Disease Consultation Center, Xuanwu Hospital, National Center for Neurological Disorders, National Clinical Research Center for Geriatric Diseases, Capital Medical University, Beijing 100053, China
| | - Kai Dong
- Division of Neuropsychiatry and Psychosomatics, Department of Neurology, Beijing Psychosomatic Disease Consultation Center, Xuanwu Hospital, National Center for Neurological Disorders, National Clinical Research Center for Geriatric Diseases, Capital Medical University, Beijing 100053, China
| | - Qian Zhang
- Division of Neuropsychiatry and Psychosomatics, Department of Neurology, Beijing Psychosomatic Disease Consultation Center, Xuanwu Hospital, National Center for Neurological Disorders, National Clinical Research Center for Geriatric Diseases, Capital Medical University, Beijing 100053, China
| | - Shuqin Zhan
- Division of Neuropsychiatry and Psychosomatics, Department of Neurology, Beijing Psychosomatic Disease Consultation Center, Xuanwu Hospital, National Center for Neurological Disorders, National Clinical Research Center for Geriatric Diseases, Capital Medical University, Beijing 100053, China
| | - Chunqiu Fan
- Division of Neuropsychiatry and Psychosomatics, Department of Neurology, Beijing Psychosomatic Disease Consultation Center, Xuanwu Hospital, National Center for Neurological Disorders, National Clinical Research Center for Geriatric Diseases, Capital Medical University, Beijing 100053, China
| | - Baoquan Min
- Division of Neuropsychiatry and Psychosomatics, Department of Neurology, Beijing Psychosomatic Disease Consultation Center, Xuanwu Hospital, National Center for Neurological Disorders, National Clinical Research Center for Geriatric Diseases, Capital Medical University, Beijing 100053, China
| | - Aihong Zhou
- Division of Neuropsychiatry and Psychosomatics, Department of Neurology, Beijing Psychosomatic Disease Consultation Center, Xuanwu Hospital, National Center for Neurological Disorders, National Clinical Research Center for Geriatric Diseases, Capital Medical University, Beijing 100053, China
| | - Yunyan Xie
- Division of Neuropsychiatry and Psychosomatics, Department of Neurology, Beijing Psychosomatic Disease Consultation Center, Xuanwu Hospital, National Center for Neurological Disorders, National Clinical Research Center for Geriatric Diseases, Capital Medical University, Beijing 100053, China
| | - Haiqing Song
- Division of Neuropsychiatry and Psychosomatics, Department of Neurology, Beijing Psychosomatic Disease Consultation Center, Xuanwu Hospital, National Center for Neurological Disorders, National Clinical Research Center for Geriatric Diseases, Capital Medical University, Beijing 100053, China
| | - Jing Ye
- Division of Neuropsychiatry and Psychosomatics, Department of Neurology, Beijing Psychosomatic Disease Consultation Center, Xuanwu Hospital, National Center for Neurological Disorders, National Clinical Research Center for Geriatric Diseases, Capital Medical University, Beijing 100053, China
| | - Aihua Liu
- Division of Neuropsychiatry and Psychosomatics, Department of Neurology, Beijing Psychosomatic Disease Consultation Center, Xuanwu Hospital, National Center for Neurological Disorders, National Clinical Research Center for Geriatric Diseases, Capital Medical University, Beijing 100053, China
| | - Ran Gao
- Division of Neuropsychiatry and Psychosomatics, Department of Neurology, Beijing Psychosomatic Disease Consultation Center, Xuanwu Hospital, National Center for Neurological Disorders, National Clinical Research Center for Geriatric Diseases, Capital Medical University, Beijing 100053, China
| | - Liyuan Huang
- Division of Neuropsychiatry and Psychosomatics, Department of Neurology, Beijing Psychosomatic Disease Consultation Center, Xuanwu Hospital, National Center for Neurological Disorders, National Clinical Research Center for Geriatric Diseases, Capital Medical University, Beijing 100053, China
| | - Lidong Jiao
- Division of Neuropsychiatry and Psychosomatics, Department of Neurology, Beijing Psychosomatic Disease Consultation Center, Xuanwu Hospital, National Center for Neurological Disorders, National Clinical Research Center for Geriatric Diseases, Capital Medical University, Beijing 100053, China
| | - Yang Song
- Division of Neuropsychiatry and Psychosomatics, Department of Neurology, Beijing Psychosomatic Disease Consultation Center, Xuanwu Hospital, National Center for Neurological Disorders, National Clinical Research Center for Geriatric Diseases, Capital Medical University, Beijing 100053, China
| | - Huiqing Dong
- Division of Neuropsychiatry and Psychosomatics, Department of Neurology, Beijing Psychosomatic Disease Consultation Center, Xuanwu Hospital, National Center for Neurological Disorders, National Clinical Research Center for Geriatric Diseases, Capital Medical University, Beijing 100053, China
| | - Zichen Tian
- Department of Biology, Carleton College, Northfield, MN 55057, USA
| | - Tianmei Si
- Key Laboratory of Mental Health, Ministry of Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Peking University Sixth Hospital and Peking University Institute of Mental Health, Beijing 100191, China
| | - Xiangyang Zhang
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing 100101, China
| | - Xinmin Li
- Department of Psychiatry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Albert T6G 2B7, Canada
| | - Atsushi Kamiya
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore MD 21287, USA
| | - Fiammetta Cosci
- Department of Health Sciences, University of Florence, Florence 50135, Italy
| | - Keming Gao
- Department of Psychiatry, Case Western Reserve University, School of Medicine, Cleveland, OH 44106, USA
| | - Yuping Wang
- Division of Neuropsychiatry and Psychosomatics, Department of Neurology, Beijing Psychosomatic Disease Consultation Center, Xuanwu Hospital, National Center for Neurological Disorders, National Clinical Research Center for Geriatric Diseases, Capital Medical University, Beijing 100053, China
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Abstract
OBJECTIVE Microstate analysis is a powerful tool to probe the brain functions, and changes in microstates under electroencephalography (EEG) have been repeatedly reported in patients with schizophrenia. This study aimed to investigate the dynamics of EEG microstates in drug-naïve, first-episode schizophrenia (FE-SCH) and to test the relationship between EEG microstates and clinical symptoms. METHODS Resting-state EEG were recorded for 23 patients with FE-SCH and 23 healthy controls using a 64-channel cap. Three parameters, i.e., contribution, duration, and occurrence, of the four microstate classes were calculated. Group differences in EEG microstates and their clinical symptoms [assessed using the Positive and Negative Syndrome Scale (PANSS)] were analyzed. RESULTS Compared with healthy controls, patients with FE-SCH showed increased duration, occurrence and contribution of microstate class C and decreased contribution and occurrence of microstate class D. In addition, the score of positive symptoms in PANSS was negatively correlated with the occurrence of microstate D. CONCLUSION Our findings showed abnormal patterns of EEG microstates in drug-naïve, first-episode schizophrenia, which might help distinguish individuals with schizophrenia in the early stage and develop early intervention strategies.
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Affiliation(s)
- Qiaoling Sun
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, China National Technology Institute on Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Linlin Zhao
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, China National Technology Institute on Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Liwen Tan
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, China National Technology Institute on Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, China
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14
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Cento V, Perno CF. Dolutegravir Plus Lamivudine Two-Drug Regimen: Safety, Efficacy and Diagnostic Considerations for Its Use in Real-Life Clinical Practice-A Refined Approach in the COVID-19 Era. Diagnostics (Basel) 2021; 11:809. [PMID: 33947009 DOI: 10.3390/diagnostics11050809] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Revised: 04/27/2021] [Accepted: 04/28/2021] [Indexed: 11/17/2022] Open
Abstract
The diagnostic and therapeutic management of the Coronavirus Disease 2019 (COVID-19) pandemic in the HIV population brought some known criticalities (and opportunities) to the forefront, for both those who are facing their first therapeutic line today, and for those already well viro-suppressed. The clinical, socioeconomic, and psychological impact of the COVID-19 pandemic should not affect the long-term care of people living with HIV, which creates an urgent need to optimize the diagnostic and treatment approach to the first-line or switch regimens. The use of dolutegravir plus a lamivudine two-drug regimen is one of the most promising solutions to ease the management of HIV treatment in this difficult period. In this review, we report the most salient features related to the use of this regimen from real-life cohorts, meta-analyses, randomized clinical trials, and studies presented at international conferences up to March 2021. We focused on the diagnostic and clinical-management implications of its use in real life, and how these comply with the contingent historical situation. The issue of the timing and type of diagnostic procedures and the relevance of classical diagnostic tests (such as genotype for resistance detection) is also discussed. According to the currently available results, dolutegravir plus a lamivudine two-drug regimen represents an outstanding tool, whose expected advantages fulfill the current requirements for optimal daily care of our HIV patients.
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15
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Çakici N, Sutterland AL, Penninx BWJH, de Haan L, van Beveren NJM. Changes in peripheral blood compounds following psychopharmacological treatment in drug-naïve first-episode patients with either schizophrenia or major depressive disorder: a meta-analysis. Psychol Med 2021; 51:538-549. [PMID: 33653423 PMCID: PMC8020491 DOI: 10.1017/s0033291721000155] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Revised: 12/27/2020] [Accepted: 01/13/2021] [Indexed: 12/12/2022]
Abstract
BACKGROUND This meta-analysis on peripheral blood compounds in drug-naïve first-episode patients with either schizophrenia or major depressive disorder (MDD) examined which compounds change following psychopharmacological treatment. METHODS The Embase, PubMed and PsycINFO databases were systematically searched for longitudinal studies reporting measurements of blood compounds in drug-naïve first-episode schizophrenia or MDD. RESULTS For this random-effects meta-analysis, we retrieved a total of 31 studies comprising 1818 schizophrenia patients, and 14 studies comprising 469 MDD patients. Brain-derived neurotrophic factor (BDNF) increased following treatment in schizophrenia (Hedges' g (g): 0.55; 95% confidence interval (CI) 0.39-0.70; p < 0.001) and MDD (g: 0.51; CI 0.06-0.96; p = 0.027). Interleukin (IL)-6 levels decreased in schizophrenia (g: -0.48; CI -0.85 to -0.11; p = 0.011), and for MDD a trend of decreased IL-6 levels was observed (g: -0.39; CI -0.87 to 0.09; p = 0.115). Tumor necrosis factor alpha (TNFα) also decreased in schizophrenia (g: -0.34; CI -0.68 to -0.01; p = 0.047) and in MDD (g: -1.02; CI -1.79 to -0.25; p = 0.009). Fasting glucose levels increased only in schizophrenia (g: 0.26; CI 0.07-0.44; p = 0.007), but not in MDD. No changes were found for C-reactive protein, IL-1β, IL-2 and IL-4. CONCLUSIONS Psychopharmacological treatment has modulating effects on BDNF and TNFα in drug-naïve first-episode patients with either schizophrenia or MDD. These findings support efforts for further research into transdiagnostic preventive strategies and augmentation therapy for those with immune dysfunctions.
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Affiliation(s)
- Nuray Çakici
- Department of Psychiatry and Amsterdam Neuroscience, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, 1105 AZAmsterdam, the Netherlands
- Parnassia Academy, Parnassia Psychiatric Institute, Kiwistraat 43, 2552 DHThe Hague, the Netherlands
| | - Arjen L. Sutterland
- Department of Psychiatry and Amsterdam Neuroscience, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, 1105 AZAmsterdam, the Netherlands
| | - Brenda W. J. H. Penninx
- Department of Psychiatry, Amsterdam Public Health Research Institute and Amsterdam Neuroscience, Amsterdam UMC, Vrije Universiteit, De Boelelaan 1105, 1081 HVAmsterdam, the Netherlands
| | - Lieuwe de Haan
- Department of Psychiatry and Amsterdam Neuroscience, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, 1105 AZAmsterdam, the Netherlands
| | - Nico J. M. van Beveren
- Parnassia Academy, Parnassia Psychiatric Institute, Kiwistraat 43, 2552 DHThe Hague, the Netherlands
- Department of Psychiatry, Erasmus Medical Center, Doctor Molewaterplein 40, 3015 GDRotterdam, the Netherlands
- Department of Neuroscience, Erasmus Medical Center, Doctor Molewaterplein 40, 3015 GDRotterdam, the Netherlands
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16
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De Micco R, Agosta F, Basaia S, Siciliano M, Cividini C, Tedeschi G, Filippi M, Tessitore A. Functional Connectomics and Disease Progression in Drug-Naïve Parkinson's Disease Patients. Mov Disord 2021; 36:1603-1616. [PMID: 33639029 DOI: 10.1002/mds.28541] [Citation(s) in RCA: 6] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Revised: 01/06/2021] [Accepted: 01/11/2021] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND Functional brain connectivity alterations may be detectable even before the occurrence of brain atrophy, indicating their potential as early markers of pathological processes. OBJECTIVE We aimed to determine the whole-brain network topologic organization of the functional connectome in a large cohort of drug-naïve Parkinson's disease (PD) patients using resting-state functional magnetic resonance imaging and to explore whether baseline connectivity changes may predict clinical progression. METHODS One hundred and forty-seven drug-naïve, cognitively unimpaired PD patients were enrolled in the study at baseline and compared to 38 age- and gender-matched controls. Non-hierarchical cluster analysis using motor and non-motor data was applied to stratify PD patients into two subtypes: 77 early/mild and 70 early/severe. Graph theory analysis and connectomics were used to assess global and local topological network properties and regional functional connectivity at baseline. Stepwise multivariate regression analysis investigated whether baseline functional imaging data were predictors of clinical progression over 2 years. RESULTS At baseline, widespread functional connectivity abnormalities were detected in the basal ganglia, sensorimotor, frontal, and occipital networks in PD patients compared to controls. Decreased regional functional connectivity involving mostly striato-frontal, temporal, occipital, and limbic connections differentiated early/mild from early/severe PD patients. Connectivity changes were found to be independent predictors of cognitive progression at 2-year follow-up. CONCLUSIONS Our findings revealed that functional reorganization of the brain connectome occurs early in PD and underlies crucial involvement of striatal projections. Connectomic measures may be helpful to identify a specific PD patient subtype, characterized by severe motor and non-motor clinical burden as well as widespread functional connectivity abnormalities. © 2021 International Parkinson and Movement Disorder Society.
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Affiliation(s)
- Rosa De Micco
- Department of Advanced Medical and Surgical Sciences, University of Campania "Luigi Vanvitelli", Naples, Italy.,MRI Research Center, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Federica Agosta
- Neuroimaging Research Unit, Institute of Experimental Neurology, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy.,Neurology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy.,Vita-Salute San Raffaele University, Milan, Italy
| | - Silvia Basaia
- Neuroimaging Research Unit, Institute of Experimental Neurology, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Mattia Siciliano
- Department of Advanced Medical and Surgical Sciences, University of Campania "Luigi Vanvitelli", Naples, Italy.,Department of Psychology, University of Campania "Luigi Vanvitelli", Caserta, Italy
| | - Camilla Cividini
- Neuroimaging Research Unit, Institute of Experimental Neurology, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Gioacchino Tedeschi
- Department of Advanced Medical and Surgical Sciences, University of Campania "Luigi Vanvitelli", Naples, Italy.,MRI Research Center, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Massimo Filippi
- Neuroimaging Research Unit, Institute of Experimental Neurology, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy.,Neurology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy.,Vita-Salute San Raffaele University, Milan, Italy.,Neurorehabilitation Unit and Neurophysiology Service, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Alessandro Tessitore
- Department of Advanced Medical and Surgical Sciences, University of Campania "Luigi Vanvitelli", Naples, Italy.,MRI Research Center, University of Campania "Luigi Vanvitelli", Naples, Italy
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Aydın MS, Bolu A, Kılınçkaya MF, Öznur T, Çelik C, Uzun Ö, Özmenler KN. Brain-derived neurotrophic factor levels and psychopathology scores in drug-naïve first-episode psychosis. Asia Pac Psychiatry 2020; 12:e12415. [PMID: 32827247 DOI: 10.1111/appy.12415] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2019] [Accepted: 07/30/2020] [Indexed: 01/02/2023]
Abstract
INTRODUCTION Brain-derived neurotrophic factor (BDNF) is involved in the regulation of many neuronal processes, including neurogenesis. Therefore, it is thought to be closely associated with many psychopathologies with a neurodevelopmental basis, for example, schizophrenia. METHODS The patients admitted to the Psychiatry Department of the Faculty of Medicine with a diagnosis of non-affective drug-naïve first-episode psychosis (FEP) were included in the study. The relationship between laboratory and clinical findings and psychometric data (Positive and Negative Syndrome Scale) was examined. RESULTS The study population consisted of 34 FEP and 34 healthy control (HC) volunteers. Mean BNDF levels of FEP and HC groups were 14.95 ± 6.13 and 17.89 ± 4.84 pg/ml, respectively. The difference between the groups was statistically significant (t = 2.197; p = .032). There was a negative correlation between mean BDNF levels and PANSS general psychopathology subscale scores (r = .358; p = .038), and total PANSS scores (r = .356; p = .039). DISCUSSION There is a consensus on low serum BDNF levels both in FEP and in schizophrenia. However, it is still not clear which clinical findings are associated with lower serum BDNF levels. The relationship between BDNF levels and psychopathologies in schizophrenia has to be investigated.
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Affiliation(s)
- Mehmet Sinan Aydın
- Atatürk Education and Research Hospital of Chest Diseases and Pulmonary Surgery, Ankara, Turkey
| | - Abdullah Bolu
- Gülhane Education and Research Hospital, Department of Psychiatry, Ankara, Turkey
| | | | - Taner Öznur
- Atatürk Education and Research Hospital of Chest Diseases and Pulmonary Surgery, Ankara, Turkey
| | - Cemil Çelik
- Atatürk Education and Research Hospital of Chest Diseases and Pulmonary Surgery, Ankara, Turkey
| | - Özcan Uzun
- Atatürk Education and Research Hospital of Chest Diseases and Pulmonary Surgery, Ankara, Turkey
| | - Kamil Nahit Özmenler
- Atatürk Education and Research Hospital of Chest Diseases and Pulmonary Surgery, Ankara, Turkey
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18
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Fründt O, Grashorn W, Buhmann C, Forkmann K, Mainka T, Bingel U, Schmidt K. Quantitative Sensory Testing (QST) in Drug-Naïve Patients with Parkinson's Disease. J Parkinsons Dis 2020; 9:369-378. [PMID: 30829618 DOI: 10.3233/jpd-181513] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
BACKGROUND Pain is highly prevalent in patients with Parkinson's disease (PD), but underlying pathophysiological mechanisms are largely unclear. Alterations in somatosensory processing might contribute to sensory abnormalities in PD. OBJECTIVE This study investigated sensory processing in PD patients. METHODS We used the standardized "Quantitative Sensory Testing" (QST) protocol (German Research Network on Neuropathic Pain) to investigate 13 somatosensory parameters in 19 PD patients naïve to dopaminergic medication and 19 healthy controls matched for age, gender, and handedness. We tested for differences in sensory parameters between i) drug-naïve PD patients and healthy controls, ii) patients' more and less affected body side, and iii) for an association of somatosensory parameters with disease-specific factors. RESULTS We did not observe any significant group differences in somatosensory parameters between PD patients and healthy subjects. In PD patients, QST mean z-scores did not differ between the predominantly and the less affected body side, PD patients with and without PD-specific chronic pain or between different PD subtypes. Age, but not PD disease severity, was associated with a greater loss of function in thermal and mechanical detection thresholds. CONCLUSIONS Somatosensory processing, as assessed with the well-established QST protocol, was normal in drug-naïve PD patients. Thus, somatosensory abnormalities previously reported in medicated PD patients might rather be a result of dopaminergic medication, or may occur later in the course of the disease or with increasing age.
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Affiliation(s)
- Odette Fründt
- Department of Neurology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Wiebke Grashorn
- Department of Neurology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Carsten Buhmann
- Department of Neurology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Katarina Forkmann
- Department of Neurology, University Hospital Essen, University Duisburg-Essen, Essen, Germany
| | - Tina Mainka
- Department of Neurology, Charité Berlin, Berlin
| | - Ulrike Bingel
- Department of Neurology, University Hospital Essen, University Duisburg-Essen, Essen, Germany.,Erwin L. Hahn Institute for magnetic resonance imaging, Essen, Germany
| | - Katharina Schmidt
- Department of Neurology, University Hospital Essen, University Duisburg-Essen, Essen, Germany
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19
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Carvalho S, Gonçalves ÓF, Brunoni AR, Fernandes-Gonçalves A, Fregni F, Leite J. Transcranial Direct Current Stimulation as an Add-on Treatment to Cognitive-Behavior Therapy in First Episode Drug-Naïve Major Depression Patients: The ESAP Study Protocol. Front Psychiatry 2020; 11:563058. [PMID: 33240121 PMCID: PMC7669750 DOI: 10.3389/fpsyt.2020.563058] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Accepted: 10/01/2020] [Indexed: 12/28/2022] Open
Abstract
Background: Major Depressive Disorder (MDD) affects more than 264 million people worldwide. Current treatments include the use of psychotherapy and/or drugs, however ~30% of patients either do not respond to these treatments, or do not tolerate the side effects associated to the use of pharmacological interventions. Thus, it is important to study non-pharmacological interventions targeting mechanisms not directly involved with the regulation of neurotransmitters. Several studies demonstrated that transcranial Direct Current Stimulation (tDCS) can be effective for symptoms relief in MDD. However, tDCS seems to have a better effect when used as an add-on treatment to other interventions. Methods/Design: This is a study protocol for a parallel, randomized, triple-blind, sham-controlled clinical trial in which a total of 90 drug-naïve, first-episode MDD patients (45 per arm) will be randomized to one of two groups to receive a 6-weeks of CBT combined with either active or sham tDCS to the dorsolateral prefrontal cortex (DLPFC). The primary outcome will depressive symptoms improvement as assessed by the Montgomery-Asberg Depression Rating Scale (MADRS) at 6-weeks. The secondary aim is to test whether CBT combined with tDCS can engage the proposed mechanistic target of restoring the prefrontal imbalance and connectivity through the bilateral modulation of the DLPFC, as assessed by changes over resting-state and emotional task eliciting EEG. Discussion: This study evaluates the synergetic clinical effects of CBT and tDCS in the first episode, drug-naïve, patients with MDD. First episode MDD patients provide an interesting opportunity, as their brains were not changed by the pharmacological treatments, by the time course, or by the recurrence of MDD episodes (and other comorbidities). Trial Registration: This study is registered with the United States National Library of Medicine Clinical Trials Registry (NCT03548545). Registered June 7, 2018, clinicaltrials.gov/ct2/show/NCT03548545. Protocol Version 1.
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Affiliation(s)
- Sandra Carvalho
- Psychological Neuroscience Laboratory, CIPsi, School of Psychology, University of Minho, Braga, Portugal.,Department of Physical Medicine and Rehabilitation, Spaulding Neuromodulation Center, Spaulding Rehabilitation Hospital, Massachusetts General Hospital and Harvard Medical School, Boston, MA, United States
| | - Óscar F Gonçalves
- Psychological Neuroscience Laboratory, CIPsi, School of Psychology, University of Minho, Braga, Portugal.,Department of Physical Medicine and Rehabilitation, Spaulding Neuromodulation Center, Spaulding Rehabilitation Hospital, Massachusetts General Hospital and Harvard Medical School, Boston, MA, United States.,Proaction Laboratory, Faculty of Psychology and Educational Sciences, University of Coimbra, Coimbra, Portugal
| | - André R Brunoni
- Department and Institute of Psychiatry, Service of Interdisciplinary Neuromodulation, Laboratory of Neurosciences (LIM-27), Interdisciplinary Center for Applied Neuromodulation University Hospital, University of São Paulo, São Paulo, Brazil
| | | | - Felipe Fregni
- Department of Physical Medicine and Rehabilitation, Spaulding Neuromodulation Center, Spaulding Rehabilitation Hospital, Massachusetts General Hospital and Harvard Medical School, Boston, MA, United States
| | - Jorge Leite
- Department of Physical Medicine and Rehabilitation, Spaulding Neuromodulation Center, Spaulding Rehabilitation Hospital, Massachusetts General Hospital and Harvard Medical School, Boston, MA, United States.,Univ Portucalense, Portucalense Institute for Human Development-INPP, Porto, Portugal
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20
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Li S, Qui Y, Teng Z, Chen J, Kang D, Tang H, Xiang H, Wu C, Tan Y, Wang L, Yang Y, Wang B, Wu H. Association Between Bipolar Disorder and Low Bone Mass: A Cross-Sectional Study With Newly Diagnosed, Drug-Naïve Patients. Front Psychiatry 2020; 11:530. [PMID: 32587534 PMCID: PMC7299052 DOI: 10.3389/fpsyt.2020.00530] [Citation(s) in RCA: 8] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2019] [Accepted: 05/22/2020] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Medical comorbidities in people with mental disorders have recently gained more attention. People with bipolar disorder (BD) often have comorbid low bone mass, which is associated with increased fracture risk and related severe outcomes. However, few clinical studies on bone metabolism in BD patients are available. This study was designed to assess bone mineral density (BMD) and related influencing factors in a sample of newly diagnosed, drug-naïve individuals with BD and age- and sex-matched healthy controls. METHODS Sixty-one drug-naïve individuals with BD (DSM-V) and 95 healthy volunteers had their lumbar spine (L1-L4) and left hip (Neck/Troch/Ward's) BMD determined by dual-energy X-ray absorptiometry. Besides, sociodemographic and clinical assessment were collected. Between-group comparisons and within subgroup analysis were performed. RESULTS Drug-naïve patients with BD had significantly lower BMD in comparison to healthy controls in multiple sites (L1, L3, Neck, Troch, Ward's, and total hip). On subgroup analysis, overweight individuals with BD had higher bone mass, while females presented reduced BMD. Binary logistic regression showed that low BMD in multiple regions was associated with BD diagnosis, body mass index (BMI), gender, and age. CONCLUSION Drug-naïve individuals with BD have lower BMD when compared to an age- and gender-matched healthy control sample. Low BMI and female gender are factors associated with this outcome. The underlying pathological mechanisms of BD comorbid with osteoporosis should be further explored. CLINICAL TRIAL REGISTRATION www.chictr.org.cn, identifier ChiCTR190002137.
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Affiliation(s)
- Sujuan Li
- Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, China.,National Clinical Research Center for Mental Disorders, Changsha, China
| | - Yan Qui
- Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, China.,National Clinical Research Center for Mental Disorders, Changsha, China
| | - Ziwei Teng
- Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, China.,National Clinical Research Center for Mental Disorders, Changsha, China
| | - Jindong Chen
- Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, China.,National Clinical Research Center for Mental Disorders, Changsha, China
| | - Dongyu Kang
- Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, China.,National Clinical Research Center for Mental Disorders, Changsha, China
| | - Hui Tang
- Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, China.,National Clinical Research Center for Mental Disorders, Changsha, China
| | - Hui Xiang
- Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, China.,National Clinical Research Center for Mental Disorders, Changsha, China
| | - Chujun Wu
- Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, China.,National Clinical Research Center for Mental Disorders, Changsha, China
| | - Yuxi Tan
- Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, China.,National Clinical Research Center for Mental Disorders, Changsha, China
| | - Lu Wang
- Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, China.,National Clinical Research Center for Mental Disorders, Changsha, China
| | - Yanyi Yang
- Health Management Center, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Bolun Wang
- Department of Orthopedics, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Haishan Wu
- Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, China.,National Clinical Research Center for Mental Disorders, Changsha, China
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Abstract
OBJECTIVE To study the benefits and harms of antipsychotics in drug-naïve patients with psychosis. METHODS This study is a systematic review and meta-analysis of placebo-controlled trials. MAIN OUTCOME MEASURES Mortality, activities of daily living, quality of life, core psychiatric events, and relapse and recovery rates. DATA SOURCES PubMed, Embase, the Cochrane Central Register of Controlled Trials (CENTRAL), two trial registers and references in potentially eligible articles. DATA EXTRACTION Two researchers extracted data independently. The outcomes were planned to be meta-analysed using Review Manager based on a fixed effect model. RESULTS Our searches resulted in 493 unique records of which 447 were clearly not eligible. We read the full text of the 46 potentially eligible articles and found one eligible trial in drug-naïve patients, which was unreliable. It was a Chinese trial comparing olanzapine with placebo in 261 patients with first-episode schizophrenia. After 12 weeks, there was an extremely large difference favouring placebo, but the authors reported the opposite, that olanzapine was effective. CONCLUSIONS The use of antipsychotics cannot be justified based on the evidence we currently have. Withdrawal effects in the placebo groups make existing placebo-controlled trials unreliable.
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Affiliation(s)
- P B Danborg
- Nordic Cochrane Centre, Rigshospitalet, Copenhagen, Denmark
| | - P C Gøtzsche
- Institute for Scientific Freedom, Copenhagen, Denmark
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22
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Sano H, Asai Y, Miyazaki M, Iwakura M, Maeda Y, Hara M. Safety profile and clinical course of patients with insomnia administered suvorexant by initial treatment status in a post-marketing survey. Expert Opin Drug Saf 2019; 18:1109-1118. [PMID: 31478753 DOI: 10.1080/14740338.2019.1657091] [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] [Indexed: 10/26/2022]
Abstract
Objectives: Suvorexant is a dual orexin receptor antagonist used for treating insomnia. The authors elucidated the safety profiles and clinical course of insomnia therapy with suvorexant under different initial treatment status seen in daily routine practice. Methods: Subgroup analysis of a post-marketing survey (PMS; 2015-2017) divided patients based on their initial treatment status with suvorexant into 'hypnotic-naïve (Group N)', 'switching from a prior sleep medication (Group S),' 'add-on therapy (Group A),' and 'others (Group O).' Results: Among 3248 patients analyzed in the PMS, the number of patients in Groups N, S, A, and O was 1946 (59.9%), 703 (21.6%), 536 (16.5%), and 63 (1.9%), respectively. The incidence of insomnia-related adverse drug reactions (ADRs) in Group S (5.3%) tended to be higher than that in Groups N (0.46%) and A (1.5%). Discontinuation rate due to an inadequate effect at 6 months in Group S (14.9%) tended to be higher than that in Groups N (9.6%) and A (10.4%). Conclusion: The results suggest that initiating suvorexant treatment after switching from other insomnia medication must require careful monitoring of insomnia-related ADRs, which might be due to abrupt discontinuation of the prior insomnia medication use.
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Affiliation(s)
- Hideki Sano
- CNS Medical Information, Medical Affairs, MSD K.K ., Tokyo , Japan
| | - Yuko Asai
- Pharmacovigilance, MSD K.K ., Tokyo , Japan
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23
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Lai L, Lee PE, Chan P, Fok MC, Hsiung GYR, Sepehry AA. Prevalence of delusions in drug-naïve Alzheimer disease patients: A meta-analysis. Int J Geriatr Psychiatry 2019; 34:1287-1293. [PMID: 29023987 DOI: 10.1002/gps.4812] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2017] [Accepted: 08/23/2017] [Indexed: 11/12/2022]
Abstract
INTRODUCTION Neuropsychiatric symptoms (NPS) are common at all stages of Alzheimer disease (AD). Delusions in AD are associated with negative clinical consequences and may signal rapid disease progression. Hence, we sought to determine the prevalence of delusions in drug-naïve (no cholinesterase inhibitor or neuroleptic medications) AD patients. METHODS In this meta-analysis, a search of the EMBASE, MEDLINE, and PsycINFO databases was performed. We selected studies reporting delusion prevalence measured by the Neuropsychiatric Inventory (NPI) in drug-naïve AD patients. An aggregate delusion event rate with 95% confidence interval (CI) was calculated. The I2 statistic was used to assess the magnitude of between-study heterogeneity. Single variable meta-regressions allowed examination of the effect of moderating factors and heterogeneity. Quantitative measures were used to appraise for publication bias. RESULTS We identified 6 studies with 591 participants allowing calculation of the aggregate delusional prevalence rate. Irrespective of dementia severity, the aggregate event rate for delusions was 29.1% (95% CI: 20-41%; I2 = 84.59). No publication bias was observed. CONCLUSION This meta-analysis calculates a 29.1% prevalence rate of delusions in AD patients. There is a trend towards increasing delusion prevalence in concordance with increasing severity of dementia. Given delusions are associated with poorer outcomes, the obtained prevalence should motivate clinicians to screen carefully for delusions. Current literature limitations warrant future studies, with sub-analyses on dementia severity, and other neurobiological factors known to influence the presence of delusions.
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Affiliation(s)
- Leo Lai
- University of British Columbia, Department of Medicine, Division of Geriatric Medicine, Vancouver, Canada
| | - Philip E Lee
- University of British Columbia, Department of Medicine, Division of Geriatric Medicine, Vancouver, Canada
| | - Peter Chan
- University of British Columbia, Department of Psychiatry, Division of Geriatric Psychiatry, Vancouver, Canada
| | - Mark C Fok
- University of British Columbia, Department of Medicine, Division of Geriatric Medicine, Vancouver, Canada
| | - Ging-Yuek R Hsiung
- University of British Columbia, Department of Medicine, Division of Neurology, Vancouver, Canada
| | - Amir A Sepehry
- University of British Columbia, Department of Medicine, Division of Neurology, Vancouver, Canada
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24
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De Micco R, Esposito F, di Nardo F, Caiazzo G, Siciliano M, Russo A, Cirillo M, Tedeschi G, Tessitore A. Sex-related pattern of intrinsic brain connectivity in drug-naïve Parkinson's disease patients. Mov Disord 2019; 34:997-1005. [PMID: 31180598 DOI: 10.1002/mds.27725] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [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: 12/18/2018] [Revised: 05/02/2019] [Accepted: 05/06/2019] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Sex difference is related to specific clinical features in PD patients over the disease course. OBJECTIVES To investigate the potential sex-difference effect on the spontaneous neuronal activity within the most reported resting-state networks in early untreated PD patients and its correlation with baseline and longitudinal clinical features. METHODS Fifty-six drug-naïve PD patients (30/26 male/female) and 30 (15/15 male/female) matched controls were enrolled in the study. Topological and spectral resting-state functional MRI features of the sensorimotor, dorsal and ventral attention, frontoparietal, and default-mode networks were analyzed for possible sex-difference effects in both PD patients and controls groups. Additionally, a region-of-interest analysis was performed to test for a sex effect on basal ganglia connectivity. Multivariate ordinal regression was used to investigate whether connectivity findings at baseline were predictors of motor impairment over a 2-year follow-up period. RESULTS Compared to female PD patients and controls, male PD patients showed an abnormal spectral composition of the sensorimotor and dorsal attention networks in the slow-5 band. The region-of-interest analysis showed an increased connectivity within the basal ganglia in female PD patients compared to males. Functional sensorimotor connectivity changes at baseline showed to be an independent predictor of disease severity at 2-year follow-up. CONCLUSIONS Our findings revealed the presence of a disease-related, sex-specific cortical and subcortical connectivity pattern within the sensorimotor network, in the early stage of PD. We hypothesize that these findings may be related to the presence of different sex-specific nigrostriatal dopaminergic pathways and might predict PD progression. © 2019 International Parkinson and Movement Disorder Society.
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Affiliation(s)
- Rosa De Micco
- Department of Advanced Medical and Surgical Sciences, University of Campania "Luigi Vanvitelli", Napoli, Italy.,MRI Research Center, University of Campania "Luigi Vanvitelli", Napoli, Italy
| | - Fabrizio Esposito
- Department of Medicine, Surgery and Dentistry, Scuola Medica Salernitana, University of Salerno, Baronissi, (SA), Italy
| | - Federica di Nardo
- Department of Advanced Medical and Surgical Sciences, University of Campania "Luigi Vanvitelli", Napoli, Italy.,MRI Research Center, University of Campania "Luigi Vanvitelli", Napoli, Italy
| | - Giuseppina Caiazzo
- Department of Advanced Medical and Surgical Sciences, University of Campania "Luigi Vanvitelli", Napoli, Italy.,MRI Research Center, University of Campania "Luigi Vanvitelli", Napoli, Italy
| | - Mattia Siciliano
- Department of Advanced Medical and Surgical Sciences, University of Campania "Luigi Vanvitelli", Napoli, Italy.,Neuropsychology Laboratory, Department of Psychology, University of Campania "Luigi Vanvitelli", Caserta, Italy
| | - Antonio Russo
- Department of Advanced Medical and Surgical Sciences, University of Campania "Luigi Vanvitelli", Napoli, Italy.,MRI Research Center, University of Campania "Luigi Vanvitelli", Napoli, Italy
| | - Mario Cirillo
- Department of Advanced Medical and Surgical Sciences, University of Campania "Luigi Vanvitelli", Napoli, Italy.,MRI Research Center, University of Campania "Luigi Vanvitelli", Napoli, Italy
| | - Gioacchino Tedeschi
- Department of Advanced Medical and Surgical Sciences, University of Campania "Luigi Vanvitelli", Napoli, Italy.,MRI Research Center, University of Campania "Luigi Vanvitelli", Napoli, Italy
| | - Alessandro Tessitore
- Department of Advanced Medical and Surgical Sciences, University of Campania "Luigi Vanvitelli", Napoli, Italy.,MRI Research Center, University of Campania "Luigi Vanvitelli", Napoli, Italy
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25
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Ruiz M, Arias A, Sánchez-Llanos E, Gil MP, López-Ortega R, Dakterzada F, Purroy F, Piñol-Ripoll G. Minor Hallucinations in Alzheimer's Disease. J Alzheimers Dis 2018; 64:543-549. [PMID: 29889069 DOI: 10.3233/jad-180234] [Citation(s) in RCA: 7] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Hallucinations may have a broad spectrum and include so-called minor hallucinations (MHs). MHs include passage hallucinations (PHs), visual illusions, and presence hallucinations (PrHs). OBJECTIVE To determine the prevalence and characteristics of MHs in Alzheimer's disease (AD) and amnestic mild cognitive impairment (aMCI) patients, and to describe their potential relationship with cognition, behavioral symptoms, and use of psychoactive drugs. METHODS We have recruited prospectively and consecutively 268 subjects (90 AD mild-moderate drug-naïve patients, 78 aMCI, and 100 controls). All patients responded to a semi-structured questionnaire in order to rate psychotic phenomena. Clinical, neuropsychological, and demographic data of patients with and without MH were compared with those of age, sex, and education-matched controls. RESULTS The prevalence of MHs was 21.1% (19) in AD, 12.8% (10) in aMCI, and 3% (3) in controls (p < 0.01). The most frequent MH was PrH (9.3%), followed by PH (4.9%) and illusion (0.7%). Eight (27.8%) patients had more than one MH. After adjusting for age and gender, there was a negative correlation between the presence of MHs and MMSE score (r = -0.261; p < 0.01) and a positive correlation between MHs and Neuropsychiatric Inventory score (r = 0.237; p < 0.01). We did not observe a significant relationship between presence of MHs and the consumption of psychoactive drugs (p > 0.05). CONCLUSION We have shown that the presence of MHs in patients with newly diagnosed, untreated AD and aMCI is more than controls. MHs were correlated with other behavioral symptoms and a worse cognitive performance. We suggest the specific interrogation for MHs as a clinical feature for this population.
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Affiliation(s)
- Maria Ruiz
- Servicio de Neurología, Clinical Neuroscience Research Group, IRBLleida-Hospital Universitari Arnau de Vilanova, Spain
| | - Alfonso Arias
- Unitat Trastorns Cognitius, Clinical Neuroscience Research Group, IRBLleida-Hospital Universitari Santa Maria Lleida, Spain
| | - Ernesto Sánchez-Llanos
- Unitat Trastorns Cognitius, Clinical Neuroscience Research Group, IRBLleida-Hospital Universitari Santa Maria Lleida, Spain
| | - Maria Pilar Gil
- Unitat Trastorns Cognitius, Clinical Neuroscience Research Group, IRBLleida-Hospital Universitari Santa Maria Lleida, Spain
| | | | - Faridé Dakterzada
- Clinical Neuroscience Research Group, IRBLleida-Department of Experimental Medicine, Lleida, Spain
| | - Francisco Purroy
- Servicio de Neurología, Clinical Neuroscience Research Group, IRBLleida-Hospital Universitari Arnau de Vilanova, Spain
| | - Gerard Piñol-Ripoll
- Unitat Trastorns Cognitius, Clinical Neuroscience Research Group, IRBLleida-Hospital Universitari Santa Maria Lleida, Spain
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26
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Mojtahed Zadeh M, Ashraf-Ganjouei A, Ghazi Sherbaf F, Haghshomar M, Aarabi MH. White Matter Tract Alterations in Drug-Naïve Parkinson's Disease Patients With Impulse Control Disorders. Front Neurol 2018; 9:163. [PMID: 29662464 PMCID: PMC5890183 DOI: 10.3389/fneur.2018.00163] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [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: 12/15/2017] [Accepted: 03/05/2018] [Indexed: 12/18/2022] Open
Abstract
Impulse control disorders (ICDs) are relatively frequent in patients with Parkinson’s disease (PD), although it is still unclear whether an underlying pathological process plays a significant role in the development of ICD in PD apart from dopaminergic replacement therapy. In this study, we have investigated alterations of white matter tract in drug-naïve PD patients with ICDs via diffusion MRI connectometry. Our results showed that disrupted connectivity in the complex network of dynamic connections between cerebellum, basal ganglia, cortex, and its spinal projections serves as the underlying neuropathology of ICD in PD not interfered with the contribution of dopaminergic replacement therapy. These findings provide the first evidence on involved white matter tracts in the neuropathogenesis of ICD in drug-naïve PD population, supporting the hypothesis that neural disturbances intrinsic to PD may confer an increased risk for ICDs. Future studies are needed to validate the attribution of the impaired corticocerebellar network to impulsivity in PD.
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Affiliation(s)
- Mahtab Mojtahed Zadeh
- Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran.,Students' Scientific Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Amir Ashraf-Ganjouei
- Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran.,Students' Scientific Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Farzaneh Ghazi Sherbaf
- Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran.,Students' Scientific Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Maryam Haghshomar
- Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran.,Students' Scientific Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Hadi Aarabi
- Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran.,Students' Scientific Research Center, Tehran University of Medical Sciences, Tehran, Iran
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Tessitore A, Russo A, De Micco R, Fratello M, Caiazzo G, Giordano A, Cirillo M, Tedeschi G, Esposito F. Central pain processing in " drug-naïve" pain-free patients with Parkinson's disease. Hum Brain Mapp 2017; 39:932-940. [PMID: 29143414 DOI: 10.1002/hbm.23892] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2017] [Revised: 10/26/2017] [Accepted: 11/08/2017] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND Despite its clinical relevance, the pathophysiology of pain in Parkinson's disease (PD) is still largely unknown, and both central and peripheral mechanisms have been invoked. OBJECTIVES To investigate whether central pain processing is altered in "drug-naive" pain-free PD (dnPD) patients. METHODS Using event-related functional MRI (fMRI), functional response to forearm heat stimulation (FHS) at two different intensities (41°C and 53°C) was investigated in 20 pain-free dnPD patients, compared with 18 healthy controls (HCs). Secondary analyses were performed to evaluate associations between BOLD signal changes and PD clinical features and behavioral responses. RESULTS During low-innocuous FHS (41°C), no activation differences were found between dnPD patients and HCs. During high-noxious FHS (53°C) a significantly increased activation in the left somatosensory cortex, left cerebellum, and right low pons was observed in dnPD patients compared to HCs. In the latter experimental condition, fMRI BOLD signal changes in the right low pons (p < .0001; R = -0.8) and in the cerebellum (p = .004; R = -0.7) were negatively correlated with pain intensity ratings only in dnPD patients. No statistically significant difference in experimental pain perception was detected between dnPD patients and HCs. CONCLUSIONS Our findings suggest that a functional remodulation of pain processing pathways occurs even in the absence of clinically overt pain symptoms in dnPD patients. These mechanisms may eventually become dysfunctional over time, contributing to the emergence of pain symptoms in more advanced PD stages. The comprehension of pain-related mechanisms may improve the clinical approach and therapeutic management of this disabling nonmotor symptom.
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Affiliation(s)
- Alessandro Tessitore
- Department of Medical, Surgical, Neurological, Metabolic and Aging Sciences, University of Campania "Luigi Vanvitelli", Naples, Italy.,MRI Research Center SUN-FISM, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Antonio Russo
- Department of Medical, Surgical, Neurological, Metabolic and Aging Sciences, University of Campania "Luigi Vanvitelli", Naples, Italy.,MRI Research Center SUN-FISM, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Rosa De Micco
- Department of Medical, Surgical, Neurological, Metabolic and Aging Sciences, University of Campania "Luigi Vanvitelli", Naples, Italy.,MRI Research Center SUN-FISM, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Michele Fratello
- Department of Medical, Surgical, Neurological, Metabolic and Aging Sciences, University of Campania "Luigi Vanvitelli", Naples, Italy.,Department of Medicine, Surgery and Dentistry, Scuola Medica Salernitana, University of Salerno, Baronissi, Salerno, Italy
| | - Giuseppina Caiazzo
- Department of Medical, Surgical, Neurological, Metabolic and Aging Sciences, University of Campania "Luigi Vanvitelli", Naples, Italy.,MRI Research Center SUN-FISM, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Alfonso Giordano
- Department of Medical, Surgical, Neurological, Metabolic and Aging Sciences, University of Campania "Luigi Vanvitelli", Naples, Italy.,MRI Research Center SUN-FISM, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Mario Cirillo
- Department of Medical, Surgical, Neurological, Metabolic and Aging Sciences, University of Campania "Luigi Vanvitelli", Naples, Italy.,Neuroradiology Unit, Department of Clinical and Experimental Medicine and Surgery, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Gioacchino Tedeschi
- Department of Medical, Surgical, Neurological, Metabolic and Aging Sciences, University of Campania "Luigi Vanvitelli", Naples, Italy.,MRI Research Center SUN-FISM, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Fabrizio Esposito
- Department of Medicine, Surgery and Dentistry, Scuola Medica Salernitana, University of Salerno, Baronissi, Salerno, Italy
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Chiou YJ, Huang TL. Serum Brain-Derived Neurotrophic Factors in Taiwanese Patients with Drug-Naïve First-Episode Major Depressive Disorder: Effects of Antidepressants. Int J Neuropsychopharmacol 2016; 20:213-218. [PMID: 27811136 PMCID: PMC5408974 DOI: 10.1093/ijnp/pyw096] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2016] [Accepted: 11/01/2016] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND Brain-derived neurotrophic factors are known to be related to the psychopathology of major depressive disorder. However, studies focusing on drug-naïve first-episode patients are still rare. METHODS Over a 6-year period, we examined the serum brain-derived neurotrophic factors levels in patients with first-episode drug-naïve major depressive disorder and compared them with sex-matched healthy controls. We also investigated the relationships between serum brain-derived neurotrophic factors levels, suicidal behavior, and Hamilton Depression Rating Scale scores before and after a 4-week antidepressant treatment. RESULTS The baseline serum brain-derived neurotrophic factors levels of 71 patients were significantly lower than those of the controls (P=.017), and the Hamilton Depression Rating Scale scores in 71 patients did not correlate with brain-derived neurotrophic factor levels. Brain-derived neurotrophic factor levels were significantly lower in 13 suicidal major depressive disorder patients than in 58 nonsuicidal major depressive disorder patients (P=.038). Among 41 followed-up patients, there was no alteration in serum brain-derived neurotrophic factors levels after treatment with antidepressants (P=.126). In receiver operating characteristic curve analysis of using pretreatment brain-derived neurotrophic factors to estimate the response to treatment, the area under the curve was 0.684. The most suitable cut-off point was 6.1 ng/mL (sensitivity=78.6%, specificity = 53.8%). CONCLUSIONS Our data support the serum brain-derived neurotrophic factor levels in patients with drug-naïve first-episode major depressive disorder were lower than those in the healthy controls, and patients with pretreatment brain-derived neurotrophic factors >6.1 ng/mL were more likely to be responders. Although the relationship of our results to the mechanism of drug action and pathophysiology of depression remains unclear, the measure may have potential use as a predictor of response to treatment. In the future, it needs a large sample to prove these results.
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Affiliation(s)
- Yu-Jie Chiou
- Department of Psychiatry, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Tiao-Lai Huang
- Department of Psychiatry, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
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Yang Z, Zhu Y, Song Z, Mei L, Zhang J, Chen T, Wang Y, Xu Y, Jiang K, Li Y, Liu D. Comparison of the density of gamma-aminobutyric acid in the ventromedial prefrontal cortex of patients with first-episode psychosis and healthy controls. Shanghai Arch Psychiatry 2016; 27:341-7. [PMID: 27199525 PMCID: PMC4858505 DOI: 10.11919/j.issn.1002-0829.215130] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
Background Abnormality in the concentration and functioning of gamma-aminobutyric acid (γ-aminobutyric
acid, GABA) in the brain is not only an important hypothetical link to the cause of schizophrenia but it may
also be correlated with the cognitive decline and negative symptoms of schizophrenia. Studies utilizing
high field magnetic resonance spectroscopy (MRS) report abnormal density of GABA in the ventromedial
prefrontal cortex (vmPFC) of patients with chronic schizophrenia, but these results may be confounded by
study participants’ prior use of antipsychotic medications. Aim Compare the density of GABA in the vmPFC of patients with first-episode psychosis to that in healthy
controls and assess the relationship of GABA density in the vmPFC to the severity of psychotic symptoms. Methods Single-voxel 1H-MRS was used to assess the concentration of GABA and other metabolites in the
vmPFC of 22 patients with first-episode psychosis (10 with schizophrenia and 12 with schizophreniform
disorder) and 23 healthy controls. Thirteen of the 22 patients were drug-naïve and 9 had used antipsychotic
medication for less than 3 days. The Positive and Negative Syndrome Scale (PANSS) was used to evaluate the
severity of psychotic symptoms in the patient group. Results The mean (sd) GABA density in the vmPFC was significantly higher in patients than in controls (2.28
[0.54] v. 1.93 [0.32] mM, t=2.62, p=0.012). The densities of other metabolites – including N-acetylaspartic
acid (NAA), glutamic acid (GLU), and glutamine (GLN) – were not significantly different between patients and
controls. Among the patients, GABA density in the vmPFC was not significantly correlated with PANSS total
score or with any of the three PANSS subscale scores for positive symptoms, negative symptoms, and general
psychopathology. GABA concentration was not associated with the duration of illness, but it was significantly
correlated with patient age (r=0.47, p=0.026). Conclusion Elevation of GABA density in the vmPFC of patients with first-episode psychosis confirms that
this abnormality is independent of medication use. The failure to find a correlation of GABA density in the
vmPFC with the severity of psychotic symptoms needs to be confirmed in larger studies, but it suggests that
there are several intervening steps between brain pathology and clinical symptoms.
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Affiliation(s)
- Zhilei Yang
- First-episode Schizophrenia and Early Psychosis Program, Division of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China; First-episode Schizophrenia and Early Psychosis Program, Division of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yajing Zhu
- Shanghai Jiading District Mental Health Center, Shanghai, China
| | - Zhenhua Song
- First-episode Schizophrenia and Early Psychosis Program, Division of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Li Mei
- First-episode Schizophrenia and Early Psychosis Program, Division of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jianye Zhang
- First-episode Schizophrenia and Early Psychosis Program, Division of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Tianyi Chen
- First-episode Schizophrenia and Early Psychosis Program, Division of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Shanghai Hongkou District Mental Health Center, Shanghai, China
| | - Yingchan Wang
- First-episode Schizophrenia and Early Psychosis Program, Division of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yifeng Xu
- First-episode Schizophrenia and Early Psychosis Program, Division of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Kaida Jiang
- First-episode Schizophrenia and Early Psychosis Program, Division of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yao Li
- First-episode Schizophrenia and Early Psychosis Program, Division of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Dengtang Liu
- First-episode Schizophrenia and Early Psychosis Program, Division of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
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Liu Y, Fan JH, Gao X, Ma L, Qiao YL, Zhang L. The Natural Progression of Parkinson's Disease in a Small Cohort with 15 Drug-naïve Patients. Chin Med J (Engl) 2015; 128:1761-4. [PMID: 26112717 PMCID: PMC4733712 DOI: 10.4103/0366-6999.159350] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2015] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND The studies of the natural progression of Parkinson's disease (PD) in Chinese populations have been lacking. To address this issue and obtain a preliminary data, we conducted a PD progression assessment in 15 adults with de novo PD from a nutritional intervention trial (NIT) cohort in Lin County China. METHODS Using the Copiah County screening questionnaire and United Kingdom Parkinson's Disease Society Brain Bank diagnostic criteria, we surveyed the available NIT cohort members in 2000 and diagnosed 86 patients as PD. In 2010, we resurveyed all PD patients and confirmed definite PD diagnosis in 15 cases with the rest of them being dead (54); having probable (10) PD or vascular Parkinsonism (3); refusing to participate (2); or being away (2). In both surveys, we used Hoehn and Yahr (HY) scale and assessed the disease progression. Unified Parkinson's Disease Rating Scale (UPDRS) was added to the second survey. RESULTS In 2010, the average disease duration for 15 definite PD patients was 13.6 ± 7.3 years. Over a 10-year time span, 9 out of 15 patients remained at the same HY stage while the remaining 6 progressed. Rigidity (47% vs. 100%; P = 0.002) and postural instability (7% vs. 47%; P = 0.005) worsened significantly. The mean UPDRS motor scores in 2010 were 39.4 ± 23.7. CONCLUSIONS Overall worsening of motor function in PD seems to be the rule in this untreated cohort, and their rate of progression seemed to be slower than those reported in the western populations.
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Affiliation(s)
- Ying Liu
- Department of Neurology, Dalian Municipal Friendship Hospital, Dalian, Liaoning 116001, China
| | - Jin-Hu Fan
- Department of Cancer Epidemiology, Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - Xiang Gao
- Department of Medicine, Channing Laboratory, Brigham and Women's Hospital, and Harvard Medical School, Boston, MA 02115, USA
- Department of Nutrition, Harvard University School of Public Health, Boston, MA 02115, USA
| | - Li Ma
- Department of Epidemiology, Dalian Medical University, Dalian, Liaoning 116044, China
| | - You-Lin Qiao
- Department of Cancer Epidemiology, Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - Lin Zhang
- Department of Neurology, University of California Davis School of Medicine, Sacramento, CA 95817, USA
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Noto C, Ota VK, Gouvea ES, Rizzo LB, Spindola LMN, Honda PHS, Cordeiro Q, Belangero SI, Bressan RA, Gadelha A, Maes M, Brietzke E. Effects of risperidone on cytokine profile in drug-naïve first-episode psychosis. Int J Neuropsychopharmacol 2015; 18:pyu042. [PMID: 25522386 PMCID: PMC4360233 DOI: 10.1093/ijnp/pyu042] [Citation(s) in RCA: 61] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND There is robust evidence that schizophrenia is characterized by immune-inflammatory abnormalities, including variations on cytokine levels. The results of previous studies, however, are heterogeneous due to several confounding factors, such as the effects of antipsychotic drugs. Therefore, research on drug-naïve first-episode psychosis (FEP) patients is essential to elucidate the role of immune processes in that disorder. METHODS The aim of this study is to compare cytokine levels (IL-2, IL-10, IL-4, IL-6, IFN-γ, TNF-α, and IL-17) in drug-naïve FEP patients both before and after treatment with risperidone for 10 weeks, and to investigate possible associations between cytokine levels and clinical responses to treatment and presence of depressive symptoms. It this study, we included 55 drug-naïve FEP patients who had repeated measurements of cytokine levels and 57 healthy controls. RESULTS We found that FEP patients had significantly higher IL-6, IL-10 and TNF-α levels than healthy controls. After risperidone treatment, these three cytokines and additionally IL-4 decreased significantly. No significant difference was found between the post-treatment cytokine levels in FEP patients and in healthy controls, suggesting that these alterations in cytokine profiles are a state marker of FEP. No significant association was found between risperidone-induced changes in cytokines and the clinical response to treatment or the presence of depression. There was a significant inverse association between the risperidone-induced changes in IL-10 and the negative symptoms. CONCLUSIONS In conclusion, our results show a specific cytokine profile in FEP patients (monocytic and regulatory T-cell activation) and suggest immunoregulatory effects of risperidone treatment, characterized by suppressant effects on monocytic, Th2, and T-regulatory functions.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | - Elisa Brietzke
- Department of Psychiatry, Universidade Federal de São Paulo, São Paulo, Brazil (Drs Noto, Rizzo, Cordeiro, Bressan, Gadelha, and Brietzke); First Episode Psychosis Program, Faculdade de Ciências Médicas da Santa Casa de São Paulo, São Paulo, Brazil (Drs Noto, Gouveia, Honda, and Cordeiro); Genetics Division, Department of Morphology and Genetics, Universidade Federal de Sao Paulo, São Paulo, Brazil (Drs Ota, Gouveia, Spindola, and Belangero); Department of Psychiatry, Deakin University, Geelong, Vic., Australia (Dr Maes); Department of Psychiatry, Chulalongkorn University, Bangkok, Thailand (Dr Maes).
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Pallanti S, Tofani T, Zanardelli M, Di Cesare Mannelli L, Ghelardini C. BDNF and Artemin are increased in drug-naïve non-depressed GAD patients: preliminary data. Int J Psychiatry Clin Pract 2014; 18:255-60. [PMID: 24994477 DOI: 10.3109/13651501.2014.940051] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
OBJECTIVE While the role of neuronal and glial plasticity are well established in the pathophysiology of mood disorders, the pattern and measures of neuronal and glial cell line-derived neurotrophic factors are unknown in generalized anxiety disorder (GAD). The present study evaluates brain-derived neurotrophic factor (BDNF) and Artemin (ARTN) plasma levels in GAD patients. METHODS Fourteen drug-naïve GAD patients without major depression were enrolled and plasmatic levels of BDNF and ARTN mRNA were measured by RT-PCR, and compared to matched healthy controls. RESULTS The results showed an unexpected increase in mRNA levels of both BDNF and ARTN in patients with GAD, that appeared almost doubled when compared to healthy controls. In comparison, both BDNF and ARTN are reduced in patients with major depressive disorder. Further, the results are intriguing and might involve distinguishing pathophysiological pathways. CONCLUSIONS This is the first report of increased levels of a neurotrophic factor and of a glial cell line-derived neurotrophic factor family member in GAD patients. While further studies to confirm these results and the functional meaning in terms of pathophysiology of GAD are needed, the potential conceptual and clinical meanings are discussed.
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Affiliation(s)
- Stefano Pallanti
- UC Davis Department of Psychiatry and Behavioral Sciences , Sacramento, CA , USA
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Wu X, Huang Z, Han H, Zhong Z, Gan Z, Guo X, Diao F, Han Z, Zhao J. The comparison of glucose and lipid metabolism parameters in drug-naïve, antipsychotic-treated, and antipsychotic discontinuation patients with schizophrenia. Neuropsychiatr Dis Treat 2014; 10:1361-8. [PMID: 25092981 PMCID: PMC4114900 DOI: 10.2147/ndt.s63140] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Although many studies have reported that glucose and lipid metabolism disorders are a significant side effect associated with the use of antipsychotic drugs, the characteristics of glucose and lipid metabolism disorders in patients with schizophrenia who are taking antipsychotic drugs remain poorly understood, and the possible effects that antipsychotic discontinuation may have on glucose and lipid metabolism remain unclear. METHODS The sample consisted of 131 Chinese patients with schizophrenia, including 70 first-episode, drug-naïve patients; 33 patients who had received continuous antipsychotic drug treatment for ≥1 year prior to the beginning of the study; and 28 patients who had discontinued antipsychotic drug treatment for ≥3 months prior to the beginning of study. We compared the glucose and lipid metabolic parameter levels among the three groups of patients with schizophrenia. All assessments were performed upon hospital admission. RESULTS The characteristics of glucose and lipid metabolism disorders in Chinese patients with schizophrenia who are taking antipsychotic drugs included significant augmentation of the body mass index and waist circumference, significantly higher levels of fasting plasma insulin and insulin resistance, and significantly lower plasma high-density lipoprotein cholesterol levels. Antipsychotic discontinuation appeared to not significantly improve any plasma glucose and lipid metabolic parameter levels. CONCLUSION The results suggest that antipsychotic drugs aggravate glucose and lipid metabolism disorders and that antipsychotic discontinuation is generally not associated with improvements in the parameters that indicate glucose and lipid metabolism disorders in Chinese patients with schizophrenia.
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Affiliation(s)
- Xiaoli Wu
- Mental Health Institute of the Second Xiangya Hospital, Key Laboratory of Psychiatry and Mental Health of Hunan Province, Central South University, Changsha, Hunan, People's Republic of China ; Psychiatry Department, the Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, People's Republic of China
| | - Zeping Huang
- Ultrasound Department, The Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, People's Republic of China
| | - Hongying Han
- Psychiatry Department, the Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, People's Republic of China
| | - Zhiyong Zhong
- Psychiatry Department, the Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, People's Republic of China
| | - Zhaoyu Gan
- Psychiatry Department, the Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, People's Republic of China
| | - Xiaofeng Guo
- Mental Health Institute of the Second Xiangya Hospital, Key Laboratory of Psychiatry and Mental Health of Hunan Province, Central South University, Changsha, Hunan, People's Republic of China
| | - Feici Diao
- Psychiatry Department, the Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, People's Republic of China
| | - Zili Han
- Psychiatry Department, the Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, People's Republic of China
| | - Jingping Zhao
- Mental Health Institute of the Second Xiangya Hospital, Key Laboratory of Psychiatry and Mental Health of Hunan Province, Central South University, Changsha, Hunan, People's Republic of China
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Abstract
PURPOSE To clarify the effects of missing values due to behavioral and psychological symptoms in dementia (BPSD) in Alzheimer's disease (AD) patients on the neuropsychological tests, this study describes the pattern of missing values due to BPSD, and its influence on tests. MATERIALS AND METHODS Drug-naïve probable AD patients (n=127) with BPSD and without BPSD (n=32) were assessed with Seoul Neuropsychological Screening Battery including measures of memory, intelligence, and executive functioning. Moreover, patients were rated on Korean Neuropsychiatry Inventory (K-NPI). RESULTS The more severe the K-NPI score, the less neuropsychological tests were assessable, leading to many missing values. Patients with BPSD were more severely demented than those without BPSD. K-NPI scores were significantly correlated with the number of missing values. The effect of BPSD was largest for tests measuring frontal functions. The replacement of the missing values due to BPSD by the lowest observed score also showed the largest effect on tests of frontal function. CONCLUSION The global cognitive and behavior scales are related with missing values. Among K-NPI sub-domains, delusion, depressing, apathy, and aberrant motor behavior are significantly correlated for missing values. Data imputation of missing values due to BPSD provides a more differentiated picture of cognitive deficits in AD with BPSD.
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Affiliation(s)
- Yong Tae Kwak
- Department of Neurology, Hyoja Geriatric Hospital, 1-30 Jungbu-daero 874beon-gil, Giheung-gu, Yongin 446-512, Korea.
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Garcia-Rizo C, Fernandez-Egea E, Miller BJ, Oliveira C, Justicia A, Griffith JK, Heaphy CM, Bernardo M, Kirkpatrick B. Abnormal glucose tolerance, white blood cell count, and telomere length in newly diagnosed, antidepressant-naïve patients with depression. Brain Behav Immun 2013; 28. [PMID: 23207109 PMCID: PMC3587123 DOI: 10.1016/j.bbi.2012.11.009] [Citation(s) in RCA: 61] [Impact Index Per Article: 5.5] [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] [Indexed: 12/19/2022] Open
Abstract
Chronic mood disorders have been associated with a shortened telomere, a marker of increased mortality rate and aging, and impaired cellular immunity. However, treatment may confound these relationships. We examined the relationship of glucose tolerance, white blood cell count and telomere length to depression in newly diagnosed, antidepressant-naïve patients. Subjects with major depression (n=15), and matched healthy control subjects (n=70) underwent a two-hour oral glucose tolerance test and evaluation of blood cell count and telomere content. The depression group had significantly higher two-hour glucose concentrations and a lower lymphocyte count than control subjects (respective means [SD] for two-hour glucose were 125.0mg/dL [67.9] vs 84.6 [25.6] (p<.001); for lymphocyte count 2.1×10(9)/L [0.6] vs 2.5×10(9)/L [0.7] p=.028). Telomere content was significantly shortened in the depression group (87.9 [7.6]) compared to control subjects (101.0 [14.3]; p<0.01). Abnormal glucose tolerance, lymphopenia and a shortened telomere are present early in the course of depression independently of the confounding effect of antidepressant treatment, supporting the concept of major depression as an accelerated aging disease.
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Affiliation(s)
- Clemente Garcia-Rizo
- Schizophrenia Program, Department of Psychiatry, Neuroscience Institute, Hospital Clinic, University of Barcelona, Barcelona, Spain.
| | - Emilio Fernandez-Egea
- Department of Psychiatry, University of Cambridge, Addenbrooke´s Hospital, CB2 0QQ Cambridge, UK,Cambridgeshire and Peterborough NHS Foundation Trust, Huntingdon PE29 3RJ, UK
| | - Brian J. Miller
- Department of Psychiatry and Health Behavior, Georgia Health Sciences University, Augusta, GA, USA
| | - Cristina Oliveira
- Schizophrenia Program, Department of Psychiatry, Neuroscience Institute, Hospital Clinic, University of Barcelona, Barcelona, Spain
| | - Azucena Justicia
- Department of Psychiatry, University of Cambridge, Addenbrooke´s Hospital, CB2 0QQ Cambridge, UK
| | - Jeffrey K. Griffith
- Department of Biochemistry and Molecular Biology, University of New Mexico, Albuquerque, NM, United States
| | - Christopher M. Heaphy
- Department of Biochemistry and Molecular Biology, University of New Mexico, Albuquerque, NM, United States
| | - Miguel Bernardo
- Schizophrenia Program, Department of Psychiatry, Neuroscience Institute, Hospital Clinic, University of Barcelona, Barcelona, Spain,Institute of Biomedical Research Agusti Pi i Sunyer (IDIBAPS), Barcelona, Spain,CIBERSAM, Madrid, Spain
| | - Brian Kirkpatrick
- Department of Psychiatry, Texas A&M University College of Medicine and Scott & White Healthcare, Temple, TX, USA
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Abstract
BACKGROUND Insight in psychosis and schizophrenia is considered a complex biopsychosocial phenomenon. Premorbid personality is regarded by some authors as part of the substrate to many psychiatric phenomena, but it is not clear if this applies to insight. AIM To examine longitudinal relationships between personality traits and insight dimensions in first-episode psychosis. METHODS One hundred consecutive antipsychotic-naïve first-episode nonaffective psychotic patients admitted to hospital were included in the study. Eighty-one patients completed at 1 month a premorbid personality evaluation, plus baseline, and 6-month insight assessments. We used the Assessment and Documentation of Psychopathology inventory for assessing insight dimensions (not feeling ill, lack of insight, and refusal of treatment) and the Personality Assessment Schedule for ascertaining 5 dimensions of premorbid personality (schizoid, passive-dependent, anancastic, sociopathic, and schizotypy). RESULTS At baseline, personality dimensions did not show any association with insight dimensions, with the exception of schizotypy traits. At 6 months, schizoid and sociopathic personality showed a significant association with not feeling ill (r = .30, P ≤ .007; r = .27, P = .01) and lack of insight (r = .36, P = .001; r = .41, P < .001), respectively. When we calculated insight change, schizoid and sociopathic personality had moderate correlation with the lack of insight dimension (r = -.34, P = .002; r = .38, P < .001, respectively). After applying partial correlations for potential confounders and Bonferroni correction, the associations remained significant. Moreover, using a regression model, sociopathic and schizoid personality significantly predicted lack of insight at 6 months and change from baseline to the 6 months assessment. CONCLUSIONS Sociopathic and schizoid personality dimensions were not only significantly associated with lack of insight at 6 months but also predicted change on lack of insight over 6 months. Therefore, exploring premorbid personality traits at the beginning of a psychotic episode may be helpful in identifying patients at high risk for lack of insight during the initial course of the illness.
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Affiliation(s)
- Maria S. Campos
- Psychiatric Unit of Virgen del Camino Hospital, c/Irunlarrea 4, E-31008 Pamplona, Spain
| | - Elena Garcia-Jalon
- Psychiatric Unit of Virgen del Camino Hospital, c/Irunlarrea 4, E-31008 Pamplona, Spain
| | - James K. Gilleen
- Section of Cognitive Neuropsychiatry, Institute of Psychiatry, King’s College London, UK
| | - Anthony S. David
- Section of Cognitive Neuropsychiatry, Institute of Psychiatry, King’s College London, UK
| | - Victor Peralta MD
- Psychiatric Unit of Virgen del Camino Hospital, c/Irunlarrea 4, E-31008 Pamplona, Spain
| | - Manuel J. Cuesta
- Psychiatric Unit of Virgen del Camino Hospital, c/Irunlarrea 4, E-31008 Pamplona, Spain,To whom correspondence should be addressed; tel: +34-848-422488, fax: +34-848-422488, e-mail:
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Fernandez-Egea E, Bernardo M, Parellada E, Justicia A, Garcia-Rizo C, Esmatjes E, Conget I, Kirkpatrick B. Glucose abnormalities in the siblings of people with schizophrenia. Schizophr Res 2008; 103:110-3. [PMID: 18514487 PMCID: PMC2665913 DOI: 10.1016/j.schres.2008.04.017] [Citation(s) in RCA: 74] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2008] [Revised: 04/09/2008] [Accepted: 04/14/2008] [Indexed: 10/22/2022]
Abstract
BACKGROUND Some studies suggest that schizophrenia may be associated with an increased risk of diabetes, independently of antipsychotic medications and other confounding factors. Previous studies have also suggested that there is an increased prevalence of diabetes in the relatives of schizophrenia probands. METHOD First-degree siblings of schizophrenia probands (N=6) and control subjects (N=12) were administered a glucose tolerance test. Subjects were matched for gender, age, body mass index, neighborhood of residence, socio-economic status and smoking habits. RESULTS The siblings of schizophrenia probands had a significantly increased two-hour mean glucose concentration compared to the control subjects (respective means [SD] were 100.5 mg/dL [27.7] vs. 78.0 [12.3]; p<0.03). Baseline glucose concentrations did not differ. CONCLUSIONS Although confirmation with larger samples is needed, these results and other studies suggest that diabetes may share familial risk factors with schizophrenia.
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Affiliation(s)
- Emilio Fernandez-Egea
- Hospital Clinic Schizophrenia Program, Department of Psychiatry, Neuroscience Institute, Hospital Clinic, Barcelona, Spain
| | - Miguel Bernardo
- Hospital Clinic Schizophrenia Program, Department of Psychiatry, Neuroscience Institute, Hospital Clinic, Barcelona, Spain, Institute of Biomedical Research Agusti Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Eduard Parellada
- Hospital Clinic Schizophrenia Program, Department of Psychiatry, Neuroscience Institute, Hospital Clinic, Barcelona, Spain
| | - Azucena Justicia
- Hospital Clinic Schizophrenia Program, Department of Psychiatry, Neuroscience Institute, Hospital Clinic, Barcelona, Spain
| | - Clemente Garcia-Rizo
- Hospital Clinic Schizophrenia Program, Department of Psychiatry, Neuroscience Institute, Hospital Clinic, Barcelona, Spain
| | - Enric Esmatjes
- Institute of Biomedical Research Agusti Pi i Sunyer (IDIBAPS), Barcelona, Spain, Endocrinology and Diabetes Section, Institute of Digestive and Metabolic Diseases, Hospital Clinic, Spain
| | - Ignacio Conget
- Institute of Biomedical Research Agusti Pi i Sunyer (IDIBAPS), Barcelona, Spain, Endocrinology and Diabetes Section, Institute of Digestive and Metabolic Diseases, Hospital Clinic, Spain
| | - Brian Kirkpatrick
- Department of Psychiatry and Health Behavior, Medical College of Georgia, 997 St. Sebastian Way, Augusta, Georgia 30912, USA,Corresponding author. Tel.: +1 706 721 9852; fax: +1 706 721 1793. E-mail address: (B. Kirkpatrick)
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