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Fennema D, Barker GJ, O'Daly O, Duan S, Godlewska BR, Goldsmith K, Young AH, Moll J, Zahn R. Neural responses to facial emotions and subsequent clinical outcomes in difficult-to-treat depression. Psychol Med 2024:1-9. [PMID: 38757184 DOI: 10.1017/s0033291724001144] [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: 05/18/2024]
Abstract
BACKGROUND Amygdala and dorsal anterior cingulate cortex responses to facial emotions have shown promise in predicting treatment response in medication-free major depressive disorder (MDD). Here, we examined their role in the pathophysiology of clinical outcomes in more chronic, difficult-to-treat forms of MDD. METHODS Forty-five people with current MDD who had not responded to ⩾2 serotonergic antidepressants (n = 42, meeting pre-defined fMRI minimum quality thresholds) were enrolled and followed up over four months of standard primary care. Prior to medication review, subliminal facial emotion fMRI was used to extract blood-oxygen level-dependent effects for sad v. happy faces from two pre-registered a priori defined regions: bilateral amygdala and dorsal/pregenual anterior cingulate cortex. Clinical outcome was the percentage change on the self-reported Quick Inventory of Depressive Symptomatology (16-item). RESULTS We corroborated our pre-registered hypothesis (NCT04342299) that lower bilateral amygdala activation for sad v. happy faces predicted favorable clinical outcomes (rs[38] = 0.40, p = 0.01). In contrast, there was no effect for dorsal/pregenual anterior cingulate cortex activation (rs[38] = 0.18, p = 0.29), nor when using voxel-based whole-brain analyses (voxel-based Family-Wise Error-corrected p < 0.05). Predictive effects were mainly driven by the right amygdala whose response to happy faces was reduced in patients with higher anxiety levels. CONCLUSIONS We confirmed the prediction that a lower amygdala response to negative v. positive facial expressions might be an adaptive neural signature, which predicts subsequent symptom improvement also in difficult-to-treat MDD. Anxiety reduced adaptive amygdala responses.
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Affiliation(s)
- Diede Fennema
- Centre of Affective Disorders, Institute of Psychiatry, Psychology & Neuroscience, Centre for Affective Disorders, King's College London, London, UK
| | - Gareth J Barker
- Department of Neuroimaging, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Owen O'Daly
- Department of Neuroimaging, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Suqian Duan
- Centre of Affective Disorders, Institute of Psychiatry, Psychology & Neuroscience, Centre for Affective Disorders, King's College London, London, UK
| | - Beata R Godlewska
- Psychopharmacology Research Unit, University Department of Psychiatry, University of Oxford, Oxford, UK
- Oxford Health NHS Foundation Trust, Warneford Hospital, Oxford, UK
| | - Kimberley Goldsmith
- Department of Biostatistics and Health Informatics, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Allan H Young
- Centre of Affective Disorders, Institute of Psychiatry, Psychology & Neuroscience, Centre for Affective Disorders, King's College London, London, UK
- National Service for Affective Disorders, South London and Maudsley NHS Foundation Trust, London, UK
| | - Jorge Moll
- Cognitive and Behavioural Neuroscience Unit, D'Or Institute for Research and Education (IDOR), Pioneer Science Program, Rio de Janeiro, Brazil
| | - Roland Zahn
- Centre of Affective Disorders, Institute of Psychiatry, Psychology & Neuroscience, Centre for Affective Disorders, King's College London, London, UK
- National Service for Affective Disorders, South London and Maudsley NHS Foundation Trust, London, UK
- Cognitive and Behavioural Neuroscience Unit, D'Or Institute for Research and Education (IDOR), Pioneer Science Program, Rio de Janeiro, Brazil
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Yang X, Lawrence AJ, Harrison P, Liu Y, Chen L, Wang C, Yan C, Zahn R. Positive effects of the COVID-19 pandemic on depression and anxiety in Chinese adolescents. Eur Child Adolesc Psychiatry 2024; 33:1551-1561. [PMID: 37486386 PMCID: PMC11098867 DOI: 10.1007/s00787-023-02263-z] [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: 02/13/2023] [Accepted: 07/13/2023] [Indexed: 07/25/2023]
Abstract
The potential impact on mental health of home schooling and social isolation due to COVID-19 lockdowns has led to widespread concern, particularly for adolescents. However, studies including pre-pandemic data from longitudinal cohorts with an assessment of the longer-term impact of the Covid-19 pandemic beyond the first months of 2020 are scarce. This longitudinal study of 1534 adolescents attending a secondary school in Hunan province investigated self-reported symptoms of anxiety and depression using two validated scales (Screen for Child Anxiety Related Disorders, Child Mood and Feelings Questionnaire) at six time points before, during, and after the 2020 national lockdown restrictions in China. Perceived COVID-related stress was assessed by an author-developed scale at two timepoints during the lockdown. We investigated trends in symptoms over time with a fixed effects model and multiple imputations of missing data. Counter to our expectations, depressive and anxiety symptoms were reduced during the 2020 lockdown relative to pre-lockdown (depression: b = - 3.37, SE = 0.345, Cohen's d = - 0.25, p < 0.0001; anxiety: b = - 4.55, SE = 0.382, Cohen's d = - 0.30, p < 0.0001). Symptoms remained significantly reduced even after lockdown restrictions eased. Higher symptom levels during lockdown were associated with greater self-reported COVID-related stress (depression: b = 0.11, SE = 0.026, p < 0.0001; anxiety: b = 0.11, SE = 0.036, p < 0.0001). Although COVID-related stresses correlated with higher levels of anxiety and depression, the lockdown period was associated with improved symptom levels in the adolescents taking part in our study. School closures may have improved the mental health of adolescents in China. We speculate this beneficial effect of lockdown can be explained by the adverse effects of attending school itself such as exposure to bullying and achievement pressures.
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Affiliation(s)
- Xinhua Yang
- Changning Mental Health Center, 299 Xiehe Road, Changning District, Shanghai, 200335, China.
- Centre for Affective Disorders, Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
| | - Andrew J Lawrence
- Centre for Affective Disorders, Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Phillippa Harrison
- Centre for Affective Disorders, Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Yanlong Liu
- The Affiliated Kangning Hospital, Wenzhou Medical University, Wenzhou, China
| | - Liangliang Chen
- Changning Mental Health Center, 299 Xiehe Road, Changning District, Shanghai, 200335, China
| | - Chenglei Wang
- Changning Mental Health Center, 299 Xiehe Road, Changning District, Shanghai, 200335, China
| | - Chao Yan
- School of Psychology and Cognitive Science, East China Normal University, Shanghai, China
| | - Roland Zahn
- Centre for Affective Disorders, Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- South London and Maudsley NHS Foundation Trust, London, UK
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3
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Fennema D, Barker GJ, O’Daly O, Duan S, Carr E, Goldsmith K, Young AH, Moll J, Zahn R. The Role of Subgenual Resting-State Connectivity Networks in Predicting Prognosis in Major Depressive Disorder. Biol Psychiatry Glob Open Sci 2024; 4:100308. [PMID: 38645404 PMCID: PMC11033067 DOI: 10.1016/j.bpsgos.2024.100308] [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: 08/18/2023] [Revised: 12/18/2023] [Accepted: 03/05/2024] [Indexed: 04/23/2024] Open
Abstract
Background A seminal study found higher subgenual frontal cortex resting-state connectivity with 2 left ventral frontal regions and the dorsal midbrain to predict better response to psychotherapy versus medication in individuals with treatment-naïve major depressive disorder (MDD). Here, we examined whether these subgenual networks also play a role in the pathophysiology of clinical outcomes in MDD with early treatment resistance in primary care. Methods Forty-five people with current MDD who had not responded to ≥2 serotonergic antidepressants (n = 43, meeting predefined functional magnetic resonance imaging minimum quality thresholds) were enrolled and followed over 4 months of standard care. Functional magnetic resonance imaging resting-state connectivity between the preregistered subgenual frontal cortex seed and 3 previously identified left ventromedial, ventrolateral prefrontal/insula, and dorsal midbrain regions was extracted. The clinical outcome was the percentage change on the self-reported 16-item Quick Inventory of Depressive Symptomatology. Results We observed a reversal of our preregistered hypothesis in that higher resting-state connectivity between the subgenual cortex and the a priori ventrolateral prefrontal/insula region predicted favorable rather than unfavorable clinical outcomes (rs39 = -0.43, p = .006). This generalized to the sample including participants with suboptimal functional magnetic resonance imaging quality (rs43 = -0.35, p = .02). In contrast, no effects (rs39 = 0.12, rs39 = -0.01) were found for connectivity with the other 2 preregistered regions or in a whole-brain analysis (voxel-based familywise error-corrected p < .05). Conclusions Subgenual connectivity with the ventrolateral prefrontal cortex/insula is relevant for subsequent clinical outcomes in current MDD with early treatment resistance. Its positive association with favorable outcomes could be explained primarily by psychosocial rather than the expected pharmacological changes during the follow-up period.
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Affiliation(s)
- Diede Fennema
- Centre of Affective Disorders, Institute of Psychiatry, Psychology and Neuroscience, Centre for Affective Disorders, King’s College London, London, United Kingdom
| | - Gareth J. Barker
- Department of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, United Kingdom
| | - Owen O’Daly
- Department of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, United Kingdom
| | - Suqian Duan
- Centre of Affective Disorders, Institute of Psychiatry, Psychology and Neuroscience, Centre for Affective Disorders, King’s College London, London, United Kingdom
| | - Ewan Carr
- Department of Biostatics and Health Informatics, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, United Kingdom
| | - Kimberley Goldsmith
- Department of Biostatics and Health Informatics, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, United Kingdom
| | - Allan H. Young
- Centre of Affective Disorders, Institute of Psychiatry, Psychology and Neuroscience, Centre for Affective Disorders, King’s College London, London, United Kingdom
- National Service for Affective Disorders, South London and Maudsley National Health Service Foundation Trust, London, United Kingdom
| | - Jorge Moll
- Cognitive and Behavioural Neuroscience Unit, D’Or Institute for Research and Education, Rio de Janeiro, Brazil
| | - Roland Zahn
- Centre of Affective Disorders, Institute of Psychiatry, Psychology and Neuroscience, Centre for Affective Disorders, King’s College London, London, United Kingdom
- Cognitive and Behavioural Neuroscience Unit, D’Or Institute for Research and Education, Rio de Janeiro, Brazil
- National Service for Affective Disorders, South London and Maudsley National Health Service Foundation Trust, London, United Kingdom
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Marquez-Martinez S, Salisch N, Serroyen J, Zahn R, Khan S. Peak transgene expression after intramuscular immunization of mice with adenovirus 26-based vector vaccines correlates with transgene-specific adaptive immune responses. PLoS One 2024; 19:e0299215. [PMID: 38626093 PMCID: PMC11020485 DOI: 10.1371/journal.pone.0299215] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Accepted: 02/07/2024] [Indexed: 04/18/2024] Open
Abstract
Non-replicating adenovirus-based vectors have been broadly used for the development of prophylactic vaccines in humans and are licensed for COVID-19 and Ebola virus disease prevention. Adenovirus-based vectored vaccines encode for one or more disease specific transgenes with the aim to induce protective immunity against the target disease. The magnitude and duration of transgene expression of adenovirus 5- based vectors (human type C) in the host are key factors influencing antigen presentation and adaptive immune responses. Here we characterize the magnitude, duration, and organ biodistribution of transgene expression after single intramuscular administration of adenovirus 26-based vector vaccines in mice and evaluate the differences with adenovirus 5-based vector vaccine to understand if this is universally applicable across serotypes. We demonstrate a correlation between peak transgene expression early after adenovirus 26-based vaccination and transgene-specific cellular and humoral immune responses for a model antigen and SARS-CoV-2 spike protein, independent of innate immune activation. Notably, the memory immune response was similar in mice immunized with adenovirus 26-based vaccine and adenovirus 5-based vaccine, despite the latter inducing a higher peak of transgene expression early after immunization and a longer duration of transgene expression. Together these results provide further insights into the mode of action of adenovirus 26-based vector vaccines.
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Affiliation(s)
| | - Nadine Salisch
- Janssen Vaccines & Prevention B.V, Leiden, CN, The Netherlands
| | - Jan Serroyen
- Janssen Vaccines & Prevention B.V, Leiden, CN, The Netherlands
| | - Roland Zahn
- Janssen Vaccines & Prevention B.V, Leiden, CN, The Netherlands
| | - Selina Khan
- Janssen Vaccines & Prevention B.V, Leiden, CN, The Netherlands
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Bortolini T, Laport MC, Latgé-Tovar S, Fischer R, Zahn R, de Oliveira-Souza R, Moll J. The extended neural architecture of human attachment: An fMRI coordinate-based meta-analysis of affiliative studies. Neurosci Biobehav Rev 2024; 159:105584. [PMID: 38367888 DOI: 10.1016/j.neubiorev.2024.105584] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Revised: 01/30/2024] [Accepted: 02/12/2024] [Indexed: 02/19/2024]
Abstract
Functional imaging studies and clinical evidence indicate that cortical areas relevant to social cognition are closely integrated with evolutionarily conserved basal forebrain structures and neighboring regions, enabling human attachment and affiliative emotions. The neural circuitry of human affiliation is continually being unraveled as functional magnetic resonance imaging (fMRI) becomes increasingly prevalent, with studies examining human brain responses to various attachment figures. However, previous fMRI meta-analyses on affiliative stimuli have encountered challenges, such as low statistical power and the absence of robustness measures. To address these issues, we conducted an exhaustive coordinate-based meta-analysis of 79 fMRI studies, focusing on personalized affiliative stimuli, including one's infants, family, romantic partners, and friends. We employed complementary coordinate-based analyses (Activation Likelihood Estimation and Signed Differential Mapping) and conducted a robustness analysis of the results. Findings revealed cluster convergence in cortical and subcortical structures related to reward and motivation, salience detection, social bonding, and cognition. Our study thoroughly explores the neural correlates underpinning affiliative responses, effectively overcoming the limitations noted in previous meta-analyses. It provides an extensive view of the neural substrates associated with affiliative stimuli, illuminating the intricate interaction between cortical and subcortical regions. Our findings significantly contribute to understanding the neurobiology of human affiliation, expanding the known human attachment circuitry beyond the traditional basal forebrain regions observed in other mammals to include uniquely human isocortical structures.
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Affiliation(s)
- Tiago Bortolini
- Cognitive Neuroscience and Neuroinformatics Unit, The D'Or Institute for Research and Education (IDOR), Rio de Janeiro, Brazil; IDOR - Pioneer Science Initiative, São Paulo, Brazil.
| | - Maria Clara Laport
- Cognitive Neuroscience and Neuroinformatics Unit, The D'Or Institute for Research and Education (IDOR), Rio de Janeiro, Brazil
| | - Sofia Latgé-Tovar
- Institute of Psychiatry, Center for Alzheimer's Disease, Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro, RJ, Brazil
| | - Ronald Fischer
- Cognitive Neuroscience and Neuroinformatics Unit, The D'Or Institute for Research and Education (IDOR), Rio de Janeiro, Brazil; IDOR - Pioneer Science Initiative, São Paulo, Brazil; School of Psychology, PO Box 600, Victoria University of Wellington, Wellington 6021, New Zealand
| | - Roland Zahn
- Centre for Affective Disorders, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London SE5 8AF, UK
| | - Ricardo de Oliveira-Souza
- Cognitive Neuroscience and Neuroinformatics Unit, The D'Or Institute for Research and Education (IDOR), Rio de Janeiro, Brazil; The Federal University of the State of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Jorge Moll
- Cognitive Neuroscience and Neuroinformatics Unit, The D'Or Institute for Research and Education (IDOR), Rio de Janeiro, Brazil; IDOR - Pioneer Science Initiative, São Paulo, Brazil
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6
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Anmella G, Primé-Tous M, Segú X, Solanes A, Ruíz V, Martín-Villalba I, Morilla I, Also-Fontanet A, Sant E, Murgui S, Sans-Corrales M, Murru A, Zahn R, Young AH, Vicens V, Viñas-Bardolet C, Martínez-Cerdá JF, Blanch J, Radua J, Fullana MÀ, Cavero M, Vieta E, Hidalgo-Mazzei D. PRimary carE digital Support ToOl in mental health (PRESTO): Design, development and study protocols. Span J Psychiatry Ment Health 2024; 17:114-125. [PMID: 33933665 DOI: 10.1016/j.rpsm.2021.04.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Revised: 03/22/2021] [Accepted: 04/19/2021] [Indexed: 12/24/2022]
Abstract
BACKGROUND About 30-50% of Primary Care (PC) users in Spain suffer mental health problems, mostly mild to moderate anxious and depressive symptoms, which account for 2% of Spain's total Gross domestic product and 50% of the costs associated to all mental disorders. Mobile health tools have demonstrated to cost-effectively reduce anxious and depressive symptoms while machine learning (ML) techniques have shown to accurately detect severe cases. The main aim of this project is to develop a comprehensive ML digital support platform (PRESTO) to cost-effectively screen, assess, triage, and provide personalized treatments for anxious and depressive symptoms in PC. METHODS The project will be carried out in 3 complementary phases: First, a ML predictive severity model will be built based on all the cases referred to the PC mental health support programme during the last 5 years in Catalonia. Simultaneously, a smartphone app to monitor and deliver psychological interventions for anxiety and depressive symptoms will be developed and tested in a clinical trial. Finally, the ML models and the app will be integrated in a comprehensive decision-support platform (PRESTO) which will triage and assign to each patient a specific intervention based on individual personal and clinical characteristics. The effectiveness of PRESTO to reduce waiting times in receiving mental healthcare will be tested in a stepped-wedge cluster randomized controlled trial in 5 PC centres. DISCUSSION PRESTO will offer timely and personalized cost-effective mental health treatment to people with mild to moderate anxious and depressive symptoms. This will result in a reduction of the burden of mental health problems in PC and on society as a whole. TRIAL REGISTRATION The project and their clinical trials were registered in Clinical Trials.gov: NCT04559360 (September 2020).
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Affiliation(s)
- Gerard Anmella
- Department of Psychiatry and Psychology, Institute of Neuroscience, Hospital Clínic de Barcelona, 170 Villarroel st, 12-0, 08036 Barcelona, Catalonia, Spain; Digital Innovation Group, Bipolar and Depressive Disorders Unit, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Catalonia, Spain; University of Barcelona, Barcelona, Catalonia, Spain; Mental Health Research Networking Center (CIBERSAM), Madrid, Spain
| | - Mireia Primé-Tous
- Department of Psychiatry and Psychology, Institute of Neuroscience, Hospital Clínic de Barcelona, 170 Villarroel st, 12-0, 08036 Barcelona, Catalonia, Spain
| | - Xavier Segú
- Department of Psychiatry and Psychology, Institute of Neuroscience, Hospital Clínic de Barcelona, 170 Villarroel st, 12-0, 08036 Barcelona, Catalonia, Spain
| | - Aleix Solanes
- Mental Health Research Networking Center (CIBERSAM), Madrid, Spain; Imaging of Mood- and Anxiety-Related Disorders (IMARD) group, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Victoria Ruíz
- Department of Psychiatry and Psychology, Institute of Neuroscience, Hospital Clínic de Barcelona, 170 Villarroel st, 12-0, 08036 Barcelona, Catalonia, Spain
| | - Inés Martín-Villalba
- Department of Psychiatry and Psychology, Institute of Neuroscience, Hospital Clínic de Barcelona, 170 Villarroel st, 12-0, 08036 Barcelona, Catalonia, Spain
| | - Ivette Morilla
- Department of Psychiatry and Psychology, Institute of Neuroscience, Hospital Clínic de Barcelona, 170 Villarroel st, 12-0, 08036 Barcelona, Catalonia, Spain; University of Barcelona, Barcelona, Catalonia, Spain
| | - Antonieta Also-Fontanet
- CAP Casanova, Consorci d'Atenció Primaria de Salut Barcelona Esquerra (CAPSBE), Barcelona, Catalonia, Spain
| | - Elisenda Sant
- CAP Casanova, Consorci d'Atenció Primaria de Salut Barcelona Esquerra (CAPSBE), Barcelona, Catalonia, Spain
| | - Sandra Murgui
- CAP Borrell, Consorci d'Atenció Primaria de Salut Barcelona Esquerra (CAPSBE), Barcelona, Catalonia, Spain
| | - Mireia Sans-Corrales
- CAP Borrell, Consorci d'Atenció Primaria de Salut Barcelona Esquerra (CAPSBE), Barcelona, Catalonia, Spain
| | - Andrea Murru
- Department of Psychiatry and Psychology, Institute of Neuroscience, Hospital Clínic de Barcelona, 170 Villarroel st, 12-0, 08036 Barcelona, Catalonia, Spain; Digital Innovation Group, Bipolar and Depressive Disorders Unit, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Catalonia, Spain; University of Barcelona, Barcelona, Catalonia, Spain; Mental Health Research Networking Center (CIBERSAM), Madrid, Spain
| | - Roland Zahn
- Centre for Affective Disorders, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom
| | - Allan H Young
- Centre for Affective Disorders, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom
| | - Victor Vicens
- Chief Medical Officer and co-founder of Abi Global Health, Spain
| | - Clara Viñas-Bardolet
- Data Analytics Programme for Health Research and Innovation (PADRIS) from the Catalan Agency for Health Quality and Evaluation (AQuAS), Catalonia, Spain
| | - Juan Francisco Martínez-Cerdá
- Data Analytics Programme for Health Research and Innovation (PADRIS) from the Catalan Agency for Health Quality and Evaluation (AQuAS), Catalonia, Spain
| | - Jordi Blanch
- Department of Psychiatry and Psychology, Institute of Neuroscience, Hospital Clínic de Barcelona, 170 Villarroel st, 12-0, 08036 Barcelona, Catalonia, Spain; University of Barcelona, Barcelona, Catalonia, Spain; Chief Medical Officer and co-founder of Abi Global Health, Spain; Director of the Mental Health and Addiction Programme, Department of Health, Generalitat de Catalunya, Spain; President of the European Association of Psychosomatic Medicine, Spain
| | - Joaquim Radua
- Mental Health Research Networking Center (CIBERSAM), Madrid, Spain; Imaging of Mood- and Anxiety-Related Disorders (IMARD) group, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Early Psychosis: Interventions and Clinical-detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom; Centre for Psychiatric Research and Education, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Miquel-Àngel Fullana
- Department of Psychiatry and Psychology, Institute of Neuroscience, Hospital Clínic de Barcelona, 170 Villarroel st, 12-0, 08036 Barcelona, Catalonia, Spain; Mental Health Research Networking Center (CIBERSAM), Madrid, Spain; Imaging of Mood- and Anxiety-Related Disorders (IMARD) group, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Myriam Cavero
- Department of Psychiatry and Psychology, Institute of Neuroscience, Hospital Clínic de Barcelona, 170 Villarroel st, 12-0, 08036 Barcelona, Catalonia, Spain; University of Barcelona, Barcelona, Catalonia, Spain; Mental Health Research Networking Center (CIBERSAM), Madrid, Spain
| | - Eduard Vieta
- Department of Psychiatry and Psychology, Institute of Neuroscience, Hospital Clínic de Barcelona, 170 Villarroel st, 12-0, 08036 Barcelona, Catalonia, Spain; Digital Innovation Group, Bipolar and Depressive Disorders Unit, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Catalonia, Spain; University of Barcelona, Barcelona, Catalonia, Spain; Mental Health Research Networking Center (CIBERSAM), Madrid, Spain
| | - Diego Hidalgo-Mazzei
- Department of Psychiatry and Psychology, Institute of Neuroscience, Hospital Clínic de Barcelona, 170 Villarroel st, 12-0, 08036 Barcelona, Catalonia, Spain; Digital Innovation Group, Bipolar and Depressive Disorders Unit, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Catalonia, Spain; University of Barcelona, Barcelona, Catalonia, Spain; Mental Health Research Networking Center (CIBERSAM), Madrid, Spain; Centre for Affective Disorders, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom.
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7
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Rutten L, Swart M, Koornneef A, Bouchier P, Blokland S, Sadi A, Juraszek J, Vijayan A, Schmit-Tillemans S, Verspuij J, Choi Y, Daal CE, Perkasa A, Torres Morales S, Myeni SK, Kikkert M, Tolboom J, van Manen D, Kuipers H, Schuitemaker H, Zahn R, Langedijk JPM. Impact of SARS-CoV-2 spike stability and RBD exposure on antigenicity and immunogenicity. Sci Rep 2024; 14:5735. [PMID: 38459086 PMCID: PMC10923862 DOI: 10.1038/s41598-024-56293-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Accepted: 03/05/2024] [Indexed: 03/10/2024] Open
Abstract
The spike protein (S) of SARS-CoV-2 induces neutralizing antibodies and is the key component of current COVID-19 vaccines. The most efficacious COVID-19 vaccines are genetically-encoded spikes with a double proline substitution in the hinge region to stabilize S in the prefusion conformation (S-2P). A subunit vaccine can be a valuable addition to mRNA and viral vector-based vaccines but requires high stability of spike. In addition, further stabilization of the prefusion conformation of spike might improve immunogenicity. To test this, five spike proteins were designed and characterized, ranging from low to high stability. The immunogenicity of these proteins was assessed in mice, demonstrating that a spike (S-closed-2) with a high melting temperature, which still allowed ACE2 binding, induced the highest neutralization titers against homologous and heterologous strains (up to 16-fold higher than the least stabilized spike). In contrast, the most stable spike variant (S-locked), in which the receptor binding domains (RBDs) were locked in a closed conformation and thus not able to breathe, induced relatively low neutralizing antibody titers against heterologous strains. These data demonstrate that S protein stabilization with RBDs exposing highly conserved epitopes may be needed to increase the immunogenicity of spike proteins for future COVID-19 vaccines.
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Affiliation(s)
- Lucy Rutten
- Janssen Vaccines and Prevention B.V., Archimedesweg 4-6, Leiden, The Netherlands
| | - Maarten Swart
- Janssen Vaccines and Prevention B.V., Archimedesweg 4-6, Leiden, The Netherlands
| | - Annemart Koornneef
- Janssen Vaccines and Prevention B.V., Archimedesweg 4-6, Leiden, The Netherlands
| | - Pascale Bouchier
- Janssen Vaccines and Prevention B.V., Archimedesweg 4-6, Leiden, The Netherlands
| | - Sven Blokland
- Janssen Vaccines and Prevention B.V., Archimedesweg 4-6, Leiden, The Netherlands
| | - Ava Sadi
- Janssen Vaccines and Prevention B.V., Archimedesweg 4-6, Leiden, The Netherlands
| | - Jarek Juraszek
- Janssen Vaccines and Prevention B.V., Archimedesweg 4-6, Leiden, The Netherlands
| | - Aneesh Vijayan
- Janssen Vaccines and Prevention B.V., Archimedesweg 4-6, Leiden, The Netherlands
| | | | - Johan Verspuij
- Janssen Vaccines and Prevention B.V., Archimedesweg 4-6, Leiden, The Netherlands
| | - Ying Choi
- Janssen Vaccines and Prevention B.V., Archimedesweg 4-6, Leiden, The Netherlands
| | - Chenandly E Daal
- Janssen Vaccines and Prevention B.V., Archimedesweg 4-6, Leiden, The Netherlands
| | - Aditya Perkasa
- Janssen Vaccines and Prevention B.V., Archimedesweg 4-6, Leiden, The Netherlands
| | - Shessy Torres Morales
- Molecular Virology Laboratory, Department of Medical Microbiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Sebenzile K Myeni
- Molecular Virology Laboratory, Department of Medical Microbiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Marjolein Kikkert
- Molecular Virology Laboratory, Department of Medical Microbiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Jeroen Tolboom
- Janssen Vaccines and Prevention B.V., Archimedesweg 4-6, Leiden, The Netherlands
| | - Daniëlle van Manen
- Janssen Vaccines and Prevention B.V., Archimedesweg 4-6, Leiden, The Netherlands
| | - Harmjan Kuipers
- Janssen Vaccines and Prevention B.V., Archimedesweg 4-6, Leiden, The Netherlands
| | - Hanneke Schuitemaker
- Janssen Vaccines and Prevention B.V., Archimedesweg 4-6, Leiden, The Netherlands
| | - Roland Zahn
- Janssen Vaccines and Prevention B.V., Archimedesweg 4-6, Leiden, The Netherlands
| | - Johannes P M Langedijk
- Janssen Vaccines and Prevention B.V., Archimedesweg 4-6, Leiden, The Netherlands.
- ForgeBio, Amsterdam, The Netherlands.
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Schiller D, Yu ANC, Alia-Klein N, Becker S, Cromwell HC, Dolcos F, Eslinger PJ, Frewen P, Kemp AH, Pace-Schott EF, Raber J, Silton RL, Stefanova E, Williams JHG, Abe N, Aghajani M, Albrecht F, Alexander R, Anders S, Aragón OR, Arias JA, Arzy S, Aue T, Baez S, Balconi M, Ballarini T, Bannister S, Banta MC, Barrett KC, Belzung C, Bensafi M, Booij L, Bookwala J, Boulanger-Bertolus J, Boutros SW, Bräscher AK, Bruno A, Busatto G, Bylsma LM, Caldwell-Harris C, Chan RCK, Cherbuin N, Chiarella J, Cipresso P, Critchley H, Croote DE, Demaree HA, Denson TF, Depue B, Derntl B, Dickson JM, Dolcos S, Drach-Zahavy A, Dubljević O, Eerola T, Ellingsen DM, Fairfield B, Ferdenzi C, Friedman BH, Fu CHY, Gatt JM, de Gelder B, Gendolla GHE, Gilam G, Goldblatt H, Gooding AEK, Gosseries O, Hamm AO, Hanson JL, Hendler T, Herbert C, Hofmann SG, Ibanez A, Joffily M, Jovanovic T, Kahrilas IJ, Kangas M, Katsumi Y, Kensinger E, Kirby LAJ, Koncz R, Koster EHW, Kozlowska K, Krach S, Kret ME, Krippl M, Kusi-Mensah K, Ladouceur CD, Laureys S, Lawrence A, Li CSR, Liddell BJ, Lidhar NK, Lowry CA, Magee K, Marin MF, Mariotti V, Martin LJ, Marusak HA, Mayer AV, Merner AR, Minnier J, Moll J, Morrison RG, Moore M, Mouly AM, Mueller SC, Mühlberger A, Murphy NA, Muscatello MRA, Musser ED, Newton TL, Noll-Hussong M, Norrholm SD, Northoff G, Nusslock R, Okon-Singer H, Olino TM, Ortner C, Owolabi M, Padulo C, Palermo R, Palumbo R, Palumbo S, Papadelis C, Pegna AJ, Pellegrini S, Peltonen K, Penninx BWJH, Pietrini P, Pinna G, Lobo RP, Polnaszek KL, Polyakova M, Rabinak C, Helene Richter S, Richter T, Riva G, Rizzo A, Robinson JL, Rosa P, Sachdev PS, Sato W, Schroeter ML, Schweizer S, Shiban Y, Siddharthan A, Siedlecka E, Smith RC, Soreq H, Spangler DP, Stern ER, Styliadis C, Sullivan GB, Swain JE, Urben S, Van den Stock J, Vander Kooij MA, van Overveld M, Van Rheenen TE, VanElzakker MB, Ventura-Bort C, Verona E, Volk T, Wang Y, Weingast LT, Weymar M, Williams C, Willis ML, Yamashita P, Zahn R, Zupan B, Lowe L. The Human Affectome. Neurosci Biobehav Rev 2024; 158:105450. [PMID: 37925091 PMCID: PMC11003721 DOI: 10.1016/j.neubiorev.2023.105450] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2022] [Revised: 10/26/2023] [Accepted: 10/27/2023] [Indexed: 11/06/2023]
Abstract
Over the last decades, theoretical perspectives in the interdisciplinary field of the affective sciences have proliferated rather than converged due to differing assumptions about what human affective phenomena are and how they work. These metaphysical and mechanistic assumptions, shaped by academic context and values, have dictated affective constructs and operationalizations. However, an assumption about the purpose of affective phenomena can guide us to a common set of metaphysical and mechanistic assumptions. In this capstone paper, we home in on a nested teleological principle for human affective phenomena in order to synthesize metaphysical and mechanistic assumptions. Under this framework, human affective phenomena can collectively be considered algorithms that either adjust based on the human comfort zone (affective concerns) or monitor those adaptive processes (affective features). This teleologically-grounded framework offers a principled agenda and launchpad for both organizing existing perspectives and generating new ones. Ultimately, we hope the Human Affectome brings us a step closer to not only an integrated understanding of human affective phenomena, but an integrated field for affective research.
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Affiliation(s)
- Daniela Schiller
- Department of Psychiatry, the Nash Family Department of Neuroscience, and the Friedman Brain Institute, at the Icahn School of Medicine at Mount Sinai, New York, NY, United States.
| | - Alessandra N C Yu
- Nash Family Department of Neuroscience, Icahn School of Medicine at Mount Sinai, New York, NY 10029, United States.
| | - Nelly Alia-Klein
- Department of Psychiatry and Neuroscience, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Susanne Becker
- Department of Cognitive and Clinical Neuroscience, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, J5, 68159 Mannheim, Germany; Integrative Spinal Research Group, Department of Chiropractic Medicine, University Hospital Balgrist, University of Zurich, Balgrist Campus, Lengghalde 5, 8008 Zurich, Switzerland
| | - Howard C Cromwell
- J.P. Scott Center for Neuroscience, Mind and Behavior, Department of Psychology, Bowling Green State University, Bowling Green, OH 43403, United States
| | - Florin Dolcos
- Beckman Institute for Advanced Science & Technology, University of Illinois at Urbana-Champaign, Urbana, IL, United States; Department of Psychology, University of Illinois at Urbana-Champaign, Champaign, IL, United States
| | - Paul J Eslinger
- Departments of Neurology, Neural & Behavioral Science, Radiology, and Public Health Sciences, Penn State Hershey Medical Center and College of Medicine, Hershey, PA, United States
| | - Paul Frewen
- Departments of Psychiatry, Psychology and Neuroscience at the University of Western Ontario, London, Ontario, Canada
| | - Andrew H Kemp
- School of Psychology, Faculty of Medicine, Health & Life Science, Swansea University, Swansea, United Kingdom
| | - Edward F Pace-Schott
- Harvard Medical School and Massachusetts General Hospital, Department of Psychiatry, Boston, MA, United States; Department of Psychiatry, Massachusetts General Hospital, Boston, MA, United States
| | - Jacob Raber
- Department of Behavioral Neuroscience, Oregon Health & Science University, Portland, OR 97239, United States; Departments of Neurology, Radiation Medicine, Psychiatry, and Division of Neuroscience, ONPRC, Oregon Health & Science University, Portland, OR, United States
| | - Rebecca L Silton
- Department of Psychology, Loyola University Chicago, Chicago, IL, United States
| | - Elka Stefanova
- Faculty of Medicine, University of Belgrade, Serbia; Neurology Clinic, Clinical Center of Serbia, Serbia
| | - Justin H G Williams
- Griffith University, Gold Coast Campus, 1 Parklands Dr, Southport, QLD 4215, Australia
| | - Nobuhito Abe
- Institute for the Future of Human Society, Kyoto University, 46 Shimoadachi-cho, Yoshida Sakyo-ku, Kyoto, Japan
| | - Moji Aghajani
- Institute of Education & Child Studies, Section Forensic Family & Youth Care, Leiden University, the Netherlands; Department of Psychiatry, Amsterdam UMC, Location VUMC, GGZ InGeest Research & Innovation, Amsterdam Neuroscience, the Netherlands
| | - Franziska Albrecht
- Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany; Clinic for Cognitive Neurology, University Hospital Leipzig, Leipzig, Germany; Division of Physiotherapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden; Karolinska University Hospital, Women's Health and Allied Health Professionals Theme, Medical unit Occupational Therapy & Physiotherapy, Stockholm, Sweden
| | - Rebecca Alexander
- Neuroscience Research Australia, Randwick, Sydney, NSW, Australia; Australian National University, Canberra, ACT, Australia
| | - Silke Anders
- Department of Neurology, University of Lübeck, Lübeck, Germany; Center of Brain, Behavior and Metabolism, University of Lübeck, Lübeck, Germany
| | - Oriana R Aragón
- Yale University, 2 Hillhouse Ave, New Haven, CT, United States; Cincinnati University, Marketing Department, 2906 Woodside Drive, Cincinnati, OH 45221-0145, United States
| | - Juan A Arias
- School of Psychology, Faculty of Medicine, Health & Life Science, Swansea University, Swansea, United Kingdom; Department of Statistics, Mathematical Analysis, and Operational Research, Universidade de Santiago de Compostela, Spain; The Galician Center for Mathematical Research and Technology (CITMAga), 15782 Santiago de Compostela, Spain
| | - Shahar Arzy
- Department of Medical Neurobiology, Hebrew University, Jerusalem, Israel
| | - Tatjana Aue
- Institute of Psychology, University of Bern, Fabrikstr. 8, 3012 Bern, Switzerland
| | | | - Michela Balconi
- International Research Center for Cognitive Applied Neuroscience, Catholic University of Milan, Milan, Italy
| | - Tommaso Ballarini
- Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
| | - Scott Bannister
- Durham University, Palace Green, DH1 RL3 Durham, United Kingdom
| | | | - Karen Caplovitz Barrett
- Department of Human Development & Family Studies, Colorado State University, Fort Collins, CO, United States; Department of Community & Behavioral Health, Colorado School of Public Health, Denver, CO, United States
| | | | - Moustafa Bensafi
- Research Center in Neurosciences of Lyon, CNRS UMR5292, INSERM U1028, Claude Bernard University Lyon 1, Lyon, Centre Hospitalier Le Vinatier, 95 bd Pinel, 69675 Bron Cedex, France
| | - Linda Booij
- Department of Psychology, Concordia University, Montreal, Canada; CHU Sainte-Justine, University of Montreal, Montreal, Canada
| | - Jamila Bookwala
- Department of Psychology, Lafayette College, Easton, PA, United States
| | - Julie Boulanger-Bertolus
- Department of Anesthesiology and Center for Consciousness Science, University of Michigan, Ann Arbor, MI, United States
| | - Sydney Weber Boutros
- Department of Behavioral Neuroscience, Oregon Health & Science University, Portland, OR 97239, United States
| | - Anne-Kathrin Bräscher
- Department of Clinical Psychology, Psychotherapy and Experimental Psychopathology, University of Mainz, Wallstr. 3, 55122 Mainz, Germany; Nathan Kline Institute for Psychiatric Research, Orangeburg, NY, United States
| | - Antonio Bruno
- Department of Biomedical, Dental Sciences and Morpho-Functional Imaging - University of Messina, Italy
| | - Geraldo Busatto
- Laboratory of Psychiatric Neuroimaging (LIM-21), Departamento e Instituto de Psiquiatria, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Lauren M Bylsma
- Departments of Psychiatry and Psychology; and the Center for Neural Basis of Cognition, University of Pittsburgh School of Medicine, Pittsburgh, PA, United States
| | | | - Raymond C K Chan
- Neuropsychology and Applied Cognitive Neuroscience Laboratory, CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China
| | - Nicolas Cherbuin
- Centre for Research on Ageing, Health, and Wellbeing, Australian National University, Canberra, ACT, Australia
| | - Julian Chiarella
- Department of Psychology, Concordia University, Montreal, Canada; CHU Sainte-Justine, University of Montreal, Montreal, Canada
| | - Pietro Cipresso
- Applied Technology for Neuro-Psychology Lab., Istituto Auxologico Italiano (IRCCS), Milan, Italy; Department of Psychology, University of Turin, Turin, Italy
| | - Hugo Critchley
- Psychiatry, Department of Neuroscience, Brighton and Sussex Medical School (BSMS), University of Sussex, Sussex, United Kingdom
| | - Denise E Croote
- Departments of Psychiatry and Neuroscience, Icahn School of Medicine at Mount Sinai and Friedman Brain Institute, New York, NY 10029, United States; Hospital Universitário Gaffrée e Guinle, Universidade do Rio de Janeiro, Brazil
| | - Heath A Demaree
- Department of Psychological Sciences, Case Western Reserve University, Cleveland, OH, United States
| | - Thomas F Denson
- School of Psychology, University of New South Wales, Sydney, NSW, Australia
| | - Brendan Depue
- Departments of Psychological and Brain Sciences and Anatomical Sciences and Neurobiology, University of Louisville, Louisville, KY, United States
| | - Birgit Derntl
- Department of Psychiatry and Psychotherapy, Tübingen Center for Mental Health, University of Tübingen, Tübingen, Germany
| | - Joanne M Dickson
- Edith Cowan University, Psychology Discipline, School of Arts and Humanities, 270 Joondalup Dr, Joondalup, WA 6027, Australia
| | - Sanda Dolcos
- Beckman Institute for Advanced Science & Technology, University of Illinois at Urbana-Champaign, Urbana, IL, United States; Department of Psychology, University of Illinois at Urbana-Champaign, Champaign, IL, United States
| | - Anat Drach-Zahavy
- The Faculty of Health and Welfare Sciences, University of Haifa, Haifa, Israel
| | - Olga Dubljević
- Neurology Clinic, Clinical Center of Serbia, Serbia; Institute for Biological Research "Siniša Stanković", National Institute of Republic of Serbia, Belgrade, Serbia
| | - Tuomas Eerola
- Durham University, Palace Green, DH1 RL3 Durham, United Kingdom
| | - Dan-Mikael Ellingsen
- Department of Diagnostic Physics, Division of Radiology and Nuclear Medicine, Oslo University Hospital, Oslo, Norway
| | - Beth Fairfield
- Department of Humanistic Studies, University of Naples Federico II, Naples, Italy; UniCamillus, International Medical University, Rome, Italy
| | - Camille Ferdenzi
- Research Center in Neurosciences of Lyon, CNRS UMR5292, INSERM U1028, Claude Bernard University Lyon 1, Lyon, Centre Hospitalier Le Vinatier, 95 bd Pinel, 69675 Bron Cedex, France
| | - Bruce H Friedman
- Department of Psychology, Virginia Tech, Blacksburg, VA, United States
| | - Cynthia H Y Fu
- School of Psychology, University of East London, United Kingdom; Centre for Affective Disorders, Institute of Psychiatry, Psychology and Neuroscience, King's College London, United Kingdom
| | - Justine M Gatt
- Neuroscience Research Australia, Randwick, Sydney, NSW, Australia; School of Psychology, University of New South Wales, Randwick, Sydney, NSW, Australia
| | - Beatrice de Gelder
- Department of Psychology and Neuroscience, Maastricht University, Maastricht, the Netherlands
| | - Guido H E Gendolla
- Geneva Motivation Lab, University of Geneva, FPSE, Section of Psychology, CH-1211 Geneva 4, Switzerland
| | - Gadi Gilam
- The Institute of Biomedical and Oral Research, Faculty of Dental Medicine, Hebrew University of Jerusalem, Jerusalem, Israel; Systems Neuroscience and Pain Laboratory, Stanford University School of Medicine, CA, United States
| | - Hadass Goldblatt
- Department of Nursing, Faculty of Social Welfare & Health Sciences, University of Haifa, Haifa, Israel
| | | | - Olivia Gosseries
- Coma Science Group, GIGA Consciousness & Centre du Cerveau2, University and University Hospital of Liege, Liege, Belgium
| | - Alfons O Hamm
- Department of Biological and Clinical Psychology/Psychotherapy, University of Greifswald, Greifswald, Germany
| | - Jamie L Hanson
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA 15206, United States
| | - Talma Hendler
- Tel Aviv Center for Brain Function, Wohl Institute for Advanced Imaging, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel; School of Psychological Sciences, Tel-Aviv University, Tel Aviv, Israel
| | - Cornelia Herbert
- Department of Applied Emotion and Motivation Psychology, Institute of Psychology and Education, Ulm University, Ulm, Germany
| | - Stefan G Hofmann
- Department of Clinical Psychology, Philipps University Marburg, Germany
| | - Agustin Ibanez
- Universidad de San Andres, Buenos Aires, Argentina; National Scientific and Technical Research Council (CONICET), Buenos Aires, Argentina; Latin American Brain Health Institute (BrainLat), Universidad Adolfo Ibáñez, Santiago, Chile; Global Brain Health Institute (GBHI), University of California San Francisco (UCSF), United States and Trinity Collegue Dublin (TCD), Ireland
| | - Mateus Joffily
- Groupe d'Analyse et de Théorie Economique (GATE), 93 Chemin des Mouilles, 69130 Écully, France
| | - Tanja Jovanovic
- Department of Psychiatry and Behavaioral Neurosciences, Wayne State University, Detroit, MI, United States
| | - Ian J Kahrilas
- Department of Psychology, Loyola University Chicago, Chicago, IL, United States
| | - Maria Kangas
- Department of Psychology, Macquarie University, Sydney, Australia
| | - Yuta Katsumi
- Department of Psychology, University of Illinois at Urbana-Champaign, Champaign, IL, United States; Department of Neurology, Massachusetts General Hospital and Harvard Medical School, Charlestown, MA, USA
| | - Elizabeth Kensinger
- Department of Psychology and Neuroscience, Boston College, Boston, MA, United States
| | - Lauren A J Kirby
- Department of Psychology and Counseling, University of Texas at Tyler, Tyler, TX, United States
| | - Rebecca Koncz
- Centre for Healthy Brain Ageing, Discipline of Psychiatry and Mental Health, University of New South Wales, Sydney, Australia; Specialty of Psychiatry, The University of Sydney, Concord, New South Wales, Australia
| | - Ernst H W Koster
- Department of Experimental Clinical and Health Psychology, Ghent University, Ghent, Belgium
| | | | - Sören Krach
- Social Neuroscience Lab, Translational Psychiatry Unit, University of Lübeck, Lübeck, Germany
| | - Mariska E Kret
- Leiden University, Cognitive Psychology, Pieter de la Court, Waassenaarseweg 52, Leiden 2333 AK, the Netherlands
| | - Martin Krippl
- Faculty of Natural Sciences, Department of Psychology, Otto von Guericke University Magdeburg, Universitätsplatz 2, Magdeburg, Germany
| | - Kwabena Kusi-Mensah
- Department of Psychiatry, Komfo Anokye Teaching Hospital, P. O. Box 1934, Kumasi, Ghana; Department of Psychiatry, University of Cambridge, Darwin College, Silver Street, CB3 9EU Cambridge, United Kingdom; Behavioural Sciences Department, School of Medicine and Dentistry, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Cecile D Ladouceur
- Departments of Psychiatry and Psychology and the Center for Neural Basis of Cognition (CNBC), University of Pittsburgh, Pittsburgh, PA, United States
| | - Steven Laureys
- Coma Science Group, GIGA Consciousness & Centre du Cerveau2, University and University Hospital of Liege, Liege, Belgium
| | - Alistair Lawrence
- Scotland's Rural College, King's Buildings, Edinburgh, Scotland; The Roslin Institute, University of Edinburgh, Easter Bush, Scotland
| | - Chiang-Shan R Li
- Connecticut Mental Health Centre, Yale University, New Haven, CT, United States
| | - Belinda J Liddell
- School of Psychology, University of New South Wales, Randwick, Sydney, NSW, Australia
| | - Navdeep K Lidhar
- Department of Psychology, University of Toronto Mississauga, Mississauga, ON, Canada
| | - Christopher A Lowry
- Department of Integrative Physiology and Center for Neuroscience, University of Colorado Boulder, Boulder, CO, United States
| | - Kelsey Magee
- Department of Psychological Sciences, Case Western Reserve University, Cleveland, OH, United States
| | - Marie-France Marin
- Department of Psychology, Université du Québec à Montréal, Montreal, Canada; Research Center, Institut universitaire en santé mentale de Montréal, Montreal, Canada
| | - Veronica Mariotti
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Loren J Martin
- Department of Psychology, University of Toronto Mississauga, Mississauga, ON, Canada
| | - Hilary A Marusak
- Department of Psychiatry and Behavaioral Neurosciences, Wayne State University, Detroit, MI, United States; Merrill Palmer Skillman Institute for Child and Family Development, Wayne State University, Detroit, MI, United States
| | - Annalina V Mayer
- Social Neuroscience Lab, Translational Psychiatry Unit, University of Lübeck, Lübeck, Germany
| | - Amanda R Merner
- Department of Psychological Sciences, Case Western Reserve University, Cleveland, OH, United States
| | - Jessica Minnier
- School of Public Health, Oregon Health & Science University, Portland, OR, United States
| | - Jorge Moll
- Cognitive Neuroscience and Neuroinformatics Unit, D'Or Institute for Research and Education, Rio de Janeiro, Brazil
| | - Robert G Morrison
- Department of Psychology, Loyola University Chicago, Chicago, IL, United States
| | - Matthew Moore
- Beckman Institute for Advanced Science & Technology, University of Illinois at Urbana-Champaign, Urbana, IL, United States; Department of Psychology, University of Illinois at Urbana-Champaign, Champaign, IL, United States; War Related Illness and Injury Study Center (WRIISC), Veterans Affairs Palo Alto Health Care System, Palo Alto, CA, United States
| | - Anne-Marie Mouly
- Lyon Neuroscience Research Center, CNRS-UMR 5292, INSERM U1028, Universite Lyon, Lyon, France
| | - Sven C Mueller
- Department of Experimental Clinical and Health Psychology, Ghent University, Ghent, Belgium
| | - Andreas Mühlberger
- Department of Psychology (Clinical Psychology and Psychotherapy), University of Regensburg, Regensburg, Germany
| | - Nora A Murphy
- Department of Psychology, Loyola Marymount University, Los Angeles, CA, United States
| | | | - Erica D Musser
- Center for Children and Families, Department of Psychology, Florida International University, Miami, FL, United States
| | - Tamara L Newton
- Department of Psychological and Brain Sciences, University of Louisville, Louisville, KY, United States
| | - Michael Noll-Hussong
- Psychosomatic Medicine and Psychotherapy, TU Muenchen, Langerstrasse 3, D-81675 Muenchen, Germany
| | - Seth Davin Norrholm
- Department of Psychiatry and Behavaioral Neurosciences, Wayne State University, Detroit, MI, United States
| | - Georg Northoff
- Mind, Brain Imaging and Neuroethics Research Unit, University of Ottawa Institute of Mental Health Research, Royal Ottawa Mental Health Centre, Canada
| | - Robin Nusslock
- Department of Psychology and Institute for Policy Research, Northwestern University, 2029 Sheridan Road, Evanston, IL, United States
| | - Hadas Okon-Singer
- School of Psychological Sciences, University of Haifa, Haifa, Israel
| | - Thomas M Olino
- Department of Psychology, Temple University, 1701N. 13th St, Philadelphia, PA, United States
| | - Catherine Ortner
- Thompson Rivers University, Department of Psychology, 805 TRU Way, Kamloops, BC, Canada
| | - Mayowa Owolabi
- Department of Medicine and Center for Genomic and Precision Medicine, College of Medicine, University of Ibadan; University College Hospital, Ibadan, Oyo State, Nigeria; Blossom Specialist Medical Center Ibadan, Oyo State, Nigeria
| | - Caterina Padulo
- Department of Psychological, Health and Territorial Sciences, University of Chieti, Chieti, Italy
| | - Romina Palermo
- School of Psychological Science, University of Western Australia, Perth, WA, Australia
| | - Rocco Palumbo
- Department of Psychological, Health and Territorial Sciences, University of Chieti, Chieti, Italy
| | - Sara Palumbo
- Department of Surgical, Medical and Molecular Pathology and of Critical Care, University of Pisa, Pisa, Italy
| | - Christos Papadelis
- Jane and John Justin Neuroscience Center, Cook Children's Health Care System, Fort Worth, TX, United States; Department of Bioengineering, University of Texas at Arlington, Arlington, TX, United States
| | - Alan J Pegna
- School of Psychology, University of Queensland, Saint Lucia, Queensland, Australia
| | - Silvia Pellegrini
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Kirsi Peltonen
- Research Centre for Child Psychiatry, University of Turku, Turku, Finland; INVEST Research Flagship, University of Turku, Turku, Finland
| | - Brenda W J H Penninx
- Department of Psychiatry, Amsterdam UMC, Location VUMC, GGZ InGeest Research & Innovation, Amsterdam Neuroscience, the Netherlands
| | | | - Graziano Pinna
- The Psychiatric Institute, Department of Psychiatry, University of Illinois at Chicago, Chicago, IL, United States
| | - Rosario Pintos Lobo
- Center for Children and Families, Department of Psychology, Florida International University, Miami, FL, United States
| | - Kelly L Polnaszek
- Department of Psychology, Loyola University Chicago, Chicago, IL, United States
| | - Maryna Polyakova
- Neurology Department, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
| | - Christine Rabinak
- Department of Pharmacy Practice, Wayne State University, Detroit, MI, United States
| | - S Helene Richter
- Department of Behavioural Biology, University of Münster, Badestraße 13, Münster, Germany
| | - Thalia Richter
- School of Psychological Sciences, University of Haifa, Haifa, Israel
| | - Giuseppe Riva
- Applied Technology for Neuro-Psychology Lab., Istituto Auxologico Italiano (IRCCS), Milan, Italy; Humane Technology Lab., Università Cattolica del Sacro Cuore, Milan, Italy
| | - Amelia Rizzo
- Department of Biomedical, Dental Sciences and Morpho-Functional Imaging - University of Messina, Italy
| | | | - Pedro Rosa
- Laboratory of Psychiatric Neuroimaging (LIM-21), Departamento e Instituto de Psiquiatria, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Perminder S Sachdev
- Centre for Healthy Brain Ageing, Discipline of Psychiatry and Mental Health, University of New South Wales, Sydney, Australia; Neuropsychiatric Institute, The Prince of Wales Hospital, Sydney, Australia
| | - Wataru Sato
- Psychological Process Research Team, Guardian Robot Project, RIKEN, 2-2-2 Hikaridai, Seika-cho, Soraku-gun, Kyoto, Japan
| | - Matthias L Schroeter
- Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany; Clinic for Cognitive Neurology, University Hospital Leipzig, Leipzig, Germany
| | - Susanne Schweizer
- Department of Psychology, University of Cambridge, Cambridge, United Kingdom; School of Psychology, University of New South Wales, Sydney, Australia
| | - Youssef Shiban
- Department of Psychology (Clinical Psychology and Psychotherapy), University of Regensburg, Regensburg, Germany; Department of Psychology (Clinical Psychology and Psychotherapy Research), PFH - Private University of Applied Sciences, Gottingen, Germany
| | - Advaith Siddharthan
- Knowledge Media Institute, The Open University, Milton Keynes MK7 6AA, United Kingdom
| | - Ewa Siedlecka
- School of Psychology, University of New South Wales, Sydney, NSW, Australia
| | - Robert C Smith
- Departments of Medicine and Psychiatry, Michigan State University, East Lansing, MI, United States
| | - Hermona Soreq
- Department of Biological Chemistry, Edmond and Lily Safra Center of Brain Science and The Institute of Life Sciences, Hebrew University, Jerusalem, Israel
| | - Derek P Spangler
- Department of Biobehavioral Health, The Pennsylvania State University, State College, PA, United States
| | - Emily R Stern
- Nathan Kline Institute for Psychiatric Research, Orangeburg, NY, United States; New York University School of Medicine, New York, NY, United States
| | - Charis Styliadis
- Neuroscience of Cognition and Affection group, Lab of Medical Physics and Digital Innovation, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | | | - James E Swain
- Departments of Psychiatry & Behavioral Health, Psychology, Obstetrics, Gynecology & Reproductive Medicine, and Program in Public Health, Renaissance School of Medicine at Stony Brook University, New York, United States
| | - Sébastien Urben
- Division of Child and Adolescent Psychiatry, Lausanne University Hospital (CHUV) and University of Lausanne, Lausanne, Switzerland
| | - Jan Van den Stock
- Neuropsychiatry, Department of Neurosciences, Leuven Brain Institute, KU Leuven, Leuven, Belgium
| | - Michael A Vander Kooij
- Translational Psychiatry, Department of Psychiatry and Psychotherapy, Universitatsmedizin der Johannes Guttenberg University Medical Center, Mainz, Germany
| | | | - Tamsyn E Van Rheenen
- University of Melbourne, Melbourne Neuropsychiatry Centre, Department of Psychiatry, 161 Barry Street, Carlton, VIC, Australia
| | - Michael B VanElzakker
- Division of Neurotherapeutics, Massachusetts General Hospital, Boston, MA, United States
| | - Carlos Ventura-Bort
- Department of Biological Psychology and Affective Science, Faculty of Human Sciences, University of Potsdam, Potsdam, Germany
| | - Edelyn Verona
- Department of Psychology, University of South Florida, Tampa, FL, United States
| | - Tyler Volk
- Professor Emeritus of Biology and Environmental Studies, New York University, New York, NY, United States
| | - Yi Wang
- Neuropsychology and Applied Cognitive Neuroscience Laboratory, CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China
| | - Leah T Weingast
- Department of Social Work and Human Services and the Department of Psychological Sciences, Center for Young Adult Addiction and Recovery, Kennesaw State University, Kennesaw, GA, United States
| | - Mathias Weymar
- Department of Biological Psychology and Affective Science, Faculty of Human Sciences, University of Potsdam, Potsdam, Germany; Faculty of Health Sciences Brandenburg, University of Potsdam, Germany
| | - Claire Williams
- School of Psychology, Faculty of Medicine, Health & Life Science, Swansea University, Swansea, United Kingdom; Elysium Neurological Services, Elysium Healthcare, The Avalon Centre, United Kingdom
| | - Megan L Willis
- School of Behavioural and Health Sciences, Australian Catholic University, Sydney, NSW, Australia
| | - Paula Yamashita
- Department of Integrative Physiology and Center for Neuroscience, University of Colorado Boulder, Boulder, CO, United States
| | - Roland Zahn
- Centre for Affective Disorders, Institute of Psychiatry, Psychology and Neuroscience, King's College London, United Kingdom
| | - Barbra Zupan
- Central Queensland University, School of Health, Medical and Applied Sciences, Bruce Highway, Rockhampton, QLD, Australia
| | - Leroy Lowe
- Neuroqualia (NGO), Truro, Nova Scotia, Canada.
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9
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Wang JJ, van der Neut Kolfschoten M, Rutten L, Armour B, Tan CW, Chataway T, Bos R, Koornneef A, Abeywickrema P, Kapur R, Porcelijn L, Khalifa M, Sadi A, Bouchier P, Kourkouta E, Perkasa A, Kwaks T, Zahn R, Solforosi L, Gordon TP. Characterization of reverse-engineered anti-PF4 stereotypic antibodies derived from serum of patients with VITT. Blood 2024; 143:370-374. [PMID: 37976451 DOI: 10.1182/blood.2023021307] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Revised: 10/26/2023] [Accepted: 10/31/2023] [Indexed: 11/19/2023] Open
Affiliation(s)
- Jing Jing Wang
- Department of Immunology, College of Medicine and Public Health, Flinders University, Bedford Park, SA, Australia
- Department of Immunology, SA Pathology, Flinders Medical Centre, Bedford Park, SA, Australia
| | | | - Lucy Rutten
- Janssen Vaccines & Prevention B.V., Leiden, The Netherlands
| | - Bridie Armour
- Department of Immunology, College of Medicine and Public Health, Flinders University, Bedford Park, SA, Australia
- Department of Immunology, SA Pathology, Flinders Medical Centre, Bedford Park, SA, Australia
| | - Chee Wee Tan
- Department of Medicine, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, SA, Australia
- Department of Hematology, SA Pathology, Adelaide, SA, Australia
- Department of Hematology, Royal Adelaide Hospital, Central Area Local Health Network, Adelaide, SA, Australia
| | - Tim Chataway
- Flinders Proteomics Facility, College of Medicine and Public Health, Flinders University, Bedford Park, SA, Australia
| | - Rinke Bos
- Janssen Vaccines & Prevention B.V., Leiden, The Netherlands
| | | | - Pravien Abeywickrema
- Structural & Protein Sciences, Janssen Research and Development, Spring House, PA
| | - Rick Kapur
- Sanquin Research, Department of Experimental Immunohematology, and Landsteiner Laboratory, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Leendert Porcelijn
- Department of Immunohematology Diagnostics, Sanquin Diagnostic Services, Amsterdam, The Netherlands
| | - Midia Khalifa
- Janssen Vaccines & Prevention B.V., Leiden, The Netherlands
| | - Ava Sadi
- Janssen Vaccines & Prevention B.V., Leiden, The Netherlands
| | | | | | - Aditya Perkasa
- Janssen Vaccines & Prevention B.V., Leiden, The Netherlands
| | - Ted Kwaks
- Janssen Vaccines & Prevention B.V., Leiden, The Netherlands
| | - Roland Zahn
- Janssen Vaccines & Prevention B.V., Leiden, The Netherlands
| | | | - Tom P Gordon
- Department of Immunology, College of Medicine and Public Health, Flinders University, Bedford Park, SA, Australia
- Department of Immunology, SA Pathology, Flinders Medical Centre, Bedford Park, SA, Australia
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10
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Swart M, Kuipers H, Milder F, Jongeneelen M, Ritschel T, Tolboom J, Muchene L, van der Lubbe J, Izquierdo Gil A, Veldman D, Huizingh J, Verspuij J, Schmit-Tillemans S, Blokland S, de Man M, Roozendaal R, Fox CB, Schuitemaker H, Capelle M, Langedijk JPM, Zahn R, Brandenburg B. Enhancing breadth and durability of humoral immune responses in non-human primates with an adjuvanted group 1 influenza hemagglutinin stem antigen. NPJ Vaccines 2023; 8:176. [PMID: 37952003 PMCID: PMC10640631 DOI: 10.1038/s41541-023-00772-1] [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] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Accepted: 11/02/2023] [Indexed: 11/14/2023] Open
Abstract
Seasonal influenza vaccines must be updated annually and suboptimally protect against strains mismatched to the selected vaccine strains. We previously developed a subunit vaccine antigen consisting of a stabilized trimeric influenza A group 1 hemagglutinin (H1) stem protein that elicits broadly neutralizing antibodies. Here, we further optimized the stability and manufacturability of the H1 stem antigen (H1 stem v2, also known as INFLUENZA G1 mHA) and characterized its formulation and potency with different adjuvants in vitro and in animal models. The recombinant H1 stem antigen (50 µg) was administered to influenza-naïve non-human primates either with aluminum hydroxide [Al(OH)3] + NaCl, AS01B, or SLA-LSQ formulations at week 0, 8 and 34. These SLA-LSQ formulations comprised of varying ratios of the synthetic TLR4 agonist 'second generation synthetic lipid adjuvant' (SLA) with liposomal QS-21 (LSQ). A vaccine formulation with aluminum hydroxide or SLA-LSQ (starting at a 10:25 µg ratio) induced HA-specific antibodies and breadth of neutralization against a panel of influenza A group 1 pseudoviruses, comparable with vaccine formulated with AS01B, four weeks after the second immunization. A formulation with SLA-LSQ in a 5:2 μg ratio contained larger fused or aggregated liposomes and induced significantly lower humoral responses. Broadly HA stem-binding antibodies were detectable for the entire period after the second vaccine dose up to week 34, after which they were boosted by a third vaccine dose. These findings inform about potential adjuvant formulations in clinical trials with an H1 stem-based vaccine candidate.
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Affiliation(s)
- Maarten Swart
- Janssen Vaccines & Prevention, Leiden, The Netherlands
| | | | - Fin Milder
- Janssen Vaccines & Prevention, Leiden, The Netherlands
| | | | - Tina Ritschel
- Janssen Vaccines & Prevention, Leiden, The Netherlands
| | | | | | | | | | | | | | | | | | - Sven Blokland
- Janssen Vaccines & Prevention, Leiden, The Netherlands
| | | | | | | | | | | | | | - Roland Zahn
- Janssen Vaccines & Prevention, Leiden, The Netherlands
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11
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McLean C, Dijkman K, Gaddah A, Keshinro B, Katwere M, Douoguih M, Robinson C, Solforosi L, Czapska-Casey D, Dekking L, Wollmann Y, Volkmann A, Pau MG, Callendret B, Sadoff J, Schuitemaker H, Zahn R, Luhn K, Hendriks J, Roozendaal R. Persistence of immunological memory as a potential correlate of long-term, vaccine-induced protection against Ebola virus disease in humans. Front Immunol 2023; 14:1215302. [PMID: 37727795 PMCID: PMC10505757 DOI: 10.3389/fimmu.2023.1215302] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Accepted: 08/09/2023] [Indexed: 09/21/2023] Open
Abstract
Introduction In the absence of clinical efficacy data, vaccine protective effect can be extrapolated from animals to humans, using an immunological biomarker in humans that correlates with protection in animals, in a statistical approach called immunobridging. Such an immunobridging approach was previously used to infer the likely protective effect of the heterologous two-dose Ad26.ZEBOV, MVA-BN-Filo Ebola vaccine regimen. However, this immunobridging model does not provide information on how the persistence of the vaccine-induced immune response relates to durability of protection in humans. Methods and results In both humans and non-human primates, vaccine-induced circulating antibody levels appear to be very stable after an initial phase of contraction and are maintained for at least 3.8 years in humans (and at least 1.3 years in non-human primates). Immunological memory was also maintained over this period, as shown by the kinetics and magnitude of the anamnestic response following re-exposure to the Ebola virus glycoprotein antigen via booster vaccination with Ad26.ZEBOV in humans. In non-human primates, immunological memory was also formed as shown by an anamnestic response after high-dose, intramuscular injection with Ebola virus, but was not sufficient for protection against Ebola virus disease at later timepoints due to a decline in circulating antibodies and the fast kinetics of disease in the non-human primates model. Booster vaccination within three days of subsequent Ebola virus challenge in non-human primates resulted in protection from Ebola virus disease, i.e. before the anamnestic response was fully developed. Discussion Humans infected with Ebola virus may benefit from the anamnestic response to prevent disease progression, as the incubation time is longer and progression of Ebola virus disease is slower as compared to non-human primates. Therefore, the persistence of vaccine-induced immune memory could be considered as a potential correlate of long-term protection against Ebola virus disease in humans, without the need for a booster.
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Affiliation(s)
| | - Karin Dijkman
- Janssen Vaccines and Prevention, Leiden, Netherlands
| | | | | | | | | | | | | | | | | | | | | | | | | | - Jerry Sadoff
- Janssen Vaccines and Prevention, Leiden, Netherlands
| | | | - Roland Zahn
- Janssen Vaccines and Prevention, Leiden, Netherlands
| | - Kerstin Luhn
- Janssen Vaccines and Prevention, Leiden, Netherlands
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12
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Jauhar S, Arnone D, Baldwin DS, Bloomfield M, Browning M, Cleare AJ, Corlett P, Deakin JFW, Erritzoe D, Fu C, Fusar-Poli P, Goodwin GM, Hayes J, Howard R, Howes OD, Juruena MF, Lam RW, Lawrie SM, McAllister-Williams H, Marwaha S, Matuskey D, McCutcheon RA, Nutt DJ, Pariante C, Pillinger T, Radhakrishnan R, Rucker J, Selvaraj S, Stokes P, Upthegrove R, Yalin N, Yatham L, Young AH, Zahn R, Cowen PJ. A leaky umbrella has little value: evidence clearly indicates the serotonin system is implicated in depression. Mol Psychiatry 2023; 28:3149-3152. [PMID: 37322065 PMCID: PMC10618084 DOI: 10.1038/s41380-023-02095-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Revised: 01/17/2023] [Accepted: 04/21/2023] [Indexed: 06/17/2023]
Affiliation(s)
- Sameer Jauhar
- Centre for Affective Disorders, Psychological Medicine, IoPPN, King's College, London, UK.
| | - Danilo Arnone
- Department of Psychiatry and Behavioural Science, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates
| | - David S Baldwin
- Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, UK
| | - Michael Bloomfield
- Mental Health Neuroscience, Division of Psychiatry, University College, London, UK
| | - Michael Browning
- Department of Psychiatry, University of Oxford, Oxford, United Kingdom; Oxford Health NHS Trust, Oxford, United Kingdom
| | - Anthony J Cleare
- Centre for Affective Disorders, Psychological Medicine, IoPPN, King's College, London, UK
| | - Phillip Corlett
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, 06519, USA
| | | | - David Erritzoe
- Division of Brain Sciences, Dept of Medicine, Imperial College, London, UK
| | - Cynthia Fu
- Department of Psychological Sciences, School of Psychology, University of East London, London, UK
| | - Paolo Fusar-Poli
- Department of Psychosis Studies, IoPPN, King's College, London, UK
| | - Guy M Goodwin
- Department of Psychiatry, University of Oxford, Oxford, United Kingdom; Oxford Health NHS Trust, Oxford, United Kingdom
| | - Joseph Hayes
- Mental Health Neuroscience, Division of Psychiatry, University College, London, UK
| | - Robert Howard
- Mental Health Neuroscience, Division of Psychiatry, University College, London, UK
| | - Oliver D Howes
- Department of Psychosis Studies, IoPPN, King's College, London, UK
- H Lundbeck A/s, Iveco House, Watford, WD17 1ET, UK
- Institute of Clinical Sciences (ICS), Faculty of Medicine, Imperial College London, Du Cane Road, London, UK
| | - Mario F Juruena
- Centre for Affective Disorders, Psychological Medicine, IoPPN, King's College, London, UK
| | - Raymond W Lam
- Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada
| | | | - Hamish McAllister-Williams
- Faculty of Medical Sciences, University of Newcastle, Newcastle upon Tyne, UK
- Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Steven Marwaha
- Institute for Mental Health, University of Birmingham, Birmingham, UK
| | - David Matuskey
- Departments of Radiology and Biomedical Sciences, Psychiatry, and Neurology, Yale University, New Haven, CT, USA
| | - Robert A McCutcheon
- Department of Psychiatry, University of Oxford, Oxford, United Kingdom; Oxford Health NHS Trust, Oxford, United Kingdom
| | - David J Nutt
- Division of Brain Sciences, Dept of Medicine, Imperial College, London, UK
| | - Carmine Pariante
- Centre for Affective Disorders, Psychological Medicine, IoPPN, King's College, London, UK
| | - Toby Pillinger
- Department of Psychosis Studies, IoPPN, King's College, London, UK
| | | | - James Rucker
- Centre for Affective Disorders, Psychological Medicine, IoPPN, King's College, London, UK
| | - Sudhakar Selvaraj
- Louis Faillace Department of Psychiatry and Behavioral Science, McGovern Medical School, University of Texas Health Science Center, Houston, TX, USA
- Intra-Cellular Therapies, Inc, New York, NY, 10016, USA
| | - Paul Stokes
- Centre for Affective Disorders, Psychological Medicine, IoPPN, King's College, London, UK
| | - Rachel Upthegrove
- Institute for Mental Health, University of Birmingham, Birmingham, UK
| | - Nefize Yalin
- Centre for Affective Disorders, Psychological Medicine, IoPPN, King's College, London, UK
| | - Lakshmi Yatham
- Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada
| | - Allan H Young
- Centre for Affective Disorders, Psychological Medicine, IoPPN, King's College, London, UK
| | - Roland Zahn
- Centre for Affective Disorders, Psychological Medicine, IoPPN, King's College, London, UK
| | - Philip J Cowen
- Department of Psychiatry, University of Oxford, Oxford, United Kingdom; Oxford Health NHS Trust, Oxford, United Kingdom
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13
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Fennema D, Barker GJ, O'Daly O, Duan S, Carr E, Goldsmith K, Young AH, Moll J, Zahn R. Self-blame-selective hyper-connectivity between anterior temporal and subgenual cortices predicts prognosis in major depressive disorder. Neuroimage Clin 2023; 39:103453. [PMID: 37352570 PMCID: PMC10336192 DOI: 10.1016/j.nicl.2023.103453] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Revised: 06/12/2023] [Accepted: 06/13/2023] [Indexed: 06/25/2023]
Abstract
BACKGROUND Self-blame-related fMRI measures were shown to predict subsequent recurrence in remitted major depressive disorder (MDD). Their role in current MDD, however, is unknown. We hypothesised that these neural signatures reflect a highly recurrent but remitting course of MDD and therefore predict favourable outcomes over a four-month follow-up period in current MDD. METHODS Forty-five participants with current MDD and non-responders to at least two serotonergic antidepressants, were encouraged to optimise their medication and followed up after receiving four months of primary care treatment-as-usual. Prior to their medication review, participants completed an fMRI paradigm in which they viewed self- and other-blame emotion-evoking statements. Thirty-nine participants met pre-defined fMRI data minimum quality thresholds. Psychophysiological interaction analysis was used to determine baseline connectivity of the right superior anterior temporal lobe (RSATL), with an a priori BA25 region-of-interest for self-blaming vs other-blaming emotions, using Quick Inventory of Depressive Symptomatology (16-item) percentage change as a covariate. RESULTS We corroborated our pre-registered hypothesis that a favourable clinical outcome was associated with higher self-blame-selective RSATL-BA25 connectivity (Family-Wise Error-corrected p <.05 over the a priori BA25 region-of-interest; rs(34) = -0.47, p =.005). This generalised to the sample including participants with suboptimal fMRI quality (rs(39) = -0.32, p =.05). CONCLUSIONS This study shows that neural signatures of overgeneralised self-blame are relevant for prognostic stratification of current treatment-resistant MDD. Future studies need to confirm whether this neural signature indeed represents a trait-like feature of a fully remitting subtype of MDD, or whether it is also modulated by depressive state and related to treatment effects.
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Affiliation(s)
- Diede Fennema
- Centre of Affective Disorders, Institute of Psychiatry, Psychology & Neuroscience, Centre for Affective Disorders, King's College London, London, UK
| | - Gareth J Barker
- Department of Neuroimaging, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Owen O'Daly
- Department of Neuroimaging, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Suqian Duan
- Centre of Affective Disorders, Institute of Psychiatry, Psychology & Neuroscience, Centre for Affective Disorders, King's College London, London, UK
| | - Ewan Carr
- Department of Biostatics and Health Informatics, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Kimberley Goldsmith
- Department of Biostatics and Health Informatics, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Allan H Young
- Centre of Affective Disorders, Institute of Psychiatry, Psychology & Neuroscience, Centre for Affective Disorders, King's College London, London, UK; National Service for Affective Disorders, South London and Maudsley NHS Foundation Trust, London, UK
| | - Jorge Moll
- Cognitive and Behavioural Neuroscience Unit, D'Or Institute for Research and Education (IDOR), Rio de Janeiro, Brazil
| | - Roland Zahn
- Centre of Affective Disorders, Institute of Psychiatry, Psychology & Neuroscience, Centre for Affective Disorders, King's College London, London, UK; Cognitive and Behavioural Neuroscience Unit, D'Or Institute for Research and Education (IDOR), Rio de Janeiro, Brazil; National Service for Affective Disorders, South London and Maudsley NHS Foundation Trust, London, UK.
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14
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McCrone P, Young AH, Zahn R, Eberhard J, Wasserman D, Brambilla P, Balazs J, Caldas-de-Almeida J, Ulrichsen A, Carli V, Antunes A, Schiena G, Quoidbach V, Boyer P, Strawbridge R. Economic impact of reducing treatment gaps in depression. Eur Psychiatry 2023; 66:e57. [PMID: 37309907 PMCID: PMC10486252 DOI: 10.1192/j.eurpsy.2023.2415] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Revised: 04/03/2023] [Accepted: 05/04/2023] [Indexed: 06/14/2023] Open
Abstract
BACKGROUND Major depressive disorder (MDD) is highly prevalent across Europe. While evidence-based treatments exist, many people with MDD have their condition undetected and/or untreated. This study aimed to assess the cost-effectiveness of reducing treatment gaps using a modeling approach. METHODS A decision-tree model covering a 27-month time horizon was used. This followed a care pathway where MDD could be detected or not, and where different forms of treatment could be provided. Expected costs pertaining to Germany, Hungary, Italy, Portugal, Sweden, and the UK were calculated and quality-adjusted life years (QALYs) were estimated. The incremental costs per QALY of reducing detection and treatment gaps were estimated. RESULTS The expected costs with a detection gap of 69% and treatment gap of 50% were €1236 in Germany, €476 in Hungary, €1413 in Italy, €938 in Portugal, €2093 in Sweden, and €1496 in the UK. The incremental costs per QALY of reducing the detection gap to 50% ranged from €2429 in Hungary to €10,686 in Sweden. The figures for reducing the treatment gap to 25% ranged from €3146 in Hungary to €13,843 in Sweden. CONCLUSIONS Reducing detection and treatment gaps, and maintaining current patterns of care, is likely to increase healthcare costs in the short term. However, outcomes are improved, and reducing these gaps to 50 and 25%, respectively, appears to be a cost-effective use of resources.
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Affiliation(s)
- Paul McCrone
- Institute for Lifecourse Development, University of Greenwich, London, UK
| | - Allan H. Young
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
- South London and Maudsley NHS Foundation Trust, Bethlem Royal Hospital, Beckenham, UK
| | - Roland Zahn
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
| | - Jonas Eberhard
- Division of Psychiatry, Department of Clinical Sciences, Lund University, Lund, Sweden
| | - Danuta Wasserman
- National Centre for Suicide Research and Prevention of Mental Ill-Health, Karolinska Institutet, Stockholm, Sweden
| | - Paolo Brambilla
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - Judit Balazs
- Department of Developmental & Clinical Child Psychology, Institute of Psychology, Eötvös Loránd University, Budapest, Hungary
- Department of Psychology, Oslo New University College, Oslo, Norway
| | - Jose Caldas-de-Almeida
- Chronic Diseases Research Center, Nova Medical School, Nova University of Lisbon, Lisbon, Portugal
| | - Andrea Ulrichsen
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
| | - Vladmir Carli
- National Centre for Suicide Research and Prevention of Mental Ill-Health, Karolinska Institutet, Stockholm, Sweden
| | - Ana Antunes
- Chronic Diseases Research Center, Nova Medical School, Nova University of Lisbon, Lisbon, Portugal
| | - Giandomenico Schiena
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
| | | | | | - Rebecca Strawbridge
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
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15
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Jaeckle T, Williams SCR, Barker GJ, Basilio R, Carr E, Goldsmith K, Colasanti A, Giampietro V, Cleare A, Young AH, Moll J, Zahn R. Self-blame in major depression: a randomised pilot trial comparing fMRI neurofeedback with self-guided psychological strategies. Psychol Med 2023; 53:2831-2841. [PMID: 34852855 PMCID: PMC10235657 DOI: 10.1017/s0033291721004797] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Revised: 02/19/2021] [Accepted: 11/02/2021] [Indexed: 11/06/2022]
Abstract
BACKGROUND Overgeneralised self-blame and worthlessness are key symptoms of major depressive disorder (MDD) and have previously been associated with self-blame-selective changes in connectivity between right superior anterior temporal lobe (rSATL) and subgenual frontal cortices. Another study showed that remitted MDD patients were able to modulate this neural signature using functional magnetic resonance imaging (fMRI) neurofeedback training, thereby increasing their self-esteem. The feasibility and potential of using this approach in symptomatic MDD were unknown. METHOD This single-blind pre-registered randomised controlled pilot trial probed a novel self-guided psychological intervention with and without additional rSATL-posterior subgenual cortex (BA25) fMRI neurofeedback, targeting self-blaming emotions in people with insufficiently recovered MDD and early treatment-resistance (n = 43, n = 35 completers). Participants completed three weekly self-guided sessions to rebalance self-blaming biases. RESULTS As predicted, neurofeedback led to a training-induced reduction in rSATL-BA25 connectivity for self-blame v. other-blame. Both interventions were safe and resulted in a 46% reduction on the Beck Depression Inventory-II, our primary outcome, with no group differences. Secondary analyses, however, revealed that patients without DSM-5-defined anxious distress showed a superior response to neurofeedback compared with the psychological intervention, and the opposite pattern in anxious MDD. As predicted, symptom remission was associated with increases in self-esteem and this correlated with the frequency with which participants employed the psychological strategies in daily life. CONCLUSIONS These findings suggest that self-blame-rebalance neurofeedback may be superior over a solely psychological intervention in non-anxious MDD, although further confirmatory studies are needed. Simple self-guided strategies tackling self-blame were beneficial, but need to be compared against treatment-as-usual in further trials. https://doi.org/10.1186/ISRCTN10526888.
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Affiliation(s)
- Tanja Jaeckle
- Department of Psychological Medicine, Centre for Affective Disorders, London, UK
| | - Steven C. R. Williams
- Department of Neuroimaging, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Gareth J. Barker
- Department of Neuroimaging, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Rodrigo Basilio
- Cognitive and Behavioral Neuroscience Unit and Neuroinformatics Workgroup, D'Or Institute for Research and Education (IDOR), Rio de Janeiro, Brazil
| | - Ewan Carr
- Department of Biostatistics, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Kimberley Goldsmith
- Department of Biostatistics, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Alessandro Colasanti
- Department of Psychological Medicine, Centre for Affective Disorders, London, UK
| | - Vincent Giampietro
- Department of Neuroimaging, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Anthony Cleare
- Department of Psychological Medicine, Centre for Affective Disorders, London, UK
| | - Allan H. Young
- Department of Psychological Medicine, Centre for Affective Disorders, London, UK
- South London and Maudsley NHS Foundation Trust, Bethlem Royal Hospital, Monks Orchard Road, Beckenham, Kent, BR3 3BX, UK
| | - Jorge Moll
- Cognitive and Behavioral Neuroscience Unit and Neuroinformatics Workgroup, D'Or Institute for Research and Education (IDOR), Rio de Janeiro, Brazil
| | - Roland Zahn
- Department of Psychological Medicine, Centre for Affective Disorders, London, UK
- Cognitive and Behavioral Neuroscience Unit and Neuroinformatics Workgroup, D'Or Institute for Research and Education (IDOR), Rio de Janeiro, Brazil
- South London and Maudsley NHS Foundation Trust, Bethlem Royal Hospital, Monks Orchard Road, Beckenham, Kent, BR3 3BX, UK
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16
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Cox F, Saeland E, Thoma A, van den Hoogen W, Tettero L, Drijver J, Vaneman C, van Polanen Y, Ritschel T, Bastian AR, Callendret B, Zahn R, van der Fits L. RSV A2-Based Prefusion F Vaccine Candidates Induce RSV A and RSV B Cross Binding and Neutralizing Antibodies and Provide Protection against RSV A and RSV B Challenge in Preclinical Models. Vaccines (Basel) 2023; 11:vaccines11030672. [PMID: 36992257 DOI: 10.3390/vaccines11030672] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Revised: 03/10/2023] [Accepted: 03/13/2023] [Indexed: 03/18/2023] Open
Abstract
RSV is divided into two antigenic subtypes, RSV A and RSV B, which is largely based on the variation in the G protein, while the fusion protein F is more conserved and a target for antibody-mediated neutralization. Here we evaluate the breadth of the protective immune responses across RSV A and RSV B subtypes, induced by vaccines based on the RSV A-based fusion protein, stabilized in the prefusion conformation (preF) in preclinical models. Immunization of naïve cotton rats with preF subunit or preF encoded by a replication incompetent Adenoviral 26, induced antibodies capable of neutralizing recent RSV A and RSV B clinical isolates, as well as protective efficacy against a challenge with RSV A and RSV B strains. Similarly, induction of cross-neutralizing antibodies was observed after immunization with Ad26-encoded preF, preF protein or a mix of both (Ad26/preF protein) in RSV pre-exposed mice and African Green Monkeys. Transfer of serum of human subjects immunized with Ad26/preF protein into cotton rats provide protection against challenges with both RSV A and RSV B, with complete protection against both strains observed in the lower respiratory tract. In contrast, almost no protection against RSV A and B infection was observed after the transfer of a human serum pool isolated pre-vaccination. These results collectively show that the RSV A-based monovalent Ad26/preF protein vaccine induced neutralizing antibodies, as well as protection against both RSV A and RSV B subtypes in animals, including by passive transfer of human antibodies alone, suggesting that clinical efficacy against both subtypes can be achieved.
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Affiliation(s)
- Freek Cox
- Janssen Vaccines & Prevention B.V. Archimedesweg 4-6, 2333 CN Leiden, The Netherlands
| | - Eirikur Saeland
- Janssen Vaccines & Prevention B.V. Archimedesweg 4-6, 2333 CN Leiden, The Netherlands
| | - Anne Thoma
- Janssen Vaccines & Prevention B.V. Archimedesweg 4-6, 2333 CN Leiden, The Netherlands
| | - Ward van den Hoogen
- Janssen Vaccines & Prevention B.V. Archimedesweg 4-6, 2333 CN Leiden, The Netherlands
| | - Lisanne Tettero
- Janssen Vaccines & Prevention B.V. Archimedesweg 4-6, 2333 CN Leiden, The Netherlands
| | - Joke Drijver
- Janssen Vaccines & Prevention B.V. Archimedesweg 4-6, 2333 CN Leiden, The Netherlands
| | - Cornelis Vaneman
- Janssen Vaccines & Prevention B.V. Archimedesweg 4-6, 2333 CN Leiden, The Netherlands
| | - Yolinda van Polanen
- Janssen Vaccines & Prevention B.V. Archimedesweg 4-6, 2333 CN Leiden, The Netherlands
| | - Tina Ritschel
- Janssen Vaccines & Prevention B.V. Archimedesweg 4-6, 2333 CN Leiden, The Netherlands
| | | | - Benoit Callendret
- Janssen Vaccines & Prevention B.V. Archimedesweg 4-6, 2333 CN Leiden, The Netherlands
| | - Roland Zahn
- Janssen Vaccines & Prevention B.V. Archimedesweg 4-6, 2333 CN Leiden, The Netherlands
| | - Leslie van der Fits
- Janssen Vaccines & Prevention B.V. Archimedesweg 4-6, 2333 CN Leiden, The Netherlands
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Duan S, Valmaggia L, Fennema D, Moll J, Zahn R. Remote virtual reality assessment elucidates self-blame-related action tendencies in depression. J Psychiatr Res 2023; 161:77-83. [PMID: 36905843 DOI: 10.1016/j.jpsychires.2023.02.031] [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: 09/09/2022] [Revised: 02/15/2023] [Accepted: 02/23/2023] [Indexed: 03/13/2023]
Abstract
BACKGROUND Action tendencies are implicit cognitive and motivational states before an action is taken, such as feeling like hiding when experiencing shame or guilt, independent of the actions people decide to take. Such "action tendencies" are key to understanding the maladaptive impact of self-blame in depression. For example, feeling like "hiding" in a text-based task was previously associated with recurrence risk in remitted depression. Despite their functional importance, action tendencies have not been systematically investigated in current depression, which was the aim of this pre-registered study. METHODS We developed and validated the first virtual reality (VR) assessment of blame-related action tendencies and compared current depression (n = 98) with control participants (n = 40). The immersive VR-task, pre-programmed on devices sent to participants' homes, used hypothetical social interactions, in which either participants (self-agency) or their friend (other-agency) were described to have acted inappropriately. RESULTS Compared with controls, people with depression showed a maladaptive profile: particularly in the other-agency condition, rather than feeling like verbally attacking their friend, they were prone to feeling like hiding, and punishing themselves. Interestingly, feeling like punishing oneself was associated with a history of self-harm but not suicide attempts. CONCLUSIONS Current depression and self-harm history were linked with distinctive motivational signatures, paving the way for remote VR-based stratification and treatment.
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Affiliation(s)
- Suqian Duan
- Department of Psychological Medicine, Centre for Affective Disorders, UK
| | - Lucia Valmaggia
- Department of Psychology, UK; South London and Maudsley, NHS Trust, UK; Ku Leuven, Belgium
| | - Diede Fennema
- Department of Psychological Medicine, Centre for Affective Disorders, UK
| | - Jorge Moll
- Cognitive and Behavioral Neuroscience Unit, D'Or Institute for Research and Education (IDOR), 22280-080, Rio de Janeiro, RJ, Brazil; Scients Institute, USA
| | - Roland Zahn
- Department of Psychological Medicine, Centre for Affective Disorders, UK; South London and Maudsley, NHS Trust, UK.
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18
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Harrison P, Carr E, Goldsmith K, Young A, Ashworth M, Fennema D, Duan S, Barrett BM, Zahn R. Antidepressant Advisor (ADeSS): a decision support system for antidepressant treatment for depression in UK primary care - a feasibility study. BMJ Open 2023; 13:e060516. [PMID: 36868594 PMCID: PMC9990646 DOI: 10.1136/bmjopen-2021-060516] [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: 01/17/2022] [Accepted: 02/10/2023] [Indexed: 03/05/2023] Open
Abstract
OBJECTIVES To develop and probe the first computerised decision-support tool to provide antidepressant treatment guidance to general practitioners (GPs) in UK primary care. DESIGN A parallel group, cluster-randomised controlled feasibility trial, where individual participants were blind to treatment allocation. SETTING South London NHS GP practices. PARTICIPANTS Ten practices and eighteen patients with treatment-resistant current major depressive disorder. INTERVENTIONS Practices were randomised to two treatment arms: (a) treatment-as-usual, (b) computerised decision support tool. RESULTS Ten GP practices participated in the trial, which was within our target range (8-20). However, practice and patient recruitment were slower than anticipated and only 18 of 86 intended patients were recruited. This was due to fewer than expected patients being eligible for the study, as well as disruption resulting from the COVID-19 pandemic. Only one patient was lost to follow-up. There were no serious or medically important adverse events during the trial. GPs in the decision tool arm indicated moderate support for the tool. A minority of patients fully engaged with the mobile app-based tracking of symptoms, medication adherence and side effects. CONCLUSIONS Overall, feasibility was not shown in the current study and the following modifications would be needed to attempt to overcome the limitations found: (a) inclusion of patients who have only tried one Selective Serotonin Reuptake Inhibitor, rather than two, to improve recruitment and pragmatic relevance of the study; (b) approaching community pharmacists to implement tool recommendations rather than GPs; (c) further funding to directly interface between the decision support tool and self-reported symptom app; (d) increasing the geographic reach by not requiring detailed diagnostic assessments and replacing this with supported remote self-report. TRIAL REGISTRATION NUMBER NCT03628027.
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Affiliation(s)
- Phillippa Harrison
- Centre for Affective Disorders, Department of Psychological Medicine, Institute of Psychiatry Psychology and Neuroscience, King's College London, London, UK
| | - Ewan Carr
- Department of Biostatistics and Health Informatics, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Kimberley Goldsmith
- Department of Biostatistics and Health Informatics, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Allan Young
- Centre for Affective Disorders, Department of Psychological Medicine, Institute of Psychiatry Psychology and Neuroscience, King's College London, London, UK
- National Service for Affective Disorders, South London and Maudsley Mental Health NHS Trust, London, UK
| | - Mark Ashworth
- Department of Population Health Sciences, King's College London, London, UK
| | - Diede Fennema
- Centre for Affective Disorders, Department of Psychological Medicine, Institute of Psychiatry Psychology and Neuroscience, King's College London, London, UK
| | - Suqian Duan
- Centre for Affective Disorders, Department of Psychological Medicine, Institute of Psychiatry Psychology and Neuroscience, King's College London, London, UK
| | - Barbara M Barrett
- Department of Health Services & Population Research, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Roland Zahn
- Centre for Affective Disorders, Department of Psychological Medicine, Institute of Psychiatry Psychology and Neuroscience, King's College London, London, UK
- National Service for Affective Disorders, South London and Maudsley Mental Health NHS Trust, London, UK
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19
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Zahn R, Schmidt M, Wallner A, Fischer T, Ohlendorf D, Wanke EM. Work-Related Dermatoses of the Feet in Professional Dancers: A Pilot Study. Med Probl Perform Art 2023; 38:16-22. [PMID: 36854972 DOI: 10.21091/mppa.2023.1003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Accepted: 10/11/2022] [Indexed: 06/18/2023]
Abstract
OBJECTIVE The feet of professional dancers are exposed to high work-related stresses. To date, data from the professional dance sector concerning this matter are lacking. The aim of this exploratory project was to analyze and evaluate skin health in the foot area with regard to the prevalence of dermatoses, their locations, as well as gender-specific and load-specific differences. METHODS Professional classical and neo-classical ballet dancers were examined at two time points: in a phase with increased stress (T0: daily training sessions, rehearsals, and high performance frequency) (n=51, 35 females, 16 males) and after a 24-day rest phase (T1: n=35, 28 females, 7 males). In addition, gender-specific and load-specific (T0 and T1) differences were evaluated. RESULTS All professional dancers were affected by skin lesions of the feet at T0. Hyperkeratosis (96.1%), onychomycosis (27.5%), and subungual hematoma (11.8%) were the most frequent dermatoses of the feet of professional dancers. Onychomycosis affected the nails of the big toes in particular (right 15.7%; left 13.7%), and subungual hematomas were found exclusively on the nails of the first toe (right 7.8%; left 7.8%). Women tended to be more frequently affected by hyperkeratosis, men more frequently by onychomycosis. There were no load-specific differences between the stress and rest phases. CONCLUSION The prevalence of work-related dermatoses is equally high among female and male dancers. The results can be used for further research and serve as a basis for specific measures of behavioral and environmental prevention in dance.
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Affiliation(s)
| | | | | | | | | | - E M Wanke
- Institute for Occupational, Social and Environmental Medicine, Johann Wolfgang Goethe University Frankfurt am Main, Theodor-Stern-Kai 7, Haus 9, 60590 Frankfurt am Main, Germany. Tel 00496963016650.
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20
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Milling TJ, Middeldorp S, Xu L, Koch B, Demchuk A, Eikelboom JW, Verhamme P, Cohen AT, Beyer-Westendorf J, Michael Gibson C, Lopez-Sendon J, Crowther M, Shoamanesh A, Coppens M, Schmidt J, Albaladejo P, Connolly SJ, Bastani A, Clark C, Concha M, Cornell J, Dombrowski K, Fermann G, Fulmer J, Goldstein J, Kereiakes D, Milling T, Pallin D, Patel N, Refaai M, Rehman M, Schmaier A, Schwarz E, Shillinglaw W, Spohn M, Takata T, Venkat A, Welker J, Welsby I, Wilson J, Van Keer L, Verschuren F, Blostein M, Eikelboom J, Althaus K, Berrouschot J, Braun G, Doeppner T, Dziewas R, Genth-Zotz S, Greinacher P, Hamann F, Hanses F, Heide W, Kallmuenzer B, Kermer P, Poli S, Royl G, Schellong S, Schnupp S, Schwarze J, Spies C, Thomalla G, von Mering M, Weissenborn K, Wollenweber F, Gumbinger C, Jaschinski U, Maschke M, Mochmann HC, Pfeilschifter W, Pohlmann C, Zahn R, Bouzat P, Schmidt J, Vallejo C, Floccard B, Coppens M, van Wissen S, Arellano-Rodrigo E, Valles E, Alikhan R, Breen K, Hall R, Crowther M, Albaladejo P, Cohen A, Demchuk A, Schmidt J, Wyse D, Garcia D, Prins M, Nakamya J, Büller H, Mahaffey KW, Alexander JH, Cairns J, Hart R, Joyner C, Raskob G, Schulman S, Veltkamp R, Meeks B, Zotova E, Ahmad S, Pinto T, Baker K, Dykstra A, Holadyk-Gris I, Malvaso A, Demchuk A. Final Study Report of Andexanet Alfa for Major Bleeding With Factor Xa Inhibitors. Circulation 2023; 147:1026-1038. [PMID: 36802876 DOI: 10.1161/circulationaha.121.057844] [Citation(s) in RCA: 20] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/22/2023]
Abstract
BACKGROUND Andexanet alfa is a modified recombinant inactive factor Xa (FXa) designed to reverse FXa inhibitors. ANNEXA-4 (Andexanet Alfa, a Novel Antidote to the Anticoagulation Effects of Factor Xa Inhibitors) was a multicenter, prospective, phase-3b/4, single-group cohort study that evaluated andexanet alfa in patients with acute major bleeding. The results of the final analyses are presented. METHODS Patients with acute major bleeding within 18 hours of FXa inhibitor administration were enrolled. Co-primary end points were anti-FXa activity change from baseline during andexanet alfa treatment and excellent or good hemostatic efficacy, defined by a scale used in previous reversal studies, at 12 hours. The efficacy population included patients with baseline anti-FXa activity levels above predefined thresholds (≥75 ng/mL for apixaban and rivaroxaban, ≥40 ng/mL for edoxaban, and ≥0.25 IU/mL for enoxaparin; reported in the same units used for calibrators) who were adjudicated as meeting major bleeding criteria (modified International Society of Thrombosis and Haemostasis definition). The safety population included all patients. Major bleeding criteria, hemostatic efficacy, thrombotic events (stratified by occurring before or after restart of either prophylactic [ie, a lower dose, for prevention rather than treatment] or full-dose oral anticoagulation), and deaths were assessed by an independent adjudication committee. Median endogenous thrombin potential at baseline and across the follow-up period was a secondary outcome. RESULTS There were 479 patients enrolled (mean age, 78 years; 54% male, 86% White; 81% anticoagulated for atrial fibrillation at a median time of 11.4 hours since last dose, with 245 (51%) on apixaban, 176 (37%) on rivaroxaban, 36 (8%) on edoxaban, and 22 (5%) on enoxaparin. Bleeding was predominantly intracranial (n=331 [69%]) or gastrointestinal (n=109 [23%]). In evaluable apixaban patients (n=172), median anti-FXa activity decreased from 146.9 ng/mL to 10.0 ng/mL (reduction, 93% [95% CI, 94-93]); in rivaroxaban patients (n=132), it decreased from 214.6 ng/mL to 10.8 ng/mL (94% [95% CI, 95-93]); in edoxaban patients (n=28), it decreased from 121.1 ng/mL to 24.4 ng/mL (71% [95% CI, 82-65); and in enoxaparin patients (n=17), it decreased from 0.48 IU/mL to 0.11 IU/mL (75% [95% CI, 79-67]). Excellent or good hemostasis occurred in 274 of 342 evaluable patients (80% [95% CI, 75-84]). In the safety population, thrombotic events occurred in 50 patients (10%); in 16 patients, this occurred during treatment with prophylactic anticoagulation that began after the bleeding event. No thrombotic episodes occurred after oral anticoagulation restart. Specific to certain populations, reduction of anti-FXa activity from baseline to nadir significantly predicted hemostatic efficacy in patients with intracranial hemorrhage (area under the receiver operating characteristic curve, 0.62 [95% CI, 0.54-0.70]) and correlated with lower mortality in patients <75 years of age (adjusted P=0.022; unadjusted P=0.003). Median endogenous thrombin potential was within the normal range by the end of andexanet alfa bolus through 24 hours for all FXa inhibitors. CONCLUSIONS In patients with major bleeding associated with the use of FXa inhibitors, treatment with andexanet alfa reduced anti-FXa activity and was associated with good or excellent hemostatic efficacy in 80% of patients. REGISTRATION URL: https://www. CLINICALTRIALS gov; Unique identifier: NCT02329327.
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Affiliation(s)
- Truman J Milling
- Seton Dell Medical School Stroke Institute, Dell Medical School, University of Texas at Austin (T.J.M.)
| | - Saskia Middeldorp
- Department of Internal Medicine and Radboud Institute of Health Sciences, Nijmegenthe Netherlands (S.M.)
| | - Lizhen Xu
- Population Health Research Institute, McMaster University, HamiltonOntario Canada. (L.X., A.S., S.J.C.)
| | - Bruce Koch
- Alexion, AstraZeneca Rare Disease, BostonMA (B.K.)
| | - Andrew Demchuk
- Departments of Clinical Neurosciences and Radiology, Cumming School of Medicine, University of Calgary, AlbertaCanada (A.D.)
| | - John W Eikelboom
- Department of Medicine, McMaster University, HamiltonOntario Canada. (J.W.E., M. Crowther)
| | - Peter Verhamme
- Center for Molecular and Vascular Biology, University of Leuven, Belgium (P.V.)
| | | | - Jan Beyer-Westendorf
- Department of Medicine I, Division of Hematology and Hemostasis, University Hospital Dresden, Germany (J.B-W.)
| | | | - Jose Lopez-Sendon
- Instituto de Investigación Hospital Universitario, La PazMadridSpain (J. L-S.)
| | - Mark Crowther
- Department of Medicine, McMaster University, HamiltonOntario Canada. (J.W.E., M. Crowther)
| | - Ashkan Shoamanesh
- Population Health Research Institute, McMaster University, HamiltonOntario Canada. (L.X., A.S., S.J.C.)
| | - Michiel Coppens
- Department of Vascular Medicine, Amsterdam Cardiovascular Sciences, Amsterdam University Medical Centers, University of Amsterdam, the Netherlands (M. Coppens)
| | - Jeannot Schmidt
- Centre Hospitalier Universitaire de Clermont-Ferrand, France (J.S.)
| | | | - Stuart J Connolly
- Population Health Research Institute, McMaster University, HamiltonOntario Canada. (L.X., A.S., S.J.C.)
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Marquez-Martinez S, Vijayan A, Khan S, Zahn R. Cell entry and innate sensing shape adaptive immune responses to adenovirus-based vaccines. Curr Opin Immunol 2023; 80:102282. [PMID: 36716578 DOI: 10.1016/j.coi.2023.102282] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Accepted: 01/05/2023] [Indexed: 01/30/2023]
Abstract
Nonreplicating adenovirus-based vectors have been successfully implemented as prophylactic vaccines against infectious viral diseases and induce protective cellular and humoral responses. Differences in the mechanisms of cellular entry or endosomal escape of these vectors contribute to differences in innate immune sensing between adenovirus species. Innate immune responses to adenovirus-based vaccines, such as interferon signaling, have been reported to affect the development of adaptive responses in preclinical studies, although limited data are available in humans. Understanding the mechanisms of these early events is critical for the development of vaccines that elicit effective and durable adaptive immune responses while maintaining an acceptable reactogenicity profile.
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Affiliation(s)
- Sonia Marquez-Martinez
- Janssen Vaccines & Prevention B.V., Archimedesweg 4-6, Leiden South Holland 2333 CN, the Netherlands.
| | - Aneesh Vijayan
- Janssen Vaccines & Prevention B.V., Archimedesweg 4-6, Leiden South Holland 2333 CN, the Netherlands
| | - Selina Khan
- Janssen Vaccines & Prevention B.V., Archimedesweg 4-6, Leiden South Holland 2333 CN, the Netherlands
| | - Roland Zahn
- Janssen Vaccines & Prevention B.V., Archimedesweg 4-6, Leiden South Holland 2333 CN, the Netherlands
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22
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Fu CHY, Erus G, Fan Y, Antoniades M, Arnone D, Arnott SR, Chen T, Choi KS, Fatt CC, Frey BN, Frokjaer VG, Ganz M, Garcia J, Godlewska BR, Hassel S, Ho K, McIntosh AM, Qin K, Rotzinger S, Sacchet MD, Savitz J, Shou H, Singh A, Stolicyn A, Strigo I, Strother SC, Tosun D, Victor TA, Wei D, Wise T, Woodham RD, Zahn R, Anderson IM, Deakin JFW, Dunlop BW, Elliott R, Gong Q, Gotlib IH, Harmer CJ, Kennedy SH, Knudsen GM, Mayberg HS, Paulus MP, Qiu J, Trivedi MH, Whalley HC, Yan CG, Young AH, Davatzikos C. AI-based dimensional neuroimaging system for characterizing heterogeneity in brain structure and function in major depressive disorder: COORDINATE-MDD consortium design and rationale. BMC Psychiatry 2023; 23:59. [PMID: 36690972 PMCID: PMC9869598 DOI: 10.1186/s12888-022-04509-7] [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] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Accepted: 12/29/2022] [Indexed: 01/24/2023] Open
Abstract
BACKGROUND Efforts to develop neuroimaging-based biomarkers in major depressive disorder (MDD), at the individual level, have been limited to date. As diagnostic criteria are currently symptom-based, MDD is conceptualized as a disorder rather than a disease with a known etiology; further, neural measures are often confounded by medication status and heterogeneous symptom states. METHODS We describe a consortium to quantify neuroanatomical and neurofunctional heterogeneity via the dimensions of novel multivariate coordinate system (COORDINATE-MDD). Utilizing imaging harmonization and machine learning methods in a large cohort of medication-free, deeply phenotyped MDD participants, patterns of brain alteration are defined in replicable and neurobiologically-based dimensions and offer the potential to predict treatment response at the individual level. International datasets are being shared from multi-ethnic community populations, first episode and recurrent MDD, which are medication-free, in a current depressive episode with prospective longitudinal treatment outcomes and in remission. Neuroimaging data consist of de-identified, individual, structural MRI and resting-state functional MRI with additional positron emission tomography (PET) data at specific sites. State-of-the-art analytic methods include automated image processing for extraction of anatomical and functional imaging variables, statistical harmonization of imaging variables to account for site and scanner variations, and semi-supervised machine learning methods that identify dominant patterns associated with MDD from neural structure and function in healthy participants. RESULTS We are applying an iterative process by defining the neural dimensions that characterise deeply phenotyped samples and then testing the dimensions in novel samples to assess specificity and reliability. Crucially, we aim to use machine learning methods to identify novel predictors of treatment response based on prospective longitudinal treatment outcome data, and we can externally validate the dimensions in fully independent sites. CONCLUSION We describe the consortium, imaging protocols and analytics using preliminary results. Our findings thus far demonstrate how datasets across many sites can be harmonized and constructively pooled to enable execution of this large-scale project.
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Affiliation(s)
- Cynthia H Y Fu
- Department of Psychological Sciences, University of East London, London, UK.
- Centre for Affective Disorders, Department of Psychological Medicine, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, UK.
| | - Guray Erus
- Center for Biomedical Image Computing and Analytics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, USA
| | - Yong Fan
- Center for Biomedical Image Computing and Analytics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, USA
| | - Mathilde Antoniades
- Center for Biomedical Image Computing and Analytics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, USA
| | - Danilo Arnone
- Centre for Affective Disorders, Department of Psychological Medicine, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, UK
- Department of Psychiatry and Behavioral Science, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates
| | | | - Taolin Chen
- Huaxi MR Research Center, Department of Radiology, West China Hospital, Sichuan University, Chengdu, China
- Research Unit of Psychoradiology, Chinese Academy of Medical Sciences, Chengdu, China
| | - Ki Sueng Choi
- Nash Family Center for Advanced Circuit Therapeutics, Icahn School of Medicine at Mount Sinai, New York, USA
| | - Cherise Chin Fatt
- Department of Psychiatry, Center for Depression Research and Clinical Care, University of Texas Southwestern Medical Center, Dallas, USA
| | - Benicio N Frey
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Canada
- Mood Disorders Treatment and Research Centre and Women's Health Concerns Clinic, St Joseph's Healthcare Hamilton, Hamilton, Canada
| | - Vibe G Frokjaer
- Neurobiology Research Unit, University Hospital Rigshospitalet, Copenhagen, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- Department of Psychiatry, Psychiatric Centre Copenhagen, Copenhagen, Denmark
| | - Melanie Ganz
- Neurobiology Research Unit, University Hospital Rigshospitalet, Copenhagen, Denmark
- Department of Computer Science, University of Copenhagen, Copenhagen, Denmark
| | - Jose Garcia
- Center for Biomedical Image Computing and Analytics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, USA
| | - Beata R Godlewska
- Department of Psychiatry, University of Oxford, Oxford, UK
- Oxford Health NHS Foundation Trust, Warneford Hospital, Oxford, UK
| | - Stefanie Hassel
- Mathison Centre for Mental Health Research and Education, University of Calgary, Calgary, Canada
- Department of Psychiatry, Cumming School of Medicine, University of Calgary, Calgary, Canada
| | - Keith Ho
- Department of Psychiatry, University Health Network, Toronto, Canada
| | - Andrew M McIntosh
- Division of Psychiatry, Royal Edinburgh Hospital, University of Edinburgh, Edinburgh, UK
| | - Kun Qin
- Huaxi MR Research Center, Department of Radiology, West China Hospital, Sichuan University, Chengdu, China
- Research Unit of Psychoradiology, Chinese Academy of Medical Sciences, Chengdu, China
| | - Susan Rotzinger
- Department of Psychiatry, University Health Network, Toronto, Canada
- Centre for Depression and Suicide Studies, Unity Health Toronto, Toronto, Canada
| | - Matthew D Sacchet
- Meditation Research Program, Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, USA
| | | | - Haochang Shou
- Center for Biomedical Image Computing and Analytics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, USA
- Penn Statistics in Imaging and Visualization Endeavor (PennSIVE) Center, Department of Biostatistics, Epidemiology and Informatics, University of Pennsylvania, Philadelphia, USA
| | - Ashish Singh
- Center for Biomedical Image Computing and Analytics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, USA
| | - Aleks Stolicyn
- Division of Psychiatry, Royal Edinburgh Hospital, University of Edinburgh, Edinburgh, UK
| | - Irina Strigo
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, USA
| | - Stephen C Strother
- Rotman Research Institute, Baycrest Centre, Toronto, Canada
- Department of Medical Biophysics, University of Toronto, Toronto, Canada
| | - Duygu Tosun
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, USA
| | | | - Dongtao Wei
- School of Psychology, Southwest University, Chongqing, China
| | - Toby Wise
- Department of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Rachel D Woodham
- Department of Psychological Sciences, University of East London, London, UK
| | - Roland Zahn
- Centre for Affective Disorders, Department of Psychological Medicine, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, UK
| | - Ian M Anderson
- Division of Neuroscience and Experimental Psychology, University of Manchester, Manchester, UK
| | - J F William Deakin
- Division of Neuroscience and Experimental Psychology, University of Manchester, Manchester, UK
| | - Boadie W Dunlop
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, USA
| | - Rebecca Elliott
- Division of Neuroscience and Experimental Psychology, University of Manchester, Manchester, UK
| | - Qiyong Gong
- Huaxi MR Research Center, Department of Radiology, West China Hospital, Sichuan University, Chengdu, China
- Research Unit of Psychoradiology, Chinese Academy of Medical Sciences, Chengdu, China
| | - Ian H Gotlib
- Department of Psychology, Stanford University, Stanford, USA
| | | | - Sidney H Kennedy
- Department of Psychiatry, University Health Network, Toronto, Canada
- Centre for Depression and Suicide Studies, Unity Health Toronto, Toronto, Canada
- Unity Health Toronto, Toronto, Canada
| | - Gitte M Knudsen
- Neurobiology Research Unit, University Hospital Rigshospitalet, Copenhagen, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Helen S Mayberg
- Nash Family Center for Advanced Circuit Therapeutics, Icahn School of Medicine at Mount Sinai, New York, USA
| | | | - Jiang Qiu
- School of Psychology, Southwest University, Chongqing, China
| | - Madhukar H Trivedi
- Department of Psychiatry, Center for Depression Research and Clinical Care, University of Texas Southwestern Medical Center, Dallas, USA
| | - Heather C Whalley
- Division of Psychiatry, Royal Edinburgh Hospital, University of Edinburgh, Edinburgh, UK
| | - Chao-Gan Yan
- CAS Key Laboratory of Behavioral Science, Institute of Psychology, Beijing, China
| | - Allan H Young
- Centre for Affective Disorders, Department of Psychological Medicine, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, UK
- South London and Maudsley NHS Foundation Trust, Bethlem Royal Hospital, London, UK
| | - Christos Davatzikos
- Center for Biomedical Image Computing and Analytics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, USA
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23
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Metzner A, Straube F, Tilz RR, Kuniss M, Noelker G, Tebbenjohanns J, Andresen D, Wieneke H, Stellbrink C, Franke J, Dorwarth U, Carion PL, Holbrook R, Hochadel M, Senges J, Hoffmann E, Kuck KH, Garcia-Alberola A, Massa T, Sabin G, Franke A, Souza JJ, Stanley A, Spitzer SG, Willems S, Dierk T, Chun KRJ, Borchard R, Seidl KH, Zahn R, Groschup G, Obel IWP, Brachmann J, Gerds-Li JH, Gopal RR, Schrickel J, Lewalter T, Stanley A, Moshage W, Eckardt L, Jung W, Kremer P, Lubinski A, Schumacher B, Lickfett L, Münzel T, Steinwender C, Efremidis M, Deneke T, Nguyen DQ. Electrophysiology lab efficiency comparison between cryoballoon and point-by-point radiofrequency ablation: a German sub-analysis of the FREEZE Cohort study. BMC Cardiovasc Disord 2023; 23:8. [PMID: 36624380 PMCID: PMC9830778 DOI: 10.1186/s12872-022-03015-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [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: 05/02/2022] [Accepted: 12/16/2022] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND Pulmonary vein isolation (PVI) is recommended to treat paroxysmal and persistent atrial fibrillation (AF). This analysis aimed to assess the hospital efficiency of single-shot cryoballoon ablation (CBA) and point-by-point radiofrequency ablation (RFA). METHODS The discrete event simulation used PVI procedure times from the FREEZE Cohort study to establish the electrophysiology (EP) lab occupancy time. 1000 EP lab days were simulated according to an illustrative German hospital, including 3 PVI cases per day using CBA at one site and RFA at the other. RESULTS The analysis included 1560 CBA patients and 1344 RFA patients from the FREEZE Cohort. Some baseline patients' characteristics were different between groups (age, AF type, and some concomitant diseases), without being statistically associated to ablation procedure time. Mean procedure time was 122.2 ± 39.4 min for CBA and 160.3 ± 53.5 min for RFA (p < 0.0001). RFA was associated with a more than five-fold increase of cumulative overtime compared to CBA over the simulated period (1285 h with RFA and 253 h with CBA). 70.7% of RFA lab days included overtime versus 25.7% for CBA. CBA was associated with more days with an additional hour at the end of the EP lab shift compared to RFA (47.8% vs 11.5% days with one hour left, respectively). CONCLUSION CBA is faster and more predictable than point-by-point RFA, and enables improvements in EP lab efficiency, including: fewer cumulative overtime hours, more days where overtime is avoided and more days with remaining time for the staff or for any EP lab usage. Clinical trial registration NCT01360008 (first registration 25/05/2011).
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Affiliation(s)
- Andreas Metzner
- Department of Cardiology, Asklepios Klinik St. Georg, Hamburg, Germany. .,Department of Cardiology, Universitätsklinikum Hamburg-Eppendorf, Martinistraße 52, Gebäude Ost 70, 20246, Hamburg, Germany.
| | - Florian Straube
- grid.419595.50000 0000 8788 1541Department of Cardiology and Internal Intensive Care Medicine, Heart Center Munich-Bogenhausen - Munich Municipal Hospital Group, Munich, Germany
| | - Roland R. Tilz
- grid.459389.a0000 0004 0493 1099Department of Cardiology, Asklepios Klinik St. Georg, Hamburg, Germany ,grid.412468.d0000 0004 0646 2097Department of Cardiology, Angiology, and Intensive Care Medicine, University Hospital Schleswig-Holstein, University Heart Centre Luebeck, Lübeck, Germany
| | - Malte Kuniss
- grid.419757.90000 0004 0390 5331Department of Cardiology, Kerckhoff-Klinik, Bad Nauheim, Germany
| | - Georg Noelker
- grid.418457.b0000 0001 0723 8327Herz- Und Diabeteszentrum Nordrhein-Westfalen, Bad Oeynhausen, Germany
| | - Juergen Tebbenjohanns
- HELIOS Klinikum Hildesheim, Medizinische Klinik I – Kardiologie, Hildesheim, Germany
| | - Dietrich Andresen
- grid.417953.d0000 0004 0560 5172Department of Cardiology Paul Gerhardt Diakonie gAG, Evangelisches Krankenhaus Hubertus, Berlin, Germany
| | - Heinrich Wieneke
- Klinik Für Kardiologie und Angiologie, Contilia Herz- Und Gefäßzentrum, Essen, Germany
| | - Christoph Stellbrink
- grid.461805.e0000 0000 9323 0964Department of Cardiology, Klinikum Bielefeld, Bielefeld, Germany
| | - Jennifer Franke
- grid.476904.8CardioVascular Center Frankfurt, Frankfurt, Germany
| | - Uwe Dorwarth
- grid.419595.50000 0000 8788 1541Department of Cardiology and Internal Intensive Care Medicine, Heart Center Munich-Bogenhausen - Munich Municipal Hospital Group, Munich, Germany
| | - Phuong Lien Carion
- grid.471158.e0000 0004 0384 6386Medtronic International Trading Sàrl, Tolochenaz, Switzerland
| | - Reece Holbrook
- grid.419673.e0000 0000 9545 2456Medtronic, Inc., Mounds View, MN USA
| | - Matthias Hochadel
- grid.488379.90000 0004 0402 5184Stiftung Institut Fur Herzinfarktforschung, Ludwigshafen, Germany
| | - Jochen Senges
- grid.488379.90000 0004 0402 5184Stiftung Institut Fur Herzinfarktforschung, Ludwigshafen, Germany
| | - Ellen Hoffmann
- grid.419595.50000 0000 8788 1541Department of Cardiology and Internal Intensive Care Medicine, Heart Center Munich-Bogenhausen - Munich Municipal Hospital Group, Munich, Germany
| | - Karl-Heinz Kuck
- grid.459389.a0000 0004 0493 1099Department of Cardiology, Asklepios Klinik St. Georg, Hamburg, Germany
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24
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Anmella G, Sanabra M, Primé-Tous M, Segú X, Solanes A, Ruíz V, Morilla I, Also Fontanet A, Sant E, Murgui S, Sans-Corrales M, Martínez-Aran A, Fico G, De Prisco M, Oliva V, Murru A, Zahn R, Young AH, Vicens V, Viñas-Bardolet C, Aparicio-Nogué V, Martínez-Cerdá JF, Mas A, Carreras B, Blanch J, Radua J, Fullana MA, Cavero M, Vieta E, Hidalgo-Mazzei D. Antidepressants overuse in primary care: Prescription trends between 2010 and 2019 in Catalonia. Rev Psiquiatr Salud Ment 2022:S1888-9891(22)00137-9. [PMID: 37758595 DOI: 10.1016/j.rpsm.2022.12.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Revised: 11/17/2022] [Accepted: 12/04/2022] [Indexed: 12/15/2022]
Abstract
INTRODUCTION There has been an increase in the prescription of antidepressants (AD) in primary care (PC). However, it is unclear whether this was explained by a rise in diagnoses with an indication for AD. We investigated the changes in frequency and the variables associated with AD prescription in Catalonia, Spain. METHODS We retrieved AD prescription, sociodemographic, and health-related data using individual electronic health records from a population-representative sample (N=947.698) attending PC between 2010 and 2019. Prescription of AD was calculated using DHD (Defined Daily Doses per 1000 inhabitants/day). We compared cumulative changes in DHD with cumulative changes in diagnoses with an indication for AD during the study period. We used Poisson regression to examine sociodemographic and health-related variables associated with AD prescription. RESULTS Both AD prescription and mental health diagnoses with an indication for AD gradually increased. At the end of the study period, DHD of AD prescriptions and mental health diagnoses with an indication for AD reached cumulative increases of 404% and 49% respectively. Female sex (incidence rate ratio (IRR)=2.83), older age (IRR=25.43), and lower socio-economic status (IRR=1.35) were significantly associated with increased risk of being prescribed an AD. CONCLUSIONS Our results from a large and representative cohort of patients confirm a steady increase of AD prescriptions that is not explained by a parallel increase in mental health diagnoses with an indication for AD. A trend on AD off-label and over-prescriptions in the PC system in Catalonia can be inferred from this dissociation.
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Affiliation(s)
- Gerard Anmella
- Department of Psychiatry and Psychology, Institute of Neuroscience, Hospital Clínic de Barcelona, Barcelona, Spain; Bipolar and Depressive Disorders Unit, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; University of Barcelona, Barcelona, Spain; Mental Health Research Networking Center (CIBERSAM), Madrid, Spain
| | - Miriam Sanabra
- Department of Psychiatry and Psychology, Institute of Neuroscience, Hospital Clínic de Barcelona, Barcelona, Spain; Bipolar and Depressive Disorders Unit, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Mireia Primé-Tous
- Department of Psychiatry and Psychology, Institute of Neuroscience, Hospital Clínic de Barcelona, Barcelona, Spain
| | - Xavier Segú
- Department of Psychiatry and Psychology, Institute of Neuroscience, Hospital Clínic de Barcelona, Barcelona, Spain
| | - Aleix Solanes
- Mental Health Research Networking Center (CIBERSAM), Madrid, Spain; Imaging of Mood- and Anxiety-Related Disorders (IMARD) Group, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Victoria Ruíz
- Department of Psychiatry and Psychology, Institute of Neuroscience, Hospital Clínic de Barcelona, Barcelona, Spain
| | - Ivette Morilla
- Department of Psychiatry and Psychology, Institute of Neuroscience, Hospital Clínic de Barcelona, Barcelona, Spain
| | - Antonieta Also Fontanet
- CAP Casanova, Consorci d'Atenció Primaria de Salut Barcelona Esquerra (CAPSBE), Barcelona, Spain
| | - Elisenda Sant
- CAP Casanova, Consorci d'Atenció Primaria de Salut Barcelona Esquerra (CAPSBE), Barcelona, Spain
| | - Sandra Murgui
- CAP Comte Borrell, Consorci d'Atenció Primaria de Salut Barcelona Esquerra (CAPSBE), Barcelona, Spain
| | - Mireia Sans-Corrales
- CAP Comte Borrell, Consorci d'Atenció Primaria de Salut Barcelona Esquerra (CAPSBE), Barcelona, Spain
| | - Anabel Martínez-Aran
- Department of Psychiatry and Psychology, Institute of Neuroscience, Hospital Clínic de Barcelona, Barcelona, Spain; Bipolar and Depressive Disorders Unit, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; University of Barcelona, Barcelona, Spain; Mental Health Research Networking Center (CIBERSAM), Madrid, Spain
| | - Giovanna Fico
- Department of Psychiatry and Psychology, Institute of Neuroscience, Hospital Clínic de Barcelona, Barcelona, Spain; Bipolar and Depressive Disorders Unit, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; University of Barcelona, Barcelona, Spain; Mental Health Research Networking Center (CIBERSAM), Madrid, Spain
| | - Michele De Prisco
- Department of Psychiatry and Psychology, Institute of Neuroscience, Hospital Clínic de Barcelona, Barcelona, Spain; Bipolar and Depressive Disorders Unit, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; University of Barcelona, Barcelona, Spain; Mental Health Research Networking Center (CIBERSAM), Madrid, Spain
| | - Vincenzo Oliva
- Department of Psychiatry and Psychology, Institute of Neuroscience, Hospital Clínic de Barcelona, Barcelona, Spain; Bipolar and Depressive Disorders Unit, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; University of Barcelona, Barcelona, Spain; Mental Health Research Networking Center (CIBERSAM), Madrid, Spain
| | - Andrea Murru
- Department of Psychiatry and Psychology, Institute of Neuroscience, Hospital Clínic de Barcelona, Barcelona, Spain; Bipolar and Depressive Disorders Unit, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; University of Barcelona, Barcelona, Spain; Mental Health Research Networking Center (CIBERSAM), Madrid, Spain
| | - Roland Zahn
- Centre for Affective Disorders, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom
| | - Allan H Young
- Centre for Affective Disorders, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom
| | | | - Clara Viñas-Bardolet
- Data Analytics Programme for Health Research and Innovation (PADRIS), Catalan Agency for Health Quality and Evaluation (AQuAS), Barcelona, Spain
| | - Vicenç Aparicio-Nogué
- Data Analytics Programme for Health Research and Innovation (PADRIS), Catalan Agency for Health Quality and Evaluation (AQuAS), Barcelona, Spain
| | - Juan Francisco Martínez-Cerdá
- Data Analytics Programme for Health Research and Innovation (PADRIS), Catalan Agency for Health Quality and Evaluation (AQuAS), Barcelona, Spain
| | - Ariadna Mas
- Department of Psychiatry and Psychology, Institute of Neuroscience, Hospital Clínic de Barcelona, Barcelona, Spain; Bipolar and Depressive Disorders Unit, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Bernat Carreras
- Department of Psychiatry and Psychology, Institute of Neuroscience, Hospital Clínic de Barcelona, Barcelona, Spain
| | - Jordi Blanch
- Department of Psychiatry and Psychology, Institute of Neuroscience, Hospital Clínic de Barcelona, Barcelona, Spain; University of Barcelona, Barcelona, Spain; Abi Global Health, Spain; Mental Health and Addiction Programme, Department of Health, Generalitat de Catalunya, Barcelona, Spain; President of the European Association of Psychosomatic Medicine, Spain
| | - Joaquim Radua
- Mental Health Research Networking Center (CIBERSAM), Madrid, Spain; Imaging of Mood- and Anxiety-Related Disorders (IMARD) Group, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Early Psychosis: Interventions and Clinical-detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom; Centre for Psychiatric Research and Education, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Miquel A Fullana
- Department of Psychiatry and Psychology, Institute of Neuroscience, Hospital Clínic de Barcelona, Barcelona, Spain; Mental Health Research Networking Center (CIBERSAM), Madrid, Spain; Imaging of Mood- and Anxiety-Related Disorders (IMARD) Group, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Myriam Cavero
- Department of Psychiatry and Psychology, Institute of Neuroscience, Hospital Clínic de Barcelona, Barcelona, Spain; University of Barcelona, Barcelona, Spain; Mental Health Research Networking Center (CIBERSAM), Madrid, Spain
| | - Eduard Vieta
- Department of Psychiatry and Psychology, Institute of Neuroscience, Hospital Clínic de Barcelona, Barcelona, Spain; Bipolar and Depressive Disorders Unit, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; University of Barcelona, Barcelona, Spain; Mental Health Research Networking Center (CIBERSAM), Madrid, Spain
| | - Diego Hidalgo-Mazzei
- Department of Psychiatry and Psychology, Institute of Neuroscience, Hospital Clínic de Barcelona, Barcelona, Spain; Bipolar and Depressive Disorders Unit, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; University of Barcelona, Barcelona, Spain; Mental Health Research Networking Center (CIBERSAM), Madrid, Spain; Centre for Affective Disorders, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom.
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25
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Kleemann T, Lampropoulou E, Kouraki K, Strauss M, Fendt A, Mohammad O, Zahn R. The role of trigger factors in the occurrence of appropriate ICD shocks and their prognostic implications. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.724] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
The role of triggers in the occurrence of appropriate ICD shocks due to ventricular tachyarrhythmias is not well known. The aim of the study was to assess the prevalence of trigger factors in appropriate ICD shocks and to analyze their prognostic impact on clinical outcome.
Methods
A total of 710 consecutive patients of a prospective single-centre ICD-registry who received a first appropriate ICD shock between 2000 and 9/2021 were analyzed.
Results
In 35% of ICD patients with first ICD shock, at least one of the following triggers was found: Ischemia (22%), Compliance (9%), Decompensation (38%), Stress (12%), Technical (5%), Electrolyte/endocrinological disorder (22%) and Medication intoxication (4%) (Table 1). The trigger factors can be summarized under the acronym ICD-STEMi. Patients with trigger associated ICD shocks had a more depressed ejection fraction and presented more often with ventricular fibrillation or electrical storm. The therapy after VT/VF shock in the trigger group comprised trigger optimization in 100% and heart failure optimization in 21% as compared to 0% respectively 10% in the no-trigger group (p<0.001). The ventricular arrhythmia therapy (antiarrhythmics or VT ablation) was not different between both groups (35% in each group). Patients with triggered first ICD shock had an increased 5-year mortality rate (50% versus 38%, p<0.001) (Figure 1).
Conclusions
In one third of ICD patients with first appropriate ICD shock, at least one trigger can be identified. Finding a trigger strongly influenced therapy after VT/VF shock. Patients with triggered ICD shock have a higher 5-year mortality rate. The evaluation of trigger factors after the occurrence of ICD shocks is mandatory and can be systematically evaluated using the acronym ICD-STEMi.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- T Kleemann
- Klinikum Ludwigshafen , Ludwigshafen , Germany
| | | | - K Kouraki
- Klinikum Ludwigshafen , Ludwigshafen , Germany
| | - M Strauss
- Klinikum Ludwigshafen , Ludwigshafen , Germany
| | - A Fendt
- Klinikum Ludwigshafen , Ludwigshafen , Germany
| | - O Mohammad
- Klinikum Ludwigshafen , Ludwigshafen , Germany
| | - R Zahn
- Klinikum Ludwigshafen , Ludwigshafen , Germany
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26
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Zeymer U, Hochadel M, Schaechinger V, Zahn R. Comparative efficacy and safety of ticagrelor vs. prasugrel in patients undergoing PCI for NSTE-ACS. Results of the prospective ALKK-Registry. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.1388] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Dual antiplatelet therapy with aspirin and a P2Y12 inhibitor has become standard of care for patients with NSTE-ACS. Guidelines recommend prasugrel and ticagrelor over clopidogrel. In the ISAR-5 trial prasugrel was superior to ticagrelor in NSTE-ACS patients. We evaluated the outcome of patients undergoing PCI for NSTE-ACS in a large number of patients in real life and compared patients treated with prasugrel and ticagrelor.
Methods
We used the data of the prospective German ALKK-PCI registry and included patients treated with prasugrel or ticagrelor and undergoing PCI for NSTE-ACS treated in 42 centers. Baseline variables, procedural features, antithrombotic therapies and in-hospital outcomes were centrally collected and analysed. Patients with cardiogenic shock were excluded.
Results
Between 2011 and 2020 a total of 7888 patients <75 years without prior stroke undergoing PCI for NSTE-ACS were included. Of these 4905 (62.2%) patients were treated with ticagrelor and 2983 (37.8%) were treated with prasugrel. Baseline characteristics, procedural features and in-hospital outcomes are given in the table.
Conclusion
In clinical practice in patients with NSTE-ACS undergoing PCI ticagrelor was used more often than prasugrel. Ticagrelor treated patients were older and had more comorbidities. Despite this higher risk profile in ticagrelor patients the in-hospital mortality and the short-term safety profile were comparable in both groups.
Funding Acknowledgement
Type of funding sources: Foundation. Main funding source(s): Institut für Herzinfarktforschung Ludwigshafen
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Affiliation(s)
- U Zeymer
- Klinikum Ludwigshafen , Ludwigshafen , Germany
| | - M Hochadel
- Stiftung Institut fuer Herzinfarktforschung , Ludwigshafen , Germany
| | | | - R Zahn
- Klinikum Ludwigshafen , Ludwigshafen , Germany
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27
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Cross RW, Longini IM, Becker S, Bok K, Boucher D, Carroll MW, Díaz JV, Dowling WE, Draghia-Akli R, Duworko JT, Dye JM, Egan MA, Fast P, Finan A, Finch C, Fleming TR, Fusco J, Geisbert TW, Griffiths A, Günther S, Hensley LE, Honko A, Hunegnaw R, Jakubik J, Ledgerwood J, Luhn K, Matassov D, Meshulam J, Nelson EV, Parks CL, Rustomjee R, Safronetz D, Schwartz LM, Smith D, Smock P, Sow Y, Spiropoulou CF, Sullivan NJ, Warfield KL, Wolfe D, Woolsey C, Zahn R, Henao-Restrepo AM, Muñoz-Fontela C, Marzi A. An introduction to the Marburg virus vaccine consortium, MARVAC. PLoS Pathog 2022; 18:e1010805. [PMID: 36227853 PMCID: PMC9560149 DOI: 10.1371/journal.ppat.1010805] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023] Open
Abstract
The emergence of Marburg virus (MARV) in Guinea and Ghana triggered the assembly of the MARV vaccine "MARVAC" consortium representing leaders in the field of vaccine research and development aiming to facilitate a rapid response to this infectious disease threat. Here, we discuss current progress, challenges, and future directions for MARV vaccines.
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Affiliation(s)
- Robert W. Cross
- Galveston National Laboratory, and Department of Microbiology and Immunology, University of Texas Medical Branch, Galveston, Texas, United States of America
| | - Ira M. Longini
- Department of Biostatistics, University of Florida, Gainesville, Florida, United States of America
| | - Stephan Becker
- Institute for Virology, Philipps-Universität Marburg, Marburg, Germany
| | - Karin Bok
- Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland, United States of America
| | - David Boucher
- U.S. COVID-19 Response at U.S. Department of Health and Human Services, Washington, DC, United States of America
| | - Miles W. Carroll
- Pandemic Sciences Institute, Nuffield Department of Medicine, Oxford University, United Kingdom
| | | | - William E. Dowling
- Coalition for Epidemic Preparedness Innovations (CEPI), Washington, Washington, DC, United States of America
| | - Ruxandra Draghia-Akli
- Johnson & Johnson—Global Public Health Research and Development, Spring House, Pennsylvania, United States of America
| | - James T. Duworko
- Partnership for Research on Infectious Diseases in Liberia, Monrovia, Liberia
| | - John M. Dye
- Virology Division, United States Army Medical Research Institute of Infectious Diseases, Frederick, Maryland, United States of America
| | - Michael A. Egan
- Auro Vaccines, Pearl River, New York, United States of America
| | | | - Amy Finan
- Sabin vaccine Institute, Washington, DC, United States of America
| | - Courtney Finch
- Sabin vaccine Institute, Washington, DC, United States of America
| | - Thomas R. Fleming
- University of Washington, Seattle, Washington, United States of America
| | - Joan Fusco
- Public Health Vaccines, Cambridge, Massachusetts, United States of America
| | - Thomas W. Geisbert
- Galveston National Laboratory, and Department of Microbiology and Immunology, University of Texas Medical Branch, Galveston, Texas, United States of America
| | - Anthony Griffiths
- National Emerging Infectious Diseases Laboratories, Boston University School of Medicine, Boston, Maryland, United States of America
| | - Stephan Günther
- Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany
| | - Lisa E. Hensley
- Integrated Research Facility, Division of Clinical Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Frederick, Maryland, United States of America
| | - Anna Honko
- National Emerging Infectious Diseases Laboratories, Boston University School of Medicine, Boston, Maryland, United States of America
| | - Ruth Hunegnaw
- Immune Biology of Retroviral Infection Section, Vaccine Branch, National Cancer Institute, National Institutes of Health, Bethesda, Maryland, United States of America
| | - Jocelyn Jakubik
- Sabin vaccine Institute, Washington, DC, United States of America
| | - Julie Ledgerwood
- Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland, United States of America
| | - Kerstin Luhn
- Janssen Vaccines & Prevention, Leiden, the Netherlands
| | | | | | - Emily V. Nelson
- Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany
| | | | - Roxana Rustomjee
- Sabin vaccine Institute, Washington, DC, United States of America
| | - David Safronetz
- Zoonotic Diseases and Special Pathogens Division, National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, Manitoba, Canada
| | | | - Dean Smith
- Bacterial and Combination Vaccines, Public Health Agency of Canada, Ottawa, Ontario, Canada
| | - Paul Smock
- Sabin vaccine Institute, Washington, DC, United States of America
| | - Ydrissa Sow
- Collaborative Clinical Research Branch, Division of Clinical Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Rockville, Maryland, United States of America
| | - Christina F. Spiropoulou
- Viral Special Pathogens Branch, Division of High-Consequence Pathogens and Pathology, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Nancy J. Sullivan
- Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland, United States of America
| | - Kelly L. Warfield
- Emergent BioSolutions, Gaithersburg, Maryland, United States of America
| | - Daniel Wolfe
- Bacterial and Combination Vaccines, Public Health Agency of Canada, Ottawa, Ontario, Canada
| | - Courtney Woolsey
- Galveston National Laboratory, and Department of Microbiology and Immunology, University of Texas Medical Branch, Galveston, Texas, United States of America
| | - Roland Zahn
- Janssen Vaccines & Prevention, Leiden, the Netherlands
| | | | | | - Andrea Marzi
- Laboratory of Virology, Division of Intramural Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Hamilton, Montana, United States of America
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28
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Tiemessen MM, Solforosi L, Dekking L, Czapska-Casey D, Serroyen J, Sullivan NJ, Volkmann A, Pau MG, Callendret B, Schuitemaker H, Luhn K, Zahn R, Roozendaal R. Protection against Marburg Virus and Sudan Virus in NHP by an Adenovector-Based Trivalent Vaccine Regimen Is Correlated to Humoral Immune Response Levels. Vaccines (Basel) 2022; 10:1263. [PMID: 36016151 PMCID: PMC9412258 DOI: 10.3390/vaccines10081263] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [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] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Revised: 07/21/2022] [Accepted: 08/01/2022] [Indexed: 11/20/2022] Open
Abstract
The Marburg virus (MARV) and Sudan virus (SUDV) belong to the filovirus family. The sporadic human outbreaks occur mostly in Africa and are characterized by an aggressive disease course with high mortality. The first case of Marburg virus disease in Guinea in 2021, together with the increased frequency of outbreaks of Ebola virus (EBOV), which is also a filovirus, accelerated the interest in potential prophylactic vaccine solutions against multiple filoviruses. We previously tested a two-dose heterologous vaccine regimen (Ad26.Filo, MVA-BN-Filo) in non-human primates (NHP) and showed a fully protective immune response against both SUDV and MARV in addition to the already-reported protective effect against EBOV. The vaccine-induced glycoprotein (GP)-binding antibody levels appear to be good predictors of the NHP challenge outcome as indicated by the correlation between antibody levels and survival outcome as well as the high discriminatory capacity of the logistic model. Moreover, the elicited GP-specific binding antibody response against EBOV, SUDV, and MARV remains stable for more than 1 year. Overall, the NHP data indicate that the Ad26.Filo, MVA-BN-Filo regimen may be a good candidate for a prophylactic vaccination strategy in regions at high risk of filovirus outbreaks.
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Affiliation(s)
- Machteld M. Tiemessen
- Janssen Vaccines & Prevention B.V., Archimedesweg 6, 2333 CN Leiden, The Netherlands
| | - Laura Solforosi
- Janssen Vaccines & Prevention B.V., Archimedesweg 6, 2333 CN Leiden, The Netherlands
| | - Liesbeth Dekking
- Janssen Vaccines & Prevention B.V., Archimedesweg 6, 2333 CN Leiden, The Netherlands
| | | | - Jan Serroyen
- Janssen Vaccines & Prevention B.V., Archimedesweg 6, 2333 CN Leiden, The Netherlands
| | - Nancy J. Sullivan
- Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD 20892, USA
| | - Ariane Volkmann
- Bavarian Nordic GmbH, Fraunhoferstrasse 13, D-82152 Martinsried, Germany
| | - Maria Grazia Pau
- Janssen Vaccines & Prevention B.V., Archimedesweg 6, 2333 CN Leiden, The Netherlands
| | - Benoit Callendret
- Janssen Vaccines & Prevention B.V., Archimedesweg 6, 2333 CN Leiden, The Netherlands
| | - Hanneke Schuitemaker
- Janssen Vaccines & Prevention B.V., Archimedesweg 6, 2333 CN Leiden, The Netherlands
| | - Kerstin Luhn
- Janssen Vaccines & Prevention B.V., Archimedesweg 6, 2333 CN Leiden, The Netherlands
| | - Roland Zahn
- Janssen Vaccines & Prevention B.V., Archimedesweg 6, 2333 CN Leiden, The Netherlands
| | - Ramon Roozendaal
- Janssen Vaccines & Prevention B.V., Archimedesweg 6, 2333 CN Leiden, The Netherlands
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29
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Strawbridge R, McCrone P, Ulrichsen A, Zahn R, Eberhard J, Wasserman D, Brambilla P, Schiena G, Hegerl U, Balazs J, Caldas de Almeida J, Antunes A, Baltzis S, Carli V, Quoidbach V, Boyer P, Young AH. Care pathways for people with major depressive disorder: a European Brain Council Value of Treatment study. Eur Psychiatry 2022; 65:1-21. [PMID: 35703080 PMCID: PMC9280921 DOI: 10.1192/j.eurpsy.2022.28] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Revised: 05/19/2022] [Accepted: 05/19/2022] [Indexed: 11/23/2022] Open
Abstract
Background Despite well-established guidelines for managing major depressive disorder, its extensive disability burden persists. This Value of Treatment mission from the European Brain Council aimed to elucidate the nature and extent of “gaps” between best-practice and current-practice care, specifically to:Identify current treatment gaps along the care pathway and determine the extent of these gaps in comparison with the stepped-care model and Recommend policies intending to better meet patient needs (i.e., minimize treatment gaps). Methods After agreement upon a set of relevant treatment gaps, data pertaining to each gap were gathered and synthesized from several sources across six European countries. Subsequently, a modified Delphi approach was undertaken to attain consensus among an expert panel on proposed recommendations for minimizing treatment gaps. Results Four recommendations were made to increase the depression diagnosis rate (from ~50% episodes), aiming to both increase the number of patients seeking help, and the likelihood of a practitioner to correctly detect depression. These should reduce time to treatment (from ~1 to ~8 years after illness onset) and increase rates of treatment; nine further recommendations aimed to increase rates of treatment (from ~25 to ~50% of patients currently treated), mainly focused on targeting the best treatment to each patient. To improve follow-up after treatment initiation (from ~30 to ~65% followed up within 3 months), seven recommendations focused on increasing continuity of care. For those not responding, 10 recommendations focused on ensuring access to more specialist care (currently at rates of ~5–25% of patients). Conclusions The treatment gaps in depression care are substantial and concerning, from the proportion of people not entering care pathways to those stagnating in primary care with impairing and persistent illness. A wide range of recommendations can be made to enhance care throughout the pathway.
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Affiliation(s)
- Rebecca Strawbridge
- Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, United Kingdom
| | - Paul McCrone
- Centre for Mental Health, University of Greenwich, London, United Kingdom
| | - Andrea Ulrichsen
- Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, United Kingdom
| | - Roland Zahn
- Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, United Kingdom
| | - Jonas Eberhard
- Division of Psychiatry, Department of Clinical Sciences, Lund University, Lund, Sweden
| | - Danuta Wasserman
- National Centre for Suicide Research and Prevention of Mental Ill-Health, Karolinska Institutet, Stockholm, Sweden
| | - Paolo Brambilla
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - Giandomenico Schiena
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Ulrich Hegerl
- Department of Psychiatry, Psychosomatics and Psychotherapy, Goethe University, Frankfurt, Germany
| | - Judit Balazs
- Institute of Psychology, Eötvös Loránd University, Budapest, Hungary
- Department of Psychology, Bjørknes University College, Oslo, Norway
| | - Jose Caldas de Almeida
- Chronic Diseases Research Center, Nova Medical School, Nova University of Lisbon, Lisbon, Portugal
| | - Ana Antunes
- Chronic Diseases Research Center, Nova Medical School, Nova University of Lisbon, Lisbon, Portugal
| | - Spyridon Baltzis
- Division of Psychiatry, Department of Clinical Sciences, Lund University, Lund, Sweden
| | - Vladmir Carli
- National Centre for Suicide Research and Prevention of Mental Ill-Health, Karolinska Institutet, Stockholm, Sweden
| | | | | | - Allan H. Young
- Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, United Kingdom
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30
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Lythe KE, Gethin JA, Workman CI, Lambon Ralph MA, Deakin JFW, Moll J, Zahn R. Subgenual activation and the finger of blame: individual differences and depression vulnerability. Psychol Med 2022; 52:1560-1568. [PMID: 32972471 DOI: 10.1017/s0033291720003372] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [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] [Indexed: 01/05/2023]
Abstract
BACKGROUND Subgenual cingulate cortex (SCC) responses to self-blaming emotion-evoking stimuli were previously found in individuals prone to self-blame with and without a history of major depressive disorder (MDD). This suggested SCC activation reflects self-blaming emotions such as guilt, which are central to models of MDD vulnerability. METHOD Here, we re-examined these hypotheses in an independent larger sample. A total of 109 medication-free participants (70 with remitted MDD and 39 healthy controls) underwent fMRI whilst judging self- and other-blaming emotion-evoking statements. They also completed validated questionnaires of proneness to self-blaming emotions including those related to internal (autonomy) and external (sociotropy) evaluation, which were subjected to factor analysis. RESULTS An interaction between group (remitted MDD v. Control) and condition (self- v. other-blame) was observed in the right SCC (BA24). This was due to higher SCC signal for self-blame in remitted MDD and higher other-blame-selective activation in Control participants. Across the whole sample, extracted SCC activation cluster averages for self- v. other-blame were predicted by a regression model which included the reliable components derived from our factor analysis of measures of proneness to self-blaming emotions. Interestingly, this prediction was solely driven by autonomy/self-criticism, and adaptive guilt factors, with no effect of sociotropy/dependency. CONCLUSIONS Despite confirming the prediction of SCC activation in self-blame-prone individuals and those vulnerable to MDD, our results suggest that SCC activation reflects blame irrespective of where it is directed rather than selective for self. We speculate that self-critical individuals have more extended SCC representations for blame in the context of self-agency.
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Affiliation(s)
- Karen E Lythe
- The University of Manchester & Manchester Academic Health Sciences Centre, School of Psychological Sciences, Neuroscience and Aphasia Research Unit, Manchester, M13 9PL, UK
| | - Jennifer A Gethin
- The University of Manchester & Manchester Academic Health Sciences Centre, School of Psychological Sciences, Neuroscience and Aphasia Research Unit, Manchester, M13 9PL, UK
| | - Clifford I Workman
- The University of Manchester & Manchester Academic Health Sciences Centre, School of Psychological Sciences, Neuroscience and Aphasia Research Unit, Manchester, M13 9PL, UK
- The University of Manchester & Manchester Academic Health Sciences Centre, Institute of Brain, Behaviour and Mental Health, Neuroscience & Psychiatry Unit, Manchester, M13 9PL, UK
| | - Matthew A Lambon Ralph
- The University of Manchester & Manchester Academic Health Sciences Centre, School of Psychological Sciences, Neuroscience and Aphasia Research Unit, Manchester, M13 9PL, UK
- MRC Cognition and Brain Sciences Unit, University of Cambridge, 15 Chaucer Road, Cambridge, CB2 7EF, UK
| | - John F W Deakin
- The University of Manchester & Manchester Academic Health Sciences Centre, Institute of Brain, Behaviour and Mental Health, Neuroscience & Psychiatry Unit, Manchester, M13 9PL, UK
| | - Jorge Moll
- Cognitive and Behavioral Neuroscience Unit, D'Or Institute for Research and Education (IDOR), 22280-080 - Rio de Janeiro, RJ, Brazil
| | - Roland Zahn
- The University of Manchester & Manchester Academic Health Sciences Centre, School of Psychological Sciences, Neuroscience and Aphasia Research Unit, Manchester, M13 9PL, UK
- Cognitive and Behavioral Neuroscience Unit, D'Or Institute for Research and Education (IDOR), 22280-080 - Rio de Janeiro, RJ, Brazil
- Institute of Psychiatry, Psychology & Neuroscience, Department of Psychological Medicine, Centre for Affective Disorders, King's College London, London, SE5 8AZ, UK
- National Service for Affective Disorders, South London and Maudsley NHS Foundation Trust, London, SE5 8AZ, UK
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31
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He X, Aid M, Chandrashekar A, Yu J, McMahan K, Wegmann F, Jacob-Dolan C, Maron JS, Atyeo C, Wan H, Sellers D, Liu J, Lifton M, Gardner S, Bondzie EA, Barrett J, Ahmad K, Anioke T, Yalley-Ogunro J, Muench J, Goode A, Andersen H, Lewis MG, Alter G, Schuitemaker H, Zahn R, Barouch DH. A homologous or variant booster vaccine after Ad26.COV2.S immunization enhances SARS-CoV-2-specific immune responses in rhesus macaques. Sci Transl Med 2022; 14:eabm4996. [PMID: 35191769 PMCID: PMC9802654 DOI: 10.1126/scitranslmed.abm4996] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Accepted: 02/11/2022] [Indexed: 01/12/2023]
Abstract
Ad26.COV2.S has demonstrated durability and clinical efficacy against symptomatic COVID-19 in humans. In this study, we report the correlates of durability of humoral and cellular immune responses in 20 rhesus macaques immunized with single-shot Ad26.COV2.S and the immunogenicity of a booster shot at 8 to 10 months after the initial immunization. Ad26.COV2.S elicited durable binding and neutralizing antibodies as well as memory B cells and long-lived bone marrow plasma cells. Innate immune responses and bone marrow plasma cell responses correlated with durable antibody responses. After Ad26.COV2.S boost immunization, binding and neutralizing antibody responses against multiple SARS-CoV-2 variants increased 31- to 69-fold and 23- to 43-fold, respectively, compared with preboost concentrations. Antigen-specific B cell and T cell responses also increased substantially after the boost immunization. Boosting with a modified Ad26.COV2.S.351 vaccine expressing the SARS-CoV-2 spike protein from the beta variant led to largely comparable responses with slightly higher beta- and omicron-specific humoral immune responses. These data demonstrate that a late boost with Ad26.COV2.S or Ad26.COV2.S.351 resulted in a marked increase in humoral and cellular immune responses that were highly cross-reactive across multiple SARS-CoV-2 variants in rhesus macaques.
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Affiliation(s)
- Xuan He
- Center for Virology and Vaccine Research, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02215, USA
| | - Malika Aid
- Center for Virology and Vaccine Research, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02215, USA
| | - Abishek Chandrashekar
- Center for Virology and Vaccine Research, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02215, USA
| | - Jingyou Yu
- Center for Virology and Vaccine Research, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02215, USA
| | - Katherine McMahan
- Center for Virology and Vaccine Research, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02215, USA
| | - Frank Wegmann
- Janssen Vaccines and Prevention, Leiden, Netherlands
| | - Catherine Jacob-Dolan
- Center for Virology and Vaccine Research, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02215, USA
- Harvard Medical School, Boston, MA 02115, USA
| | - Jenny S. Maron
- Harvard Medical School, Boston, MA 02115, USA
- Ragon Institute of MGH, MIT and Harvard, Cambridge, MA 02139, USA
| | - Caroline Atyeo
- Harvard Medical School, Boston, MA 02115, USA
- Ragon Institute of MGH, MIT and Harvard, Cambridge, MA 02139, USA
| | - Huahua Wan
- Center for Virology and Vaccine Research, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02215, USA
| | - Daniel Sellers
- Center for Virology and Vaccine Research, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02215, USA
| | - Jinyan Liu
- Center for Virology and Vaccine Research, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02215, USA
| | - Michelle Lifton
- Center for Virology and Vaccine Research, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02215, USA
| | - Sarah Gardner
- Center for Virology and Vaccine Research, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02215, USA
| | - Esther A. Bondzie
- Center for Virology and Vaccine Research, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02215, USA
| | - Julia Barrett
- Center for Virology and Vaccine Research, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02215, USA
| | - Kunza Ahmad
- Center for Virology and Vaccine Research, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02215, USA
| | - Tochi Anioke
- Center for Virology and Vaccine Research, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02215, USA
| | | | | | | | | | | | - Galit Alter
- Harvard Medical School, Boston, MA 02115, USA
- Ragon Institute of MGH, MIT and Harvard, Cambridge, MA 02139, USA
| | - Hanneke Schuitemaker
- Janssen Vaccines and Prevention, Leiden, Netherlands
- Amsterdam University Medical Center, Amsterdam, Netherlands
| | - Roland Zahn
- Janssen Vaccines and Prevention, Leiden, Netherlands
| | - Dan H. Barouch
- Center for Virology and Vaccine Research, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02215, USA
- Harvard Medical School, Boston, MA 02115, USA
- Ragon Institute of MGH, MIT and Harvard, Cambridge, MA 02139, USA
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32
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Rutherford S, Fraza C, Dinga R, Kia SM, Wolfers T, Zabihi M, Berthet P, Worker A, Verdi S, Andrews D, Han LK, Bayer JM, Dazzan P, McGuire P, Mocking RT, Schene A, Sripada C, Tso IF, Duval ER, Chang SE, Penninx BW, Heitzeg MM, Burt SA, Hyde LW, Amaral D, Wu Nordahl C, Andreasssen OA, Westlye LT, Zahn R, Ruhe HG, Beckmann C, Marquand AF. Charting brain growth and aging at high spatial precision. eLife 2022; 11:72904. [PMID: 35101172 PMCID: PMC8828052 DOI: 10.7554/elife.72904] [Citation(s) in RCA: 37] [Impact Index Per Article: 18.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Accepted: 01/26/2022] [Indexed: 11/28/2022] Open
Abstract
Defining reference models for population variation, and the ability to study individual deviations is essential for understanding inter-individual variability and its relation to the onset and progression of medical conditions. In this work, we assembled a reference cohort of neuroimaging data from 82 sites (N=58,836; ages 2-100) and used normative modeling to characterize lifespan trajectories of cortical thickness and subcortical volume. Models are validated against a manually quality checked subset (N=24,354) and we provide an interface for transferring to new data sources. We showcase the clinical value by applying the models to a transdiagnostic psychiatric sample (N=1985), showing they can be used to quantify variability underlying multiple disorders whilst also refining case-control inferences. These models will be augmented with additional samples and imaging modalities as they become available. This provides a common reference platform to bind results from different studies and ultimately paves the way for personalized clinical decision-making.
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Affiliation(s)
- Saige Rutherford
- Donders Institute for Brain, Cognition, and Behavior, Radboud University, Nijmegen, Netherlands.,Department of Cognitive Neuroscience, Radboud University Medical Center, Nijmegen, Netherlands.,Department of Psychiatry, University of Michigan, Ann Arbor, United States
| | - Charlotte Fraza
- Donders Institute for Brain, Cognition, and Behavior, Radboud University, Nijmegen, Netherlands.,Department of Cognitive Neuroscience, Radboud University Medical Center, Nijmegen, Netherlands
| | - Richard Dinga
- Donders Institute for Brain, Cognition, and Behavior, Radboud University, Nijmegen, Netherlands.,Department of Cognitive Neuroscience, Radboud University Medical Center, Nijmegen, Netherlands
| | - Seyed Mostafa Kia
- Donders Institute for Brain, Cognition, and Behavior, Radboud University, Nijmegen, Netherlands.,Department of Cognitive Neuroscience, Radboud University Medical Center, Nijmegen, Netherlands.,Department of Psychiatry, Utrecht University Medical Center, Utrecht, Netherlands
| | - Thomas Wolfers
- Department of Psychology, University of Oslo, Oslo, Norway.,Norwegian Center for Mental Disorders Research (NORMENT), University of Oslo, and Oslo University Hospital, Oslo, Norway
| | - Mariam Zabihi
- Donders Institute for Brain, Cognition, and Behavior, Radboud University, Nijmegen, Netherlands.,Department of Cognitive Neuroscience, Radboud University Medical Center, Nijmegen, Netherlands
| | - Pierre Berthet
- Department of Psychology, University of Oslo, Oslo, Norway.,Norwegian Center for Mental Disorders Research (NORMENT), University of Oslo, and Oslo University Hospital, Oslo, Norway
| | - Amanda Worker
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Serena Verdi
- Centre for Medical Image Computing, Medical Physics and Biomedical Engineering, University College London, London, United Kingdom.,Dementia Research Centre, UCL Queen Square Institute of Neurology, London, United Kingdom
| | - Derek Andrews
- The Medical Investigation of Neurodevelopmental Disorders (MIND) Institute and Department of Psychiatry and Behavioral Sciences, UC Davis School of Medicine, University of California, Davis, Sacramento, United States
| | - Laura Km Han
- Amsterdam UMC, Vrije Universiteit, Psychiatry, Amsterdam Public Health Research Institute, Amsterdam, Netherlands.,GGZ inGeest, Amsterdam Neuroscience, Amsterdam, Netherlands
| | - Johanna Mm Bayer
- Centre for Youth Mental Health, University of Melbourne, Melbourne, Australia.,Orygen Youth Health, Melbourne, Australia
| | - Paola Dazzan
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom.,National Institute for Health Research Mental Health Biomedical Research Centre, South London and Maudsley National Health Service Foundation Trust and King's College London, London, United Kingdom
| | - Phillip McGuire
- Department of Psychosis Studies, Institute of Psychiatry, King's College London, London, United Kingdom
| | - Roel T Mocking
- Department of Psychiatry, Amsterdam UMC, Location AMC, Amsterdam, Netherlands
| | - Aart Schene
- Donders Institute for Brain, Cognition, and Behavior, Radboud University, Nijmegen, Netherlands.,Department of Psychiatry, Radboud University Medical Center, Nijmegen, Netherlands
| | - Chandra Sripada
- Department of Psychiatry, University of Michigan, Ann Arbor, United States
| | - Ivy F Tso
- Department of Psychiatry, University of Michigan, Ann Arbor, United States
| | - Elizabeth R Duval
- Department of Psychiatry, University of Michigan, Ann Arbor, United States
| | - Soo-Eun Chang
- Department of Psychiatry, University of Michigan, Ann Arbor, United States
| | - Brenda Wjh Penninx
- Amsterdam UMC, Vrije Universiteit, Psychiatry, Amsterdam Public Health Research Institute, Amsterdam, Netherlands.,GGZ inGeest, Amsterdam Neuroscience, Amsterdam, Netherlands
| | - Mary M Heitzeg
- Department of Psychiatry, University of Michigan, Ann Arbor, United States
| | - S Alexandra Burt
- Department of Psychology, Michigan State University, East Lansing, United States
| | - Luke W Hyde
- Department of Psychology, University of Michigan, Ann Arbor, United States
| | - David Amaral
- The Medical Investigation of Neurodevelopmental Disorders (MIND) Institute and Department of Psychiatry and Behavioral Sciences, UC Davis School of Medicine, University of California, Davis, Sacramento, United States
| | - Christine Wu Nordahl
- The Medical Investigation of Neurodevelopmental Disorders (MIND) Institute and Department of Psychiatry and Behavioral Sciences, UC Davis School of Medicine, University of California, Davis, Sacramento, United States
| | - Ole A Andreasssen
- Norwegian Center for Mental Disorders Research (NORMENT), University of Oslo, and Oslo University Hospital, Oslo, Norway.,KG Jebsen Centre for Neurodevelopmental Disorders Research, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Lars T Westlye
- Department of Psychology, University of Oslo, Oslo, Norway.,Norwegian Center for Mental Disorders Research (NORMENT), University of Oslo, and Oslo University Hospital, Oslo, Norway.,KG Jebsen Centre for Neurodevelopmental Disorders Research, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Roland Zahn
- Centre for Affective Disorders at the Institute of Psychiatry, King's College London, London, United Kingdom
| | - Henricus G Ruhe
- Donders Institute for Brain, Cognition, and Behavior, Radboud University, Nijmegen, Netherlands.,Department of Psychiatry, Radboud University Medical Center, Nijmegen, Netherlands
| | - Christian Beckmann
- Donders Institute for Brain, Cognition, and Behavior, Radboud University, Nijmegen, Netherlands.,Department of Cognitive Neuroscience, Radboud University Medical Center, Nijmegen, Netherlands.,Centre for Functional MRI of the Brain (FMRIB), Nuffield Department of Clinical Neurosciences, Wellcome Centre for Integrative Neuroimaging, University of Oxford, Oxford, United Kingdom
| | - Andre F Marquand
- Donders Institute for Brain, Cognition, and Behavior, Radboud University, Nijmegen, Netherlands.,Department of Cognitive Neuroscience, Radboud University Medical Center, Nijmegen, Netherlands
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Abstract
BACKGROUND Despite common dissatisfaction with the syndromic heterogeneity of major depression, investigations into its symptom structure are scarce. Self-worthlessness/inadequacy is a distinctive and consistent symptom of major depression across cultures. AIMS We investigated whether self-worthlessness is associated with self-blaming attribution-related symptoms or is instead an expression of reduced positive feelings overall, as would be implied by reduced positive affect accounts of depression. METHODS 44,161 undergraduate students in Study 1, and 215 patients with current Major Depressive Disorder (MDD) and 237 age-matched healthy control participants in Study 2 completed the well-validated Symptom Check List-90. Depression-relevant items were used to construct regularized partial correlation networks with bootstrap estimates of network parameter variability. RESULTS Worthlessness co-occurred more strongly with other symptoms linked to self-blaming attributions (hopelessness, and self-blame), displaying a combined edge weight with these symptoms which was significantly stronger than the edge weight representing its connection with reduced positive emotion symptoms (such as reduced pleasure/interest/motivation, difference in edge weight sum in Study 1 = 2.95, in Study 2 = 1.64; 95% confidence intervals: Study 1: 2.6-3.4; Study 2: 0.02-3.5; Bonferroni-corrected p < 0.05). CONCLUSIONS This confirms the prediction of the revised learned helplessness model that worthlessness is most strongly linked to hopelessness and self-blame. In contrast, we did not find a strong and direct link between anhedonia items and a reduction in self-worth in either study. This supports worthlessness as a primary symptom rather than resulting from reduced positive affect.
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Affiliation(s)
- Phillippa Harrison
- Centre for Affective Disorders, Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Andrew J Lawrence
- Centre for Affective Disorders, Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Shu Wang
- Department of Psychology, Institute of Education, Hunan Agricultural University, Changsha, China
| | - Sixun Liu
- Department of Psychology, Institute of Education, Hunan Agricultural University, Changsha, China
| | - Guangrong Xie
- Key Laboratory of Psychiatry and Mental Health of Hunan Province, Mental Health Institute of the Second Xiangya Hospital, National Technology Institute of Psychiatry, Central South University, Changsha, China
| | - Xinhua Yang
- Centre for Affective Disorders, Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Roland Zahn
- Centre for Affective Disorders, Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom.,National Service for Affective Disorders, South London and Maudsley NHS Foundation Trust, London, United Kingdom
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Davies MR, Buckman JEJ, Adey BN, Armour C, Bradley JR, Curzons SCB, Davies HL, Davis KAS, Goldsmith KA, Hirsch CR, Hotopf M, Hübel C, Jones IR, Kalsi G, Krebs G, Lin Y, Marsh I, McAtarsney-Kovacs M, McIntosh AM, Mundy J, Monssen D, Peel AJ, Rogers HC, Skelton M, Smith DJ, Ter Kuile A, Thompson KN, Veale D, Walters JTR, Zahn R, Breen G, Eley TC. Comparison of symptom-based versus self-reported diagnostic measures of anxiety and depression disorders in the GLAD and COPING cohorts. J Anxiety Disord 2022; 85:102491. [PMID: 34775166 DOI: 10.1016/j.janxdis.2021.102491] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [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: 02/05/2021] [Revised: 10/13/2021] [Accepted: 10/20/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND Understanding and improving outcomes for people with anxiety or depression often requires large sample sizes. To increase participation and reduce costs, such research is typically unable to utilise "gold-standard" methods to ascertain diagnoses, instead relying on remote, self-report measures. AIMS Assess the comparability of remote diagnostic methods for anxiety and depression disorders commonly used in research. METHOD Participants from the UK-based GLAD and COPING NBR cohorts (N = 58,400) completed an online questionnaire between 2018 and 2020. Responses to detailed symptom reports were compared to DSM-5 criteria to generate symptom-based diagnoses of major depressive disorder (MDD), generalised anxiety disorder (GAD), specific phobia, social anxiety disorder, panic disorder, and agoraphobia. Participants also self-reported any prior diagnoses from health professionals, termed self-reported diagnoses. "Any anxiety" included participants with at least one anxiety disorder. Agreement was assessed by calculating accuracy, Cohen's kappa, McNemar's chi-squared, sensitivity, and specificity. RESULTS Agreement between diagnoses was moderate for MDD, any anxiety, and GAD, but varied by cohort. Agreement was slight to fair for the phobic disorders. Many participants with self-reported GAD did not receive a symptom-based diagnosis. In contrast, symptom-based diagnoses of the phobic disorders were more common than self-reported diagnoses. CONCLUSIONS Agreement for MDD, any anxiety, and GAD was higher for cases in the case-enriched GLAD cohort and for controls in the general population COPING NBR cohort. For anxiety disorders, self-reported diagnoses classified most participants as having GAD, whereas symptom-based diagnoses distributed participants more evenly across the anxiety disorders. Further validation against gold standard measures is required.
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Affiliation(s)
- Molly R Davies
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, Denmark Hill, Camberwell, London, UK; National Institute for Health Research (NIHR) Biomedical Research Centre, South London and Maudsley Hospital, London, UK
| | - Joshua E J Buckman
- Centre for Outcomes Research and Effectiveness (CORE), Research Department of Clinical, Educational and Health Psychology, University College London, Gower Street, London WC1E 7HB, UK; iCope - Camden and Islington Psychological Therapies Services, Camden & Islington NHS Foundation Trust, St Pancras Hospital, London, UK
| | - Brett N Adey
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, Denmark Hill, Camberwell, London, UK; National Institute for Health Research (NIHR) Biomedical Research Centre, South London and Maudsley Hospital, London, UK
| | - Chérie Armour
- Stress, Trauma & Related Conditions (STARC) research lab, School of Psychology, Queens University Belfast (QUB), Belfast, Northern Ireland, UK
| | - John R Bradley
- NIHR BioResource, Cambridge University Hospitals, Cambridge Biomedical Campus, Cambridge, UK
| | - Susannah C B Curzons
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, Denmark Hill, Camberwell, London, UK; National Institute for Health Research (NIHR) Biomedical Research Centre, South London and Maudsley Hospital, London, UK
| | - Helena L Davies
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, Denmark Hill, Camberwell, London, UK; National Institute for Health Research (NIHR) Biomedical Research Centre, South London and Maudsley Hospital, London, UK
| | - Katrina A S Davis
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, Denmark Hill, Camberwell, London, UK; National Institute for Health Research (NIHR) Biomedical Research Centre, South London and Maudsley Hospital, London, UK; South London and Maudsley NHS Foundation Trust, Denmark Hill, Camberwell, London, UK
| | - Kimberley A Goldsmith
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, Denmark Hill, Camberwell, London, UK; National Institute for Health Research (NIHR) Biomedical Research Centre, South London and Maudsley Hospital, London, UK
| | - Colette R Hirsch
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, Denmark Hill, Camberwell, London, UK; National Institute for Health Research (NIHR) Biomedical Research Centre, South London and Maudsley Hospital, London, UK; South London and Maudsley NHS Foundation Trust, Denmark Hill, Camberwell, London, UK
| | - Matthew Hotopf
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, Denmark Hill, Camberwell, London, UK; National Institute for Health Research (NIHR) Biomedical Research Centre, South London and Maudsley Hospital, London, UK; South London and Maudsley NHS Foundation Trust, Denmark Hill, Camberwell, London, UK
| | - Christopher Hübel
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, Denmark Hill, Camberwell, London, UK; National Institute for Health Research (NIHR) Biomedical Research Centre, South London and Maudsley Hospital, London, UK; Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden; National Centre for Register-based Research, Aarhus Business and Social Sciences, Aarhus University, Aarhus, Denmark
| | - Ian R Jones
- National Centre for Mental Health, Division of Psychiatry and Clinical Neuroscience, Cardiff University, Cardiff, UK
| | - Gursharan Kalsi
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, Denmark Hill, Camberwell, London, UK; National Institute for Health Research (NIHR) Biomedical Research Centre, South London and Maudsley Hospital, London, UK
| | - Georgina Krebs
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, Denmark Hill, Camberwell, London, UK; South London and Maudsley NHS Foundation Trust, Denmark Hill, Camberwell, London, UK
| | - Yuhao Lin
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, Denmark Hill, Camberwell, London, UK; National Institute for Health Research (NIHR) Biomedical Research Centre, South London and Maudsley Hospital, London, UK
| | - Ian Marsh
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, Denmark Hill, Camberwell, London, UK; National Institute for Health Research (NIHR) Biomedical Research Centre, South London and Maudsley Hospital, London, UK
| | - Monika McAtarsney-Kovacs
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, Denmark Hill, Camberwell, London, UK; National Institute for Health Research (NIHR) Biomedical Research Centre, South London and Maudsley Hospital, London, UK
| | - Andrew M McIntosh
- Division of Psychiatry, Centre for Clinical Brain Sciences, University of Edinburgh, Edinurgh, UK
| | - Jessica Mundy
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, Denmark Hill, Camberwell, London, UK; National Institute for Health Research (NIHR) Biomedical Research Centre, South London and Maudsley Hospital, London, UK
| | - Dina Monssen
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, Denmark Hill, Camberwell, London, UK; National Institute for Health Research (NIHR) Biomedical Research Centre, South London and Maudsley Hospital, London, UK
| | - Alicia J Peel
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, Denmark Hill, Camberwell, London, UK
| | - Henry C Rogers
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, Denmark Hill, Camberwell, London, UK; National Institute for Health Research (NIHR) Biomedical Research Centre, South London and Maudsley Hospital, London, UK
| | - Megan Skelton
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, Denmark Hill, Camberwell, London, UK; National Institute for Health Research (NIHR) Biomedical Research Centre, South London and Maudsley Hospital, London, UK
| | - Daniel J Smith
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Abigail Ter Kuile
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, Denmark Hill, Camberwell, London, UK; National Institute for Health Research (NIHR) Biomedical Research Centre, South London and Maudsley Hospital, London, UK
| | - Katherine N Thompson
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, Denmark Hill, Camberwell, London, UK; National Institute for Health Research (NIHR) Biomedical Research Centre, South London and Maudsley Hospital, London, UK
| | - David Veale
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, Denmark Hill, Camberwell, London, UK; National Institute for Health Research (NIHR) Biomedical Research Centre, South London and Maudsley Hospital, London, UK; South London and Maudsley NHS Foundation Trust, Denmark Hill, Camberwell, London, UK
| | - James T R Walters
- National Centre for Mental Health, Division of Psychiatry and Clinical Neuroscience, Cardiff University, Cardiff, UK
| | - Roland Zahn
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, Denmark Hill, Camberwell, London, UK; National Institute for Health Research (NIHR) Biomedical Research Centre, South London and Maudsley Hospital, London, UK
| | - Gerome Breen
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, Denmark Hill, Camberwell, London, UK; National Institute for Health Research (NIHR) Biomedical Research Centre, South London and Maudsley Hospital, London, UK
| | - Thalia C Eley
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, Denmark Hill, Camberwell, London, UK; National Institute for Health Research (NIHR) Biomedical Research Centre, South London and Maudsley Hospital, London, UK.
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Duan S, Lawrence A, Valmaggia L, Moll J, Zahn R. Maladaptive blame-related action tendencies are associated with vulnerability to major depressive disorder. J Psychiatr Res 2021; 145:70-76. [PMID: 34875461 PMCID: PMC8756141 DOI: 10.1016/j.jpsychires.2021.11.043] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Revised: 10/22/2021] [Accepted: 11/24/2021] [Indexed: 01/09/2023]
Abstract
Biases towards self-blaming emotions, such as self-contempt/disgust, were previously associated with vulnerability to major depressive disorder (MDD). Self-blaming emotions are thought to prompt specific action tendencies (e.g. "feeling like hiding"), which are likely to be more important for psychosocial functioning than the emotions themselves. Systematic investigations, however, of these action tendencies in MDD are lacking. Here, we investigated the role of blame-related action tendencies for MDD vulnerability and their relationship with blame-related emotions. 76 participants with medication-free remitted MDD and 44 healthy control (HC) participants without a history of MDD completed the value-related moral sentiment task, which measured their blame-related emotions during hypothetical social interactions and a novel task to assess their blame-related action tendencies (feeling like hiding, apologising, creating a distance from oneself, attacking oneself, creating a distance from other, attacking other, no action). As predicted, the MDD group showed a maladaptive profile of action tendencies: a higher proneness to feeling like hiding and creating a distance from themselves compared with the HC group. In contrast, feeling like apologising was less common in the MDD than the HC group. Apologising for one's wrongdoing was associated with all self-blaming emotions including shame, guilt, self-contempt/disgust and self-indignation. Hiding was associated with both shame and guilt. Our study shows that MDD vulnerability was associated with specific maladaptive action tendencies which were independent of the type of emotion, thus unveiling novel cognitive markers and neurocognitive treatment targets.
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Affiliation(s)
- Suqian Duan
- Institute of Psychiatry, Psychology & Neuroscience, Department of Psychological Medicine, Centre for Affective Disorders, King's College London, London, UK
| | - Andrew Lawrence
- Institute of Psychiatry, Psychology & Neuroscience, Department of Psychological Medicine, Centre for Affective Disorders, King's College London, London, UK
| | - Lucia Valmaggia
- Institute of Psychiatry, Psychology & Neuroscience, Department of Psychological Medicine, Centre for Affective Disorders, King's College London, London, UK
| | - Jorge Moll
- Cognitive and Behavioral Neuroscience Unit, D'Or Institute for Research and Education (IDOR), 22280-080, Rio de Janeiro, RJ, Brazil
| | - Roland Zahn
- Institute of Psychiatry, Psychology & Neuroscience, Department of Psychological Medicine, Centre for Affective Disorders, King's College London, London, UK; Cognitive and Behavioral Neuroscience Unit, D'Or Institute for Research and Education (IDOR), 22280-080, Rio de Janeiro, RJ, Brazil; South London and Maudsley NHS Trust, London, UK.
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Tostanoski LH, Yu J, Mercado NB, McMahan K, Jacob-Dolan C, Martinot AJ, Piedra-Mora C, Anioke T, Chang A, Giffin VM, Hope DL, Wan H, Bondzie EA, Mahrokhian SH, Wrijil LM, Bauer K, Pessaint L, Porto M, Piegols J, Faudree A, Spence B, Kar S, Amanat F, Krammer F, Andersen H, Lewis MG, Wegmann F, Zahn R, Schuitemaker H, Barouch DH. Immunity elicited by natural infection or Ad26.COV2.S vaccination protects hamsters against SARS-CoV-2 variants of concern. Sci Transl Med 2021; 13:eabj3789. [PMID: 34705477 PMCID: PMC8818312 DOI: 10.1126/scitranslmed.abj3789] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2021] [Accepted: 08/25/2021] [Indexed: 01/07/2023]
Abstract
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variants of concern have emerged and may pose a threat to both the efficacy of vaccines based on the original WA1/2020 strain and the natural immunity induced by infection with earlier SARS-CoV-2 variants. We investigated how mutations in the spike protein of circulating SARS-CoV-2 variants, which have been shown to partially evade neutralizing antibodies, affect natural and vaccine-induced immunity. We adapted a Syrian hamster model of moderate to severe clinical disease for two variant strains of SARS-CoV-2: B.1.1.7 (alpha variant) and B.1.351 (beta variant). We then assessed the protective efficacy conferred by either natural immunity from WA1/2020 infection or by vaccination with a single dose of the adenovirus serotype 26 vaccine, Ad26.COV2.S. Primary infection with the WA1/2020 strain provided potent protection against weight loss and viral replication in lungs after rechallenge with WA1/2020, B.1.1.7, or B.1.351. Ad26.COV2.S induced cross-reactive binding and neutralizing antibodies that were reduced against the B.1.351 strain compared with WA1/2020 but nevertheless still provided robust protection against B.1.351 challenge, as measured by weight loss and pathology scoring in the lungs. Together, these data support hamsters as a preclinical model to study protection against emerging variants of SARS-CoV-2 conferred by prior infection or vaccination.
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Affiliation(s)
- Lisa H. Tostanoski
- Center for Virology and Vaccine Research, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02115, USA
| | - Jingyou Yu
- Center for Virology and Vaccine Research, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02115, USA
| | - Noe B. Mercado
- Center for Virology and Vaccine Research, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02115, USA
| | - Katherine McMahan
- Center for Virology and Vaccine Research, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02115, USA
| | - Catherine Jacob-Dolan
- Center for Virology and Vaccine Research, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02115, USA
- Harvard Medical School, Boston, MA 02115, USA
| | - Amanda J. Martinot
- Center for Virology and Vaccine Research, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02115, USA
- Department of Biomedical Sciences, Section of Pathology, Cummings School of Veterinary Medicine, Tufts University, North Grafton, MA 01536, USA
| | - Cesar Piedra-Mora
- Center for Virology and Vaccine Research, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02115, USA
- Department of Biomedical Sciences, Section of Pathology, Cummings School of Veterinary Medicine, Tufts University, North Grafton, MA 01536, USA
| | - Tochi Anioke
- Center for Virology and Vaccine Research, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02115, USA
| | - Aiquan Chang
- Center for Virology and Vaccine Research, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02115, USA
- Harvard Medical School, Boston, MA 02115, USA
| | - Victoria M. Giffin
- Center for Virology and Vaccine Research, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02115, USA
| | - David L. Hope
- Center for Virology and Vaccine Research, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02115, USA
| | - Huahua Wan
- Center for Virology and Vaccine Research, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02115, USA
| | - Esther A. Bondzie
- Center for Virology and Vaccine Research, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02115, USA
| | - Shant H. Mahrokhian
- Center for Virology and Vaccine Research, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02115, USA
| | - Linda M. Wrijil
- Department of Biomedical Sciences, Section of Pathology, Cummings School of Veterinary Medicine, Tufts University, North Grafton, MA 01536, USA
| | - Katherine Bauer
- Department of Biomedical Sciences, Section of Pathology, Cummings School of Veterinary Medicine, Tufts University, North Grafton, MA 01536, USA
| | | | | | | | | | | | | | - Fatima Amanat
- Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Florian Krammer
- Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | | | | | - Frank Wegmann
- Janssen Vaccines & Prevention BV, Leiden, 2333 CN, Netherlands
| | - Roland Zahn
- Janssen Vaccines & Prevention BV, Leiden, 2333 CN, Netherlands
| | | | - Dan H. Barouch
- Center for Virology and Vaccine Research, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02115, USA
- Harvard Medical School, Boston, MA 02115, USA
- Ragon Institute of MGH, MIT and Harvard, Cambridge, MA 02139, USA
- Massachusetts Consortium on Pathogen Readiness, Boston, MA 02115, USA
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Abstract
Background Treatment-resistant depression (TRD) is classically defined according to the number of suboptimal antidepressant responses experienced, but multidimensional assessments of TRD are emerging and may confer some advantages. Patient characteristics have been identified as risk factors for TRD but may also be associated with TRD severity. The identification of individuals at risk of severe TRD would support appropriate prioritisation of intensive and specialist treatments. Aims To determine whether TRD risk factors are associated with TRD severity when assessed multidimensionally using the Maudsley Staging Method (MSM), and univariately as the number of antidepressant non-responses, across three cohorts of individuals with depression. Method Three cohorts of individuals without significant TRD, with established TRD and with severe TRD, were assessed (n = 528). Preselected characteristics were included in linear regressions to determine their association with each outcome. Results Participants with more severe TRD according to the MSM had a lower age at onset, fewer depressive episodes and more physical comorbidities. These associations were not consistent across cohorts. The number of episodes was associated with the number of antidepressant treatment failures, but the direction of association varied across the cohorts studied. Conclusions Several risk factors for TRD were associated with the severity of resistance according to the MSM. Fewer were associated with the raw number of inadequate antidepressant responses. Multidimensional definitions may be more useful for identifying patients at risk of severe TRD. The inconsistency of associations across cohorts has potential implications for the characterisation of TRD.
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Zahn R, Kment H, Schofer J, Lubos E, Geist V, Eggebrecht H, Butter C, Wolf A, Schaefer U, Schumacher B, Schneider S. Interventional treatment of para-valvular leaks after prosthetic valve replacement with plug devices -first results from a prospective registry. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.1639] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Interventional closure of symptomatic paravalvular leaks (PVL) after surgical or interventional valve replacement by plug implantation has emerged as an alternative to surgical correction, which is associated with high morbitity and mortality rates. To date, data on procedural efficacy and clinical outcome after transcatheter closure with plugs is sparse, especially prospective data are missing.
Methods
We analysed data from a multi-center prospective registry on interventional PVL closure with plug devices.
Results
Between 06/2012 and 04/2020 55 interventions were performed with different numbers of plugs (maximal 4) in 51 patients at 9 hospitals. Interventions were performed in 15 women and 36 men at high surgical risk for repeat surgery. 48% of procedures were performed for mitral PVLs and 52% procedures were performed for aortic PVLs. Mean age of the population treated was 69±13 years and mean log. Euro-Score I was 22.5±14.2%. Patients were treated by implantation of Amplatzer Vascular Plug III (80%) and Occlutec occluders (9%). Aortic PVLs were treated using a retrograde transfemoral access, mitral PVLs were treated using either a transseptal (25/26) or transapical access (1/26) with 3-dimensional transesophageal echocardiographic and fluoroscopic guidance. Indication for PVL closure was previous surgery (n=39), high-risk patients (n=24), heart failure (n=22), age (n=20) and hemolysis (n=12). 40 patients had NYHA class III/IV at admission. Interventional closure of PVL was completely successful in 40 procedures (73%), partially successful in 7 procedures (13%) and failed in 7 procedures (13%). NYHA class I/II after PVL closure was achieved in 75% patients. However, 8 out of 12 patients with hemolysis as indication still hemolyzed at discharge. Complications occurred in 16% of patients. In-hospital mortality rate was 4% of procedures (2/51). After hospital discharge no death occurred during 30-day follow-up.
Conclusions
In this prospective interventional PVL registry inclusion rate was lower than expected. There was an equal distribution of aortal and mitral PVLs. At least partial success could be achieved in 86% of patients, with significant functional improvement in most patients. In this high risk population hospital mortaliy was low (4%), indicating that interventional PVL treatment should be the treatment of choice, when discussed by a heart team.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- R Zahn
- Klinikum Ludwigshafen, Ludwigshafen, Germany
| | - H Kment
- Klinikum Ludwigshafen, Ludwigshafen, Germany
| | - J Schofer
- Medical Care Center Hamburg, Hamburg, Germany
| | - E Lubos
- University Heart Center Hamburg, Hamburg, Germany
| | - V Geist
- Segeberger Clinics, Bad Segeberg, Germany
| | - H Eggebrecht
- CCB am Markus Hospital, Frankfurt am Main, Germany
| | - C Butter
- Brandenburg Heart Center, Bernau bei Berlin, Germany
| | - A Wolf
- Elisabeth-Hospital, Essen, Germany
| | - U Schaefer
- University Heart Center Hamburg, Hamburg, Germany
| | | | - S Schneider
- Klinikum Ludwigshafen, Ludwigshafen, Germany
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Roozendaal R, Solforosi L, Stieh DJ, Serroyen J, Straetemans R, Dari A, Boulton M, Wegmann F, Rosendahl Huber SK, van der Lubbe JEM, Hendriks J, Le Gars M, Dekking L, Czapska-Casey DN, Guimera N, Janssen S, Tete S, Chandrashekar A, Mercado NB, Yu J, Koudstaal W, Perez-Ruixo JJ, Sadoff J, Barouch DH, Schuitemaker H, Zahn R. SARS-CoV-2 binding and neutralizing antibody levels after Ad26.COV2.S vaccination predict durable protection in rhesus macaques. Nat Commun 2021; 12:5877. [PMID: 34620860 PMCID: PMC8497464 DOI: 10.1038/s41467-021-26117-x] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Accepted: 09/16/2021] [Indexed: 01/08/2023] Open
Abstract
Several COVID-19 vaccines have recently gained authorization for emergency use. Limited knowledge on duration of immunity and efficacy of these vaccines is currently available. Data on other coronaviruses after natural infection suggest that immunity to SARS-CoV-2 might be short-lived, and preliminary evidence indicates waning antibody titers following SARS-CoV-2 infection. In this work, we model the relationship between immunogenicity and protective efficacy of a series of Ad26 vectors encoding stabilized variants of the SARS-CoV-2 Spike protein in rhesus macaques and validate the analyses by challenging macaques 6 months after immunization with the Ad26.COV2.S vaccine candidate that has been selected for clinical development. We show that Ad26.COV2.S confers durable protection against replication of SARS-CoV-2 in the lungs that is predicted by the levels of Spike-binding and neutralizing antibodies, indicating that Ad26.COV2.S could confer durable protection in humans and immunological correlates of protection may enable the prediction of durability of protection.
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Affiliation(s)
| | | | - Daniel J Stieh
- Janssen Vaccines & Prevention B.V., Leiden, The Netherlands
| | - Jan Serroyen
- Janssen Vaccines & Prevention B.V., Leiden, The Netherlands
| | | | | | | | - Frank Wegmann
- Janssen Vaccines & Prevention B.V., Leiden, The Netherlands
| | | | | | - Jenny Hendriks
- Janssen Vaccines & Prevention B.V., Leiden, The Netherlands
| | | | | | | | - Nuria Guimera
- Janssen Vaccines & Prevention B.V., Leiden, The Netherlands
| | - Sarah Janssen
- Janssen Vaccines & Prevention B.V., Leiden, The Netherlands
| | - Sarah Tete
- Janssen Vaccines & Prevention B.V., Leiden, The Netherlands
| | - Abishek Chandrashekar
- Center for Virology and Vaccine Research, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Noe B Mercado
- Center for Virology and Vaccine Research, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Jingyou Yu
- Center for Virology and Vaccine Research, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | | | | | - Jerry Sadoff
- Janssen Vaccines & Prevention B.V., Leiden, The Netherlands
| | - Dan H Barouch
- Center for Virology and Vaccine Research, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
- Ragon Institute of MGH, MIT and Harvard, Cambridge, MA, USA
- Harvard Medical School, Boston, MA, USA
- Massachusetts Consortium on Pathogen Readiness, Boston, MA, USA
| | | | - Roland Zahn
- Janssen Vaccines & Prevention B.V., Leiden, The Netherlands.
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Eslinger PJ, Anders S, Ballarini T, Boutros S, Krach S, Mayer AV, Moll J, Newton TL, Schroeter ML, de Oliveira-Souza R, Raber J, Sullivan GB, Swain JE, Lowe L, Zahn R. The neuroscience of social feelings: mechanisms of adaptive social functioning. Neurosci Biobehav Rev 2021; 128:592-620. [PMID: 34089764 PMCID: PMC8388127 DOI: 10.1016/j.neubiorev.2021.05.028] [Citation(s) in RCA: 37] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2020] [Revised: 01/31/2021] [Accepted: 05/10/2021] [Indexed: 01/10/2023]
Abstract
Social feelings have conceptual and empirical connections with affect and emotion. In this review, we discuss how they relate to cognition, emotion, behavior and well-being. We examine the functional neuroanatomy and neurobiology of social feelings and their role in adaptive social functioning. Existing neuroscience literature is reviewed to identify concepts, methods and challenges that might be addressed by social feelings research. Specific topic areas highlight the influence and modulation of social feelings on interpersonal affiliation, parent-child attachments, moral sentiments, interpersonal stressors, and emotional communication. Brain regions involved in social feelings were confirmed by meta-analysis using the Neurosynth platform for large-scale, automated synthesis of functional magnetic resonance imaging data. Words that relate specifically to social feelings were identfied as potential research variables. Topical inquiries into social media behaviors, loneliness, trauma, and social sensitivity, especially with recent physical distancing for guarding public and personal health, underscored the increasing importance of social feelings for affective and second person neuroscience research with implications for brain development, physical and mental health, and lifelong adaptive functioning.
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Affiliation(s)
- Paul J Eslinger
- Departments of Neurology, Neural & Behavioral Sciences, Pediatrics, and Radiology, Penn State Hershey Medical Center, Hershey, PA, USA.
| | - Silke Anders
- Social and Affective Neuroscience, Department of Neurology, University of Lübeck, Lübeck, Germany
| | - Tommaso Ballarini
- Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
| | - Sydney Boutros
- Department of Behavioral Neuroscience, Oregon Health & Science University, Portland, OR, USA
| | - Sören Krach
- Social Neuroscience Lab, Translational Psychiatry Unit, University of Lübeck, Lübeck, Germany
| | - Annalina V Mayer
- Social Neuroscience Lab, Translational Psychiatry Unit, University of Lübeck, Lübeck, Germany
| | - Jorge Moll
- Cognitive Neuroscience Unit, D'Or Institute for Research and Education (IDOR), Rio de Janeiro, Brazil
| | - Tamara L Newton
- University of Louisville, Department of Psychological and Brain Sciences, Louisville, KY, USA
| | - Matthias L Schroeter
- Max Planck Institute for Human Cognitive and Brain Sciences, Clinic for Cognitive Neurology, University Hospital Leipzig, Leipzig, Germany
| | - Ricardo de Oliveira-Souza
- Cognitive Neuroscience Unit, D'Or Institute for Research and Education (IDOR), BR Hospital Universitario, Universidade do Rio de Janeiro, Brazil
| | - Jacob Raber
- Departments of Behavioral Neuroscience, Neurology, and Radiation Medicine, Division of Neuroscience, ONPRC, Oregon Health & Science University, Portland, OR, USA
| | - Gavin B Sullivan
- International Psychoanalytic University, Berlin, Germany, Centre for Trust, Peace and Social Relations, Coventry University, UK
| | - James E Swain
- Department of Psychiatry and Behavioral Health, Psychology and Obstetrics and Gynecology, Renaissance School of Medicine at Stony Brook University, Stony Brook, NY, USA
| | | | - Roland Zahn
- Centre for Affective Disorders, Institute of Psychiatry, Psychology & Neuroscience, King's College London, UK
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Bortolini T, Melo B, Basilio R, Fischer R, Zahn R, de Oliveira-Souza R, Knutson B, Moll J. Striatal and septo-hypothalamic responses to anticipation and outcome of affiliative rewards. Neuroimage 2021; 243:118474. [PMID: 34407439 DOI: 10.1016/j.neuroimage.2021.118474] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Revised: 08/06/2021] [Accepted: 08/12/2021] [Indexed: 11/16/2022] Open
Abstract
Humans are intrinsically motivated to bond with others. The ability to experience affiliative emotions (such as affection/tenderness, sexual attraction, and admiration/awe) may incentivize and promote these affiliative bonds. Here, we interrogate the role of the critical reward circuitry, especially the Nucleus Accumbens (NAcc) and the septo-hypothalamic region, in the anticipation of and response to affiliative rewards using a novel incentive delay task. During Functional Magnetic Resonance Imaging (FMRI), participants (n = 23 healthy humans; 14 female) anticipated and watched videos involving affiliative (tenderness, erotic desire, and awe) and nonaffiliative (i.e., food) rewards, as well as neutral scenes. On the one hand, anticipation of both affiliative and nonaffiliative rewards increased activity in the NAcc, anterior insula, and supplementary motor cortex, but activity in the amygdala and the ventromedial prefrontal cortex (vmPFC) increased in response to reward outcomes. On the other hand, affiliative rewards more specifically increased activity in the septo-hypothalamic area. Moreover, NAcc activity during anticipation correlated with positive arousal for all rewards, whereas septo-hypothalamic activity during the outcome correlated with positive arousal and motivation for subsequent re-exposure only for affiliative rewards. Together, these findings implicate a general appetitive response in the NAcc to different types of rewards but suggests a more specific response in the septo-hypothalamic region in response to affiliative rewards outcomes. This work also presents a new task for distinguishing between neural responses to affiliative and non-affiliative rewards.
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Affiliation(s)
- Tiago Bortolini
- Cognitive Neuroscience and Neuroinformatics Unit, D'Or Institute for Research and Education (IDOR), Rio de Janeiro 22281-100, Brazil.
| | - Bruno Melo
- Cognitive Neuroscience and Neuroinformatics Unit, D'Or Institute for Research and Education (IDOR), Rio de Janeiro 22281-100, Brazil
| | - Rodrigo Basilio
- Cognitive Neuroscience and Neuroinformatics Unit, D'Or Institute for Research and Education (IDOR), Rio de Janeiro 22281-100, Brazil
| | - Ronald Fischer
- Cognitive Neuroscience and Neuroinformatics Unit, D'Or Institute for Research and Education (IDOR), Rio de Janeiro 22281-100, Brazil; School of Psychology, PO Box 600, Victoria University of Wellington, Wellington 6021, New Zealand
| | - Roland Zahn
- Centre for Affective Disorders, King's College London, SE5 8AF, United Kingdom
| | - Ricardo de Oliveira-Souza
- Cognitive Neuroscience and Neuroinformatics Unit, D'Or Institute for Research and Education (IDOR), Rio de Janeiro 22281-100, Brazil; The Federal University of the State of Rio de Janeiro, Rio de Janeiro 22270-000, Brazil
| | - Brian Knutson
- Department of Psychology, Stanford University, Stanford, CA 94305, USA
| | - Jorge Moll
- Cognitive Neuroscience and Neuroinformatics Unit, D'Or Institute for Research and Education (IDOR), Rio de Janeiro 22281-100, Brazil; Department of Psychology, Stanford University, Stanford, CA 94305, USA; Scients Institute, Palo Alto, CA 94306, USA
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Taylor RW, Coleman JRI, Lawrence AJ, Strawbridge R, Zahn R, Cleare AJ. Predicting clinical outcome to specialist multimodal inpatient treatment in patients with treatment resistant depression. J Affect Disord 2021; 291:188-197. [PMID: 34044338 DOI: 10.1016/j.jad.2021.04.074] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Revised: 03/09/2021] [Accepted: 04/23/2021] [Indexed: 12/28/2022]
Abstract
BACKGROUND Treatment resistant depression (TRD) poses a significant clinical challenge, despite a range of efficacious specialist treatments. Accurately predicting response a priori may help to alleviate the burden of TRD. This study sought to determine whether outcome prediction can be achieved in a specialist inpatient setting. METHODS Patients at the Affective Disorders Unit of the Bethlam Royal Hospital, with current depression and established TRD were included (N = 174). Patients were treated with an individualised combination of pharmacotherapy and specialist psychological therapies. Predictors included clinical and sociodemographic characteristics, and polygenic risk scores for depression and related traits. Logistic regression models examined associations with outcome, and predictive potential was assessed using elastic net regularised logistic regressions with 10-fold nested cross-validation. RESULTS 47% of patients responded (50% reduction in HAMD-21 score at discharge). Age at onset and number of depressive episodes were positively associated with response, while degree of resistance was negatively associated. All elastic net models had poor performance (AUC<0.6). Illness history characteristics were commonly retained, and the addition of genetic risk scores did not improve performance. LIMITATIONS The patient sample was heterogeneous and received a variety of treatments. Some variable associations may be non-linear and therefore not captured. CONCLUSIONS This treatment may be most effective for recurrent patients and those with a later age of onset, while patients more severely treatment resistant at admission remain amongst the most difficult to treat. Individual level prediction remains elusive for this complex group. The assessment of homogenous subgroups should be one focus of future investigations.
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Affiliation(s)
- Rachael W Taylor
- The Centre for Affective Disorders, Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King's College London, De Crespigny Park, London, United Kingdom; National Institute for Health Research Maudsley Biomedical Research Centre, South London & Maudsley NHS Foundation Trust, London, United Kingdom.
| | - Jonathan R I Coleman
- National Institute for Health Research Maudsley Biomedical Research Centre, South London & Maudsley NHS Foundation Trust, London, United Kingdom; Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Andrew J Lawrence
- The Centre for Affective Disorders, Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King's College London, De Crespigny Park, London, United Kingdom; National Institute for Health Research Maudsley Biomedical Research Centre, South London & Maudsley NHS Foundation Trust, London, United Kingdom
| | - Rebecca Strawbridge
- The Centre for Affective Disorders, Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King's College London, De Crespigny Park, London, United Kingdom; National Institute for Health Research Maudsley Biomedical Research Centre, South London & Maudsley NHS Foundation Trust, London, United Kingdom
| | - Roland Zahn
- The Centre for Affective Disorders, Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King's College London, De Crespigny Park, London, United Kingdom; South London and Maudsley NHS Foundation Trust, London, United Kingdom
| | - Anthony J Cleare
- The Centre for Affective Disorders, Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King's College London, De Crespigny Park, London, United Kingdom; South London and Maudsley NHS Foundation Trust, London, United Kingdom
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Yu J, Tostanoski LH, Mercado NB, McMahan K, Liu J, Jacob-Dolan C, Chandrashekar A, Atyeo C, Martinez DR, Anioke T, Bondzie EA, Chang A, Gardner S, Giffin VM, Hope DL, Nampanya F, Nkolola J, Patel S, Sanborn O, Sellers D, Wan H, Hayes T, Bauer K, Pessaint L, Valentin D, Flinchbaugh Z, Brown R, Cook A, Bueno-Wilkerson D, Teow E, Andersen H, Lewis MG, Martinot AJ, Baric RS, Alter G, Wegmann F, Zahn R, Schuitemaker H, Barouch DH. Protective efficacy of Ad26.COV2.S against SARS-CoV-2 B.1.351 in macaques. Nature 2021; 596:423-427. [PMID: 34161961 PMCID: PMC8373608 DOI: 10.1038/s41586-021-03732-8] [Citation(s) in RCA: 33] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Accepted: 06/16/2021] [Indexed: 02/06/2023]
Abstract
The emergence of SARS-CoV-2 variants that partially evade neutralizing antibodies poses a threat to the efficacy of current COVID-19 vaccines1,2. The Ad26.COV2.S vaccine expresses a stabilized spike protein from the WA1/2020 strain of SARS-CoV-2, and has recently demonstrated protective efficacy against symptomatic COVID-19 in humans in several geographical regions-including in South Africa, where 95% of sequenced viruses in cases of COVID-19 were the B.1.351 variant3. Here we show that Ad26.COV2.S elicits humoral and cellular immune responses that cross-react with the B.1.351 variant and protects against B.1.351 challenge in rhesus macaques. Ad26.COV2.S induced lower binding and neutralizing antibodies against B.1.351 as compared to WA1/2020, but elicited comparable CD8 and CD4 T cell responses against the WA1/2020, B.1.351, B.1.1.7, P.1 and CAL.20C variants. B.1.351 infection of control rhesus macaques resulted in higher levels of virus replication in bronchoalveolar lavage and nasal swabs than did WA1/2020 infection. Ad26.COV2.S provided robust protection against both WA1/2020 and B.1.351, although we observed higher levels of virus in vaccinated macaques after B.1.351 challenge. These data demonstrate that Ad26.COV2.S provided robust protection against B.1.351 challenge in rhesus macaques. Our findings have important implications for vaccine control of SARS-CoV-2 variants of concern.
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Affiliation(s)
- Jingyou Yu
- Center for Virology and Vaccine Research, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Lisa H Tostanoski
- Center for Virology and Vaccine Research, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Noe B Mercado
- Center for Virology and Vaccine Research, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Katherine McMahan
- Center for Virology and Vaccine Research, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Jinyan Liu
- Center for Virology and Vaccine Research, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Catherine Jacob-Dolan
- Center for Virology and Vaccine Research, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - Abishek Chandrashekar
- Center for Virology and Vaccine Research, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Caroline Atyeo
- Harvard Medical School, Boston, MA, USA
- Ragon Institute of MGH, MIT and Harvard, Cambridge, MA, USA
| | - David R Martinez
- University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Tochi Anioke
- Center for Virology and Vaccine Research, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Esther A Bondzie
- Center for Virology and Vaccine Research, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Aiquan Chang
- Center for Virology and Vaccine Research, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - Sarah Gardner
- Center for Virology and Vaccine Research, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Victoria M Giffin
- Center for Virology and Vaccine Research, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - David L Hope
- Center for Virology and Vaccine Research, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Felix Nampanya
- Center for Virology and Vaccine Research, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Joseph Nkolola
- Center for Virology and Vaccine Research, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Shivani Patel
- Center for Virology and Vaccine Research, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Owen Sanborn
- Center for Virology and Vaccine Research, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Daniel Sellers
- Center for Virology and Vaccine Research, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Huahua Wan
- Center for Virology and Vaccine Research, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Tammy Hayes
- Tufts University Cummings School of Veterinary Medicine, North Grafton, MA, USA
| | - Katherine Bauer
- Tufts University Cummings School of Veterinary Medicine, North Grafton, MA, USA
| | | | | | | | | | | | | | | | | | | | - Amanda J Martinot
- Tufts University Cummings School of Veterinary Medicine, North Grafton, MA, USA
| | - Ralph S Baric
- University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Galit Alter
- Ragon Institute of MGH, MIT and Harvard, Cambridge, MA, USA
| | - Frank Wegmann
- Janssen Vaccines & Prevention, Leiden, The Netherlands
| | - Roland Zahn
- Janssen Vaccines & Prevention, Leiden, The Netherlands
| | | | - Dan H Barouch
- Center for Virology and Vaccine Research, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA.
- Harvard Medical School, Boston, MA, USA.
- Ragon Institute of MGH, MIT and Harvard, Cambridge, MA, USA.
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Bland AR, Zahn R, Elliott R, Taylor JR, Hill J. Patrolling the boundaries of social domains: Neural activations to violations of expectations for romantic and work relationships. Soc Neurosci 2021; 16:513-521. [PMID: 34228605 DOI: 10.1080/17470919.2021.1953134] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
According to the social domains hypothesis, we reduce the information-processing demands of complex social cues by classifying them into a limited number of domains, each with distinct sets of expectations. This requires rapid identification of violations of the boundaries between social domains. We hypothesized that these violations are likely to be associated with neural activation of the salience system. Using fMRI we compared responses of 20 adults to expected and unexpected everyday social scenarios in personal and work interactions. The vignettes exemplified different kinds of scenarios presented in the work setting, i.e., task-focused scenarios which are expected at work and scenarios with a personal focus, which are unexpected at work. The key contrast between task and personal focussed scenarios presented in the work setting was associated with fronto-insular activation. Perceived inappropriateness of the unexpected scenarios, and shorter response time to judgment of inappropriateness were also associated with fronto-insular activation, after controlling for unpleasantness. This study indicates specific neural responses to violations of expectations in different social situations. Our findings suggest that the fronto-insular region is implicated in rapid detection of behaviors that cross the boundaries of social domains, which are hypothesized to be necessary for efficient social information processing.
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Affiliation(s)
- A R Bland
- Department of Psychology, Manchester Metropolitan University, Manchester, UK
| | - R Zahn
- Centre for Affective Disorders, Institute of Psychiatry, Psychology and Neuroscience, Kings College London, UK
| | - R Elliott
- Neuroscience and Psychiatry Unit, University of Manchester, UK.,Division of Neuroscience and Experimental Psychology, School of Biological Sciences, University of Manchester, UK
| | - J R Taylor
- Division of Neuroscience and Experimental Psychology, School of Biological Sciences, University of Manchester, UK
| | - J Hill
- School of Psychology and Clinical Language Sciences, University of Reading, UK
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Harrison P, Walton S, Fennema D, Duan S, Jaeckle T, Goldsmith K, Carr E, Ashworth M, Young AH, Zahn R. Development and validation of the Maudsley Modified Patient Health Questionnaire (MM-PHQ-9). BJPsych Open 2021; 7:e123. [PMID: 34210374 PMCID: PMC8281039 DOI: 10.1192/bjo.2021.953] [Citation(s) in RCA: 3] [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: 01/25/2021] [Revised: 05/17/2021] [Accepted: 05/26/2021] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND The Patient Health Questionnaire-9 (PHQ-9) is a widely used measure of depression in primary care. It was, however, originally designed as a diagnostic screening tool, and not for measuring change in response to antidepressant treatment. Although the Quick Inventory of Depressive Symptomology (QIDS-SR-16) has been extensively validated for outcome measurement, it is poorly adopted in UK primary care, and, although free for clinicians, has licensing restrictions for healthcare organisation use. AIMS We aimed to develop a modified version of the PHQ-9, the Maudsley Modified PHQ-9 (MM-PHQ-9), for tracking symptom changes in primary care. We tested the measure's validity, reliability and factor structure. METHOD A sample of 121 participants was recruited across three studies, and comprised 78 participants with major depressive disorder and 43 controls. MM-PHQ-9 scores were compared with the QIDS-SR-16 and Clinical Global Impressions improvement scale, for concurrent validity. Internal consistency of the scale was assessed, and principal component analysis was conducted to determine the items' factor structure. RESULTS The MM-PHQ-9 demonstrated good concurrent validity with the QIDS-SR-16, and excellent internal consistency. Sensitivity to change over a 14-week period was d = 0.41 compared with d = 0.61 on the QIDS-SR-16. Concurrent validity between the paper and mobile app versions of the MM-PHQ-9 was r = 0.67. CONCLUSIONS These results indicate that the MM-PHQ-9 is a valid and reliable measure of depressive symptoms in paper and mobile app format, although further validation is required. The measure was sensitive to change, demonstrating suitability for use in routine outcome assessment.
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Affiliation(s)
- Phillippa Harrison
- Department of Psychological Medicine, Centre for Affective Disorders, Institute of Psychiatry, Psychology & Neuroscience, King's College London, UK
| | - Syndi Walton
- Department of Psychological Medicine, Centre for Affective Disorders, Institute of Psychiatry, Psychology & Neuroscience, King's College London, UK
| | - Diede Fennema
- Department of Psychological Medicine, Centre for Affective Disorders, Institute of Psychiatry, Psychology & Neuroscience, King's College London, UK
| | - Suqian Duan
- Department of Psychological Medicine, Centre for Affective Disorders, Institute of Psychiatry, Psychology & Neuroscience, King's College London, UK
| | - Tanja Jaeckle
- Department of Psychological Medicine, Centre for Affective Disorders, Institute of Psychiatry, Psychology & Neuroscience, King's College London, UK
| | - Kimberley Goldsmith
- Department of Biostatistics and Health Informatics, Institute of Psychiatry, Psychology & Neuroscience, King's College London, UK
| | - Ewan Carr
- Department of Biostatistics and Health Informatics, Institute of Psychiatry, Psychology & Neuroscience, King's College London, UK
| | - Mark Ashworth
- School of Population Health and Environmental Sciences, King's College London, UK
| | - Allan. H. Young
- Department of Psychological Medicine, Centre for Affective Disorders, Institute of Psychiatry, Psychology & Neuroscience, King's College London, UK; and National Service for Affective Disorders, South London and Maudsley NHS Foundation Trust, UK
| | - Roland Zahn
- Department of Psychological Medicine, Centre for Affective Disorders, Institute of Psychiatry, Psychology & Neuroscience, King's College London, UK; and National Service for Affective Disorders, South London and Maudsley NHS Foundation Trust, UK
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Lawrence AJ, Stahl D, Duan S, Fennema D, Jaeckle T, Young AH, Dazzan P, Moll J, Zahn R. Neurocognitive Measures of Self-blame and Risk Prediction Models of Recurrence in Major Depressive Disorder. Biol Psychiatry Cogn Neurosci Neuroimaging 2021; 7:256-264. [PMID: 34175478 DOI: 10.1016/j.bpsc.2021.06.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Revised: 04/30/2021] [Accepted: 06/13/2021] [Indexed: 11/19/2022]
Abstract
BACKGROUND Overgeneralized self-blaming emotions, such as self-disgust, are core symptoms of major depressive disorder and prompt specific actions (i.e., action tendencies), which are more functionally relevant than the emotions themselves. We have recently shown, using a novel cognitive task, that when feeling self-blaming emotions, maladaptive action tendencies (feeling like hiding and feeling like creating a distance from oneself) and an overgeneralized perception of control are characteristic of major depressive disorder, even after remission of symptoms. Here, we probed the potential of this cognitive signature, and its combination with previously employed functional magnetic resonance imaging (fMRI) measures, to predict individual recurrence risk. For this purpose, we developed a user-friendly hybrid machine/statistical learning tool, which we make freely available. METHODS A total of 52 medication-free patients with remitted major depressive disorder, who had completed the action tendencies task and our self-blame fMRI task at baseline, were followed up clinically over 14 months to determine recurrence. Prospective prediction models included baseline maladaptive self-blame-related action tendencies and anterior temporal fMRI connectivity patterns across a set of frontolimbic a priori regions of interest, as well as including established clinical and standard psychological predictors. Prediction models used elastic net regularized logistic regression with nested 10-fold cross-validation. RESULTS Cross-validated discrimination was highly promising (area under the receiver-operating characteristic curve ≥ 0.86), and positive predictive values over 80% were achieved when including fMRI in multimodal models, but only up to 71% (area under the receiver-operating characteristic curve ≤ 0.74) when solely relying on cognitive and clinical measures. CONCLUSIONS This study shows the high potential of multimodal signatures of self-blaming biases to predict recurrence risk at an individual level and calls for external validation in an independent sample.
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Affiliation(s)
- Andrew J Lawrence
- Centre for Affective Disorders, Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom
| | - Daniel Stahl
- Department of Biostatistics, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Suqian Duan
- Centre for Affective Disorders, Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom
| | - Diede Fennema
- Centre for Affective Disorders, Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom
| | - Tanja Jaeckle
- Centre for Affective Disorders, Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom
| | - Allan H Young
- Centre for Affective Disorders, Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom; National Service for Affective Disorders, South London and Maudsley NHS Foundation Trust, London, United Kingdom
| | - Paola Dazzan
- Centre for Affective Disorders, Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom; National Service for Affective Disorders, South London and Maudsley NHS Foundation Trust, London, United Kingdom
| | - Jorge Moll
- Cognitive and Behavioral Neuroscience Unit, D'Or Institute for Research and Education, Rio de Janeiro, Brazil
| | - Roland Zahn
- Centre for Affective Disorders, Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom; National Service for Affective Disorders, South London and Maudsley NHS Foundation Trust, London, United Kingdom; Cognitive and Behavioral Neuroscience Unit, D'Or Institute for Research and Education, Rio de Janeiro, Brazil.
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He X, Chandrashekar A, Zahn R, Wegmann F, Yu J, Mercado NB, McMahan K, Martinot AJ, Piedra-Mora C, Beecy S, Ducat S, Chamanza R, Huber SR, van Heerden M, van der Fits L, Borducchi EN, Lifton M, Liu J, Nampanya F, Patel S, Peter L, Tostanoski LH, Pessaint L, Van Ry A, Finneyfrock B, Velasco J, Teow E, Brown R, Cook A, Andersen H, Lewis MG, Schuitemaker H, Barouch DH. Low-dose Ad26.COV2.S protection against SARS-CoV-2 challenge in rhesus macaques. Cell 2021; 184:3467-3473.e11. [PMID: 34133941 PMCID: PMC8166510 DOI: 10.1016/j.cell.2021.05.040] [Citation(s) in RCA: 34] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Revised: 03/18/2021] [Accepted: 05/25/2021] [Indexed: 11/21/2022]
Abstract
We previously reported that a single immunization with an adenovirus serotype 26 (Ad26)-vector-based vaccine expressing an optimized SARS-CoV-2 spike (Ad26.COV2.S) protected rhesus macaques against SARS-CoV-2 challenge. To evaluate reduced doses of Ad26.COV2.S, 30 rhesus macaques were immunized once with 1 × 1011, 5 × 1010, 1.125 × 1010, or 2 × 109 viral particles (vp) Ad26.COV2.S or sham and were challenged with SARS-CoV-2. Vaccine doses as low as 2 × 109 vp provided robust protection in bronchoalveolar lavage, whereas doses of 1.125 × 1010 vp were required for protection in nasal swabs. Activated memory B cells and binding or neutralizing antibody titers following vaccination correlated with protective efficacy. At suboptimal vaccine doses, viral breakthrough was observed but did not show enhancement of disease. These data demonstrate that a single immunization with relatively low dose of Ad26.COV2.S effectively protected against SARS-CoV-2 challenge in rhesus macaques, although a higher vaccine dose may be required for protection in the upper respiratory tract.
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Affiliation(s)
- Xuan He
- Center for Virology and Vaccine Research, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02215, USA
| | - Abishek Chandrashekar
- Center for Virology and Vaccine Research, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02215, USA
| | - Roland Zahn
- Janssen Vaccines & Prevention BV, Leiden, the Netherlands
| | - Frank Wegmann
- Janssen Vaccines & Prevention BV, Leiden, the Netherlands
| | - Jingyou Yu
- Center for Virology and Vaccine Research, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02215, USA
| | - Noe B Mercado
- Center for Virology and Vaccine Research, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02215, USA
| | - Katherine McMahan
- Center for Virology and Vaccine Research, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02215, USA
| | - Amanda J Martinot
- Tufts University Cummings School of Veterinary Medicine, North Grafton, MA 01536, USA
| | - Cesar Piedra-Mora
- Tufts University Cummings School of Veterinary Medicine, North Grafton, MA 01536, USA
| | - Sidney Beecy
- Tufts University Cummings School of Veterinary Medicine, North Grafton, MA 01536, USA
| | - Sarah Ducat
- Tufts University Cummings School of Veterinary Medicine, North Grafton, MA 01536, USA
| | | | | | | | | | - Erica N Borducchi
- Center for Virology and Vaccine Research, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02215, USA
| | - Michelle Lifton
- Center for Virology and Vaccine Research, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02215, USA
| | - Jinyan Liu
- Center for Virology and Vaccine Research, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02215, USA
| | - Felix Nampanya
- Center for Virology and Vaccine Research, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02215, USA
| | - Shivani Patel
- Center for Virology and Vaccine Research, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02215, USA
| | - Lauren Peter
- Center for Virology and Vaccine Research, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02215, USA
| | - Lisa H Tostanoski
- Center for Virology and Vaccine Research, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02215, USA
| | | | | | | | | | | | | | | | | | | | | | - Dan H Barouch
- Center for Virology and Vaccine Research, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02215, USA; Ragon Institute of MGH, MIT, and Harvard, Cambridge, MA 02139, USA; Massachusetts Consortium on Pathogen Readiness, Boston, MA 02215, USA.
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Bovet M, Wadsack D, Kosely F, Zink W, Zahn R. [Fatal course of COVID-19 despite IL-6 receptor blockade in cytokine storm : Perimyocarditis and coagulopathy after administration of tocilizumab]. Anaesthesist 2021; 70:121-126. [PMID: 33064176 PMCID: PMC7563901 DOI: 10.1007/s00101-020-00871-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Revised: 08/27/2020] [Accepted: 09/21/2020] [Indexed: 02/07/2023]
Abstract
A 59-year-old male patient was admitted to hospital diagnosed with moderate pneumonia associated with COVID-19. Upfront treatment with hydroxychloroquine and azithromycin was started. Due to a clinical deterioration (ARDS, circulatory shock) and greatly increased inflammation markers 6 days after admission, a cytokine storm was suspected and off-label treatment with the IL‑6 receptor antagonist tocilizumab was initiated. Subsequently there was a dramatic rise of D‑dimers indicating pulmonary intravascular coagulopathy and respiratory insufficiency worsened. After a second dose of tocilizumab was administered severe perimyocarditis with cardiac arrhythmia, hemodynamic instability and ST elevation occurred. Shortly afterwards the patient died due to multiorgan failure. From our experience, exacerbation of COVID-19 following treatment with tocilizumab cannot be ruled out. Randomized controlled studies are necessary to further investigate the efficacy, safety and patient selection criteria for tocilizumab treatment in COVID-19.
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Affiliation(s)
- M Bovet
- Klinik für Kardiologie, Pneumologie, Angiologie und Internistische Intensivmedizin (Medizinische Klinik B), Klinikum Ludwigshafen, Bremserstraße 79, 67073, Ludwigshafen, Deutschland.
| | - D Wadsack
- Klinik für Innere Medizin, Hämato-Onkologie, Nephrologie, Infektiologie und Rheumatologie (Medizinische Klinik A), Klinikum Ludwigshafen, Ludwigshafen, Deutschland
| | - F Kosely
- Klinik für Kardiologie, Pneumologie, Angiologie und Internistische Intensivmedizin (Medizinische Klinik B), Klinikum Ludwigshafen, Bremserstraße 79, 67073, Ludwigshafen, Deutschland
| | - W Zink
- Klinik für Anästhesiologie, Operative Intensivmedizin und Notfallmedizin, Klinikum Ludwigshafen, Ludwigshafen, Deutschland
| | - R Zahn
- Klinik für Kardiologie, Pneumologie, Angiologie und Internistische Intensivmedizin (Medizinische Klinik B), Klinikum Ludwigshafen, Bremserstraße 79, 67073, Ludwigshafen, Deutschland
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He X, Chandrashekar A, Zahn R, Wegmann F, Yu J, Mercado NB, McMahan K, Martinot AJ, Piedra-Mora C, Beecy S, Ducat S, Chamanza R, Huber SR, van der Fits L, Borducchi EN, Lifton M, Liu J, Nampanya F, Patel S, Peter L, Tostanoski LH, Pessaint L, Van Ry A, Finneyfrock B, Velasco J, Teow E, Brown R, Cook A, Andersen H, Lewis MG, Schuitemaker H, Barouch DH. Low-Dose Ad26.COV2.S Protection Against SARS-CoV-2 Challenge in Rhesus Macaques. bioRxiv 2021:2021.01.27.428380. [PMID: 33532782 PMCID: PMC7852276 DOI: 10.1101/2021.01.27.428380] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
We previously reported that a single immunization with an adenovirus serotype 26 (Ad26) vector-based vaccine expressing an optimized SARS-CoV-2 spike (Ad26.COV2.S) protected rhesus macaques against SARS-CoV-2 challenge. In this study, we evaluated the immunogenicity and protective efficacy of reduced doses of Ad26.COV2.S. 30 rhesus macaques were immunized once with 1×10 11 , 5×10 10 , 1.125×10 10 , or 2×10 9 vp Ad26.COV2.S or sham and were challenged with SARS-CoV-2 by the intranasal and intratracheal routes. Vaccine doses as low as 2×10 9 vp provided robust protection in bronchoalveolar lavage, whereas doses of 1.125×10 10 vp were required for protection in nasal swabs. Activated memory B cells as well as binding and neutralizing antibody titers following vaccination correlated with protective efficacy. At suboptimal vaccine doses, viral breakthrough was observed but did not show evidence of virologic, immunologic, histopathologic, or clinical enhancement of disease compared with sham controls. These data demonstrate that a single immunization with a relatively low dose of Ad26.COV2.S effectively protected against SARS-CoV-2 challenge in rhesus macaques. Moreover, our findings show that a higher vaccine dose may be required for protection in the upper respiratory tract compared with the lower respiratory tract.
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