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1.
Artigo em Inglês | MEDLINE | ID: mdl-38083532

RESUMO

The evaluation and diagnosis of structural changes in brain caused by disease or treatment over time has become one of the important applications of medical imaging methods, in particular MRI, and it is growing. It is critical to evaluate the reliability of the changes in measurements observed in an individual patient for any clinical decision-making. In this paper, we calculated the repeatability coefficient (RC) as a measure of uncertainty for MRI measurements of subcortical volumes and cortical thickness, and within-network connectivity using test-retest data of 20 healthy subjects. We also evaluated changes in 13 patients who received 20 sessions of transcranial magnetic stimulation as a treatment. The most reliable measure seems to be in the thickness of the left occipital with RC% of 3.5 and the least reliable measure is the brain connectivity within visual network using Yeo's atlas with RC% of 29.4. The most sensitive measure to the percentage of true changes in treated patients is the connectivity within subcortical network of AAL with 76.9%.Clinical Relevance- The results of this study can be useful for evaluating changes in the gray matter structures or functional connectivity of the brain due to a neurological disease such as Alzheimer's or Parkinson's. Also, the obtained results can be used to evaluate the changes caused by any intervention or treatment that may have any positive or negative effect on the brain.


Assuntos
Encéfalo , Substância Cinzenta , Humanos , Reprodutibilidade dos Testes , Encéfalo/diagnóstico por imagem , Estimulação Magnética Transcraniana , Imageamento por Ressonância Magnética/métodos
2.
Front Psychiatry ; 10: 877, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31920740

RESUMO

Although there is general consensus that altered brain structure and function underpins addictive disorders, clinicians working in addiction treatment rarely incorporate neuroscience-informed approaches into their practice. We recently launched the Neuroscience Interest Group within the International Society of Addiction Medicine (ISAM-NIG) to promote initiatives to bridge this gap. This article summarizes the ISAM-NIG key priorities and strategies to achieve implementation of addiction neuroscience knowledge and tools for the assessment and treatment of substance use disorders. We cover two assessment areas: cognitive assessment and neuroimaging, and two interventional areas: cognitive training/remediation and neuromodulation, where we identify key challenges and proposed solutions. We reason that incorporating cognitive assessment into clinical settings requires the identification of constructs that predict meaningful clinical outcomes. Other requirements are the development of measures that are easily-administered, reliable, and ecologically-valid. Translation of neuroimaging techniques requires the development of diagnostic and prognostic biomarkers and testing the cost-effectiveness of these biomarkers in individualized prediction algorithms for relapse prevention and treatment selection. Integration of cognitive assessments with neuroimaging can provide multilevel targets including neural, cognitive, and behavioral outcomes for neuroscience-informed interventions. Application of neuroscience-informed interventions including cognitive training/remediation and neuromodulation requires clear pathways to design treatments based on multilevel targets, additional evidence from randomized trials and subsequent clinical implementation, including evaluation of cost-effectiveness. We propose to address these challenges by promoting international collaboration between researchers and clinicians, developing harmonized protocols and data management systems, and prioritizing multi-site research that focuses on improving clinical outcomes.

3.
Neurosci Biobehav Rev ; 104: 118-140, 2019 09.
Artigo em Inglês | MEDLINE | ID: mdl-31271802

RESUMO

There is growing interest in non-invasive brain stimulation (NIBS) as a novel treatment option for substance-use disorders (SUDs). Recent momentum stems from a foundation of preclinical neuroscience demonstrating links between neural circuits and drug consuming behavior, as well as recent FDA-approval of NIBS treatments for mental health disorders that share overlapping pathology with SUDs. As with any emerging field, enthusiasm must be tempered by reason; lessons learned from the past should be prudently applied to future therapies. Here, an international ensemble of experts provides an overview of the state of transcranial-electrical (tES) and transcranial-magnetic (TMS) stimulation applied in SUDs. This consensus paper provides a systematic literature review on published data - emphasizing the heterogeneity of methods and outcome measures while suggesting strategies to help bridge knowledge gaps. The goal of this effort is to provide the community with guidelines for best practices in tES/TMS SUD research. We hope this will accelerate the speed at which the community translates basic neuroscience into advanced neuromodulation tools for clinical practice in addiction medicine.


Assuntos
Medicina do Vício/métodos , Avaliação de Resultados em Cuidados de Saúde/normas , Guias de Prática Clínica como Assunto/normas , Transtornos Relacionados ao Uso de Substâncias/terapia , Estimulação Transcraniana por Corrente Contínua/normas , Estimulação Magnética Transcraniana/normas , Humanos , Avaliação de Resultados em Cuidados de Saúde/métodos , Estimulação Transcraniana por Corrente Contínua/métodos , Estimulação Magnética Transcraniana/métodos
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