Parent rated bedtime resistance and comorbidity may predict levels of attention among Turkish children diagnosed with ADHD in on-line education classes during the COVID-19 outbreak.

OBJECTIVE: This study aimed to compare the attention levels, of Turkish children and adolescents with Attention Deficit/ Hyperactivity Disorder (ADHD) in on-line education classes with healthy controls. METHODS: This study is a cross-sectional, internet-based, case-control study that recruited 6-18 years old patients diagnosed with ADHD and receving treatment and healthy controls from eight centers. The measurements used in the study were prepared in the google survey and delivered to the participants via Whatsapp application. RESULTS: Within the study period, 510 children with ADHD and 893 controls were enrolled. Parent- rated attention decreased significantly in both groups during on-line education classes due to COVID-19 outbreak (p<0.001; for each). Children and adolescents with ADHD had significantly elevated bedtime resistance, problems in family functioning difficulties than control children according to parental reports (p=0.003; p<0.001; p<0.001, respectively). Furthermore, bedtime resistance and comorbidity significantly predicted attention levels in on-line education. CONCLUSION: Our findings may underline the need to augment student engagement in on-line education both for children without attention problems and those with ADHD. Interventions shown to be effective in the management of sleep difficulties in children as well as parent management interventions should continue during on-line education.

Choroidal structural analysis in ultra-high risk and first-episode psychosis.

Both structural and functional alterations in the retina and the choroid of the eye, as parts of the central nervous system, have been shown in psychotic disorders, especially in schizophrenia. In addition, genetic and imaging studies indicate vascular and angiogenesis anomalies in the psychosis spectrum disorders. In this ocular imaging study, choroidal structure and vascularity were investigated using enhanced depth imaging (EDI) optical coherence tomography (OCT) in first-episode psychosis (FEP), ultra-high risk for psychosis (UHR-P), and age- and gender- matched healthy controls (HCs). There were no significant differences between groups in central choroidal thickness, stromal choroidal area (SCA), luminal choroidal area (LCA) and total subfoveal choroidal area. The LCA/SCA ratio (p<0.001) and the choroidal vascularity index (CVI) (p<0.001) were significantly different between FEP, UHR-P and HCs. CVI and LCA/SCA ratio were significantly higher in patients with FEP compared to help-seeking youth at UHR-P. CVI and LCA/SCA ratio were not different between UHR-P and HCs. However, CVI was higher in UHR-P compared to HCs after excluding the outliers for the sensitivity analysis (p = 0.002). Current findings suggest that choroidal thickness is normal, but there are abnormalities in choroidal microvasculature in prodromal and first-episode psychosis. Further longitudinal studies are needed to investigate oculomics, especially CVI, as a promising biomarker for the prediction of conversion to psychosis in individuals at clinical high-risk.

Blood neurofilament light chain and thrombospondin-1 levels of patients with autism spectrum disorder.

BACKGROUND: Neurofilaments are intermediary filaments associated with neurodegenerative processes. Thrombospondin-1 (TSP-1) is a biological marker playing a role in synaptogenesis. This study aimed to investigate serum neurofilament light chain (NFL), and TSP1 levels of patients with autism spectrum disorder (ASD) compared to typically developing (TD) children. METHODS: Forty-three patients with ASD and forty-five TD children were included. Serum biomarker levels were measured using the sandwich ELISA technique. The Childhood Autism Rating Scale (CARS) was implemented to measure the severity of ASD. RESULTS: NFL and TSP1 levels did not differ between study groups (For NFL, ASD = 47.8 ± 11.4 vs. TD = 48.2 ± 15.3 pg/mL, p = 0.785; for TSP1, ASD = 224.4 ± 53.7 vs. TD = 224.7 ± 69.0 ng/mL, p = 0.828). Stereotyped behavior and sensory sensitivity domain of the CARS scale was negatively correlated with serum TSP-1 (r = -0.390, p = 0.010) and NFL (r = -0.377, p = 0.013) levels. Age was also positively correlated with NFL levels (r = 0.332, p = 0.030) in the ASD groups but not in the TD group. DISCUSSION: Our results did not support the neurodegenerative process of ASD. Future studies are needed to investigate neuroprogression in a longitudinal follow-up.

Brain-derived neurotrophic factor in bipolar disorder: Associations with age at onset and illness duration.

Bipolar disorder (BD) is a heterogeneous disorder that contains neurodevelopmental differences. Defining homogeneous subgroups of BD patients by using age at onset (AAO) as a specifier may promote the classification of biomarkers. This study compares peripheral BDNF levels between pediatric and adult BD patients to investigate the associations between BDNF levels, AAO, and illness duration. We enrolled two groups of euthymic patients, those with pediatric BD (n = 39) and those with adult BD (n = 31), as well as a group of healthy controls (HCs) (n = 90). Participants were assessed using clinical measures and BDNF serum levels were obtained using ELISA. We observed that BDNF levels were comparable between adult BD and HCs, but were clearly lower in pediatric BD than in HCs. In adult BD with AAO ≥30 years, BDNF levels were significantly higher than in adult BD with AAO <30 years. In pediatric BD, patients with prepubertal-onset had higher BDNF levels than those with pubertal-onset. BDNF levels demonstrated the accuracy of being able to distinguish pediatric BD from healthy controls in a receiver operating characteristic (ROC) curve analysis (area under the curve [AUC] = 0.792). In adult BD, higher BDNF levels were associated with later disease onset, but this was not the case in pediatric BD. Finally, reduced BDNF levels were associated with illness duration in adult BD. The findings indicate that BDNF levels in BD patients are associated with AAO. BDNF may, therefore, potentially serve as a developmental marker in BD, when AAO is taken into account.

Parental psychological distress associated with COVID-19 outbreak: A large-scale multicenter survey from Turkey.

AIMS: Pandemics can cause substantial psychological distress; however, we do not know the impact of the COVID-19 related lockdown and mental health burden on the parents of school age children. We aimed to comparatively examine the COVID-19 related the stress and psychological burden of the parents with different occupational, locational, and mental health status related backgrounds. METHODS: A large-scale multicenter online survey was completed by the parents (n = 3,278) of children aged 6 to 18 years, parents with different occupational (health care workers-HCW [18.2%] vs. others), geographical (Istanbul [38.2%] vs. others), and psychiatric (child with a mental disorder [37.8%]) backgrounds. RESULTS: Multivariable logistic regression analysis showed that being a HCW parent (odds ratio 1.79, p < .001), a mother (odds ratio 1.67, p < .001), and a younger parent (odds ratio 0.98, p = .012); living with an adult with a chronic physical illness (odds ratio 1.38, p < .001), having an acquaintance diagnosed with COVID-19 (odds ratio 1.22, p = .043), positive psychiatric history (odds ratio 1.29, p < .001), and living with a child with moderate or high emotional distress (odds ratio 1.29, p < .001; vs. odds ratio 2.61, p < .001) were independently associated with significant parental distress. CONCLUSIONS: Parents report significant psychological distress associated with COVID-19 pandemic and further research is needed to investigate its wider impact including on the whole family unit.

Are language features and emotion regulation related to maternal depression in autism and language delay?

BACKGROUND: Language and communication are very important in child social, emotional and cognitive development. Delay in language is usually the first complaint for children diagnosed with autism spectrum disorder (ASD) or developmental language delay (DLD). This study evaluated language features and emotion regulation skills in children diagnosed with ASD and DLD and their association with maternal depression. METHOD: The sample consisted of children aged 24-54 months diagnosed with ASD (n = 31), or with DLD (n = 45), and 52 healthy controls. The Test of Early Language Development (TELD-3) was used to evaluate language profiles, and the beck depression inventory (BDI) was used to examine maternal depression. Children's emotion regulation skills were evaluated using the emotion regulation checklist. RESULTS: Children with DLD had a significantly higher developmental age, were linguistically more developed and had better emotion regulation than the ASD group. All domains of language on TELD-3 except expressive syntax were more developed in DLD. Maternal BDI score did not differ significantly between DLD and ASD. Both of these disorders were not associated with maternal depression. CONCLUSION: Children with DLD were less impaired than children with ASD, both in terms of language and in emotion regulation.

Emotional and Behavioral Characteristics of Gifted Children and Their Families.

INTRODUCTION: To compare the quality of life, areas of social, emotional, behavioural and mental problems and family functionality of gifted children and children of normal intelligence. METHODS: The study included 49 gifted children aged 9-18 years and 56 age and gender-matched healthy children of normal intelligence. The Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime Version (K-SADS-PL), and the Children's Depression Rating Scale were applied to all the cases. The Quality of Life Scale for Children, the Depression Scale for Children, the Trait-State Anxiety Inventory, and the Strengths and Difficulties Questionnaire- Adolescent Form were completed by all the participants. All the parents completed the Family Evaluation Scale, the Strengths and Difficulties Questionnaire- Parents Form and the Parents Form of the Quality of Life Scale for Children. RESULTS: Compared to children of normal intelligence, gifted children described themselves as more inattentive and lively, social functionality was reported to be low and they had a worse perception of their physical health status. Gifted boys were determined to have more depressive symptoms than gifted girls. The parents of boys of normal intelligence reported lower academic performance than the parents of giftedboys. This difference was not determined for girls between the cases and comparative groups. CONCLUSION: All the findings obtained in this study suggest that gifted children are at risk in respect of mental health. Therefore, to be able to become healthy adults in a biopsychosocial aspect, it is important for the future of gifted children that this status can be identified at an early age, that they can receive appropriate education, that support and counselling are provided for emotional needs and that parents and teachers are fully informed.

Genetic imaging study with [Tc-99m] TRODAT-1 SPECT in adolescents with ADHD using OROS-methylphenidate.

AIM: To examine theeffects on the brain of 2-month treatment withamethylphenidate extended-release formulation (OROS-MPH) using [Tc-99m] TRODAT-1SPECT in a sample of treatment-naïve adolescents with Attention Deficit/Hyperactivity Disorder (ADHD). In addition, to assess whether risk alleles (homozygosity for 10-repeat allele at the DAT1 gene were associated with alterations in striatal DAT availability. METHODS: Twenty adolescents with ADHD underwent brain single-photon emission computed tomography (SPECT) scans with [Tc-99m] TRODAT-1 at baseline and two months after starting OROS-MPH treatment with dosages up to 1 mg/kg/day. Severity of illness was estimated using the Clinical Global Impression Scale (CGI-S) and DuPaul ADHD Rating Scale-Clinician version (ARS) before treatment,1 month and 2 months after initiating OROS-MPH treatment. RESULTS: Decreased DAT availability was found in both the right caudate (pretreatment DAT binding: 224.76 ±â€¯33.77, post-treatment DAT binding: 208.86 ±â€¯28.75, p = 0.02) and right putamen (pre-treatment DAT binding: 314.41 ±â€¯55.24, post-treatment DAT binding: 285.66 ±â€¯39.20, p = 0.05) in adolescents with ADHD receiving OROS-MPH treatment. Adolescents with ADHD who showed a robust response to OROS-MPH (n = 7) had significantly greater reduction of DAT density in the right putamen than adolescents who showed less robust response to OROS-MPH (n = 13) (p = 0.02). However, between-group differences by treatment responses were not related with DAT density in the right caudate. Risk alleles (homozygosity for the 10-repeat allele of DAT1 gene) in the DAT1 gene were not associated with alterations in striatal DAT availability. CONCLUSION: Two months of OROS-MPH treatment decreased DAT availability in both the right caudate and putamen. Adolescents with ADHD who showed a robust response to OROS-MPH had greater reduction of DAT density in the right putamen. However,our findings did not support an association between homozygosity for a 10-repeat allele in the DAT1 gene and DAT density, assessedusing[Tc-99m] TRODAT-1SPECT.

[Validity and Reliability Analysis of Turkish Version of Childhood Autism Rating Scale]. / Çocukluk Otizmi Derecelendirme Ölçegi Türkçe Formunun Geçerlik ve Güvenilirlik Çalismasi.

OBJECTIVE: The purpose of this study is to expand validity and reliability analysis of Turkish Version of Childhood Autism Rating Scale (CARS), whose internal consistency,content validity and discriminant validity for a limited size of sample group were examined by Sucuoglu et al. METHOD: 96 children and adolescents aged between 4-18, (48 diagnosed with pervasive developmental disorder (PDD) and 48 diagnosed with mental disability (MD) and developmental delay based on DSM-IV-TR criteria,) were included in the study. Regarding reliability analysis of Turkish Version of the scale; Cronbach's alpha values as internal consistency indicator, inter-rater reliability, and test-retest reliability were calculated. Principal components analysis and Varimax rotation were used in order to determine factors. The scale was compared with Autism Behavior Checklist and Clinical Global Impression-Severity of Illness. The most appropriate cut-off point was determined for CARS by conducting ROC analysis. RESULTS: As a result of principal components analysis and Varimax rotation, one component factor was obtained. Correlations between CARS and the other scales were statistically significant. The Cronbach's alpha value of total score of the scale was determined as 0,95. Test-retest reliability (r=0,98, p<0,01), and inter-rater reliability (r=0,98, p<0,01) were determined for total score of the scale. The cut-off point of the scale was 29,5. CONCLUSION: All of these results support that the scale adapted into Turkish is a valid and reliable assessment instrument.

Atomoxetine treatment may decrease striatal dopaminergic transporter availability after 8 weeks: pilot SPECT report of three cases.

Attention deficit/hyperactivity disorder is one of the most common neurodevelopmental disorders. The pathophysiology is thought to involve noradrenaline and dopamine. The role of dopamine transporter (DAT) was evaluated in imaging studies using mostly dopamine reuptake inhibitors. Atomoxetine is a selective noradrenaline reuptake inhibitor. Here we report the results of a pilot study conducted to evaluate changes in striatal DAT after 8 weeks of atomoxetine treatment. Our results suggest that 8 weeks of atomoxetine treatment may change striatal DAT bioavailability as measured via SPECT but that change was not correlated with genotype or clinical improvement.

Correlations between amygdala volumes and serum levels of BDNF and NGF as a neurobiological markerin adolescents with bipolar disorder.

BACKGROUND: The amygdala is repeatedly implicated as a critical component of the neurocircuitry regulating emotional valence. Studies have frequently reported reduced amygdala volumes in children and adolescents with bipolar disorder (BD). Brain derived neurotrophic factor (BDNF) and nerve growth factor (NGF) play critical roles in growth, differentiation, maintenance, and synaptic plasticity of neuronal systems in adolescent brain development. The aim of the present study was to assess amygdala volumesand its correlation with serum levels of NGF and BDNF in euthymic adolescents with BD and healthy controls. METHODS: Using structural MRI, we compared the amygdala volumes of 30 euthymic subjects with BD with 23 healthy control subjects aged between 13 and 19 years during a naturalistic clinical follow-up. The boundaries of the amygdala were outlined manually. Serum BDNF and NGF levels were measured using sandwich-ELISA and compared between the study groups. RESULTS: The right or left amygdala volume did not differ between the study groups.The right and left amygdala volumes were highly correlated with levels of BDNF in the combined BD group and the valproate-treated group.Both R and L amygdala volumes were correlated with BDNF levels in healthy controls. The left amygdala volumes were correlated with BDNF levels in the lithium-treated group. LIMITATIONS: This cross-sectional study cannot inform longitudinal changes in brain structure. Further studies with larger sample sizes are needed to improve reliability. CONCLUSIONS: The correlations between amygdala volumes and BDNF levels might be an early neuromarker for diagnosis and/or treatment response in adolescents with BD.

Decreased right hippocampal volumes and neuroprogression markers in adolescents with bipolar disorder.

OBJECTIVES: The aim of the present study was to assess differences and correlations between the hippocampal volumes (HCVs), serum nerve growth factor (NGF), and brain-derived neurotrophic factor (BDNF) levels in adolescents with bipolar disorder (BP) compared to healthy controls. METHODS: Using structural magnetic resonance imaging, we compared HCVs of 30 patients with euthymic BP who were already enrolled in a naturalistic clinical follow-up. For comparison, we enrolled 23 healthy controls between the ages of 13 and 19. The boundaries of the hippocampus were outlined manually. The BDNF and NGF serum levels were measured with the sandwich ELISA. RESULTS: The groups did not differ in the right or left HCVs or in the NGF or BDNF serum levels. However, negative correlations were found between the right HCVs and the duration of the disorder and medication and positive correlations were found between the duration of the medications and the NGF and BDNF levels in the patient group. Additionally, positive correlations were found between the follow-up period and left normalized HCVs in both the BP and lithium-treated groups. CONCLUSIONS: The right HCVs may vary with illness duration and the medication used to treat BP; NGF and BDNF levels may be affected by long-term usage. Further research is needed to determine whether these variables and their structural correlates are associated with clinical or functional differences between adolescents with BP and healthy controls.

Psychopathology and Related Psychosocial Factors in Children with Office Discipline Referrals at School: Evidence from a Developing Country.

Many childhood psychiatric disorders present their first symptoms as challenging behaviors at school. Evidence from cross-national studies enhance the understanding of the biological and cultural variables underlying these behaviours. In this study, we aim to identify the psychopathology among children with office disciplinary referrals and assess psychosocial risk factors related to this situation. Forty-seven students who had received an office discipline referral and eighty-three controls who had never been given an office disciplinary referral participated in this study. The Kiddie Schedule for Affective Disorders and Schizophrenia for School-Age Children--Present and Lifetime, socio-demographic data form were administered to children to assess their respective psychopathologies and psychosocial risk factors. Attention deficit hyperactivity disorder, oppositional defiant disorder, conduct disorder, and obsessive compulsive disorder were significantly higher in children with Office discipline referrals. Psychiatric assessment should be one of the first steps in the evaluation processes of assessing challenging behaviors at school.

[The validity and reliability of the Social Communication Questionnaire- Turkish form in autistics aged 4-18 years]. / 4-18 Yas Araligindaki Otistik Bireylerde Sosyal Iletisim Ölçegi Türkçe Formunun Geçerlik ve Güvenilirlik Çalismasi.

OBJECTIVE: The Social Communication Questionnaire (SCQ) is a valid and reliable 40- item scale used to assess of pervasive developmental disorders (PDDs). The aim of this study was to determine the validity and reliability of the SCQ-Turkish Form (SCQ-TF). MATERIALS AND METHODS: The study included 100 children and adolescents aged 4-18 years 50 were diagnosed as PDD and 50 were diagnosed with intellectual disability (ID) based on DSM-IV-TR criteria. The consistency, test-retest reliability, content validity, and discriminant validity of SCQ-TF for the groups in the study sample were evaluated. SCQ-TF was compared to the Childhood Autism Rating Scale (CARS), Autism Behavioural Checklist (ABC), and Clinical Global Impression Severity of Illness (CGI-SI). The most appropriate SCQ-TF cut-off point was determined via ROC analysis. RESULTS: The 4-factor structure of SCQ-TF accounted for 43% of the observed total variance. Correlations between the Social Communication Questionnaire -Turkish Form and the other measures were significant. The Cronbach's alpha value for the SCQ-TF total score was 0.80. Intraclass correlation coefficient (ICC) varied between 0.87 and 0.96, and the cut-off point was 15. CONCLUSION: The findings show that SCQ-TF is valid and reliable for use in Turkey in those aged 4-18 years.

Forensic child and adolescent psychiatry: from field experiences to education standards.

OBJECTIVE: Forensic evaluation of children is one of the most problematic areas of child and adolescent psychiatry. In this study we aimed to examine Turkish Child and adolescent psychiatrists' attitudes and problems in forensic psychiatry. METHOD: Thirty nine (80%) of all practitioners who are on their compulsory medical service programme countrywide were reached and requested to complete a questionnaire. RESULTS: 76.9% of the specialists found their education to be inadequate in dealing with practical issues. The most common reason of this inadequacy was endorsed as not receiving structured forensic evaluation training. The inadequate number or skills of health professionals from other disciplines and excessive workload were the leading factors mentioned as negatively affecting the quality of assessments. Most favoured solutions to solve current problems were reported as reorganising the residency training and curriculum of child and adolescent psychiatrists and establishing education programmes for other disciplines. CONCLUSION: The standardisation of forensic psychiatry education in child and adolescent psychiatry training and the establishment of global standards for forensic evaluation teams and processes should be considered as the first steps in enhancing the global quality of child and adolescent forensic psychiatric evaluations.

Triage of Patients in the Child and Adolescent Psychiatry Outpatient Clinic.

INTRODUCTION: The aim of this study was to evaluate and describe the three-stage triage method used in a child and adolescent psychiatry outpatient clinic. METHOD: The study investigated the new allocation process of 1482 children and adolescents who were assessed using this triage system for the duration of one year, in the year 2005. Data of 1423 children and adolescents who presented in 2003 regarding the waiting time for the first appointment and the rate of nonattendance at the first appointment were used for the comparison. In triage system, new patients presenting to the outpatient clinic in the morning four days a week were assessed by a three-stage procedure: An initial Strengths and Difficulties Questionnaire screening and a structured interview administered by an intern was then followed by a clinical interview. RESULTS: Of the 1482 children and adolescents who presented to the outpatient clinic during the study period, 1291 were given further appointments. Among patients who presented in 2005, the 207 non-attendant patients were significantly more likely to have longer waiting times than the 1084 attendant patients. When compared to year 2003, it was found that there was a significant decrease in the median waiting time for the first appointment and the rate of nonattendance at the first appointment among patients who presented in 2005. CONCLUSION: The triage procedure used in this study may constitute a model for developing countries with limited health care resources.

[Phenotypic features in autistic individuals: the finger length ratio (2D:4D), hair whorl, and hand dominance]. / Otistik bireylerde fenotipik özellikler: 2D/4D parmak oranlari, saç döneri ve el baskinligi özellikleri.

OBJECTIVE: The aim of this study was to compare the finger length ratio (2D:4D), hair whorl direction, and hand, foot, and eye dominance in autistic and healthy individuals, and to investigate the phenotypic characteristics of autism. MATERIALS AND METHODS: The study included 37 males diagnosed with autistic disorder and 121 healthy males, all aged 4-18 years. The length of the index and ring fingers of both hands--from the proximal bend of the metacarpophalangeal joint to the fingertips--was measured with digital calipers and the index-ring finger (2D:4D) ratio was determined. The distance between hair whorls, their perpendicular distance from the mid-sagittal line, and their direction of rotation were calculated in the autism and control groups. Hand, foot, and eye dominance were determined in both groups. The findings were evaluated using SPSS v.15.0. RESULTS: The autism group had a greater number of hair whorls than the control group. The distance between hair whorls and the mid-sagittal line was longer in those with left hand and left eye dominance. A significant difference in the 2D:4D ratio of the right and left hands between the 2 groups was not observed. CONCLUSION: The autism group had more hair whorls than the control group and the hair whorls in the autistic individuals with left hand and left eye dominance were located further from the mid-saggital line. We think that these novel findings might contribute to the determination of the phenotypic features specific to autism.

Anxiety correlates to decreased blood and prefrontal cortex IGF-1 levels in streptozotocin induced diabetes.

It is well known that diabetes mellitus may cause neuropsychiatric disorders such as anxiety disorders. Diabetes may also cause reduced IGF-1 (insulin like growth factor-1) levels in brain and blood. The purpose of the present study was to investigate the relationship between diabetes induced anxiety and IGF-1 levels in diabetic rats. The anxiety levels of rats were assessed 2 weeks after intraperitoneal injection of streptozotocin. Diabetic rats had higher levels of anxiety, as they spent more time in closed branches in elevated-plus-maze-test and less time in the center cells of open-field-arena. Prefrontal cortex (PFC) IGF-1 levels and neuron numbers were decreased and apoptosis was increased in diabetic rats. Blood IGF-1 levels decreased in a time dependent fashion following streptozotocin injection while blood corticosterone levels increased. They had higher malondialdehyde levels and lower superoxide dismutase enzyme activity. Oxidative stress may negatively affect blood and PFC tissue IGF-1 levels. Reduction in IGF-1 may cause PFC damage, which may eventually trigger anxiety in diabetic rats. Therapeutic strategies that increase blood and brain tissue IGF-1 levels may be promising to prevent psychiatric sequelae of diabetes mellitus.

Anxiety caused by traumatic brain injury correlates to decreased prefrontal cortex VEGF immunoreactivity and neuron density in immature rats.

AIM: Traumatic brain injury (TBI) may cause neuropsychiatric disorders such as anxiety disorder which has negative effects on cognitive functions and behavior. The aim of this study is to investigate the effects of TBI on anxiety and vascular endothelial growth factor (VEGF) immunoreactivity on the prefrontal cortex of immature rats, which is one of the anxiety-related regions of the brain in 7-day-old immature rats subjected to contusion injury. MATERIAL and METHODS: Rats were divided into three groups: Control (n=7), Sham (n=7) and TBI (n=7). Anxiety levels were assessed with open field activity and elevated plus maze in postnatal 27 days. Prefrontal cortex damage related to TBI was examined by cresyl violet staining and VEGF immunostaining. Prefrontal cortex neuronal density was calculated. Serum corticosterone levels were determined. RESULTS: The anxiety level in the TBI group was significantly greater than the control and sham groups. The prefrontal cortex VEGF immunostaining score and neuron density were decreased in the TBI group compared to control and sham group. Serum corticosterone levels were significantly increased in the TBI group. CONCLUSION: These results indicate that TBI decreases VEGF immunoreactivity in prefrontal cortex neurons and increases the anxiety levels of immature rats.

Increased hippocampal volumes in lithium treated adolescents with bipolar disorders: a structural MRI study.

BACKGROUND: Structural neuroimaging studies in bipolar disorder (BD) have consistently identified several anatomical abnormalities in many brain areas related to mood regulation. Hippocampus is one of the key components of emotional regulatory networks in the brain. Evidence about hippocampal changes in BD is quite limited and inconsistent particularly for adolescent onset BD. It is aimed to compare hippocampus volumes of euthymic BD-I adolescents with healthy controls using structural MRI. METHODS: Hippocampal volumes of seventeen youths between 13 and 19 age period with DSM-IV BD (seven boys) and twelve healthy comparison subjects (five boys) were compared using structural MRI. Differences in hippocampal volumes between groups were tested. RESULTS: There was no significant difference between the right and left hippocampus volumes of patients with BD and the control group. However boys tended to have significantly larger right hippocampal volumes than girls both in BD and control group. Right hippocampal volumes were enlarged in lithium treated bipolar patients. This enlargement is not related to sex. LIMITATIONS: Future, longitudinal follow-up studies need large enough sample sizes of both sexes and a sex-matched healthy comparison group to sort out developmental, gender and medication influences on brain structures over time in BD. CONCLUSIONS: Lithium treatment in adolescent-onset BD has a significant effect on hippocampus volumes.