Transdiagnostic alterations in neural emotion regulation circuits - neural substrates of cognitive reappraisal in patients with depression and post-traumatic stress disorder.

BACKGROUND: Impaired cognitive reappraisal, associated with the social functioning and well-being of patients affected by mood or anxiety disorders, is characterized by distinct neural activation patterns across clinical populations. To date, studies dedicated to identifying common and distinct neural activation profiles need to be clarified. The aim of the present study was to investigate transdiagnostic differences and commonalities in brain activation patterns during reappraisal-mediated downregulation of emotions. METHODS: Cognitive reappraisal of negative images was contrasted with maintaining emotions during a control viewing condition. Brain activation in 35 patients with major depressive disorder (MDD), 20 patients with post-traumatic stress disorder (PTSD), and 34 healthy controls (HC) during cognitive reappraisal was compared. Moreover, the neural circuitry of emotion regulation in these clinical populations was examined using seed-to-voxel and voxel-to-voxel functional connectivity analyses. RESULTS: Whole-brain fMRI analyses showed less right-lateralized activation of the inferior, middle, and superior frontal gyrus during cognitive reappraisal compared to viewing of negative images in MDD and PTSD patients compared to HCs. Right IFG activation was negatively correlated with the severity of anxiety and depressive symptomatology. In addition, increased seed-to-voxel connectivity of the right IFG as well as increased voxel-to-voxel connectivity was observed in PTSD patients compared to HCs and MDD patients. CONCLUSIONS: FMRI results therefore suggested a common deficit of depression and anxiety symptomatology reflected by reduced activation in right IFG during cognitive reappraisal as well as diagnosis specific effects in patients with PTSD based on seed-to-voxel and voxel-to-voxel connectivity showing an overactive and hyperconnected salience network. Findings highlight the role of transdiagnostic research to identify disorder specific brain patterns as well as patterns common across disorders.

fMRI Neurofeedback-Enhanced Cognitive Reappraisal Training in Depression: A Double-Blind Comparison of Left and Right vlPFC Regulation.

Affective disorders are associated with maladaptive emotion regulation strategies. In particular, the left more than the right ventrolateral prefrontal cortex (vlPFC) may insufficiently regulate emotion processing, e.g., in the amygdala. A double-blind cross-over study investigated NF-supported cognitive reappraisal training in major depression (n = 42) and age- and gender-matched controls (n = 39). In a randomized order, participants trained to upregulate either the left or the right vlPFC during cognitive reappraisal of negative images on two separate days. We wanted to confirm regional specific NF effects with improved learning for left compared to right vlPFC (ClinicalTrials.gov NCT03183947). Brain responses and connectivity were studied with respect to training progress, gender, and clinical outcomes in a 4-week follow-up. Increase of vlPFC activity was stronger after NF training from the left- than the right-hemispheric ROI. This regional-specific NF effect during cognitive reappraisal was present across patients with depression and controls and supports a central role of the left vlPFC for cognitive reappraisal. Further, the activity in the left target region was associated with increased use of cognitive reappraisal strategies (r = 0.48). In the 4-week follow-up, 75% of patients with depression reported a successful application of learned strategies in everyday life and 55% a clinically meaningful symptom improvement suggesting clinical usability.

Functional Connectivity and Quantitative EEG in Women with Alcohol Use Disorders: A Resting-State Study.

This study was aimed at exploring the electroencephalographic features associated with alcohol use disorders (AUD) during a resting-state condition, by using quantitative EEG and Functional Connectivity analyses. In addition, we explored whether EEG functional connectivity is associated with trait impulsivity. Absolute and relative powers and Synchronization Likelihood (SL) as a measure of functional connectivity were analyzed in 15 AUD women and fifteen controls matched in age, gender and education. Correlation analysis between self-report impulsivity as measured by the Barratt impulsiveness Scale (BIS-11) and SL values of AUD patients were performed. Our results showed increased absolute and relative beta power in AUD patients compared to matched controls, and reduced functional connectivity in AUD patients predominantly in the beta and alpha bands. Impaired connectivity was distributed at fronto-central and occipito-parietal regions in the alpha band, and over the entire scalp in the beta band. We also found that impaired functional connectivity particularly in alpha band at fronto-central areas was negative correlated with non-planning dimension of impulsivity. These findings suggest that functional brain abnormalities are present in AUD patients and a disruption of resting-state EEG functional connectivity is associated with psychopathological traits of addictive behavior.

Caracterización del reconocimiento emocional con caras dinámicas como posible marcador de susceptibilidad en la esquizofrenia / Caracterization by dynamic facial emotion recognition as a possible marker of susceptibility to schizophrenia

Introducción: Existen estudios que han demostrado que las alteraciones en el reconocimiento emocional son heredables y constituyen marcadores endofenotípicos para la esquizofrenia, sin embargo estos estudios se han realizado con caras estáticas. Con empleo de caras dinámicas se ha reportado mayor activación de los circuitos neurales involucrados en el reconocimiento emocional, por tanto podría ser también un endofenotipo para la enfermedad. Objetivo: Evaluar el criterio de heredabilidad para el reconocimiento emocional en una muestra de pacientes cubanos. Métodos: Se realizó un estudio transversal. La muestra estuvo constituida por 96 pacientes con diagnóstico de esquizofrenia según los criterios del DSM-IV. Se evaluaron además 192 familiares de primer grado de los pacientes y 107 sujetos sanos como controles. Para la evaluación clínica se aplicaron escalas clinimétricas y el test de reconocimiento emocional a partir de expresiones faciales dinámicas. Resultados: A pesar de las evidencias de asociación familiar previamente reportadas, los valores de heredabilidad para las 6 emociones exploradas fueron bajas. Conclusiones: La baja heredabilidad indica mayor efecto de los factores ambientales que los genéticos para el reconocimiento emocional con caras dinámicas. Por tanto, no hay evidencias suficientes de que sea un endofenotipo para la enfermedad(AU)

Introduction: Several studies have documented that the alterations in emotional recognition is heritable and constitute endophenotype markers for schizophrenia, however, these studies have been develop with static faces. It has been reported that using dynamic faces there is higher activation of neural circuits involved in emotional recognition and then could be an endophenotype for the illness. Objective: To evaluate heritability criteria for emotional recognition in a sample of Cuban patients. Methods: A transversal study was carried out. The sample was composed by 96 patients with diagnosis of schizophrenia according to the DSM-IV criterias. For the study, were evaluated 192 first-degree relatives of the patients and 107 healthy subjects as controls. To consider clinical evaluation, clinimetric scales and the emotional recognition test with dynamic facial expressionswere applied. Results: In spite ofevidence of family association previous reported, rates of heritability for the 6 emotion explored were low. Conclusions: Low heritability suggest higher effect of environmental factors than genetic factor for emotional recognition with dynamic faces. However, there is no enough evidence for it to be an endophenotype for schizophrenia(AU)

[Evoked potentials N200/P300 disorders and clinical phenotype in Cuban families with paranoid schizophrenia: a family-based association study]. / Estudio de asociación familiar entre las alteraciones de los potenciales evocados N200/P300 y el fenotipo clínico en familias cubanas con esquizofrenia paranoide.

INTRODUCTION: N200 and P300 event-related evoked potentials provide sensitive measurements of sensory and cognitive function and have been used to study information processing in patients with schizophrenia and their unaffected first-degree relatives. Reduced amplitude and increased latency of N200 and P300 potentials have been consistently reported in schizophrenia. Thus, event-related evoked potentials abnormalities are promising possible biological markers for genetic vulnerability to schizophrenia. OBJECTIVE: To assess the association of changes in latency, amplitude and topographic distribution of potentials N200 and P300 of patients with paranoid schizophrenia and their healthy first-degree relatives, in families with schizophrenia multiplex. METHODOLOGY: We measured latency and amplitude of the N200 and P300 component of evoked potentials using an auditory odd-ball paradigm in 25 schizophrenic patients (probands) from 60 families multiply affected with paranoid schizophrenia, 23 of their non-schizophrenic first-degree relatives and 25 unrelated healthy controls, through a study of family association. RESULTS: Schizophrenic patients and their relatives showed significant latency prolongation and amplitude reduction of the N200 and P300 waves compared to controls. Left-temporal as compared to right-temporal N200 and P300 were significantly smaller in schizophrenic patients and their non-schizophrenic first-degree relatives than in controls. Our results suggest that event-related evoked potentials abnormalities may serve as markers of genetic vulnerability in schizophrenia. CONCLUSIONS: Confirming results of other researchers, this present study suggests that latency prolongation and amplitude reduction of the N200 and P300 waves and an altered topography at temporal sites may be a trait “marker” of paranoid schizophrenia.

INTRODUCCIÓN: Los potenciales relacionados a eventos N200 y P300 son herramientas sensibles para evaluar el funcionamiento sensorial y cognitivo. Debido a que, frecuentemente se reporta una prolongación de la latencia y una disminución de la amplitud de los componentes N200 y P300 en pacientes con esquizofrenia, estos potenciales constituyen marcadores biológicos de vulnerabilidad genética para este trastorno mental. OBJETIVO: Precisar la asociación de las alteraciones en la latencia, la amplitud y la distribución topográfica de los potenciales N200 y P300 de pacientes con esquizofrenia paranoide y sus familiares sanos de primer grado, pertenecientes a familias con esquizofrenia multiplex. MÉTODOS: Se utilizó un paradigma “odd-ball” auditivo para evaluar la latencia, la amplitud y la distribución topográfica de los componentes N200 y P300 en 25 pacientes con esquizofrenia paranoide (probandos), 23 familiares sanos de primer grado y 25 sujetos controles, mediante un estudio de asociación familiar en 60 familias afectadas con esquizofrenia multiplex. RESULTADOS: Los probandos y sus familiares mostraron una prolongación significativa de la latencia y una disminución de amplitud de las ondas N200 y P300 cuando se compararon con los sujetos sanos. De igual forma, la amplitud de los potenciales N200 y P300 resultó significativamente disminuida en regiones temporales del hemisferio izquierdo de los probandos y sus familiares con respecto al grupo control. CONCLUSIONES: En concordancia con resultados de otros investigadores, este estudio sugiere que, la prolongación de latencia, la disminución de amplitud y las alteraciones en la distribución topográficas detectadas en regiones temporales de los potenciales N200 y P300, pueden constituir por su elevada asociación familiar, marcadores de rasgo para la esquizofrenia paranoide.

Patología Dual: trastornos del estado de ánimo y de ansiedad en mujeres drogodependientes. La Habana, 2011- 2013 / Dual Pathology: Disorders of Mood and Anxiety on Drug dependent Women. Havana, 2011 - 2013

Objetivo: evaluar la frecuencia de trastornos del estado de ánimo y de ansiedad, en mujeres ingresadas en el Servicio Femenino de Adicciones de La Habana. Métodos: se realizó durante los años 2011 y 2013 un estudio no experimental, descriptivo y transversal con 150 pacientes, que ingresaron con el diagnóstico de dependencia alcohólica y a otras drogas. Los datos se analizaron mediante estadística descriptiva. Se efectuó la comparación de los puntajes medios de las escalas clínicas para los grupos clasificados según el tipo de dependencia. Resultados: predominó la ausencia de vínculos laborales o estudiantiles, y les caracteriza una frecuente inestabilidad en las relaciones de parejas, mostrando un comportamiento similar en los tres tipos de dependencias. La sustancia de mayor consumo es el alcohol. Los hipnóticos y el crack, son las otras drogas que más se utilizan, aunque en menor escala de consumo a diferencia del alcohol.La mayoría, presentó dificultad para abstenerse del consumo en el último año y persiste en el consumo, a pesar de los daños físicos o mentales que estas les han producido. La tolerancia está desarrollada, en mayor o menor medida, en la totalidad de las pacientes estudiadas. El 69.3 por ciento de las pacientes, presentó un trastorno del estado de ánimo y ansiedad. Conclusiones: los trastornos más frecuentes fueron; el episodio depresivo moderado, el leve, el trastorno mixto de ansiedad y depresión. Las pacientes con dependencia alcohólica fueron las más representativas, aunque los dos grupos restantes, mostraron un comportamiento similar(AU)

Objective: this research was carried outto assess the frequency of moodand anxietydisorders on women admitted in the Addition Feminine Service of Havana. Methods: a non experimental, descriptive and transverse design. A group of 150 patients were admitted with the diagnosis of alcoholic and other drugs dependence. Data were analyzed by means of descriptive statistics. Data were analyzed through descriptive statistical. Average grade of clinical scales for classified was done according groups´ classification related to dependence. Results: It predominate d on the studied patients the absence of scholar and labor affiliation. They are characterized by a frequent instability on their relations and a similar behavior on the three kinds of drug dependence.The bigger- consumption substance is alcohol. The hypnotics and the use of Crack are the drugs more used, but in a minor scale. The majority of them presented difficulties in relation to abstinence in the last year and keeps consuming though the physical and mental injuries that are suffering. The whole group of studied patients has developed tolerance in a large or lesser extent. A mood and anxiety disorder was present on the 69.3 percent of the patients. Conclusions: the moderate mild incident, and the depression and anxiety mixed disorder were the more common disorders. The group of patients with a alcoholic dependent were the most representative, even though the other two groups showed a similar behavior(AU)

Perceptual/attentional anomalies in schizophrenia: a family study.

Endophenotypes have emerged as an important concept in the study of schizophrenia. Perceptual/attentional anomalies were examined as potential endophenotypes in a family study using a strategy for "multiplex/simplex schizophrenia". The sample was comprised of 797 subjects: 206 schizophrenia patients, 302 first-degree relatives and 289 controls. The Spanish versions of the Structured Interview for Assessing Perceptual/attentional Anomalies (SIAPA) and Positive and Negative Symptoms Scale (PANSS) were applied to measure the presence of perceptual/attentional anomalies, and positive and negative subscale respectively. An ANCOVA was carried out for global comparisons between groups. The multiplex schizophrenic group had significantly more frequent auditory and visual perceptual/attentional anomalies than Simplex schizophrenic and control groups. The most interesting finding was that the severity of auditory and visual perceptual/attentional anomalies and negative symptoms was significantly higher in the relatives of the multiplex schizophrenia group than in those relatives from the simplex schizophrenia and control groups. The existence of perceptual/attentional anomalies in nonaffected relatives suggests the presence of familial association for these symptoms which may therefore be a potential endophenotype suitable for genetic studies.