Recognition of Facial Emotion Expressions in Patients with Depressive Disorders: A Functional MRI Study.

BACKGROUND: The present study evaluated the cortical activation during emotional information recognition. METHODS: The study group included 16 patients with depression, and 16 healthy subjects were enrolled as a control group. Patients received eight weeks of antidepressant therapy. Functional MRI evaluated the cortical activation twice in the patient group and once in the control group. The fMRI task processed the emotional information with face demonstration from the PennCNP test battery. RESULTS: During the processing of emotional information, patients showed activation in the middle and the inferior frontal gyri, the fusiform gyrus, and the occipital cortex. After treatment, patients showed a significant decrease in the frontal cortex activation for negative face demonstration and no frontal activation for positive emotion recognition. The left superior temporal gyrus activation zone appeared in patients after treatment and in the control group. Healthy subjects showed more intense frontal cortex activation when processing neutral emotions and less when showing happy and sad faces. Activation zones in the amygdala and the insula and deactivation zones in the posterior cingulate cortex were revealed in the controls. CONCLUSION: This study confirms the hypothesis that anomalies in the processing of emotional stimuli can be a sign of a depressive disorder.

Reliability of coronary computed tomography angiography in acute coronary syndrome in an emergency setting.

BACKGROUND: Cardiovascular computed tomography (cardiovascular CT) is currently used as a fast non-invasive method for the visualization of coronary plaques and walls and the assessment of lumen stenosis severity. Previous studies demonstrated the high negative predictive value of CT for the exclusion of coronary lumen stenoses. In this study we hypothesize that coronary CT angiography (CTA) represents a reliable method as diagnostic procedure in acute coronary syndrome (ACS) even in emergency settings. METHODS: 36 patients (51 lesions) with ACS who underwent cardiovascular CT, intravascular ultrasound (IVUS) and invasive coronary angiography (ICA) within 48 h were included. The percentage of coronary stenoses were measured and compared by three methods. Influence of available predictors that can potentially affect the measurement results was assessed. RESULTS: Cardiac CTA provided comparable results to IVUS (mean difference -0.45%, PPV: 98%, NPV: 75%). ICA tends to estimate lower stenoses degrees than cardiac CTA and IVUS (mean difference 13.19% and 13.64%, respectively). The final diagnosis and positive remodeling did not lead to any significant influence on measurements. CONCLUSIONS: The cardiovascular CT results show that even in emergency settings it is possible to identify morphological changes as sequels of coronary artery sclerosis with comparable results to the reference method IVUS. Deviations of IVUS and cardiovascular CT from ICA are comparable and can to a large extent be explained by differences in the measurement technique.

The Relationship Between Brown Adipose Tissue Content in Supraclavicular Fat Depots and Insulin Sensitivity in Patients with Type 2 Diabetes Mellitus and Prediabetes.

BACKGROUND: The evaluation of brown adipose tissue (BAT) and its role in metabolism and obesity remains an important topic in the recent literature. This study evaluated the influence of the BAT triglyceride content measured by proton magnetic resonance (MR) spectroscopy in patients with type 2 diabetes mellitus (DM2) and prediabetes on insulin sensitivity. METHODS: A total of 25 patients with DM2 and prediabetes (45.9 ± 10.1 years old, body mass index [BMI] of 31.6 ± 5.4 kg/m2) underwent anthropometric measurements (BMI), insulin sensitivity analysis (M value during euglycemic hyperinsulinemic clamp and homeostasis model assessment of insulin resistance), proton MR spectroscopy, and blood tests (total cholesterol, low-density lipoproteins, high-density lipoproteins, and triglycerides). The relationship between the triglyceride content in the supraclavicular fat depot and insulin sensitivity, anthropometric measurements, and blood test results was assessed. RESULTS: The triglyceride content in the supraclavicular fat depot varied between 79.2% and 97.1% (mean: 92.6% ± 4.2%). The triglyceride content in the subcutaneous white adipose tissue of the neck was significantly higher (85.3%-99.3%; mean: 95.5% ± 2.9%; P = 0.0007). The triglyceride content in the supraclavicular fat depot exhibited a significantly moderate correlation with the BMI (r = 0.64; P = 0.0009). A significant weak negative correlation between the supraclavicular fat content and M value was revealed (r = -0.44; P = 0.002). Patients with high insulin resistance (IR) had a higher triglyceride content in the supraclavicular fat depot than patients with normal and lower IR (94.3% ± 2.0% vs. 90.4% ± 5.2%; P = 0.02). CONCLUSIONS: Reducing the BAT content in the supraclavicular fat depot can influence the development of IR in patients with DM2 and prediabetes.

Modern medical treatment with or without carotid endarterectomy for severe asymptomatic carotid atherosclerosis.

OBJECTIVE: This study assessed the value of modern medical treatment (MMT) with and without carotid endarterectomy (CEA) in patients with asymptomatic severe carotid artery stenosis. METHODS: We conducted a randomized trial involving 55 patients with 70% to 79% carotid stenosis at three Russian centers. Between 2009 and 2013, 31 patients were randomized to undergo CEA with MMT (CEA group) and 24 to receive MMT alone. The primary end point was nonfatal ipsilateral stroke or death from any cause during a follow-up period of 5.0 years. The secondary end point was any nonfatal stroke, carotid revascularization, or death from any cause during follow-up. RESULTS: The trial was stopped after a median follow-up of 3.3 years (maximum, 5.0 years). There were two primary events in the CEA group and nine events in the MMT group. The 3.3-year cumulative primary event rates were 6.5% in the CEA group and 37.5% in the MMT group (hazard ratio for the MMT group, 5.06; 95% confidence interval, 1.53-16.79; P = .008). The 3.3-year cumulative secondary end point was 12.9% in the CEA group and 50.0% in the MMT group (hazard ratio for the MMT group, 4.23; 95% confidence interval, 1.55-11.53; P = .0048). CONCLUSIONS: CEA as an initial management strategy could reduce the risk of death and major cerebrovascular events when added to MMT.