Translocator Protein Distribution Volume Predicts Reduction of Symptoms During Open-Label Trial of Celecoxib in Major Depressive Disorder.

BACKGROUND: Gliosis is common among neuropsychiatric diseases, but the relationship between gliosis and response to therapeutics targeting effects of gliosis is largely unknown. Translocator protein total distribution volume (TSPO VT), measured with positron emission tomography, mainly reflects gliosis in neuropsychiatric disease. Here, the primary objective was to determine whether TSPO VT in the prefrontal cortex (PFC) and anterior cingulate cortex (ACC) predicts reduction of depressive symptoms following open-label celecoxib administration in treatment-resistant major depressive disorder. METHODS: A total of 41 subjects with treatment-resistant major depressive disorder underwent one [18F]FEPPA positron emission tomography scan to measure PFC and ACC TSPO VT. Open-label oral celecoxib (200 mg, twice daily) was administered for 8 weeks. Change in symptoms was measured with the 17-item Hamilton Depression Rating Scale (HDRS). RESULTS: Cumulative mean change in HDRS scores between 0 and 8 weeks of treatment was plotted against PFC and ACC TSPO VT, showing a significant nonlinear relationship. At low TSPO VT values, there was no reduction in HDRS scores, but as TSPO VT values increased, there was a reduction in HDRS scores that then plateaued. This was modeled with a 4-parameter sigmoidal model in which PFC and ACC TSPO VT accounted for 84% and 92% of the variance, respectively. CONCLUSIONS: Celecoxib administration in the presence of gliosis labeled by TSPO VT is associated with greater reduction of symptoms. Given the predictiveness of TSPO VT on symptom reduction, this personalized medicine approach of matching a marker of gliosis to medication targeting effects of gliosis should be applied in early development of novel therapeutics, in particular for treatment-resistant major depressive disorder.

A systematic scoping review: Resources targeting the training and education of health and recreation practitioners to support physical activity among people with physical disabilities.

BACKGROUND: Health and recreation practitioners play an important role in promoting and supporting leisure time physical activity (LTPA) among persons with physical disabilities (PWPD), yet many practitioners lack training and education to provide the basic knowledge, skills, and resources necessary.1 Little is known about existing LTPA information and training resources for health and recreation practitioners and there has been no known systematic effort to identify existing resources. OBJECTIVE: The purpose of the current study was to engage systematic scoping methodologies to identify resources that target the training and education of health and recreation practitioners to promote and support LTPA among PWPD. To further analyze the identified resources, an assessment of quality was conducted. METHODS: Systematic scoping review methodologies were employed, which included searches of academic and grey literature, online materials (i.e., Google search) and expert consultation. RESULTS: Several (N = 46) resources were identified from academic, government and non-government, and professional organizations. Most resources were targeted to a specific PWPD population. The resources were of high technical quality. CONCLUSION: The paper serves as a listing of existing resources for practitioners working with PWPD in LTPA settings. The review provides a catalyst for action in further research and practice regarding the analysis, design, development, implementation and evaluation of optimally effective resources targeting practitioners to promote and support LTPA among PWPD. RESULTS: Several (N = 46) resources were identified from academic, government and non-government, and professional organizations. Most resources were targeted to a specific PWPD population. The resources were of high technical quality. CONCLUSION: The paper serves as a listing of existing resources for practitioners working with PWPD in LTPA settings. The review provides a catalyst for action in further research and practice regarding the analysis, design, development, implementation and evaluation of optimally effective resources targeting practitioners to promote and support LTPA among PWPD.