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1.
Heliyon ; 10(7): e28558, 2024 Apr 15.
Artículo en Inglés | MEDLINE | ID: mdl-38590842

RESUMEN

Background: No reports of organ donation have been documented in patients suffering from severe autoimmune glial fibrillary acidic protein (GFAP) astrocytopathy. Case presentation: A 27-year-old male patient developed a fever and headache, followed a week later by weakness and unsteadiness in his limbs. He attended his local hospital, but no cause was found. Thirteen days later, he became unconscious and was promptly moved to the intensive care unit for symptomatic support treatment, with no improvement. He was then transferred to our hospital, where he suffered a cardiac arrest on the same day. The family abandoned treatment and opted for organ donation, for financial reasons. Cell-based assays demonstrated GFAP antibodies in the cerebrospinal fluid. Two kidney recipients and one liver recipient showed no abnormal reactions 15 months after receiving organ transplants. Conclusions: We report a case of organ donation following brain death in a patient diagnosed with GFAP astrocytopathy, highlighting the need for vigilance regarding the potential occurrence of cardiac arrest in patients with this condition. Considering the potential of GFAP astrocytopathy is crucial when observing deteriorating symptoms, seizures, and consciousness disturbances subsequent to a suspected viral infection. Successful organ donation from patients with GFAP astrocytopathy may be feasible given the exclusion of systemic infection and the absence of peripheral organ involvement.

2.
Heliyon ; 10(6): e27947, 2024 Mar 30.
Artículo en Inglés | MEDLINE | ID: mdl-38509880

RESUMEN

Cerebral small vessel disease (SVD) may be associated with an increased risk of depressive symptoms. Serum uric acid (SUA), an antioxidant, may be involved in the occurrence and development of depressive symptoms, but the mechanism remains unknown. Moreover, the relationship between structural brain networks and SUA has not been explored. This study examined the relationship between SUA and depressive symptoms in patients with SVD using graph theory analysis. We recruited 208 SVD inpatients and collected fasting blood samples upon admission. Depressive symptoms were assessed using the 24-item Hamilton Depression Rating Scale (HAMD-24). Magnetic resonance imaging was used to evaluate SVD, and diffusion tensor images were used to analyze structural brain networks using graph theory. Patients with depressive symptoms (n = 34, 25.76%) compared to those without (334.53 vs 381.28 µmol/L, p = 0.017) had lower SUA levels. Graph theoretical analyses showed a positive association of SUA with betweenness centrality, nodal efficiency, and clustering coefficients and a negative correlation with the shortest path length in SVD with depressive symptoms group. HAMD scores were significantly associated with nodal network metrics in the right cerebral hemisphere. Our findings suggested that lower SUA levels are significantly associated with disrupted structural brain networks in the right cerebral hemisphere of patients with SVD who have depressive symptoms.

3.
United European Gastroenterol J ; 12(3): 374-389, 2024 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-38315582

RESUMEN

AIMS: To investigate the current situation of mental psychology and quality of life (QoL) in patients with inflammatory bowel disease (IBD) in China, and analyze the influencing factors. METHODS: A unified questionnaire was developed to collect clinical data on IBD patients from 42 hospitals in 22 provinces from September 2021 to May 2022. Multivariate Logistic regression analysis was conducted, and independent influencing factors were screened out to construct nomogram. The consistency index (C-index), receiver operating characteristic (ROC) curve, area under the ROC curve (AUC), calibration curve, and decision curve analysis (DCA) were used to evaluate the discrimination, accuracy, and clinical utility of the nomogram model. RESULTS: A total of 2478 IBD patients were surveyed, including 1371 patients with ulcerative colitis (UC) and 1107 patients with Crohn's disease (CD). Among them, 25.5%, 29.7%, 60.2%, and 37.7% of IBD patients had anxiety, depression, sleep disturbance and poor QoL, respectively. The proportion of anxiety, depression, and poor QoL in UC patients was significantly higher than that in CD patients (all p < 0.05), but there was no difference in sleep disturbance between them (p = 0.737). Female, higher disease activity and the first visit were independent risk factors for anxiety, depression and sleep disturbance in IBD patients (all p < 0.05). The first visit, higher disease activity, abdominal pain and diarrhea symptoms, anxiety, depression and sleep disturbance were independent risk factors for the poor QoL of patients (all p < 0.05). The AUC value of the nomogram prediction model for predicting poor QoL was 0.773 (95% CI: 0.754-0.792). The calibration diagram of the model showed that the calibration curve fit well with the ideal curve, and DCA showed that the nomogram model could bring clinical benefits. CONCLUSION: IBD patients have higher anxiety, depression, and sleep disturbance, which affect their QoL. The nomogram prediction model we constructed has high accuracy and performance when predicting QoL.


Asunto(s)
Colitis Ulcerosa , Enfermedad de Crohn , Enfermedades Inflamatorias del Intestino , Trastornos del Sueño-Vigilia , Femenino , Humanos , China/epidemiología , Colitis Ulcerosa/diagnóstico , Colitis Ulcerosa/epidemiología , Colitis Ulcerosa/psicología , Enfermedad de Crohn/diagnóstico , Enfermedad de Crohn/epidemiología , Enfermedad de Crohn/psicología , Enfermedades Inflamatorias del Intestino/epidemiología , Enfermedades Inflamatorias del Intestino/psicología , Calidad de Vida , Trastornos del Sueño-Vigilia/epidemiología , Trastornos del Sueño-Vigilia/etiología , Trastornos del Sueño-Vigilia/diagnóstico , Masculino
4.
Int J Biol Macromol ; 255: 128123, 2024 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-37981275

RESUMEN

Hydrogen peroxide combined with acid treatment demonstrates its respective characteristics for the separation of lignocellulosic biomass. Herein, holocellulose was extracted from Cattail leaves (CL) by a two-step treatment with alkali and hydrogen peroxide-acetic acid (HPAA). Then carboxylated nanocellulose was hydrolyzed with a mixed organic/inorganic acid. The chemical composition of the holocellulose and the physicochemical properties of the separated carboxylated nanocellulose were comparable. Carboxyl groups were introduced on the nanocellulose as a result of the esterification process with citric acid (CA), which endows the nanocellulose with high thermal stability (315-318 °C) and good light transmission (>80 %). Furthermore, morphological analyses revealed that nanocellulose had a spider-web-like structure with diameter between 5 and 20 nm.


Asunto(s)
Celulosa , Typhaceae , Celulosa/química , Peróxido de Hidrógeno
5.
Skin Res Technol ; 29(11): e13515, 2023 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-38009032

RESUMEN

BACKGROUND: Structural abnormalities in the brain of patients with atopic dermatitis (AD) have been reported; however, the cause has not been determined yet. Herein, we used Mendelian randomization (MR) to reveal the causal effect of AD on brain structure. METHODS: This study utilized summary statistics from genome-wide association studies (GWASs) to investigate a collection of cerebral structural measures, encompassing cortical thickness (CT), cortical surface area (CA), and subcortical volumes in T1 images. A comprehensive GWAS meta-analysis identified a total of 20 independent single nucleotide polymorphisms linked to AD, surpassing the genome-wide significance threshold (p < 5 × 10⁻8). MR estimates were aggregated through the application of the inverse variance weighted method. Additional complementary analyses (i.e., MR-Egger and weighted median approaches) were conducted to further assess the robustness of the obtained results. Sensitivity analysis and multivariate MR (MVMR) while adjusting for brain structural changes risk factors (i.e., depression and anxiety) were performed to assess the reliability and stability of observed causality. RESULTS: Genetically determined AD exhibited a causal link with reduced caudate volumes (IVW-MR: ß = -0.186, p = 0.001, p-corrected = 0.009). Furthermore, we identified potential causal associations between AD and reduced CT in the cingulate region (posterior cingulate, IVW-MR: ß = -0.065, p = 0.018, p-corrected = 0.551; isthmus cingulate, IVW-MR: ß = -0.086, p = 0.003, p-corrected = 0.188), as well as abnormal cortical surface area (CA) in the supramarginal (IVW-MR: ß = -0.047, p = 0.044, p-corrected = 0.714) and isthmus cingulate (IVW-MR: ß = 0.053, p = 0.018, p-corrected = 0.714). Additional supplementary analyses yielded consistent outcomes. There was no evidence of horizontal pleiotropy. MVMR analysis showed that the causal effects of AD on abnormal brain structure remained significant while adjusting for depression and anxiety. CONCLUSION: This MR study provided suggestive evidence that decreased caudate nucleus, posterior cingulate cortex, isthmus cingulate cortex and supramarginal gyrus are suggestively associated with higher AD risk. Future investigation into the brain regions is recommended, which helps to clarify the underlying mechanisms and point to new therapies against AD.


Asunto(s)
Dermatitis Atópica , Humanos , Dermatitis Atópica/diagnóstico por imagen , Dermatitis Atópica/genética , Estudio de Asociación del Genoma Completo , Análisis de la Aleatorización Mendeliana , Reproducibilidad de los Resultados , Encéfalo/diagnóstico por imagen
6.
J Affect Disord ; 328: 39-46, 2023 05 01.
Artículo en Inglés | MEDLINE | ID: mdl-36775253

RESUMEN

BACKGROUND: Apathy has been considered a common neuropsychiatric symptom and an important contributor to cognitive impairment in cerebral small vessel disease (SVD). However, the mechanism leading to apathy in SVD and the process whereby apathy promotes cognitive impairments remain largely unknown. We aimed to explore the relationship between apathy, cognition, and structural changes of deep grey matter (DGM) in SVD patients. METHODS: Participants were screened for SVD, completed assessments of apathy cognition, underwent magnetic resonance imaging (MRI) scanning, and then stratified into apathy and non-apathy groups. We used region of interest (ROI)-based, voxel-based volume, and vertex-based shape analyses to compare DGM structures between study groups. Using linear regression analysis, we examined the association between apathy, structural changes, and cognition, followed by a mediation analysis of these factors. RESULTS: A total of sixty-four SVD participants were included, with thirty in the apathy group and thirty-four in the non-apathy group. Intergroup comparison showed significantly lower volumes in bilateral caudate, right putamen, and pallidum and smaller vertex-based shapes in the right caudate and pallidum in participants with apathy compared to those without apathy. Apathy was associated with the striatal atrophy (i.e., lower volumes and smaller shape) and independently contributed to cognitive impairments in SVD. However, the above structural differences did not mediate the association between apathy and cognitive impairments. CONCLUSION: These results highlight the important role of striatal atrophy in apathy in SVD and call for additional studies to explore the relationship between apathy, cognition, and DGM.


Asunto(s)
Apatía , Enfermedades de los Pequeños Vasos Cerebrales , Disfunción Cognitiva , Humanos , Disfunción Cognitiva/complicaciones , Cognición , Imagen por Resonancia Magnética/métodos , Enfermedades de los Pequeños Vasos Cerebrales/complicaciones , Atrofia
7.
BMJ Open ; 12(12): e063442, 2022 12 30.
Artículo en Inglés | MEDLINE | ID: mdl-36585134

RESUMEN

INTRODUCTION: Insomnia affects physical and mental health due to the lack of continuous and complete sleep architecture. Polysomnograms (PSGs) are used to record electrical information to perform sleep architecture using deep learning. Although acupuncture combined with cognitive-behavioural therapy for insomnia (CBT-I) could not only improve sleep quality, solve anxiety, depression but also ameliorate poor sleep habits and detrimental cognition. Therefore, this study will focus on the effects of electroacupuncture combined with CBT-I on sleep architecture with deep learning. METHODS AND ANALYSIS: This randomised controlled trial will evaluate the efficacy and effectiveness of electroacupuncture combined with CBT-I in patients with insomnia. Participants will be randomised to receive either electroacupuncture combined with CBT-I or sham acupuncture combined with CBT-I and followed up for 4 weeks. The primary outcome is sleep quality, which is evaluated by the Pittsburgh Sleep Quality Index. The secondary outcome measures include a measurement of depression severity, anxiety, maladaptive cognitions associated with sleep and adverse events. Sleep architecture will be assessed using deep learning on PSGs. ETHICS AND DISSEMINATION: This trial has been approved by the institutional review boards and ethics committees of the First Affiliated Hospital of Sun Yat-sun University (2021763). The results will be disseminated through peer-reviewed journals. The results of this trial will be disseminated through peer-reviewed publications and conference abstracts or posters. TRIAL REGISTRATION NUMBER: CTR2100052502.


Asunto(s)
Terapia por Acupuntura , Terapia Cognitivo-Conductual , Trastornos del Inicio y del Mantenimiento del Sueño , Humanos , Trastornos del Inicio y del Mantenimiento del Sueño/terapia , Resultado del Tratamiento , Sueño , Terapia Cognitivo-Conductual/métodos , Ensayos Clínicos Controlados Aleatorios como Asunto
8.
Front Psychiatry ; 13: 1038312, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-36532172

RESUMEN

Background: Many studies have shown the efficacy of repetitive transcranial magnetic stimulation (rTMS) in treatment-resistant depression (TRD). However, the choice of different parameters has been a challenging issue. Methods: PubMed, Cochrane, and Embase databases were searched for relevant studies until June 20, 2022. The treatment efficacy was evaluated by the relative risk (RR) using the pairwise test for response and remission rates. Subgroup and sensitivity analyses were conducted to explore the primary outcome differences and to assess the reliability of the results. Results: Thirty-seven trials comprising 2120 participants with TRD were included. The more efficacious interventions compared to sham controls included high-frequency left followed by low-frequency right sup-threshold (HFL-LFR-sup-rTMS, RR = 5.29, 95% CI: 1.24-22.50), high-frequency left sup-threshold (HFL-sup-rTMS, RR = 2.97, 95% CI: 1.74-5.05), low-frequency right sup-threshold (LFR-sup-rTMS, RR = 2.72, 95% CI: 1.50-4.90), low-frequency right followed by high-frequency left sup-threshold (LFR-HFL-sup-rTMS, RR = 2.71, 95% CI: 1.62-4.53), and high-frequency left sub-threshold (HFL-sub-rTMS, RR = 1.91, 95% CI: 1.18-3.10) rTMS. The estimated relative ranking of treatments suggested that HFL-LFR-sup-rTMS (84.4%) might be the most efficacious among all rTMS strategies. No treatments showed a lower acceptability than the sham control. Limitations: Subgroup analysis was not conducted to compare the efficacy of rTMS treatment between bipolar and unipolar depression, and small-study effects possibly introduced bias. Conclusion: Treatment with HFL-LFR-sup-rTMS, HFL-sup-rTMS, LFR-sup-rTMS, LFR-HFL-sup-rTMS, or HFL-sub-rTMS is more efficacious than the sham control. HFL-LFR-sup-rTMS and HFL-sup-rTMS may be the two best among the most efficacious rTMS treatments. Systematic review registration: [https://www.crd.york.ac.uk/PROSPERO], identifier [CRD42022334481].

9.
Front Hum Neurosci ; 16: 838123, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-35308619

RESUMEN

Mindfulness and accordant interventions are often used as complementary treatments to psychological or psychosomatic problems. This has also been gradually integrated into daily lives for the promotion of psychological well-being in non-clinical populations. The experience of mindful acceptance in a non-judgmental way brought about the state, which was less interfered by a negative effect. Mindfulness practice often begins with focused attention (FA) meditation restricted to an inner experience. We postulate that the brain areas related to an interoceptive function would demonstrate an intrinsic functional change after mindfulness training for the mindful novices along with paying more attention to internal processes. To further explore the influence of mindfulness on the organization of the brain regions, both functional connectivity (FC) in the voxel and the region of interest (ROI) level were calculated. In the current study, 32 healthy volunteers, without any meditation experiences, were enrolled and randomly assigned to a mindfulness-based stress reduction group (MBSR) or control group (CON). Participants in the MBSR group completed 8 weeks of mindfulness-based stress reduction (MBSR) and rated their mindfulness skills before and after MBSR. All subjects were evaluated via resting-state functional MRI (rs-fMRI) in both baselines and after 8 weeks. They also completed a self-report measure of their state and trait anxiety as well as a positive and negative affect. Pre- and post-MBSR assessments revealed a decreased amplitude of low-frequency fluctuations (ALFF) in the right anterior cingulate gyrus (ACC.R), left anterior and posterior insula (aIC.L, pIC.L), as well as left superior medial frontal gyrus (SFGmed.L) in MBSR practitioners. Strengthened FC between right anterior cingulate cortex (ACC.R) and aIC.R was observed. The mean ALFF values of those regions were inversely and positively linked to newly acquired mindful abilities. Along with a decreased negative affect score, our results suggest that the brain regions related to attention and interoceptive function were involved at the beginning of mindfulness. This study provides new clues in elucidating the time of evaluating the brain mechanisms of mindfulness novices.

10.
J Affect Disord ; 302: 50-57, 2022 04 01.
Artículo en Inglés | MEDLINE | ID: mdl-35074460

RESUMEN

BACKGROUND: Bipolar disorder (BP) is a common psychiatric disorder characterized by extreme fluctuations in mood. Recent studies have indicated the involvement of cerebellum in the pathogenesis of BP. However, no study has focused on the precise role of cerebellum exclusively in patients with bipolar I disorder (BP-I). METHODS: Forty-five patients with BP-I and 40 healthy controls were recruited. All subjects underwent clinical evaluation and Magnetic Resonance diffusion Tension Imaging scans. For structural images, we used a spatially unbiased infratentorial template toolbox to isolate the cerebellum and then preformed voxel-based morphometry (VBM) analyses to assess the difference in cerebellar gray matter volume (GMV) between the two groups. For the functional images, we chose the clusters that survived from VBM analysis as seeds and performed functional connectivity (FC) analysis. Between-group differences were assessed using the independent Students t test or the nonparametric Mann-Whitney U Test. For multiple comparisons, the results were further corrected with Gaussian random field (GRF) approach (voxel-level P < 0.001, cluster-level P < 0.05). RESULTS: Compared with healthy controls, BP-I patients showed significantly decreased GMV in left lobule V and left lobule VI (P < 0.05, GRF corrected). The FC of cerebellum with bilateral superior temporal gyrus, bilateral insula, bilateral rolandic operculum, right putamen, and left precentral gyrus was disrupted in BP-I patients (P < 0.05, GRF corrected). CONCLUSIONS: BP-I patients showed decreased cerebellar GMV and disrupted cerebellar-cortex resting-state FC. This suggests that cerebellar abnormalities may play an important role in the pathogenesis of BP-I.


Asunto(s)
Trastorno Bipolar , Corteza Cerebelosa , Sustancia Gris , Trastorno Bipolar/patología , Trastorno Bipolar/fisiopatología , Corteza Cerebelosa/patología , Corteza Cerebelosa/fisiopatología , Sustancia Gris/patología , Sustancia Gris/fisiopatología , Humanos , Imagen por Resonancia Magnética/métodos
11.
J Affect Disord ; 287: 115-124, 2021 05 15.
Artículo en Inglés | MEDLINE | ID: mdl-33780827

RESUMEN

BACKGROUND: Nearly half of the patients with depression experience suboptimal benefits from antidepressants. Neuromodulation therapies, a kind of technology that can regulate neuronal firing activity by electrical or magnetic stimulation, were introduced to improve this situation. However, the results from clinical trials have been inconsistent. METHODS: We followed the extension of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement to perform this network meta-analysis (NMA). The results were evaluated by relative risk (RR) for the response, remission, and discontinuation rates. RESULTS: In total, 49 trials with 2,941 patients were included in this study. Bilateral theta burst stimulation (TBS, RR 5.00, 95% CI 1.11-22.44), priming transcranial magnetic stimulation (pTMS, RR 2.97, 95% CI 1.20-7.39), low-frequency right repetitive transcranial magnetic stimulation (TMS) (LFR-rTMS, RR 2.62, 95% CI 1.56-4.39), high-frequency left repetitive TMS (HFL-rTMS, RR 2.18, 95% CI 1.52-3.13), and bilateral repetitive TMS (BL-rTMS, RR 3.08, 95% CI 1.78-5.31) were demonstrated to have higher response rates than sham control. BL-rTMS (RR 3.12, 95% CI 1.06-9.09) was found to have a higher response rate than deep brain stimulation in this NMA. All measures had the non-inferiority acceptability than the sham-control. BL-rTMS was more acceptable than bitemporal ECT (BT-ECT, RR 0.18, 95% CI 0.03-0.89), while pTMS was more acceptable than BT-ECT (RR 0.08, 95% CI 0.01-0.55), HFL-rTMS (RR 0.34, 95% CI 0.12-0.93), and deep TMS (RR 0.15, 95% CI 0.02-0.96). CONCLUSION: Besides electroconvulsive therapy (ECT), rTMS, priming TMS, and bilateral TBS proved effective for patients with treatment-resistant depression (TRD). BL-rTMS showed high efficacy and acceptability, and bilateral TBS had the potential to be the most efficacious neuromodulation measures.


Asunto(s)
Depresión , Trastorno Depresivo Mayor , Trastorno Depresivo Mayor/terapia , Humanos , Metaanálisis en Red , Ensayos Clínicos Controlados Aleatorios como Asunto , Estimulación Magnética Transcraneal , Resultado del Tratamiento
12.
J Affect Disord ; 282: 662-668, 2021 03 01.
Artículo en Inglés | MEDLINE | ID: mdl-33445089

RESUMEN

Identifying cognitive dysfunction in the early stages of Bipolar Disorder (BD) can allow for early intervention. Previous studies have shown a strong correlation between cognitive dysfunction and number of manic episodes. The objective of this study was to apply machine learning (ML) techniques on a battery of cognitive tests to identify first-episode BD patients (FE-BD). Two cohorts of participants were used for this study. Cohort #1 included 74 chronic BD patients (CHR-BD) and 53 healthy controls (HC), while the Cohort #2 included 37 FE-BD and 18 age- and sex-matched HC. Cognitive functioning was assessed using the Cambridge Neuropsychological Test Automated Battery (CANTAB). The tests examined domains of visual processing, spatial memory, attention and executive function. We trained an ML model to distinguish between chronic BD patients (CHR-BD) and HC at the individual level. We used linear Support Vector Machines (SVM) and were able to identify individual CHR-BD patients at 77% accuracy. We then applied the model to Cohort #2 (FE-BD patients) and achieved an accuracy of 76% (AUC = 0.77). These results reveal that cognitive impairments may appear in early stages of BD and persist into later stages. This suggests that the same deficits may exist for both CHR-BD and FE-BD. These cognitive deficits may serve as markers for early BD. Our study provides a tool that these early markers can be used for detection of BD.


Asunto(s)
Trastorno Bipolar , Trastornos del Conocimiento , Trastorno Bipolar/diagnóstico , Función Ejecutiva , Humanos , Aprendizaje Automático , Pruebas Neuropsicológicas
13.
Bipolar Disord ; 23(5): 474-486, 2021 08.
Artículo en Inglés | MEDLINE | ID: mdl-32981096

RESUMEN

BACKGROUND: Bipolar I disorder (BD-I) is associated with a high risk of suicide attempt; however, the neural circuit dysfunction that confers suicidal vulnerability in individuals with this disorder remains largely unknown. Resting-state functional magnetic resonance imaging (rs-fMRI) allows non-invasive mapping of brain functional connectivity. The current study used an unbiased voxel-based graph theory analysis of rs-fMRI to investigate the intrinsic brain networks of BD-I patients with and without suicide attempt. METHODS: A total of 30 BD-I patients with suicide attempt (attempter group), 82 patients without suicide attempt (non-attempter group), and 67 healthy controls underwent rs-fMRI scan, and then global brain connectivity (GBC) was computed as the sum of connections of each voxel with all other gray matter voxels in the brain. RESULTS: Compared with the non-attempter group, we found regional differences in GBC values in emotion-encoding circuits, including the left superior temporal gyrus, bilateral insula/rolandic operculum, and right precuneus (PCu)/cuneus in the bipolar disorder (BD) attempter group, and these disrupted hub-like regions displayed fair to good power in distinguishing attempters from non-attempters among BD-I patients. GBC values of the right PCu/cuneus were positively correlated with illness duration and education in the attempter group. CONCLUSIONS: Our results indicate that abnormal connectivity patterns in emotion-encoding circuits are associated with the increasing risk of vulnerability to suicide attempt in BD patients, and global dysconnectivity across these emotion-encoding circuits might serve as potential biomarkers for classification of suicide attempt in BD patients.


Asunto(s)
Trastorno Bipolar , Trastorno Bipolar/complicaciones , Trastorno Bipolar/diagnóstico por imagen , Encéfalo/diagnóstico por imagen , Mapeo Encefálico , Sustancia Gris , Humanos , Imagen por Resonancia Magnética , Intento de Suicidio
14.
BMC Psychiatry ; 20(1): 488, 2020 10 06.
Artículo en Inglés | MEDLINE | ID: mdl-33023515

RESUMEN

BACKGROUND: Bipolar disorder (BPD) is a common mood disorder that is often goes misdiagnosed or undiagnosed. Recently, machine learning techniques have been combined with neuroimaging methods to aid in the diagnosis of BPD. However, most studies have focused on the construction of classifiers based on single-modality MRI. Hence, in this study, we aimed to construct a support vector machine (SVM) model using a combination of structural and functional MRI, which could be used to accurately identify patients with BPD. METHODS: In total, 44 patients with BPD and 36 healthy controls were enrolled in the study. Clinical evaluation and MRI scans were performed for each subject. Next, image pre-processing, VBM and ReHo analyses were performed. The ReHo values of each subject in the clusters showing significant differences were extracted. Further, LASSO approach was recruited to screen features. Based on selected features, the SVM model was established, and discriminant analysis was performed. RESULTS: After using the two-sample t-test with multiple comparisons, a total of 8 clusters were extracted from the data (VBM = 6; ReHo = 2). Next, we used both VBM and ReHo data to construct the new SVM classifier, which could effectively identify patients with BPD at an accuracy of 87.5% (95%CI: 72.5-95.3%), sensitivity of 86.4% (95%CI: 64.0-96.4%), and specificity of 88.9% (95%CI: 63.9-98.0%) in the test data (p = 0.0022). CONCLUSIONS: A combination of structural and functional MRI can be of added value in the construction of SVM classifiers to aid in the accurate identification of BPD in the clinic.


Asunto(s)
Trastorno Bipolar , Trastorno Bipolar/diagnóstico por imagen , Encéfalo , Humanos , Aprendizaje Automático , Imagen por Resonancia Magnética , Máquina de Vectores de Soporte
15.
J Affect Disord ; 268: 82-87, 2020 05 01.
Artículo en Inglés | MEDLINE | ID: mdl-32158010

RESUMEN

BACKGROUND: The ß2 subunit of the voltage-gated l-type calcium channel gene(CACNB2) rs11013860 polymorphism is a putative genetic susceptibility marker for bipolar disorder (BD). However, the neural effects of CACNB2 rs11013860 in BD are largely unknown. METHODS: Forty-six bipolar patients with first-episode mania and eighty-three healthy controls (HC) were genotyped for CACNB2 rs11013860 and were scanned with a 3.0 Tesla structural magnetic resonance imaging system to measure cortical thickness of prefrontal cortex (PFC) components (superior frontal cortex, orbitofrontal cortex, middle and inferior frontal gyri). RESULTS: Cortical thickness was thinner in patients on all PFC measurements compared to HC (p < 0.050). Moreover, we found a significant interaction between CACNB2 genotype and diagnosis for the right superior frontal cortical thickness (F = 8.190, p = 0.040). Bonferroni corrected post-hoc tests revealed that, in CACNB2 A-allele carriers, patients displayed thinner superior frontal thickness compared to HC (p < 0.001). In patients, CACNB2 A-allele carriers also exhibited reduced superior frontal thickness compared to CACNB2 CC-allele carriers (p = 0.016). LIMITATIONS: Lithium treatment may influence our results, and the sample size in our study is relatively small. CONCLUSIONS: Our results suggest that the CACNB2 rs11013860 might impact PFC thickness in patients with first-episode mania. These findings provide evidence to support CACNB2 rs11013860 involvement in the emotion-processing neural circuitry abnormality in the early stage of BD, which will ultimately contribute to revealing the link between the variation in calcium channel genes and the neuropathological mechanism of BD.


Asunto(s)
Trastorno Bipolar , Trastorno Bipolar/diagnóstico por imagen , Trastorno Bipolar/genética , Canales de Calcio Tipo L/genética , Humanos , Litio , Imagen por Resonancia Magnética , Manía , Corteza Prefrontal/diagnóstico por imagen
16.
Front Hum Neurosci ; 13: 376, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31680921

RESUMEN

Mindfulness is described as the non-judgmental awareness of experiences in the present moment. The sustained practice of mindfulness may also have beneficial effects on an individual's well-being. For instance, mindfulness meditation is an effective approach for improving emotion regulation. Specifically, the early stage of mindfulness meditation training enhances emotional monitoring systems related to attention regulation and executive function. Reduced activity in the default mode network (DMN) would probably be observed corresponding to the attenuated mind wandering. In the present study, we hypothesized that alterations in functional activity in the frontal-parietal cortex and DMN may be induced by short-term mindfulness meditation. In this study, before and after 8 weeks of weekly Mindfulness-Based Stress Reduction (MBSR) training, healthy participants were evaluated using a mindfulness questionnaire and an affect schedule, as well as via resting-state functional magnetic resonance imaging. Sixteen right-handed non-meditators were enrolled. Another 16 demographically matched healthy adults without any meditation experience were recruited as controls. Pre- and post-MBSR assessments were compared. Increased regional homogeneity in the right superior parietal lobule and left postcentral gyrus (PoCG), as well as altered functional connectivity in PoCG-related networks, were observed post-MBSR. The mindfulness questionnaire scores also improved and negative affect was significantly decreased after MBSR. Together with reduced involvement of the posterior brain, our results suggest a tendency toward stronger involvement of the parietal cortex in mindfulness beginners. This study provides novel evidence regarding the optimization of emotional processing with short-term mindfulness meditation.

17.
Seizure ; 72: 33-39, 2019 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-31585249

RESUMEN

PURPOSE: We conducted a meta-analysis to determine the predictors of early-onset seizure in patients with cerebral venous sinus thrombosis (CVST) and to provide a basis for further clinical trials of prophylactic use of antiepileptic drugs in patients with CVST. METHOD: The meta-analysis was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. Relevant observational studies that investigated risk factors for early-onset seizures after CVST were retrieved from Pubmed and Embase databases. Odds ratios (OR) for early-onset seizures were calculated from the pooled data using the random effects model. RESULTS: Six observational studies (combined n = 1244) were included in this meta-analysis. Coma [OR, 2.265; 95% confidence interval (CI) 1.251-4.100], mental status (OR, 3.450; 95% CI 1.150-10.356), motor symptoms (OR, 3.726; 95% CI 2.519-5.514), involvement of cortical veins (OR, 3.574; 95% CI 2.521-5.068), supratentorial lesion (OR, 5.041; 95% CI 3.622-7.015), frontal lobe (OR, 3.481; 95% CI 1.703-7.114), parietal lobe (OR, 3.638; 95% CI 1.911-6.925), hemorrhagic lesions (OR, 2.505; 95% CI 1.485-4.225), and pregnancy (OR, 2.054; 95% CI 1.043-4.048) showed a significant association with early-onset seizures. CONCLUSION: Involvement of a numer of specific cortical regions in the post-CVST phase may induce early-onset seizures, especially in the setting of concomitant hemorrhagic infarct or cortical vein involvement.


Asunto(s)
Estudios Observacionales como Asunto/métodos , Convulsiones/etiología , Convulsiones/fisiopatología , Trombosis de los Senos Intracraneales/complicaciones , Trombosis de los Senos Intracraneales/fisiopatología , Humanos , Factores de Riesgo , Convulsiones/diagnóstico , Trombosis de los Senos Intracraneales/diagnóstico
18.
Bioinformatics ; 35(4): 628-635, 2019 02 15.
Artículo en Inglés | MEDLINE | ID: mdl-30101339

RESUMEN

MOTIVATION: It remains challenging to unravel new susceptibility genes of complex diseases and the mechanisms in genome-wide association studies. There are at least two difficulties, isolation of the genuine susceptibility genes from many indirectly associated genes and functional validation of these genes. RESULTS: We first proposed a novel conditional gene-based association test which can use only summary statistics to isolate independently associated genes of a disease. Applying this method, we detected 185 genes of independent association with schizophrenia. We then designed an in-silico experiment based on expression/co-expression to systematically validate pathogenic potential of these genes. We found that genes of independent association with schizophrenia formed more co-expression pairs in normal post-natal but not pre-natal human brain regions than expected. Interestingly, no co-expression enrichment was found in the brain regions of schizophrenia patients. The genes with independent association also had more significant P-values for differential expression between schizophrenia patients and controls in the brain regions. In contrast, indirectly associated genes or associated genes by other widely-used gene-based tests had no such differential expression and co-expression patterns. In summary, this conditional gene-based association test is effective for isolating directly associated genes from indirectly associated genes, and the results insightfully suggest that common variants might contribute to schizophrenia largely by distorting expression and co-expression in post-natal brains. AVAILABILITY AND IMPLEMENTATION: The conditional gene-based association test has been implemented in a platform 'KGG' in Java and is publicly available at http://grass.cgs.hku.hk/limx/kgg/. SUPPLEMENTARY INFORMATION: Supplementary data are available at Bioinformatics online.


Asunto(s)
Estudio de Asociación del Genoma Completo , Esquizofrenia/genética , Humanos , Polimorfismo de Nucleótido Simple
19.
Psychiatry Res ; 272: 258-264, 2019 02.
Artículo en Inglés | MEDLINE | ID: mdl-30594758

RESUMEN

Patients with depression have lower heart rate variability (HRV) compared with controls. However, studies have indicated HRV difference between male and female controls. The gender effect might be interactive with the depression effect on the HRV, resulting in a low accuracy of recognising the patients with depression from the controls. Our study explores the effect of gender-related depression on HRV. Four ANS tests including resting, deep breathing, Valsalva, and orthostatic test are employed as stimuli. HRV were collected from 182 subjects comprising 91 depressive patients (33 females/58 males) and 91 controls (33 females/58 males) in the four tests. Time and frequency domains and nonlinear parameters are employed to quantify HRV. Two-way ANOVA is applied to evaluate the effect of gender-related depression. Most HRV parameters of the patients significantly differ from those of the controls, but some parameters indicate different depression effect between the males and females in the deep breathing and Valsalva test. Some HRV parameters illustrate significant difference between the male and female controls. Therefore, the effect of depression on HRV of each gender should be investigated.


Asunto(s)
Sistema Nervioso Autónomo/fisiología , Depresión/fisiopatología , Trastorno Depresivo/fisiopatología , Frecuencia Cardíaca/fisiología , Adulto , Sistema Nervioso Autónomo/fisiopatología , Femenino , Humanos , Masculino , Persona de Mediana Edad , Factores Sexuales
20.
Medicine (Baltimore) ; 97(31): e11315, 2018 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-30075498

RESUMEN

Although the association of the psychological problems and androgenetic alopecia (AGA) gained the increasing attention, the psychosocial state in college students with AGA remains unknown. We recruited a total number of 355 college students with AGA from 18 universities in Southern China for interview. The Symptom Checklist-90-R (SCL-90-R) survey was used to assess the psychological state of these students. There were significant differences in somatization, obsessive-compulsive, interpersonal sensitivity, depression, phobic anxiety, psychoticism, and global severity index (GSI) between college students with AGA and the controls. Moreover, regarding the impact of specialty, scores for the interpersonal sensitivity, depression, and phobic anxiety in medical students and art students with AGA were significantly higher than other professions. In addition, obsessive-compulsive and GSI in art students with AGA were significantly higher compared with other professions. These findings suggested that the therapeutic approach for the psychological problems should be considered in the tailored treatment for AGA in the college students.


Asunto(s)
Alopecia/psicología , Pueblo Asiatico/psicología , Trastornos Mentales/epidemiología , Estudiantes/psicología , Adolescente , Adulto , Alopecia/etnología , Estudios de Casos y Controles , China , Estudios Transversales , Femenino , Humanos , Masculino , Trastornos Mentales/diagnóstico , Evaluación de Síntomas , Adulto Joven
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