Animal hoarding: a systematic review

Objectives: Animal hoarding is a special manifestation of hoarding disorder, characterized by the accumulation of animals and failure to provide them with minimal care. The main objective of this systematic review is to evaluate the characteristics of animal hoarding, focusing on the profile of affected individuals and the features of accumulation behavior. Methods: A systematic search of the literature was conducted in the electronic databases MEDLINE, Scopus, and LILACS until October 2022. We included case series (n ≥ 10) and cross-sectional studies assessing animal hoarding. Results: A total of 374 studies were initially retrieved. Most studies were classified as having poor quality and significant risk of bias. A total of 538 individuals with animal hoarding were evaluated. These individuals were predominantly middle-aged, unmarried women who lived alone in urban areas. Most of their residences had unsanitary conditions. Recidivism rates varied from 13-41%. Cats and dogs were the main hoarded species, mostly acquired through unplanned breeding, and disease, injury, behavioral problems, and a lack of hygiene were characreristic of their condition. Animal carcasses were found in up to 60% of the properties. Conclusion: Animal hoarding is a complex condition that requires urgent attention. More research is necessary to develop effective strategies that can save community resources, improve animal and human welfare, and prevent recidivism.

Animal Hoarding: a systematic review.

OBJECTIVE: Animal hoarding is a special manifestation of Hoarding Disorder, characterized by the accumulation of animals and failure to provide them with minimal care. The main objective of this systematic review is to evaluate the characteristics of animal hoarding with a focus on the profile of affected individuals and accumulation behavior features. METHODS: A systematic search of the literature using the electronic databases MEDLINE, SCOPUS and LILACS was conducted until October 2022. We included case series (n ≥ 10) and cross-sectional studies assessing animal hoarding. RESULTS: 374 studies were initially retrieved. Most studies were classified as poor quality and significant risk of bias. 538 individuals with animal hoarding were evaluated. These individuals were predominantly middle-aged, unmarried females who lived alone in urban areas. Most residences presented unsanitary conditions. Recidivism rates varied from 13-41%. Cats and dogs were the main hoarded species, mostly acquired through unplanned breeding and found with lack of hygiene; diseases; injuries; and behavioral problems. Animal carcasses were found in up to 60% of the properties. CONCLUSION: Animal hoarding is a complex condition that requires urgent attention. More research is necessary to develop effective strategies that can save community resources, improve animal and human welfare, and prevent recidivism.

Social cognition across bipolar disorder and behavioral-variant frontotemporal dementia: an exploratory study

Objectives: Bipolar disorder type 1 (BD1) and behavioral-variant frontotemporal dementia (bvFTD) share similar behavioral and cognitive symptoms, rendering the differential diagnosis between them a clinical challenge. We investigated the accuracy of social cognition (SC) measures to differentiate bvFTD from BD. Methods: We included three groups of participants: early-onset BD1 (in remission, n=20), bvFTD (n=18), and cognitively healthy controls (HC) (n=40), matched for age, schooling, and sex. All participants underwent cognitive assessment, including the Facial Emotion Recognition (FER) and Modified Faux-Pas (mFP) tests, which assess mentalizing. Results: Compared to HC, BD1 and bvFTD patients underperformed on both SC measures. BD1 and bvFTD did not differ regarding FER or mFP total scores, although patients with bvFTD had significantly higher difficulties than those in the BD1 group to detect social faux-pas (p < 0.001, d = 1.35). Conclusion: BD1 and bvFTD share deficits in the core SC functions. These findings should be considered in the development of tasks aiming to improve clinical differentiation between the two disorders.

Social cognition across bipolar disorder and behavioral variant frontotemporal dementia: an exploratory study.

OBJECTIVES: Bipolar disorder type 1 (BD1) and behavioral-variant frontotemporal dementia (bvFTD) share similar behavioral and cognitive symptoms, rendering the differential diagnosis between them a clinical challenge. We investigated the accuracy of social cognition (SC) measures to differentiate bvFTD from BD. METHODS: We included three groups of participants: early-onset BD1 (in remission, n=20), bvFTD (n=18), and cognitively healthy controls (HC) (n=40), matched for age, schooling, and sex. All participants underwent cognitive assessment, including the Facial Emotion Recognition (FER) and Modified Faux-Pas (mFP) tests, which assess mentalizing. RESULTS: Compared to HC, BD1 and bvFTD patients underperformed on both SC measures. BD1 and bvFTD did not differ regarding FER or mFP total scores, although patients with bvFTD had significantly higher difficulties than those in the BD1 group to detect social faux-pas (p < 0.001, d = 1.35). CONCLUSION: BD1 and bvFTD share deficits in the core SC functions. These findings should be considered in the development of tasks aiming to improve clinical differentiation between the two disorders.

Frequency and burden of neurological manifestations upon hospital presentation in COVID-19 patients: Findings from a large Brazilian cohort.

BACKGROUND: Scientific data regarding the prevalence of COVID-19 neurological manifestations and prognosis in Latin America countries is still lacking. Therefore, the study aims to understand neurological manifestations of SARS-CoV 2 infection and outcomes in the Brazilian population. METHODS: This study is part of the Brazilian COVID-19 Registry, a multicentric cohort, including data from 37 hospitals. For the present analysis, patients were grouped according to the presence of reported symptoms (i.e., headache; anosmia and ageusia; syncope and dizziness) vs. clinically-diagnosed neurological manifestations (clinically-defined neurological syndrome: neurological signs or diagnoses captured by clinical evaluation) and matched with patients without neurological manifestations by age, sex, number of comorbidities, hospital of admission, and whether or not patients had underlying neurological disease. RESULTS: From 6,635 hospitalized patients with COVID-19, 30.8% presented reported neurological manifestations, 10.3% were diagnosed with a neurological syndrome and 60.1% did not show any neurological manifestations. In patients with reported symptoms, the most common ones were headache (20.7%), ageusia (11.1%) and anosmia (8.0%). In patients with neurological syndromes, acute encephalopathy was the most common diagnosis (9.7%). In the matched analysis, patients with neurological syndromes presented more cases of septic shock (17.0 vs. 13.0%, p = 0.045), intensive care unit admission (45.3 vs. 38.9%, p = 0.023), and mortality (38.7 vs. 32.6%, p = 0.026; and 39.2 vs. 30.3%, p < 0.001) when compared to controls. CONCLUSION: COVID-19 in-hospital patients with clinically defined neurological syndromes presented a higher incidence of septic shock, ICU admission and death when compared to controls.

Transtorno Depressivo Maior: Um Estudo Comparativo sobre Cognição Socioemocional e Funções Executivas / Major Depressive Disorder: A Comparative Study on Socio-Emotional Cognition and Executive Functions

Resumo O objetivo deste estudo foi avaliar a cognição socioemocional e as funções executivas em pacientes com Transtorno Depressivo Maior unipolar. A amostra incluiu 22 pacientes entre 36 e 93 anos de idade (M = 59,32; DP = 12,89) e 23 indivíduos controles entre 30 e 81 anos de idade (M = 63,00; DP = 13,56). Além de dados demográficos, foram avaliados sintomas de ansiedade e de depressão, empatia, teoria da mente, reconhecimento de emoções, controle inibitório, flexibilidade cognitiva e fluência verbal. Não houve diferença estatística significativa entre os grupos quanto à idade e à escolaridade. Os pacientes apresentaram significativamente mais ansiedade, depressão e angústia pessoal do que os controles. Indivíduos com sintomas depressivos mais graves apresentaram menor velocidade de processamento.

Abstract The present study aimed to assess socioemotional cognition and executive functions in patients with unipolar Major Depressive Disorder. The sample included 22 patients between 36 and 93 years of age (M = 59.32; SD = 12.89) and 23 patients between 30 and 81 years of age (M = 63.00; SD = 13.56) controls. In addition to demographic data, symptoms of anxiety and depression, empathy, theory of mind, recognition of emotions, inhibitory control, cognitive flexibility and phonemic verbal fluency were obtained. There was no statistical difference between the groups regarding age and education. Patients had significantly more anxiety, depression and personal distress than controls. Individuals with more severe depressive symptoms had a lower processing speed than the others.

IL-6 levels are associated with clinical status in patients with Myasthenia Gravis / Os níveis de IL-6 estão associados com o status clínico de pacientes com Miastenia Gravis

BACKGROUND: Myasthenia gravis (MG) is an autoimmune disease marked by fluctuating course of muscle weakness. OBJECTIVES: The current study was designed to evaluate plasma levels of cytokines (IL-2, IL-4, IL-6, IL-10, TNF, IFN-γ, and IL17A) in patients with MG and controls and to investigate whether cytokines levels are associated with clinical parameters. This study was conducted at the Neuromuscular Diseases Outpatient Clinic, Hospital das Clínicas, Universidade Federal de Minas Gerais (UFMG), Brazil. METHODS: Peripheral blood was drawn, and plasma levels of cytokines were measured by cytometric bead array (CBA) in 80 treated patients with MG and 50 controls. The MG Composite (MGC) was used to evaluate muscle weakness and severity of typical motor symptoms of MG. RESULTS: Patients with MG undergoing treatment exhibit lower levels of all evaluated cytokines compared to controls. There was a negative correlation between IL-6 levels and the MG Composite score, indicating that higher levels of IL-6 were associated with better control of the disease. CONCLUSION: This exploratory study suggests that IL-6 is associated with MG clinical status, as assessed by the MGC.

INTRODUÇÃO: A Miastenia Gravis (MG) é uma doença autoimune caracterizada por fraqueza muscular flutuante. OBJETIVOS: avaliar os níveis plasmáticos de citocinas (IL-2, IL-4, IL-6, IL-10, TNF, IFN-γ, e IL-17A) em pacientes com MG e controles e investigar se essas citocinas estão associadas com parâmetros clínicos. Este estudo foi conduzido no ambulatório de doenças neuromusculares do Hospital das Clínicas, Universidade Federal de Minas Gerais (UFMG), Brasil. MÉTODOS: Foi coletado sangue periféricos e os níveis plasmáticos das citocinas foram medidos por citometria em 80 pacientes com MG tratados e em 50 controles. O MG composite (MGC) foi utilizado para avaliar a fraqueza muscular e a gravidade dos sintomas motores típicos da MG. RESULTADOS: Os pacientes com MG em tratamento apresentaram menores níveis de todas as citocinas avaliadas comparados ao controle. Houve uma correlação negativa entre os níveis de IL-6 e o MGC, indicando que altos níveis de IL-6 estão associados com melhor controle da doença. CONCLUSÃO: este estudo exploratório sugere que a IL-6 está associada com o status clínico da MG, quando avaliado pelo MGC.

Millipore xMap® Luminex (HATMAG-68K): An Accurate and Cost-Effective Method for Evaluating Alzheimer's Biomarkers in Cerebrospinal Fluid.

Background: Alzheimer's disease (AD) biomarkers are of great relevance in clinical research, especially after the AT(N) framework. They enable early diagnosis, disease staging and research with new promising drugs, monitoring therapeutic response. However, the high cost and low availability of the most well-known methods limits their use in low and medium-income countries. In this context, Millipore xMap® Luminex may be a cost-effective alternative. In our study, using INNOTEST® as reference, we assess the diagnostic accuracy of Millipore xMap® and propose a cutoff point for AD. Methods: We performed lumbar puncture of seven older individuals with clinically defined AD, 17 with amnestic mild cognitive impairment (aMCI) and 11 without objective cognitive impairment-control group (CG). Cerebrospinal fluid (CSF) biomarkers concentrations for aB42, p-Tau, and t-Tau were measured by INNOTEST® and Millipore xMap®, and then the techniques were compared to assess the diagnostic accuracy of the new test and to define a cutoff. Results: INNOTEST® and Millipore xMap® measurements showed all correlations >0.8 for the same biomarker, except for t-Tau that was 0.66. Millipore xMap® measurements showed a robust accuracy for all biomarkers, with AUC higher than 0.808 (t-Tau), and the best for Aß42 (AUC = 0.952). The most accurate cutoffs were found at 1012.98 pg/ml (Aß42), 64.54 pg/ml (p-tau), 3251.81 pg/ml (t-tau), 3.370 (t-Tau/Aß42), and 0.059 (p-Tau/Aß42). Conclusion: Given its good accuracy and cost-effectiveness, Milliplex xMap® tests seems a reliable and promising tool, especially for low and middle-income countries.

Psychoeducation in bipolar disorder: A systematic review.

BACKGROUND: Bipolar disorder (BD) is a severe psychiatric disorder characterized by mood swings. Psychosocial interventions, such as psychoeducation, play an essential role in promoting social rehabilitation and improving pharmacological treatment. AIM: To investigate the role of psychoeducation in BD. METHODS: A systematic review of original studies regarding psychoeducation interventions in patients with BD and their relatives was developed. A systematic literature search was performed using the Medline, Scopus, and Lilacs databases. No review articles or qualitative studies were included in the analysis. There were no date restriction criteria, and studies published up to April 2021 were included. RESULTS: A total of forty-seven studies were selected for this review. Thirty-eight studies included patients, and nine included family members. Psychoeducation of patients and family members was associated with a lower number of new mood episodes and a reduction in number and length of stay of hospitalizations. Psychoeducational interventions with patients are associated with improved adherence to drug treatment. The strategies studied in patients and family members do not interfere with the severity of symptoms of mania or depression or with the patient's quality of life or functionality. Psychoeducational interventions with family members do not alter patients' adherence to pharmacotherapy. CONCLUSION: Psychoeducation as an adjunct strategy to pharmacotherapy in the treatment of BD leads to a reduction in the frequency of new mood episodes, length of hospital stay and adherence to drug therapy.

Livro de resumos: XVII Jornada Acadêmica de Saúde Mental da Faculdade de Medicina da Universidade Federal de Minas Gerais / Livro de resumos: XVII Jornada Acadêmica de Saúde Mental da Faculdade de Medicina da Universidade Federal de Minas Gerais

A XVII Jornada Acadêmica de Saúde mental é um evento que busca aproximar os estudantes de cursos variados do campo de estudo da Saúde Mental. Além de aulas ministradas na forma de palestras, os acadêmicos são convidados a produzirem trabalhos para serem apresentados aos demais participantes, ampliando o leque de assuntos abordados. Além de proporcionar aos estudantes interessados maior contato com temas específicos da área, a produção de resumos para apresentação é uma ferramenta para aprimoramento das técnicas de escrita e produção de conteúdo. Elaborar os trabalhos amplia os conhecimentos dos alunos sobre escrita científica e os aproxima do meio acadêmico científico. Ademais, o contato com professores e pesquisadores da área, que orientam os participantes durante o processo, cria canais de comunicação e abre novas oportunidades para os estudantes. Para esta edição do evento, os trabalhos foram selecionados pela Comissão Científica da Jornada, que verificou um alto nível nas submissões. Aqueles mais originais, relevantes e bem produzidos foram aprovados e compõem esse livro, mostrando à comunidade a qualidade dos estudantes e do conteúdo apresentado na XVII JASME. Os assuntos discutidos nos próximos capítulos, desenvolvidos por estudantes de cursos da área da saúde, abrangem a saúde mental por variados ângulos e sob diversas abordagens. Escolher alguns trabalhos significa, necessariamente, prescindir de outros. Cientes do desafio de estabelecer uma coletânea que tivesse o padrão de qualidade e a feição da UFMG sem nos obnubilar pela subjetividade, estabelecemos critérios objetivos e submetemos cada resumo à apreciação independente de pelo menos três integrantes da junta científica para apreciação. Por fim, aferimos que não houve divergência de rigor entre os subgrupos e selecionamos os trinta melhores, ou seja, os mais inovadores, bem escritos, objetivos e bem fundamentados. Procuramos, diante dos diversos recortes da pandemia da COVID-19, incluir aqueles que, em vez de vagos de tão abrangentes, descreviam impactos tangíveis, mensuráveis e inusitados, isto é, Relacionados a grupos que não têm sido abordados pela grande mídia e tampouco pelo profissional de saúde médio. Assim, cremos que os resumos a seguir são os que mais bem abordam tanto questões atemporais em saúde mental quanto aquelas que emergiram nos últimos meses e ainda não sabemos por quanto tempo perdurarão. Os trabalhos tratam desde questões relacionadas aos fatores de risco para o desenvolvimento de transtornos psiquiátricos aos aspectos do tratamento farmacológico. Com uma perspectiva atual e relevante para as condições de saúde vigente, as temáticas se relacionam com diversas áreas da saúde mental, como as consequências da pandemia da SARS-COV2, aspectos da saúde mental em jovens e idosos, condutas da saúde mental na saúde primária, psicofarmacologia, transtornos psiquiátricos.

The Renin Angiotensin System and Bipolar Disorder: A Systematic Review.

Bipolar Disorder (BD) is a chronic a multifactorial psychiatric illness that affects mood, cognition, and functioning. BD is associated with several psychiatric conditions as well clinical comorbidities, particularly cardiovascular diseases. The neurobiology of BD is complex and multifactorial and several systems have been implicated. Considering that the Renin Angiotensin System (RAS) plays an important role in cardiovascular diseases and that recently evidence has suggested its role in psychiatric disorders, the aim of the present study is to summarize and to discuss recent findings related to the modulation of RAS components in BD. A systematic search of the literature using the electronic databases MEDLINE and LILACS was conducted through March 2019. The search terms were: "Bipolar Disorder"; "Renin Angiotensin System"; "Angiotensin 2"; "Angiotensin receptors"; "Angiotensin 1-7"; "ACE"; "ACE2"; "Mas Receptor". We included original studies assessing RAS in BD patients. Two hundred twenty-two citations were initially retrieved. Eleven studies were included in our systematic review. In the majority of studies (6 of 8), the ACE insertion/deletion (I/D) polymorphism did not differ between BD patients and controls. BD patients presented higher plasma renin activity in comparison with controls. The studies evaluating the RAS molecules in BD are very scarce and heterogeneous. The literature suggests a potential role of RAS in BD. Further studies are necessary to investigate this relationship.

Personality disorders are associated with more severe forms of migraine.

To investigate the clinical manifestation, disease course, and prognosis of migraine patients with or without personality disorders. This cross-sectional study evaluated 61 patients with migraine diagnosed according to the criteria of the International Headache Society (IHS). Personality disorders were assessed with the Structured Clinical Interview for DSM-IV (SCID-II). Migraine severity was assessed with the Headache Impact Test-6 (HIT-6). We also used a structured clinical interview to diagnose comorbid mood disorders. Of the 61 patients, 20 (32.8%) had personality disorders. Personality disorders included obsessive-compulsive 14/61 (23.0%), avoidant 6/61 (9.8%), borderline 6/61 (9.8%), paranoid 6/61 (9.8%), schizoid 2/61 (3.3%), histrionic 1/61 (1.6%) and dependent 1/61 (1.6%) types. Compared to migraine patients without personality disorders, comorbidity with any personality disorders was associated with an increased frequency of chronic migraine (p < 0.001) and more severe headache as assessed by the HIT-6 (p < 0.001). Comorbidity with personality disorders was associated with more severe forms of migraine symptoms.

Predictors of cognitive performance in bipolar disorder: The role of educational degree and inflammatory markers.

BACKGROUND: The aim of this article was to evaluate the cognitive status of remitted patients with bipolar disorder (BD) using Mini-Mental State Examination (MMSE), Frontal Assessment Battery, and Brief Assessment of Cognition in Affective Disorders (BAC-A). The BAC-A is a comprehensive test battery addressing the cognitive domains compromised in BD. We also aimed to analyze potential clinical and immune predictors of cognitive performance in BD. METHODS: Remitted patients with BD (M ±â€¯S.E: 43.80 ±â€¯10.87 years) and age-matched controls (M ±â€¯S.E: 43.52 ±â€¯11.72) were administered clinical questionnaires and cognitive tests. Inflammatory plasma levels (IL-2, IL-4, IL-6, IL-10, IFN-γ, TNFα, IL-17A, sTNFR1, and sTNFR2) were measured using an enzyme-linked immunosorbent assay. We generated a global cognitive performance index based on BAC-A scores. Multivariate analyses compared cognitive and immune measures across groups. A regression analysis was performed to examine the relationship between global cognitive performance, clinical and immune parameters in BD. RESULTS: Remitted patients with BD performed poorly on tasks of affective processing, verbal memory, working verbal memory, and executive functioning. Patients with BD presented higher plasma levels sTNFR1, TNFα, IFN, IL2, IL4, IL6, IL10, and IL17compared with controls. Education and MMSE were found to be positively correlated with global cognitive performance. IL6 plasma levels were negatively correlated with global cognitive performance. CONCLUSION: The major determinants of poor cognitive performance in BD were education and IL6 plasma levels.

Circulating levels of neurotrophic factors are unchanged in patients with Parkinson's disease.

There is great evidence linking neurotrophic factor (NF) dysfunction with Parkinson's disease (PD) pathophysiology. This study was conducted to evaluate plasma levels of NFs and their possible associations with clinical symptoms in PD. For this purpose, 40 PD patients and 25 controls were subjected to a clinical evaluation and peripheral blood draw. Plasma levels of brain-derived neurotrophic factor (BDNF), pro-BDNF, neurotrophin 3, neurotrophin 4, nerve growth, glial cell line-derived neurotrophic factor and ciliary neurotrophic factor were measured by enzyme-linked immunosorbent assay. There was no significant difference between PD patients and controls regarding the plasma levels of the evaluated NFs. In addition, NF levels were not associated with disease duration, degree of motor or functional impairment, cognitive performance or severity of depressive symptoms. In conclusion, although NFs may play relevant roles in the pathophysiology of PD, the circulating levels of these molecules are not necessarily changed in patients with PD.

The effects of gender, age, schooling, and cultural background on the identification of facial emotions: a transcultural study.

ABSTRACTBackground:Social cognition tasks, such as identification of emotions, can contribute to the diagnosis of neuropsychiatric disorders. The wide use of Facial Emotion Recognition Test (FERT) is hampered by the absence of normative dataset and by the limited understanding of how demographic factors such as age, education, gender, and cultural background may influence the performance on the test. METHODS: We analyzed the influence of these variables in the performance in the FERT from the short version of the Social and Emotional Assessment. This task is composed by 35 pictures with 7 different emotions presented 5 times each. Cognitively healthy Brazilian participants (n = 203; 109 females and 94 males) underwent the FERT. We compared the performance of participants across gender, age, and educational subgroups. We also compared the performance of Brazilians with a group of French subjects (n = 60) matched for gender, age, and educational level. RESULTS: There was no gender difference regarding the performance on total score and in each emotion subscore in the Brazilian sample. We found a significant effect of aging and schooling on the performance on the FERT, with younger and more educated subjects having higher scores. Brazilian and French participants did not differ in the FERT and its subscores. Normative data for employing the FERT in Brazilian population is presented. CONCLUSIONS: Data here provided may contribute to the interpretation of the results of FERT in different cultural contexts and highlight the common bias that should be corrected in the future tasks to be developed.

Circulating levels of neurotrophic factors are unchanged in patients with Parkinson's disease / Os níveis circulantes de fatores neurotróficos não estão alterados em pacientes com doença de Parkinson

ABSTRACT There is great evidence linking neurotrophic factor (NF) dysfunction with Parkinson's disease (PD) pathophysiology. This study was conducted to evaluate plasma levels of NFs and their possible associations with clinical symptoms in PD. For this purpose, 40 PD patients and 25 controls were subjected to a clinical evaluation and peripheral blood draw. Plasma levels of brain-derived neurotrophic factor (BDNF), pro-BDNF, neurotrophin 3, neurotrophin 4, nerve growth, glial cell line-derived neurotrophic factor and ciliary neurotrophic factor were measured by enzyme-linked immunosorbent assay. There was no significant difference between PD patients and controls regarding the plasma levels of the evaluated NFs. In addition, NF levels were not associated with disease duration, degree of motor or functional impairment, cognitive performance or severity of depressive symptoms. In conclusion, although NFs may play relevant roles in the pathophysiology of PD, the circulating levels of these molecules are not necessarily changed in patients with PD.

RESUMO Há evidências de que alteracões nas ações exercidas por fatores neurotróficos (FNs) estejam associadas à fisiopatologia da doença de Parkinson (DP). O presente estudo foi conduzido para avaliar os níveis plasmáticos de FNs e suas possíveis associações com sintomas clínicos na DP. Para este fim, 40 pacientes com DP e 25 controles foram submetidos à avaliação clínica e coleta de sangue periférico. Os níveis plasmáticos do fator neurotrófico derivado do cérebro (BDNF), pro-BDNF, neurotrofina 3, neurotrofina 4, fator de crescimento do nervo, fator neurotrófico derivado da glia e fator neurotrófico ciliar foram avaliados por ensaio de imunoadsorção enzimática. Não houve diferença significativa entre pacientes com DP e controles quanto aos níveis plasmáticos dos FNs avaliados. Além disso, não encontramos associação entre os níveis dos FNs e duração da doença, grau de comprometimento motor ou funcional, desempenho cognitivo e gravidade dos sintomas depressivos. Em conclusão, embora os FNs possam desempenhar papéis relevantes na fisiopatologia da DP, os níveis circulantes dessas moléculas não estão necessariamente alterados em pacientes com DP.

Muscle strength and psychiatric symptoms influence health-related quality of life in patients with myasthenia gravis.

Myasthenia gravis (MG) is a neuromuscular autoimmune disease characterized by skeletal muscle weakness which can impact motor function and, furthermore, produce negative impact on the health-related quality of life (HRQOL). OBJECTIVE: To evaluate the predictors for HRQOL in patients with MG. METHODS: Eighty patients were evaluated with the MG Foundation of America classification and the MG Composite scale. HRQOL was estimated by the MGQOL15, while anxious and depressive symptoms were evaluated with the Hospital Anxiety and Depression Scale (HAD). RESULTS: The mean age of patients was 41.9 years with mean illness duration of 13.5 years. Almost half of the patients (43.75%) had significant anxiety and more than a quarter (27.50%) had depressive symptoms. Factors that influenced the HRQOL in MG were skeletal muscle weakness and anxiety and depressive symptoms (p < .001 in logistic regression model). CONCLUSION: Anxiety and depressive symptoms, besides motor symptoms, influence HRQOL in MG. Mental health must be a clinical focus in addition to the treatment of somatic symptoms during the course of MG.

Reduced Activated T Lymphocytes (CD4+CD25+) and Plasma Levels of Cytokines in Parkinson's Disease.

Parkinson's disease (PD) is the second most common neurodegenerative disease. The cause of neurodegeneration in PD is not completely understood, and evidence has shown that inflammatory/immune changes may be involved in PD pathophysiology. Herein, we aimed to determine the profile of the peripheral immune system in patients with PD in comparison with controls. Forty patients with PD and 25 age- and gender-matched controls were enrolled in this study. From these, 23 PD patients and 21 controls were included in the immunophenotyping analyses. Peripheral blood was drawn on the same day of the clinical assessment and submitted to plasma separation for enzyme-linked immunosorbent assay or cytometric bead array. Immunophenotyping analyses of the peripheral blood were performed by flow cytometry. We found that patients with PD presented peripheral immune changes evidenced by decreased percentage of T lymphocytes (CD3+ cells), especially activated T lymphocytes (CD4+CD25+ cells), when compared with controls. In line with these results, we also found decreased plasma levels of the cytokines IL-4, IL-6, IL-10, TNF, IFN-γ, and IL-17A in the PD group. In vitro experiments demonstrated that the production of cytokines by peripheral blood mononuclear cells harvested from healthy young donors was reduced after exposure to the anti-parkinsonian drugs levodopa and pramipexole. Our data corroborate the hypothesis that immunological mechanisms are involved in PD. It is not clear whether the differences that we have found are due to adaptive mechanisms or to changes associated with PD, including pharmacological treatment, or even directly related to the disease pathophysiology. Future studies are needed in this regard.

Toxoplasma gondii infection and chronic schizophrenia: is there any association?

ABSTRACT Background: Toxoplasma gondii (T. gondii) infection has been identified as a risk factor for schizophrenia. Objectives: Herein, we sought to evaluate the association between T. gondii infection and clinical symptoms and quality of life in patients with schizophrenia. Methods: We conducted a cross-sectional study with 48 patients with chronic schizophrenia and 40 controls. Peripheral blood was drawn, and IgM and IgG anti-T. gondii antibodies were evaluated by Enzyme-Linked Immunosorbent Assay (ELISA). Depressive, positive and negative symptoms were assessed, respectively, by the Calgary Depression Scale (CDS) and the Positive and Negative Syndrome Scale (PANSS). Cognitive performance was assessed in patients by the Brazilian version of the Schizophrenia Cognition Rating Scale (SCoRS-BR). Quality of life was assessed by the Brazilian version of the Quality of Life in Schizophrenia scale (QLS-BR). Results: The prevalence and titers of T. gondii IgM and IgG antibodies did not differ between patients and controls. The positive serology for T. gondii IgG antibodies was not associated with illness symptoms, cognitive performance, depressive symptoms or quality of life. Discussion: Our findings suggest that toxoplasmosis infection is not associated with severity of symptoms, quality of life, cognitive or depressive symptoms in schizophrenia patients.

Klotho dysfunction: A pathway linking the aging process to bipolar disorder?

AIM: Although accelerated aging profile has been described in bipolar disorder (BD), the biology linking BD and aging is still largely unknown. Reduced levels and/or activity of a protein named Klotho is associated with decreased life span, premature aging and occurrence of age-related diseases. Therefore, this study was designed to evaluate plasma levels of Klotho in BD patients and controls. METHODS: Forty patients with type 1 BD and 30 controls were enrolled in this study. After clinical evaluation, peripheral blood samples were drawn and plasma levels of Klotho were measured using enzyme-linked immunosorbent assay. RESULTS: Patients with BD and controls presented similar age and sex distribution. The mean ± SD length of illness was 24.00 ± 12.75 years. BD patients presented increased frequency of clinical comorbidities in comparison with controls, mainly arterial hypertension, diabetes mellitus, and hypothyroidism. Both patients with BD in remission and in mania exhibited increased plasma levels of Klotho in comparison with controls. There was no significant difference between patients in mania and patients in remission regarding the levels of Klotho. CONCLUSION: Klotho-related pathway is altered in BD. Contrary to our original hypothesis, our sample of patients with BD presented increased plasma levels of Klotho in comparison with controls. Elevated levels of Klotho in long-term BD patients may be associated with the disorder progression. Further studies are needed to better understand the role of Klotho in BD and other mood disorders.