Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 58
Filtrar
1.
Braz. J. Psychiatry (São Paulo, 1999, Impr.) ; 42(6): 673-686, Nov.-Dec. 2020. tab, graf
Artigo em Inglês | LILACS-Express | LILACS | ID: biblio-1132145

RESUMO

Objective: Obstacles for computational tools in psychiatry include gathering robust evidence and keeping implementation costs reasonable. We report a systematic review of automated speech evaluation for the psychosis spectrum and analyze the value of information for a screening program in a healthcare system with a limited number of psychiatrists (Maputo, Mozambique). Methods: Original studies on speech analysis for forecasting of conversion in individuals at clinical high risk (CHR) for psychosis, diagnosis of manifested psychotic disorder, and first-episode psychosis (FEP) were included in this review. Studies addressing non-verbal components of speech (e.g., pitch, tone) were excluded. Results: Of 168 works identified, 28 original studies were included. Valuable speech features included direct measures (e.g., relative word counting) and mathematical embeddings (e.g.: word-to-vector, graphs). Accuracy estimates reported for schizophrenia diagnosis and CHR conversion ranged from 71 to 100% across studies. Studies used structured interviews, directed tasks, or prompted free speech. Directed-task protocols were faster while seemingly maintaining performance. The expected value of perfect information is USD 9.34 million. Imperfect tests would nevertheless yield high value. Conclusion: Accuracy for screening and diagnosis was high. Larger studies are needed to enhance precision of classificatory estimates. Automated analysis presents itself as a feasible, low-cost method which should be especially useful for regions in which the physician pool is insufficient to meet demand.

2.
Artigo em Inglês | MEDLINE | ID: mdl-33346031

RESUMO

OBJECTIVE: It is unclear if pediatric executive dysfunction, assessed only with cognitive-tasks, predicts clinically-relevant outcomes independently of psychiatric diagnoses. This study tests the stability and validity of a task-based classification of executive function. METHOD: A total of 2207 individuals (6-17 years old) from the Brazilian High-Risk Cohort Study participated in this study (1930 at baseline, 1532 at follow-up). Executive function was measured using tests of working memory and inhibitory control. Dichotomized age- and sex-standardized performances were used as input in a Latent Class Analysis and Receiver Operating Curves to create an Executive Dysfunction Classification (EDC). The study tests EDC's stability over time, association with symptoms, functional impairment, a polymorphism in the CADM2 gene, polygenic risk scores (PRS), and brain structure. Analyses covaried for age, sex, social class, intelligence quotient, and psychiatric diagnoses. RESULTS: EDC at baseline predicted itself at follow-up (OR=5.11, CI 95% 3.41-7.64). Participants in the EDC reported symptoms spanning several domains of psychopathology and exhibited impairment in multiple settings, including more adverse school events (OR=2.530, CI95% 1.838-3.483). Children in the EDC presented higher ADHD and lower educational attainment PRS at baseline, higher schizophrenia PRS at follow-up, and lower chances of presenting a polymorphism in a gene previously linked to high performance in executive function (CADM2 gene). They also exhibited smaller intracranial volumes and smaller bilateral cortical surface areas in several brain regions. CONCLUSION: Task-based executive dysfunction is associated with several validators, independently of psychiatric diagnoses and intelligence. Further refinement of task-based assessments might generate clinically useful tools.

3.
Artigo em Inglês | MEDLINE | ID: mdl-33030612

RESUMO

In genetics, aggregation of many loci with small effect sizes into a single score improved prediction. Nevertheless, studies applying easily replicable weighted scores to neuroimaging data are lacking. Our aim was to assess the reliability and validity of the Neuroimaging Association Score (NAS), which combines information from structural brain features previously linked to mental disorders. Participants were 726 youth (aged 6-14) from two cities in Brazil who underwent MRI and psychopathology assessment at baseline and 387 at 3-year follow-up. Results were replicated in two samples: IMAGEN (n = 1627) and the Healthy Brain Network (n = 843). NAS were derived by summing the product of each standardized brain feature by the effect size of the association of that brain feature with seven psychiatric disorders documented by previous meta-analyses. NAS were calculated for surface area, cortical thickness and subcortical volumes using T1-weighted scans. NAS reliability, temporal stability and psychopathology and cognition prediction were analyzed. NAS for surface area showed high internal consistency and 3-year stability and predicted general psychopathology and cognition with higher replicability than specific symptomatic domains for all samples. They also predicted general psychopathology with higher replicability than single structures alone, accounting for 1-3% of the variance, but without directionality. The NAS for cortical thickness and subcortical volumes showed lower internal consistency and less replicable associations with behavioural phenotypes. These findings indicate the NAS based on surface area might be replicable markers of general psychopathology, but these links are unlikely to be causal or clinically useful yet.

4.
CNS Spectr ; : 1-5, 2020 Aug 10.
Artigo em Inglês | MEDLINE | ID: mdl-32772934

RESUMO

BACKGROUND.: Resistance to antipsychotic treatment affects up to 30% of patients with schizophrenia. Although the time course of development of treatment-resistant schizophrenia (TRS) varies from patient to patient, the reasons for these variations remain unknown. Growing evidence suggests brain dysconnectivity as a significant feature of schizophrenia. In this study, we compared fractional anisotropy (FA) of brain white matter between TRS and non-treatment-resistant schizophrenia (non-TRS) patients. Our central hypothesis was that TRS is associated with reduced FA values. METHODS.: TRS was defined as the persistence of moderate to severe symptoms after adequate treatment with at least two antipsychotics from different classes. Diffusion-tensor brain MRI obtained images from 34 TRS participants and 51 non-TRS. Whole-brain analysis of FA and axial, radial, and mean diffusivity were performed using Tract-Based Spatial Statistics (TBSS) and FMRIB's Software Library (FSL), yielding a contrast between TRS and non-TRS patients, corrected for multiple comparisons using family-wise error (FWE) < 0.05. RESULTS.: We found a significant reduction in FA in the splenium of corpus callosum (CC) in TRS when compared to non-TRS. The antipsychotic dose did not relate to the splenium CC. CONCLUSION.: Our results suggest that the focal abnormality of CC may be a potential biomarker of TRS.

5.
Br J Psychiatry ; : 1-7, 2020 Aug 18.
Artigo em Inglês | MEDLINE | ID: mdl-32807243

RESUMO

BACKGROUND: Social and environmental factors such as poverty or violence modulate the risk and course of schizophrenia. However, how they affect the brain in patients with psychosis remains unclear. AIMS: We studied how environmental factors are related to brain structure in patients with schizophrenia and controls in Latin America, where these factors are large and unequally distributed. METHOD: This is a multicentre study of magnetic resonance imaging in patients with schizophrenia and controls from six Latin American cities. Total and voxel-level grey matter volumes, and their relationship with neighbourhood characteristics such as average income and homicide rates, were analysed with a general linear model. RESULTS: A total of 334 patients with schizophrenia and 262 controls were included. Income was differentially related to total grey matter volume in both groups (P = 0.006). Controls showed a positive correlation between total grey matter volume and income (R = 0.14, P = 0.02). Surprisingly, this relationship was not present in patients with schizophrenia (R = -0.076, P = 0.17). Voxel-level analysis confirmed that this interaction was widespread across the cortex. After adjusting for global brain changes, income was positively related to prefrontal cortex volumes only in controls. Conversely, the hippocampus in patients with schizophrenia, but not in controls, was relatively larger in affluent environments. There was no significant correlation between environmental violence and brain structure. CONCLUSIONS: Our results highlight the interplay between environment, particularly poverty, and individual characteristics in psychosis. This is particularly important for harsh environments such as low- and middle-income countries, where potentially less brain vulnerability (less grey matter loss) is sufficient to become unwell in adverse (poor) environments.

6.
Hum Brain Mapp ; 2020 Jun 29.
Artigo em Inglês | MEDLINE | ID: mdl-32596977

RESUMO

The ENIGMA group on Generalized Anxiety Disorder (ENIGMA-Anxiety/GAD) is part of a broader effort to investigate anxiety disorders using imaging and genetic data across multiple sites worldwide. The group is actively conducting a mega-analysis of a large number of brain structural scans. In this process, the group was confronted with many methodological challenges related to study planning and implementation, between-country transfer of subject-level data, quality control of a considerable amount of imaging data, and choices related to statistical methods and efficient use of resources. This report summarizes the background information and rationale for the various methodological decisions, as well as the approach taken to implement them. The goal is to document the approach and help guide other research groups working with large brain imaging data sets as they develop their own analytic pipelines for mega-analyses.

7.
Schizophr Bull ; 46(3): 670-679, 2020 04 10.
Artigo em Inglês | MEDLINE | ID: mdl-32227226

RESUMO

Psychosis has been proposed to develop from dysfunction in a hippocampal-striatal-midbrain circuit, leading to aberrant salience processing. Here, we used functional magnetic resonance imaging (fMRI) during novelty salience processing to investigate this model in people at clinical high risk (CHR) for psychosis according to their subsequent clinical outcomes. Seventy-six CHR participants as defined using the Comprehensive Assessment of At-Risk Mental States (CAARMS) and 31 healthy controls (HC) were studied while performing a novelty salience fMRI task that engaged an a priori hippocampal-striatal-midbrain circuit of interest. The CHR sample was then followed clinically for a mean of 59.7 months (~5 y), when clinical outcomes were assessed in terms of transition (CHR-T) or non-transition (CHR-NT) to psychosis (CAARMS criteria): during this period, 13 individuals (17%) developed a psychotic disorder (CHR-T) and 63 did not. Functional activation and effective connectivity within a hippocampal-striatal-midbrain circuit were compared between groups. In CHR individuals compared to HC, hippocampal response to novel stimuli was significantly attenuated (P = .041 family-wise error corrected). Dynamic Causal Modelling revealed that stimulus novelty modulated effective connectivity from the hippocampus to the striatum, and from the midbrain to the hippocampus, significantly more in CHR participants than in HC. Conversely, stimulus novelty modulated connectivity from the midbrain to the striatum significantly less in CHR participants than in HC, and less in CHR participants who subsequently developed psychosis than in CHR individuals who did not become psychotic. Our findings are consistent with preclinical evidence implicating hippocampal-striatal-midbrain circuit dysfunction in altered salience processing and the onset of psychosis.

8.
Braz J Psychiatry ; 42(6): 673-686, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32321060

RESUMO

OBJECTIVE: Obstacles for computational tools in psychiatry include gathering robust evidence and keeping implementation costs reasonable. We report a systematic review of automated speech evaluation for the psychosis spectrum and analyze the value of information for a screening program in a healthcare system with a limited number of psychiatrists (Maputo, Mozambique). METHODS: Original studies on speech analysis for forecasting of conversion in individuals at clinical high risk (CHR) for psychosis, diagnosis of manifested psychotic disorder, and first-episode psychosis (FEP) were included in this review. Studies addressing non-verbal components of speech (e.g., pitch, tone) were excluded. RESULTS: Of 168 works identified, 28 original studies were included. Valuable speech features included direct measures (e.g., relative word counting) and mathematical embeddings (e.g.: word-to-vector, graphs). Accuracy estimates reported for schizophrenia diagnosis and CHR conversion ranged from 71 to 100% across studies. Studies used structured interviews, directed tasks, or prompted free speech. Directed-task protocols were faster while seemingly maintaining performance. The expected value of perfect information is USD 9.34 million. Imperfect tests would nevertheless yield high value. CONCLUSION: Accuracy for screening and diagnosis was high. Larger studies are needed to enhance precision of classificatory estimates. Automated analysis presents itself as a feasible, low-cost method which should be especially useful for regions in which the physician pool is insufficient to meet demand.


Assuntos
Transtornos Psicóticos , Esquizofrenia , Humanos , Programas de Rastreamento , Transtornos Psicóticos/diagnóstico , Fala
9.
CNS Spectr ; : 1-7, 2019 Dec 17.
Artigo em Inglês | MEDLINE | ID: mdl-31845634

RESUMO

OBJECTIVE.: Mental disorders can have a major impact on brain development. Peripheral blood concentrations of brain-derived neurotrophic factor (BDNF) are lower in adult psychiatric disorders. Serum BDNF concentrations and BDNF genotype have been associated with cortical maturation in children and adolescents. In 2 large independent samples, this study tests associations between serum BDNF concentrations, brain structure, and psychopathology, and the effects of BDNF genotype on BDNF serum concentrations in late childhood and early adolescence. METHODS.: Children and adolescents (7-14 years old) from 2 cities (n = 267 in Porto Alegre; n = 273 in São Paulo) were evaluated as part of the Brazilian high-risk cohort (HRC) study. Serum BDNF concentrations were quantified by sandwich ELISA. Genotyping was conducted from blood or saliva samples using the SNParray Infinium HumanCore Array BeadChip. Subcortical volumes and cortical thickness were quantified using FreeSurfer. The Development and Well-Being Behavior Assessment was used to identify the presence of a psychiatric disorder. RESULTS.: Serum BDNF concentrations were not associated with subcortical volumes or with cortical thickness. Serum BDNF concentration did not differ between participants with and without mental disorders, or between Val homozygotes and Met carriers. CONCLUSIONS.: No evidence was found to support serum BDNF concentrations as a useful marker of developmental differences in brain and behavior in early life. Negative findings were replicated in 2 of the largest independent samples investigated to date.

10.
J Psychosom Res ; 127: 109864, 2019 12.
Artigo em Inglês | MEDLINE | ID: mdl-31706071

RESUMO

The impact of early life stress on mental health and telomere length shortening have been reported. Changes in brain default mode network (DMN) were found to be related to a myriad of psychiatric conditions in which stress may play a role. In this context, family environment and adverse childhood experiences (ACEs) are potential causes of stress. This is a hypothesis-driven study focused on testing two hypotheses: (i) there is an association between telomere length and the function of two main hubs of DMN: the posterior cingulate cortex (PCC) and the medial prefrontal cortex (mPFC); (ii) this association is modulated by family environment and/or ACEs. To the best of our knowledge, this is the first study investigating these hypotheses. Resting-state functional magnetic resonance imaging data and blood sample were collected from 389 subjects (6-15 age range). We assessed DMN fractional amplitude of low-frequency fluctuations (fALFF) and leukocyte telomere length (LTL). We fitted general linear models to test the main effects of LTL on DMN hubs and the interaction effects with Family Environment Scale (FES) and ACEs. The results did not survive a strict Bonferroni correction. However, uncorrected p-values suggest that LTL was positively correlated with fALFF in PCC and a FES interaction between FES and LTL at mPFC. Although marginal, our results encourage further research on the interaction between DMN hubs, telomere length and family environment, which may play a role on the biological embedding of stress.


Assuntos
Mapeamento Encefálico/métodos , Leucócitos/metabolismo , Imagem por Ressonância Magnética/métodos , Telômero/metabolismo , Adolescente , Criança , Feminino , Humanos , Masculino
11.
Neurobiol Aging ; 82: 10-17, 2019 10.
Artigo em Inglês | MEDLINE | ID: mdl-31376729

RESUMO

Research suggested accumulation of tau proteins might lead to the degeneration of functional networks. Studies investigating the impact of genetic risk for Alzheimer's disease (AD) on early brain connections might shed light on mechanisms leading to AD development later in life. Here, we aim to investigate whether the polygenic risk score for Alzheimer's disease (AD-PRS) influences the connectivity among regions susceptible to tau pathology during childhood and adolescence. Participants were youth, aged 6-14 years, and recruited in Porto Alegre (discovery sample, n = 332) and São Paulo (replication sample, n = 304), Brazil. Subjects underwent genotyping and 6-min resting state funcional magnetic resonance imaging. Connections between the local maxima of tau pathology networks were used as dependent variables. The AD-PRS was associated with the connectivity between the right precuneus and the right superior temporal gyrus (discovery sample: ß = 0.180, padjusted = 0.036; replication sample: ß = 0.202, p = 0.031). This connectivity was also associated with inhibitory control (ß = 0.157, padjusted = 0.035) and moderated the association between the AD-PRS and both immediate and delayed recall. These findings suggest the AD-PRS may affect brain connectivity in youth, which might impact memory performance and inhibitory control in early life.


Assuntos
Doença de Alzheimer/diagnóstico por imagem , Doença de Alzheimer/genética , Encéfalo/diagnóstico por imagem , Predisposição Genética para Doença/genética , Rede Nervosa/diagnóstico por imagem , Polimorfismo de Nucleotídeo Único/genética , Adolescente , Doença de Alzheimer/epidemiologia , Brasil/epidemiologia , Criança , Estudos Transversais , Feminino , Neuroimagem Funcional/métodos , Predisposição Genética para Doença/epidemiologia , Humanos , Masculino
12.
Eur Psychiatry ; 59: 52-59, 2019 06.
Artigo em Inglês | MEDLINE | ID: mdl-31075522

RESUMO

BACKGROUND: Gender differences in symptomatology in chronic schizophrenia and first episode psychosis patients have often been reported. However, little is known about gender differences in those at risk of psychotic disorders. This study investigated gender differences in symptomatology, drug use, comorbidity (i.e. substance use, affective and anxiety disorders) and global functioning in patients with an at-risk mental state (ARMS) for psychosis. METHODS: The sample consisted of 336 ARMS patients (159 women) from the prodromal work package of the EUropean network of national schizophrenia networks studying Gene-Environment Interactions (EU-GEI; 11 centers). Clinical symptoms, drug use, comorbidity and functioning were assessed at first presentation to an early detection center using structured interviews. RESULTS: In unadjusted analyses, men were found to have significantly higher rates of negative symptoms and current cannabis use while women showed higher rates of general psychopathology and more often displayed comorbid affective and anxiety disorders. No gender differences were found for global functioning. The results generally did not change when corrected for possible cofounders (e.g. cannabis use). However, most differences did not withstand correction for multiple testing. CONCLUSIONS: Findings indicate that gender differences in symptomatology and comorbidity in ARMS are similar to those seen in overt psychosis and in healthy controls. However, observed differences are small and would only be reliably detected in studies with high statistical power. Moreover, such small effects would likely not be clinically meaningful.


Assuntos
Diagnóstico Precoce , Transtornos Psicóticos/epidemiologia , Esquizofrenia/epidemiologia , Adolescente , Adulto , Transtornos de Ansiedade/epidemiologia , Comorbidade , Europa (Continente)/epidemiologia , Feminino , Humanos , Masculino , Transtornos Psicóticos/psicologia , Esquizofrenia/diagnóstico , Distribuição por Sexo , Fatores Sexuais , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Adulto Jovem
13.
Surg Endosc ; 33(12): 4116-4121, 2019 12.
Artigo em Inglês | MEDLINE | ID: mdl-30815740

RESUMO

BACKGROUND: Symptoms may be unreliable to diagnose gastroesophageal reflux disease (GERD) in patients with minor psychiatric disorders (MPD). This study aims to evaluate the influence of MPD in the diagnosis of GERD. METHODS: We prospectively studied 245 patients (based on a sample size calculation) with suspected GERD. All patients underwent manometry and pH monitoring and MPD evaluation based on the Hospital Anxiety and Depression Scale (HADS). RESULTS: Based on the results of the pH monitoring, patients were classified as GERD + (n = 136, 55% of the total, mean age 46 years, 47% females) or GERD - (n = 109, 45% of the total, mean age 43 years, 60% females). The mean HADS score for GERD + and GERD - for anxiety was 7.8 and 8.5, respectively (p = 0.8) and for depression was 5.4 and 6.1, respectively (p = 0.1). DeMeester score (DS) did not correlate with total HADS score (p = 0.08) or depression domain (p = 0.9) but there was a negative correlation between DS and anxiety level (p < 0.001). A significant threshold accuracy value for HADS to diagnose GERD was not found on receiver operating characteristics curve analysis. CONCLUSION: Almost half of the patients evaluated for GERD did not have the disease on objective evaluation. GERD + and GERD - patients had similar levels of MPD. However, the amount of reflux correlated negatively with the severity of anxiety. Symptoms and HADS cannot accurately diagnose or exclude GERD. pH monitoring should be more liberally used especially in patients with high levels of anxiety.


Assuntos
Ansiedade/diagnóstico , Depressão/diagnóstico , Refluxo Gastroesofágico/diagnóstico , Adulto , Idoso , Monitoramento do pH Esofágico , Feminino , Humanos , Masculino , Manometria , Pessoa de Meia-Idade , Estudos Prospectivos , Índice de Gravidade de Doença
14.
Brain Connect ; 9(5): 379-387, 2019 06.
Artigo em Inglês | MEDLINE | ID: mdl-30880423

RESUMO

The fractional amplitude of low-frequency fluctuations (fALFFs) of the BOLD signal have been successfully applied as exploratory tools in neuroimaging. This metric has been useful in mapping brain functional changes in many clinical populations. However, little is known about the neurophysiological correlates of fALFF. This study aimed at demonstrating that fALFF is related to local network centrality during childhood and adolescence. The establishment of this relationship is fundamental to provide a more meaningful explanation to previous clinical and neurodevelopmental studies based on fALFF. Our findings show a correlation of ∼0.5 between these two metrics at a group level, which is a finding replicated in four large independent samples. However, when considering the across-subject and intra-subject correlations between the two metrics, the correlation is much lower, probably due to the low signal-to-noise ratio. Moreover, we found that regions with high fALFF and degree centrality overlapped modestly, particularly the posterior cingulate/precuneus and lateral parietal cortices.


Assuntos
Conectoma/métodos , Rede Nervosa/fisiologia , Neuroimagem/métodos , Adolescente , Encéfalo/fisiopatologia , Mapeamento Encefálico/métodos , Brasil , Criança , Meios de Contraste/metabolismo , Análise de Dados , Feminino , Humanos , Imagem por Ressonância Magnética/métodos , Masculino , Descanso
15.
Psychiatry Res ; 274: 391-394, 2019 04.
Artigo em Inglês | MEDLINE | ID: mdl-30901624

RESUMO

We investigated the role of DGCR2, a corticogenesis-related gene, on schizophrenia (SZ) and its subphenotypes, including brain morphology. A total of 221 SZ patients, 263 controls and 70 antipsychotic-naïve first episode of psychosis (FEP) were genotyped for 17 DGCR2 polymorphisms. While no association between DGCR2 polymorphisms and SZ was found, the missense variant rs2072123 was associated to left rostral anterior cingulate thickness, showing that DGCR2 seems not to be associated directly with the SZ but might be influencing the brain morphology. We also showed a DGCR2 downregulation in SZ patients when compared to controls and FEP.


Assuntos
Giro do Cíngulo/patologia , Complexo Glicoproteico GPIb-IX de Plaquetas/genética , Esquizofrenia/genética , Esquizofrenia/patologia , Adulto , Feminino , Genótipo , Humanos , Masculino , Mutação de Sentido Incorreto , Transtornos Psicóticos/genética , Transtornos Psicóticos/patologia
16.
Neuroimage Clin ; 22: 101695, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30738374

RESUMO

OBJECTIVES: So far, few studies have investigated cortical thickness (CT) and surface area (SA) measures in bipolar disorder type I (BDI) in comparison to a high genetic risk group such as first-degree relatives (FR). This study aimed to examine CT and SA differences between BDI, FR and healthy controls (HC). METHODS: 3D T1 magnetic resonance images were acquired from 27 euthymic BDI patients, 24 unaffected FR and 29 HC. CT and SA measures were obtained with FreeSurfer version 5.3.0. Generalized estimating equations were used to compare CT and SA between groups. Group comparisons were repeated with restricting the FR group to 17 siblings (FR-SB) only. RESULTS: \Mean age in years was 36.3 ±â€¯9.5 for BDI, 32.1 ±â€¯10.9 for FR, 34.7 ±â€¯9.8 for FR-SB and 33.1 ±â€¯9.0 for HC group respectively. BDI patients revealed larger SA of left pars triangularis (LPT) compared to HC (p = .001). In addition, increased SA in superior temporal cortex (STC) in FR-SB group compared to HC was identified (p = .0001). CONCLUSIONS: Our result of increased SA in LPT of BDI could be a disease marker and increased SA in STC of FR-SB could be a marker related with resilience to illness.


Assuntos
Transtorno Bipolar/patologia , Córtex Cerebral/patologia , Endofenótipos , Neuroimagem/métodos , Adulto , Biomarcadores , Transtorno Bipolar/diagnóstico por imagem , Córtex Cerebral/diagnóstico por imagem , Feminino , Humanos , Imagem por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Irmãos , Adulto Jovem
17.
Artigo em Inglês | MEDLINE | ID: mdl-30396768

RESUMO

Social and environmental factors are known risk factors and modulators of mental health disorders. We here conducted a nonsystematic review of the neuroimaging literature studying the effects of poverty, urbanicity, and community violence, highlighting the opportunities of studying non-Western developing societies such as those in Latin America. Social and environmental factors in these communities are widespread and have a large magnitude, as well as an unequal distribution, providing a good opportunity for their characterization. Studying the effect of poverty in these settings could help to explore the brain effect of economic improvements, disentangle the effect of absolute and relative poverty, and characterize the modulating impact of poverty on the underlying biology of mental health disorders. Exploring urbanicity effects in highly unequal cities could help identify the specific factors that modulate this effect as well as examine a possible dose-response effect by studying megacities. Studying brain changes in those living among violence, which is particularly high in places such as Latin America, could help to characterize the interplay between brain predisposition and exposure to violence. Furthermore, exploring the brain in an adverse environment should shed light on the mechanisms underlying resilience. We finally provide examples of two methodological approaches that could contribute to this field, namely a big cohort study in the developing world and a consortium-based meta-analytic approach, and argue about the potential translational value of this research on the development of effective social policies and successful personalized medicine in disadvantaged societies.


Assuntos
Encéfalo/fisiopatologia , Meio Ambiente , Neuroimagem , Meio Social , Encéfalo/patologia , Países em Desenvolvimento , Humanos , América Latina , Pobreza , Resiliência Psicológica , Fatores Socioeconômicos , População Urbana , Violência
18.
CNS Spectr ; 24(3): 333-337, 2019 06.
Artigo em Inglês | MEDLINE | ID: mdl-29248027

RESUMO

IntroductionOxidative stress has been documented in chronic schizophrenia and in the first episode of psychosis, but there are very little data on oxidative stress prior to the disease onset. OBJECTIVE: This work aimed to compare serum levels of superoxide dismutase (SOD) and glutathione peroxidase (GPx) in young individuals at ultra-high risk (UHR) of developing psychosis with a comparison healthy control group (HC). METHODS: Thirteen UHR subjects and 29 age- and sex-matched healthy controls (HC) were enrolled in this study. Clinical assessment included the Comprehensive Assessment of At-Risk Mental States (CAARMS), the Semi-Structured Clinical Interview for DSM-IV Axis-I (SCID-I) or the Kiddie-SADS-Present and Lifetime Version (K-SADS-PL), and the Global Assessment of Functioning (GAF) scale. Activities of SOD and GPx were measured in serum by the spectrophotometric method using enzyme-linked immunosorbent assay kits. RESULTS: After adjusting for age and years of education, there was a significant lower activity of SOD and lower GPX activity in the UHR group compared to the healthy control group (rate ratio [RR]=0.330, 95% CI 0.187; 0.584, p<0.001 and RR=0.509, 95% CI 0.323; 0.803, p=0.004, respectively). There were also positive correlations between GAF functioning scores and GPx and SOD activities. CONCLUSION: Our results suggest that oxidative imbalances could be present prior to the onset of full-blown psychosis, including in at-risk stages. Future studies should replicate and expand these results.


Assuntos
Glutationa Peroxidase/sangue , Transtornos Psicóticos/sangue , Superóxido Dismutase/sangue , Adolescente , Adulto , Biomarcadores/sangue , Estudos de Casos e Controles , Suscetibilidade a Doenças , Feminino , Humanos , Masculino , Transtornos Psicóticos/diagnóstico , Transtornos Psicóticos/epidemiologia
19.
Eur Child Adolesc Psychiatry ; 28(6): 835-845, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-30392120

RESUMO

The family environment in childhood has a strong effect on mental health outcomes throughout life. This effect is thought to depend at least in part on modifications of neurodevelopment trajectories. In this exploratory study, we sought to investigate whether a feasible resting-state fMRI metric of local spontaneous oscillatory neural activity, the fractional amplitude of low-frequency fluctuations (fALFF), is associated with the levels of children's family coherence and conflict. Moreover, we sought to further explore whether spontaneous activity in the brain areas influenced by family environment would also be associated with a mental health outcome, namely the incidence of behavioral and emotional problems. Resting-state fMRI data from 655 children and adolescents (6-15 years old) were examined. The quality of the family environment was found to be positively correlated with fALFF in the left temporal pole and negatively correlated with fALFF in the right orbitofrontal cortex. Remarkably, increased fALFF in the temporal pole was associated with a lower incidence of behavioral and emotional problems, whereas increased fALFF in the orbitofrontal cortex was correlated with a higher incidence.


Assuntos
Encéfalo/diagnóstico por imagem , Transtornos do Comportamento Infantil/diagnóstico por imagem , Transtornos do Comportamento Infantil/psicologia , Relações Familiares/psicologia , Comportamento Problema/psicologia , Estresse Psicológico/diagnóstico por imagem , Estresse Psicológico/psicologia , Adolescente , Adulto , Encéfalo/fisiopatologia , Mapeamento Encefálico/métodos , Mapeamento Encefálico/psicologia , Criança , Estudos de Coortes , Emoções/fisiologia , Feminino , Seguimentos , Humanos , Imagem por Ressonância Magnética/métodos , Imagem por Ressonância Magnética/psicologia , Masculino , Gravidez , Estudos Prospectivos , Estresse Psicológico/fisiopatologia
20.
Psychiatry Res Neuroimaging ; 275: 14-20, 2018 05 30.
Artigo em Inglês | MEDLINE | ID: mdl-29548527

RESUMO

In this study, we employed the Maximum Uncertainty Linear Discriminant Analysis (MLDA) to investigate whether the structural brain patterns in first episode psychosis (FEP) patients would be more similar to patients with chronic schizophrenia (SCZ) or healthy controls (HC), from a schizophrenia model perspective. Brain regions volumetric data were estimated by using MRI images of SCZ and FEP patients and HC. First, we evaluated the MLDA performance in discriminating SCZ from controls, which provided a score based on a model for changes in brain structure in SCZ. In the following, we compared the volumetric patterns of FEP patients with patterns of SCZ and healthy controls using these scores. The FEP group had a score distribution more similar to patients with schizophrenia (p-value = .461; Cohen's d=-.15) in comparison with healthy subjects (p-value=.003; Cohen's d = .62). Structures related to the limbic system and the circuitry involved in goal-directed behaviours were the most discriminant regions. There is a distinct pattern of volumetric changes in patients with schizophrenia in contrast to healthy controls, and this pattern seem to be detectable already in FEP.


Assuntos
Encéfalo/patologia , Aprendizado de Máquina , Imagem por Ressonância Magnética/métodos , Neuroimagem/métodos , Reconhecimento Automatizado de Padrão/métodos , Transtornos Psicóticos/patologia , Esquizofrenia/patologia , Adulto , Encéfalo/diagnóstico por imagem , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Transtornos Psicóticos/diagnóstico por imagem , Esquizofrenia/diagnóstico por imagem , Adulto Jovem
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA
...