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1.
Estud. pesqui. psicol. (Impr.) ; 18(4): 1137-1154, out.-dez. 2019.
Artigo em Português | LILACS, Index Psicologia - Periódicos técnico-científicos | ID: biblio-994979

RESUMO

Apresenta-se um panorama da Neuropsicologia brasileira, enfocando sua inserção no país, caracterizando o momento atual e desafios à sua consolidação. Aborda-se a trajetória da Neuropsicologia, traçando-se cinco períodos que a caracterizam, bem como sua trajetória nacional. A Neuropsicologia brasileira assiste à sofisticação da neuroimagem e ao avanço da pesquisa e interesse na área, à criação de entidades representativas, ao crescente número de publicações, grupos de pesquisa e de cursos de pós-graduação, ao desenvolvimento de instrumentos brasileiros e à ampliação da normatização e validação de instrumentos estrangeiros. Apesar desses avanços, ressalta-se a necessidade de constituir uma Neuropsicologia brasileira, sintonizada com os desafios de um país diverso, que contribua com políticas públicas, produza conhecimentos que atinjam diferentes populações e contribua para a diminuição das desigualdades sociais.(AU)


This paper aims to present an overview of Brazilian neuropsychology, focusing on the way the discipline was brought to Brazil, the present panorama of the discipline, and the challenges related to its consolidation. This article addresses the historical course of Neuropsychology, mapping the five distinct periods that characterized its history, as well as its national course. Brazilian neuropsychology is currently aided by the sophistication of neuroimaging techniques, the advancement in research and the interest in the area, as well as the creation of representative professional associations, the growing number of publications, research groups and graduate courses, the development of Brazilian instruments and the increase in standardization and validation of foreign instruments. Despite these advances, it is necessary to emphasize the need to make a Brazilian Neuropsychology, in tune with the challenges that come from a diverse country, one which contributes with public policies, produces knowledge that reaches different peoples and contributes towards reducing social inequalities.(AU)


Este artículo presenta un panorama de la Neuropsicología en Brasil, enfocándose en su inserción en el país, caracterizando el momento actual y los desafíos a su consolidación. Aborda la historia de la Neuropsicología, trazando los cinco períodos que la caracterizan y su trayectoria nacional. La Neuropsicología brasileña presencia la sofisticación de las técnicas de neuroimagen y el avance de la investigación y el interés de los estudiantes y profesionales, así como la creación de órganos representativos, el creciente número de grupos de investigación, cursos postgrado y publicaciones, el desarrollo de instrumentos brasileños de evaluación neuropsicológica y la estandarización de los procesos y validación de instrumentos extranjeros. A pesar de esos avances, se destaca la necesidad de establecer una Neuropsicología brasileña, en sintonía con desafíos y urgencias de un país diverso, que contribuya con políticas públicas, produzca y ponga en práctica conocimientos que alcancen diferentes poblaciones y contribuya con la reducción de las desigualdades sociales.(AU)


Assuntos
Humanos , Psicologia Aplicada , Neuropsicologia , Pesquisa , Brasil , Neuroimagem/psicologia , História
2.
Soc Cogn Affect Neurosci ; 14(3): 237-251, 2019 03 05.
Artigo em Inglês | MEDLINE | ID: mdl-30715524

RESUMO

Recent investigations in neuroscience elucidate the neural basis of close other cognitive representations, which serve functions central to our health and happiness. Yet, there are persistent barriers to this research, including disparate research methods and the absence of a common theoretical background. The present review connects neuroimaging and attachment theory within a novel social, cognitive and affective framework. We apply attachment theory to understand why we would expect cognitive representations of close others to be different from other social neural representations. Developing reliable markers of attachment is a critical step in mapping close other neural representations. We then examine existing neuroimaging literature on close other representations, highlighting the recruitment of neural systems supporting reward, motivation and distress alleviation, in addition to the mirror neuron system, default network and salience network. We then review the methodologies of past studies, revealing a diverse array of self-report measures assessing `closeness' and social cognitive tasks that, taken together, preclude meaningful synthesis of findings. Lastly, we discuss specific behavioral measures of attachment and closeness with recommendations for the field. This attachment framework integrates brain and behavioral sciences and unites theoretical principles with empirical methods to further our understanding of how the brain represents close others.


Assuntos
Encéfalo/fisiologia , Neuroimagem/psicologia , Comportamento Social , Encéfalo/diagnóstico por imagem , Mapeamento Encefálico , Humanos , Neurônios-Espelho/fisiologia , Recompensa
3.
Psychiatry Res Neuroimaging ; 279: 1-7, 2018 09 30.
Artigo em Inglês | MEDLINE | ID: mdl-30014966

RESUMO

The diagnosis of posttraumatic stress disorder (PTSD) is vulnerable to the simulation or exaggeration of symptoms as it depends on the individual's self-report of symptoms. The use of symptom validity tests is recommended to detect malingering in PTSD. However, in neuroimaging research, PTSD diagnosis is often taken at face validity. To date, no neuroimaging study has compared credible PTSD patients with those identified as malingering, and the potential impacts of including malingerers along with credible patients on results is unclear. We classified male patients with combat-related PTSD as either credible (n = 37) or malingerers (n = 9) based on the Morel Emotional Numbing Test and compared structural neuroimaging and psychological questionnaire data. Patients identified as malingerers had larger gray matter volumes in the hippocampus, right inferior frontal gyrus and thalamus, and reported higher PTSD symptoms than credible PTSD patients. This is the first structural neuroimaging study to compare credible PTSD patients and malingerers. We find evidence of structural differences between these groups, in regions implicated in PTSD, inhibition and deception. These results emphasize the need for the inclusion of SVTs in neuroimaging studies of PTSD to ensure future findings are not confounded by an unknown mix of valid PTSD patients and malingerers.


Assuntos
Distúrbios de Guerra/diagnóstico por imagem , Distúrbios de Guerra/psicologia , Hipocampo/diagnóstico por imagem , Transtornos de Estresse Pós-Traumáticos/diagnóstico por imagem , Transtornos de Estresse Pós-Traumáticos/psicologia , Adulto , Emoções/fisiologia , Substância Cinzenta/diagnóstico por imagem , Humanos , Masculino , Simulação de Doença/diagnóstico por imagem , Simulação de Doença/epidemiologia , Simulação de Doença/psicologia , Neuroimagem/métodos , Neuroimagem/psicologia
4.
J Eval Clin Pract ; 24(4): 909-915, 2018 08.
Artigo em Inglês | MEDLINE | ID: mdl-29744995

RESUMO

One of the early concerns regarding the use of neuroscience data in criminal trials is that even if the brain images are ambiguous or inconclusive, they still might influence a jury in virtue of the fact that they appear easy to understand. By appearing visually simple, even though they are really statistically constructed maps with a host of assumptions built into them, a lay jury or a judge might take brain scans to be more reliable or relevant than they actually are. Should courts exclude brain scans for being more prejudicial than probative? Herein, we rehearse a brief history of brain scans admitted into criminal trials in the United States, then describe the results of a recent analysis of appellate court decisions that referenced 1 or more brain scans in the judicial decision. In particular, we aim to explain how courts use neuroscience imaging data: Do they interpret the data correctly? Does it seem that scans play an oversized role in judicial decision-making? And have they changed how criminal defendants are judged? It is our hope that in answering these questions, clinicians and defence attorneys will be able to make better informed decisions regarding about how to manage those incarcerated.


Assuntos
Encéfalo/diagnóstico por imagem , Criminosos/psicologia , Tomada de Decisões , Prova Pericial , Jurisprudência , Neuroimagem , Direito Penal/métodos , Prova Pericial/métodos , Prova Pericial/normas , Humanos , Neuroimagem/métodos , Neuroimagem/psicologia , Filosofia Médica , Estados Unidos
6.
Biomed Res Int ; 2017: 6875850, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-28367446

RESUMO

In visual perspective taking (vPT) one has to concern oneself with what other people see and how they see it. Since seeing is a mental state, developmental studies have discussed vPT within the domain of "theory of mind (ToM)" but imaging studies have not treated it as such. Based on earlier results from several meta-analyses, we tested for the overlap of visual perspective taking studies with 6 different kinds of ToM studies: false belief, trait judgments, strategic games, social animations, mind in the eyes, and rational actions. Joint activation was observed between the vPT task and some kinds of ToM tasks in regions involving the left temporoparietal junction (TPJ), anterior precuneus, left middle occipital gyrus/extrastriate body area (EBA), and the left inferior frontal and precentral gyrus. Importantly, no overlap activation was found for the vPT tasks with the joint core of all six kinds of ToM tasks. This raises the important question of what the common denominator of all tasks that fall under the label of "theory of mind" is supposed to be if visual perspective taking is not one of them.


Assuntos
Imagem por Ressonância Magnética/psicologia , Neuroimagem/psicologia , Teoria da Mente , Mapeamento Encefálico , Lobo Frontal/fisiologia , Humanos , Imagem por Ressonância Magnética/métodos , Neuroimagem/métodos , Lobo Occipital/fisiologia , Percepção Visual/fisiologia
7.
Mol Psychiatry ; 22(6): 900-909, 2017 06.
Artigo em Inglês | MEDLINE | ID: mdl-27137745

RESUMO

The neuro-anatomical substrates of major depressive disorder (MDD) are still not well understood, despite many neuroimaging studies over the past few decades. Here we present the largest ever worldwide study by the ENIGMA (Enhancing Neuro Imaging Genetics through Meta-Analysis) Major Depressive Disorder Working Group on cortical structural alterations in MDD. Structural T1-weighted brain magnetic resonance imaging (MRI) scans from 2148 MDD patients and 7957 healthy controls were analysed with harmonized protocols at 20 sites around the world. To detect consistent effects of MDD and its modulators on cortical thickness and surface area estimates derived from MRI, statistical effects from sites were meta-analysed separately for adults and adolescents. Adults with MDD had thinner cortical gray matter than controls in the orbitofrontal cortex (OFC), anterior and posterior cingulate, insula and temporal lobes (Cohen's d effect sizes: -0.10 to -0.14). These effects were most pronounced in first episode and adult-onset patients (>21 years). Compared to matched controls, adolescents with MDD had lower total surface area (but no differences in cortical thickness) and regional reductions in frontal regions (medial OFC and superior frontal gyrus) and primary and higher-order visual, somatosensory and motor areas (d: -0.26 to -0.57). The strongest effects were found in recurrent adolescent patients. This highly powered global effort to identify consistent brain abnormalities showed widespread cortical alterations in MDD patients as compared to controls and suggests that MDD may impact brain structure in a highly dynamic way, with different patterns of alterations at different stages of life.


Assuntos
Córtex Cerebral/patologia , Transtorno Depressivo Maior/diagnóstico por imagem , Transtorno Depressivo Maior/patologia , Adolescente , Adulto , Encéfalo/patologia , Córtex Cerebral/diagnóstico por imagem , Feminino , Lobo Frontal/patologia , Substância Cinzenta/patologia , Giro do Cíngulo/patologia , Humanos , Imagem por Ressonância Magnética/métodos , Masculino , Neuroimagem/métodos , Neuroimagem/psicologia , Córtex Pré-Frontal/patologia , Lobo Temporal/patologia
8.
Int J Law Psychiatry ; 46: 58-67, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-27209602

RESUMO

Neuroscientific evidence is increasingly being used in criminal trials as part of psychiatric testimony. Up to now, "neurolaw" literature remained focused on the use of neuroscience for assessments of criminal responsibility. However, in the field of forensic psychiatry, responsibility assessments are progressively being weakened, whereas dangerousness and risk assessment gain increasing importance. In this paper, we argue that the introduction of neuroscientific data by forensic experts in criminal trials will be mostly be used in the future as a means to evaluate or as an indication of an offender's dangerousness, rather than their responsibility. Judges confronted with the pressure to ensure public security may tend to interpret neuroscientific knowledge and data as an objective and reliable way of evaluating one's risk of reoffending. First, we aim to show how the current socio-legal context has reshaped the task of the forensic psychiatrist, with dangerousness assessments prevailing. In the second part, we examine from a critical point of view the promise of neuroscience to serve a better criminal justice system by offering new tools for risk assessment. Then we aim to explain why neuroscientific evidence is likely to be used as evidence of dangerousness of the defendants. On a theoretical level, the current tendency in criminal policies to focus on prognostics of dangerousness seems to be "justified" by a utilitarian approach to punishment, supposedly revealed by new neuroscientific discoveries that challenge the notions of free will and responsibility. Although often promoted as progressive and humane, we believe that this approach could lead to an instrumentalization of neuroscience in the interest of public safety and give rise to interventions which could entail ethical caveats and run counter to the interests of the offenders. The last part of this paper deals with some of these issues-the danger of stigmatization for brain damaged offenders because of adopting a purely therapeutic approach to crime, and the impact on their sentencing, in particular.


Assuntos
Comportamento Perigoso , Psiquiatria Legal/legislação & jurisprudência , Neurociências/legislação & jurisprudência , Prisioneiros/legislação & jurisprudência , Prisioneiros/psicologia , Dano Encefálico Crônico/diagnóstico , Dano Encefálico Crônico/psicologia , Prova Pericial/legislação & jurisprudência , Humanos , Defesa por Insanidade , Comunicação Interdisciplinar , Colaboração Intersetorial , Competência Mental/legislação & jurisprudência , Neuroimagem/psicologia , Prognóstico , Medição de Risco/legislação & jurisprudência , Estigma Social
9.
Brain Behav ; 6(3): e00428, 2016 03.
Artigo em Inglês | MEDLINE | ID: mdl-26893955

RESUMO

BACKGROUND: Although incidental findings (IF) are commonly encountered in neuroimaging research, there is no consensus regarding what to do with them. Whether researchers are obligated to review scans for IF, or if such findings should be disclosed to research participants at all, is controversial. Objective data are required to inform reasonable research policy; unfortunately, such data are lacking in the published literature. This manuscript summarizes the development of a radiology review and disclosure system in place at a neuroimaging research institute and its impact on key stakeholders. METHODS: The evolution of a universal radiology review system is described, from inception to its current status. Financial information is reviewed, and stakeholder impact is characterized through surveys and interviews. RESULTS: Consistent with prior reports, 34% of research participants had an incidental finding identified, of which 2.5% required urgent medical attention. A total of 87% of research participants wanted their magnetic resonance imaging (MRI) results regardless of clinical significance and 91% considered getting an MRI report a benefit of study participation. A total of 63% of participants who were encouraged to see a doctor about their incidental finding actually followed up with a physician. Reasons provided for not following-up included already knowing the finding existed (14%), not being able to afford seeing a physician (29%), or being reassured after speaking with the institute's Medical Director (43%). Of those participants who followed the recommendation to see a physician, nine (38%) required further diagnostic testing. No participants, including those who pursued further testing, regretted receiving their MRI report, although two participants expressed concern about the excessive personal cost. The current cost of the radiology review system is about $23 per scan. CONCLUSIONS: It is possible to provide universal radiology review of research scans through a system that is cost-effective, minimizes investigator burden, and does not overwhelm local healthcare resources.


Assuntos
Revelação/ética , Imagem por Ressonância Magnética/ética , Revelação/normas , Humanos , Achados Incidentais , Neuroimagem/ética , Neuroimagem/psicologia , Médicos , Pesquisa/normas , Inquéritos e Questionários
10.
PLoS One ; 10(10): e0141133, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-26496709

RESUMO

Pain-related anxiety and fear are associated with increased difficulties in attention, increased awareness of pain, impaired disengagement from pain, and can moderate the effects of attentional coping attempts. Accurately assessing the direct impact of pain-related anxiety and fear on pain behavior has proved difficult. Studies have demonstrated no or limited influence of pain-related fear and anxiety on behavior but this may be due to inherent problems with the scales used. Neuroimaging has improved the understanding of neural processes underlying the factors that influence pain perception. This study aimed to establish if a Picture and Imagination Task (PIT), largely developed from the Photographs of Daily Activity (PHODA) assessment tool, could help explore how people living with chronic pain process information about daily activities. Blood oxygenation level dependent (BOLD) functional magnetic resonance imaging (fMRI) was used to compare brain responses in patients with chronic musculoskeletal pain (CMSKP) (n = 15) and healthy controls (n = 15). Subjects were asked to imagine how they would feel mentally and physically if asked to perform daily activities illustrated in PIT. The results found that a number of regions involved in pain processing saw increased BOLD activation in patients compared with controls when undertaking the task and included the insula, anterior cingulate cortex, thalamus and inferior and superior parietal cortices. Similarly, increased BOLD responses in patients compared to controls in the frontal pole, paracingulate and the supplementary motor cortex may be suggestive of a memory component to the responses The amygdala, orbitofrontal cortex, substantia nigra/ventral tegmentum, putamen, thalamus, pallidum, inferior parietal (supramarginal and angular gyrus) and cingulate cortex were also seen to have greater differences in BOLD signal changes in patients compared with controls and many of these regions are also associated with general phobic responses. Therefore, we suggest that PIT is a useful task to explore pain- and movement-related anxiety and fear in fMRI studies. Regions in the Default Mode Network remained active or were less deactivated during the PIT task in patients with CMSKP compared to healthy controls supporting the contention that the DMN is abnormal in patients with CMSKP.


Assuntos
Ansiedade/fisiopatologia , Encéfalo/fisiopatologia , Dor Crônica/fisiopatologia , Rememoração Mental , Dor Musculoesquelética/fisiopatologia , Rede Nervosa/fisiopatologia , Atividades Cotidianas/psicologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Ansiedade/patologia , Ansiedade/psicologia , Encéfalo/patologia , Mapeamento Encefálico , Estudos de Casos e Controles , Dor Crônica/patologia , Dor Crônica/psicologia , Medo/psicologia , Feminino , Humanos , Imagem por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Atividade Motora , Dor Musculoesquelética/patologia , Dor Musculoesquelética/psicologia , Rede Nervosa/patologia , Neuroimagem/métodos , Neuroimagem/psicologia , Fotografação
12.
Prim Health Care Res Dev ; 15(4): 362-74, 2014 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-24252666

RESUMO

AIM: To investigate the informed consent experiences of women with human immunodeficiency virus (HIV) and childhood trauma involved in a neurocognitive and neuroimaging study. BACKGROUND: There is no previous research on the consent process for people with both HIV and childhood trauma, conditions that are syndemic in South Africa. Research on the consent process for each individual condition has shown that individuals with either of these conditions may be vulnerable research participants. This study aimed to investigate the opinions of the women involved in order to refine future consent processes and ensure that they are appropriate for this population. METHODS: A qualitative semi-structured interview was conducted with women from Khayelitsha township in South Africa involved in a cohort study on neurocognitive and neuroimaging outcomes in HIV and childhood trauma, who agreed to participate in an interview immediately following their final study appointment. FINDINGS: Aspects most frequently commented upon by participants during the interview were community recruitment, incentives for participation, quality of information provided, and misunderstandings and unexpected events. The overarching finding was that of therapeutic misconception; participants expected, and highlighted as incentives for participation, health benefits that were not part of the study. A minority of participants reported discomfort from questions concerning their traumatic experiences. Despite this, the consent process was well received and there was good understanding of confidentiality issues and the voluntariness of participation. CONCLUSION: Full disclosure of true benefits from participation must be emphasised throughout the recruitment process. This is particularly important for participants with HIV who appear to participate because of perceived health incentives. Providing prior notification that questions about traumatic experiences will be asked may improve the experiences of participants. A generic but thoroughly conducted consent process is suitable in this population.


Assuntos
Sobreviventes Adultos de Maus-Tratos Infantis/psicologia , Atitude Frente a Saúde , Cognição , Soropositividade para HIV/psicologia , Consentimento Livre e Esclarecido , Neuroimagem/psicologia , Adulto , Feminino , Humanos , Entrevistas como Assunto , Pessoa de Meia-Idade , Pesquisa Qualitativa , África do Sul
13.
PLoS One ; 8(9): e74449, 2013.
Artigo em Inglês | MEDLINE | ID: mdl-24040251

RESUMO

Several highly-cited experiments have presented evidence suggesting that neuroimages may unduly bias laypeople's judgments of scientific research. This finding has been especially worrisome to the legal community in which neuroimage techniques may be used to produce evidence of a person's mental state. However, a more recent body of work that has looked directly at the independent impact of neuroimages on layperson decision-making (both in legal and more general arenas), and has failed to find evidence of bias. To help resolve these conflicting findings, this research uses eye tracking technology to provide a measure of attention to different visual representations of neuroscientific data. Finding an effect of neuroimages on the distribution of attention would provide a potential mechanism for the influence of neuroimages on higher-level decisions. In the present experiment, a sample of laypeople viewed a vignette that briefly described a court case in which the defendant's actions might have been explained by a neurological defect. Accompanying these vignettes was either an MRI image of the defendant's brain, or a bar graph depicting levels of brain activity-two competing visualizations that have been the focus of much of the previous research on the neuroimage bias. We found that, while laypeople differentially attended to neuroimagery relative to the bar graph, this did not translate into differential judgments in a way that would support the idea of a neuroimage bias.


Assuntos
Atenção/fisiologia , Tomada de Decisões , Neuroimagem/psicologia , Punição/psicologia , Percepção Visual , Viés , Encéfalo/patologia , Crime , Movimentos Oculares/fisiologia , Feminino , Humanos , Imagem por Ressonância Magnética , Masculino , Adulto Jovem
14.
Cognition ; 129(3): 501-11, 2013 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-24041836

RESUMO

A series of highly-cited experiments published in 2008 demonstrated a biasing effect of neuroimages on lay perceptions of scientific research. More recent work, however, has questioned this bias, particularly within legal contexts in which neuroscientific evidence is proffered by one of the parties. The present research moves away from the legal framework and describes five experiments that re-examine this effect. Experiments 1 through 4 present conceptual and direct replications of some of the original 2008 experiments, and find no evidence of a neuroimage bias. A fifth experiment is reported that confirms that, when laypeople are allowed multiple points of reference (e.g., when directly comparing neuroimagery to other graphical depictions of neurological data), a neuroimage bias can be observed. Together these results suggest that, under the right conditions, a neuroimage might be able to bias judgments of scientific information, but the scope of this effect may be limited to certain contexts.


Assuntos
Conhecimentos, Atitudes e Prática em Saúde , Julgamento/fisiologia , Neuroimagem/psicologia , Reconhecimento Visual de Modelos/fisiologia , Adulto , Viés , Encéfalo , Humanos , Distribuição Aleatória
15.
Neurology ; 81(13): 1114-21, 2013 Sep 24.
Artigo em Inglês | MEDLINE | ID: mdl-23966249

RESUMO

OBJECTIVE: To inform whether the Alzheimer's Disease Neuroimaging Initiative (ADNI) should change its policy of not returning research results to ADNI participants, we surveyed investigators and research staff about disclosing ADNI biomarker information to research participants, with particular emphasis on amyloid imaging results. METHODS: In April 2012, just before Food and Drug Administration approval of the amyloid-binding radiotracer, florbetapir, all ADNI investigators and personnel were recruited to complete an anonymous online survey that contained fixed choice and free-text questions. RESULTS: Although ADNI participants often requested amyloid imaging results (the proportions of investigators who reported requests from more than half of their participants with normal cognition or mild cognitive impairment were 20% and 22%, respectively), across all diagnostic groups, the majority of ADNI investigators (approximately 90%) did not return amyloid imaging results to ADNI participants. However, the majority of investigators reported that, if the Food and Drug Administration approved florbetapir, they would support the return of amyloid imaging results to participants with mild cognitive impairment and normal cognition, but they emphasized the need for guidance on how to provide these results to participants and for research to assess the value of returning results as well as how returning results will affect study validity and participant well-being. CONCLUSIONS: A majority of ADNI investigators support returning amyloid imaging results to ADNI participants. The findings that they want guidance on how to do this and research on the impact of disclosure suggest how to develop and monitor a disclosure process.


Assuntos
Doença de Alzheimer/diagnóstico , Atitude , Biomarcadores/metabolismo , Encéfalo/metabolismo , Neuroimagem , Pesquisadores/psicologia , Doença de Alzheimer/complicações , Doença de Alzheimer/diagnóstico por imagem , Compostos de Anilina , Encéfalo/diagnóstico por imagem , Encéfalo/patologia , Disfunção Cognitiva/diagnóstico , Disfunção Cognitiva/etiologia , Escolaridade , Etilenoglicóis , Feminino , Radioisótopos de Flúor , Inquéritos Epidemiológicos , Humanos , Masculino , Neuroimagem/psicologia , Cintilografia , Estados Unidos , United States Food and Drug Administration
17.
Rev. psiquiatr. salud ment ; 6(1): 4-16, ene.-mar. 2013. tab, ilus
Artigo em Espanhol | IBECS | ID: ibc-109140

RESUMO

PEPs es un estudio multicéntrico, naturalístico, prospectivo y longitudinal diseñado para evaluar las variables clínicas, neuropsicológicas, de neuroimagen, bioquímicas, ambientales y genéticas en una muestra de casi 350 pacientes con un primer episodio psicótico y 250 controles sanos. El proyecto PEPs ha sido realizado en España desde enero de 2009 hasta diciembre de 2011. En este artículo se describe la justificación de los métodos de evaluación adoptados, proporcionando una breve descripción de las medidas clínicas y funcionales seleccionadas. Los objetivos principales son: a) el examen clínico y la caracterización neuropsicológica de una muestra de primeros episodios de psicosis, y b) el estudio de las interacciones entre las variables genéticas y ambientales seleccionadas para predecir los resultados clínicos y de estructura cerebral y determinar la relación de polimorfismos genéticos implicados en la farmacocinética y la farmacodinámica, y la respuesta en los efectos adversos del tratamiento(AU)


The PEPs study is multicenter, naturalistic, prospective, longitudinal study designed to evaluate clinical, neuropsychological, neuroimaging, biochemical, environmental and pharmacogenetic variables in a sample of nearly 350 first episode of psychosis patients and 250 healthy controls. The PEPs project was conducted in Spain from January 2009 to December 2011. This article describes the rationale for the measurement approach adopted, providing an overview of the selected clinical and functional measures. The main objectives are: (a) the thorough clinical and neurocognitive characterization of a sample of first episodes of psychosis and (b) the study of the interactions between the genetic and environmental variables selected to predict clinical and brain structural outcomes, and to determine the relationship of genetic polymorphisms involved in the pharmacokinetics and pharmacodynamics, and the responses and adverse effects of treatment(AU)


Assuntos
Humanos , Masculino , Feminino , Escalas de Graduação Psiquiátrica Breve/normas , Transtornos Psicóticos Afetivos/diagnóstico , Transtornos Psicóticos Afetivos/psicologia , Psicopatologia/métodos , Psicopatologia/tendências , Esquizofrenia/diagnóstico , Psicologia do Esquizofrênico , Neuroimagem/instrumentação , Neuroimagem/métodos , Psicopatologia/organização & administração , Psicopatologia/normas , Estudos Prospectivos , Estudos Longitudinais , Neuropsicologia/métodos , Neuropsicologia/tendências , Neuroimagem/psicologia , Neuroimagem , Inquéritos e Questionários
18.
Curr Psychiatry Rep ; 15(3): 345, 2013 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-23397252

RESUMO

Schizophrenia is characterized by neurostructural and neurofunctional aberrations that have now been demonstrated through neuroimaging research. The article reviews recent studies that have attempted to use neuroimaging to understand the relation between neurological abnormalities and aspects of the phenomenology of schizophrenia. Neuroimaging studies show that neurostructural and neurofunctional abnormalities are present in people with schizophrenia and their close relatives and may represent putative endophenotypes. Neuroimaging phenotypes predict the emergence of psychosis in individuals classified as high-risk. Neuroimaging studies have linked structural and functional abnormalities to symptoms; and progressive structural changes to clinical course and functional outcome. Neuroimaging has successfully indexed the neurotoxic and neuroprotective effects of schizophrenia treatments. Pictures can inform about aspects of the phenomenology of schizophrenia including etiology, onset, symptoms, clinical course, and treatment effects but this assertion is tempered by the scientific and practical limitations of neuroimaging.


Assuntos
Encéfalo/patologia , Neuroimagem , Esquizofrenia/patologia , Encéfalo/fisiopatologia , Humanos , Neuroimagem/métodos , Neuroimagem/psicologia , Valor Preditivo dos Testes , Esquizofrenia/fisiopatologia , Esquizofrenia/terapia
19.
Aust N Z J Psychiatry ; 47(4): 321-32, 2013 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-23411094

RESUMO

Although the etiology of bipolar disorder remains uncertain, multiple studies examining neuroimaging, peripheral markers and genetics have provided important insights into the pathophysiologic processes underlying bipolar disorder. Neuroimaging studies have consistently demonstrated loss of gray matter, as well as altered activation of subcortical, anterior temporal and ventral prefrontal regions in response to emotional stimuli in bipolar disorder. Genetics studies have identified several potential candidate genes associated with increased risk for developing bipolar disorder that involve circadian rhythm, neuronal development and calcium metabolism. Notably, several groups have found decreased levels of neurotrophic factors and increased pro-inflammatory cytokines and oxidative stress markers. Together these findings provide the background for the identification of potential biomarkers for vulnerability, disease expression and to help understand the course of illness and treatment response. In other areas of medicine, validated biomarkers now inform clinical decision-making. Although the findings reviewed herein hold promise, further research involving large collaborative studies is needed to validate these potential biomarkers prior to employing them for clinical purposes. Therefore, in this positional paper from the ISBD-BIONET (biomarkers network from the International Society for Bipolar Disorders), we will discuss our view of biomarkers for these three areas: neuroimaging, peripheral measurements and genetics; and conclude the paper with our position for the next steps in the search for biomarkers for bipolar disorder.


Assuntos
Comitês Consultivos , Transtorno Bipolar/fisiopatologia , Fator Neurotrófico Derivado do Encéfalo/sangue , Predisposição Genética para Doença/genética , Mediadores da Inflamação/sangue , Neuroimagem/psicologia , Estresse Oxidativo/fisiologia , Biomarcadores/metabolismo , Transtorno Bipolar/sangue , Transtorno Bipolar/genética , Transtorno Bipolar/metabolismo , Transtorno Bipolar/patologia , Humanos
20.
Biol Psychiatry ; 73(2): 144-52, 2013 Jan 15.
Artigo em Inglês | MEDLINE | ID: mdl-22818781

RESUMO

BACKGROUND: To translate our knowledge about neuroanatomy of bipolar disorder (BD) into a diagnostic tool, it is necessary to identify the neural signature of predisposition for BD and separate it from effects of long-standing illness and treatment. Thus, we examined the associations among genetic risk, illness burden, lithium treatment, and brain structure in BD. METHODS: This is a two-center, replication-design, structural magnetic resonance imaging study. First, we investigated neuroanatomic markers of familial predisposition by comparing 50 unaffected and 36 affected relatives of BD probands as well as 49 control subjects using modulated voxel-based morphometry. Second, we investigated effects of long-standing illness and treatment on the identified markers in 19 young participants early in the course of BD, 29 subjects with substantial burden of long-lasting BD and either minimal lifetime (n = 12), or long-term ongoing (n = 17) lithium treatment. RESULTS: Five groups, including the unaffected and affected relatives of BD probands from each center as well as participants early in the course of BD showed larger right inferior frontal gyrus (rIFG) volumes than control subjects (corrected p < .001). The rIFG volume correlated negatively with illness duration (corrected p < .01) and, relative to the controls, was smaller among BD individuals with long-term illness burden and minimal lifetime lithium exposure (corrected p < .001). Li-treated subjects had normal rIFG volumes despite substantial illness burden. CONCLUSIONS: Brain structural changes in BD may result from interplay between illness burden and compensatory processes, which may be enhanced by lithium treatment. The rIFG volume could aid in identification of subjects at risk for BD even before any behavioral manifestations.


Assuntos
Transtorno Bipolar/patologia , Lobo Frontal/patologia , Neuroimagem/psicologia , Adolescente , Adulto , Transtorno Bipolar/tratamento farmacológico , Estudos de Casos e Controles , Filho de Pais Incapacitados/psicologia , Estudos Transversais , Diagnóstico Precoce , Família/psicologia , Feminino , Lobo Frontal/efeitos dos fármacos , Predisposição Genética para Doença/psicologia , Humanos , Processamento de Imagem Assistida por Computador/métodos , Compostos de Lítio/farmacologia , Imagem por Ressonância Magnética/métodos , Imagem por Ressonância Magnética/psicologia , Masculino , Pessoa de Meia-Idade , Neuroimagem/métodos , Fatores de Risco , Fatores de Tempo
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