scholarly journals M161. NEURAL CHANGES INDUCED BY ELECTROCONVULSIVE THERAPY (ECT) IN SCHIZOPHRENIA PATIENTS: A SYSTEMATIC REVIEW

2020 ◽  
Vol 46 (Supplement_1) ◽  
pp. S197-S197
Author(s):  
Sun-Young Moon ◽  
Minah Kim ◽  
Sanghoon Oh ◽  
Jun Soo Kwon
Keyword(s):  
Blood Flow ◽  
Electroconvulsive Therapy ◽  
Medial Temporal Lobe ◽  
Neural Substrates ◽  
Resonance Spectroscopy ◽  
Medical Subject Headings ◽  
Functional Brain ◽  
Mesh Terms ◽  
Cochrane Reviews ◽  
Study Results

Abstract Background Despite the remarkable progress of antipsychotic drugs, electroconvulsive therapy (ECT) remains a potent treatment option for schizophrenia. However, the underlying neural mechanism of ECT effect on schizophrenia remains unclear. For this reason, we reviewed literature which investigated structural and functional brain changes after ECT in schizophrenia patients. Methods We searched the PubMed, EMBASE, Cochrane Reviews database to search for eligible articles. Following medical subject headings (MeSH) terms were used: ECT AND schizophrenia AND (MRI OR MRS OR PET OR SPECT OR NIRS OR DTI). Results Thirteen studies were eligible for the reviewing process. Of them, three studies investigated the effect of ECT upon volumetric changes of cerebral regions; 4 studies on the effect of ECT upon functional brain activities; three studies using magnetic resonance spectroscopy (MRS); and another three studies investigating blood flow changes. Medial temporal lobe (MTL) structures seemed to be increased after ECT sessions in schizophrenia patients, as in major depressive disorder (MDD) patients. Insula and left dorsolateral prefrontal cortex (DLFPC) is other potential neural substrates that might be disease specific for ECT induced changes in schizophrenia. Outcomes of functional imaging seemed to vary among studies, with divergent region of interests (ROI). MRS study results suggests the ratio of left prefrontal NAA/Cr might be increase after adequate ECT sessions. Studies investigating effect of ECT upon cerebral blood flow largely varied among studies with mixed results. Discussion Despite the treatment effect of ECT in schizophrenia patients, there have been only a handful of studies investigating the biological mechanisms underlying ECT. Of them, the effect of ECT in schizophrenia seemed also to be mediated by structural volume increases in the MTL region (as in MDD), and the insula and left DLPFC might be other potential neural substrates of ECT effect in schizophrenia patients. Future studies are needed to validate the neural mechanisms that underlie the effect of ECT in schizophrenia, which might help to aid in tailoring treatment plans for refractory schizophrenia patients.

Structural–functional brain changes in depressed patients during and after electroconvulsive therapy

2016 ◽  
Vol 30 (1) ◽  
pp. 17-28 ◽  
Author(s):  
Antoine Yrondi ◽  
Patrice Péran ◽  
Anne Sauvaget ◽  
Laurent Schmitt ◽  
Christophe Arbus
Keyword(s):  
Electroconvulsive Therapy ◽  
Structural Changes ◽  
Diffusion Tensor ◽  
Network Connectivity ◽  
Structural Mri ◽  
Medical Subject Headings ◽  
Functional Changes ◽  
Mesh Terms ◽  
Before And After ◽  
Brain Changes

ObjectivesElectroconvulsive therapy (ECT) is a non-pharmacological treatment that is effective in treating severe and treatment-resistant depression. Although the efficacy of ECT has been demonstrated to treat major depressive disorder (MDD), the brain mechanisms underlying this process remain unclear. Structural–functional changes occur with the use of ECT as a treatment for depression based on magnetic resonance imaging (MRI). For this reason, we have tried to identify the changes that were identified by MRI to try to clarify some operating mechanisms of ECT. We focus to brain changes on MRI [structural MRI (sMRI), functional MRI (fMRI) and diffusion tensor imging (DTI)] after ECT.MethodsA systematic search of the international literature was performed using the bibliographic search engines PubMed and Embase. The research focused on papers published up to 30 September 2015. The following Medical Subject Headings (MESH) terms were used: electroconvulsive therapy AND (MRI OR fMRI OR DTI). Papers published in English were included. Four authors searched the database using a predefined strategy to identify potentially eligible studies.ResultsThere were structural changes according to the sMRI performed before and after ECT treatment. These changes do not seem to be entirely due to oedema. This investigation assessed the functional network connectivity associated with the ECT response in MDD. ECT response reverses the relationship from negative to positive between the two pairs of networks.ConclusionWe found structural–functional changes in MRI post-ECT. Because of the currently limited MRI data on ECT in the literature, it is necessary to conduct further investigations using other MRI technology.

Liraglutide for the Treatment of Obesity: Analyzing Published Reviews

2019 ◽  
Vol 25 (15) ◽  
pp. 1783-1790 ◽  
Author(s):  
Rosario Pastor ◽  
Josep A. Tur
Keyword(s):  
Weight Loss ◽  
Clinical Trials ◽  
Systematic Reviews ◽  
Randomized Clinical Trials ◽  
Statistical Tests ◽  
Overweight And Obesity ◽  
Cochrane Library ◽  
Medical Subject Headings ◽  
Mesh Terms ◽  
Treatment Of Obesity

Background: Several drugs have been currently approved for the treatment of obesity. The pharmacokinetic of liraglutide, as well as the treatment of type 2 diabetes mellitus, have been widely described. Objective: To analyze the published systematic reviews on the use of liraglutide for the treatment of obesity. Methods: Systematic reviews were found out through MEDLINE searches, through EBSCO host and the Cochrane Library based on the following terms: "liraglutide" as major term and using the following Medical Subject Headings (MesH) terms: "obesity", "overweight", "weight loss". A total of 3 systematic reviews were finally included to be analyzed. Results: From the three systematic reviews selected, only two included the randomized clinical trials, while the third study reviewed both randomized and non-randomized clinical trials. Only one review performed statistical tests of heterogeneity and a meta-analysis, combining the results of individual studies. Another review showed the results of individual studies with odds ratio and confidence interval, but a second one just showed the means and confidence intervals. In all studies, weight loss was registered in persons treated with liraglutide in a dose dependent form, reaching a plateau at 3.0 mg dose, which was reached just in men. Most usual adverse events were gastrointestinal. Conclusion: More powerful and prospective studies are needed to assess all aspects related to liraglutide in the overweight and obesity treatment.

The Role of Leukotrienes Inhibitors in the Management of Chronic Inflammatory Diseases

2020 ◽  
Vol 14 (1) ◽  
pp. 15-31
Author(s):  
Deepak Meshram ◽  
Khushbo Bhardwaj ◽  
Charulata Rathod ◽  
Gail B. Mahady ◽  
Kapil K. Soni
Keyword(s):  
Respiratory Diseases ◽  
Inflammatory Diseases ◽  
Leukotriene B4 ◽  
Published Data ◽  
Free Text ◽  
Plant Origin ◽  
Medical Subject Headings ◽  
Leukotriene Antagonists ◽  
Mesh Terms ◽  
Mediators Of Inflammation

Background: Leukotrienes are powerful mediators of inflammation and interact with specific receptors in target cell membrane to initiate an inflammatory response. Thus, Leukotrienes (LTs) are considered to be potent mediators of inflammatory diseases including allergic rhinitis, inflammatory bowel disease and asthma. Leukotriene B4 and the series of cysteinyl leukotrienes (C4, D4, and E4) are metabolites of arachidonic acid metabolism that cause inflammation. The cysteinyl LTs are known to increase vascular permeability, bronco-constriction and mucus secretion. Objectives: To review the published data for leukotriene inhibitors of plant origin and the recent patents for leukotriene inhibitors, as well as their role in the management of inflammatory diseases. Methods: Published data for leukotrienes antagonists of plant origin were searched from 1938 to 2019, without language restrictions using relevant keywords in both free text and Medical Subject Headings (MeSH terms) format. Literature and patent searches in the field of leukotriene inhibitors were carried out by using numerous scientific databases including Science Direct, PubMed, MEDLINE, Google Patents, US Patents, US Patent Applications, Abstract of Japan, German Patents, European Patents, WIPO and NAPRALERT. Finally, data from these information resources were analyzed and reported in the present study. Results: Currently, numerous anti-histaminic medicines are available including chloropheneremine, brompheniramine, cetirizine, and clementine. Furthermore, specific leukotriene antagonists from allopathic medicines are also available including zileuton, montelukast, pranlukast and zafirlukast and are considered effective and safe medicines as compared to the first generation medicines. The present study reports leukotrienes antagonistic agents of natural products and certain recent patents that could be an alternative medicine in the management of inflammation in respiratory diseases. Conclusion: The present study highlights recent updates on the pharmacology and patents on leukotriene antagonists in the management of inflammation respiratory diseases.

scholarly journals Evolution of knowledge on meniscal biomechanics: a 40 year perspective

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Amin Mohamadi ◽  
Kaveh Momenzadeh ◽  
Aidin Masoudi ◽  
Kempland C. Walley ◽  
Kenny Ierardi ◽  
...  
Keyword(s):  
Future Research ◽  
Fe Model ◽  
Cruciate Ligaments ◽  
Fe Modeling ◽  
Meniscal Tears ◽  
Medical Subject Headings ◽  
Model Studies ◽  
The Past ◽  
Mesh Terms ◽  
Kinematic Studies

Abstract Background Knowledge regarding the biomechanics of the meniscus has grown exponentially throughout the last four decades. Numerous studies have helped develop this knowledge, but these studies have varied widely in their approach to analyzing the meniscus. As one of the subcategories of mechanical phenomena Medical Subject Headings (MeSH) terms, mechanical stress was introduced in 1973. This study aims to provide an up-to-date chronological overview and highlights the evolutionary comprehension and understanding of meniscus biomechanics over the past forty years. Methods A literature review was conducted in April 2021 through PubMed. As a result, fifty-seven papers were chosen for this narrative review and divided into categories; Cadaveric, Finite element (FE) modeling, and Kinematic studies. Results Investigations in the 1970s and 1980s focused primarily on cadaveric biomechanics. These studies have generated the fundamental knowledge basis for the emergence of FE model studies in the 1990s. As FE model studies started to show comparable results to the gold standard cadaveric models in the 2000s, the need for understanding changes in tissue stress during various movements triggered the start of cadaveric and FE model studies on kinematics. Conclusion This study focuses on a chronological examination of studies on meniscus biomechanics in order to introduce concepts, theories, methods, and developments achieved over the past 40 years and also to identify the likely direction for future research. The biomechanics of intact meniscus and various types of meniscal tears has been broadly studied. Nevertheless, the biomechanics of meniscal tears, meniscectomy, or repairs in the knee with other concurrent problems such as torn cruciate ligaments or genu-valgum or genu-varum have not been extensively studied.

scholarly journals Newer Volatile Anesthetic Agents in Cardiac Anesthesia: Review of Literature

2021 ◽  
Author(s):  
Alka Mandke ◽  
Manjula Sarkar ◽  
Charulata Deshpande ◽  
Arun Maheshwari ◽  
Bhupesh Kumar ◽  
...  
Keyword(s):  
Volatile Anesthetic ◽  
Cochrane Library ◽  
Cochrane Central Register ◽  
Cardiac Anesthesia ◽  
Medical Subject Headings ◽  
Holistic View ◽  
Anesthetic Agents ◽  
Cardiac Anaesthesia ◽  
Mesh Terms ◽  
Inhalational Anaesthesia

AbstractMyocardial protection with volatile anesthetic agents have been suggested by multiple studies. These studies, however, are scattered and are often limited to a particular aspect of cardiac anesthesia. Older inhalational agents like halothane is known to cause significant hepatic damage in patients undergoing long duration surgeries while isoflurane is known to have marked vasodilating properties that also affects the coronary arteries leading to coronary “steal” phenomenon. Additionally, newer agents, like sevoflurane and desflurane, have shown more prominent cardioprotective effects than older agents. We searched ScholarOne, Medline, Embase, and the Cochrane Central Register of Controlled Trials (CENTRAL) in the Cochrane Library. The medical subject headings (MeSH) terms “anaesthesia, inhalational,” “anaesthesia, intravenous, or TIVA,” and “Cardiac anaesthesia or Cardiac Surgery” were used. Additional studies were identified by review of the reference sections of all eligible studies. The aim of this review article is to bring together the evidences with newer inhalational agents and provide a holistic view of their benefits and shortcomings in cardiac anesthesia.

Hyaluronic Acid Fillers for Midface Augmentation: A Systematic Review

2021 ◽  
Author(s):  
Lily N. Trinh ◽  
Amar Gupta
Keyword(s):  
Systematic Review ◽  
Hyaluronic Acid ◽  
Subcutaneous Tissue ◽  
Age Groups ◽  
Medical Subject Headings ◽  
Mesh Terms ◽  
Full Text Review ◽  
Filler Injections ◽  
Subjective Measurements ◽  
Meta Analyses

AbstractInjectable fillers represent one of the most requested minimally invasive treatments to rejuvenate the aging face, and its popularity is steadily rising. A vast majority of filler treatments are with hyaluronic acid (HA). The aim of this systematic review is to evaluate patient outcomes, safety profile, and administration techniques of various HA fillers for malar augmentation. A systematic review of the published literature was conducted in accordance with the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines and included PubMed, Embase, and Science Direct databases. Medical Subject Headings (MeSH) terms used were “cheek” OR “midface” OR “malar” and “filler” OR “hyaluronic acid” OR “Juvederm” OR “Restylane” OR “Perlane” OR “Belotero.” The initial search identified 699 articles; 256 duplicates were removed. Additional 12 studies were identified from reference lists. A total of 455 were screened by title and abstract and 387 studies were eliminated based on criteria. Also, 68 articles underwent full-text review, and 18 articles were included in the final review and involved seven different HA formulations. Men and women from many age groups were highly satisfied with their results following HA treatment for midface augmentation up to 24 months. The most common adverse events included bruising, swelling, and tenderness, and typically lasted no more than 2 weeks. Upper cheek filler injections near the zygoma should be placed in the submuscular plane while lower cheek injections should be placed in the subcutaneous tissue. HA is an attractive choice for midface augmentation due to its high patient satisfaction, long-lasting effects, and low side-effect profile. Due to the variability in technique, level of expertise, and subjective measurements across studies, one optimal regimen could not be concluded. However, midface augmentation treatment should be personalized to each patient. Additional clinical trials are required to more conclusively determine the most appropriate approach for this procedure.

Structural and Functional MRI Brain Changes in Patients with Schizophrenia Following Electroconvulsive Therapy: A Systematic Review

2021 ◽  
Vol 19 ◽  
Author(s):  
Yuchao Jiang ◽  
Mingjun Duan ◽  
Hui He ◽  
Dezhong Yao ◽  
Cheng Luo
Keyword(s):  
Systematic Review ◽  
Functional Mri ◽  
Electroconvulsive Therapy ◽  
Brain Regions ◽  
Parahippocampal Gyrus ◽  
Medical Subject Headings ◽  
Therapeutic Mechanisms ◽  
Brain Changes ◽  
Meta Analyses ◽  
Induced Changes

Background: Schizophrenia (SZ) is a severe psychiatric disorder typically characterized by multidimensional psychotic syndromes. Electroconvulsive therapy (ECT) is a treatment option for medication-resistant patients with SZ or to resolve acute symptoms. Although the efficacy of ECT has been demonstrated in clinical use, its therapeutic mechanisms in the brain remain elusive. Objective: This study aimed to summarize brain changes on structural magnetic resonance imaging (sMRI) and functional MRI (fMRI) after ECT. Methods: According to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, a systematic review was carried out. The PubMed and Medline databases were systematically searched using the following medical subject headings (MeSH): (electroconvulsive therapy OR ECT) AND (schizophrenia) AND (MRI OR fMRI OR DTI OR DWI). Results: This review yielded 12 MRI studies, including 4 with sMRI, 5 with fMRI and 3 with multimodal MRI. Increases in volumes of the hippocampus and its adjacent regions (parahippocampal gyrus and amygdala) as well as insula and frontotemporal regions were noted after ECT. fMRI studies found ECT-induced changes in different brain regions/networks, including the hippocampus, amygdala, default model network, salience network and other regions/networks that are thought to highly correlate with the pathophysiologic characteristics of SZ. The results of the correlation between brain changes and symptom remissions are inconsistent Conclusion: Our review provides evidence supporting ECT-induced brain changes on sMRI and fMRI in SZ and explores the relationship between these changes and symptom remission.

scholarly journals Brain network dynamics correlate with personality traits

2019 ◽  
Author(s):  
Aya Kabbara ◽  
Veronique Paban ◽  
Arnaud Weill ◽  
Julien Modolo ◽  
Mahmoud Hassan
Keyword(s):  
Functional Connectivity ◽  
Personality Traits ◽  
Resting State ◽  
Brain Networks ◽  
Neural Substrates ◽  
Brain Network ◽  
Functional Brain ◽  
Human Connectome Project ◽  
Functional Brain Networks ◽  
The Brain

AbstractIntroductionIdentifying the neural substrates underlying the personality traits is a topic of great interest. On the other hand, it is now established that the brain is a dynamic networked system which can be studied using functional connectivity techniques. However, much of the current understanding of personality-related differences in functional connectivity has been obtained through the stationary analysis, which does not capture the complex dynamical properties of brain networks.ObjectiveIn this study, we aimed to evaluate the feasibility of using dynamic network measures to predict personality traits.MethodUsing the EEG/MEG source connectivity method combined with a sliding window approach, dynamic functional brain networks were reconstructed from two datasets: 1) Resting state EEG data acquired from 56 subjects. 2) Resting state MEG data provided from the Human Connectome Project. Then, several dynamic functional connectivity metrics were evaluated.ResultsSimilar observations were obtained by the two modalities (EEG and MEG) according to the neuroticism, which showed a negative correlation with the dynamic variability of resting state brain networks. In particular, a significant relationship between this personality trait and the dynamic variability of the temporal lobe regions was observed. Results also revealed that extraversion and openness are positively correlated with the dynamics of the brain networks.ConclusionThese findings highlight the importance of tracking the dynamics of functional brain networks to improve our understanding about the neural substrates of personality.

scholarly journals The impact of leptomeningeal collaterals in acute ischemic stroke

2020 ◽  
Author(s):  
Nida Fatima ◽  
Maher Saqqur ◽  
Ashfaq Shuaib
Keyword(s):  
Blood Flow ◽  
Ischemic Stroke ◽  
Clinical Outcome ◽  
Acute Ischemic Stroke ◽  
Meta Analysis ◽  
Random Effect ◽  
Random Effect Model ◽  
Mesh Terms ◽  
Favorable Clinical Outcome ◽  
The Impact

Abstract Objectives: Leptomeningeal collaterals provide an alternate pathway to maintain cerebral blood flow in stroke to prevent ischemia, but their role in predicting outcome is still unclear. So, our study aims at assessing the significance of collateral blood flow (CBF) in acute stroke. Methods: Electronic databases were searched under different MeSH terms from Jan 2000 to Feb 2019. Studies were included if there was available data on good and poor CBF in acute ischemic stroke (AIS). The clinical outcomes included were modified rankin scale (mRS), recanalization, mortality, and symptomatic intracranial hemorrhage (sICH) at 90 days. Data was analyzed using random-effect model.Results: A total of 47 studies with 8,194 patients were included. Pooled meta-analysis revealed that there exist 2-fold higher likelihood of favorable clinical outcome (mRS≤2) at 90 days with good CBF compared with poor CBF (RR: 2.27; 95%CI: 1.94-2.65; p<0.00001) irrespective of the thrombolytic therapy [RR with IVT: 2.90; 95%CI: 2.14-3.94; p<0.00001, and RR with IAT/EVT: 1.99; 95% CI: 1.55-2.55; p<0.00001]. Moreover, there exists 1-fold higher probability of successful recanalization with good CBF (RR: 1.31; 95% CI: 1.15-1.49; p<0.00001). However, there was 54% and 64% lower risk of sICH and mortality respectively in patients with good CBF in AIS (p<0.00001).Conclusions: The relative risk of favorable clinical outcome is more in patients with good pretreatment CBF. This could be explained due to better chances of recanalization, combined with lesser risk of intracerebral hemorrhage in good CBF status.

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