Acta Neuropsychiatrica
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Published By Cambridge University Press

1601-5215, 0924-2708

2022 ◽  
pp. 1-8
Hande Yüceer ◽  
Duygu Gezen Ak ◽  
Gülçin Benbir Şenel ◽  
Erdinç Dursun ◽  
Vuslat Yılmaz ◽  

Abstract Objective: Narcolepsy is a chronic sleep disorder long hypothesised to be an autoimmune disease. Complement-mediated immune mechanisms have not been investigated in detail in narcolepsy. Our aim was to establish the significance of classical pathway activation in narcolepsy. Methods: Sera of 42 narcolepsy patients and 26 healthy controls were screened with ELISA to determine the levels of C1q, C3a, C4d and complement component 4 binding protein (C4BP). A home-made ELISA method was developed to detect antibodies to C4BP-alpha (anti-C4BPA). The correlation between complement levels and clinical findings was examined. Results: C1q levels were significantly higher in narcolepsy patients while C4d and C4BP levels were significantly lower compared to healthy controls. C3a levels were comparable among patients and controls. Eleven narcolepsy patients showed serum anti-C4BPA levels. Total rapid eye movements (REM) time, sleep onset latency, REM sleep latency, sleep activity, percentage of wakefulness after sleep onset and Epworth sleepiness scale scores were correlated with levels of different complement factors. Conclusion: Complement-mediated immune mechanisms might partake in narcolepsy pathogenesis. The precise role of autoantibodies on complement level alterations needs to be investigated. Levels of complement factors and degradation products may potentially be utilised as biomarkers to predict the clinical severity of narcolepsy.

2022 ◽  
pp. 1-10
Helene Tilma Vistisen ◽  
Ziggi Ivan Santini ◽  
Kim Mannemar Sønderskov ◽  
Søren Dinesen Østergaard

2022 ◽  
pp. 1-1
Oskar Hougaard Jefsen ◽  
Pernille Kølbæk ◽  
Yael Gil ◽  
Maria Speed ◽  
Peter Thisted Dinesen ◽  

2021 ◽  
pp. 1-50
Siu Wa Tang ◽  
Wayne Hans Tang ◽  
Brian E Leonard

Abstract Many patients under treatment for mood disorders, in particular patients with bipolar mood disorders, experience episodes of mood switching from one state to another. Various hypotheses have been proposed to explain the mechanism of mood switching, spontaneously or induced by drug treatment. Animal models have also been used to test the role of psychotropic drugs in the switching of mood states. We examine the possible relationship between the pharmacology of psychotropic drugs and their reported incidents of induced mood switching, with reference to the various hypotheses of mechanisms of mood switching.

2021 ◽  
pp. 1-21
Elsa Arrua-Duarte ◽  
Marta Migoya-Borja ◽  
Igor Barahona ◽  
Lena C. Quilty ◽  
Sakina J. Rizvi ◽  

Abstract Objective: The Dimensional Anhedonia Rating Scale (DARS) is a novel questionnaire to assess anhedonia of recent validation. In this work we aim to study the equivalence between the traditional paper-and-pencil and the digital format of DARS. Methods: 69 patients filled the DARS in a paper-based and digital versions. We assessed differences between formats (Wilcoxon test), validity of the scales (Kappa and Intraclass Correlation Coefficients), and reliability (Cronbach’s alpha and Guttman’s coefficient). We calculated the Comparative Fit Index and the Root Mean Squared Error associated with the proposed one-factor structure. Results: Total scores were higher for paper-based format. Significant differences between both formats were found for three items. The weighted Kappa coefficient was approximately 0.40 for most of the items. Internal consistency was greater than 0.94, and the Intraclass Correlation Coefficient for the digital version was 0.95 and 0.94 for the paper-and-pencil version (F= 16.7, p < 0.001). Comparative Adjustment Index was 0.97 for the digital DARS and 0.97 for the paper-and-pencil DARS, and Root Mean Squared Error was 0.11 for the digital DARS and 0.10 for the paper-and-pencil DARS. Conclusion: The digital DARS is consistent in many respects to the paper-and-pencil questionnaire, but equivalence with this format cannot be assumed without caution.

2021 ◽  
pp. 1-18
Soroush Pakniyat-Jahromi ◽  
Panagiota Korenis ◽  
Leo Sher

Abstract Objective: This paper will emphasize the necessity to improve education about pain, its close relationship with suicide, and effective suicide screening as well as management strategies for medical providers. Methods: A review of the relevant literature. Results: Chronic pain is a debilitating medical condition affecting a significant percentage of the population worldwide. Considerable evidence suggests that pain is an independent risk factor for suicide and inadequately managing pain has been identified as a risk for suicidal behavior. Additionally, medications used to treat pain may also contribute to suicidal behavior. Extensive research on pain highlights deficiencies in the clinical management of pain with more gaps in care when patients have pain in combination with mental illness and suicidal behavior. Conclusion: Providing trainees with additional knowledge and equipping them with relevant tools to screen and manage chronic pain efficiently is a potential strategy to mitigate suicide risk. Also, trainees need to be educated on how to screen for suicidality in individuals with pain and apply suicide prevention interventions. With additional research, it is the hope that novel treatment modalities will be developed to treat pain to improve the quality of life of individuals suffering from this condition and to decrease suicide risk in this patient population.

2021 ◽  
pp. 1-24
Kyoko Hasebe ◽  
Mohammadreza Mohebbi ◽  
Laura Gray ◽  
Adam J. Walker ◽  
Chiara C. Bortolasci ◽  

Abstract Objective: This study aimed to explore effects of adjunctive minocycline treatment on inflammatory and neurogenesis markers in major depressive disorder (MDD). Methods: Serum samples were collected from a randomised, placebo-controlled 12-week clinical trial of minocycline (200mg/day, added to treatment as usual) for adults (n=71) experiencing MDD to determine changes in interleukin-6 (IL-6), lipopolysaccharide binding protein (LBP) and brain derived neurotrophic factor (BDNF). General Estimate Equation modelling explored moderation effects of baseline markers and exploratory analyses investigated associations between markers and clinical outcomes. Results: There was no difference between adjunctive minocycline or placebo groups at baseline or week 12 in the levels of IL-6 (week 12; placebo 2.06±1.35 pg/ml; minocycline 1.77±0.79 pg/ml; p=0.317), LBP (week 12; placebo 3.74±0.95 µg/ml; minocycline 3.93±1.33 µg/ml; p=0.525) or BDNF (week 12; placebo 24.28±6.69 ng/ml; minocycline 26.56±5.45 ng/ml; p=0.161). Higher IL-6 levels at baseline were a predictor of greater clinical improvement. Exploratory analyses suggested that the change in IL-6 levels were significantly associated with anxiety symptoms (HAMA; p=0.021) and quality of life (Q-LES-Q-SF; p=0.023) scale scores. No other clinical outcomes were shown to have this mediation effect, nor did the other markers (LBP or BDNF) moderate clinical outcomes. Conclusion: There were no overall changes in IL-6, LBP or BDNF following adjunctive minocycline treatment. Exploratory analyses suggest a potential role of IL-6 on mediating anxiety symptoms with MDD. Future trials may consider enrichment of recruitment by identifying several markers or a panel of factors to better represent an inflammatory phenotype in MDD with larger sample size.

2021 ◽  
pp. 1-33
Aneth Lvovs ◽  
Denis Matrov ◽  
Triin Kurrikoff ◽  
Toomas Veidebaum ◽  
Jaanus Harro

Abstract Objective: Cholecystokinin is a neuropeptide with a role in the neurobiology of adaptive behaviour that is implicated in anxiety disorders, while the underlying mechanisms currently remain insufficiently explained. The rs2941026 variation in the cholecystokinin B receptor gene has previously been associated with trait anxiety. Our aim was to investigate associations between the CCKB receptor gene polymorphism rs2941026 with anxiety, personality, depressiveness, and suicidality in a longitudinal study of late adolescence and early adulthood. Methods: We used reports on trait and state anxiety, depressiveness and suicidal thoughts, as well as Affective Neuroscience Personality Scales, from the two birth cohorts of the Estonian Children Personality, Behaviour and Health Study. We measured associations between the CCKBR gene rs2941026 and anxiety-related phenotypes both longitudinally and cross-sectionally at ages 15, 18, 25 and 33. Results: Homozygosity for both alleles of the CCKBR rs2941026 was associated with higher trait and state anxiety in the longitudinal analysis. Cross-sectional comparisons were statistically significant at ages 18 and 25 for trait anxiety and at ages 25 and 33 for state anxiety. Higher depressiveness and suicidal thoughts were associated with the A/A genotype at age 18. Additionally, homozygosity for the A-allele was related to higher FEAR and SADNESS in the Affective Neuroscience Personality Scales. The genotype effects were more apparent in females, who displayed higher levels of negative affect overall. Conclusions: CCKBR genotype is persistently associated with negative affect in adolescence and young adulthood. The association of the CCKBR rs2941026 genotype with anxiety-related phenotypes is more pronounced in females.

2021 ◽  
pp. 1-21
Ibrahim Akbas ◽  
Ozlem Devrim Balaban

Abstract Objectives: It has been postulated that neurotrophin dysregulation leads to disorganization in neuronal networks, which results in schizophrenia. The current study sets out to evaluate if the finding of lower BDNF levels in schizophrenia patients could be confirmed in an independent cohort, and to investigate if the BDNF levels can be altered with different treatment modalities such as electroconvulsive therapy (ECT) and/or antipsychotic pharmacotherapy (PT). Methods: A total of 54 male patients with schizophrenia and 35 healthy controls were included in the study. Schizophrenia patients were subdivided into two groups as the ones who underwent ECT+PT and only PT. Clinical and sociodemographic data questionnaire, Positive and Negative Syndrome Scale (PANSS) and blood sample collection for BDNF assessment were applied to all patients (on first and last days of admissions) and healthy participants (on the day of the interview). Then, clinical parameters and blood sample outcomes were statistically analyzed. Results: Mean BDNF levels of healthy individuals was significantly higher than mean pre and post-treatment BDNF levels in both PT only and ECT+PT groups. While serum BDNF levels did not increase after ECT+PT, there was a trend level increase in the PT only group. There was no significant correlation between the change in serum BDNF levels with total PANSS scores in either group after treatment. Conclusions: We could confirm previously suggested data of lower serum BDNF levels in schizophrenia patients compared to healthy population but we couldn’t find significant increase in serum BDNF levels with ECT+PT or only PT as some previous studies suggested.

2021 ◽  
pp. 1-34
Shang-ying Tsai ◽  
Martha Sajatovic ◽  
Jung-Lung Hsu ◽  
Kuo-Hsuan Chung ◽  
Pao-Huan Chen ◽  

Abstract Background: Neuroinflammation and brain structural abnormalities are found in bipolar disorder (BD). Elevated levels of cytokines and chemokines have been detected in the serum and cerebrospinal fluid of patients with BD. This study investigated the association between peripheral inflammatory markers and brain subregion volumes in BD patients. Methods: Euthymic patients with bipolar I disorder (BD-I) aged 20 to 45 years underwent whole-brain magnetic resonance imaging. Plasma levels of monocyte chemoattractant protein-1, chitinase-3-like protein 1 (also known as YKL-40), fractalkine, soluble tumor necrosis factor receptor-1 (sTNF-R1), interleukin-1β, and transforming growth factor-β1 were measured on the day of neuroimaging. Clinical data were obtained from medical records and interviewing patients and reliable others. Results: We recruited 31 patients with a mean age of 29.5 years. In multivariate regression analysis, plasma level YKL-40, a chemokine, was the most common inflammatory marker among these measurements displaying significantly negative association with the volume of various brain subareas across the frontal, temporal, and parietal lobes. Higher YKL-40 and sTNF-R1 levels were both significantly associated with lower volumes of the left anterior cingulum, left frontal lobe, right superior temporal gyrus and supramarginal gyrus. A greater number of total lifetime mood episodes was also associated with smaller volumes of the right caudate nucleus and bilateral frontal lobes. Conclusions: The volume of brain regions known to be relevant to BD-I may be diminished in relation to higher plasma level of YKL-40, sTNF-R1, and more lifetime mood episodes. Macrophage and macrophage-like cells may be involved in brain volume reduction among BD-I patients.

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