OBJECTIVES: Despite the clinical importance of bipolar depression (BDE), effective treatment options are still limited. Transcranial magnetic stimulation (rTMS) has proven of moderate efficacy in major depression, but the evidence remains inconclusive for BDE. METHODS: A 4-week, double-blind, randomised, parallel-group, sham-controlled study (trial ID ISRCTN77188420) explored the benefits of 10 Hz MRI-guided right ventrolateral (RVL) rTMS and left dorsolateral (LDL) rTMS as add-on treatments for BDE. Outcome measures included changes in the Montgomery-Åsberg Depression Rating Scale (MADRS) score, self-assessment, response and remission rates, and side effects. RESULTS: Sixty patients were randomly assigned to study groups, and forty-six completed the double-blind phase. The mean change from baseline to Week 4 in MADRS was greater in both active groups compared to the sham, yet differences did not achieve significance (RVL vs sham: -4.50, 95%CI -10.63 to 1.64, p = 0.3; LDL vs sham: -4.07, 95%CI -10.24 to 2.10, p = 0.4). None of the other outcome measures yielded significant results. CONCLUSIONS: While not demonstrating the superiority of either 10 Hz rTMS over sham, with the limited sample size, we can not rule out a moderate yet clinically meaningful effect. Further well-powered studies are essential to elucidate the role of rTMS in managing BDE.
- MeSH
- bipolární porucha * terapie MeSH
- dospělí MeSH
- dvojitá slepá metoda MeSH
- kombinovaná terapie MeSH
- lidé středního věku MeSH
- lidé MeSH
- psychiatrické posuzovací škály MeSH
- transkraniální magnetická stimulace * MeSH
- výsledek terapie MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- randomizované kontrolované studie MeSH
OBJECTIVES: Pilot study validating the animal model of depression - the bilateral olfactory bulbectomy in rats - by two nuclear magnetic resonance methods, indirectly detecting the metabolic state of the brain. Furthermore, the study focussed on potential differences in brain laterality. METHODS: Arterial spin labelling assessed cerebral brain flow in prefrontal, sensorimotor, and piriform cortices, nucleus accumbens, hippocampus, thalamus, circle of Willis, and whole brain. Proton magnetic resonance spectroscopy provided information about relative metabolite concentrations in the cortex and hippocampus. RESULTS: Arterial spin labelling found no differences in cerebral perfusion in the group comparison but revealed lateralisation in the thalamus of the control group and the sensorimotor cortex of the bulbectomized rats. Lower Cho/tCr and Cho/NAA levels were found in the right hippocampus in bulbectomized rats. The differences in lateralisation were shown in the hippocampus: mI/tCr in the control group, Cho/NAA, NAA/tCr, Tau/tCr in the model group, and in the cortex: NAA/tCr, mI/tCr in the control group. CONCLUSION: Olfactory bulbectomy affects the neuronal and biochemical profile of the rat brain laterally and, as a model of depression, was validated by two nuclear magnetic resonance methods.
- MeSH
- cholin metabolismus MeSH
- kreatin metabolismus MeSH
- krysa rodu rattus MeSH
- kyselina asparagová metabolismus MeSH
- magnetická rezonanční spektroskopie metody MeSH
- magnetická rezonanční tomografie * MeSH
- mozek * patologie MeSH
- pilotní projekty MeSH
- receptory antigenů T-buněk metabolismus MeSH
- zvířata MeSH
- Check Tag
- krysa rodu rattus MeSH
- zvířata MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
OBJECTIVE: Comorbidity of depression and drug addiction is common, but effective treatment is missing. A rat model combining the olfactory bulbectomy (OBX) model and IV drug self-administration has provided evidence of differential reactivity of the OBX rats towards drugs of abuse. This study evaluates nicotine taking and seeking behaviour in this model. METHODS: Adult male Wistar rats were used; in one group, the OBX was performed while the other group was sham-operated. After three weeks of nicotine self-administration (fixed ratio-1 schedule), rats underwent two weeks of forced abstinence followed by a drug-free relapse-like session. Two doses of nicotine were studied: 0.019 and 0.030 mg/kg per infusion. The locomotor test took place before the self-administration protocol and on the first day of abstinence. RESULTS: OBX induced characteristic hyperactive locomotor phenotype. OBX rats self-administered more nicotine in the experiment using 0.019 mg/kg per infusion, but they reached lower drug intake in the study using 0.030 mg/kg per infusion. However, relapse of nicotine seeking after forced abstinence was significantly higher in the OBX groups in both cohorts. CONCLUSION: These results are in line with previous studies showing OBX-induced dissimilarities in drug-seeking and drug-taking and represent complementary information to reports on other substances.
- MeSH
- autoaplikace MeSH
- bulbus olfactorius * chirurgie MeSH
- fenotyp MeSH
- krysa rodu rattus MeSH
- nikotin * farmakologie MeSH
- potkani Wistar MeSH
- recidiva MeSH
- zvířata MeSH
- Check Tag
- krysa rodu rattus MeSH
- mužské pohlaví MeSH
- zvířata MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
OBJECTIVES: Thus far, the diagnosis of insomnia is based on purely clinical criteria. Although a broad range of altered physiological parameters has been identified in insomniacs, the evidence to establish their diagnostic usefulness is very limited. Purpose of this WFSBP Task Force consensus paper is to systematically evaluate a series of biomarkers as potential diagnostic tools for insomnia. METHODS: A newly created grading system was used for assessing the validity of various measurements in establishing the diagnosis of insomnia; these measurements originated from relevant studies selected and reviewed by experts. RESULTS: The measurements with the highest diagnostic performance were those derived from psychometric instruments. Biological measurements which emerged as potentially useful diagnostic instruments were polysomnography-derived cyclic alternating pattern, actigraphy, and BDNF levels, followed by heart rate around sleep onset, deficient melatonin rhythm, and certain neuroimaging patterns (mainly for the activity of frontal and pre-frontal cortex, hippocampus and basal ganglia); yet, these findings need replication, as well as establishment of commonly accepted methodology and diagnostic cut-off points. Routine polysomnography, EEG spectral analysis, heart rate variability, skin conductance, thermoregulation, oxygen consumption, HPA axis, and inflammation indices were not shown to be of satisfactory diagnostic value. CONCLUSIONS: Apart from psychometric instruments which are confirmed to be the gold standard in diagnosing insomnia, six biomarkers emerge as being potentially useful for this purpose.
PURPOSE: The current COVID-19 pandemic confronts psychiatric patients and mental health services with unique and severe challenges. METHODS: In order to identify these trans-national challenges across Europe, an ad-hoc survey was conducted among 23 experts, each answering for one European or aligned country. RESULTS: A number of important themes and issues were raised for the impact of COVID-19 on mental health and mental health services, barriers to service provision and future consequences. A number of key issues were reported by colleagues across several jurisdictions, even though these were at different stages of their national epidemics. CONCLUSIONS: Based on these findings, we articulate some important learnings from the early stages of the COVID-19 European pandemic, and highlight key considerations for all countries' mental health services as the current pandemic develops and for future pandemics.
- MeSH
- COVID-19 * MeSH
- lidé MeSH
- pandemie MeSH
- SARS-CoV-2 MeSH
- služby péče o duševní zdraví * MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- Geografické názvy
- Evropa MeSH
OBJECTIVE: Adolescence drinking and subsequent development of alcohol use disorder (AUD) is a worldwide health concern. In particular, mood dysregulation or early alcohol exposure can be the cause of heavy drinking in some individuals or a consequence of heavy drinking in others. METHODS: This study investigated the effects of voluntary alcohol intake during adolescence, i.e. continuous 10% alcohol access between postnatal days (PND) 29 to 43 and olfactory bulbectomy (OBX) model of depression (performed on PND 59) on alcohol drinking in Wistar rats during adulthood (PND 80-120, intermittent 20% alcohol access). In addition, the effect of NBQX, an AMPA/kainate receptor antagonist (5 mg/kg, IP) on spontaneous alcohol consumption was examined. RESULTS: Rats exposed to 10% alcohol during adolescence exhibited a lower 20% alcohol intake in the intermittent paradigm during adulthood, while the OBX-induced phenotype did not exert a significant effect on the drinking behaviour. NBQX exerted a transient reduction on alcohol intake in the OBX rats. CONCLUSIONS: Our results indicate that exposure to alcohol during adolescence can affect alcohol drinking in adulthood and that further exploration of AMPA and/or kainate receptor antagonists in co-morbid alcoholism-depression is warranted.
OBJECTIVE: Pharmacological manipulations of glutamatergic ionotropic receptors have been suggested as a promising target for addiction treatment. Antagonists of AMPA/kainate receptors were shown to reduce alcohol intake or alcohol-seeking in various animal models. In this study, we evaluated the effect of NBQX, an AMPA/kainate receptor antagonist, on methamphetamine (METH) and nicotine self-administration in rats. METHODS: Male Wistar rats were trained to self-administer METH (0.08 mg/kg per infusion, session of 90 min) and nicotine (0.03 mg/kg per infusion, session of 60 min) under the fixed ratio 1 schedule of reinforcement. The maintenance training was 2 weeks. During the second week, NBQX was injected subcutaneously at doses of 5 or 10 mg/kg 20 min before the session or intravenously (IV) at doses of 1 and 5 mg/kg 10 min before the session. Following the maintenance training, rats were subjected to forced abstinence for 2 weeks and 1 day of the drug-free relapse-like session with IV NBQX treatment performed as before. RESULTS: Although NBQX did not affect nicotine maintenance, it significantly suppressed the drug-paired responding in the relapse session. Regarding METH, NBQX did not exert a significant effect at either phase of the study. CONCLUSIONS: These findings suggest selective involvement of AMPA/kainate receptors in the relapse of nicotine seeking after a period of forced abstinence.
- MeSH
- autoaplikace MeSH
- chinoxaliny MeSH
- krysa rodu rattus MeSH
- methamfetamin * farmakologie MeSH
- nikotin MeSH
- potkani Wistar MeSH
- recidiva MeSH
- vztah mezi dávkou a účinkem léčiva MeSH
- zvířata MeSH
- Check Tag
- krysa rodu rattus MeSH
- mužské pohlaví MeSH
- zvířata MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
- Research Support, N.I.H., Extramural MeSH
OBJECTIVES: Biological strategies to improve treatment efficacy in clozapine-treated patients are urgently needed. Repetitive transcranial magnetic stimulation (rTMS) merits consideration as intervention for patients with persistent auditory hallucinations (AH) or negative symptoms (NS) not responding sufficiently to clozapine treatment. METHODS: Data from 10 international RCTs of rTMS for patients being treated with clozapine were pooled. Two levels of symptomatic response were defined: improvement of ≥20% and ≥50% on study-specific primary endpoint scales. Changes in the positive and negative syndrome scale (PANSS) from baseline to endpoint assessment were also analysed. RESULTS: Analyses of 131 patients did not reveal a significant difference for ≥20% and ≥50% response thresholds for improvement of AH, negative or total symptoms between active and sham rTMS groups. The number needed to treat (NNT) for an improvement in persistent AH was nine following active rTMS. PANSS scores did not improve significantly from baseline to endpoint between active and sham groups in studies investigating NS and AH. CONCLUSIONS: rTMS as a treatment for persistent symptoms in clozapine-treated patients did not show a beneficial effect of active compared to sham treatment. For AH, the size of the NNTs indicates a possible beneficial effect of rTMS.
Objectives: To review available evidence of pharmacological and non-pharmacological treatment for MCI and analyse information and limitations in national and international guidelines.Methods: Experts from several European countries conducted a qualitative review of the literature on MCI and treatments for MCI, as well as respective chapters in national and international guidelines on dementia/MCI. Psychotherapeutic/psychosocial treatments were excluded from the review.Results: Consensus diagnostic criteria for MCI are available, making early recognition and accurate classification of MCI subtypes possible. MCI can be identified in a primary care setting. Further corroboration and differential diagnosis should be done at specialist level. Mixed pathologies are the rule in MCI, thus a multi-target treatment approach is a rational strategy. Promising evidence has been generated for multi-domain interventions. Limited evidence is available for different pharmacological classes that have been investigated in MCI clinical trials (e.g. acetylcholinesterase inhibitors). EGb 761® improved symptoms in some clinical trials; it is the only pharmacological treatment recommended in existing guidelines for the symptomatic treatment of MCI.Conclusions: MCI is recognised as an important treatment target and some recent national guidelines have considered symptomatic treatment recommendations for MCI. However, more needs to be done, especially at an international level.
- MeSH
- Alzheimerova nemoc diagnóza farmakoterapie terapie MeSH
- kognitivní dysfunkce klasifikace diagnóza farmakoterapie terapie MeSH
- konsensus MeSH
- lidé MeSH
- mezinárodní spolupráce * MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- směrnice pro lékařskou praxi jako téma * MeSH
- Check Tag
- lidé MeSH
- mužské pohlaví MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- Geografické názvy
- Evropa MeSH
OBJECTIVES: Patients with schizophrenia have difficulties processing the emotional and cognitive states of others. Neuroimaging studies show inconsistent findings. METHODS: We used a Seed-based d Mapping meta-analytic method to explore brain activation during facial emotion recognition and theory of mind tasks in schizophrenia patients. RESULTS: The patients showed lesser recruitment of the facial emotion processing network; behavioural performance was associated with the activation of the precentral gyrus. We found abnormal activation of the mentalising network in schizophrenia patients during reasoning about other people's mental states; patients with worse performances showed lesser activation in the right insula and superior temporal gyrus. Multimodal meta-analysis showed overlaps of brain-related abnormalities for both modalities in schizophrenia, with reduced recruitment of the right insula, anterior cingulate and medial prefrontal cortex and increased activation in the bilateral parietal cortex. Meta-regression results indicate that illness duration, medication and symptomatology might influence social-cognitive network disruptions in schizophrenia. CONCLUSIONS: These findings suggest the complex impairment of social cognition, as demonstrated by neural-related circuit disruptions during facial emotion processing and theory of mind tasks in schizophrenia.
- MeSH
- emoce * MeSH
- lidé MeSH
- magnetická rezonanční tomografie MeSH
- mapování mozku MeSH
- neurozobrazování MeSH
- schizofrenie (psychologie) MeSH
- schizofrenie patofyziologie MeSH
- sociální chování * MeSH
- teorie mysli * MeSH
- výraz obličeje MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- metaanalýza MeSH
- práce podpořená grantem MeSH
- přehledy MeSH
