167 results on '"Narcís Cardoner"'
Search Results
2. Randomized clinical trial of integral cognitive remediation program for major depression (INCREM)
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Muriel Vicent-Gil, Sara González-Simarro, Beatriz Raventós, Javier Vera, Eduardo D. Marín Martínez, Carlota Sabaté-Cao, Josefina Pérez-Blanco, Dolors Puigdemont, Javier de Diego-Adeliño, Carlo Alemany, Maria Serra-Blasco, Narcís Cardoner, and Maria J. Portella
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Depressive Disorder, Major ,Psychiatry and Mental health ,Clinical Psychology ,Treatment Outcome ,Depression ,COVID-19 ,Humans ,Single-Blind Method ,Pandemics ,Cognitive Remediation - Abstract
Despite achieving clinical remission, patients with depression encounter difficulties to return to their premorbid psychosocial functioning. Cognitive dysfunction has been proposed to be a primary mediator of functional impairment. Therefore, the new non-pharmacological procognitive strategy INtegral Cognitive REMediation for Depression (INCREM) has been developed with the aim of targeting cognitive and psychosocial functioning.This is a single-blind randomized controlled clinical trial with three treatment arms. Fifty-two depressed patients in clinical remission, with psychosocial difficulties and cognitive impairment, were randomly assigned to receive INCREM intervention, Psychoeducation programme, or treatment as usual. Patients were assessed before and after the study period, and six months after. The primary outcome was the change from baseline of patients' psychosocial functioning. Changes in cognitive functioning and other variables were considered secondary outcomes.The analysis showed a significant improvement in psychosocial functioning in the INCREM group, especially six months after the intervention, compared to patients who received the psychoeducation programme. An improvement in cognitive performance was also observed in the INCREM group.This study includes a small sample size due to the anticipated end of the clinical trial because of the COVID-19 pandemic.These results provide preliminary evidence on the feasibility and potential efficacy of the INCREM program to improve not only cognitive performance but also psychosocial functioning in clinically remitted depressed patients, and such improvement is maintained six months after. It can be speculated that the maintenance is mediated by the cognitive enhancement achieved with INCREM.
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- 2022
3. Volume of subcortical brain regions in social anxiety disorder: Mega-analytic results from 37 samples in the ENIGMA-Anxiety Working Group
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Nynke A. Groenewold, Janna Marie Bas-Hoogendam, Alyssa R. Amod, Max A. Laansma, Laura S. Van Velzen, Moji Aghajani, Kevin Hilbert, Hyuntaek Oh, Ramiro Salas, Andrea P. Jackowski, Pedro M. Pan, Giovanni A. Salum, James R. Blair, Karina S. Blair, Joy Hirsch, Spiro P. Pantazatos, Franklin R. Schneier, Ardesheer Talati, Karin Roelofs, Inge Volman, Laura Blanco-Hinojo, Narcís Cardoner, Jesus Pujol, Katja Beesdo-Baum, Christopher R. K. Ching, Sophia I. Thomopoulos, Andreas Jansen, Tilo Kircher, Axel Krug, Igor Nenadić, Frederike Stein, Udo Dannlowski, Dominik Grotegerd, Hannah Lemke, Susanne Meinert, Alexandra Winter, Michael Erb, Benjamin Kreifelts, Qiyong Gong, Su Lui, Fei Zhu, Benson Mwangi, Jair C. Soares, Mon-Ju Wu, Ali Bayram, Mesut Canli, Raşit Tükel, P. Michiel Westenberg, Alexandre Heeren, Henk R. Cremers, David Hofmann, Thomas Straube, Alexander G. G. Doruyter, Christine Lochner, Jutta Peterburs, Marie-José Van Tol, Raquel E. Gur, Antonia N. Kaczkurkin, Bart Larsen, Theodore D. Satterthwaite, Courtney A. Filippi, Andrea L. Gold, Anita Harrewijn, André Zugman, Robin Bülow, Hans J. Grabe, Henry Völzke, Katharina Wittfeld, Joscha Böhnlein, Katharina Dohm, Harald Kugel, Elisabeth Schrammen, Peter Zwanzger, Elisabeth J. Leehr, Lisa Sindermann, Tali M. Ball, Gregory A. Fonzo, Martin P. Paulus, Alan Simmons, Murray B. Stein, Heide Klumpp, K. Luan Phan, Tomas Furmark, Kristoffer N. T. Månsson, Amirhossein Manzouri, Suzanne N. Avery, Jennifer Urbano Blackford, Jacqueline A. Clauss, Brandee Feola, Jennifer C. Harper, Chad M. Sylvester, Ulrike Lueken, Dick J. Veltman, Anderson M. Winkler, Neda Jahanshad, Daniel S. Pine, Paul M. Thompson, Dan J. Stein, Nic J. A. Van der Wee, Department of Psychology, Education and Child Studies, Erasmus University Rotterdam, Clinical Psychology, UCL - SSH/IPSY - Psychological Sciences Research Institute, and UCL - SSS/IONS/NEUR - Clinical Neuroscience
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Adult ,Adolescent ,230 Affective Neuroscience ,Brain ,Phobia, Social ,Anxiety ,Experimental Psychopathology and Treatment ,Cellular and Molecular Neuroscience ,Psychiatry and Mental health ,methods [Magnetic Resonance Imaging] ,Humans ,ddc:610 ,methods [Neuroimaging] ,Molecular Biology - Abstract
Contains fulltext : 288062.pdf (Publisher’s version ) (Closed access) There is limited convergence in neuroimaging investigations into volumes of subcortical brain regions in social anxiety disorder (SAD). The inconsistent findings may arise from variations in methodological approaches across studies, including sample selection based on age and clinical characteristics. The ENIGMA-Anxiety Working Group initiated a global mega-analysis to determine whether differences in subcortical volumes can be detected in adults and adolescents with SAD relative to healthy controls. Volumetric data from 37 international samples with 1115 SAD patients and 2775 controls were obtained from ENIGMA-standardized protocols for image segmentation and quality assurance. Linear mixed-effects analyses were adjusted for comparisons across seven subcortical regions in each hemisphere using family-wise error (FWE)-correction. Mixed-effects d effect sizes were calculated. In the full sample, SAD patients showed smaller bilateral putamen volume than controls (left: d = -0.077, pFWE = 0.037; right: d = -0.104, pFWE = 0.001), and a significant interaction between SAD and age was found for the left putamen (r = -0.034, pFWE = 0.045). Smaller bilateral putamen volumes (left: d = -0.141, pFWE
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- 2023
4. Predictive factors of hesitancy to vaccination against SARS-CoV-2 virus in young adults in Spain: Results from the PSY-COVID study
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Corel Mateo-Canedo, Juan Pablo Sanabria-Mazo, Laura Comendador, Juan Sebastián Rojas, Meritxell Carmona, Neus Crespo-Puig, Fiorella Anyosa, Clara Selva, Albert Feliu-Soler, Narcís Cardoner, Juan Deus, Juan V. Luciano, Jorge Luis Méndez-Ülrich, and Antoni Sanz
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Infectious Diseases ,General Veterinary ,General Immunology and Microbiology ,Public Health, Environmental and Occupational Health ,Molecular Medicine - Published
- 2023
5. Obsessive–compulsive symptoms in anxiety and depressive disorders: Influence of recent and/or traumatic life events
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Guillermo Lahera, Narcís Cardoner, María Vicens, Arantxa Orozco, Miguel Angel Alvarez-Mon, Salvador Ruiz-Murugarren, and Cristina F. Aragón
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Persistence (psychology) ,Obsessive-Compulsive Disorder ,Anxiety ,03 medical and health sciences ,0302 clinical medicine ,Humans ,Medicine ,HARS ,Prospective Studies ,Depression (differential diagnoses) ,Psychiatric Status Rating Scales ,Response rate (survey) ,Depressive Disorder ,business.industry ,Life events ,General Medicine ,medicine.disease ,Comorbidity ,030227 psychiatry ,Psychiatry and Mental health ,Observational study ,medicine.symptom ,business ,030217 neurology & neurosurgery ,Clinical psychology - Abstract
INTRODUCTION A high prevalence of obsessive-compulsive symptoms (OCSs) in anxiety-depressive disorders ranging from 30 to 67% has been described. OBJECTIVE This study aims to assess the presence and persistence of OCSs in an outpatient sample of subjects with anxiety and depressive disorders, as well as its relationship with recent life events (RLEs) and/or traumatic experiences (TEs). METHOD We conducted a prospective, observational, analytical study of 200 subjects with DSM-5 diagnoses of anxiety and/or depression. Participants were included by consecutive sampling and were evaluated at baseline and after 6-12 months (mean 8.5 months) of follow-up. The severity of the symptoms was assessed through the Hamilton Anxiety Scale (HARS) and Hamilton Scale for the evaluation of depression (HRSD-17), and comorbidity was assessed through the International Neuropsychiatric Interview (MINI). The Revised Inventory of Obsessions and Compulsions (OCI-R), the Recent Vital Changes Questionnaire (CVSV), and the Diagnostic Scale for Post-Traumatic Stress (PDS) were also administered. RESULTS 54% of the sample presented OCSs, and 30.5% presented one or more TEs throughout life. At the baseline visit, the presence of OCSs was associated with the severity of depressive symptoms (p=0.028), the presence of TEs (p
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- 2021
6. Brain-Based Classification of Youth with Anxiety Disorders: an ENIGMA-ANXIETY Transdiagnostic Examination using Machine Learning
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Willem B. Bruin, Paul Zhutovsky, Guido van Wingen, Janna Marie Bas-Hoogendam, Nynke A. Groenewold, Kevin Hilbert, Anderson M. Winkler, André Zugman, Federica Agosta, Fredrik Åhs, Carmen Andreescu, Chase Antonacci, Takeshi Asami, Michal Assaf, Jacques Barber, Jochen Bauer, Shreya Bavdekar, Katja Beesdo-Baum, Francesco Benedetti, Rachel Bernstein, Johannes Björkstrand, Robert Blair, Karina S. Blair, Laura Blanco-Hinojo, Joscha Böhnlein, Paolo Brambilla, Rodrigo Bressan, Fabian Breuer, Marta Cano, Elisa Canu, Elise M Cardinale, Narcís Cardoner, Camilla Cividini, Henk Cremers, Udo Dannlowski, Gretchen J. Diefenbach, Katharina Domschke, Alexander Doruyter, Thomas Dresler, Angelika Erhardt, Massimo Filippi, Gregory Fonzo, Gabrielle Felice Freitag, Tomas Furmark, Tian Ge, Andrew J. Gerber, Savannah Gosnell, Hans J. Grabe, Dominik Grotegerd, Ruben C. Gur, Raquel E. Gur, Alfons O. Hamm, Laura K. M. Han, Jennifer Harper, Anita Harrewijn, Alexandre Heeren, David Hoffman, Andrea P. Jackowski, Neda Jahanshad, Laura Jett, Antonia N. Kaczkurkin, Parmis Khosravi, Ellen Kingsley, Tilo Kircher, Milutin Kostić, Bart Larsen, Sang-Hyuk Lee, Elisabeth Leehr, Ellen Leibenluft, Christine Lochner, Su Lui, Eleonora Maggioni, Gisele Gus Manfro, Kristoffer Månsson, Claire Marino, Frances Meeten, Barbara Milrod, Ana Munjiza, Benson Irungu, Michael Myers, Susanne Neufang, Jared Nielsen, Patricia Ohrmann, Cristina Ottaviani, Martin P Paulus, Michael T. Perino, K Luan Phan, Sara Poletti, Daniel Porta-Casteràs, Jesus Pujol, Andrea Reinecke, Grace Ringlein, Pavel Rjabtsenkov, Karin Roelofs, Ramiro Salas, Giovanni Salum, Theodore D. Satterthwaite, Elisabeth Schrammen, Lisa Sindermann, Jordan Smoller, Jair Soares, Rudolf Stark, Frederike Stein, thomas straube, Benjamin Straube, Jeffrey Strawn, Benjamin Suarez-Jimenez, Chad M. Sylvester, Ardesheer Talati, Sophia I Thomopoulos, Raşit Tükel, Helena van Nieuwenhuizen, Katy E. Werwath, Katharina Wittfeld, Barry Wright, Mon-Ju Wu, Yunbo Yang, Anna Zilverstand, Peter Zwanzger, Jennifer Blackford, Suzanne Avery, Jacqueline Clauss, Ulrike Lueken, Paul Thompson, Daniel Pine, Dan J. Stein, Nic van der Wee, Dick Veltman, and Moji Aghajani
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Neuroimaging studies point to neurostructural abnormalities in youth with anxiety disorders. Yet, findings are based on small-scale studies, often with small effect sizes, and have limited generalizability and clinical relevance. These issues have prompted a paradigm shift in the field towards highly powered (i.e., big data) individual-level inferences, which are data-driven, transdiagnostic, and neurobiologically informed. Here, we built and validated neurostructural machine learning (ML) models for individual-level inferences based on the largest-ever multi-site neuroimaging sample of youth with anxiety disorders (age: 10-25 years, N=3,343 individuals from 32 global sites), as compiled by three ENIGMA Anxiety Working Groups: Panic Disorder (PD), Generalized Anxiety Disorder (GAD), and Social Anxiety Disorder (SAD). ML classifiers were trained on MRI-derived regional measures of cortical thickness, surface area, and subcortical volumes to classify patients and healthy controls (HC) for each anxiety disorder separately and across disorders (transdiagnostic classification). Modest, yet robust, classification performance was achieved for PD vs. HC (AUC=0.62), but other disorder-specific and transdiagnostic classifications were not significantly different from chance. However, above chance-level transdiagnostic classifications were obtained in exploratory subgroup analyses of male patients vs. male HC, unmedicated patients vs. HC, and patients with low anxiety severity vs. HC (AUC 0.59-0.63). The above chance-level classifications were based on plausible and specific neuroanatomical features in fronto-striato-limbic and temporo-parietal regions. This study provides a realistic estimate of classification performance in a large, ecologically valid, multi-site sample of youth with anxiety disorders, and may as such serve as a benchmark.
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- 2022
7. Efficacy and fMRI-based response predictors to mindfulness-based cognitive therapy in obsessive-compulsive disorder: Study protocol for a randomised clinical trial
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Neus Miquel-Giner, Muriel Vicent-Gil, Ignacio Martínez-Zalacaín, Daniel Porta-Casteras, Lorea Mar, Marina López-Solà, Jessica R. Andrews-Hanna, Carles Soriano-Mas, José Manuel Menchón, Narcís Cardoner, Pino Alonso, Maria Serra-Blasco, and Clara López-Solà
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Psychiatry and Mental health - Published
- 2022
8. Tracking temporal response dynamics in the ventral striatum during social feedback in anorexia nervosa: A functional magnetic resonance imaging exploratory study
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Marina López-Solà, Ben J. Harrison, Sonia Membrives, José M. Menchón, Charlotte Keating, Carles Soriano-Mas, Ignacio Martínez-Zalacaín, Jesús Pujol, Esther Via, Christopher G. Davey, Susan L. Rossell, Fernando Fernández-Aranda, Narcís Cardoner, Diego Palao, Joan Carles Oliva, and Isabel Sánchez
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medicine.medical_specialty ,Anorexia Nervosa ,medicine.diagnostic_test ,business.industry ,Ventral striatum ,Exploratory research ,Hemodynamics ,Audiology ,Magnetic Resonance Imaging ,Feedback ,Psychiatry and Mental health ,Social feedback ,Reward system ,medicine.anatomical_structure ,Reward ,Anorexia nervosa (differential diagnoses) ,Ventral Striatum ,Humans ,Medicine ,Female ,business ,Functional magnetic resonance imaging ,Social rejection - Abstract
Objective Research suggests abnormalities in reward-based processes in anorexia nervosa (AN). However, few studies have explored if such alterations might be associated with different temporal activation patterns. This study aims to characterize alterations in time-dependent processes in the ventral striatum (VS) during social feedback in AN using functional magnetic resonance imaging (fMRI). Method Twenty women with restrictive-subtype AN and 20 age-matched healthy controls (HC) underwent a social judgment experimental fMRI task. Temporal VS hemodynamic responses were extracted in SPM for each participant and each social condition (acceptance/rejection). Results Compared with age-matched HC, patients with AN showed a significant time by group interaction of peak VS response throughout the task, with a progressive blunting of peak activation responses, accompanied by a progressive increase in baseline activity levels over time. Discussion The results suggest an attenuated response pattern to repetitive social rejection in the VS in patients with AN, together with a difficulty in returning to baseline. The information obtained from this study will guide future, design-specific studies to further explore alterations temporal dynamics.
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- 2021
9. Higher order theory of mind in patients with bipolar disorder and schizophrenia/schizoaffective disorder
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Guillermo Lahera, Diego Palao, M. Serra-Blasco, Jesús Cobo, Sol Fernandez-Gonzalo, Ximena Goldberg, Josep Maria Crosas, Guillem Navarra-Ventura, Narcís Cardoner, Mercè Jodar, Eduard Vieta, and Muriel Vicent-Gil
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Intelligence quotient ,business.industry ,Context (language use) ,Schizoaffective disorder ,General Medicine ,Executive functions ,medicine.disease ,030227 psychiatry ,03 medical and health sciences ,Psychiatry and Mental health ,0302 clinical medicine ,Schizophrenia ,medicine ,Pharmacology (medical) ,Bipolar disorder ,Verbal memory ,business ,Neurocognitive ,030217 neurology & neurosurgery ,Biological Psychiatry ,Clinical psychology - Abstract
Some evidence suggests that patients with bipolar disorder (BD) have better Theory of Mind (ToM) skills than patients with schizophrenia/schizoaffective disorder (SCH). However, this difference is not consistently reported across studies, so rather than being global, it may be restricted to specific aspects of ToM. Our primary objective was to compare higher order ToM performance between BD and SCH patients using the Hinting Task (HT). Ninety-four remitted patients were recruited (BD = 47, SCH = 47). Intelligence quotient (IQ), attention, memory, executive functions, and processing speed were also assessed. Patients with BD performed better on the HT than patients with SCH, even when the analysis was adjusted for IQ and neurocognition (p
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- 2021
10. Biomarkers of response to rapid-acting antidepressants
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Narcís Cardoner and Marta Cano
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Pharmacology ,Oncology ,medicine.medical_specialty ,Treatment response ,Depression ,business.industry ,Antidepressive Agents ,Psychiatry and Mental health ,Neurology ,Internal medicine ,Medicine ,Biomarker (medicine) ,Ketamine ,Pharmacology (medical) ,Neurology (clinical) ,business ,Biomarkers ,Biological Psychiatry - Published
- 2021
11. Longitudinal changes in telomere length in a cohort of obese patients submitted to bariatric surgery: a 2-year follow-up
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Narcís Cardoner, Araceli Rosa, Elionora Peña, Assumpta Caixàs, Timothy R. Powell, Concepción Arenas, Pere Rebasa, and Alexis Luna
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medicine.medical_specialty ,Bariatric Surgery ,030209 endocrinology & metabolism ,Type 2 diabetes ,03 medical and health sciences ,0302 clinical medicine ,Class II obesity ,Weight loss ,medicine ,Humans ,Obesity ,Telomere Shortening ,Class III obesity ,business.industry ,Telomere ,medicine.disease ,Surgery ,Diabetes Mellitus, Type 2 ,Spain ,030211 gastroenterology & hepatology ,Metabolic syndrome ,medicine.symptom ,business ,Body mass index ,Cell aging ,Follow-Up Studies - Abstract
Background Telomere length (TL) is one biomarker of cell aging used to explore the effects of the environment on age-related pathologies. Obesity and high body mass index have been identified as a risk factors for shortened TL. Objective To evaluate TL in different subtypes of obese patients, and to examine changes in TL in relation to weight loss after bariatric surgery. Setting University Hospital in Spain. Methods A cohort of 94 patients submitted to bariatric surgery were followed-up during 24 months (t24m: lost to follow-up = 0%). All patients were evaluated before surgery (t0) and during the postoperative period (t6m, t12m, and t24m) for body mass index and metabolic variables. We assessed TL at each timepoint using quantitative polymerase chain reactions and the telomere sequence to single-copy gene sequence ratio method. Results Patients with class III obesity showed significantly shorter TL at baseline than those patients with class II obesity (P = .027). No differences in TL were found between patients with or without type 2 diabetes or metabolic syndrome. Longitudinal analysis did not show an effect of time, type of surgery, age, or sex on TL. However, a generalized estimating equation model showed that TL was shorter amongst class III obesity patients across the time course (P = .008). Comparison between patients with obesity class II and class III showed differences in TL at t6m (adjusted P = .024), whereby class II patients had longer TL. However, no difference was observed at the other evaluated times. Conclusion Obesity severity may have negative effects on TL independently of type 2 diabetes or metabolic syndrome. Although TL is significantly longer in class II obesity patients relative to class III 6 months after bariatric surgery. This difference is not apparent after 24 months.
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- 2020
12. Role of the FKBP5 polymorphism rs1360780, age, sex, and type of surgery in weight loss after bariatric surgery: a follow-up study
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Assumpta Caixàs, Elionora Peña, Araceli Rosa, Concepción Arenas, Narcís Cardoner, Mercedes Rigla, and Sara Crivillés
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Male ,medicine.medical_specialty ,Sleeve gastrectomy ,medicine.medical_treatment ,Gastric Bypass ,Bariatric Surgery ,030209 endocrinology & metabolism ,Tacrolimus Binding Proteins ,03 medical and health sciences ,Sex Factors ,0302 clinical medicine ,Gastrectomy ,Weight loss ,Weight Loss ,Genotype ,medicine ,Humans ,Allele ,Alleles ,Aged ,Retrospective Studies ,business.industry ,Age Factors ,Middle Aged ,medicine.disease ,Obesity ,Obesity, Morbid ,Surgery ,Treatment Outcome ,Spain ,Cohort ,Female ,Laparoscopy ,030211 gastroenterology & hepatology ,FKBP5 ,medicine.symptom ,business ,Body mass index ,Follow-Up Studies - Abstract
Background Emerging evidence suggests that the FK506 binding protein 51 (FKBP5/FKBP51), encoded by the FKBP5 gene, influences weight and metabolic regulation. The T allele of a functional polymorphism in FKBP5 (rs1360780), has been associated with the expression of FKBP51 and weight loss after bariatric surgery. Objective To examine the role of the FKBP5 rs1360780 polymorphism in relation to age, sex, and type of surgery in weight loss after bariatric surgery in patients with severe obesity. Setting University Hospital in Spain Methods A cohort of 151 obese patients submitted to Roux-en-Y gastric bypass (62.3%) and sleeve gastrectomy (37.7%) were followed-up during 24-months (t24m; loss to follow-up: 0%). During the postoperative period body mass index (BMI) and percentage of excess and total weight loss were evaluated. Results The BMI analysis showed an effect of the interaction FKBP5 genotype by sex (P = .0004) and a tendency to the interaction genotype by surgery (P = .048), so that men carrying the T allele had higher BMI at t24m than those without the T allele, and T-allele carriers that underwent sleeve gastrectomy had higher BMI at t24m than the noncarriers. Additionally, we found an interaction between FKBP5 and age for the percentage of excess weight loss and BMI (P = .0005 and P = 1.5e−7, respectively), whereby individuals >48 years with the T allele displayed significant differences for the analyzed variables at t24m compared with the homozygotes for the alternate C allele showing lower weight loss. Conclusion FKBP5 rs1360780 genotype has specific effects on weight loss outcomes after bariatric surgery depending on sex, age, and type of surgery, suggesting worse results in older males carrying the T allele who have undergone sleeve gastrectomy.
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- 2020
13. Clinical outcome after discontinuation of maintenance electroconvulsive therapy. A retrospective follow-up study
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Lara Urraca, Ximena Goldberg, Pilar Serra, Narcís Cardoner, Erika Martínez-Amorós, Mikel Urretavizcaya, and D. Palao
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Pediatrics ,medicine.medical_specialty ,Clinical variables ,business.industry ,medicine.medical_treatment ,Follow up studies ,General Medicine ,behavioral disciplines and activities ,030227 psychiatry ,Discontinuation ,03 medical and health sciences ,0302 clinical medicine ,Electroconvulsive therapy ,Risk groups ,Time to recurrence ,mental disorders ,Hospital admission ,Medicine ,business ,030217 neurology & neurosurgery ,Survival analysis - Abstract
Introduction Continuation and maintenance electroconvulsive therapy (c/m-ECT) is a therapeutic option after an acute ECT course. Although it is widely used, both duration and the outcome of patients when ECT-c/m is discontinued is not yet well established. The aim of the study was to evaluate the recurrence rate and associated clinical factors when c/m-ECT is discontinued. Materials and methods Retrospective evaluation of 73 patients who were discontinued from c/m-ECT. The minimum evaluation time was one year. The need of hospital admission or a new acute course of ECT was considered a relapse. The recurrence rate was calculated as a percentage and the estimated time to recurrence was analyzed through a survival analysis. Possible associations between clinical variables and recurrence were analyzed by univariate and multivariate Cox analysis. Results Thirty-six patients (49.3%) relapsed: 61.1% of them relapsed during the first year after the c/m-ECT discontinuation (36.1% during the first 6 months). The estimated time to recurrence was 38.67 months. Fifty percent of patients who relapsed required a new acute course of ECT and 44.4% of them restarted c/m-ECT. Patients with an interval between sessions of less than one month and those with more previous episodes showed a higher risk of recurrence. Conclusions The risk of recurrence should be considered before the discontinuation of c/m-ECT. After the discontinuation, almost half of the patients relapsed, most of them within the first year. Close monitoring should be conducted in these patients and the discontinuation is not recommended when it is administered at intervals between sessions of less than a month. Further studies are required to identify risk groups for relapse.
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- 2020
14. Evolución clínica tras la discontinuación de la terapia electroconvulsiva de mantenimiento. Estudio de seguimiento retrospectivo
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Ximena Goldberg, Pilar Serra, Mikel Urretavizcaya, Lara Urraca, Diego Palao, Narcís Cardoner, and Erika Martínez-Amorós
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03 medical and health sciences ,Psychiatry and Mental health ,0302 clinical medicine ,030217 neurology & neurosurgery ,030227 psychiatry - Abstract
Resumen Introduccion La terapia electroconvulsiva de continuacion/mantenimiento (TEC-c/m) es una opcion terapeutica tras la TEC aguda. Aunque es ampliamente usada, tanto su duracion como la evolucion de los pacientes tras su discontinuacion no estan bien establecidas. El objetivo del estudio fue evaluar la tasa de recidivas y los factores clinicos asociados a la misma tras discontinuar la TEC-c/m. Material y metodos Evaluacion retrospectiva de 73 pacientes a los que se les discontinuo la TEC-c/m. El tiempo de evaluacion minimo fue de un ano. Se considero recidiva la necesidad de ingreso o de nueva tanda aguda de TEC. La tasa de recidivas se determino como porcentaje y el tiempo estimado hasta la recidiva se analizo a traves de un analisis de supervivencia. Posibles asociaciones entre la recidiva y variables clinicas se analizaron mediante analisis univariado y multivariado de Cox. Resultados Treinta y seis pacientes (49,3%) recidivaron. El 61,1% lo hizo durante el primer ano tras la discontinuacion de la TEC-c/m (36,1% durante los primeros 6 meses). El tiempo estimado hasta la recidiva fue de 38,67 meses. El 50% de los pacientes que recayeron precisaron una nueva tanda aguda de TEC y el 44,4% reiniciaron TEC-c/m posteriormente. Los pacientes con un intervalo entre sesiones inferior a un mes y aquellos con mas episodios previos presentaron mayor riesgo de recidiva. Conclusiones Ante la discontinuacion de la TEC-c/m debe considerarse el riesgo de recidiva. Tras la discontinuacion, casi la mitad de los pacientes recidivaron, la mayoria en el primer ano. Es recomendable realizar un seguimiento estrecho tras la discontinuacion de la TEC-c/m y no es aconsejable su retirada cuando se administra con intervalos entre sesiones inferiores a un mes. Se requieren nuevos estudios para identificar grupos de riesgo para la recidiva.
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- 2020
15. Barriers, Facilitators, and Proposals for Improvement in the Implementation of a Collaborative Care Program for Depression: A Qualitative Study of Primary Care Doctor and Nurse Experiences
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Catarina Tomé-Pires, Daniel Porta-Casteràs, Enric Aragonès, Germán López-Cortacans, D. Palao, and Narcís Cardoner
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Nursing ,Collaborative Care ,Primary care ,Psychology ,Depression (differential diagnoses) ,Qualitative research - Abstract
Background: Primary care plays a central role in the treatment of depression. Nonetheless, shortcomings in its management and suboptimal outcomes have been identified. Collaborative care models improve processes for the management of depressive disorders and associated outcomes. We developed a strategy to implement the INDI collaborative care program for the management of depression in primary health care centers across Catalonia. The aim of this qualitative study was to evaluate a trial implementation of the program to identify barriers, facilitators, and proposals for improvement. Methods: One year after the implementation of the INDI program in 18 public primary health care centers we performed a qualitative study in which the opinions and experiences of 23 primary care doctors and nurses from the participating centers were explored in focus groups. We performed thematic content analysis of the focus group transcripts. Results: The results were organized into three categories: facilitators, barriers, and proposals for improvement as perceived by the health care professionals involved. The most important facilitator identified was the perception that the INDI collaborative care program could be a useful tool for reorganizing processes and improving the management of depression in primary care, currently viewed as deficient. The main barriers identified were of an organizational nature: heavy workloads, lack of time, high staff turnover and shortages, and competing demands. Additional obstacles were inertia and resistance to change among health care professionals. Proposals for improvement included institutional buy-in to guarantee enduring support and the organizational changes needed for successful implementation.Conclusions: The INDI program is perceived as a useful, viable program for improving the management of depression in primary care. Uptake by primary care centers and health care professionals, however, was poor. The identification and analysis of barriers and facilitators will help refine the strategy to achieve successful, widespread implementation.Trial registration: ClinicalTrials.gov identifier: NCT03285659; Registered 18th September, 2017.
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- 2021
16. The pituitary adenylate cyclase-activating polypeptide system as a sex-specific modulator of hippocampal response to threat stimuli
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Daniel Porta-Casteràs, Marta Cano, Trevor Steward, Raül Andero, and Narcís Cardoner
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Cellular and Molecular Neuroscience ,Endocrinology ,Endocrine and Autonomic Systems ,Physiology ,Molecular Biology ,Biochemistry - Abstract
Pituitary adenylate cyclase-activating polypeptide (PACAP) receptor gene polymorphism has been postulated as a potential sex-specific diagnostic biomarker of trauma-related disorders. However, no research to date has evaluated whether the PACAPergic system may act as a vulnerability/resilience neuromechanism to trauma-induced psychopathology in healthy participants without heightened risk to experience traumatic events.Here, we compared the amygdala and hippocampus response to fearful faces in participants with at-risk genotype versus non-risk participants from the Human Connectome Project (n = 991; 53.4% female).Increased hippocampal response to fearful faces in the female risk group emerged in sex by genetic risk interaction.Our findings revealed the first sex-specific neurogenetic vulnerability factor to trauma-related disorders, and emphasize the importance of prevention-based strategies to ameliorate neuropsychiatric pathophysiology.
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- 2021
17. Spanish validation of the Empirically Developed Clinical Staging Model (EmDe-5) for patients with bipolar disorder
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Ana García-Blanco, Jose María Pelayo-Terán, Pilar A. Saiz, Estanislao Mur, Pilar Sierra, Carla Hernandez, Belén Arranz, Gemma Safont, Manuel Arrojo, Vicent Balanzá-Martínez, Lorena de la Fuente-Tomás, Esther Jiménez, Luis Gutiérrez-Rojas, Eduard Vieta, Narcís Cardoner, Ruben Catalán-Barragán, Miguel Ruiz-Veguilla, Mónica Sanchez-Autet, María Paz García-Portilla, Víctor Pérez-Sola, Sonia Ll. Vidal-Rubio, Julio Bobes, Jesús Gómez-Trigo, Ana González-Pinto, Yolanda Zapico-Merayo, Clara Martínez-Cao, and Iñaki Zorrilla
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Pediatrics ,medicine.medical_specialty ,business.industry ,media_common.quotation_subject ,Construct validity ,Cognition ,medicine.disease ,Personality disorders ,Psychiatry and Mental health ,Quality of life ,Progressive disorder ,Medicine ,Personality ,Bipolar disorder ,Stage (cooking) ,business ,media_common - Abstract
Introduction Bipolar disorder (BD) has been reconceptualised as a progressive disorder that develops from mild to severe presentations. An empirical staging model – the Empirically Developed Clinical Staging Model for BD (EmDe-5) – was developed in a previous study. This study aims to further validate that model using a larger and more representative Spanish sample. Material and methods 183 BD outpatients were recruited at 11 sites in Spain. Assessment included clinical characteristics of the BD (number of hospitalisations, number of suicide attempts, comorbid personality disorders), physical health (BMI, metabolic syndrome, number of physical illnesses), cognition (SCIP), functioning (permanently disabled due to BD, FAST), and quality of life (SF-36). The CGI-S, VAS-S, and psychopharmacological treatment pattern were used as external validators. Results Ten patients (51.5%) were classified as stage 1, 33 (18%) as stage 2, 93 (50 8%) as stage 3, 37 (20 2%) as stage 4, and 10 (5 5%) as stage 5. All profilers, other than number of suicide attempts (p = 0.311) and comorbid personality disorder (p = 0.061), exhibited worse scores from stage 1 to 5. As expected, VAS-S and CGI-S scores were worse in the later stages. Regarding treatment, early stages (1–2) were associated with the use of one to three drugs while late stages (4–5) were associated with four or more drugs (p = 0.002). Conclusions We confirm the EmDe-5 staging model's construct validity. The ease of obtaining the profilers, together with the operational criteria provided to quantify them, will facilitate the use of the EmDe-5 staging model in daily clinical practice.
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- 2021
18. Adherence to Desvenlafaxine Versus Usual Care and Its Impact on Health Outcomes: A Comparative Real-world Clinical Study
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Beatriz Armada, Antoni Sicras-Mainar, Javier Rejas, and Narcís Cardoner
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medicine.medical_specialty ,Depressive Disorder, Major ,business.industry ,General Medicine ,medicine.disease ,Antidepressive Agents ,Desvenlafaxine ,Internal medicine ,Desvenlafaxine Succinate ,Usual care ,Health care ,medicine ,Major depressive disorder ,Antidepressant ,Humans ,Pharmacology (medical) ,Observational study ,Disease management (health) ,business ,Reuptake inhibitor ,Selective Serotonin Reuptake Inhibitors ,medicine.drug ,Retrospective Studies - Abstract
Background and objective Low adherence to treatment is associated with poorer clinical outcome and greater healthcare resources utilization (HRU). Limited data are available on the extent of adherence to each individual antidepressant. The goal of this study was to compare the adherence rate to desvenlafaxine versus usual care with selective serotonin reuptake inhibitors (SSRI) and/or other serotonin-norepinephrine reuptake inhibitors (SNRI), in subjects with major depressive disorder (MDD). Methods Retrospective, multi-centric, observational study including 574 outpatients with MDD. Data were collected from mental and primary care centers. Adherence, persistence, effectiveness, and HRU was evaluated through multivariate regression models. Results At 12-months, adjusted adherence rate was higher with desvenlafaxine versus SNRI/SSRI, 67.9% versus 59.9% (OR 1.66, 95% CI 1.07-2.59, p = 0.024). Remission rate was numerically higher with desvenlafaxine versus SNRI/SSRI, 55.9% versus 50.1% (OR 1.35, 95% CI 0.93-1.98, p = 0.118), as well as treatment response, 76.5% in desvenlafaxine group versus 70.8% in SNRI/SSRI group (OR 1.25, 95% CI 0.82-1.90, p = 0.300). Medical visits use was higher in SNRI/SSRI than in desvenlafaxine group [9.8 (4.8) versus 9.1 (6.0), p = 0.019]. Conclusions Desvenlafaxine is significantly associated with a higher adherence rate at 12 months compared to usual care based on SSRI or other SNRI. This suggests that desvenlafaxine could improve disease management having a positive impact on disease-associated costs.
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- 2021
19. Telomere length in patients with obesity submitted to bariatric surgery: A systematic review
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Araceli Rosa, Josep León-Mengíbar, Eleonora Peña, Timothy R. Powell, Narcís Cardoner, and Assumpta Caixàs
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Adult ,medicine.medical_specialty ,business.industry ,MEDLINE ,Bariatric Surgery ,Telomere ,medicine.disease ,Obesity ,Surgery ,Psychiatry and Mental health ,Clinical Psychology ,Eating disorders ,Web of knowledge ,Weight loss ,medicine ,Effective treatment ,Humans ,In patient ,Prospective Studies ,medicine.symptom ,business ,Telomere Shortening - Abstract
Background Patients with obesity show evidence of increased levels of inflammation, oxidative stress and premature ageing. Telomere length (TL) is a key marker of cellular ageing, and patients with obesity often present shorter TL. Bariatric surgery (BS) is currently the most effective treatment for severe obesity. The aim of this systematic review was to explore whether the beneficial health effects observed after surgery in obese patients correspond to a restoration in TL or slower rates of shortening. As a secondary aim, we evaluated, at baseline and post-surgery, the relationship between TL and different factors that could play a role in TL changes along time. Methods Searches for relevant articles were performed in MEDLINE, Web of Knowledge and SCOPUS. Prospective longitudinal studies that evaluated leukocyte TL in adult patients who had undergone BS were included. Data were extracted and evaluated by two independent researchers. The protocol was registered in PROSPERO with the number CRD42020197711. Results Seven studies based on independent samples that fulfilled our inclusion criteria were included. Obese patients showed shorter telomeres compared to healthy individuals. Long-term studies (>2 years) seem to suggest an improvement in TL after surgery presumably due to the improvement of the inflammatory and oxidative levels of the patients induced by weight loss. Conclusion Studies seem to point towards a beneficial long-term effect of BS on TL recovery. However, the scarce number of studies and the heterogeneity in the variables analysed in the different cohorts make it difficult to draw a firm conclusion. More studies are needed to evaluate long-term changes to TL following BS.
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- 2021
20. Can routine Primary Care Records Help in Detecting Suicide Risk? A Population-Based Case-Control Study in Barcelona
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Marc Fradera, Oriol Prat, Maria Campillo, Víctor Pérez-Solà, Diego Palao, Rosa Morros, Narcís Cardoner, Carles Martin-Fumadó, Caridad Pontes, and Dan Ouchi
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Male ,050103 clinical psychology ,medicine.medical_specialty ,Epidemiology ,Population ,Suicide, Attempted ,Primary care ,Population based ,03 medical and health sciences ,0302 clinical medicine ,Risk Factors ,medicine ,Humans ,0501 psychology and cognitive sciences ,education ,Suicide Risk ,Risk assessment ,Aged ,Retrospective Studies ,education.field_of_study ,Primary Health Care ,business.industry ,Public health ,Mental Disorders ,05 social sciences ,Case-control study ,humanities ,030227 psychiatry ,Psychiatry and Mental health ,Clinical Psychology ,Suicide ,Family medicine ,Case-Control Studies ,Female ,business ,Information technologies - Abstract
Objectives: To characterize people who died by suicide after having previous contacts with public health system using the data available in a primary care setting. Method: A retrospective, population-based case-control study identified through autopsy reports subjects who died from suicide between 2010 and 2015 in Barcelona province. Those who had previous interaction with primary healthcare services were selected, and 20 controls per case with similar age, sex and residence area were randomly sampled from a primary healthcare medical database; the available medical data derived from routine primary care records were anonymised and retrieved for analysis in all subjects. Results: Of 2109 people deceased by suicide, 971 had previous primary healthcare interactions; 33.8% aged over 65 and 74% men. Of those with previous contact, 33% died during the week after and 58.5% within one month. A multivariable analysis identified several significant risk factors in the database, including previous suicide attempts, psychiatric diagnosis, number of primary healthcare visits, referrals to mental health, number of drugs prescribed, recent psychoactive drug prescriptions, and being on sick leave due to mental conditions in the previous year. Conclusions: Nearly half of suicide subjects contacted primary healthcare before dying but remained either undetected or not effectively managed for prevention. In cases who interacted, available data on risk factors included high frequentation and being on sick leave due to mental health disorders, in addition to other well-known factors. Routine electronic medical records represent an opportunity to provide clinical-decision support tools that could be implemented through automatized risk calculation.HIGHLIGHTSMost of suicide patients had a recent interaction with the healthcare systemWell known risk factors were available in the routine electronic medical recordsAdditional alerting tools could be implemented through automatized risk calculation.
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- 2021
21. Is glutamate associated with fear extinction and cognitive behavior therapy outcome in OCD? A pilot study
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Ignacio Martínez-Zalacaín, Miquel A. Fullana, Lawrence S. Kegeles, José M. Menchón, Jodi J. Weinstein, Carles Soriano-Mas, Marta Cano, Xiaoyan Xu, Cinto Segalàs, Eva Real, Mónica Giménez, Narcís Cardoner, Josep Munuera, and Pino Alonso
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Adult ,Male ,Obsessive-Compulsive Disorder ,Magnetic Resonance Spectroscopy ,medicine.medical_treatment ,Ventromedial prefrontal cortex ,Glutamic Acid ,Prefrontal Cortex ,Pilot Projects ,Ventromedial prefrontal cortex (vmPFC) ,Severity of Illness Index ,behavioral disciplines and activities ,Extinction, Psychological ,Young Adult ,03 medical and health sciences ,Obsessive–compulsive disorder (OCD) ,0302 clinical medicine ,Outcome Assessment, Health Care ,mental disorders ,medicine ,Humans ,Pharmacology (medical) ,Obsessive-compulsive disorder (OCD) ,Biological Psychiatry ,Cognitive behavioral therapy (CBT) ,Cognitive Behavioral Therapy ,Recall ,business.industry ,Glutamate receptor ,Cognition ,Fear ,Galvanic Skin Response ,General Medicine ,Extinction (psychology) ,Middle Aged ,medicine.disease ,humanities ,030227 psychiatry ,Exposure and response prevention ,Cognitive behavioral therapy ,Psychiatry and Mental health ,Fear extinction ,medicine.anatomical_structure ,Female ,Glutamate ,business ,030217 neurology & neurosurgery ,Clinical psychology - Abstract
Cognitive behavioral therapy (CBT) including exposure and response prevention is a well-established treatment for obsessive-compulsive disorder (OCD) and is based on the principles of fear extinction. Fear extinction is linked to structural and functional variability in the ventromedial prefrontal cortex (vmPFC) and has been consistently associated with glutamate neurotransmission. The relationship between vmPFC glutamate and fear extinction and its effects on CBT outcome have not yet been explored in adults with OCD. We assessed glutamate levels in the vmPFC using 3T magnetic resonance spectroscopy, and fear extinction (learning and recall) using skin conductance responses during a 2-day experimental paradigm in OCD patients (n = 17) and in healthy controls (HC; n = 13). Obsessive-compulsive patients (n = 12) then received manualized CBT. Glutamate in the vmPFC was negatively associated with fear extinction recall and positively associated with CBT outcome (with higher glutamate levels predicting a better outcome) in OCD patients. Glutamate levels in the vmPFC in OCD patients were not significantly different from those in HC, and were not associated with OCD severity. Our results suggest that glutamate in the vmPFC is associated with fear extinction recall and CBT outcome in adult OCD patients.
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- 2019
22. Cognitive failures in healthy middle-aged Spanish adults: A cross-sectional study describing magnitude categories of subjective cognitive deficits
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Muriel Vicent-Gil, Sol Fernandez-Gonzalo, Diego Palao, M. Serra-Blasco, Narcís Cardoner, and Guillem Navarra-Ventura
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education.field_of_study ,Ecological validity ,Cross-sectional study ,business.industry ,Population ,Cognition ,humanities ,030227 psychiatry ,03 medical and health sciences ,Psychiatry and Mental health ,0302 clinical medicine ,Quartile ,Retrospective memory ,hemic and lymphatic diseases ,Prospective memory ,Medicine ,030212 general & internal medicine ,Cognitive skill ,business ,education ,Clinical psychology - Abstract
Background and objectives Healthy people with intact cognitive functioning may also experience subjective cognitive deficits (SCD). However, no study has thoroughly explored these symptoms in healthy Spaniards. Therefore, we aimed to: (i) describe the pattern of SCD in this population, (ii) report magnitude categories of SCD, and (iii) correlate SCD with age, gender and years of education. Methods 102 healthy Spaniards (51 men) were recruited. Men and women subgroups were matched by age and years of education. SCD were evaluated using the 20-item Perceived Deficits Questionnaire (PDQ-20). Magnitude categories of SCD were described as distribution-based quartiles of the total PDQ-20 score, with higher scores/quartiles indicating greater SCD. Participants with a total PDQ-20 score greater than 2 standard deviations (SD) above normal variation were considered at risk of clinically significant SCD. Results Mean total PDQ-20 score was 17.98 (SD = 8.29), with higher scores on “Attention/Concentration” and “Retrospective Memory” subscales than on “Planning/Organization” and “Prospective Memory” subscales. Total PDQ-20 score distribution by quartile was: 0–11 (1 st quartile), 12–17 (2 nd quartile), 18–23 (3 rd quartile) and 24–80 (4 th quartile). Only 1.96% of participants were at risk of clinically significant SCD. There was a marginal trend in the association between age and “Retrospective Memory” subscale ( r s = 0.256; p = 0.009). Conclusions Our findings may help health professionals interpret PDQ-20 scores more accurately in clinical settings. A total PDQ-20 score equal or greater to 35 may be a valid threshold for identifying people at risk of clinically significant SCD. Assessment of SCD may improve the ecological validity of research on human cognition.
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- 2019
23. An examination of orbitofrontal sulcogyral morphology in obsessive–compulsive disorder
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Rebekah Delahoy, Jesús Pujol, Hugh G. Pemberton, Pino Alonso, Ben J. Harrison, José M. Menchón, Narcís Cardoner, Carles Soriano-Mas, and Cali F. Bartholomeusz
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Adult ,Male ,Obsessive-Compulsive Disorder ,Population ,Neuroscience (miscellaneous) ,Prefrontal Cortex ,behavioral disciplines and activities ,Young Adult ,03 medical and health sciences ,0302 clinical medicine ,Neuroimaging ,Cortex (anatomy) ,mental disorders ,Image Processing, Computer-Assisted ,Humans ,Medicine ,Radiology, Nuclear Medicine and imaging ,Young adult ,education ,Prefrontal cortex ,Gyrification ,education.field_of_study ,business.industry ,Case-control study ,Magnetic Resonance Imaging ,030227 psychiatry ,Psychiatry and Mental health ,medicine.anatomical_structure ,Case-Control Studies ,Female ,Orbitofrontal cortex ,business ,Neuroscience ,030217 neurology & neurosurgery - Abstract
Obsessive-compulsive disorder (OCD) has been consistently associated with structural and functional alteration of the orbitofrontal cortex (OFC) and its subcortical connections. In exploring these alterations, a neurodevelopmental basis to OCD has been suggested. While some studies have examined outcomes of early cortical maturation processes, such as global cortical thickness and gyrification, no work has specifically examined the OFC. Within the OFC, three types of sulcogyral patterns have been identified as a result of variance in cortical folding. The distribution of these patterns has been found to differ in patients of various neuropsychiatric disorders relative to the general population, however no study has yet investigated this distribution in individuals with OCD. Eighty OCD patients and 78 healthy controls were evaluated using magnetic resonance imaging, with identification of the sulcogyral pattern based on the method of Chiavaras and Petrides (2000). While gross changes in OFC sulcogyral patterning did not distinguish OCD patients from healthy controls, expression of both the Type II and Type III patterns was significantly associated with increased OCD illness severity. This finding indicates that early neurodevelopmental factors may influence illness severity.
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- 2019
24. Discrepancy between objective and subjective cognition in major depressive disorder
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Esther Via, Muriel Vicent-Gil, Ines Figuereo, Narcís Cardoner, Raymond W. Lam, Eva Aguilar, Maria J. Portella, Ivan J. Torres, M. Serra-Blasco, Ximena Goldberg, Guillem Navarra-Ventura, and Diego Palao
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Male ,Self report ,Neuropsychological Tests ,Cognitive functioning ,Executive Function ,Cognition ,0302 clinical medicine ,Attention ,Pharmacology (medical) ,Neuropsychological assessment ,Intelligence Tests ,medicine.diagnostic_test ,Depression ,Remission Induction ,Middle Aged ,Executive functions ,Psychiatry and Mental health ,Neurocognition ,Neurology ,Major depressive disorder ,Female ,Psychology ,Clinical psychology ,Adult ,Adolescent ,Diagnostic Self Evaluation ,Young Adult ,03 medical and health sciences ,Memory ,medicine ,Humans ,Cognitive skill ,Effects of sleep deprivation on cognitive performance ,Biological Psychiatry ,Aged ,Pharmacology ,Depressive Disorder, Major ,medicine.disease ,Affective disorders ,030227 psychiatry ,Mood ,Neurology (clinical) ,Neurocognitive ,030217 neurology & neurosurgery - Abstract
Objective and subjective cognitive measures are altered in major depressive disorder (MDD), but there is a poor correlation between them. This study aims to explore such discrepancy and the characteristics explaining this phenomenon. 229 patients with MDD subdivided into remitted (n = 57), partially remitted (n = 90) and acute (n = 82) underwent a clinical interview, completed self-report questionnaires and a neuropsychological assessment. The association between objective and subjective cognition was evaluated in the areas of attention and memory. Also, dependent measures of concordance and self-appraisal were calculated for each patient. Potential predictors of these outcomes were evaluated through regression analysis. Depressive symptoms correlated negatively with objective but especially with subjective cognition. Patients in an acute episode showed a significant correlation between objective and subjective attention/ memory measures, but also the greatest underestimation of their cognitive performance. In those with fewer depressive symptoms, objective and subjective cognition showed poor correspondence between them. In the regression analyses with the full MDD sample, higher scores on depressive symptoms, intelligence quotient and executive functions predicted lower self-appraisal. Objective and subjective cognition show poor concordance in MDD patients, especially in those with residual mood symptoms. Higher executive functions also explain this discrepancy. Assessments of both subjective cognitive complaints and objective performance seem necessary as they may be measuring different aspects of cognitive functioning. (c) 2018 Elsevier B.V. and ECNP. All rights reserved.
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- 2019
25. Discontinuation of maintenance electroconvulsive therapy: Lessons learned from the COVID-19 pandemic
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Adriana Bassa, Narcís Cardoner, Erika Martínez-Amorós, Pilar Serra, and Diego Palao
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2019-20 coronavirus outbreak ,medicine.medical_specialty ,Coronavirus disease 2019 (COVID-19) ,business.industry ,SARS-CoV-2 ,Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) ,medicine.medical_treatment ,MEDLINE ,COVID-19 ,General Medicine ,Discontinuation ,Psychiatry and Mental health ,Electroconvulsive therapy ,Pandemic ,medicine ,Humans ,Intensive care medicine ,business ,Electroconvulsive Therapy ,Letter to the Editor ,Pandemics - Published
- 2021
26. Effectiveness of enhancing cognitive reserve in children, adolescents and young adults at genetic risk for psychosis: Study protocol for a randomized controlled trial
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Eduard Vieta, Anabel Martínez-Arán, Patricia Camprodon-Boadas, Muriel Vicent-Gil, Gisela Sugranyes, Josefina Castro-Fornieles, Carla Torrent, M. Serra-Blasco, Brisa Solé, Elena de la Serna, Mireia Rosa-Justicia, Laura Montejo, and Narcís Cardoner
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education.field_of_study ,medicine.medical_specialty ,business.industry ,Population ,Psychological intervention ,Neuropsychology ,Cognition ,medicine.disease ,Mental health ,030227 psychiatry ,law.invention ,03 medical and health sciences ,Psychiatry and Mental health ,0302 clinical medicine ,Randomized controlled trial ,law ,medicine ,Physical therapy ,Bipolar disorder ,education ,business ,030217 neurology & neurosurgery ,Cognitive reserve - Abstract
Background Offspring of patients diagnosed with bipolar disorder and schizophrenia (Off-BDSZ) have a high genetic risk of developing a mental illness. The aim of this project is to develop and investigate the efficacy of an intervention aimed at this population, based on the concept of cognitive reserve. Methods This is a multicenter randomized trial with an experimental test–retest design study with control group. Two groups will be included: a community comparison group (CC) and a Off-BDSZ group. A total of 108 Off-BDSZ and 65 CC aged between 6 and 25 years will be recruited. Off-BDSZ participants will be randomized to receive either Cognitive Reserve EnhAncement ThErapy (CREATE) (n = 54), or a supportive approach (n = 54). The CC group will be assessed at baseline. The duration of the intervention will be 3 months, with 12 weekly group sessions. The primary outcome will be the improvement in CR measured according to change in the Cognitive Reserve Assessment Scale in Health (CRASH) and Cognitive Reserve scale for Adolescents (CORE-A). All participants will be blindly evaluated using clinical, cognitive and neuroimaging measures at baseline, at three months (after the psychological intervention), and at twelve-month follow-up after treatment completion. Discussion The results will provide insight into whether the CREATE-Offspring version may enhance cognitive reserve (CR) in child, adolescent and young adult Off-BDSZ as well as advance knowledge about changes in clinical manifestations, neuropsychological performance and brain structure and function associated with improving CR. This novel and cost-effective intervention represents an advance in the framework of preventive interventions in mental health. Trial registration Clinicaltrials.gov, NCT03722082 . Registered on 26 October 2018.
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- 2021
27. Is processing speed a valid neurocognitive endophenotype in bipolar disorder? Evidence from a longitudinal, family study
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Patricia Correa-Ghisays, Narcís Cardoner, Rafael Tabarés-Seisdedos, Sussy C. Luperdi, Vicent Balanzá-Martínez, Miguel Ruiz-Veguilla, Lorenzo Livianos, José Salazar-Fraile, Gabriel Selva-Vera, Joan Vila-Francés, and Instituto de Salud Carlos III
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Longitudinal study ,Endophenotypes ,Bipolar disorder ,Neuropsychological Tests ,Cognition ,Visual memory ,Humans ,Medicine ,Longitudinal Studies ,Biological Psychiatry ,business.industry ,medicine.disease ,Family study ,Psychiatry and Mental health ,Endophenotype ,Mood ,Digit symbol substitution test ,Cognition Disorders ,business ,Processing speed ,Neurocognitive ,Clinical psychology - Abstract
[Background] Substantial evidence supports the existence of neurocognitive endophenotypes in bipolar disorder (BD), but very few longitudinal studies have included unaffected relatives. In a 5-year, follow-up, family study, we have recently suggested that deficits in manual motor speed and visual memory could be endophenotype candidates for BD. We aimed to explore whether this also applies to processing speed., [Methods] A sample of 348 individuals, including 163 BD patients, 65 unaffected first-degree relatives (BD-Rel) and 120 genetically unrelated healthy controls (HC), was assessed with the Digit Symbol Substitution Test (DSST) on two occasions over a 2-year period (T1, T2). DSST values were controlled for age, years of education, occupational status, and subsyndromic mood symptoms. Differences between groups were evaluated with ANCOVAs., [Results] At T1 BD performed significantly worse than HC (p < 0.001; Cohen's d = 1.38) and BD-Rel (p < 0.001; Cohen's d = 0.82). BD-Rel showed an intermediate performance with significant differences with HC (p < 0.01; Cohen's d = 0.50). Similarly, at T2 BD performed significantly worse than HC (p < 0.001; Cohen's d = 1.44) and BD-Rel (p < 0.01; Cohen's d = 0.51). BD-Rel performance was intermediate and significantly lower than that of HC (p < 0.01; Cohen's d = 0.97). A Repeated Measures ANOVA revealed no significant between-group differences in performance over time (p > 0.05)., [Conclusions] The results of this longitudinal, family study suggest that impaired processing speed may represent a suitable cognitive endophenotype for BD. Further research on the field is required to confirm these preliminary findings., Dr Vicent Balanzá-Martínez acknowledges the support from Instituto de Salud Carlos III (PI16/1770, PROBILIFE Study).
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- 2021
28. Group and sex differences in social cognition in bipolar disorder, schizophrenia/schizoaffective disorder and healthy people
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Sol Fernandez-Gonzalo, Carmen Massons, M. Serra-Blasco, Mercè Jodar, Eduard Vieta, Abigail Jubert, Narcís Cardoner, Ximena Goldberg, D. Palao, Guillermo Lahera, Guillem Navarra-Ventura, Muriel Vicent-Gil, Jesús Cobo, and Josep Maria Crosas
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Healthy people ,Male ,Social Cognition ,Bipolar Disorder ,Bipolar disorder ,RC435-571 ,Theory of Mind ,Schizoaffective disorder ,Gènere ,Subthreshold depression ,Cognition ,Social cognition ,Theory of mind ,Sex differences ,medicine ,Humans ,Manic-depressive illness ,Depression (differential diagnoses) ,Aged ,Psychiatry ,Sex Characteristics ,Trastorn bipolar ,Intelligence quotient ,Gender ,medicine.disease ,Psychiatry and Mental health ,Clinical Psychology ,Cross-Sectional Studies ,Psychotic Disorders ,Schizophrenia ,Female ,Esquizofrènia ,Emotion recognition ,Psychology ,Clinical psychology - Abstract
Background: Impairment of social cognition is documented in bipolar disorder (BD) and schizophrenia/schizoaffective disorder (SCH). In healthy individuals, women perform better than men in some of its sub-domains. However, in BD and SCH the results are mixed. Our aim was to compare emotion recognition, affective Theory of Mind (ToM) and first- and second-order cognitive ToM in BD, SCH and healthy subjects, and to investigate sex-related differences. Methods: 120 patients (BD = 60, SCH = 60) and 40 healthy subjects were recruited. Emotion recognition was assessed by the Pictures of Facial Affect (POFA) test, affective ToM by the Reading the Mind in the Eyes Test (RMET) and cognitive ToM by several false-belief stories. Group and sex differences were analyzed using parametric (POFA, RMET) and non-parametric (false-belief stories) tests. The impact of age, intelligence quotient (IQ) and clinical variables on patient performance was examined using a series of linear/logistic regressions. Results: Both groups of patients performed worse than healthy subjects on POFA, RMET and second-order falsebelief (p < 0.001), but no differences were found between them. Instead, their deficits were related to older age and/or lower IQ (p < 0.01). Subthreshold depression was associated with a 6-fold increased risk of first-order false-belief failure (p < 0.001). Sex differences were only found in healthy subjects, with women outperforming men on POFA and RMET (p
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- 2021
29. An fMRI study of cognitive reappraisal in major depressive disorder and borderline personality disorder
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Carles Soriano-Mas, Mercedes Berruga-Sánchez, Trevor Steward, Agustina E. Wainsztein, Ignacio Martínez-Zalacaín, Salvador M. Guinjoan, Víctor De la Peña-Arteaga, José M. Menchón, Narcís Cardoner, Carolina Abulafia, Mirta F. Villarreal, Mariana N. Castro, and Ximena Goldberg
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emotion regulation ,Emotions ,behavioral disciplines and activities ,Amygdala ,Cognitive reappraisal ,03 medical and health sciences ,Cognition ,0302 clinical medicine ,Neuroimaging ,mental disorders ,medicine ,Humans ,Depressió psíquica ,Trastorns de la personalitat ,Personality disorders ,Prefrontal cortex ,Borderline personality disorder ,Depressive Disorder, Major ,Neural correlates of consciousness ,neuroimaging ,major depressive disorder ,medicine.diagnostic_test ,fMRI ,medicine.disease ,Magnetic Resonance Imaging ,030227 psychiatry ,Diagnòstic per la imatge ,Psychiatry and Mental health ,medicine.anatomical_structure ,Depression, Mental ,Diagnostic imaging ,Major depressive disorder ,Functional magnetic resonance imaging ,Psychology ,Neuroscience ,030217 neurology & neurosurgery ,Research Article - Abstract
Background One common denominator to the clinical phenotypes of borderline personality disorder (BPD) and major depressive disorder (MDD) is emotion regulation impairment. Although these two conditions have been extensively studied separately, it remains unclear whether their emotion regulation impairments are underpinned by shared or distinct neurobiological alterations. Methods We contrasted the neural correlates of negative emotion regulation across an adult sample of BPD patients (n = 19), MDD patients (n = 20), and healthy controls (HCs; n = 19). Emotion regulation was assessed using an established functional magnetic resonance imaging cognitive reappraisal paradigm. We assessed both task-related activations and modulations of interregional connectivity. Results When compared to HCs, patients with BPD and MDD displayed homologous decreased activation in the right ventrolateral prefrontal cortex (vlPFC) during cognitive reappraisal. In addition, the MDD group presented decreased activations in other prefrontal areas (i.e., left dorsolateral and bilateral orbitofrontal cortices), while the BPD group was characterized by a more extended pattern of alteration in the connectivity between the vlPFC and cortices of the visual ventral stream during reappraisal. Conclusions This study identified, for the first time, a shared neurobiological contributor to emotion regulation deficits in MDD and BPD characterized by decreased vlPFC activity, although we also observed disorder-specific alterations. In MDD, results suggest a primary deficit in the strength of prefrontal activations, while BPD is better defined by connectivity disruptions between the vlPFC and temporal emotion processing regions. These findings substantiate, in neurobiological terms, the different profiles of emotion regulation alterations observed in these disorders.
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- 2021
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30. Structural brain correlates in major depression, anxiety disorders and post-traumatic stress disorder: A voxel-based morphometry meta-analysis
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Carles Soriano-Mas, Sevdalina Kandilarova, Kevin Hilbert, David Mataix-Cols, Alba Gómez-Benlloch, Daniel Porta-Casteràs, Marta Carulla-Roig, Narcís Cardoner, Eduard Vieta, Esther Via, Eric J. Canales-Rodríguez, Yuqui Cheng, Paul Klauser, Joaquim Radua, Toby Wise, Danilo Arnone, M. Serra-Blasco, and Anton Albajes-Eizagirre
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Meta-analysis ,Comorbidity ,Neuropsychiatry ,Stress Disorders, Post-Traumatic ,Behavioral Neuroscience ,Medicine ,Gray Matter ,gray matter volume ,panic disorder ,structural neuroimaging ,Depression ,Traumatic stress ,Brain ,Magnetic Resonance Imaging ,Comorbidities ,anterior cingulate cortex ,Neuropsychology and Physiological Psychology ,medicine.anatomical_structure ,posttraumatic stress disorder ,neurphyiatry ,Anxiety ,Major depressive disorder ,abnormalities ,Anxiety disorders ,medicine.symptom ,Clinical psychology ,Psychology, Pathological ,emotion regulation ,Cognitive Neuroscience ,hippocampal volume ,Grey matter ,comorbidities ,behavioral disciplines and activities ,anxiety disorders ,Comorbiditat ,mental disorders ,drug-naive ,Humans ,unipolar depression ,Structural neuroimaging ,Depressive Disorder, Major ,major depressive disorder ,medication-naive patients ,business.industry ,Gray matter volume ,Posttraumatic stress disorder ,Voxel-based morphometry ,medicine.disease ,Psicopatologia ,meta-analysis ,gray-matter volume ,orbitofrontal cortex ,business - Abstract
The high comorbidity of Major Depressive Disorder (MDD), Anxiety Disorders (ANX), and Posttraumatic Stress Disorder (PTSD) has hindered the study of their structural neural correlates. The authors analyzed specific and common grey matter volume (GMV) characteristics by comparing them with healthy controls (HC). The meta-analysis of voxel-based morphometry (VBM) studies showed unique GMV diminutions for each disorder (p < 0.05, corrected) and less robust smaller GMV across diagnostics (p < 0.01, uncorrected). Pairwise comparison between the disorders showed GMV differences in MDD versus ANX and in ANX versus PTSD. These results endorse the hypothesis that unique clinical features characterizing MDD, ANX, and PTSD are also reflected by disorder specific GMV correlates.
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- 2021
31. Childhood adversity modulation of central autonomic network components during cognitive regulation of emotion in major depressive disorder and borderline personality disorder
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Ximena Goldberg, Soledad Ladrón-de-Guevara, Charles B. Nemeroff, Carolina Abulafia, Agustina E. Wainsztein, Carles Soriano-Mas, Narcís Cardoner, Vicente Camacho-Téllez, Salvador M. Guinjoan, Mercedes Vulcano, José M. Menchón, Mariana N. Castro, and Mirta F. Villarreal
- Subjects
Emotions ,Neuroscience (miscellaneous) ,DEPRESION ,behavioral disciplines and activities ,TRASTORNO PSICOLOGICO ,Cognitive reappraisal ,Cognition ,Adverse Childhood Experiences ,Borderline Personality Disorder ,mental disorders ,REGULACION EMOCIONAL ,medicine ,Heart rate variability ,Humans ,Radiology, Nuclear Medicine and imaging ,SISTEMA NERVIOSO AUTONOMO ,Borderline personality disorder ,BORDERLINE ,Depressive Disorder, Major ,business.industry ,Regulation of emotion ,RESONANCIA MAGNETICA NUCLEAR ,medicine.disease ,Psychiatry and Mental health ,Autonomic nervous system ,Superior frontal gyrus ,ADVERSIDAD VIDA TEMPRANA ,Major depressive disorder ,business ,Clinical psychology - Abstract
Fil: Wainsztein, Agustina E. Instituto de Neurociencias FLENI-CONICET. Grupo de Investigación en Neurociencias Aplicadas a las Alteraciones de la Conducta; Argentina Fil: Wainsztein, Agustina E. Fundación FLENI. Servicio de Psiquiatría; Argentina Fil: Castro, Mariana N. Instituto de Neurociencias FLENI-CONICET. Grupo de Investigación en Neurociencias Aplicadas a las Alteraciones de la Conducta; Argentina Fil: Castro, Mariana N. Universidad de Buenos Aires. Facultad de Medicina. Departamento de Psiquiatría y Salud Mental; Argentina Fil: Castro, Mariana N. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina Fil: Castro, Mariana N. Universidad de Buenos Aires. Facultad de Medicina. Departamento de Fisiología; Argentina Fil: Goldberg, Ximena. Universitat Autònoma de Barcelona. Institut d'Investigació i Innovació Parc Taulí I3PT. Hospital Universitario Parc Taulí. Área de Investigación en Neurociencias y Salud Mental. Departamento de Salud Mental; España Fil: Camacho-Téllez, Vicente. Instituto de Neurociencias FLENI-CONICET. Grupo de Investigación en Neurociencias Aplicadas a las Alteraciones de la Conducta; Argentina Fil: Camacho-Téllez, Vicente. Fundación FLENI. Servicio de Psiquiatría; Argentina Fil: Camacho-Téllez, Vicente. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina Fil: Vulcano, Mercedes. Fundación FLENI. Servicio de Psiquiatría; Argentina Fil: Vulcano, Mercedes. Universidad de Buenos Aires. Facultad de Medicina. Departamento de Psiquiatría y Salud Mental; Argentina Fil: Abulafia, Carolina Andrea. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina Fil: Abulafia, Carolina Andrea. Pontificia Universidad Católica Argentina. Instituto de Investigaciones Biomédicas; Argentina Fil: Abulafia, Carolina Andrea. Instituto de Neurociencias FLENI-CONICET. Grupo de Investigación en Neurociencias Aplicadas a las Alteraciones de la Conducta; Argentina Fil: Ladrón de Guevara, M. Soledad. Instituto de Neurociencias FLENI-CONICET. Grupo de Investigación en Neurociencias Aplicadas a las Alteraciones de la Conducta; Argentina Fil: Ladrón de Guevara, M. Soledad. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina Fil: Cardoner, Narcís. Universitat Autònoma de Barcelona. Institut d'Investigació i Innovació Parc Taulí I3PT. Hospital Universitario Parc Taulí. Área de Investigación en Neurociencias y Salud Mental. Departamento de Salud Mental; España Fil: Nemeroff, Charles B.Universidad de Texas en Austin. Institute for Early Life Adversity Research, Dell Medical School; Estados Unidos Fil: Menchón, José M. Hospital Universitario de Bellvitge. Departamento de Psiquiatría. Instituto de Investigación Biomédica de Bellvitge-IDIBELL; España Fil: Soriano-Mas, Carles. Universidad de Texas en Austin. Institute for Early Life Adversity Research, Dell Medical School; Estados Unidos Fil: Villarreal, Mirta F. Instituto de Neurociencias FLENI-CONICET. Grupo de Investigación en Neurociencias Aplicadas a las Alteraciones de la Conducta; Argentina Fil: Villarreal, Mirta F. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina Fil: Villarreal, Mirta F. Universidad de Buenos Aires. Facultad de Ciencias Exactas y Naturales. Departamento de Física; Argentina Fil: Guinjoan, Salvador M. Universidad de Buenos Aires. Facultad de Medicina. Departamento de Salud Mental; Argentina Fil: Guinjoan, Salvador M. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina Fil: Guinjoan, Salvador M. Laureate Institute for Brain Research; Estados Unidos Fil: Guinjoan, Salvador M. Universidad de Buenos Aires. Facultad de Psicología; Argentina Abstract: Adverse childhood experiences (ACEs) have lifelong effects on emotional behavior and are frequent in Borderline Personality Disorder (BPD) and Major Depressive Disorder (MDD). The Central Autonomic Network (CAN), which modulates heart rate variability (HRV), comprises brain regions that mediate emotion regulation processes. However, it remains unclear the effect of ACEs on CAN dynamics and its relationship with HRV in these disorders. We studied the effects of ACEs on the brain and HRV simultaneously, during regulation of psychological stress in 19 BPD, 20 MDD and 20 healthy controls (HC). Participants underwent a cognitive reappraisal task during fMRI with simultaneous ECG acquisition. ACEs exposure was associated with increased activity of CAN and salience network components in patients with MDD compared to BPD during cognitive reappraisal. A brain-autonomic coupling was found in BPD relative to HC during emotion regulation, whereby greater activity of left anterior cingulate and medial superior frontal gyrus areas was coupled with increased HRV. Results suggest that ACEs exposure is associated with a distinct activation of the CAN and salience network regions governing responses to psychological stress in MDD compared to BPD. These alterations may constitute a distinctive neurobiological mechanism for abnormal emotion processing and regulation related to ACEs in MDD.
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- 2020
32. Neural correlates of fear conditioning and fear extinction and its association with cognitive-behavioral therapy outcome in adults with obsessive-compulsive disorder
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Narcís Cardoner, David Torrents-Rodas, Cinto Segalàs, Miquel A. Fullana, Pino Alonso, I. Martínez-Zalacaín, José M. Menchón, Mónica Giménez, Marta Cano, Josep Munuera, Carles Soriano-Mas, and Eva Real
- Subjects
Adult ,medicine.medical_specialty ,Obsessive-Compulsive Disorder ,medicine.medical_treatment ,Experimental and Cognitive Psychology ,Audiology ,behavioral disciplines and activities ,Extinction, Psychological ,mental disorders ,medicine ,Humans ,Fear conditioning ,Anterior cingulate cortex ,Neural correlates of consciousness ,medicine.diagnostic_test ,Recall ,Cognitive Behavioral Therapy ,business.industry ,Brain ,Extinction (psychology) ,Fear ,Magnetic Resonance Imaging ,humanities ,Cognitive behavioral therapy ,Psychiatry and Mental health ,Clinical Psychology ,medicine.anatomical_structure ,Functional magnetic resonance imaging ,business ,Insula - Abstract
Recent neurobiological models of obsessive-compulsive disorder (OCD) have highlighted the potential role of abnormalities in fear learning processes. We compared brain activation -as assessed with whole-brain functional magnetic resonance imaging- during fear conditioning, fear extinction learning, and fear extinction recall in patients with OCD (n = 18) and healthy controls (n = 18). We also investigated whether brain activation during any of these processes was associated with exposure-based cognitive-behavioral therapy (CBT) outcome in patients. Patients with OCD showed significantly lower brain activation in the right insulo-opercular region and the dorsal anterior cingulate cortex during fear conditioning in comparison to healthy controls. Moreover, brain activation in the right insula predicted CBT outcome, with lower activation predicting a better outcome. Brain activation during extinction learning or recall did not differ between patients and controls or predicted CBT outcome in patients. Our results suggest that neural activations during fear conditioning in patients with OCD are abnormal and predict CBT outcome.
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- 2020
33. Higher order theory of mind in patients with bipolar disorder and schizophrenia/schizoaffective disorder
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Guillem, Navarra-Ventura, Muriel, Vicent-Gil, Maria, Serra-Blasco, Jesús, Cobo, Sol, Fernández-Gonzalo, Ximena, Goldberg, Mercè, Jodar, Josep Maria, Crosas, Diego, Palao, Guillermo, Lahera, Eduard, Vieta, and Narcís, Cardoner
- Subjects
Bipolar Disorder ,Cross-Sectional Studies ,Psychotic Disorders ,Schizophrenia ,Theory of Mind ,Humans ,Neuropsychological Tests - Abstract
Some evidence suggests that patients with bipolar disorder (BD) have better Theory of Mind (ToM) skills than patients with schizophrenia/schizoaffective disorder (SCH). However, this difference is not consistently reported across studies, so rather than being global, it may be restricted to specific aspects of ToM. Our primary objective was to compare higher order ToM performance between BD and SCH patients using the Hinting Task (HT). Ninety-four remitted patients were recruited (BD = 47, SCH = 47). Intelligence quotient (IQ), attention, memory, executive functions, and processing speed were also assessed. Patients with BD performed better on the HT than patients with SCH, even when the analysis was adjusted for IQ and neurocognition (p 0.001, [Formula: see text] = 0.144). Regression analysis in the total sample showed that a diagnosis of SCH and lower IQ were associated with lower HT scores (R
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- 2020
34. Influence of the BDNF Val66Met polymorphism on weight loss after bariatric surgery: a 24-month follow-up
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Timothy R. Powell, Araceli Rosa, Narcís Cardoner, Rocío Pareja, Elionora Peña, Mercedes Rigla, Assumpta Caixàs, Josep León-Mengíbar, and Concepción Arenas
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Sleeve gastrectomy ,medicine.medical_specialty ,endocrine system diseases ,medicine.medical_treatment ,Gastric Bypass ,Bariatric Surgery ,030209 endocrinology & metabolism ,Type 2 diabetes ,Body Mass Index ,03 medical and health sciences ,0302 clinical medicine ,Weight loss ,Gastrectomy ,Genotype ,Weight Loss ,medicine ,Humans ,business.industry ,Brain-Derived Neurotrophic Factor ,nutritional and metabolic diseases ,medicine.disease ,Obesity ,Surgery ,Obesity, Morbid ,Treatment Outcome ,Diabetes Mellitus, Type 2 ,Spain ,Cohort ,030211 gastroenterology & hepatology ,medicine.symptom ,business ,Body mass index ,rs6265 ,Follow-Up Studies - Abstract
Background Bariatric surgery is currently the most effective long-term treatment for severe obesity. However, interindividual variation in surgery outcome has been observed, and research suggests a moderating effect of several factors including baseline co-morbidities (e.g., type 2 diabetes [T2D] and genetic factors). No data are currently available on the interaction between T2D and variants in brain derived neurotrophic factor (BDNF) and its effect on weight loss after surgery. Objectives To examine the role of the BDNF Val66Met polymorphism (rs6265) and the influence of T2D and their interaction on weight loss after bariatric surgery in a cohort of patients with severe obesity. Setting University hospital in Spain. Methods The present study evaluated a cohort of 158 patients with obesity submitted to bariatric surgery (Roux-en-Y gastric bypass or sleeve gastrectomy) followed up for 24 months (loss to follow-up: 0%). During the postoperative period, percentage of excess body mass index loss (%EBMIL), percentage of excess weight loss (%EWL), and total weight loss (%TWL) were evaluated. Results Longitudinal analyses showed a suggestive effect of BDNF genotype on the %EWL (P = .056) and indicated that individuals carrying the methionine (Met) allele may experience a better outcome after bariatric surgery than those with the valine/valine (Val/Val) genotype. We found a negative effect of a T2D diagnosis at baseline on %EBMIL (P = .004). Additionally, we found an interaction between BDNF genotype and T2D on %EWL and %EBMIL (P = .027 and P = .0004, respectively), whereby individuals with the Met allele without T2D displayed a greater %EWL and greater %EBMIL at 12 months and 24 months than their counterparts with T2D or patients with the Val/Val genotype with or without T2D. Conclusion Our data showed an association between the Met variant and greater weight loss after bariatric surgery in patients without T2D. The presence of T2D seems to counteract this positive effect.
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- 2020
35. Prefrontal-amygdala connectivity in trait anxiety and generalized anxiety disorder: Testing the boundaries between healthy and pathological worries
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Esther Via, Narcís Cardoner, Carles Soriano-Mas, Ben J. Harrison, Diego Palao, D. Tinoco, Jesús Pujol, Miquel A. Fullana, Daniel Porta-Casteràs, and I. Martínez-Zalacaín
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Generalized anxiety disorder ,Trait anxiety ,Functional magnetic resonance imaging ,Ventromedial prefrontal cortex ,Prefrontal Cortex ,Anxiety ,ventromedial prefrontal cortex ,03 medical and health sciences ,0302 clinical medicine ,medicine ,Humans ,Prefrontal cortex ,Resting state ,Resting state fMRI ,medicine.diagnostic_test ,Cognition ,medicine.disease ,Amygdala ,Anxiety Disorders ,Magnetic Resonance Imaging ,030227 psychiatry ,Psychiatry and Mental health ,Clinical Psychology ,medicine.anatomical_structure ,Cross-Sectional Studies ,Anxiety sensitivity ,medicine.symptom ,Psychology ,030217 neurology & neurosurgery ,Clinical psychology - Abstract
BACKGROUND: Current brain-based theoretical models of generalized anxiety disorder (GAD) suggest a dysfunction of amygdala-ventromedial prefrontal cortex emotional regulatory mechanisms. These alterations might be reflected by an altered resting state functional connectivity between both areas and could extend to vulnerable non-clinical samples such as high worriers without a GAD diagnosis. However, there is a lack of information in this regard. METHODS: We investigated differences in resting state functional connectivity between the basolateral amygdala and the ventromedial prefrontal cortex (amygdala-vmPFC) in 28 unmedicated participants with GAD, 28 high-worriers and 28 low-worriers. We additionally explored selected clinical variables as predictors of amygdala-vmPFC connectivity, including anxiety sensitivity. RESULTS: GAD participants presented higher left amygdala-vmPFC connectivity compared to both groups of non-GAD participants, and there were no differences between the latter two groups. In our exploratory analyses, concerns about the cognitive consequences of anxiety (the cognitive dimension of anxiety sensitivity) were found to be a significant predictor of the left amygdala-vmPFC connectivity. LIMITATIONS: The cross-sectional nature of our study preclude us from assessing if functional connectivity measures and anxiety sensitivity scores entail an increased risk of GAD. CONCLUSIONS: These results suggest a neurobiological qualitative distinction at the level of the amygdala-vmPFC emotional-regulatory system in GAD compared to non-GAD participants, either high- or low-worriers. At this neural level, they question previous hypotheses of continuity between high worries and GAD development. Instead, other anxiety traits such as anxiety sensitivity might confer a greater proneness to the amygdala-vmPFC connectivity alterations observed in GAD.
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- 2020
36. Curso de formación onlinepara la implementación de un nuevo modelo de atención a la depresión en atención primaria
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E. Aragonès, J. Roigé-Castellví, D. Palao, D. Porta-Casteràs, J.A. Monreal, G. López-Cortacans, Narcís Cardoner, and C. Tomé-Pires
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biology ,General Engineering ,Primary care ,Formación continuada ,Atencion primaria ,biology.organism_classification ,Formación online ,Foro ,Clinical Practice ,Manejo de enfermedades ,Qualitative analysis ,Atención primaria de salud ,Online course ,Depresión ,Psychology ,Humanities - Abstract
espanolIntroduccion. En el marco de una estrategia para implementar un nuevo programa clinico para la depresion en atencion primaria, desarrollamos un curso online con clases videograbadas dirigido a los medicos y enfermeras que van a introdu-cir el programa en su practica clinica. Sujetos y metodos.La evaluacion del curso se realizo mediante un cuestionario estandarizado a los alumnos y un analisis tematico de los contenidos de un foro de discusion. Resultados.En la encuesta, los alumnos mostraron satisfaccion respecto a sus expectativas, valorando positivamente el formato y el diseno general, los contenidos y su utilidad practica, sin diferencias significativas segun el perfil profesional. En el analisis cualitativo del foro se detectaron potencialidades del programa y del curso, destacando la percepcion de que se abordaba una necesidad asistencial relevante. Tambien se senalaron insuficiencias del curso y del programa, y obstacu-los externos que pueden dificultar o impedir la implementacion: falta de tiempo, inestabilidad en los equipos o exceso de trabajo y requerimientos en el dia a dia. Conclusiones.Hemos ensayado un eficaz formato online para la formacion de profesionales. La evaluacion del curso ha sido satisfactoria. El feedback de los alumnos permitira modelar y perfeccionar futuras ediciones del curso y el propio programa. EnglishIntroduction. Within the framework of a strategy to implement a new clinical program for depression in primary care, we developed an online course with videotaped lectures targeted at doctors and nurses who will introduce the program into their clinical practice. Subjects and methods. The evaluation of the course was carried out by a standardized questionnaire for students and a thematic analysis of the contents of a discussion forum. Results.In the survey, the students showed satisfaction regarding their expectations, positively valuing the format and the general design, the contents and their practical utility, without significant differences according to professional profile. In the qualitative analysis of the forum potentialities of the program and the course were detected, highlighting the perception that a relevant care need was addressed. There were also shortcomings of the course and the program, and external obstacles that may hinder or impede implementation: lack of time, instability in the staff, or excessive work and requirements on a day-to-day basis. Conclusions. We have tested an effective online format for the training of professionals. The evaluation of the course has been satisfactory. The feedback of the students will allow us to model and improve future editions of the course and the program itself.
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- 2020
37. Catalonia Suicide Risk Code Epidemiology (CSRC-Epi) study: protocol for a population-representative nested case-control study of suicide attempts in Catalonia, Spain
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Ana De Inés Trujillo, Javier Gómez Sánchez, Victor Perez Sola, Gemma Vilagut, Laura Ballester Coma, Mario Martín Sánchez, Rosa Morros, Jordi Alonso, Diego Palao, Anna García-Altés, Philippe Mortier, Beatriz Puértolas Gracia, Bibiana Prat Pubill, Itxaso Alayo Bueno, Matilde Elices, Ronald C. Kessler, Lars Mehlum, María Jesús Blasco Cubedo, Manel Gené Badia, Narcís Cardoner, Ping Qin, and Cristina Colls
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suicide attempt ,Risk ,medicine.medical_specialty ,Epidemiology ,Population ,lcsh:Medicine ,Suicide, Attempted ,Clinical decision support system ,Article ,Suicidal Ideation ,Risk Factors ,Suicide & self-harm ,Medicine ,Humans ,Statistics & research methods ,human ,education ,Psychiatry ,education.field_of_study ,Public health ,Suicide attempt ,business.industry ,lcsh:R ,risk assessment ,General Medicine ,case control study ,mortality ,predictor variable ,machine learning ,Clinical research ethics ,risk factor ,Spain ,Relative risk ,Family medicine ,Case-Control Studies ,Attributable risk ,Nested case-control study ,incidence ,Mental health ,epidemiology ,business - Abstract
Introduction: Suicide attempts represent an important public health burden. Centralised electronic health record (EHR) systems have high potential to provide suicide attempt surveillance, to inform public health action aimed at reducing risk for suicide attempt in the population, and to provide data-driven clinical decision support for suicide risk assessment across healthcare settings. To exploit this potential, we designed the Catalonia Suicide Risk Code Epidemiology (CSRC-Epi) study. Using centralised EHR data from the entire public healthcare system of Catalonia, Spain, the CSRC-Epi study aims to estimate reliable suicide attempt incidence rates, identify suicide attempt risk factors and develop validated suicide attempt risk prediction tools. Methods and analysis: The CSRC-Epi study is registry-based study, specifically, a two-stage exposure-enriched nested case-control study of suicide attempts during the period 2014-2019 in Catalonia, Spain. The primary study outcome consists of first and repeat attempts during the observation period. Cases will come from a case register linked to a suicide attempt surveillance programme, which offers in-depth psychiatric evaluations to all Catalan residents who present to clinical care with any suspected risk for suicide. Predictor variables will come from centralised EHR systems representing all relevant healthcare settings. The study's sampling frame will be constructed using population-representative administrative lists of Catalan residents. Inverse probability weights will restore representativeness of the original population. Analysis will include the calculation of age-standardised and sex-standardised suicide attempt incidence rates. Logistic regression will identify suicide attempt risk factors on the individual level (ie, relative risk) and the population level (ie, population attributable risk proportions). Machine learning techniques will be used to develop suicide attempt risk prediction tools. Ethics and dissemination: This protocol is approved by the Parc de Salut Mar Clinical Research Ethics Committee (2017/7431/I). Dissemination will include peer-reviewed scientific publications, scientific reports for hospital and government authorities, and updated clinical guidelines. This project was supported by ISCIII/FEDER PI17/00521, ISCIII/FEDER PI17/01205, and Generalitat de Catalunya (2017 SGR 452). The Catalonia Suicide Risk Code surveillance programme is an initiative of the Mental Health and Addictions Plan of the Department of Health of the Catalan Government. PM has a Sara Borrell research contract awarded by the ISCIII (CD18/00049). ME has a Juan de la Cierva research contract awarded by the ISCIII (FJCI-2017–31738). VPS and ME want to thank unrestricted research funding from Secretaria d′Universitats i Recerca del Departament d′Economia i Coneixement (2017 SGR 134 to ‘Mental Health Research Group’), and Generalitat de Catalunya (Government of Catalonia). BPG and ADIT received funding from ISCIII FI18/00012 and FPU2017-06447, respectively. LBC received funding by Ministerio de Educación, Cultura y Deporte (FPU15/05728). DP and JA received funding by ISCIII/FEDER PI17/01205.
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- 2020
38. Early improvement as a predictor of final remission in major depressive disorder: New insights in electroconvulsive therapy
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Verònica Gálvez, Virginia Soria, Mikel Urretavizcaya, Diego Palao, Aida de Arriba Arnau, Narcís Cardoner, Erika Martínez-Amorós, Ximena Goldberg, and José M. Menchón
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Male ,medicine.medical_specialty ,Time Factors ,medicine.medical_treatment ,Logistic regression ,Sensitivity and Specificity ,behavioral disciplines and activities ,03 medical and health sciences ,0302 clinical medicine ,Electroconvulsive therapy ,Predictive Value of Tests ,Internal medicine ,mental disorders ,Humans ,Medicine ,Time point ,Electroconvulsive Therapy ,Depression (differential diagnoses) ,Aged ,Depressive Disorder, Major ,Inpatients ,Receiver operating characteristic ,business.industry ,Remission Induction ,Small sample ,Middle Aged ,medicine.disease ,030227 psychiatry ,Psychiatry and Mental health ,Clinical Psychology ,Logistic Models ,Treatment Outcome ,ROC Curve ,Antidepressant ,Major depressive disorder ,Female ,business ,030217 neurology & neurosurgery - Abstract
Background Early improvement to antidepressant drugs predicts remission, but the predictive value of early improvement to electroconvulsive therapy (ECT) is still unclear. The main aim of this study was to determine the optimal definition of early improvement in the treatment of major depressive disorder (MDD) with ECT, by analyzing its value as a predictor of remission. Methods A naturalistic study was conducted in 87 adult MDD patients treated with acute ECT. ROC curves were generated to identify the best time point (week 1 or 2 of treatment) predicted remission. Sensibility, specificity, and predictive values were calculated for several definitions of early improvement previously proposed in the literature (20%, 25%, 30%, and 35%). Complementary, time to remission was analyzed and a logistic regression model was performed to further characterize the impact of the optimal definition of early improvement on remission while adjusting for other clinically relevant variables. Results A 30% reduction in the HAM-D score after 2 weeks was identified as the optimal definition of early improvement, with acceptable sensitivity (76%), and specificity (67%). Complementary analyses provided further support for this definition showing a shorter time to remission and a significant effect adjusted for the rest of variables. Limitations Relatively small sample size, ECT restricted to brief bilateral treatment. Conclusions Early improvement, defined as a 30% of reduction in the HAM-D21 score at week 2, is a good predictor of remission in MDD patients treated with bilateral ECT, with potential clinical impact. Lack of early improvement could indicate a need for further changes in treatment strategies.
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- 2018
39. Cognitive predictors of illness course at 12 months after first-episode of depression
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Muriel Vicent-Gil, Enric Álvarez, J. de Diego-Adeliño, Maria J. Portella, Alejandro Keymer-Gausset, Víctor Pérez, M. Serra-Blasco, Mar Carceller-Sindreu, Joan Trujols, M. Mur, and Narcís Cardoner
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Adult ,Male ,Adolescent ,Neuropsychological Tests ,Young Adult ,03 medical and health sciences ,Cognition ,Mental Processes ,0302 clinical medicine ,medicine ,First-episode ,Major depression ,Humans ,Cognitive Dysfunction ,Pharmacology (medical) ,Effects of sleep deprivation on cognitive performance ,Biological Psychiatry ,Depression (differential diagnoses) ,Pharmacology ,First episode ,Cognitive predictors ,Depressive Disorder, Major ,business.industry ,Working memory ,Neuropsychology ,Middle Aged ,Prognosis ,medicine.disease ,030227 psychiatry ,Psychiatry and Mental health ,Neurology ,Disease Progression ,Major depressive disorder ,Female ,Neurology (clinical) ,Verbal memory ,business ,030217 neurology & neurosurgery ,Follow-Up Studies ,Clinical psychology - Abstract
Major Depressive Disorder (MDD) entails cognitive dysfunction in many cognitive domains, but it is still uncertain whether such deficits are present in the early stages. The purpose of the study is to determine the cognitive performance in first episode depression (FED) exploring the presence of different cognitive profiles, and the role of cognition in FED at baseline and long-term. Ninety subjects (18-50 years) were included, 50 patients with a FED and 40 healthy controls. Participants were assessed with a neuropsychological battery, covering language, attention, verbal memory, processing speed and executive domains. Neuropsychological group comparisons were performed with MANOVAs. A hierarchical cluster analysis was run to identify clusters of patients with similar neuropsychological performance. Two generalized linear models were built to predict baseline HDRS-17 and changes at 12 months. Patients performed significantly worse than healthy controls in language, attention/working memory, verbal memory, processing speed and executive functioning, with moderate to large effect sizes (0.5 - 1). Two clusters were found: cognitively preserved patients (n=37) and cognitively impaired patients (n=13). Large effect sizes of cognitive impairment in FED were observed between the two cognitive clusters (preserved and impaired). Depressive symptoms at baseline were predicted by verbal memory (p=0.003), while 12-month changes were predicted by executive function (p=0.041) and language (p=0.037). Cognitive performance predicted depressive symptoms at baseline and at follow-up, pointing to the usefulness of cognitive assessment even at the commencement of the illness. (C) 2018 Elsevier B.V. and ECNP. All rights reserved.
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- 2018
40. Can the Addition of Maintenance Electroconvulsive Therapy to Pharmacotherapy Improve Relapse Prevention in Severe Major Depressive Disorder? A Randomized Controlled Trial
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Aida de Arriba-Arnau, Verònica Gálvez, Narcís Cardoner, Erika Martínez-Amorós, Diego Palao, Virginia Soria, José M. Menchón, and Mikel Urretavizcaya
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medicine.medical_specialty ,recurrence ,medicine.medical_treatment ,Neurosciences. Biological psychiatry. Neuropsychiatry ,Relapse prevention ,behavioral disciplines and activities ,Assaigs clínics de medicaments ,Article ,electroconvulsive therapy ,maintenance ,law.invention ,Medicina preventiva ,Electroconvulsive therapy ,Pharmacotherapy ,prevention ,Randomized controlled trial ,law ,Rating scale ,Internal medicine ,mental disorders ,Medicine ,Depressió psíquica ,Depression (differential diagnoses) ,Preventive medicine ,relapse ,major depressive disorder ,business.industry ,General Neuroscience ,Drug testing ,medicine.disease ,Mental depression ,Tolerability ,Major depressive disorder ,business ,RC321-571 - Abstract
Few systematic evaluations have been performed of the efficacy of electroconvulsive therapy (ECT) as a relapse prevention strategy in major depressive disorder (MDD). This is a single-blind, multicenter, randomized controlled trial to compare the efficacy and tolerability of pharmacotherapy plus maintenance ECT (M-Pharm/ECT) versus pharmacotherapy alone (M-Pharm) in the prevention of MDD relapse. Subjects with MDD who had remitted with bilateral acute ECT (n = 37) were randomly assigned to receive M-Pharm/ECT (n = 19, 14 treatments) or M-Pharm (n = 18) for nine months. The subjects were followed up for 15 months. The main outcome was relapse of depression, defined as a score of 18 or more on the Hamilton Depression Rating Scale. At nine months, 35% of the subjects treated with M-Pharm/ECT relapsed as compared with 61% of the patients treated with M-Pharm. No statistically significant differences between groups were indicated by either Kaplan–Meier or Cox proportional hazards regression analyses. The subjects without psychotic features were at higher risk of relapse. There were no statistically significant differences in the MMSE scores of the two groups at the end of the study. Further studies are needed to better define the indications for M-ECT in order to improve its efficacy as a relapse prevention strategy.
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- 2021
41. Gender Differences in Social Cognition: A Cross-Sectional Pilot Study of Recently Diagnosed Patients with Schizophrenia and Healthy Subjects
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Guillem Navarra-Ventura, Esther Pousa, Sol Fernandez-Gonzalo, Merce Jodar, Marc Turon, Narcís Cardoner, and Diego Palao
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Adult ,Male ,Cross-sectional study ,media_common.quotation_subject ,Emotions ,Theory of Mind ,Pilot Projects ,Empathy ,Young Adult ,03 medical and health sciences ,Sex Factors ,0302 clinical medicine ,Social cognition ,Theory of mind ,medicine ,Humans ,Young adult ,Original Research ,media_common ,Sex Characteristics ,Social perception ,business.industry ,Cognition ,medicine.disease ,030227 psychiatry ,Psychiatry and Mental health ,Cross-Sectional Studies ,Psychotic Disorders ,Social Perception ,Schizophrenia ,Female ,business ,Facial Recognition ,030217 neurology & neurosurgery ,Clinical psychology - Abstract
Objectives: This study had 2 objectives: First, to explore the gender-related differences in emotional processing (EP) and theory of mind—both cognitive (CToM) and affective (AToM)—in patients with schizophrenia and in a control group of healthy subjects; and, second, to examine, from a gender perspective, the possible association between EP and CToM in the AToM performance. Methods: Forty patients with schizophrenia/schizoaffective disorder were recruited and matched by gender, age and years of education with 40 healthy subjects. EP was measured by the pictures of facial affect (POFA) test. CToM was measured using first- and second-order false-belief (FB) stories. AToM was measured by the reading the mind in the eyes test (RMET). Group and gender differences in CToM were analysed using the X2 test, whereas EP and AToM were analysed using the non-parametric Mann–Whitney U Test and a general linear model. Results were adjusted by intelligence quotient and negative symptomatology. Results: Patients with schizophrenia underperformed against healthy subjects in the POFA test, second-order FB, and RMET, but not in first-order FB. No significant gender differences were found. However, there was a trend showing that females outperformed males in the POFA ( P = 0.056). Group ( P < 0.001), POFA ( P < 0.001) and second-order FB ( P = 0.022) were the best factors predicting RMET performance (adjusted R2 = 0.584). Conclusions: Our results suggest that the illness is the main factor related to the deficit in social cognition, except for the basic aspects of the CToM that were unimpaired in most patients. Nevertheless, the influence of female gender in EP should not be neglected in any group. Finally, the hierarchal interaction between these domains is discussed.
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- 2017
42. The Neurobiological Basis of Cognitive Side Effects of Electroconvulsive Therapy: A Systematic Review
- Author
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Marta Cano, Teresa Sagués, Pilar Serra, Adriana Bassa, Diego Palao, Narcís Cardoner, Erika Martínez-Amorós, and Daniel Porta-Casteràs
- Subjects
MDD ,hippocampus ,medicine.medical_treatment ,Hippocampus ,Neurosciences. Biological psychiatry. Neuropsychiatry ,behavioral disciplines and activities ,electroconvulsive therapy ,memory ,Electroconvulsive therapy ,NSE ,Neuroimaging ,Neurotrophic factors ,mental disorders ,Medicine ,S-100 ,Effects of sleep deprivation on cognitive performance ,cognitive impairment ,Cognitive vulnerability ,business.industry ,General Neuroscience ,biomarkers ,ECT ,Cognition ,medicine.disease ,side effects ,Major depressive disorder ,Systematic Review ,business ,Neuroscience ,RC321-571 - Abstract
Decades of research have consistently demonstrated the efficacy of electroconvulsive therapy (ECT) for the treatment of major depressive disorder (MDD), but its clinical use remains somewhat restricted because of its cognitive side effects. The aim of this systematic review is to comprehensively summarize current evidence assessing potential biomarkers of ECT-related cognitive side effects. Based on our systematic search of human studies indexed in PubMed, Scopus, and Web of Knowledge, a total of 29 studies evaluating patients with MDD undergoing ECT were reviewed. Molecular biomarkers studies did not consistently identify concentration changes in plasma S-100 protein, neuron-specific enolase (NSE), or Aβ peptides significantly associated with cognitive performance after ECT. Importantly, these findings suggest that ECT-related cognitive side effects cannot be explained by mechanisms of neural cell damage. Notwithstanding, S-100b protein and Aβ40 peptide concentrations, as well as brain-derived neurotrophic factor (BDNF) polymorphisms, have been suggested as potential predictive biomarkers of cognitive dysfunction after ECT. In addition, recent advances in brain imaging have allowed us to identify ECT-induced volumetric and functional changes in several brain structures closely related to memory performance such as the hippocampus. We provide a preliminary framework to further evaluate neurobiological cognitive vulnerability profiles of patients with MDD treated with ECT.
- Published
- 2021
43. A multimetric systematic review of fMRI findings in patients with MDD receiving ECT
- Author
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Carles Soriano-Mas, Daniel Porta-Casteràs, Narcís Cardoner, Marta Cano, Diego Palao, Colleen Loo, and Joan A. Camprodon
- Subjects
medicine.medical_treatment ,behavioral disciplines and activities ,03 medical and health sciences ,0302 clinical medicine ,Electroconvulsive therapy ,mental disorders ,medicine ,Humans ,Effective treatment ,In patient ,Electroconvulsive Therapy ,Biological Psychiatry ,Anterior cingulate cortex ,Pharmacology ,Depressive Disorder, Major ,medicine.diagnostic_test ,business.industry ,Functional Neuroimaging ,Functional connectivity ,Brain ,medicine.disease ,Magnetic Resonance Imaging ,030227 psychiatry ,medicine.anatomical_structure ,Major depressive disorder ,Functional magnetic resonance imaging ,business ,Neuroscience ,Biomarkers - Abstract
Background Electroconvulsive therapy (ECT) is considered the most effective treatment for major depressive disorder (MDD). In recent years, the pursuit of the neurobiological mechanisms of ECT action has generated a significant amount of functional magnetic resonance imaging (fMRI) research. Objective In this systematic review, we integrated all fMRI research in patients with MDD receiving ECT and, importantly, evaluated the level of convergence and replicability across multiple fMRI metrics. Results While according to most studies changes in patients with MDD after ECT appear to be widely distributed across the brain, our multimetric review revealed specific changes involving functional connectivity increases in the superior and middle frontal gyri as the most replicated and across-modality convergent findings. Although this modulation of prefrontal connectivity was associated to ECT outcome, we also identified fMRI measurements of the subgenual anterior cingulate cortex as the fMRI signals most significantly linked to clinical response. Conclusion We identified specific prefrontal and cingulate territories which activity and connectivity with other brain regions is modulated by ECT, critically accounting for its mechanism of action.
- Published
- 2021
44. Human ventromedial prefrontal cortex and the positive affective processing of safety signals
- Author
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Carles Soriano-Mas, Ben J. Harrison, Ignacio Martínez-Zalacaín, Bram Vervliet, Jesús Pujol, Miquel A. Fullana, Esther Via, Christopher G. Davey, Narcís Cardoner, Tilo Kircher, and Benjamin Straube
- Subjects
Adult ,Male ,Adolescent ,Cognitive Neuroscience ,Conditioning, Classical ,Ventromedial prefrontal cortex ,Prefrontal Cortex ,Brain mapping ,Developmental psychology ,Discrimination Learning ,Young Adult ,03 medical and health sciences ,0302 clinical medicine ,Neuroimaging ,medicine ,Humans ,Discrimination learning ,Prefrontal cortex ,Default mode network ,Adaptive behavior ,Brain Mapping ,medicine.diagnostic_test ,Brain ,Magnetic Resonance Imaging ,030227 psychiatry ,Affect ,medicine.anatomical_structure ,Neurology ,Female ,Safety ,Functional magnetic resonance imaging ,Psychology ,Neuroscience ,030217 neurology & neurosurgery - Abstract
Human functional magnetic resonance imaging (fMRI) studies suggest that the ventromedial prefrontal cortex (vmPFC) contributes to the learned discrimination of threat and safety signals, although its precise contribution to these processes remains unclear. One hypothesis is that the vmPFC supports the positive affective processing of safety signals linked to their implicit stress-relieving properties. We set out to test this hypothesis and to examine the specificity of vmPFC responses to safety signal processing versus its high level of 'default mode' activity. Sixty participants completed an fMRI conditioning task that involved the generation of a conditioned threat (CS+) and safety (CS-) signal following the completion of a pre-conditioning baseline. Confirming past findings, activation of the vmPFC and other midline cortical and parietal areas - broadly resembling the default mode network - robustly discriminated between the CS- and CS+. However, when adjusting for this network's characteristic 'baseline' activity, only a subset of regions, including the vmPFC, was activated by the CS-. Regional selectivity for safety signal processing was confirmed by demonstrating a significant correlation between the magnitude of vmPFC responses and self-rated positive affect evoked by the CS-. Taken together, our current findings confirm a link between human vmPFC activity and the positive affective processing of safety signals. We discuss these findings with regards a broader model of human vmPFC function and its suggested higher-order contribution to emotionally adaptive behavior.
- Published
- 2017
45. Early Life Adversity Modulation of Central Autonomic Network During Emotion Regulation in Borderline Personality Disorder
- Author
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Agustina E. Wainsztein, Narcís Cardoner, Mirta F. Villarreal, Ximena Goldberg, Daniel Eduardo Vigo, Vulcano Mercedes, Alvarez Mercé Rocío, Mariana N. Castro, Salvador M. Guinjoan, Carolina Abulafia, Camacho Vicente, Charles B. Nemeroff, and Carles Soriano-Mas
- Subjects
medicine ,Psychology ,medicine.disease ,Borderline personality disorder ,Biological Psychiatry ,Early life ,Clinical psychology - Published
- 2020
46. Structural alterations of the pyramidal pathway in schizoid and schizotypal cluster A personality disorders
- Author
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Narcís Cardoner, Carles Orfila, Antoni Rovira, Carles Soriano-Mas, Diego Palao, José M. Menchón, Jordi E. Obiols, Esther Via, and Carla Pedreño
- Subjects
Adult ,Male ,Psychosis ,medicine.medical_specialty ,Adolescent ,Pyramidal Tracts ,Audiology ,Schizotypal Personality Disorder ,White matter ,Young Adult ,03 medical and health sciences ,0302 clinical medicine ,Schizoid personality disorder ,Physiology (medical) ,mental disorders ,medicine ,Humans ,Psychiatry ,medicine.diagnostic_test ,General Neuroscience ,Magnetic resonance imaging ,Cognition ,medicine.disease ,Magnetic Resonance Imaging ,White Matter ,Personality disorders ,Schizotypal personality disorder ,030227 psychiatry ,Neuropsychology and Physiological Psychology ,medicine.anatomical_structure ,Endophenotype ,Female ,Psychology ,030217 neurology & neurosurgery - Abstract
Aim Schizoid (ScPD) and Schizotypal (SPD) personality disorders are rare and severe disorders. They are associated with high liability to schizophrenia and present an attenuated form of its negative symptoms, which are considered a putative endophenotype for schizophrenia. The trans-diagnostic study of negative symptoms in non-psychotic populations such as ScPD/SPD might provide useful markers of a negative-symptom domain; however, little is known about their neurobiological substrates. The aim of the study was to investigate differences in gray and white matter volumes in subjects with ScPD/SPD compared to a group of healthy controls. Methods Structural magnetic resonance images were obtained from 20 never-psychotic subjects with ScPD/SPD and 28 healthy controls. Resulting values from clusters of differences were correlated in patients with relevant clinical variables (O-LIFE scale). Results ScPD/SPD presented greater bilateral white matter volume compared to healthy controls in the superior part of the corona radiata, close to motor/premotor regions, which correlated with the O-LIFE subtest of cognitive disorganization. No differences were found in regional gray matter or global gray/white matter volumes. Conclusion Greater volumes in motor pathways might relate to cognitive symptoms and motor alterations commonly present in schizophrenia-related disorders. Given the established link between motor signs and psychosis, structural alterations in motor pathways are suggested as a putative biomarker of a negative-symptom domain in psychosis subject to further testing.
- Published
- 2016
47. Self and other body perception in anorexia nervosa: The role of posterior DMN nodes
- Author
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Esther Via, José M. Menchón, Christopher G. Davey, Ximena Goldberg, Carles Soriano-Mas, Isabel Sánchez, Ben J. Harrison, Ignacio Martínez-Zalacaín, Fernando Fernández-Aranda, Narcís Cardoner, Laura Forcano, and Jesús Pujol
- Subjects
Adult ,Anorexia Nervosa ,Visual perception ,Precuneus ,Anorexia ,Gyrus Cinguli ,050105 experimental psychology ,Developmental psychology ,Young Adult ,03 medical and health sciences ,0302 clinical medicine ,Body Image ,Connectome ,medicine ,Humans ,0501 psychology and cognitive sciences ,Biological Psychiatry ,Anterior cingulate cortex ,Default mode network ,Cerebral Cortex ,Resting state fMRI ,05 social sciences ,Magnetic Resonance Imaging ,Self Concept ,Psychiatry and Mental health ,medicine.anatomical_structure ,Anorexia nervosa (differential diagnoses) ,Posterior cingulate ,Visual Perception ,Female ,Nerve Net ,medicine.symptom ,Psychology ,Neuroscience ,030217 neurology & neurosurgery - Abstract
Body image distortion is a core symptom of anorexia nervosa (AN), which involves alterations in self- (and other's) evaluative processes arising during body perception. At a neural level, self-related information is thought to rely on areas of the so-called default mode network (DMN), which, additionally, shows prominent synchronised activity at rest.Twenty female patients with AN and 20 matched healthy controls were scanned using magnetic resonance imaging when: (a) viewing video clips of their own body and another's body; (b) at rest. Between-group differences within the DMN during task performance were evaluated and further explored for task-related and resting-state-related functional connectivity alterations.AN patients showed a hyperactivation of the dorsal posterior cingulate cortex during their own-body processing but a response failure to another's body processing at the precuneus and ventral PCC. Increased task-related connectivity was found between dPCC-dorsal anterior cingulate cortex and precuneus-mid-temporal cortex. Further, AN patients showed decreased resting-state connectivity between the dPCC and the angular gyrus.The PCC and the precuneus are suggested as key components of a network supporting self-other-evaluative processes implicated in body distortion, while the existence of DMN alterations at rest might reflect a sustained, task-independent breakdown within this network in AN.
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- 2016
48. Inter-individual variability in emotion regulation: Pathways to obsessive-compulsive symptoms
- Author
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Narcís Cardoner, Ximena Goldberg, Susana Jiménez-Murcia, Marta Subirà, Cinto Segalàs, Clara López-Solà, José M. Menchón, Pino Alonso, Carles Soriano-Mas, Eva Real, and Rosa Hernández-Ribas
- Subjects
Cognitive rigidity ,Cognition ,Affect (psychology) ,Obsessive compulsive symptoms ,030227 psychiatry ,Developmental psychology ,Cognitive reappraisal ,03 medical and health sciences ,Psychiatry and Mental health ,Clinical Psychology ,0302 clinical medicine ,Outcome variable ,Expressive Suppression ,Psychology ,030217 neurology & neurosurgery - Abstract
Background Individuals vary in their use of emotion regulation strategies and this variation has been associated with obsessive-compulsive disorder (OCD). Previous studies suggest that affect and cognitive rigidity mediate this association, but such mediation effects have not yet been tested in an integrated model of inter-individual variation of OC symptoms. Methods We used a total sample of 111 subjects (79 OCD patients and 32 controls) and a path-analytic approach to simultaneously explore the associations between two emotion regulation strategies (i.e. cognitive reappraisal and expressive suppression), positive and negative affect, and cognitive rigidity with obsessive-compulsive symptoms as the outcome variable. Results Results showed that 49% of the variance of OC symptoms was explained by the best-fitting model ( χ 2 =0.915, p=0.922, df=4). Cognitive reappraisal was associated with reduced presence/severity of OC symptoms, and this association was mediated by positive affect and decreased cognitive rigidity. In contrast, expressive suppression was associated with negative affect, increased cognitive rigidity and increased presence/severity of OC symptoms. Conclusions A deep-rooted interconnection between emotion and cognition – indicated by both full and partial mediations – is a key mechanism underlying vulnerability to OC symptoms.
- Published
- 2016
49. Smartphone-based self-monitoring in bipolar disorder: evaluation of usability and feasibility of two systems
- Author
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Diego Palao, Oscar Mayora, Jesús Cobo, Lars Vedel Kessing, Olaf Andreatta, Maria Faurholt-Jepsen, Daryoush Yazdanyar, Narcís Cardoner, and Emanuale Torri
- Subjects
medicine.medical_specialty ,Randomization ,lcsh:RC321-571 ,law.invention ,03 medical and health sciences ,0302 clinical medicine ,Randomized controlled trial ,law ,Medicine ,media_common.cataloged_instance ,In patient ,Bipolar disorder ,European union ,lcsh:Neurosciences. Biological psychiatry. Neuropsychiatry ,Biological Psychiatry ,media_common ,business.industry ,Research ,lcsh:QP351-495 ,Significant difference ,Usability ,medicine.disease ,3. Good health ,030227 psychiatry ,Psychiatry and Mental health ,lcsh:Neurophysiology and neuropsychology ,Physical therapy ,Self-monitoring ,business ,030217 neurology & neurosurgery - Abstract
BACKGROUND: The aims of the present multicenter pilot study were to examine the feasibility and usability of two different smartphone-based monitoring systems (the Pulso system and the Trilogis-Monsenso system) from two IT companies in patients with bipolar disorder, developed and selected to be testes as a part of a European Union funded Pre-Commercial Procurement (the NYMPHA-MD project).METHODS: Patients with bipolar disorder (ICD-10), > 18 years of age during a remitted, partial remitted or mild to moderate depressive state (HDRS-17 RESULTS: A total of 60 patients aged 18-69 years with bipolar disorder (ICD-10) recruited from Italy, Spain, Denmark were included-59 patients completed the study. In Denmark, the patients evaluated the Trilogis-Monsenso system with a statistically significant higher usability compared with the Pulso system. In Italy and Spain, the patients evaluated no statistically significant difference between the two systems in any of the categories, except for the usefulness category favoring the Trilogis-Monsenso system (z = 2.68, p CONCLUSIONS: Both monitoring systems showed acceptable usability and feasibility. There were differences in patient-based evaluations of the two monitoring systems related to the country of the study. Studies investigating the usability and feasibility during longer follow-up periods could perhaps reveal different findings. Future randomized controlled trials investigating the possible positive and negative effects of smartphone-based monitoring systems are needed.
- Published
- 2019
50. Brain Volumetric Correlates of Right Unilateral Versus Bitemporal Electroconvulsive Therapy for Treatment-Resistant Depression
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Narcís Cardoner, Jesús Pujol, Ignacio Martínez-Zalacaín, Nikos Makris, Joan A. Camprodon, José M. Menchón, Erik Lee, Marta Cano, Mikel Urretavizcaya, Rosa Hernández-Ribas, Carles Soriano-Mas, Michael M. Henry, Oren Contreras-Rodríguez, and Esther Via
- Subjects
Adult ,Male ,Electroteràpia ,Electrotherapeutics ,medicine.medical_treatment ,behavioral disciplines and activities ,Article ,03 medical and health sciences ,Depressive Disorder, Treatment-Resistant ,0302 clinical medicine ,Electroconvulsive therapy ,mental disorders ,medicine ,Limbic System ,Humans ,Depressió psíquica ,Cervell ,Electroconvulsive Therapy ,Electrode placement ,Selection (genetic algorithm) ,Cerebral Cortex ,business.industry ,Brain morphometry ,Brain ,Middle Aged ,medicine.disease ,Magnetic Resonance Imaging ,030227 psychiatry ,Psychiatry and Mental health ,Diagnòstic per la imatge ,Mental depression ,Treatment Outcome ,Anesthesia ,Diagnostic imaging ,Female ,Neurology (clinical) ,business ,Treatment-resistant depression ,030217 neurology & neurosurgery - Abstract
Objective: The selection of a bitemporal (BT) or right unilateral (RUL) electrode placement affects the efficacy and side effects of ECT. Previous studies have not entirely described the neurobiological underpinnings of such differential effects. Recent neuroimaging research on gray matter volumes is contributing to our understanding of the mechanism of action of ECT and could clarify the differential mechanisms of BT and RUL ECT. Methods: To assess the whole-brain gray matter volumetric changes observed after treating patients with treatment-resistant depression with BT or RUL ECT, the authors used MRI to assess 24 study subjects with treatment-resistant depression (bifrontotemporal ECT, N=12; RUL ECT, N=12) at two time points (before the first ECT session and after ECT completion). Results: Study subjects receiving BT ECT showed gray matter volume increases in the bilateral limbic system, but subjects treated with RUL ECT showed gray matter volume increases limited to the right hemisphere. The authors observed significant differences between the two groups in midtemporal and subcortical limbic structures in the left hemisphere. Conclusions: These findings highlight that ECT-induced gray matter volume increases may be specifically observed in the stimulated hemispheres. The authors suggest that electrode placement may relevantly contribute to the development of personalized ECT protocols.
- Published
- 2018
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