[Neonatal hypoxia-ischemia: cellular and molecular brain damage and therapeutic modulation of neurogenesis]. / Hipoxia-isquemia neonatal: bases celulares y moleculares del daño cerebral y modulacion terapeutica de la neurogenesis.

INTRODUCTION: Perinatal asphyxia remains a major cause of both mortality and neurological morbidity. Neonatal encephalopathy affects to 1-3/1,000 newborns, leading to significant brain damage and childhood disability. The only standard therapy is moderate hypothermia, whose efficacy, despite proved, is limited, being partially effective. DEVELOPMENT: The capacity of hypothermia in promoting cell proliferation in the neurogenic niches of the central nervous system remains subject of investigation. The use of therapeutic agents such as erythropoietin and cannabinoids and mesenchymal stem cells have shown promising results in experimental models of perinatal asphyxia, being able of modulate neurogenesis, neuronal plasticity and neuroreparation processes after hypoxic-ischemic brain injury. CONCLUSIONS: The effects of these therapies in clinics are still unknown, so as if the newborn cells will be able to effectively integrate in the existing neuronal networks or if they will develop their proper functions in a brain-damaged microenvironment, thus being necessary new works focused on the evaluation of the real potential of these therapies in the modulation of neurogenesis after neonatal hypoxia-ischemia.

TITLE: Hipoxia-isquemia neonatal: bases celulares y moleculares del daño cerebral y modulacion terapeutica de la neurogenesis.Introduccion. La asfixia perinatal continua siendo una de las mayores causas de morbimortalidad neurologica. La encefalopatia neonatal derivada constituye una causa importante de daño cerebral, que afecta de manera moderada-grave a 1-3 de cada 1.000 recien nacidos y comporta un alto riesgo de deficits neurologicos permanentes. La unica aproximacion terapeutica actual consiste en la hipotermia moderada, cuya eficacia, aunque constatada, no siempre consigue una recuperacion funcional total. Desarrollo. Se desconoce con certeza si la hipotermia tiene la capacidad de promover la proliferacion celular en los nichos neurogenicos cerebrales, donde permanecen celulas madre neuronales con capacidad de proliferacion y diferenciacion. El empleo de agentes terapeuticos, como la eritropoyetina o los cannabinoides, y de celulas madre mesenquimales ha mostrado resultados prometedores en diversos modelos experimentales de asfixia perinatal y es capaz de modular los procesos de neurogenesis, de plasticidad neuronal y de neurorreparacion tras un daño cerebral hipoxico-isquemico. Conclusiones. Aun se desconocen los efectos de estas terapias en modelos clinicos y si las celulas recien formadas seran capaces de integrarse de forma efectiva en las redes neuronales existentes o si podran desarrollar sus funciones adecuadamente en un microambiente de lesion cerebral, por lo que se hace necesario el desarrollo de nuevos trabajos enfocados a evaluar el potencial real de estos agentes en la modulacion terapeutica de la neurogenesis tras una hipoxia-isquemia neonatal.

Differentiating the bipolar disorders from borderline personality disorder.

OBJECTIVE: To identify features differentiating bipolar disorder (BP) from borderline personality disorder (BPD) and with each condition variably defined. METHOD: Participants were assigned a BP or BPD diagnosis on the basis of DSM criteria and, separately, by clinical judgment, and undertook a diagnostic interview and completed self-report measures. RESULTS: Predictors of BPD status varied according to diagnostic decisions, but with the most consistent items being childhood sexual abuse, childhood depersonalization, personality variables relating to relationship difficulties and sensitivity to criticism, and the absence of any BP family history. Across diagnostic groups, personality measure items alone predicted diagnostic allocation with an accuracy of 81-84%, the refined study variables other than hypo/manic features improved the classification rates to 88%, and when the presence or absence of hypo/manic features was added, classification rates increased to 92-95%. CONCLUSION: Study findings indicate that BPD can be differentiated from BP with a high degree of accuracy.