Comparing the Anti-Depressive Effect of Electroconvulsive Therapy (ECT) Versus Transcranial Magnetic Stimulation (TMS) in the Treatment of Patients with Depression.

BACKGROUND: Electroconvulsive therapy (ECT) is one of the most effective treatments for depressive disorders. However, ECT has a number of limitations, such as significant side effects in the neurocognitive domain and the requirement for general anesthesia. Transcranial magnetic stimulation (TMS) is an intervention that applies electric stimulation to the brain without causing convulsions, thus representing an attractive alternative to ECT. The aim of our study is to review systematic reports of the effectiveness of ECT and TMS in the treatment of depressive spectrum disorders. SUBJECTS AND METHODS: We performed search queries in PubMed and eLibrary databases, which retrieved 391 articles, of which 14 met our inclusion criteria for the analysis. The articles comprised three comparisons: TMS vs SHAM, ECT vs sham ECT (SECT), and ECT vs PHARM. The protocol parameters analyzed for TMS were coil type, targeted brain area, amplitude of resting motor threshold, duration of session, number of sessions in total and per week, number and pulses per session and inter-train pause. For ECT, we evaluated the type of ECT device, targeted brain area, type of stimuli, and for ECT vs PHARM we recorded types of anesthesia and antidepressant medication. RESULTS: Three of 6 studies showed a therapeutic effect of TMS compared to placebo; efficacy was greater for TMS frequency exceeding 10 Hz, and with stimulation of two areas of cerebral cortex rather than a single area. There was insufficient data to identify a relationship between the success of TMS and intertrain pause (IP). Three of four studies showed a therapeutic effect of ECT compared to placebo. Three studies of bilateral ECT showed a significant reduction in depression scores compared to the SECT groups. ECT protocols with brief pulses were generally of lesser efficacy. Four of 5 ECT vs PHARM studies showed superior efficacy of ECT compared to PHARM. Among several antidepressants, only the ketamine study showed greater efficacy compared to ECT. CONCLUSIONS: There of six TMS studies and 7 of 9 ECT studies showed efficacy in reducing depressive symptoms. A prospective study of crossover design might reveal the relative efficacies of ECT and TMS.

Peripheral Blood Mononuclear Cell-Related Biomarkers in Schizophrenia.

INTRODUCTION: Schizophrenia is a severe mental illness causing significant impairment in personal, family, social, educational, occupational, and other important areas of life. While there is no widely accepted endophenotype, peripheral blood cells may serve as an accessible model of intracellular changes in schizophrenia. METHODS: We reviewed the literature on the query "peripheral blood mononuclear cells AND schizophrenia" in Medline (Pubmed), selecting studies that searched for specific biomarkers of schizophrenia. We considered both diagnostic biomarkers and biomarkers of therapeutic response, specific schizophrenia disorders or differential diagnostic biomarkers. RESULTS: We retrieved 41 articles matching the search criteria, among which were studies that considered changes in the production of pro-inflammatory and anti-inflammatory markers, proteins, receptors, enzyme activity, and gene expression as potential biomarkers. CONCLUSION: Approaches analysing a biological axis or a group of related biomarkers may hold the greatest promise for identifying schizophrenia. In addition, pharmacological status, smoking status, inflammatory markers and glucose metabolites, the presence of comorbidities should be considered. Certain biomarkers, while not specific for the diagnosis of schizophrenia, may indicate the prognosis and effectiveness of treatment in the established diagnosis.

Genetic Contributors to PTSD: the Role of SNVs, Gene Interactions and Haplotypes for Developing PTSD Prevention Measures. A Comprehensive Review.

BACKGROUND: Post-traumatic stress disorder (PTSD) is a trauma- or stressor-related mental health condition with high socioeconomic burden. We aimed in this review to identify promising genetic markers predisposing for PTSD, which might serve in the design subsequent studies aiming to develop PTSD prevention and remediation measures. SUBJECTS AND METHODS: Our search queries in the PubMed database yielded 547 articles, of which 20 met our inclusion criteria for further analysis: published between 2018 and 2022, original research, containing molecular-genetic and statistical data, containing diagnosis verification methods, PTSD as a primary condition, and a sample of at least 60 patients. RESULTS: Among the 20 analyzed studies were reports of significant associations between PTSD and: FKBP5 variants rs9470080, regardless of the C or T allele; two FKBP5 haplotypes (A-G-C-C and A-G-C-T); gene-gene DRDхANNK1-COMT (rs1800497 × rs6269) and OXTR-DRD2 (rs2268498 × rs1801028); C-allele of CRHR1 (rs1724402). Other findings, such as the association of FKBP5 haplotypes (A-G-C-C, A-G-C-T) and the FKBP5-CRHR1 genotype, were of lesser statistical significance and less extensively studied. CONCLUSIONS: Although our literature analysis implicates certain genetic factors in PTSD, our understanding of the polygenic nature underlying the disorder remains limited, especially considering the hitherto underexplored epigenetic mechanisms. Future research endeavors should prioritize exploring these aspects to provide a more nuanced understanding of PTSD and its genetic underpinnings.

Post-COVID Neuropsychiatric Complications in Children and Adolescents: a Study Design for Early Diagnosis and Treatment Using Innovative Technologies.

BACKGROUND: The COVID-19 pandemic has had significant impacts on the child and adolescent population, with long-term consequences for physical health, socio-psychological well-being, and cognitive development, which require further investigation. We herein describe a study design protocol for recognizing neuropsychiatric complications associated with pediatric COVID-19, and for developing effective prevention and treatment strategies grounded on the evidence-based findings. METHODS: The study includes two cohorts, each with 163 participants, aged from 7 to 18 years old, and matched by gender. One cohort consisted of individuals with a history of COVID-19, while the other group presents those without such a history. We undertake comprehensive assessments, including neuropsychiatric evaluations, blood tests, and validated questionnaires completed by parents/guardians and by the children themselves. The data analysis is based on machine learning techniques to develop predictive models for COVID-19-associated neuropsychiatric complications in children and adolescents. RESULTS: The first model is focused on a binary classification to distinguish participants with and without a history of COVID-19. The second model clusters significant indicators of clinical dynamics during the follow-up observation period, including the persistence of COVID-19 related somatic and neuropsychiatric symptoms over time. The third model manages the predictors of discrete trajectories in the dynamics of post-COVID-19 states, tailored for personalized prediction modeling of affective, behavioral, cognitive, disturbances (academic/school performance), and somatic symptoms of the long COVID. CONCLUSIONS: The current protocol outlines a comprehensive study design aiming to bring a better understanding of COVID-19-associated neuropsychiatric complications in a population of children and adolescents, and to create a mobile phone-based applications for the diagnosis and treatment of affective, cognitive, and behavioral conditions. The study will inform about the improved management of preventive and personalized care strategies for pediatric COVID-19 patients. Study results support the development of engaging and age-appropriate mobile technologies addressing the needs of this vulnerable population group.