Top PDF Cognitive manic symptoms in bipolar disorder associated with polymorphisms in the DAOA and COMT genes.

Cognitive manic symptoms in bipolar disorder associated with polymorphisms in the DAOA and COMT genes.

Cognitive manic symptoms in bipolar disorder associated with polymorphisms in the DAOA and COMT genes.

manic symptoms were compared with ABD population controls. In both models, logistic regression with qualitative measurments was used to test for allelic association, where gender and rs1718119 was used as covariates, taking into account our previously published associations with rs1718119 (P2RX7) geno- types and cognitive deficit [20]. Associations were corrected for multiple testing by the max(T) permutation in PLINK with 1,000 permutations per SNP. Further, haploblocks were calculated for anonymous blood donors (ABD) using Haploview in PLINK [23]. Haploblocks, including SNPs allele-wise nominally associated to cognitive manic symptoms (p,0.05) or SNPs nearby (D’.0.80), were tested for haplotype distribution difference with x 2 -test using a sliding window (3 SNP window) approach. Association of specific haplotypes to cognitive manic symptoms was tested using logistic regression with gender and rs1718119 as covariates. A 3 SNP window existed only for DAOA. p#0.05 was regarded significant in the analyses of haplotype distribution. SNPs with nominal allele frequency associated with cognitive manic symptoms (p,0.05) were further tested for genotype association using logistic regression in dominant, recessive and codominant models. An allele by allele epistasis test was performed between the SNPs rs2391191 in DAOA and rs5993883 in COMT using logistic regression with a multiplicative interaction term, Genotype by genotype epistasis was performed using logistic binary regression with the interaction term rs2391191*rs5993883, where the SNP genotypes were binary categorized according to dominance of the alleles A and T, repectively, using IBM SPSS Statistics version 20.0 (IBM Coporation, USA). All other calculations were performed using PLINK in BC|SNPmax data management and analysis (http://pngu.mgh.harvard.edu/purcell/plink/) [24]. The statistical power to exclude association between CMS and allele frequency of a SNP at alpha = 0.05 was calculated according to http://pngu.mgh.harvard.edu/Bpurcell/gpc/cc2.html.
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Validity and reliability of the Cognitive Complaints in Bipolar Disorder Rating Assessment (COBRA) in Brazilian bipolar patients

Validity and reliability of the Cognitive Complaints in Bipolar Disorder Rating Assessment (COBRA) in Brazilian bipolar patients

Results: The COBRA showed a one-factor structure with very high internal consistency (Cronbach’s alpha=0.890). Concurrent validity was indicated by a strong correlation with the cognitive domain of the FAST (r=0.811, p<0.001). Bipolar patients experienced greater cognitive complaints (mean=14.69; standard deviation [SD]=10.03) than healthy controls (mean=6.78; SD=5.49; p<0.001), suggesting discriminative validity of the instrument. No significant correlations were found between the COBRA and objective cognitive measures. Furthermore, higher COBRA scores were associated with residual depressive (r=0.448; p<0.001) and manic (r=0.376; p<0.001) symptoms, number of depressive episodes (r=0.306; p=0.011), number of total episodes (r=0.256; p=0.038), and suicide attempts (r=0.356; p=0.003).
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Speci fic alterations in plasma proteins during depressed, manic, and euthymic states of bipolar disorder

Speci fic alterations in plasma proteins during depressed, manic, and euthymic states of bipolar disorder

controls, and thus, are specific to those mood states and may be associated with the molecular basis of specific BD mood states (Supplementary Table S1). To identify the biological networks associated with deregulated plasma proteins in BD, we used MetaCore (Table 3). Immuno- regulation displayed the highest statistical significance. Increasing evidence suggests that chronic, mild inflam- matory processes in the peripheral and central nervous system (neuro-inflammation) are involved in BD patho- physiology. BD is accompanied by: i) moderately increased plasma levels of pro-inflammatory cytokines, such as interleukin (IL)-6 and tumor necrosis factor-a; ii) increased protein and mRNA levels of IL-1b, and IL-1RA in the frontal cortex of post-mortem bipolar patients (12,13); and iii) increased acute phase protein levels, including haptoglobin and C-reactive protein (CRP), as well as complement factors, such as plasma C3 or C4 concentrations (12). Recently, Goldstein et al. (14) reviewed the literature and found 27 articles suggesting that inflammation and BD are linked through shared genetic polymorphisms and gene expression. It has also been hypothesized that certain inflammatory mediators are related to neuroprogression in BD (15,16). This corroborates the previous hypothesis that inflammatory mediators may be related to episode-related cognitive decline in BD patients (16). Furthermore, inflammation Table 3. Top-10 ranked GeneGo pathway maps and GeneGo process networks associated with differentially expressed proteins in bipolar disorder.
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COMT and MAO-A Polymorphisms and Obsessive-Compulsive Disorder: A Family-Based Association Study

COMT and MAO-A Polymorphisms and Obsessive-Compulsive Disorder: A Family-Based Association Study

DNA from peripheral blood samples were extracted using the “salting-out” protocol [31]. On the basis of Tagger software [32], COMT and MAOA genomic regions were specified and tag SNPs were picked (a local copy of HapMap data was used) within them. Tagger produced a list of tag SNPs and corresponding statistical tests to capture all variants of interest, and a summary coverage report of the selected tag SNPs. Eleven SNPs in the COMT gene region and six SNPs in the MAO-A gene region were selected. These SNPs were genotyped at the Psychiatric and Neurodevelopmental Genetics Unit of Massachusetts General Hospital, a teaching hospital as- sociated with Harvard University. Genotyping was performed in 384-well plates with the Sequenom MassARRAY platform (Sequenom, San Diego, CA, USA). Primers for polymerase chain reaction (PCR) amplification and single-base extension assays were designed using Assay Design software, version 3.1 on the basis of FASTA sequences surrounding the SNPs, de- rived from SNPper [33]. Multiplex PCR was performed, followed by a pooled single-base ex- tension reaction (iPLEX Gold). Samples were analyzed with a MassARRAY RT mass
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Altered regional homogeneity in pediatric bipolar disorder during manic state: a resting-state fMRI study.

Altered regional homogeneity in pediatric bipolar disorder during manic state: a resting-state fMRI study.

Pediatric bipolar disorder (PBD) is a severely debilitating illness, which is characterized by episodes of mania and depression separated by periods of remission. Nearly 1% of adolescents and children have diagnosis of PBD [1]. One study showed that nearly 65% of PBD attempted suicide and almost 75% had been in hospital [2]. Compared to adults, a juvenile onset PBD leads to have a higher rate of suicide and substance abuse behavior [3]. Currently, diagnosis of this disorder is based almost entirely on a review of clinical history. The complaints of patients themselves play an important part for diagnosis. Young people will not describe their symptoms readily or easily, even to their parents. Thus, neurobiological studies on pediatric BD may help illustrate the pathophysiological mechanisms of PBD.
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Cognitive performance and cerebrospinal fluid biomarkers of neurodegeneration: a study of patients with bipolar disorder and healthy controls.

Cognitive performance and cerebrospinal fluid biomarkers of neurodegeneration: a study of patients with bipolar disorder and healthy controls.

The key clinical assessment instrument was a Swedish version of the Affective Disorder Evaluation ADE), which is a standardized interview protocol developed for the Systematic treatment Enhancement Program of Bipolar Disorder (STEP-BD) [23]. The ADE directs the interviewer through a systematic assessment of the patient’s current mental state, psychiatric history, and diagnosis according to DSM-IV criteria as per the Structured Clinical Interview for DSM-IV (SCID) [24]. The ADE includes a social anamnesis, and a medical history. The lifetime severity of bipolar disorder is rated using the 7-point Likert scale Clinical Global Im- pression (CGI), which ranges from healthy to extremely ill. In addition to the ADE, the Mini International Neuropsychiatric Interview (M.I.N.I.) [25] was completed to screen for other psychiatric diagnoses than bipolar disorder. Alcohol Use Disorders Identification Test (AUDIT) and the Drug Use Disorders Identification Test (DUDIT) were used to screen for substance and alcohol abuse, as well as serum levels of carbohydrate-deficient transferrin [26]. The ADE and M.I.N.I. interviews were conducted by board-certified psychiatrists working at the tertiary bipolar outpatient unit, or residents in psychiatry completing their training at this unit. To minimize risk of inter-rater bias, a best-estimate diagnostic decision was made based on all information available at admission by a consensus panel of experienced board certified psychiatrists specialized in bipolar disorder. All available sources of information, encompassing patient interview, case records and, if available, interview with the next of kin, were utilized in the diagnostic assessment.
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Sleep in Bipolar Disorder

Sleep in Bipolar Disorder

BPB’de sık kullanılan ilaç gruplarından biri de antipsikotik ilaçlardır. H1 reseptör- leri, alfa-adrenerjik reseptörler veya 5HT2 reseptörleri üzerine olan antagonistik etkileri fazla olan antipsikotik ilaçlar daha fazla sedasyona yol açarlar (Aşkan Parlakoğlu ve ark. 2013). Sedasyon yapıcı etki tipik antipsikotik ilaçlarda daha sık gözlenmekle birlikte atipik antipsikotiklerin de çoğunun sedasyon yaptığı bilinmektedir. İnsomnia yaptığı bilinen antipsikotik ajanlar da mevcuttur (Miller 2004, Aşkan Parlakoğlu ve ark. 2013). Tipik antipsikotiklerden düşük potensli klorpromazin ve mezoridazinin sedasyon yapıcı etkileri, yüksek potensli haloperidol ve flufenazine göre belirgindir. Yüksek potensli bir atipik antipsikotik ilaç olan olanzapinin sedasyon yapıcı etkisi H1 reseptörlerine olan yüksek afinitesi ile ilişkilendirilmiştir. Ketiyapinin H1 reseptörlerine afinitesi düşüktür ve antipsikotik etkinlik için yüksek dozlarda kullanılmalıdır. Ketiyapinin sedasyon yapıcı etkisi doz ile doğru orantılı olarak artar (Miller 2004). Klozapin tüm antipsikotik ilaçlar arasında en fazla, aripiprazol ise en az sedasyon yapan ilaçtır (Miller 2004, Aşkan Parlakoğlu ve ark. 2013). Risperidon ve olanzapinin 5HT2 reseptör antagonizması ile yavaş dalga uykusunu ve uyku kalitesini arttırdığı bildirilmiştir (Miller 2004). Klozapin, olanzapin ve risperidonun toplam uyku süresi ile evre 2 uykusunu arttırdığı, tipik antip- sikotiklerden haleperidol, tiyotiksen ve flupentiksolün evre 2 uyku latansını azalttığı ve uyku etkinliğini arttırdığı bilinmektedir (Monti ve Monti 2004). Bipolar depresyonu olan hastalarda ziprasidon kullanımının plasebo ile karşılaştırıldığı bir çalışmada zipra- sidonun REM latansında, yavaş dalga uykusunda, evre 2 uyku süresinde, uyanma sayı- sında ve uyku etkinliğinde düzelme sağladığı bildirilmiştir (Baskaran ve ark. 2013). Antipsikotik ilaçlar, etki düzeneği tam bilinmemekle birlikte, insomniaya da yol açabi- lir. Olanzapin, risperidon, ketiapin ve klozapin gibi ilaçların 5-HT1A reseptör antago- nizması ve dopamin antagonizmasına ikincil huzursuz bacak sendromu belirtilerini ortaya çıkardığı ve bu yolla insomnia yapabileceği düşünülmektedir (Aşkan Parlakoğlu ve ark. 2013).
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Association of IL-6 and CRP gene polymorphisms with obesity and metabolic disorders in children and adolescents

Association of IL-6 and CRP gene polymorphisms with obesity and metabolic disorders in children and adolescents

A retrospective, cross-sectional study consisting of 470 children (aged 7-9 years) and adolescents (aged 10-17 years), 54% girls, from five schools in the municipality of Santa Cruz do Sul, state of Rio Grande do Sul, Brazil. This study is part of a larger project, whose sample size was calculated according to the formula of the Division of Research Nea (Christensen 1980) of which a population of 20,540 from the public and private education system in Santa Cruz do Sul-RS, were considered. 470 students were selected as a convenience sample in this preliminary sampling. The population of this research is predominantly of Germanic origin (Filho and Monasterio 2012). All study participants reported their free participation in the study by having the free and informed consent form signed by their parents or guardians. This study was reviewed by the Research Ethics Committee of the Universidade Santa Cruz do Sul, under protocol number 120.090/2012.
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Rev. Bras. Psiquiatr.  vol.28 número3

Rev. Bras. Psiquiatr. vol.28 número3

In a sample comprising subjects from outpatient services of a University general hospital in Brazil, we were able to document an association between adult mood disorders and childhood psychological trauma. In other words, we found a higher odds ratio for exposure to multiple incidents of community violence and for physical abuse by parents or caregivers during childhood/adolescence in the group with mood disorders than in the control group, when these associations were assessed in the context of several potential confounding variables. Specifically, manic patients were the only group that showed significantly higher rates of exposure to multiple incidents of community violence and childhood physical and sexual abuse than the control group.
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Rev. Bras. Psiquiatr.  vol.28 número4

Rev. Bras. Psiquiatr. vol.28 número4

Objective: Treatment-emergent affective switch has been associated to cycle acceleration and poorer outcome, but there are few studies addressing this issue. The aim of this study was to prospectively compare the outcome of patients presenting treatment-emergent affective switch with patients with spontaneous mania, regarding presence and polarity of a new episode and time to relapse. Method: Twenty-four patients with bipolar disorder according to the DSM-IV were followed for 12 months. Twelve patients had treatment-emergent affective switch and twelve had spontaneous mania. Patients were evaluated weekly with the Young Mania Rating Scale and the Hamilton Depression Scale until remission of the index episode, and monthly until completion of the 12-month follow-up. Results: Eleven patients with treatment-emergent affective switch had a recurrence on follow-up, all of them with major depressive episodes. In the group with spontaneous mania, six patients had a recurrence: two had a depressive episode, and four had a manic episode (p = 0.069 for new episode, p = 0.006 for polarity of the episode). Patients with treatment-emergent affective switch relapsed in a shorter period than patients with spontaneous mania (p = 0.016). Conclusions: In this first prospective study, treatment-emergent affective switch patients were at greater risk of relapses, especially depressive episodes, and presented a shorter duration of remission when compared with patients with spontaneous mania.
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The catecholO  (COMT) Val158Met genotype modulates working memoryrelated dorsolateral prefrontal response and performance in bipolar disorder

The catecholO (COMT) Val158Met genotype modulates working memoryrelated dorsolateral prefrontal response and performance in bipolar disorder

The moderate sample size of the present study may have influ- enced the validity of the findings, limits generalization of results and impedes further analysis of the effects of medication status on WM abilities by COMT genotype group. The findings therefore require replication in a larger sample. It was also a limitation that we had not recorded information about patients’ particular antipsy- chotic drugs or doses or whether they had experienced psychotic episodes in the course of their illness, as these variables may dif- fer between the COMT Val158Met genotypes and thus potentially confound the findings. Indeed, numerically (but not statistically sig- nificantly) more Val homozygotes were treated with antipsychotic drugs. Nevertheless, post hoc analyses revealed no association be- tween antipsychotic treatment and high- load specific dlPFC activity or WM performance across the entire cohort. In addition, the lack of a healthy control group hampered direct assessment of whether the dlPFC in BD Val homozygotes was hypoactive during high- load WM. Another limitation was that the SWM was not administered on the same day as the fMRI scan but merely within the same week and that daily variations in mood were therefore not controlled for. Although other single nucleotide polymorphisms (SNPs) have been shown to have an effect on DA availability, cognition, and risk for BD (e.g., rs165599), participants in the present study were strati- fied only for COMT Val158Met genotype. Nevertheless, the present study is the first to demonstrate the moderating effect of COMT Val158Met genotype on WM- related dlPFC activity and WM per- formance in a well- characterized partially or fully remitted sample of BD patients.
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Nigeria SMEs P articipation in  E lectronic  E conomy:  Problems and the  W ay  F orward

Nigeria SMEs P articipation in E lectronic E conomy: Problems and the W ay F orward

Firms need to attract attention to their products and services. This could prove to be quite a task for the typical Nigeria firm, with a practically unknown brand name and weak advertising dollars. Goldstein and O’Connor (2001) state that “even the best e-marketing strategy does not substitute for traditional media. Indeed, such advertising is normally viewed as an unavoidable sunk cost to establish brand name recognition.” Small firms by themselves will be unable to afford the advertising sunk cost that is necessary for effective market penetration. By engaging in a cooperative effort in marketing, using a Web portal and sharing advertising cost, firms may better penetrate the on-line market. Nigeria government needs to encourage and recognize innovative applications of ICTs and help in instituting mechanisms to spread best practices. Government should create a national demonstration and help desks to assist SMEs in ICTs choice, implementation and maintenance. If possible, provide motivation to encourage SMEs’ use of ICTs through various mechanisms, facilitate, support and encourage e-commerce applications through establishing appropriate frameworks, removing hurdles and leading by example. There is need for education and training. Education institutions in Nigeria should Institute compulsory courses in information and communications technology as early as possible into the curriculum. They should also encourage local hardware shops to collect- refurbish and roll-out computers that are gathering dust in most offices to high schools and elementary schools, at least where there is electricity, so that students will get exposure at an early age.Education administrators must ensure that tertiary education curriculum reflects changes in the global environment, expand tertiary level information and communications technology education, establish specialized institutions (like the Egyptian Information technology and South African software development institute) to prepare young cadres for the information economy in collaboration with the local private sector and other international institutions.In addition, they should also encourage, recognize, accredit and certify private institutions involved in high level ICTs training, set requirements and (social) obligations for organizations to provide ICTs skills to their staff and provide incentive and motivation.
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Interactions of polymorphisms in different clock genes associated with circadian phenotypes in humans

Interactions of polymorphisms in different clock genes associated with circadian phenotypes in humans

Polymorphisms in other clock genes were also re- ported to be associated with circadian phenotypes. Ebisawa et al. (2001) found that polymorphisms in the Per3 gene could be associated with Delayed Sleep Phase Syndrome (DSPS). Archer et al. (2003) reduced the region of influ- ence of the Per3 gene in DSPS to a variable number of tan- dem repeats (VNTR) (four or five repeats) localized in exon 18, and reported that the shorter allele was associated with DSPS. Pereira et al. (2005) also reported that this VNTR in the Per3 gene was associated with DSPS, but cu- riously they found that the longer allele was associated with the disease. As the two studies were performed in popula- tions with a Caucasian European genetic background, liv- ing at very different latitudes, these conflicting results sug- gest that latitude can affect the expression of clock genes. Archer et al. (2003) and Pereira et al. (2005) also found that the VNTR polymorphism in the Per3 gene is associated with morning-evening tendencies. Viola et al. (2006) have studied the effects of the Per3 VNTR polymorphism in reg- ulation of diurnal preferences more extensively, under lab- oratory controlled conditions, and have found that it has predictive value in the response to sleep loss.
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Repositório Institucional UFC: Bipolar disorders

Repositório Institucional UFC: Bipolar disorders

E.V. has received grants and honoraria from AstraZeneca, Ferrer, Forest Research Institute, Gedeon Richter, GlaxoSmithKline, H. Lundbeck, Janssen, Otsuka, Pfizer, Sanofi‑Aventis, Sunovion and Takeda. M.B. has received research grants from Bristol‑Myers Squibb, Eli Lilly, GlaxoSmithKline, the Meat and Livestock Board, Mayne Pharma, Novartis, Organon, Servier and Woolworths. M.B. has also acted as a speaker for AstraZeneca, Bristol‑Myers Squibb, Eli Lilly, GlaxoSmithKline, H. Lundbeck, Janssen‑ Cilag, Merck, Pfizer, Sanofi Synthelabo, Servier, Solvay and Wyeth and has served as a consultant to AstraZeneca, Bioadvantex Pharma, Bristol‑Myers Squibb, Eli Lilly, GlaxoSmithKline, H. Lundbeck, Janssen‑Cilag, Merck and Servier. T.S. has received grant funding from Elan Pharma International, Merck and Sunovion and has received personal fees from AstraZeneca, CMEology, Global Medication Education, H. Lundbeck, Medscape Education, Merck and Sunovion, and has received royalties from Jones & Bartlett Learning and UpToDate. J.R.C. has received grant support from Abbott Laboratories, AstraZeneca, Bristol‑Myers Squibb, Cephalon (now Teva Pharmaceutical Industries), Dainippon Sumitomo Pharma, Eli Lilly, GlaxoSmithKline, H. Lundbeck, Intra‑Cellular Therapies, Janssen, Pfizer,, Sunovion and Takeda. J.R.C. has also served as a consultant, advisory board member and speaker for Abbott Laboratories, Allergan, AstraZeneca, Bristol‑Myers Squibb, Cephalon (now Teva Pharmaceutical Industries), Dainippon Sumitomo Pharma, GlaxoSmithKline, H. Lundbeck, Janssen, Merck & Co., Otsuka, Pfizer, Repligen, Servier, Solvay, Sunovion and Takeda. K.G. has been on a speakers’ bureau and an advisory board of Sunovion and has received grant support from AstraZeneca. K.W.M. has received consultancy fees in the past 3 years from Allergan and H. Lundbeck. I.G. has consulted for Ferrer and has been a speaker for Ferrer and Janssen‑Cilag. T.G.S. and A.F.C. declare no competing interests.
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Polymorphisms in RYBP and AOAH genes are associated with chronic rhinosinusitis in a Chinese population: a replication study.

Polymorphisms in RYBP and AOAH genes are associated with chronic rhinosinusitis in a Chinese population: a replication study.

Diagnosis of CRSwNP and CRSsNP was based on American Academy of Otolaryngology-Head and Neck Surgery (AAO-HNS) 2004 guidelines [17], based on assement by a single ENT doctor specialized in sinus diseases. All the CRS cases recruited in present study were unresponsive to all forms of medical therapies such as topical or intranasal corticosteroid and long term-low dose antibiotic or presented persistent signs/symptoms of CRS despite previous endoscopic sinus surgery (ESS). Patients were interviewed by trained personnel, and a standardized questionnaire was used to obtain items including demographic variables and personal and familial antecedents of allergies. Patients also underwent a standard set of laboratory tests that included measurements of total IgE to assess allergic status. Controls were recruited following two strategies: either spouses or non-blood relatives living in the same household and individuals recruited from a geographic area similar to that of CRS patients. The only attempt at matching subjects and control is their geographical location to minimize differences secondary to differences in potential environmental exposures. Nevertheless, a standardized questionnaire assessing age, sex and ethnic origin (but not smoking, history of atopy or physician diagnosed asthma) was obtained for controls. Moreover, all the controls showed negative of serum phadiatop determination.
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Genome-wide association analysis of tolerance to methylmercury toxicity in Drosophila implicates myogenic and neuromuscular developmental pathways.

Genome-wide association analysis of tolerance to methylmercury toxicity in Drosophila implicates myogenic and neuromuscular developmental pathways.

Methylmercury (MeHg) is a persistent environmental toxin present in seafood that can compromise the developing nervous system in humans. The effects of MeHg toxicity varies among individuals, despite similar levels of exposure, indicating that genetic differences contribute to MeHg susceptibility. To examine how genetic variation impacts MeHg tolerance, we assessed developmental tolerance to MeHg using the sequenced, inbred lines of the Drosophila melanogaster Genetic Reference Panel (DGRP). We found significant genetic variation in the effects of MeHg on development, measured by eclosion rate, giving a broad sense heritability of 0.86. To investigate the influence of dietary factors, we measured MeHg toxicity with caffeine supplementation in the DGRP lines. We found that caffeine counteracts the deleterious effects of MeHg in the majority of lines, and there is significant genetic variance in the magnitude of this effect, with a broad sense heritability of 0.80. We performed genome-wide association (GWA) analysis for both traits, and identified candidate genes that fall into several gene ontology categories, with enrichment for genes involved in muscle and neuromuscular development. Overexpression of glutamate-cysteine ligase, a MeHg protective enzyme, in a muscle-specific manner leads to a robust rescue of eclosion of flies reared on MeHg food. Conversely, mutations in kirre, a pivotal myogenic gene identified in our GWA analyses, modulate tolerance to MeHg during development in accordance with kirre expression levels. Finally, we observe disruptions of indirect flight muscle morphogenesis in MeHg-exposed pupae. Since the pathways for muscle development are evolutionarily conserved, it is likely that the effects of MeHg observed in Drosophila can be generalized across phyla, implicating muscle as an additional hitherto unrecognized target for MeHg toxicity. Furthermore, our observations that caffeine can ameliorate the toxic effects of MeHg show that nutritional factors and dietary manipulations may offer protection against the deleterious effects of MeHg exposure.
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Cognitive impairment in bipolar disorder neuroprogression or behavioral variant frontotemporal dementia?

Cognitive impairment in bipolar disorder neuroprogression or behavioral variant frontotemporal dementia?

RESUMO. Pacientes com Transtorno Bipolar (TB) costumam apresentar déficits cognitivos ao envelhecer. No entanto, a correlação com síndromes demenciais é inconclusiva, apesar da similaridade com a variante comportamental da demência frontotemporal (bvFTD). Nós relatamos uma paciente de 78 anos de idade com TB tipo 1 desde a adolescência. Seus sintomas variavam de apatia a mania psicótica. A paciente passou por 3 internações, sendo a última há 10 anos, seguida de estabilização clínica. No entanto, nos últimos 2 anos, ela apresentou sintomas diferentes, como irritabilidade expressada por agressões verbal e física, comprometimento cognitivo, padrão repetitivo de comportamento, perambulação, delírios persecutórios, desorientação e hiporexia. O tratamento com anticolinesterásicos ou estabilizadores de humor não revelou melhora. Apresentou 17/30 pontos no miniexame do estado mental, a avaliação neuropsicológica sugeriu déficit de função executiva, atenção e memória. Os exames de neuroimagem demonstraram atrofia e hipoperfusão fronto-temporal. Abordagens diagnósticas e terapêuticas para este tipo de paciente representam um desafio significativo para os clínicos.
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Rev. Bras. Psiquiatr.

Rev. Bras. Psiquiatr.

In the present study, 75.6% of patients, despite having different traditional CVR profiles and different durations and numbers of BD exacerbations, had a CCS of 0. The absence of calcified plaques in the coronary arteries would translate to an excellent prognosis regarding incident cardiovascular events for several years. It is unknown, however, which individuals with BD will be more prone to experience a hard CV event even without calcified coronary plaques as detected by CCS. In individuals with BD, besides the increased prevalence of traditional CVR factors, the younger age and pro-inflammatory changes related to the disease itself may be associated with non- calcified plaques, although this hypothesis requires con- firmation. CCS does not detect non-calcified plaque and Figure 1 CCS and number of previous psychiatric hospita-
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Rev. Bras. Psiquiatr.  vol.26 suppl.3

Rev. Bras. Psiquiatr. vol.26 suppl.3

Recently, the use of psychoeducation as an add-on prophylactic tool has been acknowledged by several prestigious treatment guidelines broadening and updating the treatment paradigms of bipolar disorders. Clinicians should keep this in mind in the everyday clinical practice with bipolar patients specially because the benefits – in terms of less relapses and hospitalizations – are unquestionable and the cost very low. To this end, there is an emergent need for training professionals in good communicational skills and psychoeducation techniques to worldwide implement its use in bipolar disorders. Psychoeducation provides us with a strong tool not only to improve our patients’ outcome but to help them to manage despair, fears, stigma and low self-esteem. Psychoeducation should be always an add-on to mood-stabilizers as it optimizes their efficacy.
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Peripheral interleukin-2 level is associated with negative symptoms and cognitive performance in schizophrenia

Peripheral interleukin-2 level is associated with negative symptoms and cognitive performance in schizophrenia

and elongation in primary rat brain cultures. Corroborating these neuro- protective effects, Awatsuji, Furukawa [49] showed that IL-2 promoted cell survival in cortical, striatal and septal neurons. IL-2 effects are mediated by binding to its specific receptor (IL-2R). IL-2 receptor is expressed in cerebral areas related to cognition, like the neocortex, cer- ebellum and hippocampus [50]. We have shown that, in our group of patients, higher IL-2 levels were associated with better cognitive scores, suggesting that IL-2 may be acting as a neuroprotector in SZ individuals. The results of this study must be interpreted at light of its limitations. First, the relatively small sample size limited the possibility to include more covariates, such as time of illness or current medications. Also, the results could have been influenced by the intergroup differences re- garding marital status and sex, although we found no differences in the levels of IL-2 between married and non-married controls and between male and female controls. In addition, the cross sectional design does not allow strong inferences of causality between IL-2 levels and cogni- tive deficits and symptoms. As all the patients were under antipsychotic pharmacological treatment, we cannot completely rule out its influence on biomarker's levels, which has been previously shown as a potential confounder. On the other hand, we tried to minimize confounders ex- cluding individuals with recent changes in medication regimen and general medical comorbidity. Furthermore, we assessed the possible impact of clozapine use in IL-2 levels, clinical and cognitive variables and found no significant differences between patients using clozapine and those using other atypical antipsychotics.
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