Progress in neuro-psychopharmacology & biological psychiatry
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Prog. Neuropsychopharmacol. Biol. Psychiatry · Aug 2019
Randomized Controlled TrialNeurocognitive performance under combined regimens of ketamine-dexmedetomidine and ketamine-fentanyl in healthy adults: A randomised trial.
Analgesic doses of ketamine affects neurocognition; however, deficits under co-administration regimens are unknown. This study evaluated the effects of ketamine, alone and in combination with dexmedetomidine or fentanyl on neurocognition. Using a randomised, within-subjects gender stratified design, 39 participants (mean age = 28.4, SD ± 5.8) received a ketamine bolus of 0.3 mg/kg followed by 0.15 mg/kg/h infusion of ketamine (3 h duration). ⋯ Ketamine, norketamine and dexmedetomidine concentrations were modestly associated with reduced psychomotor speed and accuracy (all p < .05), and an inverse relationship was found between blood concentrations of ketamine, norketamine and dexmedetomidine and performance on memory tasks. Co-administration of ketamine with dexmedetomidine but not with fentanyl exerts synergistic effects on psychomotor performance and memory without executive dysfunction. Assessment of these effects in clinical groups is warranted.
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Prog. Neuropsychopharmacol. Biol. Psychiatry · Aug 2019
Influence of early adversity on cortisol reactivity, SLC6A4 methylation and externalizing behavior in children of alcoholics.
Children of parents with alcoholism face considerable stress, and often have externalizing behaviors. Early adversity is known to affect DNA methylation and the functioning of the HPA axis. We investigated the association of early adversity with cortisol reactivity, 5HTTLPR genotype, site specific DNA methylation in the SLC6A4 gene and externalizing behavior in children of alcoholics (COA), and a matched sample of control children. ⋯ Our study provides further evidence that early adversity is associated with blunted cortisol reactivity, increased site-specific CpG DNA methylation at the SLC6A4 gene, and high externalizing behavior.
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Prog. Neuropsychopharmacol. Biol. Psychiatry · Jul 2019
Non-invasive brain stimulation in generalized anxiety disorder: A systematic review.
In the last years, several studies using non-invasive brain stimulation (NIBS) techniques demonstrated that the dorsolateral prefrontal cortex (DLPFC) plays a key role in the neurobiological bases of anxiety disorders. Both transcranial magnetic stimulation (TMS) and transcranial direct current stimulation (tDCS) applied primarily over the prefrontal cortex have been shown to modulate anxiety symptomatology and attention allocation in the generalized anxiety disorder. A literature search on PubMed and PsycINFO databases following PRISMA guidelines identified 4 TMS studies (one open-label study and three randomized trials with active/sham conditions) and one tDCS case report study that have applied NIBS in patients with GAD. ⋯ Overall, the findings would suggest that NIBS could ameliorate anxiety symptoms and that improvements remained stable in the follow-up. Although a limited number of NIBS studies has been conducted on patients with anxiety disorders, these techniques could represent promising tools for the study of neurofunctional basis of anxiety disorders. Further sham-controlled studies are needed to clarify the mechanisms of action of NIBS in order to optimize stimulation protocols and to verify their effectiveness for treating anxiety symptoms.
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Prog. Neuropsychopharmacol. Biol. Psychiatry · Apr 2019
ReviewTranslational machine learning for psychiatric neuroimaging.
Despite its initial promise, neuroimaging has not been widely translated into clinical psychiatry to assist in the prediction of diagnoses, prognoses, and optimal therapeutic strategies. Machine learning approaches may enhance the translational potential of neuroimaging because they specifically focus on overcoming biases by optimizing the generalizability of pipelines that measure complex brain patterns to predict targets at a single-subject level. ⋯ Promising initial results are then balanced by the description of limitations that should be considered in order to interpret existing research and maximize the possibility of future translation. Future directions are then presented in order to inspire further research and progress the field towards clinical translation.