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Back to the future: the Brazilian Journal of Psychiatry embraces change and innovation future
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Brunoni, Andre R.

; Nardi, Antonio E.

Brazilian Journal of Psychiatry

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2024, Volume 46 elocation e20240056

Resumo: En | Texto: En | PDF: En

https://doi.org/10.47626/1516-4446-2024-0056

Back to the future: the Brazilian Journal of Psychiatry embraces change and innovation future
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Brunoni, Andre R.

; Nardi, Antonio E.

Brazilian Journal of Psychiatry

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2024, Volume 46 elocation e20240056

Resumo: En | Texto: En | PDF: En

https://doi.org/10.47626/1516-4446-2024-0056

An electric field modeling study with meta-analysis to understand the antidepressant effects of transcranial direct current stimulation (tDCS) metaanalysis meta analysis tDCS (tDCS
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Razza, Lais B.

; Wischnewski, Miles

; Suen, Paulo

; De Smet, Stefanie

; da Silva, Pedro Henrique Rodrigues

; Catoira, Beatriz

; Brunoni, André R.

; Vanderhasselt, Marie-Anne

Brazilian Journal of Psychiatry

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Dez 2023, Volume 45 Nº 6 Páginas 518 - 529

Resumo: En | Texto: En | PDF: En

Objective: Transcranial direct current stimulation (tDCS) has mixed effects for major depressive disorder (MDD) symptoms, partially owing to large inter-experimental variability in tDCS protocols and their correlated induced electric fields (E-fields). We investigated whether the E-field strength of distinct tDCS parameters was associated with antidepressant effect. Methods: A meta-analysis was performed with placebo-controlled clinical trials of tDCS enrolling MDD patients. PubMed, EMBASE, and Web of Science were searched from inception to March 10, 2023. Effect sizes of tDCS protocols were correlated with E-field simulations (SimNIBS) of brain regions of interest (bilateral dorsolateral prefrontal cortex [DLPFC] and bilateral subgenual anterior cingulate cortex [sgACC]). Moderators of tDCS responses were also investigated. Results: A total of 20 studies were included (21 datasets, 1,008 patients), using 11 distinct tDCS protocols. Results revealed a moderate effect for MDD (g = 0.41, 95%CI 0.18-0.64), while cathode position and treatment strategy were found to be moderators of response. A negative association between effect size and tDCS-induced E-field magnitude was seen, with stronger E-fields in the right frontal and medial parts of the DLPFC (targeted by the cathode) leading to smaller effects. No association was found for the left DLPFC and the bilateral sgACC. An optimized tDCS protocol is proposed. Conclusions: Our results highlight the need for a standardized tDCS protocol in MDD clinical trials. Registration number: PROSPERO CRD42022296246. Objective (tDCS (MDD symptoms interexperimental inter experimental Efields. Efields E . (E-fields) Efield field Methods metaanalysis meta analysis placebocontrolled placebo controlled patients PubMed EMBASE 10 2023 SimNIBS (SimNIBS [DLPFC sgACC [sgACC]) 2 21 (2 datasets 1008 1 008 1,00 patients, , patients) g 041 0 41 0.41 95CI CI 95 0.180.64, 018064 0.18 0.64 18 64 0.18-0.64) response tDCSinduced seen targeted proposed Conclusions number CRD42022296246 CRD (E-fields 202 [sgACC] ( 100 00 1,0 04 4 0.4 9 180 0.180.64 01806 018 0.1 064 0.6 6 0.18-0.64 CRD4202229624 [sgACC 1, 0. 0.180.6 0180 01 06 0.18-0.6 CRD420222962 0.180. 0.18-0. CRD42022296 0.180 0.18-0 CRD4202229 0.18- CRD420222 CRD42022 CRD4202 CRD420 CRD42 CRD4

https://doi.org/10.47626/1516-4446-2023-3116

Treatment resistance in schizophrenia: a meta-analysis of prevalence and correlates schizophrenia metaanalysis meta analysis
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Diniz, Elton

; Fonseca, Lais

; Rocha, Deyvis

; Trevizol, Alisson

; Cerqueira, Raphael

; Ortiz, Bruno

; Brunoni, André R.

; Bressan, Rodrigo

; Correll, Christoph U.

; Gadelha, Ary

Brazilian Journal of Psychiatry

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Out 2023, Volume 45 Nº 5 Páginas 448 - 458

Resumo: En | Texto: En | PDF: En

Objectives: To determine the prevalence and correlates of treatment-resistant schizophrenia (TRS) through a systematic review and meta-analysis. Methods: Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) criteria, an electronic search was performed in PubMed and Embase through May 17, 2022. All study designs that assessed a minimum of 20 schizophrenia-spectrum patients and provided data on TRS prevalence or allowed its calculation were included. Estimates were produced using a random-effects model meta-analysis. Results: The TRS prevalence across 50 studies (n = 29,390) was 36.7% (95%CI 33.1-40.5, p < 0.0001). The prevalence ranged from 22% (95%CI 18.4-25.8) in first-episode to 39.5% (95%CI 32.2-47.0) in multiple-episode samples (Q = 18.27, p < 0.0001). Primary treatment resistance, defined as no response from the first episode, was 23.6% (95%CI 20.5-26.8) vs. 9.3% (95%CI 6.8-12.2) for later-onset/secondary (≥ 6 months after initial treatment response). Longer illness duration and recruitment from long-term hospitals or clozapine clinics were associated with higher prevalence estimates. In meta-regression analyses, older age and poor functioning predicted greater TRS. When including only studies with lower bias risk, the TRS prevalence was 28.4%. Conclusion: Different study designs and recruitment strategies accounted for most of the observed heterogeneity in TRS prevalence rates. The results point to early-onset and later-onset TRS as two separate disease pathways requiring clinical attention. Registration number: PROSPERO CRD42018092033. Objectives treatmentresistant resistant (TRS metaanalysis. metaanalysis meta analysis. analysis meta-analysis Methods MetaAnalyses Meta Analyses PRISMA (PRISMA criteria 17 2022 2 schizophreniaspectrum spectrum included randomeffects random effects Results 5 n 29,390 29390 29 390 367 36 7 36.7 95%CI 95CI CI 95 33.140.5, 331405 33.1 40.5, 33 1 40 33.1-40.5 0.0001. 00001 0.0001 . 0 0001 0.0001) 22 18.425.8 184258 18.4 25.8 18 4 25 8 18.4-25.8 firstepisode episode 395 39 39.5 32.247.0 322470 32.2 47.0 32 47 32.2-47.0 multipleepisode multiple Q 1827 27 18.27 resistance 236 23 23.6 20.526.8 205268 20.5 26.8 26 20.5-26.8 vs 93 9 3 9.3 6.812.2 68122 6.8 12.2 12 6.8-12.2 lateronset/secondary lateronsetsecondary later onset/secondary onset secondary ≥ ( response. response) longterm long term estimates metaregression regression analyses risk 284 28 28.4% Conclusion rates earlyonset early lateronset attention number CRD42018092033 CRD 202 29,39 2939 36. 140 33.140.5 33140 331 33. 405 40.5 33.1-40. 0000 0.000 000 425 18.425. 18425 184 18. 258 25. 18.4-25. 39. 247 32.247. 32247 322 32. 470 47. 32.2-47. 182 18.2 23. 526 20.526. 20526 205 20. 268 26. 20.5-26. 9. 812 6.812. 6812 68 6. 122 12. 6.8-12. onsetsecondary 28.4 CRD4201809203 29,3 293 14 33.140. 3314 40. 33.1-40 0.00 00 42 18.425 1842 18.4-25 24 32.247 3224 32.2-47 52 20.526 2052 20.5-26 81 6.812 681 6.8-12 28. CRD420180920 29, 33.140 33.1-4 0.0 18.42 18.4-2 32.24 32.2-4 20.52 20.5-2 6.81 6.8-1 CRD42018092 33.14 33.1- 0. 18.4- 32.2- 20.5- 6.8- CRD4201809 CRD420180 CRD42018 CRD4201 CRD420 CRD42 CRD4

https://doi.org/10.47626/1516-4446-2023-3126

Interventional psychiatry: 13 reasons why
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Brunoni, Andre R.

; Valiengo, Leandro

; Gallucci-Neto, Jose

Brazilian Journal of Psychiatry

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Dez 2022, Volume 44 Nº 6 Páginas 565 - 566

Resumo: En | Texto: En | PDF: En

https://doi.org/10.47626/1516-4446-2022-0042

Interventional psychiatry: the elephants in the room
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Padberg, Frank

; Burkhardt, Gerrit

; Goerigk, Stephan

; Brunoni, Andre R.

Brazilian Journal of Psychiatry

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Dez 2022, Volume 44 Nº 6 Páginas 567 - 569

Resumo: En | Texto: En | PDF: En

https://doi.org/10.47626/1516-4446-2022-0044

Distractibility, anxiety, irritability, and agitation symptoms are associated with the severity of depressive and manic symptoms in mixed depression
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Tavares, Diego Freitas

; Suen, Paulo

; Moreno, Doris Hupfeld

; Vieta, Eduard

; Moreno, Ricardo Alberto

; Brunoni, André R.

Brazilian Journal of Psychiatry

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Dez 2022, Volume 44 Nº 6 Páginas 576 - 583

Resumo: En | Texto: En | PDF: En

Objective: To explore whether there is an association between distractibility, anxiety, irritability, and agitation (DAIA) symptoms and the severity of depressive and manic symptoms. Methods: Patients with unipolar and bipolar disorder (I and II) and mixed depression were evaluated. DAIA symptoms were assessed using previously described definitions. Results: The full analysis set comprised 100 patients. The severity of depressive symptoms in mixed depression, assessed by Montgomery-Åsberg Depression Rating Scale (MADRS), was significantly associated with the presence of two or more DAIA symptoms in the bipolar sample, influenced mainly by anxiety. The severity of manic symptoms in mixed depression, assessed by Young Mania Rating Scale (YMRS), was significantly associated with the presence of two or more DAIA symptoms in the bipolar sample and three or four DAIA symptoms in the unipolar sample. Conclusion: DAIA symptoms were associated with greater severity of manic symptoms in mixed depression. DAIA symptoms must be evaluated in all patients with mixed features and are associated with the severity of depressive and manic symptoms in mixed depression. Clinical trial registration: ClinicalTrials.gov (NCT04123301).

https://doi.org/10.47626/1516-4446-2022-2606

Neurocircuit models of obsessive-compulsive disorder: limitations and future directions for research
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Shephard, Elizabeth

; Batistuzzo, Marcelo C.

; Hoexter, Marcelo Q.

; Stern, Emily R.

; Zuccolo, Pedro F.

; Ogawa, Carolina Y.

; Silva, Renata M.

; Brunoni, Andre R.

; Costa, Daniel L.

; Doretto, Victoria

; Saraiva, Leonardo

; Cappi, Carolina

; Shavitt, Roseli G.

; Simpson, H. Blair

; van den Heuvel, Odile A.

; Miguel, Euripedes C.

Brazilian Journal of Psychiatry

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Abr 2022, Volume 44 Nº 2 Páginas 187 - 200

Resumo: En | Texto: En | PDF: En

Obsessive-compulsive disorder (OCD) is a common psychiatric condition classically characterized by obsessions (recurrent, intrusive and unwanted thoughts) and compulsions (excessive, repetitive and ritualistic behaviors or mental acts). OCD is heterogeneous in its clinical presentation and not all patients respond to first-line treatments. Several neurocircuit models of OCD have been proposed with the aim of providing a better understanding of the neural and cognitive mechanisms involved in the disorder. These models use advances in neuroscience and findings from neuropsychological and neuroimaging studies to suggest links between clinical profiles that reflect the symptoms and experiences of patients and dysfunctions in specific neurocircuits. Several models propose that treatments for OCD could be improved if directed to specific neurocircuit dysfunctions, thereby restoring efficient neurocognitive function and ameliorating the symptomatology of each associated clinical profile. Yet, there are several important limitations to neurocircuit models of OCD. The purpose of the current review is to highlight some of these limitations, including issues related to the complexity of brain and cognitive function, the clinical presentation and course of OCD, etiological factors, and treatment methods proposed by the models. We also provide suggestions for future research to advance neurocircuit models of OCD and facilitate translation to clinical application.

https://doi.org/10.1590/1516-4446-2020-1709

Chronic inflammatory diseases, subclinical atherosclerosis, and cardiovascular diseases: Design, objectives, and baseline characteristics of a prospective case-cohort study ‒ ELSA-Brasil
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Bensenor, Isabela M.

; Goulart, Alessandra C.

; Pereira, Alexandre C.

; Brunoni, André R.

; Alencar, Airlane

; Santos, Raul D.

; Bittencourt, Márcio S.

; Telles, Rosa W.

; Machado, Luciana Andrade Carneiro

; Barreto, Sandhi Maria

; de Almeida-Pititto, Bianca

; Janovsky, Carolina Porto Silva

; Sgarbi, José Augusto

; Tebar, William R.

; Meneghini, Vandrize

; Barbosa Junior, Fernando

; Ribeiro, Ana Cristina de Medeiros

; Pasoto, Sandra Gofinet

; Pereira, Rosa Maria R.

; Bonfá, Eloísa

; Sipahi, Aytan M.

; Santos, Itamar de S.

; Lotufo, Paulo A.

Clinics

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2022, Volume 77 elocation 100013

Resumo: En | Texto: En | PDF: En

Abstract Objectives This analysis describes the protocol of a study with a case-cohort to design to prospectively evaluate the incidence of subclinical atherosclerosis and Cardiovascular Disease (CVD) in Chronic Inflammatory Disease (CID) participants compared to non-diseased ones. Methods A high-risk group for CID was defined based on data collected in all visits on self-reported medical diagnosis, use of medicines, and levels of high-sensitivity C-Reactive Protein >10 mg/L. The comparison group is the Aleatory Cohort Sample (ACS): a group with 10% of participants selected at baseline who represent the entire cohort. In both groups, specific biomarkers for DIC, markers of subclinical atherosclerosis, and CVD morbimortality will be tested using weighted Cox. Results The high-risk group (n = 2,949; aged 53.6 ± 9.2; 65.5% women) and the ACS (n=1543; 52.2±8.8; 54.1% women) were identified. Beyond being older and mostly women, participants in the high-risk group present low average income (29.1% vs. 24.8%, p < 0.0001), higher BMI (Kg/m2) (28.1 vs. 26.9, p < 0.0001), higher waist circumference (cm) (93.3 vs. 91, p < 0.0001), higher frequencies of hypertension (40.2% vs. 34.5%, p < 0.0001), diabetes (20.7% vs. 17%, p = 0.003) depression (5.8% vs. 3.9%, p = 0.007) and higher levels of GlycA a new inflammatory marker (p < 0.0001) compared to the ACS. Conclusions The high-risk group selected mostly women, older, lower-income/education, higher BMI, waist circumference, and of hypertension, diabetes, depression, and higher levels of GlycA when compared to the ACS. The strategy chosen to define the high-risk group seems adequate given that multiple sociodemographic and clinical characteristics are compatible with CID.

https://doi.org/10.1016/j.clinsp.2022.100013

10.

Combined effects of theta-burst stimulation with transcranial direct current stimulation of the prefrontal cortex: study protocol of a randomized, double-blinded, sham-controlled trial using 99mTc-ECD SPECT
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Razza, Laís B.

; Buchpiguel, Carlos A.

; De Smet, Stefanie

; Klein, Izio

; Baeken, Chris

; Galhardoni, Ricardo

; Vanderhasselt, Marie-Anne

; Brunoni, André R.

Trends in Psychiatry and Psychotherapy

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Dez 2021, Volume 43 Nº 4 Páginas 293 - 301

Resumo: En | Texto: En | PDF: En

Abstract Introduction Non-invasive brain stimulation (NIBS) as monotherapy has been increasingly used to enhance the activity of brain networks. However, it is unclear whether a combination of distinct NIBS approaches could enhance prefrontal cortical (PFC) activity. Objective We propose to investigate the combined and standalone effects of two NIBS modalities on the PFC through a working memory task, single photon emission computed tomography (SPECT), and salivary cortisol. We hypothesize that the combined protocol will provoke greater changes in the collected measures compared to the remining protocols. Methods A randomized, double-blind, sham-controlled, full-factorial design will be conducted. The effects of transcranial direct current stimulation (tDCS) and intermittent theta-burst stimulation (iTBS) will be investigated over four different sessions (sham tDCS + sham iTBS, anodal tDCS + sham iTBS, anodal tDCS + active iTBS and sham tDCS + active iTBS) in 30 healthy adult volunteers. A 99mTc-ethylene cysteine dimer (99mTC-ECD) will be administered during the NIBS session and neuroimaging will be acquired within one hour. Salivary cortisol will be collected before and after each session and an n-back working memory task will be applied after the end of each NIBS session. The outcomes will be cerebral perfusion alterations (99mTC-ECD SPECT), accuracy and reaction time in the n-back task, and changes in salivary cortisol level. Conclusion The results from this trial can guide future therapeutic protocols for NIBS treatments stimulating the PFC by demonstrating that the combination of NIBS techniques is feasible, tolerable, and can lead to greater enhancement of PFC activity.

https://doi.org/10.47626/2237-6089-2020-0110

11.

Appraising the effectiveness of electrical and magnetic brain stimulation techniques in acute major depressive episodes: an umbrella review of meta-analyses of randomized controlled trials
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Razza, Laís B.

; Afonso dos Santos, Leonardo

; Borrione, Lucas

; Bellini, Helena

; Branco, Luis C.

; Cretaz, Eric

; Duarte, Dante

; Ferrão, Ygor

; Galhardoni, Ricardo

; Quevedo, João

; Simis, Marcel

; Fregni, Felipe

; Correll, Christoph U.

; Padberg, Frank

; Trevizol, Alisson

; Daskalakis, Zafiris J.

; Carvalho, Andre F.

; Solmi, Marco

; Brunoni, André R.

Brazilian Journal of Psychiatry

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Out 2021, Volume 43 Nº 5 Páginas 514 - 524

Resumo: En | Texto: En | PDF: En

Electrical and magnetic brain stimulation techniques present distinct mechanisms and efficacy in the acute treatment of depression. This was an umbrella review of meta-analyses of randomized controlled trials of brain stimulation techniques for managing acute major depressive episodes. A systematic review was performed in the PubMed/MEDLINE databases from inception until March 2020. We included the English language meta-analysis with the most randomized controlled trials on the effects of any brain stimulation technique vs. control in adults with an acute depressive episode. Continuous and dichotomous outcomes were assessed. A Measurement Tool to Assess Systematic Reviews-2 was applied and the credibility of evidence was assessed using the Grading of Recommendations Assessment, Development and Evaluation framework. Seven meta-analyses were included (5,615 patients), providing evidence for different modalities of brain stimulation techniques. Three meta-analyses were evaluated as having high methodological quality, three as moderate, and one as low. The highest quality of evidence was found for high frequency-repetitive transcranial magnetic stimulation (rTMS), transcranial direct current stimulation, and bilateral rTMS. There is strong clinical research evidence to guide future clinical use of some techniques. Our results confirm the heterogeneity of the effects across these techniques, indicating that different mechanisms of action lead to different efficacy profiles.

https://doi.org/10.1590/1516-4446-2020-1169 306 downloads

12.

COMVC-19: A Program to protect healthcare workers’ mental health during the COVID-19 Pandemic. What we have learned
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Fukuti, Pedro

; Uchôa, Caroline Louise Mesquita

; Mazzoco, Marina Flaborea

; Cruz, Isabella D'Andrea Garcia da

; Echegaray, Mariana V.F.

; Humes, Eduardo de Castro

; Silveira, Júlia Belizário

; Santi, Talita Di

; Miguel, Euripedes Constantino

; Corchs, Felipe

; Fatori, Daniel

; Campello, Guilherme

; Oliveira, Gabriel M. de

; Argolo, Felipe C.

; Ferreira, Felipe de M.

; Machado, Gustavo

; Argeu, Adriana

; Oliveira, Graça Maria Ramos de

; Serafim, Antônio de Pádua

; Siqueira, Luciana de Lima

; Rossi, Luciane de

; Rios, Izabel Cristina

; Oliveira, Talita Rodrigues de

; Antoniazzi, Leilane C. K.

; Gagliotti, Daniel Augusto Mori

; Abelama Neto, Emílio

; Oliveira Junior, Paulo Novais de

; Correia, Aline Villalobo

; Gonçalves, Luca Schilling

; Tortato, Liana Silva

; Busato, Wagner Machado Moraes

; Guimarães-Fernandes, Flávio

; Alves, Marcos

; Leite Netto, Oswaldo Ferreira

; Schoueri, Patrícia de Campos Lindenberg

; Roque, Márcio de Assis

; Merlin, Silvia Stahl

; Boer, Giovana Cardoso Machado

; Sallet, Paulo Clemente

; Malbergier, André

; Spedo, Mariana Abrahão

; Kamitsuji, Carla Satie

; Faria, Elizabeth de

; Moreira, Moacyr Vergara de Godoy

; Kaufman, Arthur

; Abdo, Carmita

; Scanavino, Marco de Tubino

; Lancman, Selma

; Tavares, Hermano

; Polanczyk, Guilherme

; Brunoni, André R.

; Forlenza, Orestes V.

; Barros-Filho, Tarcísio Eloy Pessoa de

Clinics

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2021, Volume 76 elocation e2631

Resumo: En | Texto: En | PDF: En

OBJECTIVE: In 2020, the COVID-19 pandemic brought a work and stress overload to healthcare workers, increasing their vulnerability to mental health impairments. In response, the authors created the COMVC-19 program. The program offered preventive actions and mental health treatment for the 22,000 workers of The Hospital das Clinicas da Faculdade de Medicina da Universidade de São Paulo (HCFMUSP). This paper aims to describe its implementation and share what we have learned from this experience. METHODS: Workers were able to easily access the program through a 24/7 hotline. Additionally, a mobile phone app that screened for signs and symptoms of emotional distress and offered psychoeducation and/or referral to treatment was made available. Data from both these sources as well as any subsequent psychiatric evaluations were collected. RESULTS: The first 20 weeks of our project revealed that most participants were female, and part of the nursing staff working directly with COVID-19 patients. The most frequently reported symptoms were: anxiety, depression and sleep disturbances. The most common diagnoses were Adjustment, Anxiety, and Mood disorders. CONCLUSIONS: Implementing a mental health program in a multimodal intervention was feasible in a major quaternary public hospital. Our data also suggests that preventive actions should primarily be aimed at anxiety and depression symptoms, with a particular focus on the nursing staff.

https://doi.org/10.6061/clinics/2021/e2631

13.

Precision non-implantable neuromodulation therapies: a perspective for the depressed brain
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Borrione, Lucas

; Bellini, Helena

; Razza, Lais Boralli

; Avila, Ana G.

; Baeken, Chris

; Brem, Anna-Katharine

; Busatto, Geraldo

; Carvalho, Andre F.

; Chekroud, Adam

; Daskalakis, Zafiris J.

; Deng, Zhi-De

; Downar, Jonathan

; Gattaz, Wagner

; Loo, Colleen

; Lotufo, Paulo A.

; Martin, Maria da Graça M.

; McClintock, Shawn M.

; O’Shea, Jacinta

; Padberg, Frank

; Passos, Ives C.

; Salum, Giovanni A.

; Vanderhasselt, Marie-Anne

; Fraguas, Renerio

; Benseñor, Isabela

; Valiengo, Leandro

; Brunoni, Andre R.

Brazilian Journal of Psychiatry

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Ago 2020, Volume 42 Nº 4 Páginas 403 - 419

Resumo: En | Texto: En | PDF: En

Current first-line treatments for major depressive disorder (MDD) include pharmacotherapy and cognitive-behavioral therapy. However, one-third of depressed patients do not achieve remission after multiple medication trials, and psychotherapy can be costly and time-consuming. Although non-implantable neuromodulation (NIN) techniques such as transcranial magnetic stimulation, transcranial direct current stimulation, electroconvulsive therapy, and magnetic seizure therapy are gaining momentum for treating MDD, the efficacy of non-convulsive techniques is still modest, whereas use of convulsive modalities is limited by their cognitive side effects. In this context, we propose that NIN techniques could benefit from a precision-oriented approach. In this review, we discuss the challenges and opportunities in implementing such a framework, focusing on enhancing NIN effects via a combination of individualized cognitive interventions, using closed-loop approaches, identifying multimodal biomarkers, using computer electric field modeling to guide targeting and quantify dosage, and using machine learning algorithms to integrate data collected at multiple biological levels and identify clinical responders. Though promising, this framework is currently limited, as previous studies have employed small samples and did not sufficiently explore pathophysiological mechanisms associated with NIN response and side effects. Moreover, cost-effectiveness analyses have not been performed. Nevertheless, further advancements in clinical trials of NIN could shift the field toward a more “precision-oriented” practice.

https://doi.org/10.1590/1516-4446-2019-0741 1546 downloads

14.

Association of BDNF, HTR2A, TPH1, SLC6A4, and COMT polymorphisms with tDCS and escitalopram efficacy: ancillary analysis of a double-blind, placebo-controlled trial
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Brunoni, Andre R.

; Carracedo, Angel

; Amigo, Olalla M.

; Pellicer, Ana L.

; Talib, Leda

; Carvalho, Andre F.

; Lotufo, Paulo A.

; Benseñor, Isabela M.

; Gattaz, Wagner

; Cappi, Carolina

Brazilian Journal of Psychiatry

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Abr 2020, Volume 42 Nº 2 Páginas 128 - 135

Resumo: En | Texto: En | PDF: En

Objective: We investigated whether single nucleotide polymorphisms (SNPs) associated with neuroplasticity and activity of monoamine neurotransmitters, such as the brain-derived neurotrophic factor (BDNF, rs6265), the serotonin transporter (SLC6A4, rs25531), the tryptophan hydroxylase 1 (TPH1, rs1800532), the 5-hydroxytryptamine receptor 2A (HTR2A, rs6311, rs6313, rs7997012), and the catechol-O-methyltransferase (COMT, rs4680) genes, are associated with efficacy of transcranial direct current stimulation (tDCS) in major depression. Methods: Data from the Escitalopram vs. Electrical Current Therapy for Treating Depression Clinical Study (ELECT-TDCS) were used. Participants were antidepressant-free at baseline and presented with an acute, moderate-to-severe unipolar depressive episode. They were randomized to receive escitalopram/tDCS-sham (n=75), tDCS/placebo-pill (n=75), or placebo-pill/sham-tDCS (n=45). General linear models assessed the interaction between treatment group and allele-wise carriers. Additional analyses were performed for each group and each genotype separately. Results: Pairwise group comparisons (tDCS vs. placebo, tDCS vs. escitalopram, and escitalopram vs. placebo) did not identify alleles associated with depression improvement. In addition, exploratory analyses also did not identify any SNP unequivocally associated with improvement of depression in any treatment group. Conclusion: Larger, combined datasets are necessary to identify candidate genes for tDCS response.

https://doi.org/10.1590/1516-4446-2019-0620 1172 downloads

15.

Precision noninvasive brain stimulation: is it precise? Is it needed?
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Borrione, Lucas

; Brunoni, Andre R.

Brazilian Journal of Psychiatry

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Out 2019, Volume 41 Nº 5 Páginas 376 - 377

Resumo: En | Texto: En | PDF: En

https://doi.org/10.1590/1516-4446-2019-4110 531 downloads

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