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Background: Discovering biological markers is essential for understanding and treating mental disorders. Despite the limitations of current non-invasive methods, neural progenitor cells from the olfactory epithelium (hNPCs-OE) have been emphasized as potential biomarker sources. This study measured soluble factors in these cells in Major Depressive Disorder (MDD), Borderline Personality Disorder (BPD), and healthy controls (HC). Methods: We assessed thirty-five participants divided into MDD (n=14), BPD (n=14), and HC (n=7). MDD was assessed using the Hamilton Depression Rating Scale. BPD was evaluated using the DSM-5 criteria and the Structured Clinical Interview for Personality Disorders. We isolated hNPCs-OE, collected intracellular proteins and conditioned medium, and quantified markers and soluble factors, including Interleukin-6, interleukin-8, and others. Analysis was conducted using one-way ANOVA or Kruskal-Wallis test and linear regression. Results: We found that hNPCs-OE of MDD and BPD decreased Sox2 and laminin receptor-67 kDa levels. MASH-1 decreased in BPD, while tubulin beta-III decreased in MDD compared to controls and BPD. Also, we found significant differences in IL-6, IL-8, MCP-1, and thrombospondin-1 levels between controls and MDD, or BPD, but not between MDD and BPD. Conclusions: Altered protein markers are evident in the nhNPCs-OE in MDD and BPD patients. These cells also secrete higher concentrations of inflammatory cytokines than HC cells. The results suggest the potential utility of hNPCs-OE as an in vitro model for researching biological protein markers in psychiatric disorders. However, more extensive validation studies are needed to confirm their effectiveness and specificity in neuropsychiatric disorders.

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Cocaine use disorder (CUD) is a substance use disorder (SUD) characterized by compulsion to seek, use and abuse of cocaine, with severe health and economic consequences for the patients, their families and society. Due to the lack of successful treatments and high relapse rate, more research is needed to understand this and other SUD. Here, we present the SUDMEX CONN dataset, a Mexican open dataset of 74 CUD patients (9 female) and matched 64 healthy controls (6 female) that includes demographic, cognitive, clinical, and magnetic resonance imaging (MRI) data. MRI data includes: 1) structural (T1-weighted), 2) multishell high-angular resolution diffusion-weighted (DWI-HARDI) and 3) functional (resting state fMRI) sequences. The repository contains unprocessed MRI data available in brain imaging data structure (BIDS) format with corresponding metadata available at the OpenNeuro data sharing platform. Researchers can pursue brain variability between these groups or use a single group for a larger population sample.

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BACKGROUND: There is research evidence regarding the presence of stigmatising attitudes in psychiatrists towards people with mental illness, but a lack of studies and interventions focused on this issue in low and middle-income countries. AIMS: To assess the feasibility of implementing an anti-stigma intervention for Mexican psychiatric trainees, and its potential effects. METHODS: This study comprised a pre-post design with outcome measures compared between baseline and 3-month follow-up. Quantitative outcome measures were used to evaluate the potential effects of the intervention, whilst the process evaluation required the collection and analysis of both quantitative and qualitative data. RESULTS: Twenty-nine trainees (25% of those invited) participated in the intervention, of whom 18 also participated in the follow-up assessment. Outcome measures showed the intervention had moderately large effects on reducing stereotypes and the influence of other co-workers on trainees' own attitudes. The main mechanisms of impact identified were recognition of negative attitudes in oneself and colleagues, self-reflection about the impact of stigma, one's own negative attitudes and recognition of one's ability to make change. Participants accepted and were satisfied with the intervention, which many considered should be part of their routine training. However, trainees' work overload and lack of support from the host organisation were identified as barriers to implement the intervention. CONCLUSIONS: A brief anti-stigma intervention for Mexican psychiatric trainees is feasible, potentially effective, well accepted and was considered necessary by participants. This study also suggests mechanisms of impact and mediators should be considered for developing further interventions, contributing to reducing the damaging effects that mental health-related stigma has on people's lives.

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Despite their training, psychiatrists have been found to have negative attitudes towards people with mental illness, including the patients they treat. Similarly, studies focused on service users have identified psychiatrists as a source of stigma. Even though negative attitudes in psychiatrists have been identified in different countries and settings, in Mexico the attitudes of these professionals have never been assessed. Because of this, we invited psychiatric trainees from a hospital in Mexico to participate in individual interviews to describe their opinions regarding mental health-related stigma, to evaluate their attitudes towards people with mental illness and to identify factors that could be influencing their attitudes. Interviews were audio recorded, transcribed and analysed using thematic analysis. A total of 29 trainees participated in the study. The results suggested that trainees recognised psychiatrists can have negative attitudes towards people with mental illness, such as poor empathy, judgement and labelling, and mainly towards patients considered difficult and with borderline personality disorder. Participants recognised these attitudes can influence their relationship with patients, and considered it is necessary to develop interventions to improve their own attitudes and reduce mental health stigma. From this study we concluded Mexican psychiatrists are not free from stigma towards people with mental illness. However, Mexican psychiatric trainees are interested in improving their attitudes and reactions towards their patients.

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Objective: The mental health problems and perceived needs of healthcare workers involved with coronavirus disease (COVID-19) may vary due to individual and contextual characteristics. The objective of this study was to evaluate healthcare workers' mental health problems during the common COVID-19 exposure scenario in Mexico, comparing those on the frontline with other healthcare workers according to gender and profession, determining the main risk factors for the most frequent mental health problems. Methods: A cross-sectional online study was conducted with a non-probabilistic sample of 5,938 Mexican healthcare workers who completed brief screening measures of mental health problems and ad hoc questions about sociodemographic professional characteristics, conditions related to increased risk of COVID-19 infection, life stressors during the COVID-19 emergency, and perceived need to cope with COVID-19. Results: The identified mental health problems were insomnia, depression, and posttraumatic stress disorder (PTSD), all of which were more frequent in frontline healthcare workers (52.1, 37.7, and 37.5%, respectively) and women (47.1, 33.0 %, and 16.3%, respectively). A lack of rest time was the main risk factor for insomnia (OR = 3.1, 95%CI 2.6-3.7, p ≤ 0.0001). Mourning the death of friends or loved ones due to COVID-19 was the main risk factor for depression (OR = 2.2, 95%CI 1.8-2.7, p ≤ 0.0001), and personal COVID-19 status was the main risk factor for PTSD (OR = 2.2, 95%CI 1.7-2.9, p ≤ 0.0001). Conclusion: The most frequent mental health problems during the common exposure scenario for COVID-19 in Mexico included the short-term psychological consequences of intense adversity. A comprehensive strategy for preventing mental health problems should focus on individuals with cumulative vulnerability and specific risk factors.

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Abstract Background Abuse in early life stages has been proposed as an etiological risk factor for developing menstrually-related mood disorders (MRMDs). Objetive To evaluate whether there is a relation between the occurrence of physical and/or sexual violence in childhood and/or adolescence and the development of MRMDs in adulthood. Method A systematic search was conducted in PubMed, Web of Science, and ScienceDirect, with the route ("Premenstrual Syndrome"[Mesh]) OR ("Premenstrual Dysphoric Disorder"[MeSH]) AND ("Violence"[Mesh]) / ("menstrually-related mood disorders" AND "abuse"). Fifty-four articles were initially reviewed and 32 were excluded based on the criteria. Twenty-two articles were thoroughly reviewed. Finally, five articles (publication years 2014, 2013, 2012, 2007, and 2003) were included in the systematic review and submitted to a meta-analysis. Results Results indicate that having been exposed to physical and/or sexual violence in childhood and/or adolescence increases 1.99 times the risk of experiencing MRMDs in adulthood in comparison with women who did not experience that type of violence (odds ratio [OR] = 1.99; 95% confidence interval [1.58, 2.51]). Discussion and conclusion The present work provides evidence that a woman who experienced violence through physical and/or sexual abuse during childhood and/or adolescence has a greater risk of developing MRMDs in adulthood.

Resumen Antecedentes El abuso en las etapas tempranas de la vida se ha propuesto como un factor de riesgo etiológico para desarrollar trastornos del estado de ánimo relacionados con la menstruación (TEARM). Objetivo Evaluar si existe una relación entre la ocurrencia de violencia física y/o sexual en la infancia y/o la adolescencia y el desarrollo de MRMD en la edad adulta. Método Se realizó una búsqueda sistemática en PubMed, Web of Science y ScienceDirect con la ruta ("Premenstrual Syndrome"[Mesh]) OR ("Premenstrual Dysphoric Disorder"[MeSH]) AND ("Violence"[Mesh]) / ("menstrually-related mood disorders" AND "abuse"). Cincuenta y cuatro artículos fueron revisados inicialmente y 32 fueron excluidos con base en los criterios establecidos. Veintidós artículos fueron revisados exhaustivamente. Por último, se incluyeron cinco artículos (años de publicación 2014, 2013, 2012, 2007 y 2003) en la revisión sistemática, y cinco de ellos fueron sometidos a un metaanálisis. Resultados Los resultados indican que haber estado expuesta a violencia física y/o sexual en la niñez y/o la adolescencia aumenta 1.99 veces el riesgo de experimentar TEARM en la edad adulta en comparación con las mujeres que no experimentaron ese tipo de violencia (odds ratio [OR] = 1.99; intervalo de confianza del 95% [1.58-2.51]). Discusión y conclusión El presente trabajo aporta evidencia de que una mujer que experimentó violencia por abuso físico y/o sexual durante la niñez y/o la adolescencia tiene un mayor riesgo de desarrollar TEARM en la edad adulta.

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Negative attitudes towards people with mental health disorders have been widely studied and identified in the general population, and even within health care professionals. Moreover, studies focused on service users have also identified mental health professionals, including psychiatrists, as a source of stigma. However, in Mexico and Latin America few studies have been conducted addressing this issue. To explore mental health service users' perceptions of stigma by members of the general population and by psychiatrists in Mexico, service users at a psychiatric hospital in Mexico were invited to participate in either focus groups or individual interviews, which were audio recorded, transcribed and analysed using thematic analysis. A total of 47 service users participated in this study. The results suggested that participants were not only aware of the possible consequences of mental health related stigma, but they have also experienced stigmatisation for having a mental illness. Participants also considered psychiatrists can hold negative attitudes towards people with mental illness, something that can represent a barrier for them to have optimal quality of care. Therefore, participants agreed that these attitudes should be addressed to improve the care they received from these professionals. This study suggests that, like members of the general population, psychiatrists are also considered as a source of stigma by people with mental illness in Mexico. These findings not only add to previous work conducted in Mexico and other countries, they also confirm the importance of addressing negative attitudes in this group of health professionals.

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OBJECTIVE: The mental health problems and perceived needs of healthcare workers involved with coronavirus disease (COVID-19) may vary due to individual and contextual characteristics. The objective of this study was to evaluate healthcare workers' mental health problems during the common COVID-19 exposure scenario in Mexico, comparing those on the frontline with other healthcare workers according to gender and profession, determining the main risk factors for the most frequent mental health problems. METHODS: A cross-sectional online study was conducted with a non-probabilistic sample of 5,938 Mexican healthcare workers who completed brief screening measures of mental health problems and ad hoc questions about sociodemographic professional characteristics, conditions related to increased risk of COVID-19 infection, life stressors during the COVID-19 emergency, and perceived need to cope with COVID-19. RESULTS: The identified mental health problems were insomnia, depression, and posttraumatic stress disorder (PTSD), all of which were more frequent in frontline healthcare workers (52.1, 37.7, and 37.5%, respectively) and women (47.1, 33.0 %, and 16.3%, respectively). A lack of rest time was the main risk factor for insomnia (OR = 3.1, 95%CI 2.6-3.7, p ≤ 0.0001). Mourning the death of friends or loved ones due to COVID-19 was the main risk factor for depression (OR = 2.2, 95%CI 1.8-2.7, p ≤ 0.0001), and personal COVID-19 status was the main risk factor for PTSD (OR = 2.2, 95%CI 1.7-2.9, p ≤ 0.0001). CONCLUSION: The most frequent mental health problems during the common exposure scenario for COVID-19 in Mexico included the short-term psychological consequences of intense adversity. A comprehensive strategy for preventing mental health problems should focus on individuals with cumulative vulnerability and specific risk factors.

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Abstract Introduction Inhalant use disorder has increased in spite of its adverse medical consequences. Due to the inherent difficulties of working with this population, so far there has been no quantifiable clinical evidence of the cognitive characteristics of inhalants users in early withdrawal and the clinic effect of consumption time. Objective To evaluate the clinical and cognitive performance of inhalant users and the clinic effects of consumption time. Method A cross-sectional study in which 28 adult users of inhalants were included, divided in two groups according to their consumption time: less than or greater than seven years. They were all evaluated in terms of clinical and neuropsychological values. Results Consumers of inhalant showed presence of craving (M = 479.14, SD = 213.51), altered frontal behavior before (M = 119.18, SD = 29.53) and now (M = 130, SD = 33.03), sleeping problems (M = 8.93, SD = 3.4), and cognitive difficulties (inhibitory control, planning, decision-making, working memory, verbal fluency, and cognitive flexibility); all these tasks were statistically significant (p = < .05). Discussion and conclusion Executive functioning is impaired with inhalant use disorder; these alterations increase with withdrawal and craving and changes remain independent from the use time.

Resumen Introducción El trastorno por uso de inhalables ha aumentado a pesar de las consecuencias médicas adversas. Debido a las dificultades que entraña trabajar con estas poblaciones, hasta hace poco no había evidencia clínica cuantificable de las características cognitivas de los usuarios de inhalables en la abstinencia temprana y de los efectos clínicos del tiempo de consumo. Objetivo Se analizó el rendimiento clínico y cognitivo de usuarios de inhalables y los efectos clínicos del tiempo de consumo. Método Estudio transversal en el que se incluyeron 28 adultos usuarios de inhalables, divididos en dos grupos dependiendo del tiempo de consumo, menor o mayor a siete años. Todos fueron evaluados en términos de valores clínicos y neuropsicológicos. Resultados Los consumidores de inhalables mostraron presencia de craving (M = 479.14, SD = 213.51), comportamiento frontal alterado antes (M = 119.18, SD = 29.53) y actualmente (M = 130, SD = 33.03), problemas para dormir (M = 8.93, SD = 3.4) y dificultades cognitivas (control inhibitorio, planificación, toma de decisiones, memoria de trabajo, fluidez verbal y flexibilidad cognitiva); todas estas tareas fueron estadísticamente significativas (p = < .05). Discusión y conclusión El funcionamiento ejecutivo se ve afectado en el trastorno por uso de inhalables. Estas alteraciones aumentan en la abstinencia y en la apetencia, y los cambios se mantienen independientes del tiempo de uso.

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There is a growing need to address the variability in detecting cognitive deficits with standard tests in cocaine dependence (CD). The aim of the current study was to identify cognitive deficits by means of Machine Learning (ML) algorithms: Generalized Linear Model (Glm), Random forest (Rf) and Elastic Net (GlmNet), to allow more effective categorization of CD and Non-dependent controls (NDC and to address common methodological problems. For our validation, we used two independent datasets, the first consisted of 87 participants (53 CD and 34 NDC) and the second of 40 participants (20 CD and 20 NDC). All participants were evaluated with neuropsychological tests that included 40 variables assessing cognitive domains. Using results from the cognitive evaluation, the three ML algorithms were trained in the first dataset and tested on the second to classify participants into CD and NDC. While the three algorithms had a receiver operating curve (ROC) performance over 50%, the GlmNet was superior in both the training (ROC = 0.71) and testing datasets (ROC = 0.85) compared to Rf and Glm. Furthermore, GlmNet was capable of identifying the eight main predictors of group assignment (CD or NCD) from all the cognitive domains assessed. Specific variables from each cognitive test resulted in robust predictors for accurate classification of new cases, such as those from cognitive flexibility and inhibition domains. These findings provide evidence of the effectiveness of ML as an approach to highlight relevant sections of standard cognitive tests in CD, and for the identification of generalizable cognitive markers.

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Borderline personality disorder (BPD) is a chronic condition characterized by high levels of impulsivity, affective instability, and difficulty to establish and manage interpersonal relationships. However, little is known about its etiology and neurobiological substrates. In our study, we wanted to investigate the influence of child abuse in the psychopathology of BPD by means of social cognitive paradigms [the Movie for the Assessment of Social Cognition (MASC) and the reading the mind in the eyes test (RMET)], and resting state functional magnetic resonance imaging (rs-fMRI). For this, we recruited 33 participants, 18 BPD patients, and 15 controls. High levels of self-reported childhood maltreatment were reported by BPD patients. For the sexual abuse subdimension, there were no differences between the BPD and the control groups, but there was a negative correlation between MASC scores and total childhood maltreatment levels, as well as between physical abuse, physical negligence, and MASC. Both groups showed that the higher the level of childhood maltreatment, the lower the performance on the MASC social cognitive test. Further, in the BPD group, there was hypoconnectivity between the structures responsible for emotion regulation and social cognitive responses that have been described as part of the frontolimbic circuitry (i.e., amygdala). Differential levels of connectivity, associated with different types and levels of abuse were also observed.

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Although motor activity is actively inhibited during rapid eye movement (REM) sleep, specific activations of the facial mimetic musculature have been observed during this stage, which may be associated with greater emotional dream mentation. Nevertheless, no specific biomarker of emotional valence or arousal related to dream content has been identified to date. In order to explore the electromyographic (EMG) activity (voltage, number, density and duration) of the corrugator and zygomaticus major muscles during REM sleep and its association with emotional dream mentation, this study performed a series of experimental awakenings after observing EMG facial activations during REM sleep. The study was performed with 12 healthy female participants using an 8-hr nighttime sleep recording. Emotional tone was evaluated by five blinded judges and final valence and intensity scores were obtained. Emotions were mentioned in 80.4% of dream reports. The voltage, number, density and duration of facial muscle contractions were greater for the corrugator muscle than for the zygomaticus muscle, whereas high positive emotions predicted the number (R2 0.601, p = 0.0001) and voltage (R2 0.332, p = 0.005) of the zygomaticus. Our findings suggest that zygomaticus events were predictive of the experience of positive affect during REM sleep in healthy women.

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Background: Borderline personality disorder is present in 19% of cocaine dependence cases; however, this dual pathology is poorly understood. We wished to characterize the dual pathology and find its functional connectivity correlates to better understand it. Methods: We recruited 69 participants divided into 4 groups: dual pathology (n = 20), cocaine dependence without borderline personality disorder (n = 19), borderline personality without cocaine dependence (n = 10) and healthy controls (n = 20). We used self-reported instruments to measure impulsivity and emotional dysregulation. We acquired resting state fMRI and performed seed-based analyses of the functional connectivity of bilateral amygdala. Results: Borderline personality disorder and cocaine dependence as factors had opposing effects in impulsivity and emotional dysregulation, as well as on functional connectivity between left amygdala and medial prefrontal cortex. On the other hand, in the functional connectivity between right amygdala and left insula, the effect of having both disorders was instead additive, reducing functional connectivity strength. The significant functional connectivity clusters were correlated with impulsivity and emotional dysregulation. Conclusions: In this study, we found that clinical scores of dual pathology patients were closer to those of borderline personality disorder without cocaine dependence than to those of cocaine dependence without borderline personality disorder, while amygdala-medial prefrontal cortex functional connectivity patterns in dual pathology patients were closer to healthy controls than expected.

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Objective: Current treatment of borderline personality disorder (BPD) consists of psychotherapy and pharmacological interventions. However, the use of repetitive transcranial magnetic stimulation (rTMS) could be beneficial to improve some BPD symptoms. The objective of this study was to evaluate clinical improvement in patients with BPD after application of rTMS over the right or left dorsolateral prefrontal cortex (DLPFC). Method: Twenty-nine patients with BPD from the National Institute of Psychiatry, Mexico, were randomized in two groups to receive 15 sessions of rTMS applied over the right (1 Hz, n=15) or left (5 Hz, n=14) DLPFC. Improvement was measured by the Clinical Global Impression Scale for BPD (CGI-BPD), Borderline Evaluation of Severity Over Time (BEST), Beck Depression Inventory (BDI), Hamilton Anxiety Rating Scale (HAM-A), and Barratt Impulsiveness Scale (BIS). Results: Intragroup comparison showed significant (p < 0.05) reductions in every psychopathologic domain of the CGI-BPD and in the total scores of all scales in both groups. Conclusions: Both protocols produced global improvement in severity and symptoms of BPD, particularly in impulsiveness, affective instability, and anger. Further studies are warranted to explore the therapeutic effect of rTMS in BPD. Clinical trial registration: NCT02273674.

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Aim The aim of this study was to determine if the problem-solving therapy (PST) helps control metabolic variables in patients with type 2 diabetes mellitus (T2DM) who show depressive and anxiety symptoms. BACKGROUND: T2DM is a chronic-degenerative multifactorial disease. It is considered one of the main public health problems in the world, and it represents an important social and economic burden. It is frequently associated with major depression and anxiety disorders, which are related with high glycated hemoglobin (HbA1c) concentrations and poor metabolic control. METHOD: We initially included 123 patients diagnosed with T2DM from five primary care centers (PCC) in Mexico City. HbA1c, central glucose, and lipid profile were measured in each patient. In addition, the Kessler psychological distress scale (K-10), the Beck Depression Inventory, and the Beck Anxiety Inventory were applied at the beginning and, to those who continued, at the end of the PST, as well as four months later. Findings In total, 36 patients completed the PST and the follow-up. There was a significant decrease in depressive and anxiety symptoms (P<0.001), as well as in total cholesterol (P=0.002), HbA1c (P=0.05), and low-density lipoprotein (LDL) (P=0.022). The PST helps reduce depressive and anxiety symptoms and may help stabilize glucose and cholesterol up to four months. Further studies on this area are recommended. If our findings are confirmed, the PST could help improve the quality of life of thousands of individuals with psychiatric-metabolic co-morbidity who only visit PCC.

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OBJECTIVE: Current treatment of borderline personality disorder (BPD) consists of psychotherapy and pharmacological interventions. However, the use of repetitive transcranial magnetic stimulation (rTMS) could be beneficial to improve some BPD symptoms. The objective of this study was to evaluate clinical improvement in patients with BPD after application of rTMS over the right or left dorsolateral prefrontal cortex (DLPFC). METHOD: Twenty-nine patients with BPD from the National Institute of Psychiatry, Mexico, were randomized in two groups to receive 15 sessions of rTMS applied over the right (1 Hz, n=15) or left (5 Hz, n=14) DLPFC. Improvement was measured by the Clinical Global Impression Scale for BPD (CGI-BPD), Borderline Evaluation of Severity Over Time (BEST), Beck Depression Inventory (BDI), Hamilton Anxiety Rating Scale (HAM-A), and Barratt Impulsiveness Scale (BIS). RESULTS: Intragroup comparison showed significant (p < 0.05) reductions in every psychopathologic domain of the CGI-BPD and in the total scores of all scales in both groups. CONCLUSIONS: Both protocols produced global improvement in severity and symptoms of BPD, particularly in impulsiveness, affective instability, and anger. Further studies are warranted to explore the therapeutic effect of rTMS in BPD. CLINICAL TRIAL REGISTRATION: NCT02273674

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Neurogenesis constitutively occurs in the olfactory epithelium of mammals, including humans. The fact that new neurons in the adult olfactory epithelium derive from resident neural stem/progenitor cells suggests a potential use for these cells in studies of neural diseases, as well as in neuronal cell replacement therapies. In this regard, some studies have proposed that the human olfactory epithelium is a source of neural stem/progenitor cells for autologous transplantation. Although these potential applications are interesting, it is important to understand the cell biology and/or whether human neural stem/progenitor cells in the olfactory epithelium sense external signals, such as brain-derived neurotrophic factor (BDNF), that is also found in other pro-neurogenic microenvironments. BDNF plays a key role in several biological processes, including cell migration. Thus, we characterized human neural stem/progenitor cells derived from the olfactory epithelium (hNS/PCs-OE) and studied their in vitro migratory response to BDNF. In the present study, we determined that hNS/PCs-OE express the protein markers Nestin, Sox2, Ki67 and ßIII-tubulin. Moreover, the doubling time of hNS/PCs-OE was approximately 38h. Additionally, we found that hNS/PCs-OE express the BDNF receptor TrkB, and pharmacological approaches showed that the BDNF-induced (40ng/ml) migration of differentiated hNS/PCs-OE was affected by the compound K252a, which prevents TrkB activation. This observation was accompanied by changes in the number of vinculin adhesion contacts. Our results suggest that hNS/PCs-OE exhibit a migratory response to BDNF, accompanied by the turnover of adhesion contacts.

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In the clinical area, some symptoms of attention deficit hyperactivity disorder (ADHD) also present in patients with autism spectrum disorders (ASD). Research has shown that there are alterations in brain circuits that have an impact upon specific cognitive and behavioural failures in each of these disorders. Yet, little research has been conducted on the brain correlates underlying both the similarities and the differences in the symptoms. In this review, the structural and functional meta-analytical studies that have been carried out to date on ADHD and ASD have been analysed. On the one hand, there are convergences in the attentional dorsal, executive functions, visual, somatomotor circuits and the default activation circuit. These similarities can account for the comorbid manifestations between the disorders, such as failure in the integration of information, fine motor control and specific attention processes. On the other hand, specifically in ADHD, there is a deficit in the reward circuit and in the attentional ventral, which are systems involved in the measurement of the effects of reinforcement and monitoring of attention. In ASD, the circuits that are most strongly affected are those involved in social cognition and language processes. In conclusion, there are neuronal correlates in both disorders that explain both the convergent and divergent clinical and behavioural manifestations.

TITLE: Neurobiologia del autismo y del trastorno por deficit de atencion/hiperactividad mediante tecnicas de neuroimagen: divergencias y convergencias.En el area clinica, algunos sintomas del trastorno por deficit de atencion/hiperactividad (TDAH) se presentan en los pacientes con trastorno del espectro autista (TEA). Se ha demostrado que existen alteraciones en circuitos cerebrales que impactan en fallos cognitivos y de comportamiento especificos en cada uno de estos trastornos. Sin embargo, se han estudiado poco los correlatos cerebrales que hay detras tanto de las similitudes como de las diferencias sintomatologicas. En la presente revision, se analizaron los estudios metaanaliticos existentes estructurales y funcionales en el TDAH y el TEA. Por un lado, se observan convergencias en circuitos como el dorsal atencional, de funciones ejecutivas, visual, somatomotor y circuito de activacion por defecto. Estas similitudes pueden explicar las manifestaciones comorbidas entre los trastornos como el fallo en la integracion de informacion, la motricidad fina y los procesos de atencion especificos. Por otro lado, especificamente en el TDAH, se observa deficit en el circuito de recompensa y en el ventral atencional, sistemas involucrados en la medicion de efectos de refuerzo y monitorizacion de la atencion. En el TEA, los circuitos mas afectados son los implicados en los procesos de cognicion social y lenguaje. En conclusion, existen correlatos neuronales en ambos trastornos que explican las manifestaciones clinicas y de comportamiento tanto convergentes como divergentes.

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Transcranial Magnetic Stimulation (rTMS) is a technique that allows noninvasive electrical stimulation of the cortex with few side effects. An antidepressant effect has been proposed when rTMS is delivered over prefrontal dorsolateral cortex (DLPFC) ≥5Hz. Quantitative EEG studies have shown increases in alpha and theta power bands as well as frontal interhemispheric asymmetries in most recordings from depressed patients. rTMS over left DLPFC at 5Hz involve a safer and more tolerable procedure, and its neurophysiological correlates has not been explored using EEG source analysis. The aim of this research was to study changes in EEG sources using VARTERA method in a group of patients with major depressive disorder (MDD) treated with 5Hz rTMS over left DLPFC as single or combined treatment with escitalopram. Methods 18 patients with DSM-IV MDD diagnosis without treatment for the current episode were included. Subjects were randomly assigned to one of two groups: A) rTMS+escitalopram 10mg, n=9; B) rTMS+placebo, n=9. Subjects received 15 sessions of rTMS on a daily basis. In order to compare changes in EEG sources two recordings were obtained, prior and after treatment. HDRS, BDI and HARD were used for clinical assessments. Results All patients of group A and eight patients of group B showed response to treatment (considered as a reduction of 50% in HDRS score). An increase in absolute power at 9.37Hz and 10.17Hz in temporal and postcentral gyrus on the left hemisphere was found in group B. Absolute power in those frequencies was decreased in the same regions for group A. In addition, an increased power in beta band frequencies was observed in both hemispheres for group A. Conclusion Increases in alpha band could be the hallmark of the 5Hz rTMS, but it could be reduced by escitalopram. Besides, increases observed in beta band for group A could be related to escitalopram effect.

La estimulación magnética transcraneal repetitiva (EMTr) es una técnica que permite estimular eléctricamente la corteza cerebral de manera no invasiva y con pocos efectos secundarios. Se ha propuesto que la EMTr aplicada sobre la corteza prefrontal dorsolateral (CPFDL) izquierda con frecuencias ≥5Hz tiene efectos antidepresivos. Se ha encontrado que en el electroencefalograma cuantitativo (QEEG por sus siglas en inglés) la mayoría de pacientes deprimidos presentan incrementos en las bandas theta y alfa, así como asimetrías interhemisféricas en la actividad alfa en regiones anteriores. La EMTr sobre la CPFDL izquierda a 5Hz ofrece ventajas considerables en seguridad y tolerabilidad; sin embargo, sus correlatos neurofisiológicos no han sido explorados por el análisis de fuentes del EEG. Objetivo Estudiar los cambios en las fuentes del EEG según el método VARETA en un grupo de pacientes con trastorno depresivo mayor que recibieron EMTr a 5Hz sobre la corteza prefrontal dorsolateral izquierda como tratamiento único o en combinación con escitalopram. Material y métodos Se estudiaron 18 pacientes con diagnóstico de trastorno depresivo mayor de acuerdo con los criterios del DSM-IV sin tratamiento para el episodio en curso. Los sujetos habían sido aleatoriamente asignados a uno de los siguientes grupos de tratamiento: A) EMTr+escitalopram 10mg, n=9; B) EMTr+placebo, n=9. Se aplicó EMTr, a 5Hz en una sesión diaria durante 15 días. Se obtuvieron dos registros electroencefalográficos, uno basal y otro final, con el fin de comparar los cambios en las fuentes de actividad eléctrica cerebral, pretratamiento y post-tratamiento. Se realizaron evaluaciones clinimétricas con las escalas de Hamilton para Depresión y Ansiedad y el Inventario de Depresión de Beck. Resultados Todos los pacientes en el grupo A y ocho pacientes en el grupo B respondieron al tratamiento, con una reducción de 50% o más en la escala HDRS. En el análisis de fuentes se encontró un efecto en el grupo B caracterizado por incremento en la PA de 9.37 a 10.17Hz, en regiones temporales y giro poscentral izquierdos, mismo que se encontró disminuido en el grupo A, Además se encontró un incremento en fracuencias correspondientes a la banda beta en regiones frontales de ambos hemisferios en el grupo A. Conclusiones Podría considerarse que el incremento en la banda alfa es característico de la EMTr a 5Hz, mismo que se ve reducido por efecto del escitalopram. Por otro lado, se observó que el grupo A mostró incrementos en fuentes correspondientes a la banda beta como posible efecto relacionado del fármaco antidepresivo.

RESUMO

Major Depressive Disorder (MDD) is a common psychiatric disorder that represents one of the main public health problems worldwide. It has been projected that for 2020 it will be the second cause of disability-adjusted life years just below ischemic heart disease. Quantitative electroencephalogram provides the opportunity to study cortical oscillatory activity across the different frequency bands. It constitutes an accessible tool to explore the clinical and neurophysiologic correlates underlying psychiatric disorders as well as the effect of diverse therapeutic options and the performance through cognitive tasks. Repetitive transcranial magnetic stimulation is a technique that allows the stimulation of the cerebral cortex noninvasively, relatively painlessly and with fairly few side effects. The vast majority of rTMS studies target left dorsolateral prefrontal cortex (DLPFC) based on imaging studies showing that left prefrontal cortex dysfunction is pathophysiologically linked to depression. However, there is some evidence implicating right PFC in the pathophysiology of depression. Comparison of antidepressant efficacy of diverse stimulation frequencies is relevant since a main concern around rTMS is its potential to induce seizures; hence we consider that frequency of stimulation is an important aspect to be studied. For this study we aimed to elucidate the clinical efficacy of rTMS comparing two groups of depressed patients stimulated over DLPFC, one over the left (at 5 Hz) and other over the right (at 1 Hz). We also meant to know if there were clinical and electroencephalographic differential long-term after-effects between those groups of treatment. We included twenty right-handed patients with a DSM-IVR diagnosis of MDD. They were assigned into two groups of treatment. Group 1 received 5Hz rTMS over the left DLPFC. Group 2 received 1Hz rTMS over the right DLPFC. We obtained two EEG measurements in order to analyze Z score of broad-band spectral parameters and cross-spectral. No statistical differences among groups were found in response to treatment after weekly comparisons of clinimetric scores and significant differences between baseline and final assessment by HDRS, MADRS, BDI and HARS. The major rTMS effect on EEG was observed in the group that received 1 Hz over the right DLPFC and no significant effects were observed for the group that received 5 Hz over the left DLPFC. Our results propose that administration of 15 sessions on either left (5 Hz) or right (1 Hz) rTMS over DLPFC is sufficient to reach response to treatment, assessed by HDRS, MADRS, BDI and HARS in subjects with MDD. Moreover, in both cases rTMS was able to induce an equivalent antidepressant effect. The major effect of rTMS on EEG was observed in the right 1 Hz rTMS group where changes were elicited mainly over frontal, central and temporal regions on alpha and particularly beta frequency bands. In a lesser extent for left 5 Hz rTMS group the main effect was observed on anterior regions for beta and particularly alpha frequency bands. We believe it is pertinent to continue exploring the therapeutic potential of lower stimulation frequencies, for what further research including larger samples is still necessary to confirm these trends.

El trastorno depresivo mayor es una entidad psiquiátrica que representa uno de los principales problemas de salud pública a nivel mundial. Se ha proyectado que para el año 2020 será la segunda causa de discapacidad únicamente por debajo de la cardiopatía isquémica. La utilización del electroencefalograma cuantitativo ofrece la oportunidad de estudiar la actividad oscilatoria cortical a través de las diferentes bandas de frecuencias. Éste constituye una herramienta para explorar las características clínicas y neurofisiológicas que subyacen a los trastornos psiquiátricos, así como un instrumento para evaluar el efecto de diversas opciones terapéuticas y el desempeño de los sujetos durante la realización de tareas cognitivas. La estimulación magnética transcraneal repetitiva (EMTr) es una técnica que permite la estimulación de la corteza cerebral de manera no invasiva, relativamente sin dolor y con pocos efectos secundarios. Con base en los estudios de neuroimagen que vinculan la fisiopatología de la depresión con disfunción en la corteza prefrontal dorsolateral (CPFDL), la mayoría de las investigaciones se han enfocado en estimular dicha corteza en el hemisferio izquierdo. No obstante, existen pruebas que implican a la corteza prefrontal derecha con la fisiopatología de la depresión. La relevancia de comparar la eficacia antidepresiva de diversas frecuencias radica en el hecho de que un tema de interés particular alrededor de la EMTr es su potencial para inducir convulsiones, por ello consideramos que la exploración de las diversas frecuencias de estimulación con efecto terapéutico constituye un aspecto importante de estudio. Para este trabajo nos propusimos determinar la eficacia antidepresiva de la EMTr comparando dos grupos de pacientes que fueron estimulados en la CPFDL derecha a 1 Hz o en la izquierda a 5 Hz. También buscamos dilucidar si existen diferencias clínicas y electroencefalográficas a largo plazo entre grupos de tratamiento. Para este estudio se incluyeron 20 pacientes con diagnóstico de trastorno depresivo mayor de acuerdo con los criterios del DSM-I V. Los sujetos fueron asignados aleatoriamente a uno de dos grupos de tratamiento. Un grupo recibió EMTr sobre la CPFDL izquierda a 5Hz; el otro recibió estimulación a 1 Hz sobre la corteza contralateral. Se obtuvieron dos registros electroencefalográficos, uno basal y otro final, con el fin de comparar las medidas espectrales de banda ancha y estrecha, pretratamiento y postratamiento. Se realizaron evaluaciones clinimétricas con las escalas de Hamilton para Depresión y Ansiedad, la escala de Depresión de Montgomery-Asberg y el Inventario de Beck. No encontramos diferencias significativas al comparar la respuesta a la EMTr entre ambos grupos. Los pacientes de ambos grupos presentaron respuesta a tratamiento (disminución de ≥50% de la sintomatología depresiva) medida por clinimetría. El efecto más importante de la EMTr sobre el EEG se observó en el grupo de estimulación derecha a 1 Hz donde encontramos disminución postratamiento en los valores Z de banda estrecha alfa y beta, principalmente en regiones fronto-centro-temporales. Aunque en menor proporción, en el grupo de estimulación izquierda a 5 Hz encontramos incrementos significativos post EMTr, predominantemente en las bandas beta y alfa sobre todo en regiones anteriores. No se encontraron resultados significativos en el análisis de banda ancha. Nuestros resultados sugieren que la administración de 15 sesiones de EMTr ya sea sobre la CPFDL derecha (1 Hz) o izquierda (5 Hz) es capaz de lograr respuesta antidepresiva. Nuestros hallazgos electrofisiológicos sugieren que uno de los efectos a largo plazo de la EMTr es la reorganización de los circuitos neuronales implicados en la depresión.