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The default mode network (DMN) is atypically active in patients with ADHD, likely contributing to the inattention patterns observed in patients with the disorder. Nonetheless, magnetic resonance spectroscopy (MRS) studies have rarely targeted the posterior cingulate cortex, a key DMN region, and little is known about the biochemical setting within this network in patients with ADHD. We aimed to assess the differences in metabolite profiles of the posterior cingulate cortex-a key region of the DMN-between patients with ADHD and controls. Five brain metabolites-glutamate, inositol, N-acetyl aspartate, choline, and creatine-were measured through MRS in the posterior cingulate cortex of patients and controls in a 3.0 T scanner. Between-group comparison of neurometabolite concentrations in PCC was performed using multivariate analysis of covariance. A total of 88 patients and 44 controls were included in the analysis. Patients with ADHD showed lower levels of glutamate in the posterior cingulate cortex compared to controls (p = 0.003). Lower concentrations of glutamate in the posterior cingulate cortex suggest that a glutamatergic imbalance within the posterior cingulate cortex might play a role in the pathogenesis of ADHD. Further understanding of the causes and consequences of such glutamate decrease might help explain how some glutamate-related drug effects impact on ADHD symptomatology.
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Several GWAS reported Myocyte Enhancer Factor 2 C (MEF2C) gene associations with white matter microstructure and psychiatric disorders, and MEF2C involvement in pathways related to neuronal development suggests a common biological factor underlying these phenotypes. We aim to refine the MEF2C effects in the brain relying on an integrated analysis of white matter and psychiatric phenotypes in an extensively characterized sample. This study included 870 Brazilian adults (47% from an attention-deficit/hyperactivity disorder outpatient clinic) assessed through standardized psychiatric interviews, 139 of which underwent a magnetic resonance imaging scan. We evaluated variants in the MEF2C region using two approaches: 1) a gene-wide analysis, which uses the sum of polymorphism effects, and 2) SNP analyses, restricted to the independent variants within the gene. The outcomes included psychiatric phenotypes and fractional anisotropy for brain images. Results: The gene-wide analyses pointed to a nominal association between MEF2C and the Temporal Portion of the Superior Longitudinal Fasciculus (SLFTEMP). The SNP analysis identified four independent variants significantly associated with SLFTEMP and one (rs4218438) with Substance Use Disorder. Our findings showing specific associations of MEF2C variants with temporal-frontal circuitry components may help to elucidate how the MEF2C gene underlies a broad range of psychiatric phenotypes since these regions are relevant to executive and cognitive functions.
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Transtorno do Deficit de Atenção com Hiperatividade , Substância Branca , Humanos , Substância Branca/diagnóstico por imagem , Substância Branca/patologia , Fatores de Transcrição MEF2/genética , Encéfalo/diagnóstico por imagem , Encéfalo/patologia , Imageamento por Ressonância Magnética , Transtorno do Deficit de Atenção com Hiperatividade/genética , AnisotropiaRESUMO
The course of ADHD from childhood up to young adulthood has been characterized in several studies. However, little is known about the course of symptoms into middle age and beyond. This study aims to evaluate predictors of ADHD trajectories in midlife based on three assessments. The follow-up sample comprised 323 adults with ADHD, evaluated at baseline and seven and thirteen years later, from the average ages of 34 up to 47 years old. ADHD status at reassessments was used to characterize trajectories. Demographics, ADHD features, comorbidities, and polygenic scores for ADHD and genetically correlated psychiatric disorders were evaluated to predict ADHD trajectories. Study retention rate was 67% at T2 (n = 216) and 62% at T3 (n = 199). Data from patients evaluated three times showed that 68.8% coursed stable, 25.5% unstable, and 5.7% remission trajectory of ADHD. Women, individuals with more severe syndromes, higher frequency of comorbidities at reassessments, and genetic liability to depression present a higher probability of a stable trajectory. Our findings shed light on midlife ADHD trajectories and their gender, genomic and clinical correlates.
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Background: Most early children's experiences will occur in a family context; therefore, the quality of this environment is critical for development outcomes. Not many studies have assessed the correlations between brain functional connectivity (FC) in important areas such as the default mode network (DMN) and the quality of parent-child relationships in school-age children and early adolescence. The quality of family relationships and maternal behavior have been suggested to modulate DMN FC once they act as external regulators of children's affect and behavior. Objective: We aimed to test the associations between the quality of family environment/maternal behavior and FC within the DMN of school-age children. Method: Resting-state, functional magnetic resonance imaging data, were collected from 615 children (6-12 age range) enrolled in the Brazilian High-Risk Cohort (HRC) study. We assessed DMN intra-connectivity between the medial prefrontal cortex (mPFC), posterior cingulate cortex (PCC), and inferior parietal lobule (IPL-bilateral) regions. The family functioning was assessed by levels of family cohesiveness and conflict and by maternal behavior styles such as maternal responsiveness, maternal stimulus to the child's autonomy, and maternal overprotection. The family environment was assessed with the Family Environment Scale (FES), and maternal behavior was assessed by the mother's self-report. Results: We found that the quality of the family environment was correlated with intra-DMN FC. The more conflicting the family environment was, the greater the FC between the mPFC-left IPL (lIPL), while a more cohesive family functioning was negatively correlated with FC between the PCC-lIPL. On the other hand, when moderated by a positive maternal behavior, cohesive family functioning was associated with increased FC in both regions of the DMN (mPFC-lIPL and PCC-lIPL). Conclusions: Our results highlight that the quality of the family environment might be associated with differences in the intrinsic DMN FC.
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Mapeamento Encefálico , Rede de Modo Padrão , Adolescente , Mapeamento Encefálico/métodos , Feminino , Giro do Cíngulo , Humanos , Imageamento por Ressonância Magnética/métodos , Comportamento MaternoRESUMO
One of the main challenges in investigating the neurobiology of ADHD is our limited capacity to study its neurochemistry in vivo. Magnetic resonance spectroscopy (MRS) estimates metabolite concentrations within the brain, but approaches and findings have been heterogeneous. To assess differences in brain metabolites between patients with ADHD and healthy controls, we searched 12 databases screening for MRS studies. Studies were divided into 'children and adolescents' and 'adults' and meta-analyses were performed for each brain region with more than five studies. The quality of studies was assessed by the Newcastle-Ottawa Scale. Thirty-three studies met our eligibility criteria, including 874 patients with ADHD. Primary analyses revealed that the right medial frontal area of children with ADHD presented higher concentrations of a composite of glutamate and glutamine (p = 0.02, SMD = 0.53). Glutamate might be implicated in pruning and neurodegenerative processes as an excitotoxin, while glutamine excess might signal a glutamate depletion that could hinder neurotrophic activity. Both neuro metabolites could be implicated in the differential cortical thinning observed in patients with ADHD across all ages. Notably, more homogeneous designs and reporting guidelines are the key factors to determine how suitable MRS is for research and, perhaps, for clinical psychiatry. Results of this meta-analysis provided an overall map of the brain regions evaluated so far, addressed the role of glutamatergic metabolites in the pathophysiology of ADHD, and pointed to new perspectives for consistent use of the tool in the field.
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Transtorno do Deficit de Atenção com Hiperatividade , Adulto , Criança , Adolescente , Humanos , Transtorno do Deficit de Atenção com Hiperatividade/diagnóstico por imagem , Glutamina/metabolismo , Ácido Glutâmico/metabolismo , Espectroscopia de Ressonância Magnética/métodos , Córtex Pré-Frontal/metabolismoRESUMO
There is compelling evidence showing that between-subject variability in several functional and structural brain features is sufficient for unique identification in adults. However, individuation of brain functional connectomes depends on the stabilization of neurodevelopmental processes during childhood and adolescence. Here, we aimed to (1) evaluate the intra-subject functional connectome stability over time for the whole brain and for large scale functional networks and (2) determine the long-term identification accuracy or 'fingerprinting' for the cortical volumetric profile and the functional connectome. For these purposes, we analysed a longitudinal cohort of 239 children and adolescents scanned in two sessions with an interval of approximately 3 years (age range 6-15 years at baseline and 9-18 years at follow-up). Corroborating previous results using short between-scan intervals in children and adolescents, we observed a moderate identification accuracy (38%) for the whole functional profile. In contrast, identification accuracy using cortical volumetric profile was 95%. Among the large-scale networks, the default-mode (26.8%), the frontoparietal (23.4%) and the dorsal-attention (27.6%) networks were the most discriminative. Our results provide further evidence for a protracted development of specific individual structural and functional connectivity profiles.
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Conectoma , Adolescente , Adulto , Atenção , Encéfalo/diagnóstico por imagem , Criança , Humanos , Imageamento por Ressonância Magnética , Rede Nervosa/diagnóstico por imagemRESUMO
Attention-Deficit/Hyperactivity Disorder (ADHD) has been associated with altered brain anatomy in neuroimaging studies. However, small and heterogeneous study samples, and the use of region-of-interest and tissue-specific analyses have limited the consistency and replicability of these effects. We used a data-driven multivariate approach to investigate neuroanatomical features associated with ADHD in two independent cohorts: the Dutch NeuroIMAGE cohort (n = 890, 17.2 years) and the Brazilian IMpACT cohort (n = 180, 44.2 years). Using independent component analysis of whole-brain morphometry images, 375 neuroanatomical components were assessed for association with ADHD. In both discovery (corrected-p = 0.0085) and replication (p = 0.032) cohorts, ADHD was associated with reduced volume in frontal lobes, striatum, and their interconnecting white-matter. Current results provide further evidence for the role of the fronto-striatal circuit in ADHD in children, and for the first time show its relevance to ADHD in adults. The fact that the cohorts are from different continents and comprise different age ranges highlights the robustness of the findings.
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Transtorno do Deficit de Atenção com Hiperatividade , Adulto , Transtorno do Deficit de Atenção com Hiperatividade/diagnóstico por imagem , Encéfalo/diagnóstico por imagem , Brasil , Criança , Substância Cinzenta , Humanos , Longevidade , Imageamento por Ressonância MagnéticaRESUMO
The aim of this review is to present a brief historical perspective, the current status of psychiatric education in Brazil, discuss its role in Latin America, and its challenges ahead. The history of psychiatry in Brazil is intertwined with the history of medical assistance in Brazil. Psychiatric education in Brazil started in the asylum-centric era during the second half of the 19th century and evolved to occupy university teaching-hospital in the 20th century. The medical residency in psychiatry has shown considerable growth since its implementation 70 years ago. Undoubtedly, it currently occupies a prominent place in Brazilian medicine. However, there is a need to create and expand it in the less developed regions of the country. Brazilian psychiatric journals also have a leading position in developing evidence-based psychiatry in Latin America.
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Internato e Residência , Psiquiatria/educação , Brasil , História do Século XIX , História do Século XX , História do Século XXI , Humanos , Internato e Residência/história , Psiquiatria/históriaRESUMO
Objective: This study evaluated the hypothesis that methylphenidate immediate release (MPH-IR) treatment would improve Default Mode Network (DMN) within-connectivity. Method: Resting-state functional connectivity of the main nodes of DMN was evaluated in a highly homogeneous sample of 18 drug-naive male adult participants with ADHD. Results: Comparing resting-state functional connectivity functional magnetic resonance imaging (R-fMRI) scans before and after MPH treatment focusing exclusively on within-DMN connectivity, we evidenced the strengthening of functional connectivity between two nodes of the DMN: posterior cingulate cortex (PCC) and left lateral parietal cortex (LLP). Conclusion: Our results contribute to the further understanding on how MPH affects functional connectivity within DMN of male adults with ADHD and corroborate the hypothesis of ADHD being a delayed neurodevelopmental disorder.
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Transtorno do Deficit de Atenção com Hiperatividade , Metilfenidato , Adulto , Transtorno do Deficit de Atenção com Hiperatividade/diagnóstico por imagem , Transtorno do Deficit de Atenção com Hiperatividade/tratamento farmacológico , Encéfalo/diagnóstico por imagem , Mapeamento Encefálico , Giro do Cíngulo/diagnóstico por imagem , Humanos , Imageamento por Ressonância Magnética , Masculino , Metilfenidato/farmacologia , Metilfenidato/uso terapêuticoRESUMO
The fractional amplitude of low-frequency fluctuations (fALFFs) of the BOLD signal have been successfully applied as exploratory tools in neuroimaging. This metric has been useful in mapping brain functional changes in many clinical populations. However, little is known about the neurophysiological correlates of fALFF. This study aimed at demonstrating that fALFF is related to local network centrality during childhood and adolescence. The establishment of this relationship is fundamental to provide a more meaningful explanation to previous clinical and neurodevelopmental studies based on fALFF. Our findings show a correlation of â¼0.5 between these two metrics at a group level, which is a finding replicated in four large independent samples. However, when considering the across-subject and intra-subject correlations between the two metrics, the correlation is much lower, probably due to the low signal-to-noise ratio. Moreover, we found that regions with high fALFF and degree centrality overlapped modestly, particularly the posterior cingulate/precuneus and lateral parietal cortices.
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Conectoma/métodos , Rede Nervosa/fisiologia , Neuroimagem/métodos , Adolescente , Encéfalo/fisiopatologia , Mapeamento Encefálico/métodos , Brasil , Criança , Meios de Contraste/metabolismo , Análise de Dados , Feminino , Humanos , Imageamento por Ressonância Magnética/métodos , Masculino , DescansoRESUMO
The family environment in childhood has a strong effect on mental health outcomes throughout life. This effect is thought to depend at least in part on modifications of neurodevelopment trajectories. In this exploratory study, we sought to investigate whether a feasible resting-state fMRI metric of local spontaneous oscillatory neural activity, the fractional amplitude of low-frequency fluctuations (fALFF), is associated with the levels of children's family coherence and conflict. Moreover, we sought to further explore whether spontaneous activity in the brain areas influenced by family environment would also be associated with a mental health outcome, namely the incidence of behavioral and emotional problems. Resting-state fMRI data from 655 children and adolescents (6-15 years old) were examined. The quality of the family environment was found to be positively correlated with fALFF in the left temporal pole and negatively correlated with fALFF in the right orbitofrontal cortex. Remarkably, increased fALFF in the temporal pole was associated with a lower incidence of behavioral and emotional problems, whereas increased fALFF in the orbitofrontal cortex was correlated with a higher incidence.
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Encéfalo/diagnóstico por imagem , Transtornos do Comportamento Infantil/diagnóstico por imagem , Transtornos do Comportamento Infantil/psicologia , Relações Familiares/psicologia , Comportamento Problema/psicologia , Estresse Psicológico/diagnóstico por imagem , Estresse Psicológico/psicologia , Adolescente , Adulto , Encéfalo/fisiopatologia , Mapeamento Encefálico/métodos , Mapeamento Encefálico/psicologia , Criança , Estudos de Coortes , Emoções/fisiologia , Feminino , Seguimentos , Humanos , Imageamento por Ressonância Magnética/métodos , Imageamento por Ressonância Magnética/psicologia , Masculino , Gravidez , Estudos Prospectivos , Estresse Psicológico/fisiopatologiaRESUMO
BACKGROUND: The brain-derived neurotrophic factor (BDNF) Val66Met polymorphism (rs6265) has been associated with several neuropsychiatric disorders and regional structural brain changes in adults, but little is known about Val66Met's effect on brain morphology during typical or atypical neurodevelopment. Windows of vulnerability to psychopathology may be associated with the different alleles of the Val66Met polymorphism during childhood and adolescence. METHODOLOGY: We investigated the effect of Val66Met on cortical thickness in MRI scans of 718 children and adolescents (6-12 years old) with typical development, and in those meeting DSM criteria for a psychiatric disorder. RESULTS: Val66Met had a significant effect on cortical thickness. Considering the typically developing group, Met-carriers presented thicker parietal and occipital lobes and prefrontal cortices compared to Val homozygotes. Met-carriers with psychiatric disorders presented thicker medial and lateral temporal cortices than Val homozygotes. Furthermore, a significant genotypeâ¯×â¯psychiatric diagnosis interaction was found: Met-carriers with a psychiatric diagnosis presented thinner bilateral prefrontal cortices than Val homozygotes. CONCLUSION: This study provides evidence that Val66Met is associated with cortical maturation in children and adolescents with and without psychiatric disorders.
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Fator Neurotrófico Derivado do Encéfalo/genética , Córtex Cerebral/anatomia & histologia , Córtex Cerebral/crescimento & desenvolvimento , Desenvolvimento Infantil/fisiologia , Transtornos Mentais/genética , Transtornos Mentais/patologia , Brasil , Córtex Cerebral/diagnóstico por imagem , Córtex Cerebral/patologia , Criança , Estudos de Coortes , Feminino , Humanos , Imageamento por Ressonância Magnética , Masculino , Transtornos Mentais/diagnóstico por imagem , Polimorfismo de Nucleotídeo ÚnicoRESUMO
OBJECTIVES: One of the major challenges facing psychiatry is how to incorporate biological measures in the classification of mental health disorders. Many of these disorders affect brain development and its connectivity. In this study, we propose a novel method for assessing brain networks based on the combination of a graph theory measure (eigenvector centrality) and a one-class support vector machine (OC-SVM). METHODS: We applied this approach to resting-state fMRI data from 622 children and adolescents. Eigenvector centrality (EVC) of nodes from positive- and negative-task networks were extracted from each subject and used as input to an OC-SVM to label individual brain networks as typical or atypical. We hypothesised that classification of these subjects regarding the pattern of brain connectivity would predict the level of psychopathology. RESULTS: Subjects with atypical brain network organisation had higher levels of psychopathology (p < 0.001). There was a greater EVC in the typical group at the bilateral posterior cingulate and bilateral posterior temporal cortices; and significant decreases in EVC at left temporal pole. CONCLUSIONS: The combination of graph theory methods and an OC-SVM is a promising method to characterise neurodevelopment, and may be useful to understand the deviations leading to mental disorders.
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Desenvolvimento do Adolescente/fisiologia , Córtex Cerebral/fisiologia , Desenvolvimento Infantil/fisiologia , Conectoma/métodos , Transtornos Mentais/fisiopatologia , Rede Nervosa/fisiologia , Máquina de Vetores de Suporte , Adolescente , Córtex Cerebral/diagnóstico por imagem , Córtex Cerebral/fisiopatologia , Criança , Feminino , Humanos , Imageamento por Ressonância Magnética , Masculino , Transtornos Mentais/diagnóstico por imagem , Rede Nervosa/diagnóstico por imagem , Rede Nervosa/fisiopatologiaRESUMO
Functional brain hubs are key integrative regions in brain networks. Recently, brain hubs identified through resting-state fMRI have emerged as interesting targets to increase understanding of the relationships between large-scale functional networks and psychopathology. However, few studies have directly addressed the replicability and consistency of the hub regions identified and their association with symptoms. Here, we used the eigenvector centrality (EVC) measure obtained from graph analysis of two large, independent population-based samples of children and adolescents (7-15 years old; total N=652; 341 subjects for site 1 and 311 for site 2) to evaluate the replicability of hub identification. Subsequently, we tested the association between replicable hub regions and psychiatric symptoms. We identified a set of hubs consisting of the anterior medial prefrontal cortex and inferior parietal lobule/intraparietal sulcus (IPL/IPS). Moreover, lower EVC values in the right IPS were associated with psychiatric symptoms in both samples. Thus, low centrality of the IPS was a replicable sign of potential vulnerability to mental disorders in children. The identification of critical and replicable hubs in functional cortical networks in children and adolescents can foster understanding of the mechanisms underlying mental disorders.
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Encéfalo/diagnóstico por imagem , Conectoma/normas , Imageamento por Ressonância Magnética/normas , Transtornos do Neurodesenvolvimento/diagnóstico por imagem , Descanso , Adolescente , Brasil/epidemiologia , Criança , Conectoma/métodos , Feminino , Humanos , Imageamento por Ressonância Magnética/métodos , Masculino , Vias Neurais/diagnóstico por imagem , Transtornos do Neurodesenvolvimento/epidemiologia , Córtex Pré-Frontal/diagnóstico por imagem , Psicopatologia , Distribuição Aleatória , Reprodutibilidade dos TestesRESUMO
Diffusion tensor imaging (DTI) studies showed that microstructural alterations are correlated to reading skills. In this study, we aim to investigate white matter microstructure of a group of Portuguese speakers with poor reading level, using different parameters of DTI. To perform this analysis, we selected children ranging from 8 to 12 years of age, poor readers (n = 17) and good readers (n = 23), evaluated in the word-level ability based on a Latent Class Analysis (LCA) of Academic Performance Test (TDE). Poor readers exhibited significant fractional anisotropy (FA) reductions in many tracts of both hemispheres, but small and restricted clusters of increased radial diffusivity (RD) in the left hemisphere. Spatial coherence of fibers might be the main source of differences, as changes in FA were not similarly accompanied in terms of extension by changes in RD. Widespread structural alterations in the white matter could prevent good reading ability at word level, which is consistent with recent studies demonstrating the involvement of multiple cortical regions and white matter tracts in reading disabilities.
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Encéfalo/anatomia & histologia , Leitura , Substância Branca/anatomia & histologia , Anisotropia , Aptidão , Testes de Aptidão , Criança , Imagem de Tensor de Difusão , Feminino , Humanos , MasculinoRESUMO
OBJECTIVES: In accordance with consolidated clinical practice, Diagnostic and Statistical Manual of Mental Disorders, 5th edition suggests a key role of collateral information in the evaluation of retrospective childhood attention-deficit/hyperactivity disorder symptoms in adults despite poor evidence supporting its use. This study aims to assess the incremental value of collateral information on the presence of childhood attention-deficit/hyperactivity disorder symptoms when evaluating adults with attention-deficit/hyperactivity disorder. METHODS: Adult patients with attention-deficit/hyperactivity disorder (n = 449) and non-attention-deficit/hyperactivity disorder subjects (n = 143) underwent an extensive clinical assessment based on Diagnostic and Statistical Manual of Mental Disorders, 4th edition criteria. For patients, retrospective collateral information regarding childhood attention-deficit/hyperactivity disorder was obtained and used to sort them into two groups: agreement (n = 277) and disagreement (n = 172) between self- and collateral reports. We compared demographic, clinical and response to treatment profiles among groups to test the relevance of collateral information on the specific issue of childhood attention-deficit/hyperactivity disorder symptoms. RESULTS: Both attention-deficit/hyperactivity disorder groups had higher rates of several comorbidities (oppositional defiant, conduct, substance use and bipolar disorders; all p < 0.001) and impairments than controls. Disagreement between self- and collateral reports on childhood attention-deficit/hyperactivity disorder symptoms occurred in 38% of patients. Overall, attention-deficit/hyperactivity disorder disagreement and agreement groups had similar profiles in response to treatment and comorbidity, and the few differences detected in impairment measures were of small magnitude (Eta(2) < 0.05). CONCLUSION: Although collateral report has an important role for diagnosing attention-deficit/hyperactivity disorder in children, it has no incremental value in the evaluation of childhood attention-deficit/hyperactivity disorder symptoms in adults with a self-reported history of attention-deficit/hyperactivity disorder assessed in clinical settings.
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Transtorno do Deficit de Atenção com Hiperatividade/diagnóstico , Transtorno do Deficit de Atenção com Hiperatividade/tratamento farmacológico , Estimulantes do Sistema Nervoso Central/uso terapêutico , Metilfenidato/uso terapêutico , Adolescente , Adulto , Brasil , Criança , Comorbidade , Demografia , Manual Diagnóstico e Estatístico de Transtornos Mentais , Feminino , Humanos , Masculino , Estudos Retrospectivos , Autorrelato , Índice de Gravidade de DoençaRESUMO
BACKGROUND: The human default mode (DMN) is involved in a wide array of mental disorders. Current knowledge suggests that mental health disorders may reflect deviant trajectories of brain maturation. METHOD: We studied 654 children using functional magnetic resonance imaging (fMRI) scans under a resting-state protocol. A machine-learning method was used to obtain age predictions of children based on the average coefficient of fractional amplitude of low frequency fluctuations (fALFFs) of the DMN, a measure of spontaneous local activity. The chronological ages of the children and fALFF measures from regions of this network, the response and predictor variables were considered respectively in a Gaussian Process Regression. Subsequently, we computed a network maturation status index for each subject (actual age minus predicted). We then evaluated the association between this maturation index and psychopathology scores on the Child Behavior Checklist (CBCL). RESULTS: Our hypothesis was that the maturation status of the DMN would be negatively associated with psychopathology. Consistent with previous studies, fALFF significantly predicted the age of participants (p < .001). Furthermore, as expected, we found an association between the DMN maturation status (precocious vs. delayed) and general psychopathology scores (p = .011). CONCLUSIONS: Our findings suggest that child psychopathology seems to be associated with delayed maturation of the DMN. This delay in the neurodevelopmental trajectory may offer interesting insights into the pathophysiology of mental health disorders.
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Abnormal connectivity patterns have frequently been reported as involved in pathological mental states. However, most studies focus on "static," stationary patterns of connectivity, which may miss crucial biological information. Recent methodological advances have allowed the investigation of dynamic functional connectivity patterns that describe non-stationary properties of brain networks. Here, we introduce a novel graphical measure of dynamic connectivity, called time-varying eigenvector centrality (tv-EVC). In a sample 655 children and adolescents (7-15 years old) from the Brazilian "High Risk Cohort Study for Psychiatric Disorders" who were imaged using resting-state fMRI, we used this measure to investigate age effects in the temporal in control and default-mode networks (CN/DMN). Using support vector regression, we propose a network maturation index based on the temporal stability of tv-EVC. Moreover, we investigated whether the network maturation is associated with the overall presence of behavioral and emotional problems with the Child Behavior Checklist. As hypothesized, we found that the tv-EVC at each node of CN/DMN become more stable with increasing age (P < 0.001 for all nodes). In addition, the maturity index for this particular network is indeed associated with general psychopathology in children assessed by the total score of Child Behavior Checklist (P = 0.027). Moreover, immaturity of the network was mainly correlated with externalizing behavior dimensions. Taken together, these results suggest that changes in functional network dynamics during neurodevelopment may provide unique insights regarding pathophysiology.
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Transtorno da Personalidade Antissocial/patologia , Mapeamento Encefálico , Encéfalo/patologia , Redes Neurais de Computação , Adolescente , Fatores Etários , Criança , Estudos de Coortes , Feminino , Humanos , Processamento de Imagem Assistida por Computador , Imageamento por Ressonância Magnética , Masculino , Vias Neurais/fisiologiaRESUMO
Com o incrível avanço tecnológico das últimas décadas, os jogos eletrônicos se tornaram uma das principais atividades de lazer de crianças e adolescentes. Os problemas relacionados ao uso excessivo dos games despertam cada vez mais a atenção de profissionais da saúde, e o número de artigos sobre o tema tem aumentado progressivamente. MÉTODOS: Foi realizada uma revisão não sistemática da literatura utilizandose os bancos de dados PubMed, SciELO e LILACS. RESULTADOS: São descritas as características dos jogos e dos jogadores que parecem estar envolvidos nesse comportamento de dependência, assim como as características clínicas, as bases neurobiológicas, o perfil de comorbidades e as opções de tratamento. A inclusão da categoria Internet Gaming Disorder no DSM-5 demonstra a importância que a comunidade científica tem dado ao assunto e estimula o desenvolvimento de mais pesquisas nessa área. Estudos epidemiológicos, clínicos e de neuroimagem observam que trata-se de um transtorno prevalente principalmente entre os jovens, que acarreta prejuízo significativo na vida dos indivíduos acometidos e que apresenta grandes semelhanças com outros comportamentos de dependência. Discute-se também a influência e os potenciais mecanismos pelos quais os jogos violentos podem estimular a agressividade, principalmente entre os jogadores que já apresentam outros fatores de risco para esse comportamento. CONCLUSÃO: Apesar do crescente corpo de evidências científicas disponíveis na literatura, muitas dúvidas ainda necessitam de esclarecimento e mais pesquisas sobre o tema devem ser estimuladas para que se tenha um maior êxito no reconhecimento e tratamento desse transtorno.(AU)
Along with the amazing technological development seen in the last decades, video games have become one of the main entertainment activities of children and adolescents. The problems due to the overuse of video games have increasingly drawn more attention from health professionals, and the number of publications is growing steadily. METHODS: A non-systematic literature review using the PubMed database, SciELO and LILACS databases was performed. RESULTS: The characteristics of games and players that seem to be involved in addictive behavior, as well as clinical characteristics, neurobiology, comorbidity profile and treatment options are described. The inclusion of Internet Gaming Disorder in DSM-5 demonstrates the importance that the scientific community has given to the subject, and stimulates the development of further research. Epidemiological, clinical and neuroimaging studies show that it is a prevalent disorder particularly among youth, which causes significant impairment in the life of affected individuals, and that presents strong similarities with other addictive behaviors. The influence and potential mechanisms by which violent games can stimulate aggression, especially among players who already have other risk factors for this behavior is also discussed. CONCLUSION: Despite the growing body of scientific evidence available in the literature, many questions still need clarification, and further research on the topic should be encouraged in order to improve the recognition and treatment of this disorder.(AU)
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Criança , Adolescente , Dependência Psicológica , Jogos de Vídeo , Jogos de Vídeo/efeitos adversosRESUMO
O crescente envolvimento dos jovens com as novas tecnologias da comunicação e da informação aumenta o risco de uso problemático ou mesmo dependência de tecnologia. O Grupo de Estudos sobre Adições Tecnológicas (GEAT) estuda essa dependência comportamental desde 2006 e apresenta neste artigo o processo de criação de um website psicoeducativo sobre o assunto. O resultado desse trabalho encontra-se em www.dependenciadetecnologia.org e tem como objetivo final orientar pais, professores e outros profissionais de saúde sobre o envolvimento dos jovens com as novas tecnologias.(AU)
The increasing involvement of youth with new communication and information technologies increases the risk of problematic use or dependence on technology (technology addiction). The Study Group on Technology Addiction (GEAT) studies this behavioral addiction since 2006. This article presents the process of creating a psychoeducational website on the subject. The result of this work can be found at www.dependenciadetecnologia.org and aims to guide parents, teachers and other healthcare professionals about youth engagement with new technologies.(AU)