Circadian rhythms in obsessive-compulsive disorder

The etiopathology and neurobiology of obsessive-compulsive disorder (OCD) are not fully understood. As for altered circadian rhythms associated with OCD, hormonal dysregulation and a delayed sleep phase have come into the focus of research. The novel antidepressant agomelatine is able to resynchronize circadian rhythms and the augmentative administration of this compound has been shown to be of benefit in some OCD patients who are refractory to common forms of pharmacotherapy. Adjunctive chronotherapy might also enhance the outcome in treatment-refractory OCD. The present review summarises the findings regarding circadian abnormalities in OCD

Sport and exercise as medicine in the prevention and treatment of depression

Emerging evidence has demonstrated an impressive link between physical activity and improved mood. While evidence of beneficial mental health effects of exercise is mounting, doctors, psychologists and other health practitioners are slow to consider exercise and seldom use it as a therapy tool. The present opinion piece argues that, in view of the unsatisfactory mitigation of disease burden and limited long-term effectiveness of the available treatments for depressive disorders, physical exercise and sport deserve far greater consideration and may become a viable measure in the prevention and treatment of depression. The available research findings make a robust case for exercise as a means of protecting and improving mental health as well as physical health. Depression is highly prevalent across the entire lifespan worldwide and has become the leading cause of burden of disability globally (1). Depression is highly debilitating, causing reduced quality of life and severe functional disability, and because of its high rate of recurrence, depression is difficult to treat (2). The therapies available for major depressive disorder remain less than satisfactory, with a significant proportion of people treated for depression remaining refractory to treatment. The long-term effectiveness of pharmacotherapy, such as the administration of selective serotonin reuptake inhibitors, and psychological treatment, such as cognitive behavioural therapy, remains a matter of debate, and the capacity of these treatments to ameliorate the cumulative burden of depression on society is limited. There is therefore an urgent need to find novel approaches to the prevention and treatment of depression. The major impact of lifestyle on the development of depression often goes unrecognised, and an ever-growing body of research findings suggest a significant contribution of maladaptive lifestyle choices to the pathogenesis of the disorder. Available evidence supports the view that modifiable lifestyle factors, such as diet and physical exercise, should be considered in the management of common mental disorders. Lifestyle-oriented interventions may be capable of reducing the occurrence and severity of depressive disorders and could become targets of health campaigns at population level. Diet and exercise modification has also been suggested as a treatment strategy in the management of depressive disorders arising during the current coronavirus pandemic (3–6). While various nutrients and food bioactives have been claimed to be effective in alleviating depression, evidence of their clinical efficacy is lacking (7–10)

Nutrition in the Management of ADHD: A Review of Recent Research

Purpose of Review Various nutrients and diet quality have been suggested to be involved in the pathophysiology of ADHD. The purpose of this review was to examine data from recent cohort studies and dietary interventions to determine whether nutrition may play a role in the management of ADHD. Recent Findings Preliminary evidence suggests that minerals might have beneficial effects on ADHD symptomatology. Probiotics might offer novel strategies to prevent or treat ADHD. Inverse associations between adherence to “healthy” diets and ADHD symptoms have been observed. Children with ADHD responding to the few-foods diet (or oligoantigenic diet) with an elimination of individually identified food items show substantially improved behavior and cognitive functioning. Summary Evidence from recent research does not allow any recommendations regarding the use of micronutrients or probiotics in the management of ADHD. The few-foods diet may become an additional therapeutic option for children with ADHD

Polyunsaturated fatty acids in the treatment of attention deficit hyperactivity disorder

Background: Attention deficit/hyperactivity disorder (ADHD) is one of the most common behavioral disorders in children. Insufficient dietary intake of long-chain polyunsaturated fatty acids (LC-PUFAs) has been suggested to have an impact on the development of symptoms of ADHD in children. Individuals with ADHD have been demonstrated to have significantly reduced blood concentrations of PUFAs and, in particular, reduced levels of omega-3 (n-3) PUFAs. These findings suggest that PUFA supplementation may reduce the attention and behavior problems associated with ADHD. Objective: To provide an overview of the efficacy of dietary LC-PUFA supplementation in the treatment of ADHD. Methods: Literature published up until December 2013 on the effects of n-3 PUFA supplementation on ADHD symptoms was obtained using a PubMed search and critically reviewed. Results: Dietary PUFA supplementation appears to have beneficial effects on ADHD symptoms although these effects are small. The clinical relevance of these observations remains to be determined. Conclusion: There is only limited support for the efficacy of PUFA supplementation for the core symptoms of ADHD. Given the small effect sizes regarding PUFA supplementation, it may not be a sufficient therapy for a majority of patients with ADHD

Staphylococcus aureus pathogenicity in cystic fibrosis patients-results from an observational prospective multicenter study concerning virulence genes, phylogeny, and gene plasticity

Staphylococcus aureus and cystic fibrosis (CF) are closely interlinked. To date, however, the impact of S. aureus culture in CF airways on lung function and disease progression has only been elucidated to a limited degree. This analysis aims to identify bacterial factors associated to clinical deterioration. Data were collected during an observational prospective multi-center study following 195 patients from 17 centers. The average follow-up time was 80 weeks. S. aureus isolates (n = 3180) were scanned for the presence of 25 virulence genes and agr-types using single and multiplex PCR. The presence of specific virulence genes was not associated to clinical deterioration. For the agr-types 1 and 4, however, a link to the subjects' clinical status became evident. Furthermore, a significant longitudinal decrease in the virulence gene quantity was observed. Analyses of the plasticity of the virulence genes revealed significantly increased plasticity rates in the presence of environmental stress. The results suggest that the phylogenetic background defines S. aureus pathogenicity rather than specific virulence genes. The longitudinal loss of virulence genes most likely reflects the adaptation process directed towards a persistent and colonizing rather than infecting lifestyle

Severity of current depression and remission status are associated with structural connectome alterations in major depressive disorder

Major depressive disorder (MDD) is associated to affected brain wiring. Little is known whether these changes are stable over time and hence might represent a biological predisposition, or whether these are state markers of current disease severity and recovery after a depressive episode. Human white matter network ("connectome") analysis via network science is a suitable tool to investigate the association between affected brain connectivity and MDD. This study examines structural connectome topology in 464 MDD patients (mean age: 36.6 years) and 432 healthy controls (35.6 years). MDD patients were stratified categorially by current disease status (acute vs. partial remission vs. full remission) based on DSM-IV criteria. Current symptom severity was assessed continuously via the Hamilton Depression Rating Scale (HAMD). Connectome matrices were created via a combination of T1-weighted magnetic resonance imaging (MRI) and tractography methods based on diffusion-weighted imaging. Global tract-based metrics were not found to show significant differences between disease status groups, suggesting conserved global brain connectivity in MDD. In contrast, reduced global fractional anisotropy (FA) was observed specifically in acute depressed patients compared to fully remitted patients and healthy controls. Within the MDD patients, FA in a subnetwork including frontal, temporal, insular, and parietal nodes was negatively associated with HAMD, an effect remaining when correcting for lifetime disease severity. Therefore, our findings provide new evidence of MDD to be associated with structural, yet dynamic, state-dependent connectome alterations, which covary with current disease severity and remission status after a depressive episode

Bone Morphogenetic Protein (BMP)-7 expression is decreased in human hypertensive nephrosclerosis

Background: Bone Morphogenetic Protein (BMP)-7 is protective in different animal models of acute and chronic kidney disease. Its role in human kidneys, and in particular hypertensive nephrosclerosis, has thus far not been described. Methods: BMP-7 mRNA was quantified using real-time PCR and localised by immunostaining in tissue samples from normal and nephrosclerotic human kidneys. The impact of angiotensin (AT)-II and the AT-II receptor antagonist telmisartan on BMP-7 mRNA levels and phosphorylated Smad 1/5/8 (pSmad 1/5/8) expression was quantified in proximal tubular cells (HK-2). Functional characteristics of BMP-7 were evaluated by testing its influence on TGF-b induced epithelial-to-mesenchymal transition (EMT), expression of TGF-b receptor type I (TGF-bRI) and phosphorylated Smad 2 (pSmad 2) as well as on TNF-a induced apoptosis of proximal tubular cells. Results: BMP-7 was predominantly found in the epithelia of the distal tubule and the collecting duct and was less abundant in proximal tubular cells. In sclerotic kidneys, BMP-7 was significantly decreased as demonstrated by real-time PCR and immunostaining. AT-II stimulation in HK-2 cells led to a significant decrease of BMP-7 and pSmad 1/5/8, which was partially ameliorated upon co-incubation with telmisartan. Only high concentrations of BMP-7 (100 ng/ml) were able to reverse TNF-a-induced apoptosis and TGF-b-induced EMT in human proximal tubule cells possibly due to a decreased expression of TGF-bRI. In addition, BMP-7 was able to reverse TGF-b-induced phosphorylation of Smad 2. Conclusions: The findings suggest a protective role for BMP-7 by counteracting the TGF-b and TNF-a-induced negative effects. The reduced expression of BMP-7 in patients with hypertensive nephrosclerosis may imply loss of protection and regenerative potential necessary to counter the disease