Erratum to "Double-blind Randomized Trial of tDCS Versus Sham in Parkinson Patients With Mild Cognitive Impairment Receiving Cognitive Training" Brain Stimulation 8 (2015) 1223-1225.

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Impact of Cognitive Profile on Impulse Control Disorders Presence and Severity in Parkinson's Disease

Background: Impulse control disorders (ICDs) and related behaviors are frequent in Parkinson's disease (PD). Mild cognitive impairment (PD-MCI) and dementia (PDD), both characterized by heterogeneous cognitive phenotypes, are also commonly reported in PD. However, the frequency and severity of ICD within PD cognitive states is unknown.Methods: Three hundred and twenty-six PD patients completed a comprehensive neuropsychological assessment and were classified as PD-MCI, PDD, or without cognitive alterations (PD-NC). The Minnesota impulsive disorders interview was used to ascertain the presence (ICD+) or absence (ICD–) of ICD. The Questionnaire for Impulsive-Compulsive Disorders in Parkinson's Disease-Rating Scale was used to assess ICD severity. A subsample of 286 patients evaluated with the same cognitive tasks was selected in order to investigate the characteristics of ICD in PD cognitive phenotypes.Results: ICDs were present in 55% of PD-NC, in 50% of PD-MCI, and in 42% of PDD patients. Frequencies of ICD+ with attentive (ICD+: 20% vs. ICD–: 4%; p = 0.031) and executive impairments (ICD+: 44% vs. ICD–: 30%; p = 0.027) were higher in the PD-MCI and PDD subgroups, respectively. As expected, no differences were observed in the PD-NC. PD-MCI with attentive impairments presented higher percentage of ICD+ with deficits in the Trail Making Test B-A but not in the Digit Span Sequencing task. In PDD, executive failures concerned Similarities task (ICD+: 67%; ICD–: 29%; p = 0.035), with no differences between ICD+ and ICD– in the Stroop task.Conclusions: Prevalence and severity of ICDs and related behaviors do not differ in PD with different cognitive states. However, ICD+ are more likely to show deficits, respectively in attentive and in executive domains, specifically in the Trail Making Test B-A task for the attention and working memory domain in PD-MCI and in the Similarities task for the executive function domain in PDD. Prospective studies should evaluate if these tests can be used as screening tool for ICDs in PD

Goodbye Hartmann trial: a prospective, international, multicenter, observational study on the current use of a surgical procedure developed a century ago

Background: Literature suggests colonic resection and primary anastomosis (RPA) instead of Hartmann's procedure (HP) for the treatment of left-sided colonic emergencies. We aim to evaluate the surgical options globally used to treat patients with acute left-sided colonic emergencies and the factors that leading to the choice of treatment, comparing HP and RPA. Methods: This is a prospective, international, multicenter, observational study registered on ClinicalTrials.gov. A total 1215 patients with left-sided colonic emergencies who required surgery were included from 204 centers during the period of March 1, 2020, to May 31, 2020. with a 1-year follow-up. Results: 564 patients (43.1%) were females. The mean age was 65.9 ± 15.6 years. HP was performed in 697 (57.3%) patients and RPA in 384 (31.6%) cases. Complicated acute diverticulitis was the most common cause of left-sided colonic emergencies (40.2%), followed by colorectal malignancy (36.6%). Severe complications (Clavien-Dindo ≥ 3b) were higher in the HP group (P < 0.001). 30-day mortality was higher in HP patients (13.7%), especially in case of bowel perforation and diffused peritonitis. 1-year follow-up showed no differences on ostomy reversal rate between HP and RPA. (P = 0.127). A backward likelihood logistic regression model showed that RPA was preferred in younger patients, having low ASA score (≤ 3), in case of large bowel obstruction, absence of colonic ischemia, longer time from admission to surgery, operating early at the day working hours, by a surgeon who performed more than 50 colorectal resections. Conclusions: After 100 years since the first Hartmann's procedure, HP remains the most common treatment for left-sided colorectal emergencies. Treatment's choice depends on patient characteristics, the time of surgery and the experience of the surgeon. RPA should be considered as the gold standard for surgery, with HP being an exception

Dynamic functional connectivity changes associated with dementia in Parkinson's disease

Dynamic functional connectivity captures temporal variations of functional connectivity during MRI acquisition and it may be a suitable method to detect cognitive changes in Parkinson's disease. In this study, we evaluated 118 patients with Parkinson's disease matched for age, sex and education with 35 healthy control subjects. Patients with Parkinson's disease were classified with normal cognition (n = 52), mild cognitive impairment (n = 46), and dementia (n = 20) based on an extensive neuropsychological evaluation. Resting state functional MRI and a sliding-window approach were used to study the dynamic functional connectivity. Dynamic analysis suggested two distinct connectivity 'States' across the entire group: a more frequent, segregated brain state characterized by the predominance of within-network connections, State I, and a less frequent, integrated state with strongly connected functional internetwork components, State II. In Parkinson's disease, State I occurred 13.89% more often than in healthy control subjects, paralleled by a proportional reduction of State II. Parkinson's disease subgroups analyses showed the segregated state occurred more frequently in Parkinson's disease dementia than in mild cognitive impairment and normal cognition groups. Further, patients with Parkinson's disease dementia dwelled significantly longer in the segregated State I, and showed a significant lower number of transitions to the strongly interconnected State II compared to the other subgroups. Our study indicates that dementia in Parkinson's disease is characterized by altered temporal properties in dynamic connectivity. In addition, our results show that increased dwell time in the segregated state and reduced number of transitions between states are associated with presence of dementia in Parkinson's disease. Further studies on dynamic functional connectivity changes could help to better understand the progressive dysfunction of networks between Parkinson's disease cognitive states

The Psychonauts: mind’s navigators or chemical experimenters?

Laura Orsolini et al, "Gli Psiconauti: navigatori della mente o sperimentatori chimici?", Medicina delle Dipendenze, Vol. 6 Issue 22, June 2016. Available online at: http://www.medicinadelledipendenze.it/rivista/tutti-i-numeri/le-nuove-sostanze-psicoattive/gli-psiconauti-navigatori-della-mente-o-sperimentatori-chimici.html © 2010-2016 Publishday Srl , P.IVA 03316280928 Via Nazario Sauro 10, 09123 Cagliari, ItalyRecentemente, all’interno delle comunità online (forum, blog, social network), si sta diffondendo una nuova generazione di consumatori di sostanze, altamente informati ed esperti nel campo delle nuove sostanze psicoattive (NSP), capaci di fornire qualsiasi tipo di informazione in merito alle caratteristiche farmacologiche e chimiche nonché cliniche delle NSP, suggerendo le ‘migliori’ combinazioni, dosaggi e vie di somministrazioni al fine di ottenere il miglior ‘high’. Il presente articolo ha lo scopo di fornire una descrizione dettagliata sulle principali caratteristiche (socio-demografiche, psicologiche, etc.) di tali psiconauti del web, mediante l’analisi dei loro siti di discussione (forum/blog/account sui social network), utilizzando un approccio di osservazione non invasivo di tipo qualitativo (metodo netnografico). Post e discussioni sono stati accuratamente selezionati, revisionati, analizzati e confrontati in merito alla presenza di cluster comportamentali e caratterizzanti comuni. Generalmente gli psiconauti non si ritengono degli abusatori o dipendenti dalle sostanze psicoattive, definendosi piuttosto come dei ‘ricercatori psichedelici’, ‘filosofi dell’alchimia’, ‘alchimisti’ mentre altri si considerano i ‘nuovi sciamani’. Sono stati osservati una ottima padronanza linguistica ed abilità descrittive, essenziali per riportare in modo accurato e preciso le proprie esperienze psichedeliche. La maggior parte sono giovani, di sesso maschile, non sposati, caucasici e con una buona posizione lavorativa (es. ingegneri informatici, impiegati, docenti universitari, etc.). Una predisposizione all’esplorazione del proprio ‘mondo interno’ mediante l’impiego di sostanze psicoattive, un ottimo di repertorio di conoscenze di tipo farmacologico/chimico/informatico e una attitudine alla ricerca in ambito psichedelico/chimico nonché alla condivisione delle proprie esperienze (‘trip reports’), in particolare con le NSP, si associano ad elevati livelli di novelty seeking e decision making di tipo impulsivo.Peer reviewe

Novel psychoactive substances

Laura Orsolini, Duccio Papanti, Roberta Vecchiotti, Alessandro Valchera, John Corkery, Fabrizio Schifano, "Novel psychoactive substances" in the 24th European Congress of Psychiatry (EPA 2016), 12-15 March 2016, Madrid, Spain, Meeting abstracts, European Psychiatry Vol. 33, DOI: 10.1016/j.eurpsy.2016.01.945Peer reviewe

Herbal Highs: Review on Psychoactive Effects and Neuropharmacology

background: a new trend among users of new psychoactive substances' the consumption of "herbal highs": plant parts containing psychoactive substances. most of the substances extracted from herbs, in old centuries were at the centre of religious ceremonies of ancient civilizations. currently, these herbal products are mainly sold by internet web sites and easily obtained since some of them have no legal restriction. objective: we reviewed psychoactive effects and neuropharmacology of the most used "herbal highs" with characterized active principles, with studies reporting mechanisms of action, pharmacological and subjective effects, eventual secondary effects including intoxications and/or fatalities method: the pubmed database was searched using the following key.words: herbal highs, argyreia nervosa, Ipomoea violacea and rivea corymbosa; catha edulis; datura stramonium; piper methysticum; mitragyna speciosa. results: sychoactive plants here reviewed have been known and used from ancient times, even if for some of them limited information still exist regarding subjective and neuropharmacological effects and consequent eventual toxicity when plants are used alone or in combination with "classical" drugs of abuse. conclusion: some "herbal highs" should be classified as harmful drugs since chronic administration has been linked with addiction and cognitive impairment; for some others taking into consideration only the recent trends of abuse, studies investigating these aspects are lacking

Herbal Highs: Review on Psychoactive Effects and Neuropharmacology

Background: A new trend among users of new psychoactive substances' the consumption of "herbal highs": plant parts containing psychoactive substances. Most of the substances extracted from herbs, in old centuries were at the centre of religious ceremonies of ancient civilizations. Currently, these herbal products are mainly sold by internet web sites and easily obtained since some of them have no legal restriction.Objective: We reviewed psychoactive effects and neuropharmacology of the most used "herbal highs" with characterized active principles, with studies reporting mechanisms of action, pharmacological and subjective effects, eventual secondary effects including intoxications and/or fatalitiesMethod: The PubMed database was searched using the following key. words: herbal highs, Argyreia nervosa, Ipomoea violacea and Rivea corymbosa; Catha edulis; Datura stramonium; Piper methysticum; Mitragyna speciosa.Results: Psychoactive plants here reviewed have been known and used from ancient times, even if for some of them limited information still exist regarding subjective and neuropharmacological effects and consequent eventual toxicity when plants are used alone or in combination with "classical" drugs of abuse.Conclusion: Some "herbal highs" should be classified as harmful drugs since chronic administration has been linked with addiction and cognitive impairment; for some others taking into consideration only the recent trends of abuse, studies investigating these aspects are lacking

Erratum to “Double-blind Randomized Trial of tDCS Versus Sham in Parkinson Patients With Mild Cognitive Impairment Receiving Cognitive Training” Brain Stimulation 8 (2015) 1223–1225

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