The hypothesis of connecting two spinal cords as a way of sharing information between two brains and nervous systems

Copyright © 2017 Silva-dos-Santos A. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.Direct communication between different nervous systems has been recently reported through Brain-to-Brain-Interfaces and brainet. Closed loops systems between the brain and the spinal cord from the same individual have also been demonstrated. However, the connection between different nervous systems through the spinal cord has not yet been considered. This paper raises the hypothesis that connecting two spinal cords (spinal cord - spinal cord connection) is an indirect mean for communication of two brains and a direct way of communication between two nervous systems. A concept of electrical fingerprint of a drug is introduced. The notion of connection between two parts of the same spinal cord to treat a paraplegic patient is also introduced. Possible applications of this technique are discussed in the context of psychology, psychiatry and mental health. Also, it is discussed that external information injected to a spinal cord as well as spinal cord - spinal cord connection can become new tools to (1) study the physiology of the nervous system, (2) model specific behaviors, (3) study and model disease traits (4) treat neuropsychiatric disorders and (5) share information between two nervous systems.info:eu-repo/semantics/publishedVersio

Neuroversion: a possible mechanism of action of ECT in acute mania

The first-line treatments for acute mania are lithium, antiepileptic moodstabilizers, and antipsychotic drugs. Electroconvulsive therapy (ECT) is reserved for drug-resistant patients, although it is the first-line treatment for severe or delirious mania with life-threatening physical exhaustion. Contrary to depression, there is a paucity of evidence for the use of ECT in acute mania. However, available literature indicates that ECT seems effective in treating acute mania, with response rates between 80% and 90%, even in drug-resistant patients. Yet, its electrophysiological and molecular pathways remain unknown. We present the curious case of a 63-year-old woman, followed at our psychiatric outpatient clinic for bipolar disorder type I, admitted to our inpatient unit in a manic state with psychotic features. Due to bradycardia episodes secondary to the psychiatric medication, she was submitted to ECT. After a single session, her symptoms improved, despite no evoked seizures. We compare this curious phenomenon to the well-known procedure of cardioversion and name it neuroversion e in other words, a possible normalization of brain activity and behavior triggered by a unique session of electrical stimulation. However, we acknowledge that further research, including randomized clinical trials, are needed to study this reported event.info:eu-repo/semantics/publishedVersio

First-episode psychosis in a 15 year-old female with clinical presentation of anti-NMDA receptor encephalitis: a case report and review of the literature

© 2016 The Author(s). Open Access. This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.Background: Anti-NMDA receptor encephalitis is an autoimmune disease that was identified in 2007, and manifests in a stepwise manner with psychiatric, neurological and autonomic symptoms. The disease is caused by autoantibodies against NMDA receptors. It can have a paraneoplastic origin, mainly secondary to ovarian teratomas, but it can also be unrelated to the tumor. This disease can affect both sexes and all ages. Case presentation: Here, we present a case of a 15 year-old female adolescent with first-episode psychosis with anti-NMDA receptor encephalitis not related to tumor, which manifested with delusion, hallucinations, panic attacks, agitation, and neurological symptoms, and later with autonomic instability. She was treated with immunotherapy and psychiatric medication resulting in improvement of her main psychiatric and neurological symptoms. Conclusion: Our main objective in presenting this case is to alert clinicians to this challenging and recent disease that has a clinical presentation that might resemble a functional psychiatric condition and can be underdiagnosed in the context of child and adolescent psychiatry.info:eu-repo/semantics/publishedVersio

A new viewpoint on the etiopathogenesis of depression : insights from the neurophysiology of deep brain stimulation in Parkinson's Disease and treatment-resistant depression

Copyright © 2021 Silva-dos-Santos, Sales, Sebastião and Gusmão. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.In this opinion article, we humbly propose a new viewpoint on the etiopathogenesis of depression. We base the model on our interpretation of selected recent neurophysiological findings, mainly regarding Deep Brain Stimulation (DBS) to treat Parkinson’s Disease and also DBS to treat Treatment-Resistant Depression (TRD). We coin the idea a mental kindling-like mechanism. However, future clinical research, possibly complemented with human laboratory research or animal experiments, will be needed to test the validity of our proposed model. On the current manuscript framework, following the first and introductory section, we will set the stage by presenting selected studies and insights mainly from DBS to treat TRD and PD, on the second and middle section. Finally, we will discuss the proposed viewpoint on the third and last section of the present work.info:eu-repo/semantics/publishedVersio

The need to improve care transition interventions in psychiatry and mental health

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Sudden and Transient Block of Left Brain Hemisphere Activity in Catatonic Patients Undergoing Electroconvulsive Therapy (ECT)

Introduction: In the last 21 years, there has been an increase in studies on visual and quantitative EEG (qEEG). Although new findings have been reported, such as the extreme delta brush waves in anti-NMDA receptors encephalitis, there are still undocumented visual EEG alterations. In Psychiatry, these new findings are harder to detect because most patients do not undergo routine EEG. In this work, we report for the first time an EEG finding of a sudden and transient block of left brain hemisphere activity in two patients who underwent treatment with ECT. Methods: The EEG activity of the two patients undergoing ECT treatment was recorded using a Thymatron System IV device. Patient number 1: 23 year-old man with severe major depressive disorder with psychotic features and catatonia. Patient number 2: 48 year-old woman with bipolar disorder with mixed features and catatonia. Results and Discussion: The EEG recording of these two patients during their ECTs sessions showed a sudden and transient block (or arrest) of the left brain hemisphere activity. These findings are not attributed to background noise, electrode disconnection or device malfunction. Also, they were detected in two different patients. In patient 2 in two distinct admissions, two hospitals, utilizing two devices and by two different observers. After clinical improvement, these EEG alterations were not detected. Conclusion: To our knowledge, this is the first report of a sudden and transient block of the left brain hemisphere activity in psychiatric patients. Although the exact meaning of this finding remains unknown, a comparison can be made between this transient bradypsychia/block (arrest) of brain activity and bradycardia events in cardiology. We acknowledge the need for further studies to better understand these findings, particularly studies addressing different EEG abnormalities and the clinical traits they are associated with.info:eu-repo/semantics/publishedVersio

An Umbrella Review of Meta-Analyses

Background. Repetitive transcranial magnetic stimulation (rTMS) has been increasingly used for treating obsessive-compulsive disorder (OCD). Although several meta-analyses have explored its effectiveness and safety, there is no umbrella review specifically focused on rTMS for OCD. This umbrella review followed Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and analyzed relevant meta-analyses on rTMS for OCD. Methods. Twenty-three articles were identified from PubMed, and after screening, 12 meta-analyses were included in the review. The studies analyzed in the meta-analyses ranged from 10 to 27, with total participants ranging from 282 to 791. The most commonly studied regions were the dorsolateral prefrontal cortex (DLPFC), supplementary motor area (SMA), and orbitofrontal cortex (OFC). Result. The majority of the meta-analyses consistently supported the effectiveness of rTMS in reducing OCD symptoms when applied to the DLPFC and SMA. Encouraging results were also observed when targeting the medial prefrontal cortex (mPFC) and anterior cingulate cortex (ACC) through deep transcranial magnetic stimulation (dTMS). However, there was a high level of heterogeneity in the findings of nine out of 12 meta-analyses. Conclusion. In conclusion, existing evidence suggests that rTMS targeting the DLPFC and SMA consistently reduces OCD symptoms, but targeting the mPFC and ACC through dTMS shows variable results. However, the high heterogeneity in the study findings indicates a need for further research and standardization in the field.publishersversionpublishe

Quantitative EEG (qEEG) in Patients with Bipolar Psychotic Depression and Unipolar Psychotic Depression under Electroconvulsive Therapy (ECT)

In the last 21 years, there has been an increase in studies on quantitative electroencephalogram (qEEG) in psychiatry. Patients with unipolar and bipolar depression show different brain wave patterns. However, there is no consensus on the findings. In this study, we aimed to clarify some qEEG changes in patients with unipolar psychotic depression (UPD) and bipolar psychotic depression (BPD) during the ECT course. Methods: 10 patients undergoing treatment with ECT were considered. Of the 128 total ECT sessions, 34 sessions from six patients included had valid EEG recordings (3 patients with UPD and 3 with BPD, some with catatonic features). They underwent bifrontal ECT on a Thymatron IV device. EEG data were digitally recorded from two frontal leads with a Thymatron device and the Genie software. Data were analyzed with WinEEG soft package. EEG activity was divided into 4 phases: 1) background (resting state); 2) anesthesia; 3) ECT-induced stimulation/seizure, and 4) recovery. Regression analysis was performed for each phase through the sessions. The following EEG power spectrums were analyzed: delta (1.5-3.75 Hz), theta (4-7.75 Hz), alpha1 (8-9.75 Hz), alpha2 (10-13 Hz), beta1 (13.25-18 Hz), and beta2 (18.25-30 Hz). Results: Patients with psychotic unipolar depression showed an increase in the power spectrum of beta1 and/or beta2 in the resting phase over time (p < 0.05, linear regression). This increase was linked with clinical improvement. Patients with bipolar psychotic depression did not show this pattern. Conclusion: Clinical improvement in patients with unipolar psychotic depressionwas linked to an increase in the beta power spectrum. The same does not occur in bipolar patients. One possible reason for this finding might be that some bipolar patients have an increased basal beta activity. However, more studies are needed to assess the significance of our findings.info:eu-repo/semantics/publishedVersio

Acute Psychosis as Major Clinical Presentation of Legionnaires’ Disease

We report a case of a 61-year-old woman who presented with acute psychosis as a major manifestation of Legionnaires’ disease in the absence of other neuropsychiatric symptoms. Clinical history revealed dry cough and nausea. Observation showed fever and auscultation crackles in the lower lobe of the right lung. Laboratory testing demonstrated elevated C-reactive protein and lung chest radiograph showed patchy peribronchial and right lower lobe consolidation. Soon after admission, she started producing purulent sputum. Epidemiological data suggested Legionella pneumophila as possible cause of the clinical picture that was confirmed by urinary antigen detection and polymerase chain reaction of the sputum. She was treated with levofloxacin 750 mg/day for 10 days with complete remission of pulmonary and psychiatric symptoms. She has not had further psychotic symptoms

Low Level Laser Therapy Reduces the Development of Lung Inflammation Induced by Formaldehyde Exposure.

Lung diseases constitute an important public health problem and its growing level of concern has led to efforts for the development of new therapies, particularly for the control of lung inflammation. Low Level Laser Therapy (LLLT) has been highlighted as a non-invasive therapy with few side effects, but its mechanisms need to be better understood and explored. Considering that pollution causes several harmful effects on human health, including lung inflammation, in this study, we have used formaldehyde (FA), an environmental and occupational pollutant, for the induction of neutrophilic lung inflammation. Our objective was to investigate the local and systemic effects of LLLT after FA exposure. Male Wistar rats were exposed to FA (1%) or vehicle (distillated water) during 3 consecutive days and treated or not with LLLT (1 and 5 hours after each FA exposure). Non-manipulated rats were used as control. 24 h after the last FA exposure, we analyzed the local and systemic effects of LLLT. The treatment with LLLT reduced the development of neutrophilic lung inflammation induced by FA, as observed by the reduced number of leukocytes, mast cells degranulated, and a decreased myeloperoxidase activity in the lung. Moreover, LLLT also reduced the microvascular lung permeability in the parenchyma and the intrapulmonary bronchi. Alterations on the profile of inflammatory cytokines were evidenced by the reduced levels of IL-6 and TNF-α and the elevated levels of IL-10 in the lung. Together, our results showed that LLLT abolishes FA-induced neutrophilic lung inflammation by a reduction of the inflammatory cytokines and mast cell degranulation. This study may provide important information about the mechanisms of LLLT in lung inflammation induced by a pollutant