Gyrification brain abnormalities as predictors of outcome in anorexia nervosa.

Gyrification brain abnormalities are considered a marker of early deviations from normal developmental trajectories and a putative predictor of poor outcome in psychiatric disorders. The aim of this study was to explore cortical folding morphology in patients with anorexia nervosa (AN). A MRI brain study was conducted on 38 patients with AN, 20 fully recovered patients, and 38 healthy women. Local gyrification was measured with procedures implemented in FreeSurfer. Vertex-wise comparisons were carried out to compare: (1) AN patients and healthy women; (2) patients with a full remission at a 3-year longitudinal follow-up assessment and patients who did not recover. AN patients exhibited significantly lower gyrification when compared with healthy controls. Patients with a poor 3-year outcome had significantly lower baseline gyrification when compared to both healthy women and patients with full recovery at follow-up, even after controlling for the effects of duration of illness and gray matter volume. No significant correlation has been found between gyrification, body mass index, amount of weight loss, onset age, and duration of illness. Brain gyrification significantly predicted outcome at follow-up even after controlling for the effects of duration of illness and other clinical prognostic factors. Although the role of starvation in determining our findings cannot be excluded, our study showed that brain gyrification might be a predictor of outcome in AN. Further studies are needed to understand if brain gyrification abnormalities are indices of early neurodevelopmental alterations, the consequence of starvation, or the interaction between both factors

Graphene oxide sheets-based platform for induced pluripotent stem cells culture: toxicity, adherence, growth and application

It was prepared the graphene oxide (GO) sheets by suspension of GO in ultrapure deionized water or in Pluronic F-68 using a ultrasonicator bath. Total characterization of GO sheets was carried out. The results on suspension of GO in water showed excellent growth and cell adhesion. GO/Pluronic F-68 platform for the growth and adhesion of adipose-derived stem cells (ASCs) that exhibits excellent properties for these processes. GO in water suspension exhibited an inhibition of the cell growth over 5 mu g/mL In vivo study with GO suspended in water (100 g/mL) on Fisher 344 rats via i.p. administration showed low toxicity. Despite GO particle accumulates in the intraperitoneal cavity, this fact did not interfere with the final absorption of GO. The AST (aspartate aminotransferase) and ALT (alanine aminotransferase) levels (liver function) did not differ statistically in all experimental groups. Also, creatinine and urea levels (renal function) did not differ statistically in all experimental groups. Taking together, the data suggest the great potential of graphene oxide sheets as platform to ACSs, as well as, new material for treatment several urological diseases6174th International Conference on Safe Production and Use of Nanomaterials (Nanosafe

Linguistic embodiment in typical and atypical anorexia nervosa: Evidence from an image-word matching task

Objective: The integration of sensory, motor, and cognitive systems is embodied cognition, according to which mind and body are not separate and distinct, and our body (and our brain, as part of the body) contributes to determining our mental and cognitive processes. In spite of limited data available, Anorexia nervosa (AN) appears as a condition in which embodied cognition is altered, in particular, if we consider bodily sensations and visuospatial information processing. We aimed to evaluate the ability to correctly identify body parts and actions in both full (AN) and atypical AN (AAN), looking at the role of the underweight status. Method: A group of 143 females (AN = 45, AAN = 43, unaffected women = 55) was enrolled. All participants performed a linguistic embodied task to evaluate the association between a picture-showing a bodily action-and a written verb. Additionally, a subsample of 24 AN participants performed a retest after stable weight recovery. Results: Both AN and AAN demonstrated an abnormal ability to evaluate the picture-written verb associations, especially if the involved bodily effectors were the same in both stimuli (i.e., pictorial and verbal) and needed a longer response time. Conclusions: Specific embodied cognition linked to body schema seems to be impaired in persons with AN. The longitudinal analysis showed a difference between AN and AAN only in the underweight condition, suggesting the presence of an abnormal linguistic embodiment. More attention should be devoted to embodiment during AN treatment to improve bodily cognition, which might, in turn, diminish body misperception

Late Onset Anorexia Nervosa Treated With Olanzapine: A Case Report

A case of late onset anorexia nervosa (AN) treated with olanzapine is reported. The patient suffered AN onset at the age of 53 and was brought to our attention four years later in a very poor state of health due to extreme starvation and laxative abuse. She presented severe obsessions about food, a very disturbed body image, and “ascetic” rituals of self-punishment. There was no improvement of her symptoms with cognitive behavioural therapy, antidepressant drugs and inpatient nutritional therapy. After the prescription of olanzapine, the patient was more cooperative and able to maintain a stable acceptable weight, although her psychiatric and anorexic symptoms only improved partially

The association between smoking prevalence and eating disorders: a systematic review and meta-analysis

Background and Aims: Cigarette smoking is associated with severe mental illness, including schizophrenia and bipolar disorder, and with morbidity and mortality, but the association with anorexia (AN), bulimia nervosa (BN) and binge eating disorder (BED) is unclear. This meta-analysis compared the odds of smoking in eating disorders (ED) (ED = AN or BN or BED) versus healthy controls (HC) and calculated the prevalence of smokers in people with ED.  Methods: Three independent authors searched PubMed, MEDLINE and Scopus from database inception until 31 December 2015 for studies reporting data on life-time or current smoking prevalence in BED, BN and AN with or without control group. Meta-analyses were undertaken, calculating odds ratios (ORs) of life-time smoking in BED, BN, AN versus healthy controls (HCs) or prevalence of smoking in BED, BN and AN with 95% confidence intervals (CI).  Results: Thirty-one studies (ED = 8517, controls = 68 335) were meta-analysed. Compared with HCs, there were significantly more smokers among people with BN (life-time OR = 2.165) and BED (life-time OR = 1.792) but not AN (life-time OR = 0.927). BED was associated with smoking the most (life-time prevalence = 47.73%) followed by BN (life-time prevalence = 39.4%) and AN (life-time prevalence = 30.8%). In BN, life-time smoking prevalence was highest in Europe. In AN, higher age moderated both life-time and current smoking prevalence, and body mass index moderated higher life-time smoking prevalence. In BN, female sex moderated higher life-time smoking prevalence.  Conclusions: People with binge eating disorder and bulimia nervosa are significantly more likely to be life-time smokers than healthy controls, which is not the case for anorexia nervosa

Cortical Complexity Estimation Using Fractal Dimension: A Systematic Review of the Literature on Clinical and Nonclinical Samples

Fractal geometry has recently been proposed as a useful tool for characterizing the complexity of the brain cortex, which is likely to derive from the recurrence of sulci–gyri convolution patterns. The index used to describe the cortical complexity is called fractal dimensional (FD) and was employed by different research exploring the neurobiological correlates of distinct pathological and nonpathological conditions. This review aims to describe the literature on the application of this index, summarize the heterogeneities between studies and inform future research on this topic. Sixty-two studies were included in the systematic review. The main research lines concern neurodevelopment, aging and the neurobiology of specific psychiatric and neurological disorders. Overall, the included papers indicate that cortical complexity is likely to reduce during aging and in various pathological processes affecting the brain. Nevertheless, the high heterogeneity between studies strongly prevents the possibility of drawing conclusions. Further research considering this index besides other morphological values is needed to better clarify the role of FD in characterizing the cortical structure

Time to make a change:A call for more experimental research on key mechanisms in anorexia nervosa

Anorexia nervosa (AN) is a life‐threatening eating disorder, characterised by persistent pathological weight loss behaviours and an intense fear of weight gain and food consumption. Although there is an abundance of scientific theories on the neurobiological, psychological and sociocultural factors thought to be involved in the maintenance of AN, there is little experimental research testing these ideas. The need for theory firmly grounded in empirical evidence becomes strikingly clear when we consider that current treatments for patients with AN are limited in their effectiveness, and relapse after treatment is common

Fatores de risco de transtornos alimentares: revisão guarda-chuva de metanálises publicadas

Objetivo: Graduar as evidências sobre fatores de risco de transtornos alimentares (anorexia nervosa, bulimia nervosa e transtorno de compulsão alimentar periódica) com o método de revisão guarda-chuva. Métodos: Trata-se de revisão sistemática de estudos observacionais sobre fatores de risco de transtornos alimentares publicados no PubMed, PsycInfo, e Embase até 11 de dezembro de 2019. Recalculamos metanálises de efeitos aleatórios, heterogeneidade, efeito de estudo pequeno, viés de excesso de significância e intervalo de confiança de 95% e graduamos evidências significativas (p < 0,05) de convincentes a fracas, conforme os critérios estabelecidos. A qualidade foi avaliada com a ferramenta Assessment of Multiple Systematic Reviews 2 (AMSTAR-2). Resultados: Foram incluídas 9 das 2.197 metanálises, as quais apresentavam evidências de 50 fatores de risco, 29.272 sujeitos com transtornos alimentares e 1.679.385 controles. Embora não houvesse associação com evidências convincentes, evidências altamente sugestivas apoiaram a associação entre abuso sexual infantil e bulimia nervosa (k = 29, 1.103 casos com distúrbios alimentares, 8.496 controles, RC, 2,73, IC95% 1,96-3.79, p = 2,1x10-9, qualidade AMSTAR-2 moderada) e entre vitimização por provocação relacionada à aparência e quaisquer transtornos alimentares (k = 10, 1.341 casos com transtornos alimentares, 3.295 controles, RC 2,91, IC95% 2,05-4,12, p = 1,8x10-9, qualidade AMSTAR-2 moderada). Evidências sugestivas, fracas ou nenhuma evidência sustentaram 11, 29 e 8 associações, respectivamente. Conclusões: Evidência mais confiáveis indicam que eventos traumáticos e estressantes precoces são fatores de risco de transtornos alimentares. São necessários estudos de coorte colaborativos prospectivos maiores para identificar fatores de risco de transtornos alimentares, especialmente a anorexia nervos

The impact of COVID-19 lockdown and of the following "re-opening" period on specific and general psychopathology in people with Eating Disorders: the emergent role of internalizing symptoms

BACKGROUND: We assessed the impact of the coronavirus disease 2019 (COVID-19) pandemic on specific Eating Disorder (ED) and general psychopathology in people with an ED diagnosis during the lockdown period and after the end of the related containment measures.METHODS: People with clinically defined diagnosis and undergoing treatment for an ED completed an online survey, which included adapted questions from standardized psychometric scales. Data relative to three different time periods (before, during and after the end of lockdown) were collected. Psychopathological changes over these periods were investigated and compared through one-way analysis of variance or covariance with repeated measures.RESULTS: Three hundred twelve people completed the survey (57.4% diagnosed with Anorexia Nervosa (AN) or atypical AN, 20.2% with Bulimia Nervosa, 15.4% with Binge Eating Disorder, 7.05% with Other Specified Feeding or Eating Disorders). The severity of both specific and general psychopathology increased during the lockdown and the rise of general symptoms persisted in the following re-opening phase, except for suicide ideation. Almost all of these findings were not affected by ED diagnosis, participants' age and illness duration.LIMITATIONS: The retrospective nature of data collection is the main limitation of the study.CONCLUSIONS: People with EDs showed a COVID-19 emergency-induced worsening of both general and specific psychopathology. The effect on general psychopathology persisted in the re-opening period. These findings suggest a high stress vulnerability of ED individuals with important effects on internalizing symptoms, which are worth of attention by clinicians