Nucleus Accumbens Deep Brain Stimulation Results in Insula and Prefrontal Activation: A Large Animal FMRI Study.

Nucleus accumbens deep brain stimulation results in insula and prefrontal activation: a large animal FMRI study.

PLoS One. 2013; 8(2): e56640
Knight EJ, Min HK, Hwang SC, Marsh MP, Paek S, Kim I, Felmlee JP, Abulseoud OA, Bennet KE, Frye MA, Lee KH

Deep Brain Stimulation (DBS) of the nucleus accumbens (NAc) has previously been investigated clinically for the treatment of several psychiatric conditions, including obsessive-compulsive disorder and treatment resistant depression. However, the mechanism underlying the therapeutic benefit of DBS, including the brain areas that are activated, remains largely unknown. Here, we utilized 3.0 T functional Magnetic Resonance Imaging (fMRI) changes in Blood Oxygenation Level-Dependent (BOLD) signal to test the hypothesis that NAc/internal capsule DBS results in global neural network activation in a large animal (porcine) modelAnimals (n?=?10) were implanted in the NAc/internal capsule with DBS electrodes and received stimulation (1, 3, and 5 V, 130 Hz, and pulse widths of 100 and 500 µsec). BOLD signal changes were evaluated using a gradient echo-echo planar imaging (GRE-EPI) sequence in 3.0 T MRI. We used a normalized functional activation map for group analysis and applied general linear modeling across subjects (FDR<0.001). The anatomical location of the implanted DBS lead was confirmed with a CT scanWe observed stimulation-evoked activation in the ipsilateral prefrontal cortex, insula, cingulate and bilateral parahippocampal region along with decrease in BOLD signal in the ipsilateral dorsal region of the thalamus. Furthermore, as the stimulation voltage increased from 3 V to 5 V, the region of BOLD signal modulation increased in insula, thalamus, and parahippocampal cortex and decreased in the cingulate and prefrontal cortex. We also demonstrated that right and left NAc/internal capsule stimulation modulates identical areas ipsilateral to the side of the stimulationOur results suggest that NAc/internal capsule DBS results in modulation of psychiatrically important brain areas notably the prefrontal cortex, cingulate, and insular cortex, which may underlie the therapeutic effect of NAc DBS in psychiatric disorders. Finally, our fMRI setup in the large animal may be a useful platform for translational studies investigating the global neuromodulatory effects of DBS. HubMed – depression


Psychological Morbidity Status Among the Rural Geriatric Population of Tamil Nadu, India: A Cross-sectional Study.

Indian J Psychol Med. 2012 Jul; 34(3): 227-31
Reddy NB, Pallavi M, Reddy NN, Reddy CS, Singh RK, Pirabu RA

Mental health problems like depression, cognitive impairment, anxiety, sleep disorders, and so on, arising out of senility, neurosis, and living conditions are common in the geriatric population.To study the psychiatric morbidity among the rural elderly.A community-based, cross-sectional study.A study was conducted on 800 rural elderly subjects, aged 60 years and more, living in ten randomly selected villages, served by the Rural Health Training Center (RHTC), Valadi, in Tamilnadu state, India. Cognitive functioning was assessed by the Mini Mental Status Examination (MMSE), and the depression by the Geriatric Depression Scale – Shorter version.The data was analyzed with SPSS 16 version statistical software using proportions, and the chi-square.A majority of the subjects were widows / widowers, illiterates, living with family, and showing economic dependency. The prevalence of cognitive impairment was 43.25%, with a mean MMSE score of 23.32±4.4, and the depression was 47.0% and 6.16±3.4. Cognitive impairment, depression, and a disturbed sleep pattern were associated with female sex, age, illiteracy, poverty, loneliness, and the low socioeconomic status of the family.The study showed a definite association between the sociodemographic factors and psychiatric morbidity. Encouraging the Non-governmental Organizations (NGOs) working for the elderly, running of separate geriatric clinics, and effective implementation of schemes like old age pension are some of the measures to be taken. HubMed – depression


Perception of illness in patients with traumatic brain injury.

Indian J Psychol Med. 2012 Jul; 34(3): 223-6
Var FA, Rajeswaran J

Perception of illness plays an important role in recovery process. It affects our coping behaviors, adherence to treatment and preventive measures taken for healthy recovery.The aim of the study is to examine perception of illness in patients with traumatic brain injury (TBI).This was a cross sectional study design done on sample of 31 patients with mild to moderate TBI. Depression anxiety stress scales-21 (DASS-21), Brief illness perception questionnaire (IPQ) and Rivermead Post Concussion Symptoms Questionnaire (RPQ) was used.Descriptive and correlational statistics was used.The results indicated that overall higher percentage falls within low and medium range of IPQ. However higher percentage falls within higher range, on coherence and emotional response subscales of IPQ. Consequence, timeline, personal control, treatment control, concern, emotional control, and total of the subscales of IPQ were positively correlated with RPQ3 and RPQ13 at 0.01 and 0.05 level of significance. A significant correlation was found between demographic variables and subscales of IPQ at 0.01 and 0.05 level of significance.The study shows one to one relationship between symptoms experienced by patients, how they perceive their illness and socio demographic variables. HubMed – depression


IPS multicentric study: Functional somatic symptoms in depression.

Indian J Psychiatry. 2013 Jan; 55(1): 31-40
Grover S, Avasthi A, Kalita K, Dalal PK, Rao GP, Chadda RK, Lakdawala B, Bang G, Chakraborty K, Kumar S, Singh PK, Kathuria P, Thirunavukarasu M, Sharma PS, Harish T, Shah N, Deka K

As a pilot project, Indian Psychiatric Society conducted the first multicentric study involving diverse settings from teaching institutions in public and private sectors and even privately run psychiatric clinics.To study the typology of functional somatic complaints (FSC) in patients with first episode depression.A total of 741 patients from 16 centers across the country participated in the study. They were assessed on Bradford Somatic Symptom inventory for FSC, Beck Depression Inventory for severity of depression, and Comprehensive Psychopathological Rating Scale- anxiety index (CPRS-AI) for anxiety symptoms.The mean age of the study sample was 38.23 years (SD-11.52). There was equal gender distribution (male – 49.8% vs. females 50.2%). Majority of the patients were married (74.5%), Hindus (57%), and from nuclear family (68.2%). A little over half of the patients were from urban background (52.9%). The mean duration of illness at the time of assessment was 25.55 months. Most of the patients (77%) had more than 10 FSCs, with 39.7% having more than 20 FSCs as assessed on Bradford Somatic Inventory. The more common FSC as assessed on Bradford Somatic Inventory were lack of energy (weakness) much of the time (76.2%), severe headache (74%) and feeling tired when not working (71%), pain in legs (64%), aware of palpitations (59.5%), head feeling heavy (59.4%), aches and pains all over the body (55.5%), mouth or throat getting dry (55.2%), pain or tension in neck and shoulder (54%), head feeling hot or burning (54%), and darkness or mist in front of the eyes (49.1%). The prevalence and typology of FSCs is to a certain extent influenced by the sociodemographic variables and severity of depression.Functional somatic symptoms are highly prevalent in Indian depressed patients and hence deserve more attention while diagnosing depression in Indian setting. HubMed – depression



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