Multifocal White Matter Lesions Associated With the D313Y Mutation of the ?-Galactosidase a Gene.

Multifocal White Matter Lesions Associated with the D313Y Mutation of the ?-Galactosidase A Gene.

Filed under: Depression Treatment

PLoS One. 2013; 8(2): e55565
Lenders M, Duning T, Schelleckes M, Schmitz B, Stander S, Rolfs A, Brand SM, Brand E

White matter lesions (WML) are clinically relevant since they are associated with strokes, cognitive decline, depression, or epilepsy, but the underlying etiology in young adults without classical risk factors still remains elusive. Our aim was to elucidate the possible clinical diagnosis and mechanisms leading to WML in patients carrying the D313Y mutation in the ?-galactosidase A (GLA) gene, a mutation that was formerly described as nonpathogenic. Pathogenic GLA mutations cause Fabry disease, a vascular endothelial glycosphingolipid storage disease typically presenting with a symptom complex of renal, cardiac, and cerebrovascular manifestations. We performed in-depths clinical, biochemical and genetic examinations as well as advanced magnetic resonance imaging analyses in a pedigree with the genetically determined GLA mutation D313Y. We detected exclusive neurologic manifestations of the central nervous system of the “pseudo”-deficient D313Y mutation leading to manifest WML in 7 affected adult family members. Furthermore, two family members that do not carry the mutation showed no WML. The D313Y mutation resulted in a normal GLA enzyme activity in leukocytes and severely decreased activities in plasma. In conclusion, our results provide evidence that GLA D313Y is potentially involved in neural damage with significant WML, demonstrating the necessity of evaluating patients carrying D313Y more thoroughly. D313Y might broaden the spectrum of hereditary small artery diseases of the brain, which preferably occur in young adults without classical risk factors. In view of the existing causal therapy regime, D313Y should be more specifically taken into account in these patients.
HubMed – depression

Interpersonal Psychotherapy-Adolescent Skills Training: Effects on School and Social Functioning.

Filed under: Depression Treatment

School Ment Health. 2012 Dec 12; 4(4): 254-264
Young JF, Kranzler A, Gallop R, Mufson L

This paper reports on school and social functioning outcomes in a randomized depression prevention study that compared Interpersonal Psychotherapy-Adolescent Skills Training (IPT-AST) with usual school counseling (SC). Outcome analyses were performed utilizing hierarchical linear models and mixed model analysis of variance. IPT-AST adolescents had significantly greater improvements than SC adolescents in total social functioning and friend functioning during the intervention. IPT-AST adolescents also demonstrated improvements in school, dating, and family functioning and emotional engagement in school, although these improvements were not significantly greater than seen in SC adolescents. Finally, in the 18 months following the intervention, IPT-AST adolescents were less likely than SC adolescents to be asked to leave school for academic or behavioral reasons. These findings extend the potential range of impact of depression prevention programs such as IPT-AST and provide preliminary evidence of the benefits of these programs on school and social functioning.
HubMed – depression

Antidepressant chronotherapeutics for bipolar depression.

Filed under: Depression Treatment

Dialogues Clin Neurosci. 2012 Dec; 14(4): 401-11
Benedetti F

Chronotherapeutics refers to treatments based on the principles of circadian rhythm organization and sleep physiology, which control the exposure to environmental stimuli that act on biological rhythms, in order to achieve therapeutic effects in the treatment of psychiatric conditions. It includes manipulations of the sleep-wake cycle such as sleep deprivation and sleep phase advance, and controlled exposure to light and dark. The antidepressant effects of chronotherapeutics are evident in difficult-to-treat conditions such as bipolar depression, which has been associated with extremely low success rates of antidepressant drugs in naturalistic settings and with stable antidepressant response to chronotherapeutics in more than half of the patients. Recent advances in the study of the effects of chronotherapeutics on neurotransmitter systems, and on the biological clock machinery, allow us to pinpoint its mechanism of action and to transform it from a neglected or “orphan” treatment to a powerful clinical instrument in everyday psychiatric practice.
HubMed – depression

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