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Dialogues in Clinical Neuroscience

Gregory L Fricchione
Clinical neuroscience struggles with poor scientific validity of neuropsychiatric diagnosis and its negative impact on management. Sydenham's ancient conformity of type approach to nosology with its assumption that the symptom cluster and course of a disorder are due to a common etiology, has proven no match for the complicated comorbidities faced in neuropsychiatry. In the absence of accurate pathological biomarkers there is a challenge in finding a solid foundation for modern neuropsychiatry. We find standard psychiatric nosology to be of limited benefit at the general hospital bedside in evaluating and treating neuropsychiatric disorders...
June 2018: Dialogues in Clinical Neuroscience
Scott Marek, Nico U F Dosenbach
The frontoparietal network is critical for our ability to coordinate behavior in a rapid, accurate, and flexible goal-driven manner. In this review, we outline support for the framing of the frontoparietal network as a distinct control network, in part functioning to flexibly interact with and alter other functional brain networks. This network coordination likely occurs in a 4 Hz to 73 Hz θ/α rhythm, both during resting state and task state. Precision mapping of individual human brains has revealed that the functional topography of the frontoparietal network is variable between individuals, underscoring the notion that group-average studies of the frontoparietal network may be obscuring important typical and atypical features...
June 2018: Dialogues in Clinical Neuroscience
Alessandra Griffa, Martijn P Van den Heuvel
Over the past decades, network neuroscience has played a fundamental role in the understanding of large-scale brain connectivity architecture. Brains, and more generally nervous systems, can be modeled as sets of elements (neurons, assemblies, or cortical chunks) that dynamically interact through a highly structured and adaptive neurocircuitry. An interesting property of neural networks is that elements rich in connections are central to the network organization and tend to interconnect strongly with each other, forming so-called rich clubs...
June 2018: Dialogues in Clinical Neuroscience
Olaf Sporns
Network neuroscience is a thriving and rapidly expanding field. Empirical data on brain networks, from molecular to behavioral scales, are ever increasing in size and complexity. These developments lead to a strong demand for appropriate tools and methods that model and analyze brain network data, such as those provided by graph theory. This brief review surveys some of the most commonly used and neurobiologically insightful graph measures and techniques. Among these, the detection of network communities or modules, and the identification of central network elements that facilitate communication and signal transfer, are particularly salient...
June 2018: Dialogues in Clinical Neuroscience
Guusje Collin, Matcheri S Keshavan
The brain is the ultimate adaptive system, a complex network organized across multiple levels of spatial and temporal resolution that is sculpted over several decades via its interactions with the environment. This review sets out to examine how fundamental biological processes in early and late neurodevelopment, in interaction with environmental inputs, guide the formation of the brain's network and its ongoing reorganization throughout the course of development. Moreover, we explore how disruptions in these processes could lead to abnormal brain network architecture and organization and thereby give rise to schizophrenia...
June 2018: Dialogues in Clinical Neuroscience
Vincent Calhoun
Brain imaging technology provides a powerful tool to visualize the living human brain, provide insights into disease mechanisms, and potentially provide a tool to assist clinical decision-making. The brain has a very specific structural substrate providing a foundation for functional information; however, most studies ignore the very interesting and complex relationships between brain structure and brain function. While a variety of approaches have been used to study how brain structure informs function, the study of such relationships in living humans in most cases is limited to noninvasive approaches at the macroscopic scale...
June 2018: Dialogues in Clinical Neuroscience
Florence Thibaut
Inside the brain, neural regions dynamically interact at multiple spatial and temporal scales through a highly structured and adaptive neurocircuitry. Comprehensive maps of brain connectivity have led to the emerging field of connectomics. Graph theory methods are interesting tools to improve our understanding of the brain as a complex interconnected system.
June 2018: Dialogues in Clinical Neuroscience
Dieter Naber, Monika Bullinger
This manuscript summarizes the literature on mental health outcomes after cardiac arrest. Survivors of cardiac arrest show high rates of mental illness with more than 40% suffering from anxiety, 30% from depression, and 25% from posttraumatic stress disorder (PTSD). Mental health outcomes may differ depending on the setting in which the cardiac arrest occurred. A major problem is reduced neuropsychological functioning. Between 30% and 50% of survivors of cardiac arrest suffer from cognitive deficits. Deficits of attention, declarative memory, executive function, visual-spatial abilities, and verbal fluency have been observed...
March 2018: Dialogues in Clinical Neuroscience
Brenda W J H Penninx, Sjors M M Lange
Psychiatric patients have a greater risk of premature mortality, predominantly due to cardiovascular diseases (CVDs). Convincing evidence shows that psychiatric conditions are characterized by an increased risk of metabolic syndrome (MetS), a clustering of cardiovascular risk factors including dyslipidemia, abdominal obesity, hypertension, and hyperglycemia. This increased risk is present for a range of psychiatric conditions, including major depressive disorder (MDD), bipolar disorder (BD), schizophrenia, anxiety disorder, attention-deficit/hyperactivity disorder (ADHD), and posttraumatic stress disorder (PTSD)...
March 2018: Dialogues in Clinical Neuroscience
Winfried Häuser, Mary-Ann Fitzcharles
Fibromyalgia (FM) is characterized by chronic widespread pain, unrefreshing sleep, physical exhaustion, and cognitive difficulties. It occurs in all populations throughout the world, with prevalence between 2% and 4% in general populations. Definition, pathogenesis, diagnosis, and treatment of FM remain points of contention, with some even contesting its existence. The various classification systems according to pain medicine, psychiatry, and neurology (pain disease; persistent somatoform pain disorder; masked depression; somatic symptom disorder; small fiber neuropathy; brain disease) mostly capture only some components of this complex and heterogeneous disorder...
March 2018: Dialogues in Clinical Neuroscience
Norman Sartorius
The comorbidity of mental and physical disorders is a major challenge for health care worldwide. Its prevalence is increasing and is likely to continue to grow due to the increase in life expectancy and a variety of other reasons. The comorbidity of depression and diabetes can be seen as a prototypical example of mental/physical comorbidity. The prevalence of both conditions is growing, and depression is twice as frequent in people with diabetes compared with those without diabetes. Health services are by and large inadequately prepared to deal with comorbid depression and diabetes, and the increasing specialization (and fragmentation) of medicine will probably make things worse...
March 2018: Dialogues in Clinical Neuroscience
Kristin L Rooney, Alice D Domar
The relationship between stress and infertility has been debated for years. Women with infertility report elevated levels of anxiety and depression, so it is clear that infertility causes stress. What is less clear, however, is whether or not stress causes infertility. The impact of distress on treatment outcome is difficult to investigate for a number of factors, including inaccurate self-report measures and feelings of increased optimism at treatment onset. However, the most recent research has documented the efficacy of psychological interventions in lowering psychological distress as well as being associated with significant increases in pregnancy rates...
March 2018: Dialogues in Clinical Neuroscience
Marc De Hert, Johan Detraux, Davy Vancampfort
Coronary heart disease (CHD) and mental illness are among the leading causes of morbidity and mortality worldwide. Decades of research has revealed several, and sometimes surprising, links between CHD and mental illness, and has even suggested that both may actually cause one another. However, the precise nature of these links has not yet been clearly established. The goal of this paper, therefore, is to comprehensively review and discuss the state-of-the-art nature of the epidemiological and pathophysiological aspects of the bidirectional links between mental illness and CHD...
March 2018: Dialogues in Clinical Neuroscience
Peter Henningsen
This review paper gives an overview of the management of somatic symptom disorder. It starts with a description of the clinical problem of patients with persistent bodily distress, discusses classificatory, epidemiological, and etiological issues and then describes the evidence and practical principles of dealing with these patients who are often seen as "difficult" to treat. It is concluded that the best-suited approach is stepped care with close cooperation of primary care, a somatic specialist, and mental health care professionals operating on the basis of a biopsychosocial model of integrating somatic as well as psychosocial determinants of distress and therapeutic factors...
March 2018: Dialogues in Clinical Neuroscience
Isabelle Lang-Rollin, Götz Berberich
Medical progress, the improvement of general living conditions, and an increase in life expectancy have led to an increase in the general prevalence of oncologic disease. More importantly, more and more patients survive cancer or live with the disease for long periods of time. While the battle for survivorship is continuously being fought, improving patients' quality of life has come to the fore. Psychosocial issues may modulate the course of the disease, but mainly have a deep impact on patients' physical and mental wellbeing...
March 2018: Dialogues in Clinical Neuroscience
German E Berrios
This paper deals with the history of the relationship between the mind-body dualism and the epistemology of madness. Earlier versions of such dualism posed little problem in regard to the manner of their communication. The Cartesian view that mind and body did, in fact, name different substances introduced a problem of incommunicability that is yet to be resolved. Earlier views that madness may be related to changes in the brain began gaining empirical support during the 17th century. Writers on madness chose to resolve the mind-body problem differently Some stated that such communication was not needed; others, that mind was a redundant concept, as madness could be fully explained by structural changes in the brain; and yet others described psychological spaces for madness to inhabit as a symbolic conflict...
March 2018: Dialogues in Clinical Neuroscience
Florence Thibaut
The French philosopher René Descartes (1596-1650) argued that the natures of mind and body are completely different from one another and that each could exist by itself. How can these two structures with different natures causally interact in order to give rise to a human being with voluntary bodily motions and sensations? Even today, the problem of mind-body causal interaction remains a matter of debate.
March 2018: Dialogues in Clinical Neuroscience
Michael Davidson
Despite significant progress in the study of the epidemiology and genetics of autism, the etiology and patho-physiology of this condition is far from being elucidated and no curative treatment currently exists. Although solid scientific research continues, in an attempt to find explanations and solutions, a number of nonscientific and pure myths about autism have emerged. Myths that vaccines or mercury are associated with autism have been amplified by misguided scientists; frustrated, but effective parent groups; and politicians...
December 2017: Dialogues in Clinical Neuroscience
Ekaterina Stepanova, Susannah Dowling, Molly Phelps, Robert L Findling
Autism spectrum disorder (ASD) is characterized by impairment in social communication and restricted patterns of behavior. Although there is no pharmacological treatment approved by the US Food and Drug Administration (FDA) for the core symptoms of ASD, there is mounting support in the literature for the management of behavioral symptoms associated with this developmental disorder, in particular, irritability and hyperactivity. Aripiprazole and risperidone are currently approved by the FDA for the treatment of irritability in youth with ASD...
December 2017: Dialogues in Clinical Neuroscience
Daniel Schöttle, Peer Briken, Oliver Tüscher, Daniel Turner
Like nonaffected adults, individuals with autism spectrum disorders (ASDs) show the entire range of sexual behaviors. However, due to the core symptoms of the disorder spectrum, including deficits in social skills, sensory hypo- and hypersensitivities, and repetitive behaviors, some ASD individuals might develop quantitatively above-average or nonnormative sexual behaviors and interests. After reviewing the relevant literature on sexuality in high-functioning ASD individuals, we present novel findings on the frequency of normal sexual behaviors and those about the assessment of hypersexual and paraphilic fantasies and behaviors in ASD individuals from our own study...
December 2017: Dialogues in Clinical Neuroscience
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