RESUMO
Standard functional magnetic resonance imaging (fMRI) analyses cannot assess the potential of a neuroimaging signature as a biomarker to predict individual vulnerability to major depression (MD). Here, we use machine learning for the first time to address this question. Using a recently identified neural signature of guilt-selective functional disconnection, the classification algorithm was able to distinguish remitted MD from control participants with 78.3% accuracy. This demonstrates the high potential of our fMRI signature as a biomarker of MD vulnerability.
Assuntos
Algoritmos , Transtorno Depressivo Maior/diagnóstico , Transtorno Depressivo Maior/fisiopatologia , Diagnóstico por Computador , Imagem Ecoplanar/métodos , Interpretação de Imagem Assistida por Computador/métodos , Aprendizado de Máquina , Imageamento por Ressonância Magnética/métodos , Adulto , Biomarcadores , Estudos de Casos e Controles , Feminino , Culpa , Humanos , Masculino , Rede Nervosa/fisiopatologia , Valores de Referência , Sensibilidade e Especificidade , Lobo Temporal/fisiopatologiaRESUMO
Psychosis is commonly observed in patients with mesial temporal lobe epilepsy related to hippocampal sclerosis (MTLE-HS). Interictal single photon emission computed tomography (SPECT) was performed to compare regional cerebral blood flow (rCBF) pattern of MTLE-HS patients with psychosis of epilepsy (POE) comorbidity and MTLE-HS patients without any psychiatric disorders (Control group). For this, 21 patients with POE and 23 Control patients were matched by educational level, clinical, demographic, electrophysiological, and MRI data. SPECT scans were acquired using (99m)Tc and interpreted with a semiquantitative method. We analyzed brain regions of interest (ROI) of frontal, temporal, and parietal cortex, in addition to subcortical structures. There were no significant statistical differences of ROI between the POE group and the Control group after Bonferroni adjustment. However, we observed a trend for rCBF increase of right posterior cingulate in the POE Group. This increase would be in accordance with recent findings of cingulate abnormalities in schizophrenia, suggesting that abnormal function in this region might be associated with the psychotic phenomena.
Assuntos
Circulação Cerebrovascular , Epilepsia do Lobo Temporal/fisiopatologia , Transtornos Psicóticos/fisiopatologia , Esquizofrenia/fisiopatologia , Tomografia Computadorizada de Emissão de Fóton Único , Adulto , Estudos de Casos e Controles , Comorbidade , Epilepsia do Lobo Temporal/diagnóstico , Epilepsia do Lobo Temporal/epidemiologia , Feminino , Lobo Frontal/anatomia & histologia , Lobo Frontal/irrigação sanguínea , Lobo Frontal/fisiopatologia , Lateralidade Funcional/fisiologia , Giro do Cíngulo/anatomia & histologia , Giro do Cíngulo/irrigação sanguínea , Giro do Cíngulo/fisiopatologia , Humanos , Imageamento por Ressonância Magnética , Masculino , Lobo Parietal/anatomia & histologia , Lobo Parietal/irrigação sanguínea , Lobo Parietal/fisiopatologia , Cuidados Pré-Operatórios , Transtornos Psicóticos/diagnóstico , Transtornos Psicóticos/epidemiologia , Fluxo Sanguíneo Regional/fisiologia , Esquizofrenia/diagnóstico , Esquizofrenia/epidemiologia , Lobo Temporal/anatomia & histologia , Lobo Temporal/irrigação sanguínea , Lobo Temporal/fisiopatologiaRESUMO
We report the case of a patient with epilepsy who had interictal severe affective aggression, and whose epilepsy significantly improved (but not aggression) after successful temporal lobectomy. Olanzapine significantly improved these aggressive episodes refractory to neurosurgery and previous pharmacological treatments including antipsychotics, anticonvulsants/mood stabilizers and benzodiazepines.