Variation in the μ-opioid receptor gene (OPRM1) moderates the influence of early maternal care on fearful attachment

There is evidence that both early experience and genetic variation play a role in influencing sensitivity to social rejection. In this study, we aimed at ascertaining if the A118G polymorphism of the k-opioid receptor gene (OPRM1) moderates the impact of early maternal care on fearful attachment, a personality trait strongly related to rejection sensitivity. In 112 psychiatric patients, early maternal care and fearful attachment were measured using the Parental Bonding Inventory and the Relationship Questionnaire (RQ), respectively. The pattern emerging from the RQ data was a crossover interaction between genotype and maternal caregiving. Participants expressing the minor 118 G allele had similar and relatively high scores on fearful attachment regardless of the quality of maternal care. By contrast, early experience made a major difference for participants carrying the A/A genotype. Those who recalled higher levels of maternal care reported the lowest levels of fearful attachment whereas those who recalled lower levels of maternal care scored highest on fearful attachment. Our data fit well with the differential susceptibility model which stipulates that plasticity genes would make some individuals more responsive than others to the negative consequences of adversity and to the benefits of environmental support and enrichment

Correlatos de la terapia EMDR en la neuroimagen funcional y estructural: Un resumen cr?tico de los hallazgos recientes

Neuroimaging investigations of the effects of psychotherapies treating posttraumatic stress disorder (PTSD), including eye movement desensitization and reprocessing (EMDR), have reported findings consistent with modifications in cerebral blood flow (CBF; single photon emission computed tomography [SPECT]), in neuronal volume and density (magnetic resonance imaging [MRI]), and more recently in brain electric signal (electroencephalography [EEG]). Additionally in the recent past, EMDR- related neurobiological changes were monitored by EEG during therapy itself and showed a shift of the maximal activation from emotional limbic to cortical cognitive brain regions. This was the first time in which neurobiological changes occurring during any psychotherapy session have been reported, making EMDR the first psychotherapy with a proven neurobiological effect. The purpose of this article was to review the results of functional and structural changes taking place at PTSD treatment and presented during the period of 1999-2012 by various research groups. The reported pathophysiological changes are presented by neuropsychological technique and implemented methodology and critically analyzed.Las investigaciones con neuroimagen sobre los efectos de las psicoterapias que tratan el trastorno de estr?s postraum?tico (TEPT), incluyendo la terapia de desensibilizaci?n y reprocesamiento por movimientos oculares (EMDR), han mostrado hallazgos conformes con modificaciones en el flujo sangu?neo cerebral (FSC; tomograf?a computerizada de emisi?n monofot?nica [SPECT]), en el volumen y la densidad neuronal (im?genes por resonancia magn?tica [MRI]) y, m?s recientemente, en las se?ales el?ctricas del cerebro (electroencefalograf?a [EEG]). Adem?s, en el pasado reciente, se han monitorizado, por medio de EEG, cambios neurobiol?gicos relacionados con EMDR durante la misma terapia y han mostrado un cambio en la activaci?n m?xima desde las regiones l?mbicas emocionales a las regiones cognitivas corticales del cerebro. Esta ha sido la primera vez que se han se?alado los cambios neurobiol?gicos que tienen lugar durante una sesi?n de psicoterapia, lo que ha hecho que EMDR sea la primera psicoterapia con un efecto neurobiol?gico probado. El prop?sito de este art?culo ha sido analizar los resultados de los cambios funcionales y estructurales que han tenido lugar durante el tratamiento del TEPT y que han sido presentados por diversos grupos de investigaci?n durante el per?odo entre 1999 y 2012. Los cambios fisiopatol?gicos referidos se presentan en funci?n de las t?cnicas neuropsicol?gicas y la metodolog?a implementadas y son analizados de manera cr?tica

The upstream Variable Number Tandem Repeat polymorphism of the monoamine oxidase type A gene influences trigeminal pain-related evoked responses

Monoamines have an important role in neural plasticity, a key factor in cortical pain processing that promotes changes in neuronal network connectivity. Monoamine oxidase type A (MAOA) is an enzyme that, due to its modulating role in monoaminergic activity, could play a role in cortical pain processing. The X-linked MAOA gene is characterized by an allelic variant of length, the MAOA upstream Variable Number Tandem Repeat (MAOA-uVNTR) region polymorphism. Two allelic variants of this gene are known, the high-activity MAOA (HAM) and low-activity MAOA (LAM). We investigated the role of MAOA-uVNTR in cortical pain processing in a group of healthy individuals measured by the trigeminal electric pain-related evoked potential (tPREP) elicited by repeated painful stimulation. A group of healthy volunteers was genotyped to detect MAOA-uVNTR polymorphism. Electrical tPREPs were recorded by stimulating the right supraorbital nerve with a concentric electrode. The N2 and P2 component amplitude and latency as well as the N2-P2 inter-peak amplitude were measured. The recording was divided into three blocks, each containing 10 consecutive stimuli and the N2-P2 amplitude was compared between blocks. Of the 67 volunteers, 37 were HAM and 30 were LAM. HAM subjects differed from LAM subjects in terms of amplitude of the grand-averaged and first-block N2-P2 responses (HAM>LAM). The N2-P2 amplitude decreased between the first and third block in HAM subjects but not LAM subjects. The MAOA-uVNTR polymorphism seemed to influence the brain response in a repeated tPREP paradigm and suggested a role of the MAOA as a modulator of neural plasticity related to cortical pain processing

External validation of the preoperative Karakiewicz nomogram in a large multicentre series of patients with renal cell carcinoma

To perform a formal external validation of the preoperative Karakiewicz nomogram (KN) for the prediction of cancer-specific survival (CSS) using a large series of surgically treated patients diagnosed with organ-confined or metastatic renal cell carcinoma (RCC).Patient population originated from a series of retrospectively gathered cases that underwent radical or partial nephrectomy between years 1995 and 2007 for suspicion of kidney cancer. The original Cox coefficients were used to generate the predicted risk of CSS at 1, 2, 5, and 10 years following surgery and compared to the observed risk of CSS in the current population. External validation was quantified using measures of predictive accuracy, defined as model discrimination and calibration.A total of 3,374 patients were identified. Relative to the original development cohort, the current sample population had a larger proportion of patients with localized (40.0 vs. 26.3 \%, P < 0.001) and non-metastatic (92.2 vs. 88.1 \%, P = 0.03) disease at presentation. Model discrimination for the prediction of CSS was 87.8 \% (95 \% CI, 84.4-91.4) at 1 year, 87.0 \% (95 \% CI, 84.4-89.5) at 2 years, 84.7 \% (95 \% CI, 82.3-87.1) at 5 years, and 85.9 \% (95 \% CI, 83.2-88.6) at 10 years. The relationship between predicted and observed CSS risk was adequate in the calibration plot.The use of the KN for the prediction of CSS in patients diagnosed with renal cell carcinoma was validated in the current study. In consequence, this tool may be recommended for routine clinical counseling in patients with various stages of RCC in the preoperative setting

An Easy and Efficient Method for Native and Immunoreactive Echinococcus granulosus Antigen 5 Enrichment from Hydatid Cyst Fluid

Background: Currently, the serodiagnosis of cystic echinococcosis relies mostly on crude Echinococcus granulosus hydatid cyst fluid as the antigen. Consequently, available immunodiagnostic tests lack standardization of the target antigen and, in turn, this is reflected on poor sensitivity and specificity of the serological diagnosis. Methodology/Principal Findings: Here, a chromatographic method enabling the generation of highly enriched Antigen 5 (Ag5) is described. The procedure is very easy, efficient and reproducible, since different hydatid cyst fluid (HCF) sources produced very similar chromatograms, notwithstanding the clearly evident and extreme heterogeneity of the starting material. In addition, the performance of the antigen preparation in immunological assays was preliminarily assessed by western immunoblotting and ELISA on a limited panel of cystic echinococcosis patients and healthy controls. Following western immunoblotting and ELISA experiments, a high reactivity of patient sera was seen, with unambiguous and highly specific results. Conclusions/Significance: The methods and results reported open interesting perspectives for the development of sensitive diagnostic tools to enable the timely and unambiguous detection of cystic echinococcosis antibodies in patient sera.This work was supported by Regione Autonoma della Sardegna (http://www.regione.sardegna.it/)Pubblicat

Positive and psycho-pathological aspects between shame and shamelessness

Interpersonal relationships represent an essential aspect of mental wellbeing and social functioning. If all the symptoms contain a relational meaning, shame represents the relational affect par excellence both in terms of its origin and its purpose. This paper aims to highlight the role of shame as an affect inherent in the rhythmic nature of the encounter with the other, as well as the pathological elements of this aspect in both its conscious and unconscious dimensions. There is a heterogeneous quantitative and qualitative declination of shame, or of the defenses against this affect, among the various pathologies. We consider the fundamental needs of belonging and acceptance and the parallel abandonment anguish from various psychoanalytic and philosophical theoretical perspectives and then analyze the link between their dissatisfaction and the origin of shame. We also touch on the different interpretaions of shame based on eastern and western cultural norms. These hypotheses are closely intertwined with the beliefs of classical psychopathology. The role of the body in the encounter with the other and in the experience of shame is also examined. In particular, we study the role of this affect in schizophrenia, depression, eating disorders, and personality disorders

Characterization of the inflammatory cell infiltrate and expression of costimulatory molecules in chronic echinococcus granulosus infection of the human liver

Background: The local immune responses to chronic echinococcal infections in various organs are largely unknown. Since the liver is the most frequently involved organ in such infections in human we aimed to characterize the inflammatory as well as immune cell infiltrate around hydatid cysts in the liver and compared to common inflammatory processes of the liver. Method: Surgical samples from the liver of 21 cystic echinococcosis (CE) patients were studied and the distribution of different types of inflammatory and immune cells were determined by immunohistochemistry. Furthermore, expression levels of costimulatory CTLA4, CD28, CD80 and CD86 molecules were measured at RNA level by PCR. Liver biopsy samples from patients with steatohepatitis (SH, n = 11) and chronic hepatitis (CH, n = 11) were used as non-inflammatory and chronic inflammatory controls, respectively. The composition and density of the inflammatory and immune cell infiltrates have been compared by using morphometry. Results: CD3+ T cells predominated the inflammatory infiltrate in all pathological processes, while in CE samples CD20+ B cells, in CH samples CD68+ macrophages were also frequent. Both myeloperoxidase (MPO) + leukocytes and CD68+ macrophages were found to be significantly decreased in CE as compared to either SH or CH samples. Concerning T cell subtypes, only CD8+ T cells were found to be significantly decreased in SH samples. CD1a + dendritic cells were almost completely missing from CE biopsies unlike in any other sample types. There were no differences detected in the mRNA expression of costimulatory molecules except decreased expression of CD28 in CE samples. Conclusion: In the hydatid lesions of the liver of chronic echinococcal infections T cell-mediated immunity seems to be impaired as compared to other types of chronic inflammatory processes, suggesting an immunosuppressive role for Echinococcus granulosus, which deserve further attentions