Objective The aim of this paper was to examine the relationship between childhood maltreatment and adult psychopathology, as reflected in hypothalamic-pituitary-adrenal axis dysfunction. Method A selective review of the relevant literature was undertaken in order to identify key and illustrative research findings. Results There is now a substantial body of preclinical and clinical evidence derived from a variety of experimental paradigms showing how early-life stress is related to hypothalamic-pituitary-adrenal axis function and psychological state in adulthood, and how that relationship can be modulated by other factors. Discussion The risk for adult psychopathology and hypothalamic-pituitary-adrenal axis dysfunction is related to a complex interaction among multiple experiential factors, as well as to susceptibility genes that interact with those factors. Although acute hypothalamic-pituitary-adrenal axis responses to stress are generally adaptive, excessive responses can lead to deleterious effects. Early-life stress alters hypothalamic-pituitary-adrenal axis function and behavior, but the pattern of hypothalamic-pituitary-adrenal dysfunction and psychological outcome in adulthood reflect both the characteristics of the stressor and other modifying factors. Conclusion Research to date has identified multiple determinants of the hypothalamic-pituitary-adrenal axis dysfunction seen in adults with a history of childhood maltreatment or other early-life stress. Further work is needed to establish whether hypothalamic-pituitary-adrenal axis abnormalities in this context can be used to develop risk endophenotypes for psychiatric and physical illnesses.
Functional imaging studies have implicated the orbitofrontal cortex (OFC) in the pathophysiology of borderline personality disorder (BPD). To date, however, volume-based magnetic resonance imaging (MRI) studies have yielded mixed results. We used a surface-based processing approach that allowed us to measure five morphometric cortical features of the OFC, including volumetric (cortical thickness and surface area) and geometric (mean curvature, depth of sulcus, and metric distortion – three indicators of cortical folding) parameters. Participants comprised 25 female BPD patients with no other current psychiatric comorbidity and 25 age- and gender-matched healthy controls who received structural MRI scans. Images were processed using the Freesurfer package. All BPD patients had a history of comorbid psychiatric disorder(s) and were currently on medications. Compared with controls, the BPD group showed reduced cortical thickness, surface area, mean curvature, depth of sulcus, and metric distortion in the right medial OFC. In the left medial OFC, the BPD group had reduced cortical thickness and mean curvature, but increased metric distortion. This study confirmed the utility of surface-based analysis in the study of BPD cortical structures. In addition, we observed extensive structural abnormalities in the medial OFC of female subjects with BPD, findings that were most pronounced in the right OFC, with preliminary data suggesting hemispheric asymmetry.
Study question Are patients with a low ovarian response more likely to develop embryos with chromosomal alterations? Summary answer Low ovarian response has an impact on embryonic development and the genetic normality rate of embryos. What is known already Low ovarian response is characterized by a reduction in the follicular response resulting in a reduced number of eggs. This fact has an impact on the outcome of assisted reproduction treatments. Therefore, understanding the genetic behavior of the embryos of these patients is still a great challenge for both the clinic and the in vitro fertilization laboratory, because, with a better understanding of the embryo's genetic segregation process, it will be possible to apply more assertive behaviors in the human reproduction routine. Study design, size, duration This retrospective cross-sectional study included 73 patients up to 35 years old, splitted into two groups. The poor ovarian responder group (n = 32) and the controls (n = 41). The study group included patients with poor ovarian response, less than six MII oocytes after ovarian punction. The control group was selected according to the following inclusion criteria: the presence of tubal factor unexplained infertility, or adenomyosis. The data were collected between January 2019 and December 2021. Participants/materials, setting, methods All patients included in the study (n = 73) underwent the same assisted reproduction treatment with embryos transferred after biopsy and PGT-A. The T-Students test was applied to compare numerical variables and the q-square test for categorical variables. All the analysis was performed in SPSS software (V26). Patients who had other factors associated with poor ovarian response were excluded. Main results and the role of chance In the comparison between the groups, the differences in the levels of AMH, progesterone, and the number of oocytes in MII were observed, as expected for the two groups (p < 0.05). However, the control group had a higher rate of chromosomally normal embryos when compared to patients with a low ovarian response (60.9%± 30.1 vs 37.6%± 39.7, p = 0.0057) respectively. The other variables such as age, FSH, LH, BMI, estradiol, fertilization rate, rate of blastocyst formation, and quality of blastocysts did not show statistically significant differences. Limitations, reasons for caution Preliminary results with a low number of patients. Wider implications of the findings Patients with a low ovarian response may have lower rates of embryonic chromosomal normality, this fact is important for the indication of genetic testing for these couples. Future prospective studies should be carried out with a larger number of patients to understand the mechanisms that cause genetic alterations in embryos. Trial registration number non applicable
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
customersupport@researchsolutions.com
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.