Background Multiple sclerosis (MS) is a major cause of neurological disability in adults. Depression is one of the most common psychiatric comorbidities in MS patients with negative impact on patients’ quality of life. The aim of the study is to evaluate the role of diffusion tensor imaging (DTI) in monitoring the therapeutic response after high-frequency repetitive transcranial magnetic stimulation (HF-rTMS) versus selective serotonin reuptake inhibitor (SSRI) therapy for relapsing remitting multiple sclerosis (RRMS) patients presenting with depression by measuring the factional anisotropy of the dorsolateral prefrontal cortex (DLPFC) before and after treatment and also to assess the treatments’ impact on patients’ cognitive functions and depression. Results Fractional anisotropy (FA) only increased in rTMS group (0.44 ± 0.03 pre-rTMS vs 0.53 ± 0.05 post-rTMS, P < 0.001), but there were no significant changes in the SSRI group (0.44 ± 0.04 pre-SSRIs vs 0.45 ± .37 post-SSRIs, P = 0.072). Both rTMS and SSRI groups showed significant clinical improvement in Beck Depression Inventory (BDI) and Paced Auditory Serial Addition Test (PASAT) after either intervention (17.6 ± 3.25 pre-rTMS vs 10.6 ± 1.89 post-rTMS and 23 ± 6.36 pre-rTMS vs 24.87 ± 6.6 post-rTMS, respectively, P < 0.001; 17.67 ± 3.15 pre-SSRIs vs 0.6 ± 1.84 post-SSRIs and 23.8 ± 6.45 pre-SSRIs vs 25.07 ± 7.02 post-SSRIs, respectively, P < 0.001). Conclusion DTI is an ideal non-invasive tool for examining white matter integrity and can detect microstructural changes in the dorsolateral prefrontal cortex after rTMS and SSRI therapies for patients with MS and depression. FA increased only with rTMS denoting positive alteration in white matter microstructure. Both rTMS and SSRIs were equally effective in improving depression and cognition.

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Background: Interstitial lung disease (ILD) is a chronic progressive disease resulting in substantial morbidity and mortality. The cardinal symptom of ILD is dyspnea; however, other pulmonary and extra-pulmonary symptoms are often present. Depression is a common comorbidity of many chronic diseases and directly impacts quality of life.Aim of work: To determine the relationship of dyspnea with selected clinical and psychiatric variables including functional status and depression in patients with ILD.Patients and methods: The work included thirty five clinically and radiologically known cases of ILD and ten healthy controls, they were subdivided into Group I: Twenty patients without pulmonary hypertension. Group II: Fifteen patients with pulmonary hypertension. Group III: Ten healthy controls. All cases subjected to medical history, clinical examination, plain X-ray chest, HRCT, 6-minute walk test, arterial blood gases, Flow/volume loop , echocardiography, Other investigations e.g., collagen profile and depression, anxiety, pain, sleep and dyspnea questionnaire.Results: Among ILD groups: Dyspnea score showed a statistically significant positive correlation with psychiatric disorders (depression score, anxiety score, sleep disorders and pain score) while a statistically significant negative correlation with 6MWD, spirometric variables (FEV1 % and FVC %) and ABG variables (PaO 2 and SO 2 %). Dyspnea score, clinical variables (6MWD, RVSP, Abbreviations: ILD, interstitial lung disease; HRCT, high resolution computed tomography; PHTN, pulmonary hypertension; 6MWD, 6 min walk distance; RVSP, right ventricular systolic pressure; FEV1, forced expiratory volume in 1st second; FVC, forced vital capacity; PaO 2 , partial pressure of arterial oxygen; PaCO 2 , partial pressure of arterial carbon dioxide; SO 2 , oxy-hemoglobin saturation; IPF, idiopathic pulmonary fibrosis; NSIP, nonspecific interstitial pneumonia; LIP, lymphocytic interstitial pneumonia; DIP, desquamative interstitial pneumonia; RA, rheumatoid arthritis; HSP, hypersensitivity pneumonitis; GE, general electic; spirometric and ABG variables) and psychiatric disorders were statistically significantly more affected in ILD group with PHTN than in ILD group without PHTN. There was no statistically significant correlation between psychiatric disorders and both sex and smoking history among ILD groups.Conclusion: Dyspnea is common in ILD and is strongly correlated with functional status and psychiatric disorders. Dyspnea score, functional status and psychiatric disorders are more affected in ILD with PHTN than in ILD without PHTN. Accordingly, routine screening for mental disorders is recommended for patients with ILD, and should be accompanied by accurate assessment of patient's symptoms, particularly in patients with high levels of functional impairment.

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Background Given the scarcity of data on gender-related romantic attachment changes and the potential role of oxytocin (OT) in the pathophysiology of obsessive-compulsive illness (OCD), the current study aimed to assess gender-related differences in romantic attachment characteristics and their relationship to serum oxytocin in a set of forty OCD cases compared with a similar group of healthy controls .Simultaneously examining the gender differences in serum oxytocin levels in OCD patients, the diagnosis of OCD patients was determined using DSM-5 criteria, and the severity of OCD was determined using the Y-BOCS rating scale. All of the patients were drug-free and not depressed. The romantic attachment was assessed using the “Experiences in Close Relationship” Questionnaire. Standard ELISA kits were used to assess plasma OT levels. Results Regarding romantic attachments, patients with obsessive compulsive disorder scored higher on the anxiety and avoidance domains than controls with no significant gender difference. Serum oxytocin was higher in patients with OCD than in healthy controls, indicating a possible underlying pathophysiology of the illness. Also, there was a significant gender difference, with female patients having higher serum oxytocin and symptoms severity being negatively associated. Conclusions Taken together, these findings propose that OT may play a role in OCD pathophysiology with gender specificity. Also, OCD associated with insecure romantic attachment.