Eigenvector-Centrality (EC) has shown promising results in the field of Psychiatry, with early results also pertaining to ADHD. Parallel efforts have focused on the description of aberrant interhemispheric coordination in ADHD, as measured by Voxel-Mirrored-Homotopic-Connectivity (VMHC), with early evidence of altered Resting-State fMRI. A sample was collected from the ADHD200-NYU initiative: 86 neurotypicals and 89 participants with ADHD between 7 and 18 years old were included after quality control for motion. After preprocessing, voxel-wise EC and VMHC values between diagnostic groups were compared, and network-level values from 15 functional networks extracted. Age, ADHD severity (Connor’s Parent Rating-Scale), IQ (Wechsler-Abbreviated-Scale), and right-hand dominance were correlated with EC/VMHC values in the whole sample and within groups, both at the voxel-wise and network-level. Motion was controlled by censoring time-points with Framewise-Displacement > 0.5 mm, as well as controlling for group differences in mean Framewise-Displacement values. EC was significantly higher in ADHD compared to neurotypicals in the left inferior Frontal lobe, Lingual gyri, Peri-Calcarine cortex, superior and middle Occipital lobes, right inferior Occipital lobe, right middle Temporal gyrus, Fusiform gyri, bilateral Cuneus, right Precuneus, and Cerebellum (FDR-corrected-p = 0.05). No differences were observed between groups in voxel-wise VMHC. EC was positively correlated with ADHD severity scores at the network level (at p-value < 0.01, Inattentive: Cerebellum rho = 0.273; Hyper/Impulsive: High-Visual Network rho = 0.242, Cerebellum rho = 0.273; Global Index Severity: High-Visual Network rho = 0.241, Cerebellum rho = 0.293). No differences were observed between groups for motion (p = 0.443). While EC was more related to ADHD psychopathology, VMHC was consistently and negatively correlated with age across all networks.
IntroductionNeurocysticercosis (NCC) is one of the leading causes of epilepsy worldwide. The majority of cases in Europe are diagnosed in immigrants. Currently in Italy, routine serological screening for cysticercosis is recommended for internationally adopted children (IAC) coming from endemic countries. Methods: We retrospectively analyse the results of the serological screening for cysticercosis in IAC 16 years old or younger, attending two Italian third level paediatric clinics in 2001–16. Results: Of 2,973 children included in the study, 2,437 (82.0%) were screened by enzyme-linked immune electro transfer blot (EITB), 1,534 (51.6%) by ELISA, and 998 (33.6%) by both tests. The seroprevalence of cysticercosis ranged between 1.7% and 8.9% according to EITB and ELISA, respectively. Overall, 13 children were diagnosed with NCC accounting for a NCC frequency of 0.4% (95% confidence interval (CI): 0.2–0.6%). Among the 168 seropositive children, only seven (4.2%) were diagnosed with NCC. Of these children, three were asymptomatic and four presented epilepsy. Among seronegative children (n = 2,805), seven presented with neurological symptoms that lead to the diagnosis of NCC in six cases. The sensitivity, specificity, positive and negative predictive value for the diagnosis of NCC were 54.5%, 98.6%, 14.6%, 99.8% for EITB and 22.2%, 91.1%, 1.4%, 99.5% for ELISA. The yield of the screening programme was 437 NCC cases per 100,000. The number needed to screen to detect one NCC case was 228. The cost per NCC case detected was EUR 10,372. Conclusion: On the base of our findings we suggest the ongoing serological screening for cysticercosis to be discontinued, at least in Italy, until further evidence in support will be available.
Introduction The high technical barrier to entry in the field of neuroimaging can hinder early insight from promising results and the development of evidence-based clinical practice. Objectives The working group focused on published literature in order to develop a new methodology in the analysis, visualization, and representation of fMRI data in the psychiatric setting. Methods Three valid and established measures were chosen, in order to achieve dimensionality reduction, stability and explainability of results, namely Regional-Homogeneity; fractional Amplitude of Low-Frequency Fluctuations; Eigenvector-Centrality. Each measure was color coded and individual images per subject compiled, averaging results by functional networks as described the FIND lab of the University of Stanford. 272 individual scans were processed (130 neurotypicals, 50 patients with Schizophrenia, 49 with Bipolar Disorder, 43 with ADHD). Results The discriminative power between clinical groups of the novel method was significant both by human eye, and later confirmation by statistical tests, and by computer vision algorithms (Convolutional Neural Networks). The precision-recall Area Under the Curve, dividing by 80/20 proportion between train and test sets, was >84.5% for each group. The group of patients with Bipolar Disorder showed a partial overlap with the group of patients suffering from Schizophrenia – by a dominance of Eigenvector-Centrality and Regional-Homogeneity, as well as a lower prevalence of fractional Amplitude of Low-Frequency Fluctuations, for both in comparison to controls. Conclusions The present study offers preliminary evidence for the adoption of i-ECO (integrated-Explainability through Color Coding) in fMRI analyses during rest in the Psychiatric field. Disclosure No significant relationships.
Purpose: Anorexia nervosa (AN) is an eating disorder (ED) that is divided in a restrictive (R-AN) and atypical (A-AN) form depending on the body mass index (BMI). In 100 adolescents with AN, we reviewed the diagnosis (R-AN and A-AN) in relation to different diagnostic criteria (absolute BMI, DSM-5 criteria, European Guidelines and Cacciari percentile curves) and we studied the prevalence of suicidality (suicidal thoughts and behaviours). We also observed the association between suicidality and severity of AN symptoms and psychiatric comorbidities.Methods: We subdivided AN in R-AN and A-AN, considering the four diagnostic criteria previously described. We used the Fisher’s exact test and the Mann-Whitney test for categorical and continuous variables, and we applied multivariate analysis of variance and covariance. Results: Thirty-one % of patients changed diagnosis from R-AN to A-AN depending on which diagnostic criteria was used. Twenty-seven % of patients presented suicidality and they showed greater severity of specific AN psychopathology.Conclusions: Categorization of the AN in childhood can change depending on the diagnostic criteria used. Suicidality is independent from BMI, and seems to be related to specific ED psychopathology and psychiatric comorbidity. These data confirm the need to conceptualize the pathology in a different way and improve the therapeutic intervention. Our findings also highlight the importance of screening for suicidality among children and adolescents at onset of AN to prevent suicide.Level of evidence: level IV
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