Population neuroscience: challenges and opportunities for psychiatric research in low- and middle-income countries

Cirillo, Alessandra; Diniz, Elton; Gadelha, Ary; Asevedo, Elson; Axelrud, Luiza Kvitko; Miguel, Eurí­pedes Constantino; Rohde, Luís Augusto; Bressan, Rodrigo Affonseca; Pan, Pedro Mário; Mari, Jair de Jesus

doi:10.1590/1516-4446-2019-0761

Cited by 5 publications

(8 citation statements)

References 67 publications

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“…Population Neuroscience is an emerging and interdisciplinary field that combines neuroscience and epidemiology shifting the focus from individuals to population groups ( 21 , 24 , 59 ). The aim of Population Neuroscience is to pinpoint the factors that affect the health and wellbeing of the human brain during the life cycle by investigating large populations utilizing approaches from the fields of epidemiology, data science, genetics, and neuroscience with the investigation of genes and their regulation, external and internal environmental factors, and neural mechanisms, respectively ( 22 , 24 ).…”

Section: Introductionmentioning

confidence: 99%

“…Pan et al ( 26 ) in a resting-state fMRI study reported that aberrant connectivity in the ventral striatum (i.e., a brain area involved in the reward system) may increase the risk of depressive disorder. Cirillo et al ( 59 ) reviewed the scientific evidence and concluded that conducting longitudinal cohort studies in mental health research using a Population Neuroscience strategy is possible.…”

Section: Introductionmentioning

confidence: 99%

“…Guided by locally specific evidence on SI risk factors, interventions could also involve targeted community action plans helping prevent suicide in identified areas ( 76 ). More research is needed in this domain to determine legal, ethical, and effective approaches to prevent suicide once ideation has been expressed on digital and non-digital platforms ( 59 ).…”

Section: Introductionmentioning

confidence: 99%

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Detecting Suicide Ideation in the Era of Social Media: The Population Neuroscience Perspective

et al. 2022

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Social media platforms are increasingly used across many population groups not only to communicate and consume information, but also to express symptoms of psychological distress and suicidal thoughts. The detection of suicidal ideation (SI) can contribute to suicide prevention. Twitter data suggesting SI have been associated with negative emotions (e.g., shame, sadness) and a number of geographical and ecological variables (e.g., geographic location, environmental stress). Other important research contributions on SI come from studies in neuroscience. To date, very few research studies have been conducted that combine different disciplines (epidemiology, health geography, neurosciences, psychology, and social media big data science), to build innovative research directions on this topic. This article aims to offer a new interdisciplinary perspective, that is, a Population Neuroscience perspective on SI in order to highlight new ways in which multiple scientific fields interact to successfully investigate emotions and stress in social media to detect SI in the population. We argue that a Population Neuroscience perspective may help to better understand the mechanisms underpinning SI and to promote more effective strategies to prevent suicide timely and at scale.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Detecting Suicide Ideation in the Era of Social Media: The Population Neuroscience Perspective

et al. 2022

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“…For many diseases, delineation of geographical variations in their distribution -termed geospatial research -has played an important role in enabling the identification of specific genetic or environmental factors that contribute to their causation or course of illness (1)(2)(3)(4). It is now widely recognized that stimulation of population-level investigations in lowand middle-income countries must be a principal priority of mental health research -both to reduce health inequities and to increase our opportunities for transformative scientific discoveries (5). With a few exceptions (6,7), however, geospatial studies of mental disorders have been limited to upper-income countries.…”

Section: Introductionmentioning

confidence: 99%

Geospatial analysis reveals distinct hotspots of severe mental illness

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Ramírez

Okano

et al. 2022

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Background: The identification of geographic variation in incidence can be an important step in the delineation of disease risk factors, but has mostly been undertaken in upper-income countries. Here, we use Electronic Health Records (EHR) from a middle-income country, Colombia, to characterize geographic variation in major mental disorders. Method: We leveraged geolocated EHRs of 16,295 patients at a psychiatric hospital serving the entire state of Caldas, all of whom received a primary diagnosis of bipolar disorder, schizophrenia, or major depressive disorder at their first visit. To identify the relationship between travel time and incidence of mental illness we used a zero-inflated negative binomial regression model. We used spatial scan statistics to identify clusters of patients, stratified by diagnosis and severity: mild (outpatients) or severe (inpatients). Results: We observed a significant association between incidence and travel time for outpatients (N = 11,077, relative risk (RR) = 0.80, 95% confidence interval (0.71, 0.89)), but not inpatients (N = 5,218). We found seven clusters of severe mental illness: the cluster with the most extreme overrepresentation of bipolar disorder (RR = 5.83, p < 0.001) has an average annual incidence of 8.7 inpatients per 10,000 residents, among the highest frequencies worldwide. Conclusions: The hospital database reflects the geographic distribution of severe, but not mild, mental illness within Caldas. Each hotspot is a candidate location for further research to identify genetic or environmental risk factors for severe mental illness. Our analyses highlight how existing infrastructure from middle-income countries can be extraordinary resources for population studies.

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“…Facilitating MRI research in remote and resource-limited settings can also diversify reference databases in neuroscience by enlarging the range of populations represented ( Cirillo et al, 2020 ; ISMRM 2021 ), improving understanding of brain development and degeneration across the lifespan in diverse populations, and helping to create reliable and generalizable measurements of infant and childhood development ( Katus et al, 2019 ; Wedderburn et al, 2020 ). These deeper understandings can lead to new strategies to help remote communities mitigate and hopefully overcome challenges that negatively impact brain development and quality of life.…”

Section: Introductionmentioning

confidence: 99%

Emerging ethical issues raised by highly portable MRI research in remote and resource-limited international settings

et al. 2021

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Smaller, more affordable, and more portable MRI brain scanners offer exciting opportunities to address unmet research needs and long-standing health inequities in remote and resource-limited international settings. Field-based neuroimaging research in low- and middle-income countries (LMICs) can improve local capacity to conduct both structural and functional neuroscience studies, expand knowledge of brain injury and neuropsychiatric and neurodevelopmental disorders, and ultimately improve the timeliness and quality of clinical diagnosis and treatment around the globe. Facilitating MRI research in remote settings can also diversify reference databases in neuroscience, improve understanding of brain development and degeneration across the lifespan in diverse populations, and help to create reliable measurements of infant and child development. These deeper understandings can lead to new strategies for collaborating with communities to mitigate and hopefully overcome challenges that negatively impact brain development and quality of life. Despite the potential importance of research using highly portable MRI in remote and resource-limited settings, there is little analysis of the attendant ethical, legal, and social issues (ELSI). To begin addressing this gap, this paper presents findings from the first phase of an envisioned multi-staged and iterative approach for creating ethical and legal guidance in a complex global landscape. Section 1 provides a brief introduction to the emerging technology for field-based MRI research. Section 2 presents our methodology for generating plausible use cases for MRI research in remote and resource-limited settings and identifying associated ELSI issues. Section 3 analyzes core ELSI issues in designing and conducting field-based MRI research in remote, resource-limited settings and offers recommendations. We argue that a guiding principle for field-based MRI research in these contexts should be including local communities and research participants throughout the research process in order to create sustained local value. Section 4 presents a recommended path for the next phase of work that could further adapt these use cases, address ethical and legal issues, and co-develop guidance in partnership with local communities.

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Population neuroscience: challenges and opportunities for psychiatric research in low- and middle-income countries

Cited by 5 publications

References 67 publications

Detecting Suicide Ideation in the Era of Social Media: The Population Neuroscience Perspective

Detecting Suicide Ideation in the Era of Social Media: The Population Neuroscience Perspective

Geospatial analysis reveals distinct hotspots of severe mental illness

Emerging ethical issues raised by highly portable MRI research in remote and resource-limited international settings

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