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Structural brain MRI studies in autism spectrum disorder
- J. M. Petrović, I. Binic, A. Stojanovic, M. Zdravkovic, F. Petrovic
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- Journal:
- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, p. S914
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Introduction
Autism spectrum disorder (ASD) refers to a group of conditions characterized by quantitative differences in the morphology of the cortex and subcortex. Analyzing brain morphology qualitatively provides complementary information about possible underlying neurobiology. Studies of neuroradiological findings in ASD have produced mixed results in a large and independent sample.
ObjectivesA small cerebellum associated with pons hypoplasia, or a posterior fossa cyst, may indicate causal developmental mechanisms. Therefore, neuroradiological findings could help elucidate the neurodevelopmental processes associated with ASD.
MRI “minor abnormalities” also included dilatation of the Virchow-Robin gaps, an enlarged cisterna magna, pineal gland cysts, and arachnid or choroidal cysts not included in specified categories.
MethodsThere were anomalies in the corpus callosum (hypoplasia), cerebellum, brain stem, abnormal white matter signal intensity, macrocephaly, ventriculomegaly, abnormal myelination patterns, ventricular system size, Arnold Chiari I malformation, cortical dysplasia and atrophy, hippocampal malformations, and pituitary glands. These anomalies were referred to as “major abnormal findings”.
ResultsThe most common minor abnormality is the mega cisterna magna. Some authors propose a minor abnormality such as this as a marker for brain dysgenesis. According to Zimmer and colleagues, enlargements of the cisterna magna are generally accompanied by cerebellar hypoplasia and ventriculomegaly, as well as lower performance on speech tasks (verbal and semantic fluency) common among individuals with autism spectrum disorders. The relationship between the presence of mega cisterna magna and language difficulties could be studied further in a subsequent study. Abnormal dilation of the cisterna magna is thought to be related to alterations in the cerebellar volumes.
ConclusionsClinical MRI assessments may be helpful in the context of diagnoses and are potentially valuable for further studies of the pathogenesis of autism. The potential utility of routine brain MRI is in discovering early morphologic biomarkers for ASD.
Disclosure of InterestNone Declared
Cognitive behavioral therapy for patients with schizophrenia
- I. Binic, J. Petrovic, J. Antonijevic, D. Pancic, M. Zdravkovic, F. Petrovic
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- Journal:
- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, pp. S1025-S1026
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Introduction
In treating schizophrenia, there is growing interest in introducing and renewing psychosocial therapies, including psychotherapy. In recent years, this has specifically entailed the adaption of particular cognitive behavioral therapy (CBT) approaches, which were previously only utilized for treating anxiety and mood disorders. The negative symptomatology of schizophrenia, which has proven to be especially difficult to treat, can be a challenge for CBT, particularly in terms of enhancing relationships with family and friends and work engagement.
ObjectivesThe objective was to summarize the advantages of CBT treatment in schizophrenia briefly.
MethodsPatients with schizophrenia frequently have comorbid problems, such as anxiety disorders (and disorders) and traumatic experiences, which can be effectively treated with CBT. In addition to pharmacological therapy, CBT is acknowledged as the gold standard in several countries for the treatment of schizophrenia. According to studies, combining CBT with medication can minimize psychotic symptoms.
ResultsRegarding treatment, Beck describes the use of typical CBT techniques: building trust and engagement; working collaboratively to understand the meaning of symptoms; understanding the patient’s interpretation of past and present events, particularly those that the patient believes are related to the development and persistence of his or her current problems; normalizing these experiences and educating the patient about the stress-vulnerability model, and socialization. Clarifying the emotional and behavioral repercussions of a delusion’s activation leads to an initial examination of the evidence-based on more peripheral interpretations. It is recommended to treat negative symptoms such as amotivation, anergia, anhedonia, and social disengagement with behavioral self-monitoring, activity scheduling, ratings of mastery and enjoyment, graded work assignments, and assertiveness training.
ConclusionsIn treatment settings where physicians are already utilizing high-quality psychoeducational materials to enhance adherence, an excellent foundation exists for introducing individual CBT for schizophrenia patients.
Disclosure of InterestNone Declared
Neuroimaging in psychiatry: is it relevant?
- I. Binic, J. Petrovic, J. Antonijevic, O. Zikic, D. Pancic, F. Petrovic
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- Journal:
- European Psychiatry / Volume 65 / Issue S1 / June 2022
- Published online by Cambridge University Press:
- 01 September 2022, p. S642
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Introduction
The upturn of neuroimaging techniques in the past 30 years has changed the study of the biology of psychiatric disorders with implications for psychiatric practice. Thrive in medical imaging technology has, in fact, truly reformed nearly every medical field.
ObjectivesThese advances include both improvements in image resolution and the development of novel imaging techniques all of which provide an unprecedented view, in detail, of anatomical structures and/or functions in the human body.
MethodsNowadays, we are familiar with the role of some brain structures such as the amygdala, the thalamus, the hippocampus, the dorsolateral prefrontal cortex, and the insula in neuropsychiatric function. For example, lesions to the frontal cortex can disrupt judgment, motivation and social behavior.
ResultsCurrently, most imaging techniques have some sort of clinical application, but this is usually restricted to a limited number of cases. New techniques have provided invaluable information not only about the brain structure and function associated with psychiatric disorders but increasingly about the mechanisms underpinning these disorders.
ConclusionsGrowing understanding of the specific pathophysiology of mental disorders prepares us for improvement in the identification of diagnostic and prognostic biomarkers, which could lead to more accurate diagnoses and prediction of treatment response of the disorders managed in everyday clinical practice. Of note, the identification of neural biomarkers could potentially identify people at risk of developing a particular illness.
DisclosureNo significant relationships.