in structure of various mental diseases and in general somatic network: among population it is fr... more in structure of various mental diseases and in general somatic network: among population it is from 0.5 to 2%. Objectives: Our aim was to study the effect of complex therapy, combining traditional psychopharmacological drugs and hyperbaric oxygenation, on indicators of acid-base balance of blood, neurotransmitter metabolism, immune and hormonal status in experimental modeling of stress, as well as reduction of psychopathological symptoms in various forms of hysterical disorders. Methods: Studies were conducted with the participation of 160 patients (145 women and 15 men), average age 33.5 AE 6.1 years, Сontent of adrenaline, norepinephrine, dopamine, serotonin was determined by concentration of prolactin, thyroid-stimulating hormone (TSH), free thyroxine (T4 light), cortisol using ELISA. Immune status was assessed according to following indicators: determination of level of immunoglobulins of classes A, M and G by the method of radial immunodiffusion in a gel; study of total complementary activity of blood serum by hemolytic method. Results: It is necessary to highlight a significant increase in the concentration of Ig G and Ig A, a higher level of large, medium and small circulating immune complexes, which does not exclude the development of autoimmune reactions as a result of a long course of the mental process, which occurs with damage to the own cells of the nervous tissue. Conclusions: Кevealed changes in the immune and endocrine reactions upon admission, under the influence of HBO treatment indicate involvement of these structures in the pathogenetic mechanisms. Disclosure: No significant relationships.
Introduction: Schizophrenia is one of the most severe mental disorders. Haloperidol and other fir... more Introduction: Schizophrenia is one of the most severe mental disorders. Haloperidol and other first-generation antipsychotics are widely used for schizophrenia treatment, but have prominent side effects, primarily extrapyramidal symptoms (EPS). The EPS severity is highly variable and may be underlied by genetic factors. Objectives: We performed a prospective study to test the association of DRD2/ANKK1 Taq1A polymorphism (rs18000497) and CYP2D6 phenotype, predicted from genotypes using 8 CYP2D6 alleles (*3, *4, *5, *6,*9, *10,*41, xN) with EPS severity during haloperidol treatment in schizophrenia spectrum disorders patients. Methods: 57 inpatients with schizophrenia spectrum disorders (42,1% females; mean age -46,7AE11,8 y.o (MAESD) of European ancestry were enrolled in the study. Abnormal Involuntary Movement Scale (AIMS), Barnes Akathisia Rating Scale (BARS), Simpson-Angus Scale (SAS) were used to assess EPS on two timepoints: day 1 and day 21 of haloperidol treatment. Results: TaqIA T-allele carriers in contrast to wild-type allele homozygous patients had higher scores of BARS (p=0.029) and SAS (p=0.024) on day 21. After stratification by CYP2D6 phenotype, these differences were observed only in extensive metabolizers (p=0.006 and p=0.001 respectively), although the CYP2D6 phenotype itself was not associated with EPS severity. The combined effect of TaqIA T allele with CYP2D6 extensive phenotype on BARS score on day 21 was confirmed by General Linear Model (p=0.013). Conclusions: Our results show that minor TaqIA T-allele is associated with the severity of EPS after 3 weeks of haloperidol treatment only in CYP2D6 extensive metabolizers. That highlights the importance of using both pharmacokinetic and pharmacodynamic genetic markers in pharmacogenetic EPS risk assessment. Disclosure: No significant relationships.
Attention deficit hyperactivity disorder (ADHD) is a common neurodevelopmental disorder in childr... more Attention deficit hyperactivity disorder (ADHD) is a common neurodevelopmental disorder in children and adolescents, with environmental and biological causal influences. Pharmacological medication is the first choice in ADHD treatment; recently, many studies have concentrated on dietary supplementation approaches to address nutritional deficiencies, to which part of non-responses to medications have been imputed. This review aims to evaluate the efficacy of non-pharmacological supplementations in children or adolescents with ADHD. We reviewed 42 randomized controlled trials comprised of the following supplementation categories: polyunsaturated fatty acids (PUFAs), peptides and amino acids derivatives, single micronutrients, micronutrients mix, plant extracts and herbal supplementations, and probiotics. The reviewed studies applied heterogeneous methodologies, thus making it arduous to depict a systematic overview. No clear effect on single cognitive, affective, or behavioral domain was found for any supplementation category. Studies on PUFAs and micronutrients found symptomatology improvements. Peptides and amino acids derivatives, plant extracts, herbal supplementation, and probiotics represent innovative research fields and preliminary results may be promising. In conclusion, such findings, if confirmed through future research, should represent evidence for the efficacy of dietary supplementation as a support to standard pharmacological and psychological therapies in children and adolescents with ADHD.
medRxiv (Cold Spring Harbor Laboratory), Mar 29, 2023
Early motor difficulties are a common in many, but not all, autistic individuals. These difficult... more Early motor difficulties are a common in many, but not all, autistic individuals. These difficulties tend to be highly present in individuals carrying rare genetic mutations with high penetrance for autism. Many of these rare genetic mechanisms also cause neurophysiological dysregulation of excitation-inhibition balance (E:I). A predicted downstream consequence of E:I imbalance in motor circuitry would translate behaviorally into enhanced 'motor noise'that is, increased variability in execution of motor actions. Here we tested the hypothesis that autistic individuals with the most pronounced motor difficulties would be most affected by enhanced motor noise. Unsupervised data-driven clustering on a standardized test of motor skills (n=156, age = 3-16 years) identified the presence of two robust and highly stable autism motor subtypes described by relatively intact versus highly impaired motor skills. With motor kinematics data recorded during a simple reach-to-drop task, we observed that enhanced motor noise is a specific characteristic of the autism subtype with highly impaired motor skills.
European Child & Adolescent Psychiatry, Jan 25, 2023
Recently, there has been an increase in telemedicine applied to child neuropsychiatry, such as th... more Recently, there has been an increase in telemedicine applied to child neuropsychiatry, such as the use of online platforms to collect remotely case histories and demographic and behavioral information. In the present proof-of-concept study, we aimed to understand to what extent information parents and teachers provide through online questionnaires overlaps with clinicians' diagnostic conclusions on attention-deficit/hyperactivity disorder (ADHD). Moreover, we intended to explore a possible role that autism spectrum disorders (ASD) symptoms played in this process. We examined parent-and teacher-rated questionnaires collected remotely and an on-site evaluation of intelligence quotients from 342 subjects (18% females), aged 3-16 years, and referred for suspected ADHD. An easily interpretable machine learning model-decision tree (DT)-was built to simulate the clinical process of classifying ADHD/non-ADHD based on collected data. Then, we tested the DT model's predictive accuracy through a cross-validation approach. The DT classifier's performance was compared with those that other machine learning models achieved, such as random forest and support vector machines. Differences in ASD symptoms in the DT-identified classes were tested to address their role in performing a diagnostic error using the DT model. The DT identified the decision rules clinicians adopt to classify an ADHD diagnosis with an 82% accuracy rate. Regarding the cross-validation experiment, our DT model reached a predictive accuracy of 74% that was similar to those of other classification algorithms. The caregiver-reported ADHD core symptom severity proved the most discriminative information for clinicians during the diagnostic decision process. However, ASD symptoms were a confounding factor when ADHD severity had to be established. Telehealth procedures proved effective in obtaining an automated output regarding a diagnostic risk, reducing the time delay between symptom detection and diagnosis. However, this should not be considered an alternative to on-site procedures but rather as automated support for clinical practice, enabling clinicians to allocate further resources to the most complex cases.
Attention deficit hyperactivity disorder (ADHD) is a neurodevelopmental disorder characterized by... more Attention deficit hyperactivity disorder (ADHD) is a neurodevelopmental disorder characterized by deficits in cognitive and emotional self-control. Optical technique acquisitions, such as near infrared spectroscopy (NIRS), seem to be very promising during developmental ages, as they are non-invasive techniques and less influenced by body movements than other neuroimaging methods. Recently, these new techniques are being widely used to measure neural correlates underlying neuropsychological deficits in children with ADHD. In a short series of articles, we will review the results of functional NIRS (fNIRS) studies in children with ADHD. The present brief review will focus on the results of the fNIRS studies that investigate cortical activity during neuropsychological and/or emotional tasks. According to the reviewed studies, children and adolescents with ADHD show peculiar cortical activation both during neurological and emotional tasks, and the majority of the reviewed studies revealed lower prefrontal cortex activation in patients compared to typically developmental controls. Limitations: a consistent interpretation of these results is limited by the substantial methodological heterogeneity including patients' medication status and washout period, explored cerebral regions, neuropsychological tasks, number of channels and sampling temporal resolutions.
Epidemiology and Psychiatric Sciences, Apr 11, 2012
Aims. Adolescence is a critical transition phase between childhood and adulthood, when the burden... more Aims. Adolescence is a critical transition phase between childhood and adulthood, when the burden of mental disorder may still be prevented. The aim of this study was to evaluate the continuity and discontinuity of behavioural problems in adolescence while taking into account the multiple co-variation of psychopathological traits and the complex role of recent stressful life events (SLEs). Methods. This is a 5-year follow-up investigation of emotional and behavioural problems assessed by the newly developed Child Behavior Checklist (CBCL) DSM-Oriented Scales (DOSs) in 420 general population subjects aged 15-19 years. Results. The DOSs showed good stability, even when multiple co-variation was taken into account. Longitudinal data showed that homotypic evolution of psychopathology was to be expected in the first place. Equifinality and multifinality were also found. Oppositional Defiant Problems emerged to be polyvalent predictors of both internalizing and externalizing problems. Furthermore, Oppositional Defiant Problems predicted more SLEs, which in turn predicted more Depression, Anxiety and Oppositional Defiant Problems. Mediational analyses confirmed the role of SLEs in partially accounting for the continuity of Oppositional Defiant Problems and for the heterotypic progression towards Affective Problems. Conclusions. These data underscore early adolescence behavioural problems as an important focus for primary and secondary intervention.
Pre-and peri-natal complications represent well-known risk factors for the future development of ... more Pre-and peri-natal complications represent well-known risk factors for the future development of psychiatric disorders. Such in uence might become manifested during childhood and adolescence, as key periods for brain and behavioral changes. Internalizing and externalizing behaviors in adolescence have been associated with the risk of psychiatric onset later in life. Both brain morphology and behavior seem to be affected by obstetric complications, but a clear link between these three aspects is missing. Here, we aimed at analyzing the association between pre-and peri-natal complications, behavioral issues, and brain volumes in a group of children and adolescents. Eighty-two adolescents with emotional-behavioral problems underwent clinical and 3T brain magnetic resonance imaging (MRI) assessments. The former included information on behavior, through the Child Behavior Checklist/6-18 (CBCL), and on the occurrence of obstetric complications. The relationships between clinical and gray matter volume (GMV) measures were investigated through multiple generalized linear models and mediation models. We found a mutual link between prenatal complications, GMV alterations in the frontal gyrus, and withdrawn problems. Speci cally, complications during pregnancy were associated with higher withdrawn scores and GMV reductions in the right superior frontal lobe and anterior cingulate cortex. Finally, a mediation effect of these GMV measures on the association between prenatal infections and the withdrawn dimension was identi ed. Our ndings suggest a key role of obstetric complications in affecting brain structure and behavior. For the rst time, we showed a mediator role of frontal GMV in the relationship between prenatal complications and internalizing symptoms.
Background: Children with attention deficit hyperactivity disorder (ADHD) exhibit behavioral inhi... more Background: Children with attention deficit hyperactivity disorder (ADHD) exhibit behavioral inhibition deficits, which often lead to emotional dysregulation (ED) affecting individual ability to control emotions and behavioral responses. In ADHD, ED is associated with poor outcomes and comorbidities, with both externalizing and internalizing disorders. This work aims to evaluate sensitivity to emotional stimuli in children with ADHD using functional Near Infrared Spectroscopy (fNIRS). Methods: During frontal fNIRS recording, 20 children with ADHD and 25 typically developing (TD) peers performed a visual continuous performance task with stimuli of different emotional content (i.e., positive, negative, neutral, and control stimuli without emotional content). This is a cognitive task designed to evaluate the ability to recognize emotional stimuli and to deal with emotional interference. Results: The ADHD sample showed more variability in response time to stimuli and more false alarms compared to TD group. fNIRS data showed between-group differences in right prefrontal and frontal cortices, with wider hemoglobin concentration changes in the TD group, during positive, negative, and neutral conditions. Limitations: Owing to the limited possibility of near infrared light to penetrate tissue, fNIRS can only measure cortical activations, while it would be of interest to identify the subcortical areas linked to emotional processing, too. Conclusions: Findings suggest the presence of emotional processing deficits in children with ADHD, as suggested by poor performances on the e-CPT task, and of peculiar sensitivity to emotional stimuli, linked to atypical hemodynamics of right prefrontal and frontal areas. delay in decision process; iii) an incapacity to remain focused and to operate interference control. In addition to the behavioral domain, impairment in response inhibition also affects the ability to control emotions, arousal, and self-regulation . In daily living, emotional self-regulation includes the individual ability to identify and properly interpret environmental emotional stimuli, to recognize individual self-emotions, and to deal with them, generating appropriate social responses (Doumond et al., 2019). Emotional dysregulation (ED) is a transdiagnostic psychopathological trait which is frequently found in ADHD and associated with poor outcomes and comorbidities with both externalizing (e.g., oppositional
Recently there has been an increase in telemedicine applied to child neuropsychiatry, such as the... more Recently there has been an increase in telemedicine applied to child neuropsychiatry, such as the use of online platforms to remotely collect anamnestic and behavioral information. In the present proof-ofconcept study, we aimed to understand to what extent information provided by parents and teachers through online questionnaires overlaps with clinicians' diagnostic conclusions on Attention-De cit/Hyperactivity Disorder (ADHD). Moreover, we intended to explore a possible role played by autism spectrum disorders (ASD) symptoms in this process. We examined parent-and teacher-rated questionnaires collected remotely and an on-site evaluation of intelligence quotients from 342 subjects (18% females), aged 3 to 16 years, referred for suspected ADHD. A machine learning model (decision tree, DT) was built to simulate the clinical process of classifying ADHD/non-ADHD. Differences in ASD symptoms in the DT-identi ed classes were tested to address their role in performing a diagnostic error using the DT model. The DT identi ed the decision rules adopted by clinicians to classify ADHD diagnosis and proved accurate in 82% of our subjects. The caregiver-reported ADHD core symptom severity proved the most discriminative information for clinicians during the diagnostic decision process. However, ASD symptoms were a confounding factor when ADHD severity had to be established. Telehealth procedures proved effective in obtaining an automated output regarding a diagnostic risk, reducing the time delay between symptom detection and diagnosis. However, this should not be considered as an alternative to on-site procedures but as automated support for clinical practice, enabling clinicians to allocate more resources to the most complex cases.
European Child & Adolescent Psychiatry, Sep 24, 2018
This study aimed to investigate the efficacy of docosahexaenoic acid (DHA) dietary supplementatio... more This study aimed to investigate the efficacy of docosahexaenoic acid (DHA) dietary supplementation on behavior and cognition in school-aged, drug-naïve children with attention-deficit/hyperactivity disorder (ADHD). A total of 50 participants with ADHD aged 7 to 14 were enrolled in a 6-month randomized, placebo-controlled clinical trial and received either DHA or placebo. The primary outcome measure was the change in the ADHD rating scale IV Parent Version-Investigator (ADHD-RS-IV) after 4 and 6 months. Secondary outcome measures included Conners Parent Rating Scale-revised, other behavioral rating scales including quality of life and global functioning, and computerized cognitive tasks. Baseline assessment also addressed the blood fatty acids profile. No superiority of DHA supplement to placebo was observed on ADHD-RS-IV, the a priori primary outcome. DHA supplementation showed a significant, nonetheless quite small, effect on children's psychosocial functioning, emotional problems, and focused attention. Neither major nor minor adverse events were reported throughout the trial. This study shows that 6-month DHA supplementation has no beneficial effect on the symptoms of ADHD in school-aged, drug-naïve children with an established diagnosis of ADHD. Nevertheless, the 6 months treatment with supplemental DHA appears to have small positive effects on other behavioral and cognitive difficulties, which, in light of the absence of side-effects, could be reasonably followed up in future intervention studies. ( caltr ials.gov/ct2/ show/NCT01 79626 2: The Effects of DHA on Attention Deficit and Hyperactivity Disorder (DADA)).
European Journal of Paediatric Neurology, Jul 1, 2017
Higher prevalence of Autism Spectrum Disorder (14.8%) in DMD boys. Higher prevalence of Intellect... more Higher prevalence of Autism Spectrum Disorder (14.8%) in DMD boys. Higher prevalence of Intellectual Disability (36.2%) in DMD. Higher prevalence of CBCL Internalizing Problems (23.4%) in DMD. First study in DMD based on reliable psychopathological assessment.
The brain's intrinsic organization into large-scale functional networks, the resting state networ... more The brain's intrinsic organization into large-scale functional networks, the resting state networks (RSN), shows complex inter-individual variability, consolidated during development. Nevertheless, the role of gene and environment on developmental brain functional connectivity (FC) remains largely unknown. Twin design represents an optimal platform to shed light on these effects acting on RSN characteristics. In this study, we applied statistical twin methods to resting-state functional magnetic resonance imaging (rs-fMRI) scans from 50 young twin pairs (aged 10-30 years) to preliminarily explore developmental determinants of brain FC. Multi-scale FC features were extracted and tested for applicability of classical ACE and ADE twin designs. Epistatic genetic effects were also assessed. In our sample, genetic and environmental effects on the brain functional connections largely varied between brain regions and FC features, showing good consistency at multiple spatial scales. Although we found selective contributions of common environment on temporo-occipital connections and of genetics on frontotemporal connections, the unique environment showed a predominant effect on FC link-and node-level features. Despite the lack of accurate genetic modeling, our preliminary results showed complex relationships between genes, environment, and functional brain connections during development. A predominant role of the unique environment on multi-scale RSN characteristics was suggested, which needs replications on independent samples. Future investigations should especially focus on nonadditive genetic effects, which remain largely unexplored. Recent technical and methodological advancements in functional Magnetic Resonance Imaging (fMRI) field have enabled an accurate characterization of functional brain networks during resting state, leading to important information about the brain pathophysiology. At rest the human brain is organized in multiple large-scale networks, called resting-state networks (RSNs), resulting from the synchronous activation of distant brain regions involved in processes like vision, audition, motor planning, memory, and attention . Independent component analysis (ICA) findings demonstrated high spatial consistency of the RSNs across subjects 2,3,5,6 . Their reproducibility was confirmed by seed-based functional connectivity (FC) studies, which identified sets of nodes being consistently organized into functional modules . Of note, connectivity's alterations within and among the RSNs were observed in different neuropsychiatric disorders . Shifting from a group-level to a subject-level perspective, recent fMRI findings showed the existence of individual functional brain network characteristics that remain unique and stable across years . Accordingly, subject-specific functional brain network topography seems predictive of behavioral phenotypes 14 . In this respect, how developmental changes result in individualized FC signatures is still debated. Studying the developmental determinants of FC might inform on individual differences in behavior, giving insight into complex mental disorders' etiology 15 . Although RSNs result to be largely established early in development, passing from childhood to adolescence they exhibit a shift from a local (segregated) to a more distributed
Background: Deficits in emotional processing and, in particular, in emotional self-regulation rep... more Background: Deficits in emotional processing and, in particular, in emotional self-regulation represent nonspecific risk factors for transdiagnostic poor outcomes. Researches have been focusing on the investigation of possible emotional processing and regulation biomarkers. The present brief review of the literature aims to evaluate whether NIRS signal might be one of them. Methods: We reviewed 8 original articles investigating children's hemodynamic response to emotional tasks using NIRS, or exploring the association between NIRS response to cognitive tasks and behavioral emotional regulation. Results: All the works revised found significant associations between NIRS data and emotional indexes. Furthermore, significant hemodynamic response is found in different age-groups (3-12 years of age), suggesting that cortical response to emotional processing as measured by NIRS is a marker consistently recognizable throughout the development. Limitations: Given that the studies in this field were still limited and used heterogeneous protocols, addressed different functions or aspects of emotional processing, these results are preliminary. Conclusions: NIRS seems a reliable tool to describe brain activation during emotional processing and regulation. Moreover, it seems to be particularly useful in studies including either developmental-aged participants or clinical samples, due to its clear advantages and non-intrusiveness, offering a potential marker for deficits in emotional processing and regulation.
Background: Increasing evidence suggests a complex role of family influences, such as the exposur... more Background: Increasing evidence suggests a complex role of family influences, such as the exposure to parent psychopathology through parenting behavior, in parent-to-child psychopathology transmission. Parenting behaviour could represent a relevant target of psychoeducative intervention. Given these premises, we aimed to evaluate homotypic and heterotypic relationships between parent and child psychopathology, mediated by parenting behaviours, taking into account the constructs of parent and offspring internalizing and externalizing psychopathology. Methods: Internalizing and externalizing symptoms in 272 clinically-referred subjects (mean age = 14.5 ± 2.3; F = 23.5%) and their parents (mothers n = 272, fathers n = 242) were assessed through the Child Behavior Checklist and the Adult Self Report; four areas of parenting behaviours were investigated through the Family Life Questionnaire. Multiple mediation models were built, considering mother and father psychopathology scales as independent variables, parenting measures and family functioning as mediators (Affirmation, Rules, Discipline and Special Allowances), child psychopathology scales as dependent variables and demographic variables as covariates. Results: Regression models showed a significant effect of maternal internalizing symptomatology on child externalizing behavioral problems; high levels of maternal pathology predicted high levels of children's psychopathology. A total mediating effect of parenting measures was found: high levels of internalizing symptoms in mothers predicted low levels of affirmation, which in turn predicted high levels of externalizing psychopathology in children. Conclusions: Our study results confirmed the existence of interdependent links between mothers' psychiatric symptomatology, parenting behaviour and offspring outcomes, specifically in an Italian context. On a clinical and rehabilitation basis, this work offers suggestions about parenting practices, specifically maternal, involved in the maintenance of child psychopathology.
Background Living with a progressive disease as muscular dystrophy (MD) can be challenging for th... more Background Living with a progressive disease as muscular dystrophy (MD) can be challenging for the patient and the entire family from both emotional and practical point of view. We aimed to extend our previously published data about mental health in patients with MDs, also investigating coping profiles of both themselves and their parents. Furthermore, we wanted to verify whether psychological adaptation of patients can be predicted by coping strategies, taking also into account physical impairment, cognitive level and socioeconomic status. Methods 112 patients with MDs, aged 2-32 were included. Their emotional and behavioural features were assessed through parent-and self-report Achenbach System for Empirically Based Assessment questionnaires and Strength and Difficulties Questionnaires. Development and Well-Being Assessment or Autism Diagnostic Observation Schedule were administered to confirm suspected diagnoses. Coping profile of both parents and patients was assessed through the self-administered New Italian Version of the Coping Orientation to the Problems Experienced questionnaire and its relationship with emotional/ behavioural outcome was examined in linear regression analyses. Results High prevalence of intellectual disability and autism spectrum disorders was confirmed in Duchenne MD. Despite the high rate of internalizing symptomatology, we did not report higher rate of psychopathological disorders compared to general population. Parents tend to rely more on positive reinterpretation and less on disengagement coping. Avoidance coping, whether used by parents or patients, and ID, predicted increased emotional/behavioural problems. Conclusions Psychosocial interventions should address problems of anxiety and depression that people with MDs frequently experience, even through fostering parents' and childrens' engagement coping over disengagement coping.
Objective: This study aimed to investigate the relationship between polyunsaturated fatty acids (... more Objective: This study aimed to investigate the relationship between polyunsaturated fatty acids (PUFAs) status, cognitive, and behavioral traits of ADHD in school-aged children. Method: Seventy-three children with and without ADHD were assessed with cognitive tasks and behavioral rating scales including quality of life and global functioning at baseline of an intervention trial (clinicaltrials.gov NCT01796262). Correlation analyses were performed between the cognitive tasks/ behavioral ratings and blood PUFA levels. Results: Children with ADHD had lower levels of DHA, omega-3 index, and total PUFA. PUFAs were positively associated with behavior but not consistently related to cognitive domains. The present study confirms that children with ADHD display abnormal fatty acid profiles within an Italian setting. Furthermore, PUFAs were associated with behavior but not with cognition. Accordingly, for the first time, lower blood levels of PUFA were associated not only with symptoms of ADHD but also with a poorer quality of life. (J. of Att. Dis. XXXX; XX(X) XX-XX
Background: Mood disorders are characterized by heterogeneity in severity, symptoms and treatment... more Background: Mood disorders are characterized by heterogeneity in severity, symptoms and treatment response. The possibility of selecting the correct therapy on the basis of patient-specific biomarker may be a considerable step towards personalized psychiatry. Machine learning methods are gaining increasing popularity in the medical field. Once trained, the possibility to consider single patients in the analyses instead of whole groups makes them particularly appealing to investigate treatment response. Deep learning, a branch of machine learning, lately gained attention, due to its effectiveness in dealing with large neuroimaging data and to integrate them with clinical, molecular or -omics biomarkers. Methods: In this mini-review, we summarize studies that use deep learning methods to predict response to treatment in depression. We performed a bibliographic search on PUBMED, Google Scholar and Web of Science using the terms "psychiatry", "mood disorder", "depression", "treatment", "deep learning", "neural networks". Only studies considering patients' datasets are considered. Results: Eight studies met the inclusion criteria. Accuracies in prediction of response to therapy were considerably high in all studies, but results may be not easy to interpret. Limitations: The major limitation for the current studies is the small sample size, which constitutes an issue for machine learning methods. Conclusions: Deep learning shows promising results in terms of prediction of treatment response, often outperforming regression methods and reaching accuracies of around 80%. This could be of great help towards personalized medicine. However, more efforts are needed in terms of increasing datasets size and improved interpretability of results.
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Papers by Maria Nobile