Browsing by Author "Ramírez Mahaluf, Juan Pablo"
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- ItemGender, age and geographical representation over the past 50 years of schizophrenia research(2022) Alliende, Luz MarÍa; Czepielewski, Leticia S.; Aceituno Farías, David; Paz Castaneda, Carmen; Díaz, Camila; Iruretagoyena Bruce, Bárbara Arantzazu; Mena, Carlos; Mena, Cristian; Ramírez Mahaluf, Juan Pablo; Tepper, Ángeles; Vásquez, Javiera; Fonseca, Lais; Machado, Viviane; Hernández, Camilo E.; Vargas Upegui, Cristian; Gómez Cruz, Gladys; Kobayashi Romero, Luis F.; Moncada Habib, Tomas; Evans Lacko, Sara; Bressan, Rodrigo; Gama, Clarissa S.; López Jaramillo, Carlos; de la Fuente Sandoval, Camilo; González Valderrama, Alfonso; Undurraga, Juan; Gadelha, Ary; Crossley Karmelic, Nicolás Andrés; ANDES NetworkPrevious studies have suggested that subjects participating in schizophrenia research are not representative of the demographics of the global population of people with schizophrenia, particularly in terms of gender and geographical location. We here explored if this has evolved throughout the decades, examining changes in geographical location, gender and age of participants in studies of schizophrenia published in the last 50 years. We examined this using a meta-analytical approach on an existing database including over 3,000 studies collated for another project. We found that the proportion of studies and participants from low-and-middle income countries has significantly increased over time, with considerable input from studies from China. However, it is still low when compared to the global population they represent. Women have been historically underrepresented in studies, and still are in high-income countries. However, a significantly higher proportion of female participants have been included in studies over time. The age of participants included has not changed significantly over time. Overall, there have been improvements in the geographical and gender representation of people with schizophrenia. However, there is still a long way to go so research can be representative of the global population of people with schizophrenia, particularly in geographical terms.
- ItemQuantitative Susceptibility Mapping MRI in Deep-Brain Nuclei in First-Episode Psychosis(2023) García Saborit, Marisleydis; Jara Vallejos, Alejandro Antonio; Muñoz Camelo, Néstor Andrés; Milovic, Carlos; Tepper, Angeles; Alliende Correa, Luz María; Mena, Carlos; Iruretagoyena Bruce, Bárbara Arantzazu; Ramírez Mahaluf, Juan Pablo; Diaz, Camila; Nachar, Rubén; Castaneda, Carmen Paz; Gonzalez, Alfonso; Undurraga, Juan; Crossley, Nicolás; Tejos Núñez, Cristián AndrésBackground Psychosis is related to neurochemical changes in deep-brain nuclei, particularly suggesting dopamine dysfunctions. We used an magnetic resonance imaging-based technique called quantitative susceptibility mapping (QSM) to study these regions in psychosis. QSM quantifies magnetic susceptibility in the brain, which is associated with iron concentrations. Since iron is a cofactor in dopamine pathways and co-localizes with inhibitory neurons, differences in QSM could reflect changes in these processes. Methods We scanned 83 patients with first-episode psychosis and 64 healthy subjects. We reassessed 22 patients and 21 control subjects after 3 months. Mean susceptibility was measured in 6 deep-brain nuclei. Using linear mixed models, we analyzed the effect of case-control differences, region, age, gender, volume, framewise displacement (FD), treatment duration, dose, laterality, session, and psychotic symptoms on QSM. Results Patients showed a significant susceptibility reduction in the putamen and globus pallidus externa (GPe). Patients also showed a significant R2* reduction in GPe. Age, gender, FD, session, group, and region are significant predictor variables for QSM. Dose, treatment duration, and volume were not predictor variables of QSM. Conclusions Reduction in QSM and R2* suggests a decreased iron concentration in the GPe of patients. Susceptibility reduction in putamen cannot be associated with iron changes. Since changes observed in putamen and GPe were not associated with symptoms, dose, and treatment duration, we hypothesize that susceptibility may be a trait marker rather than a state marker, but this must be verified with long-term studies.
- ItemReduced resilience of brain state transitions in anti-N-methyl-D-aspartate receptor encephalitis(John Wiley and Sons Inc, 2023) Schwanenflug, Nina von; Ramírez Mahaluf, Juan Pablo; Krohn, Stephan; Romanello, Amy; Heine, Josephine; Prüss, Herald; Crossley, Nicolás A.; Carsten, FinkePatients with anti-N-methyl-aspartate receptor (NMDA) receptor encephalitis suffer from a severe neuropsychiatric syndrome, yet most patients show no abnormalities in routine magnetic resonance imaging. In contrast, advanced neuroimaging studies have consistently identified disrupted functional connectivity in these patients, with recent work suggesting increased volatility of functional state dynamics. Here, we investigate these network dynamics through the spatiotemporal trajectory of meta-state transitions, yielding a time-resolved account of brain state exploration in anti-NMDA receptor encephalitis. To this end, resting-state functional magnetic resonance imaging data were acquired in 73 patients with anti-NMDA receptor encephalitis and 73 age- and sex-matched healthy controls. Time-resolved functional connectivity was clustered into brain meta-states, giving rise to a time-resolved transition network graph with states as nodes and transitions between brain meta-states as weighted, directed edges. Network topology, robustness and transition cost of these transition networks were compared between groups. Transition networks of patients showed significantly lower local efficiency (t = ?2.41, pFDR =.029), lower robustness (t = ?2.01, pFDR =.048) and higher leap size (t = 2.18, pFDR =.037) compared with controls. Furthermore, the ratio of within-to-between module transitions and state similarity was significantly lower in patients. Importantly, alterations of brain state transitions correlated with disease severity. Together, these findings reveal systematic alterations of transition networks in patients, suggesting that anti-NMDA receptor encephalitis is characterized by reduced stability of brain state transitions and that this reduced resilience of transition networks plays a clinically relevant role in the manifestation of the disease.
- ItemUso de cannabis en jóvenes hospitalizados por un primer episodio de psicosis: un estudio caso-control(2020) Castañeda, Carmen Paz; Alliende Correa, Luz María; Iruretagoyena, Bárbara; Nachar, Rubén; Mancilla, Felipe; Diaz, Camila; Gallardo, Carlos; Mena, Cristian; Ramírez Mahaluf, Juan Pablo; Undurraga, Juan; González Valderrama, Alfonso; Crossley, NicolásBackground: Cannabis use among young people in Chile has increased significantly in the last years. There is a consistent link between cannabis and psychosis. Aim: To compare cannabis use in patients with a first episode of psychosis and healthy controls. Material and Methods: We included 74 patients aged 20 +/- 3 years (78% males) admitted to hospital with a first episode of psychosis and a group of 60 healthy controls aged 23 +/- 4 years (63% males). Cannabis consumption was assessed, including age of first time use and length of regular use. Results: Patients with psychosis reported a non-significantly higher frequency of life-time cannabis use. Patients had longer periods of regular cannabis use compared with healthy subjects (Odds ratio [OR] 2.4; 95% confidence intervals [CI] 1.14-5.05). Patients also used cannabis for the first time at an earlier age (16 compared with 17 years, p < 0.0). The population attributable fraction for regular cannabis use associated with hospital admissions due to psychosis was 17.7% (95% CI 1.2-45.5%). Conclusions: Cannabis use is related to psychosis in this Chilean group of patients. This relationship is stronger in patients with early exposure to the drug and longer the regular use. One of every five admissions due to psychosis is associated with cannabis consumption. These data should influence cannabis legislation and the public policies currently being discussed in Chile.