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Current Status of Ketamine and Related Therapies for Mood and Anxiety Disorders
Abstract Major depressive disorder (MDD) is a leading cause of disability worldwide. Despite a plethora of established treatments, less than one third of individuals with MDD achieve stable remission of symptoms. Given limited efficacy and significant lag time to onset of therapeutic action among conventional antidepressants, interest has shifted to treatments that act outside of the monoamine neurotransmitter systems (e.g., serotonin, norepinephrine, and dopamine). Preclinical and clinical research on the glutamate system has been particularly promising in this regard. Accumulating evidence shows support...
Source: Current Behavioral Neuroscience Reports - October 1, 2015 Category: Neuroscience Source Type: research

Can Cognitive Therapy Be Conducted by Computers?
This report examines research comparing computer-assisted therapy for major depression and anxiety disorders with controls and other treatments. Overall, results indicate moderate treatment effect sizes as compared to wait-list controls and equivalent results when compared to therapist-delivered treatment. However, dropout rates tend to be high with little clinician involvement and some studies show treatment effects attenuating in the long term. Additional and methodologically stronger studies are needed. Future directions may include integration of computer-assisted methods into clinics and training settings, capitalizin...
Source: Current Behavioral Neuroscience Reports - September 24, 2015 Category: Neuroscience Source Type: research

Deep Brain Stimulation for Treatment-Refractory Mood and Obsessive-Compulsive Disorders
Abstract Deep brain stimulation (DBS) is an invasive therapy in which electrodes are surgically placed into the brain and deliver continuous electrical stimulation. It was originally developed for Parkinson’s disease and other movement disorders. As evidence emerged that certain mental disorders involved abnormal function of specific brain nuclei, multiple investigators launched trials of DBS for mental disorders, particularly major depression (MDD) and obsessive-compulsive disorder (OCD). While open-label results were promising, recent large well-designed clinical trials in MDD have failed. We review t...
Source: Current Behavioral Neuroscience Reports - August 28, 2015 Category: Neuroscience Source Type: research

The Role of Pharmacogenomics to Guide Treatment in Mood and Anxiety Disorders
Abstract Interest has grown in genetic testing to personalize treatment approaches in psychiatry, especially mood disorders and to a lesser extent anxiety. However, numerous studies of genetic variants of metabolizing enzymes, along with fewer studies of single nucleotide polymorphisms of drug transporter proteins, receptors, and other putative drug targets such as neurotransmitter reuptake pumps and receptors, have reported contradictory findings that have not translated into practical, cost-effective treatment recommendations. In this article, we review basic principles of genetic testing and highlight ...
Source: Current Behavioral Neuroscience Reports - July 16, 2015 Category: Neuroscience Source Type: research

Biomarkers for Antidepressant Selection: iSPOT-D Study
Abstract The International Study to Predict Optimized Treatment in Depression (iSPOT-D) is a randomized clinical trial conducted at 22 sites across 5 countries, looking at biomarkers of improvement in depressive symptoms to treatment with SSRIs escitalopram and sertraline, and the SNRI venlafaxine-XR. It is the first to take an integrative neuroscience approach to biomarker discovery, looking across the disciplines of structural and functional MRI, EEG, cognitive performance, and genomics, all in the same patients. The initial biomarkers from within each of these disciplines have now been reported. Sympto...
Source: Current Behavioral Neuroscience Reports - July 14, 2015 Category: Neuroscience Source Type: research

Anhedonia and the Brain Reward Circuitry in Depression
Abstract Anhedonia, or the loss of pleasure in previously rewarding stimuli, is a core symptom of major depressive disorder that may reflect an underlying dysregulation in reward processing. The mesolimbic dopamine circuit, also known as the brain’s reward circuit, is integral to processing the rewarding salience of stimuli to guide actions. Manifestation of anhedonia and associated depression symptoms, like feelings of sadness, changes in appetite, and psychomotor effects, may reflect changes in the brain reward circuitry as a common underlying disease process. This review will synthesize the recent li...
Source: Current Behavioral Neuroscience Reports - July 12, 2015 Category: Neuroscience Source Type: research

Recent Developments in Noninvasive Neuromodulation for Mood and Anxiety Disorders
Abstract Noninvasive neuromodulation refers to a family of device-based interventions that apply electrical or magnetic fields, either at convulsive or subconvulsive levels, to the brain through the intact skull to modulate neural function. This is a rapidly evolving field, with new research emerging regarding the various roles that these devices can play both in studying the neural mechanisms underlying mood and anxiety disorders, and in treating pharmacoresistant conditions either on their own or in combination with other therapies. Each neuromodulation modality has its pros and cons and should be caref...
Source: Current Behavioral Neuroscience Reports - July 10, 2015 Category: Neuroscience Source Type: research

Latest Developments in Cognitive Functioning in Mood and Anxiety Disorders
Abstract Cognitive impairments are well-documented features of mood and anxiety disorders. Recent developments in research on cognition, assessment techniques, treatments, and comorbidities in cognitive changes across major depression, bipolar disorder, and post-traumatic stress disorder (PTSD) are reviewed. Promising treatments have been reported but are tempered by self-reported cognitive performance and its minimal relationship to objective data. The need for objective assessment as well as assessment of subjective impressions of cognition is discussed. The use of assessment of performance-based measur...
Source: Current Behavioral Neuroscience Reports - July 9, 2015 Category: Neuroscience Source Type: research

Evidence-Based Treatments in Treatment-Naïve and Treatment-Resistant Pediatric Obsessive-Compulsive Disorder
We describe the treatments available and evidence from studies of adult OCD. Evidence for emerging treatments such as modifying CBT and glutamatergic drugs is also described. (Source: Current Behavioral Neuroscience Reports)
Source: Current Behavioral Neuroscience Reports - July 9, 2015 Category: Neuroscience Source Type: research

Neuromodulation Approaches for the Treatment of Post-Traumatic Stress Disorder: Stimulating the Brain Following Exposure-based Therapy
Abstract Exposure-based therapies, medications, or device-based brain stimulation techniques are now current therapies that are offered to individuals suffering from post-traumatic stress disorder. Despite the refinement and evolution of these different interventions, some individuals still remain symptomatic. Neuroscience-based knowledge suggests that fear conditioning and extinction paradigms are a good experimental model to mimic exposure-based therapy. The field has recently put considerable efforts to test various pharmacological compounds that could be used as adjuncts to therapy by increasing the c...
Source: Current Behavioral Neuroscience Reports - April 15, 2015 Category: Neuroscience Source Type: research

Biomarkers for Psychosis: the Molecular Genetics of Psychosis
Abstract Substantial progress has been made in understanding the genetic architecture of psychosis but also in identifying a subset of the contributory risk genes. At a molecular level, there is significant overlap between major psychotic disorders (e.g., schizophrenia, bipolar disorder, schizoaffective disorder) but also moderate levels of covariance with other psychiatric conditions (e.g., depression, autistic spectrum disorders). Despite advances, psychosis remains a clinical, syndromal diagnosis in almost all cases. The challenge is to translate progress in genomics into understanding of biological pr...
Source: Current Behavioral Neuroscience Reports - April 13, 2015 Category: Neuroscience Source Type: research

Examining the Psychosis Continuum
Abstract The notion that psychosis may exist on a continuum with normal experience has been proposed in multiple forms throughout the history of psychiatry. However, in recent years, there has been an exponential increase in efforts aimed at elucidating what has been termed the “psychosis continuum.” The present review seeks to summarize some of the more basic characteristics of this continuum and to present some of the recent findings that provide support for its validity. While there is still considerable work to be done, the emerging data holds considerable promise for advancing our understanding o...
Source: Current Behavioral Neuroscience Reports - March 14, 2015 Category: Neuroscience Source Type: research

Ablative Limbic System Surgery: Review and Future Directions
Abstract The limbic system is a network of interconnected brain regions regulating emotion, memory, and behavior. Pathology of the limbic system can manifest as psychiatric disease, including obsessive-compulsive disorder and major depressive disorder. For patients with these disorders who have not responded to standard pharmacological and cognitive-behavioral therapy, ablative surgery is a neurosurgical treatment option. The major ablative limbic system procedures currently used are anterior capsulotomy, dorsal anterior cingulotomy, subcaudate tractotomy, and limbic leucotomy. In this review, we include ...
Source: Current Behavioral Neuroscience Reports - March 12, 2015 Category: Neuroscience Source Type: research

Clinical Outcome and Mechanisms of Deep Brain Stimulation for Obsessive-Compulsive Disorder
Abstract Clinical outcome of deep brain stimulation (DBS) for obsessive-compulsive disorder (OCD) shows robust effects in terms of a mean Yale-Brown Obsessive-Compulsive Scale (YBOCS) reduction of 47.7 % and a mean response percentage (minimum 35 % YBOCS reduction) of 58.2 %. It appears that most patients regain a normal quality of life (QoL) after DBS. Reviewing the literature of the last 4 years, we argue that the mechanisms of action of DBS are a combination of excitatory and inhibitory as well as local and distal effects. Evidence from DBS animal models converges with human DBS EEG and imaging fin...
Source: Current Behavioral Neuroscience Reports - March 11, 2015 Category: Neuroscience Source Type: research

A Review of Low-Intensity Transcranial Focused Ultrasound for Clinical Applications
Abstract The field of therapeutic focused ultrasound neuromodulation has made great advances in the last few years. While no clinical trials of focused ultrasound neuromodulation are yet underway, several human experiments have recently been conducted. There are many potential uses of this new technology, including treatment of numerous psychiatric and neurologic disorders, as well as a brainmapping tool for discoveries in basic science. In this review, we examine recent research data on the use of focused ultrasound in neuronal tissue, animal models, and humans. We also investigate ideal parameters for n...
Source: Current Behavioral Neuroscience Reports - March 7, 2015 Category: Neuroscience Source Type: research