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  • 1.
    Castelnuovo, Gianluca
    et al.
    San Giuseppe Hosp, Psychol Res Lab, Ist Auxol Italiano IRCCS, Verbania, Italy.;Catholic Univ Milan, Dept Psychol, Milan, Italy..
    Giusti, Emanuele Maria
    San Giuseppe Hosp, Psychol Res Lab, Ist Auxol Italiano IRCCS, Verbania, Italy.;Catholic Univ Milan, Dept Psychol, Milan, Italy..
    Manzoni, Gian Mauro
    San Giuseppe Hosp, Psychol Res Lab, Ist Auxol Italiano IRCCS, Verbania, Italy.;eCampus Univ, Fac Psychol, Novedrate, Italy..
    Saviola, Donatella
    Santo Stefano Rehabil Ist, Cardinal Ferrari Rehabil Ctr, Fontanellato, Italy..
    Gabrielli, Samantha
    San Pio X Clin, Pain Med Ctr, Humanitas, Milan, Italy..
    Lacerenza, Marco
    San Pio X Clin, Pain Med Ctr, Humanitas, Milan, Italy..
    Pietrabissa, Giada
    San Giuseppe Hosp, Psychol Res Lab, Ist Auxol Italiano IRCCS, Verbania, Italy.;Catholic Univ Milan, Dept Psychol, Milan, Italy..
    Cattivelli, Roberto
    San Giuseppe Hosp, Psychol Res Lab, Ist Auxol Italiano IRCCS, Verbania, Italy.;Catholic Univ Milan, Dept Psychol, Milan, Italy..
    Spatola, Chiara Anna Maria
    San Giuseppe Hosp, Psychol Res Lab, Ist Auxol Italiano IRCCS, Verbania, Italy.;Catholic Univ Milan, Dept Psychol, Milan, Italy..
    Rossi, Alessandro
    San Giuseppe Hosp, Psychol Res Lab, Ist Auxol Italiano IRCCS, Verbania, Italy..
    Varallo, Giorgia
    San Giuseppe Hosp, Psychol Res Lab, Ist Auxol Italiano IRCCS, Verbania, Italy..
    Novelli, Margherita
    San Giuseppe Hosp, Psychol Res Lab, Ist Auxol Italiano IRCCS, Verbania, Italy..
    Villa, Valentina
    San Giuseppe Hosp, Psychol Res Lab, Ist Auxol Italiano IRCCS, Verbania, Italy..
    Luzzati, Francesca
    IRCCS Galeazzi Orthoped Inst, Milan, Italy..
    Cottini, Andrea
    IRCCS Galeazzi Orthoped Inst, Milan, Italy..
    Lai, Carlo
    Sapienza Univ Rome, Dept Dynam & Clin Psychol, Rome, Italy..
    Volpato, Eleonora
    Catholic Univ Milan, Dept Psychol, Milan, Italy.;IRCCS Fdn Don Carlo Gnocchi, HD Resp Rehabil Unit, Milan, Italy..
    Cavalera, Cesare
    Catholic Univ Milan, Dept Psychol, Milan, Italy..
    Pagnini, Francesco
    Catholic Univ Milan, Dept Psychol, Milan, Italy.;Harvard Univ, Dept Psychol, 33 Kirkland St, Cambridge, MA 02138 USA..
    Tesio, Valentina
    Univ Turin, Dept Psychol, Turin, Italy..
    Castelli, Lorys
    Univ Turin, Dept Psychol, Turin, Italy..
    Tavola, Mario
    ASST Lecco, Anesthesia & Intens Care, Lecce, Italy..
    Torta, Riccardo
    Univ Turin, Dept Neurosci Rita Levi Montalcini, Turin, Italy..
    Arreghini, Marco
    San Giuseppe Hosp, Rehabil Unit, Ist Auxol Italiano IRCCS, Verbania, Italy..
    Zanini, Loredana
    San Giuseppe Hosp, Rehabil Unit, Ist Auxol Italiano IRCCS, Verbania, Italy..
    Brunani, Amelia
    San Giuseppe Hosp, Rehabil Unit, Ist Auxol Italiano IRCCS, Verbania, Italy..
    Seitanidis, Ionathan
    San Giuseppe Hosp, Rehabil Unit, Ist Auxol Italiano IRCCS, Verbania, Italy..
    Ventura, Giuseppe
    San Giuseppe Hosp, Rehabil Unit, Ist Auxol Italiano IRCCS, Verbania, Italy..
    Capodaglio, Paolo
    San Giuseppe Hosp, Rehabil Unit, Ist Auxol Italiano IRCCS, Verbania, Italy..
    D'Aniello, Guido Edoardo
    San Giuseppe Hosp, Psychol Res Lab, Ist Auxol Italiano IRCCS, Verbania, Italy.;Catholic Univ Milan, Dept Psychol, Milan, Italy..
    Scarpina, Federica
    San Giuseppe Hosp, Psychol Res Lab, Ist Auxol Italiano IRCCS, Verbania, Italy..
    Brioschi, Andrea
    San Giuseppe Hosp, Dept Neurol & Neurorehabil, Ist Auxol Italiano IRCCS, Verbania, Italy..
    Bigoni, Matteo
    San Giuseppe Hosp, Dept Neurol & Neurorehabil, Ist Auxol Italiano IRCCS, Verbania, Italy..
    Priano, Lorenzo
    Univ Turin, Dept Neurosci Rita Levi Montalcini, Turin, Italy.;San Giuseppe Hosp, Dept Neurol & Neurorehabil, Ist Auxol Italiano IRCCS, Verbania, Italy..
    Mauro, Alessandro
    Univ Turin, Dept Neurosci Rita Levi Montalcini, Turin, Italy.;San Giuseppe Hosp, Dept Neurol & Neurorehabil, Ist Auxol Italiano IRCCS, Verbania, Italy..
    Riva, Giuseppe
    San Giuseppe Hosp, Psychol Res Lab, Ist Auxol Italiano IRCCS, Verbania, Italy.;Catholic Univ Milan, Dept Psychol, Milan, Italy..
    Di Lernia, Daniele
    Catholic Univ Milan, Dept Psychol, Milan, Italy..
    Repetto, Claudia
    Catholic Univ Milan, Dept Psychol, Milan, Italy..
    Regalia, Camillo
    Catholic Univ Milan, Dept Psychol, Milan, Italy..
    Molinari, Enrico
    San Giuseppe Hosp, Psychol Res Lab, Ist Auxol Italiano IRCCS, Verbania, Italy.;Catholic Univ Milan, Dept Psychol, Milan, Italy..
    Notaro, Paolo
    AO Osped Niguarda Ca Granda, Anesthesiol Dept, Pain Med, Milan, Italy..
    Paolucci, Stefano
    Fdn Santa Lucia IRCCS, Rome, Italy..
    Sandrini, Giorgio
    C Mondino Natl Neurol Inst, Pavia, Italy.;Univ Pavia, Dept Brain & Behav Sci, Pavia, Italy..
    Simpson, Susan
    Univ South Australia, Adelaide, SA, Australia.;NHS Lothian, Reg Eating Disorders Unit, Livingston, Scotland..
    Wiederhold, Brenda Kay
    Virtual Real Med Inst, Brussels, Belgium..
    Gaudio, Santino
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Functional Pharmacology.
    Jackson, Jeffrey B.
    Virginia Tech, Falls Church, VA USA..
    Tamburin, Stefano
    Univ Verona, Dept Neurosci Biomed & Movement Sci, Verona, Italy..
    Benedetti, Fabrizio
    Univ Turin, Dept Neurosci Rita Levi Montalcini, Turin, Italy..
    What Is the Role of the Placebo Effect for Pain Relief in Neurorehabilitation?: Clinical Implications From the Italian Consensus Conference on Pain in Neurorehabilitation2018In: Frontiers in Neurology, ISSN 1664-2295, E-ISSN 1664-2295, Vol. 9, article id 310Article, review/survey (Refereed)
    Abstract [en]

    Background: It is increasingly acknowledged that the outcomes of medical treatments are influenced by the context of the clinical encounter through the mechanisms of the placebo effect. The phenomenon of placebo analgesia might be exploited to maximize the efficacy of neurorehabilitation treatments. Since its intensity varies across neurological disorders, the Italian Consensus Conference on Pain in Neurorehabilitation (ICCP) summarized the studies on this field to provide guidance on its use.

    Methods: A review of the existing reviews and meta-analyses was performed to assess the magnitude of the placebo effect in disorders that may undergo neurorehabilitation treatment. The search was performed on Pubmed using placebo, pain, and the names of neurological disorders as keywords. Methodological quality was assessed using a pre-existing checklist. Data about the magnitude of the placebo effect were extracted from the included reviews and were commented in a narrative form.

    Results: 11 articles were included in this review. Placebo treatments showed weak effects in central neuropathic pain (pain reduction from 0.44 to 0.66 on a 0-10 scale) and moderate effects in postherpetic neuralgia (1.16), in diabetic peripheral neuropathy (1.45), and in pain associated to HIV (1.82). Moderate effects were also found on pain due to fibromyalgia and migraine; only weak short-term effects were found in complex regional pain syndrome. Confounding variables might have influenced these results.

    Clinical implications: These estimates should be interpreted with caution, but underscore that the placebo effect can be exploited in neurorehabilitation programs. It is not necessary to conceal its use from the patient. Knowledge of placebo mechanisms can be used to shape the doctor-patient relationship, to reduce the use of analgesic drugs and to train the patient to become an active agent of the therapy.

  • 2.
    Dakanalis, Antonios
    et al.
    Univ Milano Bicocca, Dept Med & Surg, Via Cadore 48, I-20900 Monza, Italy.;Univ Pavia, Dept Brain & Behav Sci, Pavia, Italy..
    Gaudio, Santino
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Functional Pharmacology.
    Riva, Giuseppe
    IRCSS Ist Auxol Italiano, Appl Technol Neuropsychol Lab, Milan, Italy.;Catholic Univ Milan, Dept Psychol, Milan, Italy..
    Clerici, Massimo
    Univ Milano Bicocca, Dept Med & Surg, Via Cadore 48, I-20900 Monza, Italy..
    Severity of bulimia nervosa and its impact on treatment outcome2017In: Eating and Weight Disorders, ISSN 1124-4909, E-ISSN 1590-1262, Vol. 22, no 4, p. 727-729Article in journal (Other academic)
  • 3.
    Dakanalis, Antonios
    et al.
    Univ Milano Bicocca, Dept Med & Surg, Via Cadore 48, I-20900 Monza, Italy.;Univ Pavia, Dept Brain & Behav Sci, Pavia, Italy..
    Riva, Giuseppe
    IRCSS Ist Auxol Italiano, Appl Technol Neuropsychol Lab, Milan, Italy.;Catholic Univ Milan, Dept Psychol, Milan, Italy..
    Gaudio, Santino
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Functional Pharmacology.
    Clerici, Massimo
    Univ Milano Bicocca, Dept Med & Surg, Via Cadore 48, I-20900 Monza, Italy..
    Cognitive-behavioral or psychodynamic therapy for people with bulimia nervosa2017In: Eating and Weight Disorders, ISSN 1124-4909, E-ISSN 1590-1262, Vol. 22, no 3, p. 555-556Article in journal (Other academic)
  • 4.
    Gaudio, Santino
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Schiöth: Functional Pharmacology. Univ Campus Biomed Roma, Area Diagnost Imaging, Ctr Integrated Res, Rome, Italy.
    Carducci, Filippo
    Sapienza Univ, Neuroimaging Lab, Dept Physiol & Pharmacol, Rome, Italy.
    Piervincenzi, Claudia
    Sapienza Univ, Neuroimaging Lab, Dept Physiol & Pharmacol, Rome, Italy.
    Olivo, Gaia
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Schiöth: Functional Pharmacology.
    Schiöth, Helgi B.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Schiöth: Functional Pharmacology. Sechenov First Moscow State Med Univ, Inst Translat Med & Biotechnol, Moscow, Russia.
    Altered thalamo-cortical and occipital-parietal-temporal-frontal white matter connections in patients with anorexia and bulimia nervosa: a systematic review of diffusion tensor imaging studies2019In: Journal of Psychiatry & Neuroscience, ISSN 1180-4882, E-ISSN 1488-2434, Vol. 44, no 5, p. 324-339Article, review/survey (Refereed)
    Abstract [en]

    Background: Anorexia nervosa and bulimia nervosa are complex mental disorders, and their etiology is still not fully understood. This paper reviews the literature on diffusion tensor imaging studies in patients with anorexia nervosa and bulimia nervosa to explore the usefulness of white matter microstructural analysis in understanding the pathophysiology of eating disorders.

    Methods: We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines to identify diffusion tensor imaging studies that compared patients with an eating disorder to control groups. We searched relevant databases for studies published from database inception to August 2018, using combinations of select keywords. We categorized white matter tracts according to their 3 main classes: projection (i.e., thalamo-cortical), association (i.e., occipital-parietal-temporal-frontal) and commissural (e.g., corpus callosum).

    Results: We included 19 papers that investigated a total of 427 participants with current or previous eating disorders and 444 controls. Overall, the studies used different diffusion tensor imaging approaches and showed widespread white matter abnormalities in patients with eating disorders. Despite differences among the studies, patients with anorexia nervosa showed mainly white matter microstructural abnormalities of thalamo-cortical tracts (i.e., corona radiata, thalamic radiations) and occipital-parietal-temporal-frontal tracts (i.e., left superior longitudinal and inferior fronto-occipital fasciculi). It was less clear whether white matter alterations persist after recovery from anorexia nervosa. Available data on bulimia nervosa were partially similar to those for anorexia nervosa.

    Limitations: Study sample composition and diffusion tensor imaging analysis techniques were heterogeneous. The number of studies on bulimia nervosa was too limited to be conclusive.

    Conclusion: White matter microstructure appears to be affected in anorexia nervosa, and these alterations may play a role in the pathophysiology of this eating disorder. Although we found white matter alterations in bulimia nervosa that were similar to those in anorexia nervosa, white matter changes in bulimia nervosa remain poorly investigated, and these findings were less conclusive. Further studies with longitudinal designs and multi-approach analyses are needed to better understand the role of white matter changes in eating disorders.

  • 5.
    Gaudio, Santino
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Functional Pharmacology.
    Dakanalis, Antonios
    Univ Milano Bicocca, Dept Med & Surg, Monza, Italy..
    Personality and eating and weight disorders: an open research challenge2018In: Eating and Weight Disorders, ISSN 1124-4909, E-ISSN 1590-1262, Vol. 23, no 2, p. 143-147Article in journal (Other academic)
  • 6.
    Gaudio, Santino
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Functional Pharmacology.
    Dakanalis, Antonios
    Univ Milano Bicocca, Dept Med & Surg, Monza, Italy..
    What about the assessment of personality disturbance in adolescents with eating disorders?2017In: Eating and Weight Disorders, ISSN 1124-4909, E-ISSN 1590-1262, Vol. 22, no 3, p. 551-552Article in journal (Other academic)
  • 7.
    Gaudio, Santino
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Functional Pharmacology. Eating Disorders Ctr La Cura Girasole ONLUS, Via Gregorio 7,186-B, I-00165 Rome, Italy;Univ Campus Biomed Roma, Departmental Fac Med & Surg, Area Diagnost Imaging, Via Alvaro del Portillo 200, I-00133 Rome, Italy.
    Olivo, Gaia
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Functional Pharmacology.
    Zobel, Bruno Beomonte
    Univ Campus Biomed Roma, Departmental Fac Med & Surg, Area Diagnost Imaging, Via Alvaro del Portillo 200, I-00133 Rome, Italy.
    Schiöth, Helgi B.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Functional Pharmacology.
    Altered cerebellar-insular-parietal-cingular subnetwork in adolescents in the earliest stages of anorexia nervosa: a network-based statistic analysis2018In: Translational Psychiatry, ISSN 2158-3188, E-ISSN 2158-3188, Vol. 8, article id 127Article in journal (Refereed)
    Abstract [en]

    To date, few functional magnetic resonance imaging (fMRI) studies have explored resting-state functional connectivity (RSFC) in long-lasting anorexia nervosa (AN) patients via graph analysis. The aim of the present study is to investigate, via a graph approach (i.e., the network-based statistic), RSFC in a sample of adolescents at the earliest stages of AN (i.e., AN duration less than 6 months). Resting-state fMRI data was obtained from 15 treatment-naive female adolescents with AN restrictive type (AN-r) in its earliest stages and 15 age-matched healthy female controls. A network-based statistic analysis was used to isolate networks of interconnected nodes that differ between the two groups. Group comparison showed a decreased connectivity in a sub-network of connections encompassing the left and right rostral ACC, left paracentral lobule, left cerebellum (10th sub-division), left posterior insula, left medial fronto-orbital gyrus, and right superior occipital gyrus in AN patients. Results were not associated to alterations in intranodal or global connectivity. No sub-networks with an increased connectivity were identified in AN patients. Our findings suggest that RSFC may be specifically affected at the earliest stages of AN. Considering that the altered sub-network comprises areas mainly involved in somatosensory and interoceptive information and processing and in emotional processes, it could sustain abnormal integration of somatosensory and homeostatic signals, which may explain body image disturbances in AN. Further studies with larger samples and longitudinal designs are needed to confirm our findings and better understand the role and consequences of such functional alterations in AN.

  • 8.
    Gaudio, Santino
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Functional Pharmacology. Univ Campus Biomed Roma, Dept Fac Med & Surg, Rome, Italy.;Eating Disorders Ctr La Cura Girasole ONLUS, Rome, Italy..
    Quattrocchi, Carlo Cosimo
    Univ Campus Biomed Roma, Dept Fac Med & Surg, Rome, Italy..
    Piervincenzi, Claudia
    Sapienza Univ, Dept Physiol & Pharmacol, Neuroimaging Lab, Rome, Italy..
    Zobel, Bruno Beomonte
    Univ Campus Biomed Roma, Dept Fac Med & Surg, Rome, Italy..
    Montecchi, Francesca Romana
    Eating Disorders Ctr La Cura Girasole ONLUS, Rome, Italy..
    Dakanalis, Antonios
    Univ Pavia, Dept Brain & Behav Sci, Pza Botta 11, I-27100 Pavia, Italy.;Univ Milano Bicocca, Dept Med & Surg, Milan, Italy..
    Riva, Giuseppe
    Ist Auxol Italian, Appl Technol Neuropsychol Lab, Milan, Italy.;Univ Cattolica Sacro Cuore, Dept Psychol, Milan, Italy..
    Carducci, Filippo
    Sapienza Univ, Dept Physiol & Pharmacol, Neuroimaging Lab, Rome, Italy..
    White matter abnormalities in treatment-naive adolescents at the earliest stages of Anorexia Nervosa: A diffusion tensor imaging study2017In: Psychiatry Research: Neuroimaging, ISSN 0925-4927, E-ISSN 1872-7506, Vol. 266, p. 138-145Article in journal (Refereed)
    Abstract [en]

    Few studies have examined white matter (WM) integrity in long-lasting Anorexia Nervosa (AN) patients using Diffusion Tensor Imaging (DTI). In this paper, we investigated WM integrity at the earliest stages of AN (i.e. less than 6 months duration). Fourteen treatment-naive female adolescents with AN restrictive type (AN-r) in its earliest stages and 15 age-matched healthy females received brain MRI. Fractional Anisotropy (FA), Axial Diffusivity (AD), Radial diffusivity (RD), and Mean Diffusivity (MD) maps were computed from DTI data using Tract-Based Spatial Statistics analysis. AN-r patients showed FA decreases compared to controls (p(FwE) < 0.05) mainly in left anterior and superior corona radiata and left superior longitudinal fasciculus. AN-r patients also showed decreased AD in superior longitudinal fasciculus bilaterally and left superior and anterior corona radiata, (p(FwE) < 0.05). No significant differences were found in RD and MD values between the two groups. FA and AD integrity appears to be specifically affected at the earliest stages of AN. Alterations in the microstructural properties of the above mentioned tracts, also involved in cognitive control and visual perception and processing, may be early mechanisms of vulnerability/resilience of WM in AN and sustain the key symptoms of AN, such as impaired cognitive flexibility and body image distortion.

  • 9.
    Gaudio, Santino
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Functional Pharmacology. Univ Campus Biomed Roma, Ctr Integrated Res, Area Diagnost Imaging, Via Alvaro Portillo 200, I-00133 Rome, Italy..
    Wiemerslage, Lyle
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Functional Pharmacology.
    Brooks, Samantha J.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Functional Pharmacology. Univ Cape Town, Dept Psychiat & Mental Hlth, Old Groote Schuur Hosp, Psychiat Neuroimaging Grp, Anzio Rd, ZA-7925 Cape Town, South Africa..
    Schiöth, Helgi B.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Functional Pharmacology.
    A systematic review of resting-state functional-MRI studies in anorexia nervosa: Evidence for functional connectivity impairment in cognitive control and visuospatial and body-signal integration2016In: Neuroscience and Biobehavioral Reviews, ISSN 0149-7634, E-ISSN 1873-7528, Vol. 71, p. 578-589Article, review/survey (Refereed)
    Abstract [en]

    This paper systematically reviews the literature pertaining to the use of resting-state functional magnetic resonance imaging (rsfMRI) in anorexia nervosa (AN), classifying studies on the basis of different analysis approaches. We followed PRISMA guidelines. Fifteen papers were included, investigating a total of 294 participants with current or past AN and 285 controls. The studies used seed-based, whole-brain independent component analysis (ICA), network-of-interest ICA based and graph analysis approaches. The studies showed relatively consistent overlap in results, yet little overlap in their analytical approach and/or a-priori assumptions. Functional connectivity alterations were mainly found in the corticolimbic circuitry, involved in cognitive control and visual and homeostatic integration. Some overlapping findings were found in brain areas putatively important in AN, such as the insula. These results suggest altered functional connectivity in networks/areas linked to the main symptom domains of AN, such as impaired cognitive control and body image disturbances. These preliminary evidences suggest that more targeted treatments need to be developed that focus on these two symptom domains. Further studies with multi-approach analyses and longitudinal designs are needed to better understand the complexity of AN.

  • 10.
    Olivo, Gaia
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Schiöth: Functional Pharmacology. Uppsala Univ, Dept Neurosci Funct Pharmacol, S-75124 Uppsala, Sweden.
    Gaudio, Santino
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Schiöth: Functional Pharmacology. Univ Campus Biomed Roma, CIR, Area Diagnost Imaging, I-00128 Rome, Italy.
    Schiöth, Helgi B.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Schiöth: Functional Pharmacology. Sechenov First Moscow State Med Univ, Inst Translat Med & Biotechnol, Moscow 119146, Russia.
    Brain and Cognitive Development in Adolescents with Anorexia Nervosa: A Systematic Review of fMRI Studies2019In: Nutrients, ISSN 2072-6643, E-ISSN 2072-6643, Vol. 11, no 8, article id 1907Article, review/survey (Refereed)
    Abstract [en]

    Anorexia nervosa (AN) is an eating disorder often occurring in adolescence. AN has one of the highest mortality rates amongst psychiatric illnesses and is associated with medical complications and high risk for psychiatric comorbidities, persisting after treatment. Remission rates range from 23% to 33%. Moreover, weight recovery does not necessarily reflect cognitive recovery. This issue is of particular interest in adolescence, characterized by progressive changes in brain structure and functional circuitries, and fast cognitive development. We reviewed existing literature on fMRI studies in adolescents diagnosed with AN, following PRISMA guidelines. Eligible studies had to: (1) be written in English; (2) include only adolescent participants; and (3) use block-design fMRI. We propose a pathogenic model based on normal and AN-related neural and cognitive maturation during adolescence. We propose that underweight and delayed puberty-caused by genetic, environmental, and neurobehavioral factors-can affect brain and cognitive development and lead to impaired cognitive flexibility, which in turn sustains the perpetuation of aberrant behaviors in a vicious cycle. Moreover, greater punishment sensitivity causes a shift toward punishment-based learning, leading to greater anxiety and ultimately to excessive reappraisal over emotions. Treatments combining physiological and neurobehavioral rationales must be adopted to improve outcomes and prevent relapses.

  • 11.
    Olivo, Gaia
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Functional Pharmacology.
    Solstrand Dahlberg, Linda
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Functional Pharmacology.
    Wiemerslage, Lyle
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Functional Pharmacology.
    Swenne, Ingemar
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Research group (Dept. of women´s and children´s health), Pediatric Endocrinology.
    Zhukovsky, Christina
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Functional Pharmacology.
    Salonen-Ros, Helena
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Child and Adolescent Psychiatry.
    Larsson, Elna-Marie
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Radiology.
    Gaudio, Santino
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Functional Pharmacology. Univ Campus BioMed Roma, Ctr Integrated Res CIR, Area Diagnost Imaging, Rome, Italy.
    Brooks, Samantha J
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Functional Pharmacology.
    Schiöth, Helgi B.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Functional Pharmacology.
    Atypical anorexia nervosa is not related to brain structural changes in newly diagnosed adolescent patients.2018In: International Journal of Eating Disorders, ISSN 0276-3478, E-ISSN 1098-108X, Vol. 51, no 1, p. 39-45Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: Patients with atypical anorexia nervosa (AN) have many features overlapping with AN in terms of genetic risk, age of onset, psychopathology and prognosis of outcome, although the weight loss may not be a core factor. While brain structural alterations have been reported in AN, there are currently no data regarding atypical AN patients.

    METHOD: We investigated brain structure through a voxel-based morphometry analysis in 22 adolescent females newly-diagnosed with atypical AN, and 38 age- and sex-matched healthy controls (HC). ED-related psychopathology, impulsiveness and obsessive-compulsive traits were assessed with the Eating Disorder Examination Questionnaire (EDE-Q), Barratt Impulsiveness Scale (BIS-11) and Obsessive-compulsive Inventory Revised (OCI-R), respectively. Body mass index (BMI) was also calculated.

    RESULTS: Patients and HC differed significantly on BMI (p < .002), EDE-Q total score (p < .000) and OCI-R total score (p < .000). No differences could be detected in grey matter (GM) regional volume between groups.

    DISCUSSION: The ED-related cognitions in atypical AN patients would suggest that atypical AN and AN could be part of the same spectrum of restrictive-ED. However, contrary to previous reports in AN, our atypical AN patients did not show any GM volume reduction. The different degree of weight loss might play a role in determining such discrepancy. Alternatively, the preservation of GM volume might indeed differentiate atypical AN from AN.

  • 12.
    Olivo, Gaia
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Functional Pharmacology.
    Swenne, Ingemar
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Research group (Dept. of women´s and children´s health), Pediatric Endocrinology.
    Zhukovsky, Christina
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Functional Pharmacology.
    Tuunainen, Anna-Kaisa
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Functional Pharmacology.
    Salonen-Ros, Helena
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Child and Adolescent Psychiatry.
    Larsson, Elna-Marie
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Radiology.
    Gaudio, Santino
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Functional Pharmacology. Univ Campus Biomed Roma, Ctr Integrated Res, Area Diagnost Imaging, Rome, Italy.
    Brooks, Samantha J.
    Univ Cape Town, Dept Human Biol, Cape Town, South Africa.
    Schiöth, Helgi B.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Functional Pharmacology.
    Reduced resting-state connectivity in areas involved in processing of face-related social cues in female adolescents with atypical anorexia nervosa2018In: Translational Psychiatry, ISSN 2158-3188, E-ISSN 2158-3188, Vol. 8, article id 275Article in journal (Refereed)
    Abstract [en]

    Atypical anorexia nervosa (AN) has a high incidence in adolescents and can result in significant morbidity and mortality. Neuroimaging could improve our knowledge regarding the pathogenesis of eating disorders (EDs), however research on adolescents with EDs is limited. To date no neuroimaging studies have been conducted to investigate brain functional connectivity in atypical AN. We investigated resting-state functional connectivity using 3 T MRI in 22 drug-naive adolescent patients with atypical AN, and 24 healthy controls. Psychological traits related to the ED and depressive symptoms have been assessed using the Eating Disorders Examination Questionnaire (EDE-Q) and the Montgomery-Asberg Depression Rating Scale self-reported (MADRS-S) respectively. Reduced connectivity was found in patients in brain areas involved in face-processing and social cognition, such as the left putamen, the left occipital fusiform gyrus, and specific cerebellar lobules. The connectivity was, on the other hand, increased in patients compared with controls from the right inferior temporal gyrus to the superior parietal lobule and superior lateral occipital cortex. These areas are involved in multimodal stimuli integration, social rejection and anxiety. Patients scored higher on the EDE-Q and MADRS-S questionnaires, and the MADRS-S correlated with connectivity from the right inferior temporal gyrus to the superior parietal lobule in patients. Our findings point toward a role for an altered development of socio-emotional skills in the pathogenesis of atypical AN. Nonetheless, longitudinal studies will be needed to assess whether these connectivity alterations might be a neural marker of the pathology.

  • 13.
    Olivo, Gaia
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Functional Pharmacology.
    Wiemerslage, Lyle
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Functional Pharmacology.
    Swenne, Ingemar
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health.
    Zhukowsky, Christina
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Functional Pharmacology.
    Salonen-Ros, Helena
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Child and Adolescent Psychiatry.
    Larsson, Elna-Marie
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Radiology.
    Gaudio, Santino
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Functional Pharmacology. Univ Campus Biomed Roma, Area Diagnost Imaging, CIR, Rome, Italy.
    Brooks, Samantha J
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Functional Pharmacology. Univ Cape Town, Deptartment Psychiat & Mental Hlth, Cape Town, South Africa.
    Schiöth, Helgi B.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Functional Pharmacology.
    Limbic-thalamo-cortical projections and reward-related circuitry integrity affects eating behavior: A longitudinal DTI study in adolescents with restrictive eating disorders2017In: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203, Vol. 12, no 3, article id e0172129Article in journal (Refereed)
    Abstract [en]

    Few studies have used diffusion tensor imaging (DTI) to investigate the micro-structural alterations of WM in patients with restrictive eating disorders (rED), and longitudinal data are lacking. Twelve patients with rED were scanned at diagnosis and after one year of family-based treatment, and compared to twenty-four healthy controls (HCs) through DTI analysis. A tract-based spatial statistics procedure was used to investigate diffusivity parameters: fractional anisotropy (FA) and mean, radial and axial diffusivities (MD, RD and AD, respectively). Reduced FA and increased RD were found in patients at baseline in the corpus callosum, corona radiata and posterior thalamic radiation compared with controls. However, no differences were found between follow-up patients and controls, suggesting a partial normalization of the diffusivity parameters. In patients, trends for a negative correlation were found between the baseline FA of the right anterior corona radiata and the Eating Disorder Examination Questionnaire total score, while a positive trend was found between the baseline FA in the splenium of corpus callosum and the weight loss occurred between maximal documented weight and time of admission. A positive trend for correlation was also found between baseline FA in the right anterior corona radiata and the decrease in the Obsessive-Compulsive Inventory Revised total score over time. Our results suggest that the integrity of the limbic-thalamo-cortical projections and the reward-related circuitry are important for cognitive control processes and reward responsiveness in regulating eating behavior.

  • 14.
    Paniccia, Maria Francesca
    et al.
    Bambino Gesu Pediat Hosp, Div Clin Psychol, Dept Neurosci & Neurorehabil, Via Tullio Levi Civita 5, I-00146 Rome, Italy.
    Gaudio, Santino
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Functional Pharmacology.
    Puddu, Alessia
    Bambino Gesu Pediat Hosp, Div Clin Psychol, Dept Neurosci & Neurorehabil, Via Tullio Levi Civita 5, I-00146 Rome, Italy.
    Di Trani, Michela
    Sapienza Univ Rome, Dept Dynam & Clin Psychol, Rome, Italy.
    Dakanalis, Antonios
    Univ Pavia, Dept Brain & Behav Sci, Pavia, Italy.
    Gentile, Simonetta
    Bambino Gesu Pediat Hosp, Div Clin Psychol, Dept Neurosci & Neurorehabil, Via Tullio Levi Civita 5, I-00146 Rome, Italy.
    Di Ciommo, Vincenzo
    Bambino Gesu Pediat Hosp, Epidemiol Unit, Rome, Italy.
    Alexithymia in parents and adolescents with generalised anxiety disorder2018In: Clinical Psychologist, ISSN 1328-4207, E-ISSN 1742-9552, Vol. 22, no 3, p. 336-343Article in journal (Refereed)
    Abstract [en]

    Background: The relationship between generalised anxiety disorder (GAD) and alexithymia has been poorly studied in adolescents. The present study examined the alexithymia levels in adolescents with GAD and their parents compared with healthy control participants (adolescents and their parents).

    Method: The sample included 300 participants: 50 adolescents with GAD and 50 healthy adolescents, 13-18 years of age, and their 200 parents (100 mothers and 100 fathers). The Schedule for Affective Disorders and Schizophrenia for School-Age Children was performed to evaluate adolescents' mental health while the 20-item Toronto Alexithymia Scale was performed to assess alexithymia levels in both adolescents and their parents.

    Results: Adolescents with GAD showed a significantly higher rate of alexithymia when compared with control adolescents. The mothers of adolescents with GAD showed an alexithymia score higher than did the controls' mothers. The fathers of the two groups showed no differences of in their rate of alexithymia. Moreover, in the clinical sample, adolescent and maternal alexithymia scores were not correlated, while significant directed correlations were found between these adolescents and their own fathers.

    Conclusions: Our findings show an association between GAD and alexithymia in adolescents. A significant presence of alexithymic traits in the mothers of the patients with GAD was shown. An intergenerational transmission of alexithymia could be supposed but this cannot be a linear mechanism. The assessment of alexithymia in adolescents with psychological disorders, and in their parents, could be useful to plan a more targeted therapeutic approach.

  • 15.
    Riva, Giuseppe
    et al.
    Univ Cattolica Sacro Cuore, Ctr Studi & Ric Psicol Comunicaz, Milan, Italy; Ist Auxol Italiano, Appl Technol Neuropsychol Lab, Milan, Italy.
    Gaudio, Santino
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Functional Pharmacology. Univ Campus Biomed Roma, Area Diagnost Imaging, CIR, Rome, Italy.
    Locked to a wrong body: Eating disorders as the outcome of a primary disturbance in multisensory body integration2018In: Consciousness and Cognition, ISSN 1053-8100, E-ISSN 1090-2376, Vol. 59, p. 57-59Article in journal (Refereed)
    Abstract [en]

    In his recent paper "Distorted body representations in anorexia nervosa" Gadsby (2017) discussed empirical evidence regarding anorexic patients' distorted body representations. In particular, he interpreted them using the O'Shaughnessy's long-term body image (LTB) hypothesis (O'Shaughnessy, 1998): individuals with anorexia nervosa (AN) have a distorted LTB that tracks changes in the spatial content of the body and supplies this distorted content to other body representations. Even if we agree on the involvement of body memory in the distorted body representation, an open issue not fully addressed in the paper is: why AN patients do not update their LTBs to reflect their true dimensions? Our correspondence tries to answer to this question using a new neuropsychological and neurobiological theory: the Allocentric Lock Theory - ALT.

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