More anxious than depressed:prevalence and correlates in a 15-nation study of anxiety disorders in people with type 2 diabetes mellitus

Background Anxiety disorder, one of the highly disabling, prevalent and common mental disorders, is known to be more prevalent in persons with type 2 diabetes mellitus (T2DM) than the general population, and the comorbid presence of anxiety disorders is known to have an impact on the diabetes outcome and the quality of life. However, the information on the type of anxiety disorder and its prevalence in persons with T2DM is limited. Aims To assess the prevalence and correlates of anxiety disorder in people with type 2 diabetes in different countries. Methods People aged 18-65 years with diabetes and treated in outpatient settings were recruited in 15 countries and underwent a psychiatric interview with the Mini-International Neuropsychiatric Interview. Demographic and medical record data were collected. Results A total of 3170 people with type 2 diabetes (56.2% women;with mean (SD) duration of diabetes 10.01 (7.0) years) participated. The overall prevalence of anxiety disorders in type 2 diabetic persons was 18%;however, 2.8% of the study population had more than one type of anxiety disorder. The most prevalent anxiety disorders were generalised anxiety disorder (8.1%) and panic disorder (5.1%). Female gender, presence of diabetic complications, longer duration of diabetes and poorer glycaemic control (HbA1c levels) were significantly associated with comorbid anxiety disorder. A higher prevalence of anxiety disorders was observed in Ukraine, Saudi Arabia and Argentina with a lower prevalence in Bangladesh and India. Conclusions Our international study shows that people with type 2 diabetes have a high prevalence of anxiety disorders, especially women, those with diabetic complications, those with a longer duration of diabetes and poorer glycaemic control. Early identification and appropriate timely care of psychiatric problems of people with type 2 diabetes is warranted.

The Contribution of EEG to the Diagnosis of Dementia

Changes induced by cerebrovascular damage (CVD) and amigdalo-hippocampal atrophy (AHC) on brain rhythmicity as?revealed?by scalp electroencephalography (EEG) were evaluated in a cohort of subjects with mild cognitive impairment (MCI) in order to detect different EEG patterns due to the vascular or degenerative impairment. All subjects underwent EEG recording and magnetic resonance imaging (MRI). EEGs were recorded at rest. Relative power was separately computed for delta, theta, alpha1, alpha2, and alpha 3 frequency bands. Increased delta power and decreased alpha2 power were associated with the load of cerebrovascular damage (CVD). Moreover, the theta/alpha 1 ratio could be a reliable index for the estimation of the individual extent of CV damage. No association of vascular damage was observed with alpha3 power. On the other side, moderate hippocampal atrophy was related to an increase of alpha2 and alpha3 frequency power ratio. Our results show that different EEG markers are associated to vascular dementia and Alzheimer’s disease (AD). EEG markers could be expression of different global network pathological changes, helping in differentiation of prodromal AD from vascular demented patients. MCI stated that EEG markers could have a prospective value in differential diagnosis between vascular and degenerative MCI.

Translational aspects of themodern genetics in head and neck cancers

Oral cancer(OC)is one of the most recurrent cancers in the head and neck squamous cancer(SCCHN)category.Recently,the genome-wide association studies(GWAS)have gained growing interest in the scientific community.GWAS have identified several pathways involved in the interactions among general risk factors and genomic variants affecting SCCHN.This systematic overview aims to critically evaluate the latest data reported within the scientific literature.The aim was to investigate the impact of genetic aspects on SCCHN onset and prognosis,involving other clinical and systemic co-factors.PubMed,Google Scholar,and Cancer Genetics Web databases have been systematically investigated for original articles published in the last two years,reporting studies on the main queries addressed in this work.This review also comparatively describes the impact of environmental and pathological co-factors in different types of cancers,clarifying and updating the role of genetic factors in SCCHN onset and development.The main outcomes reported may be helpful to drive clinicians towards their clinical evaluations for the most appropriate therapeutic approach in SCCHN.

Transcranial direct current stimulation enhances theory of mind in Parkinson’s disease patients with mild cognitive impairment:a randomized,double-blind,sham-controlled study

Background:Parkinson’s Disease(PD)with mild cognitive impairment(MCI)(PD-MCI)represents one of the most dreaded complications for patients with PD and is associated with a higher risk of developing dementia.Although transcranial direct current stimulation(tDCS)has been demonstrated to improve motor and non-motor symptoms in PD,to date,no study has investigated the effects of tDCS on Theory of Mind(ToM),i.e.,the ability to understand and predict other people’s behaviours,in PD-MCI.Methods:In this randomized,double-blind,sham-controlled study,we applied active tDCS over the medial frontal cortex(MFC)to modulate ToM performance in twenty patients with PD-MCI.Twenty matched healthy controls(HC)were also enrolled and were asked to perform the ToM task without receiving tDCS.Results:In the patients with PD-MCI,i)ToM performance was worse than that in the HC,ii)ToM abilities were poorer in those with fronto-executive difficulties,and iii)tDCS over the MFC led to significant shortening of latency for ToM tasks.Conclusions:We show for the first time that active tDCS over the MFC enhances ToM in patients with PD-MCI,and suggest that non-invasive brain stimulation could be used to ameliorate ToM deficits observed in these patients.

Language training for oral and written naming impairment in primary progressive aphasia:a review

Background Primary progressive aphasia(PPA)is a neurodegenerative disorder characterized by a gradual,insidious and progressive loss of language abilities,with naming difficulties being an early and persistent impairment common to all three variants.In the absence of effective pharmacological treatments and given the progressive nature of the disorder,in the past few decades,many studies have investigated the effectiveness of language training to minimize the functional impact of word-finding difficulties in daily life.Main body We review language treatments most commonly used in clinical practice among patients with different variants of PPA,with a focus on the enhancement of spoken and written naming abilities.Generalization of gains to the ability to name untrained stimuli or to other language abilities and the maintenance of these results over time are also discussed.Forty-eight studies were included in this literature review,identifying four main types of language treatment:a)lexical retrieval treatment,b)phonological and/or orthographic treatment,c)semantic treatment,and d)a multimodality approach treatment.Overall,language training is able to induce immediate improvements of naming abilities in all variants of PPA.Moreover,despite the large variability among results,generalization and long-term effects can be recorded after the training.The reviewed studies also suggest that one factor that determines the choice of a particular approach is the compromised components of the lexical/semantic processing system.Conclusion The majority of studies have demonstrated improvements of naming abilities following language treatments.Given the progressive nature of PPA,it is essential to apply language treatment in the early stages of the disease.