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  • Neural Mechanisms of Exercise: Anti-Depression, Neurogenesis, and Serotonin Signaling
    Publication . Yuan, Ti-Fei; Paes, Flávia; Arias-Carrión, Oscar; Rocha, Nuno; de Sá Filho, Alberto Souza; Machado, Sergio
    Depression is associated with decreased serotonin metabolism and functioning in the central nervous system, evidenced by both animal models of depression and clinical patient studies. Depression is also accompanied by decreased hippocampal neurogenesis in diverse animal models. Neurogenesis is mainly defined in dentate gyrus of hippocampus as well as subventricular zone. Moreover, hypothalamus, amygdala, olfactory tubercle, and piriform cortex are reported with evidences of adult neurogenesis. Physical exercise is found to modulate adult neurogenesis significantly, and results in mood improvement. The cellular mechanism such as adult neurogenesis upregulation was considered as one major mood regulator following exercise. The recent advances in molecular mechanisms underlying exercise-regulated neurogenesis have widen our understanding in brain plasticity in physiological and pathological conditions, and therefore better management of different psychiatric disorders.
  • Aerobic exercise reduces anxiety symptoms and improves fitness in patients with panic disorder
    Publication . Lamego, Murilo Khede; Lattari, Eduardo; Sá Filho, Alberto Souza de; Paes, Flávia; Mascarenhas Jr., Jarbas; Maranhão Neto, Geraldo; Oliveira, Aldair José de; Campos, Carlos; Rocha, Nuno; Nardi, Antonio E.; Machado, Sergio
    To investigate the effects of a regularly repeated aerobic exercise series on anxiety and maximum oxygen consumption (VO2max) in Panic Disorder patients. METHODS: Ten previously sedentary female subjects diagnosed with Panic Disorder performed 36 sessions of aerobic exercise (at 70 to 75% of VO2max), 3 times per week during 12 weeks. A cardiopulmonary evaluation (ergospirometry test) was used to set the intensity of training as well as to establish baseline and post-training VO2max parameters. The assessment of anxiety symptoms was performed at baseline, at the end of the 6th and 12th weeks, using the Trait Anxiety Inventory (STAI-T) and State Anxiety Inventory (STAI-S), and the Subjective Units of Distress Scale (SUDS) questionnaires. One-way ANOVA for repeated measurements (at 3 moments: Baseline, 6th week (mid-training) and 12th week (post-training) was used to compare the evolution of the questionnaires; the Bonferroni post hoc test was applied to identify differences between moments. A dependent t-test was performed for measures of VO2max. RESULTS: Compared to baseline, (a) STAI-T showed significant anxiety reductions at mid- and post-training moments; (b) STAI-S and SUDS recorded anxiety reductions only at Post-training; (c) VO2max showed a significant improvement at Post-training. CONCLUSION: This protocol promoted beneficial effects on cardiorespiratory fitness and anxiety levels of Panic Disorder patients.
  • Potential therapeutic effects of physical exercise for bipolar disorder
    Publication . Sá Filho, Alberto Souza de; Souza Moura, Antonio Marcos de; Lamego, Murilo Khede; Rocha, Nuno; Paes, Flavia; Oliveira, Ana Cristina; Lattari, Eduardo; Rimes, Ridson; Manochio, Joao; Budde, Henning; Wegner, Mirko; Mura, Gioia; Arias-Carrión, Oscar; Cheniaux, Elie; Yuan, Ti-Fei; Nardi, Antonio Egidio; Machado, Sergio
    Cognitive deficits are observed in a variety of domains in patients with bipolar disorder (BD). These deficits are attributed to neurobiological, functional and structural brain factors, particularly in prefrontal cortex. Furthermore, cortical alterations in each phase (mania/hypomania, euthymia and depression) are also present. A growing basis of evidence supports aerobic exercise as an alternative treatment method for BD symptoms. Its benefits for physical health in healthy subjects and some psychiatric disorders are fairly established; however evidence directly addressed to BD is scant. Lack of methodological consistency, mainly related to exercise, makes it difficult accuracy and extrapolation of the results. Nevertheless, mechanisms related to BD physiopathology, such as hormonal and neurotransmitters alterations and mainly related to brain-derived neurotrophic factors (BDNF) can be explored. BDNF, specially, have a large influence on brain ability and its gene expression is highly responsive to aerobic exercise. Moreover, aerobic exercise trough BDNF may induce chronic stress suppression, commonly observed in patients with BD, and reduce deleterious effects caused by allostatic loads. Therefore, it is prudent to propose that aerobic exercise plays an important role in BD physiopathological mechanisms and it is a new way for the treatment for this and others psychiatric disorders.
  • Comparative Study of Subcortical Atrophy in Patients with Frontotemporal Dementia and Dementia with Extrapyramidal Signs
    Publication . Caixeta, Leonardo; Vieira, Renata Teles; Paes, Flávia; Carta, Mauro Giovanni; Nardi, Antonio Egidio; Arias-Carrión, Oscar; Rocha, Nuno; Budde, Henning; Machado, Sergio
    To investigate the severity of subcortical atrophy in frontotemporal dementia (FTD) without extrapyramidal symptoms (EPS) and dementia with EPS. In addition, we aim to verify if there is correlation between demographic and clinical characteristics and subcortical atrophy in the groups. Methodology : The sample was composed of 21 patients with dementia and EPS as well as 19 patients with FTD without EPS. A linear assessment was conducted in order to identify the degree of subcortical atrophy (i.e., bifrontal index - BFI) using MRI. Moreover, the Mini-Mental State Examination (MMSE), Pfeffer Functional Activities Questionnaire (FAQ) and the Clinical Dementia Rating (CDR) were used to investigate clinical aspects. Results : It was verified that patients with dementia and EPS was older than the patients with FTD (p=0.01). The severity of cognitive deficits was associated with BFI, as well as the dementia severity in the EPS group. Conclusion : FTD group presented mean BFI scores above the cutoff for normal elderly population, indicating the presence of subcortical atrophy in this group. Mean BFI was higher (although not statistically significant) in FTD group than in dementia with EPS, which can suggest at least that subcortical pathology in FTD may be as important as in the dementia with EPS group. Subcortical atrophy is a good biological marker for cognitive deterioration in FTD and in dementia with EPS.
  • Neural Mechanisms of Exercise: Effects on Gut Miccrobiota and Depression
    Publication . Yuan, Ti-Fei; Rocha, Nuno; Paes, Flávia; Arias-Carrión, Oscar; Machado, Sergio; de Sá Filho, Alberto Souza
    Microbiota is a set of microorganisms resident in gut ecosystem that reacts to psychological stressful stimuli, and is involved in depressed or anxious status in both animals and human being. Interestingly, a series of studies have shown the effects of physical exercise on gut microbiota dynamics, suggesting that gut microbiota regulation might act as one mediator for the effects of exercise on the brain. Recent studies found that gut microbiota dynamics are also regulated by metabolism changes, such as through physical exercise or diet change. Interestingly, physical exercise modulates different population of gut bacteria in compared to food restriction or rich diet, and alleviates gut syndromes to toxin intake. Gut microbiota could as well contribute to the beneficial effects of exercise on cognition and emotion, either directly through serotonin signaling or indirectly by modulating metabolism and exercise performance.
  • Physical Exercise As Stabilizer For Alzheimer'S Disease Cognitive Decline: Current Status
    Publication . Machado, Sergio; Filho, Alberto Souza de Sá; Wilbert, Matheus; Barbieri, Gabriela; Almeida, Victor; Gurgel, Alexandre; Rosa, Charles V.; Lins, Victor; Paixão, Alexandre; Santana, Kamila; Ramos, Gabriel; Neto, Geraldo Maranhão; Paes, Flávia; Rocha, Nuno; Murillo-Rodriguez, Eric
    Mental health decline is one of the main responsible factors for augments in health care costs, and diagnosis of Alzheimer’s disease (AD). Some studies stated physical exercise is useful for reduction in cognitive decline and AD. Moreover, a recent review argued that evidence are scarce due to few studies published and lack of configuration information of exercise protocol, such as intensity and duration of exercise, number of sessions and other relevant data, to allow appropriate assessment. Materials and Methods: Here, we discussed the possible confounders or factors responsible for these differences and possible neurophysiological mechanisms. Results: Most studies revealed a possible positive association between physical exercise and cognitive assessments. There are inconsistencies in studies design responsible for varying use of cognitive assessments and different assessments of fitness. However, these studies do not fail to provide evidence about the benefits of exercise, but fail to make it possible because of the lack of dose-response information in AD patients. Physical exercise of moderate intensity should be considered as standard recommendation to reduce cognitive decline, probably due to the improvement in neurodegenerative mechanisms, and the increase in neuroplastic and neuroprotective neurotrophic factors. Conclusion: Therefore, it is suggested that physical exercise is an important neuroprotective modulator, bringing significant control of the disease and amplifying brain functions.
  • Relationship Among Body Image, Anthropometric Parameters and Mental Health in Physical Education Students
    Publication . Legey, Sandro; Lamego, Murilo Khede; Lattari, Eduardo; Campos, Carlos; Paes, Flávia; Sancassiani, Federica; Mura, Gioia; Carta, Mauro Giovanni; Rocha, Nuno; Nardi, Antônio Egídio; José de Oliveira, Aldair; Neto, Geraldo Maranhão; Murillo-Rodriguez, Eric; Arias-Carrión, Oscar; Budde, Henning; Machado, Sergio
    Background The prevalence of body image dissatisfaction (BID) is currently high. Given that psychological well-being is associated with the body measurements imposed by esthetic standards, BID is an important risk factor for mental disorders. Objective Identify the prevalence of BID, and compare anthropometric and mental health parameters between individuals satisfied and dissatisfied with their body image. Method A total of 140 university students completed the silhouette scale to screen for BID. Anthropometric measures, body mass index (BMI), waist circumference (WC) and body fat percentage (BFP) were used. To investigate mental health, The State-Trait Anxiety Inventories (STAI-S and STAI-T), Profile of Mood States (POMS) scale and Quality of Life (QOL-36) questionnaire were used to investigate mental health. The Student’s t-test was applied to compare anthropometric and mental health parameters. Results 67.1% of university students exhibited BID. There was a significant difference (p = 0.041) in BF and WC (p = 0.048) between dissatisfied and satisfied individuals. With respect to mood states, significant differences were observed for anger (p = 0.014), depression (p = 0.011), hostility (p = 0.006), fatigue (p = 0.013), mental confusion (p = 0.021) and total mood disturbance (TMD) (p = 0.001). The mental aspect of QOL was significantly higher (p = 0.001) in satisfied university students compared to their dissatisfied counterparts. Conclusion BID was high and it seems to be influenced by anthropometric measures related to the amount and distribution of body fat. This dissatisfaction may have a negative effect on the quality of life and mood state of young adults.
  • A Cross-National Investigation of Hallucination-Like Experiences in 10 Countries: The E-CLECTIC Study
    Publication . Siddi, Sara; Ochoa, Susana; Laroi, Frank; Cella, Matteo; Raballo, Andrea; Saldivia, Sandra; Quijada, Yanet; Laloyaux, Julien; Rocha, Nuno; Lincoln, Tania M; Schlier, Björn; Ntouros, Evangelos; Bozikas, Vasileios P; Gawęda, Łukasz; Machado, Sergio; Nardi, Antonio E; Rodante, Demián; Deshpande, Smita N; Haro, Josep Maria; Preti, Antonio
    Hallucination-like experiences (HLEs) are typically defined as sensory perceptions in the absence of external stimuli. Multidimensional tools, able to assess different facets of HLEs, are helpful for a better characterization of hallucination proneness and to investigate the cross-national variation in the frequencies of HLEs. The current study set out to establish the validity, factor structure, and measurement invariance of the Launay-Slade Hallucinations Scale-Extended (LSHS-E), a tool to assess HLEs. A total of 4419 respondents from 10 countries were enrolled. Network analyses between the LSHS-E and the 3 dimensions of the Community Assessment of Psychic Experiences (CAPE) were performed to assess convergent and divergent validity of the LSHS-E. Confirmatory factor analysis was used to test its measurement invariance. The best fit was a 4-factor model, which proved invariant by country and clinical status, indicating cross-national stability of the hallucination-proneness construct. Among the different components of hallucination-proneness, auditory-visual HLEs had the strongest association with the positive dimension of the CAPE, compared with the depression and negative dimensions. Participants who reported a diagnosis of a mental disorder scored higher on the 4 LSHS-E factors. Small effect size differences by country were found in the scores of the 4 LSHS-E factors even after taking into account the role of socio-demographic and clinical variables. Due to its good psychometric properties, the LSHS-E is a strong candidate tool for large investigations of HLEs.
  • Comprehensive treatments for social cognitive deficits in schizophrenia: A critical review and effect-size analysis of controlled studies
    Publication . Kurtz, Matthew M; Gagen, Emily; Rocha, Nuno; Machado, Sergio; Penn, David L
    Recent advances in psychosocial treatments for schizophrenia have targeted social cognitive deficits. A critical literature review and effect-size (ES) analysis was conducted to investigate the efficacy of comprehensive programs of social cognitive training in schizophrenia. Results revealed 16 controlled studies consisting of seven models of comprehensive treatment with only three of these treatment models investigated in more than one study. The effects of social cognitive training were reported in 11/15 studies that included facial affect recognition skills (ES=.84) and 10/13 studies that included theory-of-mind (ES=.70) as outcomes. Less than half (4/9) of studies that measured attributional style as an outcome reported effects of treatment, but effect sizes across studies were significant (ESs=.30-.52). The effect sizes for symptoms were modest, but, with the exception of positive symptoms, significant (ESs=.32-.40). The majority of trials were randomized (13/16), selected active control conditions (11/16) and included at least 30 participants (12/16). Concerns for this area of research include the absence of blinded outcome raters in more than 50% of trials and low rates of utilization of procedures for maintaining treatment fidelity. These findings provide preliminary support for the broader use of comprehensive social cognitive training procedures as a psychosocial intervention for schizophrenia.
  • Relationship Between Brain-Derived Neurotrofic Factor (Bdnf) and Sleep on Depression: A Critical Review
    Publication . Monteiro, Bárbara C.; Monteiro, Suzana; Candida, Maristela; Adler, Nathalia; Paes, Flavia; Rocha, Nuno; Nardi, Antonio Egidio; Murillo-Rodriguez, Eric; Machado, Sergio
    The Brain-Derived Neurotrofic Factor (BDNF) is one of the most important neurotrophins in the brain and it is suggested influences the activity of the serotonergic, noradrenergic and dopaminergic pathways. In the last few years, it has been hypothesized that BDNF level is related with depression and sleep. Several studies show that depressive subjects present low levels of BDNF in the brain. Poor sleep quality is also related with alterations in the BDNF concentration. Some authors argue that most of the cases show that impaired sleep quality increases the stress and, consequently, the vulnerability to depressive disorders, suggesting that there is a relationship between sleep, depression and BDNF levels.