Browsing by Author "Guinjoan, Salvador M."

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    Abnormal brain network community structure related to psychological stress in schizophrenia
    (2023) Castro, Mariana N.; Bocaccio, Hernan; De Pino, Gabriela; Sanchez, Stella M.; Wainsztein, Agustina E.; Drucaroff, Lucas; Costanzo, Elsa Y.; Crossley, Nicolás; Villarreal, Mirta F.; Guinjoan, Salvador M.
    Recent functional imaging studies in schizophrenia consistently report a disruption of brain connectivity. However, most of these studies analyze the brain connectivity during resting state. Since psychological stress is a major factor for the emergence of psychotic symptoms, we sought to characterize the brain connectivity reconfiguration induced by stress in schizophrenia. We tested the hypothesis that an alteration of the brain's integration-segregation dynamic could be the result of patients with schizophrenia facing psychological stress. To this end, we studied the modular organization and the reconfiguration of networks induced by a stress paradigm in forty subjects (twenty patients and twenty controls), thus analyzing the dynamics of the brain in terms of integration and segregation processes by using 3T-fMRI. Patients with schizophrenia did not show statistically significant differences during the control task compared with controls, but they showed an abnormal community structure during stress condition and an under-connected reconfiguration network with a reduction of hub nodes, suggesting a deficit of integration dynamic with a greater compromise of the right hemisphere. These results provide evidence that schizophrenia has a normal response to undemanding stimuli but shows a disruption of brain functional connectivity between key regions involved in stress response, potentially leading to altered functional brain dynamics by reducing integration capacity and showing deficits recruiting right hemisphere regions. This could in turn underlie the hyper-sensitivity to stress characteristic of schizophrenia.
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    Effects of socioeconomic status in cognition of people with schizophrenia: Results from a Latin American collaboration network with 1175 subjects
    (2021) Sanguinetti Czepielewski, Letícia; Alliende Serra, Luz María; Castañeda, Carmen Paz; Castro, Mariana; Guinjoan, Salvador M.; Massuda, Raffael; Berberian, Arthur A.; Fonseca, Ana Olivia; González-Valderrama A.; Gadelha, Ary; Bressan, Rodrigo; Crivelaro, Marisa; Louzã, Mario; Undurraga, Juan; González-Valderrama, Alfonso; López-Jaramillo, Carlos; Nieto, Rodrigo R.; Montes, Cristián; Silva, Henán; Langer, Álvaro I.; Valencia-Echeverry, Johanna; López-Jaramillo, Carlos; Solís-Vivanco, Rodolfo; Reyes-Madrigal, Francisco; Fuente-Sandoval, Camilo de la; Crossley, Nicolás A.; Gama, Clarissa S.
    Background Cognition heavily relies on social determinants and genetic background. Latin America comprises approximately 8% of the global population and faces unique challenges, many derived from specific demographic and socioeconomic variables, such as violence and inequality. While such factors have been described to influence mental health outcomes, no large-scale studies with Latin American population have been carried out. Therefore, we aim to describe the cognitive performance of a representative sample of Latin American individuals with schizophrenia and its relationship to clinical factors. Additionally, we aim to investigate how socioeconomic status (SES) relates to cognitive performance in patients and controls. Methods We included 1175 participants from five Latin American countries (Argentina, Brazil, Chile, Colombia, and Mexico): 864 individuals with schizophrenia and 311 unaffected subjects. All participants were part of projects that included cognitive evaluation with MATRICS Consensus Cognitive Battery and clinical assessments. Results Patients showed worse cognitive performance than controls across all domains. Age and diagnosis were independent predictors, indicating similar trajectories of cognitive aging for both patients and controls. The SES factors of education, parental education, and income were more related to cognition in patients than in controls. Cognition was also influenced by symptomatology. Conclusions Patients did not show evidence of accelerated cognitive aging; however, they were most impacted by a lower SES suggestive of deprived environment than controls. These findings highlight the vulnerability of cognitive capacity in individuals with psychosis in face of demographic and socioeconomic factors in low- and middle-income countries.
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    Neuroethics and cultural context: The case of electroconvulsive therapy in Argentina
    (2023) Castelli, Paula; Guinjoan, Salvador M.; Wajnerman-Paz, Abel; Salles, Arleen
    As neuroethics continues to grow as an established discipline, it has been charged with not being sufficiently sensitive to the way in which the identification, conceptualization, and management of the ethical issues raised by neuroscience and its applications are shaped by local systems of knowledge and structures. Recently there have been calls for explicit recognition of the role played by local cultural contexts and for the development of cross-cultural methodologies that can facilitate meaningful cultural engagement. In this article, we attempt to fill this perceived gap by providing a culturally situated analysis of the practice of electroconvulsive therapy (ECT) in Argentina. ECT was introduced as a psychiatric treatment in Argentina in the 1930s but it is largely underutilized. While the use of ECT remains low in several countries, what makes the Argentinian case interesting is that the executive branch of government has taken a stance regarding both the scientific and moral appropriateness of ECT, recommending its prohibition. Here, we begin with a recent controversy over the use of ECT in Argentina and explain the legal recommendation to ban its application. Next, we offer an overview of some of the salient aspect of the international and local discussions on ECT. We argue that the governmental recommendation to ban the procedure should be rethought. While acknowledging the role that contexts and local conditions play in shaping the identification and assessment of the relevant ethical issues, we caution against using contextual and cultural considerations to avoid a necessary ethical debate on controversial issues.