Vol 5, No 3 (2024)

BACKGROUND: Schizophrenia is a psychiatric disorder known to affect brain structure and functionality. Structural changes in the brain at the level of gross anatomical structures have been fairly well studied, while microstructural changes, especially those associated with changes in the molecular composition of the brain, are still being investigated. Of special interest are lipids and metabolites, for which some previous studies have shown association with schizophrenia.

AIM: To utilize a spatially resolved analysis of the brain lipidome composition to investigate the degree and nature of schizophrenia-associated lipidome alterations in the gray and white matter structures of two neocortical regions — the dorsolateral prefrontal cortex (Brodmann area 9, BA9) and the posterior part of the superior temporal gyrus (Brodmann area 22, posterior part, BA22p), as well compare the distribution of the changes between the two regions and tissue types.

METHODS: We employed Matrix-Assisted Laser Desorption/Ionization Mass Spectrometric Imaging (MALDI-MSI), supplemented by a statistical analysis, to examine the lipid composition of brain sections. A total of 24 neocortical sections from schizophrenia patients (n=2) and a healthy control group (n=2), representing the two aforementioned neocortical areas, were studied, yielding data for 131 lipid compounds measured across more than a million MALDI-MSI pixels.

RESULTS: Our findings revealed an uneven distribution of schizophrenia-related lipid alterations across the two neocortical regions. The BA22p showed double the differences in its subcortical white matter structures compared to BA9, while less bias was detected in the gray matter layers. While the schizophrenia-associated lipid differences generally showed good agreement between brain regions at the lipid class level for both gray and white matter, there were consistently more discrepancies for white matter structures.

CONCLUSION: Our study found a consistent yet differential association of schizophrenia with the brain lipidome composition of distinct neocortical areas, particularly subcortical white matter. These findings highlight the need for broader brain coverage in future schizophrenia research and underscore the potential of spatially resolved molecular analysis methods in identifying structure-specific effects.

BACKGROUND: The need for scientific knowledge about aging is predicated on the demand of modern society to extend the active life of a person. To maintain intellectual longevity, it is necessary to take into account not only the pathological, but also compensatory mechanisms that arise during aging. The cerebral-cognitive reserve (CCR) influences the rate of transition from pre-phenomenological stages to the clinical stage of the disease, thereby changing the prognosis of Alzheimer’s disease (AD).

AIM: The aim of this work was to review meta-analyses from studies that have examined the principles and functions of the CCR in people with AD.

METHODS: The work included 83 scientific publications devoted to the issues of the CCR in neurodegenerative diseases such as AD. The Results and Discussion sections of this article provide reviews of the results of 12 meta-analyses published from 2012 to 2024 and selected from the PubMed and eLibrary databases using the following keywords in English and Russian: “cerebral reserve”, “cognitive “reserve”, and “Alzheimer’s disease”. The scope of the definition was not limited, since the goal here was to determine the terminological boundaries of the concepts of “cognitive reserve” and “single brain reserve”.

RESULTS: The modern understanding of AD as a biological continuum covering the preclinical, prodromal, and clinical phases of the disease makes it possible to infer that insufficiency of protective factors underlies the progression of AD. The cognitive reserve is involved in the sanogenetic protective mechanism during neurodegeneration. The cognitive reserve is a theoretical concept that reflects modern research’s understanding of how the integrative functioning of the brain (cerebral) and cognitive reserves extend the period of active intellectual longevity through energy-saving mechanisms. It considers these mechanisms as central to healthy mental activity and in slowing the progression of neurodegenerative diseases. At some point, an increase in excess interneuronal activity that reflects the hypercompensatory function of the reserve would accelerate the depletion of brain structures and contribute to clinical and psychopathological manifestations of AD.

CONCLUSION: The concept of the CCR puts the spotlight on the need to determine the compensatory indicators of cognitive deficit in AD, assess the architecture and volume of the reserve, and develop and follow protocols for its maintenance. It appears just as crucial to adopt measures to prevent the Reserve’s depletion as early as at the preclinical stages of the disease. Elaborating protective and compensatory mechanisms that help to maintain the functional activity of the brain in conditions of neurodegeneration, that is, CCR, require further research and can form a conceptual basis for the prevention of AD, starting from the preclinical stages of the disease.

BACKGROUND: Schizoaffective disorder (SAD) is one of the most complex and controversial diagnoses in clinical psychiatry. Despite the significant changes that have occurred in the conceptualization of SAD in modern classifications and the publications of recent years, many unresolved issues remain regarding the disease, from the point of view of clinical psychiatry and basic neuroscience.

AIM: The purpose of this paper is to summarize published data on the concept of SAD, its clinical characteristics, cognitive profile, potential biomarkers, as well as the place of the disease in the following modern international classifications: the International Classification of Diseases (ICD) 9^th, 10^th and 11^th revisions, and the Diagnostic and Statistical Manual of Mental Disorders, 5^th edition (DSM-5).

METHODS: We undertook a review of the scientific studies in the relevant bibliographic systems and databases (eLIBRARY, PubMed) of the past 15 years. The descriptive analysis method was used to summarize the collected information. A total of 70 publications were selected for review, including different versions of international classifications of diseases (ICD and DSM-5).

RESULTS: There has been some improvement in the inter-rater reliability of SAD criteria in modern classifications, but this has not yet led to a clearer understanding among mental health specialists, while the various subtypes of SAD identified so far fail to account for the heterogeneity in the clinical presentation of the disorder. The dimensional approach to diagnosing SAD, according to which the intensity of psychotic and affective symptoms can fluctuate over time and they can influence one another, more accurately reflects the disease’s ability to embody different forms. Basic research does not support the identification of a distinct cognitive, neuroimaging, or immunological SAD endophenotype that differs qualitatively from schizophrenia and affective psychoses.

CONCLUSION: The conceptualization of SAD remains incomplete, and new approaches rooted in neuroscience are needed to better understand the coexistence of affective and psychotic symptoms.

The escalating suicide rate in Nigeria, exacerbated by economic, political, health, and social crises, represents a pressing concern. The aftermath of the global COVID-19 pandemic and subsequent lockdowns has exacerbated this issue, particularly in African nations with bare-bones governmental support systems. This paper examines the underlying causes of the alarming number of suicides in Nigeria, utilizing interviews to explore the risk factors, preventative measures adopted, and crisis interventions. Our findings reveal that spousal conflicts, job loss, and bereavement are significant triggers of suicidal ideation. Recommendations include fostering supportive environments, crisis interventions, and psychological rehabilitation services. Urgent attention is warranted to address this growing trend and mitigate its socioeconomic repercussions in Nigeria.

BACKGROUND: The Maslow's hierarchy of needs (Maslow's pyramid) and the Mental Health and Psychosocial Support (MHPSS) pyramid are integral frameworks in humanitarian settings whose aim is to address individual and community needs. However, confusion often arises among non-governmental organization (NGO) workers about the application and differentiation of these models.

AIM: This study aims to investigate the extent of confusion among NGO workers in Iraq as regards the Maslow's and MHPSS pyramids, identify the causes of this confusion, and explore its implications in the context of humanitarian mental health support.

METHODS: A pilot descriptive study was conducted in December 2023 through an online survey involving 61 local NGO workers from MHPSS components in Iraq. We created a measure to assess the participants’ familiarity with both models, their perceived differences, and their views on the models’ applicability in humanitarian contexts.

RESULTS: Male participants represented 55.7% (n=34) of the sample, while females accounted for 44.3% (n=27). Most participants were aged 25–34 (57%, n=35) and 35–44 (34%, n=21). A majority held bachelor’s degrees (67.2%, n=41), with 21.3% (n=13) holding master’s degrees. In terms of occupation, 49.2% (n=30) were engaged in the protection sector (gender-based violence and child protection), followed by health (19.7%, n=12), education (4.9%, n=3), and MHPSS staff roles in other sectors (26.2%, n=16). The study revealed that 54.1% (n=33) of the participants struggled to understand or differentiate between Maslow's and MHPSS pyramids. The causes of this confusion were related to perceived structural similarities (18.03%, n=11), lack of awareness and knowledge about the MHPSS pyramid (63.93%, n=39), and a combination of both (18.03%, n=11).

CONCLUSION: The study underscores the importance of better training and education for NGO workers to improve their understanding of the Maslow's and MHPSS pyramids. Addressing this knowledge gap can increase efficacy in humanitarian aid provision, ensuring that individual and community needs are adequately met in crisis situations.