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Browsing by Author "Zugman, Andre"

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    Imaging Social and Environmental Factors as Modulators of Brain Dysfunction: Time to Focus on Developing Non-Western Societies
    (2019) Crossley, Nicolas A.; Alliende, Luz Maria; Ossandon, Tomas; Castañeda, Carmen Paz; González-Valderrama, Alfonso; Undurraga, Juan; Castro, Mariana; Guinjoan, Salvador; Díaz-Zuluaga, Ana M.; Pineda-Zapata, Julián A.; López-Jaramillo, Carlos; Reyes-Madrigal, Francisco; León-Ortíz, Pablo; Fuente-Sandoval, Camilo de la; Sanguinetti Czepielewski, Leticia; Gama, Clarissa S.; Zugman, Andre; Gadelha, Ary; Jackowski, Andrea; Bressa, Rodrigo
    Social and environmental factors are known risk factors and modulators of mental health disorders. We here conducted a nonsystematic review of the neuroimaging literature studying the effects of poverty, urbanicity, and community violence, highlighting the opportunities of studying non-Western developing societies such as those in Latin America. Social and environmental factors in these communities are widespread and have a large magnitude, as well as an unequal distribution, providing a good opportunity for their characterization. Studying the effect of poverty in these settings could help to explore the brain effect of economic improvements, disentangle the effect of absolute and relative poverty, and characterize the modulating impact of poverty on the underlying biology of mental health disorders. Exploring urbanicity effects in highly unequal cities could help identify the specific factors that modulate this effect as well as examine a possible dose–response effect by studying megacities. Studying brain changes in those living among violence, which is particularly high in places such as Latin America, could help to characterize the interplay between brain predisposition and exposure to violence. Furthermore, exploring the brain in an adverse environment should shed light on the mechanisms underlying resilience. We finally provide examples of two methodological approaches that could contribute to this field, namely a big cohort study in the developing world and a consortium-based meta-analytic approach, and argue about the potential translational value of this research on the development of effective social policies and successful personalized medicine in disadvantaged societies.
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    Structural brain abnormalities in schizophrenia in adverse environments: examining the effect of poverty and violence in six Latin American cities
    (2021) Crossley, Nicolas; Zugman, Andre; Reyes, Francisco; Czepielewski, Leticia; Castro, Mariana; Diaz, Ana; Pineda, Julian; Reckziegel, Ramiro; Gadelha, Ary; Jackowski, Andrea; Noto, Cristiano; Alliende, Luz; Iruretagoyena, Bárbara; Ossandon, Tomas; Ramírez, Juan; Castañeda, Carmen; González, Alfonso; Nachar, Ruben; León, Pablo; Undurraga, Juan; De la Fuente, Camilo; Bressan, Rodrigo; ANDES Network
    Background: Social and environmental factors such as poverty or violence modulate the risk and course of schizophrenia. However, how they affect the brain in patients with psychosis remains unclear. Aims: We studied how environmental factors are related to brain structure in patients with schizophrenia and controls in Latin America, where these factors are large and unequally distributed. Method: This is a multicentre study of magnetic resonance imaging in patients with schizophrenia and controls from six Latin American cities. Total and voxel-level grey matter volumes, and their relationship with neighbourhood characteristics such as average income and homicide rates, were analysed with a general linear model. Results: A total of 334 patients with schizophrenia and 262 controls were included. Income was differentially related to total grey matter volume in both groups (P = 0.006). Controls showed a positive correlation between total grey matter volume and income (R = 0.14, P = 0.02). Surprisingly, this relationship was not present in patients with schizophrenia (R = -0.076, P = 0.17). Voxel-level analysis confirmed that this interaction was widespread across the cortex. After adjusting for global brain changes, income was positively related to prefrontal cortex volumes only in controls. Conversely, the hippocampus in patients with schizophrenia, but not in controls, was relatively larger in affluent environments. There was no significant correlation between environmental violence and brain structure. Conclusions: Our results highlight the interplay between environment, particularly poverty, and individual characteristics in psychosis. This is particularly important for harsh environments such as low- and middle-income countries, where potentially less brain vulnerability (less grey matter loss) is sufficient to become unwell in adverse (poor) environments.

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