In the past Rodrigo B. Mansur has collaborated on articles with Julia A. Hamer and Lucas Bortolotto Rizzo. One of their most recent publications is Review ArticleBrain insulin resistance: A treatment target for cognitive impairment and anhedonia in depression. Which was published in journal Experimental Neurology.

More information about Rodrigo B. Mansur research including statistics on their citations can be found on their Copernicus Academic profile page.

Rodrigo B. Mansur's Articles: (13)

Review ArticleBrain insulin resistance: A treatment target for cognitive impairment and anhedonia in depression

AbstractType 2 Diabetes Mellitus (T2DM) and Major Depressive Disorder (MDD) are leading causes of disability worldwide. Indeed, both are costly and burdensome diseases at both individual and socio-economic levels. Notably, there are similar pathophysiological elements, which might explain the overlap in phenotypic symptoms and the high rate of comorbidity. Brain insulin resistance is a shared metabolic abnormality amongst many individuals with T2DM and MDD. Patients with either or both diseases often exhibit disturbances in cognition and mood, as well as the presence of anhedonia-like symptoms. However, individuals with T2DM with high glycemic control have reduced cognitive and depressive symptom burden. Based on this evidence, it is possible that repurposing therapies approved for treating insulin resistance may be useful in treating cognitive and anhedonia symptoms in depression. The objective of this review is to discuss the relationship between brain insulin resistance and depression, as well as possible disease modifying therapeutic agents targeting insulin signalling.

ReviewThe theory of bipolar disorder as an illness of accelerated aging: Implications for clinical care and research

Highlights•Pathophysiological changes observed in BD converge on a model of premature aging.•Individuals with BD present high rates of age related medical illnesses.•Dysregulation in immune system and neurotrophins are present in both conditions.•Recognition of BD as an accelerated aging disease opens a new avenue of investigation.

ReviewIs there a “metabolic-mood syndrome”? A review of the relationship between obesity and mood disorders

Highlights•The relationship between obesity and mood disorders is bidirectional and convergent.•It has been proposed that this co-occurrence represents a distinct illness subtype.•However, there are significant inconsistencies in the studies of this association.•We explore the phenotypic and etiological heterogeneity of these illnesses.•We discuss using domain-specific and dimensional approaches in subtyping strategies.

Review articleGluten related illnesses and severe mental disorders: a comprehensive review

Highlights•Epidemiological studies indicate the existence of an association between coeliac disease and severe mental disorders.•The immune response to gluten could be different in individuals with schizophrenia and mood disorders.•There are few evidence that gluten-free diets could be beneficial for individuals with severe mental disorders.

Research reportThe prevalence and illness characteristics of DSM-5-defined “mixed feature specifier” in adults with major depressive disorder and bipolar disorder: Results from the International Mood Disorders Collaborative Project

AbstractBackgroundA substantial proportion of individuals with mood disorders present with sub-syndromal hypo/manic features. The objective of this analysis was to evaluate the prevalence and illness characteristics of the Diagnostic and Statistical Manual Version-5 (DSM-5) – defined mixed features specifier (MFS) in adults with major depressive disorder (MDD) and bipolar disorder (BD).MethodData from participants who met criteria for a current mood episode as part of MDD (n=506) or BD (BD-I: n=216, BD-II: n=130) were included in this post-hoc analysis. All participants were enrolled in the International Mood Disorders Collaborative Project (IMDCP): a collaborative research platform at the Mood Disorders Psychopharmacology Unit, University of Toronto and the Cleveland Clinic, Cleveland, Ohio. Mixed features specifier was operationalized as a score≥1 on 3 or more select items on the Young Mania Rating Scale (YMRS) or≥1 on 3 select items of the Montgomery Åsberg Depression Rating Scale (MADRS) or Hamilton Depression Rating Scale (HAMD-17) during an index major depressive episode (MDE) or hypo/manic episode, respectively.ResultsA total of 26.0% (n=149), 34.0% (n=65), and 33.8% (n=49) of individuals met criteria for MFS during an index MDE as part of MDD, BD-I and BD-II, respectively. Mixed features specifier during a hypo/manic episode was identified in 20.4% (n=52) and 5.1% (n=8) in BD-I and BD-II participants, respectively. Individuals with MDE–MFS as part of BD or MDD exhibited a more severe depressive phenotype (p=0.0002 and p<0.0002, respectively) and reported a higher rate of alcohol/substance use disorder in the context of BD but not MDD (p=0.002). Individuals with MFS were more likely to have co-existing heart disease suggestive of a distinct pattern of comorbidity and neurobiology.LimitationsData were post-hoc and obtained from individuals utilizing a university-based mood disorder centre which may affect generalizability.ConclusionsDiagnostic and Statistical Manual Version-5-defined MFS is common during an MDE as part of MDD and BD. The presence of MFS identifies a subgroup of individuals with greater illness complexity and possibly a higher rate of cardiovascular comorbidity. The results herein underscore the common occurrence of MFS in adults with either BD or MDD. Moreover, the results of our analysis indicate that adults with mood disorders and MFS have distinct clinical characteristics and comorbidity patterns.

Research paperImpaired glucose metabolism moderates the course of illness in bipolar disorder

Highlights•The longitudinal course of BD is highly heterogeneous.•We show that impaired glucose metabolism (IGM) moderates BD course and severity.•Individuals with IGM had an earlier age at onset and a multi-episodic illness.•Results suggested a possible accelerating course in the IGM subpopulation.

Research paperThe association between insulin resistance and depression in the Korean general population

Highlights•Increased insulin resistance was associated with depressive symptoms in the Korean general population (N=165,443).•The subgroup analysis revealed the association was statistically significant in female, non-diabetic and young groups.•Increased insulin resistance in non-diabetic participants was more strongly associated with depressive symptoms.•These findings suggest that early management of insulin resistance may prevent progression toward depressive symptoms.

Review articleEfficacy of antidepressants on measures of workplace functioning in major depressive disorder: A systematic review

Highlights•Cost-of-illness studies implicate work-related disability as the largest single contributor in depression.•Mechanistically dissimilar antidepressants exert beneficial effects on workplace functioning.•Modelling cost effectiveness of treatments in depression should be informed by effects on workplace functioning.•Comparator data (e.g. network analysis) on antidepressant efficacy and functional outcomes is a research priority.

Research paperEffort-based decision-making is affected by overweight/obesity in major depressive disorder

Highlights•Abnormalities in reward are core features of major depressive disorder (MDD).•Overweight/obesity (OW) is independently associated with reward disturbances.•We investigated effort-based decision making in individuals with MDD and OW.•OW significantly moderated the association between MDD and lower effort behavior.•Body mass index was more strongly associated with effort than depressive symptoms.

Tryptophan breakdown and cognition in bipolar disorder

Highlights•Cognitive deficits contribute to the large burden of illness associated with bipolar disorder.•Chronic inflammation in the CNS results in alterations in neural structures that subserve cognitive function.•An imbalance towards neurotoxic TRYCATs may be involved in the development of structural abnormalities.•In males with a higher 3-hydroxykynurenine/kynureninc acid ratio was associated with poorer verbal memory performance.•The correction of these inflammatory alterations may constitute a potential therapeutic target.

Is there a role for curcumin in the treatment of bipolar disorder?

AbstractCurcumin is a polyphenolic nonflavonoid compound extracted from the rhizome of turmeric (Curcuma longa), a plant commonly used in Indian and Chinese traditional medicine to treat rheumatism, cough, inflammation and wounds. Curcumin putative targets, known based on studies of diverse central nervous system disorders other than bipolar disorders (BD) include several proteins currently implicated in the pathophysiology of BD. These targets include, but are not limited to, transcription factors activated by environmental stressors and pro-inflammatory cytokines, protein kinases (PKA, PKC), enzymes, growth factors, inflammatory mediators, and anti-apoptotic proteins (Bcl-XL). Herein, we review previous studies on the anti-inflammatory and anti-oxidant properties of curcumin and discuss its therapeutic potential in BD.

Original ArticleBinge eating in adults with mood disorders: Results from the International Mood Disorders Collaborative Project

SummaryA post hoc analysis was conducted using data from participants (N = 631) with a DSM-IV-TR defined diagnosis of major depressive disorder (MDD) or bipolar disorder (BD) who were enrolled in the International Mood Disorders Collaborative Project (IMDCP) between January 2008 and July 2013.It was determined that 20.6% of adults with mood disorders as part of the IMDCP fulfilled criteria for binge eating behaviour (BE). A higher percentage of individuals with BD met criteria for BE when compared to MDD (25.4% vs. 16%; p = 0.004) Univariate analyses indicated that individuals with a mood disorder (i.e., MDD or BD) and BE had greater scores on measures of anxiety severity (p = 0.013) and higher rates of lifetime and current substance dependence, lifetime alcohol abuse (p = 0.007, p = 0.006, and p = 0.015, respectively), Attention Deficit Hyperactivity Disorder (ADHD) (p = 0.018) and measures of neuroticism (p = 0.019). Individuals with a mood disorder and concurrent BE had lower scores on measures of conscientiousness (p = 0.019). Individuals meeting criteria for BE were also significantly more likely to be obese (i.e., BMI ≥ 30 kg/m2) (50% vs. 25.5%; p < 0.001).Binge eating is common amongst adults utilising tertiary care services principally for a mood disorder. The presence of BE identifies a subset of adults with mood disorders who have greater illness complexity as evidenced by course of illness variables and comorbidity. Screening for BE amongst individuals with mood disorders is warranted; parsing neurobiological substrates subserving non-homeostatic eating behaviour amongst individuals with mood disorders is a future research vista.

Digital revolution in depression: A technologies update for clinicians

AbstractTechnology is becoming increasingly intertwined with our lives every year. As technology advances, it offers promising new methods to help detect, manage, and improve the care of major depressive disorder (MDD). Unlike other specialties in medicine, psychiatry has been slow to adopt new technologies. Other areas of medicine, primarily cardiology and oncology, have made use of technological methods to patients’ great benefits. In psychiatry, new technological methods can predict which antidepressants will be most effective, provide therapies to patients, and empower patients to manage their own medical records. We offer an overview to new technologies and their applications to psychiatry for novices. Our particular focus is big data, machine learning, mobile applications, and blockchain technology. We summarise the uses of technology as assisting physicians in decision making, facilitating patient-patient interaction, and securely storing and managing health-care data. We suggest possible advantages and challenges to adopting these methods. Continued research and technological innovation is needed to improve the psychiatrist’s toolbox and to monitor the adoption and consequences of new technologies.

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