👤 Simone Prezzavento

Schizophrenia Spectrum Disorders are complex mental health conditions that significantly impact cognitive function and quality of life. While pharmacological and psychotherapeutic interventions are available, their effectiveness remains limited, particularly for negative symptoms and cognitive impairments. These limitations, alongside drug side effects and adherence difficulties, highlight the need for new treatments. Cognitive remediation strategies like Neurofeedback show promise by harnessing neuroplasticity. This systematic review aims to evaluate the neurocognitive and humoral changes induced by Neurofeedback and its therapeutic effects in patients with schizophrenia spectrum disorders. Our review was conducted following PRISMA guidelines. Databases including EMBASE, ScienceDirect, Scopus, PsycINFO, and MEDLINE were searched for relevant studies: 14 studies, 10 RCTs, and 4 Clinical trials were selected. Inclusion criteria encompassed studies involving patients with schizophrenia spectrum disorders, Neurofeedback interventions, and outcomes related to neurocognitive and humoral changes. The Cochrane Risk-of-Bias Tool for randomized trials (RoB 2) was used to assess the quality of included studies. The reviewed studies suggest that Neurofeedback shows promise in addressing various aspects of schizophrenia spectrum disorders. Improvements were observed in processing speed, social functioning, working memory, and emotional regulation. Several studies reported successful modulation of brain activity in regions associated with auditory hallucinations. Neurofeedback training also led to increased functional connectivity between language networks and the default mode network. Some studies found improvements in brain-derived neurotrophic factor (BDNF) levels, self-efficacy, and clinical symptoms in schizophrenia patients. Future research should focus on personalizing Neurofeedback approaches and exploring their mechanisms of action in the context of schizophrenia pathophysiology. Show less

Familial hypercholesterolemia (FH) is characterized by elevated LDL-C and an increased risk of premature cardiovascular events. Inclisiran is a small interfering RNA that inhibits hepatic PCSK9 synthesis and promotes LDL-C clearance by enhancing LDLR expression on hepatocytes. This study aimed to evaluate the efficacy of six-months add-on inclisiran on lipid profile and PWV in FH; furthermore, we investigated the association between LDL-C reduction and PWV variation. This prospective observational study involved 78 genetically confirmed FH subjects with an LDL-C off-target despite high-intensity statins plus ezetimibe. All subjects obtained biochemical analysis and PWV evaluation at baseline and after six months add-on inclisiran. After six months add-on inclisiran, 41 % of subjects achieved LDL-C targets. Significant reductions of LDL-C (-41.5 %, p < 0.001), ApoB (-33.7 %, p < 0.01), Non-HDL-C (-35.9 %, p < 0.001), and Lp(a) (-18 %, p < 0.01) were observed, while PWV improved by 14.4 % (p < 0.001). In a secondary analysis, the Primary prevention group showed a higher prevalence of subjects on LDL-C target than the Secondary prevention group (59 % vs 23.1 %, p < 0.001). Both groups exhibited significant improvements of lipid profile and PWV (Δ - 14.1 %, p < 0.01 and Δ - 14.6 %, p < 0.001, respectively). Linear regression showed a significant association between ΔPWV and ΔLDL-C in the whole study population as well as in the Primary and Secondary prevention groups (p for all <0.001). Inclisiran significantly improved lipid profile and PWV in FH subjects. ΔPWV was significantly associated with ΔLDL-C. Show less