👤 Giuseppe Plazzi

Suicidal ideation is prevalent among university students and is associated with a complex interplay of psychological, interpersonal, and behavioral factors. While prior research has examined individual predictors such as sleep disturbances, depressive symptoms, and impulsivity, less is known about how these factors co-occur in clinically distinct profiles. This study aimed to identify latent profiles of suicide risk using a multidimensional model.We conducted a secondary data analysis using the Assessing Nocturnal Sleep/Wake Effects on Risk of Suicide (ANSWERS) dataset, which includes self-reported data from 971 U.S. university students aged 18 to 52 years (M = 20.10, SD = 2.41). Seven continuous variables were included as indicators: sleep quality (PSQI), insomnia severity (ISI), depressive symptoms (CES-D), suicidal ideation severity (C-SSRS), thwarted belongingness and perceived burdensomeness (INQ), and total impulsivity (UPPS-P). Latent Profile Analysis (LPA) was employed to identify subgroups, and model fit was assessed using the AIC, BIC, and entropy.Latent Profile Analysis identified five distinct profiles based on indicators of sleep, affect, interpersonal behavior, and impulsivity. These included a severely distressed profile characterized by elevated depressive symptoms, suicidal ideation, sleep disturbances, and interpersonal burden; an interpersonally burdened profile with mild affective symptoms; a moderately symptomatic profile; a psychologically resilient profile with minimal symptoms across domains; and a high impulsivity profile accompanied by emotional dysregulation.This study identified five clinically distinct profiles of suicide risk in a large sample of university students. These results may inform the development of tailored screening and intervention strategies in campus-based mental health settings. Show less

Kleine-Levin syndrome (KLS) is characterized by relapsing-remitting episodes of hypersomnia, cognitive impairment, and behavioral disturbances. We quantified cerebrospinal fluid (CSF) and serum proteins in KLS cases and controls. SomaScan was used to profile 1133 CSF proteins in 30 KLS cases and 134 controls, while 1109 serum proteins were profiled in serum from 26 cases and 65 controls. CSF and serum proteins were both measured in seven cases. Univariate and multivariate analyses were used to find differentially expressed proteins (DEPs). Pathway and tissue enrichment analyses (TEAs) were performed on DEPs. Univariate analyses found 28 and 141 proteins differentially expressed in CSF and serum, respectively (false discovery rate <0.1%). Upregulated CSF proteins included IL-34, IL-27, TGF-b, IGF-1, and osteonectin, while DKK4 and vWF were downregulated. Pathway analyses revealed microglial alterations and disrupted blood-brain barrier permeability. Serum profiles show upregulation of Src-family kinases (SFKs), proteins implicated in cellular growth, motility, and activation. TEA analysis of up- and downregulated proteins revealed changes in brain proteins (p < 6 × 10-5), notably from the pons, medulla, and midbrain. A multivariate machine-learning classifier performed robustly, achieving a receiver operating curve area under the curve of 0.90 (95% confidence interval [CI] = 0.78-1.0, p = 0.0006) in CSF and 1.0 (95% CI = 1.0-1.0, p = 0.0002) in serum in validation cohorts, with some commonality across tissues, as the model trained on serum sample also discriminated CSF samples of controls versus KLS cases. Our study identifies proteomic KLS biomarkers with diagnostic potential and provides insight into biological mechanisms that will guide future research in KLS. Show less

There is only partial overlap in the genetic background of isolated rapid-eye-movement sleep behavior disorder (iRBD) and Parkinson's disease (PD). To examine the role of autosomal dominant and recessive PD or atypical parkinsonism genes in the risk of iRBD. Ten genes, comprising the recessive genes PRKN, DJ-1 (PARK7), PINK1, VPS13C, ATP13A2, FBXO7, and PLA2G6 and the dominant genes LRRK2, GCH1, and VPS35, were fully sequenced in 1039 iRBD patients and 1852 controls of European ancestry, followed by association tests. We found no association between rare heterozygous variants in the tested genes and risk of iRBD. Several homozygous and compound heterozygous carriers were identified, yet there was no overrepresentation in iRBD patients versus controls. Our results do not support a major role for variants in these genes in the risk of iRBD. © 2020 International Parkinson and Movement Disorder Society. Show less