SUPERVISOR :DR SABAR P. SIREGAR, SPKJ

BNDF-TRKB SIGNALLING AND NEUROPROTECTION IN

SCHIZOPHRENIA

Chirayu D.pandyaAmmar kutiynawalla

Anikulmar pillai

JOURNAL READING

Medical Faculty Christian University of Indonesia

AIM

To knowing that the role of BNDF-TrkB signalling in pathofisiology of schizophrenia and antipsychotic drugs effect to level of BNDF in peripheal

HYPOTHESIS

Atypicall antipsychotics exhibit less deleterious effects on BNDF levels compare to

typicall antipsychotics

SAMPLE

DATA SOURCES

• Writers used data and compare it from many related journals between 1996-2010 to complete this journal.

DATA ANALYSIS

RESULTS

BNDF & SCHIZOFRENIA

• BDNF protein levels were significantly lower in prefrontal cortex samples from schizophrenia subjects• BDNF levels were found lower in CSF samples from schizophrenia

subjects compare to control

DNA METHYLATION OF BNDF GENE AND ITS ASSOCIATION WITH SCHIZOPHRENIA

• A number of studies have also shed light on the potential role of DNA methylation in the dynamic regulation of the BDNF gene in adults, and have highlighted the fact that altered BDNF regulation could contribute to schizophrenia

POLYMORPHISMS OF BNDF GENE IN SCHIZOPHRENIA

• A number of studies have investigated the relationship between BDNFMet polymorphism and schizophrenia, but the results are mostly inconsistent• Val66met related to hippocampal volume.

NEUROPROTECTIVE ROLES OF BNDF/TRKB SIGNALLING

• BDNF induced activation of TrkB is essential to synaptic plasticity• The protective effect of BDNF against apoptosis requires the

activation of the PI-3K/Akt and ERK pathways

CONCLUSION

• There is growing intersest in understanding of BNDF-TrkB signalling in pathofisiology of schizophrenia• Atypicall antipsychotics exhibit less deleterious effects on

BNDF levels compare to typicall antipsychotics• Neuroprotective/neurotrophic compounds might be used

to be adjunctive therapeutic strategy

CRITICAL APPRAISAL

Describe Opinion

Title Consists less than12 words. The title is enough

Content Describe enough the content of the study, interesting enough, with abbreviasion

Informatively enough

Author The author are psychiatrists from the department of health care. Medical college of georgia,georgia heallth science university, USA

Avowed

Publisher Asian Journals Psychiatry. The publisher is one of well-known publisher among Asia.

Avowed

Abstract (-) : words total >260the content is appropriate according to journal.

(+): easy to understand the methode of study and the result

Not Informatively enough

PICO

DESCRIBES ON THE FIGURE AND TABLES

CRITICAL APPRAISAL

Form a critical assessment of evidence-based medicine

-Therapeutic aspect-

• Therapeutic aspect

Whether the evidence about therapeutic aspect is valid?

1. whether the allocation of patients to treatment in this study was done randomly? Or whether the study, explanation random sampling are described in detail and complete?

NoThis study is not explaining the method and the sampling

2. whether the observation of the patient is done long enough and complete?

Yes,This study are collecting data from 1996 journals.

3. whether all the patients in the randomized groups analyzed (when drop out is too large more than 20% done with the intention to treat analysis taking the worst case scenario)

No,This study is not explaining the method and the sampling

Whether the evidence about therapeutic aspect is valid?

4. Do patients and physicians remain blind to the therapy given (because not all therapies do blind)?

unknown.

5. Whether all groups are treated equally apart from therapy?

NoDepending on where group the patient is.

6. Whether the treatment and control groups the same or similar at baseline (typically shown in the data display base)?

Unknown

whether evidence of a valid therapeutic aspects of this important?

1. How much influence the therapy? (significant amount indicated by counting the number needed to treat)?

unknown

2. How exactly estimate of the treatment effect (the amount of 95% RC)

unknown

SAMPLE CALCULATIONSRelative risk reduction(RRR)

Absolute risk reduction (ARR)

The number of required treatment(NRT)

Control Event Rate(CER)

Experimental Event Rate(EER)

CER-EER

IRE

CER-EER 1/ARR

No data No data No data No data No data

Application whether we can apply the proof of a valid therapeutic aspects of this important and our patients?

Are there any differences in our patients compared with this study so that the findings cannot be applied to our patients?

unknown

Was the therapy applicable to our patients?

YesThis study can be applied for our psychotic patients

Were the patients have beneficial or harmful potention if the therapy being applied?

Yes

Whether the values and expectations of our patients, if the end result we are trying to prevent and treat, we offer?

Unknown

CRITICAL APPRAISAL GUIDELINES

Element

Evaluation Criteria

Way of Thinking

1. Is a credible argument given for why a case study is appropriate?

2. Are the philosophical stance and perspective of the authors stated?

3. Is there evidence that any bias is taken into account when performing data analysis?

Yes

Yes

Yes

No

No

No

Unknown

Unknown

Unknown

Element Evaluation Criteria

Way of Control-ling

4. Have the criteria for analysis been confirmed by an independent researcher?

5. Have any opportunities for various forms of triangulation been exploited?

6. Is the research process auditable?7. Has relevant literature been used to

support the selection of an appropriate theoretical framework to guide the research?

8. Does the study use appropriate theory to support the findings?

9. Does the study describe how the conclusions were arrived at and how they are justified by the results?

10.Are assertions / conclusions made well grounded in the data?

Yes

Yes

YesYes

Yes

Yes

Yes

No

No

NoNo

No

No

No

Unknown

Unknown

UnknownUnknown

Unknown

Unknown

Unknown

Element

Evaluation Criteria

Way of Working

11.Are the criteria used to select the appropriate case and participants clearly described?

12.Does the study provide a clearly formulated question describing an important IS issue?

13.Are the approaches and techniques for data collection and analysis described in detail?

14.Is the conceptual framework for the research explicitly described?

Yes

Yes

Yes

Yes

No

No

No

No

Unknown

Unknown

Unknown

Unknown

Element Evaluation Criteria

Way of Supporting

15.Does the study describe an orderly process for the collection of data?

16.Does the study describe and employ a systematic way to analyse the data?

17.Is the history and context of the research clearly described?

Yes

Yes

Yes

No

No

No

Unknown

Unknown

Unknown

Element Evaluation Criteria

Way of Communi-cating (1)

18.Are the aims and objectives of the study clearly stated?

19.Are limitations to the study acknowledged and described?

20.Does the study suggest if and how the findings might be transferable to other settings?

21.Is sufficient detail given to allow readers to evaluate the potential transferability of the research to other contexts?

22.Does the report identify questions or issues for future research?

23.Is the presentation of the research appropriate to the intended audience?

Yes

Yes

Yes

Yes

Yes

Yes

No

No

No

No

No

No

Unknown

Unknown

Unknown

Unknown

Unknown

Unknown

Element Evaluation Criteria

Way of Communi-cating (2)

24. *Could this research potentially make a contribution to the work of IS practitioners?

25. *Does the research provide new insights into some aspect of IS work?

26. *Is the research presented in such a way that there is evidence of logical rigour throughout the study?

27. *Does the study place the findings in the context of IS practice?

28. *Does the study place the findings in the context of IS research?

29. *Is the research process open to scrutiny?

Yes

Yes

Yes

Yes

Yes

Yes

No

No

No

No

No

No

Unknown

Unknown

Unknown

Unknown

Unknown

Unknown

CONCLUSION

- This study is not valid - The research of this study maybe

can applied in the future and the further research could be better that this.