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IntroductionAutism Spectrum Disorder (ASD) includes a group of developmental disabilities characterized by patterns of delay and deviance in the development of social, communicative, cognitive skills and the presence of repetitive and stereotyped behaviors as well as restricted interests (APA, 2013 DSM 5th ed.).ObjectivesA 22-years old male outpatient affected by Autism Spectrum Disorder (Level 3) and severe ID presented serious challenging behaviors. The patient did not suffer from other psychiatric or neurologic pathologies. The patient did not have constipation or diarrhea or painful symptoms. The patients assumed carbamazepine (modified release) 800 mg/day (blood dosage 6,8 microgram/ml), clonazepam 2,5 mg/ml 15 drops/day, lorazepam 7,5 mg/die.MethodsDue to the onset of challenging behaviors risperidone was introduced. At the dosage of 2 mg/day, the patient reached a discrete control of challenging behaviors. After stopping risperidone because of oculogyric crisis, the patient started to assume valproic acid (chronic formulation) up to 1000 mg/day. After three weeks the patient presented an increase in the blood dosage of ammonium. After the drug stop, the patient began to re-present challenging behaviors. The authors decided to add topiramate at a dosage of 25 mg per day. After three days, the patient began to present nocturnal urinary incontinence. Topiramate was stopped and Gabapentin was introduced in the treatment up to the dosage of 900 mg/day. Lorazepam was gradually tapered off until the intake was terminated, and clonazepam was reduced to 5 drops/day taken at bedtime. The dosage of carbamazepine remained stable.ResultsTable 1.Behavior Problems Inventory subscales scoresPre-treatment (T0)Post-treatment (T1)% ImprovementsBehavior Problems Inventory SubscalesFrequencySeverityFrequencySeverityFrequencySeveritySelf-Injurious Behavior625216,7%0%Stereotyped Behavior4919381622,5%15,8%Aggressive/destructive Behavior3925242038,5%20%ConclusionsAccording to the GABAergic hypothesis of ASD, inhibitory signaling of GABA within and between cortical minicolumns appears to be altered. This alteration would result in information processing with high discrimination between correlated stimuli rather than a generalization of them (Casanova et al. Neuroscientist 2003; 9: 496-507). Gabapentin is a ligand of the auxiliary alpha-2-delta subunit site of voltage-dependent calcium channels and acts as an inhibitor of the channel (Sills Curr Opin Pharmacol 2006; 6 (1):108-13). The altered expression of alpha-2-delta 1 or alpha-2-delta 3 can cause a chronic imbalance between arousal and inhibition that is quite characteristic of ASD (Nelson et al. Neuron 2015;87:684-698). The authors want to speculate on a hypothetical function of gabapentin in remodeling the expression of alpha-2-delta subunits in people with autism and the processing of neural information.Disclosure of InterestNone Declared

IntroductionAutism Spectrum Disorder (ASD) includes a group of developmental disabilities characterized by patterns of delay and deviance in the development of social, communicative, cognitive skills and the presence of repetitive and stereotyped behaviors as well as restricted interests (APA, 2013 DSM 5th ed.). Although the etiopathogenesis of autism has not yet been elucidated, past literature has highlighted an imbalance between glutamatergic and gamma-aminobutyric acid (GABA)-ergic neurotransmission (Harada et al. J Autism Dev Disord 2011;41:447-54.). A cortical deficiency of GABA in young people with ASD has been reported (Rojas et al. Neuroimage 2013;86:28-34.). Endocannabinoids act in numerous synapses of the central nervous system, maintaining an adequate synaptic homeostasis, preventing excess stimulation at the level of excitatory or inhibitory synapses. They therefore appear to be fundamental for the short- and long-term control of synaptic plasticity (Castillo et al. Neuron 2012;76,70-81). The endocannabinoid system appears to play an important role in some clinical presentations of autism, such as socialization. Indeed, Autism Spectrum Disorder seems to be characterized by a hypo-functionality of the endocannabinoid system (Aran et al. Mol Autism 2019;10, 2).ObjectivesThe present work aims to describe the current state of the art regarding the possible role of cannabinoids in the modulation of the excitatory and inhibitory systems in individuals with ASD.MethodsWe carried out a search on PubMed concerning the randomized clinical trials on the modulating effect of excitatory and inhibitory cannabinoid systems in autism. Three eligible articles were found according to the purpose of the present study.ResultsThe results of the three articles considered highlighted a cannabinoid (CBD)-related increase in glutamate in subcortical regions (basal ganglia) and a decrease in cortical regions (dorsomedial prefrontal cortex), both in subjects with and without ASD. CBD increased GABA transmission in the subcortical regions of neurotypical subjects, while it decreased it in the same areas of the ASD group. Furthermore, CBD modulated low-frequency activity, used as a measure of brain activity and functional connectivity in the brains of adults with ASD.ConclusionsData from the three functional MRI studies demonstrated that CBD influences cortical and subcortical connectivity on an adult sample. This effect was notable only in the ASD group but not in the controls. However, further studies are needed to confirm the results obtained so far.Disclosure of InterestNone Declared

IntroductionAffective flattening is one of the main symptoms in Schizophrenia, several studies highlighted the importance of social skills training in improving negative symptoms. However, Covid-19 pandemic is changing our life with limitations in social contacts and in psychosocial rehabilitation; pre COVID-19 strategies should be implemented with new ones.ObjectivesTo evaluate the practicability of a narrative method in improving affective flattening, general social skills in stable outpatients with a diagnosis for schizophrenia during Italian lockdown in March – April 2020MethodsOutpatients with a stable psychopathology have been involved in a narrative project during lockdown. We asked to patients to write daily a story telling about their experience and emotions and send us their diary. Every week the diary has been used to discuss their story telling in group in a web conference. At end of the experience we administered a survey about the enjoyment and the subjective benefits.ResultsFrom ten people with a known psychopathology we recruited six patients. All participants completed the project and all of them referred for a subjective benefit as to feel more reassured by the contact with their psychiatrist. Four patients explicated initial discomfort about share their experiences in group. One patient started to share his own thoughts about mental disease on social media.ConclusionsNarrative Psychiatry might be a pragmatic opportunity to implement conventional strategies to contrast affective flattening and negative symptoms in Schizophrenia. Sharing digital story telling is a useful method in lockdown and general social restriction condition.

IntroductionPsychosis itself may be associated with an increased risk of atrial fibrillation. Moreover, antipscyhotic treatment increases this risk. Recently D’Urso et al. reported aripiprazole-induced atrial fibrillation in a patient with concomitant risk factors.ObjectivesTo the best of author’s knowledge no data has been published about the safety and the efficacy of lurasidone treatment in psychotic patient with comorbid atrial fibrillation.MethodsA 68 years old patient with persistent atrial fibrillation and hypertension in treatment with amiodarone 100 mg/day, lurasidone 25 mg/day, rivaroxaban 15 mg/day, clopidogrel 75 mg/day, bisoprolol 1,25 mg/day, tamsulosin 0,4 mg/day presented delusional ideas of jealousy for not real betrayal by his wife, social withdrawal, reduced sleep. Blood pressure 130/80 mmHg, heart rate 70 bpm, Qtc 420 msec. The patient was drug-naïve for any psychotropic treatment. The authors decided to start lurasidone treatment at the dosage of 18,5 mg/day.ResultsAfter the first administration of lurasidone treatment sleep was resolved. After two weeks delusional ideas and social withdrawal were markedly improved. After one month of treatment, blood pressure, heart rate and Qtc remained almost stable. The authors decided not to increase the dosage of lurasidone because of the age of the patient and the comorbid cardiovascular pathologies.ConclusionsLurasidone has showed safety and efficacy in the treatment of this patient with delusional disorder and comorbid atrial fibrillation. This is a preliminary data that requires follow up and further studies to confirm the usefulness of lurasidone in psychotic patients with atrial fibrillation and cardiovascular risks.DisclosureNo significant relationships.

A new electrochemical sensor, based on NdFeO3 nanoparticles as electrocatalytic material, was proposed here for the detection of dopamine (DA). NdFeO3 nanoparticles were first synthesized by a simple thermal treatment method and subsequent annealing at high temperature (700 °C). The prepared electrocatalytic material has been characterized in detail by SEM-EDX, XRD, and Raman techniques. Characterization results display its sheet-like morphology, constituted by a porous network of very small orthorhombic NdFeO3 nanoparticles. NdFeO3 electrocatalytic material was then used to modify the working electrode of screen-printed carbon electrodes (SPCEs). Electrochemical tests demonstrated that NdFeO3– modified screen-printed carbon electrode (NdFeO3/SPCE) exhibited a remarkable enhancement of the dopamine electrooxidation, compared to the bare SPCE one. The analytical performance of the developed sensor has been evaluated for the detection of this analyte by means of the square-wave voltammetry (SWV) technique. The modified electrode showed two linear concentration ranges, from 0.5 to 100 μM and 150 to 400 μM, respectively, a limit of detection (LOD) of 0.27 μM (at S/N = 3), and good reproducibility, stability, and selectivity. Additionally, we also report an attempt made to propose the modified sensor for the simultaneous detection of dopamine and uric acid (UA). The procedure was also applied for the determination of dopamine in spiked real samples. So, this paper reports for the first time the use of a modified NdFeO3 screen-printed electrode for developing an electrochemical sensor for the quantification of important biomolecules.

Laser wakefield accelerators offer a promising solution for producing highenergy electron beams in compact setups. Beyond obtaining the required energy, the applications require achieving precise transverse parameters of the accelerated beam. This study investigates the evolution of the emittance and Twiss parameters through the plasma stage, including the density plateau, upramp, and downramp and their connection to conventional transport lines. Particular attention is given to the matching conditions between the plasma and the transport line, with recommendations proposed to mitigate emittance growth. A new approach is used, based on tracking through a series of special quadrupoles simulating the plasma transverse focusing, with a computational speed-up of over four orders of magnitude compared to laser-plasma Particle-In-Cell simulations.

IntroductionThe high technical barrier to entry in the field of neuroimaging can hinder early insight from promising results and the development of evidence-based clinical practice.ObjectivesThe working group focused on published literature in order to develop a new methodology in the analysis, visualization, and representation of fMRI data in the psychiatric setting.MethodsThree valid and established measures were chosen, in order to achieve dimensionality reduction, stability and explainability of results, namely Regional-Homogeneity; fractional Amplitude of Low-Frequency Fluctuations; Eigenvector-Centrality. Each measure was color coded and individual images per subject compiled, averaging results by functional networks as described the FIND lab of the University of Stanford. 272 individual scans were processed (130 neurotypicals, 50 patients with Schizophrenia, 49 with Bipolar Disorder, 43 with ADHD).ResultsThe discriminative power between clinical groups of the novel method was significant both by human eye, and later confirmation by statistical tests, and by computer vision algorithms (Convolutional Neural Networks). The precision-recall Area Under the Curve, dividing by 80/20 proportion between train and test sets, was >84.5% for each group. The group of patients with Bipolar Disorder showed a partial overlap with the group of patients suffering from Schizophrenia – by a dominance of Eigenvector-Centrality and Regional-Homogeneity, as well as a lower prevalence of fractional Amplitude of Low-Frequency Fluctuations, for both in comparison to controls.ConclusionsThe present study offers preliminary evidence for the adoption of i-ECO (integrated-Explainability through Color Coding) in fMRI analyses during rest in the Psychiatric field.DisclosureNo significant relationships.

In the present work we investigate the dynamics of electrons under the action of wave packets of high-frequency electromagnetic carrier waves. When the group velocities of the packets are subluminal, electrons can be efficiently accelerated. We show that the whole process can be described by an accurate ponderomotive canonical formalism that includes relevant extensions of the original ponderomotive approach applied to carriers moving at the speed of light. Single-particle simulations validate our analytical approach and show that extended canonical methods provide better agreement with numerics than previous investigations. In particular, we obtain a precise relationship between the wave amplitude and group velocity for optimum acceleration of initially stationary targets.

In the present work, we extend the results of a previous investigation on the dynamics of electrons under the action of an inverse free-electron-laser scheme (Almansa et al., Phys. Plasmas, vol. 26, 2019, 033105). While the former work examined electrons as single test particles subject to the combined action of a modulated wiggler plus a laser field, we now look at electrons as composing a particle beam, where collective space-charge effects are relevant and included in the analysis. Our previous work showed that effective acceleration is achieved when the initial velocities of the particles are close enough to the phase velocity of the beat-wave mode formed by the laser and the wiggler fields. Electrons are then initially accelerated by a ponderomotive uphill effect generated by the beat mode and, once reaching the phase velocity of the beat, undergo a final strong resonant acceleration step resembling a catapult effect. The present work shows that, under proper conditions, space-charge effects play a similar role as the initial (or injected) velocity of the beam. Even if acceleration is absent when space charge is neglected, it may be present and effective when charge effects are taken into account. We also discuss how far the space charge can grow without affecting the sustainability of the acceleration process.

For Laser WakeField Accelerators with dedicated applications, the role of the transport line is essential, as its mission is to drive the accelerated beam from the plasma exit to the application, where all the requirements on beam quality should be met. This article investigates a two-quadrupole transport line with typical beam parameters at its entrance and exit. Consequences on its capacities and limits are discussed, considering the emittance growth that can be significant.