Ana Ganho-Ávila

University of Coimbra | UC · CINEICC, Faculty of Psychology and Educational Sciences

Purpose of the review To present the latest data on the efficacy, safety, and acceptability of transcranial magnetic stimulation (TMS) and transcranial direct current stimulation (tDCS) in peripartum depression (PPD), complemented by notes emerging from our clinical and research experience. Recent findings TMS and tDCS show promising results to ma...

A significant amount of European basic and clinical neuroscience research includes the use of transcranial magnetic stimulation (TMS) and low intensity transcranial electrical stimulation (tES), mainly transcranial direct current stimulation (tDCS). Two recent changes in the EU regulations, the introduction of the Medical Device Regulation (MDR) (2...

The Montgomery-Åsberg Depression Rating Scale (MADRS) is considered one of the gold-standard measures to assess depression severity. To standardise the MADRS administration, a structured interview was developed (SIGMA). This study aims to translate and validate the SIGMA for European Portuguese. Twenty patients (80% women) were interviewed by ten d...

The objective and scope of this Limited Output Transcranial Electrical Stimulation 2023 (LOTES-2023) guidance is to update the previous LOTES-2017 guidance. These documents should therefore be considered together. The LOTES provides a clearly articulated and transparent framework for the design of devices providing limited output (specified low-int...

Clark and Wells' model for social anxiety proposed several maintenance factors for social anxiety (SA), which is assumed to exist in a continuum from normative to pathological levels (i.e., Social Anxiety Disorder-SAD). Based on these premises, we used a cross-sectional design to investigate pathways linking those maintenance factors to SA, in adol...

Clark and Wells’ model for social anxiety proposed several maintenance factors for social anxiety (SA), which is assumed to exist in a continuum from normative to pathological levels (i.e., Social Anxiety Disorder – SAD). Based on these premises, we used a cross-sectional design to investigate pathways linking those maintenance factors to SA, in ad...

Background: Breastfeeding promotes children's health and is associated with positive effects to maternal physical and mental health. Uncertainties regarding SARS-CoV-2 transmission led to worries experienced by women and health professionals which impacted breastfeeding plans. We aimed to investigate the impact of self-reported and country-specifi...

Cognitive therapy has been established as the frontline treatment for adults with social anxiety disorder (SAD); its efficacy with socially anxious adolescents is incipient but promising. This work investigated change in social anxiety symptoms reported by adolescents and their therapist as they go through remotely delivered 10-session cognitive th...

Background/Objective Anxiety disorders are highly prevalent and negatively impact daily functioning and quality of life. Transcranial direct current stimulation (tDCS) targeting the dorsolateral prefrontal cortex (dlPFC), especially in the right hemisphere impacts extinction learning; however, the underlying neural mechanisms are elusive. Therefore...

This qualitative investigation explored the social and academic experiences of socially anxious adolescents and young adults in Portugal and the US as they lived through the restrictions imposed by the COVID-19 pandemic. Participants were 10 Portuguese adolescents (mean age = 16.9 years; 50% female) and 7 young adults in the US (mean age = 19.67 ye...

Introduction Complementary and alternative therapies (CATs) refer to a diverse range of approaches that can be used as add-on or an alternative to conventional therapies. While a number of individual studies and systematic reviews (SRs) or meta-analyses (MAs) have investigated the effectiveness of specific types of CATs to treat depressive symptoms...

Currently, the gold standard measure to assess loneliness is the University of California, Los Angeles Loneliness scale version 3 (UCLA v3). Objective. The aim of this study was to analyze the psychometric properties of UCLA v3 for the European Portuguese population. Method: A sample of 282 participants was surveyed in Portugal. Results: Confirmato...

Transcranial direct current stimulation (tDCS) is a potential treatment strategy across some psychiatric conditions. However, there is high heterogeneity in tDCS efficacy as a stand-alone treatment. To increase its therapeutic potential, researchers have begun to explore the efficacy of combining tDCS with psychological and pharmacological interven...

Introduction Significant changes in routine maternity care have been introduced globally in response to the COVID-19 pandemic to reduce infection risk, but also due to lack of medical facilities, staff shortages and the unpredictable nature of the disease. However, it is yet to be established if specialised perinatal mental health (PMH) services ha...

SAD is an intense fear or anxiety associated with past, current, or future social situations. The Clark and Wells (1995) cognitive model for SAD has been proved to be clinically effective in adults, and its developmentally sensitive adaptations for adolescents have recently shown promising results. Given this evidence and considering that adolescen...

During the postpartum period, the paternal brain suffers extensive and complex neurobiological alterations, through the experience of father–infant interactions. Although the impact of such experience in the mother has been increasingly studied over the past years, less is known about the neurobiological correlates of fatherhood—that is, the altera...

Transcranial direct current stimulation (tDCS) has been studied to enhance extinction-based treatments for anxiety disorders. However, the field shows conflicting results about its anxiolytic effect and only a few studies have observed the extinction of consolidated memories. We looked to study the effect of offline 1 mA tDCS over the right dorsola...

Este trabalho investigou a eficácia da Terapia Focada na Compaixão (TFC) nos sintomas da perturbação de ansiedade social (PAS) na adolescência, com base em dados recolhidos ao longo da intervenção. A TFC contribuiu para o bem-estar psicológico em várias populações, mas é escassa a evidência sobre a sua eficácia no tratamento da PAS em adolescentes....

Loneliness refers to the perception of mismatch between the perceived and desired quantity and quality of meaningful relationships. Currently, the golden standard measure to assess loneliness is the University of Los Angeles Loneliness scale version 3 (UCLA v3). The aim of this study was to analyze the psychometric properties and the factor structu...

Cortical thickness has been increasingly studied in the context of structural-brain-behavior associations, such as anxiety; however, the literature is scattered across methods and research fields. This scoping review aims to summarize the available data concerning the association between cortical thickness and anxiety-related measures and identify...

Perinatal mental illness refers to the most frequent mental health disorders that emerge during pregnancy and up to 12 months postpartum. When untreated, perinatal mental illness leads to devastating adverse impact that can affect not only newborn neurodevelopment but also the mother and family functioning, ultimately leading to negative social and...

Background Non-invasive brain stimulation (NIBS) techniques have been suggested as alternative treatments to decrease depression symptoms during the perinatal period. These include brain stimulation techniques that do not require surgery and that are nonpharmacological and non-psychotherapeutic. NIBS that have showed antidepressant effect so far in...

The COVID-19 pandemic has altered the normal course of life, with measures to reduce the virus spread impacting motherhood expectations and, in particular, breastfeeding practices. This study aimed to review evidence regarding the impact of COVID-19 on breastfeeding plans and how these relate to women’s psychological outcomes. Searches were conduct...

Background Corona Virus Disease 19 (COVID-19) is a new pandemic, declared a public health emergency by the World Health Organization, which could have negative consequences for pregnant and postpartum women. The scarce evidence published to date suggests that perinatal mental health has deteriorated since the COVID-19 outbreak. However, the few stu...

The COVID-19 ongoing pandemic constitutes a major challenge for countries throughout the world due to the rapid spread of SARS-CoV-2 and devastating consequences in health. No one is free from COVID-19 impact. In this regard, pregnant women are not the exception. The COVID-19 outbreak represents a massive source of stressful agents for women and th...

The main and best evidence-based indication to date to apply repetitive Transcranial Magnetic Stimulation (rTMS) in psychiatric disorders is major depression. Nevertheless, given that the high occurrence of major depressive disorders poses a major challenge for health systems worldwide, there is an urgent need for improving the clinical efficacy of...

Background : Peripartum depression [PPD] is a public health problem which has been widely studied. Nonetheless, study findings and clinical guidelines for PPD treatment differ among countries and the condition is still underdiagnosed and undertreated, suggesting the importance of a global understanding of PPD. The Riseup-PPD Cost Action aims to est...

Special Issue

Current first-line treatments for major depressive disorder (MDD) include pharmacotherapy and cognitive-behavioral therapy. However, one-third of depressed patients do not achieve remission after multiple medication trials, and psychotherapy can be costly and time-consuming. Although non-implantable neuromodulation (NIN) techniques such as transcra...

Transcranial direct current stimulation (tDCS) has been studied as an add-on enhancer of extinction-based treatments for anxiety disorders. However, previous studies have failed to address one issue of translational significance: the to-be extinguished fear memory must be consolidated. Additionally, extant literature shows conflicting results about...

Background Extinction-based procedures are often used to inhibit maladaptive fear responses. However, because extinction procedures show efficacy limitations, transcranial direct current stimulation (tDCS) has been suggested as a promising add-on enhancer. Objective In this study, we tested how cathodal tDCS over the right dorsolateral prefrontal...

Background: Repetitive Transcranial Magnetic Stimulation (rTMS) has been suggested as an alternative treatment to postnatal depression (PPD). Objectives: This systematic review aims to examine and summarise evidence on rTMS efficacy in treating depression during the postnatal period. Methods: We included randomized and non-randomized, single arm, a...

We evaluated the Portuguese version of the Anxiety Sensitivity Index 3 (ASI–3–PT). Results of a confirmatory factor analysis (N¼603; 65.3% women, M age ¼ 28.55, SD¼10.42) confirmed multidimensionality of the construct and the receiver operating characteristic confirmed the discriminant capacity of the measure between clinical and nonclinical sample...

Background: Repetitive Transcranial Magnetic Stimulation (rTMS) has been suggested as an alternative treatment to postnatal depression (PPD). Objectives: This systematic review aims to examine and summarise evidence on rTMS efficacy in treating depression during the postnatal period. Methods: We included randomized and non-randomized, single a...

Brief Introduction–Perinatal mental illness–diagnosis, etiology, treatment options, dilemas, case report presentation Perinatal mental illness is a significant complication of pregnancy and the postpartum period. These disorders include depression, anxiety disorders and postpartum psychosis. Perinatal depression and anxiety are the most common. The...

Background Transcranial direct current stimulation (tDCS) has been studied as an add-on enhancer of extinction-based treatments for anxiety disorders. Previous studies have showed that although anodal tDCS enhances fear extinction it also leads to decreased stimuli discrimination and consequent generalization of the fear response. Here we aim to un...

Background Extinction-based procedures are used to inhibit maladaptive fear responses. However, due to extinction efficacy limitations, transcranial direct current stimulation (tDCS) has been studied as a promising add-on enhancer. Previous fundamental research found anodal tDCS to have an adverse effect in increasing generalization of the fear res...

Purpose of review: After three decades of clinical research on repetitive transcranial magnetic stimulation (rTMS), major depressive disorder (MDD) has proven to be the primary field of application. MDD poses a major challenge for health systems worldwide, emphasizing the need for improving clinical efficacy of existing rTMS applications and promo...

Anxiety sensitivity (AS; the degree of fear of experiencing or imagining experiencing anxiety symptoms and its possible consequences) is associated with expression of conditioned fear responses. However, findings regarding the relationship between AS and fear acquisition indexed by skin conductance responses are rather conflicting. Here we aim to c...

Extinction-based procedures are often used to inhibit maladaptive fear responses. However, because extinction procedures show efficacy limitations, transcranial direct current stimulation (tDCS) has been suggested as a promising add-on enhancer. In this study, we tested the effect of cathodal tDCS over extinction, to unveil the processes at play th...

Neuromodulation techniques such as transcranial direct current stimulation (tDCS) are routinely used for treating neurological and neuropsychiatric disorders, and for enhancement of cognitive abilities. Recently, their effectiveness in modulating behavioral and neural responses has been questioned. Here we use excitatory and inhibitory tDCS prior t...

The objective of the present study was to research the patterns of Default Mode Network (DMN) deactivation in Obsessive Compulsive Disorder (OCD) in the transition between a resting and a non-rest emotional condition. Twenty-seven participants, 15 diagnosed with OCD and 12 healthy controls (HC), underwent a functional neuroimaging paradigm in which...

While the ethio-pathogenesis of Obsessive-Compulsive disorder (OCD) remains unknown, there is increased evidence of widespread structural alterations in both white and gray matter in OCD patients that include, but are not restricted, to abnormalities in corticostriatal- thalamo-cortical (CSTC) regions. The objective of this study was to test the ex...

Background: Postpartum Depression affects a considerable number of women worldwide. This condition inflicts severe consequences to mother and child health. Thus far, available treatments have low response and high relapse rates. We designed this trial to evaluate a safe and more efficacious innovative therapy. Aims: To report a feasible and ethical...

Neuroplasticity - the capacity of the brain to change as a response to internal and external pressures - has been studied from a number of different perspectives. Perhaps one of the most powerful models is the study of populations that have been congenitally deprived of a sense. It has been shown that the right Auditory Cortex (AC) of congenitally...

The aim of the present study is to explore obsessive-compulsive disorder (OCD)-related abnormalities in white matter connectivity in OCD for a core region associated with inhibitory control [i.e. inferior frontal gyrus (IFG)]. Fifteen patients with OCD (11 men) and 15 healthy controls (nine men) underwent diffusion tensor imaging scanning to study...

Several studies have shown that basic emotions are responsible for a significant enhancement of early visual processes and increased activation in visual processing brain regions. It may be possible that the cognitive uncertainty and repeated behavioral checking evident in Obsessive Compulsive Disorder (OCD) is due to the existence of abnormalities...