Introduction The European Psychiatric Association (EPA) Summer School allows psychiatric trainees and early career psychiatrists (ECPs) from all over Europe to meet, network, and learn together. After the 2020 edition being cancelled due to COVID-19, the 10th edition in 2021 focused for the first time on research and was conducted remotely. Objectives To provide an overview and feedback about the first Virtual EPA Research Summer School as a new way to encourage international networking during COVID-19. Methods The School was organized by the EPA Secretary for Education, and 4 Faculty members. It started with a “breaking the ice session” one week before and then a two-days meeting on 23-24 September 2021 using an online video-platform. This was preceded by all the 21 participants (from 18 different countries) recording a short 4-minute video presentation, which was uploaded and shared with other participants and Faculty. Results Participants were divided on a voluntary basis into three working groups: 1) “Drug repurposing: overcoming challenges in pharmacoepidemiology” 2) “Psychopathological research in psychiatry”; 3) “How to conduct a cross-sectional survey?”. The Summer School program was composed of plenary sessions with lectures by the Faculty members, discussion sessions, and working groups time. At the end, each group presented a summary of the work done to the rest of the participants. Conclusions Although the remote format limits social interactions during the Summer School, overall participants’ high satisfaction and productivity indicate that not only online formats, but also the topic of research might be covered in future editions. Disclosure No significant relationships.

The hippocampus is a morphologically complex region of the brain limbic system centrally involved in important cognitive, affective, and behavioural regulatory roles. It has exquisite vulnerability to neuroinflammatory processes, with some of its subregions found to be specific sites of neuroinflammatory pathology in ex-vivo studies. Optimising neuroimaging correlates of hippocampal neuroinflammation would enable direct study of functional consequences of hippocampal neuroinflammatory pathology, as well as the definition of therapeutic end points for treatments targeting neuroinflammation, and their related affective or cognitive sequelae. However, in vivo traditional imaging of the hippocampus and its subregions is fraught with difficulties, due to methodological challenges deriving from its unique anatomical characteristics. The main objective of this review is to provide a current update on the characterisation of quantitative neuroimaging correlates of hippocampal neuroinflammation, by focusing on three prototypical autoimmune neuro-inflammatory conditions [Multiple Sclerosis (MS), Systemic Lupus Erythematosus- (SLE), Autoimmune Encephalitis (AE)]. We focused on studies employing TSPO-targeting Positron Emission Tomography (PET), and Quantitative Magnetic Resonance Imaging (MRI) and Spectroscopy techniques assumed to be sensitive to neuroinflammatory tissue changes. We found 18 eligible studies (14, 2 and 2 studies in MS, AE and SLE respectively). Across conditions, the largest effect was seen in TSPO PET and diffusion weighted MRI studies. No study examined neuroinflammation-related changes at hippocampal subfields level. Overall, results were largely inconsistent due to heterogeneous imaging methods, small sample sizes and different population studies. We discuss how these data could inform future study design and conclude by suggesting further methodological directions aimed at improving precision and sensitivity of neuroimaging techniques to characterise hippocampal neuroinflammatory pathology in the human brain.

Introduction The hippocampus is an important, complex limbic structure anatomically embedded in the medial temporal lobe of each cerebral cortex, which has been implicated in the pathogenesis of neuro-inflammatory disease conditions. Few studies have focused on the characterization of the MRI neuroimaging signatures of highly physio- pathologically relevant subfields of the hippocampus (CA1, CA4-DG, CA2/CA3, SLRM). Objectives Using self-guided manually segmented, Diffusion weighted and NODDI maps created from data obtained from the Human Connectome Project (HCP) we intend to test whether Diffusion MRI-based quantitative imaging parameters (MD, FA, ODI, ISOVF, ICVF), indicative of microstructural characteristics of major hippocampal subfields (CA1, CA2/CA3, CA4-DG and SLRM), correspond to predictions for animal literature and imaging-histology correlations. We will also explore the correlations between these parameters and age. Methods We used images from the Public connectome data (updated April 2018), exploring subjects with the 3T MRI sessions obtainable from the WU-Minn HCP Data section. For the purpose of this study, we selected and downloaded 10 preliminary imaging data (6 females and 4 males) based on age variability in the following ranges (26-30, 31-35 and 36+). We manually segmented, and computed quantitative parameters. Results Converging and consistent literature allude to decreasing volumes with increasing age. Analyzing the volumes from the diffusion maps (pilot data), this was also the case, with volumes computed from CA1 and DG-CA4 sub regions. IQT also allowed for better appreciation of neuroanatomical boundaries and land marks, hence allowing more regions to be easily manually segmented (addition of CA2/CA3). Conclusions Application to Neuroinflammatory imaging data. Disclosure No significant relationships.

AimsTo summarise the tolerability profile following an infusion of methylene blue (MB), including subjective effects on mood and energy levels and haemodynamic changes, in patients with Bipolar Affective Disorder (BPAD).BackgroundBPAD is associated with mitochondrial dysfunction and impaired cellular energy production. MB is proposed to enhance mitochondria function via rerouting electrons and intracellular reduction of oxidative stress, and is therefore a candidate compound for use as a probe to reveal alterations in brain oxygen metabolism in vivo in patients with BPAD. Although there are reports of MB used as treatment for BPAD, the tolerability and subjective effects of a single IV dose in this population has not yet been defined.MethodUsing a single-blind, randomised, within-subject design, 7 patients with BPAD on stable pharmacological treatment and 6 healthy controls (HCs) received an infusion of 0.5mg/kg MB and a placebo glucose solution one week apart. Visual Analogue Scales (VAS) assessing ‘Mood’ and ‘Energy’ levels were completed by 11 participants, and blood pressure (BP), heart rate (HR) and any subsequent side effects were recorded before and after infusions.ResultA significant, albeit very small, effect of MB on ‘Mood’ levels relative to placebo was demonstrated, independent of groups (change relative to baseline: 5.5% ± 11 increase (placebo) vs -1.6 % ± 9.5 reduction (MB); p = 0.027). Although there was no effect of MB on energy levels in either group, there appeared to be a trend for a general group difference in ‘Energy’ levels across all trials, with lower ratings in BPAD patients (p = 0.058).There was a trend for significantly lower post-infusion HR relative to pre-infusion (-6.4 ± 8.8 bpm, p = 0.07. Diastolic BP was higher (3.0 ± 7.8mmHg, p = 0.039). These effects were independent of groups and drug. The most common side effect with MB was mild/moderate pain at infusion site (n = 10/13), resolving within median 32.5 minutes (IQR 6-102), and discoloured urine in 7/13 subjects lasting median 44.5 hours (IQR 36-59). No difference in frequency of side effects reported between groups.ConclusionAlthough limited by small sample size, this tolerability analysis demonstrates a acceptable profile of effects of MB on subjective ratings and blood pressure, in both BPAD and HCs. Common side effects of discoloured urine and pain at infusion site are in line with previous reports in the literature. We observed a small effect of MB on mood ratings which could be related to the discomfort experienced during infusion.