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Effect of concomitant use of yokukansan on steady-state blood concentrations of donepezil and risperidone in real-world clinical practice. 在实际临床实践中,同时使用育康散对多奈哌齐和利培酮稳态血药浓度的影响。
IF 2 Q3 NEUROSCIENCES Pub Date : 2024-09-01 Epub Date: 2024-07-08 DOI: 10.1002/npr2.12459
Junji Saruwatari, Tetsuya Kaneko, Tsukasa Murata, Haruka Narise, Sawa Kugimoto, Eri Nishimura, Natsuki Tetsuka, Misaki Ando, Momo Oi, Masako Ota, Nayumi Hamada, Keiichiro Kaneda, Shiro Furusho, Masakatsu Sakamoto, Ayami Kajiwara-Morita, Kazutaka Oda, Kentaro Oniki, Keishi Ueda, Hirofumi Jono, Norio Yasui-Furukori

Aim: Yokukansan is one of the most frequently used herbal medicines that can improve the behavioral and psychological symptoms of dementia. In this exploratory study, we investigated whether yokukansan affects the steady-state blood concentrations of donepezil, risperidone, and the major metabolites of both drugs in a real-world clinical setting.

Methods: A non-randomized, open-label, single-arm study examining drug-drug interactions was conducted. Fifteen dementia patients taking donepezil for at least 4 weeks and eight schizophrenia patients taking risperidone for at least 2 weeks were orally administered 2.5 g of yokukansan three times a day before or between meals, and blood samples were collected before and 8 weeks after starting co-treatment with yokukansan. Plasma concentrations of donepezil, risperidone, and each metabolite were measured using high-performance liquid chromatography-tandem mass spectrometry and compared before and after the 8-week administration of yokukansan.

Results: The plasma concentrations of donepezil and its metabolites (6-O-desmethyl-donepezil, 5-O-desmethyl-donepezil, and donepezil-N-oxide), risperidone, and its metabolite paliperidone did not differ before and after the 8-week treatment with yokukansan.

Conclusions: The findings of this study show that the concomitant use of yokukansan may have little clinical impact on the steady-state blood levels of donepezil and risperidone in patients with dementia or schizophrenia.

目的:横断山是最常用的中药之一,可以改善痴呆症的行为和心理症状。在这项探索性研究中,我们调查了在实际临床环境中,横贯散是否会影响多奈哌齐、利培酮以及这两种药物主要代谢产物的稳态血药浓度:方法: 我们进行了一项非随机、开放标签、单臂研究,考察药物之间的相互作用。15 名服用多奈哌齐至少 4 周的痴呆症患者和 8 名服用利培酮至少 2 周的精神分裂症患者在餐前或餐间口服 2.5 克的横贯散,每天三次,并在开始服用横贯散联合治疗之前和之后 8 周采集血液样本。使用高效液相色谱-串联质谱法测定多奈哌齐、利培酮和各代谢物的血浆浓度,并比较服用横贯散 8 周前后的结果:结果:多奈哌齐及其代谢物(6-O-去甲基多奈哌齐、5-O-去甲基多奈哌齐和多奈哌齐-N-氧化物)、利培酮及其代谢物帕利哌酮的血浆浓度在服用育康散8周前后没有差异:本研究结果表明,在痴呆症或精神分裂症患者中同时使用育康散可能对多奈哌齐和利培酮的稳态血药浓度影响不大。
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引用次数: 0
Role of uric acid in neurodegenerative diseases, focusing on Alzheimer and Parkinson disease: A new perspective. 尿酸在神经退行性疾病(重点是阿尔茨海默病和帕金森病)中的作用:新视角。
IF 2 Q3 NEUROSCIENCES Pub Date : 2024-09-01 Epub Date: 2024-07-29 DOI: 10.1002/npr2.12445
Mohammed Alrouji, Hayder M Al-Kuraishy, Ali I Al-Gareeb, Mohammed S Alshammari, Athanasios Alexiou, Marios Papadakis, Mostafa M Bahaa, Gaber El-Saber Batiha

Neurodegenerative diseases (NDs) such as Alzheimer disease (AD) and Parkinson disease (PD) are group of diseases affecting the central nervous system (CNS) characterized by progressive neurodegenerations and cognitive impairment. Findings from different studies highlighted the beneficial and detrimental effects of serum uric acid on the development and progression of NDs. Therefore, this mini-review aims to discuss the beneficial and detrimental effects of uric on NDs. The neuroprotective effect of uric acid is mainly related to the antioxidant effect of uric acid which alleviates oxidative stress-induced neurodegeneration in AD and PD. However, long-term effect of hyperuricemia prompts for the development and progression of cognitive impairment. Hyperuricemia is associated with cognitive impairment and dementia, and gout increases dementia risk. In addition, hyperuricemia can cause cerebral vascular injury which is a risk factor for vascular dementia and cognitive impairment. Taken together, the relationship between uric acid and NDs risk remains conflicting. Hence, preclinical and clinical studies are indicated in this regard.

神经退行性疾病(NDs),如阿尔茨海默病(AD)和帕金森病(PD),是一组影响中枢神经系统(CNS)的疾病,其特征是进行性神经退行性变和认知功能障碍。不同研究的结果表明,血清尿酸对 NDs 的发生和发展有利有弊。因此,本微型综述旨在讨论尿酸对 NDs 的有利和不利影响。尿酸的神经保护作用主要与尿酸的抗氧化作用有关,尿酸的抗氧化作用可减轻氧化应激诱导的 AD 和 PD 神经变性。然而,高尿酸血症的长期效应会促使认知障碍的发生和发展。高尿酸血症与认知障碍和痴呆症有关,痛风会增加痴呆症风险。此外,高尿酸血症可导致脑血管损伤,而脑血管损伤是血管性痴呆和认知障碍的风险因素。综上所述,尿酸与 NDs 风险之间的关系仍然相互矛盾。因此,在这方面需要进行临床前和临床研究。
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引用次数: 0
Successful utilization of clozapine for a patient with treatment-resistant schizophrenia after recurrent violent behavior. 成功使用氯氮平治疗一名反复出现暴力行为的难治性精神分裂症患者。
IF 2 Q3 NEUROSCIENCES Pub Date : 2024-09-01 Epub Date: 2024-07-03 DOI: 10.1002/npr2.12462
Rikuto Christopher Shinohara, Tomomi Oshima, Takafumi Otsubo, Keita Ariga, Tesshu Ono, Koya Muneoka, Hiroki Umezu, Nobuhiro Mikami

Background: In patients with schizophrenia, violent behavior is a clinically important factor that prevents their discharge. Clozapine is an effective antipsychotic medication for treatment-resistant schizophrenia, and its usefulness for aggressive behavior has also been suggested.

Case presentation: We present the case of a 38-year-old male patient diagnosed with schizophrenia who was successfully treated with clozapine after recurrent violent behavior. He was diagnosed with schizophrenia during his adolescence. He was hospitalized for treatment in his teens, but his hallucinations and delusions persisted even after discharge. In his 30s, he became noticeably emotionally unstable, and despite being treated for an adequate period with sufficient doses of several antipsychotics, his symptoms did not improve. This led to repeated hospitalizations triggered by violent behavior toward his parents and siblings within the home. During his fourth hospitalization, clozapine was initiated due to multiple incidents of violence toward nursing staff secondary to hallucinations and delusions. As the dose of clozapine was gradually increased with therapeutic drug monitoring, the patient's hostility, uncooperativeness, and suspiciousness markedly improved, and his aggressive behavior disappeared. He was discharged to a facility on day 194 after starting clozapine and has continued outpatient visits.

Conclusion: Clozapine was suggested to be effective for aggressive behavior in patients with treatment-resistant schizophrenia and should be actively considered. In such cases, regular measurement of blood concentration is useful for adjusting the dosage of clozapine.

背景:在精神分裂症患者中,暴力行为是阻碍他们出院的一个重要临床因素。氯氮平是治疗耐药精神分裂症的有效抗精神病药物,也有人认为它对攻击行为也有作用:本病例是一名被诊断为精神分裂症的 38 岁男性患者,他在反复出现暴力行为后成功接受了氯氮平治疗。他在青春期被诊断出患有精神分裂症。十几岁时他曾住院接受治疗,但出院后他的幻觉和妄想仍然存在。30 多岁时,他的情绪明显变得不稳定,尽管服用了足够剂量的几种抗精神病药物进行了一段时间的治疗,但症状并没有改善。这导致他在家中对父母和兄弟姐妹的暴力行为引发了多次住院治疗。在第四次住院期间,由于幻觉和妄想引发了多起针对护理人员的暴力事件,他开始服用氯氮平。随着氯氮平剂量在治疗药物监测下逐渐增加,患者的敌意、不合作和多疑明显改善,攻击行为也消失了。他在开始服用氯氮平的第 194 天出院,并继续接受门诊治疗:结论:氯氮平对耐药精神分裂症患者的攻击性行为有效,应积极考虑使用。在这种情况下,定期测量血药浓度有助于调整氯氮平的剂量。
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引用次数: 0
Long prodromal symptoms of neuroleptic malignant syndrome in patient with intellectual developmental disorder-A case report. 智力发育障碍患者神经性恶性综合征的长期前驱症状--病例报告。
IF 2 Q3 NEUROSCIENCES Pub Date : 2024-09-01 Epub Date: 2024-06-04 DOI: 10.1002/npr2.12454
Seyedehnasibeh Sadati, Forouzan Elyasi, Zahra Shyasi, Behzad Rouhanizadeh

Background: Neuroleptic malignant syndrome (NMS) is a rare and potentially life-threatening condition that may arise at any point during treatment and is often associated with adverse reactions to dopamine-blocking agents. This syndrome is normally characterized by features such as muscle rigidity, alteration in consciousness, autonomic instability, and leukocytosis.

Aim: The aim of this study is to investigate a borderline intellectual functioning (BIF) case in which NMS with insidious disease progression and long prodromal symptoms was developed.

Case presentation: The investigated patient was a 38-year-old female diagnosed with bipolar disorder and a variety of corresponding disorders. The patient exhibited gastrointestinal symptoms and restlessness in the weeks leading up to the study, subsequent to the administration of elevated doses of haloperidol, risperidone, and lithium. In addition, she was hospitalized for restlessness and aggressiveness in the summer of 2023. Furthermore, due to her chief complaint, she received parenteral haloperidol twice in the emergency room, subsequently experiencing fever, altered consciousness, generalized rigidity, and dysphagia. Moreover, the patient's initial creatine phosphokinase (CPK) level was 2550 IU/L, and she was hospitalized in an intensive care unit with the diagnosis of NMS for 8 days.

Conclusions: This case study highlights the necessity of being attentive about prodromal symptoms of NMS and emergent interventions.

背景:神经性恶性综合征(NMS)是一种罕见的、可能危及生命的疾病,可能在治疗过程中的任何时候出现,通常与多巴胺阻滞剂的不良反应有关。该综合征通常具有肌肉僵硬、意识改变、自主神经不稳定和白细胞增多等特征。目的:本研究旨在调查一例边缘智力功能(BIF)病例,该病例出现了隐匿性疾病进展和长期前驱症状的 NMS:被调查的患者是一名 38 岁的女性,被诊断患有双相情感障碍和多种相应的疾病。在研究开始前的几周,患者表现出胃肠道症状和烦躁不安,随后服用了高剂量的氟哌啶醇、利培酮和锂。此外,2023 年夏天,她曾因烦躁不安和攻击性而住院治疗。此外,由于她的主诉,她在急诊室接受了两次肠外氟哌啶醇治疗,随后出现发热、意识改变、全身僵硬和吞咽困难。此外,患者最初的肌酸磷酸激酶(CPK)水平为 2550 IU/L,她在重症监护室住院 8 天,诊断为 NMS:本病例研究强调了关注 NMS 前驱症状和紧急干预的必要性。
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引用次数: 0
Evaluation of the effect of Modafinil in the improvement of the level of consciousness in patients with COVID-19 encephalopathy: A randomized controlled trial. 评估莫达非尼对改善 COVID-19 脑病患者意识水平的影响:随机对照试验。
IF 2 Q3 NEUROSCIENCES Pub Date : 2024-09-01 Epub Date: 2024-05-08 DOI: 10.1002/npr2.12447
Fatemeh Talebi Kiasari, Mobin Naghshbandi, Maziar Emamikhah, Omid Moradi Moghaddam, Mohammad Niakan Lahiji, Mohammad Rohani, Narges Yazdi, Hamidreza Movahedi, Alireza Amanollahi, Pardis Irandoost, Roya Ghafoury

Aim: COVID-19 can lead to encephalopathy and loss of consciousness. This double-blinded randomized clinical trial conducted in Tehran, Iran, aimed to assess the potential effectiveness of modafinil in patients with COVID-19-related encephalopathy.

Methods: Nineteen non-intubated COVID-19 patients with encephalopathy were randomized into two groups: a treatment group receiving crushed modafinil tablets and a placebo group receiving starch powder. Modafinil was administered at a dose of 100 mg every 2 h, reaching a peak dosage of 400 mg. The level of consciousness was assessed using the Glasgow Coma Score (GCS) at multiple time points on the day of medication administration. The trial was registered under IRCT20170903036041N3 on 23/5/2021.

Results: The average age in the modafinil and placebo groups was 75.33 and 70 years, respectively. No significant differences were observed between the two groups in terms of chronic conditions, clinical symptoms, or laboratory data. GCS scores were similar between the groups at baseline (p-value = 0.699). After four doses of modafinil, GCS scores were slightly higher in the treatment group, but this difference was not statistically significant (p-value = 0.581). GCS scores after each round of drug administration didn't significantly differ between the treatment and placebo groups (p-value = 0.908).

Conclusion: Modafinil exhibited a slight improvement in the level of consciousness among COVID-19 patients with encephalopathy, although this improvement did not reach statistical significance when compared to the control group. Further research with larger sample sizes and longer treatment durations is recommended to explore modafinil's potential benefits in managing altered consciousness in COVID-19 patients.

目的:COVID-19可导致脑病和意识丧失。这项在伊朗德黑兰进行的双盲随机临床试验旨在评估莫达非尼对 COVID-19 相关脑病患者的潜在疗效:19名未插管的COVID-19脑病患者被随机分为两组:治疗组服用莫达非尼压片,安慰剂组服用淀粉粉。莫达非尼的剂量为每 2 小时 100 毫克,最高剂量为 400 毫克。在用药当天的多个时间点使用格拉斯哥昏迷评分(GCS)评估意识水平。该试验于 2021 年 5 月 23 日在 IRCT20170903036041N3 下注册:莫达非尼组和安慰剂组的平均年龄分别为 75.33 岁和 70 岁。两组患者在慢性疾病、临床症状或实验室数据方面无明显差异。基线时,两组的 GCS 评分相似(P 值 = 0.699)。四次服用莫达非尼后,治疗组的 GCS 评分略高,但差异无统计学意义(p 值 = 0.581)。每轮用药后,治疗组和安慰剂组的 GCS 评分均无显著差异(P 值 = 0.908):结论:莫达非尼对COVID-19脑病患者的意识水平有轻微改善,但与对照组相比,这种改善未达到统计学意义。建议进一步开展样本量更大、疗程更长的研究,以探索莫达非尼在控制COVID-19患者意识改变方面的潜在益处。
{"title":"Evaluation of the effect of Modafinil in the improvement of the level of consciousness in patients with COVID-19 encephalopathy: A randomized controlled trial.","authors":"Fatemeh Talebi Kiasari, Mobin Naghshbandi, Maziar Emamikhah, Omid Moradi Moghaddam, Mohammad Niakan Lahiji, Mohammad Rohani, Narges Yazdi, Hamidreza Movahedi, Alireza Amanollahi, Pardis Irandoost, Roya Ghafoury","doi":"10.1002/npr2.12447","DOIUrl":"10.1002/npr2.12447","url":null,"abstract":"<p><strong>Aim: </strong>COVID-19 can lead to encephalopathy and loss of consciousness. This double-blinded randomized clinical trial conducted in Tehran, Iran, aimed to assess the potential effectiveness of modafinil in patients with COVID-19-related encephalopathy.</p><p><strong>Methods: </strong>Nineteen non-intubated COVID-19 patients with encephalopathy were randomized into two groups: a treatment group receiving crushed modafinil tablets and a placebo group receiving starch powder. Modafinil was administered at a dose of 100 mg every 2 h, reaching a peak dosage of 400 mg. The level of consciousness was assessed using the Glasgow Coma Score (GCS) at multiple time points on the day of medication administration. The trial was registered under IRCT20170903036041N3 on 23/5/2021.</p><p><strong>Results: </strong>The average age in the modafinil and placebo groups was 75.33 and 70 years, respectively. No significant differences were observed between the two groups in terms of chronic conditions, clinical symptoms, or laboratory data. GCS scores were similar between the groups at baseline (p-value = 0.699). After four doses of modafinil, GCS scores were slightly higher in the treatment group, but this difference was not statistically significant (p-value = 0.581). GCS scores after each round of drug administration didn't significantly differ between the treatment and placebo groups (p-value = 0.908).</p><p><strong>Conclusion: </strong>Modafinil exhibited a slight improvement in the level of consciousness among COVID-19 patients with encephalopathy, although this improvement did not reach statistical significance when compared to the control group. Further research with larger sample sizes and longer treatment durations is recommended to explore modafinil's potential benefits in managing altered consciousness in COVID-19 patients.</p>","PeriodicalId":19137,"journal":{"name":"Neuropsychopharmacology Reports","volume":" ","pages":"490-501"},"PeriodicalIF":2.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11544445/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140876941","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
A psychometric analysis of the Japanese version of the clinically useful depression outcome scale supplemented with questions for the DSM-5 anxious distress specifier (CUDOS-A). 对日文版临床实用抑郁结果量表进行心理计量分析,并对 DSM-5 焦虑困扰指标(CUDOS-A)的问题进行补充。
IF 2 Q3 NEUROSCIENCES Pub Date : 2024-09-01 Epub Date: 2024-06-05 DOI: 10.1002/npr2.12432
Yumi Aoki, Yoshikazu Takaesu, Yasuyuki Matsumoto, Hitoshi Sakurai, Takashi Tsuboi, Isa Okajima, Hisateru Tachimori, Yoko Komada, Koichiro Watanabe, Mark Zimmerman

Aim: The aim of the study was to identify the clinical significance of anxiety in those with depression, the Diagnostic and Statistical Manual of Mental Disorders 5th edition (DSM-5) defined criteria for an anxious distress specifier for major depressive disorder (MDD). The Clinically Useful Depression Outcome Scale (CUDOS) supplemented with questions for the DSM-5 anxious distress specifier (CUDOS-A) is a self-report instrument to assess the clinical significance of anxiety in addition to assess symptoms and the severity of depression. This study aimed to evaluate the psychometric properties of the Japanese version of the CUDOS-A.

Methods: An observational, prospective study was conducted with 131 MDD outpatients and 200 healthy controls. The Japanese version of the CUDOS-A, along with other measures, was administered to assess depressive symptoms, anxiety, social function, and biological rhythm. Reliability and validity analyses were performed, including internal consistency, test-retest reliability, convergent validity, and contrasted-groups validity.

Results: The Japanese version of the CUDOS-A demonstrated excellent internal consistency (Cronbach's alpha = 0.96) and test-retest reliability (ICC = 0.78). Significant positive correlations were found between the CUDOS-A and measures of depression, anxiety, social function, and biological rhythm (all, p < 0.001), supporting its convergent validity. The CUDOS-A effectively differentiated between patients with MDD and healthy controls (p < 0.001), indicating good contrasted-groups validity.

Conclusions: The Japanese version of the CUDOS-A is a useful measure for research and for clinical practice, enabling the efficient assessment of anxious distress in individuals with depression.

目的:本研究旨在确定焦虑在抑郁症患者中的临床意义,即《精神疾病诊断与统计手册》第 5 版(DSM-5)所定义的重度抑郁障碍(MDD)焦虑困扰指标标准。临床实用抑郁结果量表(CUDOS)补充了DSM-5焦虑不安指标的问题(CUDOS-A),是一种自我报告工具,除了评估抑郁症的症状和严重程度外,还可评估焦虑的临床意义。本研究旨在评估日文版 CUDOS-A 的心理测量特性:方法:对 131 名 MDD 门诊患者和 200 名健康对照者进行了一项前瞻性观察研究。日语版 CUDOS-A 与其他测量方法一起用于评估抑郁症状、焦虑、社会功能和生物节律。研究进行了信度和效度分析,包括内部一致性、重测信度、收敛效度和组间对比效度:结果:日文版 CUDOS-A 表现出良好的内部一致性(Cronbach's alpha = 0.96)和重测信度(ICC = 0.78)。CUDOS-A 与抑郁、焦虑、社会功能和生物节律的测量结果之间存在显著的正相关(均为 p 结论:CUDOS-A 与抑郁、焦虑、社会功能和生物节律的测量结果之间存在显著的正相关:日语版 CUDOS-A 是一种对研究和临床实践非常有用的测量方法,可有效评估抑郁症患者的焦虑痛苦。
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引用次数: 0
Severe behavioral and psychological symptoms of dementia successfully treated at home with a blonanserin transdermal patch: A case report. 在家中使用布隆色林透皮贴片成功治疗老年痴呆症的严重行为和心理症状:病例报告。
IF 2.5 Q3 NEUROSCIENCES Pub Date : 2024-06-01 Epub Date: 2024-04-01 DOI: 10.1002/npr2.12434
Junji Yamaguchi, Ryoichi Sadahiro, Takatoshi Hirayama, Saho Wada, Rika Nakahara, Hiromichi Matsuoka

Aim: Behavioral psychological symptoms of dementia (BPSD) are sometimes difficult to treat due to severe psychiatric symptoms such as delusions of poisoning and violent behavior. Moreover, in cases of parental neglect, the management of these psychiatric symptoms becomes more difficult. Therefore, home-visiting doctors sometimes have to manage patients with BPSD and severe psychiatric symptoms, and a new approach is needed. In this case report, the effect of blonanserin transdermal patch on these patients is to be highlighted.

Methods: The patient is a 91-year-old woman diagnosed with Alzheimer's disease. She had severe BPSD such as delusion of robbery and violent behavior, and refused oral medications including memantine and yokukansan. Then she was treated with blonanserin transdermal patch (20 mg/day). The severity of psychiatric symptoms of BPSD was assessed over time using the Neuropsychiatric Inventory (NPI) score. Moreover, the patient's cognitive function was also assessed over time by Mini-Mental State Examination (MMSE).

Results: After the introduction of blonanserin patch, the patient's psychiatric symptoms were stabilized markedly, and both NPI and MMSE scores improved. The patient was able to stay at home calmly and was mentally well stabilized to the extent that she did not require hospitalization. No apparent side effects were admitted.

Conclusions: The blonanserin transdermal patch may be able to manage BPSD at home and is effective in patients who refuse oral medications. Home-visiting doctors may consider the use of blonanserin patches at home for patients with severe BPSD, manifesting as delusions of poisoning and refusing oral drugs.

目的:痴呆症的行为心理症状(BPSD)有时会因中毒妄想和暴力行为等严重精神症状而难以治疗。此外,在父母疏于照顾的情况下,这些精神症状的治疗也变得更加困难。因此,上门服务的医生有时不得不处理具有 BPSD 和严重精神症状的患者,这就需要一种新的方法。在本病例报告中,将重点介绍布隆色林透皮贴剂对这类患者的效果:患者是一名 91 岁的女性,被诊断患有阿尔茨海默病。方法:患者是一名 91 岁的老年痴呆症患者,被诊断为阿尔茨海默病。她有严重的 BPSD,如抢劫妄想和暴力行为,并拒绝口服药物,包括美金刚和育康散。随后,她接受了布隆色林透皮贴剂(20 毫克/天)治疗。使用神经精神症状量表(NPI)评分对 BPSD 的精神症状严重程度进行了长期评估。此外,还通过小型精神状态检查(MMSE)对患者的认知功能进行了评估:结果:使用布南色林贴片后,患者的精神症状明显稳定,NPI和MMSE评分均有所改善。患者能够平静地待在家里,精神状态稳定,无需住院治疗。没有发现明显的副作用:布洛奈色林透皮贴片可在家中控制 BPSD,对拒绝口服药物的患者有效。家庭巡诊医生可以考虑在家中为表现为中毒妄想和拒绝口服药物的严重 BPSD 患者使用布隆色林贴片。
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引用次数: 0
EEG and video documentation of benzodiazepine challenge in catatonic stupor: A case report. 在紧张性昏迷中挑战苯二氮卓的脑电图和视频记录:病例报告。
IF 2.5 Q3 NEUROSCIENCES Pub Date : 2024-06-01 Epub Date: 2024-03-07 DOI: 10.1002/npr2.12427
Hidetaka Tamune, Yu Tsukioka, Shota Sakuma, Daiki Taira, Yoshie Takaoka, Naoto Tamura, Tadafumi Kato

Introduction: Catatonia, a psychomotor disorder characterized by diverse clinical signs, including stupor and mutism, remains elusive in its causes and a challenge to diagnose. Moreover, it is often underrecognized due to its resemblance to disorders of consciousness. However, when diagnosing catatonia, an antipsychotic medication may exacerbate the condition. The first-line treatment typically includes benzodiazepines and/or electroconvulsive therapy (ECT).

Case report: A 60-year-old woman with systemic lupus erythematosus (SLE) and epilepsy presented with catatonic stupor. Despite stable treatment, she experienced an acute deterioration in consciousness, requiring hospitalization. Her condition improved markedly following a benzodiazepine challenge, as documented on EEG. This improvement was short-lived, but a second benzodiazepine challenge restored her from E1V1M1 (stupor) to E4V5M6 within minutes, as documented by a video recording. The patient was treated with lorazepam 1.5 mg/day orally and did not experience further relapses.

Discussion: The diagnosis of catatonia had been based on her scores on the Bush-Francis Catatonia Rating Scale (BFCRS; Screening, 6/14; Severity, 19), despite meeting only two DSM-5 criteria for catatonia (stupor and mutism). The diagnosis was supported by EEG and video documentation, excluding other potential differential diagnoses such as nonconvulsive status epilepticus and encephalopathy. Additional quantitative EEG analyses indicated that benzodiazepine administration increased brainwide alpha and beta band power significantly, suggesting that the benzodiazepine normalized attention, consciousness, and long-range synchronization. This report additionally emphasizes the significance of video recordings in managing catatonia, and it helps in accurately tracking symptoms, documenting comprehensively, and improving patient understanding, which is crucial for treatment adherence.

简介紧张症是一种精神运动障碍疾病,以昏迷和缄默等多种临床表现为特征。此外,由于与意识障碍相似,它往往不被充分认识。然而,在诊断紧张症时,抗精神病药物可能会加重病情。一线治疗通常包括苯二氮卓类药物和/或电休克疗法(ECT):一名患有系统性红斑狼疮(SLE)和癫痫的 60 岁女性出现紧张性昏迷。尽管接受了稳定的治疗,她还是出现了急性意识衰退,需要住院治疗。根据脑电图记录,她在接受苯二氮卓类药物挑战后病情明显好转。这种改善是短暂的,但第二次苯二氮卓类药物挑战使她在几分钟内从 E1V1M1(昏迷)恢复到 E4V5M6,视频记录也证明了这一点。患者接受了劳拉西泮 1.5 毫克/天的口服治疗,之后没有再复发:根据布什-弗朗西斯紧张症评定量表(Bush-Francis Catatonia Rating Scale,BFCRS;筛查,6/14;严重程度,19)的评分,患者被诊断为紧张症,尽管她只符合DSM-5中紧张症的两项标准(昏迷和缄默)。诊断得到了脑电图和视频文件的支持,排除了其他潜在的鉴别诊断,如非惊厥性癫痫状态和脑病。额外的脑电图定量分析显示,苯二氮卓类药物能显著增加全脑阿尔法和贝塔波段的功率,这表明苯二氮卓类药物能使注意力、意识和长程同步正常化。本报告还强调了视频记录在治疗紧张性精神分裂症中的重要性,它有助于准确跟踪症状、全面记录和提高患者的理解能力,这对坚持治疗至关重要。
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引用次数: 0
Research hotspots and frontiers of alcohol and epilepsy: A bibliometric analysis. 酒精与癫痫的研究热点和前沿:文献计量分析。
IF 2.5 Q3 NEUROSCIENCES Pub Date : 2024-06-01 Epub Date: 2024-03-01 DOI: 10.1002/npr2.12421
Wenhui Liu, Huan Li, Simei Lin

Purpose: Alcohol is implicated in epileptogenesis and seizures attack. An increasing number of studies about alcohol and epilepsy have been published. We aimed to assess research trends and hot spots in the field of alcohol and epilepsy.

Patients and methods: Literature concerning alcohol and epilepsy was systemically searched through the Web of Science database. Collaborative maps were quantitatively analyzed by using the VOSviewer and CiteSpace tools.

Results: A total of 1578 papers about the field of alcohol and epilepsy were taken into analysis, which was written by 6840 authors from 2153 institutions in 85 countries, published in 676 journals, and cited 79 667 references from 10 750 journals. The United States was the leading country and had close ties with others. The University of Toronto was the most productive institution. Alcoholism-clinical and experimental research was the fastest-growing journal. Richard J. Bodnar was the author contributing the most literature. Analysis of keywords showed epilepsy, alcohol, seizures, alcohol withdrawal, and management were common themes.

Conclusion: The presented study conducted the first bibliometric analysis of the field of alcohol and epilepsy, which will provide insights into the latest progress, evolution paths, frontier research hot spots, and future research trends in the field.

目的:酒精与癫痫的发生和发作有关。有关酒精与癫痫的研究越来越多。我们旨在评估酒精与癫痫领域的研究趋势和热点:我们通过 Web of Science 数据库对有关酒精与癫痫的文献进行了系统检索。使用 VOSviewer 和 CiteSpace 工具对协作图进行定量分析:共分析了 1578 篇有关酒精与癫痫领域的论文,这些论文由来自 85 个国家 2153 个机构的 6840 位作者撰写,发表在 676 种期刊上,被 10 750 种期刊引用了 79 667 次。美国居首位,与其他国家也有密切联系。多伦多大学是成果最多的机构。酒精中毒-临床与实验研究》是增长最快的期刊。理查德-J-博德纳是发表文献最多的作者。关键词分析表明,癫痫、酒精、癫痫发作、酒精戒断和管理是常见的主题:本研究首次对酒精与癫痫领域进行了文献计量分析,有助于深入了解该领域的最新进展、演变路径、前沿研究热点和未来研究趋势。
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引用次数: 0
The effective perospirone augmentation with clonazepam for treatment-resistant burning mouth syndrome: A case report. 氯硝西泮与培罗匹隆联用可有效治疗耐药性灼口综合征:病例报告。
IF 2.5 Q3 NEUROSCIENCES Pub Date : 2024-06-01 Epub Date: 2024-03-18 DOI: 10.1002/npr2.12425
Motoko Watanabe, Chihiro Takao, Chizuko Maeda, Gayatri Nayanar, Risa Tominaga, Yasuyuki Kimura, Trang Thi Huyen Tu, Takahiko Nagamine, Akira Toyofuku

Burning mouth syndrome (BMS) is characterized by burning sensations in the oral region without corresponding abnormalities and is often accompanied by uncomfortable sensations. Herein, we present cases of BMS in which the remaining uncomfortable sensations improved with perospirone augmentation with clonazepam. Case 1: A 61-year-old man complained of a burning pain in his tongue, a sensation of dryness and discomfort as if his tongue was sticking to a palatal plate. With the diagnosis of BMS, psychopharmacotherapy was initiated with amitriptyline. At the dose of amitriptyline 50 mg, the pain lessened but uncomfortable sensations persisted. Further attempts to alleviate symptoms by combining aripiprazole with amitriptyline, aripiprazole with mirtazapine, or aripiprazole with clonazepam were limited; however, nearly all symptoms were relieved by a combination of perospirone 8.0 mg with clonazepam 1.5 mg. Case 2: A 51-year-old woman complained of a burning sensation along with oral dryness and crumb-like feeling on her tongue. She was diagnosed with BMS and began treatment with amitriptyline. Her burning sensation improved at the dose of 25 mg, but uncomfortable sensations persisted. Augmentation of amitriptyline with aripiprazole, aripiprazole either with valproate, mirtazapine, or clonazepam failed to produce a significant improvement. However, a regimen of perospirone 6.0 mg and clonazepam 1.5 mg relieved the crumb-like sensation and pain and culminated in a stabilized condition. The reported cases suggested that multiple approaches targeting the dopaminergic circuit in basal ganglia involving the serotoninergic and GABA systems, through the administration of perospirone with clonazepam is an effective adjunctive treatment for the remaining uncomfortable sensations in patients with BMS.

烧灼感口腔综合征(BMS)的特征是口腔区域有烧灼感,但没有相应的异常,而且常常伴有不舒适感。在本文中,我们介绍了一些 BMS 病例,这些病例在使用氯硝西泮增强围磷期酮后,剩余的不舒适感觉得到了改善。病例 1:一名 61 岁的男性主诉其舌头有灼痛感、干燥感以及舌头好像粘在腭板上的不适感。诊断为 BMS,开始使用阿米替林进行精神药物治疗。阿米替林的剂量为 50 毫克,疼痛有所减轻,但不舒服的感觉仍然存在。进一步尝试将阿立哌唑与阿米替林、阿立哌唑与米氮平或阿立哌唑与氯硝西泮联合使用以减轻症状,但效果有限;然而,将围螺匹隆 8.0 毫克与氯硝西泮 1.5 毫克联合使用后,几乎所有症状都得到了缓解。病例 2:一名 51 岁的女性主诉有灼烧感,口腔干燥,舌头上有碎屑样感觉。她被诊断为 BMS,并开始接受阿米替林治疗。当剂量为 25 毫克时,她的烧灼感有所改善,但不舒服的感觉仍然存在。阿米替林与阿立哌唑、阿立哌唑与丙戊酸钠、米氮平或氯硝西泮联用,均未能明显改善症状。然而,使用 perospirone 6.0 毫克和氯硝西泮 1.5 毫克的治疗方案缓解了面包屑样感觉和疼痛,病情最终趋于稳定。所报告的病例表明,通过服用培罗匹隆和氯硝西泮,针对基底神经节多巴胺能回路(涉及血清素能和 GABA 系统)的多种方法是治疗 BMS 患者剩余不适感觉的有效辅助疗法。
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引用次数: 0
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Neuropsychopharmacology Reports
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