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Effect of Methylphenidate in Patients with Acute Traumatic Brain Injury; a Randomized Clinical Trial 哌甲酯治疗急性颅脑损伤的疗效观察随机临床试验
Pub Date : 2008-03-01 DOI: 10.1017/S1748232107000079
Hosseinali Khalili, Kamyar Keramatian
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引用次数: 3
New Approaches to Treatment of Schizophrenia by Enhancing N -methyl- D -aspartate Neurotransmission 加强N -甲基- D -天冬氨酸神经传递治疗精神分裂症的新途径
Pub Date : 2008-03-01 DOI: 10.1017/S1748232107000055
G. Tsai
ABSTRACT Background: There is a great need to develop new antipsychotic agents. In addition to dopaminergic neurotransmission, glutamatergic neurotransmission has been implicated in the pathophysiology of schizophrenia. The most compelling link between glutamatergic N -methyl- d -aspartate (NMDA) neurotransmission and schizophrenia concerns the mechanism of action of the psychotomimetic drug phencyclidine and the dissociative anesthetic, ketamine; both are NMDA antagonists. The psychosis induced by the NMDA antagonists causes not only positive symptoms similar to the action of dopaminergic enhancers but also negative symptoms and cognitive deficits typical of schizophrenia in normal volunteers and worsening of the psychotic symptoms in patients with schizophrenia. Accordingly, enhancing NMDA neurotransmission should benefit the symptoms of schizophrenia. Methods: Most clinical trials were done by the addition of the NMDA-enhancing agents, glycine, d -serine, d -alanine, d -cycloserine and sarcosine to the stable regimens of antipsychotics in double-blind, placebo-controlled designs. Results: When taken together, the trials of NMDA-enhancing agents in patients with chronic schizophrenia receiving stable dose of antipsychotics, the NMDA-enhancing agents were effective in the domains of negative symptoms, cognition, depression, positive symptoms and general psychopathology. The agents also significantly improved extrapyramidal symptoms. No significant side-effects or safety concerns emerged. Interpretation: In addition to testing more lead compounds, dose-finding and long-term trials are required to determine the optimal dose and functional improvement capacity of NMDA receptor agonist. The agents may also be applied to prevention and the treatment for prodromal phases of the illness.
背景:迫切需要开发新的抗精神病药物。除了多巴胺能神经传递外,谷氨酸能神经传递也与精神分裂症的病理生理有关。谷氨酸能N -甲基- d -天冬氨酸(NMDA)神经传递与精神分裂症之间最令人信服的联系涉及拟精神药物苯环利定和解离麻醉剂氯胺酮的作用机制;两者都是NMDA拮抗剂。NMDA拮抗剂引起的精神病不仅引起类似多巴胺能增强剂作用的阳性症状,而且在正常志愿者中引起精神分裂症典型的阴性症状和认知缺陷,并使精神分裂症患者的精神病症状恶化。因此,增强NMDA神经传递应该有利于精神分裂症的症状。方法:大多数临床试验采用双盲、安慰剂对照设计,在稳定的抗精神病药物方案中加入nmda增强剂、甘氨酸、d -丝氨酸、d -丙氨酸、d -环丝氨酸和肌氨酸。结果:综合考虑nmda增强剂在稳定剂量抗精神病药物治疗的慢性精神分裂症患者中的临床试验,nmda增强剂在阴性症状、认知、抑郁、阳性症状和一般精神病理等方面均有效。这些药物还能显著改善锥体外系症状。没有出现明显的副作用或安全问题。解释:除了测试更多的先导化合物外,还需要进行剂量测定和长期试验,以确定NMDA受体激动剂的最佳剂量和功能改善能力。这些药物也可用于预防和治疗疾病的前驱期。
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引用次数: 2
Modafinil: A Candidate for Pharmacotherapy of Negative Symptoms in Schizophrenia 莫达非尼:精神分裂症阴性症状药物治疗的候选药物
Pub Date : 2008-03-01 DOI: 10.1017/S1748232107000134
John H. Peloian, J. Pierre
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引用次数: 2
Intranasal Zolmitriptan Is Effective and Well Tolerated in Acute Cluster Headache: A Randomized Placebo-Controlled Double-Blind Crossover Study 鼻内佐米曲坦治疗急性丛集性头痛有效且耐受性良好:一项随机安慰剂对照双盲交叉研究
Pub Date : 2008-03-01 DOI: 10.1017/S174823210700016X
E. Cittadini, P. Goadsby
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引用次数: 1
A randomized-controlled trial of bilateral rTMS for treatment-resistant depression 双侧rTMS治疗难治性抑郁症的随机对照试验
Pub Date : 2008-03-01 DOI: 10.1017/S1748232107000018
P. Fitzgerald
ABSTRACT Background : Antidepressant effects have been demonstrated with both high-frequency left-sided repetitive transcranial magnetic stimulation (rTMS) (HFL-TMS) and low-frequency stimulation to the right prefrontal cortex (LFR-TMS). However, doubts remain about the extent of these reported treatment effects. Design and Methods : The study was a 6 week double-blind randomized sham-controlled trial of sequential bilateral rTMS (SBrTMS) in depression. The method consisted of 3 trains of LFR-TMS of 140 s duration at 1 Hz being applied daily followed immediately by 15 trains of 5 s duration of HFL-TMS at 10 Hz. Sham stimulation was applied using identical parameters, but with the coil angled at 45 degrees from the scalp resting on the side of one wing of the coil. Results : There was a significant difference in response between the two groups at the 2-week time-point ( F (1,25) = 25.5, p F (5,44) = 3.9, p = 0.005). A significant proportion of the active study group met response (11/25) and remission criteria (9/25) by study end compared to the sham group (2 and 0/22). Interpretation : Bilateral rTMS treatment, involving the sequential application of both HFL-TMS and LFR-TMS, has substantial treatment efficacy in patients with treatment-resistant depression. The treatment response is clinically significant following 4–6 weeks of active treatment. Therefore this novel style of bilateral rTMS has the potential to become a substantive clinical intervention, although the study requires replication.
背景:高频左侧重复经颅磁刺激(rTMS) (HFL-TMS)和低频右前额叶皮质刺激(LFR-TMS)均有抗抑郁作用。然而,对这些报道的治疗效果的程度仍然存在疑问。设计与方法:本研究是一项为期6周的双盲随机假对照试验,采用顺序双侧rTMS (SBrTMS)治疗抑郁症。该方法包括每天使用3列持续时间为140秒、频率为1hz的低通量-经颅磁刺激,紧接着使用15列持续时间为5秒、频率为10hz的高通量-经颅磁刺激。假性刺激使用相同的参数,但线圈与头皮成45度角,放置在线圈的一侧。结果:两组在2周时间点的疗效差异有统计学意义(F (1,25) = 25.5, p F (5,44) = 3.9, p = 0.005)。与假手术组(2和0/22)相比,活跃研究组在研究结束时达到缓解标准(11/25)和缓解标准(9/25)的比例显著。解释:双侧rTMS治疗,包括HFL-TMS和LFR-TMS的顺序应用,对难治性抑郁症患者具有显著的治疗效果。在4-6周的积极治疗后,治疗反应具有临床意义。因此,这种新型的双侧rTMS有可能成为一种实质性的临床干预措施,尽管该研究需要复制。
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引用次数: 2
A Randomized Trial Comparing Unilateral Pallidotomy with Bilateral Subthalamic Nucleus Stimulation in PD: Perspectives for Future Implication in Clinical Practice 一项比较PD患者单侧苍白球切开术与双侧丘脑下核刺激的随机试验:对未来临床实践意义的展望
Pub Date : 2007-03-01 DOI: 10.1017/S1748232106000036
R. Esselink, R. D. Bie, R. Haan, P. Schuurman, P. Munckhof, J. Speelman
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引用次数: 0
A Double-Blind, Randomized Clinical Trial to Assess the Augmentation with Nimodipine of Antidepressant Therapy in the Treatment of “Vascular Depression” 评价尼莫地平增强抗抑郁药物治疗“血管性抑郁症”的双盲随机临床试验
Pub Date : 2007-03-01 DOI: 10.1017/S1748232106000103
F. Taragano, P. Bagnati, R. Allegri
ABSTRACT There is evidence for an association between vascular disease and depression, and in particular between cerebrovascular disease and depression, especially that occurring later in life. Among the diverse psychiatric diseases, the one which is most widely studied concerning the relationship with the vascular system, is depression. The risk relationship between depression and vascular events is a two-way road: the presence of depression increases the cerebrovascular and cardiovascular event risk (worsening its evolution and prognosis, as well) and a patient evidencing cerebrovascular or heart disease, will also show an increase in the risk of suffering depression ( Taragano et al. , 2005 ). Depression is a common cause of disability in the elderly. It reduces quality of life and represents a serious public health problem ( Beekman et al. , 2001 ; Steffens et al. , 2000 ). Its prevalence in late life is 2–3% for major depression and 12–15% for all depressive syndromes ( Beekman et al. , 1999 ).
有证据表明血管疾病与抑郁症之间存在关联,特别是脑血管疾病与抑郁症之间,特别是发生在生命后期的抑郁症。在各种精神疾病中,与血管系统的关系研究得最广泛的是抑郁症。抑郁症与血管事件之间的风险关系是双向的:抑郁症的存在增加了脑血管和心血管事件的风险(也恶化了其演变和预后),而患有脑血管或心脏病的患者也会增加患抑郁症的风险(Taragano et al., 2005)。抑郁症是老年人致残的常见原因。它降低了生活质量,是一个严重的公共卫生问题(Beekman等人,2001年;Steffens et al., 2000)。其在晚年的患病率在重度抑郁症中为2-3%,在所有抑郁综合征中为12-15% (Beekman et al., 1999)。
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引用次数: 2
Can Quality of Life be Improved in Schizophrenia? Results From A Pragmatic, Randomized, Controlled Trial Comparing Olanzapine with First Generation Antipsychotics 精神分裂症患者的生活质量可以改善吗?一项比较奥氮平与第一代抗精神病药物的实用、随机、对照试验的结果
Pub Date : 2007-03-01 DOI: 10.1017/S1748232106000176
M. S. Lima, A. Breier, J. Mari
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引用次数: 0
Symptomatic Remission in Patients with Bipolar Mania: Results from a Double-Blind, Placebo-Controlled Trial of Risperidone Monotherapy 双相躁狂症患者的症状缓解:利培酮单药治疗的双盲、安慰剂对照试验结果
Pub Date : 2007-03-01 DOI: 10.1017/S1748232106000152
S. Gopal, J. Beyer, D. Steffens, M. Kramer
ABSTRACTBackground: The purpose of this analysis was to compare symptomatic remission rates between risperidone and placebo in a completed randomized controlled trial. Design and Methods: Two hundred ninety (290) adult patients who met DSM-IV criteria for Bipolar I Disorder Manic or Mixed episode were randomized to flexible doses of risperidone or placebo for 3 weeks. An entry Young Mania Rating Scale (YMRS) score of > 20 was required at trial screening and baseline. Time to first onset of remission (as defined as a YMRS score of < 8) was assessed using Cox proportional hazards. Persence or absence of sustained remission was analyzed using logistic regression. Sustained remission was defined as maintaining a YMRS < 8 for the remainder of the trial or until censor. Results: After adjusting for presence of psychosis, baseline YMRS, gender, number of mood cycles in the previous year and treatment,the odds of sustained remission for subjects on risperidone was 5.6 (p < 0.0001). Similarly the adjusted hazard or remission for subjects on rsiperidone was 4.0 (p < 0.0001). Interpretaion: A statistically significant proportion of manic patients receiving risperidone monotherapy achieved symptomatic remission within 3 weeks as compared to placebo.
摘要背景:本分析的目的是在一项完整的随机对照试验中比较利培酮和安慰剂的症状缓解率。设计和方法:290例符合DSM-IV双相I型躁狂症或混合性发作标准的成年患者随机接受灵活剂量的利培酮或安慰剂治疗3周。在试验筛选和基线时,要求青年躁狂症评定量表(YMRS)得分> 20。使用Cox比例风险评估到首次发作缓解的时间(定义为YMRS评分< 8)。使用逻辑回归分析是否存在持续缓解。持续缓解被定义为在试验剩余时间或直到审查前维持YMRS < 8。结果:在调整精神病的存在、基线YMRS、性别、前一年的情绪周期次数和治疗后,利培酮受试者持续缓解的几率为5.6 (p < 0.0001)。同样,利培酮治疗的调整后危险度或缓解度为4.0 (p < 0.0001)。解释:与安慰剂相比,接受利培酮单药治疗的躁狂患者在3周内症状缓解的比例具有统计学意义。
{"title":"Symptomatic Remission in Patients with Bipolar Mania: Results from a Double-Blind, Placebo-Controlled Trial of Risperidone Monotherapy","authors":"S. Gopal, J. Beyer, D. Steffens, M. Kramer","doi":"10.1017/S1748232106000152","DOIUrl":"https://doi.org/10.1017/S1748232106000152","url":null,"abstract":"ABSTRACTBackground: The purpose of this analysis was to compare symptomatic remission rates between risperidone and placebo in a completed randomized controlled trial. Design and Methods: Two hundred ninety (290) adult patients who met DSM-IV criteria for Bipolar I Disorder Manic or Mixed episode were randomized to flexible doses of risperidone or placebo for 3 weeks. An entry Young Mania Rating Scale (YMRS) score of > 20 was required at trial screening and baseline. Time to first onset of remission (as defined as a YMRS score of < 8) was assessed using Cox proportional hazards. Persence or absence of sustained remission was analyzed using logistic regression. Sustained remission was defined as maintaining a YMRS < 8 for the remainder of the trial or until censor. Results: After adjusting for presence of psychosis, baseline YMRS, gender, number of mood cycles in the previous year and treatment,the odds of sustained remission for subjects on risperidone was 5.6 (p < 0.0001). Similarly the adjusted hazard or remission for subjects on rsiperidone was 4.0 (p < 0.0001). Interpretaion: A statistically significant proportion of manic patients receiving risperidone monotherapy achieved symptomatic remission within 3 weeks as compared to placebo.","PeriodicalId":347111,"journal":{"name":"Progress in Neurotherapeutics and Neuropsychopharmacology","volume":"5 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2007-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121226964","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 2
Repetitive Transcranial Magnetic Stimulation: A Novel, Noninvasive Add-on Treatment for Medication-Resistant Depression 重复经颅磁刺激:一种新的、无创的附加治疗药物抵抗性抑郁症
Pub Date : 2007-03-01 DOI: 10.1017/S1748232106000115
T. Su, Chih-Chia Huang
{"title":"Repetitive Transcranial Magnetic Stimulation: A Novel, Noninvasive Add-on Treatment for Medication-Resistant Depression","authors":"T. Su, Chih-Chia Huang","doi":"10.1017/S1748232106000115","DOIUrl":"https://doi.org/10.1017/S1748232106000115","url":null,"abstract":"","PeriodicalId":347111,"journal":{"name":"Progress in Neurotherapeutics and Neuropsychopharmacology","volume":"15 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2007-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123703635","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
期刊
Progress in Neurotherapeutics and Neuropsychopharmacology
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