Pub Date : 2019-01-01DOI: 10.4172/Neuropsychiatry.1000564
I. Sinkeviciute, R. Gjestad, E. Kjelby, Laimonas Ratkus, K. Hugdahl, R. Kroken, E. Løberg, H. Jørgensen, I. Sommer, E. Johnsen
Objective Hallucinations are highly prevalent in schizophrenia and related disorders. Antipsychotics are generally effective in treating hallucinations, but major inter-individual differences in treatment response exist. Previous studies have identified heterogeneity of over-all antipsychotic response patterns in schizophrenia. The aim of this study was to explore the heterogeneity in the response of hallucinations to antipsychotic drug treatment in a representative sample of patients acutely admitted for psychosis. Methods 226 adult patients with symptoms of active psychosis were included in a randomized pragmatic trial of second-generation antipsychotics and followed for 27 weeks. Latent-mixture and latent growth curve models were conducted to analyze heterogeneity of treatment response for hallucinations to second-generation antipsychotics. Results We found five different trajectories of treatment response for patients with hallucinations at baseline. These included two groups of “dramatic responders” who had rapid reduction followed by extinction of hallucinations during the first four weeks of treatment, then groups of “gradual responders”, “temporal responders” and “non-responders”. Most responders, 80% of those with hallucinations at baseline, were dramatic responders. Patients who showed no response in the early weeks remained non-responders also after longer follow-up. Conclusions The study suggests the existence of differential response patterns of hallucinations to antipsychotic treatment, and that a significant subgroup are dramatic responders. Hallucinations generally respond quickly to antipsychotic treatment. With no improvement in the very first weeks an early change of treatment should be considered.
{"title":"Trajectories of Treatment Response in Hallucinations","authors":"I. Sinkeviciute, R. Gjestad, E. Kjelby, Laimonas Ratkus, K. Hugdahl, R. Kroken, E. Løberg, H. Jørgensen, I. Sommer, E. Johnsen","doi":"10.4172/Neuropsychiatry.1000564","DOIUrl":"https://doi.org/10.4172/Neuropsychiatry.1000564","url":null,"abstract":"Objective Hallucinations are highly prevalent in schizophrenia and related disorders. Antipsychotics are generally effective in treating hallucinations, but major inter-individual differences in treatment response exist. Previous studies have identified heterogeneity of over-all antipsychotic response patterns in schizophrenia. The aim of this study was to explore the heterogeneity in the response of hallucinations to antipsychotic drug treatment in a representative sample of patients acutely admitted for psychosis. Methods 226 adult patients with symptoms of active psychosis were included in a randomized pragmatic trial of second-generation antipsychotics and followed for 27 weeks. Latent-mixture and latent growth curve models were conducted to analyze heterogeneity of treatment response for hallucinations to second-generation antipsychotics. Results We found five different trajectories of treatment response for patients with hallucinations at baseline. These included two groups of “dramatic responders” who had rapid reduction followed by extinction of hallucinations during the first four weeks of treatment, then groups of “gradual responders”, “temporal responders” and “non-responders”. Most responders, 80% of those with hallucinations at baseline, were dramatic responders. Patients who showed no response in the early weeks remained non-responders also after longer follow-up. Conclusions The study suggests the existence of differential response patterns of hallucinations to antipsychotic treatment, and that a significant subgroup are dramatic responders. Hallucinations generally respond quickly to antipsychotic treatment. With no improvement in the very first weeks an early change of treatment should be considered.","PeriodicalId":49013,"journal":{"name":"Neuropsychiatry","volume":"9 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70328583","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}
Pub Date : 2019-01-01DOI: 10.4172/Neuropsychiatry.1000548
A. Sontheimer, G. Coll, S. Mathais, F. Vassal, J. Lemaire
Background We report the first documented case of visual hallucinations with disembodiment and selfmotion illusion on eye closure. Clinical presentation A 71-year-old woman was operated on for a cyst of the left centrum semiovale, adjacent to the precuneus, the posterior cingulate cortex and the splenium of corpus callosum. Two days after, she complained of visual hallucinations occurring on eye closure. She reported reminiscences of landscapes, trees and animals. She had a sensation of floating and moving, flying over the landscapes or walking on lanes. She could stop the hallucinations by opening her eyes. The hallucinations lasted for six days. Pharmacological and neurological possible origins of the hallucinations were explored. Conclusion No direct relation could be found between the pharmacological treatment and the hallucinations. Cerebral volumetric analysis showed a structural reorganization following cyst drainage, which might have conducted to transient hyper excitability of the surrounding structures. The release phenomenon induced by eye closure might have triggered the activation of a distributed network within associative visual, parietal and temporal cortices. The involvement of the splenium and the cingulum is discussed. Furthermore, MRI- and DTI-follow-up suggests that structural reorganization after surgery can be spread over long periods until disappearance of cyst-related deformations. Stabilization of cyst volume, near to zero, was observed after about 2 years.
{"title":"Visual Hallucinations with Disembodiment and Self-Motion Illusion on Eye Closure after Brain Cyst Drainage: A Case Report","authors":"A. Sontheimer, G. Coll, S. Mathais, F. Vassal, J. Lemaire","doi":"10.4172/Neuropsychiatry.1000548","DOIUrl":"https://doi.org/10.4172/Neuropsychiatry.1000548","url":null,"abstract":"Background We report the first documented case of visual hallucinations with disembodiment and selfmotion illusion on eye closure. Clinical presentation A 71-year-old woman was operated on for a cyst of the left centrum semiovale, adjacent to the precuneus, the posterior cingulate cortex and the splenium of corpus callosum. Two days after, she complained of visual hallucinations occurring on eye closure. She reported reminiscences of landscapes, trees and animals. She had a sensation of floating and moving, flying over the landscapes or walking on lanes. She could stop the hallucinations by opening her eyes. The hallucinations lasted for six days. Pharmacological and neurological possible origins of the hallucinations were explored. Conclusion No direct relation could be found between the pharmacological treatment and the hallucinations. Cerebral volumetric analysis showed a structural reorganization following cyst drainage, which might have conducted to transient hyper excitability of the surrounding structures. The release phenomenon induced by eye closure might have triggered the activation of a distributed network within associative visual, parietal and temporal cortices. The involvement of the splenium and the cingulum is discussed. Furthermore, MRI- and DTI-follow-up suggests that structural reorganization after surgery can be spread over long periods until disappearance of cyst-related deformations. Stabilization of cyst volume, near to zero, was observed after about 2 years.","PeriodicalId":49013,"journal":{"name":"Neuropsychiatry","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70328600","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}
Pub Date : 2019-01-01DOI: 10.4172/NEUROPSYCHIATRY.1000549
E. Palazzo, L. Luongo, F. Guida, V. Novellis, S. Boccella, C. Cristiano, I. Marabese, S. Maione
Pain and neuroinflammation are protective responses aimed at preventing and removing injurious stimuli. However, when prolonged, they can override the bounds of physiological control and become destructive. Chronic pain and neuroinflammation are critical components in the pathophysiology of neurodegenerative diseases, stroke, spinal cord injury, diabetes, and neuropsychiatric disorders. Natural mechanisms, including the production of lipid mediators, represent an endogenous protective process and a program of resolution stimulated and triggered by tissue injury or inflammation. Lipid mediators include N-acylethanolamines (NAEs) such as palmitoylethanolamide (PEA), an endocannabinoid anandamide congener which has shown to be endowed of neuroprotective and antinflammatory properties activated under several pathological states. PEA does not bind the classical cannabinoid receptors but indirectly stimulates the effects of cannabinoids. Its antinflammatory, analgesic and neuroprotective actions have been however associated with peroxisome proliferator-activated receptor-α (PPAR-α) activation. The administration of exogenous PEA requires parenteral routes owing to its lipid structure. The micronized and ultramicronized (m- and um-) formulation permits oral administration increasing the versatility, easiness and compliance of administrations in clinical studies. This review is intended to deal with the effects of m- and um-PEA on chronic pain and neuroinflammation in several animal models of chronic pain and neudegenerative disorders and in clinical studies.
{"title":"Role of N-Acylethanolamines in the Neuroinflammation: Ultramicronized Palmitoylethanolamide in the Relief of Chronic Pain and Neurodegenerative DiseasesRole of N-Acylethanolamines in the Neuroinflammation: Ultramicronized Palmitoylethanolamide in the Relief of Chronic Pain and Neurodegenerative Dise","authors":"E. Palazzo, L. Luongo, F. Guida, V. Novellis, S. Boccella, C. Cristiano, I. Marabese, S. Maione","doi":"10.4172/NEUROPSYCHIATRY.1000549","DOIUrl":"https://doi.org/10.4172/NEUROPSYCHIATRY.1000549","url":null,"abstract":"Pain and neuroinflammation are protective responses aimed at preventing and removing injurious stimuli. However, when prolonged, they can override the bounds of physiological control and become destructive. Chronic pain and neuroinflammation are critical components in the pathophysiology of neurodegenerative diseases, stroke, spinal cord injury, diabetes, and neuropsychiatric disorders. Natural mechanisms, including the production of lipid mediators, represent an endogenous protective process and a program of resolution stimulated and triggered by tissue injury or inflammation. Lipid mediators include N-acylethanolamines (NAEs) such as palmitoylethanolamide (PEA), an endocannabinoid anandamide congener which has shown to be endowed of neuroprotective and antinflammatory properties activated under several pathological states. PEA does not bind the classical cannabinoid receptors but indirectly stimulates the effects of cannabinoids. Its antinflammatory, analgesic and neuroprotective actions have been however associated with peroxisome proliferator-activated receptor-α (PPAR-α) activation. The administration of exogenous PEA requires parenteral routes owing to its lipid structure. The micronized and ultramicronized (m- and um-) formulation permits oral administration increasing the versatility, easiness and compliance of administrations in clinical studies. This review is intended to deal with the effects of m- and um-PEA on chronic pain and neuroinflammation in several animal models of chronic pain and neudegenerative disorders and in clinical studies.","PeriodicalId":49013,"journal":{"name":"Neuropsychiatry","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70328632","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}
Pub Date : 2019-01-01DOI: 10.4172/NEUROPSYCHIATRY.1000560
B. Escribano, Medina Fern, ez Fj, J. CaballeroVillarraso, M. Feijóo, E. Agüera, I. Túnez
Objective Recently we found that chronic immobilization stress (CIS) induced low levels of glutamate (Glu) and glutamine (Gln) and hypoactive glutamatergic signaling in the mouse prefrontal cortex (PFC), which was closely related with Glu-Gln cycle. Moreover, Gln-supplemented diet ameliorated CISinduced deleterious changes. In the present study, therefore, we investigated the effects of CIS and Gln supplementation on Glu-Gln cycle-related proteins to understand underlying mechanisms. Methods Using CIS-induced depression mouse model, we confirmed depressive behaviors caused by CIS and antidepressant property of Gln-supplementation with behavioral test and blood corticosterone assay. We examined expression of eleven proteins involving Glu-Gln cycle in the PFC. Results CIS decreased glutamate transporter 1 (GLT1), sodium-coupled neutral amino acid transporter (SNAT) 3, SNAT5, and mature SNAT2, suggesting excitotoxicity in synaptic cleft and shortage of Glu and Gln in astrocytes and neurons. Gln-supplementation did not affect non-stressed group, but significantly increased SNAT1 and SNAT3, which are the major Gln transporter in neurons and astrocytes respectively, as well as the mature SNAT2, implicating increasing transportation of Gln into neurons. Conclusion As a result, we confirmed that CIS disturbed Glu-Gln cycle toward shortage of Glu and Gln levels in astrocytes and neurons, but Gln supplementation changed Glu-Gln cycle toward facilitating translocation of Gln into neurons for glutamatergic signaling. Moreover, these results also supported the antidepressant property of Gln.
{"title":"Effects and Therapeutic Use of TMS in Psychiatric Disorders: An Evidence-Based Review","authors":"B. Escribano, Medina Fern, ez Fj, J. CaballeroVillarraso, M. Feijóo, E. Agüera, I. Túnez","doi":"10.4172/NEUROPSYCHIATRY.1000560","DOIUrl":"https://doi.org/10.4172/NEUROPSYCHIATRY.1000560","url":null,"abstract":"Objective Recently we found that chronic immobilization stress (CIS) induced low levels of glutamate (Glu) and glutamine (Gln) and hypoactive glutamatergic signaling in the mouse prefrontal cortex (PFC), which was closely related with Glu-Gln cycle. Moreover, Gln-supplemented diet ameliorated CISinduced deleterious changes. In the present study, therefore, we investigated the effects of CIS and Gln supplementation on Glu-Gln cycle-related proteins to understand underlying mechanisms. Methods Using CIS-induced depression mouse model, we confirmed depressive behaviors caused by CIS and antidepressant property of Gln-supplementation with behavioral test and blood corticosterone assay. We examined expression of eleven proteins involving Glu-Gln cycle in the PFC. Results CIS decreased glutamate transporter 1 (GLT1), sodium-coupled neutral amino acid transporter (SNAT) 3, SNAT5, and mature SNAT2, suggesting excitotoxicity in synaptic cleft and shortage of Glu and Gln in astrocytes and neurons. Gln-supplementation did not affect non-stressed group, but significantly increased SNAT1 and SNAT3, which are the major Gln transporter in neurons and astrocytes respectively, as well as the mature SNAT2, implicating increasing transportation of Gln into neurons. Conclusion As a result, we confirmed that CIS disturbed Glu-Gln cycle toward shortage of Glu and Gln levels in astrocytes and neurons, but Gln supplementation changed Glu-Gln cycle toward facilitating translocation of Gln into neurons for glutamatergic signaling. Moreover, these results also supported the antidepressant property of Gln.","PeriodicalId":49013,"journal":{"name":"Neuropsychiatry","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70328995","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}
Pub Date : 2019-01-01DOI: 10.4172/Neuropsychiatry.1000561
M. M. Cengotitabengoa, S. Alberich, M. Parellada, B. Cabrera, E. Berrocoso, R. Rodríguez, A. Lobo, Maria Paz Garcia Portilla, M. Bernardo, J. Leza, A. G. Pinto, Flamm PEPs study
Brain plasticity has demonstrated to play a role in the pathophysiology of schizophrenia. Cognitive deterioration in these patients can be prevented by ensuring the adequate functioning of signaling pathways associated with brain plasticity. As BDNF exerts its action through receptors, in this study, we hypothesized that levels of some BDNF receptors during a first episode of psychosis (FEP) would correlate with the cognitive and global functioning of patients in the long term. We also hypothesized that the improvement of the ratio of full-length (TrKB-FL) and truncated (TrKB-T) TrKB receptors, and the predominance of the full-length isoform would be associated with better cognition and functioning. Peripheral levels of full-length (TrKB-FL) and truncated (TrKB-T) TrKB receptors were assessed in a sample of 97 FEP patients and 97 matched healthy controls. TrKB-FL/TrKB-T ratio(hereinafter, FL/T) was calculated for each patient. Cognitive and global functioning was measured at inclusion and at two years. A high baseline FL/T ratio was found to be related to a better cognitive function (global cognition, verbal memory, working memory and premorbid IQ). Cognitive performance at disease onset and at two years improved when the levels of the ratio were higher than one, with functional BDNF receptor (TrKB-FL) exceeding the value of the truncated isoform (TrKB-T). In addition the increase in the FL/T ratio during the two years of follow-up had positive effects on global functioning. This may be due either to a reduction in TrKB-T or to an increase in TrKB-FL, or both. In conclusion FL / T ratio was related to general functioning and cognition in the long-term.
{"title":"Evolution of BDNF Full-Length/Truncated Receptor Ratio and Cognitive/General Functioning After a First Episode of Psychosis","authors":"M. M. Cengotitabengoa, S. Alberich, M. Parellada, B. Cabrera, E. Berrocoso, R. Rodríguez, A. Lobo, Maria Paz Garcia Portilla, M. Bernardo, J. Leza, A. G. Pinto, Flamm PEPs study","doi":"10.4172/Neuropsychiatry.1000561","DOIUrl":"https://doi.org/10.4172/Neuropsychiatry.1000561","url":null,"abstract":"Brain plasticity has demonstrated to play a role in the pathophysiology of schizophrenia. Cognitive deterioration in these patients can be prevented by ensuring the adequate functioning of signaling pathways associated with brain plasticity. As BDNF exerts its action through receptors, in this study, we hypothesized that levels of some BDNF receptors during a first episode of psychosis (FEP) would correlate with the cognitive and global functioning of patients in the long term. We also hypothesized that the improvement of the ratio of full-length (TrKB-FL) and truncated (TrKB-T) TrKB receptors, and the predominance of the full-length isoform would be associated with better cognition and functioning. Peripheral levels of full-length (TrKB-FL) and truncated (TrKB-T) TrKB receptors were assessed in a sample of 97 FEP patients and 97 matched healthy controls. TrKB-FL/TrKB-T ratio(hereinafter, FL/T) was calculated for each patient. Cognitive and global functioning was measured at inclusion and at two years. A high baseline FL/T ratio was found to be related to a better cognitive function (global cognition, verbal memory, working memory and premorbid IQ). Cognitive performance at disease onset and at two years improved when the levels of the ratio were higher than one, with functional BDNF receptor (TrKB-FL) exceeding the value of the truncated isoform (TrKB-T). In addition the increase in the FL/T ratio during the two years of follow-up had positive effects on global functioning. This may be due either to a reduction in TrKB-T or to an increase in TrKB-FL, or both. In conclusion FL / T ratio was related to general functioning and cognition in the long-term.","PeriodicalId":49013,"journal":{"name":"Neuropsychiatry","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70328531","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}
Pub Date : 2019-01-01DOI: 10.4172/NEUROPSYCHIATRY.1000556
V. S. Gistau, L. Martorell, Á. Cabezas, S. Arranz, LorenaMoreno, R. Mariné, J. Labad, E. Vilella
Background The T allele of rs1800497 SNP of ANKK1 gene has been linked to a poorer performance on prefrontal cognitive processes. There is the lack of studies investigating the effect of this variant on cognition in schizophrenia. Our main aim therefore was to investigate its impact on cognition in a sample of subjects with a recent diagnosis of psychosis Methods We included 128 patients with recent –onset psychosis (ROP) and 70 healthy controls (HC) with both complete neuropsychological assessment by MATRICS Consensus Cognitive Battery (MCCB) and blood specimen drawn for DNA analysis. Genotypes were grouped following an additive model. We explored main effects of disease (ROP and HC) and genetics (T+ and T-) and their interaction term on cognition. Results Two-way ANOVAs showed a significant genetic and disease interaction effect in WMS –SS (non-verbal working memory) (F=10.32, p=0.002, partial eta squared =0.05) and on MCCB total score (F=5.02, p=0.02, partial eta squared =0.03). When sample was stratified by allele status, ROP- T+ performed poorly than HC-T+ in WMS-SS, while that difference was not found among T-. Within ROP, T carriers presented a worse cognitive profile than non-carriers but within HC, cognitive profile did not differ as a function of allele status. When adjusting for clinical confounders both WMS-SS (F=9.53, p=0.003, partial eta squared =0.09) and total MCBB scores (F=7.09, p=0.009, partial eta squared=0.08) continued to be lower in ROP-T+ compared with ROP-T–. Conclusion This is the first study to report an association of the vulnerability allele of Taq1A with cognitive impairment in psychosis assessed by a standardized instrument as the MCCB battery. Our study therefore, provides preliminary evidence for the potential role of the ANNK1 gene in modulating cognitive performance in psychosis.
{"title":"The Effect of ANKK1 Taq1A Polymorphism on Cognition in Recent-Onset Psychosis: A Controlled Study","authors":"V. S. Gistau, L. Martorell, Á. Cabezas, S. Arranz, LorenaMoreno, R. Mariné, J. Labad, E. Vilella","doi":"10.4172/NEUROPSYCHIATRY.1000556","DOIUrl":"https://doi.org/10.4172/NEUROPSYCHIATRY.1000556","url":null,"abstract":"Background The T allele of rs1800497 SNP of ANKK1 gene has been linked to a poorer performance on prefrontal cognitive processes. There is the lack of studies investigating the effect of this variant on cognition in schizophrenia. Our main aim therefore was to investigate its impact on cognition in a sample of subjects with a recent diagnosis of psychosis Methods We included 128 patients with recent –onset psychosis (ROP) and 70 healthy controls (HC) with both complete neuropsychological assessment by MATRICS Consensus Cognitive Battery (MCCB) and blood specimen drawn for DNA analysis. Genotypes were grouped following an additive model. We explored main effects of disease (ROP and HC) and genetics (T+ and T-) and their interaction term on cognition. Results Two-way ANOVAs showed a significant genetic and disease interaction effect in WMS –SS (non-verbal working memory) (F=10.32, p=0.002, partial eta squared =0.05) and on MCCB total score (F=5.02, p=0.02, partial eta squared =0.03). When sample was stratified by allele status, ROP- T+ performed poorly than HC-T+ in WMS-SS, while that difference was not found among T-. Within ROP, T carriers presented a worse cognitive profile than non-carriers but within HC, cognitive profile did not differ as a function of allele status. When adjusting for clinical confounders both WMS-SS (F=9.53, p=0.003, partial eta squared =0.09) and total MCBB scores (F=7.09, p=0.009, partial eta squared=0.08) continued to be lower in ROP-T+ compared with ROP-T–. Conclusion This is the first study to report an association of the vulnerability allele of Taq1A with cognitive impairment in psychosis assessed by a standardized instrument as the MCCB battery. Our study therefore, provides preliminary evidence for the potential role of the ANNK1 gene in modulating cognitive performance in psychosis.","PeriodicalId":49013,"journal":{"name":"Neuropsychiatry","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70328920","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}
Pub Date : 2019-01-01DOI: 10.4172/Neuropsychiatry.1000545
A. Samico, A. Venancio
Background Psychosis associated with epilepsy is one of the temporal and frontal lobe epilepsy (TFLE) forms of presentation. Non-convulsive epileptic status (NCSE) clinical features are subtle and non-specific and, consequently, they are generally not diagnosed and confused with behavioral or psychiatric disorders. It remains a challenge to characterize neurobiological changes that contribute to the genesis or maintenance of both conditions, with a clear need for further investigation. Case report A 56-year-old male patient was hospitalized due to a one month period with persecutory delusions, auditory hallucinations, thought diffusion, passivity phenomena and total insomnia. There were no relevant changes in the general and neurological physical examinations, analytical study, urine’s substance abuse drugs and cerebral CT. His psychotic symptoms diminished with paliperidone, but one month after his admission he began to present periods of confusion, consciousness floating, temporal and spatial disorientation, disperse attention, behavioral disorganization at night and ataxia. He realized an electroencephalogram (EEG) and had practically continued epileptic activity in the temporal and frontal lobes, which ceased with the addition of valproic acid (VPA). Four months later the patient was discharged, medicated with paliperidone and VPA, with no psychotic symptomatology. Conclusions Today the most accepted theory is that both Psychosis and Epilepsy are the consequence of underlying neuropath physiological dysfunction, going towards the specter of a Psychosis’s “continuum”. The NCES can have a variety of clinical presentations and the EEG is necessary to make a definitive diagnosis, but this can be difficult especially due to its low availability and because there is currently no consensus on the EEG diagnostic criteria. This clinical case was particularly challenging and the diagnostic delay could represent a liability to the patient’s recovery. In both pathologies, the treatment remains a challenge for psychiatrists and neurologists, and further studies are needed to clarify the best diagnostic and therapeutic approach.
{"title":"A Rare Case of Non Convulsive Status Epileptic with Psychotic Presentation","authors":"A. Samico, A. Venancio","doi":"10.4172/Neuropsychiatry.1000545","DOIUrl":"https://doi.org/10.4172/Neuropsychiatry.1000545","url":null,"abstract":"Background Psychosis associated with epilepsy is one of the temporal and frontal lobe epilepsy (TFLE) forms of presentation. Non-convulsive epileptic status (NCSE) clinical features are subtle and non-specific and, consequently, they are generally not diagnosed and confused with behavioral or psychiatric disorders. It remains a challenge to characterize neurobiological changes that contribute to the genesis or maintenance of both conditions, with a clear need for further investigation. Case report A 56-year-old male patient was hospitalized due to a one month period with persecutory delusions, auditory hallucinations, thought diffusion, passivity phenomena and total insomnia. There were no relevant changes in the general and neurological physical examinations, analytical study, urine’s substance abuse drugs and cerebral CT. His psychotic symptoms diminished with paliperidone, but one month after his admission he began to present periods of confusion, consciousness floating, temporal and spatial disorientation, disperse attention, behavioral disorganization at night and ataxia. He realized an electroencephalogram (EEG) and had practically continued epileptic activity in the temporal and frontal lobes, which ceased with the addition of valproic acid (VPA). Four months later the patient was discharged, medicated with paliperidone and VPA, with no psychotic symptomatology. Conclusions Today the most accepted theory is that both Psychosis and Epilepsy are the consequence of underlying neuropath physiological dysfunction, going towards the specter of a Psychosis’s “continuum”. The NCES can have a variety of clinical presentations and the EEG is necessary to make a definitive diagnosis, but this can be difficult especially due to its low availability and because there is currently no consensus on the EEG diagnostic criteria. This clinical case was particularly challenging and the diagnostic delay could represent a liability to the patient’s recovery. In both pathologies, the treatment remains a challenge for psychiatrists and neurologists, and further studies are needed to clarify the best diagnostic and therapeutic approach.","PeriodicalId":49013,"journal":{"name":"Neuropsychiatry","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70328547","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}
Pub Date : 2019-01-01DOI: 10.4172/NEUROPSYCHIATRY.1000559
F. Magalhães, V. Marinho, Carla Ayre, K. Rocha, S. Teixeira, D. Gupta, V. Bastos, M. Cagy, B. Velasques, P. Ribeiro
Background and objectives Several studies indicate that subjects with Parkinson’s disease present motor impaired, timing and many interventions used to improve their motor behavior, but so far no training protocols that use time-estimation tasks. In this preliminary study, we aimed to report the effects of the time-estimation task training on motor behaviour and the electroencephalographic activity of the dorsolateral prefrontal cortex and motor cortex. Methods We analysed motor-exploration behaviour in 5 Parkinson’s patients using the Unified Parkinson’s Disease Rating Scale, in addition to the alpha band absolute power activity of the electroencephalogram. Results Our results show the motor-exploration behaviour improvement in Parkinson patients after the training (p<0.05). Moreover, the alpha band oscillations in the right dorsolateral prefrontal cortex and the motor area bilaterally increased with training (p<0.05). Conclusion We propose that the increase in alpha band absolute power following the training may underlie an efficient accumulation of temporal pulses, which could be responsible for the improvement in the patient motor behaviour demonstrated in the current study.
{"title":"Time-Interval Estimation Training Modulate Motor Behavior and Cerebral Cortex Activity in Parkinson Disease Patients: Preliminary Study","authors":"F. Magalhães, V. Marinho, Carla Ayre, K. Rocha, S. Teixeira, D. Gupta, V. Bastos, M. Cagy, B. Velasques, P. Ribeiro","doi":"10.4172/NEUROPSYCHIATRY.1000559","DOIUrl":"https://doi.org/10.4172/NEUROPSYCHIATRY.1000559","url":null,"abstract":"Background and objectives Several studies indicate that subjects with Parkinson’s disease present motor impaired, timing and many interventions used to improve their motor behavior, but so far no training protocols that use time-estimation tasks. In this preliminary study, we aimed to report the effects of the time-estimation task training on motor behaviour and the electroencephalographic activity of the dorsolateral prefrontal cortex and motor cortex. Methods We analysed motor-exploration behaviour in 5 Parkinson’s patients using the Unified Parkinson’s Disease Rating Scale, in addition to the alpha band absolute power activity of the electroencephalogram. Results Our results show the motor-exploration behaviour improvement in Parkinson patients after the training (p<0.05). Moreover, the alpha band oscillations in the right dorsolateral prefrontal cortex and the motor area bilaterally increased with training (p<0.05). Conclusion We propose that the increase in alpha band absolute power following the training may underlie an efficient accumulation of temporal pulses, which could be responsible for the improvement in the patient motor behaviour demonstrated in the current study.","PeriodicalId":49013,"journal":{"name":"Neuropsychiatry","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70328985","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}
Pub Date : 2019-01-01DOI: 10.4172/NEUROPSYCHIATRY.1000566
D. Shek
This article reviews the impact of a youth enhancement program entitled “P.A.T.H.S. to Adulthood: A Jockey Club Youth Enhancement Scheme” (Project P.A.T.H.S.) initiated and funded by The Hong Kong Jockey Club Charities Trust. The Research Team developed curricula-based programs for Grade 7 to Grade 9 students based on the positive youth development approach and trained over 7,000 teachers and allied professionals. To date, more than 320 schools and 284,400 students (with 601,198 man-times) participated in the project in the Initial, Extension and Community-Based Implementation Phases. Findings based on different evaluation methods showed that the program was well-received by different stakeholders and the participants changed positively after joining the program. Because of its overwhelming success, the project was transplanted to 30+ schools in mainland China with the support of Tin Ka Ping Foundation. Client satisfaction and qualitative evaluation findings suggest that the project has positive impact on holistic development in students in mainland China.
{"title":"Impact of the Project P.A.T.H.S. in Hong Kong and China","authors":"D. Shek","doi":"10.4172/NEUROPSYCHIATRY.1000566","DOIUrl":"https://doi.org/10.4172/NEUROPSYCHIATRY.1000566","url":null,"abstract":"This article reviews the impact of a youth enhancement program entitled “P.A.T.H.S. to Adulthood: A Jockey Club Youth Enhancement Scheme” (Project P.A.T.H.S.) initiated and funded by The Hong Kong Jockey Club Charities Trust. The Research Team developed curricula-based programs for Grade 7 to Grade 9 students based on the positive youth development approach and trained over 7,000 teachers and allied professionals. To date, more than 320 schools and 284,400 students (with 601,198 man-times) participated in the project in the Initial, Extension and Community-Based Implementation Phases. Findings based on different evaluation methods showed that the program was well-received by different stakeholders and the participants changed positively after joining the program. Because of its overwhelming success, the project was transplanted to 30+ schools in mainland China with the support of Tin Ka Ping Foundation. Client satisfaction and qualitative evaluation findings suggest that the project has positive impact on holistic development in students in mainland China.","PeriodicalId":49013,"journal":{"name":"Neuropsychiatry","volume":"26 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70328656","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}
Pub Date : 2019-01-01DOI: 10.4172/NEUROPSYCHIATRY.1000554
Lianping Zhao, Guanmao Chen, Yanbin Jia, S. Zhong, Yao Sun, Zhifeng Zhou, Zhongping Zhang, Ying Wang, Li Huang
Introduction The red nucleus is an important node of the prefrontal-thalamic-cerebellar circuit, which is related to both cognitive and affective functions. However, the structural and functional changes of the red nucleus in depressive bipolar II disorder (BD-II) or unipolar depression (UD) have rarely been studied. Methods Thirty-five patients with depressive BD-II, 29 patients with UD, and 40 healthy controls underwent diffusion kurtosis imaging (DKI) and three-dimensional arterial spin labeling (3D ASL). Region-of-interest analysis was performed to measure the mean kurtosis (MK), axial kurtosis (Ka), radial kurtosis (Kr), fractional anisotropy (FA), mean diffusivity (MD), axial diffusivity (Da), radial diffusivity (Dr), and cerebral blood flow (CBF) in the red nucleus. Multivariate analysis of variance (MANOVA) with Bonferroni pairwise comparison tests was performed to compare the DKI parameters and CBF values of the ROIs among patients with depressive BD-II, patients with UD, and HCs, in the left and right red nucleus respectively; Pearson correlation coefficients were then used to assess whether the clinical variables for the patients correlated with their measured DKI or 3D ASL parameters. Results Compared with controls, patients with UD exhibited significantly decreased MK and Kr in the left red nucleus; patients with depressive BD-II exhibited significantly decreased MK in the right red nucleus. No significant changes were found in the remaining DKI/3D ASL parameters, and no significant correlations were revealed between the DKI/3D ASL parameters and clinical variables in patients with either depressive BD-II or UD. Conclusion The present study suggests that microstructural impairment exists in the red nucleus in patients with depressive BD-II and patients with UD, which may provide new insights into the underlying neurobiological mechanisms of the two disorders.
{"title":"Alteration of Red Nucleus Microstructure in Depressive Bipolar II Disorder and Unipolar Depression: A Diffusion Kurtosis and Perfusion Imaging Study","authors":"Lianping Zhao, Guanmao Chen, Yanbin Jia, S. Zhong, Yao Sun, Zhifeng Zhou, Zhongping Zhang, Ying Wang, Li Huang","doi":"10.4172/NEUROPSYCHIATRY.1000554","DOIUrl":"https://doi.org/10.4172/NEUROPSYCHIATRY.1000554","url":null,"abstract":"Introduction The red nucleus is an important node of the prefrontal-thalamic-cerebellar circuit, which is related to both cognitive and affective functions. However, the structural and functional changes of the red nucleus in depressive bipolar II disorder (BD-II) or unipolar depression (UD) have rarely been studied. Methods Thirty-five patients with depressive BD-II, 29 patients with UD, and 40 healthy controls underwent diffusion kurtosis imaging (DKI) and three-dimensional arterial spin labeling (3D ASL). Region-of-interest analysis was performed to measure the mean kurtosis (MK), axial kurtosis (Ka), radial kurtosis (Kr), fractional anisotropy (FA), mean diffusivity (MD), axial diffusivity (Da), radial diffusivity (Dr), and cerebral blood flow (CBF) in the red nucleus. Multivariate analysis of variance (MANOVA) with Bonferroni pairwise comparison tests was performed to compare the DKI parameters and CBF values of the ROIs among patients with depressive BD-II, patients with UD, and HCs, in the left and right red nucleus respectively; Pearson correlation coefficients were then used to assess whether the clinical variables for the patients correlated with their measured DKI or 3D ASL parameters. Results Compared with controls, patients with UD exhibited significantly decreased MK and Kr in the left red nucleus; patients with depressive BD-II exhibited significantly decreased MK in the right red nucleus. No significant changes were found in the remaining DKI/3D ASL parameters, and no significant correlations were revealed between the DKI/3D ASL parameters and clinical variables in patients with either depressive BD-II or UD. Conclusion The present study suggests that microstructural impairment exists in the red nucleus in patients with depressive BD-II and patients with UD, which may provide new insights into the underlying neurobiological mechanisms of the two disorders.","PeriodicalId":49013,"journal":{"name":"Neuropsychiatry","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70328845","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}
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