Research publications - Association for Research in Nervous and Mental Disease最新文献

MS and CIP are inflammatory diseases of the CNS and PNS that are characterized by focal demyelination. Both disorders are thought to involve autoimmune processes. The factors that lead to a chronic inflammatory process have not been completely defined, but the immune system is thought to play a prominent role as has been discussed in this chapter. The role of a persistent or recurrent viral exposure has not been reviewed here but may well be a contributing factor. Since chronic relapsing experimental encephalomyelitis in animal models is a T-cell-mediated disease that pathologically resembles MS, T cells are postulated to be of primary importance in human demyelinating diseases. Oligoclonal T-cell populations can be found in the CSF of MS patients, even though their antigenic specificity is not known. HLA associations (HLA Dw2 and HLA DR2 in MS and HLA Dw3 in chronic inflammatory neuropathy) might relate to the proposed immunopathogenesis, as class II antigens encoded by these loci might serve as restriction elements for T-cell recognition of an autoantigen by encephalitogenic cell populations. Humoral factors are thought to play an important role in the pathogenesis of CIP, as plasma exchange has been shown to be beneficial. Experimental work with an antimyelin glycoprotein monoclonal antibody demonstrates the in vivo demyelinating activity of antibodies as well as the importance of cellular elements in the demyelinating process. Finally, a number of immunoregulatory abnormalities have been demonstrated in MS patients that point to defects in immunoregulation, in particular in the generation of suppression. Decreases in AMLR in active MS might be of importance, as the AMLR is a reaction against self MHC determinants during which suppression is generated. Defects in suppression might allow self-reactive cells to escape regulation and cause inflammatory lesions in the nervous system.

There is increasing evidence of reciprocal CNS-immune system interactions. The reaction of such processes to behavior and psychiatric disorders remains to be determined. It is not clear at this time if alterations in measures of the immune system associated with stress have clinical relevance, nor is there evidence that immune alterations are associated with the pathogenesis of psychiatric disorders. With the exciting advances in neurobiology, immunobiology, and biologic psychiatry, and with the availability of a wide range of methodologies, elucidation of the complexities of brain, behavior, and the immune system may be achieved.

The perception and recognition of faces and nonface stimuli were investigated by means of EP techniques in normal subjects. Neuropsychological studies on recognition of faces, facial expression, and gestures were performed in normal subjects, brain-lesioned patients, and schizophrenic patients. 1. Two neuropsychological tests investigating recognition of faces, mimic expression, and gestures were applied in normals and brain-lesioned patients. In the first test, the recognition of faces and vases was tested 1 hr and 1 week after an inspection series. It was found that the size rather than the location of the lesion (excluding occipital lobe lesions) was an important determinant of the error score. No significant differences were found between patients suffering from RH and LH lesions. In general the same observation was true when recognition of faces, expression, and gestures was studied by means of a movie test consisting of 12 10-sec movie scenes and 10 multiple-choice tests following inspection of each scene. A slight tendency to higher error scores appeared in patients suffering from right temporo-occipital lesions compared with other RH lesions. 2. Impairment in the perception and recognition of faces, facial expression, and gestures was also found in schizophrenic patients. Their error score, especially in the movie tests, was on the average higher than in brain-lesioned patients, indicating a major perceptual or cognitive deficit in this disease. This observation is consistent with some clinical symptoms of schizophrenia. It is remarkable that in the slide test, schizophrenic patients had a significantly higher error score in the easy tasks (recognition of upright faces) than normals, whereas in the difficult tasks (involving upside-down faces) their performance was not significantly different from that of an age- and socially matched group. 3. The degree of schizophrenic defect and acute psychotic symptoms had some effect on the impairment in schizophrenics performing these tests. When the error scores of adolescent and middle-aged schizophrenics were compared to corresponding control group error scores, the relative impairment of adolescent schizophrenic patients was found to be somewhat stronger than that of adult schizophrenics. This supports the hypothesis that the impairment in face and mimic recognition found in schizophrenic patients is caused by the disease and not by other factors such as duration of illness or hospitalization. It is conjectured that a component very specific to schizophrenia leads to the dramatic cognitive defect found in our tests in these patients.(ABSTRACT TRUNCATED AT 400 WORDS)