Journal articles on the topic 'Neuropsychiatric fluctuations'
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1
Magalhães, Andreia D., Deborah Amstutz, Katrin Petermann, Ines Debove, Mário Sousa, Marie E. Maradan-Gachet, Martin Lenard Lachenmayer, et al. "Subthalamic stimulation has acute psychotropic effects and improves neuropsychiatric fluctuations in Parkinson’s disease." BMJ Neurology Open 6, no. 1 (January 2024): e000524. http://dx.doi.org/10.1136/bmjno-2023-000524.
Abstract:
BackgroundSubthalamic nucleus deep brain stimulation (STN-DBS) is a well-established treatment for motor complications in Parkinson’s disease (PD). However, its effects on neuropsychiatric symptoms remain disputed. The aim of this study was to evaluate the effects of STN-DBS on neuropsychiatric symptoms in PD.MethodsWe retrospectively assessed 26 patients with PD who underwent a preoperative levodopa challenge and postoperative levodopa and stimulation challenges 1 year after STN-DBS. Based on the Neuropsychiatric Fluctuations Scale, Neuropsychiatric State Scores and Neuropsychiatric Fluctuation Indices (NFIs) were calculated. Mixed-effects models with random effects for intercept were used to examine the association of Neuropsychiatric State Score and NFI with the different assessment conditions.ResultsIn acute challenge conditions, there was an estimated increase of 15.9 points in the Neuropsychiatric State Score in stimulation ON conditions (95% CI 11.4 to 20.6, p<0.001) and 7.6 points in medication ON conditions (95% CI 3.3 to 11.9, p<0.001). Neuropsychiatric fluctuations induced by levodopa, quantified with NFI, decreased by 35.54% (95% CI 49.3 to 21.8, p<0.001) 1 year after STN-DBS.ConclusionsBilateral STN-DBS at therapeutic parameters has acute psychotropic effects similar to levodopa and can modulate and decrease levodopa-induced neuropsychiatric fluctuations.
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Fox, Susan H., Naomi Visanji, Gaby Reyes, Philippe Huot, Jordi Gomez-Ramirez, Tom Johnston, and Jonathan M. Brotchie. "Neuropsychiatric Behaviors in the MPTP Marmoset Model of Parkinson’s Disease." Canadian Journal of Neurological Sciences / Journal Canadien des Sciences Neurologiques 37, no. 1 (January 2010): 86–95. http://dx.doi.org/10.1017/s0317167100009707.
Abstract:
Objectives:Neuropsychiatric symptoms are increasingly recognised as a significant problem in patients with Parkinson's disease (PD). These symptoms may be due to ‘sensitisation’ following repeated levodopa treatment or a direct effect of dopamine on the disease state. The levodopa-treated MPTP-lesioned marmoset was used as a model of neuropsychiatric symptoms in PD patients. Here we compare the time course of levodopa-induced motor fluctuations and neuropsychiatric-like behaviors to determine the relationship between duration of treatment and onset of symptoms.Methods:Marmosets were administered 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (2.0 mg/kg s.c.) for five days, resulting in stable parkinsonism. Levodopa (15 mg/kg and benserazide, 3.75 mg/kg) p.o. b.i.d. was administered for 30 days. Animals were evaluated for parkinsonian disability, dyskinesia and on-time (motor fluctuations) and neuropsychiatric-like behaviors on Day 0 (prior to levodopa) and on Days 1, 7, 13, 27 and 30 of treatment using post hoc DVD analysis by a trained rater, blind to the treatment day.Results:The neuropsychiatric-like behavior rating scale demonstrated high interrater reliability between three trained raters of differing professional backgrounds. As anticipated, animals exhibited a progressive increase in levodopa-induced motor fluctuations, dyskinesia and wearing-off, that correlated with the duration of levodopa therapy. In contrast, levodopa-induced neuropsychiatric-like behaviors were present on Day 1 of levodopa treatment and their severity did not correlate with duration of treatment.Conclusions:The data suggest that neuropsychiatric disorders in PD are more likely an interaction between levodopa and the disease state than a consequence of sensitisation to repeated dopaminergic therapy.
3
Abbes, Marie, Eugénie Lhommée, Stéphane Thobois, Hélène Klinger, Emmanuelle Schmitt, Amélie Bichon, Anna Castrioto, et al. "Subthalamic stimulation and neuropsychiatric symptoms in Parkinson’s disease: results from a long-term follow-up cohort study." Journal of Neurology, Neurosurgery & Psychiatry 89, no. 8 (February 7, 2018): 836–43. http://dx.doi.org/10.1136/jnnp-2017-316373.
Abstract:
BackgroundReports on behavioural outcomes after subthalamic nucleus deep brain stimulation in Parkinson’s disease are controversial and limited to short-term data. Long-term observation in a large cohort allows a better counselling and management.MethodsTo determine whether a long-term treatment with subthalamic stimulation induces or reduces impulse control behaviours, neuropsychiatric fluctuations and apathy, 69 patients treated with subthalamic stimulation are prospectively and retrospectively assessed using Ardouin Scale of Behavior in Parkinson’s Disease before and after 3–10 years of stimulation.ResultsAt a mean follow-up of 6 years, all impulse control disorders and dopaminergic addiction were significantly decreased, apart from eating behaviour and hypersexuality. Neuropsychiatric fluctuations also significantly improved (ON euphoria: 38% of the patients before surgery and 1% after surgery, P<0.01; OFF dysphoria: 39% of the patients before surgery and 10% after surgery, P<0.01). However, apathy increased (25% of the patients after surgery and 3% before, P<0.01). With the retrospective analysis, several transient episodes of depression, apathy, anxiety and impulse control disorders occurred.ConclusionsBilateral subthalamic nucleus stimulation was overall very effective in improving impulse control disorders and neuropsychiatric fluctuations in parkinsonian patients in the long term despite a counteracting frequent apathy. Transient episodes of impulse control disorders still occurred within the follow-up. These findings recommend a close follow-up in parkinsonian patients presenting with neuropsychiatric symptoms before deep brain stimulation surgery.Clinical trial registrationNCT01705418;Post-results.
4
Schmitt, Emmanuelle, Paul Krack, Anna Castrioto, Helene Klinger, Amelie Bichon, Eugénie Lhommée, Pierre Pelissier, et al. "The Neuropsychiatric Fluctuations Scale for Parkinson's Disease: A Pilot Study." Movement Disorders Clinical Practice 5, no. 3 (March 23, 2018): 265–72. http://dx.doi.org/10.1002/mdc3.12607.
5
Matar, Elie, Simon R. White, John-Paul Taylor, Alan Thomas, Ian G. McKeith, Joseph P. M. Kane, Ajenthan Surendranathan, Glenda M. Halliday, Simon J. G. Lewis, and John T. O'Brien. "Progression of Clinical Features in Lewy Body Dementia Can Be Detected Over 6 Months." Neurology 97, no. 10 (August 17, 2021): e1031-e1040. http://dx.doi.org/10.1212/wnl.0000000000012450.
Abstract:
ObjectiveThis study aimed to quantify the trajectory and magnitude of change of the key clinical features and corresponding symptom domains of dementia with Lewy bodies (DLB) and Parkinson disease dementia (PDD), including global cognition, parkinsonism, recurrent visual hallucinations, cognitive fluctuations, and sleep disturbance.MethodsOne hundred sixteen patients with Lewy body dementia (DLB = 72, PDD = 44) underwent assessment at baseline and 3 and 6 months as part of a prospective multicenter randomized controlled trial. Linear mixed models were constructed for core outcome measures using the Mini-Mental State Examination (MMSE), motor section of the Unified Parkinson's Disease Rating Scale (UPDRS-III), Dementia Cognitive Fluctuations Scale (DCFS), and Neuropsychiatric Inventory (NPI).ResultsWithin the time frame of our study (6 months), we were able to identify a significant cognitive decline of 1.3 points on the MMSE (p = 0.002) and significant worsening of motor parkinsonism with an increase in UPDRS-III score of 3.2 points (p = 0.018). Fluctuation severity also increased using the DCFS with a 6-month change in score of 1.3 points (p = 0.001). Uniquely, a signal for increased severity of sleep symptoms of 1.2 points (NPI-sleep) was also detectable (p = 0.04). Significant changes in neuropsychiatric symptoms were not detected. There was no difference in rates of change of scores between DLB and PDD.DiscussionClinically significant rates of change in core clinical features can be detected and quantified in Lewy body dementia over a relatively short period (6 months) using common clinical instruments and thus may be useful as clinical endpoints for therapeutic trials of disease-modifying and symptomatic agents.
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Zimmer, Eduardo R., Maxime J. Parent, Antoine Leuzy, Antonio Aliaga, Arturo Aliaga, Luc Moquin, Esther S. Schirrmacher, et al. "Imaging in Vivo Glutamate Fluctuations with [11C]ABP688: A GLT-1 Challenge with Ceftriaxone." Journal of Cerebral Blood Flow & Metabolism 35, no. 7 (March 25, 2015): 1169–74. http://dx.doi.org/10.1038/jcbfm.2015.35.
Abstract:
Molecular imaging offers unprecedented opportunities for investigating dynamic changes underlying neuropsychiatric conditions. Here, we evaluated whether [11C]ABP688, a positron emission tomography (PET) ligand that binds to the allosteric site of the metabotropic glutamate receptor type 5 (mGluR5), is sensitive to glutamate fluctuations after a pharmacological challenge. For this, we used ceftriaxone (CEF) administration in rats, an activator of the GLT-1 transporter (EAAT2), which is known to decrease extracellular levels of glutamate. MicroPET [11C]ABP688 dynamic acquisitions were conducted in rats after a venous injection of either saline (baseline) or CEF 200 mg/kg (challenge). Binding potentials (BPND) were obtained using the simplified reference tissue method. Between-condition statistical parametric maps indicating brain regions showing the highest CEF effects guided placement of microdialysis probes for subsequent assessment of extracellular levels of glutamate. The CEF administration increased [11C]ABP688 BPND in the thalamic ventral anterior (VA) nucleus bilaterally. Subsequent microdialysis assessment revealed declines in extracellular glutamate concentrations in the VA. The present results support the concept that availability of mGluR5 allosteric binding sites is sensitive to extracellular concentrations of glutamate. This interesting property of mGluR5 allosteric binding sites has potential applications for assessing the role of glutamate in the pathogenesis of neuropsychiatric conditions.
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Donaghy, Paul C., John-Paul Taylor, John T. O'Brien, Nicola Barnett, Kirsty Olsen, Sean J. Colloby, Jim Lloyd, George Petrides, Ian G. McKeith, and Alan J. Thomas. "Neuropsychiatric symptoms and cognitive profile in mild cognitive impairment with Lewy bodies." Psychological Medicine 48, no. 14 (January 24, 2018): 2384–90. http://dx.doi.org/10.1017/s0033291717003956.
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AbstractBackgroundThe accurate clinical characterisation of mild cognitive impairment (MCI) is becoming increasingly important. The aim of this study was to compare the neuropsychiatric symptoms and cognitive profile of MCI with Lewy bodies (MCI-LB) with Alzheimer's disease MCI (MCI-AD).MethodsParticipants were ⩾60 years old with MCI. Each had a thorough clinical and neuropsychological assessment and 2β-carbomethoxy-3β-(4-iodophenyl)-N-(3-fluoropropyl)-nortropane single photon emission computed tomography FP-CIT SPECT). MCI-LB was diagnosed if two or more diagnostic features of dementia with Lewy bodies were present (visual hallucinations, cognitive fluctuations, motor parkinsonism, rapid eye movement sleep behaviour disorder or positive FP-CIT SPECT). A Lewy body Neuropsychiatric Supportive Symptom Count (LBNSSC) was calculated based on the presence or absence of the supportive neuropsychiatric symptoms defined by the 2017 DLB diagnostic criteria: non-visual hallucinations, delusions, anxiety, depression and apathy.ResultsMCI-LB (n = 41) had a higher LBNSSC than MCI-AD (n = 24; 1.8 ± 1.1 v. 0.7 ± 0.9, p = 0.001). 67% of MCI-LB had two or more of those symptoms, compared with 16% of MCI-AD (Likelihood ratio = 4.2, p < 0.001). MCI-LB subjects scored lower on tests of attention, visuospatial function and verbal fluency. However, cognitive test scores alone did not accurately differentiate MCI-LB from MCI-AD.ConclusionsMCI-LB is associated with neuropsychiatric symptoms and a cognitive profile similar to established DLB. This supports the concept of identifying MCI-LB based on the presence of core diagnostic features of DLB and abnormal FP-CIT SPECT imaging. The presence of supportive neuropsychiatric clinical features identified in the 2017 DLB diagnostic criteria was helpful in differentiating between MCI-LB and MCI-AD.
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Krouse, Adam, Huihua Li, Joseph A. Krenzer, and William Nicholas Rose. "Plasmapheresis, Rituximab, and Ceftriaxone Provided Lasting Improvement for a 27-Year-Old Adult Male with Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections (PANDAS)." Case Reports in Psychiatry 2021 (November 2, 2021): 1–4. http://dx.doi.org/10.1155/2021/8697902.
Abstract:
Pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections (PANDAS) is a specific autoimmune response to group-A streptococcal (GAS) infections in children and adolescents with a sudden onset of neuropsychiatric disorders including obsessive-compulsive disorder (OCD) or tic-like symptoms. We present a case report of a 27-year-old male patient who had lasting improvement with plasmapheresis, rituximab, and ceftriaxone. Our patient first developed sudden psychosis and confusion after GAS infections at age 17. He had elevated anti-streptolysin O (ASO) titers, negative urine drug screen, no ETOH in blood, normal CBC, normal TSH, normal salicylate, normal acetaminophen, and a normal head CT. The tentative diagnosis of PANDAS was made, and the patient was thereafter treated with antipsychotics, antibiotics, tonsillectomy, and IVIG which resulted in remissions and relapses of his neuropsychiatric symptoms. Once he reached age 27, he received a trial of therapeutic plasma exchange (TPE), rituximab, and ceftriaxone. This eventually resulted in sustained benefit and minimal fluctuations of his clinical symptoms. Our report is noteworthy in three ways.One, he is a 27-year-old adult with PANDAS.Two, he improved after TPE, rituximab, and ceftriaxone. Our literature search yielded minimal data on the use of plasmapheresis for nonteenage adults with PANDAS. Three, he had unusual symptoms of PANDAS, as the typical OCD and/or tic-like symptoms were not observed.
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Infante, Roberto, Emmanuelle Schmitt, Sara Meoni, Valerie Fraix, Amelie Bichon, Andrea Kistner, Pierre Pelissier, Bettina Debu, and Elena Moro. "Effects of subthalamic deep brain stimulation on neuropsychiatric fluctuations in patients with Parkinson's disease (psychostim study)." Journal of the Neurological Sciences 429 (October 2021): 117639. http://dx.doi.org/10.1016/j.jns.2021.117639.
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Oliveira, S. G., S. M. Pereira, and J. Mendes. "Dementia in Parkinson's disease: Case report." European Psychiatry 26, S2 (March 2011): 846. http://dx.doi.org/10.1016/s0924-9338(11)72551-2.
Abstract:
IntroductionParkinson's disease (PD) dementia is a rapidly growing global health problem. Dementia in PD is often accompanied with neuropsychiatric manifestations, such as depression, insomnia, visual hallucinations and psychomotor agitation, which need psychiatric attention.ObjectivesThe authors’ aim is to report a case of a 76-year-old female suffering from PD who was admitted to the psychiatric yard exhibiting neuropsychiatric symptoms. A literature's review about PD dementia was also made.Case reportPatient had one psychiatric hospitalization at age 41, due to depressive symptoms. PD diagnose was made at age 65 and initially responded well to levodopa. Over the subsequent years, motor fluctuations and dyskinesias as well as autonomic, cognitive and psychological symptoms gradually developed. At 75 years, patient's family stated that she had been more forgetful, impulsive, showing signs of anxiety and dysphoria. She was hospitalized exhibiting psychomotor agitation, disorientation, insomnia and mainly nocturnal visual hallucinations with persons. Diagnostic testing included: cranial tomography which showed mild generalized atrophy but no other structural cause of her symptoms; laboratory tests with B12, folic acid, thyroid function; syphilis detection test and examinations of serum and urine were normal. The MMSE scored 19. Attention deficits and constructional apraxia were present in clock drawing test. Treatment was initiated with memantine and a low dose of quetiapine. She was discharged after 20 days with improvement of neuropsychiatric symptoms.ConclusionsEarly diagnosis and treatment of dementia in PD may prevent psychiatric hospitalization and avoid patient's and family's distress.
11
Yılmaz, Rezzak, Çağlar Sarılar, and Cenk Akbostancı. "Continuous infusion of apomorphine in a series of thirty patients with parkinson's disease." NATIONAL JOURNAL OF NEUROLOGY, no. 3 (January 9, 2019): 43–47. http://dx.doi.org/10.28942/nnj.v1i3.181.
Abstract:
Apomorphine is a dopamine agonist primarily used for the treatment of motor fluctuations and severe dyskinesias in late – stage Parkinson’s Disease. We retrospectively studied medical records of 30 patients who were on continuous apomorphine infusion treatment. They were evaluated for their disease characteristics, satisfaction for the therapy and adverse events. Results showed that 17 patients were satisfied with the therapy. The main reason of cessation of therapy (15 patients) was subthalamic nucleus deep brain stimulation. Arrythmia and subcutaneous nodules were relatively rare (3 patients). Results were compared with similar studies. Apomorphine therapy appears as a safe option for patients with motor complications and cognitive or neuropsychiatric problems.
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Yılmaz, Rezzak, A. Çağlar Sarılar, and M. Cenk Akbostancı. "CONTINUOUS INFUSION OF APOMORPHINE IN A SERIES OF THIRTY PATIENTS WITH PARKINSON'S DISEASE." National Journal of Neurology 1, no. 03 (July 30, 2013): 55–59. http://dx.doi.org/10.61788/njn.v1i13.08.
Abstract:
Apomorphine is a dopamine agonist primarily used for the treatment of motor fluctuations and severe dyskinesias in late – stage Parkinson’s Disease. We retrospectively studied medical records of 30 patients who were on continuous apomorphine infusion treatment. They were evaluated for their disease characteristics, satisfaction for the therapy and adverse events. Results showed that 17 patients were satisfied with the therapy. The main reason of cessation of therapy (15 patients) was subthalamic nucleus deep brain stimulation. Arrythmia and subcutaneous nodules were relatively rare (3 patients). Results were compared with similar studies. Apomorphine therapy appears as a safe option for patients with motor complications and cognitive or neuropsychiatric problems.
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Bransfield, Robert C., Dylan M. Aidlen, Michael J. Cook, and Sagar Javia. "A Clinical Diagnostic System for Late-Stage Neuropsychiatric Lyme Borreliosis Based upon an Analysis of 100 Patients." Healthcare 8, no. 1 (January 6, 2020): 13. http://dx.doi.org/10.3390/healthcare8010013.
Abstract:
Many late-stage chronic Lyme disease clinical findings are neuropsychiatric. A total clinical assessment is critical in diagnosis, especially since controversy surrounds the reliability of laboratory testing. The clinical findings of one hundred Lyme disease patients with chronic neuropsychiatric symptoms were entered into a database. The prevalence of each clinical finding pre-infection and post-infection was compared and calculated within the 95% confidence interval. Patients had minimal symptoms pre-infection, but a high post-infection prevalence of a broad spectrum of acquired multisystem symptoms. These findings included impairments of attention span, memory, processing, executive functioning, emotional functioning, behavior, psychiatric syndromes, vegetative functioning, neurological, musculoskeletal, cardiovascular, upper respiratory, dental, pulmonary, gastrointestinal, genitourinary, and other symptoms. The most prevalent symptoms included sustained attention impairments, brain fog, unfocused concentration, joint symptoms, distraction by frustration, depression, working memory impairments, decreased school/job performance, recent memory impairments, difficulty prioritizing multiple tasks, fatigue, non-restorative sleep, multitasking difficulties, sudden mood swings, hypersomnia, mental apathy, decreased social functioning, insomnia, tingling, word finding difficulties, name retrieval, headaches, sound hypersensitivity, paresis, anhedonia, depersonalization, cold intolerance, body temperature fluctuations, light sensitivity and dysfluent speech. The average patient had five symptoms pre-infection and 82 post-infection. Pattern recognition is critical in making a diagnosis. This study was used to develop three clinical assessment forms.
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Löhle, Matthias, Wiebke Hermann, Denise Hausbrand, Martin Wolz, Julia Mende, Bettina Beuthien-Baumann, Liane Oehme, et al. "Putaminal Dopamine Turnover in de novo Parkinson’s Disease Predicts Later Neuropsychiatric Fluctuations but Not Other Major Health Outcomes." Journal of Parkinson's Disease 9, no. 4 (October 11, 2019): 693–704. http://dx.doi.org/10.3233/jpd-191672.
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Prange, Stéphane, Teodor Danaila, Chloé Laurencin, Catherine Caire, Elise Metereau, Hélène Merle, Emmanuel Broussolle, Delphine Maucort-Boulch, and Stéphane Thobois. "Age and time course of long-term motor and nonmotor complications in Parkinson disease." Neurology 92, no. 2 (December 12, 2018): e148-e160. http://dx.doi.org/10.1212/wnl.0000000000006737.
Abstract:
ObjectiveTo determine the time course of hazard for motor and nonmotor milestones of Parkinson disease (PD) in the long term and to investigate whether risk scales nonlinearly with time is instrumental in identifying changes in pathological processes and evaluating disease-modifying therapies in PD.MethodsOutpatients with PD at the Lyon University Movement Disorders Center were evaluated for 7 clinical milestones in this retrospective cohort study, encompassing 4 domains of PD progression: (1) motor (motor fluctuations, dyskinesias); (2) axial (postural instability and falls, freezing of gait); (3) neuropsychiatric (impulse control disorders, hallucinations); and (4) cognitive (dementia) complications. For each complication, we estimated the outcome-specific hazard using parsimonious smooth parametric Poisson regression models allowing for nonlinear scaling over disease duration, age at diagnosis, current age, and their interaction.ResultsA total of 1,232 patients with PD experienced 1,527 disease-related complications in up to 12 years of follow-up. Specific to each complication, hazard rates increased dramatically starting from diagnosis and were highest for motor fluctuations and lowest for dementia up to 6 years after diagnosis in patients aged 65 years at diagnosis. Nonlinear patterns indicated dramatic changes in the course of PD after 5 years and predicted more severe axial prognosis after 70 years and for motor fluctuations, dyskinesias, and impulse control disorders before 60 years at diagnosis.ConclusionTime course of motor and nonmotor milestones in PD is determined by disease duration and age at diagnosis in nonlinear patterns and their interaction. This indicates disease- and age-specific thresholds across the multiple neurodegenerative processes accumulating in PD at different paces.
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Cotterell, Phil, Debbie Weight, Sharon Joseph, and Paul Joseph. "Complex Parkinson's disease: review and experiences." British Journal of Healthcare Assistants 13, no. 8 (August 2, 2019): 394–400. http://dx.doi.org/10.12968/bjha.2019.13.8.394.
Abstract:
The rate of Parkinson's disease progression is highly individual. It is important to identify those in the complex stage of the disease. Non-oral therapies may be appropriate for those in the complex stage of the disease who experience motor fluctuations, but there can be reasons for a failure to explore these options. Complex Parkinson's disease is a challenging time for the patient, their carer/s and for Parkinson's specialists. Changes to independence can be difficult to deal with, and the disease has an impact both physically and psychologically. For carers, the impact of Parkinson's can also result in physical and psychological issues, as well as social and financial problems. Consideration often turns to moving into a care environment, dealing with neuropsychiatric issues and challenging unmet need. Dealing with symptoms and problems using a team and a palliative approach is required.
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Cotterell, Phil, Debbie Weight, Sharon Joseph, and Paul Joseph. "Complex Parkinson's disease: review and experiences." British Journal of Neuroscience Nursing 15, no. 3 (June 2, 2019): 140–45. http://dx.doi.org/10.12968/bjnn.2019.15.3.140.
Abstract:
The rate of Parkinson's disease progression is highly individual. It is important to identify those in the complex stage of the disease. Non-oral therapies may be appropriate for those in the complex stage of the disease who experience motor fluctuations, but there can be reasons for a failure to explore these options. Complex Parkinson's disease is a challenging time for the patient, their carer/s and for Parkinson's specialists. Changes to independence can be difficult to deal with, and the disease has an impact both physically and psychologically. For carers, the impact of Parkinson's can also result in physical and psychological issues as well as social and financial problems. Consideration often turns to moving into a care environment, dealing with neuropsychiatric issues and challenging unmet need. Dealing with symptoms and problems using a team and a palliative approach is required.
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Gupta, Sugandha, Mengya Wang, Yoshiaki Azuma, and Nancy A. Muma. "Regulation of Serotonin 1A Receptor SUMOylation by SENP2 and PIASxα." International Journal of Molecular Sciences 22, no. 24 (December 7, 2021): 13176. http://dx.doi.org/10.3390/ijms222413176.
Abstract:
Serotonin 1A receptors (5-HT1ARs) are implicated in the control of mood, cognition, and memory and in various neuropsychiatric disorders such as depression and anxiety. As such, understanding the regulation of 5-HT1ARs will inform the development of better treatment approaches. We previously demonstrated 5-HT1ARs are SUMOylated by SUMO1 in the rat brain. Agonist stimulation increased SUMOylation and was further enhanced when combined with 17β-estradiol-3-benzoate (EB), which are treatments that cause the transient and prolonged desensitization of 5-HT1AR signaling, respectively. In the current study, we identified the protein inhibitor of activated STAT (PIAS)xα as the enzyme that facilitates SUMOylation, and SENP2 as the protein that catalyzes the deSUMOylation of 5-HT1ARs. We demonstrated that PIASxα significantly increased in the membrane fraction of rats co-treated with EB and an agonist, compared to either the EB-treated or vehicle-treated groups. The acute treatment with an agonist alone shifted the location of SENP2 from the membrane to the cytoplasmic fraction, but it has little effect on PIASxα. Hence, two separate mechanisms regulate SUMOylation and the activity of 5-HT1ARs by an agonist and EB. The effects of EB on 5-HT1AR SUMOylation and signaling may be related to the higher incidence of mood disorders in women during times with large fluctuations in estrogens. Targeting the SUMOylation of 5-HT1ARs could have important clinical relevance for the therapy for several neuropsychiatric disorders in which 5-HT1ARs are implicated.
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Ruiz, Marina, and Natalia Pérez. "FC20: Prevalence, Incidence, and Clinical Features of Lewy Body Dementia in the South Eastern of Spain." International Psychogeriatrics 35, S1 (December 2023): 81–82. http://dx.doi.org/10.1017/s1041610223001187.
Abstract:
Background:Lewy body dementia (LBD) is the second most common degenerative dementia in people over 65 (1,2). LBD is underdiagnosed, with only one third of patients correctly diagnosed in daily clinical practice (3); data on the distribution of the disease are scarce. Our study was designed to measure the incidence, prevalence and clinical characteristics of LBD in south-eastern Spain. Healthcare system in Spain is free and universal.Methods:Prospective epidemiological study of LBD in San Vicente del Raspeig between October 18, 2021, and October 17, 2022. The total population aged 60 or over based on the 2019 census was 11445 inhabitants (5227 males, 6218 females). Diagnosis of LBD was based on 2017 McKeith criteria. Only “probable” cases were registered for greater diagnostic certainty. Incidence was studied for the one-year period. Collected data included gender, age, cardinal symptoms for LBD, abnormal biomarkers, neuropsychiatric symptoms, medical treatment, years from diagnosis and GDS score (Reisberg) in the last visit. Protocol was approved by the ethical committee.Results:Global prevalence was 0.67% among the population over 60. Annual incidence was 3.2/1000 person-year.Mean age of prevalent cases was 78 years (SD 7.5). 68.8% were studied with at least one biomarker (mainly 123I-ioflupane and less frequent polysomnography or MIBG gammagraphy); most suffered 2 or 3 core symptoms (79.2%) (in descending order: parkinsonism, visual hallucinations, rapid eye movement sleep behavior disorder and fluctuations). Two out of five prevalent cases were in an early phase of the disease: 22.1% in mild cognitive impairment (MCI) and 16.9 % in mild dementia. Mean me of disease was 1.9 years (SD 2.2). Other neuropsychiatric symptoms appeared in up to 74% of patients (apathy 18,2%, anxiety 19,5%, depression 23,4%, minor hallucinations 22%, delusions 17%, auditory and tactile hallucinations 1,2%).Conclusions:Prevalence is in line with previous reports. Higher incidence than previously reported may be due to high attention on MCI-LBD and our expertise as a referral Memory Unit. We found a wide dominance of aged women and high prevalence of neuropsychiatric symptoms.
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Kabaya, Sonoko, Chieko Greiner, Masahide Nakamura, Yuko Yamaguchi, and Hirochika Ryuno. "EXPLORATION OF STRESS FLUCTUATIONS IN FAMILY CAREGIVERS OF OLDER PEOPLE WITH MILD COGNITIVE IMPAIRMENT." Innovation in Aging 7, Supplement_1 (December 1, 2023): 1035–36. http://dx.doi.org/10.1093/geroni/igad104.3328.
Abstract:
Abstract Mild cognitive impairment (MCI) is common, affecting 10%-35% of people over 65, and around two-thirds overall develop dementia over their lifetime. Previous studies have reported that family caregivers (FCs) caring for older people with MCI experience considerable burden, which tends to cause various neuropsychiatric symptoms, such as depression, apathy, and irritability. However, it is not clear how FCs’ stress, which leads to increased burden, fluctuates within a day through their daily activities. The aim of this study was to explore the characteristics of stress variability in FCs. We recruited one dyad of an older adult with MCI over the age of 65 and a FC. Data collection was performed continuously for 7 consecutive days. We adopted smart watches (GARMIN vívosmart 4) to measure Heart Rate Variability (HRV)-based stress. Moreover, we asked a FC to talk with a Virtual Agent (VA) on a laptop freely to understand when and what kind of daily activities were done and the FC’s feelings. Detecting change points in time series data was performed using Python 3.9. Results showed that change points in the FC’s daily stress appeared when the FC starts specific activities such as preparing meals and confirming some medicine that an older adult with MCI should take and daily schedules. The FC also expressed anticipatory grief at the prospect of future dementia through the VA. This finding is beneficial for considering how to reduce FCs’ stress during daily activities.
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Osipova, N. N., L. M. Bardenstein, G. A. Aleshkina, and E. V. Dmitrieva. "The structure of affective fluctuations in a non-clinical sample." Bulletin of Siberian Medicine 20, no. 3 (October 22, 2021): 79–87. http://dx.doi.org/10.20538/1682-0363-2021-3-79-87.
Abstract:
Aim. To study the structure of mood fluctuations at the preclinical stage based on the findings of screening methods.Materials and methods. A total of 129 students participated in the study. The average age was 18.95 ± 0.08 years. We used the clinical and psychopathological method, the Mini-International Neuropsychiatric Interview (MINI), and screening methods, such as the diagnostic questionnaire for bipolar disorder (Hypomania Checklist-32 (HCL-32)), and Hamilton Depression Scale (HAMD-17).Results. Upon a clinical and psychopathological examination according to ICD-10 criteria, class V, mental and behavioral disorders (F00-F99), including affective pathology, were not detected. According to the findings of the HCL-32 screening technique, 61.2% (n = 79) of respondents had a cumulative score above the threshold. Analysis of individual items on the HCL-32 scale across the entire sample revealed that the majority of examinees positively assessed the impact of mood elevations on the family sphere (63.57%; n = 82), social activities (68.99%; n = 89), work (75.19%; n = 91), and recreational sphere (82.17%; n = 106). Positive (36.43%; n = 47; 95% confidence interval (CI) 28.13–44.74) and neutral (37.21%; n = 48; 95% CI 33.35–50.37) assessments of mood elevations were also detected by the respondents’ immediate circle, which, in general, significantly complicates recognition of hypomania symptoms and delays seeking specialized care. In the structure of mood elevation episodes irritability (r = –0.684), conflict (r = –0.665), risk-taking behavior (r = –0.550), increased sexual desire (r = 0.527), increased energy and activity (r = 0.431), distractibility (r = –0.467), stimulant use (r = –0.467), and decreased need for sleep (r = 0.408) dominated. These signs are very similar to the clinical manifestations of a hypomanic episode in bipolar II disorder.Signs of mild depression revealed according to the HAMD-17 scale in 34.8% (n = 45) of respondents included sleep disorders (r = 0.693), decreased ability to work (r = 0.520), depressive mood (r = 0.579), hypochondria (r = 0.466), general somatic symptoms (r = –0.508), and gastrointestinal disorders (r = 0.513). These signs did not result in chief complaints and were not the reason for seeking specialized care.Conclusion. In the non-clinical sample, in the structure of mood swings, mood elevations dominated, which were not subjectively identified as illness symptoms and did not appear as complaints in clinical and psychopathological examinations. Low mood was accompanied by general somatic symptoms, which may indicate subsequent formation of comorbid pathology. The identified subsyndromal signs of hypomania and depression in the nonclinical sample in the absence of complaints and psychiatric care-seeking are of clinical significance as predictors of a bipolar affective disorder and require further clinical and dynamic monitoring.
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Wu, Lanxiang, Qingqing Zhan, Qian Liu, Suheng Xie, Sheng Tian, Liang Xie, and Wei Wu. "Abnormal Regional Spontaneous Neural Activity and Functional Connectivity in Unmedicated Patients with Narcolepsy Type 1: A Resting-State fMRI Study." International Journal of Environmental Research and Public Health 19, no. 23 (November 22, 2022): 15482. http://dx.doi.org/10.3390/ijerph192315482.
Abstract:
Background: Previous Resting-state functional magnetic resonance imaging (fMRI) studies have mainly focused on cerebral functional alteration in processing different emotional stimuli in patients with narcolepsy type 1 (NT1), but were short of exploration of characteristic brain activity and its remote interaction patterns. This study aimed to investigate the spontaneous blood oxygen fluctuations at rest and to elucidate the neural mechanisms underlying neuropsychiatric behavior. Method: A total of 18 unmedicated patients with NT1 and matched healthy individuals were recruited in a resting-state fMRI study. Magnetic resonance imaging (MRI) data were first analyzed using fractional low-frequency amplitude of low-frequency fluctuation (fALFF) to detect changes in local neural activity, and regions with group differences were taken as regions of interest (ROIs). Secondly, functional connectivity (FC) analysis was used to explore altered connectivity between ROIs and other areas. Lastly, the relationship between functional brain activity and neuropsychiatric behaviors was analyzed with correlation analysis. Results: fALFF analysis revealed enhanced neural activity in bilateral fusiform gyrus (FFG), right precentral gyrus, and left postcentral gyrus (PoCG) in the NT1 group. The patients indicated reduced activity in the bilateral temporal pole middle temporal gyrus (TPOmid), left caudate nucleus (CAU), left parahippocampus, left precuneus (PCUN), right amygdala, and right anterior cingulate and paracingulate gyri. ESS score was negatively correlated with fALFF in the right FFG. The NT1 group revealed decreased connectivity between left TPOmid and right PoCG, the bilateral middle frontal gyrus, left superior frontal gyrus, medial, and right supramarginal gyrus. Epworth Sleepiness Scale (ESS) was negatively correlated with FC of the left TPOmid with left putamen (PUT) in NT1. Compared with healthy controls (HCs), enhanced FC of the left CAU with right FFG was positively associated with MSLT-SOREMPs in patients. Furthermore, increased FC of the left PCUN with right PoCG was positively correlated with SDS score. Conclusions: We found that multiple functional activities related to the processing of emotional regulation and sensory information processing were abnormal, and some were related to clinical characteristics. fALFF in the left postcentral or right precentral gyrus may be used as a biomarker of narcolepsy, whereas fALFF in the right fusiform and the FC strength of the left temporal pole middle temporal gyrus with the putamen may be clinical indicators to assess the drowsiness severity of narcolepsy.
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Chyzhyk, Darya, Manuel Graña, Döst Öngür, and Ann K. Shinn. "Discrimination of Schizophrenia Auditory Hallucinators by Machine Learning of Resting-State Functional MRI." International Journal of Neural Systems 25, no. 03 (April 8, 2015): 1550007. http://dx.doi.org/10.1142/s0129065715500070.
Abstract:
Auditory hallucinations (AH) are a symptom that is most often associated with schizophrenia, but patients with other neuropsychiatric conditions, and even a small percentage of healthy individuals, may also experience AH. Elucidating the neural mechanisms underlying AH in schizophrenia may offer insight into the pathophysiology associated with AH more broadly across multiple neuropsychiatric disease conditions. In this paper, we address the problem of classifying schizophrenia patients with and without a history of AH, and healthy control (HC) subjects. To this end, we performed feature extraction from resting state functional magnetic resonance imaging (rsfMRI) data and applied machine learning classifiers, testing two kinds of neuroimaging features: (a) functional connectivity (FC) measures computed by lattice auto-associative memories (LAAM), and (b) local activity (LA) measures, including regional homogeneity (ReHo) and fractional amplitude of low frequency fluctuations (fALFF). We show that it is possible to perform classification within each pair of subject groups with high accuracy. Discrimination between patients with and without lifetime AH was highest, while discrimination between schizophrenia patients and HC participants was worst, suggesting that classification according to the symptom dimension of AH may be more valid than discrimination on the basis of traditional diagnostic categories. FC measures seeded in right Heschl's gyrus (RHG) consistently showed stronger discriminative power than those seeded in left Heschl's gyrus (LHG), a finding that appears to support AH models focusing on right hemisphere abnormalities. The cortical brain localizations derived from the features with strong classification performance are consistent with proposed AH models, and include left inferior frontal gyrus (IFG), parahippocampal gyri, the cingulate cortex, as well as several temporal and prefrontal cortical brain regions. Overall, the observed findings suggest that computational intelligence approaches can provide robust tools for uncovering subtleties in complex neuroimaging data, and have the potential to advance the search for more neuroscience-based criteria for classifying mental illness in psychiatry research.
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Pisu, Maria Giuseppina, Luca Concas, Carlotta Siddi, Mariangela Serra, and Patrizia Porcu. "The Allopregnanolone Response to Acute Stress in Females: Preclinical and Clinical Studies." Biomolecules 12, no. 9 (September 8, 2022): 1262. http://dx.doi.org/10.3390/biom12091262.
Abstract:
The neuroactive steroid allopregnanolone ((3α,5α)-3-hydroxypregnan-20-one or 3α,5α-THP) plays a key role in the response to stress, by normalizing hypothalamic-pituitary-adrenal (HPA) axis function to restore homeostasis. Most studies have been conducted on male rats, and little is known about the allopregnanolone response to stress in females, despite that women are more susceptible than men to develop emotional and stress-related disorders. Here, we provide an overview of animal and human studies examining the allopregnanolone responses to acute stress in females in the context of stress-related neuropsychiatric diseases and under the different conditions that characterize the female lifespan associated with the reproductive function. The blunted allopregnanolone response to acute stress, often observed in female rats and women, may represent one of the mechanisms that contribute to the increased vulnerability to stress and affective disorders in women under the different hormonal fluctuations that occur throughout their lifespan. These studies highlight the importance of targeting neuroactive steroids as a therapeutic approach for stress-related disorders in women.
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Krejčí, Milada, and Dobroslava Jandová. "Homeostasis and balance in senium." Acta Salus Vitae 8, no. 2 (December 8, 2020): 14–27. http://dx.doi.org/10.58743/asv2020vol8no2.240.
Abstract:
The body's homeostasis ensures the individual's survival in a constantly changing environment, such as changes and fluctuations of temperature, humidity, pressure, etc. The central nervous system and cardiovascular system play a priority in maintaining homeostasis. State of balance is closely related to the theory of homeostasis and homedynamics, where the term homeostasis is characterized as the tendency of the organism to a relatively stable balance between interdependent elements maintained by physiological processes. The study is aimed on content and descriptive analysis of the context of homeostasis, homeodynamics and bio-psycho-social balance in aging in frame of the GAČR project ID 17-25710S “Basic research of balance changes in seniors”. Methods of content and descriptive analysis were used as a base. There is experimental evidence that various forms of stress, especially when severe or recurrent, can induce corresponding structural and neurochemical or neurophysiological changes in the neural and glial networks. It can be assumed that many of these stress-induced structural and functional changes in the CNS may cause the development of some neuropsychiatric disorders typical of old age. According to yoga practice, it is known that many of these changes are reversible with sufficient recovery time.
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Cagnin, Annachiara, Cinzia Bussè, Simona Gardini, Nela Jelcic, Caterina Guzzo, Francesca Gnoato, Micaela Mitolo, Mario Ermani, and Paolo Caffarra. "Clinical and Cognitive Phenotype of Mild Cognitive Impairment Evolving to Dementia with Lewy Bodies." Dementia and Geriatric Cognitive Disorders Extra 5, no. 3 (November 24, 2015): 442–49. http://dx.doi.org/10.1159/000441184.
Abstract:
Objective: The aim of this study was to determine which characteristics could better distinguish dementia with Lewy bodies (DLB) from Alzheimer's disease (AD) at the mild cognitive impairment (MCI) stage, with particular emphasis on visual space and object perception abilities. Methods: Fifty-three patients with mild cognitive deficits that were eventually diagnosed with probable DLB (MCI-DLB: n = 25) and AD (MCI-AD: n = 28) at a 3-year follow-up were retrospectively studied. At the first visit, the patients underwent cognitive assessment including the Qualitative Scoring Mini Mental State Examination Pentagon Test and the Visual Object and Space Perception Battery. The Neuropsychiatric Inventory Questionnaire, Unified Parkinson's Disease Rating Scale (UPDRS) and questionnaires for cognitive fluctuations and sleep disorders were also administered. Results: The best clinical predictor of DLB was the presence of soft extrapyramidal signs (mean UPDRS score: 4.04 ± 5.9) detected in 72% of patients, followed by REM sleep behavior disorder (60%) and fluctuations (60%). Wrong performances in the pentagon's number of angles were obtained in 44% of DLB and 3.7% of AD patients and correlated with speed of visual attention. Executive functions, visual attention and visuospatial abilities were worse in DLB, while verbal episodic memory impairment was greater in AD. Deficits in the visual-perceptual domain were present in both MCI-DLB and AD. Conclusions: Poor performance in the pentagon's number of angles is specific of DLB and correlates with speed of visual attention. The dorsal visual stream seems specifically more impaired in MCI-DLB with respect to the ventral visual stream, the latter being involved in both DLB and AD. These cognitive features, associated with subtle extrapyramidal signs, should alert clinicians to a diagnostic hypothesis of DLB.
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Krukow, Paweł, Małgorzata Plechawska-Wójcik, and Arkadiusz Podkowiński. "Manipulations of the Response-Stimulus Intervals as a Factor Inducing Controlled Amount of Reaction Time Intra-Individual Variability." Brain Sciences 11, no. 5 (May 20, 2021): 669. http://dx.doi.org/10.3390/brainsci11050669.
Abstract:
Aggrandized fluctuations in the series of reaction times (RTs) are a very sensitive marker of neurocognitive disorders present in neuropsychiatric populations, pathological ageing and in patients with acquired brain injury. Even though it was documented that processing inconsistency founds a background of higher-order cognitive functions disturbances, there is a vast heterogeneity regarding types of task used to compute RT-related variability, which impedes determining the relationship between elementary and more complex cognitive processes. Considering the above, our goal was to develop a relatively new assessment method based on a simple reaction time paradigm, conducive to eliciting a controlled range of intra-individual variability. It was hypothesized that performance variability might be induced by manipulation of response-stimulus interval’s length and regularity. In order to verify this hypothesis, a group of 107 healthy students was tested using a series of digitalized tasks and their results were analyzed using parametric and ex-Gaussian statistics of RTs distributional markers. In general, these analyses proved that intra-individual variability might be evoked by a given type of response-stimulus interval manipulation even when it is applied to the simple reaction time task. Collected outcomes were discussed with reference to neuroscientific concepts of attentional resources and functional neural networks.
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De Benedictis, Chiara A., Claudia Haffke, Simone Hagmeyer, Ann Katrin Sauer, and Andreas M. Grabrucker. "Expression Analysis of Zinc Transporters in Nervous Tissue Cells Reveals Neuronal and Synaptic Localization of ZIP4." International Journal of Molecular Sciences 22, no. 9 (April 26, 2021): 4511. http://dx.doi.org/10.3390/ijms22094511.
Abstract:
In the last years, research has shown that zinc ions play an essential role in the physiology of brain function. Zinc acts as a potent neuromodulatory agent and signaling ions, regulating healthy brain development and the function of both neurons and glial cells. Therefore, the concentration of zinc within the brain and its cells is tightly controlled. Zinc transporters are key regulators of (extra-) cellular zinc levels, and deregulation of zinc homeostasis and zinc transporters has been associated with neurodegenerative and neuropsychiatric disorders. However, to date, the presence of specific family members and their subcellular localization within brain cells have not been investigated in detail. Here, we analyzed the expression of all zinc transporters (ZnTs) and Irt-like proteins (ZIPs) in the rat brain. We further used primary rat neurons and rat astrocyte cell lines to differentiate between the expression found in neurons or astrocytes or both. We identified ZIP4 expressed in astrocytes but significantly more so in neurons, a finding that has not been reported previously. In neurons, ZIP4 is localized to synapses and found in a complex with major postsynaptic scaffold proteins of excitatory synapses. Synaptic ZIP4 reacts to short-term fluctuations in local zinc levels. We conclude that ZIP4 may have a so-far undescribed functional role at excitatory postsynapses.
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Arora, Anshu, and Peter Fletcher. "Problem based review: A patient with Parkinson’s disease." Acute Medicine Journal 12, no. 4 (October 1, 2013): 246–50. http://dx.doi.org/10.52964/amja.0327.
Abstract:
Parkinson’s disease (PD) is a chronic, progressive neurodegenerative disease characterized by bradykinesia, tremor and/ or rigidity, often with gait disturbance and postural instability. In addition to these typical features, patients with PD may experience further problems related to the disease itself or to the medications used to treat it. These comorbid problems include neuropsychiatric conditions (including psychosis, hallucinations, excessive daytime sleepiness, anxiety, depression, fatigue and dementia) as well as problems associated with autonomic nervous system function such as bowel and bladder function. PD can also present in emergency situations with a ‘neuroleptic malignant like picture’ and acute psychosis. It is not uncommon to see motor fluctuations due to drug interactions and ‘withdrawal’ symptoms following dose reduction of dopamine agonists. In patients with PD, disturbances of mental state constitute some of the most difficult treatment challenges of advanced disease, often limiting effective treatment of motor symptoms and leading to increased disability and poor quality of life. While some of these symptoms may be alleviated by antiparkinsonian medication, especially if they are ‘off-period’ related, treatment-related phenomena are usually exacerbated by increasing the number or dosage of antiparkinsonian drugs. Elimination of exacerbating factors and simplification of drug regimens are the first and most important steps in improvement of such symptoms.
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Allkoja, B., E. Mitro, B. Zenelaj, and V. Alikaj. "Relationship Between Brain Structural Abnormalities and Early Onset Psychotic Disorder–case Presentation." European Psychiatry 41, S1 (April 2017): s800—s801. http://dx.doi.org/10.1016/j.eurpsy.2017.01.1544.
Abstract:
IntroductionContemporary structural models of several psychiatric disorders propose abnormalities in the structure and function of distinct neural networks. Clinical observations of affective and cognitive changes arising from cerebellar lesions and stimulation permit the hypothesis that the cerebellum may not be irrelevant in some neuropsychiatric states. There is evidence that patients with schizophrenia have altered corticocerebellar connectivity.ObjectivesTo evidence a case with early onset psychosis accompanied with brain structural abnormalities.MethodCase description.ResultsThe patient is 15 years old girl with an acute psychotic episode. For more than two months she had demonstrated odd behavior, getting around all the time purposelessly, abandoned school etc. She presented with disorders of perceptions, disorganized speech, insomnia and fluctuations in her mood and behavior. In her brain, MRI was found vermian atrophy, and CT was found hypocampal glyosis and dilatation of temporal corn.ConclusionsAlthough the structural mapping studies have been equivocal, the weight of evidence supports extending the study of cerebellar activity in schizophrenia. For example, the finding that unaffected first-degree relatives of probands with schizophrenia have reduced cerebellar volumes, along with the observation of reduced cerebellar volumes in neurolepticnaïve patients with schizophrenia, suggests that cerebellar atrophy may be a hereditary trait rather than a psychotropic associated epiphenomenon.Disclosure of interestThe authors have not supplied their declaration of competing interest.
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Echeverria, C., J. Libuy, J. Alarcón, and J. Rodriguez. "ELECTROCONVULSIVE THERAPY FOR AGITATION IN LEWY BODIES DEMENTIA." European Psychiatry 66, S1 (March 2023): S1020—S1021. http://dx.doi.org/10.1192/j.eurpsy.2023.2167.
Abstract:
IntroductionDementia with Lewy Bodies (DLB) is a primary degenerative dementing syndrome characterized by visual hallucinations, fluctuation in cognition, depressive symptoms and parkinsonism. Literature has shown the utility of electroconvulsive therapy (ECT) in demented patients regarding depressive symptoms and agitation. Nevertheless, the majority of cases described include patients with vascular dementia and Alzheimer’s disease. There are no cases informed concerning ECT in DLB patients with agitation and aggressive behaviors.ObjectivesEvaluate the impact of electroconvulsive therapy (ECT) for agitation in a patient with diagnosis of Lewy Bodies Dementia (DLB).MethodsCase report. 68-year-old male, with no prior neuropsychiatric history, was present for psychiatric evaluation for 5 year history of progressive dementia with fluctuations in cognition, complex visual hallucinations, delusional beliefs, depressive mood, anhedonia, irritability, associated to parkinsonism and increasing autoaggressive behaviors and agitation.An extensive neurologic workup including neuroimaging, EEG and laboratory studies failed to reveal a specific etiology. Neuropsychological testing reveals frontal, attentional, and visuospatial dysfunction. A presumptive diagnosis of DLB was made.Medication trials including donepezil, memantine, lamotrigine, sertraline, quetiapine, risperidone and melatonin failed to manage his depressive, psychotic and behavioral disturbances.ResultsConsidering past medication failures and prominent behavioral disturbances family consented for an acute course of ECT.Initial acute phase consisted of 6 sessions of right unilateral, brief pulse width (0.3 ms) ECT tri-weekly utilizing Mecta Spectrum. Anesthesia was induced with propofol, and received succinylcholine for muscle relaxation. Initial charge was 115 mC (6x seizure threshold), then raised to 192 mC. Seizure duration averaged in 22 seconds. No adverse reactions reported.Clinical outcomes were measured with the CGI-Efficacy Index. Pre-ECT CGI-SI score was 6 (severely ill) and post-ECT CGI-I was 3 (minimally improved).ConclusionsMood and behavioral disturbances are a frequent primary motive consultations in DLB patients. The treatment is challenging due to the sensitivity to antidopaminergic medications evidenced in this type of patients. This case suggests that ECT has an impact in the treatment of agitation and aggression in DLB patients, although further investigation is needed.Disclosure of InterestNone Declared
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Chin, Kai Sin, Andrew Teodorczuk, and Rosie Watson. "Dementia with Lewy bodies: Challenges in the diagnosis and management." Australian & New Zealand Journal of Psychiatry 53, no. 4 (March 8, 2019): 291–303. http://dx.doi.org/10.1177/0004867419835029.
Abstract:
Objective: Dementia with Lewy bodies is the second most common form of neurodegenerative dementia in older age yet is often under-recognised and misdiagnosed. This review aims to provide an overview of the clinical features of dementia with Lewy bodies, discussing the frequent challenges clinicians experience in diagnosing dementia with Lewy bodies, and outlines a practical approach to the clinical management, particularly in the Australian setting. Methods: This paper is a narrative review and a semi-structured database (PubMed and MEDLINE) search strategy was implemented. Articles were screened and clinically relevant studies were selected for inclusion. Results: Dementia with Lewy bodies is clinically characterised by complex visual hallucinations, spontaneous motor parkinsonism, prominent cognitive fluctuations and rapid eye movement sleep behaviour disorder. Neuropsychiatric features and autonomic dysfunction are also common. The new diagnostic criteria and specific diagnostic biomarkers help to improve detection rates and diagnostic accuracy, as well as guide appropriate management. Clinical management of dementia with Lewy bodies is challenging and requires an individualised multidisciplinary approach with specialist input. Conclusion: Dementia with Lewy bodies is a common form of dementia. It often presents as a diagnostic challenge to clinicians, particularly at early stages of disease, and in patients with mixed neuropathological changes, which occur in over 50% of people with dementia with Lewy bodies. Prompt diagnosis and comprehensive treatment strategies are important in improving patients’ care.
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Chen, Wei, Maode Wang, Ning Wang, Changwang Du, Xudong Ma, and Qi Li. "The Impacts of Subthalamic Nucleus-Deep Brain Stimulation (STN-DBS) on the Neuropsychiatric Function of Patients with Parkinson’s Disease Using Image Features of Magnetic Resonance Imaging under the Artificial Intelligence Algorithms." Contrast Media & Molecular Imaging 2021 (July 8, 2021): 1–7. http://dx.doi.org/10.1155/2021/9915206.
Abstract:
This study was to explore the effect of subthalamic nucleus- (STN-) deep brain stimulation (DBS) on the neuropsychiatric function of Parkinson’s disease (PD) patients using the magnetic resonance imaging (MRI) image analysis technology and the artificial intelligence (AI) algorithm. In this study, 40 PD patients admitted to our hospital from August 2018 to March 2020 were selected as the research objects, and they were divided into a control group and an observation group according to the random number table method, with 20 cases in each group. The patients in the control group were given oral treatment with levodopa tablets; and patients in the observation group were treated with STN-DBS + levodopa tablets. In patients, MRI examinations were performed before and after the treatment, and the image optimization processing algorithm under AI was adopted to process the images. The MRI imaging results of the two groups of patients were observed, analyzed, and compared before and after treatment; and the sports, cognition, and mental states of the two groups of patients were analyzed. It was believed that the MRI image before using the AI algorithm was blurry, and the image was clear after the noise reduction optimization process, which was convenient for observation. The data analysis revealed that the signal-to-noise ratio (SNR) after denoising (32.41) and structural similarity (SSIM) (0.79) had been improved. The results of the study suggested that the space occupation and bleeding symptoms of the two groups of patients were reduced after treatment, and those in the observation group were better than those of the control group; the incidences of dyskinesia and motor symptom fluctuations in the observation group were 5% and 0%, respectively, which were lower than those in the control group (35% and 25%, respectively). After treatment, the Unified Parkinson’s Disease Rating Scale (UPDRS) score of the two groups of patients decreased, and it was lower in the observation group than in the control group; and the Montreal Cognitive Assessment (MoCA) and Mini-Mental State Scale (MMSE) scores increased, and those in the observation group were higher in contrast to those in the control group (all P < 0.05 ). STN-DBS was beneficial to improve the clinical symptoms of patients and delay the progress of the disease, and MRI based on AI algorithms can effectively observe the changes in the neuropsychiatric function of patients, which was conducive to further clinical diagnosis and treatment.
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Santos García, Diego, María Álvarez Sauco, Matilde Calopa, Fátima Carrillo, Francisco Escamilla Sevilla, Eric Freire, Rocío García Ramos, et al. "MNCD: A New Tool for Classifying Parkinson’s Disease in Daily Clinical Practice." Diagnostics 12, no. 1 (December 28, 2021): 55. http://dx.doi.org/10.3390/diagnostics12010055.
Abstract:
Background and objective: Parkinson’s disease (PD) is a clinically heterogeneous disorder in which the symptoms and prognosis can be very different among patients. We propose a new simple classification to identify key symptoms and staging in PD. Patients and Methods: Sixteen movement disorders specialists from Spain participated in this project. The classification was consensually approved after a discussion and review process from June to October 2021. The TNM classification and the National Institutes of Health Stroke Scale (NIHSS) were considered as models in the design. Results: The classification was named MNCD and included 4 major axes: (1) motor symptoms; (2) non-motor symptoms; (3) cognition; (4) dependency for activities of daily living (ADL). Motor axis included 4 sub-axes: (1) motor fluctuations; (2) dyskinesia; (3) axial symptoms; (4) tremor. Four other sub-axes were included in the non-motor axis: (1) neuropsychiatric symptoms; (2) autonomic dysfunction; (3) sleep disturbances and fatigue; (4) pain and sensory disorders. According to the MNCD, 5 stages were considered, from stage 1 (no disabling motor or non-motor symptoms with normal cognition and independency for ADL) to 5 (dementia and dependency for basic ADL). Conclusions: A new simple classification of PD is proposed. The MNCD classification includes 4 major axes and 5 stages to identify key symptoms and monitor the evolution of the disease in patients with PD. It is necessary to apply this proof of concept in a properly designed study.
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Calabresi, Paolo, Veronica Ghiglieri, Petra Mazzocchetti, Ilenia Corbelli, and Barbara Picconi. "Levodopa-induced plasticity: a double-edged sword in Parkinson's disease?" Philosophical Transactions of the Royal Society B: Biological Sciences 370, no. 1672 (July 5, 2015): 20140184. http://dx.doi.org/10.1098/rstb.2014.0184.
Abstract:
The long-term replacement therapy with the dopamine (DA) precursor 3,4-dihydroxy-l-phenylalanine (L-DOPA) is a milestone in the treatment of Parkinson's disease (PD). Although this drug precursor can be metabolized into the active neurotransmitter DA throughout the brain, its therapeutic benefit is due to restoring extracellular DA levels within the dorsal striatum, which lacks endogenous DA as a consequence of the neurodegenerative process induced by the disease. In the early phases of PD, L-DOPA treatment is able to restore both long-term depression (LTD) and long-term potentiation (LTP), two major forms of corticostriatal synaptic plasticity that are altered by dopaminergic denervation. However, unlike physiological DA transmission, this therapeutic approach in the advanced phase of the disease leads to abnormal peaks of DA, non-synaptically released, which are supposed to trigger behavioural sensitization, namely L-DOPA-induced dyskinesia. This condition is characterized by a loss of synaptic depotentiation, an inability to reverse previously induced LTP. In the advanced stages of PD, L-DOPA can also induce non-motor fluctuations with cognitive dysfunction and neuropsychiatric symptoms such as compulsive behaviours and impulse control disorders. Although the mechanisms underlying the role of L-DOPA in both motor and behavioural symptoms are still incompletely understood, recent data from electrophysiological and imaging studies have increased our understanding of the function of the brain areas involved and of the mechanisms implicated in both therapeutic and adverse actions of L-DOPA in PD patients.
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Sobolevskaia, P. A., A. N. Gvozdeckii, I. V. Kudryavtsev, V. A. Chereshnev, and L. P. Сhurilov. "Role of proinflammatory cytokines in Hashimoto's thyroiditis associated with psychiatric disorders." Medical Immunology (Russia) 25, no. 5 (June 1, 2023): 1247–52. http://dx.doi.org/10.15789/1563-0625-rop-2812.
Abstract:
Mental disorders often accompany autoimmune diseases, for example, since 1949 it has been known about “myxedematous madness”, a psychosis caused by hypothyroidism. The most common cause of hypothyroidism is Hashimoto's autoimmune thyroiditis. It is also known about another neuropsychiatric disorder associated with autoimmune thyroiditis, Hashimoto's encephalopathy. It is a severe dysfunction of the central nervous system, the pathogenesis of which is not associated with hormonal disorders. Cytokines are regulators and participants of inflammation, including autoimmune. Certainly, when we are talking about high concentrations cytokines, we mean systemic inflammation. The minimal or mediocre fluctuations in cytokines within the ranges that are characteristic of healthy status or normergic acute phase response in disease cannot be interpreted from the point of view of binary endocrinological logic. In the CNS, cytokines are able to influence on the neuroendocrine control of systemically regulated functions. It is also important that glial cells (astroglia, microglia) are capable of producing a number of cytokines and can affect neurons and develop behavioral changes. In addition, the ability of a number of cytokines outside the CNS itself to act on vagal afferents and through them to convey information to the CNS, affecting its state and functions, has been proven. It is reasonable to assume that minimal fluctuations in cytokine levels may also affect the state and function of the CNS. The aim of the study was to investigate the levels of cytokines in patients with thyroiditis; in patients with thyroiditis associated with mental disorders; in a group of healthy individuals; and evaluate the effect of cytokine levels on clinical manifestations. In the group of patients with thyroiditis and mental disorders, the levels of CCL20/MIP3α, IL-13, IL-2, IL-27, IL-5 were significantly higher than in other groups. At the same time, no positive correlation was found between the clinical manifestations of mental disorders and the levels of cytokines. A positive correlation was found between the levels of some cytokines and free triiodothyronine, as well as the level of antithyroid antibodies. Mental disorders associated with autoimmune thyroiditis may be associated with changes in the cytokine profile and result from neuroinflammation.
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Missig, Galen, James O. Robbins, Emery L. Mokler, Kenneth M. McCullough, Staci D. Bilbo, Christopher J. McDougle, and William A. Carlezon. "Sex-dependent neurobiological features of prenatal immune activation via TLR7." Molecular Psychiatry 25, no. 10 (January 4, 2019): 2330–41. http://dx.doi.org/10.1038/s41380-018-0346-4.
Abstract:
Abstract Immune activation during pregnancy via infection or autoimmune disease is a risk factor for neuropsychiatric illness. Mouse models of prenatal immune activation often involve maternal administration of agents that activate toll-like receptors (TLRs), a class of pattern recognition receptors that initiate innate immune responses. Such studies have focused primarily on activating the TLR3 or TLR4 subtypes, to mimic immune responses to viral or bacterial infections, respectively. Here, we characterize the effects of prenatal activation of TLR7, which is implicated in the pathogenesis of autoimmune disease. Prenatal TLR7 activation via administration of the selective agonist imiquimod (5.0 mg/kg) induces a phenotype in offspring characterized by reduced anxiety-like behavior, fragmented social behavior, and altered ultrasonic vocalization patterns at 6–12 weeks of age. The characteristics of this phenotype are readily distinguishable from—and in some ways opposite to—those seen following prenatal activation of TLR3 and/or TLR4. Prenatal TLR7-activated mice have normal baseline locomotor activity, but are hyperresponsive to stimuli including social partners, circadian cues, and gonadal hormone fluctuations. These alterations are accompanied by decreases in microglia density but increases in ramifications. RNA-sequencing of dorsal striatum, a region showing profound changes in microglial markers, indicates that prenatal TLR7 activation induces differential expression of hundreds of genes at 13 weeks of age, with virtually no overlap in differentially expressed genes between males and females. Our findings demonstrate that prenatal immune activation can promote a wide range of developmental trajectories, depending on the type and/or pattern of TLR activation and the sex of the offspring.
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Moneglia, M., A. Santangelo, I. Burian, L. Gragnani, F. Elisa, M. Quargnolo, S. Pallanti, and A. L. Zignego. "Second generation direct-acting antiviral (DAAs) Treatment on HCV+ patients: Patient reported outcomes (PROs) and psychiatric symptoms in a real world setting sample." European Psychiatry 41, S1 (April 2017): S316—S317. http://dx.doi.org/10.1016/j.eurpsy.2017.02.230.
Abstract:
IntroductionAnti-HCV treatments are moving away from interferon-alpha towards DAAs, associated with fewer side effects, better tolerability, and better PROs.AimsTo describe neuropsychiatric symptoms and PROs during DAAs treatment in a group of HCV+ patients.MethodsForty outpatients, scheduled for DAAs treatment, were assessed at enrolment (T0), 4 weeks (T1), at the end of treatment (EOT) and after 12 weeks of follow up (F-UP), by means of MDRS, HAM-D, HAM-A, MRS, Y-BOCS and SF-36. Afterwards the sample was divided into two groups as a function of a positive psychiatric history (19) and compared with each other.ResultsTotal sample mean scores between W0 and F-UP were compared and an improving trend was observed in all administered scales. An SF-36 items analysis showed a statistically significant difference in emotional role functioning between W0 vs EOT and EOT vs F-UP, in change in overall health status between W0 vs EOT and W0 vs F-UP.A multivariate logistic regression analysis showed that a positive psychiatric history was not associated with an improvement in vitality of 4.3 (minimal clinically important difference). Comparing the two groups, no significant fluctuations in SF-36 scores were founded and major deviations score increases were recorded in patients with a psychiatric history in all scales.ConclusionsOur real world data shows that new regimens do not seem to be associated with psychiatric side effects and conversely a clinical improvement compared to baseline was found, suggesting an immediate gain in PROs over the treatment period, particularly the psychiatric subgroup.Disclosure of interestThe authors have not supplied their declaration of competing interest.
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Matar, Elie, Kaylena A. Ehgoetz Martens, Glenda M. Halliday, and Simon JG Lewis. "093 How to diagnose lewy body dementia? Prevalence and underlying relationship between clinical and neuropsychological features of DLB." Journal of Neurology, Neurosurgery & Psychiatry 90, e7 (July 2019): A30.1—A30. http://dx.doi.org/10.1136/jnnp-2019-anzan.81.
Abstract:
IntroductionDespite its importance for management, prognostication and selection of patients for clinical trials, the diagnosis of Dementia with Lewy Bodies (DLB) remains challenging. Complicating this is a recent change in the diagnostic criteria which has arguably shifted the expected phenotype of DLB patients. In this study we aimed to characterize and examine the relationship between cognitive and clinical diagnostic variables in DLB patients to uncover latent symptom clusters that may streamline future diagnostic approaches in the clinic.MethodsThe clinical and neuropsychological profile of 27 prospectively recruited participants diagnosed with probable DLB and 25 age-matched controls was characterized according to the most recent consensus criteria.Symptoms were scored using a novel combination of established clinical and research instruments.ResultsWe demonstrate comparable sensitivity of formal neuropsychological testing and bedside screening tools (MOCA/MMSE) for identifying domain-specific differences between controls and patients(p<0.001). Optimal sensitivity thresholds for diagnosis of Parkinsonism (88.9%) were explored yielding a prevalence range of 50%-90% within our cohort.Factor analysis using all core and supportive features of the diagnostic criteria identified 6 independent factors accounting for 81% of the total variance. Unique relationships identified included between hallucinations and fluctuations and excessive daytime somnolence; between REM sleep behavior disorder and orthostatic hypotension; and Parkinsonism and urinary disturbance. ‘Prodromal’ symptoms including autonomic and early neuropsychiatric features are represented in the remaining factors.ConclusionParsimonious delineation of clinical variables using identified symptom clusters can aid DLB diagnosis.Clusters are also used to highlight latent pathological relationships. Appropriate instruments and thresholds for detecting dementia and core and suggestive features are presented.
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Durmayüksel, Esra, Fadime Çinar, Bulent Baris Guven, and Fatma Eti Aslan. "Risk factors for the development of delirium in elderly patients undergoing orthopaedic surgery: A systematic review and metaanalysis." Journal of Clinical and Investigative Surgery 6, no. 2 (November 15, 2021): 94–103. http://dx.doi.org/10.25083/2559.5555/6.2.3.
Abstract:
Objective. Delirium is a temporary neuropsychiatric syndrome characterized by fluctuations in cognition and attention. Delirium is one of the most common complications seen in old individuals after orthopaedic surgery. With a high incidence, the clinical picture of delirium increases the length of hospital stay and increases healthcare-related costs. This study has aimed to systematically review the national and international studies that investigated the risk factors leading to delirium in geriatric patients after orthopaedic surgery and to perform a meta-analysis using the data reported by those studies. Materials and Methods. A preliminary literature review was performed on six databases. The following English keyword combinations were used including 'Orthopaedic Surgery', 'Geriatrics', 'Elderly', and 'Delirium'. The results of trials were evaluated with random or fixed effect model according to the heterogeneity. Statistical evaluation was performed by using Comprehensive Meta Analysis version 3 programme. Results. The total sample size of the studies included in the analysis was 892. In geriatric patients; who had undergone orthopaedic surgery and developed delirium, the random-effects model revealed a high-level, in the positive direction, and statistically significant (p<0.05) overall effect size of 5.21 (CI; 1.33-20.33) for gender, 1.33 (CI; 0.58-2.06) for age, 11.30 (CI; 4.70-27.12 for polypharmacy, and a low-level, in the positive direction, and statistically significant (p<0.05) overall effect size of 0.12 (CI; 0.05-0.27) for mini-mental state examination as the risk factors leading to the development of delirium. Conclusions. Advanced age, female gender, polypharmacy, and a mini-mental state examination score of 17-23 are major risk factors for the development of delirium after orthopaedic surgery.
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Solerdelcoll Arimany, M., P. Bruguera, P. Guzmán, and M. Balcells Oliveiró. "A case report of an acute confusional state related with perampanel." European Psychiatry 41, S1 (April 2017): S761. http://dx.doi.org/10.1016/j.eurpsy.2017.01.1429.
Abstract:
IntroductionPerampanel (PER) is a new selective, non-competitive AMPA glutamate receptor antagonist. PER is generally well tolerated, with dizziness, somnolence, headache, and fatigue as the most common treatment-emergent adverse events, however neuropsychiatric adverse reactions; particularly irritability and aggressiveness can be expected.ObjectiveWe describe a patient who developed and acute confusional state presumably related to treatment with PER.AimsAt the conclusion, the participants should be able to remember that PER is associated with psychiatric side effects.MethodsCollect the data of the clinical history of the patient, who was admitted in the acute psychiatry ward of our hospital.ResultsA 32-year-old woman diagnosed with pharmacoresistant juvenile myoclonic epilepsy, was referred to the emergency department because of severe behavioral disturbances, insomnia, irritability and aggressivity after increasing the dose of PER from 6 to 12 mg. Physical exploration, drug screen and blood tests were all normal. No abnormalities were found in CT, EEG and MRI, and then she was referred to psychiatric ward. At her admission, she presented fluctuations of her mental state and level of consciousness. She was diagnosed with acute confusional syndrome induced by PER, and consequently PER was stopped and risperidone was initiated. In the 4th week symptomatology remitted.ConclusionAnti-epileptic drug's (AEDs) are associated with psychiatric side effects. Patients with epilepsy have higher risk develop psychiatric symptoms and behavioral disturbances. There is evidence to suggest that AMPA receptors are involved in the pathogenesis of psychiatric conditions. Such mechanisms could be responsible of the psychiatric symptoms observed. Neuropsychological profiles of AEDs are important considerations for treatment selection, particularly in children and adolescents.Disclosure of interestThe authors have not supplied their declaration of competing interest.
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Viñas-Noguera, Mireia, Kristína Csatlósová, Eva Šimončičová, Ezster Bögi, Eduard Ujházy, Michal Dubovický, and Kristína Belovičová. "Sex- and age- dependent effect of pre-gestational chronic stress and mirtazapine treatment on neurobehavioral development of Wistar rat offspring." PLOS ONE 17, no. 2 (February 3, 2022): e0255546. http://dx.doi.org/10.1371/journal.pone.0255546.
Abstract:
Hormonal fluctuations, such as the perinatal period, may increase susceptibility of women to depression, which in turn exert a negative impact on child’s neurodevelopment, becoming a risk factor in development of neuropsychiatric disorders. Moreover, the use of antidepressants during this critical period presents a serious health concern for both the mother and the child, due to the consequences of treatment in terms of the reliability and safety for the proper neurodevelopment of the organism being not well known. Atypical antidepressants, such as mirtazapine, that targets both serotonergic and noradrenergic systems in the central nervous system (CNS), represent a novel focus of research due to its unique pharmacological profile. The aim of this work was to study the effects of maternal depression and/or perinatal antidepressant mirtazapine treatment on the neurobehavioral development of the offspring. Pre-gestationally chronically stressed or non-stressed Wistar rat dams were treated with either mirtazapine (10 mg/kg/day) or vehicle during pregnancy and lactation followed by analysis of offspring’s behavior at juvenile and adolescent age. We found mirtazapine induced significant alterations of nursing behavior. In offspring, pregestational stress (PS) had an anxiogenic effect on adolescent males (p≤0.05) and increased their active behavior in forced swim test (p≤0.01). Interaction between pregestational stress and mirtazapine treatment variously induced anxiolytic changes of juvenile (p≤0.05) and adolescent (p≤0.05) females and impairment of spatial memory (p≤0.01) in adolescent females as well. Hippocampal density of synaptophysin, pre-synaptic protein marker, was decreased mainly by mirtazapine treatment. In conclusion, our results show mirtazapine induced significant alterations in maternal behavior and several sex- and age-dependent changes in neurobehavioral development of offspring caused by both prenatal mirtazapine treatment and/or chronic pregestational stress.
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Jang, Jung-Hee, Kyungsook Jung, Joong-Sun Kim, Inchul Jung, Horyong Yoo, and Changjong Moon. "Potential Application of Yokukansan as a Remedy for Parkinson’s Disease." Evidence-Based Complementary and Alternative Medicine 2018 (December 20, 2018): 1–19. http://dx.doi.org/10.1155/2018/1875928.
Abstract:
Parkinson’s disease (PD), the second most common progressive neurodegenerative disorder, is characterized by complex motor and nonmotor symptoms. The clinical diagnosis of PD is defined by bradykinesia and other cardinal motor features, although several nonmotor symptoms are also related to disability, an impaired quality of life, and shortened life expectancy. Levodopa, which is used as a standard pharmacotherapy for PD, has limitations including a short half-life, fluctuations in efficacy, and dyskinesias with long-term use. There have been efforts to develop complementary and alternative therapies for incurable PD. Yokukansan (YKS) is a traditional herbal medicine that is widely used for treating neurosis, insomnia, and night crying in children. The clinical efficacy of YKS for treating behavioral and psychological symptoms, such as delusions, hallucinations, and impaired agitation/aggression subscale and activities of daily living scores, has mainly been investigated in the context of neurological disorders such as PD, Alzheimer’s disease, and other psychiatric disorders. Furthermore, YKS has previously been found to improve clinical symptoms, such as sleep disturbances, neuropsychiatric and cognitive impairments, pain, and tardive dyskinesia. Preclinical studies have reported that the broad efficacy of YKS for various symptoms involves its regulation of neurotransmitters including GABA, serotonin, glutamate, and dopamine, as well as the expression of dynamin and glutamate transporters, and changes in glucocorticoid hormones and enzymes such as choline acetyltransferase and acetylcholinesterase. Moreover, YKS has neuroprotective effects at various cellular levels via diverse mechanisms. In this review, we focus on the clinical efficacy and neuropharmacological effects of YKS. We discuss the possible mechanisms underpinning the effects of YKS on neuropathology and suggest that the multiple actions of YKS may be beneficial as a treatment for PD. We highlight the potential that YKS may serve as a complementary and alternative strategy for the treatment of PD.
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Федоров, В. П., О. М. Холодов, and О. П. Гундарова. "EXPERIMENTAL AND MATHEMATICAL MODELING OF THE REACTION OF BRAIN NEURONS TO IONIZING RADIATION." СИСТЕМНЫЙ АНАЛИЗ И УПРАВЛЕНИЕ В БИОМЕДИЦИНСКИХ СИСТЕМАХ 22, no. 2 (June 30, 2023): 85–92. http://dx.doi.org/10.36622/vstu.2023.22.2.013.
Abstract:
В связи с невозможностью изучения реакции нейронов центральной нервной системы человека на малые дозы ионизирующего излучения, проведено экспериментальное и математическое моделирование пострадиационных церебральных эффектов на белых лабораторных крысах. Экспериментальное исследование, выполненное с использованием традиционных патогистологических и статистических методик, не выявило среди множества воздействующих факторов приоритетный в реакции нейронов на малые дозы ионизирующего излучения. Реакция нервных клеток зависела не только от γ-облучения, но и от сроков наблюдения после начала эксперимента, а также от совместного их воздействия. Математическое моделирование показало, что малые дозы ионизирующего излучения, вызывали отклик у нервных клеток головного мозга. Большинство изменений нейронов в последующем репарировалось, но часть повреждений сохранялась и, накапливаясь, приводила к экстремумам в отдельных доза-временных интервалах. Флюктуации состояния нейронов, хотя и имели стохастический характер, свидетельствовали о нарушении постоянства их структурно-функциональной организации и сбое функционирования, которые могут служить морфологической основой для формирования пограничных психоневрологических нарушений Due to the impossibility of studying the reaction of neurons of the human nervous system to low doses of an ionizing pulse, experimental and mathematical modeling of post-radiation cerebral effects was carried out on white laboratory rats. An experimental study conducted using side pathohistological and statistical methods was not identified among the identification of influencing factors that are priority in the reaction of neurons to small cases of ionizing research. The reaction of nerve cells depends not only on γ-irradiation, but also on the period of observation after the start of the experiment, as well as on the reverse effect. Mathematical modeling showed that small doses of ionizing radiation caused a response in the nerve cells of the brain. Most of the changes in neurons were subsequently repaired, but some of the damage persisted and, accumulating, led to extremes in certain dose-time intervals. Fluctuations in the state of neurons, although they were of a stochastic nature, indicated a violation of the constancy of their structural and functional organization and a malfunction, which can serve as a morphological basis for the formation of borderline neuropsychiatric disorders
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Mуkhailova, E. А., and D. A. Mitelov. "Peculiarities of the microsocial environment in the formation of adjustment disorderin children with type 1 diabetes mellitus." Ukrainian Journal of Pediatric Endocrinology, no. 2 (July 16, 2021): 27–34. http://dx.doi.org/10.30978/ujpe2021-2-27.
Abstract:
Currently, there is a global trend towards an increase in the incidence of type 1 diabetes mellitus (DM 1) among children and adolescents. It is characterized by a lifelong progressive course, manifested by endocrine and somatic disorders, as well as neurological and mental complications. The risk of the development of emotional disorders, cognitive dysfunction, adjustment disorder is largely determined by the microsocial environment of a child with DM 1. Objective — to study role of family in the formation of the disorders inmental and psychological health of children and adolescents with severe DM 1. Materials and methods. Examinations involved 285 patients with DM 1(126 children and 159 adolescents). The investigation design included clinical and psychopathological method, pathopsychological method, sociopsychological interviewing of a child and his/her family, test “Family sociogram”, projective picture tests “Housetreeman”, “Me and my disease”, “Kinetic picture of the family”. Results. It has been established that the level of psychological health of family of a child with DM 1 corresponded to the normal indicator in 20 % of cases. The factors have been determined that destabilize psychological health of the family, typology of family relationships with a sick child and their role in the formation of persistent neuropsychiatric complications. The factors of the microsocial environment affecting the formation of sociopsychological maladjustment of a child with DM were determined. The following risk factors of the formation of mental and neurological disorders in DM 1 children have been identified: the age of endocrine disease (DM)onset less than 7 years, the disease duration ≥ 5 years, frequent fluctuations in of glycemialevel, unsatisfactory self-control of the disease, late diagnosis of early and late complications related to the central nervous system, insufficient compliance, pathological types of family sociogram. An alternative method for diagnosing psychological problems in children and adolescents with diabetes the use of projective methods has shown a high information content of target detection for the correction of emotional and behavioral disorders in the conditions of system «Life with diabetes».Conclusions. Socio-psychological patterns of maladaptation of children and adolescents with type 1 diabetes mellitushave been identified, which is important for determining the strategy of therapeutic intervention, socio-psychological support and prevention of social handicap.
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Laruelle, Marc. "Imaging Synaptic Neurotransmission with in Vivo Binding Competition Techniques: A Critical Review." Journal of Cerebral Blood Flow & Metabolism 20, no. 3 (March 2000): 423–51. http://dx.doi.org/10.1097/00004647-200003000-00001.
Abstract:
Several groups have provided evidence that positron emission tomography (PET) and single-photon emission computed tomography (SPECT) neuroreceptor imaging techniques might be applied to measure acute fluctuations in dopamine (DA) synaptic concentration in the living human brain. Competition between DA and radioligands for binding to D2 receptor is the principle underlying this approach. This new application of neuroreceptor imaging provides a dynamic measurement of neurotransmission that is likely to be informative to our understanding of neuropsychiatric conditions. This article reviews and discusses the body of data supporting the feasibility and potential of this imaging paradigm. Endogenous competition studies performed in rodents, nonhuman primates, and humans are first summarized. After this overview, the validity of the model underlying the interpretation of these imaging data is critically assessed. The current reference model is defined as the occupancy model, since changes in radiotracer binding potential (BP) are assumed to be directly caused by changes in occupancy of D2 receptors by DA. Experimental data supporting this model are presented. The evidence that manipulation of DA synaptic levels induces change in the BP of several D2 radiotracers (catecholamines and benzamides) is unequivocal. The fact that these changes in BP are mediated by changes in DA synaptic concentration is well documented. The relationship between the magnitude of BP changes measured with PET or SPECT and the magnitude of changes in DA concentration measured by microdialysis supports the use of these noninvasive techniques to measure changes in neurotransmission. On the other hand, several observations remain unexplained. First, the amphetamine-induced changes in the BP of D2 receptor antagonists [123I]IBZM and [11C]raclopride last longer than amphetamine-induced changes in DA extracellular concentration. Second, nonbenzamide D2 receptor antagonists, such as spiperone and pimozide, are not affected by changes in DA release, or are affected in a direction opposite to that predicted by the occupancy model. Similar observations are reported with D1 radiotracers. These results suggest that the changes in BP following changes in DA concentration might not be fully accounted by a simple occupancy model. Specifically, the data are reviewed supporting that agonist-mediated receptor internalization might play an important role in characterizing receptor-ligand interactions. Finally, it is proposed that a better understanding of the mechanism underlying the effects observed with benzamides is essential to develop this imaging technique to other receptor systems.
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Ivanova, M. D., K. G. Germanova, and M. Herrojo Ruiz. "Neural oscillatory correlates of motor vigor: an magnetoencephalographic study." Genes & Cells 18, no. 4 (December 15, 2023): 614–17. http://dx.doi.org/10.17816/gc623332.
Abstract:
Previous studies have shown that the anticipation of reward enhances motor performance, which reduces movement time and increases velocity [1]. In our recent study [2], we observed that when participants are required to infer the changing probabilities of a reward in a dynamic and uncertain setting, heightened expectations are consistently associated with faster motor performance. The study showed that performance time sensitivity to prediction strength remained consistent among both young and older healthy adults, as well as those with Parkinson’s disease. While the effects of dynamic motor strength have been observed, the neurological processes involved remain to be determined [3]. The study examined the neural oscillatory connections to motor vigor in dynamic and unpredictable settings. We used magnetoencephalography (MEG) and individual structural magnetic resonance imaging (MRI) to record readings from 25 healthy human participants (18 females) during the execution of our newly developed reward-based motor decision-making task [2]. This study used a reversal learning paradigm with shifting stimulus-outcome relationships. Participants were required to deduce which of two stimuli was linked to a reward on each trial, and indicate their choice through one of two finger press sequences, each with a distinct auditory response. The task was conducted in an unstable context, leading to fluctuations in the probability of reward associated with each response over time. First, we examined decision-making behavior using the validated Hierarchical Gaussian Filter (HGF, [4]). The model that most accurately described the behavioral data was the three-level “extended” HGF for binary categorical inputs, which is paired with a response model where decisions are dependent on the trial-wise estimate of volatility. This study allowed for the generation of reward probability trajectories on a trial-by-trial basis. Subsequently, applying Bayesian linear mixed models, we found a relationship between belief strength regarding reward contingencies and performance tempo on a trial-by-trial basis. The analysis of MEG signals is centered on reconstructing oscillatory activity sources using Linearly Constrained Minimum Variance beamforming [5]. Currently, we use convolution models in the source space to identify neural oscillatory correlations that differentiate motor performance and decision making. Next, we will evaluate connectivity patterns between frontal and motor regions that underlie the effects of motor invigoration. Identifying particular patterns of oscillatory connectivity that modulate motor vigor can provide insights into motor deficits observed in neurological and neuropsychiatric conditions associated with behavioral apathy.
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Lux, Danielle, Anna Naito, and Sreedharan Harikrishnan. "Congenital extrahepatic portosystemic shunt with progressive myelopathy and encephalopathy." Practical Neurology 19, no. 4 (May 2, 2019): 368–71. http://dx.doi.org/10.1136/practneurol-2018-002111.
Abstract:
Portosystemic encephalopathy commonly occurs in patients with portal hypertension caused by end-stage liver disease or portal vein thrombosis. Congenital extrahepatic portosystemic shunt (CEPS) is an underdiagnosed and treatable condition that can cause encephalopathy and various neuropsychiatric symptoms. We report an unusual case of type 2 CEPS in a 29-year-old woman who presented with progressive myelopathy and fluctuating encephalopathy on a background of congenital cardiac disease. Investigations showed hyperammonaemia, and despite no evidence of portal hypertension on ultrasound imaging, CT scan of abdomen showed a shunt between the mesenteric and left internal iliac veins. Patients with unexplained fluctuating or progressive neuropsychiatric symptoms should have their serum ammonia checked. A raised serum ammonia concentration without known portal hypertension should prompt further investigations for extrahepatic shunts.
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Carbotte, R. M., S. D. Denburg, J. A. Denburg, C. Nahmias, and E. S. Garnett. "Fluctuating cognitive abnormalities and cerebral glucose metabolism in neuropsychiatric systemic lupus erythematosus." Journal of Neurology, Neurosurgery & Psychiatry 55, no. 11 (November 1, 1992): 1054–59. http://dx.doi.org/10.1136/jnnp.55.11.1054.
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Ochoa García, D. K., G. M. Chauca Chauca, and L. Carrión Expósito. "Acute hypomania in systemic lupus erythematosus, differential diagnosis. A case report." European Psychiatry 33, S1 (March 2016): S393. http://dx.doi.org/10.1016/j.eurpsy.2016.01.1414.
Abstract:
IntroductionIt is well known that seizures and psychosis are diagnostic criteria for systemic lupus erythematosus (SLE), however, there could be many other neuropsychiatric symptoms. The American College of Rheumatology Nomenclature provides case definitions for 19 neuropsychiatric syndromes seen in SLE (NPSLE), including cognitive impairment, psychosis, mood and anxiety disorders. Lack of specific manifestations difficult diagnosis and treatment.ObjectivesTo address the diagnostic difficulties that involve the appearance of hypomanic symptoms in the course of SLE treated with high doses of corticoids in a patient with a depressive episode history.MethodDescription of case report and literature revision. We report the case of a 22-year-old woman who presented irritable mood, sexual disinhibition, insomnia and inflated self-esteem. The patient was recently diagnosed with SLE and was on treatment with 50 mg/d prednisone. She had familiar history for bipolar disorder and was taking 20 mg/d paroxetine since the last 6 months after being diagnosed with major depressive episode.ResultsWe proposed differential diagnosis between psychiatric symptoms secondary to central nervous system SLE involvement, a comorbid bipolar disorder or prednisone-induced mood symptoms. Fluctuation of hypomanic symptoms during hospitalization, poor relationship with variation in corticosteroid doses, findings on brain MRI compatible with vasculitis and positive antibodies, oriented this case to a neuropsychiatric manifestation of LES.ConclusionsWe should keep in mind that symptoms of neuropsychiatric SLE may vary from more established manifestations of NPSLE to mild diffuses ones. More studies are needed to expand knowledge in the relationship between mood disorders and neuropsychiatric SLE.Disclosure of interestThe authors have not supplied their declaration of competing interest.