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Neurocognitive Deficits in Euthymic Bipolar Patients  [PDF]
Aysegul Demirel,Omer Faruk Demirel,Muhammed Tayyib Kadak,Alaattin Duran
Psikiyatride Guncel Yaklasimlar , 2012,
Abstract: Neurocognitive deficits detected in bipolar patients have a negative influence on clinical course and severity. We reviewed studies on neurocognitive deficits in euthymic bipolar subjects and their possible neuroanatomical correlates. We also examined studies suggesting deficits seen in euthymic patients may be endophenotypes of the disorder. Results of the studies in euthymic patients and their healthy relatives indicate that have cognitive dysfunctions especially of verbal memory, learning and executive domains, which were found to be related to prefrontal cortex and temporo-limbic circuitry. Longitudinal studies investigating heritability of cognitive impairment in bipolar disorder and its relation with brain connectivity and epigenetic mechanisms are needed.
Relationship between Cognitive Deficits and Self-care Instrumental Activities Daily Living in Schizophrenic Patients in Qom's Psychiatric Ward, 2010  [cached]
V Akbari
Qom University of Medical Sciences Journal , 2012,
Abstract: Background and Objectives: Although schizophrenia disorder is not a cognitive dysfunction, it often results in cognitive deficit. Self-care is a life skill which weakens in neuro-cognitive disorders. Since relationship between cognitive deficits and self-care in schizophrenic patients is not yet known, the survey was done to clarify the relationship between cognitive deficits and self-care instrumental activities daily living in schizophrenic patients. Methods: The present study is of descriptive type, wherein 58 schizophrenic patients of psychiatric ward at Nekoo'ee hospital, Qom, were selected by population sampling. Data collection tools were PASS (for measuring the instrumental skills in daily living activities), and LOTCA-II (for measuring cognitive status). The analysis of the data was done by means of Spearman and Pearson correlation test, showing the significant level of p>0.05. Results: The results showed that between the seven cognitive domains(Orientation, Visual Perception, Spatial perception, Motor praxis, Visuomotor organization, Thinking operations, Attention and Concentration) and the aspects of self-care (independence, safety, quality and process of the task) there exists a significant relationship in schizophrenic patients, p=0.000 Conclusion: The present study displays a significant relationship between cognitive deficits and self-care instrumental activities in schizophrenic patients. Thus, by fortifying and improving the cognitive skills, we can effectively increase proper function in treatment planning of schizophrenic patients.
Hippocampal Physiology, Structure and Function and the Neuroscience of Schizophrenia: A Unified Account of Declarative Memory Deficits, Working Memory Deficits and Schizophrenic Symptoms  [PDF]
Cynthia G. Wible
Behavioral Sciences , 2013, DOI: 10.3390/bs3020298
Abstract: Memory impairment is a consistent feature of the schizophrenic syndrome. Hippocampal dysfunction has also been consistently demonstrated. This review will discuss neurophysiological and neuroanatomical aspects of memory formation and how they relate to memory impairment in schizophrenia. An understanding of the cellular physiology and connectivity of the hippocampus with other regions can also aid in understanding the relationship between schizophrenic declarative or relational memory deficits, working memory deficits and the clinical symptoms of the syndrome.
Effects of erythropoietin on depressive symptoms and neurocognitive deficits in depression and bipolar disorder
Kamilla W Miskowiak, Maj Vinberg, Catherine J Harmer, Hannelore Ehrenreich, Gitte M Knudsen, Julian Macoveanu, Allan R Hansen, Olaf B Paulson, Hartwig R Siebner, Lars V Kessing
Trials , 2010, DOI: 10.1186/1745-6215-11-97
Abstract: The trial has a double-blind, placebo-controlled, parallel-group design. 40 patients with treatment-resistant major depression and 40 patients with bipolar disorder in remission are recruited and randomised to receive weekly infusions of Epo (Eprex; 40,000 IU) or saline (NaCl 0.9%) for 8 weeks. Randomisation is stratified for age and gender. The primary outcome parameters for the two studies are: depression severity measured with the Hamilton Depression Rating Scale 17 items (HDRS-17) [1] in study 1 and, in study 2, verbal memory measured with the Rey Auditory Verbal Learning Test (RAVLT) [2,3]. With inclusion of 40 patients in each study we obtain 86% power to detect clinically relevant differences between intervention and placebo groups on these primary outcomes.The trial is approved by the Local Ethics Committee: H-C-2008-092, Danish Medicines Agency: 2612-4020, EudraCT: 2008-04857-14, Danish Data Agency: 2008-41-2711 and ClinicalTrials.gov: NCT 00916552.Depression and bipolar disorder are associated with neurodegenerative processes, reduced neuroplasticity and neuropsychological dysfunction, which often persist even after clinical remission. Current pharmacological treatment strategies have several limitations including a significant treatment-onset-response delay, only partial or no response in a large group of patients and limited effects on their cognitive deficits, which often persist into periods of remission [4-9]. These enduring cognitive impairments affect patients' psychosocial and occupational function, quality of life and prognosis [7,8,10,11]. Better treatment options are thus required to improve the onset of efficacy, address patients who are treatment resistant and remediate neurocognitive deficits. Converging evidence suggests that neural atrophy and reduced neuroplasticity are involved in depression and bipolar disorder, while restoration of synaptic plasticity may be an important mechanism of chronic antidepressant and mood stabilising drug trea
Sex-Specific Brain Deficits in Auditory Processing in an Animal Model of Cocaine-Related Schizophrenic Disorders  [PDF]
Patricia A. Broderick,Taylor Rosenbaum
Brain Sciences , 2013, DOI: 10.3390/brainsci3020504
Abstract: Cocaine is a psychostimulant in the pharmacological class of drugs called Local Anesthetics. Interestingly, cocaine is the only drug in this class that has a chemical formula comprised of a tropane ring and is, moreover, addictive. The correlation between tropane and addiction is well-studied. Another well-studied correlation is that between psychosis induced by cocaine and that psychosis endogenously present in the schizophrenic patient. Indeed, both of these psychoses exhibit much the same behavioral as well as neurochemical properties across species. Therefore, in order to study the link between schizophrenia and cocaine addiction, we used a behavioral paradigm called Acoustic Startle. We used this acoustic startle paradigm in female versus male Sprague-Dawley animals to discriminate possible sex differences in responses to startle. The startle method operates through auditory pathways in brain via a network of sensorimotor gating processes within auditory cortex, cochlear nuclei, inferior and superior colliculi, pontine reticular nuclei, in addition to mesocorticolimbic brain reward and nigrostriatal motor circuitries. This paper is the first to report sex differences to acoustic stimuli in Sprague-Dawley animals ( Rattus norvegicus) although such gender responses to acoustic startle have been reported in humans (Swerdlow et al. 1997 [1]). The startle method monitors pre-pulse inhibition (PPI) as a measure of the loss of sensorimotor gating in the brain's neuronal auditory network; auditory deficiencies can lead to sensory overload and subsequently cognitive dysfunction. Cocaine addicts and schizophrenic patients as well as cocaine treated animals are reported to exhibit symptoms of defective PPI (Geyer et al., 2001 [2]). Key findings are: (a) Cocaine significantly reduced PPI in both sexes. (b) Females were significantly more sensitive than males; reduced PPI was greater in females than in males. (c) Physiological saline had no effect on startle in either sex. Thus, the data elucidate gender-specificity to the startle response in animals. Finally, preliminary studies show the effect of cocaine on acoustic startle in tandem with effects on estrous cycle. The data further suggest that hormones may play a role in these sex differences to acoustic startle reported herein.
Facial emotion recognition in bipolar disorder: a critical review
Rocca, Cristiana Castanho de Almeida;Heuvel, Eveline van den;Caetano, Sheila C.;Lafer, Beny;
Revista Brasileira de Psiquiatria , 2009, DOI: 10.1590/S1516-44462009000200015
Abstract: objective: literature review of the controlled studies in the last 18 years in emotion recognition deficits in bipolar disorder. method: a bibliographical research of controlled studies with samples larger than 10 participants from 1990 to june 2008 was completed in medline, lilacs, pubmed and isi. thirty-two papers were evaluated. results: euthymic bipolar disorder presented impairment in recognizing disgust and fear. manic bd showed difficult to recognize fearful and sad faces. pediatric bipolar disorder patients and children at risk presented impairment in their capacity to recognize emotions in adults and children faces. bipolar disorder patients were more accurate in recognizing facial emotions than schizophrenic patients. discussion: bipolar disorder patients present impaired recognition of disgust, fear and sadness that can be partially attributed to mood-state. in mania, they have difficult to recognize fear and disgust. bipolar disorder patients were more accurate in recognizing emotions than depressive and schizophrenic patients. bipolar disorder children present a tendency to misjudge extreme facial expressions as being moderate or mild in intensity. conclusion: affective and cognitive deficits in bipolar disorder vary according to the mood states. follow-up studies re-testing bipolar disorder patients after recovery are needed in order to investigate if these abnormalities reflect a state or trait marker and can be considered an endophenotype. future studies should aim at standardizing task and designs.
Contextual Social Cognition Impairments in Schizophrenia and Bipolar Disorder  [PDF]
Sandra Baez, Eduar Herrera, Lilian Villarin, Donna Theil, María Luz Gonzalez-Gadea, Pedro Gomez, Marcela Mosquera, David Huepe, Sergio Strejilevich, Nora Silvana Vigliecca, Franziska Matth?us, Jean Decety, Facundo Manes, Agustín M. Iba?ez
PLOS ONE , 2013, DOI: 10.1371/journal.pone.0057664
Abstract: Background The ability to integrate contextual information with social cues to generate social meaning is a key aspect of social cognition. It is widely accepted that patients with schizophrenia and bipolar disorders have deficits in social cognition; however, previous studies on these disorders did not use tasks that replicate everyday situations. Methodology/Principal Findings This study evaluates the performance of patients with schizophrenia and bipolar disorders on social cognition tasks (emotional processing, empathy, and social norms knowledge) that incorporate different levels of contextual dependence and involvement of real-life scenarios. Furthermore, we explored the association between social cognition measures, clinical symptoms and executive functions. Using a logistic regression analysis, we explored whether the involvement of more basic skills in emotional processing predicted performance on empathy tasks. The results showed that both patient groups exhibited deficits in social cognition tasks with greater context sensitivity and involvement of real-life scenarios. These deficits were more severe in schizophrenic than in bipolar patients. Patients did not differ from controls in tasks involving explicit knowledge. Moreover, schizophrenic patients’ depression levels were negatively correlated with performance on empathy tasks. Conclusions/Significance Overall performance on emotion recognition predicted performance on intentionality attribution during the more ambiguous situations of the empathy task. These results suggest that social cognition deficits could be related to a general impairment in the capacity to implicitly integrate contextual cues. Important implications for the assessment and treatment of individuals with schizophrenia and bipolar disorders, as well as for neurocognitive models of these pathologies are discussed.
Evolution of Extra-Nigral Damage Predicts Behavioural Deficits in a Rat Proteasome Inhibitor Model of Parkinson's Disease  [PDF]
Anthony C. Vernon,William R. Crum,Saga M. Johansson,Michel Modo
PLOS ONE , 2012, DOI: 10.1371/journal.pone.0017269
Abstract: Establishing the neurological basis of behavioural dysfunction is key to provide a better understanding of Parkinson's disease (PD) and facilitate development of effective novel therapies. For this, the relationships between longitudinal structural brain changes associated with motor behaviour were determined in a rat model of PD and validated by post-mortem immunohistochemistry. Rats bearing a nigrostriatal lesion induced by infusion of the proteasome inhibitor lactacystin into the left-medial forebrain bundle and saline-injected controls underwent magnetic resonance imaging (MRI) at baseline (prior to surgery) and 1, 3 and 5 weeks post-surgery with concomitant motor assessments consisting of forelimb grip strength, accelerating rotarod, and apormorphine-induced rotation. Lactacystin-injected rats developed early motor deficits alongside decreased ipsilateral cortical volumes, specifically thinning of the primary motor (M1) and somatosensory cortices and lateral ventricle hypertrophy (as determined by manual segmentation and deformation-based morphometry). Although sustained, motor dysfunction and nigrostriatal damage were maximal by 1 week post-surgery. Additional volume decreases in the ipsilateral ventral midbrain; corpus striatum and thalamus were only evident by week 3 and 5. Whilst cortical MRI volume changes best predicted the degree of motor impairment, post-mortem tyrosine hydroxylase immunoreactivity in the striatum was a better predictor of motor behaviour overall, with the notable exception of performance in the accelerating rotarod, in which, M1 cortical thickness remained the best predictor. These results highlight the importance of identifying extra-nigral regions of damage that impact on behavioural dysfunction from damage to the nigrostriatal system.
Gamma Band Neural Synchronization Deficits for Auditory Steady State Responses in Bipolar Disorder Patients  [PDF]
Yuko Oda, Toshiaki Onitsuka, Rikako Tsuchimoto, Shogo Hirano, Naoya Oribe, Takefumi Ueno, Yoji Hirano, Itta Nakamura, Tomofumi Miura, Shigenobu Kanba
PLOS ONE , 2012, DOI: 10.1371/journal.pone.0039955
Abstract: Periodic auditory click stimulation has been reported to elicit an auditory steady state response (ASSR). The ASSR has been suggested to reflect the efficiency of γ-amino butyric acid (GABA) inhibitory interneuronal activity. Although a potential role for GABAergic dysfunction has been previously proposed, the role of neural synchronization in the ASSR in people with bipolar disorder (BD) has received little attention. In the current study, we investigated ASSRs to 20 Hz, 30 Hz, 40 Hz and 80 Hz click trains in BD patients. A total of 14 (4 males) BD patients and 25 (10 males) healthy controls participated in this study. ASSRs were obtained using whole-head 306-channel magnetoencephalography to calculate, ASSR power values and phase locking factors (PLF). BD patients exhibited significantly reduced mean ASSR power and PLF values bilaterally at frequencies of 30, 40, and 80 Hz (p<0.05 for these frequencies). At 20 Hz, bipolar patients showed no significant reduction in mean ASSR power and PLF values. There was a significant negative correlation between 80 Hz-ASSR-power values obtained from the right hemisphere and scores on the Hamilton Depression Rating Scale (rho = ?0.86, p = 0.0003). The current study showed reduced low and high gamma band ASSR power and PLF bilaterally with no significant beta band ASSR reduction in BD patients. BD patients are characterized by deficits in gamma band oscillations, which may be associated with GABA inhibitory interneuronal activity dysfunction.
The impact of a history of psychotic symptoms on cognitive function in euthymic bipolar patients: a comparison with schizophrenic patients and healthy controls
Brissos, Sofia;Dias, Vasco Videira;Soeiro-de-Souza, Márcio Gerhardt;Balanzá-Martínez, Vicent;Kapczinski, Flavio;
Revista Brasileira de Psiquiatria , 2011, DOI: 10.1590/S1516-44462011000400008
Abstract: background: about two-thirds of patients with bipolar disorder (bd) have a lifetime history of at least one psychotic symptom. objective: to compare the neurocognitive performance of four groups: bd patients with and without a history of psychotic symptoms (bd hps+ and bd hps-, respectively); patients with schizophrenia (sz); and healthy control (hc) subjects. method: in this cross-sectional study, 35 stabilized patients with sz, 79 euthymic (44 hps+ and 35 hps-) patients with bd, and 50 hc were administered a comprehensive battery of neuropsychological tests. results: there was worse neurocognitive functioning in both bd and sz patients compared to hc. overall, data from both groups of bd patients did not differ on sociodemographic, clinical, or neurocognitive variables. however, bd hps+ patients had significantly more negative symptoms, as measured by the positive and negative syndrome scale (panss), and showed a trend toward worse performance on executive functions compared to bd hps- patients. moreover, both bd groups had better performance on all neurocognitive tests compared to sz group. conclusions: neurocognitive dysfunction may be more marked in sz than in bd, yet qualitatively similar. a history of past psychotic symptoms in bd was not associated with more severe cognitive impairment during euthymia. therefore, bd with psychotic symptoms does not appear to be a distinct neurocognitive phenotype.
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