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Background: The stimulant methylphenidate (MPH) and the nonstimulant atomoxetine (ATX) are the most commonly- prescribed pharmacological treatments for attention deficit/hyperactivity disorder (ADHD). However, the drugspecific mechanism of action on brain function in ADHD patients is not well known. This study examined differences in prefrontal hemodynamic activity between MPH and ATX in children with ADHD as measured by near-infrared spectroscopy (NIRS) using the Stroop color-word task. Methods: Thirty children with ADHD participated in the present study. We used 24-channel NIRS (ETG-4000) to measure the relative concentrations of oxyhemoglobin in the frontal lobes of participants in the drug-naïve condition and those who had received MPH (n = 16) or ATX (n = 14) for 12 weeks. Measurements were conducted every 0.1 s during the Stroop color-word task. We used the ADHD RS-IV-J (Home Version) to evaluate ADHD symptoms. Results: Treatment with either MPH or ATX significantly reduced ADHD symptoms, as measured by the ADHD RS-IV-J, and improved performance on the Stroop color-word task in terms of number of correct words. We found significantly higher levels of oxyhemoglobin changes in the prefrontal cortex of participants in the ATX condition compared with the values seen at baseline (pre-ATX). In contrast, we found no oxyhemoglobin changes between pre- and posttreatment with MPH. Conclusions: The present study suggests that MPH and ATX have differential effects on prefrontal hemodynamic activity in children with ADHD. [ABSTRACT FROM AUTHOR]

Aim: Cognitive impairment is an important predictor of functional outcome in patients with attention deficit/hyperactivity disorder (ADHD). However, the neurophysiology of ADHDrelated cognitive impairments remains unclear. Event-related potentials (ERPs) represent the noninvasive measurement of neural correlates of cognitive function. Mismatch negativity (MMN) is an ERP component that is presumed to index the preattentive monitoring of changes in the auditory environment. Materials and methods: Previous studies have shown altered MMN amplitude and latency in patients with ADHD. However, little is known about the relationship between MMN and ADHD-symptom severity. To address this, we measured the amplitude and latency of MMN in ERPs and assessed correlations with the clinical severity of ADHD, as measured by the ADHD Rating Scale IV - Japanese version. Participants were 51 treatment-naïve children and adolescents with ADHD (mean age 10.42±3.35 years) and 15 normally developing age- and sex-matched children (mean age 11.8±3.36 years). Results: In the ADHD group, MMN amplitudes were attenuated at the central electrode and MMN latencies prolonged at the parietal electrode (Pz) relative to those in the control group. Furthermore, MMN amplitudes at Pz were negatively correlated with ADHD full-scale and hyperactivity-impulsivity and inattention subscale scores, and MMN latency at Pz was positively correlated with ADHD hyperactivity-impulsivity subscale scores. Conclusion: Our data suggest that MMN reflects the severity of ADHD symptoms in children and adolescents, and provides support for the use of ERPs in evaluating ADHD symptoms in patients. [ABSTRACT FROM AUTHOR]

Aim: Earlier brain imaging research studies have suggested that brain abnormalities in obsessive-compulsive disorder (OCD) normalize as clinical symptoms improve. However, although many studies have investigated event-related potentials (ERPs) in patients with OCD compared with healthy control subjects, it is currently unknown whether ERP changes reflect pharmacological and psychotherapeutic effects. As such, the current study examined the neurocognitive components of OCD to elucidate the pathophysiological abnormalities involved in the disorder, including the frontal-subcortical circuits. Methods: The Yale-Brown Obsessive-Compulsive Scale was used to evaluate 14 adult patients with OCD. The present study also included ten age-, sex-, and IQ-matched controls. The P300 and mismatch negativity (MMN) components during an auditory oddball task at baseline for both groups and after 1 year of treatment for patients with OCD were measured. Results: Compared with controls, P300 amplitude was attenuated in the OCD group at Cz and C4 at baseline. Pharmacotherapy and psychotherapy treatment for 1 year reduced OCD symptomology. P300 amplitude after 1 year of treatment was significantly increased, indicating normalization compared with baseline at Fz, Cz, C3, and C4. We found no differences in P300 latency, MMN amplitude, or MMN latency between baseline and after one year of treatment. Conclusion: ERPs may be a useful tool for evaluating pharmacological and cognitive behavioral therapy in adult patients with OCD. [ABSTRACT FROM AUTHOR]

Objective: The differential diagnosis of schizophrenia (SZ) versus autism spectrum disorder (ASD) can be clinically challenging because accumulating evidence suggests both clinical and biological overlaps between them. The aim of this study was to compare Rorschach profiles between young adults with SZ and those with ASD. Methods: We evaluated quantitative tendencies on the Rorschach test among 20 patients diagnosed with SZ and 20 diagnosed with ASD. Both groups were matched for age, sex, and intelligence quotient. Results: We found significant differences in six response variables on the Rorschach comprehensive system. Those with SZ had significantly higher scores on D score, adjusted D score (Adj D), developmental quality code reflecting ordinary response (DQo), and form quality minus (FQ -) than those with ASD. In contrast, those with SZ had significantly lower scores on the active and developmental quality code reflecting synthesized response (DQ+) subscales than those with ASD. Conclusion: The present findings reveal that individuals with SZ might have more stress tolerance, stronger perception distortions, and simpler and poorer recognition than those with ASD. We suggest that the Rorschach test might be a useful tool for differentiating between SZ and ASD. [ABSTRACT FROM AUTHOR]

Background: Tourette's disorder (TD) is a chronic childhood-onset disorder characterized by the presence of multiple motor and vocal tics. Despite strong evidence that the pathophysiology of TD involves structural and functional disturbances of the basal ganglia and cortical frontal areas, in vivo imaging studies have produced conflicting results. Recent developments in near-infrared spectroscopy (NIRS) technology have enabled noninvasive assessment of brain function in people with psychiatric disorders. Methods: We asked 10 individuals with pediatric TD and 10 healthy controls who were age- and sex- matched to perform the Stroop color-word task during NIRS. We used prefrontal probes and a 24-channel NIRS machine to measure the relative concentrations of oxyhemoglobin (oxy-Hb) every 0.1 s during the task. Results: We found that oxy-Hb changes in the prefrontal cortex were significantly smaller in the TD group compared with the control group, especially in the left dorsolateral prefrontal cortex. Conclusions: Our data suggest that individuals with pediatric TD have a reduced prefrontal hemodynamic response as measured by NIRS. [ABSTRACT FROM AUTHOR]

Background Nonconvulsive status epilepticus (NCSE) is a severe medical condition and heterogeneous disorder defined by different seizure types and diverse etiologies. NCSE occurs commonly in the elderly and is potentially misdiagnosed as a psychiatric disorder. Current treatment options for NCSE are still unsatisfactory. Case presentation We report a case of NCSE in a 55-year-old epileptic male patient with a history of infectious encephalitis, disinhibitory behavior, and a suspected diagnosis of frontotemporal dementia. Add-on levetiracetam (LEV) to carbamazepine treatment improved clinical manifestations and abnormal electroencephalographic discharge. Conclusion With disinhibitory behavior in the elderly, the possibility of NCSE should be considered. Moreover, LEV may be an effective and well-tolerated pharmacotherapy for elderly NCSE patients. [ABSTRACT FROM AUTHOR]

Objective A subgroup of patients with Tourette's disorder (TD) has symptoms refractory to haloperidol, a standard therapeutic drug for TD. Methods We report on three cases of pediatric and adolescent patients who were treated with paliperidone extended release. Results In two cases, TD symptoms were remarkably improved by switching from haloperidol to paliperidone extended release, and in another case, paliperidone extended release showed significant efficacy in treating TD symptoms as the first-line drug. In all cases, no significant adverse side effects were detected. Conclusion Paliperidone extended release may be a strong candidate for the treatment of pediatric and adolescent patients with TD. [ABSTRACT FROM AUTHOR]