Search

Abstract: Objective: Although there is evidence of specific associations between neuronal activity and early cerebral blood flow (CBF), little is known on a logical furtherance of this linkage, namely the association between early measures of cerebral hemodynamics and complex behavior. The present study examined the linkage between hemodynamic modulation in basal cerebral arteries and performance in a non-routine planning task by means of functional transcranial Doppler sonography (fTCD). Methods: The Stockings of Cambridge (SOC) was employed as planning paradigm. The middle and anterior cerebral arteries (MCA/ACA) were bilaterally insonated. Statistical methods comprised uni- and multivariate analyses of variance and multiple linear regression analyses. Results: Taking advantage of the excellent temporal resolution of fTCD, early cerebral hemodynamic modulation of the left MCA markedly predicted task accuracy. Pronounced early blood flow increase during planning and early decrease during movement execution were associated with better performance. No such blood flow modulations were observed in worse performers. Conclusions: Early cerebral hemodynamic modulation in the left MCA proved to be a valuable neurophysiological marker that showed a great overlap with task accuracy during non-routine planning. Significance: These results support the notion that a high temporal resolution in functional monitoring is a favorable strategy to disentangle relevant neurophysiological correlates of higher cognitive functioning. [Copyright &y& Elsevier]

Schizophrenic patients show a variety of symptoms, including positive and negative symptoms and ego pathology. Their exact underlying neuropsychological mechanisms as well as related changes in personality, however, remain unclear. We therefore conducted an exploratory study to investigate the relationship among neuropsychological functions, various dimensions in personality, and the different kinds of psychopathological symptoms. We investigated 22 paranoid schizophrenic patients and 22 age- and sex-matched healthy controls using a battery of neuropsychological, personality, and psychopathological tests and scales. Neuropsychological tests included executive function, working memory, and episodic memory, whereas personality assessment relied on the Temperament and Character Inventory by Cloninger (Arch Gen Psychiatry. 1987;44:573-88). Psychopathological rating included the scales for the assessment of positive and negative symptoms and the Ego Pathology Inventory by Scharfetter (Psychol Med. 1981;11(2):273-80). Schizophrenic patients showed significant deficits in executive function, working memory, and episodic memory. In contrast to healthy subjects, no significant correlation between working memory and executive function was observed in schizophrenic patients. Instead, both working memory and executive dysfunction were rather related to deficits in retrieval of episodic memory. Positive and negative symptoms correlated with episodic memory deficits but not with any dimension of the personality, whereas ego pathology, in contrast, correlated with executive dysfunction and working memory deficits. Moreover, schizophrenic patients showed specific changes in the self-dimensions of their personality, which correlated significantly with both executive dysfunction and ego pathology. Schizophrenic patients show deficits in working memory and executive function as well as functional dissociation between both. In contrast to positive and negative symptoms, ego pathology in these patients is specifically related to executive dysfunction and alterations in the self-dimension of their personality. It can therefore be concluded that ego pathology must be distinguished from positive and negative symptoms in both underlying neuropsychological dysfunction and predisposing changes in personality. [ABSTRACT FROM AUTHOR]

Abstract: Background: Patients with acute mania in bipolar disorder require pharmacological treatment to reduce symptoms. In addition, it is recognised that admission status is a clinically relevant aspect of bipolar disorder. There is, however, a lack of published data assessing the association of admission status with clinical or functional outcomes. The European-Mania-in-Bipolar-Longitudinal-Evaluation-of-Medication (EMBLEM) study has been designed to describe outcomes associated with medication therapies. Baseline data from this study are now available and we used these data to examine the characteristics of patients with acute mania in the Swiss EMBLEM cohort who were admitted involuntary and voluntary, respectively, and their functional and clinical status. Methods: Ninety-five patients with an acutely manic or mixed episode of bipolar disorder were included in the Swiss cohort of the study. Patients'' history, psychosocial functioning, clinical measures of mania and depression, pharmacological and compliance variables were assessed. Statistical methods comprised univariate analyses of variance and logistic regression analyses to elucidate associations between variables of interest. Results: Patients with involuntary hospital admission (n =55) were more aggressive and had less insight. They had a more frequent history of substance abuse and were less likely to take anticonvulsants or lithium. Furthermore, these patients showed lower compliance, which also guided physicians'' decision on pharmacotherapy. Limitation: The EMBLEM study had an observational and non-interventional design; therefore it was not possible to compare treatment groups by means of stringent between-group analyses. However, a main target of this study was to gather clinically relevant information on outcomes of acute mania associated with currently available medication therapies. Conclusions: Involuntary admission status was significantly associated with clinical status, especially aggression and also compliance. Admission status in bipolar patients plays a clinically important role. [Copyright &y& Elsevier]

Background: The higher prevalence of major depressive disorder (MDD) in females relative to males is well-established. Some authors have posited this difference arises to divergent symptom profiles in females vs. males. However, empirical tests of this hypothesis have yielded equivocal results. Here, we investigate sex differences in MDD of individual symptoms and symptom networks in a treatment-seeking sample.Methods: We assessed depressive symptoms using Hamilton Depression Rating Scale (HDRS-17) in 590 treatment-seeking adults with MDD (300 females). We examined group differences in symptom endorsement. We investigated symptom networks and estimated Gaussian Graphical Models. Finally, we compared the female and male networks using the Network Comparison Test.Results: Females scored significantly higher in psychological anxiety (p <0.001; rB = -0.155), somatic anxiety (p = .001; rB = -0.150) and feelings of guilt (p = .002; rB = -0.139). Male and female patients did not differ in depression sum scores. There were no sex differences in network structure or global strength.Limitations: Our study was sufficiently powered to detect only medium sized symptom differences. The generalizability of our study is limited to clinical samples and further studies are needed to investigate if findings also translate to outpatient samples.Conclusion: Females reported elevated anxiety symptoms and guilt. Clinicians should assess these symptom differences and tailor treatment to individual symptom profiles. No differences between sexes emerged in MDD network structures, indicating that features may be more similar than previously assumed. Sex differences in psychopathological features of MDD are important for future research and personalized treatment. [ABSTRACT FROM AUTHOR]

Abstract: Objective: The Beck Depression Inventory (BDI) is probably the most widely used depression scale. It has been suggested that it contains a two-factor structure measuring cognitive-affective (i.e. psychological) and somatic-vegetative depressive symptoms. In this study we aim to evaluate these factors by probing for their neural correlates. Methods: Neural responses evoked by emotional perception, relative to an emotional judgment task, were measured using functional magnetic resonance imaging (fMRI) in 20 medication-free patients with severe MDD. Psychological and somatic-vegetative symptoms were evaluated with the BDI. Results: Psychological symptoms correlated with signal changes in the dorsomedial and right ventrolateral prefrontal cortex, while somatic-vegetative symptoms correlated with signal changes in the pre-genual anterior cingulate cortex. Conclusions: These preliminary findings demonstrate segregated neural representation of psychological and somatic-vegetative symptoms of MDD in different cortical regions. Thus, our results indicate that the two-factor structure of the BDI is related to distinct neural correlates. [Copyright &y& Elsevier]

Background: Although recent neuroimaging and therapeutic transcranial magnetic cortex stimulation (TMS) studies suggest imbalance between left and right dorsolateral prefrontal cortex (DLPFC) in major depressive disorder (MDD) the fundamental neuropsychological characterization of left DLPFC hypoactivity and right DLPFC hyperactivity in MDD remains poorly understood. Methods: We used event-related functional magnetic resonance imaging (fMRI) to investigate neural activity in left and right DLPFC related to unattended (unexpected) and attended (expected) judgment of emotions. Participating in the study were 20 medication-free patients with MDD and 30 healthy subjects. Results: The MDD patients showed hypoactivity in the left DLPFC during both unattended and attended emotional judgment and hyperactivity in the right DLPFC during attended emotional judgment. In contrast to healthy subjects, left DLPFC activity during emotional judgment was not parametrically modulated by negative emotional valence and was inversely modulated by positive emotional valence in MDD patients. Hyperactivity in the right DLPFC correlated with depression severity. Conclusions: Results demonstrate that left DLPFC hypoactivity is associated with negative emotional judgment rather than with emotional perception or attention while right DLPFC hyperactivity is linked to attentional modulation. Left–right DLPFC imbalance is characterized in neuropsychological regard, which bridges the gap from resting metabolism and therapeutic repetitive transcranial magnetic stimulation effects to functional neuroanatomy of altered emotional–cognitive interaction in MDD. [Copyright &y& Elsevier]