Multiple Sclerosis (MS) is a chronic disabling neuroinflammatory disease. Psychiatric manifestations have a high prevalence in MS patients and may worsen the illness progression and the patients' ...quality of life (QoL). Depression is a highly prevalent condition in MS patients, associated with poorer adherence to treatment, decreased functional status and QoL, and increased suicide risk. Diagnosis and treatment of this disorder is challenging because of symptom overlap. Other prevalent psychiatric comorbidities are anxiety disorders, bipolar disorder, psychotic disorders, substance misuse and personality disorders. As the illness progresses, personality changes can happen, as well as affect abnormalities. Cognitive changes occur frequently in MS patients, and affect features like processing speed, attention, learning, memory, visual spatial capabilities, and some language deficits. Disease-modifying treatments may reduce cognitive impairment because of their container action on the brain's lesion burden. Other QoL determinants such as fatigue, pain, sexual dysfunction, exercise, resilience and social support should be taken into account, in order to promote the individuals' well-being. Further studies are needed in order to elucidate the effectiveness of pharmacotherapy and more neuroimaging studies are required to clarify the relationship between structural changes and psychiatric comorbidities.
The N1 and P2 components of the event-related potential are relevant markers in the processing of auditory information, indicating the presence of several acoustic phenomena, such as pure tones or ...speech sounds. In addition, the expression of these components seems to be sensitive to diverse experimental variations. The main purpose of the present investigation was to explore the role of inter-stimulus interval (ISI) on the N1 and P2 responses, considering two widely used experimental paradigms: a single tone task (1000Hz sound repeated in a fixed rhythm) and an auditory oddball (80% of the stimuli were equal to the sound used in the single tone and the remaining were a 1500Hz tone). Both tasks had four different conditions, and each one tested a fixed value of ISI (600, 1000, 3000, or 6000ms). A sample of 22 participants performed these tasks, while an EEG was recorded, in order to examine the maximum amplitude of the N1 and P2 components. Analysis of the stimuli in the single tone task and the frequent tones in the oddball task revealed a similar outcome for both tasks and for both components: N1 and P2 amplitudes were enhanced in conditions with longer ISIs regardless of task. This response pattern emphasizes the dependence of both the N1 and P2 components on the ISI, especially in a scenario of repetitive and regular stimulation. The absence of task effects suggests that the ISI effect reported may depend on refractory mechanisms rather than being due to habituation effects.
•The N1 and P2 ERP components respond to physical characteristics of auditory stimuli•N1 and P2 responses to different ISIs were examined in two different tasks inducing different levels of habituation•Similar N1 and P2 responses were found regardless habituation, suggesting refraction as possible mechanisms for ISI effects
Benzodiazepines and antidepressants have been shown to change responses to unfairness; however, the effects of their combined use on unfairness evaluation are unknown. This study examines the effects ...of concomitant benzodiazepines and antidepressants long-term use on the evaluation of fair and unfair offers. To analyze behavioral changes on responses to unfairness, we compared the performance of medicated participants and healthy controls in the Ultimatum Game (UG), both in the proposer and in the respondent role. The results showed that long-term psychotropic users had the worse economic strategy by accepting less offers than control subjects. However, in the proposer role, the unfair offers made by participants were similar between groups. The present results suggest that long-term use of psychotropic medication, specifically the combination of benzodiazepines and antidepressants, may increase the sensitivity to unfairness, resulting in higher rejection rates in conditions where this strategy is the most disadvantageous.
Auditory event-related potentials (ERP) may serve as diagnostic tools for schizophrenia and inform on the susceptibility for this condition. Particularly, the examination of N1 and P2 components of ...the auditory ERP may shed light on the impairments of information processing streams in schizophrenia. However, the habituation properties (i.e., decreasing amplitude with the repeated presentation of an auditory stimulus) of these components remain poorly studied compared to other auditory ERPs. Therefore, the current study used a roving paradigm to assess the modulation and habituation of N1 and P2 to simple (pure tones) and complex sounds (human voices and bird songs) in 26 first-episode patients with schizophrenia and 27 healthy participants. To explore the habituation properties of these ERPs, we measured the decrease in amplitude over a train of seven repetitions of the same stimulus (either bird songs or human voices). We observed that, for human voices, N1 and P2 amplitudes decreased linearly from stimulus 1-7, in both groups. Regarding bird songs, only the P2 component showed a decreased amplitude with stimulus presentation, exclusively in the control group. This suggests that patients did not show a fading of neural responses to repeated bird songs, reflecting abnormal habituation to this stimulus. This could reflect the inability to inhibit irrelevant or redundant information at later stages of auditory processing. In turn schizophrenia patients appear to have a preserved auditory processing of human voices.
•This is the first meta-analysis of individual data in chronic Trypanosoma cruzi infection after treatment.•The probability of seroreversion is variable along the course of follow-up.•An interaction ...was found between age at treatment and country setting.•The course of parasitological/molecular tests after treatment needs to be assessed.
To determine the course of serological tests in subjects with chronic Trypanosoma cruzi infection treated with anti-trypanosomal drugs.
A systematic review and meta-analysis was conducted using individual participant data. Survival analysis and the Cox proportional hazards regression model with random effects to adjust for covariates were applied. The protocol was registered in the PROSPERO database (http://www.crd.york.ac.uk/PROSPERO; CRD42012002162).
A total of 27 studies (1296 subjects) conducted in eight countries were included. The risk of bias was low for all domains in 17 studies (63.0%). Nine hundred and thirteen subjects were assessed (149 seroreversion events, 83.7% censored data) for enzyme-linked immunosorbent assay (ELISA), 670 subjects (134 events, 80.0% censored) for indirect immunofluorescence assay (IIF), and 548 subjects (99 events, 82.0% censored) for indirect hemagglutination assay (IHA). A higher probability of seroreversion was observed within a shorter time span in subjects aged 1–19 years compared to adults. The chance of seroreversion also varied according to the country where the infection might have been acquired. For instance, the pooled adjusted hazard ratio between children/adolescents and adults for the IIF test was 1.54 (95% confidence interval 0.64–3.71) for certain countries of South America (Argentina, Bolivia, Chile, and Paraguay) and 9.37 (95% confidence interval 3.44–25.50) for Brazil.
The disappearance of anti-T. cruzi antibodies was demonstrated along the course of follow-up. An interaction between age at treatment and country setting was found.
Differences in short and long-latency Event-Related Potentials (ERPs) can help us infer abnormalities in brain processing, considering early and later stages of stimuli processing across tasks and ...conditions. In autism research, the adult population remains largely understudied compared to samples at early stages of development. In this context, this scoping review briefly summarises what has been described in community and subclinical adult samples of autism.
The current scoping review and meta-analysis includes 50 records (N = 1652) and comprehensively explores short and long-latency ERP amplitudes and their relationship with autistic traits in adult community samples.
This meta-analysis identified, with small to medium effect sizes, distinctive patterns in late ERP amplitudes, indicating enhanced responses to visual stimuli and the opposite patterns to auditory tasks in the included sample. Additionally, a pattern of higher amplitudes was also found for the component P3b in autistic traits.
Differential effects in visual and auditory domains are explored in light of the predictive processing framework for Autism. It remains possible that different brain mechanisms operate to explain symptoms related with different sensory modalities. P3b is discussed as a possible component of interest in future studies as it revealed a more robust effect for differentiating severity in the expression of autistic traits in adulthood.
•This is the first meta-analysis of subclinical autism and ERP amplitudes.•Amplitudes were enhanced for P3b and visual stimuli.•Auditory stimuli amplitudes were diminished in this population.
Mismatch negativity (MMN) is an event‐related potential component automatically elicited by events that violate predictions based on prior events. To elicit this component, researchers use stimulus ...repetition to induce predictions, and the MMN is obtained by subtracting the brain response to rare or unpredicted stimuli from that of frequent stimuli. Under the Predictive Processing framework, one increasingly popular interpretation of the mismatch response postulates that MMN represents a prediction error. In this context, the reduced MMN amplitude to auditory stimuli has been considered a potential biomarker of Schizophrenia, representing a reduced prediction error and the inability to update the mental model of the world based on the sensory signals. It is unclear, however, whether this amplitude reduction is specific for auditory events or if the visual MMN reveals a similar pattern in schizophrenia spectrum disorder. This review and meta‐analysis aimed to summarise the available literature on the vMMN in schizophrenia. A systematic literature search resulted in 10 eligible studies that resulted in a combined effect size of g = −.63, CI −.86, −.41, reflecting lower vMMN amplitudes in patients. These results are in line with the findings in the auditory domain. This component offers certain advantages, such as less susceptibility to overlap with components generated by attentional demands. Future studies should use vMMN to explore abnormalities in the Predictive Processing framework in different stages and groups of the SSD and increase the knowledge in the search for biomarkers in schizophrenia.
In this review and meta‐analysis, we aimed to summarise the available literature on visual mismatch negativity (vMMN) in schizophrenia spectrum disorder. The meta‐analysis revealed reduced vMMN amplitudes in patients, with a medium combined effect size of 10 studies. These results are in line with findings in the auditory domain and the proposed abnormalities in the Predictive Processing framework for psychosis.
Forty years of a psychiatric day hospital Curral, Rosário; Lopes, Rui; Silveira, Celeste ...
Trends in Psychiatry and Psychotherapy,
2014 Jan-Mar, Letnik:
36, Številka:
1
Journal Article
Recenzirano
Odprti dostop
Day hospitals in psychiatry are a major alternative to inpatient care today, acting as key components of community and social psychiatry.
To study trends in the use of psychiatric day hospitals over ...the last decades of the 20th century and the first decade of the 21st century, focusing on patient age, sex, and diagnostic group, using data from Centro Hospitalar São João, Porto, Portugal.
Data corresponding to years 1970 to 2009 were collected from patient files. Patients were classified into seven diagnostic groups considering their primary diagnoses only.
Mean age upon admission rose from 32.7±12.1 years in the second half of the 1970s to 43.5±12.2 years in 2005-2009 (p for trend < 0.001). Most patients were female (63.2%), however their proportion decreased from nearly 70% in the 1970s to 60% in the first decade of the 21st century. In males, until the late 1980s, neurotic disorders (E) were the most common diagnosis, accounting for more than one third of admissions. In the subsequent years, this proportion decreased, and the number of admissions for schizophrenia (C) exceeded 50% in 2004- 2009. In females, until the late 1980s, affective disorders (D) and neurotic disorders (E), similarly distributed, accounted for most admissions. From the 1990s on, the proportion of neurotic disorders (E) substantially decreased, and affective disorders (D) came to represent more than 50% of all admissions.
Mean age upon admission rose with time, as did the percentage of female admissions, even though the latter tendency weakened in the last 10 years assessed. There was also an increase in the proportion of patients with schizophrenia.
We report the first stochastic dynamic causal modeling (sDCM) study of effective connectivity within the default mode network (DMN) in schizophrenia. Thirty-three patients (9 women, mean age = 25.0 ...years, SD = 5) with a first episode of psychosis and diagnosis of schizophrenia--according to the Diagnostic and Statistic Manual of Mental Disorders, 4th edition, revised criteria--were studied. Fifteen healthy control subjects (4 women, mean age = 24.6 years, SD = 4) were included for comparison. All subjects underwent resting state functional magnetic resonance imaging (fMRI) interspersed with 2 periods of continuous picture viewing. The anterior frontal (AF), posterior cingulate (PC), and the left and right parietal nodes of the DMN were localized in an unbiased fashion using data from 16 independent healthy volunteers (using an identical fMRI protocol). We used sDCM to estimate directed connections between and within nodes of the DMN, which were subsequently compared with t tests at the between subject level. The excitatory effect of the PC node on the AF node and the inhibitory self-connection of the AF node were significantly weaker in patients (mean values = 0.013 and -0.048 Hz, SD = 0.09 and 0.05, respectively) relative to healthy subjects (mean values = 0.084 and -0.088 Hz, SD = 0.15 and 0.77, respectively; P < .05). In summary, sDCM revealed reduced effective connectivity to the AF node of the DMN--reflecting a reduced postsynaptic efficacy of prefrontal afferents--in patients with first-episode schizophrenia.
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