Journal of Neuropsychiatry REGULAR ARTICLES

Quantitative EEG Abnormalities are Associated With Memory Impairment in Recently Abstinent Methamphetamine-Dependent Individuals [REGULAR ARTICLES]

2009-09-23

This study examined the association between brain electrical activity, measured using quantitative electroencephalography (QEEG), and performance on measures of episodic memory in a sample of nine methamphetamine-dependent individuals who were evaluated after 4 days of monitored abstinence and 10 non-drug-using comparison subjects. In methamphetamine users, but not in comparison subjects, increased theta power was correlated with poorer performance on the delayed recall subtests of the Rey Auditory Verbal Learning Test and the Rey-Osterrieth Complex Figure Test (p<0.05). There was no association between alpha, beta, and delta power and performance on the memory tests. These results complement previous findings by demonstrating that the electrophysiological abnormalities associated with methamphetamine dependence are likely to affect behavior in an observable and important manner (i.e., memory deficits) when users are not intoxicated.

Neuroimaging Correlates of Apathy and Depression in Alzheimer's Disease [REGULAR ARTICLES]

2009-09-23

A consecutive series of 79 patients with probable Alzheimer’s disease were assessed with a structured psychiatric evaluation, and diagnoses of apathy and depression were made using standardized criteria. Three-dimensional MRI scans were obtained from all patients, and images were segmented into gray matter, white matter, and CSF. White matter hyperintensities were edited on segmented images, and lobar assignments (frontal, temporal, parietal, and occipital) were made based on Talairach coordinates. Patients with apathy showed a significantly larger volume of frontal white matter hyperintensities than patients without apathy. Patients with depression had a significantly larger volume of right parietal white matter hyperintensities than patients without depression. However, neither apathy nor depression was significantly associated with lobar gray or white matter atrophy. Frontal and right parietal white matter hyperintensities are the strongest brain structural correlates of apathy and depression in Alzheimer’s disease.

Apathy Is Not Depression in Huntington's Disease [REGULAR ARTICLES]

Naarding, P., Janzing, J. G.E., Eling, P., van der Werf, S., Kremer, B. — 2009-09-23

Apathy and depression are common neuropsychiatric features of Huntington’s disease. The authors studied a group of 34 Huntington’s disease patients. In addition to the conventional classification according to DSM-IV criteria of depression, emphasis was put on a dimensional approach using scores on several different scales. Severe depression was found in 12% and severe apathy in 52% of all study patients. The authors found that apathy and depression are not related and are clearly distinct dimensions. Apathy was related to disease characteristics such as cognitive deterioration and functional decline, whereas depression was not.

Apathy After Hip Fracture: A Potential Target for Intervention to Improve Functional Outcomes [REGULAR ARTICLES]

2009-09-23

The authors examined apathy symptoms, their improvement, and their association with functional recovery after a hip fracture. Of 126 participants, 37% had clinically significant apathy symptoms, which predicted functional outcome (i.e., poorer recovery from the fracture among those with higher baseline apathy). Of participants with high baseline apathy, approximately one-third improved; these participants had a better functional outcome than those with persistently high apathy scores. It is concluded that apathy symptoms are common after a hip fracture, but improve in one-third of individuals, with a concomitant functional recovery after hip surgery. Interventions to prevent or improve apathy in elderly persons deserve further attention.

Discrete Shifts Within the Theta Band Between the Frontal and Parietal Regions of the Right Hemisphere and the Experiences of a Sensed Presence [REGULAR ARTICLES]

Booth, J. N., Persinger, M. A. — 2009-09-23

The attribution of personal cognition to another consciousness or sentient being is strongly correlated with altered perfusion within the frontoparietal or frontotemporal regions. The authors applied weak complex magnetic fields that produce an increased incidence of these experiences in healthy volunteers. Quantitative monopolar electroencephalographic (QEEG) measurements for each of the four lobes of the two hemispheres found that intensity of the sensed presence was significantly correlated with increased power within only the theta range over the right parietal and frontal lobes. Successive 1 Hz incremental analyses indicated specific power increases for 4 Hz–5 Hz and 7 Hz–8 Hz bands over the right parietal and frontal lobes, respectively. These results are consistent with those of other measures for both schizophrenia patients and healthy volunteers; changes in activity within these regions are associated with attribution of one’s thoughts and actions to another.

Proteomic Profiling of Plasma and Serum in Elderly Patients With Delirium [REGULAR ARTICLES]

2009-09-23

The aim of this study was to compare plasma and serum protein profiles in elderly acute hip fracture patients with and without delirium. The spectra from surface-enhanced laser desorption ionization (SELDI) using time-of-flight (TOF) mass spectrometry of 16 patients without and 16 patients with delirium (two groups of eight and eight) scored using the Confusion Assessment Method were compared. The most discriminating peak of 15.9 kDa in plasma in a testing group of eight patients with delirium to eight patients without delirium was confirmed in an independent validation group. Taking both groups together, three discriminating peaks of 7.97, 15.9, and 16.0 kDa were found in delirious patients. These peaks presumably correspond to hemoglobin-β, its doubly charged ion, and its glycosylated form.

Evaluating Patients With Suspected Nonepileptic Psychogenic Seizures [REGULAR ARTICLES]

Marchetti, R. L., Kurcgant, D., Neto, J. G., Von Bismark, M. A., Fiore, L. A. — 2009-09-23

The authors evaluate 26 patients with suspected psychogenic non-epileptic seizures (PNES) who were referred to prolonged intensive video EEG (VEEG) in an epilepsy diagnostic center at the University of São Paulo, Brazil. Following the investigative protocol, 50% of the patients received a diagnosis of PNES, 15.4% of epilepsy, and 34.6% of associated PNES and epilepsy. In all patients in our series, PNES were the pseudoneurological presentations of dissociative or conversion symptoms in patients presenting the following mental disorders: conversion disorder, somatization or undifferentiated somatoform disorder, dissociative disorder not otherwise specified, and posttraumatic stress disorder. Psychiatric comorbidities, mostly depressive disorders, were frequent.

Generalized and Symptom-Specific Insight in Behavioral Variant Frontotemporal Dementia and Primary Progressive Aphasia [REGULAR ARTICLES]

Banks, S. J., Weintraub, S. — 2009-09-23

Behavioral variant frontotemporal dementia (FTD) and primary progressive aphasia (PPA) are related dementias with different presenting symptoms but with increasing symptom overlap as they progress. Loss of insight is associated with early behavioral variant FTD, but not PPA. This study used the Frontal Behavioral Inventory to compare patient and caregiver concepts of symptom presence and severity. Patients with behavioral variant FTD were found to have worse insight overall than PPA patients. However, the PPA group showed reduced insight into behavioral symptoms, and the behavioral variant FTD groups had intact insight into some language symptoms. Theoretical and clinical implications are discussed.

Association Between Preoperative Anxiety in Spinal Stenosis Patients and Abnormal Cerebral Glucose Metabolism: Voxel-Based Statistical Analysis of F-18 FDG Brain PET [REGULAR ARTICLES]

Kim, S.-J., Suh, K. T., Cho, H. M., Kim, I.-J., Lee, J. S. — 2009-09-23

Although a possible association between preoperative anxiety and abnormal cerebral glucose metabolism may exist, the authors are not aware of any report describing preoperative anxiety and cerebral metabolism in patients with spinal stenosis in detail. Fluorine-18 fluorodeoxyglucose positron emission tomography with statistical parametric mapping analysis was used to compare regional brain glucose metabolism between 34 spinal stenosis patients and 34 healthy comparison subjects. Spinal stenosis patients with preoperative anxiety showed several voxel clusters of significantly decreased cerebral metabolism. The largest clusters were areas of left insula and left prefrontal cortex (Brodmann’s areas 9 and 11). The second largest cluster area was left prefrontal cortex (Brodmann’s area 10). The other clusters were right insula (Brodmann’s area 13), right superior temporal gyrus (Brodmann’s area 22), and right middle frontal gyrus (Brodmann’s area 8).

Education Effect on Depression and Quality of Life in Nondemented Parkinson's Disease Patients [REGULAR ARTICLES]

Klepac, N., Trkulja, V. — 2009-09-23

A comparison of nondemented Parkinson’s disease patients with lower, intermediate, and higher educational levels indicated an independent association between longer (better) education and less severe depressive difficulties based on the Beck Depression Inventory cognitive-affective items. Well-educated patients also had a better health-related quality of life based on the Parkinson’s Disease Questionnaire-39, apparently due to beneficial effects of education on cognitive performance (attention/memory, visuospatial and executive functions) and the degree of depression. More years of education favors milder depressive difficulties and a higher self-perceived life satisfaction in nondemented Parkinson’s disease patients.

Changes in Relative Glucose Metabolic Rate Following Cortisol Administration in Aging Veterans with Posttraumatic Stress Disorder: An FDG-PET Neuroimaging Study [REGULAR ARTICLES]

2009-07-21

The authors aimed to examine central glucocorticoids effects by measuring relative glucose metabolic rate (rGMR) in the hippocampus, amygdala, and anterior cingulate cortex (ACC) and the relationship between amygdala and ACC activity. The participants were male combat veterans with and without PTSD, 52 to 81 years old. The authors utilized randomized, double-blind, placebo-controlled examinations of the rGMR response to 17.5 mg hydrocortisone (HCORT) using 2-Deoxy-2-[¹⁸F]fluorodeoxyglucose (FDG) Positron Emission Tomography (PET) neuroimaging. Group differences in hemispheric laterality of rGMR were observed following placebo administration, reflecting lower rGMR in the right hippocampus and ventral amygdala, and higher rGMR in the left ventral amygdala in the PTSD+ group compared to the PTSD– group. HCORT reduced these group differences in laterality. The net effect of HCORT was to restore a normal inverse association between the ACC and amygdala in the PTSD+ group, but disrupt this neural network in the PTSD– group. The magnitude of improvement in working memory correlated with greater hemispheric laterality in the dorsal amygdala following HCORT in both groups. The restorative effects of HCORT on metabolism and working memory provide a rationale for examining the therapeutic benefits of glucocorticoid manipulation in aging PTSD patients.

Double-Blind Treatment of Apathy in Patients with Poststroke Depression Using Nefiracetam [REGULAR ARTICLES]

Robinson, R. G., Jorge, R. E., Clarence-Smith, K., Starkstein, S. — 2009-07-21

Nefiracetam is a novel pyrrolidone-type nootropic compound shown in preliminary trials to increase blood flow and improve patient outlook and energy following stroke. Of 137 stroke patients with major depression, 70 also met published diagnostic criteria for apathy (51.1%) and were randomly assigned either to placebo or 600 mg or 900 mg of nefiracetam per day, and received at least 4 weeks of treatment. Using the group with at least 4 weeks of treatment as the intention-to-treat sample with last observation carried forward, repeated measures analysis of variance of Apathy Scale scores demonstrated a significant time-by-treatment interaction. Patients taking 900 mg nefiracetam had a significantly greater change in Apathy Scale scores compared to 600 mg of nefiracetam or placebo. Future studies should assess whether apathy without depression may respond to this novel treatment.

Atrophy of Basal Ganglia Nuclei and Negative Symptoms in Temporal Lobe Epilepsy [REGULAR ARTICLES]

Geary, E. K., Seidenberg, M., Hermann, B. — 2009-07-21

Recent work has identified the presence of negative symptoms in a subset of temporal lobe epilepsy (TLE) patients. The authors hypothesized that negative symptoms in TLE are associated with disruption in the mesolimbic system. Basal ganglia and anterior cingulate region of interest volumes were compared between 22 TLE patients with negative symptoms, 22 TLE patients without negative symptoms, and 22 comparison subjects. The negative symptom group showed significantly reduced volumes in the putamen and globus pallidus. It appears that these structures within the broader mesolimbic system contribute to the phenomenon of negative symptoms in TLE.

EEG Power Spectra Differentiate Positive and Negative Subgroups in Neuroleptic-Naive Schizophrenia Patients [REGULAR ARTICLES]

2009-07-21

Electroencephalogram spectral power was estimated at 30 scalp locations in 28 neuroleptic-naive, recent-onset schizophrenia (NRS) patients and 25 healthy comparison subjects in the resting eyes closed condition. Weighted relative power values in the various bandwidths were initially compared between NRS subjects and comparison subjects and subsequently between the positive symptom subgroup, negative symptom subgroup, and comparison subjects, to look for characteristic spectral power profiles of the homogeneous symptom subgroups. Significant differences were noted especially in alpha2, delta, and theta bands between NRS patients and healthy comparison subjects, while the positive symptom and negative symptom subgroups showed characteristic spectral power profiles in alpha1, alpha2, delta, and theta bands.

Asymmetric Insular Function Predicts Positional Blood Pressure in Nondemented Elderly [REGULAR ARTICLES]

Royall, D., Gao, J.-H., Zhao, X., Polk, M. J., Kellogg, D. — 2009-07-21

Forty percent of nondemented octogenarians have Braak stages consistent with insular involvement, and may be at risk for "age-related" autonomic dysfunction. The authors examined the association between insular resting cerebral blood flow (rCBF) and cardiovascular functions in 29 nondemented elderly subjects who were highly screened to exclude comorbid cardiovascular disease. Mean insular rCBF was significantly higher on the right than left. However, 35.4% of participants had left dominant rCBF (a high-risk group). Right insular rCBF was significantly lower in the high-risk group. This subset had significantly increased positional drops in systolic blood pressure. While these data cannot address Alzheimer’s disease as the specific cause, this possibility is being investigated in other cohorts.

Factor Analysis of the Rivermead Post-Concussion Symptoms Questionnaire in Mild-to-Moderate Traumatic Brain Injury Patients [REGULAR ARTICLES]

2009-07-21

Posttraumatic brain injury patients with depressive symptoms were compared with nondepressed mild and moderate traumatic brain injury (TBI) patients based on their scores on the Rivermead Post-Concussion Symptoms Questionnaire (RPCSQ). A factor analysis demonstrated that the items of the RPCSQ loaded into three factors: mood and cognition, general somatic, and visual somatic symptom groups. Factor scores based on this model were calculated for each group and it was found that depressed subjects reported a greater severity of all three symptom groups compared to nondepressed patients. These results suggest that depression post-TBI may influence patient perception of postconcussion symptoms.

HIV-Associated Episodic Memory Impairment: Evidence of a Possible Differential Deficit in Source Memory for Complex Visual Stimuli [REGULAR ARTICLES]

2009-07-21

HIV infection is often associated with frontal systems pathology and related deficits in the strategic encoding and retrieval aspects of episodic memory. However, no prior HIV studies have explicitly examined source memory, which refers to recall of information regarding the context in which a declarative memory was formed. Source memory is heavily reliant on frontal systems and strategic cognitive processes and is singly dissociable from the content of the memory (i.e., item memory), which is more dependent on medial temporal systems and automatic processes. The present study examined item and source memory in 60 individuals with HIV infection and 35 demographically similar seronegative participants. The primary finding of interest was a significant HIV effect on source (but not item) memory for complex visual stimuli. Follow-up correlational analyses showed a significant association between visual source memory errors and impairment on measures of executive functions, working memory, and higher-level list learning encoding strategies. These findings extend the hypothesized profile of strategic encoding and retrieval deficits in HIV to the construct of source memory, which may be differentially affected relative to item memory for complex visual stimuli.

Neural Correlates of Anxiety in Healthy Volunteers: A Voxel-Based Morphometry Study [REGULAR ARTICLES]

Spampinato, M. V., Wood, J. N., De Simone, V., Grafman, J. — 2009-07-21

Studies have shown that the amygdala, temporal, and prefrontal cortices play a key role in the expression of anxiety. The correlation between gray matter volume of these structures and behavioral anxiety measures was not previously investigated in healthy volunteers. The authors used voxel-based morphometry to assess the relationship between brain regional volume and anxiety. The authors found an inverse correlation between anxiety measures and cortical volume in regions of the limbic system and prefrontal cortex implicated in the pathogenesis of anxiety disorders. The authors suggest that volumetric variability of these regions may have a correlation with the development of an anxious personality trait.

Depression, Avolition, and Attention Disorders in Patients with Schizophrenia: Associations with Verbal Memory Efficiency [REGULAR ARTICLES]

Brebion, G., Bressan, R. A., Pilowsky, L. S., David, A. S. — 2009-07-21

The authors undertook a study of the clinical correlates of verbal memory deficits in schizophrenia. The first purpose was to replicate the finding of a significant association between depression and impairment in the deep encoding memory processes. The second purpose was to test the hypothesis that certain clinical symptoms—avolition, disorders of attention—also play a role in verbal memory impairment, distinct from a global negative symptomatology score. Forty-one patients with schizophrenia underwent a memory task including forward digit span and learning lists of words with different levels of semantic organization. Regression analyses revealed that the depression score was associated with the total number of recalled words, whereas the global negative symptom score was not. Depression score was not associated with the forward digit span, a measure of superficial serial encoding processes. An analysis of individual symptoms from the Scale for the Assessment of Negative Symptoms (SANS) indicated that avolition was associated with several memory scores, suggesting a pervasive effect of this symptom. Attention disorders were associated with impaired efficiency in serial learning, but not with word recall efficiency. It is suggested that more consideration should be given to depression and motivation in the investigation of cognitive impairment in schizophrenia, as well as in cognitive remediation strategies.

Hippocampal Volumes in First-Episode Psychosis [REGULAR ARTICLES]

2009-04-09

Studies have shown that patients with schizophrenia have smaller hippocampi than healthy comparison subjects. There are, however, inconsistencies regarding the relationship between clinical characteristics and topographical differences in hippocampal volumetry. The authors investigated hippocampal volumes in minimally treated patients with first-episode schizophrenia spectrum disorders, relative to comparison subjects. Thirty-nine consecutive patients and 29 matched comparison subjects were scanned using 1.5 tesla MR system. Patients had significantly smaller right anterior, right, and anterior hippocampal volumes than comparison subjects. There was a gender by diagnosis effect: female patients showed significantly smaller anterior and right hippocampal volumes than female comparison subjects, an effect not seen in male patients. Our results suggest that smaller hippocampal volumes are present even in early stages of the illness.

Brain-Derived Neurotrophic Factor Val66Met Polymorphism: Association With Psychopathological Symptoms of Schizophrenia? [REGULAR ARTICLES]

Chang, H.-A., Lu, R.-B., Shy, M.-J., Chang, C.-C., Lee, M.-S., Huang, S.-Y. — 2009-04-09

Brain-derived neurotrophic factor (BDNF) has been proposed as a risk factor for schizophrenia, but no consistent association between BDNF Val66Met polymorphism and schizophrenia has been established. Therefore, analyses with larger sample sizes and better methodology are needed. To examine whether BDNF Val66Met polymorphism is associated with schizophrenia, schizophrenia patients (n=251) and healthy volunteers (n=284) were recruited for a case-control analysis. Pretreatment psychopathology was assessed using the Positive and Negative Syndrome Scale (PANSS) in a subset of 125 hospitalized schizophrenia patients who were drug-free or drug-naive. Genotyping was performed using polymerase chain reaction, restriction fragment length polymorphism (RFLP), and direct screening techniques. With the exception of nominally significant associations between BDNF Val66Met variation and PANSS total, negative, or general scores, no association between the BDNF Val66Met polymorphism and schizophrenia was found. However, this polymorphism may reduce psychopathology, in particular negative symptoms, in schizophrenia.

Associations of Executive Function With Concurrent and Prospective Reports of Obsessive-Compulsive Symptoms in Schizophrenia [REGULAR ARTICLES]

Lysaker, P. H., Whitney, K. A., Davis, L. W. — 2009-04-09

Obsessive-compulsive symptoms (OCS) have been widely observed in schizophrenia and linked with concurrent deficits in executive function. Less clear though is whether OCS are prospectively linked with executive function independent of anxiety level. To explore these issues, OCS, state anxiety, and executive function were assessed among 41 participants with schizophrenia spectrum disorders. Measures of OCS and anxiety were then readministered 6 months later. Correlations revealed that a factor score derived from baseline measures of the inhibition domain of executive function was linked to both concurrent and future assessments of OCS even when state anxiety was controlled.

Gender as a Moderator of Cognitive and Affective Outcome After Traumatic Brain Injury [REGULAR ARTICLES]

Liossi, C., Wood, R. Ll. — 2009-04-09

The aim of this investigation was to compare cognitive and affective functions in men and women who had suffered comparable brain injuries. In a prospective matched cohort design, 150 community-dwelling patients were individually matched on the basis of age, severity of injury, premorbid IQ, and time since injury. Women were significantly more impaired in verbal and visual memory compared with men. The degree of cognitive decline was significantly positively correlated with age in women, but not in men. Women had marginally higher scores compared with men on measures of anxiety and depression. It is concluded that gender is a moderator of cognitive and affective outcome after brain injury.

Comprehension of Affective Prosody in Veterans With Chronic Posttraumatic Stress Disorder [REGULAR ARTICLES]

Freeman, T. W., Hart, J., Kimbrell, T., Ross, E. D. — 2009-04-09

Posttraumatic stress disorder (PTSD) is one of the few psychiatric conditions in which a subjective decrease in emotional range serves as a diagnostic criterion. In order to investigate whether veterans with chronic PTSD also experienced objective limitations in emotional perception, the authors administered the Aprosodia Battery to a group of 11 veterans with chronic PTSD, nine subjects with right hemisphere damage, seven subjects with left hemisphere damage, and 12 comparison subjects. The patients with PTSD displayed significant deficiencies in the comprehension and discriminative components of affective speech, similar in severity and performance profile on the Aprosodia Battery to the individuals with focal right hemisphere damage due to ischemic infarction.

Neuropsychological Evidence of Impaired Cognitive Empathy in Euthymic Bipolar Disorder [REGULAR ARTICLES]

Shamay-Tsoory, S., Harari, H., Szepsenwol, O., Levkovitz, Y. — 2009-04-09

The empathic abilities have never been examined in bipolar disorder patients, despite frequent observations of impaired social behavior. To examine the neuropsychological processes that underlie the affective and cognitive empathic ability in bipolar disorder, the authors compared affective and cognitive empathic abilities, as well as theory of mind and executive functions, of euthymic bipolar disorder patients and healthy comparison subjects. Significant deficits in cognitive empathy and theory of mind were observed, while affective empathy was elevated in bipolar disorder. Patients showed impaired cognitive flexibility (shifting and reversal learning) but intact planning behavior. Impaired cognitive empathy was related with performance in neurocognitive tasks of cognitive flexibility, suggesting that prefrontal cortical dysfunction may account for impaired cognitive empathy in bipolar disorder.

Amount of HIV DNA in Peripheral Blood Mononuclear Cells is Proportional to the Severity of HIV-1-Associated Neurocognitive Disorders [REGULAR ARTICLES]

Shiramizu, B., Williams, A. E., Shikuma, C., Valcour, V. — 2009-04-09

Human immunodeficiency virus (HIV) DNA in peripheral blood mononuclear cells was previously associated with neuropsychological function. By including individuals encompassing the full range of HIV-1-associated neurocognitive disorders, this study reports results from subjects with normal cognition, minor cognitive motor disorder, and HIV-1-associated dementia. Individuals with normal cognition had relatively low HIV DNA levels compared to those with minor cognitive motor disorder and HIV-1-associated dementia. Neuropsychological deficits were significantly associated with entry HIV DNA in all domains. These findings demonstrate for the first time that the severity of HIV-1-associated neurocognitive disorders is proportional to the amount of circulating HIV DNA.

Neural Correlates of Automatic and Controlled Auditory Processing in Schizophrenia [REGULAR ARTICLES]

Morey, R. A., Mitchell, T. V., Inan, S., Lieberman, J. A., Belger, A. — 2009-02-05

Individuals with schizophrenia demonstrate impairments in selective attention and sensory processing. The authors assessed differences in brain function between 26 participants with schizophrenia and 17 comparison subjects engaged in automatic (unattended) and controlled (attended) auditory information processing using event-related functional MRI. Lower regional neural activation during automatic auditory processing in the schizophrenia group was not confined to just the temporal lobe, but also extended to prefrontal regions. Controlled auditory processing was associated with a distributed frontotemporal and subcortical dysfunction. Differences in activation between these two modes of auditory information processing were more pronounced in the comparison group than in the patient group.

Depression in Schizophrenia: Methodological Artifact or Distinct Feature of the Illness? [REGULAR ARTICLES]

Chemerinski, E., Bowie, C., Anderson, H., Harvey, P. D. — 2009-02-05

In schizophrenia, there is a conceptual overlap between depressive and negative symptoms. This study examined the dimensional structure of depressive symptoms and their overlap with negative symptoms in a large sample of older medicated schizophrenia outpatients. Self-reported depression was obtained with the Beck Depression Inventory-II (BDI-II). Three components from this scale (i.e., dysphoria, psychosomatic and regret domains) showed excellent factorability and good consistency. However, adequate construct validity and correlates with outcomes were found for the dysphoria and regret domains, but not for the total score or the psychosomatic domain. Thus, the evaluation of domains within the BDI-II provides a more pure and clinically-relevant assessment of depressed mood in schizophrenia than the use of this scale as a whole.

Clinical Correlates of Schizotypy in Patients With Epilepsy [REGULAR ARTICLES]

2009-02-05

Clinical correlates of schizotypy were evaluated in 89 adult consecutive outpatients with epilepsy, using the Beck Depression Inventory, the State and Trait Anxiety Inventory, and the Schizotypal Personality Questionnaire (SPQ). Age at onset of the epilepsy significantly correlated with the constricted affect subscale of the SPQ, while a diagnosis of temporal lobe epilepsy correlated with the total SPQ score, the cognitive-perceptual factor of the SPQ, and the suspiciousness subscale of the SPQ. Schizotypal symptoms correlated with early onset of the seizures and a diagnosis of temporal lobe epilepsy, further confirming an association between psychoses and epilepsy.

Predictors of Depression and Anxiety in Patients with Intracranial Neoplasms [REGULAR ARTICLES]

Appleby, B. S., Appleby, K. K., Rabins, P. V. — 2009-02-05

A retrospective review of patients with intracranial neoplasms was performed to identify characteristics of patients with comorbid depression and/or anxiety. This study suggests that depression and anxiety are common comorbidities and that preexisting psychiatric disorders predispose to their occurrence within the neuro-oncology setting.

Long-Term Follow-Up Study of Patients With Refractory Obsessive-Compulsive Disorder [REGULAR ARTICLES]

Ross, S., Fallon, B. A., Petkova, E., Feinstein, S., Liebowitz, M. R. — 2009-02-05

The authors prospectively followed patients with treatment-resistant obsessive-compulsive disorder (OCD). Between 1988 and 1995, 56 patients with a history of inadequate response to oral clomipramine received 14 infusions of intravenous clomipramine. The follow-up period ranged from 4 to 11 years after treatment. Of the 44 subjects interviewed at follow-up, 70.5% had current OCD and 29.5% had sub-threshold OCD. Almost half reported feeling much improved or very much improved compared to their state prior to treatment with intravenous clomipramine.

White Matter Anisotropy and Depression Symptoms in Patients with HIV [REGULAR ARTICLES]

2009-02-05

HIV is associated with increased risk for depression. Normal appearing white matter (NAWM) fractional anisotropy in 15 HIV-seropositive (HIV+) adults with depressive symptoms was compared to 15 HIV+ adults without depressive symptoms. HIV+ adults with depressive symptoms showed increased NAWM fractional anisotropy within the left thalamus, the temporal, and frontal regions, as well as the right cingulate. Discrete components of depression were associated with distinct regional NAWM fractional anisotropy increases. These results demonstrate altered neural complexity in HIV+ adults with depressive symptoms and support the notion that depression is multifactorial with different morphological alterations contributing to discrete aspects of depression.

Neuropsychological Deficits in Huntington's Disease Gene Carriers and Correlates of Early "Conversion" [REGULAR ARTICLES]

2009-02-05

The authors examined whether the baseline cognitive functioning of 21 clinically normal huntingtin mutation carriers who developed manifest Huntington’s disease on follow-up differed from that of 49 mutation carriers who remain asymptomatic over the same period in a longitudinal study. One hundred thirty-four gene-negative offspring of Huntington’s disease patients were studied as well. Overall, there were no differences in cognitive test performance among the three groups. However, "converters" who developed signs of Huntington’s disease within 8.6 years demonstrated poorer performance on the Wisconsin Card Sorting Test at baseline. People with the Huntington’s disease mutation who are carefully examined neurologically and found to be asymptomatic have, at most, very minimal problem-solving impairment, and only if they are within a few years of clinical onset.

Clinical and Diagnostic Features of Delayed Hypoxic Leukoencephalopathy [REGULAR ARTICLES]

2009-02-05

Delayed hypoxic leukoencephalopathy is an underrecognized syndrome of delayed demyelination, which is important to consider when delayed onset of neuropsychiatric symptoms follows a hypoxic event. The authors describe clinical and diagnostic features of three such cases, review the pathophysiology of delayed hypoxic leukoencephalopathy, and discuss features which may help distinguish it from toxic leukoencephalopathy.

Impaired Reproduction of Three-Dimensional Objects by Cocaine-Dependent Subjects [REGULAR ARTICLES]

2009-02-05

This study employed a perceptual-motor task of figure copying in 27 cocaine-dependent, 26 marijuana-abusing or dependent, and 33 healthy subjects. Cocaine-dependent and healthy individuals did not differ in their scores on the copying of a two-dimensional diamond and a cross. In contrast, cocaine-dependent subjects displayed significantly poorer ability to copy a three-dimensional Necker cube, a smoking pipe, a hidden line elimination cube, a pyramid, and a dissected pyramid. Marijuana users’ performance on all copied figures was comparable to that of the healthy comparison subjects. Considering that decreased three-dimensional copying ability has been found to be associated with fatal injuries, further studies are needed to investigate possible underlying mechanisms (e.g., parietal lobe damage) and their role in the pathophysiology of cocaine dependence.