[Value of dogmatil in schizophrenic states in the adolescent].
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Adolescent↗
Biomedical subjects
J Dalery
Publications and source records attributed to J Dalery.
[Cerebral tumours and vascular malformations, thought to be psychiatric in nature, in the child. A report based on personal experience (author's transl)].
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Adolescent↗
[Major agitated-anxious versus blunted-retarded depression: differential effects of fluoxetine].
A multi-centre study was designed to evaluate the efficacy and tolerance of fluoxetine in two groups of major depression: "agitated-anxious" and "blunted-retarded". The study included 50 patients presenting a major depressive episode (following DSM III-R criteria and score > or = 20 on MADRS): 26 in "agitated-anxious" group (score > or = 15 on Hamilton anxiety scale and > or = 10 on Tyrer anxiety brief scale) and 24 in the "blunted-retarded" group (score > or = 15 on Widlöcher retardation scale and > or = 10 on Abrams-Taylor blunted affect scale). After one week period on placebo, all patients were treated in an open design with fluoxetine at a fixed daily dose of 20 mg and followed on a period of 6 weeks with active treatment. In spite of a significant antidepressant efficacy of fluoxetine in the two groups, better results were observed in the "agitated-anxious" depressed group: marked improvement on MADRS total score at day 42 (76% decrease vs 62% in the "blunted-retarded" group, p = 0.012), greater number of "responders" defined by a decrease > or = 50% on MADRS total score and a total score < or = 12 (95% vs 63%, p = 0.04), better patient's global impression on efficacy (54% of "excellent efficacy" vs 18%, p = 0.012), more improvement on HSCL-58 total score (mean decrease of 69% vs 39%, p = 0.016), higher improvement on "hostility/interpersonal hypersensitivity" score (mean decrease of 74% vs 37%, p = 0.001) and on "anger attacks/irritability" sub-score (mean decrease of 73% vs 30%, p = 0.0002).(ABSTRACT TRUNCATED AT 250 WORDS)
Adult↗
[Value of NMR spectroscopy in exploring the cerebral metabolism of patients affected by Alzheimer's disease].
Besides imaging NMR can obtain spectrum reflecting brain tissues components able to resound. Some of these take an active part in a CNS metabolism: such are H (in water) and P (in MPA-TPA, etc.). This new investigating method already showed interest in vitro (tissues cultures) and in vivo (muscular metabolism) studies. Its application to cerebral metabolism studies are going to spread thanks to technological advances (magnetic field more powerful: air gap broad enough for human head passage). The first results of this investigation, in 5 SDAT patients diagnosed with respectively international inclusion criteria (NINCDS-ADRDA) and exclusion ones (such as XR Scan and SPECT exploration), are presented; they are divided into two different groups showing PME (phosphomonoesters) peak dropped to 3.2 or 1.8 in one part, and raised to 15.5 till 27 ppm (parts by million: conventional unit dealing with substances concentration) as the normal range is set at about 7 +/- 4.5 ppm. Such PME changes have showed in an other B. Roussel's study to be a good biological index correlated with the age and the CNS state; these results seem to be of interest, mainly (that must be emphasized) as this technique is quite non intrusive and non irradiating.
Aged↗
[The P 300 potential in schizophrenia].
UNLABELLED: The P3 component of the event-related potential (E.R.P.) is an endogenous positive wave with a latency of approximately 300 msec, which is typically elicited by rare target stimuli in a detection task. The P3 has been applied to the study of cognitive impairments. One of the most consistently replicated biologic observation in schizophrenia is the P3 amplitude reduction. More recently, a prolonged P 3 latency has been observed by some authors. Nevertheless, when the heterogeneity of the schizophrenic syndrome is taken into consideration, results reported in the literature do not show much agreement. In the present study, we attempted to explore the P 3 component in a group of schizophrenic patients with a precisely defined clinical symptomatology. METHODS: Subjects. The study included 19 inpatients and 19 healthy control subjects age and sex-matched. Patients were medication-free for at least 15 days prior recording. According to the DSM III-R diagnosis criteria, 10 patients were classified as "paranoid subtype" and 9 as "disorganized subtype". Furthermore, on the day of the neurophysiological examination, the patients were interviewed using the Scale of the Assessment of Positive Symptoms (S.A. P.S.) and the Scale of the Assessment of Negative Symptoms (S.A.N.S.). The median age (SD) of the patients was 35.3 +/- 8 years, with a median duration of illness 12.5 +/- 7.2 years, a median duration of hospitalization 4.2 +/- 4.3 years and a median IQ 82.8 +/- 13.7. E.R.P. Recording. Subjects performed a two-tone auditory discrimination task: they were instructed to count silently infrequent high-pitched tones of 2000 Hz randomly presented within a serie of low-pitched tones of 1000 Hz. E.R.P. were recorded from 16 scalp electrodes (international 10-20 system) referred to nose. The P 3 was defined as the most positive wave between 250 and 500 msec after the stimulus onset. The amplitude was measured referred to the prestimulus baseline; the latency was measured at the point of maximum amplitude. Statistical analysis. The data were submited to a statistical analysis (ANOVA, Student's t-test, Fisher PLSD and Scheffe F-test, Spearman's correlation and linear regression analysis). RESULTS: 1) The schizophrenic group (N = 19) showed both a significantly prolonged latency and a reduced amplitude, compared to the control group (p < 0.01). 2) In the paranoid subgroup (N = 10), P 3 response was later and smaller than in the control group (p < 0.05). The P 3 latency and amplitude were not significantly different between the two groups of disorganized schizophrenics and controls. 3) A significant correlation between the global score of the S.A.P.S. and the P 3 amplitude was found (r = -0.67). There was no significant correlation between the P 3 parameters and a) the global score of the S.A.N.S. and b) the different items of each evaluation scale. 4) The P 3 amplitude showed a trend toward a negative correlation with the duration of hospitalization. 5) The duration of hospitalization was more important and the global score of the S.A.P.S. was higher in the paranoid than in the disorganized subgroup. There were no significant differences concerning the global score of the S.A. N.S., age, duration of illness, duration of hospitalization, IQ and performances in the detection task between the two subgroups of patients. DISCUSSION: We confirmed the P 3 parameters modifications in schizophrenic patients. The P 3 reduced amplitude and prolonged latency only in the paranoid subgroup, while the disorganized subgroup had both values comparable to those of the controls, is the main finding in our study. Kütcher or Louza studies tend to the same results. Furthermore, we showed that task performances or clinical measures such as age, duration of illness, duration of hospitalization or IQ did not account as biases of P 3 parameters. These results could be a further indication that different subtypes of schizophrenia may have different biological substrates.
Adult↗
[Vulnerability to schizophrenia. I: Familial nature of of neuropsychologic indicators].
The existence of a genetic background is now a well admitted notion in schizophrenia, but some individuals at genetic risk for that disease could never manifest it at a clinical level. However, several vulnerability models could help us to identify such individuals. According to them, when similar perturbations at a given test are observed both in clinically stable schizophrenics and their nonschizophrenic first degree relatives, this test could be qualify as an indicator of the vulnerability to schizophrenia. In literature, that seems the case for several neuropsychological tasks, exploring attentional abilities (degraded version of the Continuous Performance Task [DS-CPT], and Span Of Apprehension task [SOA]) and executive functions (Wisconsin Card Sorting Test [WCST]). Our study was undertaken to replicate literature data and to further explore the relationship between these three neuropsychological markers. For that purpose, performances at DS-CPT, SOA and WCST were assessed among 18 clinically stable schizophrenics, 18 of their biological full siblings and 15 unrelated control subjects matched with the two others groups for several socio-demographic factors. Comparisons were performed by non parametric analysis (Kruskal-Wallis one way ANOVA, and Mann-Whitney). Compared to controls, the siblings group performances were significantly impaired on the three tasks, while they did not statistically differ from the schizophrenic ones. No relationship was observed between the markers, except for the "d'" index at DS-CPT and the number of successfully performed categories at the WCST. Results from the sibling group suggested that the observed impaired neuropsychological performances may actually represent indicators of the genetic vulnerability to schizophrenia. Moreover, the generally admitted relationship between WCST poor performances and an impairment of the prefrontal cortex, lead us to hypothesize some role of this brain area in schizophrenia vulnerability.
Adult↗
[Basic cognitive-perceptive module in schizophrenics].
A specific deficit in gaze discrimination has been hypothesized for schizophrenic patients (Rosse et al., 1994). Gaze discrimination is a basic ability for animals as well as for human beings. It plays an important role in mutual control of social interactions. According to Baron-Cohen (1995), sensitivity to eye gaze relies on a specific cognitive module, the Eye Direction Detector (EDD). The author distinguishes three basic functions of the EDD; first, the EDD is involved in eyes detection; second, the EDD is used in order to establish direction of gaze, and specially to compute whether the eyes one is looking at are directed to the subject or somewhere else; third, the EDD is implied in interpretation of gaze as seeing. Rosse et al. (1994) tested subjective impressions concerning gaze discrimination in a group of schizophrenic patients. Schizophrenics reported the subjective impression of being looked at by the portraits significantly more often than controls. The authors concluded that a specific impairment in gaze detection is present in the patients, and that it may be responsible for the paranoid symptoms often reported in schizophrenia. However, it seems difficult to assert that a response bias in schizophrenics toward perceiving faces as looking at them results from the deficit of an elementary perceptual module responsible for the detection of eye-direction. Rather we suspect such a bias to be the consequence of an impairment of the more complex level of mindreading, responsible for the interpretation of gaze as seeing in terms of mental states. The aim of the present experiment was to test in a more specific way the elementary gaze discrimination system. A series of portraits of models looking at five different directions (-30 degrees, -15 degrees, 0 degree, 15 degrees, 30 degrees), have been presented to 22 schizophrenic patients and 36 normal control subjects. In each trial one portrait was presented. Subjects were asked to determine the direction of its gaze by pressing the "z-key" (left side of the keyboard) if the portrait was looking to the left, and the "/-key" (right side of the keyboard) if the portrait was looking to the right. For each trial, we recorded both the side of the response (left key or right key) and the corresponding reaction time (RT). For the purpose of the analysis, the mean numbers of left responses were computed for each subject. The mean numbers of left responses recorded for each direction of gaze did not significantly differ between patients and controls. That is schizophrenic patients are not impaired in the gaze discrimination task used in the present study. In Rosse's experiment, subjects were required to decide whether the portrait on the screen was looking at them or not. On the contrary, in our task, subjects were simply required to state whether gaze was directed to the right or to the left. No explicit judgment was required as to whom or what gaze was directed. Therefore, we can assume that the present paradigm investigated the functioning of a more basic process than that tested by Rosse et al. Our data are consistent with those reporting that basic cognitive processes are unimpaired in schizophrenia, whereas explicit processes are extensively affected.
Adult↗