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Biomedical subjects

M Marie-Cardine

Publications and source records attributed to M Marie-Cardine.

46 records · Page 3Linked to original sources

[Melatonin and schizophrenia].

Many research studies have been conducted with melatonin, a pineal hormone, in psychiatry. Studies with melatonin in schizophrenic patients are rare. Blood plasma samples were drawn at 24 hours and 12 hours in 23 schizophrenic subjects and 26 controls, during the same season. Plasma melatonin levels were obtained using a specific radioimmunoassay technique. The 24 hours levels significant decreased in schizophrenic patients compared with controls (p less than 0.01). Methodology, specificity of results and concomitant study of cortisol levels are discussed.

Adult↗

[Retrospective comparative study of treatment with delayed-action neuroleptics and neuroleptics administrated orally in long-term psychosis].

Through a retrospective study, we have tried to compare the indication spectrum and efficacy of depot neuroleptics versus oral neuroleptics on two hundred patients suffering from long term psychosis. For each group, we selected one hundred patients who met the following requirements: the minimal duration of chemotherapy was of 3 years, the patients were aged 16 to 60. Patients receiving depot neuroleptics, although their original prognosis were worse than those of patients receiving oral neuroleptics, obtained the same good results concerning most semiological, chemotherapeutic and institutional criteria. However, good results for patients receiving depot neuroleptics must be qualified because of a more important number of chronic and defect states and a lack of autonomy.

Administration, Oral↗

[Action of clovoxamine on the sleep of depressed patients. "Polygraphic recordings"].

This study reports the action of clovoxamine, a non-tricyclic non IMAO antidepressant, on the sleep parameters of five patients suffering from primary depressive illness. Before treatment all subjects presented an EEG syndrome of primary depressive sleep disorder (decreased paradoxical sleep latency). Sleep recordings were made after 1 month and 3 months of monotherapy with clovoxamine. PS latency increased to normal values, sleep efficiency improved and wake time decreased, and, more remarkably, paradoxical sleep was not suppressed by clovoxamine.

Adult↗

[Value of amineptin in the treatment of different depressive states. Apropos of 112 cases treated as part of a national multi-centric study].

Amineptine is a new tricyclic compound with a grafted long aliphatic chain active on Dopamine synaptic release and as such more desinhibitor, safer and short acting. The study was coordinated by a national and 13 local counsellors. It was an open study. Inclusions criteria and results are examined, making obvious that patients responded well according to the Hamilton rating scale for depression (17 item version--16.4 points dropped at day 7th in 43%) and that it is an efficaceous antidepressant.

Adolescent↗

[Chemotherapy and psychotherapies. Attempt at integration].

After a brief historic reminder, the author reviews certain difficulties in integrating psychotherapeutic practice. These difficulties are within the global frame of association of techniques and therapists. Criticizing the bifocal tendency, the author justifies an integrated practice and conceptualisation in the area of severe mental disorders. Finally the author proposes elements of a general theory of psychotherapy permitting chemotherapy to find its place as an "armed psychotherapy" or "psychotherapy in reality".

Combined Modality Therapy↗

[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↗

[Long-term clinical experience with clozapine].

This study reports a clinical experience among twenty schizophrenic patients treated by clozapine during two years and eight months within a range extending from three months to seven years. These twenty patients had previously shown long-term resistance to usual neuroleptics but three out of them met the diagnosis of mental retardation or childhood disintegrative disorder (F.84.3-ICD 10). These patients were put under clozapine for their violent behavior. The methodology was retrospective, descriptive with intra-individual comparison, each patient being his own reference before and after treatment. Diagnosis met CD 10 criteria and were assessed without using standard examination. This study aimed at assessing once more clozapine efficacy and tolerance upon a long time follow up. Single therapy has been the rule and dosages have been progressively increased reaching a mean daily dosage of 350 mg per day. The efficacy, assessed by the way of BPRS, GAF (DSM III-R) and simplified form of CGIS, has been verified in approximately 30% of the patients, mainly concerning positive symptoms. Clozapine was also able to alleviate severe behavior troubles brought about by delusional states, without this latter being markedly softened when it was a long term one. Clozapine tolerance has shown it to be satisfactory, however we noticed the occurrence of a leucopenia with neutropenia after seventeen weeks of treatment, followed, some days later, by a Quincke oedema, which forced to interrupt the treatment. White blood cells came back in a normal range fifteen days later. The other side effects (transitory hypersialorrhea, tachycardia, without clinical and ECG perturbations) have been usually well tolerated and have never caused treatment interruption. No extrapyramidal side effect have been noticed among our twenty patients. The end of this paper consists in the presentation of four clinical cases: one about the efficacy of clozapine upon violent antisocial behaviour in a schizotypital disorder; one delusional chronic schizophrenic patient whose violence has been controlled despite of the delusion; one paranoid schizophrenic patient who has been able to maintain a satisfactory professional and family adaptation; and finally a childhood disintegrative disorder (F.84.3-ICD 10) in whom occurred the only leucopenia side effect of our study. These four clinical cases have seemed particularly meaningful regarding our clinical experience of clozapine which has been lasting for almost seven years now.

Adolescent↗

[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↗