Search PubMed⌕ Search

Biomedical subjects

Sophia Frangou

Publications and source records attributed to Sophia Frangou.

32 records · Page 2Linked to original sources
PubMed2004

New insights help define the pathophysiology of bipolar affective disorder: neuroimaging and neuropathology findings.

Bipolar affective disorder (BD) is a severe mental illness, characterized by episodes of mania and depression. With the development of Magnetic Resonance Imaging (MRI), neuroimaging methods are now allowing investigation of the neurocircuitry involved in this disorder. This in turn has aided further neuropathological exploration of the brain. Structural MRI and Magnetic Resonance Spectroscopy studies suggest that brain abnormalities in BD are mostly regional, as global measures (cerebral, white and gray matter and ventricular volumes) do not seem to be affected in the majority of patients. The prefrontal and anterior cingulate cortices, and amygdalae are consistently implicated in BD, whilst the evidence for hippocampal involvement is less convincing. Functional studies have found that the activity of the dorsal prefrontal cortex and the anterior cingulate are closely associated with mood symptoms. Activity in the ventral and orbital prefrontal cortex appears reduced both during episodes and in remission. In contrast, amygdala activity shows a persistent increase. We suggest that abnormal interaction between the amygdala and the ventral/orbitofrontal cortex may be a central feature of the pathophysiology of BD.

Animals↗
PubMed2004

Which executive skills should we target to affect social functioning and symptom change? A study of a cognitive remediation therapy program.

This study examined the link between executive function and functional outcome in schizophrenia to identify useful psychological intervention targets and explore how executive function changes affect social functioning and symptoms. Participants from two randomized controlled trials (n = 63) with poor social functioning, positive and negative symptoms, and cognitive impairment completed seven measures of executive function. Three cognitive factors were extracted: verbal working memory, response inhibition speed, and stimulus-driven responding. Participants received individual cognitive remediation therapy (CRT) (n = 18), a control therapy (occupational therapy activities) (n = 14), or treatment as usual (n = 19). Only the CRT group improved on verbal working memory. No group improved on the other factors. Although verbal working memory was significantly associated with social functioning and symptom severity 3 months after baseline, change in this factor did not predict change in either functional outcome. There was a significant interaction between group and the stimulus-driven responding factor, and for the CRT group only, a change to a more externally focused responding style was associated with reduced social problems and symptoms. Regardless of treatment type, increased response inhibition speed was associated with reduced negative symptoms. Stimulus-driven responding and response inhibition speed may therefore make useful targets for intervention.

Adolescent↗
PubMed2004

Cell density and cortical thickness in Heschl's gyrus in schizophrenia, major depression and bipolar disorder.

There is evidence that the superior temporal gyrus and Heschl's gyrus within it are implicated in schizophrenia. We investigated neuronal and glial cell density and cortical thickness within Heschl's gyrus, using the optical disector to estimate cell density within cortical layers 3 and 5 in tissue derived postmortem from people with diagnoses of major depressive disorder, schizophrenia and bipolar disorder, compared with normal controls (n=15 per group). No significant difference in neuronal or glial cell density or in cortical thickness was observed between the groups; our findings therefore provide no support for the presence of cellular pathology within Heschl's gyrus in schizophrenia.

Auditory Cortex↗
PubMed2004

Brain volumes in adult survivors of very low birth weight: a sibling-controlled study.

OBJECTIVES: To establish whether adults who were born very low birth weight (VLBW) show altered volumes of certain brain structures. METHODS: Unmatched case-control study was conducted of 33 individuals from a cohort of VLBW (<1500 g) infants who were born between 1966 and 1977 and 18 of their normal birth weight siblings. Whole brain, gray matter, ventricular, corpus callosum, and hippocampal volumes were measured on structural magnetic resonance imaging scans. RESULTS: VLBW individuals had a 46% increase in total ventricular volume and a 17% reduction in posterior corpus callosum volume. No differences in whole brain, gray matter, or hippocampal volumes were observed. CONCLUSION: Specific differences exist in the volumes of certain brain structures in adults who were born VLBW compared with their normal birth weight siblings.

Adult↗
PubMed2003

The Maudsley Early-Onset Schizophrenia Study: cognitive function in adolescent-onset schizophrenia.

The neuropsychological correlates of adolescent-onset schizophrenia have been investigated very little to date. We assessed intelligence, memory and executive function in 42 patients with adolescent-onset schizophrenia and 43 healthy control subjects. Cases showed impairments in most cognitive variables. Despite the overall similarity with the quantitative and qualitative performance characteristics of later-onset patients in the literature, their cognitive profile displayed a unique feature: modification of the usual pattern of thinking latencies in the Tower of London Task. After adjusting for potential confounders, no effect of illness duration, symptoms or medication dose on patient performance emerged. However, longer exposure to medication predicted a lower level of performance in aspects of attention, psychomotor processing speed and spatial working memory. Our data are not consistent with worse cognition or progression of neuropsychological impairment in adolescent-onset schizophrenia.

Adolescent↗
PubMed2003

Increased developmental deviance and premorbid dysfunction in early onset schizophrenia.

Abnormal neurodevelopment and poor premorbid function have been described in schizophrenia. It is unclear whether abnormalities in these domains are increased in patients with early onset schizophrenia (EOS; onset before the 18th birthday) and whether they act to precipitate the earlier onset of the disorder. To address these questions, we collected information based on maternal interviews about the premorbid function of 40 adolescents with recent onset schizophrenia and an equal number of healthy controls using the Developmental Scale Score, the Premorbid Schizoid and Schizotypal Trait Scale (PSST) and Premorbid Adjustment Scale (PAS). Data on the PSST and PAS were also available in 54 patients with adult onset schizophrenia (AOS; onset after the 20th birthday). Compared to healthy controls, EOS patients had (a). delayed speech milestones, difficulties in reading and spelling and greater overall developmental deviance; (b). poor premorbid adjustment in childhood, which became even more deviant in adolescence particularly in boys and (c). more schizophrenia spectrum traits. Both premorbid adjustment and personality traits were more abnormal in patients with increased developmental deviance suggesting the possibility that they represent different manifestations of ongoing abnormalities in developmental processes. EOS patients had more impaired premorbid adjustment in adolescence and schizophrenia spectrum traits compared to AOS cases. Age of onset was related to developmental deviance, premorbid schizophrenia spectrum traits and childhood adjustment in EOS patients only.

Adolescent↗
PubMed2003

The Maudsley early onset schizophrenia study: cognitive function in adolescents with recent onset schizophrenia.

Neuropsychological function has been little studied early in the course of adolescent onset schizophrenia. The present study investigated cognitive function in adolescents with recent onset schizophrenia (n=20) and healthy controls (n=21), employing a comprehensive battery of intelligence, memory and executive function paradigms. Relative to the control group, the patients showed significant or near-significant deficits in more than half of the cognitive variables we examined. A substantial proportion of this broadly based neuropsychological deficit could be accounted for, at least in part, by a mild decrement in general intellectual ability. However, deficits in general and verbal memory remained highly significant after co-varying for IQ.

Adolescent↗
PubMed2003

Hippocampal volume in familial and nonfamilial schizophrenic probands and their unaffected relatives.

BACKGROUND: There is evidence for hippocampal volume loss in schizophrenia, but the etiology of this remains unclear. The aim of our study was to assess the contribution of familial liability and obstetric complications to hippocampal volume reduction in schizophrenia. METHODS: Hippocampal volumes were obtained using stereological methods from magnetic resonance scans performed on 35 schizophrenic probands from multiply affected families and 63 of their unaffected relatives, as well as 31 schizophrenic probands from families with no other affected members, 33 of their unaffected relatives, and 68 control subjects. RESULTS: Probands with schizophrenia, regardless of family history, had significant volume reduction of the left hippocampus. Hippocampal volume was not significantly reduced in either group of relatives. Obstetric complications were associated with left hippocampal volume reduction. CONCLUSIONS: We failed to find evidence that hippocampal volume loss is associated with familial liability to schizophrenia but have confirmed the association between hippocampal volume reduction and exposure to obstetric complications.

Adolescent↗
PubMed2003

The Maudsley bipolar disorder project. Clinical characteristics of bipolar disorder I in a Catchment area treatment sample.

The clinical characteristics of bipolar I disorder (BD1) have prognostic and therapeutic importance. The aim of this study was to examine the effect of demographic and clinical variables on the course of BD1. We reviewed the case notes of all BD1 patients (n = 63) receiving treatment in a London psychiatric service during a 1-month period. Depressive and manic onsets were equally likely without any gender difference. The earlier the age of onset, the more likely it was for patients to experience psychotic features. Only depressive onsets predicted a higher number of episodes of the same polarity. Male gender and substance abuse were associated with younger age at first presentation, while women with co-morbid substance abuse had more manic episodes. Male patients were more likely than females to be unemployed or single.

Adult↗
PubMed2003

The Maudsley Bipolar Disorder Project: the effect of medication, family history, and duration of illness on IQ and memory in bipolar I disorder.

BACKGROUND: Despite the growing recognition of the importance of cognitive impairment in psychiatric disorders, the effect of clinical factors, such as medication use and family history of affective disorders, on cognition in bipolar I disorder patients still remains unclear. This study examines the contribution of known and potential predictors to both general intellectual function and memory in a representative population of bipolar I disorder patients. METHOD: Of the 425 patients receiving treatment within a defined catchment area, 63 were identified as having bipolar I disorder. Of these patients, 43 were enrolled in the study and participated in a personal interview by a psychiatrist. All patients were invited to participate in a personal interview by a psychiatrist, and information on family history, past psychiatric history, past and current treatments, duration of illness, and age at onset was collected, in addition to demographic data. Cognitive performance was assessed using the Wechsler Adult Intelligence Scale-Revised, the National Adult Reading Test, and the Wechsler Memory Test III. RESULTS: Forty-three patients with DSM-IV bipolar I disorder were enrolled into the Maudsley Bipolar Disorder Project. Patients on treatment with antipsychotic drugs had a lower current full scale IQ, lower general memory scores, and lower working memory scores. A family history of affective disorders was associated with a higher full scale IQ, but not with either general or working memory measures. Duration of illness was negatively associated with general memory scores, but had no effect on either IQ or working memory measures. CONCLUSION: Current antipsychotic medication, duration of illness, and family history of affective disorder were the most significant predictors of IQ and memory function in bipolar I disorder patients.

Adult↗
PubMed2002

Neuropsychology of bipolar disorder: a review.

BACKGROUND: Bipolar disorder (BD) may be associated with significant and persistent cognitive impairment. The aim of this study was to describe the profile of cognitive deficits in BD at different phases of the illness and determine whether it is different from that of schizophrenia and unipolar (UP) depression. METHODS: A systematic review of the computerised literature of neuropsychological studies of BD published between 1980 and 2000. RESULTS: General intellectual function: this was largely preserved in BD. Impairments when present were limited to acute episodes and to performance scores. Attention: attentional abnormalities were seen in symptomatic BD patients and persisted in remission in measures of sustained attention and inhibitory control. Memory: verbal memory was impaired even in euthymic patients while visuo-spatial memory deficits were variable depending on the tasks used. Executive function: all aspects of executive function (planning, abstract concept formation, set shifting) were impaired in symptomatic BD patients. Performance on executive function tests was sensitive to the presence of even residual symptoms but it may be normal in fully recovered patients with uncomplicated BD. Comparison to other patient groups: no major differences in cognitive profile between BD and UP depression were found. Remitted BD patients out-performed stable schizophrenics on most cognitive measures but this advantage disappeared when they were acutely symptomatic. CONCLUSIONS: Symptomatic BD patients have widespread cognitive abnormalities. Trait related deficits appear to be present in verbal memory and sustained attention. Executive function and visual memory may be also affected at least in some recovered BD patients.

Bipolar Disorder↗
PubMed2002

The Maudsley bipolar disorder project. A survey of psychotropic prescribing patterns in bipolar I disorder.

OBJECTIVES: The outcome of Bipolar 1 Disorder (BD1) is greatly dependent on the adequacy and appropriateness of its treatment. As the treatment choices in BD1 disorder are increasing the aim of this study was to examine the current use of the pharmacological agents in BD1 patients and its association with clinical characteristics. METHODS: Case note review of the pharmacotherapy of a sample of BD1 patients from a specified South London sector of a National Health Service Trust. RESULTS: Half of the patients were on mood-stabilizers (usually lithium) and their use was associated with female gender and multiple admissions. Antipsychotics were more commonly used in patients with psychotic features and multiple manic episodes. Antidepressants were rarely prescribed alone and were not associated with increased number of manic episodes. Combination treatments were mostly used in patients in acute episodes and with multiple hospitalizations. CONCLUSIONS: In ordinary care, the treatment of BD1 is often driven by symptoms and falls short of the existing practice guidelines.

Adolescent↗
PubMed2002

Adolescents who were born very preterm have decreased brain volumes.

Infants born very preterm have an increased risk of brain injury. Given the great increase in the number of such infants that are surviving, it is important to establish whether any resultant brain abnormalities persist into adolescence and adult life. We therefore examined in vivo whole brain, grey matter, white matter and hippocampal volumes, ventricular size and grey/white matter ratios in a series of adolescents who had been born very preterm, and an age-matched full-term control group. Structural MRI was carried out on a cohort of 72 adolescents (mean age 15 years) who were born before 33 weeks, and 48 age-matched full-term controls. Brain measurements were made blind to group affiliation using stereological principles. After controlling for gender and height, the very preterm subjects showed a 6.0% decrease in whole brain volume, and an 11.8% decrease in cortical grey matter volume, as well as a 15.6% decrease in right and a 12.1% decrease in left hippocampal volumes; they also had a 42.0% increase in the size of the lateral ventricles. Therefore, individuals who were born very preterm continue to show noticeable decrements in brain volumes and striking increases in lateral ventricular volume into adolescence. The functional significance of these abnormalities merits further investigation.

Adolescent↗