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Selective impairment of sensory-perceptual functions in unaffected relatives of schizophrenic patients
S258
P2 Psychotic disorders and antipsychotics
This case report is about a 25 years old man suffering from a traumatic brain injury as a result of a car accident happened in 1989. At the admission to the hospital, he was in a coma of 3”-4” degree SBM. TAC showed lacerated and contused foci in the temporal-occipital and frontal paramedian region. He recovered from the coma twenty days after the accident and left the hospital after other fifteen days with a diagnosis of Left Hemiparesis due to Brain Injury. 9 years after the trauma, SPECT shows a hypoperfusion of the right parietal lobe and of the left cerebellum and NMR highlights a hypotrophy of the right cerebral peduncle and of the right hippocampus. It was also noticed an enlargement of cortical, cistemal liquoral spaces, in the frontal lobe and in the letI cerebellar hemisphere. Few weeks after the trauma, the patients presented a symptomatology characterised by psychomotor agitation and severe anxiety, associated with visual hallucinations, persecutory and mystic delusions and suicidal ideation. Therapeutic doses of phenothiazines and butyrophenones did not ameliorated psychotic symptomatology while extrapyramidal symptoms compromised the motor activity. Carbamazepine and clonazepam administration did not improve the mental and neurological status. In December 1995, the patient started clozapine treatment: 25 mg/die progressively increased to 100 mg/die. As a result of this therapy there was a complete relief of psychotic symptoms since the second week of treatment. This improvement still exists at thirty month from the beginning of the therapy. Before clozapine treatment the global score at PANSS was 108, now is 3 1. The major improvements concern the items which detect psychotic symptoms, bizarre behaviours and depressive mood. The AA discuss the potential use of clozapine in psychotic states secondary to post-traumatic brain injury instead of “typical” neuroleptics. References
[ 1] Gualtieri T., Cox DR., The delayed neurobehavioural sequelae of traumatic brain injury. Brain injury 32: 219-232, 1991. [2] Marcia L.M., Crismon M.L., Roberts S., Childs A. Clozapine response and adverse effects in nine brain-injured patients. J. Clin, Psychopharmacology 3: 198-202, 1993. [3] Kay S.R., Fiszbein A., Opler L.A. The positive and negative syndrome scale for schizophrenia. Schizophrenia Bulletin 13: 261-276, 1987.
Ip.2.0141 Distress Scale for Adverse Symptoms: a new instrument for measuring the relationship between adverse drug symptoms and associated distress M. Ritsner, I. Modai, 0. Rivkin, E. Bystrov, J. Nehamkin, A. Ponizovsky. Institute for Psychiatric Studies, Sha’ar Menashe Mental Health Centel: Hadera. Israel
Introduction: Antipsychotic medication has been associated with side effects ranging in intensity from minimal to severe. Psychiatrist’s observations often show a substantial discrepancy between the severity of adverse drug symptoms and the resulting subjective distress. The relationship between adverse drug symptoms and associated distress should be examined. Objective: The development and clinical trial of the Distress Scale for Adverse Symptoms (DSAS), a new clinical instrument for measuring both the intensity of patient’s adverse events and the extent of associated subjective distress. Method: Based on a review of previous instruments and researcher’s experience in the area, a 22-item rating scale was developed (Table 1). All adverse drug symptoms are rated by a psychiatrist on a 5-point scale of intensity: 0 - absent or questionable, 1 - mild, 2 - moderate, 3 -marked, 4 - severe. Subjects are asked how much discomfort (subjective distress) a symptom caused during the previous week, with responses scored on the same scale. Three DSAS dimensions are established: symptom intensity, distress intensity and DSAS general index. The higher mean scores, the greater intensity of adverse drug reactions and associated distress.
Table 1. DSAS items 1
Headache
12
2 3 4
Fatigue Nervousness Dizziness Sleep disturbances Somnolence Tremor Akathisia Ataxia Dyskinetic movements Hypokinesiflradykinesia
13 14 15 16 17 18 19 20 21 22
6
8 9 10 11
Hypersalivation/Dry mouth Nausea/Vomiting Appetite disturbances Gastric discomfort Constipation/Diarrhea Weight loss/Weight gain Tachycardia HypotensionIHypertension PolyuriafDisuria Skin sensitivity/Dry skin Sexual dysfunction
Results: DSAS was used to evaluate 200 psychiatric inpatients treated with antipsychotic agents. Cronbach’s alpha reliability coefficients for DSAS dimensions ranged from 0.70 to 0.88. The DSAS indices were highly correlated with the Abnormal Involuntary Movement Scale, Talbieh Brief Distress Inventory, and Somatization Scale of the Brief Symptom Inventory. Conclusions: DSAS is a promising instrument for measuring both the intensity of adverse drug symptoms and associated distress among psychiatric patients treated with atypical and typical neuroleptics.
(P.2.0151 Selective impairment of sensory-perceptual functions in unaffected relatives of schizophrenic patients S. K&i, A. Antal, G. Benedek, Z. Janka. Departments of PsychiaQ Physiology, Albert Szent-GyQyi
and Medical Unioersity, Szeged, Hungay
Objective: Recent research identified several intermedier phenotypes associated with schizophrenia (Egan and Weinberger, 1997). These markers are trait- rather than state-dependent, and are present in healthy siblings of schizophrenic patients. Trait-markers include cognitive, neurochemical, and structural aberrations. In spite of the extensive research in this field, the specificity of trait-dependent parameters is less clear. Here we provide preliminary evidence that sensory-perceptual impairments are specific markers for schizophrenia. Methods: 30 healthy, first-degree biological relatives of psychiatric patients participated in the study (15 were siblings of schizophrenic subjects, and 15 were relatives of type I bipolar patients (DSM-IV)). In addition, 15 subjects with negative family histories were included (Family History Research Diagnostic Criteria). Subjects with mood disorder, paranoid, schizoid or schizotypal traits were excluded. The research groups were matched for age, gender, and educational level. Three levels of sensory and cognitive functions were assessed: (1) Wisconsin Card Sorting Test (WCST) (executive functions), (2) phonological and semantic fluency (lexical-verbal functions), and (3) visual backward masking (BM) (sensory-perceptual functions). For the statistical analysis, the Mann-Whitney U test was used. Results: We found no significant differences between the control subjects with negative family history and the siblings of bipolar patients. Similarly, the relatives of schizophrenic patients displayed intact performances in the WCST and in the fluency tests. In contrast, the siblings of schizophrenic patients had lower performances in the BM procedure in relation to tbe comparison subjects with negative family history (p < 0.001). Conclusions: The only difference among the three research groups was that the biological relatives of schizophrenic patients were impaired in the BM test. This suggests the disturbance of early, sensory-perceptual stage of information processing. In summary, we replicated and extended the findings of an earlier study, reporting BM deficit in siblings of schizophrenic patients (Green et al., 1997). Our results also indicate that this deficit is not only present in unaffected relatives of schizophrenic patients, but reveals marked selectivity and specificity.
P2 Psychotic disorders and antipsychotics References [1] Egan MF, WeinbergerDR (1997) Neurobiology of schizophrenia. Cur Op Neorobiol 7: 701-707. [2] Green MF, Nuechterlein KH, Breitmeyer B (1997) Backward masking performance in unaffected siblings of schizophrenic patients. Arch Gen Psychiatry 54: 465-472.
Ip.2.0161
The atypical antipsychotic olanrapine induce Parkinson-like visuo-perceptual
does not deficits
A. Antal, S. K&i, G. Szekeres, G. Benedek, Z. Janka. Departments of Psychiat?y and Physiology, Albert Szent-Gydrgyi Szeged, Hungary
Medical Uniuersiw,
Objectives: Clinical studies have reported that the atypical antipsychotic oianzapine induced significantly less Parkinson-like side effects as compared to typical neuroieptic drugs (Waddington et al., 1997). It is well established that drug-induced Parkinsonism is accompanied by visuoperceptual impairments (“blurred” vision) (Bulens et al., 1989). However, it is unknown whether atypical antipsychotics cause such disturbances. In this study, we compared the effects of olanzapine and haioperidol on the visual contrast-sensitivity (CS) dictions. Methods: 40 schizophrenic subjects (DSM-IV) and 20 age, gender and education matched healthy control volunteers (C) participated in the study. 20 patients received oianzapine (0) (15.7 mg/day (9.1)), and 20 patients were on haloperidol (H) treatment (5.4 mg/day (4.8)). There were no significant differences between the two patient groups regarding age, education, duration of illness, duration of treatment with oianzapine or haloperidol and the Brief Psychiatric Rating Scale (BPRS) score (0: 213 (7.9); H: 20.0 (12.6)) (values are mean (SD)). In the CS measurements, the minimal luminance-contrast level, required for the detection of visually presented gratings, was determined. CS was defined as the reciprocal of the contrast threshold. Stimuli were horizontal gratings at 9 different spatial frequencies (SFs) (0.48, 1.19, 1.91, 2.87, 3.58, 4.78, 5.73,7.17, and 14.38 cycles/degree (cpd)). For the measurement of CS, a forced-choice staircase method was used. CS data were log-transformed and were entered into group (C vs. 0 and C vs. H) by SF analyses of variance (ANOVAs). Results: Ail main effects and the two-way interaction remained nonsignificant in the C vs. 0 ANOVA. In contrast, the C vs. H ANOVA revealed main effects of group and SF @ < 0.005). The group by SF interaction was also significant (p < 0.001). The Newman-Keuls post hoc tests demonstrated significantly lower CSs at the middle and high SFs (>2.87 cpd) in the H group as compared to the controls (p < 0.02). Couclusions: As expected, olanzapine did not disrupt the visuoperceptual functions. In contrast, haioperdiol induced a Parkinson-like visual deficit, which was characterised by middle and low SF CS losses. The differential effects of these drugs may be based on their unequivocal affinities to distinct dopamine receptors (Waddington et al., 1997).
References
[ 11 Bulens
C, Meerwaldt JD, van der Wildt GJ, Kemink CJ (1989) Visual contrast sensitivity in drug-induced Parkinsonism. J Nemo1 Neurosorg Psychiatry 52: 341-345. [2] Waddington JL, Scully PJ, O’Callaghnsn E (1997) The new antipsychotics and their potential for early intervention in schizophrenia. Schizophr Res 28: ^^_ ^^^
m]
The effects of oianzapine, antipsychotic, on auditory potentials in schizophrenia
a novel atypical ~300 event-related
A.S. Gi_iniii,C. Siier’ , A. O&z, C. dzesmi’, i. Yabanoglu. Erciyes Unioersity School of Medicine, ‘Departments of Psychiatry and Physiology, Kayseri, Turkey Objective: A reduced amplitude of Nl and P3 have often been found to be related to schizophrenic psychopatoiogy (1). P3 latency has generally been reported to be normal in schizophrenics (2). There is a controversy
S259
on the effects of antipsychotic medication on the ERF’.The current study focuses on the effects of the treatment of oianzapine, a new atypical antipsychotic drug, and on the clinical status on these components of the ERP Methods: Event-related potentials during a two-tone discrimination task were recorded in 12 schizophrenic patients and 10 control subjects. The mean age of the patient group was 29.83 years with a standard deviation (SD) of 9.04 years and that of the control group was 30.5 years (SD 4.93). The mean duration of illness was 6.83 years (SD 4.86). 12 schizophrenics were tested when the patients were medication-free and after 6 weeks of oianzapine (10 mg/day) treatment. The Patients’ symptoms were assessed by BPRS (Brief Psychiatric Rating Scale). A reduction of 30% in BPRS scores was accepted as a response to treatment. Wilcoxon signed rank test (paired) and nonparametric Spearman’s rank correlations were used to evaluate the parameters. Results: In the schizophrenic patients the P3 amplitude was significantly reduced when compared with that in control group and increased to values of normal controls after 6 weeks of olanzapine treatment. The P3 latency was significantly prolonged and the Nl amplitude was significantly reduced when compared with those in the control group, and remained unchanged after oianzapine treatment in spite of significant clinical improvement. BPRS scores including positive and negative subscales decreased significantly (Z = 3.00 p < 0.05, Z = 2.93 p < 0.05, Z = 2.94 p < 0.05 respectively). Nine of 12 (75%) patients responded the oianzapine treatment. The amplitude of P3 correlated with negative subscaie of BPRS before and after the treatment (r = -0.48 p < 0.01 and r = -0.50 p < 0.01 respectively). P3 latency had a positive correlation with total BPRS scores not only before but also after olanzapine treatment (r = 0.47 P < 0.01 and r = 0.64 p < 0.01 respectively). Conclusion: A prolonged P3 latency and reduced P3 amplitude indicate an impairment of auditory information processing in patients with schizophrenia however, we suggest that these parameters which are dependent of the clinical status of patients are influenced by olanzapine treatment. Reduced P3 Tile finding of a reduced P3 in schizophrenics before medication that is normalized by olanzapine medication has not been reported previously. References [1] Potts, G.F., Hirayasu, Y., O’Donnell, B.F., Shenton, M.E., McCarley, R.W. 1998. High-density recording and topographic analysis of the auditory oddball event-related potential in patients with schizophrenia. Biol Psychiahy 15. 982989. [2] Pfefferbaum, A., Wenegrat, B.G., Ford, J.M., Roth, W.T., Kopell, B.S. 1984. Clinical application of the P3 component of event-related potentials. II. Dementia, depression and schizophrenia. Electroencephalogr Clin Neurophysiol 59, l&124.
Ip.2.0181
Tc-99 HMPAO SPECT study of regional cerebral blood flow in drug-free and oianzapine-treated schizophrenic patients
A.S. GBniil, S. Sotioglu, A. Tutus’, M. Kula’, M. Ba@_iirk,E. E~ei, S.S. Aslan. ‘Departments of Psychiahy and Nuclear Medicine; Erciyes University School of Medicine, Kayseri, Turkey Objective: A number of SPECT studies of regional cerebral blood flow (rCBF) have confirmed the findings of frontal hypoperfusion in schizophrenic patients (1, 2). A new novel antipsychotic compound olanzapine has been recently introduced to the treatment of schizophrenic patients. But there has been no definite data of the effect of oianzapine on brain perfusion patterns in schizophrenic patients. The objective of this study was to test the hypothesis that rCBF is changed by olanzapine treatment and possible changes of rCBF are related to some clinical correlates of schizophrenia, particularly positive and negative components of the symptoms. Methods: Seventeen patients who fully met DSM-IV criteria for schizophrenia were included in the study. Their mean age f SD was 28.29 f 8.34 years (range: 19-39), the mean age at onset f SD was 21.52 f 6.19 years, and the mean duration of illness f SD was 81.88
P2 Psychotic disorders and antipsychotics
This case report is about a 25 years old man suffering from a traumatic brain injury as a result of a car accident happened in 1989. At the admission to the hospital, he was in a coma of 3”-4” degree SBM. TAC showed lacerated and contused foci in the temporal-occipital and frontal paramedian region. He recovered from the coma twenty days after the accident and left the hospital after other fifteen days with a diagnosis of Left Hemiparesis due to Brain Injury. 9 years after the trauma, SPECT shows a hypoperfusion of the right parietal lobe and of the left cerebellum and NMR highlights a hypotrophy of the right cerebral peduncle and of the right hippocampus. It was also noticed an enlargement of cortical, cistemal liquoral spaces, in the frontal lobe and in the letI cerebellar hemisphere. Few weeks after the trauma, the patients presented a symptomatology characterised by psychomotor agitation and severe anxiety, associated with visual hallucinations, persecutory and mystic delusions and suicidal ideation. Therapeutic doses of phenothiazines and butyrophenones did not ameliorated psychotic symptomatology while extrapyramidal symptoms compromised the motor activity. Carbamazepine and clonazepam administration did not improve the mental and neurological status. In December 1995, the patient started clozapine treatment: 25 mg/die progressively increased to 100 mg/die. As a result of this therapy there was a complete relief of psychotic symptoms since the second week of treatment. This improvement still exists at thirty month from the beginning of the therapy. Before clozapine treatment the global score at PANSS was 108, now is 3 1. The major improvements concern the items which detect psychotic symptoms, bizarre behaviours and depressive mood. The AA discuss the potential use of clozapine in psychotic states secondary to post-traumatic brain injury instead of “typical” neuroleptics. References
[ 1] Gualtieri T., Cox DR., The delayed neurobehavioural sequelae of traumatic brain injury. Brain injury 32: 219-232, 1991. [2] Marcia L.M., Crismon M.L., Roberts S., Childs A. Clozapine response and adverse effects in nine brain-injured patients. J. Clin, Psychopharmacology 3: 198-202, 1993. [3] Kay S.R., Fiszbein A., Opler L.A. The positive and negative syndrome scale for schizophrenia. Schizophrenia Bulletin 13: 261-276, 1987.
Ip.2.0141 Distress Scale for Adverse Symptoms: a new instrument for measuring the relationship between adverse drug symptoms and associated distress M. Ritsner, I. Modai, 0. Rivkin, E. Bystrov, J. Nehamkin, A. Ponizovsky. Institute for Psychiatric Studies, Sha’ar Menashe Mental Health Centel: Hadera. Israel
Introduction: Antipsychotic medication has been associated with side effects ranging in intensity from minimal to severe. Psychiatrist’s observations often show a substantial discrepancy between the severity of adverse drug symptoms and the resulting subjective distress. The relationship between adverse drug symptoms and associated distress should be examined. Objective: The development and clinical trial of the Distress Scale for Adverse Symptoms (DSAS), a new clinical instrument for measuring both the intensity of patient’s adverse events and the extent of associated subjective distress. Method: Based on a review of previous instruments and researcher’s experience in the area, a 22-item rating scale was developed (Table 1). All adverse drug symptoms are rated by a psychiatrist on a 5-point scale of intensity: 0 - absent or questionable, 1 - mild, 2 - moderate, 3 -marked, 4 - severe. Subjects are asked how much discomfort (subjective distress) a symptom caused during the previous week, with responses scored on the same scale. Three DSAS dimensions are established: symptom intensity, distress intensity and DSAS general index. The higher mean scores, the greater intensity of adverse drug reactions and associated distress.
Table 1. DSAS items 1
Headache
12
2 3 4
Fatigue Nervousness Dizziness Sleep disturbances Somnolence Tremor Akathisia Ataxia Dyskinetic movements Hypokinesiflradykinesia
13 14 15 16 17 18 19 20 21 22
6
8 9 10 11
Hypersalivation/Dry mouth Nausea/Vomiting Appetite disturbances Gastric discomfort Constipation/Diarrhea Weight loss/Weight gain Tachycardia HypotensionIHypertension PolyuriafDisuria Skin sensitivity/Dry skin Sexual dysfunction
Results: DSAS was used to evaluate 200 psychiatric inpatients treated with antipsychotic agents. Cronbach’s alpha reliability coefficients for DSAS dimensions ranged from 0.70 to 0.88. The DSAS indices were highly correlated with the Abnormal Involuntary Movement Scale, Talbieh Brief Distress Inventory, and Somatization Scale of the Brief Symptom Inventory. Conclusions: DSAS is a promising instrument for measuring both the intensity of adverse drug symptoms and associated distress among psychiatric patients treated with atypical and typical neuroleptics.
(P.2.0151 Selective impairment of sensory-perceptual functions in unaffected relatives of schizophrenic patients S. K&i, A. Antal, G. Benedek, Z. Janka. Departments of PsychiaQ Physiology, Albert Szent-GyQyi
and Medical Unioersity, Szeged, Hungay
Objective: Recent research identified several intermedier phenotypes associated with schizophrenia (Egan and Weinberger, 1997). These markers are trait- rather than state-dependent, and are present in healthy siblings of schizophrenic patients. Trait-markers include cognitive, neurochemical, and structural aberrations. In spite of the extensive research in this field, the specificity of trait-dependent parameters is less clear. Here we provide preliminary evidence that sensory-perceptual impairments are specific markers for schizophrenia. Methods: 30 healthy, first-degree biological relatives of psychiatric patients participated in the study (15 were siblings of schizophrenic subjects, and 15 were relatives of type I bipolar patients (DSM-IV)). In addition, 15 subjects with negative family histories were included (Family History Research Diagnostic Criteria). Subjects with mood disorder, paranoid, schizoid or schizotypal traits were excluded. The research groups were matched for age, gender, and educational level. Three levels of sensory and cognitive functions were assessed: (1) Wisconsin Card Sorting Test (WCST) (executive functions), (2) phonological and semantic fluency (lexical-verbal functions), and (3) visual backward masking (BM) (sensory-perceptual functions). For the statistical analysis, the Mann-Whitney U test was used. Results: We found no significant differences between the control subjects with negative family history and the siblings of bipolar patients. Similarly, the relatives of schizophrenic patients displayed intact performances in the WCST and in the fluency tests. In contrast, the siblings of schizophrenic patients had lower performances in the BM procedure in relation to tbe comparison subjects with negative family history (p < 0.001). Conclusions: The only difference among the three research groups was that the biological relatives of schizophrenic patients were impaired in the BM test. This suggests the disturbance of early, sensory-perceptual stage of information processing. In summary, we replicated and extended the findings of an earlier study, reporting BM deficit in siblings of schizophrenic patients (Green et al., 1997). Our results also indicate that this deficit is not only present in unaffected relatives of schizophrenic patients, but reveals marked selectivity and specificity.
P2 Psychotic disorders and antipsychotics References [1] Egan MF, WeinbergerDR (1997) Neurobiology of schizophrenia. Cur Op Neorobiol 7: 701-707. [2] Green MF, Nuechterlein KH, Breitmeyer B (1997) Backward masking performance in unaffected siblings of schizophrenic patients. Arch Gen Psychiatry 54: 465-472.
Ip.2.0161
The atypical antipsychotic olanrapine induce Parkinson-like visuo-perceptual
does not deficits
A. Antal, S. K&i, G. Szekeres, G. Benedek, Z. Janka. Departments of Psychiat?y and Physiology, Albert Szent-Gydrgyi Szeged, Hungary
Medical Uniuersiw,
Objectives: Clinical studies have reported that the atypical antipsychotic oianzapine induced significantly less Parkinson-like side effects as compared to typical neuroieptic drugs (Waddington et al., 1997). It is well established that drug-induced Parkinsonism is accompanied by visuoperceptual impairments (“blurred” vision) (Bulens et al., 1989). However, it is unknown whether atypical antipsychotics cause such disturbances. In this study, we compared the effects of olanzapine and haioperidol on the visual contrast-sensitivity (CS) dictions. Methods: 40 schizophrenic subjects (DSM-IV) and 20 age, gender and education matched healthy control volunteers (C) participated in the study. 20 patients received oianzapine (0) (15.7 mg/day (9.1)), and 20 patients were on haloperidol (H) treatment (5.4 mg/day (4.8)). There were no significant differences between the two patient groups regarding age, education, duration of illness, duration of treatment with oianzapine or haloperidol and the Brief Psychiatric Rating Scale (BPRS) score (0: 213 (7.9); H: 20.0 (12.6)) (values are mean (SD)). In the CS measurements, the minimal luminance-contrast level, required for the detection of visually presented gratings, was determined. CS was defined as the reciprocal of the contrast threshold. Stimuli were horizontal gratings at 9 different spatial frequencies (SFs) (0.48, 1.19, 1.91, 2.87, 3.58, 4.78, 5.73,7.17, and 14.38 cycles/degree (cpd)). For the measurement of CS, a forced-choice staircase method was used. CS data were log-transformed and were entered into group (C vs. 0 and C vs. H) by SF analyses of variance (ANOVAs). Results: Ail main effects and the two-way interaction remained nonsignificant in the C vs. 0 ANOVA. In contrast, the C vs. H ANOVA revealed main effects of group and SF @ < 0.005). The group by SF interaction was also significant (p < 0.001). The Newman-Keuls post hoc tests demonstrated significantly lower CSs at the middle and high SFs (>2.87 cpd) in the H group as compared to the controls (p < 0.02). Couclusions: As expected, olanzapine did not disrupt the visuoperceptual functions. In contrast, haioperdiol induced a Parkinson-like visual deficit, which was characterised by middle and low SF CS losses. The differential effects of these drugs may be based on their unequivocal affinities to distinct dopamine receptors (Waddington et al., 1997).
References
[ 11 Bulens
C, Meerwaldt JD, van der Wildt GJ, Kemink CJ (1989) Visual contrast sensitivity in drug-induced Parkinsonism. J Nemo1 Neurosorg Psychiatry 52: 341-345. [2] Waddington JL, Scully PJ, O’Callaghnsn E (1997) The new antipsychotics and their potential for early intervention in schizophrenia. Schizophr Res 28: ^^_ ^^^
m]
The effects of oianzapine, antipsychotic, on auditory potentials in schizophrenia
a novel atypical ~300 event-related
A.S. Gi_iniii,C. Siier’ , A. O&z, C. dzesmi’, i. Yabanoglu. Erciyes Unioersity School of Medicine, ‘Departments of Psychiatry and Physiology, Kayseri, Turkey Objective: A reduced amplitude of Nl and P3 have often been found to be related to schizophrenic psychopatoiogy (1). P3 latency has generally been reported to be normal in schizophrenics (2). There is a controversy
S259
on the effects of antipsychotic medication on the ERF’.The current study focuses on the effects of the treatment of oianzapine, a new atypical antipsychotic drug, and on the clinical status on these components of the ERP Methods: Event-related potentials during a two-tone discrimination task were recorded in 12 schizophrenic patients and 10 control subjects. The mean age of the patient group was 29.83 years with a standard deviation (SD) of 9.04 years and that of the control group was 30.5 years (SD 4.93). The mean duration of illness was 6.83 years (SD 4.86). 12 schizophrenics were tested when the patients were medication-free and after 6 weeks of oianzapine (10 mg/day) treatment. The Patients’ symptoms were assessed by BPRS (Brief Psychiatric Rating Scale). A reduction of 30% in BPRS scores was accepted as a response to treatment. Wilcoxon signed rank test (paired) and nonparametric Spearman’s rank correlations were used to evaluate the parameters. Results: In the schizophrenic patients the P3 amplitude was significantly reduced when compared with that in control group and increased to values of normal controls after 6 weeks of olanzapine treatment. The P3 latency was significantly prolonged and the Nl amplitude was significantly reduced when compared with those in the control group, and remained unchanged after oianzapine treatment in spite of significant clinical improvement. BPRS scores including positive and negative subscales decreased significantly (Z = 3.00 p < 0.05, Z = 2.93 p < 0.05, Z = 2.94 p < 0.05 respectively). Nine of 12 (75%) patients responded the oianzapine treatment. The amplitude of P3 correlated with negative subscaie of BPRS before and after the treatment (r = -0.48 p < 0.01 and r = -0.50 p < 0.01 respectively). P3 latency had a positive correlation with total BPRS scores not only before but also after olanzapine treatment (r = 0.47 P < 0.01 and r = 0.64 p < 0.01 respectively). Conclusion: A prolonged P3 latency and reduced P3 amplitude indicate an impairment of auditory information processing in patients with schizophrenia however, we suggest that these parameters which are dependent of the clinical status of patients are influenced by olanzapine treatment. Reduced P3 Tile finding of a reduced P3 in schizophrenics before medication that is normalized by olanzapine medication has not been reported previously. References [1] Potts, G.F., Hirayasu, Y., O’Donnell, B.F., Shenton, M.E., McCarley, R.W. 1998. High-density recording and topographic analysis of the auditory oddball event-related potential in patients with schizophrenia. Biol Psychiahy 15. 982989. [2] Pfefferbaum, A., Wenegrat, B.G., Ford, J.M., Roth, W.T., Kopell, B.S. 1984. Clinical application of the P3 component of event-related potentials. II. Dementia, depression and schizophrenia. Electroencephalogr Clin Neurophysiol 59, l&124.
Ip.2.0181
Tc-99 HMPAO SPECT study of regional cerebral blood flow in drug-free and oianzapine-treated schizophrenic patients
A.S. GBniil, S. Sotioglu, A. Tutus’, M. Kula’, M. Ba@_iirk,E. E~ei, S.S. Aslan. ‘Departments of Psychiahy and Nuclear Medicine; Erciyes University School of Medicine, Kayseri, Turkey Objective: A number of SPECT studies of regional cerebral blood flow (rCBF) have confirmed the findings of frontal hypoperfusion in schizophrenic patients (1, 2). A new novel antipsychotic compound olanzapine has been recently introduced to the treatment of schizophrenic patients. But there has been no definite data of the effect of oianzapine on brain perfusion patterns in schizophrenic patients. The objective of this study was to test the hypothesis that rCBF is changed by olanzapine treatment and possible changes of rCBF are related to some clinical correlates of schizophrenia, particularly positive and negative components of the symptoms. Methods: Seventeen patients who fully met DSM-IV criteria for schizophrenia were included in the study. Their mean age f SD was 28.29 f 8.34 years (range: 19-39), the mean age at onset f SD was 21.52 f 6.19 years, and the mean duration of illness f SD was 81.88