- Email: [email protected]
99. Efficacy of prefrontal transcranial magnetic stimulation in major depression
30s
BIOLPSYCHIATRY 1998;43:1S-133S
duringaffectrwognitionwas significantlydecreasedin the dorsolateral prefrontalcortex of schizophrenicsubjectswhen comparedwith nonpsychiatriccontrols (t=2.08, p=.02).These results are consistentwith previousneuroimagingfindingsof decreasedleft prefrontalactivationin schizophrenicsubjectsin responseto cognitivechallengeparadigms.
97. AFFECT RECOGNITION IN SCHIZOPHRENIA: A fMR.I STUDY A.A. Bairdl’2, S.A. Gruberl’2 & D.A. Yurgelun-Toddl’2 *ConsolidatedDepartmentsof PsychiatryHarvardMedicalSchool, Boston,MA.; 2BrainImagingCenter,McLeanHospital,Belmont,MA Prior studieshave reportedleft temporal10beabnormalitiesassociated with schizophrenia.Additionally,among non-psychiatriccontrol subjects, it has been reportedthat affect recognitionis consistentlyassociated with an increasein letl amygdalaactivation.We appliedfMfUto study10DSM-IVschizophrenicpatientsand 10heakhycontrolsubjects usinga facialaffectrecognitionparadigm.Scanningwas pertormedon a 1.5Tesla scannerwhichhadbeenretrofitwitha wholebodyechoplanar coil, all images were acquired using a quadraturehead coiL A T1 weightedsagittalimagewasusedto localizea planeperpendicularto the AC-PC line. High resolution coronal images (FOV=40X20,TE=15 maec,TR=5000 msec, matrix=256x160,nex=2) were acquiredin this planeto facilitateanatomiccorrelationwiththe fictional imagingdata. Functionalimages were collected every three secondsusing an echo planer gradientecho pulse sequence(TX = 40 msec, flip angle = 75 deg.).An imagematrixof 128x65was usedwitha 3mrnx 3mmin-plane resolutionand a 6 mm slice thickness.Duringeach task condition,a seriesof 50 sequentialimageswere obtained.The task includedfive 30 second periods that alternated between fixation and viewing faces displayingfeartid affect. Followingthe imagingsequence,subjectsare asked to label the affect presented, thus no vocalizedresponse was requiredduring scanning.Data were correctedfor both rotationaland translationrdmotion.Corticafactivationwas measuredusingneuroanatomically defined regions of interest. Left amygdala activation was significantlydecreasedin schizophrenicsubjectscomparedwithcontrols (t=3.15, p=.003), however,bothgroupsretaineda left greaterthanright pattern of amygdalaactivationin responseto the task.
98. NEUROMETRIC EEG MARKERS CLASSIFY MEDICATION RESPONSE IN DSM DISORDERS
TtltiY Abstracts
a computerizeddatabae. Treatmentreqxma.eis monitotedweekly to quarterlybypaychiahistaandClinicalGlobrdIrnpmvement(CGI) mtingsam assigned.Thecurrentdatabmecontains1412patientswhowerefoflowed for >26 weeks.‘here am54medicationstrackedfor tbeireffectivenesaor ineffectiveness.Thexeare 8,467patientfollow-upassessments.Different classesofmedicationausedinpsychiatryarEincluded,withnrnnerousagents in each class. Analysisof monotherapyresponderswith a CGI = > 2 yieldeda 95%trainingsetpredictabilityof Stimldantverausanti-depressant classefficacywith75%predictabilityin the validationset;therewas 83% trainingset prwlictabiJity of anti-convulsant versusstimulantclassefficacy with 71%predictabilityin the validationsec there was 82%trainingset t classefficacywith pmtictabilityof anti-convulsants versusanti-depresaan 76%predictabilityin the validationset. NeuromehicEEGdata mntained sufficientinformadonto classifypatientpopofatiorrs intodifferentmedication classresponsegroups.
99. EFFICACY OF PREFRONTAL TRANSCR4NIAL MAGNETIC STIMULATION IN MAJOR DEPRESSION E. IUeinl; B. Kreininl, A. Chistyakov2 & M. Feinsod2 Departmentof PsycfriatrylandNeurosurgeryz, RamhamMedicalCenter andB.RappaporgFacultyof MedicineTechnionITTHaifa- Israel BackgroundTranacrad magneticbrain stimulation(TMS),a noninvasivetechniquefor stimulationof the brain,hasrecentlybeensuggestedas effectivefor the treatmentof majordepression.We conducteda doublebfindplacebo(sham)-controlledstudyto asses the etllcacy of repetitive TMS(r-TMS)in patientswithmajordepression(MD).MethodSeventyone patientswith MD (54 females, 17 males; mean age 58.7 t 17.2) were randomlyassignedto receiver-TMSor shamr-TMSin a doubleblinddesign.Treatmentwasadministeredin tendailysessionsovera two weekperiod.Severityof depressionwas blindlyassessedbefore,during and atler completionof the treatment protocol. Results AU patients completedthe fmt week of treatment and 67 completed the entire protrwol.Patients who receivedr-TMS showeda significantlygreater improvementin depressionscores as comparedto those who received sham treatment(F2/65~3.2;P=O.05).At the end of two weeka 17/36 patientsin the r-TMS group,but only 6/35 in the sham-treatedgroup, showedan improvementof greaterthan50%in their depressionratings. Furthermore,of 15 patients in the TMS group who were plannedto receiveWT. only7 receivedthe treatmenteventually,whilein the sham group, all 13 subjects who were planned to receive ECT, eventually received the treatment. ConclusionsThis controlled study provides evidencefor the short-termefficacyof r-TMSin patientswithrecurrenq nonpaychoticMD.Additionalstudiesare necessaryto assesstheefficacy of r-TMSas comparedto ECT,as well as tie long-termoutcomeof this treatmentin MD, and possiblyotherpsychiatricdisorders.
H, Emory, M. Proler & S. Suffin NuPharmDatabase,LLC;250 LombardStreet,Suites 1 /k 2; ThousandOaks,Calif. 91360 Thiselevenyearclinicalstudycontainspatien@withpsychiatricdisorders across the range of the Diagnosticand StatisticalMSISUSJ ~fravi~ classification.Priorto EEG/NEEGtestingpadentsare medication-free for seven half-livesof the longest half-life agent, and laboratorystudies includingmukiaystemchemistryevaluation,hemogram,thyroidfunction studieswithTSH,routinemograrwand urinedrugscreenmustbe within normalfimits.The conventionalEEGis reviewedby a neurologistand a minimumof thirty-two23 secondawak vigilanLartifact-freeEEGepochs is selectedandsubjectedto quantitativeanalysis.EEGllndingsandNEEG mrmericsd &@ patientdemographyandclinicalvariablesaremaintainedin
100. IDENTIFICATION OF SACCADE RELATED BRAIN REGIONS USING FMRI J.E. McDowelll’2, A. Galuhn2 & D.L. Braffl IUniveraityof California,San Diego,Departmentof Psychiatry, ‘Universityof California,San Diego,Departmentof Psychology The neuralcircuitrysuppmtingsaccadiceye movementsis relativelywell understood,suchthatparticrdartypesof abnonrudities suggest@hoIogYOf s-c neural [email protected] numberof studiesdemonstrate schizophrenia patientsandtheirbiologicalrelativeshaveabnormalitieson taskssupporied
BIOLPSYCHIATRY 1998;43:1S-133S
duringaffectrwognitionwas significantlydecreasedin the dorsolateral prefrontalcortex of schizophrenicsubjectswhen comparedwith nonpsychiatriccontrols (t=2.08, p=.02).These results are consistentwith previousneuroimagingfindingsof decreasedleft prefrontalactivationin schizophrenicsubjectsin responseto cognitivechallengeparadigms.
97. AFFECT RECOGNITION IN SCHIZOPHRENIA: A fMR.I STUDY A.A. Bairdl’2, S.A. Gruberl’2 & D.A. Yurgelun-Toddl’2 *ConsolidatedDepartmentsof PsychiatryHarvardMedicalSchool, Boston,MA.; 2BrainImagingCenter,McLeanHospital,Belmont,MA Prior studieshave reportedleft temporal10beabnormalitiesassociated with schizophrenia.Additionally,among non-psychiatriccontrol subjects, it has been reportedthat affect recognitionis consistentlyassociated with an increasein letl amygdalaactivation.We appliedfMfUto study10DSM-IVschizophrenicpatientsand 10heakhycontrolsubjects usinga facialaffectrecognitionparadigm.Scanningwas pertormedon a 1.5Tesla scannerwhichhadbeenretrofitwitha wholebodyechoplanar coil, all images were acquired using a quadraturehead coiL A T1 weightedsagittalimagewasusedto localizea planeperpendicularto the AC-PC line. High resolution coronal images (FOV=40X20,TE=15 maec,TR=5000 msec, matrix=256x160,nex=2) were acquiredin this planeto facilitateanatomiccorrelationwiththe fictional imagingdata. Functionalimages were collected every three secondsusing an echo planer gradientecho pulse sequence(TX = 40 msec, flip angle = 75 deg.).An imagematrixof 128x65was usedwitha 3mrnx 3mmin-plane resolutionand a 6 mm slice thickness.Duringeach task condition,a seriesof 50 sequentialimageswere obtained.The task includedfive 30 second periods that alternated between fixation and viewing faces displayingfeartid affect. Followingthe imagingsequence,subjectsare asked to label the affect presented, thus no vocalizedresponse was requiredduring scanning.Data were correctedfor both rotationaland translationrdmotion.Corticafactivationwas measuredusingneuroanatomically defined regions of interest. Left amygdala activation was significantlydecreasedin schizophrenicsubjectscomparedwithcontrols (t=3.15, p=.003), however,bothgroupsretaineda left greaterthanright pattern of amygdalaactivationin responseto the task.
98. NEUROMETRIC EEG MARKERS CLASSIFY MEDICATION RESPONSE IN DSM DISORDERS
TtltiY Abstracts
a computerizeddatabae. Treatmentreqxma.eis monitotedweekly to quarterlybypaychiahistaandClinicalGlobrdIrnpmvement(CGI) mtingsam assigned.Thecurrentdatabmecontains1412patientswhowerefoflowed for >26 weeks.‘here am54medicationstrackedfor tbeireffectivenesaor ineffectiveness.Thexeare 8,467patientfollow-upassessments.Different classesofmedicationausedinpsychiatryarEincluded,withnrnnerousagents in each class. Analysisof monotherapyresponderswith a CGI = > 2 yieldeda 95%trainingsetpredictabilityof Stimldantverausanti-depressant classefficacywith75%predictabilityin the validationset;therewas 83% trainingset prwlictabiJity of anti-convulsant versusstimulantclassefficacy with 71%predictabilityin the validationsec there was 82%trainingset t classefficacywith pmtictabilityof anti-convulsants versusanti-depresaan 76%predictabilityin the validationset. NeuromehicEEGdata mntained sufficientinformadonto classifypatientpopofatiorrs intodifferentmedication classresponsegroups.
99. EFFICACY OF PREFRONTAL TRANSCR4NIAL MAGNETIC STIMULATION IN MAJOR DEPRESSION E. IUeinl; B. Kreininl, A. Chistyakov2 & M. Feinsod2 Departmentof PsycfriatrylandNeurosurgeryz, RamhamMedicalCenter andB.RappaporgFacultyof MedicineTechnionITTHaifa- Israel BackgroundTranacrad magneticbrain stimulation(TMS),a noninvasivetechniquefor stimulationof the brain,hasrecentlybeensuggestedas effectivefor the treatmentof majordepression.We conducteda doublebfindplacebo(sham)-controlledstudyto asses the etllcacy of repetitive TMS(r-TMS)in patientswithmajordepression(MD).MethodSeventyone patientswith MD (54 females, 17 males; mean age 58.7 t 17.2) were randomlyassignedto receiver-TMSor shamr-TMSin a doubleblinddesign.Treatmentwasadministeredin tendailysessionsovera two weekperiod.Severityof depressionwas blindlyassessedbefore,during and atler completionof the treatment protocol. Results AU patients completedthe fmt week of treatment and 67 completed the entire protrwol.Patients who receivedr-TMS showeda significantlygreater improvementin depressionscores as comparedto those who received sham treatment(F2/65~3.2;P=O.05).At the end of two weeka 17/36 patientsin the r-TMS group,but only 6/35 in the sham-treatedgroup, showedan improvementof greaterthan50%in their depressionratings. Furthermore,of 15 patients in the TMS group who were plannedto receiveWT. only7 receivedthe treatmenteventually,whilein the sham group, all 13 subjects who were planned to receive ECT, eventually received the treatment. ConclusionsThis controlled study provides evidencefor the short-termefficacyof r-TMSin patientswithrecurrenq nonpaychoticMD.Additionalstudiesare necessaryto assesstheefficacy of r-TMSas comparedto ECT,as well as tie long-termoutcomeof this treatmentin MD, and possiblyotherpsychiatricdisorders.
H, Emory, M. Proler & S. Suffin NuPharmDatabase,LLC;250 LombardStreet,Suites 1 /k 2; ThousandOaks,Calif. 91360 Thiselevenyearclinicalstudycontainspatien@withpsychiatricdisorders across the range of the Diagnosticand StatisticalMSISUSJ ~fravi~ classification.Priorto EEG/NEEGtestingpadentsare medication-free for seven half-livesof the longest half-life agent, and laboratorystudies includingmukiaystemchemistryevaluation,hemogram,thyroidfunction studieswithTSH,routinemograrwand urinedrugscreenmustbe within normalfimits.The conventionalEEGis reviewedby a neurologistand a minimumof thirty-two23 secondawak vigilanLartifact-freeEEGepochs is selectedandsubjectedto quantitativeanalysis.EEGllndingsandNEEG mrmericsd &@ patientdemographyandclinicalvariablesaremaintainedin
100. IDENTIFICATION OF SACCADE RELATED BRAIN REGIONS USING FMRI J.E. McDowelll’2, A. Galuhn2 & D.L. Braffl IUniveraityof California,San Diego,Departmentof Psychiatry, ‘Universityof California,San Diego,Departmentof Psychology The neuralcircuitrysuppmtingsaccadiceye movementsis relativelywell understood,suchthatparticrdartypesof abnonrudities suggest@hoIogYOf s-c neural [email protected] numberof studiesdemonstrate schizophrenia patientsandtheirbiologicalrelativeshaveabnormalitieson taskssupporied