- Email: [email protected]
An update on behavioural and psychological symptoms of dementia: Pathophysiological and clinical aspects
International Journal of Psychophysiology 94 (2014) 120–261
professional shooters and novices on posterior-parietal cortex. This region may play a key role for good shooting. This result is in line with that posterior-parietal cortex is important in visuomotor transmission (Desmurget et al., 1999). doi:10.1016/j.ijpsycho.2014.08.971
ERP “old/new” effects in schizophrenia with and without hallucinations Ji Woon Jeonga, Chan Hyun Parka, Seung-Hwan Leeb, Hyun Jung Hana, Hyun Taek Kima a Department of Psychology, Korea University, Republic of Korea b Department of Psychiatry, Ilsanpaik Hospital, Inje University College of Medicine, Republic of Korea Neural correlates of episodic memory deficits may be different in schizophrenia patients with hallucinations (SH) and patients without hallucinations (SnH). However, little is known about how specific neural correlates involved in episodic retrieval may differ between SH and SnH. We aimed to determine whether event-related potentials (ERPs) in SH during episodic retrieval are different from those in SnH and normal controls (NC) after navigating rooms in a virtual environment (VE). Ten SH, 10 SnH, and 14 NC experienced a navigation (encoding) session and a retrieval session. In the navigation session, subjects passively navigated the 4 rooms in random order. In the retrieval session, subjects were asked to press one button if the object had been presented during the encoding session in the same room, i.e., “old,” and press another button if the object had not been presented during the navigation, i.e., “new.” Electroencephalogram (EEG) was only recorded during the retrieval session. As a results, the SH had a lower percentage of correct responses as compared to the other 2 groups. ERP waveforms for the old condition were more positive than those elicited by the new condition for the NC and SnH, reflecting a robust old/new effect at the right centroparietal area; however, this was not observed for the SH. These results indicate that the SH shows a quantitatively different old/new effect compared to the SC as well as NC. Importantly, the ERP old/new effects were negatively correlated with positive symptom scores on PANSS, whereas no significant correlations were found between old/new effects and negative symptom or general psychopathology scores on PANSS. The results suggest that reduced old/new effects in schizophrenia patients may be specifically linked to positive symptoms, such as hallucinations. doi:10.1016/j.ijpsycho.2014.08.972
An update on behavioural and psychological symptoms of dementia: Pathophysiological and clinical aspects Cheuk Yan Leunga, Andrew Chi Kin Lawb University of Southampton, United Kingdom b University of Hong Kong, Hong Kong a
Background: With an ageing population worldwide, dementia has emerged as a highly prevalent syndrome that comprises heterogeneous presentations of both cognitive and neuropsychiatric symptoms. At present, there is still insufficient knowledge about the aetiologies and management of Behavioural and Psychological Symptoms of Dementia (BPSD), while it is these non-cognitive complications that greatly increase the likelihood of patients requiring hospitalisation and longterm residential care due to negative impacts on functionality, activities of daily living and quality of life. The authors have reviewed current
257
literature addressing neurophysiological basis and evidence-based management strategies of BPSD. Methods: Relevant articles have been identified through a MEDLINE/ PubMed search for literature published over past three decades using key terms: “behavioural and psychological symptoms”, “BPSD”, “neuropsychiatric symptoms”, “non-cognitive symptoms”, “dementia” and “Alzheimer's disease”. Particular emphasis has been placed on evaluating evidence on several major neuropsychiatric symptoms according to the Neuropsychiatric Inventory (NPI). Results: Neuropathological findings indicate that formation of frontal plaques and neurofibrillary tangles are associated with delusions, agitation, aberrant motor behaviours and depression. Neuroanatomically, studies reveal that decreased regional grey matter density and increased cortical atrophy are associated with all of the neuropsychiatric symptoms investigated. Neurochemical evidence presents a picture of complex interactions between neurotransmitter pathways and behavioural symptoms elicited by disruption of these systems. Genetic studies have established essential roles of Apolipoprotein E polymorphisms in the heritability of delusions and depression, and amyloid-protein precursor genes in the heritability of agitation and apathy. In terms of management options for BPSD, combination of pharmacological and non-pharmacological strategies currently represents the most appropriate treatment of BPSD. Discussion: A review of the available literature suggests that profiles of regional brain abnormalities, neurotransmitter dysfunction and genetic predisposition contribute to the development of specific symptoms of BPSD, and each of these symptoms would be managed more effectively with individually targeted therapeutic approaches. Conclusion: Unravelling the mystery behind BPSD generates newer understanding of neuropathological and genetic underpinnings of dementia, enhances assessment and diagnosis, helps to devise novel symptom-targeted interventions, and moves towards a future with better care for patients and lesser distress for families and carers. doi:10.1016/j.ijpsycho.2014.08.973
Opioid-related cognitive and cardiovascular features Sofia Alexandrovna Polevayaa, Vladislav Vycheslavovich Vetyugovb, Anastasya Vladimirovna Bakhchinab, Sergey Borisovich Parina a Nizhny Novgorod State Medical Academy, N.I. Lobachevsky State University of Nizhny Novgorod, Russia b N.I. Lobachevsky State University of Nizhny Novgorod, Russia At the moment, the role of neurochemical endogenous opioid system (EOS) in management of information processes raises many questions. The results of the study of stress and pain suggest that EOS participates in the interrupt signals about a disagreement between the desired and the existing. The current study shows the results of the measurement of cardiovascular reactivity and cognitive functions of opiate dependent patients. Two groups of subjects participated in the study: 54 opiate dependent patients during opiate withdrawal (26 men and 28 women, with a mean age of 22.5 (±1.2)) and 25 healthy control participants (12 men and 13 women, with a mean age of 21.5 (±1.3)). The cardiovascular reactivity was measured with BioHarness telemetry system (Polevaya, 2012). The heart rate variability (HRV) was assessed by the frequency-domain indices (TP, LF, HF, and LF/HF), using dynamic spectral analysis. The cognitive functions were measured with hardware–software complex Hand-Tracker (Antonec, 2011). The efficiency of cognitive functions was assessed by the absolute and differential thresholds and the errors sensorimotor coordination. An independent samples t-test revealed significant difference in frequency-domain indices of HRV (p b .03). The opiate dependent
professional shooters and novices on posterior-parietal cortex. This region may play a key role for good shooting. This result is in line with that posterior-parietal cortex is important in visuomotor transmission (Desmurget et al., 1999). doi:10.1016/j.ijpsycho.2014.08.971
ERP “old/new” effects in schizophrenia with and without hallucinations Ji Woon Jeonga, Chan Hyun Parka, Seung-Hwan Leeb, Hyun Jung Hana, Hyun Taek Kima a Department of Psychology, Korea University, Republic of Korea b Department of Psychiatry, Ilsanpaik Hospital, Inje University College of Medicine, Republic of Korea Neural correlates of episodic memory deficits may be different in schizophrenia patients with hallucinations (SH) and patients without hallucinations (SnH). However, little is known about how specific neural correlates involved in episodic retrieval may differ between SH and SnH. We aimed to determine whether event-related potentials (ERPs) in SH during episodic retrieval are different from those in SnH and normal controls (NC) after navigating rooms in a virtual environment (VE). Ten SH, 10 SnH, and 14 NC experienced a navigation (encoding) session and a retrieval session. In the navigation session, subjects passively navigated the 4 rooms in random order. In the retrieval session, subjects were asked to press one button if the object had been presented during the encoding session in the same room, i.e., “old,” and press another button if the object had not been presented during the navigation, i.e., “new.” Electroencephalogram (EEG) was only recorded during the retrieval session. As a results, the SH had a lower percentage of correct responses as compared to the other 2 groups. ERP waveforms for the old condition were more positive than those elicited by the new condition for the NC and SnH, reflecting a robust old/new effect at the right centroparietal area; however, this was not observed for the SH. These results indicate that the SH shows a quantitatively different old/new effect compared to the SC as well as NC. Importantly, the ERP old/new effects were negatively correlated with positive symptom scores on PANSS, whereas no significant correlations were found between old/new effects and negative symptom or general psychopathology scores on PANSS. The results suggest that reduced old/new effects in schizophrenia patients may be specifically linked to positive symptoms, such as hallucinations. doi:10.1016/j.ijpsycho.2014.08.972
An update on behavioural and psychological symptoms of dementia: Pathophysiological and clinical aspects Cheuk Yan Leunga, Andrew Chi Kin Lawb University of Southampton, United Kingdom b University of Hong Kong, Hong Kong a
Background: With an ageing population worldwide, dementia has emerged as a highly prevalent syndrome that comprises heterogeneous presentations of both cognitive and neuropsychiatric symptoms. At present, there is still insufficient knowledge about the aetiologies and management of Behavioural and Psychological Symptoms of Dementia (BPSD), while it is these non-cognitive complications that greatly increase the likelihood of patients requiring hospitalisation and longterm residential care due to negative impacts on functionality, activities of daily living and quality of life. The authors have reviewed current
257
literature addressing neurophysiological basis and evidence-based management strategies of BPSD. Methods: Relevant articles have been identified through a MEDLINE/ PubMed search for literature published over past three decades using key terms: “behavioural and psychological symptoms”, “BPSD”, “neuropsychiatric symptoms”, “non-cognitive symptoms”, “dementia” and “Alzheimer's disease”. Particular emphasis has been placed on evaluating evidence on several major neuropsychiatric symptoms according to the Neuropsychiatric Inventory (NPI). Results: Neuropathological findings indicate that formation of frontal plaques and neurofibrillary tangles are associated with delusions, agitation, aberrant motor behaviours and depression. Neuroanatomically, studies reveal that decreased regional grey matter density and increased cortical atrophy are associated with all of the neuropsychiatric symptoms investigated. Neurochemical evidence presents a picture of complex interactions between neurotransmitter pathways and behavioural symptoms elicited by disruption of these systems. Genetic studies have established essential roles of Apolipoprotein E polymorphisms in the heritability of delusions and depression, and amyloid-protein precursor genes in the heritability of agitation and apathy. In terms of management options for BPSD, combination of pharmacological and non-pharmacological strategies currently represents the most appropriate treatment of BPSD. Discussion: A review of the available literature suggests that profiles of regional brain abnormalities, neurotransmitter dysfunction and genetic predisposition contribute to the development of specific symptoms of BPSD, and each of these symptoms would be managed more effectively with individually targeted therapeutic approaches. Conclusion: Unravelling the mystery behind BPSD generates newer understanding of neuropathological and genetic underpinnings of dementia, enhances assessment and diagnosis, helps to devise novel symptom-targeted interventions, and moves towards a future with better care for patients and lesser distress for families and carers. doi:10.1016/j.ijpsycho.2014.08.973
Opioid-related cognitive and cardiovascular features Sofia Alexandrovna Polevayaa, Vladislav Vycheslavovich Vetyugovb, Anastasya Vladimirovna Bakhchinab, Sergey Borisovich Parina a Nizhny Novgorod State Medical Academy, N.I. Lobachevsky State University of Nizhny Novgorod, Russia b N.I. Lobachevsky State University of Nizhny Novgorod, Russia At the moment, the role of neurochemical endogenous opioid system (EOS) in management of information processes raises many questions. The results of the study of stress and pain suggest that EOS participates in the interrupt signals about a disagreement between the desired and the existing. The current study shows the results of the measurement of cardiovascular reactivity and cognitive functions of opiate dependent patients. Two groups of subjects participated in the study: 54 opiate dependent patients during opiate withdrawal (26 men and 28 women, with a mean age of 22.5 (±1.2)) and 25 healthy control participants (12 men and 13 women, with a mean age of 21.5 (±1.3)). The cardiovascular reactivity was measured with BioHarness telemetry system (Polevaya, 2012). The heart rate variability (HRV) was assessed by the frequency-domain indices (TP, LF, HF, and LF/HF), using dynamic spectral analysis. The cognitive functions were measured with hardware–software complex Hand-Tracker (Antonec, 2011). The efficiency of cognitive functions was assessed by the absolute and differential thresholds and the errors sensorimotor coordination. An independent samples t-test revealed significant difference in frequency-domain indices of HRV (p b .03). The opiate dependent