Association of neuroelectrophysiology and analysis of cerebrospinal fluid immunoglobulin with pathogenetic conditions of patients with Guillain-Barre syndrome

INTRODUCTION Guillain-Barre syndrome (GBS) which is also named as acute inflam- matory demyelinating polyneuropathy is an autoimmune disease char- acterized by demyelination of peripheral nerve and nerve root, and in- flammatory reaction of lymphocyte and…     

Validation of the World Health Organization’s Quality of Life Questionnaire with Parents of Children with Autistic Disorder

The World Health Organization’s Quality of Life Questionnaire-BREF (WHOQOL-BREF) has been used in many studies that target parents of children with Autistic Disorder. However, the measure has yet to be validated and adapted to this sample group whose daily experiences are considered substantially different from those of parents of children with typical development and parents of children with other disabilities. Therefore, this study was designed to examine the psychometric properties and the theoretical structure of the WHOQOL-BREF with a sample of 184 parents of children with Autistic Disorder. The factor structure for the WHOQOL-BREF was examined using exploratory and confirmatory factor analyses. Our analyses provided no evidence of a better model than the original 4-domain model. Nevertheless, some items in the measure were re-distributed to different domains based on theoretical meanings and/or clean loading criteria. The new model structure gained the measure’s required validity with parents of children with Autistic Disorder.     

Health-related quality of life of children with epilepsy in Hong Kong: How does it compare with that of youth with epilepsy in Canada?

OBJECTIVE: The primary aim of our study was to compare the health-related quality of life (HRQL) of children with epilepsy in Hong Kong with that of children with epilepsy in Canada, and to explore possible factors affecting these findings. A second interest was to determine agreement between proxy reports and self-ratings among children with epilepsy in Hong Kong, compare these with findings in Canada, and identify factors that influence the concordance. METHODS: Child self-report and parent-proxy questionnaires on an epilepsy-specific HRQL measure, appropriately translated and validated in Chinese, were administered to 266 Hong Kong children and their parents. An unpaired t test was used to compare the scores with published results from 381 Canadian children and their parents, who used the original English version of the measure. Demographic characteristics of the two groups were compared using t tests, chi2 tests, and Fisher's exact tests. Agreement between parents' and children's scores was evaluated with intraclass correlation coefficients (ICCs) and standardized response means (SRMs). The total HRQL score differences between parents and children in Hong Kong were compared with those in Canada using an unpaired t test. Factors that might affect the parent-child score difference were studied using Pearson correlation analysis, chi2 test, and analysis of variance. Factors studied included: sex, current age, age at diagnosis, duration of epilepsy, number of antiepileptic drugs used, type of seizure, seizure severity, cognition of the child, the type of school attended, presence of neurological problems, presence of behavioral problems, recent health care usage, education and employment status of both parents, housing status of the family, and relationship of the proxy respondent to the child. RESULTS: (1) In contrast to the Canadian sample, Hong Kong children with epilepsy were older (P<0.01), had a longer duration of epilepsy (P<0.01) and less severe seizures (P<0.01), and were more likely to attend normal schools (P<0.01). Children in Hong Kong reported more interpersonal/social difficulties (P<0.01), more worries (P<0.01), and more secrecy about their epilepsy (P<0.01). Parents in Hong Kong believed that their children perceived more worries (P<0.01) and were more secretive about their epilepsy (P<0.01). (2) Moderate to good agreement between parent-proxy response scores and child self-report scores was demonstrated (ICC=0.50-0.69, SRM=0.19-0.33). The total HRQL score differences between parent and child in Hong Kong were not different from those in Canada. None of the factors studied were related to the parent-child score difference. CONCLUSIONS: Youth with epilepsy in Hong Kong and their parents reported poorer quality of life than children with epilepsy in Canada. Further studies are necessary to identify the determinants of HRQL in children with epilepsy in different cultures. Acceptable agreement between the two ratings suggests that proxy reports can be used when child self-reports cannot be obtained.     

Treatment of radiation-induced brain injury with bisdemethoxycurcumin

Radiation therapy is considered the most effective non-surgical treatment for brain tumors.However,there are no available treatments for radiation-induced brain injury.Bisdemethoxycurcumin(BDMC) is a demethoxy derivative of curcumin that has anti-proliferative,anti-inflammatory,and anti-oxidant properties.To determine whether BDMC has the potential to treat radiation-induced brain injury,in this study,we established a rat model of radiation-induced brain injury by administe ring a single 30-Gy v...     

Interaction of prolyl oligopeptidase with α-synuclein

Prolyl oligopeptidase (PO) interacts with α-syncline in vitro. It is a weak interaction that induces a nucleation prone conformation of α-synuclein. PO accelerates aggregation and fibril formation of α-syncline in a process that can be reversed by specific inhibitors and is also influenced by an impairing mutation in the PO active site. There is evidence that PO and α-synuclein also interact intracellularly, especially in conditions where the expression of α-synuclein is high. Specific PO inhibitors reduce the number of cells with α-synuclein inclusions in a cellular model of Parkinson's disease. If these interactions also exist in the human brain, PO may be a target for the treatment of Parkinson's disease and other synucleinopathies. Whether PO also contributes to the normal physiological functions of α-syncline remains an open question, but there are some intriguing parallels between the proposed functions of both proteins that deserve further investigation.     

Interventional effect of electroacupuncture combined with medicine on monoamine neurotransmitters in hypothalamus of rats with ulcerative colitis

BACKGROUND: Ulcerative colitis (UC) is conventionally treated with sulfasalazine and other aminosalicylic acids. The symptoms of UC can be rapidly controlled, but high recurrence, severe adverse reactions and other shortages exist commonly. Whether electroacupuncture combined with medicine can make up these shortages remains unclear. OBJECTIVE: This study was to observe the regulatory effect of electroacupuncture combined with medicine on monoamine neurotransmitter in hypothalamus of rats with ulcerative colitis, and to analyze the pathogenesis of UC and the action pathway of electroacupuncture combined with medicine. DESIGN: A randomized controlled observation. SETTING: Shanghai Institute of Acupuncture and Meridian. MATERIALS: Thirty involved male SD rats of clean grade, weighing （200±20）g, were provided by the Experimental Animal Center, Shanghai University of Traditional Chinese Medicine. Sulfasalazine was produced in the Shanghai Sanwei Pharmaceutical Co., Ltd [certification No. (1995)002083]. METHODS: This study was carried out in the State Laboratory (grade 3) for Acupuncture and Immunology, Shanghai Institute of Acupuncture and Meridian. The involved 30 rats were randomized into 5 groups: normal group, model group, electroacupuncture group, medicine group and electroacupuncture combined with medicine group, with 6 rats in each group. Rats in the latter 4 groups were prepared into models of UC. In the electroacupuncture group, Zusanli(shuang) point was selected. Electro-acupuncture apparatus (G6805Ⅱ type) was connected to the point and used to stimulate it with continuous wave, frequency of 2 Hz, electrical intensity 4 mA, 20 minutes a day, for 14 days successively. In the medicine group, rats were intragastrically administrated with sulfasalazine, twice a day, 3 mL once, for 14 days successively. In the electroacupuncture combined with medicine group, rats were treated with electroacupuncture and medicine simultaneously as described in the previous two groups. Rats in the model group and normal control group were untouched except for being fixed. MAIN OUTCOME MEASURES: The levels of noradrenaline acid tartrate (NE), 3-methoxy-4 hydroxyphenylglycol (MHPG), dopamine hydrochloride (DA), 3,4-dihydroxyphenylacetic acid (DOPAC), 5-hydroxytryptamine (5-HT) hydrochloride, homovanillic acid (HVA) and 5-hydroxyindole acetic acid (5-HIAA) of rats in each group were detected by high-performance liquid chromatography (HPLC)-electrochemical method. RESULTS: All the 30 involved rats entered into the stage of final analysis. ①Detection of NE and MHPG levels: After treatment, NE level in the hypothalamus of rats was significantly higher in the electroacupuncture combined with medicine group, electroacupuncture group and medicine group was all significantly higher than that in the model group, respectively (P < 0.01). After treatment, MHPG level in the metabolite of NE was very significantly higher in the electroacupuncture group than in the medicine group (P < 0.01). ②Detection of DA and DOPAC levels: After treatment, DA level in the hypothalamus of rats was very significantly higher in the medicine group than in the model group (P < 0.01). ③Detection of 5-HT, HVA and 5-HIAA levels: After treatment, 5-HIAA level in the hypothalamus of rats was significantly higher in the medicine group than in the model group (P < 0.05). CONCLUSION: The abnormal synthesis and metabolism of monoamine neurotransmitter in the central nervous system is one of pathogenesis of UC. Electroacupuncture combined with medicine might reach its goal of treatment by regulating the monoamine neurotransmitter disorder in the hypothalamus of rats with UC.     

Effects of ginsenoside of stem and leaf combined with choline on learning and memory ability of rat models with Alzheimer diseases

INTRODUCTIONGinsenoside of stem and leaf (GSL) can improve learning and memo-ry abilities through enhancing adrenergic nerve and 5-serotonergicnerve[1]; additionally, choline can improve learning and memory disor-der through enhancing central cholinergic …     

Subjective quality of life of patients with obsessive–compulsive disorder

BACKGROUND: Obsessive-compulsive disorder (OCD) is the fourth most frequent diagnosis in psychiatry. Patients with OCD suffer from obsessive thinking and compulsive behavior, which impact their everyday life negatively. OBJECTIVE: Subjective quality of life (QoL) in patients with OCD was examined and compared to the general German population and to patients with schizophrenia. METHODS: Seventy-five patients, aged 21-72, with OCD (ICD 10 F42.0-F42.2) were recruited from the outpatient clinic for anxiety disorders at the Department of Psychiatry of the University of Leipzig. By means of the WHOQOL-BREF, QoL was assessed in patients with OCD in a representative sample of patients with schizophrenia and in a sample of the general population of Saxony/Germany. RESULTS: Compared with the general population, QoL in patients with OCDs was lower in all domains of the WHOQOL-BREF. Unexpectedly, QoL in patients with OCDs was lower in the domains "psychological well-being" and "social relationships" when compared with schizophrenia patients. CONCLUSIONS: OCD has a substantial adverse effect on patients' subjective QoL, which may be even greater than the adverse effect of schizophrenia. Therefore, it will be necessary to include interventions in the treatment of OCD aimed at improving residual deficits in psychosocial functioning and QoL.     

Fragmentation of Golgi apparatus of nigral neurons with α-synuclein-positive inclusions in patients with Parkinson’s disease

We examined whether the Golgi apparatus (GA) is fragmented in nigral neurons in 18 cases with Parkinson’s disease (PD) and in 8 control cases. The nigral neurons in cases with PD showed various degrees of Lewy pathology with α-synuclein immunohistochemistry, and we divided the neurons into three subtypes according to differences in α-synuclein immunoreactivity: (1) neurons without pale bodies or Lewy bodies, (2) neurons with pale bodies, and (3) neurons with Lewy bodies. In controls, we did not observe fragmented GA in nigral neurons by immunocytochemistry with an anti-TGN46 antibody. In PD, the GA was fragmented in 3% of the nigral neurons without inclusions, and in 5% of the neurons with Lewy bodies. In contrast, fragmented GA was noted in 19% of the neurons containing pale bodies. Since pale bodies represent early stages in the development of brainstem Lewy bodies, our results suggest that the cytotoxicity of α-synuclein-positive aggregates is reduced in the process of Lewy body formation.     

Treatment of Wernicke’s encephalopathy with high dose of thiamine in a patient with pyloric sub-stenosis: description of a case

Wernicke’s encephalopathy (WE) is an acute or subacute syndrome that results from a deficiency in vitamin B1 (thiamine). The syndrome is characterised by a classical triad of symptoms: nystagmus and ophthalmoplegia, mental-status changes, and unsteadiness of stance and gait. When patients with WE are inappropriately treated with low doses of thiamine, mortality rates average out at 20% and Korsakoff’s Psychosis develops in about 85% of survivors (Sechi and Serra in Lancet Neurol 6(5):442–455, 2007). We report the case of a patient with a pyloric sub-stenosis that developed a WE, and was treated with high doses of thiamine showing after few days of treatment a great improvement of neurological and neuroradiological assessment, even though cognitive impairment was still severe at discharge and at 6 months follow-up.     

Does the risk of developing dementia increase with the number of episodes in patients with depressive disorder and in patients with bipolar disorder?

OBJECTIVE: Several findings suggest that some patients with depressive or bipolar disorder may be at increased risk of developing dementia. The present study aimed to investigate whether the risk of developing dementia increases with the number of affective episodes in patients with depressive disorder and in patients with bipolar disorder. METHODS: This was a case register study including all hospital admissions with primary affective disorder in Denmark during 1970-99. The effect of the number of prior episodes leading to admission on the rate of readmission with a diagnosis of dementia following the first discharge after 1985 was estimated. A total of 18,726 patients with depressive disorder and 4248 patients with bipolar disorder were included in the study. RESULTS: The rate of a diagnosis of dementia on readmission was significantly related to the number of prior affective episodes leading to admission. On average, the rate of dementia tended to increase 13% with every episode leading to admission for patients with depressive disorder and 6% with every episode leading to admission for patients with bipolar disorder, when adjusted for differences in age and sex. CONCLUSION: On average, the risk of dementia seems to increase with the number of episodes in depressive and bipolar affective disorders.     

Parent–child interaction of mothers with depression and their children with ADHD

Attention deficit/hyperactivity disorder (ADHD) is a developmental disorder that may have a chronic and pervasive impact on the child's function and cause long-term stress to parents. A higher rate of depression is associated with mothers of children with ADHD. This observational study aimed to investigate the effect of maternal depression and the child's ADHD on the quality of the parent–child interaction in children with ADHD and their mothers with depression. The study participants comprised 39 mother–son dyads including children with ADHD and mothers with depression, children with ADHD and mothers without depression, and children without ADHD and mothers without depression. The Specific Affect Coding System, 20-code version was used to code interactional affect, including positive engagement, negative engagement, negative disengagement, and neural affect. There were no statistically significant group-by-context interaction effects or group effects on all affective variables between the group of children with ADHD and mothers without depression and the group of children without ADHD and mothers without depression. Stimulant medication may account for these nonsignificant findings. No significant difference of positive affect between neutral and conflict-solving contexts was observed in depressed mothers whose children were diagnosed as ADHD. Children with ADHD whose mothers were depressed were less positive in their parent–child interaction compared with children in the other groups. Maternal depression may play an important role in the affective presentation of dyads of children with ADHD and mothers with depression. Implications for clinical practice and future research are provided.     

Predictors of treatment outcome in adults with ADHD treated with OROS® methylphenidate

Background

We conducted a post-hoc analysis of the Long-Acting MethylpheniDate in Adult attention-deficit hyperactivity disorder (LAMDA) study to investigate predictors of response in adults with ADHD randomly assigned to Osmotic Release Oral System (OROS)^®-methylphenidate hydrochloride (MPH) 18, 36 or 72 mg or placebo.

Methods

LAMDA comprised a 5-week, double-blind (DB) period, followed by a 7-week, open-label (OL) period. A post-hoc analysis of covariance and a logistic regression analysis were undertaken to detect whether specific baseline parameters or overall treatment compliance during the double-blind phase contributed to response. The initial model included all covariates as independent variables; a backward stepwise selection method was used, with stay criteria of p < 0.10. Six outcomes were considered: change from baseline CAARS:O-SV (physician-rated) and CAARS:S-S (self-report) scores at DB and OL end points, and response rate (≥ 30% decrease in CAARS:O-SV score from baseline) and normalization of CAARS:O-SV score at DB end point.

Results

Taking into account a significant effect of OROS^®-MPH treatment versus placebo in the original analysis (p ≤ 0.015), across the outcomes considered in this post-hoc analysis, higher baseline CAARS scores were most strongly predictive of superior outcomes. Male gender and lower academic achievement were also predictive for improved results with certain outcomes.

Conclusions

Several baseline factors may help to predict better treatment outcomes in adults receiving OROS^®-MPH; however, further research is required to confirm these findings and examine their neurobiological underpinnings.     

Risk of violence of inpatients with severe mental illness – Do patients with schizophrenia pose harm to others?

Individuals suffering from schizophrenia are frequently considered to be dangerous. The current longitudinal chart review was carried out to investigate the diagnostic mix of patients who were admitted to the Department of Psychiatry and Psychotherapy at the Medical University Innsbruck due to risk of harm to others. The sample consisted of all adult inpatients admitted to psychiatric acute care units in the years 1992, 1997, 2002, and 2007. Data collection included diagnoses, criteria for risk of harm to others, and the use of mechanical restraint. Altogether, 7222 admissions were reviewed. Of these, 529 patients had to be admitted to a locked unit because of risk of harm to others. Among those mechanical restraint was more often used in patients with organic mental disorders, Cluster B personality disorders, and mania than in patients with schizophrenia. Patients suffering from schizophrenia with comorbid psychoactive substance use constitute a potentially harmful population and are therefore frequently admitted to locked units due to risk of harm to others. However, in the current study additional coercive measures were more commonly applied in patients suffering from personality disorders and organic mental disorders.     

Is usage of hypnotics associated with mortality?

ObjectiveTo investigate the influence of hypnotic usage on all-cause and cause-specific mortality in a middle-aged population.MethodsA cohort of 1750 men and 1773 women aged 30–65 years who responded to a postal questionnaire in 1983. The questionnaire included questions about hypnotic usage, sleep duration, sleep complaints, medical conditions, depression, demographic and life style variables. Mortality data for the period 1983–2003 were collected.ResultsRegular hypnotic usage was reported by 1.7% of men and 2.2% of women, and was associated with short sleep, sleeping difficulties, several health problems and depression. During the 20-year follow-up period 379 men (21.5%) and 278 women (15.5%) died. After adjustment for potential risk factors in multivariate analyses regular hypnotic usage was associated with significantly increased risk of all-cause mortality in men (Hazard ratios [HR], 4.54; 95% confidence interval [CI], 2.47–8.37) and in women 2.03 (95% CI, 1.07–3.86). With regard to cause-specific mortality, regular hypnotic usage in men was a risk factor for coronary artery disease death, cancer death, suicide and death from “all remaining causes.” In women it was a risk factor for suicide.ConclusionsOur results show an increased risk of all-cause mortality and cause-specific mortality in regular users of hypnotics.     

Correlation of cognitive function with acetylcholinesterase activity and P300 event-related potential of patients with type 2 diabetes mellitus

IN T R O D U C T IO N Although studies dem onstrate thattype 2 diabetes m ellitus is signifi- cantly correlated w ith cognitive im pairm ent[1,2],its pathogenesis is still unclear.Itis reported thatm ild cognitive im pairm ent(M C I) is correlat- ed w ith…     

Are patients with schizophrenia under-treated with second-generation antipsychotics? A pilot study of the prescription practices of German psychiatrists

INTRODUCTION: Patients' and relatives' associations, psychiatrists, and pharmaceutical companies are complaining about a deficiency in the care of psychiatric patients with innovative medications in Germany. They estimate that only about 10- 30 % of all patients with schizophrenia receive second-generation antipsychotics, a figure that lies significantly below the international average. METHODS: In order to determine the frequency of use of second-generation antipsychotics in the actual care of schizophrenic patients, we conducted the following investigations:--Discharge papers of schizophrenic inpatients from a university hospital and from a district hospital were studied with regard to the antipsychotic discharge medication.--Practicing psychiatrists were contacted and asked whether during the first 3 months after discharge they had continued the antipsychotic discharge medication that was proposed by the hospital. RESULTS: The investigation of a total of 200 discharge papers and the subsequent questioning of the psychiatrists who carried out the follow-up treatment showed that 166 patients (83 %) received a second-generation antipsychotic upon discharge. Only 5 % of these patients were switched to conventional antipsychotics in the outpatient treatment. Thus, contrary to our expectations, there was no noteworthy change from second-generation to classical antipsychotics. DISCUSSION: Therefore, in the sample analyzed the second-generation antipsychotics were far more frequently prescribed than would have been expected according to general estimates, and it was not possible to verify the often-heard complaints of an under-treatment with second generations in this study. Our findings suggest, however, that only 60 % of the patients still receive their discharge medication 3 months after discharge from the hospital. This raises the important question as to how continuity of the antipsychotic treatment could be better ensured.     

Case of Aicardi-Goutières syndrome with long-lasting increase of cerebrospinal interferon-alpha

Aicardi-Goutières syndrome is a rare progressive encephalopathy characterized by a typical clinical picture, bilateral basal ganglia calcifications, leukodystrophy and brain atrophy, lymphocytosis, and elevated interferon-alpha in the cerebrospinal fluid. Among the cases described to date, variability in the clinical expression or in the cerebrospinal fluid abnormalities has been reported. We present a case with a delayed diagnosis at the age of 8 years, when brain computed tomography was done because there was no first image from the age of 8 months, when the disease started. Symmetric basal ganglia calcifications were visualized and led to purposeful investigation of the cerebrospinal fluid. It revealed an interferon-alpha titer of 103 IU/mL, which, together with the progressive brain damage and disease course, was crucial for the diagnosis. This rare finding of long-term highly elevated interferon-alpha in the cerebrospinal fluid is discussed with respect to the clinical course.     

Are needs and satisfaction of care associated with quality of life?

Is the quality of life of severe mentally ill patients influenced by the intensity of the care provided, their satisfaction with services and/or the amount of unmet needs? The interrelatedness of these three outcome measures was investigated in a sample of 101 patients dependent on long-term psychiatric care in the Northeast of the Netherlands. Instruments used were the Camberwell Assessment of Needs, the Verona Service Satisfaction Schedule and a health related quality of life instrument, the EuroQoL. Quality of life was unrelated to satisfaction with services but was strongly associated with unmet needs in the area of mental and physical health, and of rehabilitation. Quality of life decreased as needs increased. Needs were also strongly related to diagnosis and cognitive functioning. Furthermore, more intensive care settings were provided as needs increased. Demographic, diagnostic and treatment variables did not explain much extra variance in quality of life. Despite the availability of various services in the region there was a lack of tailor made care which took into account specific unmet needs with regard to information, social contacts, and daily activities.