Increased positive thought disorder with illness duration in patients with schizophrenia

It is unclear whether the severity of positive formal thought disorder, a core clinical feature of schizophrenia, is stable or worsening through the chronic course of the illness. The neurocognitive basis for positive thought disorder also remains unclear. The aim of the present paper was to examine the relationship between thought disorder as measured by the Thought Disorder Index (TDI) and duration of illness and neuropsychological indices in 79 patients with schizophrenia. TDI scores increased in proportion to illness duration. TDI scores were not associated with verbal memory or executive functioning. These results indicate an ongoing worsening of positive thought disorder through the course of illness in schizophrenia.     

Disrupted integrity of the fornix is associated with impaired memory organization in schizophrenia

BACKGROUND: The fornix is a major projection of the hippocampus to and from other brain regions. A previous diffusion tensor imaging (DTI) study has reported disrupted integrity of the fornix in patients with schizophrenia. However, functional significance of the DTI abnormalities of the fornix in schizophrenia has not been fully studied yet. We investigated an association between DTI abnormalities of the fornix and impairment of memory organization in schizophrenia. METHODS: Thirty-one patients with schizophrenia and 65 age- and gender-matched healthy controls underwent DTI, and fractional anisotropy (FA) and mean diffusivity (MD) were measured in cross-sections of fornix tractography. In addition, all of the patients and 32 controls performed a verbal learning task specialized for evaluating memory organization, the verbal memory subscale of the Wechsler Memory Scale-Revised, the category- and letter fluency tests, and the Japanese version of National Adult Reading Test. RESULTS: Statistically significant reduction of FA and increase of MD were found in the fornix of patients with schizophrenia compared with controls with no significant lateralization. A significant patients-specific correlation was found between increased MD in the left fornix and lower scores on utilization of semantic organization in the verbal learning task. In addition, increased MD in the right fornix showed a patients-specific association with poorer performance on the category fluency test, which indexes organization of long-term semantic memory. These patients-specific correlations, however, were not statistically lateralized to either hemisphere. CONCLUSIONS: These results indicate that disrupted integrity of the fornix contributes to impaired memory organization in schizophrenia.     

Preattentive dysfunction in bipolar disorder: A MEG study using auditory mismatch negativity

Background

Neuropsychological studies have demonstrated that cognitive dysfunction represents pathophysiological mechanisms underlying bipolar disorder. However, information processing deficits in bipolar disorder have not often been examined electrophysiologically. Here, we examined preattentive processing and sensory information processing using mismatch field (MMNm) and P1m components, respectively, using magnetoencephalography.

Methods

Ten patients with bipolar disorder and 20 healthy volunteers participated in the study. The participants were presented with auditory stimuli sequences comprising standard and deviant stimuli. MMNm was elicited in response to changes in duration and frequency of pure-tone stimuli and a vowel across-category change.

Results

The magnetic global field power of MMNm in the right hemisphere under the pure-tone condition was significantly delayed in patients with bipolar disorder compared to healthy volunteers, and that of P1m did not differ between the two groups. The MMNm dipole in the left hemisphere was located inferior in patients with bipolar disorder than in healthy volunteers. This finding did not correlate with clinical symptoms.

Conclusions

Information processing at the preattentive level is impaired in patients with bipolar disorder irrespective of clinical symptoms, and this dysfunction is not due to sensory level dysfunction. The quality of preattentive information processing impairment is different between patients with bipolar disorder and patients with major depressive disorder, as shown by the MMNm latency and power differences.     

Aging in the CNS: comparison of gray/white matter volume and diffusion tensor data

This study investigated the global and regional effects of aging on brain volume, mean diffusivity (MD), and fractional anisotropy (FA) in 73 normal female subjects using voxel-based analysis. On a global scale, gray matter volume and FA were negatively correlated, whereas MD was positively correlated with age. Voxel-wise analyses showed brain volume and FA were negatively correlated predominantly in anterior structures, whereas MD was positively correlated in the cortical gray matter and periventricular white matter. Volume preservation was observed in the cingulate gyrus and subjacent white matter. FA increase was observed in the putamen. Voxel-based direct comparisons of volume and diffusion properties showed FA was more strongly negatively correlated in the fronto-temporal white matter, compared with volume and MD. Stronger positive correlation of MD was observed in the thalamus, caudate nucleus, and midbrain and stronger negative correlation of brain volume was observed in the frontal lobe and basal ganglia, compared with the other. These results indicate that diffusion properties and brain volume are complementary markers to the effects of aging.     

Tract-specific analysis of the superior occipitofrontal fasciculus in schizophrenia

Diffusion tensor imaging has been highlighted as a non-invasive tool to explore neural connectivity in vivo. Several studies have suggested disorganization of the neural network (circuitry) including the thalamo-prefrontal connection in schizophrenia. Recent research using post-mortem brains showed that the superior occipitofrontal fasciculus (SOFF) fibers extended to the thalamus. We postulated that the SOFF has some relationship with the anatomical structural components of the thalamo-prefrontal circuitry. We quantitatively assessed the diffusion abnormalities of the SOFF using diffusion tensor tractography (DTT) in schizophrenia. Nineteen male patients with schizophrenia and 20 age-matched normal controls were studied. DTT of the SOFF (DTT-SOFF) was visualized using free software (dTV II/VOLUME-ONE), and we performed tract-specific measurement of the fractional anisotropy (FA), then calculated the apparent diffusion coefficient (ADC) of the DTT-SOFF. Tractography and tract-specific analysis of the SOFF were successfully performed in all subjects. All tracts appeared to be connecting the prefrontal area to the thalamus. The mean FA value of patients with schizophrenia [0.376 (S.D. 0.030)] was significantly lower than that of controls [0.432 (S.D. 0.032)], and the ADC value of patients with schizophrenia [0.771 (× 10^− 3 mm²/s) (S.D. 0.041)] was significantly higher than that of controls [0.726 (× 10^− 3 mm²/s) (S.D. 0.027)]. Our results suggest that the so-called SOFF may be a structural component connecting the prefrontal area to the thalamus and that it is deteriorated in schizophrenia.     

Electrophysiological abnormalities of spatial attention in adults with autism during the gap overlap task.

OBJECTIVE: We evaluated event-related potentials (ERPs) elicited by attentional disengagement in individuals with autism. METHODS: Sixteen adults with autism, 17 adults with mental retardation and 14 healthy adults participated in this study. We recorded the pre-saccade positive ERPs during the gap overlap task under which a peripheral stimulus was presented subsequent to a stimulus in the central visual field. Under the overlap condition, the central stimulus remained during the presentation of the peripheral stimulus and therefore participants need to disengage their attention intentionally in order to execute the saccade to the peripheral stimulus due to the preservation of the central stimulus. RESULTS: The autism group elicited significantly higher pre-saccadic positivity during a period of 100-70 ms prior to the saccade onset than the other groups only under the overlap condition. The higher amplitude of pre-saccadic positivity in the overlap condition was significantly correlated with more severe clinical symptoms within the autism group. CONCLUSIONS: These results demonstrate electrophysiological abnormalities of disengagement during visuospatial attention in adults with autism which cannot be attributed to their IQs. SIGNIFICANCE: We suggest that adults with autism have deficits in attentional disengagement and the physiological substrates underlying deficits in autism and mental retardation are different.     

The Usefulness of Endoscopic Color Doppler Ultrasonography (ECDUS) for Endoscopic Injection Sclerotherapy (EIS)

Abstract: We studied 12 patients using endoscopic injection sclerotherapy (EIS) guided by endoscopic color Doppler ultrasonography (ECDUS). The ECDUS was performed with a PENTAX FG-32UA (7.5MH2, convex type) and a HlTACHl EUB 565 as a display machine. The EIS needle, as well as changes in intramural blood flow before and after EIS were clearly observed with the ECDUS. When the sclerosant was injected properly into the esophageal varices, the blood flow in the esophageal varices could not be detected with color Doppler flow imaging nor with fast-Fourier transform (FFT) analysis. Therefore EIS was safely performed with an adequate volume of sclerosant having been accurately injected into the varices. Of the disadvantages of this technique, the forceps channel was found to be a bit narrow, and the anterior view was somewhat oblique. Even so, EIS guided by ECDUS is surely a promising method for the treatment of esophageal varices, especially once the technical difficulties are overcome. (Dig Endosc 1994; 6 : 39–44)     

An Application of Endoscopic Color Doppler Ultrasonography (ECDUS) in the Diagnosis of Hemodynamics of Gastric Varices,and the Therapeutic Effect of Endoscopic Therapy

Abstract: We studied 14 patients using endoscopic color Doppler ultrasonography (ECDUS) to evaluate the hemodynamics of gastric varices, and evaluated the endoscopic therapeutic effects on gastric varices in 8 patients. Three patients had F₃ type gastric varices and eleven had F₂. The ECDUS was performed with a PENTAX FG-32UA (7.5MHz, convex type) and a HITACHI EUB 565 was used as a display machine. The intramural blood flow in the gastric varices and inflows from the extra-gastric wall were clearly observed with the ECDUS in all 14 patients. The extramural blood flow (gastro or spleno-renal shunts) was detected in 9 of 14 patients. The velocity of the intramural flow in tumorous type varices (F₃) was higher than in the nodular or flat elevated type (Fa). Next, we evaluated the therapeutic effects on gastric varices of the ECDUS. The successful disappearance of intramural blood flow was observed in 6 of 8 patients who had this endoscopic therapy. In two of the 8 patients, there was not enough therapeutic effect on the intramural blood flow. The extramural blood flow, however, did not change before or after endoscopic therapy with the ECDUS. Therefore, we concluded that ECDUS is a very useful modality for the diagnosis of hemodynamics and to evaluate the therapeutic effects on gastric varices.     

Combined therapy after superselective arterial cisplatin infusion to treat maxillary squamous cell carcinoma

OBJECTIVE: We sought to assess the efficacy of combined therapy after superselective arterial cisplatin infusion (SACI) therapy to treat the maxillary squamous cell carcinoma. STUDY DESIGN: We conducted a retrospective chart review of 50 patients. After completion of two courses of SACI, 25 of the patients were successively treated by concurrent SACI and radiotherapy (AR), while the other 25 patients were treated by surgery with postoperative radiotherapy (ASR). RESULTS: Patients with surgery (ASR) had an 88% local control rate with 75% disease-free survival rate at 60 months by Kaplan-Meier analysis, compared with 62% disease-free survival rate for patients with AR treatment. A particularly good outcome was obtained in T4 cases of the ASR group (n=8) whose 5-year survival rate was 87% and local control rate was 100%. CONCLUSION/SIGNIFICANCE: Combined SACI therapy is very effective for the treatment of maxillary squamous cell carcinomas and contributes to the improving prognoses of patients and organ preservation rates.