The thyrotropin-releasing hormone and dexamethasone suppression tests in the familial classification of depression

Eighty-eight depressed patients who had received a dexamethasone suppression test (DST) and thyrotropin-releasing hormone (TRH) test were divided into four subgroups based on family history of psychiatric illness. Nonsuppression on the DST was found in 46% of familial pure depressive disease (FPDD) patients, 38% of sporadic depressive disease (SDD) patients, 38% of depressive spectrum disease (DSD) patients, and 50% of mixed depressive disease patients (patients with both a first degree relative with alcoholism and one with depression). A blunted thyroid-stimulating hormone response to TRH was found in 50% of FPDD patients, 56% of SDD patients, 47% of DSD patients, and 56% of mixed depressive disease patients. Neither the DST nor TRH test was found to distinguish significantly among the four familial subgroups of depression.     

Cognitive and brain reserve in conversion and reversion in patients with mild cognitive impairment over 12 months of follow-up

Introduction: Two reserve hypotheses have been proposed to account for the observed disjunction between the degree of brain pathology and its clinical manifestations. This study investigated whether cognitive reserve (CR), taken here as educational attainment and premorbid IQ, or brain reserve (BR; i.e., brain volume) is associated with progression and regression in patients with mild cognitive impairment (MCI) over a 12-month follow-up. Method: Patients with MCI (n = 123) were prospectively enrolled. The Mini-Mental State Examination, the Japanese version of the Cognitive subscale of the Alzheimer’s Disease Assessment Scale, the Clinical Dementia Rating (CDR), the Frontal Assessment Battery, the Neuropsychiatric Inventory, magnetic resonance imaging (MRI), and quantitative single-photon emission computed tomography were performed at intake and again at 12-month follow-up. Patients were classified into three groups: no change, conversion, and reversion. Conversion was defined as a change in CDR from 0.5 to 1, and reversion as a change from 0.5 to 0. Results: Voxel-based morphometry MRI revealed no significant differences in entorhinal and hippocampal gray matter loss among the groups. Patients with reversion had higher premorbid IQ (p = .03, η_p² = .35) as measured by the Japanese version of the National Adult Reading Test, higher atrophy ratio (hippocampal volume/whole brain volume; p = .04, η_p² = .89) at baseline, and better cognitive performance (p < .001) during the 12-month follow-up than those with conversion did. There were no statistically significant differences among the three groups in terms of years of education. Conclusion: Multinomial logistic regression analysis revealed that higher CR contributed to protecting against cognitive decline during the 12-month follow-up, whereas higher BR at baseline was the strongest predictor for reversion and conversion.     

Posturography reflects clinical imbalance in Parkinson's disease

Assessment of imbalance in idiopathic Parkinson's disease (IPD) usually relies on semi‐quantitative ratings. Posturography has been proposed as an objective means to assess imbalance but its relationship to clinical disequilibrium is questionable. In this study static and dynamic posturography was performed in 58 patients with IPD and 29 healthy controls. In patients, posturography was related to performance in established clinical tests (pull‐test and tandem gait). Posturography did not differentiate between controls and patients with impaired pull‐test (IPDimb, n = 28). Patients with normal pull‐test (IPDstab n = 30) had lower sway than controls in static (P = 0.042) and dynamic posturography (P = 0.001) and also differed from patients with impaired pull‐test in static (P = 0.007) and dynamic (P < 0.001) conditions. In patients with side‐steps in tandem gait (n = 21), sway in static and dynamic posturography was increased. Sway measures did not differentiate between patients with pull‐test scores 1 and 2 or one and >1 side step in tandem‐gait, respectively. Results of ANOVA showed that variance of static posturography was related to performance in tandem‐gait (P < 0.0001) but not to pull‐test performance (P = 0.91). In contrast, dynamic posturography was related to both, tandem‐gait (P = 0.012) and pull‐test (P = 0.03). Posturographic sway is increased in patients with IPD with disturbance of tandem gait and pull‐test. Posturographic measures did not distinguish between different degrees of deficits in clinical tests. © 2010 Movement Disorder Society     

Prenatal stress in rats predicts immobility behavior in the forced swim test. Effects of a chronic treatment with tianeptine

Prenatally-stressed (PS) rats are characterized by a general impairment of the hypothalamo-pituitary-adrenal (HPA) axis and sleep disturbances indicating that this model has face validity with some clinical features observed in a subpopulation of depressed patients. The prolonged corticosterone secretion shown by PS rats in response to stress was positively correlated with an increased immobility behavior in the forced swim test. To investigate the predictive validity of this model, a separate group of animals was chronically treated with the antidepressant tianeptine (10 mg/kg i.p. for 21 days). Such chronic treatment reduced in PS rats immobility time in the forced swim test. These findings suggest that the PS rat is an interesting animal model for the evaluation of antidepressant treatment.     

MEG biomarker of Alzheimer's disease: Absence of a prefrontal generator during auditory sensory gating

Magnetoencephalography (MEG), a direct measure of neuronal activity, is an underexplored tool in the search for biomarkers of Alzheimer's disease (AD). In this study, we used MEG source estimates of auditory gating generators, nonlinear correlations with neuropsychological results, and multivariate analyses to examine the sensitivity and specificity of gating topology modulation to detect AD. Our results demonstrated the use of MEG localization of a medial prefrontal (mPFC) gating generator as a discrete (binary) detector of AD at the individual level and resulted in recategorizing the participant categories in: (1) controls with mPFC generator localized in response to both the standard and deviant tones; (2) a possible preclinical stage of AD participants (a lower functioning group of controls) in which mPFC activation was localized to the deviant tone only; and (3) symptomatic AD in which mPFC activation was not localized to either the deviant or standard tones. This approach showed a large effect size (0.9) and high accuracy, sensitivity, and specificity (100%) in identifying symptomatic AD patients within a limited research sample. The present results demonstrate high potential of mPFC activation as a noninvasive biomarker of AD pathology during putative preclinical and clinical stages. Hum Brain Mapp 38:5180–5194, 2017. © 2017 Wiley Periodicals, Inc.     

D-Dimer test in cancer patients with suspected acute pulmonary embolism

BACKGROUND: The safety of a D-dimer (DD) measurement in cancer patients with clinically suspected pulmonary embolism (PE) is unclear. OBJECTIVES: The aim of this study was to assess the accuracy of the DD test in consecutive patients with clinically suspected PE with and without cancer. METHODS: The diagnostic accuracy of DD (Tinaquant D-dimer) was first retrospectively assessed in an unselected group of patients referred for suspected PE (n = 350). Subsequently, the predictive value of the DD was validated in a group of consecutive inpatients and outpatients with clinically suspected PE prospectively enrolled in a management study (n = 519). The results of the DD test in cancer patients were assessed according to the final diagnosis of PE and the 3-month clinical follow-up. RESULTS: In the first study group, DD showed a sensitivity and a negative predictive value (NPV) of 100% and 100% in patients with cancer and 97% and 98% in those without malignancy, respectively. In the validation cohort, the sensitivity and NPV of DD were both 100% (95% CI 82%-100% and 72%-100%, respectively), whereas in patients without malignancy, the corresponding estimates were 93% (95% CI 87%-98%) and 97% (95% CI, 95%-99%), respectively. The specificity of DD was low in patients with (21%) and without cancer (53%). CONCLUSIONS: A negative DD result safely excludes the diagnosis of PE in patients with cancer. Because of the low specificity, when testing 100 patients with suspected PE, a normal DD concentration safely excludes PE in 15 patients with cancer and in 43 patients without cancer.     

Evaluation of the rapid RIDAQUICK Campylobacter® test in a general hospital

The study objective was to evaluate the effectiveness of the new rapid immunochromatographic test RIDAQUICK Campylobacter® (r-biopharm AG, Darmstadt, Germany) for the qualitative detection of Campylobacter antigens in pathologic feces from primary and specialist care patients. Three hundred feces samples were studied from patients with diarrhea, 50.6% from adults and 49.4% from children, which were received by our microbiology laboratory for coproculture. Campylobacter culture results, with or without PCR data, served as reference values for the comparative evaluation of RIDAQUICK Campylobacter® findings. Campylobacter was detected in 12.3% of samples. The diagnostic accuracy values of the RidaQuick Campylobacter® versus culture were: sensitivity of 87%, specificity of 97%, and positive and negative predictive values of 77% and 98%, respectively. RIDAQUICK Campylobacter® is a rapid test for the diagnosis of enteritis due to Campylobacter and could be an option for the clinical diagnosis of one of the main causes of bacterial enteritis in resource-limited settings.     

Long recovery times improve the detection of cellular resistance in vitro

In vitro cytotoxicity testing is used increasingly during the development of clinical treatment protocols. These tests are influenced by many variables, not all of which have been assessed systematically yet. We analyzed the influence of the recovery time between the end of treatments and measurements on the detection of cellular resistance. The development of resistance to cisplatin and radiation was chosen as a model since the schedule of these treatments is the objective of several ongoing clinical trials. C6 rat glioma, T98G, 86HG-39, A172 human glioma and TE671 human rhabdomyosarcoma cells were pretreated with radiation or cisplatin. The cellular resistance was then compared in pretreated and wild-type cells using the 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) test. In all cell lines, apparent drug concentrations killing 50% of the cells were dependent on the recovery time. In A172 cells this concentration was 10.3 ± 02.1 μM after 48 h but decreased to 3.56 ± 0.44 μM after 120 h recovery time (P < 0.001). After recovery times of more than 168 h, 53% of all pretreated cell lines were resistant to cisplatin or radiation, 25% were unchanged and 22% were more sensitive. However, only half the resistant cells could be identified when the MTT test was done with only 48 h recovery time. The sensitivity of detection increased from 0.46 to 0.83 when the recovery time of the test system was extended from 48 h to 168 h. The specificity was not dependent on the recovery time. Experi-ments showing resistance after short recovery times are reliable, but lack of resistance can only be shown in experiments with long recovery times. Cisplatin treatment can result in resistance to radiation in glioma cells. Received: 7 March 1997 / Accepted: 18 March 1998     

Quantitative sensory testing and pain tolerance in patients with mild to moderate Alzheimer disease compared to healthy control subjects

Patients with Alzheimer disease (AD) report pain less frequently than their cognitively intact peers. It has been hypothesized that pain processing is altered in AD. The aim of this study was to investigate agreement and reliability of 3 pain sensitivity tests and to examine pain threshold and tolerance in patients with AD. We examined 29 patients with mild to moderate AD and 29 age- and gender-matched healthy control subjects with quantitative sensory testing, ie, assessments of detection threshold (warmth detection threshold [WDT]) and pain threshold (heat pain threshold [HPT], pressure algometry, cold pressor test), and assessments of tolerance (pressure algometry, cold pressor test). All procedures were done twice on day 1, 1 hour apart, and repeated on day 2. We found no difference between groups for WDT (patient vs control subjects: mean [95% confidence interval]: 35.5°C [33.4°C to 37.6°C] vs 35.4°C [34.3°C to 36.5°C], P = .8) or HPT (41.2°C [40.0°C to 42.4°C] vs 42.3°C [41.1°C to 43.5°C], P = .24). We observed comparable thresholds for pressure algometry (median [25% to 75% interquartile range]: 120 kPa [100 to 142 kPa] vs 131 kPa [113 to 192 kPa], P = .10), but significantly lower tolerance in AD patients (213 kPa [188 to 306 kPa] vs 289 kPa [262 to 360 kPa], P = .008). No differences were found for the cold pressor test. The study demonstrated good replicability of the sensory testing data with comparable data variability, for both groups, which supports the use of these methods in studies of patients with mild to moderate AD. Contrary to previous studies, we observed a reduced pain tolerance in patients with mild to moderate AD, which suggests that the reduced report of pain cannot be explained by reduced processing of painful stimuli.