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OBJECTIVE: To analyze a complex of EEG parameters and quantitative clinical evaluations of depressive-delusional conditions in patients with schizoaffective disorder and to clarify their neurophysiological mechanisms. MATERIAL AND METHODS: A study included 25 female patients, aged 22-40 years, with depressive-delusional conditions. Patients were assessed at baseline and after 4-6 weeks of treatment using HDRS and PANSS. EEG was recorded at each visit. RESULTS: Significant correlations were revealed between the values of pre-treatment background EEG spectral power in narrow frequency bands and quantitative pre-treatment and post-treatment scores of patient's clinical conditions. CONCLUSION: The results allow clarifying the brain mechanisms of depressive-delusional disorders and reveal possible EEG-predictors of therapeutic response in its treatment.
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Trastornos Psicóticos , Adulto , Encéfalo , Electroencefalografía , Femenino , Humanos , Adulto JovenRESUMEN
AIM: To determine a therapeutic effect of agomelatine (valdoxan) on post-schizophrenic depression (PSD), taking into account its psychopathological structure. MATERIAL AND METHODS: A total of 33 patients of both sexes (average age was 32.1 yrs) with symptoms of post-schizophrenic depression (F20.4 according to ICD-10) were examined by using clinical and psychometric methods in the dynamics of shift-like schizophrenia. HAMD-17, PANSS and CGI-S scales were applied. All the patients were subdivided into groups: mild, moderate and severe depressions. Valdoxan was used at a dose of 25-50 mg/day for 28 days along with preceding antipsychotic therapy at maintenance doses. Evaluation of the efficacy of treatment was carried out according to percentage reduction of average total score (ATS) in dynamics. RESULTS: A significant effect of valdoxan, with 73.5% of PANSS score reduction and quicker response to treatment, was identified. Therapeutic effect of valdoxan on separate components of PSD was uneven. The decrease of depressive disorders per se assessed by HAÐD-17 and PANSS G-subscale was equally high (78.4 and 78.2%, respectively). Therapeutic reduction of negative disorders according to PANSS N-subscale was the lowest, at the level of 'good' effect (53.6%). In 27.3%, negative disorders were irreversible and were assessed as schizophrenic defect; in 72.7% of patients they were diagnosed as 'secondary' negative symptoms in atypical depression. In the subgroups of mild, moderate, and severe depression, the reduction of negative disorders was 62.4; 44.2 and 60.8%, respectively, and that of total PANSS score were 81.5; 66.1, and 78.6%, i.e. there was no correlation between these variables. CONCLUSION: Agomelatin (valdoxan) is an effective medication for optimization of methods of PSD treatment, providing the therapeutic effect at the level of significant or complete reduction of symptoms. The quality (depth) and rate of formation of response in the dynamics of course treatment are determined not by the severity of depressive disorders in PSD structure, but by the ratio between negative (deficit) symptoms and 'secondary' symptoms, reflecting the degree of progression of the main disease.
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Acetamidas/uso terapéutico , Trastorno Depresivo , Esquizofrenia , Adulto , Depresión , Trastorno Depresivo/tratamiento farmacológico , Femenino , Humanos , Masculino , Escalas de Valoración Psiquiátrica , Psicopatología , Resultado del TratamientoRESUMEN
AIM: To assess the efficacy and safety of pantogam active (PA) in prevention and correction of neurological side-effects during the course neuroleptic treatment of acute endogenous psychoses. MATERIAL AND METHODS: Eighty schizophrenic patients (mean age 33 years) with acute psychosis were examined. All patients received 28-day course treatment with typical and atypical neuroleptics. Two equal groups were studied: patients of the first group were treated with trihexyphenidyl (THP) in dose of 0,002-0,012 mg and patients of the second group received in addition PA in dose 0,9 mg/day. Clinical-observation, psychometric scales (PANSS, CGI-S, UKU) were administered at baseline and in 1st,3rd,7th, 14th, 21st, 28st day. RESULTS: PA in the combination with THP improved tolerability to neuroleptic therapy in whole and exerted the better correction effect on neuroleptic extrapyramidal disorders (EPD) compared to THP monotherapy. The number of patients with ERD was reduced by 1.5 times and prevention of EPD was observed 3 times more frequent in the group treated with PA. In the THP group, other adverse effects (AE) were 1,7 times more frequent and the total AE score was 2,5 times greater compared to the PA group (131 vs 50). Correction and preventive effects of the combined treatment on the clinically severe symptoms of EPD (akathisia, muscle dystonia) were more frequent in patients treated with typical neuroleptics. A less amount of THP (by 1,2 times) was used to stop EPD in the PA group. CONCLUSION: PA in the combination with THP has demonstrated the clear neuroprotective effect on the development, frequency and clinical presentations of neurological side-effects. The Ð Ð can be recommended as a drug of choice for correction and prevention of neuroleptic side-effects, it promotes their tolerability and improves quality of life during the course treatment.
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Antipsicóticos/efectos adversos , Enfermedades de los Ganglios Basales/inducido químicamente , Enfermedades de los Ganglios Basales/tratamiento farmacológico , Nootrópicos/uso terapéutico , Ácido Pantoténico/análogos & derivados , Esquizofrenia/tratamiento farmacológico , Trihexifenidilo/efectos adversos , Ácido gamma-Aminobutírico/análogos & derivados , Adolescente , Adulto , Antipsicóticos/uso terapéutico , Enfermedades de los Ganglios Basales/prevención & control , Quimioterapia Combinada , Femenino , Humanos , Masculino , Persona de Mediana Edad , Ácido Pantoténico/uso terapéutico , Calidad de Vida , Resultado del Tratamiento , Trihexifenidilo/uso terapéutico , Adulto Joven , Ácido gamma-Aminobutírico/uso terapéuticoRESUMEN
BACKGROUND: Affective syndrome is thought to be a key feature that differentiates schizophrenia from schizoaffective disorder (SA) and bipolar disorder with psychotic features (BDP). However genetic underpinnings of these differences remain unresolved. OBJECTIVES: We compared clinical variables of affective psychoses (SA, BDP and schizophrenia with affective symptoms (AFF SCZ)) and schizophrenia without affective symptoms (non-AFF SCZ) and searched for a genetic variant that may differentiate affective psychosis from non-AFF SCZ. METHODS: A total of 2677 subjects, including 831 patients with affective psychosis, 785 patients with non-AFF SCZ and 1061 healthy controls, were used. Clinical symptoms were assessed with the PANSS. The sample was genotyped for 5-HTTLPR polymorphism of the serotonin transporter gene. RESULTS: The diagnostic groups differed significantly on demographic and clinical variables. The percentage of men was higher, the current age and age at illness onset were lower in non-AFF SCZ and SA compared to AFF SCZ and BDP. The severity of positive and negative symptoms decreased significantly from group to group in the following manner: non-AFF SCZ>AFF SCZ>SA>BDP. There was the association between 5-HTTLPR polymorphism and affective psychosis (p=0.01). The frequency of the SS genotype was higher in the affective psychosis group compared to non-AFF SCZ and controls. No differences in the genotype distribution were identified between the non-AFF SCZ group and controls. LIMITATIONS: Difficulties in the differentiation between non-AFF SCZ and AFF SCZ or SA and between AFF SCZ and SA due to uncertain diagnostic boundaries between these conditions. CONCLUSIONS: SA is intermediate between non-AFF SCZ and BDP in the severity of positive and negative symptoms. The first episode patients, carriers of the SS genotype have a higher risk of developing affective psychosis than non-AFF SCZ. This finding carries implications for the prognosis of psychosis outcomes in the first-episode patients.
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Trastornos Psicóticos Afectivos/genética , Polimorfismo Genético , Esquizofrenia/genética , Proteínas de Transporte de Serotonina en la Membrana Plasmática/genética , Adulto , Femenino , Genotipo , Humanos , Masculino , Trastornos Psicóticos/genética , Federación de RusiaRESUMEN
OBJECTIVE: To search for the association between the GRIN2B gene and signs of thought and speech disorders which may be the result of decreased accessibility to the mental lexicon. MATERIAL AND METHODS: The association between the GRIN2B polymorphism rs7301328 with semantic verbal fluency and five symptoms of thought and speech disorders, as assessed with the PANSS, was studied in 552 patients with schizophrenia-spectrum disorders. RESULTS AND CONCLUSION: There was the association of the GRIN2B gene with verbal fluency and the PANSS item «Difficulty in Abstract Thinking¼. The association was not modified by verbal fluency. The results suggest that the GRIN2B gene may modify the linguistic processes involved in the retrieval of information from the mental lexicon on the basis of semantic traits and, moreover, contribute to the variability of clinical symptoms of impairment of abstract thinking in patients with schizophrenia. The heterozygous genotype may be protective against the development of thought and speech disorders.
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Receptores de N-Metil-D-Aspartato/genética , Esquizofrenia/genética , Esquizofrenia/fisiopatología , Psicología del Esquizofrénico , Trastornos del Habla/genética , Pensamiento , Conducta Verbal , Adolescente , Adulto , Anciano , Femenino , Humanos , Masculino , Persona de Mediana Edad , Pruebas Neuropsicológicas , Semántica , Adulto JovenRESUMEN
OBJECTIVE: To study neurophysiologic correlates of the severity of clinical conditions and to search for possible predictors of therapeutic response in attack-like schizophrenic patients with delusional disorders. MATERIAL AND METHODS: During the treatment of 40 attack-like schizophrenic patients (all females, right-handed, aged 20--50 years old) with delusional disorders, clinical symptoms were quantitatively assessed using PANSS. Resting EEG was recorded with the consequent spectral-coherent analysis. Correlation analysis was performed at the beginning of treatment and at the stage of the development of remission. RESULTS: Significant (p<0.05) correlations between some initial (before treatment) resting EEG parameters and PANSS scores before treatment and at the stage of remission were revealed. The reduction in psychopathologic symptoms after treatment course was associated with the decrease in alpha-3 spectral power in occipital zones and increase of theta-1 and theta-2 spectral power in frontal-central regions. Besides, the number of statistically significant intra-hemispheric and inter-hemispheric links was increased in theta-1 and theta-2 frequency bands in frontal and central regions compared to initial levels. CONCLUSION: These EEG changes reflected the facilitation of cortical inhibitory processes as well as recovery of impaired intra-cortical links i.e. the normalization of the brain integrative activity.
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Deluciones/tratamiento farmacológico , Deluciones/fisiopatología , Electroencefalografía , Esquizofrenia/tratamiento farmacológico , Esquizofrenia/fisiopatología , Adulto , Femenino , Humanos , Masculino , Persona de Mediana Edad , Adulto JovenRESUMEN
OBJECTIVE: to identify a complex of neurobiological parameters informative for the assessment of severity of patient's initial clinical state and for individual prognosis of therapeutic response. MATERIAL AND METHODS: Correlation and regression analyses of clinical scores measured by the PANSS scale, resting EEG spectral parameters and immunological parameters have been performed in 45 patients (mean age 31.3±11.4 years with manic-delusional conditions in attack-like schizophrenia. RESULTS: Neurobiological data obtained before the treatment course were matched with clinical scores of the same patients at the stage of remission establishment after treatment course. The multiple linear regression equations, which contained only 3 to 4 (from 80) initial EEG parameters and one of four immunological parameters, allowed to explain with high significance from 89 to 92% of clinical scores variance before treatment course, and to predict from 72 to 87% of clinical scores variance after treatment course at the stage of remission establishment, as well. CONCLUSION: The data obtained emphasize the role of neurophysiological inhibition deficit and processes of neuroinflammation and neuroplasticity in the pathogenesis of manic-delusional conditions and may be used in practice for elaboration of methods of prediction of treatment efficacy in patients with manic-delusional disorders.
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Trastorno Bipolar/patología , Deluciones , Esquizofrenia , Adulto , Deluciones/patología , Humanos , Pronóstico , Esquizofrenia/patología , Esquizofrenia Paranoide , Psicología del Esquizofrénico , Resultado del Tratamiento , Adulto JovenRESUMEN
The present study searched for associations between gene GRIN2B (glutamate receptor, ionotropic, N-methyl-D-aspartate, subunit 2B) and component processes of verbal episodic memory in schizophrenic patients. The Rey Auditory Verbal Learning Test (RAVLT) as a part of a large neuropsychological battery was administered to 302 patients with schizophrenic spectrum disorders (sample PI). Also, 285 patients (sample P2) and 243 healthy controls (sample C2) performed the "10 words" test that measures short-term memory. The GRIN2B rs7301328 (C366G) polymorphism was genotyped for each subject. There were no associations between the polymorphism and any measure of the RAVLT either in the whole PI sample or in a subsample of patients with a severe cognitive deficit. The GRIN2B influenced immediate recall and proactive interference in the "10 words" test in the control group: homozygotes CC recalled fewer words and showed a lower effect of proactive interference than carriers of other genotypes. The results suggest that the C366G polymorphism could influence verbal episodic memory in the general population, but this influence is absent in schizophrenic patients.
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Sitios Genéticos , Memoria Episódica , Polimorfismo Genético , Receptores de N-Metil-D-Aspartato/genética , Esquizofrenia/genética , Adulto , Femenino , Humanos , Masculino , Persona de Mediana Edad , Esquizofrenia/fisiopatologíaRESUMEN
The purpose of this work was to search for associations between the serotonin receptor 2C gene (HTR2C) and the peculiarities of social behavior and social cognition in schizophrenia. To do this, patients with schizophrenia spectrum disorders and healthy control subjects were genotyped for the Cys23Ser HTR2C marker and underwent psychological examination, including assessment of Machiavellianism, recognition of emotions in facial expression, and theory of mind. In addition, we estimated the trait anxiety level as a potential factor affecting the relationship between the gene HTR2C and social behavior. We found a significant association between the Ser allele and a reduction of estimates on the Mach-LV Machiavellianism scale in the total sample of patients (n = 182) and control subjects (n = 189), which did not reach the confidence level in either of the groups. A tendency towards a HTR2C gene influence on the trait anxiety level was also revealed. The association between HTR2C and Machiavellianism was retained if the anxiety level was taken into account. The results suggest a pleiotropic effect of HTR2Con anxiety and Machiavellianism.
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Maquiavelismo , Receptor de Serotonina 5-HT2C/genética , Esquizofrenia/genética , Trastorno de la Conducta Social/genética , Adulto , Femenino , Estudios de Asociación Genética , Predisposición Genética a la Enfermedad , Genotipo , Humanos , Masculino , Polimorfismo de Nucleótido Simple/genética , Esquizofrenia/patología , Trastorno de la Conducta Social/fisiopatología , Trastorno de la Conducta Social/psicologíaRESUMEN
OBJECTIVE: To specify clinical action of venflaxine during the course treatment of patients with different depressive states of endogenous nature. MATERIAL AND METHODS: An open naturalistic study of 32 patients with different nosological forms of endogenous depression (manic-depressive psychosis, cyclothymia, schizophrenia) was carried out. Duration of the course treatment with venflaxine (velaxin) administered in daily dose of 37,5-300 mg was 56 days. Clinical and psychometric methods were used. RESULTS: Venflaxine was a highly effective antidepressant. In the end of treatment, a "good" therapeutic effect with >50% reduction in total scores on the Hamilton scale (HAMD-D) was achieved in 84,4% of patients, a "marked" effect up to complete recovery with >80% reduction in HAMD-D scores was in 78,1% of cases. CONCLUSION: Due to its clinical characteristics, venflaxine may be regarded as a multiprofile antidepressant with the distinct balanced action. In the spectrum of its antidepressant activity, a thymoleptic effect is most pronounced compared to anxiolytic and stimulating effects. This provides a high efficacy of the drug in different types of endogenous depression (anxiety, apatho-adynamic and, in particular, melancholic).
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OBJECTIVE: To analyze the therapeutic effect of valdoxan on symptoms of anhedonia in patients with endogenous depressions and to develop indications for its use. MATERIAL AND METHODS: Authors examined 30 women, mean age 35,9 years with anhedonic depression (ICD-10 items F31.3-4, F33.1-2, F20.4). Valdoxan was administered in average daily dose from 25.8 to 45.8 mg during 30 days. Patient's status was assessed on 0, 7, 14 and 30th days, using clinical and psychometric (HAMD-21, HADS, SHAPS and UKU scales) methods. The reduction of scores was used as a measure of therapeutic effect designated as «mild¼, «moderate¼, «good¼ and «marked¼. RESULTS: Antianhedonic effect of valdoxan on 30th day was superior to thymoleptic and anxiolytic effects of this drug (91.5 versus 82.2 and 76.9%). The marked effect was identified already on 14th day and enhanced to 30th day. The best effect was seen in depression of moderate severity. Single autonomic side-effects of the treatment were observed. CONCLUSION: The course treatment of anhedonic depressions with valdoxan should be considered as preferable and highly effective method that provides a dominative antianhedonic effect in the spectrum of antidepressive properties of the drug. Good and marked effects have been achieved in 96.7% of patients. The intensity and rate of its formation, good tolerability allow to tailor indications of valdoxan basing on the psychopathological characteristics of gedonic disorders.
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Acetamidas/uso terapéutico , Anhedonia/efectos de los fármacos , Antidepresivos/uso terapéutico , Trastorno Depresivo/tratamiento farmacológico , Adolescente , Adulto , Femenino , Humanos , Clasificación Internacional de Enfermedades , Masculino , Persona de Mediana Edad , Estudios Prospectivos , Escalas de Valoración Psiquiátrica , Psicometría , Resultado del Tratamiento , Adulto JovenRESUMEN
OBJECTIVE: To determine clinical and pathopsychological parameters of negative personality changes, their diagnostic and predictive significance based on the variant of neuroleptic treatment in the dynamics of remissions in shift-like schizophrenia. MATERIAL AND METHODS: Twenty-nine female patients diagnosed with ICD-10 schizophrenia (items F20.01 and F20.02) were examined. The patients were treated with typical neuroleptics (TN) or atypical (ATN) neuroleptics in the hospital and then as outpatients. Patient's state was assessed clinically and psychometrically with the PANSS at admission, at the beginning of remission and after one and two years of remission. Mean score of positive (PS) and negative (NS) symptoms was determined differentially in the dynamics basing on the neuroleptic used. Twenty-seven patients underwent experimental/pathopsychological examination. RESULTS AND CONCLUSION: In different stages of the dynamics of shift-like schizophrenia, NS had different capacity of «reversibility¼ and were distinctly associated with the illness-shaping influence of PS severity and activity and characteristics of psychotropic effect of the neuroleptics. The highest severity of NS was noted in the stage of active psychosis (up to 3.6 and 4.2 scores), with the following decrease in the beginning of remission (up to 2.3 and 2.8 scores). The most distinct trend towards the reduction of NS in the first and second years of remission (up to 2.0-1.0 scores), along with a trend to the complete reduction of PS, was identified in patients treated with ATN. In patients treated with TN, the severity of NS was relatively stable in all stages of remission, with a trend towards the increased severity (up to 2.8 and 3.2 scores) with the stable reduction of PS to1.6 scores. The distinct property of ATN to exert the reducing psychotropic effect on NS and the lack of antinegative effect in the antipsychotic spectrum of TN is discussed.
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The 5-HTTLPR SLC6A4 and catechol-o-methyltransferase (COMT) Val158Met polymorphisms are reported to be associated with processing of facial expressions in general population. Impaired recognition of facial expressions that is characteristic of schizophrenia negatively impacts on the social adaptation of the patients. To search for molecular mechanisms of this deficit, we studied main and epistatic effects of 5-HTTLPR and Val158Met polymorphisms on the facial emotion recognition in patients with schizophrenia (n=299) and healthy controls (n=232). The 5-HTTLPR polymorphism was associated with the emotion recognition in patients. The ll-homozygotes recognized facial emotions significantly better compared to those with an s-allele (F=8.00; p=0.005). Although the recognition of facial emotions was correlated with negative symptoms, verbal learning and trait anxiety, these variables did not significantly modified the association. In both groups, no effect of the COMT on the recognition of facial emotions was found.
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Emociones , Expresión Facial , Polimorfismo de Nucleótido Simple , Psicología del Esquizofrénico , Proteínas de Transporte de Serotonina en la Membrana Plasmática/genética , Adulto , Alelos , Estudios de Casos y Controles , Epistasis Genética , Femenino , Homocigoto , Humanos , MasculinoRESUMEN
To analyze the possibility of using immunological parameters for the assessment of the activity of the process and prediction of the quality and completion of remission, we compared the dynamics of clinical and immunological parameters in 76 patients with endogenous attack-like psychoses during pharmacotherapy of a psychotic episode. Authors confirmed evidence for the activation of innate and adaptive immunity in the acute stage of psychosis as well as the correlation between immunological parameters (leukocyte elastase (LE) activity, alpha(1)-proteinase inhibitor (alpha(1)-PI), the level of autoantibodies to nerve growth factor (Aab-NGF)) and clinical symptoms assessed with the PANSS. The improvement of the clinical state assessed by the reduction in PANSS total score was noted in all patients though there were variations in the dynamics of immunological parameters. The increase of immunological parameters, along with the absence of changes at the discharge from the hospital, suggests that the remission was of low quality and the pathological process did not attenuate. Outpatient examination revealed the different dynamics of psychopathological disorders: stable state in 50% patients, moderate worsening of psychological state in 50% patients. Worsening of clinical symptoms after the discharge and in the outpatient stage was correlated with the elevation of the activity/level of immunological parameters. The changes in LE activity and Aab-NGF level precede the changes in mental state of patients in the following 1-2 months. These parameters may be used for monitoring of patients and prediction of quality and completion of remission.
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Monitorización Inmunológica , Trastornos Psicóticos/diagnóstico , Trastornos Psicóticos/inmunología , Inmunidad Adaptativa , Adulto , Anciano , Femenino , Humanos , Elastasa de Leucocito/inmunología , Masculino , Persona de Mediana Edad , Factor de Crecimiento Nervioso/inmunología , Pronóstico , Adulto Joven , alfa 1-Antitripsina/inmunologíaRESUMEN
With the aim to study neurophysiologic correlates and to search for some possible predictors of therapeutic response correlation analysis has been carried out of links between temporal parameters of components of auditory event-related potentials (AERPs) and dynamics of quantitative clinical assessments of mental state conditions in two groups of patients--with depressive-delusional conditions (group 1) and with manic-delusional conditions (group 2) in the frames of attack-like schizophrenia. Statistically significant correlations have been revealed between values of peak latencies of main AERPs components and severity of psychopathologic symptoms before beginning of treatment course, as well as between initial (before treatment course) AERPs temporal parameters and quantitative clinical assessments at the stage of remission establishment. Larger severity of residual positive, negative and common psychopathologic symptoms of schizophrenia (and also of depression and anxiety in group 1) after course of treatment was associated with smaller initial (before treatment course) values of peak latencies of "early" (P1 and N1) and with larger initial values of "late" (P2, N2 and P3) AERPs components in both groups of patients. The data obtained allow to justify basic views on brain mechanisms of affective-delusional disorders, and to reveal possible neurophysiologic predictors of treatment efficacy in such disorders.
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Trastornos Psicóticos Afectivos/fisiopatología , Trastornos Psicóticos Afectivos/terapia , Trastorno Bipolar/fisiopatología , Trastorno Bipolar/terapia , Deluciones/fisiopatología , Deluciones/terapia , Potenciales Evocados Auditivos , Estimulación Acústica , Adulto , Trastornos Psicóticos Afectivos/psicología , Trastorno Bipolar/psicología , Interpretación Estadística de Datos , Deluciones/psicología , Femenino , Humanos , Persona de Mediana Edad , Pruebas Neuropsicológicas , Estimulación Luminosa , Índice de Severidad de la Enfermedad , Adulto JovenRESUMEN
Neurotoxic products produced during tryptophan metabolism via the kynurenine pathway could be involved in schizophrenia pathogenesis. It has been shown that kynurenine-3-monooxygenase (KMO) is indirectly involved in these products' formation. KMO polymorphic loci rs2275163 (C/T) and rs1053230 (A/G) were examined in 187 schizophrenia patients and 229 healthy subjects. A genetic combination of allele T and genotype GG was observed more often in a patient group compared with healthy controls (p = 0.003, OR 2.0 (95% CI 1.2-2.9). In the latter group, this combination was associated with schizophrenia endophenotype (p = 0.04), which manifested in a higher expression of schizotypal personality traits assessed using the MMPI test.
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Quinurenina 3-Monooxigenasa/genética , Polimorfismo de Nucleótido Simple , Esquizofrenia/genética , Adolescente , Adulto , Estudios de Casos y Controles , Femenino , Humanos , MasculinoRESUMEN
OBJECTIVE: To analyze background EEG parameters correlated with frontal lobe dysfunction, that might be considered, prospectively, as individual predictors of relative pharmacoresistance (or relatively lower treatment efficacy) in different forms of endogenous affective disorders. MATERIAL AND METHODS: An analysis of a set of several EEG parameters and quantitative clinical assessments has been carried out during the treatment in patients with endogenous depression (group 1), depressive-delusional conditions in the frames of attack-like schizophrenia (group 2), and manic-delusional conditions in the frames of attack-like schizophrenia (group 3). RESULTS AND CONCLUSION: Statistically significant correlations have been revealed between initial (before treatment course) values of narrow-band EEG spectral power (mainly of beta activity reflected the frontal lobe dysfunction and hyper-activation of brain stem structures) and quantitative clinical assessments of patient's conditions at remission stage. The data obtained allow to justify the basic considerations on the brain mechanisms of different affective disorders, and to reveal possible neurophysiologic predictors of relative pharmacoresistance (or relatively lower treatment efficacy) in patients with endogenous affective disorders.
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Trastorno Bipolar/tratamiento farmacológico , Trastorno Depresivo Mayor/tratamiento farmacológico , Resistencia a Medicamentos , Lóbulo Frontal/fisiopatología , Esquizofrenia/tratamiento farmacológico , Adulto , Trastorno Bipolar/fisiopatología , Trastorno Depresivo Mayor/fisiopatología , Electroencefalografía , Femenino , Humanos , Masculino , Persona de Mediana Edad , Esquizofrenia/fisiopatología , Índice de Severidad de la Enfermedad , Adulto JovenRESUMEN
To evaluate a role of dopamine transmission in the theory of mind (ToM) dysfunction in schizophrenia, authors studied the association of ToM with COMT and DRD2 gene polymorphisms in 209 patients with schizophrenia and 172 healthy people. All subjects performed second-order false belief (FB2) and faux pas stories. The association between the COMT Val158Met polymorphism and performance on FB2 was found. The association was sex-specific. The worse performance was associated with a Met allele in female patients and with the ValVal genotype in male ones. A correlation analysis of the COMT Val158Met polymorphism, performance on FB2 task, neurocognitive and clinical symptoms suggests that in female patients the association was modified, in part, by the higher stress sensitivity caused by the severity of clinical symptoms and its consequences for cognitive functioning.
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Catecol O-Metiltransferasa/genética , Cognición/fisiología , ADN/genética , Polimorfismo Genético , Receptores de Dopamina D2/genética , Esquizofrenia/genética , Teoría de la Mente/fisiología , Adulto , Alelos , Femenino , Genotipo , Humanos , Masculino , Esquizofrenia/fisiopatologíaRESUMEN
Cognitive reserve (CR) postulates that individual differences in the cognitive processes or neural networks underlying task performance allow some people to cope better than others with brain damage. An aim of the study was to search for candidate genes for CR in schizophrenia. We propose that higher frequencies of low risk alleles is observed in healthy relatives of schizophrenic patients compared to patients and controls and in patients without neurocognitive deficit and with less severity of the disease compared to other patients and controls. Besides, frequencies of these alleles in patients should be similar to those in general population. Authors studied SNAP-25 and DTNBP1 genes. The polymorphism T1065G of SNAP-25 was genotyped in 278 patients with schizophrenia, 126 their relatives and 207 controls and the polymorphism P1763 of DTNBP1 was genotyped in 202 patients, 229 relatives and 262 controls. There was a trend towards the increase in the frequency of an G allele of SNAP-25 in siblings of patients. The frequency of this allele was higher in patients without neurocognitive deficit compared to patients with cognitive deficit (p=0.003) and controls (p=0.002). The allele was associated with index of cognitive functioning in patients (p=0.012) and controls (p=0.006) and with the severity of negative symptoms in patients (p=0.023). At the same time, the polymorphism T1065G was not associated with schizophrenia. Therefore, an allele G may be considered as a marker for higher CR.
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Proteínas Portadoras/genética , Cognición/fisiología , Reserva Cognitiva , ADN/genética , Polimorfismo Genético , Esquizofrenia/genética , Proteína 25 Asociada a Sinaptosomas/genética , Adulto , Alelos , Proteínas Portadoras/metabolismo , Progresión de la Enfermedad , Disbindina , Proteínas Asociadas a la Distrofina , Femenino , Frecuencia de los Genes , Predisposición Genética a la Enfermedad , Genotipo , Humanos , Masculino , Reacción en Cadena de la Polimerasa , Esquizofrenia/metabolismo , Esquizofrenia/fisiopatología , Proteína 25 Asociada a Sinaptosomas/metabolismoRESUMEN
Growing evidence suggest that interleukin-1beta (IL-1B) and interleukin-1 receptor antagonist (IL-1RN) are involved in the pathogenesis of schizophrenia. The objective of this study was to test the association of the functional promoter polymorphism 511T>C of the IL-1B gene and the VNTR polymorphism of the IL-1RN gene with clinical symptoms of schizophrenia. We studied 758 patients, 415 men and 343 women, with the ICD-10 diagnosis of schizophrenia. Symptoms of schizophrenia were measured using the Positive and Negative Symptome Scale (PANSS). The sample was stratified by gender and type of schizophrenia (chronic or episodic). We found the association between the VNTR IL-1RN polymorphism and PANSS negative symptoms (p = 0.02) in men. Male patients with the genotype 2*2 had lower scores than those with 1*2 and 1*1 genotypes. The genotype 2*2 was associated with a more severe illness course (shorter illness duration and smaller number of hospitalizations) as well. The results suggest that the VNTR polymorphism in the IL-1RN gene may be a predictor of outcome of schizophrenia in men.