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1.
J Child Neurol ; 38(6-7): 394-406, 2023 05.
Artigo em Inglês | MEDLINE | ID: mdl-37455396

RESUMO

OBJECTIVE: To increase understanding of the impact of cannabidiol (CBD) on outcomes beyond seizure control among individuals with Dravet syndrome or Lennox-Gastaut syndrome. METHODS: Qualitative interviews were conducted with caregivers of individuals with Dravet syndrome or Lennox-Gastaut syndrome treated with plant-derived, highly purified CBD medicine (Epidiolex in the USA; Epidyolex in Europe; 100 mg/mL oral solution). Symptoms and impacts of Dravet syndrome and Lennox-Gastaut syndrome on individuals were explored, as were the effects of CBD. Data were analyzed using thematic analysis. RESULTS: Twenty-one caregivers of individuals with Dravet syndrome (n = 14) and Lennox-Gastaut syndrome (n = 7) aged 4-22 years participated. Health-related quality of life improvements associated with CBD included cognitive function, communication, behavior, mobility, and participation in daily activities. Seizure frequency reduction was commonly reported (n = 12), resulting in caregivers having greater freedom and family life being less disrupted. Adverse events were reported by 10 caregivers. CONCLUSION: In addition to reduced seizure frequency, CBD may have a wide range of beneficial effects beyond seizure control that warrant further investigation.


Assuntos
Canabidiol , Cuidadores , Epilepsias Mioclônicas , Síndrome de Lennox-Gastaut , Pesquisa Qualitativa , Adolescente , Adulto , Criança , Pré-Escolar , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Adulto Jovem , Sintomas Comportamentais/tratamento farmacológico , Canabidiol/administração & dosagem , Canabidiol/uso terapêutico , Cuidadores/psicologia , Cognição/efeitos dos fármacos , Comunicação , Epilepsias Mioclônicas/tratamento farmacológico , Epilepsias Mioclônicas/complicações , Entrevistas como Assunto , Síndrome de Lennox-Gastaut/complicações , Síndrome de Lennox-Gastaut/tratamento farmacológico , Qualidade de Vida , Convulsões/tratamento farmacológico , Convulsões/complicações , Comportamento Verbal/efeitos dos fármacos
2.
Nutrients ; 12(2)2020 Feb 14.
Artigo em Inglês | MEDLINE | ID: mdl-32075015

RESUMO

There is good evidence that cocoa flavonoids can acutely improve cognitive function in humans, possibly via mechanisms such as increased cerebral blood flow. To date, much of the evidence is based on measures of executive function with extracts and cocoa-based interventions with a high flavonoid content. The aim of the present study was to explore whether benefits to episodic verbal memory and mood are observed two hours post consumption of a commercially available dark chocolate (DC) bar relative to a 35 g white chocolate bar (WC). Ninety-eight healthy young adults (n = 57 females) aged 18-24 years consumed either a 35 g DC bar or a calorie-matched low flavonoid WC bar. Verbal episodic memory and mood were assessed pre consumption and 2 h post consumption. An ANOVA analysis showed that the DC was associated with better verbal memory performance for several outcome measures of the Rey Auditory Verbal Learning Test relative to the WC, however, there were no effects on mood. These findings lend support to the notion that everyday available portions of dark chocolate can confer benefits to the brain in healthy consumers.


Assuntos
Chocolate , Cognição/efeitos dos fármacos , Função Executiva/efeitos dos fármacos , Flavonoides/isolamento & purificação , Flavonoides/farmacologia , Memória Episódica , Memória/efeitos dos fármacos , Polifenóis/isolamento & purificação , Polifenóis/farmacologia , Comportamento Verbal/efeitos dos fármacos , Adolescente , Afeto , Chocolate/análise , Feminino , Humanos , Aprendizagem/efeitos dos fármacos , Masculino , Fatores de Tempo , Adulto Jovem
3.
Eur Neuropsychopharmacol ; 31: 100-108, 2020 02.
Artigo em Inglês | MEDLINE | ID: mdl-31812330

RESUMO

Expectancies of nicotine content have been shown to impact smokers' subjective responses and smoking behaviors. However, little is known about the neural substrates modulated by verbally induced expectancies in smokers. In this study we used functional magnetic resonance imaging (fMRI) to investigate how verbally induced expectations, regarding the presence or absence of nicotine, modulated smokers' neural response to a nicotine-free odor. While laying in the scanner, all participants (N = 24) were given a nicotine-free odor, but whereas one group was correctly informed about the absence of nicotine (control group n = 12), the other group was led to believe that the presented odor contained nicotine (expectancy group n = 12). Smokers in the expectancy group had significantly increased blood-oxygen-level-dependent (BOLD) responses during the presentation of the nicotine-free odor in the left ventral tegmental area (VTA), and in the right insula, as compared to smokers in the control group (Regions of interest analysis with pFWE-corrected p ≤ 0.05). At a more liberal uncorrected statistical level (p-unc ≤ 0.001), increased bilateral reactivity in the dorsolateral prefrontal cortex (dlPFC) was also observed in the expectancy group as compared with the control group. Our findings suggest that nicotine-expectancies induced through verbal instructions can modulate nicotine relevant brain regions, without nicotine administration, and provide further neural support for the key role that cognitive expectancies play in the cause and treatment of nicotine dependence.


Assuntos
Fumar Cigarros/psicologia , Nicotina/administração & dosagem , Odorantes , Olfato/fisiologia , Área Tegmentar Ventral/diagnóstico por imagem , Comportamento Verbal/fisiologia , Adulto , Feminino , Humanos , Masculino , Motivação/efeitos dos fármacos , Motivação/fisiologia , Olfato/efeitos dos fármacos , Área Tegmentar Ventral/efeitos dos fármacos , Comportamento Verbal/efeitos dos fármacos , Adulto Jovem
4.
Neurobiol Aging ; 77: 37-43, 2019 05.
Artigo em Inglês | MEDLINE | ID: mdl-30776650

RESUMO

There is ample evidence that phosphodiesterase 4 (PDE4) inhibition can improve memory performance in animal studies. In the present study, we examined the acute effects of the PDE4 inhibitor roflumilast on memory performance in healthy individuals (60-80 years of age). We tested the effects of acute roflumilast administration (100, 250, 1000 µg) in a double-blind, placebo-controlled, 4-way crossover design. Participants were first screened for their verbal word memory performance to ensure normal memory performance (within 0.5 standard deviation from norm score; n = 20) Drug effects on memory performance were tested in a verbal memory test and a spatial memory test. Reported side effects of drug treatment were registered. Roflumilast (100 µg) improved the delayed recall performance of the participants (Cohen's d, 0.69). No effects were observed in the spatial memory task. Roflumilast was well tolerated at this low dose. Although no clear adverse side effects were reported at the low dose, mild adverse events (including headache, dizziness, insomnia, and diarrhea) were reported after the 1000 µg dose. The present study provides first evidence that the PDE4 inhibitor roflumilast improves verbal memory performance in old participants. The current data encourage further development of PDE4 inhibitors for improving memory.


Assuntos
Aminopiridinas/administração & dosagem , Aminopiridinas/farmacologia , Benzamidas/administração & dosagem , Benzamidas/farmacologia , Envelhecimento Saudável/psicologia , Memória/efeitos dos fármacos , Inibidores da Fosfodiesterase 4/administração & dosagem , Inibidores da Fosfodiesterase 4/farmacologia , Comportamento Verbal/efeitos dos fármacos , Idoso , Idoso de 80 Anos ou mais , Aminopiridinas/efeitos adversos , Benzamidas/efeitos adversos , Cognição/efeitos dos fármacos , Estudos Cross-Over , AMP Cíclico/fisiologia , Ciclopropanos/administração & dosagem , Ciclopropanos/efeitos adversos , Ciclopropanos/farmacologia , Relação Dose-Resposta a Droga , Método Duplo-Cego , Humanos , Rememoração Mental/efeitos dos fármacos , Pessoa de Meia-Idade , Inibidores da Fosfodiesterase 4/efeitos adversos , Estimulação Química
5.
Psychoneuroendocrinology ; 100: 223-228, 2019 02.
Artigo em Inglês | MEDLINE | ID: mdl-30388596

RESUMO

Klinefelter syndrome (KS, 47,XXY) is the most common sex chromosome aneuploidy in males. A variety of complex clinical needs is associated with KS, including physical, cognitive and psychosocial impairments. Standard treatment for KS consists of androgen replacement therapy in adolescence to offset testosterone deficiency. Such treatment has a beneficial effect on the physical and behavioral manifestations of this syndrome. Whether androgen supplementation has a significant influence on the brain, however, is unknown. In the current study, we examined regional gray matter volume in boys with KS to assess whether treatment with oxandrolone, a synthetic hormone analog of testosterone, was associated with structural changes in the brain. Specifically, we focused our investigation on the hippocampus, given (1) its involvement in KS, and (2) the high concentration of androgen receptors found in this region. Structural magnetic resonance imaging data was acquired from a subsample of boys who completed a 2-year double-blind clinical trial in which patients were randomized to treatment with oxandrolone or to placebo, as well as from a sample of typically developing (TD) boys. Group differences in hippocampal volume were examined. A significant main effect of group was observed. Pairwise comparisons indicated smaller hippocampal volume in the placebo group relative to the oxandrolone group, as well as smaller volume in the placebo group relative to the TD control group. No difference in volume was observed between the treatment and TD groups. Moreover, across KS subgroups, a significant positive association was observed between hippocampus volume and performance on a spatial memory task, indicating treatment-based changes in brain structure may underlie cognitive change. These findings confirm prior reports implicating a role of the hippocampus in KS and are important in extending previous research by demonstrating a significant effect of androgens on brain structure.


Assuntos
Hipocampo/efeitos dos fármacos , Síndrome de Klinefelter/tratamento farmacológico , Oxandrolona/uso terapêutico , Adolescente , Androgênios/farmacologia , Androgênios/uso terapêutico , Encéfalo/efeitos dos fármacos , Encéfalo/crescimento & desenvolvimento , Encéfalo/patologia , Criança , Desenvolvimento Infantil/efeitos dos fármacos , Método Duplo-Cego , Hipocampo/diagnóstico por imagem , Hipocampo/crescimento & desenvolvimento , Hipocampo/patologia , Humanos , Inteligência/efeitos dos fármacos , Síndrome de Klinefelter/diagnóstico , Síndrome de Klinefelter/patologia , Imageamento por Ressonância Magnética , Masculino , Oxandrolona/farmacologia , Comportamento Verbal/efeitos dos fármacos
6.
Neurosci Lett ; 686: 101-105, 2018 11 01.
Artigo em Inglês | MEDLINE | ID: mdl-30193796

RESUMO

A number of near-infrared spectroscopy (NIRS) studies in schizophrenia have shown that there is a significant dysfunction of the prefrontal cortex (PFC) in patients with schizophrenia, but it remains unclear how atypical antipsychotics affect the function of the PFC. To investigate the changes in brain activation patterns in schizophrenia who accepted antipsychotic treatment, we used NIRS to measure the hemodynamic changes of the PFC in patients with schizophrenia at the time of enrollment and after 4 weeks of treatment during a verbal fluency task (VFT). We included 16 schizophrenia and 17 sex- and age- matched healthy controls. Compared with the healthy controls, the VFT performance was significantly worse in patients with schizophrenia, as was the activation of the PFC. Furthermore, after 4 weeks of treatment, there was no significant improvement in VFT performance and the activation of the PFC in schizophrenia. Our results suggest that the function of the PFC and cognitive skills in schizophrenia were significantly impaired and do not improve from a short-term treatment of atypical antipsychotics.


Assuntos
Antipsicóticos/farmacologia , Córtex Pré-Frontal/fisiopatologia , Esquizofrenia/fisiopatologia , Espectroscopia de Luz Próxima ao Infravermelho , Comportamento Verbal/fisiologia , Adulto , Feminino , Neuroimagem Funcional/métodos , Humanos , Masculino , Pessoa de Meia-Idade , Testes Neuropsicológicos , Córtex Pré-Frontal/efeitos dos fármacos , Esquizofrenia/diagnóstico por imagem , Espectroscopia de Luz Próxima ao Infravermelho/métodos , Comportamento Verbal/efeitos dos fármacos , Adulto Jovem
7.
Neurology ; 91(9): e811-e821, 2018 08 28.
Artigo em Inglês | MEDLINE | ID: mdl-30068633

RESUMO

OBJECTIVE: To examine the effect of maternal folic acid supplementation and maternal plasma folate and antiepileptic drug (AED) concentrations on language delay in AED-exposed children of mothers with epilepsy. METHODS: Children of mothers with and without epilepsy enrolled from 1999 to 2008 in the Norwegian Mother and Child Cohort study were included. Information on medical history, AED use, and folic acid supplementation during pregnancy was collected from parent-completed questionnaires. Maternal plasma folate and maternal plasma and umbilical cord AED concentrations were measured in blood samples from gestational weeks 17 to 19 and immediately after birth, respectively. Language development at 18 and 36 months was evaluated by the Ages and Stages Questionnaires. RESULTS: A total of 335 AED-exposed children of mothers with epilepsy and 104,222 children of mothers without epilepsy were surveyed. For those with no maternal periconceptional folic acid supplementation, the fully adjusted odds ratio (OR) for language delay in AED-exposed children compared to the controls at 18 months was 3.9 (95% confidence interval [CI] 1.9-7.8, p < 0.001) and at 36 months was 4.7 (95% CI 2.0-10.6, p < 0.001). When folic supplementation was used, the corresponding ORs for language delay were 1.7 (95% CI 1.2-2.6, p = 0.01) and 1.7 (95% CI 0.9-3.2, p = 0.13), respectively. The positive effect of folic acid supplement use on language delay in AED-exposed children was significant only when supplement was used in the period from 4 weeks before the pregnancy and until the end of the first trimester. CONCLUSION: Folic acid use early in pregnancy may have a preventive effect on language delay associated with in utero AED exposure.


Assuntos
Ácido Fólico/metabolismo , Transtornos do Desenvolvimento da Linguagem/etiologia , Efeitos Tardios da Exposição Pré-Natal/metabolismo , Efeitos Tardios da Exposição Pré-Natal/fisiopatologia , Comportamento Verbal/fisiologia , Adolescente , Adulto , Fatores Etários , Anticonvulsivantes/efeitos adversos , Pré-Escolar , Estudos de Coortes , Epilepsia/tratamento farmacológico , Feminino , Idade Gestacional , Humanos , Masculino , Relações Mãe-Filho , Noruega , Gravidez , Efeitos Tardios da Exposição Pré-Natal/induzido quimicamente , Estatísticas não Paramétricas , Comportamento Verbal/efeitos dos fármacos , Adulto Jovem
8.
Nutrients ; 10(7)2018 Jul 13.
Artigo em Inglês | MEDLINE | ID: mdl-30011836

RESUMO

Background: Previous epidemiological and clinical studies have shown that dairy products have beneficial effects on cognitive decline and dementia. Enzymatic digestion of whey protein produces a whey peptide rich in tryptophan-tyrosine-related peptides which improve cognitive performance in mice. We evaluated the effects of whey peptides on cognitive functions in healthy adults in a randomized, double-blind, placebo-controlled design. Methods: 101 healthy adults (45 to 64 years), with a self-awareness of cognitive decline received either whey peptide or placebo supplements for 12 weeks. Changes in cognitive function were assessed using neuropsychological tests at 6 and 12 weeks after the start of supplementation. Results: Verbal fluency test (VFT) score changes tended to be higher in the whey peptide group compared with the placebo at 12 weeks. Subgroup analysis classified by the degree of subjective fatigue showed that changes in the VFT as well as the Stroop and subjective memory function tests between baseline and 6 weeks of intervention were significantly better in subjects with high-level fatigue from the whey peptide group as compared to the placebo group. CONCLUSIONS: Intake of whey peptide might improve cognitive function in healthy middle- and older-aged adults with high subjective fatigue levels. Further studies will elucidate the relationship among cognitive improvement, whey peptides, and psychological fatigue.


Assuntos
Cognição/efeitos dos fármacos , Disfunção Cognitiva/dietoterapia , Suplementos Nutricionais , Fadiga Mental/dietoterapia , Triptofano/administração & dosagem , Tirosina/administração & dosagem , Proteínas do Soro do Leite/administração & dosagem , Disfunção Cognitiva/diagnóstico , Disfunção Cognitiva/psicologia , Método Duplo-Cego , Feminino , Voluntários Saudáveis , Humanos , Japão , Masculino , Memória/efeitos dos fármacos , Fadiga Mental/diagnóstico , Fadiga Mental/psicologia , Pessoa de Meia-Idade , Testes Neuropsicológicos , Fatores de Tempo , Resultado do Tratamento , Comportamento Verbal/efeitos dos fármacos
9.
Diabetes ; 67(6): 1140-1148, 2018 06.
Artigo em Inglês | MEDLINE | ID: mdl-29531139

RESUMO

It is now generally accepted that diabetes increases the risk for cognitive impairment, but the precise mechanisms are poorly understood. A critical problem in linking diabetes to cognitive impairment is that patients often have multiple comorbidities (e.g., obesity, hypertension) that have been independently linked to cognitive deficits. In the study reported here we focused on young adults with and without type 1 diabetes who were virtually free of such comorbidities. The two groups were matched on major health and demographic factors, and all participants completed a verbal working memory task during magnetoencephalographic brain imaging. We hypothesized that patients would have altered neural dynamics in verbal working memory processing and that these differences would directly relate to clinical disease measures. Accordingly, we found that patients had significantly stronger neural responses in the superior parietal cortices during memory encoding and significantly weaker activity in parietal-occipital regions during maintenance compared with control subjects. Moreover, disease duration and glycemic control were both significantly correlated with neural responses in various brain regions. In conclusion, young healthy adults with type 1 diabetes already have aberrant neural processing relative to their peers without diabetes, using compensatory responses to perform the task, and glucose management and duration may play a central role.


Assuntos
Doenças Assintomáticas , Disfunção Cognitiva/diagnóstico por imagem , Diabetes Mellitus Tipo 1/complicações , Nefropatias Diabéticas/diagnóstico por imagem , Memória de Curto Prazo , Adulto , Disfunção Cognitiva/complicações , Disfunção Cognitiva/fisiopatologia , Comorbidade , Diabetes Mellitus Tipo 1/sangue , Diabetes Mellitus Tipo 1/tratamento farmacológico , Diabetes Mellitus Tipo 1/fisiopatologia , Nefropatias Diabéticas/fisiopatologia , Nefropatias Diabéticas/prevenção & controle , Progressão da Doença , Feminino , Neuroimagem Funcional , Hemoglobinas Glicadas/análise , Humanos , Hiperglicemia/prevenção & controle , Hipoglicemia/prevenção & controle , Hipoglicemiantes/uso terapêutico , Insulina/uso terapêutico , Magnetoencefalografia , Masculino , Memória de Curto Prazo/efeitos dos fármacos , Nebraska/epidemiologia , Lobo Occipital/diagnóstico por imagem , Lobo Occipital/efeitos dos fármacos , Lobo Occipital/fisiopatologia , Lobo Parietal/diagnóstico por imagem , Lobo Parietal/efeitos dos fármacos , Lobo Parietal/fisiopatologia , Comportamento Verbal/efeitos dos fármacos , Aprendizagem Verbal/efeitos dos fármacos , Adulto Jovem
10.
Mol Psychiatry ; 23(2): 247-256, 2018 02.
Artigo em Inglês | MEDLINE | ID: mdl-27752075

RESUMO

We sought to determine whether high-dose folinic acid improves verbal communication in children with non-syndromic autism spectrum disorder (ASD) and language impairment in a double-blind placebo control setting. Forty-eight children (mean age 7 years 4 months; 82% male) with ASD and language impairment were randomized to receive 12 weeks of high-dose folinic acid (2 mg kg-1 per day, maximum 50 mg per day; n=23) or placebo (n=25). Children were subtyped by glutathione and folate receptor-α autoantibody (FRAA) status. Improvement in verbal communication, as measured by a ability-appropriate standardized instrument, was significantly greater in participants receiving folinic acid as compared with those receiving placebo, resulting in an effect of 5.7 (1.0,10.4) standardized points with a medium-to-large effect size (Cohen's d=0.70). FRAA status was predictive of response to treatment. For FRAA-positive participants, improvement in verbal communication was significantly greater in those receiving folinic acid as compared with those receiving placebo, resulting in an effect of 7.3 (1.4,13.2) standardized points with a large effect size (Cohen's d=0.91), indicating that folinic acid treatment may be more efficacious in children with ASD who are FRAA positive. Improvements in subscales of the Vineland Adaptive Behavior Scale, the Aberrant Behavior Checklist, the Autism Symptom Questionnaire and the Behavioral Assessment System for Children were significantly greater in the folinic acid group as compared with the placebo group. There was no significant difference in adverse effects between treatment groups. Thus, in this small trial of children with non-syndromic ASD and language impairment, treatment with high-dose folinic acid for 12 weeks resulted in improvement in verbal communication as compared with placebo, particularly in those participants who were positive for FRAAs.


Assuntos
Leucovorina/farmacologia , Comportamento Verbal/efeitos dos fármacos , Transtorno do Espectro Autista/tratamento farmacológico , Transtorno Autístico/tratamento farmacológico , Criança , Transtornos Globais do Desenvolvimento Infantil/tratamento farmacológico , Pré-Escolar , Método Duplo-Cego , Feminino , Receptor 1 de Folato/metabolismo , Humanos , Transtornos do Desenvolvimento da Linguagem/tratamento farmacológico , Transtornos da Linguagem/tratamento farmacológico , Leucovorina/metabolismo , Masculino , Efeito Placebo , Receptores de Peptídeos/metabolismo , Resultado do Tratamento
11.
Appl Neuropsychol Child ; 7(1): 52-60, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-27779427

RESUMO

The objective of this study was to assess cognitive performance and behavioral symptoms in a sample of children diagnosed with partial epilepsy who were seizure controlled on AED monotherapy for one year. Ninety-eight seizure-controlled children on AED monotherapy were included in this study. Specific AEDs examined included topiramate, divalproex sodium, lamotrigine, levetiracetam, and oxcarbazepine. Groups did not differ on age, region of focal epilepsy, or Full-Scale IQ. Direct measures included the WISC-IV and selected tests from the DKEFS (Verbal Fluency and Trail Making Test). Parent report measures included the BRIEF and the BASC-PRS. A series of ANOVAs revealed significant differences across the AED cohorts within many domains of cognitive functioning and behavioral presentation. Children prescribed divalproex sodium or topiramate demonstrated weaker working memory and verbal fluency, when compared with children prescribed other AEDs. Additionally, parents of children prescribed topiramate reported greater executive functioning and adaptive skills deficits. The pattern of findings suggests that children prescribed divalproex sodium or topiramate generally demonstrated a higher risk of cognitive and behavioral impairments compared to the other AEDs. Future prospective studies are required in order to better understand the relationship between AED type and these outcomes to inform clinical practice.


Assuntos
Anticonvulsivantes/efeitos adversos , Transtornos do Comportamento Infantil/induzido quimicamente , Transtornos Cognitivos/induzido quimicamente , Epilepsias Parciais/tratamento farmacológico , Adolescente , Criança , Epilepsias Parciais/fisiopatologia , Epilepsias Parciais/psicologia , Função Executiva/efeitos dos fármacos , Feminino , Humanos , Testes de Inteligência , Masculino , Memória de Curto Prazo/efeitos dos fármacos , Testes Neuropsicológicos , Pais/psicologia , Desempenho Psicomotor/efeitos dos fármacos , Resultado do Tratamento , Comportamento Verbal/efeitos dos fármacos
12.
J Inorg Biochem ; 181: 132-138, 2018 04.
Artigo em Inglês | MEDLINE | ID: mdl-29079320

RESUMO

Patients with macrophagic myofasciitis (MMF) present with diffuse arthromyalgias, chronic fatigue, and cognitive disorder. Representative features of MMF-associated cognitive dysfunction include attentional dysfunction, dysexecutive syndrome, visual memory deficit and left ear extinction. Our study aims to reevaluate the neuropsychological profile of MMF. 105 unselected consecutive MMF patients were subjected to a neuropsychological battery of screen short term and long-term memory, executive functions, attentional abilities, instrumental functions and dichotic listening. From these results, patients were classified in four different groups: Subsymptomatic patients (n=41) with performance above pathological threshold (-1.65 SD) in all tests; Fronto-subcortical patients (n=31) who showed pathological results at executive functions and selective attention tests; Papezian patients (n=24) who showed pathological results in storage, recognition and consolidation functions for episodic verbal memory, in addition to fronto-subcortical dysfunction; and Extinction patients (n=9) who had a left ear extinction at dichotic listening test in association to fronto-subcortical and papezian dysfunction. In addition, inter-test analysis showed that patients with apparently normal cognitive functions (Subsymptomatic group) performed significantly worse to attention tests compared to others. In conclusion, our study shows that (i) most patients have specific cognitive deficits; (ii) all patients with cognitive deficit have impairment of executive functions and selective attention; (iii) patients without measurable cognitive deficits display significant weakness in attention; (iv) episodic memory impairment affects verbal, but not visual, memory; (v) none of the patients show an instrumental dysfunction.


Assuntos
Adjuvantes Imunológicos/efeitos adversos , Hidróxido de Alumínio/efeitos adversos , Disfunção Cognitiva/etiologia , Fasciite/fisiopatologia , Miosite/fisiopatologia , Síndromes Neurotóxicas/fisiopatologia , Doenças Assintomáticas , Atenção/efeitos dos fármacos , Estudos de Coortes , Diagnóstico Diferencial , Testes com Listas de Dissílabos , Função Executiva/efeitos dos fármacos , Fasciite/induzido quimicamente , Fasciite/diagnóstico , Fasciite/diagnóstico por imagem , Feminino , França , Hospitais Especializados , Hospitais Universitários , Humanos , Imageamento por Ressonância Magnética , Masculino , Memória Episódica , Miosite/induzido quimicamente , Miosite/diagnóstico , Miosite/diagnóstico por imagem , Neuroimagem , Testes Neuropsicológicos , Síndromes Neurotóxicas/diagnóstico , Síndromes Neurotóxicas/diagnóstico por imagem , Estudos Retrospectivos , Comportamento Verbal/efeitos dos fármacos
13.
J Psychopharmacol ; 31(8): 1061-1069, 2017 08.
Artigo em Inglês | MEDLINE | ID: mdl-28656805

RESUMO

OBJECTIVE: Few studies have investigated verbal working memory-related functional connectivity patterns in participants with attention-deficit/hyperactivity disorder (ADHD). Thus, we aimed to compare working memory-related functional connectivity patterns in healthy children and those with ADHD, and study effects of methylphenidate (MPH). METHOD: Twenty-two boys with ADHD were scanned twice, under either MPH (single dose, 10 mg) or placebo, in a randomised, cross-over, counterbalanced placebo-controlled design. Thirty healthy boys were scanned once. We used fMRI during a numerical n-back task to examine functional connectivity patterns in case-control and MPH-placebo comparisons, using independent component analysis. RESULTS: There was no significant difference in behavioural performance between children with ADHD, treated with MPH or placebo, and healthy controls. Compared with controls, participants with ADHD under placebo showed increased functional connectivity within fronto-parietal and auditory networks, and decreased functional connectivity within the executive control network. MPH normalized the altered functional connectivity pattern and significantly enhanced functional connectivity within the executive control network, though in non-overlapping areas. CONCLUSION: Our study contributes to the identification of the neural substrates of working memory. Single dose of MPH normalized the altered brain functional connectivity network, but had no enhancing effect on (non-impaired) behavioural performance.


Assuntos
Transtorno do Deficit de Atenção com Hiperatividade/tratamento farmacológico , Transtorno do Deficit de Atenção com Hiperatividade/fisiopatologia , Memória de Curto Prazo/efeitos dos fármacos , Metilfenidato/farmacologia , Metilfenidato/uso terapêutico , Vias Neurais/efeitos dos fármacos , Comportamento Verbal/efeitos dos fármacos , Adolescente , Transtorno do Deficit de Atenção com Hiperatividade/psicologia , Encéfalo/efeitos dos fármacos , Estimulantes do Sistema Nervoso Central/uso terapêutico , Criança , Estudos Cross-Over , Humanos , Imageamento por Ressonância Magnética , Masculino
14.
Clin Neuropharmacol ; 40(3): 113-119, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-28452903

RESUMO

OBJECTIVES: Epilepsy heavily affects the quality of life (QoL) of patients with brain tumor because in addition to taking treatments for the oncological illness, patients are required to live with the long-term taking of antiepileptic drugs (AEDs). The AEDs' adverse effects are common in these patients and can negatively influence their perceptions of their QoL.We conducted an observational pilot study in patients with brain tumor-related epilepsy to verify efficacy, tolerability, and impact on QoL and global neurocognitive performances of zonisamide (ZNS) in add-on. MATERIALS AND METHODS: We recruited 13 patients (5 females, 8 males; mean age, 49.6 years) presenting uncontrolled seizures. At first visit and at final follow-up at 6 months, patients underwent neurological examination, evaluation of adverse events, and cognitive and QoL tests. A seizure diary was given. RESULTS: Eight patients underwent chemotherapy, 3 underwent radiotherapy, and 5 had disease progression. Mean dosage of ZNS at final follow-up was 300 mg/d.Of 9 patients who reached the sixth month follow-up, the mean weekly seizure number before ZNS had been 3.2 ± 5.0, and at final follow-up, the mean weekly seizure number was 0.18 ± 0.41 (P = 0.05).Compared with baseline, we observed stability in all cognitive domains, except for verbal fluency that significantly worsened.Results on QoL tests showed that QoL remained unchanged over time, which could indicate that ZNS did not influence the patients' perceived QoL. CONCLUSIONS: Zonisamide as add-on in our patients seems to be well tolerated and efficacious in controlling seizures. Despite having limitations represented by the fact that our study is observational, with a small study population and a short follow-up period, our results confirm that when choosing an AED, in addition to efficacy, the drug's effect on patients' QoL also needs to be considered, especially for patients facing many psychosocial challenges, such as those with brain tumor-related epilepsy.


Assuntos
Anticonvulsivantes/uso terapêutico , Neoplasias Encefálicas/fisiopatologia , Disfunção Cognitiva/prevenção & controle , Epilepsia/tratamento farmacológico , Isoxazóis/uso terapêutico , Nootrópicos/uso terapêutico , Qualidade de Vida , Antineoplásicos/efeitos adversos , Antineoplásicos/uso terapêutico , Neoplasias Encefálicas/tratamento farmacológico , Neoplasias Encefálicas/radioterapia , Disfunção Cognitiva/induzido quimicamente , Disfunção Cognitiva/etiologia , Disfunção Cognitiva/fisiopatologia , Terapia Combinada/efeitos adversos , Resistência a Medicamentos , Quimioterapia Combinada/efeitos adversos , Epilepsia/induzido quimicamente , Epilepsia/etiologia , Epilepsia/fisiopatologia , Feminino , Seguimentos , Humanos , Itália , Transtornos da Linguagem/induzido quimicamente , Transtornos da Linguagem/etiologia , Transtornos da Linguagem/fisiopatologia , Transtornos da Linguagem/prevenção & controle , Masculino , Pessoa de Meia-Idade , Projetos Piloto , Radioterapia/efeitos adversos , Índice de Gravidade de Doença , Comportamento Verbal/efeitos dos fármacos , Zonisamida
15.
J Clin Exp Neuropsychol ; 39(6): 596-606, 2017 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-27841098

RESUMO

Autism spectrum disorder (ASD) is characterized by impairments in social communication as well as restricted, repetitive behaviors. Evidence suggests that some individuals with ASD have cognitive impairments related to weak central coherence and hyperrestricted processing. Reducing noradrenergic activity may improve aspects of network processing and thus improve cognitive abilities, such as verbal problem solving, in individuals with ASD. The present pilot study explores the effects of acute administration of the beta-adrenergic antagonist propranolol on verbal problem solving in adults and adolescents with ASD. In a within-subject crossover-design, 20 participants with ASD received a single dose of propranolol or placebo on one of two sessions in a double-blinded, counterbalanced manner. Verbal problem solving was assessed via an anagram task. Baseline measurements of autonomic nervous system functioning were obtained, and anxiety was assessed at baseline and following drug administration. Participants solved the anagrams more quickly in the propranolol condition, as compared to the placebo condition, suggesting a potential cognitive benefit of this agent. Additionally, we observed a negative linear relationship between response to propranolol on the anagram task and two measures of baseline autonomic activity, as well as a positive linear relationship between drug response and baseline anxiety. These relationships propose potential markers for treatment response, as propranolol influences both autonomic functioning and anxiety. Further investigation is needed to expand on the present single-dose psychopharmacological challenge and explore the observed effects of propranolol in a serial-dose setting.


Assuntos
Antagonistas Adrenérgicos beta/uso terapêutico , Transtorno do Espectro Autista/tratamento farmacológico , Transtorno do Espectro Autista/psicologia , Resolução de Problemas/efeitos dos fármacos , Propranolol/uso terapêutico , Comportamento Verbal/efeitos dos fármacos , Adolescente , Adulto , Ansiedade/psicologia , Sistema Nervoso Autônomo/efeitos dos fármacos , Estudos Cross-Over , Método Duplo-Cego , Feminino , Humanos , Masculino , Projetos Piloto , Desempenho Psicomotor/efeitos dos fármacos , Resultado do Tratamento , Adulto Jovem
16.
J Nerv Ment Dis ; 204(7): 519-23, 2016 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-26998697

RESUMO

3,4-Methylenedioxymethamphetamine (MDMA) administered as an adjunct to talk therapy influences patient speech content and increases improvement in treatment-resistant posttraumatic stress disorder (PTSD). Data came from the recordings of Mithoefer et al. (2011). In the third therapeutic session studied, patients were assigned, double blind, to an MDMA or a placebo group. Condition-blind scorers listened to therapy recordings and scored utterances where patients initiated topics that were empathic (regarding others' emotions), entactic (requesting or appreciating physical touch), or ensuic (describing a change in their sense of themselves). Patients who received MDMA produced high levels of ensuic, empathic, and entactic utterances compared with those who received the placebo. Interrater discourse scoring was reliable. The relationship between the number of scored utterances and the Clinician Administered PTSD Scale scores measuring PTSD severity after the treatment was significant, and reanalysis grouped bimodally into "many" or "few" such utterances remained significant. MDMA assisted these patients in having meaningful and disorder-resolving thoughts and discourse in talk therapy.


Assuntos
N-Metil-3,4-Metilenodioxianfetamina/farmacologia , Avaliação de Resultados em Cuidados de Saúde/métodos , Psicoterapia/métodos , Serotoninérgicos/farmacologia , Transtornos de Estresse Pós-Traumáticos/terapia , Comportamento Verbal/efeitos dos fármacos , Adulto , Terapia Combinada , Método Duplo-Cego , Feminino , Humanos , Masculino , N-Metil-3,4-Metilenodioxianfetamina/administração & dosagem , Serotoninérgicos/administração & dosagem , Transtornos de Estresse Pós-Traumáticos/tratamento farmacológico
17.
Psychoneuroendocrinology ; 63: 170-7, 2016 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-26454105

RESUMO

BACKGROUND: The brain is a major target organ for cortisol considering its high density of glucocorticoid receptors. Several states of hypothalamus-pituitary-adrenal dysregulation point towards impairments in cognitive functioning. However, there is a very limited body of research on the effects of hypocortisolism on cognitive functioning. AIM: To evaluate cognitive functioning in patients with hypocortisolism (i.e., primary adrenal insufficiency (PAI)) and to examine the possible effect of postponing early-morning hydrocortisone intake on cognitive functioning. METHODS: Thirty-one patients with PAI on regular morning hydrocortisone intake and 31 healthy matched controls underwent nine neuropsychological tests, evaluating memory and executive functioning. In addition, the effect of normal timing and postponement of morning hydrocortisone intake on neuropsychological tests were assessed in an additional 29 patients with PAI. RESULTS: Compared to controls, patients with PAI performed worse on auditory and visual memory tasks (all P ≤ 0.024) and executive functioning tasks (all P ≤ 0.012). In contrast, patients performed better on a concentration and an attention task (both P<0.05). Postponement of hydrocortisone intake in the morning did not affect the outcomes of neuropsychological tests. CONCLUSION: Patients on long-term hydrocortisone replacement for PAI show mild cognitive deficits compared to controls. There was no effect of postponement of regular hydrocortisone intake on cognition.


Assuntos
Doença de Addison/complicações , Doença de Addison/tratamento farmacológico , Doença de Addison/psicologia , Disfunção Cognitiva/complicações , Hidrocortisona/uso terapêutico , Doença de Addison/epidemiologia , Adulto , Cognição/efeitos dos fármacos , Disfunção Cognitiva/tratamento farmacológico , Disfunção Cognitiva/epidemiologia , Função Executiva/efeitos dos fármacos , Feminino , Terapia de Reposição Hormonal , Humanos , Masculino , Memória/efeitos dos fármacos , Pessoa de Meia-Idade , Testes Neuropsicológicos , Comportamento Verbal/efeitos dos fármacos , Vigília/efeitos dos fármacos
18.
Clin Drug Investig ; 36(2): 109-18, 2016 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-26619839

RESUMO

BACKGROUND AND OBJECTIVE: The purpose of the present review was to study the impact of endocrine therapy (ET) on the cognitive outcomes of breast cancer patients. MATERIALS AND METHODS: We systematically searched the literature using the MEDLINE (1966-2015), Scopus (2004-2015), ClinicalTrials.gov (2008-2015) and Cochrane Central Register (CENTRAL) databases, as well as the references of the electronically retrieved articles. RESULTS: Twelve studies were included in the present systematic review, which assessed the cognitive function of 2756 patients. Among these patients, 2381 received ET, whereas the remaining 375 served as controls (placebo or no therapy). The majority of patients were postmenopausal, and the minimum follow-up period was 3 months and the maximum 2 years. Treatment with ET seems to be accompanied by altered cognitive abilities, including verbal memory, verbal fluency, motor speed, attention and working memory. Tamoxifen seems to be related to decreased cognitive performances compared with treatment with an aromatase inhibitor. CONCLUSIONS: ET among breast cancer patients seems to negatively alter the cognitive outcomes of breast cancer patients. However, the methodological heterogeneity of the included studies, as well as the relatively small follow-up period, render imperative the conduct of further studies in the field.


Assuntos
Inibidores da Aromatase/efeitos adversos , Neoplasias da Mama/prevenção & controle , Cognição/efeitos dos fármacos , Moduladores Seletivos de Receptor Estrogênico/efeitos adversos , Atenção/efeitos dos fármacos , Neoplasias da Mama/psicologia , Feminino , Humanos , Memória/efeitos dos fármacos , Desempenho Psicomotor/efeitos dos fármacos , Comportamento Verbal/efeitos dos fármacos
19.
Eur Neurol ; 74(5-6): 243-50, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-26624899

RESUMO

BACKGROUND/AIMS: Fampridine is sometimes reported to improve cognition and especially the information-processing speed. Motor improvement might be a confounding factor. The aim of this study was to evaluate the effects of fampridine on verbal fluencies in patients with multiple sclerosis (MS). METHODS: Fifty MS patients were included in a prospective monocentric open label trial with a mean Expanded Disability Status Scale of 5.3 ± 1.1. Assessments of verbal phonological and semantic fluencies were repeated twice (within 1 week) before fampridine treatment and twice after fampridine treatment in order to have the maximal practice effect. Gait velocity and fatigue (visual analogical scale) were also assessed. Distribution into gait responders, gait non-responders, fluency responders and fluency non-responders, was described. RESULTS: Verbal fluencies were significantly higher after fampridine treatment. No correlation was observed between phonological fluency improvement and semantic fluency improvement. Gait responders and gait non-responders did not present significant differences in verbal fluency performance and fatigue score. No correlation between gait velocity improvement and fatigue improvement compared with verbal fluency improvement was observed. CONCLUSION: Our results suggest that fampridine could have a selective procognitive effect on phonological fluency in MS, even in the gait non-responder patients.


Assuntos
4-Aminopiridina/uso terapêutico , Transtornos Cognitivos/tratamento farmacológico , Apraxia da Marcha/tratamento farmacológico , Esclerose Múltipla/tratamento farmacológico , Distúrbios da Fala/tratamento farmacológico , Medida da Produção da Fala , Comportamento Verbal/efeitos dos fármacos , Adulto , Avaliação da Deficiência , Feminino , França , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos
20.
Eur Neuropsychopharmacol ; 25(10): 1817-23, 2015 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-26092202

RESUMO

In the course of human evolution, the brain has evolved into a highly sensitive detector of social signals. As a consequence of this socially driven adaptation, humans display a tendency to anthropomorphize, that is they attribute social meaning to non-social agents. The evolutionarily highly conserved hypothalamic peptide oxytocin (OXT) has been identified as a key factor attaching salience to socially relevant cues, but whether it contributes to spontaneous anthropomorphism is still elusive. In the present study involving 60 healthy female participants, we measured salivary OXT concentrations and explored the effect of a single intranasal dose of synthetic OXT (24 IU) or placebo (PLC) on anthropomorphic tendencies during participants׳ verbal descriptions of short video clips depicting socially and non-socially moving geometric shapes. Our results show that endogenous OXT concentrations at baseline positively correlated with the attribution of animacy to social stimuli. While intranasal OXT had no modulatory effect on arousal ratings and did not make the participants more talkative, the treatment boosted anthropomorphic descriptions specifically for social stimuli. In conclusion, we here provide first evidence indicating that spontaneous anthropomorphism in women is facilitated by oxytocin, thereby enabling a context-specific upregulation of the propensity to anthropomorphize environmental cues.


Assuntos
Percepção de Movimento/efeitos dos fármacos , Ocitocina/administração & dosagem , Psicotrópicos/administração & dosagem , Percepção Social , Pensamento/efeitos dos fármacos , Administração Intranasal , Cognição/efeitos dos fármacos , Método Duplo-Cego , Feminino , Humanos , Ocitocina/metabolismo , Estimulação Luminosa , Escalas de Graduação Psiquiátrica , Testes Psicológicos , Psicotrópicos/metabolismo , Saliva/metabolismo , Comportamento Verbal/efeitos dos fármacos , Adulto Jovem
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