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1.
Proc Natl Acad Sci U S A ; 120(14): e2213880120, 2023 04 04.
Artículo en Inglés | MEDLINE | ID: mdl-36976765

RESUMEN

Left-right asymmetry is an important organizing feature of the healthy brain that may be altered in schizophrenia, but most studies have used relatively small samples and heterogeneous approaches, resulting in equivocal findings. We carried out the largest case-control study of structural brain asymmetries in schizophrenia, with MRI data from 5,080 affected individuals and 6,015 controls across 46 datasets, using a single image analysis protocol. Asymmetry indexes were calculated for global and regional cortical thickness, surface area, and subcortical volume measures. Differences of asymmetry were calculated between affected individuals and controls per dataset, and effect sizes were meta-analyzed across datasets. Small average case-control differences were observed for thickness asymmetries of the rostral anterior cingulate and the middle temporal gyrus, both driven by thinner left-hemispheric cortices in schizophrenia. Analyses of these asymmetries with respect to the use of antipsychotic medication and other clinical variables did not show any significant associations. Assessment of age- and sex-specific effects revealed a stronger average leftward asymmetry of pallidum volume between older cases and controls. Case-control differences in a multivariate context were assessed in a subset of the data (N = 2,029), which revealed that 7% of the variance across all structural asymmetries was explained by case-control status. Subtle case-control differences of brain macrostructural asymmetry may reflect differences at the molecular, cytoarchitectonic, or circuit levels that have functional relevance for the disorder. Reduced left middle temporal cortical thickness is consistent with altered left-hemisphere language network organization in schizophrenia.


Asunto(s)
Esquizofrenia , Masculino , Femenino , Humanos , Esquizofrenia/diagnóstico por imagen , Estudios de Casos y Controles , Encéfalo/diagnóstico por imagen , Corteza Cerebral , Imagen por Resonancia Magnética/métodos , Lateralidad Funcional
2.
Mol Psychiatry ; 2024 Feb 09.
Artículo en Inglés | MEDLINE | ID: mdl-38336840

RESUMEN

Schizophrenia is a prototypical network disorder with widespread brain-morphological alterations, yet it remains unclear whether these distributed alterations robustly reflect the underlying network layout. We tested whether large-scale structural alterations in schizophrenia relate to normative structural and functional connectome architecture, and systematically evaluated robustness and generalizability of these network-level alterations. Leveraging anatomical MRI scans from 2439 adults with schizophrenia and 2867 healthy controls from 26 ENIGMA sites and normative data from the Human Connectome Project (n = 207), we evaluated structural alterations of schizophrenia against two network susceptibility models: (i) hub vulnerability, which examines associations between regional network centrality and magnitude of disease-related alterations; (ii) epicenter mapping, which identifies regions whose typical connectivity profile most closely resembles the disease-related morphological alterations. To assess generalizability and specificity, we contextualized the influence of site, disease stages, and individual clinical factors and compared network associations of schizophrenia with that found in affective disorders. Our findings show schizophrenia-related cortical thinning is spatially associated with functional and structural hubs, suggesting that highly interconnected regions are more vulnerable to morphological alterations. Predominantly temporo-paralimbic and frontal regions emerged as epicenters with connectivity profiles linked to schizophrenia's alteration patterns. Findings were robust across sites, disease stages, and related to individual symptoms. Moreover, transdiagnostic comparisons revealed overlapping epicenters in schizophrenia and bipolar, but not major depressive disorder, suggestive of a pathophysiological continuity within the schizophrenia-bipolar-spectrum. In sum, cortical alterations over the course of schizophrenia robustly follow brain network architecture, emphasizing marked hub susceptibility and temporo-frontal epicenters at both the level of the group and the individual. Subtle variations of epicenters across disease stages suggest interacting pathological processes, while associations with patient-specific symptoms support additional inter-individual variability of hub vulnerability and epicenters in schizophrenia. Our work outlines potential pathways to better understand macroscale structural alterations, and inter- individual variability in schizophrenia.

3.
Psychophysiology ; 60(2): e14175, 2023 02.
Artículo en Inglés | MEDLINE | ID: mdl-36087044

RESUMEN

Reduced mismatch negativity (MMN), a robust finding in schizophrenia, has prompted interest in MMN as a preclinical biomarker of schizophrenia. The rat brain can generate human-like mismatch responses (MMRs) which therefore enables the exploration of the neurobiology of reduced MMRs. Given epidemiological evidence that two developmental factors, maternal infection and adolescent cannabis use, increase the risk of schizophrenia, we determined the effect of these two developmental risk factors on rat MMR amplitude in different auditory contexts. MMRs were assessed in awake adult male and female Wistar rats that were offspring of pregnant dams treated with either a viral infection mimetic (poly I:C) inducing maternal immune activation (MIA) or saline control. In adolescence, subgroups of the prenatal treatment groups were exposed to either a synthetic cannabinoid (adolescent cannabinoid exposure: ACE) or vehicle. The context under which MMRs were obtained was manipulated by employing two different oddball paradigms, one that manipulated the physical difference between rare and common auditory stimuli, and another that manipulated the probability of the rare stimulus. The design of the multiple stimulus sequences across the two paradigms also allowed an investigation of context on MMRs to two identical stimulus sequences. Male offspring exposed to each of the risk factors for schizophrenia (MIA, ACE or both) showed a reduction in MMR, which was evident only in the probability paradigm, with no effects seen in the physical difference. Our findings highlight the importance of contextual factors induced by paradigm manipulations and sex for modeling schizophrenia-like MMN impairments in rats.


Asunto(s)
Esquizofrenia , Animales , Femenino , Masculino , Embarazo , Ratas , Estimulación Acústica , Electroencefalografía , Potenciales Evocados Auditivos/fisiología , Ratas Wistar , Factores de Riesgo , Esquizofrenia/inducido químicamente
4.
Hum Brain Mapp ; 42(14): 4643-4657, 2021 10 01.
Artículo en Inglés | MEDLINE | ID: mdl-34184803

RESUMEN

During task-switching paradigms, both event-related potentials and time-frequency analyses show switch and mixing effects at frontal and parietal sites. Switch and mixing effects are associated with increased power in broad frontoparietal networks, typically stronger in the theta band (~4-8 Hz). However, it is not yet known whether mixing and switch costs rely upon common or distinct networks. In this study, we examine proactive and reactive control networks linked to task switching and mixing effects, and whether strength of connectivity in these networks is associated with behavioural outcomes. Participants (n = 197) completed a cued-trials task-switching paradigm with concurrent electroencephalography, after substantial task practice to establish strong cue-stimulus-response representations. We used inter-site phase clustering, a measure of functional connectivity across electrode sites, to establish cross-site connectivity from a frontal and a parietal seed. Distinct theta networks were activated during proactive and reactive control periods. During the preparation interval, mixing effects were associated with connectivity from the frontal seed to parietal sites, and switch effects with connectivity from the parietal seed to occipital sites. Lateralised occipital connectivity was common to both switch and mixing effects. After target onset, frontal and parietal seeds showed a similar pattern of connectivity across trial types. These findings are consistent with distinct and common proactive control networks and common reactive networks in highly practised task-switching performers.


Asunto(s)
Corteza Cerebral/fisiología , Conectoma , Electroencefalografía , Función Ejecutiva/fisiología , Red Nerviosa/fisiología , Desempeño Psicomotor/fisiología , Ritmo Teta/fisiología , Adolescente , Adulto , Femenino , Humanos , Masculino , Adulto Joven
5.
Psychiatr Q ; 92(4): 1611-1634, 2021 12.
Artículo en Inglés | MEDLINE | ID: mdl-34125366

RESUMEN

Few studies have examined the post-discharge benefits associated with recover-oriented programs delivered in inpatient and sub-acute mental health settings. The aim of this study was to evaluate the medium-term outcomes of a 6-week sub-acute inpatient intervention program for 27 service users with a diagnosis of serious mental illness (mean age = 33.22 years, 70.4% with a psychosis diagnosis). Recovery data were collected on admission, at discharge, and at 3- and 6-months post-discharge using self-report, collaborative and clinical measures. The three clinician-rated measures (assessing therapeutic engagement, functioning, and life skills) revealed linear improvements from admission to 6-month follow-up (with mean z-change ranging from 0.72 to 1.35), as did the self-reported social connection measure (Mental Health Recovery Star, MHRS; mean z-change: 1.05). There were also curvilinear improvements in self-determination and self-reported MHRS symptom management and functioning scores; however, only modest changes were detected in hope (Herth Hope Index) and MHRS self-belief scores. Change scores based on self-reported and clinician-rated measures tended to be uncorrelated. An exploration of client-level outcomes revealed three recovery trajectory subgroups: transient (21.7%), gradual (34.8%), or sustained (43.5%) improvement; with members of the latter group tending to have longer illness durations. The study's findings are encouraging, to the extent that they demonstrate recovery-focused sub-acute inpatient programs can promote clinical recovery and aspects of personal recovery. However, they also suggest that recovery perspectives differ between clients and clinicians, and that far more work is required to understand the psychological factors that generate and sustain the hope that recovery is possible.


Asunto(s)
Trastornos Mentales , Servicios de Salud Mental , Adulto , Cuidados Posteriores , Humanos , Pacientes Internos , Trastornos Mentales/terapia , Alta del Paciente
6.
Aust N Z J Psychiatry ; 54(9): 902-908, 2020 09.
Artículo en Inglés | MEDLINE | ID: mdl-31735061

RESUMEN

OBJECTIVES: Large-scale genetic analysis of common variation in schizophrenia has been a powerful approach to understanding this complex but highly heritable psychotic disorder. To further investigate loci, genes and pathways associated more specifically in the well-characterized Australian Schizophrenia Research Bank cohort, we applied genome-wide single-nucleotide polymorphism analysis in these three annotation categories. METHODS: We performed a case-control genome-wide association study in 429 schizophrenia samples and 255 controls. Post-genome-wide association study analyses were then integrated with genomic annotations to explore the enrichment of variation at the gene and pathway level. We also examine candidate single-nucleotide polymorphisms with potential function within expression quantitative trait loci and investigate overall enrichment of variation within tissue-specific functional regulatory domains of the genome. RESULTS: The strongest finding (p = 2.01 × 10-6, odds ratio = 1.82, 95% confidence interval = [1.42, 2.33]) in genome-wide association study was with rs10252923 at 7q21.13, downstream of FZD1 (frizzled class receptor 1). While this did not stand alone after correction, the involvement of FZD1 was supported by gene-based analysis, which exceeded the threshold for genome-wide significance (p = 2.78 × 10-6). CONCLUSION: The identification of FZD1, as an independent association signal at the gene level, supports the hypothesis that the Wnt signalling pathway is altered in the pathogenesis of schizophrenia and may be an important target for therapeutic development.


Asunto(s)
Estudio de Asociación del Genoma Completo , Esquizofrenia , Australia , Estudios de Cohortes , Receptores Frizzled/genética , Predisposición Genética a la Enfermedad , Humanos , Polimorfismo de Nucleótido Simple/genética , Esquizofrenia/genética
7.
Cogn Affect Behav Neurosci ; 19(3): 653-676, 2019 06.
Artículo en Inglés | MEDLINE | ID: mdl-31119652

RESUMEN

Neurobiological models explain increased risk-taking behaviours in adolescence and young adulthood as arising from staggered development of subcortical reward networks and prefrontal control networks. In this study, we examined whether individual variability in impulsivity and reward-related mechanisms is associated with higher level of engagement in risky behaviours and vulnerability to maladaptive outcomes and whether this relationship is mediated by cognitive control ability. A community sample of adolescents, young adults, and adults (age = 15-35 years) completed self-report measures and behavioural tasks of cognitive control, impulsivity, and reward-related mechanisms, and self-reported level of maladaptive outcomes. Behavioural, event-related potential (ERP), and multivariate pattern analysis (MVPA) measures of proactive control were derived from a task-switching paradigm. Adolescents, but not young adults, reported higher levels of impulsivity, reward-seeking behaviours and maladaptive outcomes than adults. They also had lower cognitive control ability, as measured by both self-report and task-based measures. Consistent with models of risk-taking behaviour, self-reported level of cognitive control mediated the relationship between self-reported levels of impulsivity and psychological distress, but the effect was not moderated by age. In contrast, there was no mediation effect of behavioural or EEG-based measures of cognitive control. These findings suggest that individual variability in cognitive control is more crucial to the relationship between risk-taking/impulsivity and outcomes than age itself. They also highlight large differences in measurement between self-report and task-based measures of cognitive control and decision-making under reward conditions, which should be considered in any studies of cognitive control.


Asunto(s)
Conducta del Adolescente/fisiología , Potenciales Evocados/fisiología , Función Ejecutiva/fisiología , Conducta Impulsiva/fisiología , Desempeño Psicomotor/fisiología , Recompensa , Adolescente , Adulto , Electroencefalografía , Femenino , Humanos , Masculino , Autoinforme , Adulto Joven
8.
Eur Arch Psychiatry Clin Neurosci ; 269(1): 17-35, 2019 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-30661105

RESUMEN

Access to cannabis and cannabinoid products is increasing worldwide for recreational and medicinal use. Two primary compounds within cannabis plant matter, Δ9-tetrahydrocannabinol (THC) and cannabidiol (CBD), are both psychoactive, but only THC is considered intoxicating. There is significant interest in potential therapeutic properties of these cannabinoids and of CBD in particular. Some research has suggested that CBD may ameliorate adverse effects of THC, but this may be dose dependent as other evidence suggests possible potentiating effects of THC by low doses of CBD. We conducted a randomised placebo controlled trial to examine the acute effects of these compounds alone and in combination when administered by vaporisation to frequent and infrequent cannabis users. Participants (n = 36; 31 male) completed 5 drug conditions spaced one week apart, with the following planned contrasts: placebo vs CBD alone (400 mg); THC alone (8 mg) vs THC combined with low (4 mg) or high (400 mg) doses of CBD. Objective (blind observer ratings) and subjective (self-rated) measures of intoxication were the primary outcomes, with additional indices of intoxication examined. CBD showed some intoxicating properties relative to placebo. Low doses of CBD when combined with THC enhanced, while high doses of CBD reduced the intoxicating effects of THC. The enhancement of intoxication by low-dose CBD was particularly prominent in infrequent cannabis users and was consistent across objective and subjective measures. Most effects were significant at p < .0001. These findings are important to consider in terms of recommended proportions of THC and CBD in cannabis plant matter whether used medicinally or recreationally and have implications for novice or less experienced cannabis users.Trial registration: ISRCTN Registry Identifier: ISRCTN24109245.


Asunto(s)
Cannabidiol/farmacología , Moduladores de Receptores de Cannabinoides/farmacología , Cannabis , Trastornos Disociativos/inducido químicamente , Dronabinol/farmacología , Efectos Colaterales y Reacciones Adversas Relacionados con Medicamentos , Trastornos de la Percepción/inducido químicamente , Adolescente , Adulto , Presión Sanguínea/efectos de los fármacos , Cannabidiol/administración & dosificación , Cannabidiol/efectos adversos , Moduladores de Receptores de Cannabinoides/administración & dosificación , Moduladores de Receptores de Cannabinoides/efectos adversos , Dronabinol/administración & dosificación , Interacciones Farmacológicas , Femenino , Frecuencia Cardíaca/efectos de los fármacos , Humanos , Masculino , Persona de Mediana Edad , Autoinforme , Adulto Joven
9.
Hum Brain Mapp ; 38(3): 1588-1603, 2017 03.
Artículo en Inglés | MEDLINE | ID: mdl-27879030

RESUMEN

Task-switching performance relies on a broadly distributed frontoparietal network and declines in older adults. In this study, they investigated whether this age-related decline in task switching performance was mediated by variability in global or regional white matter microstructural health. Seventy cognitively intact adults (43-87 years) completed a cued-trials task switching paradigm. Microstructural white matter measures were derived using diffusion tensor imaging (DTI) analyses on the diffusion-weighted imaging (DWI) sequence. Task switching performance decreased with increasing age and radial diffusivity (RaD), a measure of white matter microstructure that is sensitive to myelin structure. RaD mediated the relationship between age and task switching performance. However, the relationship between RaD and task switching performance remained significant when controlling for age and was stronger in the presence of cardiovascular risk factors. Variability in error and RT mixing cost were associated with RaD in global white matter and in frontoparietal white matter tracts, respectively. These findings suggest that age-related increase in mixing cost may result from both global and tract-specific disruption of cerebral white matter linked to the increased incidence of cardiovascular risks in older adults. Hum Brain Mapp 38:1588-1603, 2017. © 2016 Wiley Periodicals, Inc.


Asunto(s)
Envejecimiento/patología , Trastorno por Déficit de Atención con Hiperactividad/diagnóstico por imagen , Trastorno por Déficit de Atención con Hiperactividad/patología , Sustancia Blanca/diagnóstico por imagen , Adulto , Anciano , Anciano de 80 o más Años , Enfermedades Cardiovasculares/patología , Señales (Psicología) , Imagen de Difusión Tensora , Función Ejecutiva , Femenino , Humanos , Procesamiento de Imagen Asistido por Computador , Masculino , Persona de Mediana Edad , Fibras Nerviosas Mielínicas/patología , Pruebas Neuropsicológicas , Tiempo de Reacción/fisiología , Análisis de Regresión , Factores de Riesgo
10.
Brain Behav Immun ; 63: 8-20, 2017 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-27423491

RESUMEN

Maternal exposure to infectious agents during gestation has been identified as a significant risk factor for schizophrenia. Using a mouse model, past work has demonstrated that the gestational timing of the immune-activating event can impact the behavioural phenotype and expression of dopaminergic and glutamatergic neurotransmission markers in the offspring. In order to determine the inter-species generality of this effect to rats, another commonly used model species, the current study investigated the impact of a viral mimetic Poly (I:C) at either an early (gestational day 10) or late (gestational day 19) time-point on schizophrenia-related behaviour and neurotransmitter receptor expression in rat offspring. Exposure to Poly (I:C) in late, but not early, gestation resulted in transient impairments in working memory. In addition, male rats exposed to maternal immune activation (MIA) in either early or late gestation exhibited sensorimotor gating deficits. Conversely, neither early nor late MIA exposure altered locomotor responses to MK-801 or amphetamine. In addition, increased dopamine 1 receptor mRNA levels were found in the nucleus accumbens of male rats exposed to early gestational MIA. The findings from this study diverge somewhat from previous findings in mice with MIA exposure, which were often found to exhibit a more comprehensive spectrum of schizophrenia-like phenotypes in both males and females, indicating potential differences in the neurodevelopmental vulnerability to MIA exposure in the rat with regards to schizophrenia related changes.


Asunto(s)
Efectos Tardíos de la Exposición Prenatal/inmunología , Esquizofrenia/inmunología , Animales , Conducta Animal/fisiología , Modelos Animales de Enfermedad , Femenino , Masculino , Exposición Materna , Memoria a Corto Plazo/efectos de los fármacos , Actividad Motora/efectos de los fármacos , Poli I-C/farmacología , Embarazo , Ratas , Ratas Wistar , Reflejo de Sobresalto/efectos de los fármacos , Esquizofrenia/etiología
11.
Neuroimage ; 124(Pt B): 1137-1142, 2016 Jan 01.
Artículo en Inglés | MEDLINE | ID: mdl-25936806

RESUMEN

Our understanding of the complex interplay between structural and functional organisation of brain networks is being advanced by the development of novel multi-modal analyses approaches. The Age-ility Project (Phase 1) data repository offers open access to structural MRI, diffusion MRI, and resting-state fMRI scans, as well as resting-state EEG recorded from the same community participants (n=131, 15-35 y, 66 male). Raw imaging and electrophysiological data as well as essential demographics are made available via the NITRC website. All data have been reviewed for artifacts using a rigorous quality control protocol and detailed case notes are provided.


Asunto(s)
Envejecimiento/fisiología , Envejecimiento/psicología , Bases de Datos Factuales , Electroencefalografía , Electrofisiología/estadística & datos numéricos , Imagen por Resonancia Magnética/métodos , Adolescente , Conducta del Adolescente , Adulto , Artefactos , Cognición , Femenino , Humanos , Difusión de la Información , Masculino , Control de Calidad , Factores Socioeconómicos , Adulto Joven
12.
Neural Plast ; 2016: 6526437, 2016.
Artículo en Inglés | MEDLINE | ID: mdl-27019754

RESUMEN

Prolonged heavy exposure to cannabis is associated with impaired cognition and brain functional and structural alterations. We recently reported attenuated mismatch negativity (MMN) and altered P50 sensory gating in chronic cannabis users. This study investigated the extent of brain functional recovery (indexed by MMN and P50) in chronic users after cessation of use. Eighteen ex-users (median 13.5 years prior regular use; median 3.5 years abstinence) and 18 nonusers completed (1) a multifeature oddball task with duration, frequency, and intensity deviants and (2) a P50 paired-click paradigm. Trend level smaller duration MMN amplitude and larger P50 ratios (indicative of poorer sensory gating) were observed in ex-users compared to controls. Poorer P50 gating correlated with prior duration of cannabis use. Duration of abstinence was positively correlated with duration MMN amplitude, even after controlling for age and duration of cannabis use. Impaired sensory gating and attenuated MMN amplitude tended to persist in ex-users after prolonged cessation of use, suggesting a lack of full recovery. An association with prolonged duration of prior cannabis use may indicate persistent cannabis-related alterations to P50 sensory gating. Greater reductions in MMN amplitude with increasing abstinence (positive correlation) may be related to either self-medication or an accelerated aging process.


Asunto(s)
Corteza Cerebral/fisiopatología , Potenciales Evocados , Fumar Marihuana/fisiopatología , Filtrado Sensorial , Estimulación Acústica , Adulto , Electroencefalografía , Potenciales Evocados Auditivos , Femenino , Humanos , Masculino , Fumar Marihuana/efectos adversos , Persona de Mediana Edad , Adulto Joven
13.
Neuroimage ; 108: 354-63, 2015 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-25528657

RESUMEN

Cognitive control involves both proactive and reactive processes. Paradigms that rely on reactive control have shown that frontoparietal oscillatory synchronization in the theta frequency band is associated with interference control. This study examines whether proactive control is also associated with connectivity in the same frontoparietal theta network or involves a distinct neural signature. A task-switching paradigm was used to differentiate between proactive and reactive control processes, involved in preparing to switch or repeat a task and resolving post-target interference, respectively. We confirm that reactive control is associated with frontoparietal theta connectivity. Importantly, we show that proactive control is also associated with theta band oscillatory synchronization but in a different frontoparietal network. These findings support the existence of distinct proactive and reactive cognitive control processes that activate different theta frontoparietal oscillatory networks.


Asunto(s)
Cognición/fisiología , Lóbulo Frontal/fisiología , Red Nerviosa/fisiología , Lóbulo Parietal/fisiología , Ritmo Teta/fisiología , Adulto , Mapeo Encefálico , Electroencefalografía , Femenino , Humanos , Masculino
14.
J Clin Psychopharmacol ; 35(6): 672-80, 2015 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-26485340

RESUMEN

Hospital-treated deliberate self-poisoning (DSP) by central nervous system depressant drugs (CNS-D) has been associated with impairments in cognitive and psychomotor functions at the time of discharge. We aimed to replicate this finding and to compare recovery in the first month after discharge for CNS-D and CNS nondepressant drug ingestions. We also examined a series of multivariate explanatory models of recovery of neurocognitive outcomes over time. The CNS-D group was impaired at discharge compared with the CNS-nondepressant group in cognitive flexibility, cognitive efficiency, and working memory. There were no significant differences at discharge in visual attention, processing speed, visuomotor speed, or inhibition speed. Both groups improved in the latter measures over 1 month of follow-up. However, the CNS-D group's recovery was significantly slower for key neurocognitive domains underlying driving in complex traffic situations, namely, cognitive flexibility, cognitive efficiency, and working memory. Patients discharged after DSP with CNS-D drugs have impairments of some critical cognitive functions that may require up to 1 month to recover. Although more pre- than post-DSP variables were retained as explanatory models of neurocognitive performance overall, recovery over time could not be explained by any one of the measured covariates. Tests of cognitive flexibility could be used in clinical settings as a proxy measure for recovery of driving ability. Regulatory authorities should also consider the implications of these results for the period of nondriving advised after ingestion of CNS-D in overdose. Future research, with adequate sample size, should examine contributions of other variables to the pattern of recovery over time.


Asunto(s)
Conducción de Automóvil , Fármacos del Sistema Nervioso Central/envenenamiento , Depresores del Sistema Nervioso Central/envenenamiento , Trastornos del Conocimiento/inducido químicamente , Sobredosis de Droga/complicaciones , Desempeño Psicomotor/efectos de los fármacos , Intento de Suicidio , Adulto , Femenino , Humanos , Estudios Longitudinales , Masculino , Persona de Mediana Edad , Evaluación de Resultado en la Atención de Salud , Recuperación de la Función
15.
PCN Rep ; 2(3): e144, 2023 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-38867817

RESUMEN

The brain potential known as mismatch negativity (MMN) is one of the most studied indices of altered brain function in schizophrenia. This review looks at what has been learned about MMN in schizophrenia over the last three decades and why the level of interest and activity in this field of research remains strong. A diligent consideration of available evidence suggests that MMN can serve as a biomarker in schizophrenia, but perhaps not the kind of biomarker that early research supposed. This review concludes that MMN measurement is likely to be most useful as a monitoring and response biomarker enabling tracking of an underlying pathology and efficacy of interventions, respectively. The role of, and challenges presented by, pre-clinical models is discussed as well as the merits of different methodologies that can be brought to bear in pursuing a deeper understanding of pathophysiology that might explain smaller MMN in schizophrenia.

16.
J Clin Psychopharmacol ; 32(4): 503-10, 2012 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-22722510

RESUMEN

Central nervous system depressant drugs (CNS-Ds) are known to impair cognitive functions. Overdose of these drugs is common, and most of the hospital-treated patients are discharged within 24 to 48 hours. No previous studies have examined whether they have residual impairment at the time of discharge. Our aim was to evaluate whether patients with CNS-D overdose are impaired in cognitive domains important in daily activities at that time. We compared visuomotor skills (Trail-Making Test A and Choice Reaction Time), executive functions (viz attentional set-shifting: Trail-Making Test B; and planning: Stockings of Cambridge Task from the Cambridge Neuropsychological Test Automated Battery), working memory (Letter-Number Sequencing), and impulsivity and decision making (Cambridge Neuropsychological Test Automated Battery Information Sampling) in 107 patients with CNS-D overdose (benzodiazepines, opioids, or antipsychotics) with a control group of 68 with non-CNS-D overdose (acetaminophen, selective serotonin reuptake inhibitors, and serotonin noradrenaline reuptake inhibitors) on discharge from hospital. Outcome measures were adjusted for demographic and clinical covariates in multivariate regression models. Compared with the controls, patients in the CNS-D group were significantly impaired in all domains: they had prolonged Trail-Making completion times and reaction times, poorer working memory and planning and were more impulsive in decision making. Their Stockings of Cambridge Task performance was comparable to that of the control group for simple problems but worsened with increasing task complexity. The results show that patients with CNS-D overdose could be impaired in multiple cognitive domains underlying everyday functioning even at the time they are deemed medically fit to be discharged. Such impairments could adversely affect social and professional lives of this relatively young population during the immediate postdischarge period.


Asunto(s)
Analgésicos Opioides/envenenamiento , Antipsicóticos/envenenamiento , Benzodiazepinas/envenenamiento , Trastornos del Conocimiento/inducido químicamente , Adolescente , Adulto , Anciano , Atención/efectos de los fármacos , Estudios de Casos y Controles , Toma de Decisiones/efectos de los fármacos , Función Ejecutiva/efectos de los fármacos , Femenino , Humanos , Conducta Impulsiva/inducido químicamente , Masculino , Memoria a Corto Plazo/efectos de los fármacos , Persona de Mediana Edad , Destreza Motora/efectos de los fármacos , Pruebas Neuropsicológicas/estadística & datos numéricos , Mal Uso de Medicamentos de Venta con Receta , Desempeño Psicomotor/efectos de los fármacos
17.
Psychopharmacology (Berl) ; 239(5): 1409-1424, 2022 May.
Artículo en Inglés | MEDLINE | ID: mdl-34719731

RESUMEN

RATIONALE: Mismatch negativity (MMN) is a candidate endophenotype for schizophrenia subserved by N-methyl-D-aspartate receptor (NMDAR) function and there is increasing evidence that prolonged cannabis use adversely affects MMN generation. Few human studies have investigated the acute effects of cannabinoids on brain-based biomarkers of NMDAR function and synaptic plasticity. OBJECTIVES: The current study investigated the acute effects of Δ9-tetrahydrocannabinol (THC) and cannabidiol (CBD) alone and in combination on the mismatch negativity (MMN). METHODS: In a randomised, double-blind, crossover placebo-controlled study, 18 frequent and 18 less-frequent cannabis users underwent 5 randomised drug sessions administered via vaporiser: (1) placebo; (2) THC 8 mg; (3) CBD 400 mg; (4) THC 8 mg + CBD 4 mg [THC + CBDlow]; (5) THC 12 mg + CBD 400 mg [THC + CBDhigh]. Participants completed a multifeature MMN auditory oddball paradigm with duration, frequency and intensity deviants (6% each). RESULTS: Relative to placebo, both THC and CBD were observed to increase duration and intensity MMN amplitude in less-frequent users, and THC also increased frequency MMN in this group. The addition of low-dose CBD added to THC attenuated the effect of THC on duration and intensity MMN amplitude in less-frequent users. The same pattern of effects was observed following high-dose CBD added to THC on duration and frequency MMN in frequent users. CONCLUSIONS: The pattern of effects following CBD combined with THC on MMN may be subserved by different underlying neurobiological interactions within the endocannabinoid system that vary as a function of prior cannabis exposure. These results highlight the complex interplay between the acute effects of exogenous cannabinoids and NMDAR function. Further research is needed to determine how this process normalises after the acute effects dissipate and following repeated acute exposure.


Asunto(s)
Cannabidiol , Cannabinoides , Cannabis , Alucinógenos , Cannabidiol/farmacología , Dronabinol/farmacología , Humanos
18.
Neuroscience ; 456: 106-113, 2021 02 21.
Artículo en Inglés | MEDLINE | ID: mdl-32045628

RESUMEN

Mismatch negativity (MMN) is an electrophysiological signature that occurs in response to unexpected stimuli. It is often referred to as a measure of memory-based change detection, because the elicitation of a prediction error response relies on the formation of a prediction, which in turn, is dependent upon intact memory of previous auditory stimulation. As such, the MMN is altered in conditions in which memory is affected, such as Alzheimer's disease, schizophrenia and healthy aging. The most prominent pharmacological finding for MMN strengthens the link between MMN and synaptic plasticity, as glutamate N-methyl-d-aspartate receptor (NMDA-R) antagonists reduce the MMN response. However, recent data has begun to demonstrate that the link between NMDA-R function and MMN is not as clear as once thought, with low dose and low affinity NMDA-R antagonists observed to facilitate MMN.


Asunto(s)
Potenciales Evocados Auditivos , Ácido Glutámico , Estimulación Acústica , Electroencefalografía , Plasticidad Neuronal , Transmisión Sináptica
19.
Hear Res ; 399: 107992, 2021 01.
Artículo en Inglés | MEDLINE | ID: mdl-32571607

RESUMEN

Rodent models play a significant role in understanding disease mechanisms and the screening of new treatments. With regard to psychiatric disorders such as schizophrenia, however, it is difficult to replicate the human symptoms in rodents because these symptoms are often either 'uniquely human' or are only conveyed via self-report. There is a growing interest in rodent mismatch responses (MMRs) as a translatable 'biomarker' for disorders such as schizophrenia. In this review, we will summarize the attributes of human MMN, and discuss the scope of exploring the attributes of human MMN in rodents. Here, we examine how reliably MMRs that are measured in rats mimic human attributes, and present original data examining whether manipulations of stimulus conditions known to modulate human MMN, do the same for rat MMRs. Using surgically-implanted epidural electroencephalographic electrodes and wireless telemetry in freely-moving rats, we observed human-like modulations of MMRs, namely that larger MMRs were elicited to unexpected (deviant) stimuli that a) had a larger change in pitch compared to the expected (standard) stimulus, b) were less frequently presented (lower probability), and c) had no jitter (stable stimulus onset asynchrony) compared to high jitter. Overall, these findings contribute to the mounting evidence for rat MMRs as a good analogue of human MMN, bolstering the development of a novel approach in future to validate the preclinical models based on a translatable biomarker, MMN.


Asunto(s)
Potenciales Evocados Auditivos , Estimulación Acústica , Animales , Electroencefalografía , Humanos , Ratas , Esquizofrenia
20.
Front Neurol ; 12: 612177, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-34163417

RESUMEN

Background and Purpose: Altered executive functions and resting-state functional connectivity (rsFC) are common following a minor stroke or transient ischemic attack (TIA). However, the long-term persistence of these abnormalities is not well-studied. We investigated whether there were cognitive and rsFC differences between (a) controls and minor cerebrovascular event (CVE) patients and (b) between CVE patients with and without an imaging confirmed infarct (i.e., minor stroke and TIA, respectively) at an average of 3.8 years following their event. Methods: Structural and resting-state imaging and cognitive assessments including the Montreal Cognitive Assessment, the Trail Making Task and the National Institute of Health (NIH) Cognition Toolbox were conducted on 42 patients (minor stroke = 17, TIA = 25) and 20 healthy controls (total N = 62). Results: Controls performed better than patients on two measures of executive functioning (both p < 0.046) and had reduced rsFC between the frontoparietal and default mode networks (FPN and DMN, respectively; p = 0.035). No cognitive differences were found between minor stroke and TIA patients, however, rsFC differences were found within the FPN and the DMN (both p < 0.013). Specifically, increased connectivity within the FPN was associated with faster performance in the minor stroke group but not the TIA group (p = 0.047). Conclusions: These findings suggest that transient or relatively minor cerebrovascular events are associated with persistent disruption of functional connectivity of neural networks and cognitive performance. These findings suggest a need for novel interventions beyond secondary prevention to reduce the risk of persistent cognitive deficits.

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