A pilot study: comparative research of social functioning, circadian rhythm parameters, and cognitive function among institutional inpatients, and outpatients with chronic schizophrenia and healthy elderly people.

BACKGROUND: Irregular circadian rhythm and cognitive impairment are frequently observed in patients with chronic schizophrenia. However, their effects in different living environments or with aging remain unclear. The aim of this study was to clarify the characteristics of circadian rhythm and cognition function in the patients with chronic schizophrenia. METHODS: This report described data collected using continuous wrist-active monitoring in real-life settings for seven days and the Brief Assessment of Cognition in Schizophrenia Japanese Version (BACS-J) from 10 inpatients with chronic schizophrenia, 10 outpatients with chronic schizophrenia, and 15 healthy elderly people. The Global Assessment of Functioning (GAF) Scale was used to measure the social functioning in the patients with chronic schizophrenia. RESULTS: The outpatients with chronic schizophrenia exhibited highly interrupted circadian patterns in terms of stability and the fragmentation of activity (p < 0.05) as indexed according to Interdaily Stability (IS) and Intradaily Variability (IV). The inpatients with chronic schizophrenia indicated the most stable rhythm (p < 0.05) and inactive state (p = 0.001) among the groups. Also, the inpatients with chronic schizophrenia showed poorer cognitive functioning with Z-scores of subtests except digit sequencing (p < 0.01). According to stepwise linear regression analysis, the motor speed of BACS-J and IS of circadian parameters were the most powerful variables to predict the GAF in patients with chronic schizophrenia. CONCLUSIONS: The characteristics of circadian rhythm and cognition function in the inpatients with chronic schizophrenia appear distinct from those in the outpatients and the healthy elderly people. Circadian rhythm and cognition function in the patients with chronic schizophrenia may, in part, be affected by different living environments.

Phosphatidylserine induces functional and structural alterations of the membrane-associated pleckstrin homology domain of phospholipase C-delta1.

The membrane binding affinity of the pleckstrin homology (PH) domain of phospholipase C (PLC)-delta1 was investigated using a vesicle coprecipitation assay and the structure of the membrane-associated PH domain was probed using solid-state (13)C NMR spectroscopy. Twenty per cent phosphatidylserine (PS) in the membrane caused a moderate but significant reduction of the membrane binding affinity of the PH domain despite the predicted electrostatic attraction between the PH domain and the head groups of PS. Solid-state NMR spectra of the PH domain bound to the phosphatidylcholine (PC)/PS/phosphatidylinositol 4,5-bisphosphate (PIP(2)) (75 : 20 : 5) vesicle indicated loss of the interaction between the amphipathic alpha2-helix of the PH domain and the interface region of the membrane which was previously reported for the PH domain bound to PC/PIP(2) (95 : 5) vesicles. Characteristic local conformations in the vicinity of Ala88 and Ala112 induced by the hydrophobic interaction between the alpha2-helix and the membrane interface were lost in the structure of the PH domain at the surface of the PC/PS/PIP(2) vesicle, and consequently the structure becomes identical to the solution structure of the PH domain bound to d-myo-inositol 1,4,5-trisphosphate. These local structural changes reduce the membrane binding affinity of the PH domain. The effects of PS on the PH domain were reversed by NaCl and MgCl(2), suggesting that the effects are caused by electrostatic interaction between the protein and PS. These results generally suggest that the structure and function relationships among PLCs and other peripheral membrane proteins that have similar PH domains would be affected by the local lipid composition of membranes.

Quetiapine treatment of psychotic symptoms and aggressive behavior in patients with dementia with Lewy bodies: a case series.

The authors describe here the clinical outcomes of quetiapine treatment in nine patients with dementia with Lewy bodies (DLB) who manifested psychotic symptoms and aggressive behavior. Patients who had a score of 3 or higher on any of the three items of the Neuropsychiatric Inventory (NPI), agitation/aggression, hallucinations, and delusions, were given quetiapine 25-75 mg/day. Each patient's clinical status was assessed at baseline and after 4 and 8 weeks of treatment by using the NPI, Mini-Mental State Examination (MMSE), and Simpson-Angus Scale (S-A). Five of nine patients had a positive response with a decline of more than 50% in the sum of scores for three items of the NPI. The other three patients withdrew from quetiapine treatment due to somnolence or orthostatic hypotension. The remaining patient exhibited no clinically significant change in the NPI score. The S-A scale was not affected by quetiapine treatment in any patient. These findings suggest that quetiapine may be effective in treating psychotic symptoms and disruptive behavior in some patients with DLB. Further placebo-controlled, randomized, double-blind trials with this drug are needed to confirm this observation.

Effect of Duabanga grandiflora for human skin cells.

The purpose of this investigation was to evaluate the effects of Duabanga grandiflora (Sonneratiaceae), which has been used as a traditional Thai medicine on human skin cells. The leaf extract of D. grandiflora actively affected several human skin cells such as skin whitening, anti-aging and anti-inflammation. It became evident that the extract stimulated the production of type III collagen. The crude extract was fractionated and analyzed for stimulation of type III collagen production, and finally by HPLC to isolate an active compound which was determined to be eugeniin by EI-mass, (13)C NMR, (1)H NMR and acidic hydrolysis. Eugeniin has strong dose dependent activity for type III collagen production, with this being the first example of stimulation activity for type III collagen production.

Fluvoxamine augmentation in risperidone-resistant schizophrenia: an open trial.

We investigated the efficacy and safety of augmenting risperidone with fluvoxamine for the treatment of residual positive and negative symptoms in patients with chronic schizophrenia who had shown an incomplete response to risperidone. A total of 30 patients completed the open trial over a 12-week period during which fluvoxamine was added to risperidone. The result from the positive and negative syndrome scale (PANSS) and Simpson-Angus extrapyramidal effects (S-A) scale were examined at baseline, 1, 2, 4, 8 and 12 weeks of treatment. There were no significant differences in PANSS positive, negative and general psychopathology scores, or in S-A scale scores at any point during the treatment. These results suggest that fluvoxamine appears to be ineffective in augmenting the risperidone treatment response in chronic schizophrenic patients. Further controlled trials will be needed to confirm this observation.

Effect of quetiapine in the treatment of panic attacks in patients with schizophrenia: 3 case reports.

The authors describe three schizophrenic patients who suffered from panic attacks and experienced marked improvement of these episodes after switching to quetiapine from their previous antipsychotics (haloperidol, bromperidol, and risperidone), which have high dopamine antagonistic properties such as haloperidol, bromperidol, and risperidone.

Effectiveness of switching to quetiapine for neuroleptic-induced amenorrhea.

This study investigated the effectiveness and tolerability of a switching strategy using quetiapine in 16 women with schizophrenia who were suffering from haloperidol- or risperidone-induced amenorrhea. Findings revealed that 10 patients (71.6%) resumed menstruation, without worsening of psychotic symptoms.