Paradoxical Kinesia Induced by Nightmare: Unique Case Report and Insights regarding the Neural Mechanism Based on Human and Rat Studies.

Introduction: Bradykinesia, characterized by slowed movement, stands out as a primary symptom observed in individuals with Parkinson's disease (PD). Nonetheless, there are instances where PD patients exhibit sudden and effective movements despite the presence of bradykinesia. This phenomenon, referred to as paradoxical kinesia, has remained a subject of interest for neuroscientists, who have struggled to unravel its underlying neural mechanisms for decades. Case Presentation: We describe a patient who is suffering from advanced PD. The patient has severe motor limitations, including difficulty rising from bed and walking, as well as cognitive decline and visual impairment. However, an interesting occurrence took place during a nightmare episode. Surprisingly, the patient was able to get out of bed and quickly run away from the perceived threat within the nightmare, without any assistance. Conclusion: This report presents the first documented case of paradoxical kinesia induced by nightmares in a patient with PD. This phenomenon raises questions about the neurological mechanisms involved, which are still not fully understood. Based on existing research conducted on both animal and human subjects, we propose that after processing the emotion of fear, the brain aversive system activates motor outputs to generate appropriate behavior. Thus, the brain aversive system converts the emotion of fear into action through projections from the inferior colliculus to motor-related areas such as the mesencephalic locomotor region, pontine nuclei, and substantia nigra.

Association between religiosity/spirituality and substance use among homeless individuals.

BACKGROUND: Alcohol and illicit drug use are prevalent among homeless people. Religiosity and spirituality (RS) have been widely associated with lower consumption of substances. However, evidence of this relationship among homeless people is still scarce. AIMS: To evaluate the associations between RS and alcohol and illicit drug consumption among homeless people in a large Brazilian urban center. METHOD: This cross-sectional study was carried out in São Paulo city, Brazil. Aspects such as spirituality (FACIT-Sp12), religiosity (DUREL), spiritual-religious coping (Brief-RCOPE), and self-report questions concerning the current substance use (alcohol and illicit substances) were evaluated. Adjusted logistic regression models were used to assess the impact of RS beliefs on alcohol and illicit drug consumption. RESULTS: A total of 456 homeless people were included, of an average age of 44.5 (SD = 12.6) years. More than half of the participants consumed alcohol (55.7%) weekly and 34.2% used illicit drugs weekly. Adjusted logistic regression models identified that aspects of RS were associated with lower likelihood factors for alcohol and illicit drug use; conversely, negative spiritual religious coping (SRC) strategies were associated with a higher likelihood to use both. CONCLUSION: The prevalence of alcohol and illicit drug use among participants was high. RS and positive SRC were important protective factors for lower consumption of these substances. Conversely, negative SRC strategies were associated with risk factors.

Esquizofrenia e cognição: entendendo as dimensões atencionais, perceptuais e mnemônicas da esquizofrenia / Schizophrenia and cognition: understanding the attentional, perceptual and mnemonic dimensions of schizophrenia / Esquizofrenia y cognición: comprensión de las dimensiones atencional, perceptivas y mnemotécnicas de la esquizofrenia

A esquizofrenia é um transtorno mental grave e incapacitante que tem como critérios diagnósticos sintomas positivos, negativos, discurso e pensamento desorganizado ou catatônico. Cursa com importantes disfunções cognitivas com impactos na atenção, na função executiva, em memória operacional e de trabalho, entre outras. Tais déficits podem estar presentes antes dos sintomas positivos ou mesmo, de maneira subsindrômica desde a infância desses indivíduos. A hipótese dopaminérgica é a mais aceita na gênese das disfunções neuroquímicas, mas há cada vez mais evidência do envolvimento de outros sistemas como o glutamatérgico e o serotoninérgico. No que se refere especificamente aos déficits cognitivos, destacam-se disfunções em córtex pré-frontal, especialmente sua porção dorsolateral e suas conexões com o hipocampo. Entende-se ainda que é muito importante a avaliação cognitiva das pessoas acometidas por essa patologia e existem baterias de testes neuropsicológicos disponíveis como é o caso do Measurement and Treatment Research to Improve Cognition in Schizophrenia (MATRICS) e de testes validados no Brasil como o Brief Assessment of Cognition in Schizophrenia (BACS). Tendo em vista a elevada perda de funcionalidade e qualidade de vida desses pacientes, sobretudo daqueles mais acometidos na capacidade cognitiva, há uma necessidade de maiores esforços para o entendimento desse complexo transtorno com vistas a tratamentos mais eficazes e até mesmo desenvolvimento de estratégias preventivas.

Schizophrenia is a serious and disabling mental disorder whose diagnostic criteria are positive or negative symptoms, disorganized or catatonic speech and thinking. It takes place with important cognitive dysfunctions with impacts on attention, executive function, working memory, among others. Such deficits may be present before positive symptoms or even, in a subsyndromal manner since the childhood of these individuals. The dopaminergic hypothesis is the most accepted in the genesis of neurochemical disorders, but there is increasing evidence of the involvement of other systems such as glutamatergic and serotonergic. With regard specifically to cognitive deficits, dysfunctions in the prefrontal cortex stand out, especially its dorsolateral portion and its connections with the hippocampus. It is also understood that the cognitive test of people affected by this pathology is very important and there are neuropsychological tests batteries available, such as Measurement and Treatment Research to Improve Cognition in Schizophrenia (MATRICS) and tests validated in Brazil such as the Brief Assessment of Cognition in Schizophrenia (BACS). Considering the high loss of functionality and life quality of these patients, especially those more affected in cognitive ability, there is a need for greater efforts to understand this complex disorder aiming more effective treatments and even the development of preventive strategies.

La esquizofrenia es un trastorno mental grave e incapacitante cuyos criterios de diagnóstico son síntomas positivos, negativos, habla y pensamiento desorganizados o catatónicos. Se lleva a cabo con importantes disfunciones cognitivas con impactos en la atención, la función ejecutiva, el trabajo y la memoria de trabajo, entre otros. Tales déficits pueden estar presentes antes de los síntomas positivos o incluso, de manera subsindrómica desde la infancia de estos individuos. La hipótesis dopaminérgica es la más aceptada en la génesis de los trastornos neuroquímicos, pero cada vez hay más evidencia de la participación de otros sistemas como el glutamatérgico y el serotoninérgico. Con respecto específicamente a los déficits cognitivos, se destacan las disfunciones en la corteza prefrontal, especialmente su porción dorsolateral y sus conexiones con el hipocampo. También se entiende que la evaluación cognitiva de las personas afectadas por esta patología es muy importante y hay baterías de pruebas neuropsicológicas disponibles, como la Measurement and Treatment Research to Improve Cognition in Schizophrenia (MATRICS) y pruebas validadas en Brasil como el Brief Assessment of Cognition in Schizophrenia (BACS). En vista de la alta pérdida de funcionalidad y calidad de vida de estos pacientes, especialmente los más afectados por la capacidad cognitiva, existe la necesidad de realizar mayores esfuerzos para comprender este complejo trastorno con miras a tratamientos más efectivos e incluso el desarrollo de estrategias preventivas.