[Neuroscience of creativity or can the ungraspable be captured?] / A kreativitás idegtudománya, avagy megragadható-e a megfoghatatlan?

Creativity is a particularly complex entity that can be best conceptualized along dimensions of opposite polarities. It can simultaneously be considered as a phenomenon that comprises a multitude of processes but also be interpreted as a complex construct which indeed does not have a uniformly accepted definition despite extensive literature on creativity. Creativity researchers of various approaches offer alongside methodological diversity a vast array of paradigms and definitions, leading, on the other hand, to contradictions of results. Nevertheless, the concept of creativity is to be maintained in the sense that it encompasses the ability to produce innovatively original, valuable, adaptive solutions breaking with pre-existing categories and developing unconventional alternatives. Since creativity cannot definitely be subject of scientific investigations as an overarching entity and its essence has not been grasped so far, some of its components can be measured and defined such as specific cognitive processes (divergent and convergent thinking, remote associations, conceptual expansion, working memory), motivational factors, emotional/affective conditions or personality traits considered as predictors of creative performance (schizotypal, autistic spectrum traits). Even though definitional inconsistencies persist, gradually neurobiological approaches have become the main issue of creativity research. Recently, the analysis of brain network activity applying methods of electrophysiology and brain imaging seems to promote the understanding of the functional localization of creative performance. Certain brain regions were initially identified as correlates of creativity, such as lateral prefrontal cortex, inferior parietal lobe, insula, striatum. More recent studies emphasize the activation and effective functional connectivity of large brain networks (default mode network, frontoparietal executive control, and others) as well as highlight the importance of their brain and neurochemical substrate (gray matter volume, white matter integrity, dopamine), connecting with cognitive processes of opposite style (flexibility versus persistence). While this paradigm seems to converge toward the delineation of a coherent neurobiological model of creativity, obviously we would not infer the essence of such a complex phenomenon from a simplified sub-process. Orv Hetil. 2023; 164(18): 683-693.

Seasonality and Delirium Tremens in Hospitalized Patients with Alcohol Dependence Syndrome.

INTRODUCTION: Due to the high rate of mortality, recognizing the contributing factors of alcohol-related delirium tremens (DT), which is the most severe form of alcohol withdrawal state (AWS) is pivotal in clinical settings. Previous studies suggested relationship between seasonality and other types of delirium; however, to our knowledge, this is the first empirical study which examined the role of seasonality in DT in alcohol dependence syndrome (ADS). METHODS: A retrospective study was undertaken between 2008 and 2015; medical records of 1,591 patients were included, which yielded 2,900 hospital appearances. Three groups were formed based on the ICD-10 diagnoses: ADS, AWS, and DT. The characteristics of the groups were analysed with one-way ANOVA and χ2 tests. Multinomial logistic regression was used to explore the potential predictors of DT, including seasonality. RESULTS: The highest incidence of DT was in spring (36.8%; χ2 (3) = 27.666; p < 0.001), especially in March (13.9%; χ2 (11) = 33.168; p < 0.001). Spring, higher mean age, higher presence of comorbid somatic disorders, and lower occurrence of comorbid psychiatric disorders were significant predictive variables for DT with the control of socio-demographic and clinical variables. CONCLUSIONS: The present study revealed that spring, especially March is a critical period in temperate climate zone regarding DT. This can be interpreted as a late winter effect since the temperature is lower in this month compared to other spring months. Furthermore, higher age and the occurrence of comorbid somatic disorders can be considered as risk factors in case of DT. These results support the need of further clinical studies to better understand the impact of seasonality on DT.

[The role of socialisation in psychosexual development].

INTRODUCTION: In the recent research and interpretation of the genetical-biological and environmental-social factors shaping psychosexual development, in addition to scientific arguments, more and more ideological and political aspect have received unfortunate emphasis. OBJECTIVE: Since the literature investigating the development of gender identity and gender orientation has not only increased, but also polarized, it is timely to look at the scientific exchange of ideas and debates among the differing positions. METHOD: Exploring the significance of genetic, biological and social factors involved in the development of gender identity and gender orientation based on international literature data. RESULTS: Based on the current state of science it can be concluded that, in addition to the indisputably marked genetic-biological factors, education and social patterns, as well as the extremely complex environmental and media-related influence with its variable intensity and diverse emotional content also play a significant role in the psychosexual development. This is supported, among other observations, by the data indicating that homoerotic behavior is more common in people raised by same-sex couples. CONCLUSION: As psychosexual development is determined jointly by both genetic-biological and social factors (like education, media etc), belonging to a sexual minority group is not a choice, not the result of a personal decision. Therefore, any kind of discrimination in this regard is unacceptable. Further scientific studies are necessary to answer a large number of questions that still remain open.

Externalizing personality characteristics define clinically relevant subgroups of alcohol use disorder.

AIMS: Higher levels of externalizing characteristics, i.e. impulsivity, novelty seeking and aggression, could contribute to the development, progression and severity of alcohol use disorder (AUD). The present study aims to explore whether these externalizing characteristics together have a potential group-forming role in AUD using latent profile analysis (LPA). METHODS: Externalizing characteristics of 102 AUD patients were analyzed using LPA to explore the group-forming role of externalizing symptoms; groups were compared in terms of demographic and alcohol-related variables, indices of psychopathological, depressive and anxiety symptom severity. RESULTS: LPA revealed and supported a two-group model based on externalizing symptoms. The group with higher levels of externalizing symptoms showed significantly elevated levels of alcohol-related and anxio-depressive symptoms. CONCLUSIONS: Externalizing characteristics converge and have a group-forming role in chronic AUD, and are associated with a more severe form of AUD. By making the diagnostic category less heterogeneous, these different subtypes within AUD may provide aid in tailoring treatments to patients' specific needs.

["Heavy mental" psychopathology in classical music].

Depending on affinity, attitude, preference, understanding, and mental state, music can influence emotions, mood, motivation, psychomotor, cognitive, and spiritual functions in the receptive person. It is presumed that a given music may reflect the actual psychic condition of the composer and, if applicable, the nature of the chosen topic to be characterized. However, extreme situations may emerge from these components i.e. the music might overshoot the frontiers of normal psychological phenomena and 'heavy mental' psychopathological symptoms or syndromes may appear in it. Present search restricts the wide range of music categories to the classical one (instrumental and vocal, opera included) and attempts to screen for such 'heavy mental' psychopathological signs beside mentioning the slighter symptoms. Phenomena of amnesia, dementia/delirium, mental retardation, biased perception, chemical/behavioural addiction, delusion, misidentification, mania, depression, suicide, anxiety, obsession-compulsion, conversion, disso - ciation, para/hyper/insomnia, sexual and personality disorders are listed as examples from the wide repertoire. The figure of the 'fool' and the topic of 'madness' (in general, and folia, tarantella) are mentioned as well as the appearance of some behavioural traits ('seven deadly sins'), feigning psychic/somatic states, pathological lying, mutism, stutterism, famous oracles, mesmerism, and employing magic or various potions. Mad scenes as psychotic conditions (often tran - sient if due to psychotrauma from romantic love) occur in many operas. However, quite a few of them have been written by Donizetti. Considering his life, behaviour and composing features, the question arises about Donizetti's ailment: was it mood disorder, Barbaja, or luetic derailment?

Temperament, character and decision-making characteristics of patients with major depressive disorder following a suicide attempt.

BACKGROUND: Multiple psychological factors of suicidal behaviour have been identified so far; however, little is known about state-dependent alterations and the interplay of the most prominent components in a suicidal crisis. Thus, the combined effect of particular personality characteristics and decision-making performance was observed within individuals who recently attempted suicide during a major depressive episode. METHODS: Fifty-nine medication-free major depressed patients with a recent suicide attempt (within 72 h) and forty-five healthy control individuals were enrolled in this cross-sectional study. Temperament and character factors, impulsivity and decision-making performance were assessed. Statistical analyses aimed to explore between-group differences and the most powerful contributors to suicidal behaviour during a depressive episode. RESULTS: Decision-making and personality differences (i.e. impulsivity, harm avoidance, self-directedness, cooperativeness and transcendence) were observed between the patient and the control group. Among these variables, decision-making, harm avoidance and self-directedness were shown to have the strongest impact on a recent suicide attempt of individuals with a diagnosis of major depressive disorder according to the results of the binary logistic regression analysis. The model was significant, adequately fitted the data and correctly classified 79.8% of the cases. CONCLUSIONS: The relevance of deficient decision-making, high harm avoidance and low self-directedness was modelled in the case of major depressed participants with a recent suicide attempt; meaning that these individuals can be described with the myopia for future consequences, a pessimistic, anxious temperament; and a character component resulting in the experience of aimlessness and helplessness. Further studies that use a within-subject design should identify and confirm additional characteristics specific to the suicidal mind.

Detection of acute stress by smooth muscle electromyography: A translational study on rat and human.

AIMS: Non-invasive and simultaneous recording of gastrointestinal (GI) activity during stress induction is still an unexplored field. In our previous investigation, the stress-induced alteration of the gastrointestinal tract was explored in rats. Our aims were to expand our previous rat experiment and to induce stress response in rats (Study 1) and humans (Study 2) to detect the GI tract activity, heart rate and body temperature. MATERIALS AND METHODS: In the preclinical sample, acute stress was induced by immobilization in Sprague-Dawley rats (N = 10). Acute stress response was generated by the Trier Social Stress Test among healthy volunteers (N = 16). Detection of acute stress was measured by using smooth muscle electromyography, which recorded the myoelectric waves of the gastrointestinal tract (stomach, ileum and colon) simultaneously with heart rate and body temperature in rats and humans. KEY FINDINGS: The myoelectric waves of the stomach, the cecum and the ileum increased during immobilization in rats, rising in parallel with heart rate and the dermal temperature of the abdominal surface. The same alterations were found during the stress period among humans, except in the case of the colon, where no change was detected. SIGNIFICANCE: The crucial role of the GI tract in stress response was revealed by translating the outcome of basic research into human results. The similar GI alterations during stress in rats and humans underpin the robustness of our findings. In summary, our preliminary translational-based study can serve as an appropriate basis for further human studies.

Evaluation of the course and treatment of Alcohol Withdrawal Syndrome with the Clinical Institute Withdrawal Assessment for Alcohol - Revised: A systematic review-based meta-analysis.

BACKGROUND: Although the Clinical Institute Withdrawal Assessment for Alcohol - Revised (CIWA-Ar) is a gold standard tool for the clinical evaluation of alcohol withdrawal syndrome (AWS), a systematic analysis using the total scores of the CIWA-Ar as a means of an objective follow-up of the course and treatment of AWS is missing. The aims of the present study were to systematically evaluate scientific data using the CIWA-Ar, to reveal whether the aggregated CIWA-Ar total scores follow the course of AWS and to compare benzodiazepine (BZD) and non-benzodiazepine (nBZD) therapies in AWS. METHODS: 1054 findings were identified with the keyword "ciwa" from four databases (PubMed, ScienceDirect, Web of Science, Cochrane Registry). Articles using CIWA-Ar in patients treated with AWS were incorporated and two measurement intervals (cumulative mean data of day 1-3 and day 4-9) of the CIWA-Ar total scores were compared. Subgroup analysis based on pharmacotherapy regimen was conducted to compare the effectiveness of BZD and nBZD treatments. RESULTS: The random effects analysis of 423 patients showed decreased CIWA-Ar scores between the two measurement intervals (BZD: d = -1.361; CI: -1.829 < δ < -0.893; nBZD: d = -0.858; CI: -1.073 < δ < -0.643). Sampling variances were calculated for the BZD (v1 = 0.215) and the nBZD (v2 = 0.106) groups, which indicated no significant group difference (z = -1.532). CONCLUSIONS: Our findings support that the CIWA-Ar follows the course of AWS. Furthermore, nBZD therapy has a similar effectiveness compared to BZD treatment based on the CIWA-Ar total scores.

The personality profile of chronic alcohol dependent patients with comorbid gambling disorder symptoms.

BACKGROUND AND AIMS: The importance of personality characteristics in the diagnosis and treatment of gambling disorder (GD) and alcohol use disorder (AUD) is often highlighted in scientific literature. This study aimed to test predictions about the associations of temperament and character in chronic AUD patients with comorbid GD symptoms and without them. METHODS: Chronic AUD patients enrolled from an inpatient clinic were divided in two groups based on cluster analysis, AUD patients with (AUD + GD group: n = 30) and without (AUD group: n = 68) GD symptoms. Severity of GD symptoms and personality dimensions (Cloninger's Temperament and Character Inventory Revised, TCI-R) were assessed. Associations of tested variables were analysed with analysis of covariance, one-sample and independent sample t-tests. RESULTS: GD symptoms proved to be a clustering factor in terms of personality, where AUD + GD group expressed a more maladaptive personality profile. Compared to Hungarian normative TCI-R scores, both patient groups showed elevated levels of Harm Avoidance and Novelty Seeking with lower scores of Self-directedness, while the AUD + GD group scored lower on Persistence and Cooperation as well. The AUD + GD group reported significantly higher levels of Harm Avoidance, with lower scores of Reward Dependence compared to the AUD group. DISCUSSION: Comorbid GD symptom severity is an important factor in chronic AUD, where AUD patients with comorbid GD symptoms exhibited a more maladaptive personality constellation than singular AUD patients. These emphasize the need of special attention for comorbid GD symptoms in AUD, since treatment recommendations and prognosis for them may also differ.

Different aspects of impulsivity in chronic alcohol use disorder with and without comorbid problem gambling.

BACKGROUND AND AIMS: Alcohol use disorder (AUD) and problem gambling are highly comorbid disorders. This study aims to explore the role of four aspects of impulsivity (trait concept of impulsivity, choice impulsivity, impulsive aggression and response inhibition/decision-making) in long-term chronic AUD patients with and without problem or pathological gambling symptoms. METHODS: Cognitively intact chronic AUD patients were enrolled with (n = 32) and without (n = 71) problem gambling symptoms in an inpatient clinic for chronic alcohol users. Multiple facets of impulsivity, cognitive ability, psychopathological symptoms, alcohol and gambling severity were measured. RESULTS: Chronic AUD patients with gambling disorder symptoms showed longer lifetime alcohol consumption, more severe alcohol use and higher psychopathological symptom severity than AUD patients without gambling symptoms. Gambling severity correlated with overall trait impulsivity, but not with choice impulsivity, impulsive aggression or cognitive impulsivity with controlling for lifetime alcohol consumption, lifetime alcohol use and psychopathological symptom severity. High trait impulsivity and non-planning was associated with comorbid gambling symptoms in AUD patients, which was independent of the level of intelligence, age and psychopathological symptoms. CONCLUSION: Comorbid gambling disorder symptoms in chronic AUD was connected to more severe alcohol-related variables. Higher trait impulsivity was also linked with gambling disorder symptoms in patients with chronic AUD. This accents the need of special focus on comorbid GD symptoms in AUD, since prognosis and treatment for them may vary.

[Tracing trace elements in mental functions]. / Nyomozás a nyomelemek mentális világában.

Trace elements are found in the living organism in small (trace) amounts and are mainly essential for living functions. Essential trace elements are in humans the chromium (Cr), cobalt (Co), copper (Cu), fluorine (F), iodine (I), iron (Fe), manganese (Mn), molybdenum (Mo), selenium (Se), zinc (Zn), and questionably the boron (B) and vanadium (V). According to the biopsychosocial concept, mental functions have biological underpinnings, therefore the impairment of certain neurochemical processes due to shortage of trace elements may have mental consequences. Scientific investigations indicate the putative role of trace element deficiency in psychiatric disorders such in depression (Zn, Cr, Se, Fe, Co, I), premenstrual dysphoria (Cr), schizophrenia (Zn, Se), cognitive deterioration/de-mentia (B, Zn, Fe, Mn, Co, V), mental retardation (I, Mo, Cu), binge-eating (Cr), autism (Zn, Mn, Cu, Co) and attention deficit hyperactivity disorder (Fe). At the same time, the excess quantity (chronic exposure, genetic error) of certain trace elements (Cu, Mn, Co, Cr, Fe, V) can also lead to mental disturbances (depression, anxiety, psychosis, cognitive dysfunction, insomnia). Lithium (Li), being efficacious in the treatment of bipolar mood disorder, is not declared officially as a trace element. Due to nutrition (drinking water, food) the serum Li level is about a thousand times less than that used in therapy. However, Li level in the red cells is lower as the membrane sodium-Li countertransport results in a Li efflux. Nevertheless, the possibility that Li is a trace element has emerged as studies indicate its potential efficacy in such a low concentration, since certain geographic regions show an inverse correlation between the Li level of drinking water and the suicide rate in that area.

[Eighty limericks with compliments to professor László Tringer].

Current writing is a tribute of respect, on the occasion of his 80th birthday, to professor László Tringer. In a somewhat unusual way, instead of a bouquet of 80 flowers, a bunch of 80 limericks is presented for him with compliments. The origin of the idea is that professor Tringer himself also writes poems and rhymes in his leasure time. The celebrated professor is an eminently recognized person in the profession, and he is one of the founding fathers of modern psychiatry in Hungary. After receiving the diploma in medical sciences, he has obtained one in psychology and in theology as well. Beside other qualifications he has specializations in psychiatry, neurology, clinical pharmacology, clinical psychology, psychotherapy, addictology and geriatry. Thanks to the providence, the author of the current writing has many common and unforgettable experiences with him. The 80 limericks on the one hand refer to these mutual memories and on the other hand reflect the author's subjective observations on some areas of the society, life situations, character depictions, psychiatry, other medical professions, mental functions, the brain's structural and neurochemical features, and several hints for life conduct. It is assumed that professor Tringer may not necessarily agree with all of these opinions. Nevertheless, these might serve as a basis for further mutual (and for him now over 80 years) inspiring consultations and intellectual adventures.

Mild Effect of Nalmefene on Alcoholic Cue-Induced Response Invigoration in Alcohol Use Disorder Without Accompanying Changes in Electrophysiological Signatures of Early Visual Processing and Executive Control.

Nalmefene is approved for as-needed pharmacological treatment in alcohol use disorder (AUD) by the European Medicines Agency. While the cellular effects of nalmefene have been thoroughly investigated, data are very limited on how this agent influences neural signals associated with inhibitory control and the visual analysis of environmental cues. This double-blind crossover study assessed the behavioral and neural effects of acute nalmefene administration in patients diagnosed with AUD. In experiment 1, we validated our experimental paradigm (electroencephalography combined with a modified Go/NoGo task using images of alcoholic and nonalcoholic drinks as prime stimuli) in 20 healthy adults to ensure that our protocol is suitable for assessing the behavioral and neural aspects of executive control. In experiment 2, we recruited 19 patients with AUD, and in a double-blind crossover design, we investigated the effects of nalmefene versus placebo on task performance (response accuracy, the sensitivity index, and reaction times), visual responses to appetitive cues (occipital P1, N1, and P2 components), and electrophysiological markers of conflict detection and response inhibition (frontal N2 and P3 waveforms). Under placebo, patients produced faster reaction times to alcohol-primed Go stimuli, an effect that was weak despite being statistically significant. However, the effect of alcoholic cues on the speed of response initiation disappeared after receiving nalmefene. We found no placebo versus nalmefene difference regarding our patients' ability to accurately inhibit responses to NoGo stimuli or for occipital and frontal event-related potentials. Our results suggest that nalmefene might be potent in reducing the vigor to act upon alcoholic cues in AUD patients, but this effect is most probably mediated via subcortical (rather than cortical) neural circuits.

[The first step towards a unified approach: validation of the Hungarian version of the Clinical Institute Withdrawal Assessment of Alcohol, Revised in Hungarian general hospital settings]. / Elso lépés egy egységes szemlélet felé: az Alkohol Megvonási Skála bevezetése a hazai betegellátási gyakorlatba.

Introduction and aim: The available literature and protocols have unequivocally suggested that the Clinical Institute Withdrawal Assessment of Alcohol, Revised is a psychometric scale for identifying and following the signs of alcohol withdrawal. However, there has not been any validated tool for the identification of withdrawal symptoms in Hungarian general hospital settings. The aim of the present study was to evaluate the validity and the reliability of the Hungarian version of this scale among patients hospitalized with alcohol withdrawal syndrome. Method: The translation of the scale into Hungarian was done by 'back translation' method, followed by testing the face validity. The empirical phase was performed in the Department of Psychiatry, University of Szeged. Patients admitted with alcohol withdrawal syndrome (n = 30) were recruited from the inpatient units of the clinic. Clinical Institute Withdrawal Assessment of Alcohol, Revised and Clinical Global Impression - Severity Scale were recorded every two days. Statistical comparisons of data were performed with repeated-measures ANOVA. Cronbach's alpha, item-total correlation, convergent and discriminant validity were determined. Results: Significant decrease of the total scores of Clinical Institute Withdrawal Assessment of Alcohol, Revised and Clinical Global Impression - Severity Scale was observed between the six measurements (F = 202.46, p<0.001; F = 503.04, p<0.001). Cronbach alpha values were above 0.7 during the first 3 measurement days. The withdrawal and severity scores recorded the same day showed positively significant correlations (>0.45). Conclusion: Our findings demonstrate that the Clinical Institute Withdrawal Assessment of Alcohol, Revised is a reliable and valid psychometric tool for the detailed analysis of withdrawal symptoms in Hungarian general hospital settings. Orv Hetil. 2019; 160(30): 1184-1192.

[Musica et medicina]. / Musica et medicina.

Depending on the personal attitude toward a given style and performance, music can influence mental activities such as emotion, mood, motivation, psychomotor tempo and possibly cognition. Experimental data indicate that music can alter physiological parameters of somatic functions (blood pressure, heart rhythm, peripheral blood flow, respiration). However, efforts are taken in medicine and neuroscience to decipher brain physiological and morphological correlates in processing or performing music. Modern imaging techniques brought a significant advance in this respect. It appears that there is no single music center in the brain, but depending on the components (melody, rhythm) of the music, more cerebral areas with strong network connections participate in that. Important regions are the upper temporal area (primary, secondary, tertiary auditory cortex), and parts of the frontal and parietal lobes, limbic system, and cerebellum. Beyond the above aspects, medicine joins to music in the field of music therapy. Meta-analyses of controlled studies show that music can be suitable to decrease stress, anxiety, and depression in various disease groups (cardiovascular, oncological, mental) and in medical examinations (surgical, urological, cardiac catheterization). Improvements were observed in motor, cognitive and psychosocial functions after music interventions in stroke rehabilitation. The links between mood disorders and creativity in music belong to medicine as well, where eminent composers can be mentioned, and also the examples of scholar and practitioner physicians playing or composing music superbly. Orv Hetil. 2019; 160(11): 403-418.

Association study of the ABCA7 rs3752246 polymorphism in Alzheimer's disease.

The ATP-binding cassette, sub-family A, member 7 (ABCA7) gene has been identified as a strong genetic risk locus for Alzheimer's disease (AD). Our case-control study (416 AD patients and 302 controls) provides further data on the rs3752246 polymorphism in AD in the Hungarian population that has not been investigated so far regarding the ABCA7 gene variants. A modest, marginally significant association of the G allele containing genotypes with AD was observed (p = 0.054). In line with the previous results in other populations, the G allele carriers had an increased risk for developing AD considering C/C genotype as reference category.

Decision-making performance of depressed patients within 72 h following a suicide attempt.

BACKGROUND: The significance of decision-making in suicidal behaviour is often highlighted; however, the performance of persons in suicide crisis is unknown. This study aimed to explore the comprehensive decision-making profile of depressed patients following a suicide attempt. METHODS: Decision-making was measured by reward- ("ABCD") and punishment- ("EFGH") sensitive versions of the Iowa Gambling Task (IGT) in 59 medication-free depressed patients within 72 h after a suicide attempt and in 46 healthy control subjects. Severity of depressive symptoms was assessed in the patient group by the Hamilton Depression Rating Scale. RESULTS: Performance of the two groups differed significantly on the IGT ABCD, while a trend towards significant differences was seen on the IGT EFGH. Severity of depressive symptoms did not affect the depressed participants' decision-making performance. LIMITATIONS: Subjects were not matched for years of education. Administration of the IGT ABCD and IGT EFGH was not counterbalanced. Methods of suicide attempts and history of previous attempts were not collected. CONCLUSIONS: Individuals with a recent suicide attempt showed decision-making dysfunction on both IGT versions. However, on the EFGH, the overall difference between groups was not significant, depressed participants' performance remained poor during all blocks. Their behaviour reflected a focus on best immediate possible outcomes, not regarding future adverse consequences. This could be a result of psychological and cognitive alterations which modulate suicidal behaviour independent from mood. Further longitudinal studies should verify this possibility. Investigation of state-dependent neuropsychological characteristics of suicidal behaviour might be essential for detecting acute suicidal crisis.

ABCA1 rs2230805 and rs2230806 common gene variants are associated with Alzheimer's disease.

The ATP-binding cassette, sub-family A, member 1 gene (ABCA1) is a relevant positional and functional candidate gene for Alzheimer's disease (AD). A case-control association study of genetic variations covering the ABCA1 locus was performed in relation to AD risk in a Hungarian sample. Five single nucleotide polymorphisms (rs2422493: C-477T, rs2740483: G-17C, rs2230805: G474A/L158L, rs2230806: G656A/R219K and rs2066718: G2311A/V771M) were genotyped in 431 AD patients and 302 cognitively healthy, elderly controls. In single marker analysis, significant associations were found in the case of rs2230805 and rs2230806 polymorphisms: the minor A allele containing genotypes for both polymorphisms were more frequent in the control compared to the AD group. Haplotype analysis revealed that rs2230805, rs2230806 and rs2066718 polymorphisms created a linkage disequilibrium (LD) block with a strong LD between rs2230805 and rs2230806 polymorphisms. In the haplotype risk association tests, A-A-G haplotype of the rs2230805-rs2230806-rs2066718 polymorphisms was found to be nominally significantly more frequent in the control group. After correcting p values for multiple testing, only the effects of the rs2230805 and rs2230806 polymorphisms remained significant in the recessive model suggesting a modest protective effect of their minor alleles in AD, which should be interpreted with considerable caution, until further studies elucidate their role in AD pathology.

[Neuroscience of mental flexibility]. / A mentális rugalmasság idegtudománya.

Mental flexibility enabling shifts from the usual prepotent behaviour to new strategies and solutions is a significant factor in the successful adaptation to the changing environment. Components of mental flexibility comprise attention, salience detection, inhibition, working memory and switch processes which can be measured by neurocognitive tests. Data derived from examinations by the methods of cognitive neuroscience can be compared to the features, observed under resting state and during task performance, of brain structures and functions. Studying central nervous system correlates of mental flexibility by imaging, neurobiological, and pharmacological techniques revealed that certain cerebral regions (prefrontal cortex, anterior cingulate and insula, striatum, inferior parietal lobule) with their network connectivities, and some neurotransmitters (e.g. dopamine) have profound roles in this respect. Flexibility shares some similarities with artistic/scientific/everyday creativity and openness as a personality trait and this is also reflected in neurobiological parameters. According to precedents in art history, the public reception and acceptance of nonconform avant-garde artistic products are also dependent on flexibility and openness. Alterations of mental flexibility have been found in diseases (psychiatric and others), and in stress situations. Although flexible switch is generally considered as positive and beneficial, under certain conditions advantages might arise from keeping stability maintaining customs, conventions, and traditions. Orv Hetil. 2017; 158(45): 1771-1786.

Decision making measured by the Iowa Gambling Task in alcohol use disorder and gambling disorder: a systematic review and meta-analysis.

BACKGROUND AND AIMS: Gambling disorder (GD) and alcohol use disorder (AD) have similar features, such as elevated impulsivity and decision-making deficits, which are directly linked to relapse and poor therapeutic outcomes. Our aim was to assess decision-making characteristics in GD and AD patients compared to healthy controls (HC) based on one of the most frequently used measures of decision-making: the Iowa Gambling Task (IGT). METHODS: In our systematic literature search of three databases, we identified 1198 empirical articles that mentioned decision-making deficits with the use of the IGT in patients diagnosed with either AD or GD. Possible effects were calculated using meta-analysis. In the end, 17 studies (including 1360 participants) were suitable for inclusion in the meta-analysis reporting data for 23 group contrasts. RESULTS: The random effects estimate indicated impaired IGT performance in both AD patients (N=500; d=-0.581, CI:-89.5<δ<-26.6%) and an even greater deficit in GD patients (N=292; d=-1.034, CI:-156.1<δ<50.7%) compared to HCs. Sampling variances were calculated for both AD (v1=0.0056) and GD groups (v2=0.0061), from which the z-score was calculated (z=-21.0785; p<0.05), which indicates a statistically significant difference between AD and GD groups. No significant moderating effects of age, gender or education were found. CONCLUSIONS: There is enough evidence to support that decision-making deficit associated with addictive disorders, and that the deficit is more expressed in gambling disorder than in alcohol use disorder. Impaired decision-making plays an important part in poor therapeutic outcomes, thus provides a promising opportunity for cognitive intervention.