RESUMO
INTRODUCTION: Proton magnetic resonance spectroscopy (¹H MRS) enables the observation of brain function in vivo. The aim of our study was to evaluate the effects of antipsychotic medication on metabolite levels in the brain of schizophrenic patients based on a ¹H MRS examination. METHODS: We examined 42 patients previously diagnosed with chronic schizophrenia twice: firstly, after the neuroleptic wash-out (baseline) and secondly, under stable medication (follow-up, after treatment). The study had a naturalistic design and several different neuroleptic medications were used during the treatment phase. The clinical evaluation, MRI and MRS procedures were performed. The group of 26 healthy controls were also examined to compare MRS results. RESULTS: We found a significantly lower NAA/Cr (N-acetylaspartate/creatine) ratio in the frontal lobe and thalamus in patients (after the wash-out) as compared to controls. After treatment a significant decrease of the Glx/Cr ratio in the temporal lobe and a trend for an increase of the NAA/Cr ratio in the thalamus were observed. CONCLUSION: Our results confirm that antipsychotic medication modifies brain metabolism measured by means of ¹H MRS. The pattern of the changes suggests a neuroprotective action of antipsychotic medication in schizophrenia.
Assuntos
Antipsicóticos/uso terapêutico , Química Encefálica/efeitos dos fármacos , Encéfalo/efeitos dos fármacos , Encéfalo/metabolismo , Neurônios/efeitos dos fármacos , Esquizofrenia/tratamento farmacológico , Esquizofrenia/metabolismo , Adulto , Ácido Aspártico/análogos & derivados , Ácido Aspártico/metabolismo , Manual Diagnóstico e Estatístico de Transtornos Mentais , Feminino , Seguimentos , Análise de Fourier , Lobo Frontal/metabolismo , Ácido Glutâmico/metabolismo , Glutamina/metabolismo , Humanos , Imageamento por Ressonância Magnética , Espectroscopia de Ressonância Magnética/métodos , Masculino , Pessoa de Meia-Idade , Neurônios/metabolismo , Escalas de Graduação Psiquiátrica , Tálamo/metabolismo , Adulto Jovem , Ácido gama-Aminobutírico/metabolismoRESUMO
OBJECTIVE: The aim of the study was the evaluation of risperidone effect on metabolite measures in the frontal lobe, temporal lobe and thalamus in schizophrenic patients on the basis of proton magnetic resonance spectroscopy ( (1)H MRS). METHODS: A group of 14 patients with the diagnosis of schizophrenia, according to DSM-IV, were examined in the study. The patients were examined twice, once after a period of at least 7 days without neuroleptics and for the second time at least 4 weeks after stable risperidone doses. RESULTS: The significant differences in the metabolite levels before and after the treatment were observed only in thalamus: an increase in myoinositol (mI) and N-acetylaspartate (NAA) levels. Positive symptoms before the treatment correlated positively with NAA level in the frontal lobes and negatively in the temporal lobes. Negative symptoms before the treatment correlated positively with Glx (a common signal for GABA, glutamine and glutamate) level in the temporal lobes. CONCLUSION: Our results seem to confirm the influence of risperidone on the brain metabolism, specifically in the region of thalamus.
Assuntos
Antipsicóticos/administração & dosagem , Metabolismo Energético/fisiologia , Espectroscopia de Ressonância Magnética , Risperidona/administração & dosagem , Esquizofrenia/diagnóstico , Lobo Temporal/efeitos dos fármacos , Tálamo/efeitos dos fármacos , Adulto , Ácido Aspártico/análogos & derivados , Ácido Aspártico/metabolismo , Colina/metabolismo , Creatina/metabolismo , Feminino , Lobo Frontal/efeitos dos fármacos , Lobo Frontal/metabolismo , Humanos , Masculino , Pessoa de Meia-Idade , Prótons , Escalas de Graduação Psiquiátrica , Esquizofrenia/tratamento farmacológico , Estatística como Assunto , Lobo Temporal/metabolismo , Tálamo/metabolismoRESUMO
We evaluated immune-inflammatory markers in 32 first-episode schizophrenic patients during exacerbation of symptoms and during clinical improvement. Mean concentrations of sIL-2R and IFN-g was higher and mean concentration of sIL-6R was lower in cell cultures from blood of schizophrenic patients than in normal controls and there was no difference in IL-2 concentration. There was no correlation between concentrations of cytokines and demographic and clinical data. Our results may suggest that immune system disturbances could be observed in schizophrenia at the onset of the disease.
Assuntos
Citocinas/imunologia , Esquizofrenia Paranoide/imunologia , Adulto , Biomarcadores , Citocinas/sangue , Feminino , Hospitalização , Humanos , Masculino , Esquizofrenia Paranoide/diagnóstico , Esquizofrenia Paranoide/reabilitação , Índice de Gravidade de DoençaRESUMO
In the risk group, inhabiting endemic areas, even non-specific symptoms should alert the physician to the possibility of infection caused by the spirochete. The invasion of central nervous system (neuroborreliosis) may be the cause for persisting, irreversible intellectual impairment and memory deficits. Brain lesions are the result of misdiagnosis and delayed antibiotic treatment. This paper describes a case of neuroborreliosis with atypical beginning and diagnostic difficulties.
Assuntos
Encefalopatias/diagnóstico , Neuroborreliose de Lyme/diagnóstico , Transtornos da Memória/etiologia , Transtornos Mentais/diagnóstico , Doença Aguda , Adulto , Encefalopatias/complicações , Diagnóstico Diferencial , Humanos , Neuroborreliose de Lyme/complicações , Masculino , Transtornos Mentais/etiologiaRESUMO
The authors analyse problem of alcohol dependence in the patients of the traumatic department (orthopedics) and the internal department (endocrinology). The evaluation of the dependence was made by the help of MAST. This test is easy to perform by the patients themselves. As authors predicted, the probability of alcohol dependence was higher among the patients of the orthopaedics department. Although the difference was not statistically significant, the authors confirm that the alcohol dependence may be related to physical traumas, especially in men.
