[Augmentation therapy of resistant schizophrenia with rhythmic transcranial magnetic stimulation]. / Augmentatsiya terapii rezistentnoi shizofrenii metodom ritmicheskoi transkranial'noi magnitnoi stimulyatsii.

OBJECTIVE: To identify the clinical efficacy of rhythmic transcranial magnetic stimulation (rTMS) in resistant schizophrenia. MATERIAL AND METHODS: The study included 44 male patients with resistant schizophrenia, divided into 4 groups: with depressive (group 1; n=11, 25.0%), with hallucinatory (group 2; n=12, 27.3%), with negative (group 3; n=11, 25.0%) and with delusional symptoms (group 4; n=10, 22.7%). Patients received rTMS, the parameters of which were determined depending on the typological variety, for 3 weeks (15 sessions). Psychometric assessment was carried with PANSS, CGI-S, CGI-I, SANS, CDSS, AHRS when included in the study (0 day), after stimulation (21 days) and by the end of the study (42 day) that allowed evaluation of both the severity of the therapeutic effect and its duration. RESULTS: By the end of the course of stimulation, patients of the first three groups developed a distinct positive effect corresponding to a significant reduction in the total PANSS score: group 1 - 24.4% (p=0.002), group 2 - 8.3% (p=0.02), group 3 - 11.7% (p=0.001), which remained stable by day 42 in patients of the first (p=0.001) and second (p=0.005) groups. In patients with delusional symptoms (group 4), a subpsychotic state developed with a corresponding increase in the total PANSS score by 9.7% (p=0.007) requiring a course of relief therapy, which showed effectiveness by the end of the observation (day 42), indicating that resistance was overcome. CONCLUSION: The study demonstrated the validity of rTMS as an adjuvant method of treatment in the resistant schizophrenia. To implement the potential of rTMS, it is necessary first of all to take into account the structural features of the condition, as well as to continue improving the stimulation technique itself (increasing the duration of the course, developing supportive courses).

[Rhythmic transcranial magnetic stimulation in the treatment of resistant depression in schizophrenia]. / Ritmicheskaya transkranial'naya magnitnaya stimulyatsiya v terapii rezistentnykh depressii pri shizofrenii.

Rhythmic transcranial magnetic stimulation (rTMS) has long been actively used in the treatment of depressive disorders in various mental illnesses. At the same time, the question of the predictability of the results of this method for an individual patient remains open. Based on the existing ideas about the relationship of rTMS mechanisms with changes in the state of neural networks, one of the most perspective line is the search for prognostically significant neurophysiological markers. The study analyzed a wide range of EEG characteristics and evoked potentials recorded before treatment in the groups of responders and nonresponders in patients with depressive symptoms in schizophrenia, who have completed a course of rhythmic transcranial magnetic stimulation. The study revealed associations between an unfavorable treatment outcome and greater coherence in the alpha range (mainly in the caudal regions bilaterally) and less coherence in the beta1 range (involving temporal leads and left-hemisphere asymmetry). At the same time, such indicators as the amplitude of the N100 wave and the negativity of the mismatch were uninformative in terms of predicting the effectiveness of therapy.

Multimodal MRI of Conduction Tracts and Anatomy of the Cerebral Gray Matter in Familial Risk of Affective Disorders and Schizophrenia.

The present study analyzed diffusion characteristics of white matter tracts and grey matter anatomy in 48 mentally healthy participants, including first-degree relatives of patients with schizophrenia (N=13) and affective spectrum disorders (N=13). The subgroup with familial risk of schizophrenia displayed abnormalities in the structural connectivity and increased cortical thickness in the superior frontal gyrus. No differences in the analyzed characteristics were revealed in the subgroup with familial risk for affective disorders. The results are discussed within the framework of the concepts of endophenotypes and processes reflecting compensatory and protective mechanisms.

[The activity of enzymes of glutathione metabolism in blood cells of patients with a high risk of manifestation of endogenous psychoses and patients with the first psychotic episode]. / Aktivnost' fermentov glutationovogo obmena v formennykh élementakh krovi u patsientov s vysokim riskom manifestatsii éndogennykh psikhozov i bol'nykh s pervym psikhoticheskim pristupom.

AIM: To assess the activity of glutathione reductase (GR) and glutathione-S-transferase (GST) in blood cells of patients at clinical high-risk (HR) state for psychosis, in first-episode patients with schizophrenia and schizoaffective disorder (SD), and control group, and to seek correlations of these biochemical parameters with clinical assessments in patients. MATERIAL AND METHODS: The study included male patients at HR (n=21, 16-25 years old), first-episode patients with schizophrenia (F20, n=14, 18-25 years old) and SD (F25, n=20, 16-25 years old), and 12 people of the control group (19-25 years old). Psychometric scales (SOPS, HDRS, and PANSS) and psychopathological methods were employed. GR and GST enzymatic activities were determined spectrophotometrically. RESULTS: The activities of platelet GR and GST in all groups of patients both before and after treatment were lower than in controls (p<0.01). The platelet GST activity was lower in patients at HR compared to patients with schizophrenia before treatment and lower than in patients with SD after treatment (p<0.05), it was higher in patients with schizophrenia than in patients with SD before treatment (p<0.05). Erythrocyte GST activity in patients with HR was lower than in patients with SD after treatment, and in the latter it exceeded that in patients with schizophrenia and controls (p<0.05). Complex and different patterns of changes in the activities of erythrocyte and platelet GR and GST in patients with schizophrenia spectrum disorders, occurring both before the first psychotic episode in the initial stage of disease, and in the first-episode patients, were detected. CONCLUSION: The activity of glutathione-converting enzymes in endogenous psychoses of the schizophrenic spectrum, including its early stages, can be used as a biomarker for predicting the development of psychosis, the course of disease, and as criteria for evaluation of therapeutic response to antipsychotic treatment.

[Glutathione reductase and glutathione-S-transferase in blood cells in schizophrenia and schizophrenia spectrum disorders]. / Glutationreduktaza i glutation-S-transferaza v formennykh élementakh krovi pri shizofrenii i rasstroistvakh shizofrenicheskogo spektra.

AIM: To compare glutathione reductase (GR) and glutathione-S-transferase (GST) enzymatic activities in blood cells (erythrocytes and platelets) of patients with schizophrenia spectrum disorders and in the control group and to search for correlations of these biochemical parameters with clinical psychiatric assessments of the patient. MATERIAL AND METHODS: The study included patients (97 men) with schizophrenia spectrum disorder (schizophrenia and schizoaffective disorders) in an acute state of exacerbation of psychotic symptoms and 33 men without mental pathology. Symptom severity was measured with the PANSS before and after antipsychotic therapy. GR and GST activities were determined spectrophotometrically. RESULTS: There were no significant between-group differences in the activities of erythrocyte GR and GST. In platelets, the GR activity was lower in all patients' groups than in controls, whereas the GST activity in patients with schizophrenia relapses and in patients with schizoaffective disorder (SD) was lower than in controls (p<0.05) both before and after treatment. Differences between subgroups of first-episode patients (schizophrenia and SD) and patients with schizophrenia relapses were found not only in the levels of erythrocyte and platelet GR and GST activities, but also in the changes of these enzymatic activity levels under antipsychotic treatment, as well as in links binding these enzymatic activities and PANSS scores. CONCLUSION: The decreased level of GR and GST, the glutathione-dependent enzymes, contributes to the reduction of antioxidant defense in schizophrenia spectrum disorders. The correlations linking the basal levels of GR and GST activities with the results of clinical assessments after treatment allow us to consider these parameters as potential biomarkers for predicting treatment response.

[The effectiveness of high-frequency rhythmic transcranial magnetic stimulation in endogenous depressive disorders in youth]. / Éffektivnost' vysokochastotnoi ritmicheskoi transkranial'noi magnitnoi stimuliatsii pri éndogennykh depressivnykh rasstroistvakh v iunosheskom vozraste.

AIM: To search for neurophysiological predictors of the effectiveness of rhythmic transcranial magnetic stimulation (rTMS) of the left dorsolateral prefrontal cortex in patients with depressive disorder of various nosology. MATERIAL AND METHODS: Thirty-four young male patients with protracted treatment resistant depression were studied using psychopathological, psychometric methods and encephalography. A search for predictors of therapeutic efficacy was carried out in a wide range of neurophysiological indicators using different high-frequency rTMS protocols (10 Hz and 20 Hz).. RESULTS AND CONCLUSION: The most significant changes were obtained using rTMS with a frequency of 20 Hz. A favorable effect of treatment was correlated with higher spectral power of the alpha- and beta 1-rhythm bands in EEG.

[Glutamate dehydrogenase activity in platelets of patients with endogenous psychosis]. / Aktivnost' trombotsitarnoi glutamatdegidrogenazy u bol'nykh s endogennymi psikhozami.

OBJECTIVE: to evaluation of glutamate dehydrogenase (GDH) enzymatic activity in platelets of patients with endogenous psychoses. MATERIAL AND METHODS: Enzymatic cectivity of GDH evaluated in 69 patients with schizophrenia (n=48) or schizoaffective disorder (n=21) in comparison with control group (n=34) and elucidation of possible link between their platelet GDH activity and clinical psychopathological condition. RESULTS AND CONCLUSION: Generally, GDH activity in patients before antipsychotic treatment was significantly lower, than in control group. Significant differences were revealed in GDH activity before the treatment between subgroups of patients with first episode psychosis (FEP, n=34), chronic patients (n=35), and control group (n=34), wherein GDH activity correlated with PANSS in FEP patients before the treatment course. No links were found in patients with chronic schizophrenia. Besides, significant links between GDH activity determined before the treatment course and PANSS scores after the treatment were found in FEP patients: the higher were levels of platelet GDH activity in FEP patients, the lower were their PANSS scores after the treatment. CONCLUSION: Initial (baseline) levels of platelet GDH activity can have value for prognosis of antipsychotic pharmacotherapy efficacy in patients with FEP.