Cortical volume abnormalities in schizophrenia: Correlations with symptoms and cognitive impairment.

BACKGROUND: Schizophrenic symptoms are known to segregate into reality distortion, negative and disorganization syndromes, but the correlates of these syndromes with regional brain structural change are not well established. Cognitive impairment is a further clinical feature of schizophrenia, whose brain structural correlates are the subject of conflicting findings. METHODS: 165 patients with schizophrenia were rated for symptoms using the PANSS, and cognitive impairment was indexed by estimated premorbid-current IQ discrepancy. Cortical volume was measured using surface-based morphometry in the patients and in 50 healthy controls. Correlations between clinical and cognitive measures and cortical volume were examined using whole-brain FreeSurfer tools. RESULTS: No clusters of volume reduction were seen associated with reality distortion or disorganization. Negative symptom scores showed a significant inverse correlation with volume in a small cluster in the left medial orbitofrontal gyrus. Larger estimated premorbid-current IQ discrepancies were associated with clusters of reduced cortical volume in the left precentral gyrus and the left temporal lobe. The cluster of association with negative symptoms disappeared when estimated premorbid-current IQ discrepancy was controlled for. CONCLUSIONS: This study does not provide support for an association between brain structural abnormality and reality distortion or disorganization syndromes in schizophrenia. The cluster of volume reduction found in the left medial orbitofrontal cortex correlated with negative symptoms may have reflected the association between this class of symptoms and cognitive impairment. The study adds to existing findings of an association between cognitive impairment and brain structural changes in the disorder.

Utilización de olanzapina en el tratamiento de la esquizofrenia y el trastorno bipolar / Use of olanzapine in the treatment of schizophrenia and bipolar disorder

La olanzapina es un derivado tienobenzodiacepínico que pertenece al grupo de los fármacos antipsicóticos de segunda generación. Fue aprobada por la Food and Drug Administration (FDA) y la European Medicines Agency (EMA) en el año 1996 para el tratamiento de la esquizofrenia, y en el mismo año la EMA autorizó su utilización en el trastorno bipolar. Más tarde se aprobó para el tratamiento de episodios depresivos del trastorno bipolar en combinación con fluoxetina (FDA, año 2003), tratamiento a largo plazo y prevención de recaídas del trastorno bipolar I (FDA, año 2004) y depresión resistente en combinación con fluoxetina (FDA, año 2009). Los autores realizaron una revisión crítica y exhaustiva de la evidencia científica existente acerca de la eficacia y la seguridad de la olanzapina en la esquizofrenia y en el trastorno bipolar I (AU)

Olanzapine is a derived of tienobenzodiazepina that integrate in a group of second generation of antipsychotics drugs. It was aproved by the Food and Drug Administration (FDA) and the European Medicines Agency (EMA) in the year 1996 for the treatment of schizophrenia, and in the same year the EMA authorizes their use in bipolar disorder. Sooner it was approved for the treatment of depressive Bipolar Disord episodes in combination with fluoxetine (FDA, year 2003), treatment in long term and prevention relapses of bipolar disorder I (FDA, year 2004) and resistant depression in combination with fluoxetine (FDA, year 2009). The authors carried out a critical and thorough review of existing scientific evidence about the efficacy and safety of olanzapine in schizophrenia and bipolar I disorder (AU)

Visión de un residente español de la psiquiatría del siglo XXI / A Spanish resident's vision of 21 st century psychiatry

No disponible