ROI-based analysis of diffusion indices in healthy subjects and subjects with deficit or non-deficit syndrome schizophrenia.

We analyzed DTI data involving 22 healthy subjects (HC), 15 patients with deficit syndrome schizophrenia (DSZ), and 25 patients with non-deficit syndrome schizophrenia (NDSZ). We used a 1.5-T MRI scanner to collect diffusion-weighted images and T1 images, which were employed to correct distortions and deformations within the diffusion-weighted images. For 156 regions of interest (ROI), we calculated the average fractional anisotropy (FA), mean diffusion (MD), and radial diffusion (RD). Each ROI underwent a group-wise comparison using permutation F-test, followed by post hoc pairwise comparisons with Bonferroni correction. In general, we observed lower FA in both schizophrenia groups compared to HC (i.e., HC>(DSZ=NDSZ)), while MD and RD showed the opposite pattern. Notably, specific ROIs with reduced FA in schizophrenia patients included bilateral nucleus accumbens, left fusiform area, brain stem, anterior corpus callosum, left rostral and caudal anterior cingulate, right posterior cingulate, left thalamus, left hippocampus, left inferior temporal cortex, right superior temporal cortex, left pars triangularis and right lingual gyrus. Significantly, the right cuneus exhibited lower FA in the DSZ group compared to other groups ((HC=NDSZ)>DSZ), without affecting MD and RD. These results indicate that compromised neural integrity in the cuneus may contribute to the pathophysiological distinctions between DSZ and NDSZ.

The effects of sigma-1 agonist fluvoxamine on experimental induced tardive dyskinesia model in rats.

Tardive dyskinesia (TD) is a persistent involuntary complex movement disorder that is known to occur with long-term antipsychotic treatment. Despite being a well-recognized complication of this treatment, its symptoms are often masked by the antipsychotic agents, only to become apparent upon reducing or terminating the treatment. In an effort to advance our understanding of TD pathophysiology and to identify potential therapies, the current study aimed to establish an animal model of TD by administering haloperidol to rats and to evaluate the efficacy of fluvoxamine, a selective serotonin reuptake inhibitor (SSRI), in ameliorating TD symptoms. The study compared the behavioral and biochemical parameters of rats that were treated with either fluvoxamine, tetrabenazine, haloperidol, or saline (control group). The biochemical parameters of interest included the brain-derived neurotrophic factor (BDNF), nerve growth factor (NGF), superoxide dismutase (SOD), and malondialdehyde (MDA). To achieve the study objectives, 32 male Wistar Albino rats were assigned to four different groups. The control group received physiological saline for six weeks. The haloperidol group received 1 mg/kg/ip haloperidol for the first three weeks, followed by two weeks of saline. The haloperidol+fluvoxamine group received 1 mg/kg/ip haloperidol for the first three weeks, followed by 30 mg/kg/ip fluvoxamine. The haloperidol+tetrabenazine group was administered 1 mg/kg/ip haloperidol for the first three weeks, followed by 5 mg/kg/ip tetrabenazine. Behavioral assessments of the rats were performed by measuring vacuous chewing movements. Subsequently, samples were collected from the hippocampus, striatum, and frontal lobe tissues of the rats, and BDNF, NGF, SOD, and MDA levels were measured. The results of the study demonstrated significant differences between the groups with respect to behavioral observations. Furthermore, SOD levels in the hippocampus, as well as BDNF, NGF, and SOD levels in the striatum of the haloperidol+fluvoxamine group were significantly higher than those observed in the haloperidol group. Conversely, MDA levels in the hippocampus were significantly lower in the haloperidol+fluvoxamine group than in the haloperidol group. These findings provide evidence of the beneficial effects of fluvoxamine, acting as a sigma-1 agonist, in treating TD symptoms induced experimentally. The observed benefits were supported by the biochemical investigations performed on brain tissue samples. Therefore, fluvoxamine may be considered as a potential alternative treatment for TD in clinical practice, although further research is needed to corroborate these findings.

Decreased serum allopregnanolone and progesterone levels in male patients with bipolar disorder and their effects on cognitive functions.

The progression of bipolar disorder (BD) is characterized by recurrent episodes of depression, mania, and hypomania, thus affecting the daily functionality of individuals. Previous studies have shown that a large proportion of patients diagnosed with BD who are in clinical remission experience significant functional disorders. The present study aimed to investigate the relationships between cognitive impairment and serum progesterone, allopregnanolone and BDNF levels in male bipolar disorder patients who are in the euthymic period. Our study included 41 euthymic male patients with bipolar disorder and 40 age, sex, body mass index (BMI) and smoking-matched male healthy control subjects. Neuropsychiatric tests such as the Stroop Test TBAG Form, Auditory Verbal Digit Span Test- Form B (VADS-B) and Cancellation Test were administered to all participants, and 5-7 ml of peripheral venous blood sample was taken from all participants. Serum allopregnanolone, progesterone and BDNF levels were also measured in all participants. Serum allopregnanolone and progesterone levels were found to be lower in bipolar patients, and it was observed that the serum level of allopregnanolone decreased as the disease duration increased. The serum BDNF levels were similar between groups. The cognitive functions assessed using the Stroop, VADS-B and cancellation tests were found to be better in healthy subjects. The neurocognitive test performances of all participants were strongly positively correlated with allopregnanolone levels. The present study supports the hypothesis that allopregnanolone acts as an endogenous mood stabilizer.

Long-lasting cognitive effects of COVID-19: is there a role of BDNF?

Coronavirus disease 2019 (COVID-19) affects numerous systems of the body during the illness, and there have been long-lasting effects. BDNF plays an important role in synaptic plasticity and synaptic communication. According to the inclusion and exclusion criteria, 54 patients who had COVID-19 infection participated in this study. Thirty-six age-, sex-, body mass index (BMI)-, education level- and smoking status-matched healthy controls were included in the present study. All participants were individually administered the Stroop test and Visual Aural Digit Span Test Form B (VADS-B). Serum BDNF levels were measured by ELISA. Stroop test word reading spontaneous correction number and reading time, word color saying wrong number, spontaneous correction number and reading time, box color speaking spontaneous correction number and reading time, Stroop interference and speed factor duration were significantly higher in the COVID-19 group than in the control group. All scores of the VADS-B test were found to be significantly lower in the COVID-19 group. The mean serum BDNF levels were found to be 10.9 ± 6.9 ng/ml in the COVID-19 group and 12.8 ± 6.4 ng/ml in the healthy control group. Two-way ANOVA showed that the serum mean BDNF level was significantly lower in the COVID-19 group than in the control group. Gender had a significant effect on BDNF levels (F = 12.21; p = 0.008). The present study is the first to demonstrate the association between the role of serum BDNF and cognitive decline in patients with COVID-19 infection. Additionally, there is a significant role of male gender in terms of lower BDNF level and cognitive decline.

Corpus callosum in schizophrenia with deficit and non-deficit syndrome: a statistical shape analysis.

BACKGROUND: The corpus callosum (CC) is the most targeted region in the cerebrum that integrates cognitive data between homologous areas in the right and left hemispheres. AIMS: Our study used statistical analysis to determine whether there was a correlation between shape changes in the CC in patients with schizophrenia (SZ) (deficit syndrome (DS) and non-deficit syndrome (NDS)) and healthy control (HC) subjects. METHODS: This study consisted of 27 HC subjects and 50 schizophrenic patients (20 with DS and 30 with NDS). 3 patients with DS and 4 patients with NDS were excluded. Three-dimensional, sagittal, T1-spoiled, gradient-echo imaging was used. Standard anatomical landmarks were selected and marked on each image using specific software. RESULTS: As to comparing the Procrustes mean shapes of the CC, statistically significant differences were observed between HC and SZ (DS+NDS) (p=0.017, James's Fj=73.732), HC and DS (p<0.001, James's Fj=140.843), HC and NDS (p=0.006, James's Fj=89.178) and also DS and NDS (p<0.001, James's Fj=152.967). Shape variability in the form of CC was 0.131, 0.085, 0.082 and 0.086 in the HC, SZ (DS+NDS), DS and NDS groups, respectively. CONCLUSIONS: This study reveals callosal shape variations in patients with SZ and their DS and NDS subgroups that take into account the CC's topographic distribution.

Favorable Personality Traits in Women Who Have Undergone Cosmetic Breast Augmentation Surgery.

OBJECTIVE: Breast augmentation surgery is one of the most common cosmetic procedures among women. In the present study, we compared personality traits, self-esteem, and body perception between women who had undergone breast augmentation surgery and a control group of women who had not. We hypothesized that the personality traits of women who had vs those who had not undergone breast augmentation surgery would differ. MATERIALS AND METHODS: According to the inclusion and exclusion criteria, patients who had undergone breast augmentation surgery and age- and education-matched, healthy women were included in the present study. The breast augmentation group and control group were compared in terms of personality traits under the Basic Personality Traits Inventory. Additionally, self-esteem, which was assessed with the Rosenberg Self-Esteem Scale, and body perception, which was evaluated using the Body Cathexis Scale, were measured and compared between the two groups. RESULTS: When the patients (n = 80) and the control group (n = 100) were compared, the Body Cathexis Scale, extroversion, and openness scores were statistically significant and were found to be higher in the breast augmentation group (p<0.05). In regression analysis, it was found that age, openness, and the Rosenberg Self-Esteem Scale score had statistically significant effects on extroversion. CONCLUSION: We argue that there may be a presupposition, based on stigma, that women who undergo breast augmentation surgery are more neurotic than those who do not. Consequently, this may influence the outcomes of studies evaluating the personalities of these women. Our results indicate that women who had undergone breast augmentation had more positive personality traits than women in an un-operated control group.

Altered Affective Temperaments in Women With Vaginismus.

OBJECTIVE: Vaginismus is one of the most frequently occurring genito-pelvic pain disorders in women. Sexual dysfunction commonly presents with comorbid psychiatric disorders, and many patients suffering from the former exhibit the latter. The objective of this study was to investigate the affective temperaments of women with vaginismus compared to healthy controls. METHODS: Forty-eight women with vaginismus and 42 age-matched healthy women were recruited and compared in terms of their scores on the Temperament Evaluation of Memphis, Pisa, Paris, and San Diego Autoquestionnaire and a sociodemographic instrument. RESULTS: Except for the scores for hyperthymic temperament, those for depressive, cyclothymic, irritable, and anxious temperaments were significantly higher in the vaginismus group than in the healthy controls (P<.05). The analysis of covariance indicated that the anxious temperament was significantly associated with covariants. CONCLUSIONS: On the basis of the preliminary results, women with vaginismus may be candidates for bipolar disorder. This population should therefore be screened more carefully in terms of the development of the disorder. Bipolar disorder should also be considered when treatments for comorbid psychiatric disorders are needed.

Distinct temperament and character traits in patients with hyperemesis gravidarum.

Hyperemesis gravidarum (HG) is an extreme form of vomiting during pregnancy and is characterized with excessive vomiting and nausea and ketonuria, electrolyte imbalance, dehydration and severe nurtition deficiency. The etiology of HG is considered as multifactorial. Altough there is a great interest to HG in terms of psychiatric conditions, there have been limited numbers of studies that researched personality traits in patients with HG. In present study, we aimed to compare temperament and character traits between pregnant women with and without HG by Temperament and Character Inventory. 48 pregnant women with HG and 64 healthy pregnant women were included to study. The HG groups and control group were compared in terms of temperament and character traits and anxiety levels. The temperament scores of novelty seeking, harm avoidance and reward dependence were found to be similar between groups while the score of persistence was significantly lower in HG group compared with control group (p = .021). All character scores in HG group as cooperativeness, self-directedness, and self-transcendence were significantly lower compared with control groups (respectively; p = .002, p = .018 and p = .029). The scores of STAI-1 was higher in HG group compared with control group (p = .027) whereas the score of STAI-2 was found to be similar between groups. Present study is the first to demonstrate different temperament and character traits in patients with HG. We argue that our results support the psychiatric background of HG; however further studies are needed to confirm our results.

Increased serum dehydroepiandrosterone sulfate in the first episode but not in subsequent episodes in male patients with schizophrenia.

BACKGROUND: Many studies have investigated the relationship between blood levels of dehydroepiandrosterone (DHEA) and its sulfate ester (DHEA-S), cortisol, progesterone, and testosterone and the onset, prognosis, symptom severity, and treatment response of schizophrenia. In the present study, we assessed potential differences in blood levels of neurosteroids between drug-naïve first-episode patients with schizophrenia (FES), and drug-free patients with schizophrenia who were not in the first episode but were in a phase of acute exacerbation (DFP). MATERIALS AND METHODS: The present study included 32 male FES, 28 male DFP, and 24 male healthy controls (HC). Groups were compared in terms of blood levels of adrenocorticotropic hormone (ACTH), cortisol, testosterone, progesterone, and DHEA-S. RESULTS: Blood levels of ACTH, cortisol, testosterone, and progesterone were similar among the groups. The mean value of serum DHEA-S was significantly different among the groups (P<0.001). The value of serum DHEA-S was higher in the FES group than in the DFP and HC groups (both P<0.001). The mean values of serum DHEA-S in the HC and DFP groups were found to be similar (P=0.33). CONCLUSION: We suggest that higher values of DHEA-S in the FES group compared with both the DFP and HC groups indicate that this neurosteroid response is unique to first-episode schizophrenia patients. Further studies are needed to investigate the difference in blood levels of neurosteroids in different groups in terms of age of diagnosis.

Increased serum prolactin levels in drug-naive first-episode male patients with schizophrenia.

BACKGROUND: Prolactin is a hormone receiving considerable attention in psychiatry. Increased serum prolactin level is frequently associated with dopamine blocking antipsychotics. Furthermore, decreased prolactin level was considered a reflector of the effect of antipsychotics. However, there is restricted numbers of investigations that researched baseline prolactin levels in first-episode patients with schizophrenia. AIMS: We purpose to investigate serum baseline prolactin levels in drug-naive first-episode patients with schizophrenia (FES) and to explore the differences in serum prolactin levels between FES, drug-free schizophrenic patients (DFS) and healthy controls (HC). MATERIAL AND METHODS: The study was conducted in the Departments of Psychiatry, Gölbasi Hasvak and Kirklareli State Hospitals, Turkey. Thirty male FES, 41 male DFS and 32 male HC were included in study. All participants were clinically examined and individually interviewed. Before initiating any pharmacological treatment, 5 ml of venous blood was collected to measure serum prolactin levels between 08:00 and 10:00 h, which was determined by radioimmunoassay (RIA). Prolactin levels were also collected from the consenting HC using the same assay. RESULTS: The mean age was higher in the DFS group. The mean score of Brief Psychiatric Rating Scale was higher in the FES group and mean score of Scale for the Assessment of Negative Symptoms was higher in the DFS group. The mean value of prolactin was higher in the FES group (34.1 ± 19.9 ng/dl) compared with DFS (17.9 ± 6.5 ng/dl) and HC (9.7 ± 2.3 ng/dl) (F = 35.5, P < 0.001). Additionally, the mean value of serum prolactin is higher in the DFS group compared with HC (P < 0.001). CONCLUSION: To our knowledge, this study is the first to demonstrate higher serum prolactin levels in male FES compared with male DFS and male HC. Prolactin might act as a protective factor while first episode of schizophrenia is experienced. Future studies are needed to provide the role of prolactin in schizophrenia.

Relationship between SSRIs and Metabolic Syndrome Abnormalities in Patients with Generalized Anxiety Disorder: A Prospective Study.

OBJECTIVE: SSRIs are some of the most widely prescribed medications in the world. In addition to their effectiveness, SSRIs were reported to be associated with the side effects of weight gain, sexual dysfunction, drug interactions, extrapyramidal symptoms and discontinuation symptoms. However, the effects of SSRIs on metabolic parameters are poorly understood. METHODS: This study aims to describe the effects of SSRIs on the metabolic parameters of drug-naive first episode patients with generalized anxiety disorder. Ninety-seven female patients aged 20-41 years without any metabolic or psychiatric comorbidity were included in the study. Fluoxetine, sertraline, paroxetine, citalopram and escitalopram were randomly given to the patients. Metabolic parameters, including BMI, waist circumference and the levels of fasting glucose, total cholesterol, triglyceride, HDL, LDL and blood pressure, were measured before and after 16 weeks of treatment. RESULTS: In the paroxetine group, there was a significant increase in the parameters of weight, BMI, waist circumference, fasting glucose, total cholesterol, LDL and triglyceride after 16 weeks of treatment. There were significant increases in the levels of triglyceride in the citalopram and escitalopram groups. In the sertraline group, the total cholesterol level increased after treatment. In the fluoxetine group, there were significant reductions in the parameters of weight, total cholesterol and triglyceride. CONCLUSION: To our knowledge, this study is the first to prospectively describe metabolic syndrome abnormalities in patients with first episode generalized anxiety disorder. Although the effectiveness of the different SSRIs is similar, clinicians should be more careful when prescribing SSRIs to patients who have cardiac risk factors. Larger and lengthier controlled clinical trials are needed to explore the associations between SSRI use and metabolic syndrome.