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1.
Psychiatry Res Neuroimaging ; 297: 111032, 2020 Jan 25.
Artigo em Inglês | MEDLINE | ID: mdl-32028105

RESUMO

The neurobiological causes underlying suicidal behaviors in major depressive disorder (MDD) have not been identified. This study was performed to investigate the differences in brain cortical thickness, surface area, and volume between suicide attempters and non-attempters with MDD. We performed magnetic resonance imaging (MRI) in 38 MDD patients (18-65 years old; 18 male, 20 female) with and without a history of suicide attempts. FreeSurfer software was used to compare the cortical thickness, surface area, and volume of 19 suicide attempters with MDD and 19 suicide non-attempters with MDD, while controlling for age, sex, mean area (or volume), and severity of depression. Compared with suicide non-attempters, suicide attempters with MDD exhibited a larger surface area in the left postcentral area and left lateral occipital area and a larger cortical volume in the left postcentral area and left lateral orbitofrontal area. Suicide attempters exhibited a smaller surface area in the left superior frontal area than suicide non-attempters. The present findings provide evidence for neuroanatomical risk factors of suicide in MDD. Further research to replicate these results and determine the mechanisms underlying these findings is needed.

2.
Adv Exp Med Biol ; 1192: 629-641, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31705516

RESUMO

Cognitive behavioral therapy for insomnia (CBT-I) is the treatment of choice for insomnia; however, it is not widely used due to a lack of experienced therapists and its relatively high clinical cost. Recently, Internet and mobile CBT-I have been developed to replace face-to-face CBT-I, and research on this topic has been increasing. In addition, attempts have been made to use wearable devices for sleep-wake estimation. Studies on digital CBT-I thus far have shown favorable treatment effects in general, but the problem of a high dropout rate has not been sufficiently improved. In addition, more sophisticated technology is needed to develop fully automated digital CBT-I. As part of efforts to maximize the treatment effectiveness of future insomnia patients, research and development of mobile and Internet CBT-I and improvement of sleep tracker accuracy and validation studies are needed.


Assuntos
Terapia Cognitivo-Comportamental , Aplicativos Móveis , Distúrbios do Início e da Manutenção do Sono/terapia , Dispositivos Eletrônicos Vestíveis , Humanos , Internet , Sono , Resultado do Tratamento
4.
Psychiatry Clin Neurosci ; 73(5): 254-261, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-30663182

RESUMO

AIM: Patients with psychophysiological insomnia (PI) experience hyperarousal, especially as a reaction to sound stimuli. In the current study, we explored brain activity changes in response to sleep-related sounds (SS) in patients with insomnia after cognitive behavioral therapy for insomnia (CBT-I). METHODS: In 14 drug-free PI patients, regional brain activity in response to SS, and to white noise sound (NS) as neutral stimuli, was investigated before and after individual CBT-I using functional magnetic resonance imaging. Blood oxygen level-dependent (BOLD) signals to SS and NS were compared before and after CBT-I. In addition, the association between clinical improvement after CBT-I and changes in brain activity in response to SS and NS was analyzed. RESULTS: Compared with baseline, regional brain activity in response to SS after CBT-I decreased in the left middle temporal and left middle occipital gyrus. In regression analysis, a reduction in the Dysfunctional Beliefs and Attitudes about Sleep (DBAS) Scale score after CBT-I was associated with decrease in brain activity in response to SS in both thalami. However, brain activity in response to NS showed no BOLD signal changes and no association with DBAS change. CONCLUSION: Cortical hyperactivity, which may cause hyperarousal in PI, was found to decrease after CBT-I. CBT-I targeting changes in beliefs and attitudes about sleep may induce its therapeutic effects by reducing thalamic brain activity in response to sleep-related stimuli.


Assuntos
Percepção Auditiva/fisiologia , Córtex Cerebral/fisiopatologia , Neuroimagem Funcional/métodos , Distúrbios do Início e da Manutenção do Sono/fisiopatologia , Distúrbios do Início e da Manutenção do Sono/terapia , Tálamo/fisiopatologia , Adulto , Córtex Cerebral/diagnóstico por imagem , Terapia Cognitivo-Comportamental , Feminino , Humanos , Imagem por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Distúrbios do Início e da Manutenção do Sono/diagnóstico por imagem , Tálamo/diagnóstico por imagem
5.
Nord J Psychiatry ; 72(7): 534-541, 2018 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-30444158

RESUMO

BACKGROUND: Magnesium (Mg2+), an endogenous N-methyl-D-aspartate receptor antagonist, has received increased attention recently because of its role in the pathophysiology of and treatment response in depression. However, whether Mg2+ level is decreased in depression is not firmly established. We aimed to conduct a systematic review and meta-analysis to help making consensus for the association between Mg2+ levels and depression. METHODS: A systematic search was conducted in the electronic database resources PubMed and Embase. After a careful selection of relevant studies, a meta-analysis using the random effects model was conducted in each measuring source, such as serum, plasma, and cerebrospinal fluid (CSF). RESULTS: A total of 18 studies were included in this study. Among 11 studies that measured Mg2+ in the serum, Mg2+ level was lower in patients with depression than in controls (weighted mean difference = -.088, 95% confidence interval = -.164 to -.012). In the sensitivity analysis by removing studies one by one, 2 out of the 11 studies obliterated such significant differences. There were no significant differences in the Mg2+ levels in the studies for plasma and CSF. CONCLUSIONS: Despite some evidence supporting an association between decreased Mg2+ levels and depression from studies with serum, the results of our meta-analysis urge to use caution when associating Mg2+ levels and depression. Future studies are needed to establish a consensus for the role of low Mg2+ levels in depression.


Assuntos
Depressão/sangue , Depressão/diagnóstico , Magnésio/sangue , Biomarcadores/sangue , Depressão/psicologia , Humanos , Autoimagem
6.
J Nerv Ment Dis ; 206(10): 770-775, 2018 10.
Artigo em Inglês | MEDLINE | ID: mdl-30273273

RESUMO

Because suicide is irreversible, prevention is paramount. For the optimal strategy to reduce lethal means, we sought to investigate age- and sex-associated variations in suicide methods. Data on annual causes of death from 1991 to 2015 in the Republic of Korea were used. Major sociodemographic correlates of the five suicide methods were analyzed by multiple multinominal logistic regression analysis. Among a total of 239,565 suicides from 1991 to 2015, hanging was most common. Gas poisoning sharply increased from 2007 to 2015. The gap between hanging and the second most common method of suicide has increased from 659 in 2004 to 4,433 in 2015. Charcoal burning was most commonly used by males younger than 45 years of age, whereas pesticide was commonly used by both sexes ages 55 years and older. Our results suggest that age- and sex-specific suicide prevention strategies are needed, particularly for gas and pesticide poisoning.


Assuntos
Suicídio/estatística & dados numéricos , Adulto , Fatores Etários , Idoso , Escolaridade , Feminino , Humanos , Masculino , Estado Civil , Pessoa de Meia-Idade , República da Coreia/epidemiologia , Fatores Sexuais , Adulto Jovem
7.
J Psychiatry Neurosci ; 43(6): 366-374, 2018 11 01.
Artigo em Inglês | MEDLINE | ID: mdl-30371992

RESUMO

Background: Previous studies have reported functional and structural abnormalities in the thalamus and the pars triangularis of the inferior frontal gyrus in patients with insomnia disorder. However, no studies have been conducted on the white-matter tracts between these 2 brain regions. We aimed to compare the white-matter integrity and structure of the left thalamus­pars triangularis tracts between patients with insomnia and controls, and to characterize the relationship between white-matter integrity and clinical features in patients with insomnia. Methods: In total, 22 participants with insomnia disorder and 27 controls underwent overnight polysomnography and brain magnetic resonance imaging, and then completed self-report clinical questionnaires and neurocognitive tests for spatial planning. Structural and diffusion measures such as fractional anisotropy, axial diffusivity, radial diffusivity and trace were analyzed in group comparison and correlation analyses. Results: The insomnia group showed significantly lower fractional anisotropy (F = 8.647, p = 0.02) and axial diffusivity (F = 5.895, p = 0.038) in the left thalamus­pars triangularis tracts than controls. In patients with insomnia, fractional anisotropy in the tracts was correlated with the results of the Stockings of Cambridge test (r = 0.451, p = 0.034), and radial diffusivity was correlated with Epworth Sleepiness Scale score (r = 0.437, p = 0.042). Limitations: Limitations included analyses of limited brain regions and the cross-sectional design. Conclusion: The insomnia group showed decreased integrity in the left thalamus­pars triangularis tracts, and integrity was correlated with cognition and daytime sleepiness. These results may imply that insomnia is characterized by disintegration of the white-matter tract between the left thalamus and inferior frontal gyrus.


Assuntos
Córtex Pré-Frontal/diagnóstico por imagem , Distúrbios do Início e da Manutenção do Sono/diagnóstico por imagem , Tálamo/diagnóstico por imagem , Substância Branca/diagnóstico por imagem , Adolescente , Adulto , Anisotropia , Estudos Transversais , Imagem de Difusão por Ressonância Magnética , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Testes Neuropsicológicos , Polissonografia , Autorrelato , Distúrbios do Início e da Manutenção do Sono/psicologia , Tratos Espinotalâmicos/diagnóstico por imagem , Adulto Jovem
8.
Psychiatry Investig ; 15(7): 701-709, 2018 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-29898579

RESUMO

Objective: This study investigated the proposed association between restless legs syndrome (RLS) and the prevalence of hypertension. Methods: A meta-analysis was conducted based on searches of the PUBMED, EMBASE, Cochrane Library, and Korean electronic databases. Cohort and cross-sectional studies reporting the incidence of hypertension in individuals with RLS were included. Dichotomous data were pooled to obtain an odds ratio (OR) and 95% confidence interval (CI) for the prevalence of hypertension in individuals with RLS. The main outcome measure of the study was prevalence of hypertension in patients with RLS compared with a control group. Results: One cohort study and eight cross-sectional studies were included in the meta-analysis. Individuals with RLS had an increased prevalence of hypertension (all studies: OR=1.13, 95% CI=1.04-1.23; cross-sectional studies: OR=1.12, 95% CI=1.01-1.24). However, in subgroup analyses controlling for cardiovascular risk factors, such as diabetes mellitus and dyslipidemia, the differences in the prevalence of hypertension between RLS and control patients were no longer significant. Conclusion: Patients with RLS may have a higher prevalence of hypertension, according to a pooled analysis, but the results remain to be confirmed in well-designed prospective studies.

9.
J Psychiatry Neurosci ; 43(4): 170195, 2018 Jun 12.
Artigo em Inglês | MEDLINE | ID: mdl-29894286

RESUMO

BACKGROUND: Previous studies have reported functional and structural abnormalities in the thalamus and the pars triangularis of the inferior frontal gyrus in patients with insomnia disorder. However, no studies have been conducted on the white-matter tracts between these 2 brain regions. We aimed to compare the white-matter integrity and structure of the left thalamus-pars triangularis tracts between patients with insomnia and controls, and to characterize the relationship between white-matter integrity and clinical features in patients with insomnia. METHODS: In total, 22 participants with insomnia disorder and 27 controls underwent overnight polysomnography and brain magnetic resonance imaging, and then completed self-report clinical questionnaires and neurocognitive tests for spatial planning. Structural and diffusion measures such as fractional anisotropy, axial diffusivity, radial diffusivity and trace were analyzed in group comparison and correlation analyses. RESULTS: The insomnia group showed significantly lower fractional anisotropy (F = 8.647, p = 0.02) and axial diffusivity (F = 5.895, p = 0.038) in the left thalamus-pars triangularis tracts than controls. In patients with insomnia, fractional anisotropy in the tracts was correlated with the results of the Stockings of Cambridge test (r = 0.451, p = 0.034), and radial diffusivity was correlated with Epworth Sleepiness Scale score (r = 0.437, p = 0.042). LIMITATIONS: Limitations included analyses of limited brain regions and the cross-sectional design. CONCLUSION: The insomnia group showed decreased integrity in the left thalamus-pars triangularis tracts, and integrity was correlated with cognition and daytime sleepiness. These results may imply that insomnia is characterized by disintegration of the white matter tract between the left thalamus and inferior frontal gyrus.

10.
Artigo em Inglês | MEDLINE | ID: mdl-29680498

RESUMO

We aimed to identify the sleep electroencephalography (EEG) spectral power correlates of the subjective-objective discrepancy (SOD) of sleep onset latency (SOL) in major depressive disorder (MDD), primary insomnia (PI), and normal sleeping control (NSC) groups. We examined relative power values in standard frequency bands of the EEG spectra during the first Non-Rapid Eye Movement (NREM) sleep period as correlates of SOD of SOL between sleep diary and polysomnography in MDD (n = 36), PI (n = 19), and NSC (n = 23) groups. We also compared the relative spectral power of sleep EEG among MDD (n = 40), PI (n = 19), and NSC (n = 23) groups. SOD of SOL in MDD patients was positively correlated with relative sigma (r = 0.622, p corrected < 0.001), beta power (r = 0.559, p corrected = 0.002), and alpha power (r = 0.469, p corrected = 0.024) in the first NREM sleep period. There was no significant difference of sleep EEG power spectra among the three groups. SOD was positively correlated with high frequency EEG in MDD. High frequency EEG power is thought to be associated with hyperarousal and memory consolidation, and future larger-scale studies may further elucidate the neurophysiological mechanisms underlying SOD of sleep onset duration.


Assuntos
Transtorno Depressivo Maior/fisiopatologia , Eletroencefalografia , Sono/fisiologia , Adolescente , Adulto , Idoso , Transtorno Depressivo Maior/psicologia , Feminino , Humanos , Masculino , Registros Médicos , Pessoa de Meia-Idade , Percepção , Polissonografia , Autorrelato , Distúrbios do Início e da Manutenção do Sono/fisiopatologia , Adulto Jovem
11.
Psychiatry Investig ; 15(5): 520-530, 2018 May.
Artigo em Inglês | MEDLINE | ID: mdl-29551048

RESUMO

OBJECTIVE: Light pollution has become a social and health issue. We performed an experimental study to investigate impact of dim light at night (dLAN) on sleep in female subjects, with measurement of salivary melatonin. METHODS: The 25 female subjects (Group A: 12; Group B: 13 subjects) underwent a nocturnal polysomnography (NPSG) session with no light (Night 1) followed by an NPSG session randomly assigned to two conditions (Group A: 5; Group B: 10 lux) during a whole night of sleep (Night 2). Salivary melatonin was measured before and after sleep on each night. For further investigation, the female and male subjects of our previous study were collected (48 subjects), and differences according to gender were compared. RESULTS: dLAN during sleep was significantly associated with decreased total sleep time (TST; F=4.818, p=0.039), sleep efficiency (SE; F=5.072, p=0.034), and Stage R latency (F=4.664, p=0.041) for female subjects, and decreased TST (F=14.971, p<0.001) and SE (F=7.687, p=0.008), and increased wake time after sleep onset (F=6.322, p=0.015) and Stage R (F=5.031, p=0.03), with a night-group interaction (F=4.579, p=0.038) for total sample. However, no significant melatonin changes. There was no significant gender difference of the impact of dLAN on sleep, showing the negative changes in the amount and quality of sleep and the increase in REM sleep in the both gender group under 10 lux condition. CONCLUSION: We found a negative impact of exposure to dLAN on sleep in female as well as in merged subjects. REM sleep showed a pronounced increase under 10 lux than under 5 lux in merged subjects, suggesting the possibility of subtle influences of dLAN on REM sleep.

12.
Psychiatry Investig ; 15(1): 84-89, 2018 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-29422930

RESUMO

Objective: Restless legs syndrome (RLS) is considered a genetic disease and, following a genome-wide association study conducted in 2007, the mitogen-activated protein kinase 5 (MAP2K5) gene has been regarded as the promising candidate gene for RLS. The present study investigated whether polymorphisms of MAP2K5 are associated with antipsychotics-induced RLS in schizophrenia. Methods: We assessed antipsychotics-induced RLS symptoms in 190 Korean schizophrenic patients using the diagnostic criteria of the International Restless Legs Syndrome Study Group. Five single-nucleotide polymorphisms (SNPs) of MAP2K5 were genotyped. We investigated genetic and haplotypic associations of these five SNPs with the risk of antipsychotics-induced RLS symptoms. Results: We divided the 190 subjects into 2 groups: 1) those with RLS symptoms (n=96) and 2) those without RLS symptoms (n=94). There were no significant intergroup differences in the distributions of the genotypes and alleles of the rs1026732, rs11635424, rs12593813, rs4489954, and rs3784709 SNPs. However, the haplotype analysis showed that the G-G-G-G-T (rs1026732-rs11635424-rs12593813-rs4489954-rs3784709) haplotype was associated with RLS symptoms (permutation p=0.033). Conclusion: These data suggest that a haplotype of MAP2K5 polymorphisms confers increased susceptibility to antipsychotics-induced RLS symptoms in schizophrenic patients.

13.
Psychiatry Investig ; 15(2): 147-155, 2018 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-29475215

RESUMO

OBJECTIVE: The aim of the present study was to provide clinical consensus and evidence regarding initial treatment strategies for the pharmacological treatment of social anxiety disorder (SAD) in Korea. METHODS: We prepared a questionnaire to derive a consensus from clinicians regarding their preference for the pharmacological treatment of SAD in Korea. Data regarding medication regimens and psychotropic drugs used during initial treatment, the doses used, and the pharmacological treatment duration were obtained. Responses were obtained from 66 SAD experts, and their opinions were classified into three categories (first-line, second-line, third-line) using a chi-square analysis. RESULTS: Clinicians agreed upon first-line regimens for SAD involving monotherapy with selective serotonin reuptake inhibitors (SSRIs) or the serotonin-norepinephrine reuptake inhibitor (SNRI) venlafaxine, or combined therapy using antidepressants with betablockers or benzodiazepines on a standing or as-needed basis. First-line psychotropic drug choices for initial treatment included the following: escitalopram, paroxetine, sertraline, venlafaxine, and propranolol. The medication dosage used by domestic clinicians was found to be comparable with foreign guidelines. Domestic clinicians tended to make treatment decisions in a shorter amount of time and preferred a similar duration of maintenance treatment for SAD when compared with foreign clinicians. CONCLUSION: This study may provide significant information for developing SAD pharmacotherapy guidelines in Korea, especially in the early stage of treatment.

14.
Sleep Breath ; 22(2): 487-493, 2018 05.
Artigo em Inglês | MEDLINE | ID: mdl-28980102

RESUMO

PURPOSE: This study used functional magnetic resonance imaging (fMRI) to investigate differences in the functional brain activation of patients with insomnia disorder (n = 21, mean age = 36.6) and of good sleepers (n = 26, mean age = 33.2) without other comorbidities or structural brain abnormalities during a working memory task. METHODS: All participants completed a clinical questionnaire, were subjected to portable polysomnography (PSG), and performed the working memory task during an fMRI scan. The subjects who were suspected of major sleep disorder and comorbid psychiatric disorders except insomnia disorder were excluded. To compare the brain activation on working memory from the insomnia group with those from the good-sleeper group, a two-sample t test was performed. Statistical significance was determined using 3DClustSim with the updated algorithm to obtain a reasonable cluster size and p value for each analysis. RESULTS: We observed higher levels of brain activation in the right lateral inferior frontal cortex and the right superior temporal pole in the insomnia group compared to good sleepers (cluster-based multiple comparison correction, p < 0.001, k = 34 @ α = 0.01). CONCLUSION: Thus, patients with insomnia disorder showed increased brain activation during working memory relative to good sleepers, and this may be indicative of compensatory brain activation to maintain cognitive performance in patients with insomnia disorder without other comorbidities.


Assuntos
Imagem por Ressonância Magnética , Memória de Curto Prazo/fisiologia , Neuroimagem , Distúrbios do Início e da Manutenção do Sono/fisiopatologia , Adulto , Feminino , Humanos , Masculino
15.
Psychosom Med ; 80(2): 193-199, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-29189598

RESUMO

OBJECTIVE: Patients with sleep-related breathing disorders are known to have more severe psychiatric symptoms than good sleepers. The aim of this study was to compare the psychiatric symptoms of participants with obstructive sleep apnea (OSA), those with simple snoring (SS), and normal controls (NC). METHODS: A total of 386 participants (260 with OSA, 75 with SS, and 51 NC) completed self-report questionnaires including the Symptoms Checklist 90-Revised and underwent nocturnal polysomnography. The scores of nine primary symptom dimensions and three global distress indices of the Symptoms Checklist 90-Revised were compared among the three groups, adjusting for age, sex, and body mass index. RESULTS: Participants with suspected OSA (OSA + SS) reported more severe psychiatric symptoms than the NC group. Compared with the participants with OSA, those with SS manifested more severe obsessive-compulsive (1.4 (1.0) versus 1.1 (0.7), p = .008) and depressive (1.2 (1.2) versus 0.8 (0.8), p = .031) symptoms and higher Global Severity Index (1.0 (0.9) versus 0.7 (0.6), p = .039) and Positive Symptom Distress Index (2.0 (0.8) versus 1.7 (0.6), p = .009). Only higher Pittsburgh Sleep Quality Index values predicted higher Global Severity Index (B = 0.11, p = .041) and Positive Symptom Distress Index (B = 0.46, p = .007) in suspected OSA participants. CONCLUSIONS: This study found that individuals with suspected OSA experienced more severe psychiatric symptoms than NCs and that psychiatric symptoms were more severe in the SS group than in the OSA group. The psychiatric symptoms of suspected OSA patients were associated with subjective sleep quality rather than with the apnea-hypopnea index.


Assuntos
Sintomas Comportamentais/epidemiologia , Apneia Obstrutiva do Sono/epidemiologia , Ronco/epidemiologia , Adulto , Comorbidade , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Polissonografia , República da Coreia/epidemiologia
16.
Psychiatry Investig ; 14(6): 830-838, 2017 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-29209388

RESUMO

Objective: Restless legs syndrome (RLS) is a highly heritable and common neurological sensorimotor disease disturbing sleep. The objective of study was to investigate significant gene for RLS by performing GWA and replication study in a Korean population. Methods: We performed a GWA study for RLS symptom group (n=325) and non-RLS group (n=2,603) from the Korea Genome Epidemiology Study. We subsequently performed a replication study in RLS and normal controls (227 RLS and 229 controls) to confirm the present GWA study findings as well as previous GWA study results. Results: In the initial GWA study of RLS, we observed an association of rs11645604 (OR=1.531, p=1.18×10-6) in MPHOSPH6 on chromosome 16q23.3, rs1918752 (OR=0.6582, p=1.93×10-6) and rs9390170 (OR=0.6778, p=7.67×10-6) in UTRN on chromosome 6q24. From the replication samples, we found rs9390170 in UTRN (p=0.036) and rs3923809 and rs9296249 in BTBD9 (p=0.045, p=0.046, respectively) were significantly associated with RLS. Moreover, we found the haplotype polymorphisms of rs9357271, rs3923809, and rs9296249 (overall p=5.69×10-18) in BTBD9 was associated with RLS. Conclusion: From our sequential GWA and replication study, we could hypothesize rs9390170 polymorphism in UTRN is a novel genetic marker for susceptibility to RLS. Regarding with utrophin, which is encoded by UTRN, is preferentially expressed in the neuromuscular synapse and myotendinous junctions, we speculate that utrophin is involved in RLS, particularly related to the neuromuscular aspects.

17.
Sci Rep ; 7(1): 12528, 2017 10 02.
Artigo em Inglês | MEDLINE | ID: mdl-28970534

RESUMO

Psychophysiological insomnia (PI) includes arousal to sleep-related stimuli (SS), which can be treated by cognitive behavioral therapy for insomnia (CBT-I). The present study was an exploratory, prospective intervention study that aimed to explore brain response to visual SS in PI before and after CBT-I. Blood oxygen level dependent (BOLD) signal differences in response to SS and neutral stimuli (NS) were compared between 14 drug-free PI patients and 18 good sleepers (GS) using functional magnetic resonance imaging (fMRI). BOLD changes after CBT-I in patients were also examined. PI patients showed higher BOLD activation to SS in the precentral, prefrontal, fusiform, and posterior cingulate cortices before CBT-I. The increased responses to SS were reduced after CBT-I. The increased response to SS in the precentral cortex was associated with longer wake time after sleep onset (WASO), and its reduction after CBT-I was associated with improvements in WASO. Clinical improvements after CBT-I were correlated with BOLD reduction in the right insula and left paracentral cortex in response to SS. PI showed hyper-responses to SS in the precentral cortex, prefrontal cortex, and default mode network and these brain hyper-responses were normalized after CBT-I. CBT-I may exert its treatment effects on PI by reducing hyper-responses to SS in the precentral cortex and insula.


Assuntos
Cognição/fisiologia , Terapia Cognitivo-Comportamental , Distúrbios do Início e da Manutenção do Sono/terapia , Sono/fisiologia , Adulto , Encéfalo/diagnóstico por imagem , Encéfalo/fisiopatologia , Mapeamento Encefálico , Córtex Cerebral/diagnóstico por imagem , Córtex Cerebral/fisiopatologia , Feminino , Giro do Cíngulo/diagnóstico por imagem , Giro do Cíngulo/fisiopatologia , Humanos , Imagem por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Córtex Pré-Frontal/diagnóstico por imagem , Córtex Pré-Frontal/fisiopatologia , Distúrbios do Início e da Manutenção do Sono/fisiopatologia , Resultado do Tratamento
18.
Clin Psychopharmacol Neurosci ; 15(4): 402-406, 2017 Nov 30.
Artigo em Inglês | MEDLINE | ID: mdl-29073752

RESUMO

Objective: Recent studies have reported associations of retinoid-related orphan receptor alpha (RORA) gene single nucleotide polymorphisms (SNPs) with depression and anxiety disorders. Based on these, we attempt to test whether RORA polymorphism is associated with anxiety sensitivity (AS), the intermediate phenotype of depression and anxiety disorders. Considering gene-environment interactions and sex differences in AS, childhood maltreatment (CM) and sex were considered as confounders. Methods: Two-hundred and five healthy young Korean adults (female: 98, male: 107; age, 23.0±3.2 years) completed genotyping for the RORA SNP rs11071547, as well as measures for AS and CM. Generalized linear models were used to examine the main and interaction effects of RORA genotype, CM, and sex in determining AS. Results: The main effect of RORA polymorphisms was not found (p=0.760) whereas the main effect of CM and interaction effects among sex, genotype, and maltreatment were significant on AS. In separate analyses by sex, the interaction effect between RORA genotype and maltreatment was significant only in males (p<0.001). In females, the main effects of genotype and CM were significant (both were p<0.001), in which both a history of CM and C genotype tended to be associated with higher AS. Conclusion: The association between RORA polymorphism and AS might differ by sex. The interaction between RORA polymorphism and CM was significant only in males whereas RORA genotype and CM independently associated with AS in females. Further studies are encouraged to confirm the relationship between RORA polymorphism and AS.

19.
Neurosci Lett ; 661: 46-50, 2017 Nov 20.
Artigo em Inglês | MEDLINE | ID: mdl-28947383

RESUMO

Synaptosomal-associated protein 25kDa (SNAP25) is a promising candidate gene related to the treatment response to antipsychotics. Thus, the present study investigated the associations between polymorphisms of SNAP25 and the treatment response to amisulpride in patients with schizophrenia. This study enrolled 154 schizophrenic patients from six university hospitals in South Korea. All patients were assessed with the Positive and Negative Syndrome Scale (PANSS) and the Clinical Global Impression-Severity (CGI-S) scale at baseline and week 6 of treatment. Additionally, 101 subjects were genotyped for the rs8636 and rs3746544 single nucleotide polymorphisms (SNPs) of SNAP25. The genotype frequencies of rs8636 SNP significantly differed between responders and non-responders, measured by PANSS total score, in additive, recessive, and overdominant models. These findings suggest that SNAP25 might be a useful marker for predicting the response to antipsychotics. Future studies should include a larger number of subjects, a comprehensive array of SNAP25 SNPs, and functional analyses.


Assuntos
Polimorfismo de Nucleotídeo Único/genética , Esquizofrenia/tratamento farmacológico , Esquizofrenia/genética , Sulpirida/análogos & derivados , Proteína 25 Associada a Sinaptossoma/genética , Adulto , Amissulprida , Antipsicóticos/uso terapêutico , Feminino , Genótipo , Humanos , Masculino , Pessoa de Meia-Idade , Escalas de Graduação Psiquiátrica , Sulpirida/uso terapêutico , Resultado do Tratamento , Adulto Jovem
20.
Psychiatry Investig ; 14(4): 458-462, 2017 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-28845173

RESUMO

OBJECTIVE: The provision of care for elderly people with dementia by healthy elderly caregivers is one of the new health-care paradigms in South Korea. The aim of this study was to determine whether this type of care, which includes cognitive stimulation, would improve the cognitive function of dementia patients and the quality of life of the healthy elderly caregiver. METHODS: Totals of 132 dementia patients and 197 healthy elderly caregivers participated in this study. We evaluated the cognitive function of the dementia patients at baseline and after providing the program for 6 months using the Korean version of the Consortium to Establish a Registry for Alzheimer's disease, 1st Edition (CERAD-K). We also evaluated the quality of life of the healthy elderly caregivers using the World Health Organization Quality of Life-Short Version (WHOQOL-BREF) at baseline and after 6 months. RESULTS: The word-list memory results of CERAD-K for the included dementia patients improved after 6 months (Z=-2.855, p=0.004). The WHOQOL-BREF score among the elderly caregiver also improved significantly (Z=-2.354, p=0.019). CONCLUSION: These data suggest that dementia care is associated with improvements in both the cognitive function of dementia patients and the quality of life of the healthy elderly caregivers.

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