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From aberrant salience to jumping to conclusions: Dopaminergic pathways to delusions in Parkinson disease
No full textPsychotic symptoms are frequently reported in longitudinal studies on patients with Parkinson
disease (PD).1 Hallucinations are the most common psychotic symptom in PD, especially in
advanced stages of disease, with an estimated cumulative lifetime prevalence of 40% to 60%,2 and
disease-related factors play an important role in their pathophysiology in this clinical population.2
Although delusions are less common in patients with PD and often represent a deterioration of
hallucinations,2 isolated delusions have been recently described in cognitively preserved patients
with PD,3 and recent empirical findings,4,5 here presented and integrated, permit to shed light on their
pathophysiology
Alteration of affective Theory of Mind in amnestic mild cognitive impairment
No full textThe concept of amnestic mild cognitive impairment (aMCI) concerns a population of older individuals at high risk of developing probable Alzheimer's disease (AD). Impairments of the cognitive component of Theory of Mind (ToM), that is the inference about other people's beliefs, have been well documented in AD; on the contrary, controversial findings have been reported on the affective component of ToM (inference about other's feelings), a process mainly based on medial portions of the prefrontal cortex. The current study aimed at evaluating the affective component of ToM in aMCI subjects. Twenty aMCI subjects and 20 age-matched healthy controls (HC) underwent a standard neuropsychological assessment and the assessment of affective ToM with the full 36-item version of reading the mind in the eyes (RME). Although aMCI subjects had formal impaired performances only in memory tasks, HC outperformed aMCI subjects in several cognitive tasks, including also the RME (mean RME scores 21.7 ± 3.0 vs. 17.0 ± 3.8%; 60.3% of correct answers vs. 47.2%). The lower RME performance of aMCI patients provides the first empirical evidence that aMCI may be associated with difficulties in tasks of affective ToM, in accordance with recent findings of early difficulties of aMCI patients in other processes that are mainly dependent on the medial prefrontal cortex, such as reversal learning and decision making under ambiguity. Findings of the current study need further empirical confirmation in larger samples of aMCI patients and also the investigation of other MCI subtypes is needed. © 2012 The British Psychological Society
Ontogenesis of self-disorders in the schizophrenia spectrum: A phenomenological neuro-developmental model
No full textThe concept of basic Self-disorders (SD) captures the experiential aspects associated with vulnerability to schizophrenia spectrum disorders (SSD). SD emerge prior to, and constitute the underlying structure for, the emergence of major diagnostic symptoms, including positive psychotic ones. SD are also detectable in populations with familial risk for SSD. This paper proposes a two-stage phenomenological-developmental model, exploring the early deficit in multisensory integration and their impact on the ontogeny of the Minimal Self in the first years of life. It also examines subsequent emergence of schizotaxic vulnerability, which later manifests as typical anomalies of subjectivity, such as basic symptoms and self-disorders
Acute and chronic cognitive effects of levodopa and dopamine agonists on patients with Parkinson's disease: a review
No full textThe spatiotemporal progression of dopamine depletion in Parkinson's disease (PD) provides a special model for assessing dopaminergic effects on neural systems with differential baseline dopamine levels. This study aims at reviewing cognitive effects of dopaminergic stimulation in PD. While considering dopaminergic drugs (levodopa or dopamine agonists), temporal intervals (acute or chronic) and cognitive domains, we found that empirical evidence was almost focused on acute effects of levodopa on executive functions. The paucity of empirical evidence suggests that no meaningful conclusions can be actually drawn and further research is needed in relation to: (1) other cognitive domains; (2) the acute cognitive effects of dopamine agonists, as compared with levodopa; (3) possible differences between cognitive effects of different dopamine agonists; (4) the cognitive effects of chronic dopaminergic therapies. The latter issue is of particular clinical interest considering that many PD patients present a mild cognitive impairment: is this cognitive feature worsened or improved by the prolonged dopaminergic therapy? In addition to the potential risk of inducing dyskinesia and behavioral side effects such as impulse control disorders, also cognitive effects of prolonged dopaminergic treatments should be taken in account by clinicians in order to anticipate or to delay their prescription to PD patients
Mind the (transition) gap: Youth mental health-oriented early intervention services to overcome the child-adolescent vs. adult hiatus
No full textDetecting dysexecutive syndrome in neurodegenerative diseases: are we using an appropriate approach and effective diagnostic tools?
Full text linkEarly detection and intervention through the lens of the neurodevelopmental framework: the salience of developmental years and related services
No full textBroadening prediction efforts from imminent psychotic symptoms to neurodevelopmental vulnerabilities can enhance the accuracy of diagnosing severe mental disorders. Early interventions, especially during adolescence, are vital as these disorders often follow a long prodromal phase of neurodevelopmental disturbances. Child and adolescent mental health services should lead a developmentally-sensitive model for timely, effective detection and intervention
Faraway So Close: Schizophrenia and Dissociation From Clinical, Phenomenological, and Ontogenetic Viewpoints
No full textAffective theory of mind in patients with Parkinson's disease
No full textAim The aim of this study was to assess the hypothesis that patients with Parkinson's disease (PD) may have difficulties in tasks of affective theory of mind (ToM; the inference on others' feelings) especially in moderate/advanced PD stages. Difficulties of cognitive ToM have already been described in several previous studies. Methods Affective ToM was assessed with the Reading the Mind in the Eyes task in 35 PD patients and 35 healthy controls. Depression, global cognitive status and executive functioning were also evaluated. Patients were distinguished in early PD and moderate PD according to their scores in the Hoehn and Yahr Staging Scale. Results PD patients had more difficulties with affective ToM than healthy controls, also controlling for other variables that resulted in association with this ability. Early PD patients outperformed moderate PD patients, but this difference did not reach statistical significance when controlling for other variables. Conclusion These findings confirmed that affective ToM may be impaired in PD, but any conclusion can be made on the effect of disease progression on this ability of social cognition. Therefore, longitudinal studies are needed to investigate this potential effect. © 2013 The Authors. Psychiatry and Clinical Neurosciences © 2013 Japanese Society of Psychiatry and Neurology
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