1,721,342 research outputs found
The evaluation of anosognosia in stroke patients
No full textAnosognosia in stroke patients showed a relevant detrimental effect on the rehabilitation course and patients' quality of life, especially in those with brain injury. Although a number of reliable scales for the assessment of anosognosia in stroke and traumatic brain injury have been developed, at present no single measure fully explores the multifaceted nature of the phenomenon
The SNRI venlafaxine improves emotional unawareness in patients with post-stroke depression
No full textPatients with stroke have a high prevalence of depression and unawareness of emotions or alexithymia. Here we investigated the effects of the serotoninergic and noradrenergic reuptake inhibitor (SNRI) venlafaxine in comparison with the SSRI fluoxetine on alexithymia severity in patients with DSM-IV post-stroke major depressive-like episode (PSD)
Sertraline treatment of post-stroke major depression: an open study in patients with moderate to severe symptoms
No full textFirst-ever stroke patients (n=20) with a DSM-IV diagnosis of major depressive disorder (MDD) were included in an open-label study and received a single oral dose (50-100 mg) of the selective serotonin reuptake inhibitor sertraline. At days 0, 7, 14, 28, 42, and 56, a psychometric test battery comprising the Hamilton rating scales for depression and anxiety, the Mini Mental State Examination and the Barthel Index was administered. At the endpoint, 9 (45%) of the subjects were no longer depressed, 4 (20%) presented minor depression, and 7 (35%) still suffered from MDD. Considering the whole group of treated patients, depression and anxiety symptoms were found to decrease continuously and cognitive and functional performances to improve continuously during the treatment. Furthermore, differences between the values recorded by the treatment responders and non responders at the end of follow up were highly significant (p<0.02 for all comparisons). This report suggests that sertraline treatment of post-stroke MDD could be effective and well tolerated. However, non responders to the treatment are at risk of poor outcome. Double blind studies with a greater number of patients are necessary to confirm these preliminary results
Why the use of benzodiazepines a few minutes before the imaging does not affect cerebral blood flow results in single photon emission computed studies
No full textWorking memory performance and thalamus microstructure in healthy subjects
No full textResearch on the neural basis of working memory (WM) has generally focused on cortical regions, specifically frontal and parietal areas. Comparatively, evidence of a possible involvement of deep gray matter structures, that are parts of cortico-cortical circuits linking anterior and posterior cortical areas, is far less clear. The goal of the present study is to test the hypothesis that individual structural variations within deep gray matter structures may affect the cortical networks involved in WM. To this aim, a large sample (n=181) of healthy subjects underwent a high-resolution structural magnetic resonance imaging (MRI) and a diffusion tensor imaging (DTI) scan protocol. Data of micro- (mean diffusivity, MD) and macro- (volume) structural variations of six bilateral deep gray matter structures (thalamus, caudate nucleus, putamen, hippocampus, amygdala and pallidum) and lateral ventriculi volume were analyzed in association with score in a WM (the so-called n-back task) and other neuropsychological tasks. Results showed that increased MD of bilateral thalami was the only structural parameter that significantly correlated with reduced WM performance. In particular, a voxel-by-voxel analysis revealed that the greater percentage of voxels showing significant anticorrelation between WM score and MD values were localized in those thalamic nuclei projecting to prefrontal and posterior parietal cortices. Results highlight the specific involvement of thalamus microstructure, not volume, in modulating WM performance, possibly by regulating the connections among cortical areas that are recruited during WM tasks
Brain circuitries of obsessive compulsive disorder: A systematic review and meta-analysis of diffusion tensor imaging studies
No full textThe potential role of white matter (WM) abnormalities in the pathophysiology of obsessive compulsive disorder (OCD) is substantially unexplored. Apart from alterations in the WM tracts within cortico-striato-thalamo-cortical circuitry, recent theorizations predict the existence of more widespread WM abnormalities. In this paper we systematically reviewed the current diffusion tensor imaging literature in OCD and purposely evaluated the prevalence and functional significance of specific WM tissue changes in the disorder. The relationship between clinical variables (medication status, symptom severity) and WM microstructural changes was also assessed. The reviewed studies are consistent with the existence of microstructural alterations in the fronto-basal pathways targeting the orbitofrontal cortex and the anterior cingulate cortex. Moreover, altered anatomical connectivity between lateral frontal and parietal regions and microstructural abnormalities in intra-hemispheric bundles linking distinctive areas of the prefrontal cortex to posterior parietal and occipital association cortices, are consistently reported. Finally, microstructural abnormalities in the corpus callosum, characterized by decreased connectivity in the rostrum and hyperconnectivity in the genu, are substantiated by a large body of evidence
Neuropsychological correlates of cognitive insight in schizophrenia
No full textClinical practice has highlighted a possible discrepancy between patient's verbal assertions, called clinical insight, and the actual convictions about the illness, called emotional insight. The complementary construct of cognitive insight refers to the cognitive processes involved in self-reflection and the ability to modify erroneous beliefs and misinterpretations. The aim of this study was to determine the psychopathological and neuropsychological predictors of cognitive insight in schizophrenia. Sixty outpatients with Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM-IV) schizophrenia diagnosis were administered the Beck Cognitive Insight Scale, the Positive and Negative Symptom Scale (PANSS), and a comprehensive neuropsychological battery. Results indicate that poor global cognitive insight in schizophrenia is significantly related to lower visual working memory, while a higher self-overconfidence is significantly related to deficits in verbal and visual memory and to the failure in using external information to correct erroneous convictions. Thus, our study suggests that impaired cognitive insight depends mainly on reduced working memory and executive function performances. These findings highlight the fundamental importance of the development of specific therapeutic strategies to improve the metacognitive components of insight in order to enhance treatment adherence in schizophrenia
Self-awareness in Mild Cognitive Impairment: Quantitative evidence from systematic review and meta-analysis
No full textHere we quantitatively summarized evidence of impaired awareness in Mild Cognitive Impairment (MCI) and meta-analytically explored the relationship between Subjective Cognitive Complaints (SCC) and actual cognitive impairment. Twenty-three studies were included, 14 comparing awareness measures in MCI and healthy elderly subjects, and 16 also exploring the neuropsychological underpinnings of impaired awareness. Moderator analyses were conducted to determine whether self-awareness varied according to patient group, the particular state in relation to which insight was assessed, or the approach to measuring awareness. The meta-analysis shows that MCI patients have knowledge of their neuropsychological deficits and that level of awareness varies according to cognitive status, language and memory abilities. The assessment technique employed impacted on the insight phenomena. Specifically, MCI patients seem particularly accurate in evaluating the current state of their performance during an ongoing task and this could be essential in regulating their behavior so that compensative strategies are practiced and greater cognitive independence is achieved. Thus, assessment technique and cognitive status are crucial factors that influence level of awareness and should be taken into consideration in awareness evaluation and rehabilitation
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