Brainstem audiometry as a diagnostic tool in psychiatry: Preliminary results from a blinded study

2017 ◽  
Vol 41 (S1) ◽  
pp. S391-S391
Author(s):  
V. Wahlström ◽  
R. Wynn
Keyword(s):  
Bipolar Disorder ◽  
Brain Stem ◽  
Lower Degree ◽  
Healthy Controls ◽  
Blinded Study ◽  
Clinical Diagnoses ◽  
Competing Interest ◽  
Scientific Testing ◽  
High Degree ◽  
The Brain

BackgroundSome prior studies of brainstem audiometry have found illness-specific aberrations, suggesting that this procedure can be of use to clinicians in diagnosing certain psychiatric illnesses.AimsThe study aimed to examine the diagnostic properties of a brain stem audiometry procedure (SD-BERA®) for patients suffering from schizophrenia and bipolar disorder.MethodsA blinded study including 12 patients with schizophrenia, 12 patients with bipolar disorder, and 12 healthy controls was performed in 2014/2015. The patients were recruited from psychiatric specialist services and a primary care office in the County of Troms, Norway. The patients and controls were examined with brainstem audiometry. The clinical diagnoses were not known to the researchers who analysed the brain stem audiometry data at the Swedish company SensoDetect. Sensitivity and specificity for each group (compared to healthy controls) was calculated.ResultsThe brain stem audiometry procedure had a high degree of sensitivity (1.00), but a lower degree of specificity (0.45) when patients suffering from bipolar disorder were compared to healthy controls. For the diagnosis of schizophrenia, the brain stem audiometry procedure had a high degree of specificity (0.91), but a lower degree of sensitivity (0.33) when patients were compared to healthy controls.ConclusionsThis method may help clinicians by lending support to a clinically suspected diagnosis of schizophrenia. The relatively low specificity for bipolar disorder could suggest that the method needs further development before it can be useful clinically when the diagnosis of bipolar disorder is suspected. Further scientific testing is needed to verify these findings.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Agenesis of the Corpus Callosum in A Patient With Bipolar Disorder

2016 ◽  
Vol 33 (S1) ◽  
pp. S493-S493
Author(s):  
J. Nogueira ◽  
R. Ribeiro ◽  
J. Vieira ◽  
R. Sousa ◽  
S. Mendes ◽  
...  
Keyword(s):  
Bipolar Disorder ◽  
Corpus Callosum ◽  
Past History ◽  
Case Reports ◽  
Manic Episode ◽  
Psychotic Symptoms ◽  
Major Depressive ◽  
Mixed Features ◽  
Competing Interest ◽  
The Brain

BackgroundThe corpus callosum (CC) is the largest white matter structure in the brain, which plays a crucial role in interhemispheric communication. Agenesis of the CC is a rare development anomaly, with unknown cause. It could be asymptomatic or associated with mental retardation and neurologic symptoms. Some case reports, post-mortem studies and image studies have linked thickness reduction and agenesis of CC with psychotic symptoms, mainly in schizophrenia patients. Lately, anatomical abnormalities in the CC have been reported in patients with Bipolar Disorder (BD).Case reportA 52-year-old woman was brought to the emergency room by the authorities after being physically aggressive to her 13-year-old daughter and inappropriate behavior in public. At the emergency department her mood was elevated with emotional lability, dispersible attention, slight increase of motor activity, pressured and difficult to interrupt speech, grandious and self-referent delusional ideas.Her past history revealed hippomaniac episodes characterized by periods of excessive shopping and hyperphagia. In 2008, she had a major depressive episode.Head CT-SCAN revealed agenesia of CC. She received the diagnosis of Manic Episode with mixed features and was treated with valproic acid, flurazepam and olanzapine.ConclusionThis case reinforces the fact that changes in CC, probably due to deficiency in myelination, could have a crucial importance in the pathophysiology of Bipolar Disorder.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Differentiation of adductor-type spasmodic dysphonia from muscle tension dysphonia by spectral analysis

2007 ◽  
Vol 137 (4) ◽  
pp. 576-581 ◽  
Author(s):  
Catherine J. Rees ◽  
P. David Blalock ◽  
Shannon E. Kemp ◽  
Stacey L. Halum ◽  
Jamie A. Koufman
Keyword(s):  
Spectral Analysis ◽  
Muscle Tension ◽  
Spasmodic Dysphonia ◽  
Connected Speech ◽  
Speech Language Pathologists ◽  
Perceptual Analysis ◽  
Muscle Tension Dysphonia ◽  
Blinded Study ◽  
Clinical Diagnoses ◽  
High Degree

Objectives To determine the utility of spectral analysis in the differentiation of adductor-type spasmodic dysphonia (AdSD) from muscle tension dysphonia (MTD). Study Design Prospective blinded study. Methods Forty-seven samples of AdSD-connected speech spectrograms from 27 subjects and 17 samples of MTD-connected speech spectrograms from 15 subjects were selected from clinical charts and de-identified. These spectrograms were reviewed independently and blindly by two speech language pathologists experienced in spectrography. The speech language pathologists designated the spectrogram as consistent with AdSD and MTD, and these designations were compared with actual clinical diagnoses. Results The ability to differentiate AdSD from MTD with spectral analysis was 94% for rater #1 and 98% for rater #2. No MTD subjects were incorrectly diagnosed as having SD (100% specificity). Conclusions This study suggests that experienced speech language pathologists can distinguish AdSD from MTD with a high degree of sensitivity and specificity based on spectral analysis. Spectral analysis is especially useful in cases where perceptual analysis and clinical evaluation alone are insufficient.

Evaluation of Cognitive Dysfunction in a Sample of Patients Affected by Bipolar Disorder

2017 ◽  
Vol 41 (S1) ◽  
pp. S212-S212
Author(s):  
E. Stella ◽  
M. La Montagna ◽  
L. Borraccino ◽  
F. Ricci ◽  
A.I. Triggiani ◽  
...  
Keyword(s):  
Bipolar Disorder ◽  
Working Memory ◽  
Problem Solving ◽  
Verbal Memory ◽  
Visual Learning ◽  
Verbal Learning ◽  
Healthy Controls ◽  
Speed Of Processing ◽  
Cognitive Disturbances ◽  
Competing Interest

IntroductionCognitive dysfunctions concerning working memory, attention, psychomotor speed, and verbal memory are a disabling feature of the bipolar disorder (BD). According to scientific literature, cognitive disturbances are present not only in depressive and manic phases of BD, but also during the euthymic period, without regard to whether or not drugs are assumed.ObjectiveTo determine the presence of one or more dysfunctions in cognitive domains in a sample of subjects suffering from BD, in euthymic phase, compared with healthy controls.AimsEvaluation of the following cognitive performances in subjects affected by BD: speed of processing, attention/vigilance, working memory, verbal learning, visual learning, reasoning and problem solving, and social cognition.MethodsForty-six patients affected by BD in the euthymic phase (mean age: 43.17 years old; 39.13% male), and 58 healthy controls (mean age: 39.21 years old; 51.72% male) were enrolled in the psychiatric unit of Azienda Sanitaria Locale, Foggia. The neuropsychological battery MATRICS Consensus Cognitive Battery (MCCB) was administered by trained psychiatrists.ResultsWe found the presence of cognitive impairment, affecting six out of seven of cognitive functions assessed (P < 0.001): speed of processing, attention/vigilance, working memory, verbal learning, visual learning, reasoning and problem solving.ConclusionsThese preliminary results from our case-control study show that cognitive deficits are clearly present also during the euthymic phases of subjects with bipolar disorder (mainly pertaining attention/vigilance domain). These cognitive abnormalities may represent a biomarker of bipolar disorder.Disclosure of interestThe authors have not supplied their declaration of competing interest.

scholarly journals White matter microstructural properties in bipolar disorder and its relationship to the spatial distribution of lithium in the brain

2018 ◽  
Author(s):  
Joe Necus ◽  
Nishant Sinha ◽  
Fiona Elizabeth Smith ◽  
Peter Edward Thelwall ◽  
Carly Jay Flowers ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Bipolar Disorder ◽  
Spatial Distribution ◽  
White Matter ◽  
Lithium Treatment ◽  
White Matter Integrity ◽  
Healthy Controls ◽  
Resonance Imaging ◽  
The Relationship ◽  
The Brain

ABSTRACTBackgroundLithium treatment is associated with an increase in magnetic resonance imaging derived measures of white matter integrity, but the relationship between the spatial distribution of brain lithium and white matter integrity is unknown.MethodsEuthymic patients with bipolar disorder receiving lithium treatment (n=12) and those on other medications but naïve to lithium (n=17) underwent diffusion imaging alongside matched healthy controls (n=16). Generalised fractional anisotropy (gFA) within white matter was compared between groups using a standard space white matter atlas. Lithium-treated patients also underwent novel multinuclear 3D lithium magnetic resonance imaging (7Li-MRI) to determine relative lithium concentration across the brain. The relationship between 7Li-MRI signal intensity and gFA was investigated at the resolution of the 7Li-MRI sequence in native space.ResultsThe lithium-treated bipolar disorder and healthy control groups had higher mean gFA in white matter than the bipolar disorder group treated with other medications but naïve to lithium (t = 2.5, p < 0.05; t = 2.7, p < 0.03, respectively). No differences in gFA were found between patients taking lithium and healthy controls (t = 0.02, p = 1). These effects were seen consistently across most regions in the white matter atlas. In the lithium-treated group, a significant effect of the 7Li-MRI signal in predicting the gFA (p < 0.01) was identified in voxels containing over 50% white matter.ConclusionsLithium treatment of bipolar disorder is associated with higher gFA throughout brain white matter, and the spatial distribution of lithium is also positively associated with white matter gFA.

Alterations in retinal processing in regular cannabis users

2016 ◽  
Vol 33 (S1) ◽  
pp. S373-S373
Author(s):  
R. Schwan ◽  
T. Schwitzer ◽  
A. Giersch ◽  
V. Laprevote
Keyword(s):  
Visual Information ◽  
Ganglion Cells ◽  
Direct Action ◽  
Pattern Electroretinogram ◽  
Implicit Time ◽  
Clinical Electrophysiology ◽  
Healthy Controls ◽  
Rapid Improvement ◽  
Competing Interest ◽  
The Brain

IntroductionCannabis is one of the most prevalent drugs used worldwide. However, the neural consequences of cannabis remain poorly understood. There is a need for a rapid improvement of the scientific knowledge on the cerebral impact of cannabis use. Since the retina is an easy-to-access part of the central nervous system, it can reflect the neurochemistry of the brain.ObjectivesConsidering the anatomical and functional distribution of the cannabinoid system in the retinal ganglion cells, the objective of this study was to assess whether the regular use of cannabis could affect the ganglion cells functioning.AimsAssessment of the ganglion cells function in regular cannabis users compared to healthy controls.MethodsRecordings of pattern electroretinogram (PERG) were performed in regular cannabis users and healthy controls using standard of the International Society for Clinical Electrophysiology of Vision (ISCEV). The amplitude and implicit time of the PERG N95 were assessed.ResultsThe N95 implicit time of PERG was significantly decreased in regular cannabis users compared to healthy controls.ConclusionsWe found alterations in the ganglion cells function in regular cannabis users, as showed by the increase in N95 implicit time. The ganglion cells represent the ultimate retinal relay before the visual information is relayed to the brain and, according to these results, we suppose that the signal elicited by these cells and transferred through the visual pathways is altered in cannabis users. A direct action of exogenous cannabinoids in the retinal glutamatergic transmission is discussed.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Assessment of Serum IL-4, 15d-PGJ2, PPAR Gamma Levels in Patients with Bipolar Disorder

2017 ◽  
Vol 41 (S1) ◽  
pp. S75-S75
Author(s):  
G. Erzin ◽  
Ç. aydemir ◽  
R. yüksel ◽  
E. tatlıdil ◽  
B. Çakır ◽  
...  
Keyword(s):  
Bipolar Disorder ◽  
Demographic Data ◽  
Depression Scale ◽  
Ppar Gamma ◽  
Hamilton Depression Scale ◽  
Healthy Controls ◽  
Young Mania ◽  
Endogenous Factors ◽  
Anti Inflammatory ◽  
Competing Interest

IntroductionMany hypotheses have been proposed about development of bipolar disorder including inflammatory processes due to the external and endogenous factors. There are strong evidences that immunological dysfunction is present in bipolar disorder. In the pathophysiology of bipolar disorder, there are many data that support the inflammatory hypothesis.ObjectivesIn this study, to clarify the etiology of bipolar disorder, based on the inflammatory process hypothesis, it is aimed to measure and evaluate serum 15d-PGJ2 and PPARγ, anti-inflammatory cytokine IL-4 levels in patients with bipolar disorder.MethodsThis study was performed at Ankara Numune Training and Research Hospital. Ninety-five patients are included in the study that were in their mania or remission periods and meet the DSM-V criteria for bipolar disorder. Forty-four healthy volunteers are included in the study as well. Serum IL-4, 15d-PGJ2, PPARγ levels are measured in both groups. Young Mania Scale, Hamilton Depression Scale, demographic data form were given to patient group.ResultsIn our study, 15d-PGJ2, PPARγ levels were found statistically significantly lower in patients with bipolar disorder compared to healthy controls.ConclusionThere are differences in anti-inflammatory prostaglandin levels in patients with bipolar disorder who are in their mania period when compared to healthy controls and patients in their remission period. This does not show any significance according to smoking and gender. This implies that inflammation markers could be a good candidate to determine trait markers, which will provide an insight for preventing patient from mania period or prognosis after the diagnosis of bipolar disorder.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Ghrelin response to hedonic eating in underweight and short-term weight restored patients with anorexia nervosa

2017 ◽  
Vol 41 (S1) ◽  
pp. S550-S550
Author(s):  
G. Fico ◽  
A.M. Monteleone ◽  
M. Nigro ◽  
G. Patriciello ◽  
U. Volpe ◽  
...  
Keyword(s):  
Anorexia Nervosa ◽  
Energy Homeostasis ◽  
Healthy Controls ◽  
Related Disorder ◽  
Structural Abnormalities ◽  
Before And After ◽  
Underweight Patients ◽  
Competing Interest ◽  
The Brain

IntroductionRecently, anorexia nervosa (AN) has been conceptualized as a reward-related disorder, and brain imaging studies have shown functional and structural abnormalities in areas of the brain involved in reward processes in both acute and recovered AN patients. However, the role of endogenous biochemical mediators, such as Ghrelin, in the modulation of reward processes has been poorly investigated in this eating disorder.ObjectivesHedonic eating, that is the consumption of food exclusively for pleasure and not to maintain energy homeostasis, is a useful paradigm to investigate the physiology of food-related reward.AimsWe assessed the Ghrelin response to food-related reward in symptomatic AN women in order to further explore the modulation of reward processes in this severe and debilitating disorder.MethodsPlasma levels of Ghrelin were measured in 7 underweight and 7 recently weight-restored satiated AN patients before and after the ingestion of a favorite (hedonic eating) and non-favorite (non-hedonic eating) food. Ghrelin responses were compared it that of previously studied healthy controls.ResultsWe found that in satiated underweight patients with AN plasma Ghrelin levels progressively decreased after the exposure and the consumption of both the favorite and non-favorite food whereas in satiated weight-restored AN patients and satiated healthy controls plasma Ghrelin concentrations significantly increased after the exposure to the favorite food and after eating it, but decreased after the non-favorite food.ConclusionsThese results suggest a derangement in the Ghrelin modulation of food-related pleasurable and rewarding feelings, which might sustain the reduced motivation toward food intake of acute AN patients.Disclosure of interestThe authors have not supplied their declaration of competing interest.

scholarly journals Neuroanatomical voxel-based profile of schizophrenia and bipolar disorder

2016 ◽  
Vol 25 (4) ◽  
pp. 312-316 ◽  
Author(s):  
E. Maggioni ◽  
M. Bellani ◽  
A. C. Altamura ◽  
P. Brambilla
Keyword(s):  
Bipolar Disorder ◽  
Grey Matter ◽  
Structural Changes ◽  
Temporal Cortex ◽  
Treatment Strategies ◽  
Neural Mechanisms ◽  
Anterior Cingulate ◽  
Healthy Controls ◽  
Structural Differences ◽  
The Brain

Although schizophrenia (SCZ) and bipolar disorder (BD) share elements of pathology (Ellison-Wright and Bullmore, 2009), the neural mechanisms underlying these disorders are still under investigation. Up until now, many neuroimaging studies investigated the brain structural differences of SCZ and BD compared with healthy controls (HC), trying to identify the possible neuroanatomical markers for the two disorders. However, just a few studies focused on the brain structural changes between the two diagnoses. The present review summarises the findings of the voxel-based grey matter (GM) comparisons between SCZ and BD, with the objective to highlight the possible consistent anatomical differences between the two disorders. While the comparisons between patients and HC highlighted overlapping areas of GM reduction in insula and anterior cingulate cortex, the SCZ–BD comparisons suggest the presence of more generalised GM deficits in SCZ compared with BD. Indeed, in a number of studies, SCZ patients showed lower GM volumes than BD patients in fronto-temporal cortex, thalamus, hippocampus and amygdala. Conversely, only a couple of studies reported GM deficits in BD compared with SCZ, both at the level of cerebellum. In summary, the two disorders exhibit both common and specific neuroanatomical characteristics, whose knowledge is mandatory to develop innovative diagnostic and treatment strategies.

Permeability of the microcirculation in area postrema of rat

1988 ◽  
Vol 46 ◽  
pp. 348-349
Author(s):  
Shams M. Ghoneim ◽  
Frank M. Faraci ◽  
Gary L. Baumbach
Keyword(s):  
Brain Stem ◽  
Area Postrema ◽  
Upper Body ◽  
Sprague Dawley ◽  
Sodium Cacodylate ◽  
Acute Hypertension ◽  
Sprague Dawley Rats ◽  
Ultrastructural Characteristics ◽  
The Brain ◽  
Adjacent Brain

The area postrema is a circumventricular organ in the brain stem and is one of the regions in the brain that lacks a fully functional blood-brain barrier. Recently, we found that disruption of the microcirculation during acute hypertension is greater in area postrema than in the adjacent brain stem. In contrast, hyperosmolar disruption of the microcirculation is greater in brain stem. The objective of this study was to compare ultrastructural characteristics of the microcirculation in area postrema and adjacent brain stem.We studied 5 Sprague-Dawley rats. Horseradish peroxidase was injected intravenously and allowed to circulate for 1, 5 or 15 minutes. Following perfusion of the upper body with 2.25% glutaraldehyde in 0.1 M sodium cacodylate, the brain stem was removed, embedded in agar, and chopped into 50-70 μm sections with a TC-Sorvall tissue chopper. Sections of brain stem were incubated for 1 hour in a solution of 3,3' diaminobenzidine tetrahydrochloride (0.05%) in 0.05M Tris buffer with 1% H2O2.

Surgical Approaches to the Brain Stem

1993 ◽  
Vol 4 (3) ◽  
pp. 457-468 ◽  
Author(s):  
Dennis Y. Wen ◽  
Roberto C. Heros
Keyword(s):  
Brain Stem ◽  
Surgical Approaches ◽  
The Brain
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