Disturbance of spatial working memory and its neurophysiological correlates in alcohol dependence

Введение. У пациентов с алкогольной зависимостью наблюдаются нарушения в широком диапазоне когнитивных функций. Это приводит к неспособности контролировать употребление алкоголя, рецидивированию или постоянному употреблению алкоголя, несмотря на негативные физические, психологические и социальные последствия. Исполнительный контроль относится к группе когнитивных функций, который позволяют людям самостоятельно регулировать свое поведение и выбирать соответствующие действия в зависимости от долгосрочных целей. При этом рабочая память является одной из главных составляющих исполнительного контроля. Цель исследования - изучение пространственной рабочей памяти у пациентов с синдромом алкогольной зависимости с использованием метода количественной ЭЭГ и компьютерного теста Corsi. Методика. Обследовано 50 пациентов с диагнозом алкогольной зависимости (F10.2 по МКБ-10) после детоксикации. Группу контроля составили 30 психически и соматически здоровых лиц, сопоставимых по возрасту. Исследование пространственной рабочей памяти осуществляли с помощью компьютерного теста Корси (Corsi Block-Tapping). Регистрировали 16-канальную ЭЭГ: фон с открытыми глазами и во время выполнения теста Corsi. Анализировали абсолютные значения спектральной мощности θ-, α- и β-ритмов. Результаты. Согласно результатам теста Corsi, при алкогольной зависимости наблюдается выраженное снижение объема рабочей памяти относительно здоровой группы контроля. Изменения ЭЭГ в процессе выполнения теста Corsi у пациентов с синдромом алкогольной зависимости сопровождались десинхронизацией альфа-ритма в префронтальной коре мозга и левом височном локусе, что не выявлялось у обследуемых здоровой группы контроля. Было обнаружено снижение бета-ритма в центральной и теменной коре у пациентов с синдромом алкогольной зависимости в ответ на когнитивный стимул. У пациентов с синдромом алкогольной зависимости существенно повышалась тета-мощность в затылочной коре в ответ на когнитивный стимул, а также регистрировалась статистически значимо большая тета-активность в правом височном локусе. Заключение. Полученные результаты могут служить дополнительными диагностическими критериями когнитивных нарушений у пациентов с синдромом зависимости от алкоголя. Patients with alcohol dependence have disorders of multiple cognitive functions. This leads to inability to control alcohol consumption, relapse or continued use of alcohol despite negative physical, psychological, and social consequences. Executive control refers to a group of cognitive functions that allow people to regulate independently their behavior and to choose appropriate actions depending on their long-term goals. Working memory (WM) is one of the main components of the executive control. The aim of the study was to evaluate indexes of spatial working memory in patients with alcohol dependence syndrome using the quantitative EEG method and the Corsi computer test. Methods. 50 patients diagnosed with alcohol dependence (F10.2 on MKB-10) were evaluated after detoxification. The control group consisted of 30 mentally and somatically healthy, age-matched subjects. The study of spatial working memory was performed by a Corsi computer test (Corsi Block-Tapping). 16-channel EEGs were recorded at background with open eyes and during the Corsi test. Spectral power absolute values of θ -, α - and β - rhythms were analyzed. Results. According to the Corsi test in alcohol dependence, the WM volume was markedly decreased compared to the healthy control group. Changes in EEG during the Corsi test in patients with alcohol dependence syndrome were associated with alpha-rhythm desynchronization in the prefrontal cortex and left temporal locus, which was not observed in the healthy control group. Decreased beta rhythm was observed in the central and parietal cortex of patients with alcohol dependence syndrome in response to a cognitive stimulus. In patients with alcohol dependence syndrome, theta power was significantly increased in the occipital cortex in response to a cognitive stimulus, and theta activity was significantly greater in the right temporal locus. Conclusion. The results of this study may serve as additional diagnostic criteria for cognitive disorders in patients with alcohol dependence syndrome.

The unnoticed interictal disphoric disorder

IntroductionPsychiatric morbidity in refractory epilepsy is frequent and has a negative influence on quality of life. Treatment-refractory epileptic patients are at higher risk of developing psychiatric disturbances. The interictal dysphoric disorder (IDD) has been described as a pleomorphic pattern of symptoms claimed to be typical of patients with epilepsy. It is characterized by 3/8 symptoms: depressive mood, anergia, pain, insomnia, fear, anxiety, irritability, and euphoric mood.ObjectivesTo provide evidence that psychiatric morbidity is high in refractory epilepsy and to describe associations to IDD.AimsThe present study aims to show that there are typical psychiatric conditions in epilepsy that can be unnoticed.MethodsWe cross-sectional analyzed the psychopathologic outcomes of patients with refractory epilepsy. The assessments methods included SCID for DSM-IV and clinical interview for epileptic specific psychiatric conditions.ResultsThe sample consists of 153 patients, with a mean age of 37. A total of 42.5% were males. One or more Axis I diagnoses was seen in 38% of the patients. The most common condition was IDD (27.1%), followed by affective and anxiety disorders (22 and 15.3% respectively). Considering patients with IDD, we found differences in locus (P = 0.001) (present in 34.3% of non-stablished locus, 8.6% of extra-temporal locus and 57.1% of temporal locus) but not with hemisphere, sex, type of crises, treatment. We neither found correlation with age, number of crisis or number of treatments.ConclusionsPsychiatric comorbidities as IDD do not appear in the DSM-IV but are prevalent and could be related with temporal locus.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Semantic Conflict Processing in the Color-Word Stroop and the Emotional Stroop

With the aim of establishing the temporal locus of the semantic conflict in color-word Stroop and emotional Stroop phenomena, we analyzed the Event-Related Potentials (ERPs) elicited by nonwords, incongruent and congruent color words, colored words with positive and negative emotional valence, and colored words with neutral valence. The incongruent, positive, negative, and neutral stimuli produced interference in the behavioral response to the color of the stimuli. The P150/N170 amplitude was sensitive to the semantic equivalence of both dimensions of the congruent color words. The P3b amplitude was smaller in response to incongruent color words and to positive, negative, and neutral colored words than in response to the congruent color words and colored nonwords. There were no differences in the ERPs induced in response to colored words with positive, negative, and neutral valence. Therefore, the P3b amplitude was sensitive to interference from the semantic content of the incongruent, positive, negative, and neutral words in the color-response task, independently of the emotional content of the colored words. In addition, the P3b amplitude was smaller in response to colored words with positive, negative, and neutral valence than in response to the incongruent color words. Overall, these data indicate that the temporal locus of the semantic conflict generated by the incongruent color words (in the color-word Stroop task) and by colored words with positive, negative, and neutral valence (in the emotional Stroop task) appears to occur in the range 300–450 ms post-stimulus.

Visual Representations of the Body in Chinese Medical and Daoist Texts From the Song to the Qing Period (Tenth to Nineteenth Century)

This article is a preliminary survey of representations of the body produced in China from the Song to the Qjng period in the context of medicine, forensic medicine and Daoism. Despite much common theoretical background, bodily representation in each of these fields differs in function and intent. Each field came to be associated with a particular aspect of the body. For medicine, this was the description of the viscera and the channels and tracts through which qi and humours flowed; for forensic medicine, it was the description of the skeleton; for Daoism, it was the symbolic description of the body as the spatio-temporal locus of a system of mutations and correspondences with the outside world and the spirit world.These representations fall into three categories, reflecting three different approaches to the body: images of the whole body approached from without, including gymnastic postures, locations on the body, somatic measurements, channels and tracts; images of the inside of the body, i.e. the internal organs and the skeleton (which raises issues regarding dissection); and images of the symbolic body, i.e. alchemical processes within the body and the true form of the allegorical body. The images, which are always accompanied by text, require to be read according to specific cultural codes, and reveal particular mental constructions of the body. They perform multiple functions, serving as proof of knowledge, teaching material, medium of transmission, memory aid, or graphic presentation of a text; and for the Daoists, manifesting the form of the true body.