In the news round-up this week there is a new compound that could potentially be used to look indirectly at the number of microglia in the brain which could be very useful in Alzheimer’s Disease. There is also a five-factor model which predicts conversion from mild cognitive impairment to dementia with a sensitivity of 81%. Bed occupancy rates are also linked to the likelihood of staff taking antidepressants.
A new compound [11C]DAA1106 which binds to peripheral benzodiazepine receptors was examined in 10 people with Alzheimer’s Disease and 10 controls. Some analysis was performed to derive what the authors referred to as a binding potential and they found that this was increased in all regions of interest in the people with Alzheimer’s Disease compared to controls. They concluded that cellular reactions involving peripheral binding receptors were increased in Alzheimer’s although it should be interesting to follow research in this area particularly with a view to how it relates to the microglia (STT4). A study of markers in the cerebrospinal fluid in 100 people (roughly equally divided into Parkinson’s Disease, Parkinson’s Disease with dementia, Alzheimer’s Disease, Lewy Body Dementia and healthy controls) found that hyperphosphorylate Tau was increased only in the Alzheimer’s patients (as expected), that ABeta42 levels were lowest in the people with Lewy Body Dementia and that total Tau levels were correlated with dementia severity (STT1). N-acetyl aspartate levels (NAA) were higher in the hippocampus in people with the val-met form of Brain Derived Neurotrophic Factor compared with the val-val variant. NAA is used as a marker of neuronal damage and so the idea here is that one form of BDNF is more protective than the other although there are a number of assumptions in between (STT3). Five factors – immediate recall, functional assessment (from collateral history), smell test, MRI hippocampal volume and entorhinal volume were found to predict conversion from Mild Cognitive Impairment to Alzheimer’s Disease with a sensitivity of 81% compared to half that score with age and Mini-Mental State Exam Scores combined (STT2).
The metabolic syndrome was investigated in one study and found to be significantly associated with total Beck Depression Inventory scores. The somatic features of depression were particularly highly correlated with the metabolic syndrome. There was evidence for a mediating effect of inflammation (measured using inflammatory markers) on the relationship between depression and metabolic syndrome (STT2-4).
There is a fascinating discussion of Narcissistic Personality Disorder in an editorial in the November Issue of the American Journal of Psychiatry. A model of Narcissistic Personality is discussed in which three subtypes are proposed – the fragile subtype, the malignant/grandiose subtype and the high-functioning/exhibitionist subtype. This is in the context of a study which has looked at 1200 clinicians who have given feedback on the diagnosis (STT2). In the same issue there is also a proposal that suicidal behaviour is included as a sixth axis in DSM-V (STT5). There is an intriguing study suggesting that overcrowding on wards is related to antidepressant use in staff – if bed occupancy is 10% over the expected limit (STT2).
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