There was an interesting pooled analysis of mild cognitive impairment studies which found that the annual rate of conversion decreased in the longer term studies! There was also a study suggesting increased Amyloid deposition in dementia with Lewy Body Dementia but not in Parkinson’s Disease (with or without dementia). Elsewhere a glutamate hypothesis of psychosis is explored in relation to the potential of Acamprosate as a treatment.
A pooled-analysis of mild cognitive impairment conversion to dementia by Alex Mitchell and colleagues produced some rather unusual results. In 15-long term studies they found an annual conversion rate of 4.2% whereas in the shorter observation studies they found a conversion rate of 10-15%. These results are counter-intuitive and it will be interesting to look at further studies in this area (STT4). The average [11C]PIB uptake was found to be significantly increased in 13 people with Lewy Body Dementia but not in 10 people with Parkinson’s Disease or 12 people with Parkinson’s Disease and dementia (although 2 people in this group had increased uptake). [11C]PIB is a marker of Amyloid deposition and the authors conclude that this may contribute to the rapid deterioration that can occur in this condition as well as having implications for treatment (although the fluctuating course of some symptoms may still need to be explained) (STT4). In this double-blind placebo controlled study of memantine (funded by Merz Pharma and which is freely available here) there was insufficient power to detect differences in outcome measures including total brain volume, hippocampal volume and brain glucose metabolism (STT5).
Paz and colleagues hypothesise that excessive glutamate levels may contribute to increased activity in the prefrontal cortex in people with first-episode psychosis and that it may be decreased with neuroleptic treatment. They speculate as to whether acamprosate may have efficacy in treatment of psychosis (STT5).
Goodwin and colleagues provide an update on a European College of Neuropharmacology expert meeting where it was suggested that cognitive impairment in Bipolar Disorder may represent neurodegeneration rather than neurodevelopment and discuss the implications for treatment including rehabilitation (STT5). A meta-analysis compared Mirtazapine with SSRI’s using published studies and found a 67.1% response rate for Mirtazapine and a 62.1% response rate for SSRI’s with a different side-effect profile (less fatigue, excessive sleepiness, weight gain or dry mouth in the SSRI group compared to less insomnia and nausea in the Mirtazapine group (STT1).
A curious finding in one study was that people with attention-deficit/hyperactivity disorder had increased sensitivity to odours compared to controls which contrasts for example with the finding in people with Parkinson’s Disease (STT5). The authors of one study tested a hypothesis about a relationship between vagal tone and ghrelin/obestatin secretion and confirmed that circulating ghrelin increased while obestatin decreased during sham feeding in women with anorexia when compared to controls although the sample size was relatively small (8 in each arm) (STT4). 9 People who had recovered from anorexia nervosa were found to have increased 5HT1A binding in fronto-temporal regions compared to 7 controls (STT5).
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