In the news round-up this week there is an area on chromosome 8 which has been associated with late-onset Alzheimer’s Disease, a psychoeducation program has showed effectiveness on a number of measures in people with Bipolar Disorder and the authors of a neuroimaging study have been able to reasonably predict where a person is in a virtual reality environment from brain activation patterns.
The authors of a meta-analysis of six studies looking at the epidemiology of ADHD concluded that the prevalence decreased with increasing age but there were difficulties with the DSM-IV criteria in adulthood for a number of reasons. For instance although there were fewer symptoms in adulthood, people still met criteria for functional impairment (Simon et al, 2009)(STT4). In a longitudinal study of childhood temperament involving 12,150 people (with employment status at follow-up being identified for 7183) responses to the childhood questions ‘often complain of aches and pains’ and ‘often appears miserable or unhappy’ were significantly associated with middle age sickness absence after controlling for a number of other variables (Henderson et al, 2009)(STT4).
Research in Dementia
In a GSK funded population-based longitudinal study involving 2050 people without dementia and 587 people with dementia, psychological and behavioural symptoms were found in most people with dementia. There was a finding that depression and anxiety prevalence decreased at later stages of the illness although they were elevated in the initial stages (Savva et al, 2009)(STT3). A compound polybutylcyanoacrylate has been demonstrated to be effective at delivering proteins into neurons in vitro (Hasadri et al, 2009)(STT5). A small study (n=20) found evidence of altered connectivity between the dominant hand area in the motor cortex and language related areas using a combination of motor evoked potentials and transcranial magnetic stimulation in people with amnestic mild cognitive impairment (Bracco et al, 2009)(STT5). Risk factors that Alzheimer’s Disease and Diabetes share in common are examined in this review article (Gotz et al, 2009). A region on chromosome 8 was found to be significantly associated with Late-Onset Alzheimer’s Disease in a study involving 837 people with late-onset Alzheimer’s Disease (AD) and 550 controls (Nalls et al, 2009)(STT4). In a study looking at 10 people with amnestic MCI and people with AD (11 mild; 17 mod; 15 severe) there was found to be a significant correlation between the size of the white matter lesions in the periventricular and subcortical areas and severity of dementia (Targosz-Gajniak et al, 2009)(STT5). Neurosonology has been proposed as a useful measure for investigating dementia (Demarin et al, 2009)(STT5). Homocysteine levels were increased and paraoxonase levels decreased in people with Alzheimer’s Disease (AD n=51, VaD n=28, Mixed Dementia n=41) which was interpreted as a relationship between oxidative stress and the neurodegenerative process in Alzheimer’s Disease (Wehr et al, 2009)(STT4). The relationship between the blood-brain barrier and cognitive decline has been examined in a review paper in which a causal link is proposed (Popescu et al, 2009). Anosognosia for amnesia (using the everyday memory checklist) was found to be positively correlated with disease progression in Alzheimer’s Disease in a longitudinal study involving 58 people with mild Alzheimer’s Disease (Akai et al, 2009)(STT3). In a systematic review of the use of long-chain omega-3 fatty acids there was found to be no reduction in progression of dementia although other studies have shown a reduction in cognitive decline in elderly people without dementia (Fotuhi et al, 2009). Acetylcholinesterase inhibitors were found to be have different effects on blood pressure and cerebral perfusion in Alzheimer’s Disease in this review (Claassen et al, 2009). The authors of a study looking at anosognosia found that this may impact on the results of self-rated quality of life measures in people with Alzheimer’s Disease (Berwig et al, 2009)(STT4). The authors of a Cochrane review found inconsistent evidence for clinical effects of Gingko Biloba in cognitive impairment and dementia (Birks et al, 2009).
Research in Psychosis
A diffuse tensor MRI study looking at 76 people with schizophrenia and 76 controls found that in people with schizophrenia there were widespread regions of reduced fractional anisotropy (which is thought to be a marker for the integrity of white matter) in people with schizophrenia compared to the controls (Kanaan et al, 2009)(STT4).
Research In Mood Disorders
In a study which involved 25 people with bipolar I disorder without a history of psychosis and 24 people with bipolar I disorder with a history of psychosis there weren’t found to be any significant neuropsychological differences between the groups. However the authors concluded that there was a trend towards impaired verbal working memory in the people with a history of psychosis compared to those without which would be consistent with the findings of some research studies in people with schizophrenia. The scores on the Schizotypal Personality Scale were positively correlated with visual recall memory but negatively correlated with verbal memory (Savitz et al, 2009)(STT5). In a partly GSK-funded study involving 811 people with moderate to severe depression, Nortripytlline and Escitalopram were compared. The graphs showed a close overlap of the two antidepressants on measures of MADRS, HDRS-17 and BDI with time (12 weeks from baseline). However vegetative symptoms (weight loss, appetite, sleep and libido) improved further with Nortriptylline than Escitalopram while the reverse was true for observed mood and cognitive symptoms (Uher et al, 2009)(STT2). A psychoeducation program which involved 21 90-minute sessions covering awareness of illness, compliance, detection of prodromal symptoms and lifestyle and involved 120 people randomised to the treatment or control groups. Time to recurrence and number of recurrences were significantly less in the psychoeducation group as was the time spent acutely ill (Colom et al, 2009)(STT2).
News in Brief
A study found evidence that preschool children were able to recognise and follow consensus. A number of studies are reported on here which show a relationship between cognitive decline and metabolic risk factors including obesity, metabolic syndrome, and being underweight. A study has looked at a technique referred to as ‘dialectical bootstrapping’ in which evidence is provided that this improves the accuracy of decisions made by an individual. Developments in smart homes for people with dementia by a team at the University of Bath is covered here. A study looking at learning in school in children born prematurely (before 26 weeks) is covered here. A one-leg balance test that is easy to administer was found to be associated with rate of cognitive decline in Alzheimer’s Disease in this study. A widely reported fMRI study by Demis Hassabis and Eleanor Maguire found a significant relationship between hippocampal activity and location in a virtual spatial environment. A study found that higher IQ was associated with lower risk of death from a number of conditions including coronary artery disease and that this could be explained through a number of factors including lifestyle (diet, exercise, smoking). The authors of an fMRI study suggest from their results that the Amygdala and Posterior Cingulate Cortex are involved in the decision making process of forming first impressions of another person. A 300-million year old brain has been discovered in a distant relative of the shark.
Akai T et al. Longitudinal patterns of unawareness of memory deficits in mild Alzheimer’s Disease. Geriatr Gerontol Int. 209. 9(1). 16-20.
Birks J et al. 2009. Ginkgo Biloba for cognitive impairment and dementia. Cochrane Database Syst Rev. 2009.
Berwig M et al. Critical evaluation of self-rated quality of life in Mild Cognitive Impairment and Alzheimer’s Disease – Further evidence for the impact of Anosognosia and Global Cognitive Impairment. J Nutr Health Aging. 2009. 13(3). 226-230.
Bracco L et al. Mild cognitive impairment. Loss of linguistic task-induced changes in motor cortex excitability. Neurology. 2009. 72. 928-934.
Claassen J et al. Short review: acetylcholinesterase-inhibitors in Alzheimer’s Disease have opposing effects on blood pressure and cerebral perfusion. J Nutr Health Aging. 2009. 13(3). 231-3.
Colom F et al. Group psychoeducation for stabilised bipolar disorders: 5-year outcome of a randomised clinical trial. The British Journal of Psychiatry. 2009. 194. 260-265.
Demarin V et al. Evaluation of aging vs dementia by means of neurosonology. J Neurol Sci. 2009. Epub.
Fotuhi M et al. Fish consumption, long-chain omega-3 fatty acids and risk of cognitive decline or Alzheimer Disease: a complex association. Nat Clin Pract Neurol. 2009. 5(3). 140-52.
Gotz J, Ittner L M and Lim Y.A. Common features between diabetes mellitus and Alzheimer’s Disease. Cellular and Molecular Life Sciences (CMLS). 2009.
Hasadri L et al. Functional protein delivery into neurons using polymeric nanoparticles. J Biol Chem. Vol 284. 11. 6972-6981.
Henderson M et al. Childhood temperament and long-term sickness absence in adult life. The British Journal of Psychiatry. 2009. 220-223. 194.
Kanaan R et al. White matter microstructure in schizophrenia: effects of disorder, duration and medication. The British Journal of Psychiatry. 2009. 236-242. 194.
Nalls M et al. Extended tracts of homozygosity identify novel candidate genes associated with late-onset Alzheimer’s Disease. Neurogenetics. 2009. 1364-6753.
Popescu B et al. Blood-brain barrier alterations in ageing and dementia. J Neurol Sci. 2009. March. Epub.
Savitz J et al. Neuropsychological status of bipolar I disorder: impact of psychosis. The British Journal of Psychiatry. 2009. 194. 243-251.
Savva G.M et al. Prevalence, correlates and course of behavioural and psychological symptoms of dementia in the population. The British Journal of Psychiatry. 2009. 194. 212-219.
Simon et al. Prevalence and Correlates of adult attention-deficit hyperactivity disorder: meta-analysis. The British Journal of Psychiatry. 2009. 194. 204-211.
Targosz-Gajniak et al. Cerebral white matter lesions in patients with dementia – from MCI to severe Alzheimer’s Disease. J Neurol Sci. 2009.
Uher R et al. Differential efficacy of escitalopram and nortriptylline on dimensional measures of depression. The British Journal of Psychiatry. 2009. 194. 252-259.
Wehr H et al. Paraoxonase activity and dementia. J Neurol Sci. 2009. Epub.
Steps To Treatment (STT)
STT = Steps To Treatment. An estimate of the number of steps between the results and translation into practice i.e. treatment. This is an opinion. A policy statement would have a value of 1 as this a guide for practice whereas a speculative model would get a much higher score as there are more steps between statement of the model and treatment (which would involve testing the model, informing treatment approaches and trialling these approaches for instance).
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