News Round-Up: March 2009 4th Edition

In this news round-up, relapse prevention was found to be effective in first episode psychosis compared to treatment as usual in one study while late onset depression was associated with an increased prevalence of mild cognitive impairment after treatment response in a cross-sectional study.

Research in Dementia

In a prospective study of community-based people with dementia (n=48) including post-mortem, visual hallucinations were associated with a higher frequency of neocortical lewy-related pathology, abnormal posture and gait than those without visual hallucinations. However in 59% of cases the diagnosis was Alzheimer’s Disease with concurrent Lewy Body related pathology (Tsuang et al, 2009)(STT3). Iron levels were elevated in the hippocampus in 26 people with Alzheimer’s Disease compared to controls in a phase-imaging study of 26 people with Alzheimer’s Disease and 24 controls with potential diagnostic implications (Ding et al, 2009)(STT4). In a cross-sectional study looking at 109 people aged 65 years or older with depression (who had responded to treatment) and 65 controls who had never experienced depression, the depressed group had just under twice the prevalence (38% – 2/3 amnestic, 1/3 non-amnestic) of Mild Cognitive Impairment as the control group (Bhalla et al, 2009)(STT4).

In a meta-analysis of 14 studies which looked at hippocampal volume in people with Mild Cognitive Impairment and Alzheimer’s Disease compared to controls there was found to be greater atrophy in the left hippocampus in both MCI and AD groups as well as a greater degree of atrophy in AD subjects (24.2% left, 23.1% right reduction in hippocampal volume) than in MCI (12.9% left, 11.1% right reduction in hippocampal volume) with both being significantly greater than controls (Shi et al, 2009)(STT3).

In a study of 629 elderly people without dementia, vibratory threshold measured at the ankles/toes were significantly correlated with composite mobility scores (Buchman et al, 2009)(STT3). In a small case control series of Frontotemporal Dementia, 12 people with MAPT gene mutations were found to have greater grey matter loss in the frontal, parietal and anteromedial temporal lobes copared to the control group while the 12 people with PGRN gene mutations were found to have greater grey matter loss in the frontal, parietal and posterior temporal lobes than controls (Whitwell et al, 2009)(STT5). In a 5-year prospective cohort study, over 70% of people with mild behavioural impairment converted to dementia and were more likely to develop Frontotemporal Dementia than Alzheimer’s Disease and the authors suggest that MBI may be an FTD prodrome (Taragano et al, 2009).

Research In Depression

A small study (n=14) found that Verenicline, a nicotinic acetylcholine receptor partial agonist was associated with a significant improvement in mood (using a self-report measure) and 44% achieving abstinence from smoking with the authors recommending further research to confirm these findings (Philip et al, 2009)(STT5) .

Research in Psychosis

A randomised-controlled trial of treatment as usual (n=40) versus individual and family CBT relapse prevention (n=41) in people with first episode psychosis found a significantly longer time to relapse in the relapse prevention group (Gleeson et al, 2009).

News In Brief

Over 500 6-18 year-olds were scanned prospectively (using MRI) as part of the ‘NIH MRI Study of Normal Brain Development’. A significant association between cortical thickness in multimodal association areas and intelligence was found. An increase in Ghrelin and a decrease in Leptin were found in people with chronic insomnia in this study. Having extra-curricular activities at school was associated with more years of education in later life. In a test of attention, the Visual Serial Addition Test, children with ADHD were found to have similar accuracy of responses to the control group but higher variability in response times. Cortical thinning in the right hemisphere was associated with depression in a study looking at 131 people with familial depression. An association has been found between the metabotropic glutamate 5 receptor and the process of adapting to new changes in the environment. Initial results suggest that Modafanil may reduce Olanzapine associated weight gain. A study using photographic negatives has shown that contrast around the eyes is important in recognition of faces. Alpha activity was significantly higher before mistakes were made in a sustained attention task and this information has the potential to be used in jobs which require prolonged attention.

References

Bhalla R et al. Patterns of mild cognitive impairment after treatment of depression in the elderly. Am J Geriatr Psychiatry. 2009. 17(4). 308-316.

Buchman A et al. Vibratory thresholds and mobility in older persons. Muscle Nerve. 2009. Epub.

Ding B et al. Correlation of iron in the hippocampus with MMSE in patients with Alzheimer’s Disease. J Magn Res Imaging. 2009. 29(4). 793-8.

Glesson et al. A Randomised Controlled Trial of Relapse Prevention Therapy for First-Episode Psychosis Patients. J Clin Psychiatry. 2009.

Philip N et al. Varenicline augmentation in depressed smokers: An 8-week, open label study. J Clin Psychiatry. 2009.

Shi F et al. Hippocampal volume and asymmetry in mild cognitive impairment and Alzheimer’s Disease: Meta-analyses of MRI studies. Hippocampus. 2009.

Taragano F et al. Mild behavioral impairment and risk of dementia: A Prospective Cohort Study of 358 Patients. J Clin Psychiatry. 2009.

Tsuang D et al. Visual hallucinations in dementia: a prospective community-based study with autopsy. Am J Geriatr Psychiatry. 2009. 17(4). 317-23.

Whitwell J et al. Voxel-based morphometry patterns of atrophy in FTLD with mutations in MAPT or PGRN. Neurology. 2009. 72(9). 813-20.

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.

Responses

If you have any comments, you can leave them below or alternatively e-mail justinmarley17@yahoo.co.uk

Disclaimer

The comments made here represent the opinions of the author and do not represent the profession or any body/organisation. The comments made here are not meant as a source of medical advice and those seeking medical advice are advised to consult with their own doctor. The author is not responsible for the contents of any external sites that are linked to in this blog.

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