In April a number of articles were reviewed. These included a number of papers on vascular dementia, the NIMHE paper on establishment of a mental health research network, the question of whether schizoaffective disorder should be a categorical diagnosis and also some more of Winnicott’s papers. The ‘Voodoo Correlations in Neuroscience’ paper has been renamed and a number of responses to this paper have now been published. A number of books were reviewed including Ramachandran’s excellent book ‘Phantoms in the Brain’. Several blogs were reviewed including ‘The Tangled Neuron’ about the daughter of a man with dementia who sadly passes away. However she goes onto provide an astonishing amount of useful information on dementia through the blog. A number of podcasts were reviewed and an attempt was made to find more advanced information on Vascular Dementia using YouTube although in the end, the search wasn’t very effective in that particular case. In the news, Methylene blue made a reappearance, this time in the treatment of optic neuropathy where some preliminary results are positive. Various speculative risk factors for dementia have been identified with supporting evidence. One intriguing finding has been a slower progression of dementia in the presence of concurrent diabetes although it will be interesting to see further replication of these results. A case series looked at the relationship between frontotemporal dementia and earlier psychiatric illnesses with some interesting findings while Mild Behavioural Impairment was found to be associated with subsequent development of frontotemporal dementia. Repeated episodes of hypoglycaemia were associated with dementia in one study while a Cochrane review on statin treatment and later dementia was also published. Transmission Electron Micrographs of the brain are being made available on the internet for researchers. In one study, subjects with schizophrenia were significantly better able to discriminate hollow and real faces than people without schizophrenia in a paradigm which examines perception. There were many more interesting studies.
News Round-Up For March 2009
Research in Dementia
The authors of a Cochrane review concluded that Rivastigmine was effective in the treatment of mild to moderate Alzheimer’s Disease after reviewing the results of 9 trials with a combined total of 4775 participants (Birks et al, 2009). A cotton seed extract with potential antidepressant effects was found to have hippocampal neurogenesis effects (Zhang et al, 2009). A recent study showed evidence of a neuroprotective role of Methylene blue in a model of optic neuropathy further supporting evidence from last year again as a neuroprotective agent in neurodegenerative processes (Rojas et al, 2009). Ibuprofen was associated with a reduction in the increasing rate of delta rhythms with time in people with mild Alzheimer’s Disease in this small placebo controlled study and the authors recommend further studies (Babiloni et al, 2009). A study looked at factors influencing length of time till admission to a nursing home for people with dementia and found that the characteristics of the care providers were important associations with time till admission (Habermann et al. 2009).
A virtual reality spatial navigation task was found to effectively discriminate between young healthy adults and older adults with Alzheimer’s Disease suggesting the theoretical utility of this paradigm although use within clinical practice will need to be further assessed (Zakzanis et al, 2009). Distinguishing between frontal function (using a frontal assessment battery) and posterior function (using a perceptual assessment battery) was effective in distinguishing between early-onset dementias and late-onset dementias in this small pilot study which looked at 23 people with dementia and 20 controls (Mendez et al, 2009).
99 people with early-onset AD were compared with 192 people with late-onset AD and the younger-onset group were found to have a more rapid decline particularly if they were APOE4 negative (van der Vlies et al, 2009). Tau deposition in an ageing sample (from the Medical Research Council Cognitive Function and Ageing Study) was found to proceed along a pathway which included the Entorhinal cortex, CA1 and dentate (Lace et al, 2009). People with early-onset Alzheimer’s Disease and AD associated with higher education were found to have thinner cortical thickness in a number of areas compared to a control group without cognitive impairment (Seo et al, 2009). A longitudinal study with post-mortem showed an association between Alzheimer’s Disease and evidence of vascular remodelling – alphavbeta3 immunoreactivity. This was also correlated with ABeta located in the hippocampus (Desai et al, 2009). The researchers in an in-vitro study that examined cholesterol levels in the cell membranes found significantly higher cholesterol levels in older neurons compared to younger neurons and also provided evidence that lower cholesterol was associated with less vulnerability to Abeta me There was found to be no significant difference between people with Alzheimer’s Disease and controls in brain-derived neurotrophic factor levels in a study with 196 people with equal numbers of controls and people with Alzheimer’s Disease (O’Bryant et al, 2009). Another study found an association between HDL and ABeta and the authors recommend a longitudinal replication study (Bates et al, 2009). diated toxicity (Nicholson and Ferreira, 2009). Diabetes was associated with a slower progression of Alzheimer’s Disease in this prospective Italian study of 154 people with mild-to-moderate AD and it will be interesting to see further replication (Musicco et al, 2009).
Epsilon4-positive APOE4 genotype was associated with significantly increased PIB uptake in the frontal, temporal and parietal cortex compared to the Epsilon4 negative genotype although no difference was identified in grey matter volume (Drzezga et al, 2009). The APOE epsilon4 alelle was associated with frontal and temporal lobe atrophy in this small study of 15 people with Alzheimer’s Disease (AD) who were carriers and 14 non-carriers with AD (Pievani et al, 2009). In a prospective study of 34 people with traumatic brain injury, outcome on the Glasgow Coma Scale at 6 months was significantly associated with serum tau protein levels on admission although further replication studies are needed (Liliang et al, 2009). Significant variability in immunosorbent assays for Tau and Abeta in CSF exist across the world and the authors of this study have called for a standardisation of procedures (Verwey et al, 2009). An in-vitro study provided evidence that alpha-synuclein’s N and C terminal domains were required for macrophage activation (Lee et al, 2009).
An association between amnestic mild cognitive impairment and cholinergic basal forebrain volume was found in this MRI study (Muth et al, 2009). A 3-year follow-up study provided evidence that reversion to no cognitive impairment was more likely to occur if mild cognitive impairment had been assessed on a single occasion compared to cases where it had been identified on repeated testing (Loewenstein et al, 2009). A combination of a logical memory test and the California Verbal Learning Test-II were found to be accurate in 87.5% of cases in discriminating cases of Mild Cognitive Impairment that converted to AD in this 4-year prospective study of 38 people with MCI (Rabin et al, 2009). People with AD or MCI were found to be impaired on a semantic fluency task relative to depressed and non-depressed controls (Lonie et al, 2009). Using data from subjects in a Mayo Clinic longitudinal registry and the Alzheimer’s Disease Neuroimaging Initiative (21 healthy controls, 32 people with amnestic MCI and 8 people with AD) amyloid deposition in AD (using PIB-uptake PET images) was found to proceed constantly but was not associated with clinical symptoms. However MRI determined brain atrophy (baseline image versus follow-up image comparison) was associated with clinical symptoms and the authors suggest that both imaging approaches are complementary (Jack et al, 2009).
A retrospective case series of 17 people who developed Frontotemporal Dementia identified prior diagnoses of bipolar disease and schizophrenia in 5 of the people. A supplementation of the case series with a literature review provided additional evidence of a potential relationship between a small number of cases of adult-onset psychosis and later Frontotemporal Dementia. However large prospective cohort studies would be beneficial to test this relationship (Velakoulis et al, 2009). In a 5 year follow up of 239 people over the age of 65 with Mild Cognitive Impairment and 119 people with Mild Behavioural Impairment, the latter group were found to convert to dementia in 70% of cases, the most common being Frontotemporal dementia. 34% of the Mild Cognitive Impairment group converted (Taragano et al, 2009).
The authors of a genome search meta-analysis of familial late-onset Alzheimer’s Disease identified a linkage with regions on chromosomes 1, 7 and 8 (Butler et al, 2009). Incidence of dementia was not found to be increased among 2286 atomic bomb survivors compared to a control group (Yamada et al, 2009). The authors of a meta-analysis of longitudinal epidemiological studies of risk factors for Alzheimer’s Disease identified obesity and diabetes as independent risk factors (Profenno et al, 2009). There is evidence that Zinc acts as a ligand at the metabotropic receptor (Besser et al, 2009). The authors of a retrospective post-hoc study of Galantamine concluded that the optimal dose in mild Alzheimer’s Disease was 16mg/day (Aronson et al, 2009). Elevated antibodies to helicobacter pylori were found in the CSF of people with Alzheimer’s Disease (n=27) compared to age-matched controls (n=27)(Kountouras et al, 2009).
The Swedish Lund group have suggested an aggregate of MMSE scores, clock drawing test and 3D cube-copying test scores as indicating a further exclusion of Lewy Body Dementia on the basis of this study of 33 people with Lewy Body Dementia (Palmqvist et al, 2009). In a study of 21 people with vascular dementia, 79 people with AD and 352 controls there was found to be no significant difference between VaD and AD subjects on tests of prospective and retrospective memory (Livner et al, 2009). A significant difference in cognitive profiles was found between people with mild AD and subcortical ischemic vascular dementia. In this study people with subcortical vascular dementia scored significantly worse on tests of visuospatial function and working memory (Kandiah et al, 2009). An association of Cerebral Amyloid Angiopathy with cerebral infarction and haemmorhage was inferred from a significant increase in silent white matter lesions compared to a control group without CAA (Kimberly et al, 2009). A case of angiitis is reported in association with Alzheimer’s Disease (Annweiler et al, 2008). In a prospective Swedish study homocysteine levels were significantly associated with Alzheimer’s Disease in women (Zilberstein et al, 2009). Hippocampal atrophy was associated with a significant increase in the risk of progressive to dementia in 70 people undergoing Subthalamic Nucleus Deep Brain Stimulation for Parkinson’s Disease (Aybek et al, 2009). In a prospective study of 67 people with Multiple Sclerosis and 28 controls, active inflammation was associated with neurodegeneration but the inflammatory response diminished in the later stages of the disease until neurodegeneration occurred at a similar rate to the control group (Frischer et al, 2009).
Research in Psychosis
In an interesting development, two authors have proposed a group of 22 ‘facts’ that can be used in constructing models of schizophrenia (MacDonald and Schulz, 2009). People with schizoaffective disorder and related affective disorders were significantly more likely to carry the val66Met polymorphism of BDNF than people with schizophrenia in this study of 381 people with schizophrenia, affective disorders or schizoaffective disorder and 222 controls (Lencz et al, 2009). A comparison of women with and without childhood abuse found that the former group were significantly more likely to develop psychosis in adulthood in this case-control study (cases n=181, controls n=246). The same finding was not identified in men. However further prospective cohort studies could explore causality (Fisher et al, 2009). Anandamide which binds to cannabinoid receptors was found to be elevated in 27 people with the prodromal state of psychosis compared to 81 controls and the authors suggest that Adandamide may be protective in the prodromal phase (Koethe et al, 2009).
Age of onset of psychosis in families with more than one member with schizophrenia was found to have a significant heritable component in this study which included 717 families in Mexico and Central America (Hare et al, 2009). A Swedish study looking at 3 birth cohorts and a using semi-structured interview showed a 1% prevalence of psychosis in non-demented people aged 70, 78 and 82 (Sigstrom et al, 2009). In a study of 125 people with schizophrenia, physical activity levels were comparable to population norms although 70% were classed as being overweight and the authors suggest possible mechanisms to account for the difference in their sample (McLeod et al, 2009). In a study of 35 people with schizophrenia, 15 had passivity symptoms and 20 did not. Those with passivity symptoms were significantly more likely to underestimate time durations (Waters and Jablensky, 2009).
A relatively small prospective imaging study provided evidence of gray matter loss over a mean 1.8 year follow-up period in people with First Episode Psychosis (FEP) and those at ultra-high risk of developing psychosis (UHRNP). In both FEP and UHRP there was significant grey matter loss in the planum temporale and planum polare and in FEP there was also gray matter loss in the left Heschl gyrus which was significantly associated with delusional severity (Takahashi et al, 2009). Grey matter volume in the Insular Cortex was reduced in a sample of 31 people at Ultra-High Risk of progression to psychosis who later progressed (UHR-P) when compared with 66 people with Ultra-High Risk who did not progress (UHRPNP). Longitudinally there was found to be a significant reduction in grey matter volume in the insular cortex bilateraly in the UHRP group compared to both controls and the UHRPNP group (Takahashi et al, 2009).
A post-hoc analysis of 5 double-blind RCT’s comparing Olanzapine, Quetiapine, Ziprasidone, Aripiprazole and Risperidone concluded that Olanzapine did not differ from Aripiprazole but did show a lower loss of response than the other 3 antipsychotics at 24 and 28 weeks of treatment. Nevertheless it would be interesting to see the results for longer periods of treatment (Stauffer et al, 2009). A small pilot study showed some benefit for a weight-reduction program in people taking second-generation antipsychotics compared to a control group. Larger replication studies would be beneficial (Blouin et al, 2009). A population-based case-control study looked at side-effects of psychotropic medication in people over the age of 67 and found an association between SSRI’s, Olanzapine and Amitripytlline and increased risk of hypertensions at 6-months after the medication was prescribed as well as a significant association between Olanzapine and diabetes at 6-months while conventional antipsychotics were associated with a reduction in the incidence of hypertension (Kisely et al, 2009). A placebo-controlled trial of Mirtazapine as an adjunct to atypical antipsychotics for schizophrenia found no evidence of benefit in a small 6-week study with 40 participants – 20 in each arm (Berk et al, 2009). A change in prolactin levels was association with olanzapine treatment response in an open label study (Chen et al, 2009). People with non-affective psychosis and difficulties in social recovery were found to benefit from CBT when compared to treatment as usual although the authors recommend further larger replication studies (Fowler et al, 2009). Significantly greater weight gain for Risperidone and Olanzapine compared to placebo were identified from a database analysis of 21 placebo-controlled RCT’s (Parsons et al, 2009). A case of torsade de pointes occurring after haloperidol administration in a person with complete heart block was identified in this paper (Ginwalla et al, 2009). The authors of a review of 85 studies looking at coping mechanisms for psychosis conclude that multiple coping mechanisms most likely represent an optimal strategy (Phillips et al, 2009). A retrospective study of 52 elderly inpatients treated with Aripiprazole showed documentation of side effects in 17% of cases and that agitation was the most common side-effect occurring in 8% of people (Coley et al, 2009). Zolmitriptan was found to significantly improve neuroleptic-induced akathisia although not showing superiority to propranolol in this regards and the authors recommend a placebo-controlled trial (Avital et al, 2009). The authors of a systematic review of 33 structural MRI studies in people prescribed antipsychotics found evidence for an increased basal ganglia volume in people prescribed typical antipsychotics although other findings were less clear (Navari and Dazzan, 2009).
Research in Affective Disorders
Migraine with aura was found to be significantly higher in people with depression than in controls with an odds ratio of 5.6 (Samaan et al, 2009). In a study of 45 inpatients with treatment resistant depression, cortisol response was found to be reduced relative to 46 controls and the authors concluded that the HPA axis is set a higher level (i.e. higher cortisol levels)(Juruena et al, 2009).
A study in 34 people undergoing neurosurgical ablation of regions in the prefrontal cortex found evidence of social and emotional deficits on the ’social-emotional questionnaire’ (Bramham et al, 2009). A Canadian study which used data from the Canadian Community Health Survey looked at medication adherence in 6201 people prescribed psychotropic medication and estimated that non-adherence was 34.6% for antipsychotics and 45.9% for antidepressants and that the most frequent reason given was that of forgetfulness which also varied between the different types of psychotropic medication (Bulloch and Patten, 2009).
News In Brief
A widely reported study in the Journal Neuron has shown that different types of dementia including Alzheimer’s Disease and behavioural variant Frontotemporal Dementia exhibit degeneration along neuronal networks and that the network is specific to the type of dementia. The researchers used MRI BOLD imaging which gives an approximation to regional cerebral blood flow. A pilot study of a drug CPHPC has shown that it is effective in lowering the levels of serum amyloid P component (SAP) in the blood and the brain of people with Alzheimer’s Disease although follow-up studies will be required to assess the clinical implications (also reported here). An intriguing link has been found between proliferator-activated receptor coactivator 1 (a risk factor for diabetes type 2) and Alzheimer’s disease. The study shows that the gene product was decreased in Alzheimer’s Disease and may be related to processing of the Beta-Amyloid plaque. While diabetes is associated with a 2-fold increase in dementia prevalence, this study shows the heterogeneity that exists in the relationships between these two complex disorders. Episodes of hypoglycaemia were associated with an increased prevalence of dementia in this study. A new model of Alzheimer’s Disease has been developed and simulated on a computer. The model focuses on the the formation of the amyloid beta plaques and focuses on presenilin-1 and glycogen synthase kinase 3, proteins that have been implicated in Early-Onset Alzheimer’s Disease. The simulations suggests that neither protein results in disease alone but it is the combination which produces disease. Nevertheless such simulations may need to be followed up with biological studies to verify the predictions. The authors of a recent Cochrane review of relevant trials concluded that statins taken by study participants between the ages of 40 and 82 did not reduce the risk of dementia. The authors suggest that there may be different consequences for earlier administration of statins although that will require a further evaluation of relevant data. New evidence suggests that earlier experimental findings suggesting that the plaques in Alzheimer’s Disease produced calcium influx by thinning cellular membranes may instead have been an artefact produced by the use of a solvent in these studies – Hexafluoroisopropranolol. Research suggests that Huntington’s Disease is associated with a variety of changes (some of which related to glucose metabolism) that occur throughout the developmental period. Infrared tracking has been used to detect differences in duration of eye fixation on novel images in Mild Cognitive Impairment compared to controls which may have diagnostic utility.
The authors of a Cochrane review of the use of PEG feeding in advanced dementia found no randomised controlled trials and concluded that there was no evidence to suggest improved survival or quality of life although one of the authors, Dr Sampson points out that cases are assessed individually while also noting assisted oral feeding as an alternative approach. The authors of a recent report looked at studies involving non-pharmacological approaches to managing Alzheimer’s Disease and found evidence of benefits for caregiver training and cognitive training although concluding that methodologies for these studies needed to be improved. APOE4 carriers aged 20-35 were found to have different patterns of activity in the hippocampus compared to controls using fMRI although longitudinal studies will likely be needed to examine the clinical relevance of these findings. Problematic behaviours were identified in a Mayo Clinic study in one sixth of people with Parkinson’s Disease prescribed medication for their condition. A Lilly-funded study has provided evidence that a new technique known as Stable Isotope-Linked Kinetics is effective in identifying rates of A-Beta production which could be effective in identifying new therapies in Alzheimer’s Disease. There is evidence that Amyloid Plaques in Alzheimer’s Disease may produce synaptic damage by a mechanism which involves free radical production and the mitochondrial protein DRP1. Maintaining a focus on the external environment improved posture in Parkinson’s Disease in one study. A proposal has been made to create a map of mammalian brain circuitry. A protein Nurr1 was found to be involved in modulating the inflammatory response of microglia through a specific pathway and this response might be important in neurodegenerative processes. In the moderate stages of semantic dementia, a recent study provided evidence that autobiographical memory is impaired regardless of recency.
An intriguing finding is that proton pump inhibitors such as omeprazole have been shown to reduce the inflammatory response of microglia and the authors speculate as to whether this might impact on conditions such as Alzheimer’s disease which would need further investigation. Humanin peptide which has a role in cell death has also been found to strongly influence glucose metabolism offering a potential link between glucose metabolism and neurodegenerative processes. A prospective study showed evidence of an increased association with Alzheimer’s Disease in ‘heavy’ users of NSAID’s which have previously been suggested to have a protective effect. Stigma and perceptions about memory were found to influence memory performance in older adults in this study. Improved research methodology has been recommended for studies looking at delivery of psychological therapies in older adults. Two compounds have been identified which modify the action of insulin-degrading enzyme on A-Beta offering another potential therapeutic approach in Alzheimer’s Disease.
Another study in the BMJ and reported on here suggests that elderly people with strokes are undertreated. An association was found in an MRI study between aspirin and cerebral microbleeds in the elderly and this relationship will need to be explored in more detail given the various benefits associated with aspirin use. In another study, a trademarked system was effective in improving the dysarthria that developed after a stroke. A new type of shunting system is being developed following research into the flow of cerebrospinal fluid and this should have implications for hydrocephalus and a number of associated conditions.
A gene NOS1AP has been associated with schizophrenia in a study which used a new statistical method for establishing linkage. People with schizophrenia were found to be able to correctly discriminate hollow and normal faces in the ‘hollow-face paradigm in 94% of cases compared to 1% of controls. The authors identify this as evidence of a tendency towards ‘bottom-up processing’ in schizophrenia. An abnormal response to a glucose challenge was found in 16% of people with schizophrenia or related psychoses compared to none in the control group in a Spanish study. There is indirect evidence that Indoleamine 2, 3 dioxygenase may play an important role in the onset of depressive symptoms in chronic inflammation. A lack of a morning rise in cortisol in children with Asperger Syndrome is suggested as a potential contributor to their clinical presentation. 5 single nucleotide polymorphisms of transthyretin (which inhibits amyloid beta protein production) were associated with significant hippocampal atrophy (Cuenco et al, 2009).
A poll of 2000 people in England showed that many people are unaware of the calories contained within alcohol as reported here. A study has shown that cessation of drinking significantly influences survival rates in cirrhosis of the liver – for those continuing to drink – survival rates at 7 years was 44% compared to 72% in those who were abstinent. Exercises have been developed with reduced risk for aggravating migraines. Naltrexone has further evidence of benefit in people with kleptomania in one study.
Developing depression after an initial diagnosis of coronary artery disease was associated with a 2-fold increased risk of heart failure in this study with an average follow-up period of 5.6 years. A study has shown that synchronisation between breathing and heart rate alters in different stages of the sleep cycle and the techniques used in this study could be used in future sleep research. The structure of a plant protein similar to that of mammalian proteins involved in circadian rhythms has been identified with potential implications for therapeutic approaches to sleep disorders. In fruit flies, sleep deprivation was associated with a build up of a synaptic protein known as Bruchpilot (BRP) and this might well generalise to humans although further research will be needed. Sleeping less than 5 hours a day was associated with a 500% increase in the risk of hypertension compared to those who slept more than six hours. The authors of another study looked at the interaction between culture and mood and provided evidence that lowering mood resulted in stereotypical behaviour whilst exploratory behaviour resulted from elevating mood (mood was influenced by either music or modifying facial expressions). Increasing ‘mirthful laughter‘ was associated with an increase in HDL in people with diabetes. The authors of a systematic review of the use of music in coronary heart disease patients concluded that music was associated with a significant reduction in heart rate and blood pressure. Benzodiazepine use in people in the Intensive Care Unit has been associated with the subsequent development of depression.. Family therapy was associated with higher response rates in people with depression when compared with treatment as usual. A specialised visual training method known as eccentric training (which involves the use of peripheral vision) has been advocated for use in people with macular degeneration. Long-term health goals were associated with higher levels of self-control in health tasks in this study. A review of previous studies suggests that several brain regions are associated with wisdom although definitions of this term vary. Older adults were found more likely to recover functioning after admission for surgery than for medical illnesses in this study although further replication studies will be needed.
Complex and exciting developments are underway in making Transmission Electron Microscope images of the brain and retina available to scientists around the world and also to integrate them into 3-dimensional models. The interaction of microglia with neurons has been published in a recent Japanese study in which it was found that microglia make contact with the synapses of a neuron regularly and for a usual duration of a few minutes.
A Portuguese study has found that the two leading cause of alcohol related mortality are liver disease and car accidents. Research has further supported the association of the MPDZ and alcohol dependency. An M1 Acetycholine agonist has been recently discovered. Over 3000 genes that are differentially expressed within a 24-hour period have been identified. An increase in the number of neonates born with withdrawal syndrome has been reported in this Australian study – a 40 fold increase from 1980. A Finnish group has been characterising a subgroup of children with delayed speech and walking and it will be interesting to follow further research in this area. A Canadian study provides evidence of an association between perinatal factors and the comorbidity of ADHD and Tourette syndrome. A number of studies have been presented at a meeting recently identifying a link between sleep disorders and risk of type II diabetes and obesity – and this is covered in more detail here. Similar research found that a 2.5 fold increased prevalence of diabetes II was associated with sleeping less than 7 or more than 8 hours a night which may be relevant to previous epidemiological data on sleep duration.
There is evidence that neurons use proteins to fix the cell body to the extracellular matrix and then send out dendrites to target cells during development. A study of the offspring of centenerians (who would be expected to have similar longevity) were found to have low neuroticism and high extraversion. Acceptance and Commitment Therapy was found to be better than control conditions but not superior to other treatments in a meta-analysis of 18 studies A single intensive treatment for phobias which can last up to three hours was found to be effective in 55% of children in one study. Relationships formed in an online music community on the basis of shared musical tastes were found to be ‘fragile’ in one recent study. An interesting study provides evidence that we return our gaze to a previous target automatically unless we are actively searching from something (visually) in which case this action is inhibited.
Evidence is provided to suggest that the brain processes vowels and consonants at different rates. A computer-robotic system has constructed and completed an experiment in Yeast genes paving the way for a new generation of automated scientists to work alongside humans. A lack of supportive social relationships at work was associated with burnout in this Swedish study. Evidence suggests that women who were classed as obese were underrepresented amongst CEO’s of businesses compared to men which the authors interpret as suggesting weight discrimination against women although studies with different methodologies will be needed to explore this hypothesis further. Playing Baroque music at work improved the productivity and mood of radiologists in this study.
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Bramham J et al. Social and emotional functioning following bilateral and unilateral neurosurgical prefrontal cortex lesions. J Neuropsychol. 2009. 3(1). 125-43.
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Chen Y et al. Prolactin levels in Olanzapine treatment correlate with positive symptoms of schizophrenia: Results from an open-label, flexible-dose study. Prim Care Companion. J Clin Psychiatry. 2009. 11(1). 16-20.
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