Reflections on May 2009

May was an interesting month. I reviewed ‘Mean Genes’ a book with an evolutionary psychology approach to explaining human behaviours and it certainly got me thinking differently about some common behaviours. I reviewed a number of blogs. Being interested in Mental Health Informatics i’ve been surprised to find that all the health informatics action in the blogosphere seems to be happening in the Librarian’s blogs but on reflection it seems only right that society’s knowledge gurus should be surfing the crest of the health information revolution and guiding us in the process. One blog I was impressed with was ‘Stu’s Views and MS News’. Stuart has Multiple Sclerosis (MS) and writes  selflessly on his blog gathering information resources on the condition and sharing this with his increasing readership. A number of articles were reviewed including neuropsychiatric consequences of neurological conditions including MS and Huntington’s Disease. Various podcasts were reviewed including some from John Betts excellent series on Jungian Analytic Psychology and he has just covered typology in one of the podcasts listed below. I was pleasantly surprised to find a large number of statistics videos on YouTube with some really excellent talks on some tricky subjects – a 21st century slant on learning statistics. I’ve also been looking at the new Wolfram Alpha program which promises a revolution in the way we interact with information although in the first part of the series I haven’t yet asked the right questions to test its limits. I’m continuing to review various responses to Vul et al’s paper on fMRI with the intention of completing the initial analysis on the Vul paper (on the premise that critically reviewing a paper is a process which lies on a continuum from a cursory analysis through to a detailed multilayered analysis. So in this paper I wanted to push this concept of analysis a little bit and see where it leads to).

In terms of news there was a lot going on last month. The Elder Games Project is using computer technology to diagnose cognitive problems at an earlier stage. There was evidence of cognitive improvement in Schizophrenia and Schizophreniform Disorder in response to Haloperidol and 2nd generation antipsychotics in the EUFEST study. Antipsychotic side-effects in Alzheimer’s Disease were characterised in the CATIE-AD study. The use of Diffuse Tensor Imaging has elucidated hitherto unknown neural pathways in the brain. More analysis from the STAR*D has helped to characterise participants that were included in the trials. A large Norwegian study characterised psychotropic prescribing in the general population.

A lemur-like primate discovery was discussed widely in the media and there has been detailed coverage on this from such luminaries as David Attenborough. The forward facing eyes, preserved hair and nails make this especially interesting. Equally interesting was the fascinating genetic analysis in Africa that determines the San peoples as being perhaps the oldest continuous human lineage as well as a curious period of 100,000 years where the human population was effectively divided in two.

Book Reviews

Clinical Effectiveness and Clinical Governance Made Easy

Dynamic Psychotherapy Explained

Mean Genes

Stroke. Epidemiology, evidence and clinical practice

Blog Reviews

A Survivor’s Guide to Huntington’s Disease

Neuropathology Blog

Health Informatics Blog

Allan’s Library Blog

Stu’s Views and MS News

Podcast Review

John Betts on Analytic Psychology #11

John Betts on Analytic Psychology #12

John Betts on Analytic Psychology #13 – Jung on Typology

Some Nature Podcasts in April and May 2009

Statistics on YouTube

Review of Social Psychiatry Articles

The Decline and Resurgence of Vascular Dementia

Using the Internet for Health Related Activities

Mental Health Advocates Supplementary Guide

Health 2.0 and Medicine 2.0: Tensions and Controversies

Software Support for Huntington’s Disease

Review of Biological Psychiatry Articles

The Paper Formerly Known as ‘Voodoo Correlations in Social Neuroscience’

Recent Developments in Alzheimer’s Disease Therapeutics

Response to ‘Voodoo Correlations in Social Neuroscience’

SPECT, MRI and Cognitive Dysfunction in Multiple Sclerosis

Review of Psychological/psychotherapy/Phenomenological Articles

Psychopathology in Verified Huntington’s Disease Gene Carriers

Impact of Frontal Systems Behavioural Functioning in Dementia on Caregiver Burden

Cognitive Impairment after Small Vessel Disease Associated Stroke

Familial Psychiatric Presentation of Huntington’s Disease

Technology Review

Wolfram Alpha and Psychiatry: Part 1

News Round-Up for May 2009

Research in Psychosis

In the EUFEST study there was found to be an improvement in cognition in people treated for schizophreniform disorder or first-episode schizophrenia with either Haloperidol or a second-generation antipsychotic (Davidson et al, 2009). The authors of a recent paper defend the Wisconsin Card Sorting Test against critics who argue that it is not an effective measure of   functioning of the frontal lobe and suggest theoretical and practical approaches to improving its validity.  (Nyhus and Barcelo, 2009). The authors of a Cochrane review on 24-hour care for people with schizophrenia concluded after finding a single randomised trial with 22 participants and limited outcome measures that large scale service changes should be accompanied by efforts to obtain evidence of their effectiveness before the opportunity passes (Macpherson et al, 2009). The authors of a Cochrane review of Sulpiride verses placebo for people with schizophrenia concluded that there was limited evidence of superiority over placebo from randomised controlled trials (Omori and Wang, 2009).

The authors of a Cochrane review on dosing of Chlorpromazine in people with schizophrenia concluded that it has taken many decades for the average Chlorpromazine dose to decrease.  They also found that the low-dose Chlorpromazine groups from randomised controlled trials experience less side-effects than those in the high dose group (as expected).  The higher-dose group experienced higher drop-out rates due to side-effects.  Interestingly, the author’s were able to identify only four studies of relevance with a total of 1012 participants (Liu and Haan, 2009). 70 relatives of people with schizophrenia and 63 controls were assessed on an emotion recognition test and the relatives were significantly more likely to assign negative attributes to neutral faces than the control group and also to attribute emotions to neutral faces. The authors interpret this as evidence of an impairment in social cognition (Eack et al, 2009). The authors of a meta-analysis looked at neurological soft signs in people with schizophrenia and their relation to cognitive performance and positive and negative symptoms. They found that up to 10 per cent of variance of neurological signs were shared with negative and positive symptoms and cognitive performance and concluded that these phenomenon were mostly distinct from each other (Chan et al, 2009).

A meta-analysis of alcohol use in schizophrenia provided evidence that  roughly one-fifth of people with schizophrenia had a lifetime diagnosis of an alcohol use disorder (Koskinen et al, 2009). In a systematic review of the Sertindole compared with other atypical antipsychotics, the authors did not find any significant differences with the other antipsychotics other than risperidone.  As they found only two studies of relevance they stated that their conclusions were therefore limited. (Komossa et al, 2009). In a small MRI study with 19 people with schizophrenia, 11 people with bipolar disorder and 20 controls, the left amygdala volume was associated with reduced immediate and delayed verbal recall in people with schizophrenia but increased corresponding responses in people with bipolar disorder (Killgore et al, 2009). In a study of 162 people with a diagnosis of schizophrenia or schizophrenia-related disorders and receiving risperidone, the use of the positive and negative syndrome scale for schizophrenia remission criteria provided evidence that remission fluctuated and that it was correlated with insight and social outcome.  The authors however cautioned against the use of symptoms alone in defining remission (Eberhard et al, 2009).

In a 1.5T MRI study of 30 Autistic-spectrum disorder (ASD) adults (14 with psychosis ASD+P) compared to 16 controls, the ASD group had reduced grey matter in the temporal lobes and cerebellum. The ASD+P group had reduced grey matter in the frontal and occipital cortex as well as the right insular cortex (Toal et al, 2009). In another study, IL-6 and 2 hour glucose levels were found to be increased in a group of people with non-affective psychosis prior to initiation of treatment compared to a control group (Fernandez-Egea et al, 2009). A study found an improvement in global cognitive scores in people with schizophrenia-spectrum disorders at 6 months after treatment with either Risperidone or Olanzapine compared to mixed or no treatment with antipsychotics although only 10 subjects were included in the last group (Cuesta et al, 2009). In a six week double-blind randomised placebo controlled study of Paliperidone Extended-Release versus Quetiapine in people with a recent exacerbation of schizophrenia only Paliperidone Extended-Release was significantly better than placebo in improving PANSS scores at two weeks (Canuso et al, 2009). A Nigerian study looked at quality of life in people with schizophrenia using the WHOQOL-BREF.  The researchers found in their sample of 99 people 21% were classed as having a ‘good’  quality of life and and 36% having a ‘poor’ quality of life.  Several factors correlated with quality of life measures including medical conditions, unemployment and social support which are suggested as factors that could be addressed (Adewuya and Makanjuola, 2009).

Research in Dementia

In another study, 16 people with Alzheimer’s disease were compared with 22 people with Vascular Dementia.  Researchers were interested in the vascular risk factors and although they found some trends there were no significant differences between the groups on the primary outcome measures. Perhaps the study was insufficiently powered to detect a difference (Morovic et al, 2009). In the CATIE-AD study, the researchers looked at 421 people with Alzheimer’s disease in an outpatient setting. They were interested in the effects of treatment with a second generation antipsychotic relative to a placebo group during a 36-week period.  They found a significant association with weight gain in the Olanzapine and Quetiapine groups and also found that Olanzapine was associated with a significant decrease in HDL cholesterol compared to the placebo group (Zheng et al, 2009). In a small twin pair study (n = 17 pairs) with autopsy confirmed Lewy Body Dementia, 16 of the pairs were discordant for Lewy Body Dementia suggesting a role for environmental factors or else a need for a larger replication study (Wang et al, 2009).

In a cross-sectional study of 118 people with Parkinson’s disease, fatigue was significantly associated with scores of depression and anxiety, pain and Unified Parkinson’s Disease Rating Scale scores (Hagell and Brundin, 2009). In a study of 97 people over the age of 60 at death and not having dementia, 20%  had neuropathological diagnoses of Alzheimer’s disease (Price at al, 2009). In a Cochrane review of the use of Rivastigmine in people with Alzheimer’s disease the authors examined nine trials with 4775 participants and used ADAS-Cog scores and 6-12 mg of Rivastigmine.  With these doses there was a significant decrease in the rate of decline of cognition and activities of daily living.  The authors included recent trials on the transdermal patch and found that there were fewer side effects with the  smaller patch  than with an equivalent capsule dose (Birks et al, 2009).

The authors of one study concluded that of four executive functions, verbal fluency was the best indicator of the processes involved in regulating emotions.  Participants in this study included a small control group (n=17) and people with Frontotemporal Lobar Degeneration and Alzheimer’s disease.  They used the startle response as a proxy measure of emotional regulation although ecologically, emotions are regulated in various sometimes complex scenarios which can involve more than one emotion. Therefore the generalisability of such results is complex itself (Gyurak et al, 2009).  Using Diffuse Tensor Imaging, a group in America have identified pathways in humans between the amygdala and the mid-fusiform gyrus as well as the hippocampus and the mid-fusiform gyrus which potentially explains the findings of some fMRI studies in which subjects were presented with emotionally valued stimuli (Smith et al, 2009).  In another study serum antibodies against ABeta (IgM) did not significantly discriminate between people with Alzheimer’s disease and people with mild cognitive impairment or healthy controls (Marcello et al, 2009).  An American team has taken MRI images from the Alzheimer’s Disease Neuroimaging Initiative and developed a pattern classifier that discriminates people with Alzheimer’s disease from controls and then applied this to longitudinal data from the Baltimore longitudinal study of ageing neuroimaging study. The authors go on to suggest that this method can be successfully used to discriminate controls that will go on to develop cognitive decline from those that will not (Davatzikos et al, 2009).  A group from Pennsylvania have used MRI volumetric data to examine neuropsychological correlates and the findings were in keeping with the literature including dysexecutive function related to bilateral prefrontal cortical atrophy.  Interestingly the authors also found evidence to support the concept of ” double dissociation” (Listerud et al, 2009).  In a post-mortem study of 10 cases of post-encephalitic parkinsonism there was found to be an absence of alpha synuclein deposits (Jellinger, 2009). In a survey of memory clinics in Australia, the researchers found that Alzheimer’s Disease and mild cognitive impairment were the most common diagnoses (Woodward and Woodward, 2009). A small study showed no evidence of  impaired cerebral autoregulation in people with Alzheimer’s Disease compared to controls although there was evidence of increased blood pressure variability (Claassen et al, 2009). White matter hyperintensity scores were found to be inversely correlated with performance on a Korean version of the MMSE and the CDR in a structural MRI study of 142 patients with Alzheimer’s Disease (Heo et al, 2009).

In the KAME project, 1836 people with a mean age of 71.8 years were followed-up and there was found to be a significant association between rapidly declining BMI or higher baseline BMI and subsequent development of dementia (Hughes et al, 2009). Early insulin response to a glucose challenge was significantly associated with conversion to dementia in this prospective cohort study (Rönnemaa et al, 2009). A further clarification of the clinical subtypes of frontotemporal lobar degeneration (FTLD) has been published in a study which included 39 people with tau positive FTLD. Among the findings, the researchers found that type I in which there was a progressive non-fluent  was associated with neuronal cytoplasmic inclusions and dystrophic neurites (Josephs et al, 2009). Performance on a colour discrimination task was found to be inversely correlated with MMSE scores in this cross-sectional comparison of 20 people with Alzheimer’s disease compared to controls (Salamone et al, 2009). A review paper looked at the role of disordered proteins in dementia (Raychaudhuri et al, 2009). GluR1/2 antigen reactive antibodies were found to be associated with a paraneoplastic limbic encephalitis and thought to mediate their action through AMPA receptors (Lai et al, 2009). Dysexecutive MCI and amnestic MCI could be distinguished by patterns of brain atrophy in one study (Pa et al, 2009). Rivastigmine was found to be associated with no significant decrease in white matter volume over a 20-week period in one report (Venneri et al, 2009). An EEG study provided evidence that thalamocortical circuit functioning discriminated people who did and did not convert to dementia (Cantero et al, 2009). The researchers in one study found that the clock drawing test was a useful additional measure for discriminating between people with Alzheimer’s Disease and Parkinson’s Disease with Dementia (Saka and Elibol, 2009).

Research in Mood Disorders

The authors of a prospective cohort study in general practice found that screening for depression was not effective as of the initial 1687 participants, only 17 were initiated on treatment (Baas et al, 2009). In an imaging study (1.5T MRI) that compared 26 people with Bipolar I disorder with first-episode psychosis with 26 controls it was found that the people with Bipolar Disorder and first episode psychosis had reduced grey matter volume in a subregion of the Anterior Cingulate Cortex (Fornito et al, 2009).

Miscellaneous Research

131 services providing alternatives to acute psychiatric units were characterised in one study (Johnson et al, 2009). The Norwegian study combining data on over four million prescriptions of psychotropic medication with general practitioner identified 705230 people taking at least one psychotropic medication. This represented just over 15 per cent of the population.  2.4% were prescribed antipsychotics.  The mean annual drug volume peaked in those aged 40 to 59 while four hypnotics it continued to increase.  Interestingly 80% of the psychotropic drug volume was prescribed by General Practitioners (Kjosavik et al, 2009).  Greater purpose in life were significantly associated with a reduction in all causes of mortality in a community study of elderly people (n=1238)(Boyle et al, 2009).

News in Brief (click on the links for more details)

The author of a thesis using data from the H70 study, a scandinavian follow-up study of 70-year-olds concluded that tests that assessed memory were most likely to predict conversion from non-dementia to dementia and that higher levels of education were making it more difficult to establish a diagnosis of dementia at an early stage. Watching a video showing people with dementia interacting with others including famly was found to influence end of life planning in elderly people.A study looking at the side-effects of acetylcholinesterase inhibitors has been published recently and the author recommends increased awareness to improve recognition of side effects. Another study provided evidence of an impairment in prioritising information for learning in people with Alzheimer’s Disease compared to healthy controls. The Elder Games Project uses computer games to detect cognitive decline and provide cognitive stimulation and the researchers have been piloting this in a number of European centres. In older adults, hearing difficulties were found to be associated with reduced volume in the superior temporal gyrus.

An association has been found between the Neuroglobin gene and risk of Alzheimer’s disease has been identified in one study. Increased levels of Neuroglobin were found in people with Alzheimer’s disease compared to controls and previous research has suggested a protective role Neuroglobin. A potentially important study may cause a re-evaluation of glutamate induced cell death.  Glutamate induced cell death in retinal cells could be modified by interfering with signals in the local glial cells.  This type of cell death is implicated in optic neuropathy he’s but also speculated to be one of the many mechanisms that can play a role in dementia. In a secondary analysis the authors of one paper found that delirium was associated with an accelerating rate of decline in people with Alzheimer’s disease. Indirect evidence has been provided a possible role for the gene HDAC2 in Alzheimer’s disease.  HDAC stands for Histone Deacetylase.  DNA is tightly coiled around Histones and D acetylation the of Histones would influence the coiling process.  In mice an inhibitor of HDAC2 produce an improvement in memory formation and recall. In another study with 37,000 people there was found to be an association between atrial fibrillation and Alzheimer’s Disease (also covered here). CSF markers including ABeta42 were associated with rate of progression of Alzheimer’s Disease in one study and the authors suggest that such markers could be incorporated into inclusion/exclusion criteria for future studies. Evidence from a recent study indicates that an endothelial receptor in the Blood Brain Barrier interacts with adherins on three types of bacteria that can produce meningitis and the researchers suggest that this can provide a focus for future therapeutic research. Gangliosides have been shown to have a neuroprotective role in in Alpha-synuclein induced neuronal cell death. In this study, the researchers disrupted the action of lysosomes which  degrade material in the cell and then used gangliosides to reduce the subsequent damage. They suggest this as the mechanism by which gangliosides exert their neuroprotective action. A mutation in the Acta2 gene has been associated with a number of vascular disorders including premature thoracic aortic aneurysms and ischaemic stroke.

A study in the American journal of psychiatry included an analysis of data from the STAR*D trial and was used to evaluate the inclusion criteria for phase III studies. The researchers utilised data from 2855 citalopram treated patients and found that approximately 22 per cent of patients would be eligible for phase three trials.  Those that met the inclusion criteria were more likely to experience remission from depression. (34.4% this is 24.7 per cent in the remainder of the group). As the inclusion criteria for studies is not regulated this may be a future area for regulation. A marker within the von Willebrand factor gene was found to be significantly associated with depression in people with cardiovascular disease. In a web-based survey of readers of a popular magazine which included 700 women aged 18-50, 60% of respondents indicated that they would spend more money if they were feeling low in mood. 70% of women also indicated that they wanted more control over the spending. The full report can be found here on the Sheconomics website where Professor Pine looks at some of the triggers for shopping (triggers for shopping from an evolutionary psychology perspective have also been written about elsewhere), the possible economic implications and the ’seven laws of sheconomics’ a set of practical rules for managing spending and finances. The authors of a Japanese epidemiological study in the British journal of psychiatry report an association between increasing levels of lithium in the drinking water and reduced rates of suicide. The authors of a Swedish study provided evidence of malnutrition in 14.5 % of people aged 75 and 80 living at home.  The risk of malnutrition was associated with depression and perception of health. A combination of pain self-management and close monitoring of antidepressant treatment shows promise in treatment of comorbid depression and pain in a recent study in JAMA. In a study of 248 people (median age 82.4), 11% experienced both dysphonia and hearing difficulties and also a higher incidence of depression.

In another study a gene mutation associated with bipolar disorder and schizophrenia was assessed in 115 healthy volunteers and using MRI the researchers found an association between the Amygdala’s connections to other regions and the dorsolateral prefrontal cortex connections also.  In another study, patients with epilepsy who were undergoing intra-operative electrode recordings of activity participated in a study which used a reward paradigm for assessment of decision-making.  Activity in the hippocampus occurred transiently when the participants were assessing situations with high degrees of uncertainty. An interesting study which traverses numerous domains, provides evidence of a role for a variant of a potassium channel gene referred to as KCNH 2 in schizophrenia.  The variant 3.1 isoform was identified from a post-mortem study where it was identified as being 2.5 times more prevalent in people with schizophrenia than controls in the hippocampus.  Healthy controls who carried the variant were identified and found to have significantly lower measures on IQ tests.  They also showed differences from non-carriers in hippocampal activity on fMRI studies involving memory.

A magnetic transfer imaging study of Tourette’s Syndrome found evidence to suggest the involvement of the prefrontal cortex.A model of Angelman’s Syndrome which involves blocking the expression of the gene UBE3A provided evidence that synaptic plasticity is impaired as a result. The researchers found that they could reverse the impaired plasticity in their model and they plan to undertake further work in this area. In a placebo controlled trial with 58 participants with restless legs syndrome Pregabalin was associated with the resolution or improvements in the restless leg symptoms. A lady who has an unusual visual perceptual disorder misidentifies the spatial location of objects that she sees and over two decades of research on her case has recently been published in a book. Two studies examined the genetics of autism. In the first study, a genome wide association study was undertaken of people with autistic spectrum disorders, family members and controls. Gene variants were found in chromosome 5 with two candidates being Cadherin 9 and Cadherin 10 which code for neuronal cell adhesion molecules.  In another study by the same group, there was further evidence to support an association with the neuronal cell adhesion molecule and a role for  the ubiquitin degradation pathway was also found. An fMRI study of 13 children with high functioning autism and 13 controls provided evidence that children with autism were more likely to activate the supplementary motor area rather than the cerebellum during a finger tapping task. The reverse was the case in controls.  The use of the supplement motor areas suggests a tendency towards conscious control of movement in the children with autism.

An association between increased levels of glutamate and disease burden in multiple sclerosis has been identified in a longitudinal study involving 265 people with multiple sclerosis followed for an average of 1.8 years. Contactin-2 which exists in both grey and white matter has recently been identified as an auto antigen which may be of relevance in multiple sclerosis where whites matter lesions manifest initially but later followed by grey matter lesions which correlates with functioning. A study has provided evidence that Gliomas can originate in the oligodendrocyte progenitor cells.  The authors of one study found evidence of a significant increase in olfactory impairment in people with SLE compared to controls.  Approximately 10 per cent of the SLE participants experienced olfactory dysfunction.

A web-based program was found to be effective in a randomised-controlled trial in reducing alcohol consumption in a group of people who used the program and a reduction was maintained at follow-up. Parental violence was associated with increased risk of depression and alcohol dependence in one study and although there are many possible confounders, the authors did control for a number of variables including social stressors. The authors of a meta-analysis of randomised-controlled trials of web-based or computer based software for smoking cessation found an approximate two-fold increase in smoking cessation compared to those that tried to stop smoking alone. People undergoing caffeine withdrawal were found to have increased cerebral blood flow and increased theta activity with the latter was suggested as the neural correlate of tiredness. A gene whose product confers resistance to the effects of alcohol and blocks the epidermal growth factor pathway in flies is suggested as a potential therapeutic target for alcohol misuse. A study looking at young drinkers provided evidence that the labels on drinks indicating their strength are used to maximise alcohol intake at the lowest cost. Moderate alcohol consumption was associated with a significant decrease in vigilance in a reading task as well as reduced insight into this deficit.

Evidence from one study suggests that sleep apnoea is underdiagnosed in people with diabetes II and obesity. A genome-wide analysis, found evidence of an association between a T-cell variant and narcolepsy, which builds upon another association with narcolepsy –  the HLA gene.  Researchers are speculating that the T-cell variants and the HLA gene might interact in the pathogenesis of narcolepsy.

An important finding that was discussed in May 2009 was a 47-million year old lemur-like primate ancestor of humans – Ida with forward facing eyes reported on here and here.

A fascinating genetic study completed on 121 African populations  and 60 non African populations in Africa identified the border of South Africa and Namibia as the most probable origin for modern humans as well as providing further evidence for the high levels of genetic diversity.  This has been a large study with genetic samples obtained from the populations in sometimes remote places.  The research found 14 ancestral population clusters.  They also found evidence that two populations had been separated from each other as much as 100,000 years. The discovery in Germany of what might be the oldest pieces of figurative art may cause a re-evaluation of early paleolithic artwork. Variations in the FOXP2 gene in mice have been associated with changes in the ultrasonic pitches generated by baby mice. The FOXP2 gene is thought to be involved in speech and language in humans.

An fMRI study by Dr Graham Murray and colleagues provided evidence of an association between a measure of  sociability and orbitofrontal cortical thickness (here and here). The authors of a recent study identified a small percentage of people termed ’super-recognisers’ who are able to identify and recall faces at a rate far greater than average. Since many psychometric properties are normally distributed this shouldn’t be surprising although the neurobiological explanation may have many implications. The authors consider this as being the reverse of prosopagnosia which is an impairment in the ability to recognise faces. Indeed in certain social situations this skill was sometimes concealed. In a study of short term memory researchers found that when people were presented with shapes or colours and asked to match this on a screen (e.g. match against a range of presented colours), retrieval was dichotomous rather continuous such that by 10 seconds participants either recalled the information accurately or not. The authors of a paper suggest that online learning is changing the role of the learner from that seen in the typical teacher-pupil role to one in which the learning is more self-directed with implications for how online courses might be developed.

In a surface electrode recording study, children undergoing assessment prior to surgery for epilepsy, were tested on response to visual stimuli. A response was detected in the visual cortex as quickly as 100 ms after initial presentation of the stimulus.  This demonstrates the speed with which the brain is able to respond to visually presented information. Another study provided evidence that five month old babies generate hypotheses based on observational data of babies presented with solids or liquids behaving differently. A study which looked at teenagers in a driving stimulation bounds that sending text messages on a mobile phone was associated with significant variations in speed and course and associated virtual accidents. Another study looked at tensions parent-child relationships looking at how factors such as gender and age impact on tension. In particular they found that ‘unsolicited advice’ from parents was associated with tension. In a qualitative study which involved focus groups and a semi-structured interview of 17 women who had recently been in jail the researchers found evidence that being an ex-prisoner and also an ex-substance user is associated with a double stigma which interacted with social policies to limits the perception of available choices. Evidence in an in vitro study but suggests that lithium may protect cells from radiation-induced injury by influencing DNA repair mechanisms while the same protection is not evident in malignant cells.

Another study provided evidence that values are not only passed from parents to children but also from children to parents. The father and mother were found to influence their children’s values in different ways. A study looking at parent and children’s eating habits using the healthy eating index, found that in general there was a small association between the two and that a number of other factors influenced children’s eating behaviour although there was demographic heterogeneity within these associations.

A study in nature provides evidence that the theta oscillations recorded from the hippocampus do not represent synchronous firing but instead a wave progressing through the hippocampus with the phases of the oscillations coding for spatial information also. The action of BDNF in the ventral tegmental area has been causally associated with opiate dependence in one study published in Science. Another study provided evidence of a role for synaptotagmin-IV (Syt-IV) in maintaining homeostasis in memory formation through Long Term Potentiation (LTP). The researchers found that if they modified the levels of Syt-IV they could produce a corresponding change in LTP and that an optimal range was identifed. A team have identified a group of proteins – MAGUK Associated Signalling Complexes using a new method in which they were able to remove and identify aggregated proteins with a neuronal synapse. A combined MRI and MEG study showed an association between GABA levels and frequency of gamma oscillations when subjects were presented with a visual stimulus and the authors suggest that gamma oscillation frequency could be used as a marker of GABA levels. Mice with a disrupted calcium channel receptor didn’t gain weight on a high-fat diet and this same receptor has been associated with maintenance of the sleep-wake cycle suggesting a molecular link between the two and a potential target for treatment of sleep disorders or for weight dysregulation. The protein Oct3 transports dopamine into and out of cells and has been associated with both Parkinson’s disease and is also involved in the transport of MPTP (which is used in a model of Parkinson’s disease) in one study.  This may open up a new therapeutic approach. The molecular mechanism by which the ciradian rhythm in cells remains temperature invariant has been elucidated through some very complex research in two studies.

A Canadian study provided evidence that men were underusing mental health services and that 10% of people were using services much less than the percentage of the population that would be expected to be experiencing mental illness. A 3-year project referred to as Charm is looking more closely at how people’s decision making is influenced by knowing what other people are doing. An intriguing study is underway into developing robots that operate in the home environment as companions and the researchers are looking at how comfortable people feel having them around. As such machines are not yet pervasive or ‘accepted’ within culture, it will perhaps take some time for their other applications to be developed but there are many potential mental health applications. While not directly related to psychiatry, news that a man delivered his baby son after studying YouTube footage shows the many ways in which this technology is influencing  health related behaviours. The creators of the IBM sponsored Blue Brain project have now incorporated the simulated brain into a virtual body and are looking at how it interacts with a virtual environment. A recent study looked at doctor-patient visits face-to-face versus virtual visits (internet) and provided supporting evidence for the latter model on a number of measures including diagnostic concordance. An electronic device developed by NASA which is able to detect odours at as low as one part in  1,000,000 has been used to discriminate between glioma and healthy cells.  This would seem to suggest that glioma cells emanate particles and this might inform future research in this area. A new design approach for brain stimulating electrodes has been presented at a conference in Europe recently.  A scientist and project manager at a company producing these devices, Wolfgang Eberle has suggested that future designs of deep brain stimulating electrodes need to incorporate smaller electrodes at the size of single neurons in order to produce a more selective response. There is recent evidence that the recession is impacting on research grants in the life sciences.


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Baas KD, Wittkampf KA, van Weert HC, Lucassen P, Huyser J, van den Hoogen H, van de Lisdonk E, Bindels PE, Bockting CL, Ruhé HG, Schene AH. Screening for depression in high-risk groups: prospective cohort study in general practice. Br J Psychiatry. 2009 May;194(5):399-403.

Birks J et al. Rivastigmine for Alzheimer’s Disease. Cochrance Database Syst Rev. 2009. Apr. CD001191.

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Fernandez-Egea E, Bernardo M, Donner T, Conget I, Parellada E, Justicia A, Esmatjes E, Garcia-Rizo C, Kirkpatrick B. Metabolic profile of antipsychotic-naive individuals with non-affective psychosis. Br J Psychiatry. 2009 May;194(5):434-8.

Fornito A, Yücel M, Wood SJ, Bechdolf A, Carter S, Adamson C, Velakoulis D, Saling MM, McGorry PD, Pantelis C. Anterior cingulate cortex abnormalities associated with a first psychotic episode in bipolar disorder. Br J Psychiatry. 2009 May;194(5):426-33.

Gyurak A, Goodkind MS, Madan A, Kramer JH, Miller BL, Levenson RW. Do tests of executive functioning predict ability to downregulate emotions spontaneously and when instructed to suppress? Cogn Affect Behav Neurosci. 2009 Jun. 9(2). 144-52.

Hagell P and Brundin L. Towards an understanding of fatigue in Parkinson Disease. J Neurol Neurosurg Psychiatry. 2009. 80(5). 489-92. Epub.

Heo JH, Lee ST, Chu K, Park HJ, Shim JY, Kim M.J Geriatr Psychiatry Neurol. 2009 May 11. [Epub ahead of print] White Matter Hyperintensities and Cognitive Dysfunction in Alzheimer Disease.

Hughes TF, Borenstein AR, Schofield E, Wu Y, Larson EB. Neurology. 2009 May 19;72(20):1741-6.Association between late-life body mass index and dementia: The Kame Project.

Jellinger KA. Absence of alpha-synuclein pathology in postencephalitic parkinsonism. Acta Neuropathol. 2009 Apr 30. [Epub ahead of print].

Josephs KA, Stroh A, Dugger B, Dickson DW. Acta Neuropathol. 2009 May 20. [Epub ahead of print]. Evaluation of subcortical pathology and clinical correlations in FTLD-U subtypes.

Lai M, Hughes EG, Peng X, Zhou L, Gleichman AJ, Shu H, Matà S, Kremens D, Vitaliani R, Geschwind MD, Bataller L, Kalb RG, Davis R, Graus F, Lynch DR, Balice-Gordon R, Dalmau J.Ann Neurol. 2009 Apr;65(4):424-34. AMPA receptor antibodies in limbic encephalitis alter synaptic receptor location.

Killgore W et al. Amygdala volume and verbal memory performance in schizophrenia and bipolar disorder. Cogn Behav Neurol. 2009. 22(1). 28-37.

Kjosavik SR, Ruths S, Hunskaar S. Psychotropic drug use in the Norwegian general population in 2005: data from the Norwegian Prescription Database.Pharmacoepidemiol Drug Saf. 2009 Apr 28. [Epub ahead of print].

Komossa K et al. Sertindole versus other atypical antipsychotics for schizophrenia. Cochrane Database Syst Rev. 2009. Apr. 2.

Koskinen J et al. Prevalence of alchol use disorers in schizophrenia – a systematic review and meta- analysis. Acta Psychiatr Scand. 2009. Apr. Epub.

Listerud J, Powers C, Moore P, Libon DJ, Grossman M. J Int Neuropsychol Soc. 2009 May;15(3):459-70. Neuropsychological patterns in magnetic resonance imaging-defined subgroups of patients with degenerative dementia.

Liu X and De Haan S. Chlorpromazine dose for people with schizophrenia. Cochrane Database Syst Rev. 2009. CD007778.

Macpherson R et al. Twenty-four hour care for schizophrenia. Cochrane Database Syst Rev. 2009. CD004409.

Marcello A, Wirths O, Schneider-Axmann T, Degerman-Gunnarsson M, Lannfelt L,Bayer TA.J.Circulating immune complexes of Abeta and IgM in plasma of patients with Alzheimer’s disease.Neural Transm. 2009 May 5. [Epub ahead of print]

Morovic S et al. Vascular characteristics of patients with dementia. J Neurol Sci. 2009. Apr. Epub.

Nyhus E and Barcelo F. The Wisconsin Card Sorting Test and the cognitive assessment of prefrontal executive functions: A critical update. Brain Cogn. 2009. Epub.

Omori I and Wang J. Sulpiride versus placebo for schizophrenia. Cochrane Database System Rev. 2009. CD007811.

Pa J, Boxer A, Chao LL, Gazzaley A, Freeman K, Kramer J, Miller BL, Weiner MW,Neuhaus J, Johnson JK.Ann Neurol. 2009 Apr;65(4):414-23. Clinical-neuroimaging characteristics of dysexecutive mild cognitive impairment.

Price J et al. Neuropathology of nondemented aging: Presumptive evidence for preclinical Alzheimer Disease. Neurobiol Aging. 2009. Apr. Epub.

Raychaudhuri S, Dey S, Bhattacharyya NP, Mukhopadhyay D.PLoS ONE. 2009;4(5):e5566. Epub 2009 May 15. The role of intrinsically unstructured proteins in neurodegenerative diseases.

Rönnemaa E, Zethelius B, Sundelöf J, Sundström J, Degerman-Gunnarsson M, Lannfelt L, Berne C, Kilander L. Diabetologia. 2009 May 20. [Epub ahead of print]. Glucose metabolism and the risk of Alzheimer’s disease and dementia: a population-based 12 year follow-up study in 71-year-old men.

Saka E, Elibol B. Parkinsonism Relat Disord. 2009 May 14. [Epub ahead of print]. Enhanced cued recall and clock drawing test performances differ in Parkinson’s and Alzheimer’s disease-related cognitive dysfunction.

Salamone G, Di Lorenzo C, Mosti S, Lupo F, Cravello L, Palmer K, Musicco M, Caltagirone C.Dement Geriatr Cogn Disord. 2009 May 15;27(6):501-507. [Epub ahead of print]. Color Discrimination Performance in Patients with Alzheimer’s Disease.

Smith CD, Lori NF, Akbudak E, Sorar E, Gultepe E, Shimony JS, McKinstry RC, Conturo TE.. MRI diffusion tensor tracking of a new amygdalo-fusiform and hippocampo-fusiform pathway system in humans. J Magn Reson Imaging. 2009 May 5. [Epub ahead of print].

Toal F, Bloemen OJ, Deeley Q, Tunstall N, Daly EM, Page L, Brammer MJ, Murphy KC, Murphy DG. Psychosis and autism: magnetic resonance imaging study of brain anatomy. Br J Psychiatry. 2009 May;194(5):418-25.

Venneri A, Lane R. Neuroreport. 2009 Feb 18;20(3):285-8. Effects of cholinesterase inhibition on brain white matter volume in Alzheimer’s disease.

Wang C et al. Twin pairs discordant for neuropathologically confirmed Lewy Body Dementia. J Neurol Neurosurg Psychiatry. 2009. 80(5). 562-5.

Woodward MC, Woodward E.Int Psychogeriatr. 2009 May 11:1-7. [Epub ahead of print]. A national survey of memory clinics in Australia.

Zheng L et al. Metabolic changes associated with second-generation antipsychotic use in Alzheimer’s Disease patients: The CATIE-AD study. Am J Psychiatry. 2009. Apr. Epub.


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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.

10 thoughts on “Reflections on May 2009

  1. Pingback: Reflections on May 2009 « The Amazing World of Psychiatry: A …

  2. Pingback: island group » Blog Archive » GL(n,R) Wormholes and Waves in Diverse Dimensions

  3. Kirra

    Честно говоря, сначала до конца не понял, но со второго раза дошло – спасибо!


  4. Ivan Kruse

    Hi, for some reason when i location your feed into google reader, it won?t operate. Are you able to give me the Rss hyperlink simply to be certain I?m making use of probably the most appropriate one?


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