There’s a study in the American Journal of Psychiatry covered at the Schizophrenia Forum here. The reader is directed to the excellent write-up there but essentially this was a 10-year longitudinal follow-up study of 470 people assessed for psychosis at entry into the study. The diagnosis was revised in fifty percent of patients during the course of the study follow-up period. However if the diagnosis was schizophrenia or bipolar disorder these diagnoses tended to be more stable over the follow-up period compared to other diagnoses. Indeed the prevalence of schizophrenia in the cohort increased with time which was interpreted to mean that the symptoms took some time to appear and be recognised. The researchers are intending to extend the study by another decade. The authors of this paper on antipsychotic associated hyperprolactinaemia call for randomised controlled trials to evaluate these associations and provide clinicians with guidance on managing these side effects. There is the first in a three part series on Braak’s hypothesis about Lewy Body Dementia. Braak suggests that based on the localisation of Lewy Bodies in the body in a number of studies that Lewy Body Dementia begins in the enteric nervous system before progressing to the peripheral and central nervous system. There are however critics of this hypothesis and the article presents a balanced discussion of Braak’s hypothesis. 117 single nucleotide polymorphisms at or near the locus for the Alzheimer’s Disease associated gene SOR1 was found to be correlated with hippocampal volume in a group of healthy young adults (n=936) and it will be interesting to see further research in this area. There is an interesting study in which the researchers found a quite high prevalence of depression in people with Alzheimer’s Disease or Vascular Dementia (the paper is freely available here). The researchers used the DSM-IV criteria in conjunction with the Geriatric Depression Scale in 98 consecutive patients with a diagnosis of Alzheimer’s Disease or Vascular Dementia and found a prevalence of depression of 87%. The authors emphasised the importance of screening and it will be interesting to see further replication of these findings. In a moderately sized cross-sectional study (n=438), the researchers looked at the relation between apathy and executive functioning in people with amnestic Mild Cognitive Impairment and Alzheimer’s Disease. They controlled for a number of variables and concluded that there was a significant correlation between executive functioning and apathy in the aMCI group but it was not possible to see this relationship in the people with Alzheimer’s Disease. The researchers suggests that additional pathology may have obscured the relationship in the latter group and a longitudinal study design would be suitable for testing this hypothesis. MRI data from two studies (n=1349) was used to examine the relationship between cortical atrophy and white matter hyperintensities and infarcts in people with Alzheimer’s Disease and Vascular Dementia in this study. The researchers found that cerebral atrophy was correlated with the number of infarcts in people with Vascular Dementia but not Alzheimer’s Disease. A post-mortem study (n=761) examined comorbid pathology in Normal Pressure Hydrocephalus (NPH). Since cognitive impairment in people with Normal Pressure Hydrocephalus is not always reversed with shunting the researchers wanted to know whether this might be due to comorbidity. Although there was a large sample set, only 9 patients had NPH and of these 5 had comorbid Alzheimer’s Disease at autopsy. The researchers conclude that irreversibility of cognitive impairment with shunting for NPH in some cases may be due to comorbidity.
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