Doron Todder

Night locomotor activity and quality of sleep in quetiapine-treated patients with depression

This research assesses the development of the night-activity rhythm and quality of sleep during course of treatment among patients with unipolar or bipolar depression and receiving antidepressant treatment plus quetiapine. Twenty-seven patients with major depressive episode were included into a 4-week follow-up study and compared with 27 healthy controls. Motor activity was continuously measured with an electronic wrist device (actigraphy), sleep was assessed with the Pittsburgh Sleep Quality Index, and patients were clinically assessed with the Hamilton depression score. All patients received a standard antidepressant treatment plus quetiapine. Whereas we found a rapid and maintaining improvement of subjective sleep parameters during the 4-week study, we observed a rapid improvement of some objective sleep parameters (actigraph) within the first week, but no further significant change of objective sleep parameters during the rest of the study. Another main finding of this study is that changes of subjectively and objectively assessed sleep parameters do not necessarily reflect clinical improvement of depression during the same timeline. Despite partial clinical remission, objective sleep parameters still showed significantly different patterns compared with controls. This study is the first to examine the effect of quetiapine on locomotor activity alongside with sleep in depression. As the studied patients with depression showed improvement in subjective and objective sleep parameters, quetiapine may be a promising drug for patients with depression and insomnia. Further studies need to investigate in detail the timeline of clinical remission and alterations of objective and subjective sleep parameters.

Longitudinal changes of day-time and night-time gross motor activity in clinical responders and non-responders of major depression

Psychomotor retardation (PR) is among the most important features of depression. This study investigates the development of day- and night-time as well as intensity and quantity of circadian motor activity during a 4-week course of treatment among 27 patients with depression compared to 27 healthy controls. A diagnosis of major depression was made using SCID. Motor activity was continuously measured with an actigraph during the study and clinical course of depression with HAM-D-21. Motor activity was described as the quantity and intensity of movements during day- and night- time. Clinically improved patients had significantly intensified movements after 4 weeks, compared to subjects with <50% improvement on HAM-D. While the measures of day-time level of movements captured the clinical improvement of depression, clinical improvement was not reflected by the night-time measurements. This study demonstrates that the separated analysis of level and quantity of movements supports a better understanding of the nature of psychomotor retardation during depression. The subdivision in day- and night-time activity objectively measured with actigraphy captures distinct patterns of motor activity and represents prognostic factors in the treatment outcome of depression. The study also highlights the importance of studying the intensity of movements separately from the quantity of movements in relation to treatment outcome.

The influence of several changes in atmospheric states over semi-arid areas on the incidence of mental health disorders.

The incidence of suicide attempts [Deliberate Self Harm (DSH); ICD-10: X60–X84] and psychotic attacks (PsA; ICD-10, F20–F29) in association with atmospheric states, typical for areas close to big deserts, was analyzed. A retrospective study is based on the 4,325 cases of DSH and PsA registered in the Mental Health Center (MHC) of Ben-Gurion University (Be’er-Sheva, Israel) during 2001–2003. Pearson and Spearman test correlations were used; the statistical significance was tested at p < 0.1. The influence of temperature and humidity on suicide attempts (NSU) and psychotic attacks (NPS) was weakly pronounced (p > 0.1). Correlation coefficients between NSU and NPS and speed WS of westerly wind reaches 0.3 (p < 0.05), while their dependence on easterly WS was weaker (p > 0.09). Variations in easterly wind direction WD influence NSU and NPS values (p < 0.04), but no corresponding correlation with westerly winds was found (p > 0.3). Obviously ,in transition areas located between different regions ,the main role of air streams in meteorological–biological impact can scarcely be exaggerated. An unstable balance in the internal state of a weather-sensitive person is disturbed when the atmospheric state is changed by specific desert winds, which can provoke significant perturbations in meteorological parameters. Results indicate the importance of wind direction, defining mainly the atmospheric situation in semi-arid areas: changes in direction of the easterly wind influence NSU and NPS, while changes in WS are important for mental health under westerly air streams. Obviously, NSU and NPS are more affected by the disturbance of weather from its normal state, for a given season, to which the local population is accustomed, than by absolute values of meteorological parameters.

Quality of sleep in escitalopram‐treated female patients with panic disorder

The purpose of this study was to assess the development of the night‐activity rhythm and quality of sleep during escitalopram treatment of patients suffering from panic disorder.

A case series on the development of rest–activity rhythm and quality of sleep in patients hospitalized for treatment of uni- or bipolar depression: a potential role for quetiapine

Objectives. To assess the development of the rest–activity rhythm and quality of sleep during course of treatment of patients with major depressive episode receiving antidepressant treatment plus quetiapine. Methods. Ten patients with major depressive episode were followed over 4 weeks. Motor activity was measured with actigraphy, sleep with the Pittsburgh Sleep Quality Index (PSQI), and depression was followed with HAM-D-21 and BDI. Correlations and associations were calculated with non-parametric statistical tests. Results. Circadian motor activity improved during the 4 weeks treatment period only for daytime-related motor activity (M10), but not for night-time-related motor activity (L5). Patients with statistically significant higher sleep efficiency scores and sleep fraction on the actigraph after week 1 showed clinical improvement on the HAM-D score after week 4. Patients with good sleep efficiency at week 1 (assessed by PSQI) showed statistically significant clinical improvement of depression after week 4. Conclusions. Various sleep parameters at week 1 of treatment seem to be predictive for treatment outcome of depression after week 4. Actigraphy and subjective sleep assessment with PSQI are useful tools to predict treatment outcome of depression. The positive effects of quetiapine on motor activity and sleep show the clinical significance of our findings.

Influence of electroencephalography neurofeedback training on episodic memory: A randomized, sham-controlled, double-blind study

The relationships between memory processes and oscillatory electroencephalography (EEG) are well established. Neurofeedback training (NFT) may cause participants to better regulate their brain EEG oscillations. The present study is a double-blind sham-controlled design investigating the effect of NFT on memory. NFT included up-training upper alpha (UA) band, up-training sensory-motor rhythm (SMR) band and sham protocol. Thirty healthy adult volunteers were randomly divided into three treatment groups. NFT sessions (30 min each) took place twice weekly for a total of 10 sessions while memory testing took place pre- and post-training. The results indicate dissociation between SMR and UA NFT and different memory processes. While the SMR protocol resulted in improving automatic, item-specific and familiarity-based processes in memory, the UA protocol resulted in improved strategic and controlled recollection. The implications of the results are discussed.

Non-Linear Dynamic Analysis of Inter-Word Time Intervals in Psychotic Speech

“Language is a form and not a substance” - Ferdinand de Saussure Objective: Analyses of speech processes in schizophrenia are invariably focused on words as vocal signals. The results of such analyses are, however, strongly related to content, and may be language- and culture-dependent. Little attention has been paid to a pure measure of the form of speech, unrelated to its content: inter-words time intervals. Method: 15 patients with schizophrenia and 15 healthy volunteers are recorded spontaneously speaking for 10-15 min. Recordings are analyzed for inter-words time intervals using the following nonlinear dynamical methods: unstable periodic orbits, correlation dimension, bi-spectral analysis, and symbolic dynamics. Results: The series of inter-word time intervals in normal speech have the characteristics of a low-dimensional chaotic attractor with a correlation dimension of 3.2 ± 1.1. Deconstruction of the attractor appears in psychosis with re-establishment after anti-psychotic treatment. Shannon entropy, a measure of the complexity in the time series, calculated from symbolic dynamics, is higher for psychotic speech, which is also characterized by higher levels of phase coupling: higher bicoherence, obtained using bi-spectral analysis. Conclusion: Non-linear dynamical methods applied to ITIs thus enable a content-independent, pure measure of the form of normal thought, its distortion in psychosis, and its restoration under treatment.

Recurrence of suicidal ideation due to treatment with antidepressants in anxiety disorder: a case report

This report describes a patient suffering from panic disorder who developed repeated suicidal ideation specifically due to the treatment with Venlafaxine. A first suicide attempt years ago occurred while being treated with Venlafaxine. Subsequent treatment with SSRIs or other antidepressants involved no suicidal ideation. Re-commencement of Venlafaxine four years later immediately led to a second suicide attempt. This unwanted effect subsided immediately after switching to another SNRI (i.e. Duloxetine). The case report underlines the importance of onset of suicide risk in panic disorders due to specific antidepressants.

Are Resting State Spectral Power Measures Related to Executive Functions in Healthy Young Adults

ABSTRACT Resting‐state electroencephalogram (rsEEG) has been found to be associated with psychopathology, intelligence, problem solving, academic performance and is sometimes used as a supportive physiological indicator of enhancement in cognitive training interventions (e.g. neurofeedback, working memory training). In the current study, we measured rsEEG spectral power measures (relative power, between‐band ratios and asymmetry) in one hundred sixty five young adults who were also tested on a battery of executive function (EF). We specifically focused on upper Alpha, Theta and Beta frequency bands given their putative role in EF. Our indices enabled finding correlations since they had decent‐to‐excellent internal and retest reliability and very little range restriction relative to a nation‐wide representative large sample. Nonetheless, Bayesian statistical inference indicated support for the null hypothesis concerning lack of monotonic correlation between EF and rsEEG spectral power measures. Therefore, we conclude that, contrary to the quite common interpretation, these rsEEG spectral power measures do not indicate individual differences in the measured EF abilities. HIGHLIGHTSResting‐state EEG and executive functions were assessed in healthy young adults.Bayesian statistics demonstrated lack of monotonic correlation between indices.Focus on Alpha,Theta, Beta frequency bands given their role in executive function.

Enhanced cognition and emotional recognition, and reduced obsessive compulsive symptoms in two adults with high-functioning autism as a result of deep Transcranial Magnetic Stimulation (dTMS): a case report

ABSTRACT We report reduced repetitive behaviors similar to obsessive compulsive disorder and improved emotional recognition and cognitive abilities in two young patients diagnosed with high-functioning Autism as a result of deep transcranial magnetic stimulation (dTMS). The patients received daily high-frequency (5 Hz) dTMS with HAUT-coil over the medial prefrontal cortex for a period of 5–6 weeks. A computerized cognitive battery, tasks for testing emotional recognition, and clinical questionnaires were used to measure the effects of treatment. TMS might have modulated networks related to metalizing abilities and self-referential processes since both patients reported improved sociability and communication skills.