Francesca Bolino

Sensorimotor gating and habituation evoked by electro-cutaneous stimulation in schizophrenia

The present study has been performed in order to evaluate two relevant phenomena related to startle reflex (SR) evoked by electro-cutaneous stimulation in schizophrenic patients: 1) the effect of different interstimulus intervals on R1, R2 magnitude and on R2 latency in schizophrenia in order to verify if the gating effect influences all blink reflex (BR) parameters and 2) to replicate and extend our previous data on SR habituation. Our data have confirmed the existence of an impairment of habituation and an abnormal facilitatory effect of R1 component of BR in schizophrenics compared to healthy controls. The present study provides further evidence of specific defective mechanisms of information processing in schizophrenia. The methodology used for SR paradigm appears to be founded on a sound research basis and represents an advantageous paradigm for assessing attentional variables of information processing in mental disorders.

Reduced temporal lobe areas in schizophrenia: Preliminary evidences from a controlled multiplanar magnetic resonance imaging study

Seventeen young patients with relapsing schizophrenia and 13 normal controls matched for age, gender, and educational level underwent magnetic resonance imaging (MRI) scans. Three sagittal, eight axial, and seven coronal images were obtained for all subjects. Schizophrenic patients showed a reduction of brain tissue in the temporal lobes. Among the several brain structures identified, left temporal lobe area, but not ventricular brain ratio (VBR), discriminated between the two groups. As VBR has been reported to be increased in the more severe forms of schizophrenia, temporal lobe abnormalities may characterize the less severe cases of schizophrenia.

Startle reflex habituation in functional psychoses: A controlled study

The habituation of the startle reflex in a paradigm using electrical stimulation was studied in 17 psychotic patients and 18 healthy controls. The magnitude of the R2 component of the blink reflex differed between the groups (ANOVA, F = 5.81; P = 0.022) and during the course of trials (F = 25.72; P < 0.0001). Furthermore a statistically significant interaction of diagnosis x trials (F = 3.34; P = 0.022) emerged suggesting that an impairment in habituation of startle is present in patients but not in healthy controls despite a comparable reactivity.

The natural course of schizophrenia and psychopathological predictors of outcome. A community-based cohort study.

The natural course of schizophrenia is extremely heterogeneous and generally considered unpredictable. This prospective research investigated the natural course of schizophrenia in a community-based population linked to an Italian Mental Health Center, looking for the identification of psychopathological predictors of outcome. Forty schizophrenic patients were assessed at baseline in a stabilized phase of illness with clinical scales of psychopathology and social functioning and afterwards were followed up for 36 months. All of them were treated with antipsychotic drugs. According to their symptoms and function scores patients were empirically classified into three groups with a cluster analysis: a group characterized by low symptoms and good functioning, a group with high symptoms and poor functioning and an intermediate group. A crosstabs analysis revealed that the empirical classification correctly predicted long-term outcome. A survival analysis with comparison of distributions (Wilcoxon Gehan test) also revealed significant differences in terms of hospital admission and occurrence of alcohol-related diagnosis across groups. This study suggests that the long-term outcome in schizophrenic patients followed by a community-based mental health service is generally poor and multifaceted. However, outcome may be predicted on the basis of the psychopathological and social functioning profile assessed in a stabilized phase of illness defined with operational criteria.

Neuropsychological and clinical correlates of temporal lobe anatomy in schizophrenia

Twenty‐five DSM‐III schizophrenic patients were assessed neuromorphologically and neuropsychologically. Reduced temporal lobes were found through magnetic resonance imaging (MRI) evaluation. In addition, in order to look for the neuropsychological correlates of temporal anatomy in schizophrenia, patients were divided into cognitive normal and abnormal schizophrenics, according to their Luria Nebraska Neuropsychological Battery profile. The latter group had statistically significant temporal lobe abnormalities as assessed by MRI, irrespective of medication, clinical picture or any other relevant variables. The implication of such findings in the light of the diaschisis model is discussed.

Acoustic and Electrically Elicited Startle Reaction: Similar Patterns of Habituation and Reflex Modifications in Humans

The present study was performed in order to verify two relevant phenomena related to Startle Reaction in normal subjects: 1) the response habituation, that consists of an exponential decrement of the R2 component of Blink Reflex after repeated identical stimuli, and 2) the modification of R1 magnitude, R2 magnitude and latency when the startle eliciting stimulus is preceded by a warning stimulus. Our data confirm: 1) that habituation is independent of paradigm and type of stimulation (acoustic vs electrocutaneous), and 2) an electrical prestimulus has a facilitatory effect on the R2 latency of the electrically elicited Blink Reflex onset with an inhibition of R2 magnitude. The present study support the view of a systemic supramodal central mechanism of information processing and sensorial gating with super-imposable effects on the different sensorial pathways.

Symptoms and social functioning features in chronic schizophrenia are aggregate in a tripartite structure

OBJECTIVE To verify the association between schizophrenic symptoms and multidimensional variables of social functioning and to look for a possible classification based on an empirical classification outcome oriented. DESIGN Forty chronic schizophrenic patients, with a diagnosis ascertained through clinical interview and diagnostic criteria were enrolled in the study. SETTING All patients were followed in a State Mental Health center and were assessed in a stabilized phase of illness. PRINCIPAL OUTCOME MEASURES: Psychopathological assessment was made with PANSS and CGI. Psychosocial assessment was made with Life Skills Profile and Global Functioning Scale. RESULTS A pervasive correlation among symptoms and psychosocial variables emerged suggesting a unitary concept of behavior related to diagnosis. Factor analysis revealed 2 main components able to explain the 79% of variance. Cluster analysis separated the patients in 3 different groups showing that clinical symptoms are aggregated with specific variables of social functioning. CONCLUSION Schizophrenic symptoms and social functioning are organized in a tripartite structure. It suggests the existence of three different syndromes that are outcome oriented, and compatible with an unitary concept of schizophrenia.