Gergely Drótos

Different patterns of auditory information processing deficits in chronic schizophrenia and bipolar disorder with psychotic features

With the development of DSM-V and ICD-11 the definitions of psychiatric disorders are under re-evaluation. The emphasis is shifted from distinct disorders to clusters defined not only by symptomatology, but also by underlying neurobiology and cognitive deficits. Bipolar disorder I (BD-I) and schizophrenia (SZ) are of special interest since their differential diagnosis is often problematic and they partially overlap in measures ranging from genetics to neurophysiology. Event-related potentials (ERPs) are one of the most studied factors but the results are still controversial, primarily in BD-I, where ERPs reflecting different stages of auditory information processing have been much less investigated. In this study, we aimed at investigating the changes of five auditory event-related potentials (P50 and N100 suppression, duration and pitch deviant mismatch negativity (MMN) and P3b) in 20 SZ and 20 BD-I patients with a history of psychosis and 21 healthy control subjects. Our data revealed substantial differences between the two patient groups. Only patients with SZ demonstrated impaired N100 suppression, shorter duration deviant MMN latency and attenuated P3b amplitude, while prolonged pitch deviant MMN latency was found to be characteristic of the BD-I group. No shared ERP abnormalities were observed among the patient groups. Our results indicate that SZ and BD-I are characterized by highly different neurophysiological profiles when measured in the same laboratory setting.

Serum adipokine levels modified by donepezil treatment in Alzheimer's disease

Neurotransmitter enhancement therapy with acetylcholinesterase inhibitors (AChEIs) is a clinically proven approach for patients with Alzheimers disease (AD). Donepezil is one of the three currently approved AChEIs for treating AD symptoms delaying the decline in cognitive function. In addition to cholinergic hypofunction, there are several factors in AD pathogenesis. For example, adipocytokines released from adipose tissue are also thought to play a role in the progress of dementia. Adipokines, i.e., leptin and adiponectin, are involved in the modulation of certain cognitive functions in the brain. The goal of our study was to elucidate effects of donepezil therapy on the serum levels of certain adipokines, such as leptin and adiponectin in AD patients. Clinically diagnosed mild-to-moderate AD patients (n = 26) were involved in this open-labeled, single-center, prospective self-control study. ApoE polymorphism, serum adiponectin, leptin, LDL, HDL, triglyceride levels, and BMI were determined before and at 12 and 24 weeks intervals of donepezil treatment, respectively. Twenty-four weeks of donepezil treatment induced a linear decrease of serum leptin levels (p = 0.013) and a linear elevation of serum adiponectin levels (p = 0.007). BMI (p < 0.001) and abdominal circumference (p = 0.017) were significantly lower at 24 weeks as compared to control values. None of the other examined metabolic parameters were changed during the treatment period. This previously unrecognized serum adipokine regulating potential of donepezil may be relevant in its therapeutic, disease modifying effect in AD by transferring protective (by increasing serum adiponectin levels) and detrimental (by decreasing serum leptin levels) effects onto the neurodegenerative process at the same time.

Vital exhaustion and anxiety are related to subjective quality of life in patients with acute myocardial infarct before cardiac rehabilitation

AIMS AND OBJECTIVES To examine psychological risk factors and somatic factors in patients after myocardial infarction. To study the relationship between somatic and psychological factors, their influence on subjective quality of life (well-being) and also to examine possible gender differences. BACKGROUND There has been a growing body of evidence that psychosocial factors are risk factors for incident and recurrent myocardial infarction. DESIGN Descriptive correlational and cross-sectional survey design. METHODS In patients (n = 97, 67 men), the level of depression and anxiety, vital exhaustion, sleep disturbances and well-being were assessed. Left ventricular ejection fraction, left ventricular diastolic diameter, body mass index, metabolic equivalents and the number of diseased vessels were retrieved from medical records. RESULTS Anxiety, vital exhaustion and sleep disturbances were significantly higher in women than in men. Well-being showed a significant linear correlation with body mass index, anxiety, depression, vital exhaustion and sleep disturbances scores. After adjustment for psychological risk factors and somatic parameters, only vital exhaustion and anxiety correlated significantly with well-being. However, there were gender differences in predictive variables of well-being. Anxiety in men and vital exhaustion in women showed a linear correlation with the subjective quality of life. CONCLUSION Our study revealed that only vital exhaustion and anxiety showed a significant correlation with well-being in patients. RELEVANCE TO CLINICAL PRACTICE During cardiac rehabilitation, it is important to detect and treat not only depression but also vital exhaustion and anxiety, because by reducing these psychological conditions, we can improve well-being.

[Validation of the Hungarian version of Alzheimer's Disease Assessment Scale--cognitive subscale].

UNLABELLED The cognitive subscale of the Alzheimers Disease Assessment Scale is the most widely used test in the diagnostic and research work of Alzheimers disease. AIMS The aim of this study was to validate and investigate reliability of the Hungarian version of the Alzheimers Disease Assessment Scale in patients with Alzheimers disease and healthy control subjects. METHODS sixty-six patients with mild and moderate Alzheimers disease and 47 non-demented control subjects were recruited for the study. The cognitive status was established by the Hungarian version of the Alzheimers Disease Assessment Scale and Mini Mental State Examination. Discriminative validity, the relation between age and education and Alzheimers Disease Assessment Scale, and the sensitivity and specificity of the test were determined. RESULTS Both the Mini Mental State Examination and the Alzheimers Disease Assessment Scale had significant potential in differentiating between patients with mild and moderate stages of Alzheimers disease and control subjects. A very strong negative correlation was established between the scores of the Mini Mental State Examination and the Alzheimers Disease Assessment Scale in the Alzheimers disease group. The Alzheimers Disease Assessment Scale showed slightly negative relationship between education and cognitive performance, whereas a positive correlation between age and Alzheimers Disease Assessment Scale scores was detected only in the control group. According to the analysis of the ROC curve, the values of sensitivity and specificity of the Alzheimers Disease Assessment Scale were high. CONCLUSIONS The Hungarian version of the Alzheimers Disease Assessment Scale was found to be highly reliable and valid and, therefore, the application of this scale can be recommended for the establishment of the clinical stage and follow-up of patients with Alzheimers disease. However, the current Hungarian version of the Alzheimers Disease Assessment Scale is not sufficient; the list of words and linguistic elements should be selected according to the Hungarian standard in the future.

Is There Any Difference between the Findings of Clock Drawing Tests if the Clocks Show Different Times

BACKGROUND The Clock Drawing Test (CDT) is a widely-used, rapid assessment tool for the screening of cognitive decline though its evaluation and interpretation are still not uniform. The aim of present study was to investigate the difference in sensitivity and specificity of two types of CDTs and to compare the clinical benefits of quantitative and semiquantitative scoring systems. OBJECTIVE To investigate the difference in sensitivity and specificity of two types of CDTs and to compare the clinical benefits of quantitative and semiquantitative scoring systems. METHODS Six hundred and ninety-two participants with or without dementia completed 10-item CDTs in nursing homes in two counties in southern Hungary. The dementia was not further subclassified. The results of the two tests, CDT1 (representing five minutes to a quarter to four) and CDT2 (representing ten past five), were evaluated quantitatively and semiquantitatively. RESULTS In the quantitative evaluation, the sensitivity and the specificity for the diagnosis of dementia at cut-off scores of 7 points were determined: 87.1% and 51.9%, respectively, for CDT1, and 81.7% and 57% for CDT2, respectively. The semiquantitative analysis revealed a sensitivity of 67.3% and a specificity of 65.3% for CDT1, and of 64.6% and 66.6% for CDT2, respectively. CONCLUSION The results of CDT tests do not appear to depend on the positions of the clock hands and additionally suggest that the quantitative evaluation method is more sensitive than the semiquantitative method.

The effect of emotion and reward contingencies on relational memory in major depression: An eye-movement study with follow-up

Background: Episodic memory disturbances were found to constitute a potential trait marker for major depression (MD). The recall of positive or rewarding information in a relational context is specifically impaired. Eye-movement recording constitutes a novel, direct approach to examine implicit memory performance. Here we aimed to assess the effect of emotional context and implicit virtual monetary reward or loss on viewing patterns in association with relational memory in a 6-months follow-up study in MD. Materials and Methods: Twenty-eight patients with MD and 30 healthy participants were trained to associate a face (happy/sad/neutral) with a background scene. After each pair a virtual monetary reward or loss appeared briefly. During testing, scenes were presented as a cue and then overlaid with three previously studied faces. Participants were asked to recall the matching face if present (Match trials), with eye-movements and subsequent forced-choice recognition being recorded. Results: Explicit recognition of the matching face was impaired in the MD group as compared to controls. In correlation with this, viewing of the matching face was significantly reduced in the MD group. We found a significant interaction of group (MD vs HC) with the relational memory condition (Match and Non-match), facial emotion and monetary reward and loss. MD patients attended longer to previously rewarded stimuli, but significantly less to sad faces in the Match condition. The relational memory impairment persisted at follow-up and correlated with symptom severity both at baseline and follow-up. Viewing patterns associated with previous virtual reward were associated with clinical symptoms at follow-up. Conclusion: Our current results provide novel evidence for a specific relational memory impairment in MD as supported by abnormal eye-movement behavior and a deficit in explicit recognition. MD patients showed an attentional bias to rewarded stimuli and decreased viewing of sad faces when relational memory information was present.

The impact of intermediate-term alcohol abstinence on memory retrieval and suppression.

Background: The nature of episodic memory deficit in intermediate-term abstinence from alcohol in alcohol dependence (AD) is not yet clarified. Deficits in inhibitory control are commonly reported in substance use disorders. However, much less is known about cognitive control suppressing interference from memory. The Think/No-think (TNT) paradigm is a well established method to investigate inhibition of associative memory retrieval. Methods: Thirty-six unmedicated patients with AD and 36 healthy controls (HCs) performed the TNT task. Thirty image–word pairs were trained up to a predefined accuracy level. Cued recall was examined in three conditions: Think (T) for items instructed to-be-remembered, No-think (NT) assessing the ability to suppress retrieval and Baseline (B) for general relational memory. Premorbid IQ, clinical variables and impulsivity measures were quantified. Results: AD patients had a significantly increased demand for training. Baseline memory abilities and effect of practice on retrieval were not markedly different between the groups. We found a significant main effect of group (HC vs. AD) × condition (B, T, and NT) and a significant difference in mean NT–B scores for the two groups. Discussion: AD and HC groups did not differ essentially in their baseline memory abilities. Also, the instruction to focus on retrieval improved episodic memory performance in both groups. Crucially, control participants were able to suppress relational words in the NT condition supporting the critical effect of cognitive control processes over inhibition of retrieval. In contrast to this, the ability of AD patients to suppress retrieval was found to be impaired.