Henrique Teruo Akiba

Left Dorsolateral Prefrontal Cortex Anodal tDCS Effects on Negative Symptoms in Schizophrenia

Cognitive functions maintained stable (20 at baseline and 24 at the final outcome) as assessed by MOCA, with improvement on memory tasks. MDD symptoms substantially improved during the 10day treatment course and remained stable after three months follow-up, and the patient reported significant global clinical gains (see the Fig. 1). The patient was followed on a monthly basis and no risk issues were observed, such as gestational diabetes or hypertension. Caesarean section was performed opted by the gynecology and obstetrics team due to be considered high-risk pregnancy because of the MDD treatment. No complications during child-birth occurred. The neonate was a healthy full-term, 8 pounds newborn, with APGAR 10/10 and no malformations. The TNS protocol is based on a “bottom up” mechanism [7]. The electric stimuli follows the peripheral nerves pathway through central structures [7] such as the amygdala and the hippocampus, toward higher cortical area such as the dorsolateral prefrontal cortex, previously demonstrated to be involved in MDDwith symptoms amelioration when stimulated with other neuromodulation techniques [8]. Data on the use of cranial nerve stimulation for MDD during pregnancy is scant. In fact, TNS was not evaluated before. Only one case of vagus nerve stimulation (VNS) for the treatment of MDD in pregnancy was performedwith no safety issues [9]. Safety evaluation on the use of VNS in an animal model (pilot study of the teratogenicity) was performed with 10 rabbits with no safety issues reported [10]. We present the first report using TNS in a pregnant patient with successful amelioration of MDD symptoms and no considerable side effects to the newborn. TNS is a focused electrical stimulation technique without likely electric stimulation propagation to the fetus. Our findings are based on a case study, thus having limited generalizability. Nonetheless, these encouraging results should be seen as hypothesis-driven for further controlled, randomized trials exploring the safety and impact of TNS in the treatment of MDD in pregnancy.

Neuropsychological correlates of remission in chronic schizophrenia subjects: The role of general and task-specific executive processes

Background Although cognitive deficits have consistently been characterized as core features of schizophrenia, they have not been incorporated into definitions of remission. Furthermore, just a few studies have examined the relationship between cognitive deficits and symptomatic remission. The main aim of the present study is to evaluate the executive functioning of nonremitted schizophrenia patients. Methods 72 remitted and 42 nonremitted schizophrenia patients, and 119 healthy controls were examined. Subjects were tested with a comprehensive battery of cognitive tests, including a measure to assess the general components of executive functioning and individual tasks to tap the three specific executive dimensions assessed in the present study, namely updating, shifting and inhibition. Results Schizophrenia subjects performed poorly on general executive functioning and shifting tasks in comparison to healthy controls. Remitted subjects performed better than nonremitted on inhibition and updating tasks. Whereas being a male and showing decreases in updating increase the chances of being in the nonremitted schizophrenia subjects group, increases in shifting and updating enhance the odds of being in the healthy control group. Conclusion The present findings suggest that executive function deficits are present in chronic schizophrenic patients. In addition, specific executive processes might be associated to symptom remission. Future studies examining prospectively first-episode, drug naive patients diagnosed with schizophrenia may be especially elucidative.

The Effect of Highly Scaffolded Versus General Instruction on Students’ Exploratory Behavior and Arousal

Technology is changing the way students interact with knowledge, and open-ended activities are one of the main types of tasks that students engage with in technology-rich environments. However, the amount of guidance needed to promote learning in these environments remains unknown. We explore this issue by focusing on the effects of step-by-step versus generic instructions on student’s exploratory behavior and arousal levels. In this experiment, students completed three computer-based activities within a physics simulation software: building a tower, building a bridge and a free task. We did not find any effect of our experimental manipulation on students’ task performance. We found, however, that detailed instruction induced higher level of activation followed by a relaxation phase and a recovery of the activation level in the last segment of the task (U-shaped curve). On the other hand, generic instructions seemed to lead students into a continuous relaxation pattern along the task (decreasing slope). Moreover, low and high-aroused students appear to be affected by the instructions differently, with high-aroused students at baseline showing less cognitive flexibility. Finally, we observed carryover effects, where types of instruction kept influencing students’ levels of activation in a following open-ended task. We discuss implications of those results for designing learning activities in constructionist, technology-rich environments.

Transtornos mentais comuns em educadores sociais

Objective To investigate the presence of common mental disorders (CMDs) in Social Educator of hostels and housings in the city of Sao Paulo. Methods The sample was composed by 104 Guiding Youth between 18 and 60 years (male and female), who worked at the Municipal Assistance and Social Development in Sao Paulo. We used a demographic data questionnaire in addition to the Self Report Questionnaire (SRQ-20). Results The main results demonstrated a higher prevalence of women in this function; most professionals have experienced risk situations at work; 68.3% (71 individuals) presented indices that characterize the presence of CMDs; 40.4% of women presented CMDs symptoms, whereas the CMDs rate in men was 27.9%. Conclusions In this scenario, we can conclude that the female audience is more vulnerable to the presence of CMDs in comparison to the male audience.

Faux Pas Test in schizophrenic patients

Objective The aim of this study is to validate the adult version of “Faux Pas Recognition Test” created by Stone and colleagues (1998) as a reliable instrument assess and discriminate social cognition among schizophrenia patients and healthy controls. Methods This is a cross-sectional study with a total of 196 participants (mean age = 26.45; CI (95%) [25.10; 27.83]) 51% male. From those, 44 (22.4%) patients with schizophrenia and 152 (77.6%) healthy controls. The participants answered a short version of the Faux Pas Recognition Test, composed by 10 stories. Results Significant differences were found between both groups regarding their scores on Faux Pas Recognition Test (p = 0.003). Patients with schizophrenia had lower score, compared to healthy controls. Story 14 was the best to distinguish both groups, and Story 16, the worst. Among the questions of Faux Pas stories, the one related to intuition presented the most significant difference between the groups (p = 0.001), followed by the one related to understanding (p = 0.003). Conclusion The Brazilian version of the Faux Pas Recognition Test is a valid test to assess social cognition in schizophrenia and can be an important instrument to be used on the clinical practice.

Forensic neuropsychological assessment: clinical case of depression and working incapacity

Issues related to mental health in relation to court matters have increasingly required the participation of the psychologist. We present the use of forensic neuropsychological assessment in a case of retirement reversal. Incapacity was attested due to disability resulting from depression of a 35-year-old attorney, and the case was forwarded from the courts to the Forensic Psychiatry and Psychology Unit at the USP Clinical Hospital. A clinical interview and application of cognitive tests was conducted. Despite the depression, significant cognitive losses that would prevent return to his professional assignments were not detected. The neuropsychological assessment has been shown to be an important tool in the forensic context, as it assists with diagnostic value for clarification of functional aspects in the various psychopathological areas in terms of disabilities or potentialities.