Katarzyna Kucharska

Social cognitive and neurocognitive deficits in inpatients with unilateral thalamic lesions - pilot study.

Background The essential role of the thalamus in neurocognitive processes has been well documented. In contrast, relatively little is known about its involvement in social cognitive processes such as recognition of emotion, mentalizing, or empathy. The aim of the study This study was designed to compare the performance of eight patients (five males, three females, mean age ± SD: 63.7±7.9 years) at early stage of unilateral thalamic lesions and eleven healthy controls (six males, five females, 49.6±12.2 years) in neurocognitive tests (CogState Battery: Groton Maze Learning Test, GML; Groton Maze Learning Test-Delayed Recall, GML-DR; Detection Task, DT; Identification Task, IT; One Card Learning Task, OCLT; One Back Task, OBT; Two Back Task, TBT; Set-Shifting Task, S-ST) and other well-known tests (Benton Visual Retention Test, BVRT; California Verbal Learning Test, CVLT; The Rey-Osterrieth Complex Figure Test, ROCF; Trail Making Test, TMT part A and B; Color – Word Stroop Task, CWST; Verbal Fluency Test, VFT), and social cognitive tasks (The Penn Emotion Recognition Test, ER40; Penn Emotion Discrimination Task, EmoDiff40; The Penn Emotional Acuity Test, PEAT40; Reading the Mind in the Eyes Test, revised version II; Toronto Alexithymia Scale, TAS-20). Methods Thalamic-damaged subjects were included if they experienced a single-episode ischemic stroke localized in right or left thalamus. The patients were examined at 3 weeks after the stroke onset. All were right handed. In addition, the following clinical scales were used: the Mini-Mental State Examination (MMSE), Spielberger State-Trait Anxiety Inventory (STAI), Beck Depression Inventory (BDI II). An inclusion criteria was a minimum score of 23/30 in MMSE. Results Compared with the healthy controls, patients revealed significantly lower scores in CVLT, GML-DR, and VFT. Furthermore, compared to healthy controls, patients showed significantly delayed recognition of “happiness” in EmoDiff40 and significantly worse performance on Reading the Mind in the Eyes Test, revised version II. Neuropsychological assessment demonstrated some statistically significant deficits in learning and remembering both verbal and visual material, long-term information storing, problem solving, and executive functions such as verbal fluency. Conclusion Patients at early stage of unilateral thalamic stroke showed both neurocognitive and social cognitive deficits. Further research is needed to increase understanding about diagnosis, early treatment, and prognosis of patients with thalamic lesions.

Interaction Between Val158Met Catechol-O-Methyltransferase Polymorphism and Social Cognitive Functioning in Schizophrenia: Pilot Study

The Val158Met catechol‐O‐methyltransferase (COMT) functional polymorphism may influence social cognitive functioning in patients with schizophrenia.

Psychological and Physiological Changes in Cognitive Functioning inThalamic Lesion throughout the Rehabilitation Process

Aim: The aim of the study was to assess psychological and physiological changes in cognitive functioning of a thalamic-damaged patient who underwent a stroke rehabilitation program which involved treatment as usual (TAU) combined with a computer-based Neurocognitive Training (NT). Additionally, the healthy control (HC) group (n=13) was recruited to assess neural circuitry including thalamic involvement in comparison to a patient in acute thalamic stroke who underwent the same scanning procedure before implementation of NT. nMethods: The patient (initials B.D.) was examined at three weeks after the ischemic stroke localized in left tuberothalamic territory. HCs and B.D. were evaluated using various cognitive measures and clinical scales. The computer-based NT was delivered individually once weekly for 60 minutes in a 12-week program. B.D. twice underwent a fMRI scanning session using a block-designed Stroop task: 1) after three weeks from lesion onset, and 2) after therapy. nResults: Compared with HCs, B.D. before therapy demonstrated marked deficits in learning and remembering both verbal and visual material, long-term information storing, problem solving, attentional switching and working memory. After therapy, B.D. showed clinically significant improvement in memory, attention, and executive functions. B.D. showed a post-therapy decreased activation pattern and, by contrasting the congruent versus the incongruent condition, after treatment increased activations remained only in the left parietal lobule and right middle frontal gyrus. In HCs increased activation was detected in right anterior cingulate, frontal regions and striatal region during Stroop interference, which remains in line with other studies. n nConclusions: Marked improvement was described in the patient after therapy. Further research is needed to increase knowledge about the involvement of the thalamus in key cognitive processes in the context of efficacy and effectiveness of neurocognitive training.

The role of long term care centers in the Polish system of mental health care

Abstract Objective: The aim of this work is to review the role of mental health care center and treatment center specialized in psychiatry in the Polish system of mental health care as a whole. Review: For many years in Poland, the process of transformation of psychiatric care model from the institutional (inpatient setting, most expensive) to community care model (personalized, much cheaper), has been taking place. The effective - coordinated system of community care should significantly improve cooperation in the treatment, while the community forms of health care should ensure full availability, complexity, and continuity of care provision. In many cases, the community support is inadequate and cannot provide patient with care at his home environment. For mentally ill, there may be a need for the use of the long term health care centers specialized in psychiatry. Conclusions: A long term mental health care center specialised in mental health plays an important role in long-term care for the mentally ill. As far as a mental health service user’s perspective is concerned, the continuity of care and treatment in the long term health care center (as a health care unit) appears to be more useful and satisfying compared to a residential home for people with chronic mental illnesses. There is a need for broad discussion on the special place of the long term health care center specialized in psychiatry in the present Polish system of mental health care and on the improving of care pathways between inpatient-, day care-and, community care package.