Mário Rodrigues Louzä Neto

Volumetric MRI measurements can differentiate Alzheimer's disease, mild cognitive impairment, and normal aging.

BACKGROUND Volumetric magnetic resonance imaging (MRI) has been extensively studied in the last decade as a method to help with the clinical diagnosis of Alzheimers disease (AD). In recent years, researchers have also started investigating if that technique would be useful to identify individuals with mild cognitive impairment (MCI), differentiating them from AD patients and from normal elderly controls. This research project was planned to assess the accuracy of volumetric MRI to differentiate those groups of individuals. METHOD The investigation involved 39 patients with diagnosis of mild to moderate dementia in AD, according to the criteria of the NINCDS-ADRDA, DSM-III-R, and ICD-10; 21 subjects with complaints of cognitive decline without other psychiatric disorders (MCI); and 20 normal elderly controls. All the subjects were submitted to a standard protocol, including volumetric MRI evaluations. RESULTS The results indicated that all regions of interest measured (amygdala, hippocampus, and parahippocampal gyrus) were significantly different (p < .005) in AD patients compared to MCI subjects and controls. The left volumetric measures (amygdala, hippocampus, and parahippocampal gyrus) were also significantly different between the MCI subjects and controls (p < .05). The discriminant function analysis correctly classified 88.14% of the AD patients and controls, 81.67% of AD patients and MCI subjects, and 80.49% of the MCI subjects and controls. CONCLUSIONS The results suggest that measures of medial temporal lobe regions are useful to identify mild to moderate AD patients and MCI subjects, separating them from normal elderly individuals.

Insight and regional brain volumes in schizophrenia

We have investigated the relationship between insight impairment and regional brain volumes (gray and white matter) in schizophrenia using voxel-based morphometry (VBM). Fifty patients with schizophrenia were evaluated using the Scale for Unawareness of Mental Disorders. Magnetic resonance images were acquired, segmented and spatially normalized using optimized VBM routines. No significant inverse correlations were detected between insight impairment and gray or white matter volumes in the prefrontal region (where significant findings had been predicted a priori), or in any other brain areas. Our results do not support previous hypotheses suggesting a relationship between frontal lobe atrophy and impaired insight in patients with schizophrenia.

Clozapine efficacy in tardive dyskinesia in schizophrenic patients

Abstract Tardive dyskinesia (TD) is a long-term severe complication of antipsychotic treatment, with mean prevalence of 20–35%. The aim of this study was to evaluate effects of clozapine in severe TD. In an open trial seven patients with schizophrenia and severe TD were given clozapine for 6 months. Tardive dyskinesia severity was evaluated with AIMS and ESRS and schizophrenic psychopathology with PANSS. Clozapine mean dose at the end of the study was 392.86 mg/day. A mean reduction of 52% was observed in ESRS scores for TD. Two patients also had dystonic movements, and there was 50% reduction in one of them and complete remission in the other. There was also a 27% mean reduction in PANSS scores. Clozapine seems to be an alternative in the treatment of schizophrenic patients with severe TD.