Yuriko Yamakawa

High-dose of multiple antipsychotics and cognitive function in schizophrenia: The effect of dose-reduction

We evaluated the effect of antipsychotic dose-reduction on the neurocognitive function of 17 schizophrenic patients (11 male and 6 female, mean age=42.4+/-11.3) who have been taking high-doses of multiple conventional antipsychotics. The mean (+/-SD) of total daily antipsychotic doses (in mg/day, chlorpromazine-equivalent) was 2,253 (+/-668) at baseline, which was reduced to 1,315 (+/-276). Possible changes in neurocognitive function were assessed using Wisconsin card sorting test (WCST) and continuous performance test (CPT). As controls, we examined WCST and CPT in 6 schizophrenic patients (4 male and 2 female, mean age=47.7+/-14.2) who had been taking high-doses of multiple antipsychotics (mean daily antipsychotic dose=1,753+/-165 mg) and declined to change their antipsychotic regimen. In WCST, the mean number of total correct answers significantly increased (53.2+/-16.3 vs. 63.8+/-19.6, P=0.035, Wilcoxon signed rank test); perseverative errors significantly decreased (54.4+/-27.3 vs. 35.4+/-20.1, P=0.013, Wilcoxon signed rank test) after the antipsychotic dose-reduction. In contrast, the control group showed no significant difference between the two WCST performances conducted with a three-month interval. The improvements in WCST performance significantly correlated with the decreases in PANSS negative syndrome score in the subject patients. No significant change was observed in CPT performances in either group. Our preliminary data shows that, in schizophrenic patients taking high-doses of multiple conventional antipsychotics, dose-reduction might lead to improvements in cognitive functions.

Elderly adults improve verbal fluency by videophone conversations: a pilot study.

Summary We conducted videophone conversations with elderly adults living in a nursing home to discover whether their verbal ability was improved by repeated remote conversations. The control group comprised five elderly adults. The experimental group comprised six elderly adults, including three patients with dementia. They took part in three videophone conversations and their verbal ability was measured before and after the conversations. During the sessions, the participants and volunteers talked about themselves and participated in a quiz. In the experimental group, the mean number of words generated increased from 4.8 to 6.5 after the session (P < 0.05); this increase was not observed in the control group. The experimental group also showed an improvement in words generated after indirect conversations. Videophone conversations appear to have some positive effects on verbal ability and may be beneficial in the cognitive rehabilitation of elderly adults.

Structured Floral Arrangement Program Benefits in Patients With Neurocognitive Disorder

We attempted to clarify positive benefits in cognitive abilities and motivation during our cognitive intervention [structured floral arrangement (SFA) program] for patients with neurocognitive disorder due to stroke, traumatic brain injury (TBI), and other related disorders. In this SFA program, participants are required to arrange cut flowers and leaves on absorbent foam according to an instruction sheet. In a previous study of patients with schizophrenia, our SFA program encouraged participants and contributed to stimulating their visuospatial process and memory. Here, 27 patients with neurocognitive disorders participated in this study. Sixteen patients were assigned to an SFA-treated group and participated in six sessions during two phases plus to daily activities. Eleven non-treated patients engaged only daily activities during the same period. We compared Apathy Scale scores and neuropsychological scores between the SFA-treated and non-treated patients. Their mean attendance rate was more than 90% during the two phases. SFA-treated patients copied a Rey–Osterrieth complex figure more accurately than non-treated patients (p < 0.05) during the later intervention phase, whereas during the earlier phase, accuracy was comparable between treated and non-treated groups. In the SFA-treated group, recall scores also improved (p < 0.01), and the positive outcomes were maintained for about 3 months (p < 0.05). The Apathy Scale scores did not show significant change in either the SFA-treated or non-treated groups. Our present results suggest that the SFA program encouraged continuous participation to cognitive intervention and was useful for ameliorating dysfunctions in visuospatial memory and recognition in patients with neurocognitive disorder.

Finger counting habit influences on the performance in the temporal order judgment task

The development of an Alzheimer’s-like pathology has been noted in the hippocampus of the aged degu. This brain region is considered to be critical for spatial learning. Previous studies on rats have shown that aged rats have learning difficulties when trained with water maze and radial maze tasks. In this study, we compared the spatial learning ability of young (1-year old) and aged (5-year old) degus using a water maze task (n = 16 animals/group; 8 males and 8 females). To reduce the anxiety experienced by the animals while in the water maze, we used a shallow water maze with 27 grad water. Aside from this exception, the standard protocol for a Morris type water maze task was followed, and the animals were trained over 32 trials across 20 days. Initially, all of the degus showed inefficient task-solving behavior, demonstrated by jumping up near the wall or waiting until 60 s had passed without swimming. However, after several trials, half of the young degus (both genders) showed habituation to the water, and their escape latency was shortened. In contrast, none of the aged degus acquired any task-solving behavior traits, and all showed persistent inefficient task-solving behavior throughout the training. There was no difference between male and female aged degus with respect to such behavioral tendencies. It is still unclear whether the lack of task acquisition observed in the aged degus was caused by spatial learning deficits. As outlined, half of the young degus acquired this task by switching strategy or by abandoning the inefficient behavior observed in the early phase of training. However, as half of the young degus failed to adapt to the task, it is unclear whether the effect of age on special learning in the degus is generalizable. Based on these preliminary findings, we aim to conduct further study to determine whether age may be a factor in the inability to acquire strategy-switching traits and whether gender plays a role in acquiring spatial learning.

Different type of stimulation reminds different type of mental number line

In everyday life, we often experience that attentional effort for an on-going task fades away insidiously and our mind starts to wander. Such an absentminded state sometimes causes serious consequences. This functional MRI study aimed to identify the neural bases of absent-mindedness using a blockdesigned Go/NoGo task. In each task block, a NoGo stimulus was always presented at the end, while the remaining was Go stimulus. As a result, we found that shorter reaction time in Go trials was capable of predicting a following NoGo error response. This suggests that the fast and sloppy responses to Go stimuli represent the loss or attenuation of attentional effort for preparing an up-coming NoGo stimulus. We thus explored brain regions whose activity correlated with the mean reaction time in Go trials. Consequently, we found a positive correlation in the extensive frontoparietal regions, including the bilateral intraparietal sulcus, the bilateral frontal eye filed, and the right dorsolateral prefrontal cortex, as well as a negative correlation in the ventromedial prefrontal cortex. The results clearly demonstrated that as attentional effort for avoiding commission errors decreases, the ventromedial prefrontal cortex becomes reciprocally active instead of the attenuation of the dorsal attention network. We conclude that the reciprocal activation pattern represents the neural signature of absent-mindedness.