Introduction: Neuropeptide S is a biomarker related to various neuropsychiatric and neurocognitive functions. Since the need to improve cognitive functions in schizophrenia is unquestionable, it was valuable to investigate the possible relationships of plasma levels of NPS with neurocognitive, psychopathological and EEG parameters in patients with schizophrenia. Aim: Relationships between the serum NPS level and neurocognitive, clinical, and electrophysiological parameters were investigated in patients diagnosed with schizophrenia who underwent structured rehabilitation therapy. Methods: Thirty-three men diagnosed with schizophrenia were randomized into two groups. The REH group (N16) consisted of patients who underwent structured rehabilitation therapy, the CON group (N17) continued its previous treatment. Additionally, the reference NPS serum results were checked in a group of healthy people (N15). In the study several tests assessing various neurocognitive functions were used: d2 Sustained-Attention Test (d2), Color Trails Test (CTT), Beck Cognitive Insight Scale (BCIS), Acceptance of Illness Scale (AIS), and General Self-Efficacy Scale (GSES). The clinical parameters were measured with Positive and Negative Syndrome Scale (PANSS) and electrophysiological parameters were analyzed with auditory evoked potentials (AEPs) and quantitative electroencephalography (QEEG). The NPS, neurocognitive, clinical, and electrophysiological results of REH and CON groups were recorded at the beginning (T1) and after a period of 3 months (T2). Results: A decreased level of NPS was associated with the improvement in specific complex indices of d2 and BCIS neurocognitive tests, as well as the improvement in the clinical state (PANSS). No correlation was observed between the level of NPS and the results of AEPs and QEEG measurements. Conclusions: A decreased level of NPS is possibly related to the improvement in metacognition and social cognition domains, as well as to clinical improvement during the rehabilitation therapy of patients with schizophrenia.
Both Polish versions of MoCA are equivalent, and can be useful in repeated measurement of progress in cognitive impairment or in testing of the effectiveness of treatment.
Objectives. The aim of this study was to use neurofeedback (NF) training as the add-on therapy in patients with schizophrenia to improve their clinical, cognitive, and psychosocial condition. The study, thanks to the monitoring of various conditions, quantitative electroencephalogram (QEEG) and brain-derived neurotrophic factor (BDNF), was supposed to give an insight into mechanisms underlying NF training results. Methods. Forty-four male patients with schizophrenia, currently in a stable, incomplete remission, were recruited into two, 3-month rehabilitation programs, with standard rehabilitation as a control group (R) or with add-on NF training (NF). Pre- and posttherapy primary outcomes were compared: clinical (Positive and Negative Syndrome Scale (PANSS)), cognitive (Color Trails Test (CTT), d2 test), psychosocial functioning (General Self-Efficacy Scale (GSES), Beck Cognitive Insight Scale (BCIS), and Acceptance of Illness Scale (AIS)), quantitative electroencephalogram (QEEG), auditory event-related potentials (ERPs), and serum level of BDNF. Results. Both groups R and NF improved significantly in clinical ratings (Positive and Negative Syndrome Scale (PANSS)). In-between analyses unveiled some advantages of add-on NF therapy over standard rehabilitation. GSES scores improved significantly, giving the NF group of patients greater ability to cope with stressful or difficult social demands. Also, the serum-level BDNF increased significantly more in the NF group. Post hoc analyses indicated the possibility of creating a separate PANSS subsyndrome, specifically related to cognitive, psychosocial, and BDNF effects of NF therapy. Conclusions. Neurofeedback can be effectively used as the add-on therapy in schizophrenia rehabilitation programs. The method requires further research regarding its clinical specificity and understanding mechanisms of action.
Paranoid schizophrenics were scored and analyzed using PANSS and principal component method on admission (T1, 480 patients), after 4 weeks (T2, 223 patients), after 8 weeks (T3, 146 patients) and after 6 months of treatment (T4, 104 patients). Seven factor models accounted for 68–74% of the variances (including models of 104 patients present at all four stages). T1 and T2 models comprised 6–7 factors and were dominated by positive and excitement symptoms. The grandiosity factor could only be identified in T1. T3 and T4 models were reduced to 5 factors and incorporated a greater expression of depressive disorders and a relatively greater expression of negative and cognitive symptoms. Negative and cognitive dimensions were the most stable elements of all the models. The concept of the depressive factor appeared to be too restrictive to describe a whole variety of the affective dimension.
Wiele badań wskazuje na istnienie związku pomiędzy stosowaniem leków przeciwpsychotycznych (LPP) a występowaniem żylnej choroby zakrzepowo-zatorowej (VTE). Powikłania zakrzepowo-zatorowe obarczone są istotnym ryzykiem inwalidyzacji i zgonu, są również czynnikiem znacznie zwiększającym koszty leczenia. Pomimo wieloletnich badań, mechanizmy zależności pomiędzy stosowaniem LPP, a rozwojem VTE nie zostały do tej pory dokładnie wyjaśnione, jednak najprawdopodobniej łączą się z zagadnieniem nadumieralności pacjentów psychiatrycznych. Celem pracy było podsumowanie dotychczasowych doniesień dotyczących czynników ryzyka wystąpienia VTE u pacjentów stosujących leki LPP. W pracy oparto się na wynikach badań klinicznych, metaanaliz, przeglądów systematycznych oraz danych Europejskiej Agencji Leków. Na podstawie analizowanych doniesień ustalono, że do głównych czynników ryzyka wystąpienia VTE należy czas stosowania leczenia oraz czynniki związane z pacjentem, takie jak płeć, wiek, masa ciała oraz aktywność fizyczna. Dotychczasowe dane nie pozwalają na jednoznaczne zróżnicowanie potencjału prozakrzepowego poszczególnych LPP, jak również na wykazanie wyższego ryzyka VTE u chorych leczonych atypowymi LPP. Ze względu na złożoną patogenezę VTE konieczne jest przeprowadzenie dużych badań porównawczych, mogących doprecyzować różnice w prozakrzepowym działaniu poszczególnych LPP. Celowym wydaje się również wyodrębnienie produktów o najniższym ryzyku wywoływania VTE, które będzie można stosować u pacjentów obarczonych wysokim ryzykiem VTE, tym samym zwiększając bezpieczeństwo terapii. Wszystkich chorych leczonych LPP należy oceniać pod kątem ryzyka rozwoju powikłań zakrzepowo - zatorowych, wdrażać odpowiednią profilaktykę (obejmującą przede wszystkim wyeliminowanie modyfikowalnych czynników ryzyka) oraz edukować w zakresie objawów mogących przemawiać za rozwojem VTE. Każdy chory z podejrzeniem VTE powinien mieć przeprowadzoną jak najszybszą diagnostykę i wdrożone leczenie.
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