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Pintor L.,Neuroscience Institute | Valldeoriola F.,Institute Of Neurociencies | Fernandez-Egea E.,Neuroscience Institute | Sanchez R.,Institute Of Neuropsiquiatria I Addiccions | And 5 more authors.
Journal of ECT | Year: 2012

INTRODUCTION: Mental dysfunction and especially gait disorders, such as freezing and postural instability in "on phase," are partially unresponsive to dopaminergic therapy late in the course of Parkinson disease (PD). Some of them have been related to decreased sensitivity of postsynaptic dopaminergic receptors, and it is known that electroconvulsive therapy (ECT) enhances the sensitivity of these receptors. The aim of this study was to determine the efficacy and safety of ECT in patients with advanced Parkinson disease with symptoms partially unresponsive to L-dopa. METHODS: Neurologic (Parkinson's Disease Questionnaire, Unified Parkinson's Disease Rating Scale, Tinetti Scale, and the Sit-to-Stand test), psychiatric (structured interview for the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, and Hamilton Depression Rating Scale) and neuropsychological (Mini Mental State Examination, executive functions, declarative and procedural memory, visual processing, and reaction time) evaluation was performed on 9 patients with a diagnosis of L-dopa-resistant PD by the Movement Disorders Working Group. This evaluation was done before and after 8 sessions of bitemporal ECT. Six patients completed the study. RESULTS: Statistically significant differences were found in the number of steps and freezing episodes in the on phase when they were compared before and after the ECT administration. However, no statistically significant differences were found in the "off" phenomena, motor fluctuations, or dyskinesias before and after ECT administration. No patient showed psychiatric symptoms before, during, or after the ECT. No statistically significant differences were observed in the neuropsychological results between the pretreatment and posttreatment evaluations. All patients showed transient amnesia after the ECT administration, which lasted for 48 hours. CONCLUSIONS: Electroconvulsive therapy could be a safe and effective therapeutic option in L-dopa-resistant patients with PD with predominantly axial "on" phenomena; nevertheless, it needs to be confirmed in later studies. Copyright © 2012 by Lippincott Williams & Wilkins.


Murru A.,University of Barcelona | Popovic D.,University of Barcelona | Pacchiarotti I.,University of Barcelona | Hidalgo D.,University of Barcelona | And 3 more authors.
Current Psychiatry Reports | Year: 2015

Mood stabilizers such as lithium and anticonvulsants are still standard-of-care for the acute and long-term treatment of bipolar disorder (BD). This systematic review aimed to assess the prevalence of their adverse effects (AEs) and to provide recommendations on their clinical management. We performed a systematic research for studies reporting the prevalence of AEs with lithium, valproate, lamotrigine, and carbamazepine/oxcarbazepine. Management recommendations were then developed. Mood stabilizers have different tolerability profiles and are eventually associated to cognitive, dermatological, endocrine, gastrointestinal, immunological, metabolic, nephrogenic, neurologic, sexual, and teratogenic AEs. Most of those can be transient or dose-related and can be managed by optimizing drug doses to the lowest effective dose. Some rare AEs can be serious and potentially lethal, and require abrupt discontinuation of medication. Integrated medical attention is warranted for complex somatic AEs. Functional remediation and psychoeducation may help to promote awareness on BD and better medication management. © 2015, Springer Science+Business Media New York.


Cuenca-Royo A.M.,Drug Abuse Epidemiology Research Group | Cuenca-Royo A.M.,CIBER ISCIII | Sanchez-Niubo A.,Drug Abuse Epidemiology Research Group | Sanchez-Niubo A.,CIBER ISCIII | And 7 more authors.
Addictive Behaviors | Year: 2012

Aim: To assess the validity of two cannabis use severity scales among young cannabis users and to evaluate their ability to detect Substance Use Disorders (SUD). Participants: 241 volunteers (18-25. years), with a wide spectrum of cannabis use in the last 12. months. Measurements: The Cannabis Abuse Screening Test (CAST) and Severity of Dependence Scale (SDS) were self-administered. The Psychiatric Interview for Substance and Mental Disorders (PRISM) was used as gold standard for cannabis use disorders according to DSM-IV. Reliability and validity were assessed for two different CAST coding algorithms (b-binary and f-full) and for the SDS. In addition, the cannabis use diagnostic criteria contained in the PRISM were grouped to approximate forthcoming proposed DSM-V criteria to further evaluate these scales. Findings: 26.6% (95% CI: 21.0-32.2) of the subjects met criteria for cannabis dependence, and 49.0% (95% CI: 42.7-55.3) for cannabis use disorders. For both scales internal consistency (Cronbach's alpha > 0.71) and test-retest intraclass correlation coefficients (> 0.80) were good. The score 12 in the CAST-full discriminated better than others between presence and absence of dependence (27.0%; 95% CI: 21.4-32.6) while the score for discrimination of SUD was 9 (51.5%; 95% CI: 45.1-57.8). For the SDS the values were 7 (22.0%; 95% CI: 16.8-27.2) and 3 (64.7%; 95% CI: 58.7-70.8), respectively. According to proposed DSM-V criteria, for moderate and severe addiction the values for the CAST-f were 7 (68.5%; 95% CI: 62.5-74.3) and 12 (27%; 95% CI: 21.3-32.6) and for the SDS, 3 (65.0%; 95% CI: 58.7-70.8) and 7 (22%; 95% CI: 17.0-34.3), respectively. Conclusions: The CAST and SDS applied to young cannabis users are reliable and valid measures to detect cannabis use disorders when compared to both DSM-IV and proposed DSM-V criteria. © 2012 Elsevier Ltd.


Hoekzema E.,Autonomous University of Barcelona | Carmona S.,Autonomous University of Barcelona | Ramos-Quiroga J.A.,Hospital Universitari Vall dHebron | Ramos-Quiroga J.A.,Autonomous University of Barcelona | And 11 more authors.
Human Brain Mapping | Year: 2011

Experience-based neuroplasticity has typically been associated with functional changes, but growing evidence indicates that training can also render dynamic structural alterations in the brain. Although research on training-induced morphological plasticity has consistently demonstrated rapid increases of gray matter volume in task-related regions, no studies have examined if local volumetric reductions in gray matter associated with certain psychiatric disorders may be reversible by adequate training. We aimed to assess whether a training program applied to ADHD patients can contravene some of the associated neuroanatomical alterations. High-resolution anatomical scans were acquired before and after the training period, and a whole-brain tensor-based morphometric approach was applied to extract a voxel-wise estimation of longitudinal changes in regional gray matter volume. Our results show focal volumetric gray matter increases in bilateral middle frontal cortex and right inferior-posterior cerebellum after cognitive training compared with the ADHD control group. The extent of gray matter volume increase in the inferior-posterior cerebellum was associated with attentional performance. These findings illustrate the capacity of the nervous system for rapid morphological adjustments in response to environmental triggers. Moreover, the dorsolateral prefrontal cortex and cerebellum are commonly considered sites of volumetric reduction in ADHD, and the inferior-posterior lobule of the cerebellum is associated with progressive symptom-related volume loss. Hence, the clusters of volumetric change observed in our study were confined to structures typically characterized by volume reduction in ADHD patients, providing preliminary indications that cognitive training may contravene some of the neuroanatomical deficits associated with the disorder. © 2010 Wiley-Liss, Inc.


Buron E.,Institute Of Neuropsiquiatria I Addiccions
Actas españolas de psiquiatría | Year: 2013

The main objective of this study was to develop and validate a new olfactory measure that assesses the influence of olfaction on several emotional, behavioural, and cognitive issues: The Relational Scale of Olfaction (EROL). A secondary objective was to explore the relationship between the olfactory function and the anxiety and depression symptoms by means of EROL and the Hospital Anxiety and Depression Scale (HADS). A positive relationship between anxiety symptoms and the olfactory function was hypothesized. Regarding depressive symptoms, a significant relationship with the olfactory scores was not expected. Psychometric properties of EROL scale and correlations between HADS and EROL were tested in a sample from the general population. EROL showed an adequate level of test-retest reliability (ICC=.748) and good internal consistency (Cronbach's alpha=.761). Convergent validity with other olfactory measures was satisfactory. A one-factor solution was found for the scale. HADS showed a significant relationship with EROL (r=.280, p<.01), but the analysis through dimensions revealed that only the anxiety subscale correlated significantly and moderately with the olfactory measure (r=.325, p<.001), whereas the correlation with the depression subscale was non-significant (r=.146, p>.05). Given that EROL displayed good psychometrical properties, it appears as a suitable tool to assess the olfactory function in general population. The relationship between this olfactory scale and anxiety symptoms found in this study is an interesting issue that requires further research.

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