Neurocognitive deficits are known as a core feature in bipolar disorder (BPD). Persisting neurocognitive impairment is associated with low self-reported quality of life and low psychosocial functioning. Current findings indicate the importance of adjunctive psychosocial interventions in the treatment of BPD patients to enhance symptomatic and functional outcome.

To assess whether functional outcome in patients with BPD is affected by cognitive psychoeducational therapy, clinical parameters and cognitive impairment.

To identify potential predictors of functional outcome, global clinical impression and early recurrence in patients with BPD.

Using a neurocognitive test battery 43 patients with BPD in euthymic state were compared to 40 healthy controls. Patients were assigned to two treatment Conditions cognitive psychoeducational therapy over 14 weeks (n = 19, 12 female, age) and treatment-as-usual (n = 24, 14 female). Predictors for functional disability, global clinical impression and early recurrence including clinical and cognitive variables as well as treatment conditions were examined using logistic regression.

Compared to healthy controls patients with BPD showed lower performance in executive function (p < 0.01) and sustained attention (p < 0.001). Cognitive psychoeducation (p < 0.05) and subthreshold depressive symptoms (p < 0.05) were predictors for occupational functioning. Age (p < 0.05), delayed verbal memory (p < 0.05) and word fluency (p < 0.05) predicted global clinical impression. Recurrence in the follow-up period of 12 months was predicted by delayed verbal memory (p < 0.05).

Patients with BPD seem to benefit from cognitive psychoeducational training mainly in areas of working life. The extent of cognitive impairment appears to impact clinical outcome and recurrence rate.

Clinical studies point toward a potential role of the serotonin transporter (SERT) binding as a predictor of clinical outcome in the treatment of depression. After long-term treatment with clinical doses of SSRIs the expected SERT occupancy is about 80%. Here, we were interested to investigate the relationship of SERT occupancy values between short- and longterm treatment.

To test if the SERT occupancy at steady-state can be predicted based on the single dose occupancy by escitalopram (S-citalopram) or citalopram (racemate of S-citalopram and R-citalopram).

18 patients with major depressive disorder received either escitalpram (10 mg/d) or citalopram (20 mg/d) in a double-blind, randomized, longitudinal study. They underwent three PET scans using the radioligand [11C]DASB: PET1 baseline, PET2 6 hours after first drug intake and PET3 after three weeks of daily oral treatment. Occupancy of SERT was quantified in six subcortical regions: thalamus, N. caudatus, putamen, mibrain, dorsal raphe and median raphe nuclei. Data was analyzed by means of multiple linear regression models corrected for baseline SERT availability values using SPSS 15.0.

Single dose occupancy of the SERT significantly predicted steady-state occupancy after three weeks in three regions: thalamus (r2 = 0.45, p = 0.009), N. caudatus (r2 = 0.4, p = 0.006) and putamen (r2 = 0.43, p = 0.005). Other regions did not show significant relationships.

In this study we demonstrated that single-dose occupancy in SERT rich regions such as thalamus, N. caudatus and the putamen could serve as reliable predictors for steady-state occupancy. However, a linear model failed to explain the relationship in regions known for serotonergic cell origin.

While most neuroimaging studies have investigated acutely depressed patients, neural mechanisms underlying stable remission are rarely examined. Furthermore, the majority of previous functional MRI (fMRI) studies have focused on task-induced neural activity, while resting-state activity may be more reproducible across study centers.

To clarify patterns of functional coupling between subcortical structures and cortical resting state activity.

To determine whether alterations of functional coupling between the amygdala and cortical emotion processing regions characterize patients in the remitted phase of Major Depressive Disorder (rMDD).

Forty-three remitted depressed patients and thirty-five healthy controls were recruited at Medical University of Vienna, Vienna, Austria, and performed a six minute resting-state fMRI scan. The scans were corrected for slice timing and motion, as well as for mean white matter, mean CSF, and median gray matter signals. Seed time series were extracted using individual amygdala masks and correlated with all nodes in a surface based analysis using FreeSurfer, AFNI and SUMA. The resulting correlation coefficients were then Fisher-transformed, group results were determined by comparing group mean smoothed (to 8 mm FWHM) z-scores with a two-sample t-test.

Increased resting-state functional connectivity was revealed between amygdala (seed region) and posterior cingulate cortex as well as orbitofrontal cortex in the rMDD group compared to healthy controls.

Our preliminary results suggest altered functional coupling between amygdala and cortical emotion processing areas during resting state conditions, possibly representing a neural mechanism contributing to the maintenance of stable remission of MDD.

Although longitudinal magnetic resonance imaging (MRI) studies have shown that various brain regions undergo progressive tissue loss during the early phases of schizophrenia, regional pattern of these changes remain unclear.

Longitudinal MRI data were obtained from 18 (12 males and 6 females) patients with first-episode schizophrenia and 20 (11 males and 9 females) healthy controls and at baseline and follow-up with mean scan interval of 2.7 years. To compare gray matter changes over time between patients and controls were evaluated with voxel-based morphometry (VBM) using SPM8 following the longitudinal DARTEL protocol.

In both groups of patient and control longitudinal gray mater reduction was observed in various brain regions including lateral and medial frontal regions and superior temporal region. Excessive decrease in gray matter was found in patients as compared to healthy controls in the left superior temporal region and right inferior frontal region.

Our findings suggest that there are differing longitudinal gray matter changes in patients with schizophrenia during the early phases of the illness as compared to healthy individuals.

Alterations of the serotonin-1A receptor (5-HT1A) and the hypothalamic-pituitary-adrenal (HPA) axis have been reported in depression and anxiety disorders. We previously showed a strong negative correlation between cortisol plasma levels and 5-HT1A receptor binding potential (BP) in patients with social anxiety disorder but not in healthy controls using PET [1].

To investigate the relationship of cortisol and the 5-HT1A BP in postmenopausal women, a population that is at increased risk of suffering from depressive symptoms.

Subjects: 19 postmenopausal women, aged 55.26 ± 4.98, medication free, no current substance abuse or hormone replacement therapy.

Dynamic measurements (50 frames, 90 min) were performed using the radioligand [carbonyl-11C]WAY100635 and a GE-Advance scanner. PET data were normalized to a ligand-specific template [2]. Regions-of-interest (ROI) were defined as given in [3]. TACs within ROIs were averaged and the 5-HT1A receptor BP was quantified using Logan-plot and PMOD 3.1. Measurement of total cortisol plasma levels was done using electrochemoluminescence.

We found negative correlations between cortisol and 5-HT1A BP in the midbrain (Spearman's rs = −0.54, p = 0.02), the median raphe nucleus (rs = −0.47, p = 0.04) and the nucleus accumbens (rs = −0.505, p = 0.03).

In line with our previous findings [1], the observed negative association between cortisol plasma levels and 5-HT1A BP might reflect an increased vulnerability for mood disorders in postmenopausal women.

The subgenual part of the anterior cingulate cortex (sgACC) has been frequently reported to be structurally and cytoarchitectually changed in major depressive disorder (MDD) and is also a promising target in deep brain stimulation in treatment-resistant MDD. Furthermore, substantial evidence demonstrates a high density of serotonin-1A (5-HT1A) receptors in the sgACC, a key area involved in emotional processing.

Here, we investigated the relationship between the 5-HT1A receptor in the sgACC and changes in regional grey matter volume with voxel-based morphometry.

PET ([carbonyl-11C]WAY-100635) was used to quantify 5-HT1A receptor binding (BPND) together with structural magnetic resonance images from 32 healthy subjects (mean 26.68 ± 5.1 years; 17 women). Regression analysis was performed in SPM8 (p < .001 uncorr.) using sgACC 5-HT1A BPND as regressor, controlling for sex, age and total grey matter volume (GMV).

5-HT1A BPND in the sgACC was positively associated with regional GMV in the medial temporal gyri (T=4.37) and nucleus accumbens bilaterally (T = 4.19). Furthermore, sgACC 5-HT1A binding was negatively correlated with GMV within the inferior temporal gyri (T = 5.22) and putamen bilaterally (T = 5.12).

Our findings demonstrate structural relationships between sgACC 5-HT1A receptor binding and grey matter volume in the ventral striatum as well as in temporal regions, which both exhibit close neuronal connections with the sgACC. Moreover, the GMV of the ventral striatum has been reported to be decreased in patients with MDD. Conclusively, our results underpin the role of serotonergic neuronal transmission in cytoarchitectural processes within regions involved in the modulation of mood.

To evaluate 123-I mZIENT (2(S)-[(S)-2b-carbomethoxy-3b-[3′-((Z)-2-iodoethenyl)phenyl]nortropane), a novel radiopharmaceutical for imaging SERT. The bio-distribution of the radiopharmaceutical in humans was investigated and dosimetry performed.

The study includes three healthy volunteers and three patients receiving SSRIs. Whole body images obtained on a gamma camera at 10 minutes, 1, 2, 3, 6, 24 and 48 hours post administration. Dosimetry was performed. ROIs were drawn over the brain, heart, kidneys, liver, lungs, salivary glands, spleen, thyroid and intestines. Blood was sampled at 5, 15, & 30 minutes and 1, 2, 3, 6, 24 and 48 hours post administration. Urine was collected at 1, 2, 3, 4, 6, 24 and 48 hours. Brain SPECT images were obtained using a neuroSPECT scanner at 4 hours, evaluated visually and analysed using ROI analysis.

High quality SPECT images can be obtained after 100–150 MBq 123-ImZEINT. Regional brain uptake was observed in midbrain and basal ganglia in healthy volunteers, consistent with the known distribution of SERT. Biodistribution images demonstrated highest uptake in the lungs, brain, liver and intestines. The effective dose was within range of other commonly used ligands and is acceptable for clinical imaging.

123-ImZIENT is a promising agent for imaging SERT in humans with acceptable dosimetry.

This study was designed to apply subcortical analysis of first episode drug naïve major depressive disorder with panic disorder patients.

All the participating subjects received scales rating for depression and panic disorder. 15 patients and 15 healthy controls were compared to explore the differences of subcortical structures, such as hippocampus, putamen and thalamus. A new semi-automatic toolbox for computing subcortical areas by a shape and surface model was utilized for the comparison. The volumes of subcortical structures were also compared by using nonparametric t test of SPSS software to support the findings from the FSL FIRST toolbox (FMRIB Software Library, FMRIB's Integrated Registration and Segmentation Tool).

The patient group had significantly lower volumes in the left hippocampus, thalamus and putamen. The volumetric differences were also significant in these areas (2 tailed p < 0.05; Mann-Whitney U test). The volumes of thalamus and putamen were also well correlated with clinical rating scales. The relationship between left hippocampal volumes and clinical rating scales was modest. The volumes of right hippocampus were not correlated with clinical rating scales.

The structural abnormalities of putamen and thalamus might represent a specific pathology for major depressive disorder co-morbid with panic disorder. The limited deficits of hippocampal volumes should represent an intermediate type between major depressive disorder and panic disorder. The co-morbidity might have a different subcortical pathology.

Working memory deficits are considered a core feature of disturbed cognition in schizophrenia. Recent neuropsychological studies in twins suggest that there are shared genetic factors between schizophrenia and executive processes.

We used a co-twin control design to test the hypothesis that prefrontal activation during a working memory task is seen both in affected as well as unaffected twins discordant for schizophrenia, thus reflecting genetic load on this putative endophenotype.

As part of EUTwinsS, a multi-centre collaborative study on twins with schizophrenia, we obtained functional MRI scans during a Sternberg working memory task (with one maintenance and one manipulation variations) of twins discordant for schizophrenia (5 monozygotic pairs, 7 dizygotic pairs) and compared them to 10/4 healthy MZ/DZ twins, matched for age and gender.

Comparing the overall task-related effects (p < 0.001, uncorrected), we found stronger activation in control twins compared to either Sz-affected or unaffected twins in the right middle frontal gyrus and medial fronto-orbital cortex, and compared to Sz-affected twins also in the left cerebellum and right inferior occipital cortex. Comparing the manipulation vs. maintenance trials, healthy controls showed stronger activation than Sz-affected twins in the left hippocampus, but smaller in right caudate and anterior cingulate, while unaffected co-twins showed diminished right middle and left superior and middle frontal gyri compared to either group.

While diminished prefrontal activation in unaffected co-twins might indicate compensatory processes during executive control, the overall activation deficits are consistent with a genetic effect on prefrontal cortical efficiency.

Magnetic resonance spectroscopy (MRS) using 2D-chemical shift imaging (CSI) allows the quantification of brain metabolites in vivo across several brain regions. Previous studies using 31Phosphorus MRS have shown alterations of phospholipid compounds and high-energy phosphates like ATP in prefrontal and temporal regions in schizophrenia.

We used a monozygotic (MZ) co-twin study design to examine whether metabolic alterations are due to genetic effects or the expression of disease phenotype.

31P-MRS with 2D-CSI was applied at 1.5 T in 8 MZ twin pairs (3 male, 5 female; mean age 33.8, SD 13.1) discordant for a DSM-IV and ICD-10 diagnosis of either schizophrenia (4 pairs), acute schizophreniform psychosis (1 pair), or schizoaffective disorder (3 pairs)) and 8 age- and gender-matched healthy control MZ twins (mean age: 32.9, SD 14.3). Metabolic profiles were compared using oneway ANOVAs.

Voxel-wise comparisons between affected twins and healthy control twins revealed increased PDE concentrations in right cerebellum and increased ATP concentrations in right frontal cortex, insular cortex and bilateral cerebellum. Alterations in energy metabolism were shown in healthy co-twins compared to healthy control twins with an increase in PDE concentrations in right posterior lateral cerebellum, an increase in ATP concentration in left lateral prefrontal cortex as well as left anterior/ lateral temporal cortex and an increase in PCr in left lateral prefrontal cortex.

Our findings suggest that metabolic alterations in schizophrenia result from a combination of both genetic effects and disease manifestation, which can be further explored in larger twin samples.

White matter abnormalities have been repeatedly reported in both schizophrenia and bipolar disorder (BD) diseases from diffusion tensor imaging (DTI) studies respectively, while the empirical evidences about the diagnostic specificity of white matter abnormalities in these disorders are still limited.

25 patients with paranoid schizophrenia and 18 patients with bipolar mania were recruited from the in-patient unit of the Mental Health Centre, West China Hospital, China.

Patients were diagnosed according to the criteria of Diagnostic and Statistical Manual of Mental Disorders-Version IV (DSM- IV). 30 healthy controls were recruited from the community by means of leaflets distributed throughout Chengdu city.

This study sought to investigate the alterations in fractional anisotropy (FA) in white matter throughout the entire brain of patients from Chengdu, China with paranoid schizophrenia and bipolar mania.

Diffusion tensor imaging (DTI) was used to assess white matter integrity in patients with paranoid schizophrenia and bipolar mania, as well as in normal controls. The differences in FA were measured by use of voxel-based analysis.

Reduced FA was found in the left posterior corona radiate (PCR) in patients with bipolar mania and paranoid schizophrenia compared to the controls. Patients with bipolar mania also showed a significant reduction in FA in right posterior corona radiate and in right anterior thalamic radiation (ATR).

Common abnormalities in the left PCR might imply an overlap in white matter pathology of both diseases and might be related to the shared risk factors for both disorders.

While diagnosing Alzheimer’s disease, there appear certain difficulties in the correlation of cerebral atrophy and the patient's clinical status.

93 patients were examined.

Study group - 42 patients aged 34-79 with preclinical and clinical stages of Alzheimer’s disease:

1. (1) - patients with high risk of acquiring the disease (those suffering from impaired memory, without any manifestations of dementia, whose 2 or more immediate relatives suffered from Alzheimer’s disease) 6 patients

2. (2) - patients with mild dementia 14

3. (3) - patients with moderate dementia 15

4. (4) - patients with severe dementia 7

Control group - 51 patients aged 28–78 with various kinds of brain lesions accompanied by dementia but not suffering from Alzheimer’s disease:

1. - chronic cerebrovascular insufficiency 21 patients

2. - severe vascular dementia 6

3. - atherosclerotic parkinsonism 14

4. - Binswanger’s disease 6

5. - Parkinson’s disease 4

• In Study group 1, 4 (66.6%) patients showed decrease of 4–8% in the size of the brain temporal lobes.

• In Study group 2, 14 (100%) patients showed decrease of 9–18%.

• In Study group 3, 15 (100%) patients showed decrease of 19–32%.

• In Study group 4, 7 (100%) patients showed decrease of 33–62%.

Control group patients had no similar changes in the temporal lobes.

Structural and morphological changes of the brain characteristic for Alzheimer’s disease are atrophy of the temporal lobes and hippocampus which makes 4–8% in pre-clinical stages of the disease, 9–18% in mild, 19–32% in moderate and 33–62% in severe dementia.

N-acetil-aspartate (NAA) is located inside the soma and dendrites. Its believed to be an indirect indicator of the metabolic activity of these cells. Phosphomonoesters (PME) are involved in synthesis of neuronal membranes and phosphodiesters (PDE) in its degradation. Glutamine, an aminoacid produced by glial cells, is transported into the neurone for its transformation into glutamate and gamma aminobutyric acid.

Review clinical trials performed on schizophrenic patients with SF-MRI, with 31P y 1H, to measure concentration of NAA, PME, PDE and glutamine.

Detecting chemichal alterations that could be used as indicators in schizophrenia.

NAA concentration in temporal and frontal cortex of schizophrenic patients, are significantly lower than in healthy controls. In other trials, differences in NAA concentration (measured in prefrontal cortex) have not been found, comparing patients during their first psychotic episode and healthy controls. Lowered concentrations of PME and increased ones of PDE in prefrontal cortex of schizophrenic patients have been found. Glutamine levels are increased in schizophrenic patients, being directely correlated with the duration of the process. These levels are reduced when antipsychotic drugs are used.

The decrease on NAA levels at schizophrenia onset and on healthy relatives remark its value as an endophenotypical indicator, but not as an illness indicator. Changes on PME and PDE concentrations cannot be used as illness indicators. The increase on glutamine synthesis could be due to glutamatergic hypofunction in schizophrenic patients, but there are other factors that may cause it, so it cannot be used as an indicator.

Different meditation practices reportedly affect brain electric activity.

To assess common characteristics in brain electric activity during the state of meditation across different meditation traditions.

Do meditation traditions share commonalities in EEG spectral power changes from task-free resting to meditation?

Data from 71 experienced meditators of five meditation traditions were analyzed (13 Tibetan Buddhists, 15 Qigong, 14 Shaja Yoga, 14 Ananda Marga Yoga, and 15 Zen). Power spectral results of multichannel EEG recordings (average reference) during meditation were compared with those during pre- and post-meditation task-free resting. Spectra were averaged across channels (19–58), and subject-wise normalized. Integrated power was computed for the eight independent frequency bands (delta through gamma).

During meditation compared to the average of pre- and post-meditation resting, across the five traditions, there was a significant decrease of power in the alpha-2 band (10.5–12 Hz), and significant increases of power in the beta-3 (21.5–30 Hz) and gamma (35–44 Hz) bands; theta (6.5–8 Hz) band power showed an increase at p = 0.14.

The results indicate that EEG spectral power differences between task-free resting state EEG versus meditation state EEG show communalities that are shared by all five meditation traditions in spite of important differences in meditation techniques.

The measure of complex dimensionality assesses the number of independent processes that generate an observed time series.

To investigate whether meditation exercises are associated with fewer or more independently active brain processes, and whether different meditation traditions show different results.

Does brain electric complex dimensionality differ between the state of meditation and of task free resting in different meditation traditions?

Multichannel EEG recordings (19 to 25 channels) from experienced meditators of five meditation traditions (13 Tibetan Buddhists, 15 Qigong, 14 Shaja Yoga, 14 Ananda Marga Yoga, and 15 Zen) were analyzed (bandpass 1.5–30 Hz) using ‘Omega Complexity’ that obtains a single value for a set of simultaneously recorded EEG time series from a given person (J. Wackermann, Acta Neurobiol Exp (Wars) 1996;56:197–208). Omega Complexity during meditation was compared to the mean of Omega Complexity during pre- and post-meditation resting.

During meditation relative to resting (paired t tests), Omega Complexity was higher in all five traditions, significant for Tibetan Buddhists (p = 0.01), Ananda Marga Yoga (p = 0.007) and Zen (p = 0.0003).

The subjectively experienced agreeable feelings during meditation apparently occur, across meditation traditions, during a brain functional state that is characterized by an increase of independent brain processes compared to task free resting.

Arithmetic reportedly involves left parietal areas.

To test this in independent groups of healthy persons.

Which brain regions are activated / inhibited during mental arithmetic compared to task-free resting?

We examined four independent groups of healthy adults (N = 15, 14, 14, 23, respectively) during simple arithmetic (continuous subtraction of 7) and task-free resting before and after arithmetic, all with closed eyes. Multichannel head surface EEG (19–58 channels) was continually recorded, then recomputed (using sLORETA functional tomography) into current density for 6239 cortical voxels, for each of the eight EEG frequency bands (delta through gamma, 1.5–44 Hz). Pre- and post-arithmetic resting was averaged. Using paired t-tests, frequency band-wise normalized and log-transformed current density was compared between arithmetic and resting for each group. The resulting p-values were combined across groups using Fisher’s combination procedure. For each frequency band, sLORETA voxels differing between conditions at Fisher’s (across groups) p < 0.05 were computed into centers of gravity separately for increased and decreased activation.

Activity that was stronger during arithmetic compared to resting had gravity centers in midline anterior regions for slow frequency bands (delta, theta, alpha-1) and in right posterior regions for fast frequency bands (alpha-2 through gamma). Activity that was weaker during arithmetic compared to resting was centered around left parietal areas for all eight frequency bands.

The results suggest that arithmetic compared to resting involves frontal inhibition coupled with increased right parietal activation, and left parietal reduced facilitatory and reduced inhibitory activity.

The purpose of this study was to test whether such aberrant connectivity, if existent, can be modulated by a task involving the challenge of attention, working memory and executive functioning.

A functional magnetic resonance imaging (fMRI) experiment alternating between periods of “rest” and periods of visual stimulation with successive series of pictures extracted from the Wechsler Adult Intelligence Scale-III was carried out in seven patients with new onset schizophrenia according to the DSM-IV criteria and in six healthy control subjects matched for sex, age, and education. The DMN was extracted by using independent component analysis (ICA). The degree of deactivation during periods of stimulation was tested by means of a correlation analysis. To determine the existence of differences in deactivation between patients and controls, we used a non-parametric statistical test.

An overall increased activation of the DMN in patients with schizophrenia relative to control subjects seems to occur. There was also an almost significant difference in the degree of deactivation between the two groups (controls>patients, p = 0.05).

Aberrant connectivity of the DMN is indeed a consistent feature in schizophrenia. An altered deactivation of the DMN during a highly demanding task in patients with schizophrenia confirms previous results suggesting an abnormal behaviour of networks in the transition from “rest” to goal-directed activity.

The UK NICE technology guidance “Structural Neuroimaging in First-Episode Psychosis” concludes that CT/MRI is not routinely recommended as an initial investigation for first-episode psychosis.

To evaluate the use of CT/MRI in a group of Early Intervention Service (EIS) patients with a first-episode psychosis aged 18–35 years at presentation.

To develop practice guidelines for use of neuroimaging in first-episode psychosis.

All 107 patients registered with the EIS in Hounslow, London, UK, were eligible for inclusion in this review. Data was collected from the medical records and the Picture Archiving and Communications System. Data was analysed using a microsoft excel data analysis tool. Additionally, comparisons were made between the group of patients with normal scans and that with abnormal scans. Statistical significance was determined using the chi-squared method with a significance of P < 0.05.

17 patients had documented neuroimaging results. 4 scans were abnormal. There was no significant difference between the group with normal and abnormal scans in terms of gender, abnormalities of physical/neurological health, blood tests and whether the patient had any additional medical conditions. Abnormal scan results did not influence treatment or outcome for any patient.

The abnormal scans were not correlated to clinical indices of history, examination and laboratory tests. Abnormal scans appear to have a low yield in terms of clinical effectiveness. The findings support selective use of neuroimaging in this cohort of patients. The indications for it usage would appear to rely on clinical judgement as well clinical findings.