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Motor symptoms are frequent in patients with schizophrenia. Although recent DTI studies point to white matter alterations of the motor system in schizophrenia little is known about specific changes.
To date there is a lack of approaches with hypothesis driven quantification of specific anatomical fibre tracts. Therefore, we aimed to compare structural connectivity between specific parts of the motor system such as the pre-supplementary motor area (SMA), the SMA-proper, the primary motor cortex and the basal ganglia in patients with schizophrenia and in healthy controls in a DTI-fibre-tracking study.
It is the aim of this study to investigate whether fibre tract integrity of the motor system is altered in patients with schizophrenia.
DTI-data were measured in 21 patients with schizophrenia and in 21 healthy controls. Applying a probabilistic fibre tracking approach the most probable anatomical pathways between key regions of the motor system of each participant have been identified. The resulting probabilistic maps were normalized to obtain values between 0 and 1, normalized into the standard MNI-space and smoothed using an isotropic 3-mm Gaussian kernel. Group comparisons have been calculated using two-sample-t-tests.
First results point to altered fibre tract microstructure of loops including cortical motor areas and the basal ganglia. The data analysis is preliminary. Definite results will be presented at the conference.
Altered motor behaviour might be reflected by altered white matter integrity of loops including cortical motor areas and the basal ganglia.
Conventional treatment of auditory hallucinations in patients suffering from schizophrenia is successful in about 60-70% of cases. Therefore repetitive transcranial magnetic stimulation (rTMS) has been suggested to be promising alternative to conventional therapy. However, both positive and negative reports have recently been reported. Thus there seems to be responders and non-responders, but not yet any clear possibility how to identify responders. The aim of this study was to test if cerebral neuronal activity before treatment would be a possible biological marker of response to rTMS. Twenty four medicated patients underwent resting brain perfusion magnetic resonance imaging with arterial spin labeling (ASL) prior to rTMS treatment. Neuronal activity in the left superior temporal gyrus predicted the response to rTMS, suggesting this parameter as a possible bio-marker of response in patients with schizophrenia and auditory hallucinations. Being non-invasive and relatively easy to employ, ASL measurement before treatment might be a clinically relevant way to identify possible responders to rTMS in conventional treatment resistant patients.
Analysis and understanding of the role of hydrogen in metals is a significant challenge for the future of materials science, and this is a clear objective of recent work in the atom probe tomography (APT) community. Isotopic marking by deuteration has often been proposed as the preferred route to enable quantification of hydrogen by APT. Zircaloy-4 was charged electrochemically with hydrogen and deuterium under the same conditions to form large hydrides and deuterides. Our results from a Zr hydride and a Zr deuteride highlight the challenges associated with accurate quantification of hydrogen and deuterium, in particular associated with the overlap of peaks at a low mass-to-charge ratio and of hydrogen/deuterium containing molecular ions. We discuss possible ways to ensure that appropriate information is extracted from APT analysis of hydrogen in zirconium alloy systems that are important for nuclear power applications.
Atom probe tomography (APT) is rising in influence across many parts of materials science and engineering thanks to its unique combination of highly sensitive composition measurement and three-dimensional microstructural characterization. In this invited article, we have selected a few recent applications that showcase the unique capacity of APT to measure the local composition at structural defects. Whether we consider dislocations, stacking faults, or grain boundary, the detailed compositional measurements tend to indicate specific partitioning behaviors for the different solutes in both complex engineering and model alloys we investigated.
Las guías para el tratamiento de la depresión insisten uniformemente en que la farmacoterapia de la depresión debería ir acompañada de psicoterapia de apoyo y otras intervenciones psicoterapéuticas. Desconocemos la atención que prestan los psiquiatras de atención primaria a dichas terapias verbales.
En un estudio sobre el uso del fármaco venlafaxina se pidió a psiquiatras de consultas privada y de hospitales que explicaran qué terapias no farmacológicas consideraban como parte importante del tratamiento del episodio depresivo presente. Además, se evaluaron las características de los pacientes, las variables del tratamiento y las del ámbito de atención y del psiquiatra.
Los psiquiatras administraban terapias verbales al 19% de los pacientes ambulatorios y al 36,8% de los hospitalizados. Las terapias verbales se administraban con más frecuencia a pacientes más jóvenes, que tenían más diagnósticos dobles y que estaban más graves. Los pacientes que recibían terapias verbales tomaban más medicación psicotrópica. En el ámbito hospitalario, las terapias verbales se relacionaron, generalmente con más tratamiento global y con una tasa mayor de respuesta al tratamiento. En ambos ámbitos de tratamiento, las terapias verbales se relacionaron con tasas menores de abandono del antidepresivo.
Las interacciones verbales son parte de cualquier relación entre médico y paciente y deberían seguir guías teóricas como parte del proceso terapéutico de los trastornos depresivos. Teniendo esto en cuenta, la tasa de pacientes a los que los psiquiatras administraron alguna terapia verbal como parte explícita de su tratamiento podría ser mayor. Es necesaria más investigación sobre guías del paciente, consejo y psicoterapia de apoyo en psiquiatría.
Guidelines for the treatment of depression regularly emphasize that pharmacotherapy of depression should be accompanied by supportive counseling and other psychotherapeutic interventions. It is unknown which role psychiatrists in routine care give to such verbal therapies.
in a drug utilization study of venlafaxine, psychiatrists in private practice and in hospitals were asked to tell what non-pharmacological therapies they saw as an important part of the treatment of the present depressive episode. Additionally patient characteristics, treatment variables, setting characteristics and physician characteristics were assessed.
Psychiatrists reported some kind of verbal therapies in 19.0% of outpatients and 36.8% of inpatients. Verbal therapies were reported more often for younger patients, who got more double diagnoses and were more severely ill. Patients with verbal therapies got more psychotropic medication. in the inpatient setting verbal therapies were related to generally more treatment overall and a higher rate of treatment response. in both treatment settings verbal therapies were related to lower rates of discontinuation of the antidepressant.
Verbal interactions are part of any patient–physician encounter and should be theory guided as part of the therapeutic process in the treatment of depressive disorders. Under this assumption the rate of patients for which psychiatrists reported some kind of verbal therapy as explicit part of their treatment could be higher. More research is needed on patient guidance, counseling and supportive psychotherapy in psychiatry.
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