Neuroimaging-based biomarkers for treatment selection in major depressive disorder.
Authors: Dunlop BW, Mayberg HS Abstract The use of neuroimaging approaches to identify likely treatment outcomes in patients with major depressive disorder is developing rapidly. Emerging work suggests that resting state pretreatment metabolic activity in the fronto-insular cortex may distinguish between patients likely to respond to psychotherapy or medication and may function as a treatment-selection biomarker. In contrast, high metabolic activity in the subgenual anterior cingulate cortex may be predictive of poor outcomes to both medication and psychotherapy, suggesting that nonstandard treatments may be pursue...
Source: Dialogues in Clinical Neuroscience - March 5, 2015 Category: Neuroscience Tags: Dialogues Clin Neurosci Source Type: research

Neuroimaging biomarkers to predict treatment response in schizophrenia: the end of 30 years of solitude?
Authors: Dazzan P Abstract Studies that have used structural magnetic resonance imaging (MRI) suggest that individuals with psychoses have brain alterations, particularly in frontal and temporal cortices, and in the white matter tracts that connect them. Furthermore, these studies suggest that brain alterations may be particularly prominent, already at illness onset, in those individuals more likely to have poorer outcomes (eg, higher number of hospital admissions, and poorer symptom remission, level of functioning, and response to the first treatment with antipsychotic drugs). The fact that, even when present, the...
Source: Dialogues in Clinical Neuroscience - March 5, 2015 Category: Neuroscience Tags: Dialogues Clin Neurosci Source Type: research

Clinical predictors of therapeutic response to antipsychotics in schizophrenia.
Authors: Carbon M, Correll CU Abstract The search for clinical outcome predictors for schizophrenia is as old as the field of psychiatry. However, despite a wealth of large, longitudinal studies into prognostic factors, only very few clinically useful outcome predictors have been identified. The goal of future treatment is to either affect modifiable risk factors, or use nonmodifiable factors to parse patients into therapeutically meaningful subgroups. Most clinical outcome predictors are nonspecific and/or nonmodifiable. Nonmodifiable predictors for poor odds of remission include male sex, younger age at disease o...
Source: Dialogues in Clinical Neuroscience - March 5, 2015 Category: Neuroscience Tags: Dialogues Clin Neurosci Source Type: research

Intermediate phenotypes and biomarkers of treatment outcome in major depressive disorder.
Authors: Leuchter AF, Hunter AM, Krantz DE, Cook IA Abstract Major depressive disorder (MDD) is a pleomorphic illness originating from gene x environment interactions. Patients with differing symptom phenotypes receive the same diagnosis and similar treatment recommendations without regard to genomics, brain structure or function, or other physiologic or psychosocial factors. Using this present approach, only one third of patients enter remission with the first medication prescribed, and patients may take longer than 1 year to enter remission with repeated trials. Research to improve treatment effectiveness recentl...
Source: Dialogues in Clinical Neuroscience - March 5, 2015 Category: Neuroscience Tags: Dialogues Clin Neurosci Source Type: research

Using biomarkers to predict treatment response in major depressive disorder: evidence from past and present studies.
Authors: Thase ME Abstract Major depressive disorder (MDD) is a heterogeneous condition with a variable response to a wide range of treatments. Despite intensive efforts, no biomarker has been identified to date that can reliably predict response or non-response to any form of treatment, nor has one been identified that can be used to identify those at high risk of developing treatment-resistant depression (ie, non-response to a sequence of treatments delivered for adequate duration and intensity). This manuscript reviews some past areas of research that have proved informative, such as studies using indexes of hyp...
Source: Dialogues in Clinical Neuroscience - March 5, 2015 Category: Neuroscience Tags: Dialogues Clin Neurosci Source Type: research

Prediction of individual response to antidepressants and antipsychotics: an integrated concept.
Authors: Preskorn SH Abstract In both clinical trials and daily practice, there can be substantial inter- and even intraindividual variability in response-whether beneficial or adverse-to antidepressants and antipsychotic medications. So far, no tools have become available to predict the outcome of these treatments in specific patients. This is because the causes of such variability are often not known, and when they are, there is no way of predicting the effects of their various potential combinations in an individual. Given this background, this paper presents a conceptual framework for understanding known factor...
Source: Dialogues in Clinical Neuroscience - March 5, 2015 Category: Neuroscience Tags: Dialogues Clin Neurosci Source Type: research

Pharmacogenetics and outcome with antipsychotic drugs.
Authors: Pouget JG, Shams TA, Tiwari AK, Müller DJ Abstract Antipsychotic medications are the gold-standard treatment for schizophrenia, and are often prescribed for other mental conditions. However, the efficacy and side-effect profiles of these drugs are heterogeneous, with large interindividual variability. As a result, treatment selection remains a largely trial-and-error process, with many failed treatment regimens endured before finding a tolerable balance between symptom management and side effects. Much of the interindividual variability in response and side effects is due to genetic factors (heritabil...
Source: Dialogues in Clinical Neuroscience - March 5, 2015 Category: Neuroscience Tags: Dialogues Clin Neurosci Source Type: research

Ethical and public policy challenges for pharmacogenomics.
Authors: Gershon ES, Alliey-Rodriguez N, Grennan K Abstract It is timely to consider the ethical and social questions raised by progress in pharmacogenomics, based on the current importance of pharmacogenomics for avoidance of predictable side effects of drugs, and for correct choice of medications in certain cancers. It has been proposed that the entire population be genotyped for drug-metabolizing enzyme polymorphisms, as a measure that would prevent many untoward and dangerous drug reactions. Pharmacologic treatment targeting based on genomics of disease can be expected to increase greatly in the coming years. P...
Source: Dialogues in Clinical Neuroscience - March 5, 2015 Category: Neuroscience Tags: Dialogues Clin Neurosci Source Type: research

Complicated grief in Aboriginal populations.
Authors: Spiwak R, Sareen J, Elias B, Martens P, Munro G, Bolton J Abstract To date there have been no studies examining complicated grief (CG) in Aboriginal populations. Although this research gap exists, it can be hypothesized that Aboriginal populations may be at increased risk for CG, given a variety of factors, including increased rates of all-cause mortality and death by suicide. Aboriginal people also have a past history of multiple stressors resulting from the effects of colonization and forced assimilation, a significant example being residential school placement. This loss of culture and high rates of tra...
Source: Dialogues in Clinical Neuroscience - November 12, 2014 Category: Neuroscience Tags: Dialogues Clin Neurosci Source Type: research

Complicated grief in those bereaved by violent death: the effects of post-traumatic stress disorder on complicated grief.
Authors: Nakajima S, Ito M, Shirai A, Konishi T Abstract Violent death, such as homicide, accident, and suicide, is sudden, unexpected, and caused by intentional power, The prevalence of complicated grief among those bereaved by violent death is 12.5% to 78.0%. The factors affecting this prevalence rate are considered to be comorbid mental disorders, lack of readiness for the death, difficulty in making sense of the death, high level of negative appraisal about the self and others, and various social stressors. Post-traumatic stress disorder is, in particular, considered to contribute to the development of complica...
Source: Dialogues in Clinical Neuroscience - November 12, 2014 Category: Neuroscience Tags: Dialogues Clin Neurosci Source Type: research

The importance of autism research.
Authors: Thurm A, Swedo SE Abstract This editorial discusses the importance of autism research, noting areas of progress and ongoing challenges and focusing on studies of the etiology, pathophysiology, and treatment of autism spectrum disorders. PMID: 23226948 [PubMed - indexed for MEDLINE] (Source: Dialogues in Clinical Neuroscience)
Source: Dialogues in Clinical Neuroscience - November 12, 2014 Category: Neuroscience Tags: Dialogues Clin Neurosci Source Type: research

Classification of autism and related conditions: progress, challenges, and opportunities.
Authors: Volkmar FR, Reichow B, McPartland J Abstract Since Kanner's classic description of the syndrome of early infantile autism in 1943, conceptions of the disorder have evolved while retaining important continuity with what Kanner viewed as the hallmarks of the condition-social impairment (autism) and difficulties in dealing with change in the nonsocial world (insistence on sameness). This paper reviews the history of this evolution and the important potential advantages and disadvantages of changes being contemplated for DSM-5. The convergence of diagnostic approach in DSM-IV and ICD-10 provided a shared syste...
Source: Dialogues in Clinical Neuroscience - November 12, 2014 Category: Neuroscience Tags: Dialogues Clin Neurosci Source Type: research

Lighting a path: genetic studies pinpoint neurodevelopmental mechanisms in autism and related disorders.
Authors: Pescosolido MF, Yang U, Sabbagh M, Morrow EM Abstract In this review, we outline critical molecular processes that have been implicated by discovery of genetic mutations in autism. These mechanisms need to be mapped onto the neurodevelopment step(s) gone awry that may be associated with cause in autism. Molecular mechanisms include: (i) regulation of gene expression; (ii) pre-mRNA splicing; (iii) protein localization, translation, and turnover; (iv) synaptic transmission; (v) cell signaling; (vi) the functions of cytoskeletal and scaffolding proteins; and (vii) the function of neuronal cell adhesion molecu...
Source: Dialogues in Clinical Neuroscience - November 12, 2014 Category: Neuroscience Tags: Dialogues Clin Neurosci Source Type: research

The relationship of Rett syndrome and MECP2 disorders to autism.
Authors: Neul JL Abstract Rett syndrome (RTT, MIM#312750) is a neurodevelopmental disorder that is classified as an autism spectrum disorder. Clinically, RTT is characterized by psychomotor regression with loss of volitional hand use and spoken language, the development of repetitive hand stereotypies, and gait impairment. The majority of people with RTT have mutations in Methyl-CpG-binding Protein 2 (MECP2), a transcriptional regulator. Interestingly, alterations in the function of the protein product produced by MECP2, MeCP2, have been identified in a number of other clinical conditions. The many clinical feature...
Source: Dialogues in Clinical Neuroscience - November 12, 2014 Category: Neuroscience Tags: Dialogues Clin Neurosci Source Type: research

Pharmacologic treatments for the behavioral symptoms associated with autism spectrum disorders across the lifespan.
Authors: Doyle CA, McDougle CJ Abstract This review outlines pharmacologic treatments for the behavioral symptoms associated with autism spectrum disorders (ASDs) in children, adolescents, and adults. Symptom domains include repetitive and stereotyped behaviors, irritability and aggression, hyperactivity and inattention, and social impairment. Medications covered include serotonin reuptake inhibitors (SRIs), mirtazapine, antipsychotics, psychostimulants, atomoxetine, α-2 agonists, D-cycloserine, and memantine. Overall, SRIs are less efficacious and more poorly tolerated in children with ASDs than in adults. A...
Source: Dialogues in Clinical Neuroscience - November 12, 2014 Category: Neuroscience Tags: Dialogues Clin Neurosci Source Type: research

Autism risk factors: genes, environment, and gene-environment interactions.
Authors: Chaste P, Leboyer M Abstract The aim of this review is to summarize the key findings from genetic and epidemiological research, which show that autism is a complex disorder resulting from the combination of genetic and environmental factors. Remarkable advances in the knowledge of genetic causes of autism have resulted from the great efforts made in the field of genetics. The identification of specific alleles contributing to the autism spectrum has supplied important pieces for the autism puzzle. However, many questions remain unanswered, and new questions are raised by recent results. Moreover, given the...
Source: Dialogues in Clinical Neuroscience - November 12, 2014 Category: Neuroscience Tags: Dialogues Clin Neurosci Source Type: research

Translational animal models of autism and neurodevelopmental disorders.
Authors: Crawley JN Abstract Autism is a neurodevelopmental disorder whose diagnosis is based on three behavioral criteria: unusual reciprocal social interactions, deficits in communication, and stereotyped repetitive behaviors with restricted interests. A large number of de novo single gene mutations and chromosomal deletions are associated with autism spectrum disorders. Based on the strong genetic evidence, mice with targeted mutations in homologous genes have been generated as translational research tools. Mouse models of autism have revealed behavioral and biological outcomes of mutations in risk genes. The fi...
Source: Dialogues in Clinical Neuroscience - November 12, 2014 Category: Neuroscience Tags: Dialogues Clin Neurosci Source Type: research

Mechanisms of change in psychosocial interventions for autism spectrum disorders.
This article describes methods for assessing such mechanisms (ie, mediators and moderators) and presents promising candidates for common mechanisms impacting treatment response: behavior modification, therapeutic relationship, social knowledge, social motivation, social information processing, executive functioning, and internalizing comorbidities. Finally, future directions are discussed as a program of psychosocial intervention research designed to identify predictors of individual differences in treatment response (including biomarkers), isolate active therapeutic ingredients, and promote dissemination of optimized inte...
Source: Dialogues in Clinical Neuroscience - November 12, 2014 Category: Neuroscience Tags: Dialogues Clin Neurosci Source Type: research

Functional magnetic resonance imaging of autism spectrum disorders.
Authors: Dichter GS Abstract This review presents an overview of functional magnetic resonance imaging findings in autism spectrum disorders (ASDS), although there is considerable heterogeneity with respect to results across studies, common themes have emerged, including: (i) hypoactivation in nodes of the "social brain" during social processing tasks, including regions within the prefrontal cortex, the posterior superior temporal sulcus, the amygdala, and the fusiform gyrus; (ii) aberrant frontostriatal activation during cognitive control tasks relevant to restricted and repetitive behaviors and interest...
Source: Dialogues in Clinical Neuroscience - November 12, 2014 Category: Neuroscience Tags: Dialogues Clin Neurosci Source Type: research

Temporal organization as a therapeutic target.
Authors: Wirz-Justice A Abstract Biological functions occur at many different frequencies, and each has its healthy and pathological ranges, patterns, and properties. Physiology, biochemistry, and behavior are not only organized at the morphological level in cells and organs, but separated or coordinated in time for minimal interference and optimal function. One of the most important temporal frameworks is that of the 24-hour day-night cycle, and its change in day length with season. Robust circadian rhythms are important for mental and physical well-being. Though rhythms have been long neglected as irrelevant (in ...
Source: Dialogues in Clinical Neuroscience - November 12, 2014 Category: Neuroscience Tags: Dialogues Clin Neurosci Source Type: research

Brain rhythms and neural syntax: implications for efficient coding of cognitive content and neuropsychiatric disease.
Authors: Buzsáki G, Watson BO Abstract The perpetual activity of the cerebral cortex is largely supported by the variety of oscillations the brain generates, spanning a number of frequencies and anatomical locations, as well as behavioral correlates. First, we review findings from animal studies showing that most forms of brain rhythms are inhibition-based, producing rhythmic volleys of inhibitory inputs to principal cell populations, thereby providing alternating temporal windows of relatively reduced and enhanced excitability in neuronal networks. These inhibition-based mechanisms offer natural temporal fr...
Source: Dialogues in Clinical Neuroscience - November 12, 2014 Category: Neuroscience Tags: Dialogues Clin Neurosci Source Type: research

Biological rhythms and mood disorders.
Authors: Salvatore P, Indic P, Murray G, Baldessarini RJ Abstract Integration of several approaches concerning time and temporality can enhance the pathophysiological study of major mood disorders of unknown etiology. We propose that these conditions might be interpreted as disturbances of temporal profile of biological rhythms, as well as alterations of time-consciousness. Useful approaches to study time and temporality include philological suggestions, phenomenological and psychopathological conceptualizatíons, clinical descriptions, and research on circadian and ultradían rhythms, as well as nonlin...
Source: Dialogues in Clinical Neuroscience - November 12, 2014 Category: Neuroscience Tags: Dialogues Clin Neurosci Source Type: research

The effects of extremely low-frequency magnetic fields on melatonin and cortisol, two marker rhythms of the circadian system.
Authors: Touitou Y, Selmaoui B Abstract In the past 30 years the concern that daily exposure to extremely low-frequency magnetic fields (ELF-EMF) (1 to 300 Hz) might be harmful to human health (cancer, neurobehavioral disturbances, etc) has been the object of debate, and has become a public health concern. This has resulted in the classification of ELF-EMF into category 2B, ie, agents that are "possibly carcinogenic to humans" by the International Agency for Research on Cancer. Since melatonin, a neurohormone secreted by the pineal gland, has been shown to possess oncostatic properties, a "melatonin ...
Source: Dialogues in Clinical Neuroscience - November 12, 2014 Category: Neuroscience Tags: Dialogues Clin Neurosci Source Type: research

Antidepressant chronotherapeutics for bipolar depression.
Authors: Benedetti F Abstract Chronotherapeutics refers to treatments based on the principles of circadian rhythm organization and sleep physiology, which control the exposure to environmental stimuli that act on biological rhythms, in order to achieve therapeutic effects in the treatment of psychiatric conditions. It includes manipulations of the sleep-wake cycle such as sleep deprivation and sleep phase advance, and controlled exposure to light and dark. The antidepressant effects of chronotherapeutics are evident in difficult-to-treat conditions such as bipolar depression, which has been associated with extremel...
Source: Dialogues in Clinical Neuroscience - November 12, 2014 Category: Neuroscience Tags: Dialogues Clin Neurosci Source Type: research

Polysomnographic evaluation of sleep quality and quantitative variables in women as a function of mood, reproductive status, and age.
Authors: Orff HJ, Meliska CJ, Lopez A, Martinez F, Sorenson D, Parry BL Abstract This archival cross-sectional investigation examined the impact of mood, reproductive status (RS), and age on polysomnographic (PSG) measures in women. PSG was performed on 73 normal controls (NC) and 64 depressed patients (DP), in the course of studies in menstruating, pregnant, postpartum, and peri- and postmenopausal women. A two-factor, between-subjects multivariate analysis of variance (MANOVA) was used to test the main effects of reproductive status (RS: menstrual vs pregnant vs postpartum vs menopausal) and diagnosis (NC vs DP),...
Source: Dialogues in Clinical Neuroscience - November 12, 2014 Category: Neuroscience Tags: Dialogues Clin Neurosci Source Type: research

A neuropsychological approach to time estimation.
Authors: Perbal-Hatif S Abstract Time estimation, within a range of seconds, involves cognitive functions which depend on multiple brain regions. Here we report on studies investigating the reproduction and production of three durations (5, 14, and 38 seconds) in four groups of patients. The amnesic patient underproduced the length of the long durations because of episodic memory deficit following bilateral medial temporal lesions. Epileptic patients (n = 9) with right medial temporal lobe resections underproduced the three durations because of a distorted representation of time in long-term memory. Traumatic brain...
Source: Dialogues in Clinical Neuroscience - November 12, 2014 Category: Neuroscience Tags: Dialogues Clin Neurosci Source Type: research

The manifold definitions of time.
Authors: Oestreicher C Abstract We are unable, using our five senses, to feel time, nor, using our intelligence, to define it, because we stand inexorably within time. We achieve a representation of time through evaluation of changes in ourselves and in our environment. This is made possible by memory functions. What if time only existed as a construct in our minds, and what if the absence of this construct made our mode of thinking uncomfortable to us? If our two major tools for constructing our world, feeling and reasoning, are of little help, then the study of time, ie, chronology, might exist as a list of scien...
Source: Dialogues in Clinical Neuroscience - November 12, 2014 Category: Neuroscience Tags: Dialogues Clin Neurosci Source Type: research

Time representations in social science.
Authors: Schulz Y Abstract Time has long been a major topic of study in social science, as in other sciences or in philosophy. Social scientists have tended to focus on collective representations of time, and on the ways in which these representations shape our everyday experiences. This contribution addresses work from such disciplines as anthropology, sociology and history. It focuses on several of the main theories that have preoccupied specialists in social science, such as the alleged "acceleration" of life and overgrowth of the present in contemporary Western societies, or the distinction between so...
Source: Dialogues in Clinical Neuroscience - November 12, 2014 Category: Neuroscience Tags: Dialogues Clin Neurosci Source Type: research

Light and chronobiology: implications for health and disease.
Authors: Münch M, Bromundt V Abstract Environmental light synchronizes the primary mammalian biological clock in the suprachiasmatic nuclei, as well as many peripheral clocks in tissues and cells, to the solar 24-hour day. Light is the strongest synchronizing agent (zeitgeber) for the circadian system, and therefore keeps most biological and psychological rhythms internally synchronized, which is important for optimum function. Circadian sleep-wake disruptions and chronic circadian misalignment, as often observed in psychiatric and neurodegenerative illness, can be treated with light therapy. The beneficial ef...
Source: Dialogues in Clinical Neuroscience - November 12, 2014 Category: Neuroscience Tags: Dialogues Clin Neurosci Source Type: research

Diogenes syndrome in patients suffering from dementia.
Authors: Cipriani G, Lucetti C, Vedovello M, Nuti A Abstract Diogenes syndrome (DS) is a behavioral disorder of the elderly. Symptoms include living in extreme squalor, a neglected physical state, and unhygienic conditions. This is accompanied by a self-imposed isolation, the refusal of external help, and a tendency to accumulate unusual objects. To explore the phenomenon of DS in dementia we searched for the terms: "Diogenes syndrome, self-neglect, dementia. " It has long been understood that individuals with dementia often become shut-ins, living in squalor, in the Eastern Baltimore study, dementia was ...
Source: Dialogues in Clinical Neuroscience - November 12, 2014 Category: Neuroscience Tags: Dialogues Clin Neurosci Source Type: research

Aging and neuroplasticity.
Authors: Smith GS Abstract Neuroplasticity can be defined as a final common pathway of neurobiological processes, including structural, functional or molecular mechanisms, that result in stability or compensation for age- or disease-related changes. The papers in this issue address the aging process, as well as depression, dementia, and stroke and a range of interventions, including manipulations in behavior (physical and cognitive activity/exercise), physiological factors (caloric restriction, cholesterol), pharmacologic treatments (AMPA receptors) and manipulation of brain magnetic fields and electrical activity ...
Source: Dialogues in Clinical Neuroscience - November 12, 2014 Category: Neuroscience Tags: Dialogues Clin Neurosci Source Type: research

AMPA receptor trafficking and the mechanisms underlying synaptic plasticity and cognitive aging.
Authors: Henley JM, Wilkinson KA Abstract Even in healthy individuals there is an inexorable agerelated decline in cognitive function. This is due, in large part, to reduced synaptic plasticity caused by changes in the molecular composition of the postsynaptic membrane. AMPA receptors (AMPARs) are glutamate-gated cation channels that mediate the overwhelming majority of fast excitatory transmission in the brain. Changes in AMPAR number and/or function are a core feature of synaptic plasticity and age-related cognitive decline, AMPARs are highly dynamic proteins that are subject to highly controlled trafficking, rec...
Source: Dialogues in Clinical Neuroscience - November 12, 2014 Category: Neuroscience Tags: Dialogues Clin Neurosci Source Type: research

Neuropathological approaches to cerebral aging and neuroplasticity.
Authors: Jellinger KA, Attems J Abstract Cerebral aging is a complex and heterogenous process related to a large variety of molecular changes involving multiple neuronal networks, due to alterations of neurons (synapses, axons, dendrites, etc), particularly affecting strategically important regions, such as hippocampus and prefrontal areas. A substantial proportion of nondemented, cognitively unimpaired elderly subjects show at least mild to moderate, and rarely even severe, Alzheimer-related lesions, probably representing asymptomatic preclinical Alzheimer's disease, and/or mixed pathologies. While the substrate o...
Source: Dialogues in Clinical Neuroscience - November 12, 2014 Category: Neuroscience Tags: Dialogues Clin Neurosci Source Type: research

Successful brain aging: plasticity, environmental enrichment, and lifestyle.
Authors: Mora F Abstract Aging is a physiological process that can develop without the appearance of concurrent diseases. However, very frequently, older people suffer from memory loss and an accelerated cognitive decline. Studies of the neurobiology of aging are beginning to decipher the mechanisms underlying not only the physiology of aging of the brain but also the mechanisms that make people more vulnerable to cognitive dysfunction and neurodegenerative diseases. Today we know that the aging brain retains a considerable functional plasticity, and that this plasticity is positively promoted by genes activated by...
Source: Dialogues in Clinical Neuroscience - November 12, 2014 Category: Neuroscience Tags: Dialogues Clin Neurosci Source Type: research

Molecular aging of the brain, neuroplasticity, and vulnerability to depression and other brain-related disorders.
Authors: Sibille E Abstract The increased risk for neurodegenerative and neuropsychiatric disorders associated with extended lifespan has long suggested mechanistic links between chronological age and brain-related disorders, including depression, Recent characterizations of age-dependent gene expression changes now show that aging of the human brain engages a specific set of biological pathways along a continuous lifelong trajectory, and that the same genes that are associated with normal brain aging are also frequently and similarly implicated in depression and other brain-related disorders. These correlative obs...
Source: Dialogues in Clinical Neuroscience - November 12, 2014 Category: Neuroscience Tags: Dialogues Clin Neurosci Source Type: research

Pharmacologic approaches to cerebral aging and neuroplasticity: insights from the stroke model.
Authors: Chollet F Abstract Brain plasticity is an intrinsic characteristic of the nervous system that allows continuous remodeling of brain functions in pathophysiological conditions. Although normal aging is associated with morphological modifications and decline of cerebral functions, brain plasticity is at least partially preserved in elderly individuals. A growing body of evidence supports the notion that cognitive enrichment and aerobic training induce a dynamic reorganization of higher cerebral functions, thereby helping to maintain operational skills in the elderly and reducing the incidence of dementia. Th...
Source: Dialogues in Clinical Neuroscience - November 12, 2014 Category: Neuroscience Tags: Dialogues Clin Neurosci Source Type: research

Chronic depression as a model disease for cerebral aging.
Authors: Bewernick BH, Schlaepfer TE Abstract Conceptualizations of the underlying neurobiology of major depression have changed their focus from dysfunctions of neurotransmission to dysfunctions of neurogenesis and neuroprotection. The "neurogenesis hypothesis of depression" posits that changes in the rate of neurogenesis are the underlying mechanism in the pathology and treatment of major depression. Stress, neuroinflammation, dysfunctional insulin regulation, oxidative stress, and alterations in neurotrophic factors possibly contribute to the development of depression. The influence of antidepressant t...
Source: Dialogues in Clinical Neuroscience - November 12, 2014 Category: Neuroscience Tags: Dialogues Clin Neurosci Source Type: research

Applications of transcranial magnetic stimulation and magnetic seizure therapy in the study and treatment of disorders related to cerebral aging.
Authors: Luber B, McClintock SM, Lisanby SH Abstract Transcranial magnetic stimulation (TMS) can be used to probe cortical function and treat neuropsychiatric illnesses. TMS has demonstrated neuroplastic effects akin to long-term potentiation and long-term depression, and therapeutic applications are in development for post-stroke recovery, Alzheimer's disease, and depression in seniors. Here, we discuss two new directions of TMS research relevant to cerebral aging and cognition. First, we introduce a paradigm for enhancing cognitive reserve, based on our research in sleep deprivation. Second, we discuss the use of...
Source: Dialogues in Clinical Neuroscience - November 12, 2014 Category: Neuroscience Tags: Dialogues Clin Neurosci Source Type: research

Physical activity and brain plasticity in late adulthood.
Authors: Erickson KI, Gildengers AG, Butters MA Abstract The human brain shrinks with advancing age, but recent research suggests that it is also capable of remarkable plasticity, even in late life. In this review we summarize the research linking greater amounts of physical activity to less cortical atrophy, better brain function, and enhanced cognitive function, and argue that physical activity takes advantage of the brain's natural capacity for plasticity. Further, although the effects of physical activity on the brain are relatively widespread, there is also some specificity, such that prefrontal and hippocampa...
Source: Dialogues in Clinical Neuroscience - November 12, 2014 Category: Neuroscience Tags: Dialogues Clin Neurosci Source Type: research

The aging mind: neuroplasticity in response to cognitive training.
Authors: Park DC, Bischof GN Abstract Is it possible to enhance neural and cognitive function with cognitive training techniques? Can we delay age-related decline in cognitive function with interventions and stave off Alzheimer's disease? Does an aged brain really have the capacity to change in response to stimulation? In the present paper, we consider the neuroplasticity of the aging brain, that is, the brain's ability to increase capacity in response to sustained experience. We argue that, although there is some neural deterioration that occurs with age, the brain has the capacity to increase neural activity and ...
Source: Dialogues in Clinical Neuroscience - November 12, 2014 Category: Neuroscience Tags: Dialogues Clin Neurosci Source Type: research

Effect of plasma lipids and APOE genotype on cognitive decline.
We examined the combined effect of plasma lipids and APOE genotype on cognitive function in elderly individuals. Plasma concentrations of high-density lipoprotein (HDL), low-density lipoprotein, triglyceride, total cholesterol, and apolipoprotein E (apoE) were evaluated in 622 community-dwelling individuals aged 65 years and older. We investigated the associations between plasma lipids and cognitive function in APOE4 carrier (E4+) and APOE4 noncarrier (E4-) groups using 3-year longitudinal data. At baseline and 3 years later, cognitive scores were correlated with plasma apoE levels in both E4- and E4+, and HDL level in E4-...
Source: Dialogues in Clinical Neuroscience - November 12, 2014 Category: Neuroscience Tags: Dialogues Clin Neurosci Source Type: research

A perspective on the current issues in the DSM-5 classification of personality disorders.
Authors: Guelfi JD Abstract David Kupfer chaired the DSM-5 Task Force, and Andrew Skodol the working group, on personality disorders. Various initial propositions were posted on the Internet in 2010 for comment and discussion: new general definition, new criteria, new diagnostic procedures, reduction in the number of categories, and dimensional representation. Following numerous criticisms, the Task Force's final decisions were made public on December 1, 2012. Personality disorders now figure alongside other mental disorders, because of the deletion of Axis II. The methodology concerning personality traits is in a ...
Source: Dialogues in Clinical Neuroscience - November 12, 2014 Category: Neuroscience Tags: Dialogues Clin Neurosci Source Type: research

Dimensional models of personality: the five-factor model and the DSM-5.
Authors: Trull TJ, Widiger TA Abstract It is evident that the classification of personality disorder is shifting toward a dimensional trait model and, more specifically, the five-factor model (FFM). The purpose of this paper is to provide an overview of the FFM of personality disorder. It will begin with a description of this dimensional model of normal and abnormal personality functioning, followed by a comparison with a proposal for future revisions to DSM-5 and a discussion of its potential advantages as an integrative hierarchical model of normal and abnormal personality structure. PMID: 24174888 [PubMed - ...
Source: Dialogues in Clinical Neuroscience - November 12, 2014 Category: Neuroscience Tags: Dialogues Clin Neurosci Source Type: research

Milestones in the history of personality disorders.
Authors: Crocq MA Abstract This paper analyzes the major historical milestones in the study of normal and abnormal personality, from antiquity up until the 20th century. Special attention is paid to the interaction between dimensional and typological approaches, which was a major issue during the preparation of DSM-5. Theories of personality started with the humoral theory of Greek medicine. Pinel, and later Esquirol and Prichard, are credited with the first descriptions of abnormal personalities in textbooks of psychiatry. Between the late 19th and early 20th centuries, elaborate systems of normal and abnormal per...
Source: Dialogues in Clinical Neuroscience - November 12, 2014 Category: Neuroscience Tags: Dialogues Clin Neurosci Source Type: research

The relationship between borderline personality disorder and bipolar disorder.
Authors: Zimmerman M, Morgan TA Abstract It is clinically important to recognize both bipolar disorder and borderline personality disorder (BPD) in patients seeking treatment for depression, and it is important to distinguish between the two. Research considering whether BPD should be considered part of a bipolar spectrum reaches differing conclusions. We reviewed the most studied question on the relationship between BPD and bipolar disorder: their diagnostic concordance. Across studies, approximately 10% of patients with BPD had bipolar I disorder and another 10% had bipolar II disorder. Likewise, approximately 20...
Source: Dialogues in Clinical Neuroscience - November 12, 2014 Category: Neuroscience Tags: Dialogues Clin Neurosci Source Type: research

Borderline personality disorder in adolescents: the He-who-must-not-be-named of psychiatry.
This article reviews the possibility and pertinence of diagnosing borderline personality disorder in adolescents. The etiology and clinical manifestations of this disorder in adolescents are discussed, and its management is addressed in terms of psychotherapy, pharmacology, hospitalization issues, and family involvement considerations. PMID: 24174891 [PubMed - indexed for MEDLINE] (Source: Dialogues in Clinical Neuroscience)
Source: Dialogues in Clinical Neuroscience - November 12, 2014 Category: Neuroscience Tags: Dialogues Clin Neurosci Source Type: research

Psychopathy: cognitive and neural dysfunction.
Authors: R Blair RJ Abstract Psychopathy is a developmental disorder marked by emotional deficits and an increased risk for antisocial behavior. It is not equivalent to the diagnosis Antisocial Personality Disorder, which concentrates only on the increased risk for antisocial behavior and not a specific cause-ie, the reduced empathy and guilt that constitutes the emotional deficit. The current review considers data from adults with psychopathy with respect to the main cognitive accounts of the disorder that stress either a primary attention deficit or a primary emotion deficit. In addition, the current review consi...
Source: Dialogues in Clinical Neuroscience - November 12, 2014 Category: Neuroscience Tags: Dialogues Clin Neurosci Source Type: research

Fear and decision-making in narcissistic personality disorder-a link between psychoanalysis and neuroscience.
This article focuses on pathological narcissism and narcissistic personality disorder (NPD), with the aim of exploring two clinically relevant aspects of narcissistic functioning also recognized in psychoanalysis: fear and decision-making. Evidence from neuroscientific studies of related conditions, such as psychopathy, suggests links between affective and cognitive functioning that can influence the sense of self-agency and narcissistic self-regulation. Attention can play a crucial role in moderating fear and self-regulatory deficits, and the interaction between experience and emotion can be central for decision-making. I...
Source: Dialogues in Clinical Neuroscience - November 12, 2014 Category: Neuroscience Tags: Dialogues Clin Neurosci Source Type: research

Personality disorders at the interface of psychiatry and the law: legal use and clinical classification.
Authors: Johnson SC, Elbogen EB Abstract Personality disorders have a complex relationship with the law that in many ways reflects their complexity within the clinical and research communities. This paper addresses expert testimony about personality disorders, outlines how personality disorders are assessed in forensic cases, and describes how personality disorders are viewed in different legal contexts. Reasons are identified why personality disorders are not generally accepted as significant mental illness within the legal system, including high incidence of personality dysfunction in criminal populations, freque...
Source: Dialogues in Clinical Neuroscience - November 12, 2014 Category: Neuroscience Tags: Dialogues Clin Neurosci Source Type: research

Psychopharmacologic treatment of borderline personality disorder.
Authors: Ripoll LH Abstract The best available evidence for psychopharmacologic treatment of borderline personality disorder (BPD) is outlined here. BPD is defined by disturbances in identity and interpersonal functioning, and patients report potential medication treatment targets such as impulsivity, aggression, transient psychotic and dissociative symptoms, and refractory affective instability Few randomized controlled trials of psychopharmacological treatments for BPD have been published recently, although multiple reviews have converged on the effectiveness of specific anticonvulsants, atypical antipsychotic ag...
Source: Dialogues in Clinical Neuroscience - November 12, 2014 Category: Neuroscience Tags: Dialogues Clin Neurosci Source Type: research