Impaired cognition in geriatric patients with relation to earlier life mood disorder and traumatic brain injury: a hypothesis.

The challenges of the geriatric years require cognitive integrity through organic resilience of the brain. Impaired cognition in geriatric patients (age >65 years) is commonly ascribed to age but is multifactorial. Among those multiple factors this author hypothesizes that mood disorders, with major depressive disorder (MDD) as one focus of this paper and traumatic brain injury (TBI) are part of a common spectrum of pathology that, when undiagnosed and untreated at age <65 years, reduces the resilience of the brain to negotiate common challenges during geriatric years.

Cerebellar dysregulation and heterogeneity of mood disorders.

This paper discusses diverse studies to consider the hypothesis that cerebellar pathology supports the heterogeneous metabolic pathologies of mood disorders. The evidence presented includes studies selected from the following areas of scientific research: magnetic resonance imaging, histology, clinical syndromes, comparative anatomy, neuronal connections, and mitochondrial dysfunction. The gamut of different scientific study methods confirms the validity of the involvement of the cerebellum in mood disorders.

Limiting progressive hippocampal metabolic abnormalities after smoke inhalation injury.

A 46-year-old man had a smoke inhalation injury. Within 1 month, he developed neuropsychiatric problems including toxic encephalopathy, cognitive disorder, depression symptoms and personality change. From 3 to 14 years after the toxic inhalation injury, the patient received treatment with sertraline and methylphenidate.

Possible usefulness of tianeptine in treatment-resistant depression.

Objective: Tianeptine is an atypical antidepressant drug, augmenting serotonin reuptake and preventing stress-associated changes in the brain. In this paper, we present the use of tianeptine in eight American treatment-resistant patients with major depressive disorder.

Methods: Two male and six female patients with major depressive disorder, aged 44-72 years with duration of the illness 3-40 years, were studied.

Mitochondrial dysfunction, oxidative stress, and major depressive disorder.

There is controversy about depression being a physical illness, in part because a reproducible, sensitive, and specific biologic marker is not available. However, there is evidence that mitochondrial dysfunction and oxidative stress may be associated with abnormal brain function and mood disorders, such as depression. This paper reviews selected human and animal studies providing evidence that intracellular mitochondrial metabolic dysfunction in specific brain regions is associated with major depressive disorder.

Pseudodementia caused by severe depression.

The diagnosis of pseudodementia may be difficult in a patient with a history of major depressive disorder. Clinical case history. A 70-year-old man with a history of major depressive disorder, in remission for 3 years, presented with confusion, agitation and cognitive disorder.

Tianeptine in combination with monoamine oxidase inhibitors for major depressive disorder.

Major depressive disorder may respond to monotherapy with monoamine oxidase inhibitors (MAOIs) or tianeptine. Literature search showed no reports of MAOIs combined with tianeptine. The method included was clinical case history.

Progressive neuropsychiatric and brain abnormalities after smoke inhalation.

A 46-year-old man inhaled combustible smoke of unknown chemical composition for 15-20 min in an automobile body shop. Within 1 month, he noted headache, sadness, anergia, anhedonia, agitation, poor sleep and impairment of concentration, attention and learning skills. Three years later, mental status examination showed major depression and cognitive disorder manifested by apprehension, continuous sadness, agitation, exhaustion, difficulty with word finding, bradyphrenia, short-term and long-term memory impairment, and judgement impaired by impulsive and affect-laden reactions without reflection.