Dimensions of schizophrenia and their time course of response to a second generation antipsychotic olanzapine-A clinical study.

Background: The pattern of symptom response to second generation antipsychotics (SGAs) has not been studied extensively. Understanding the time course of symptom response would help to rationally monitor patient progress.

Objective: To determine the short-term differential time course of response of symptom dimensions of first episode schizophrenia viz.

MRI T(2) relaxometry of brain regions and cognitive dysfunction following electroconvulsive therapy.

Background: Although electroconvulsive therapy (ECT) causes no structural brain damage, recent studies reported altered brain perfusion acutely following ECT. This is in keeping with brain edema which was noted in animal experiments following electroconvulsive shock.

Aim: This study examined alteration in magnetic resonance imaging (MRI) T(2) relaxation time, a measure of brain edema, and its relation to therapeutic efficacy, orientation and memory impairment with ECT.

Cerebellar and other neurological soft signs in antipsychotic-naïve schizophrenia.

Objective: Cerebellar neurological abnormalities in schizophrenia have been associated with severe negative symptoms, cognitive deficits, and smaller cerebellar volume. This study assessed the comparative discriminant validity between Cerebellar Soft Signs (CSS) vs. other neurological soft signs (ONSS) [in discriminating between schizophrenia patients and healthy controls] as well as the relationship between the soft signs and psychopathology.

Antidepressant efficacy and hormonal effects of Sudarshana Kriya Yoga (SKY) in alcohol dependent individuals.

Background: Sudarshana Kriya Yoga (SKY) has demonstrable antidepressant effects. SKY was tested for this effect in inpatients of alcohol dependence.

Methods: Following a week of detoxification management consenting subjects (n=60) were equally randomized to receive SKY therapy or not (controls) for a two-week study.

Developmental reflexes and 31P Magnetic Resonance Spectroscopy of basal ganglia in antipsychotic-naive schizophrenia.

The study examined the high energy-phosphate metabolism of basal ganglia in antipsychotic-naive schizophrenia patients with and without developmental reflexes in comparison to healthy subjects. Nineteen antipsychotic-naive schizophrenics of whom 11 had developmental reflexes and 26 age-sex-matched healthy subjects without developmental reflexes underwent in-vivo 2-D 31P Magnetic Resonance Spectroscopy of basal ganglia on a 1.5-T scanner.

Optimized voxel-based morphometry of gray matter volume in first-episode, antipsychotic-naive schizophrenia.

This study examined gray matter (GM) volume abnormalities in first-episode, antipsychotic-naïve Indian schizophrenia patients. Magnetic resonance images of 18 schizophrenia patients and 18 matched healthy comparison subjects were analyzed by optimized voxel-based morphometry. Schizophrenia patients had significantly smaller global GM and greater global CSF volumes and smaller regional GM volume in superior frontal, inferior frontal, cingulate, post-central, superior temporal and parahippocampal gyri, inferior parietal lobule, insula, caudate nuclei, thalamus and cerebellum.

Basal ganglia high-energy phosphate metabolism in neuroleptic-naive patients with schizophrenia: a 31-phosphorus magnetic resonance spectroscopic study.

Objective: This study used 31-phosphorus magnetic resonance spectroscopy ((31)P MRS) to investigate basal ganglia abnormalities in neuroleptic-naive patients with schizophrenia.

Method: Nineteen schizophrenia patients and 31 age- and sex-matched healthy comparison subjects underwent (31)P MRS.

Results: The phosphocreatine/total phosphorus and phosphocreatine/total ATP ratios in both basal ganglia were significantly lower in patients.

Effect of ECT stimulus parameters on seizure physiology and outcome.

This study examined the effect of low- and high-pulse frequency stimulus electroconvulsive therapy on seizure physiology and therapeutic outcome. Forty depressed patients randomly received either low (n = 19) or high (n = 21) pulse frequency stimulus during a course of right unilateral electroconvulsive therapy. The current and pulse width were kept constant whereas the duration was proportionately varied.

Measuring the corpus callosum in schizophrenia: a technique with neuroanatomical and cytoarchtectural basis.

Background: Corpus Callosum (CC) abnormalities have been described in schizophrenia. Review of CC measurement methods in schizophrenia reveals inconsistency and lack of neuroanatomical basis.

Aims: The aims of the study are to describe a new CC measurement method with valid a neuroanatomical and cytoarchitectural basis and to demonstrate inter-rater reliability for the same.

Seizure threshold in ECT: effect of stimulus pulse frequency.

Stimulus parameters, such as pulse width, frequency, and stimulus train duration, affect seizure threshold in electroconvulsive therapy (ECT), although variably. This study examined the effect of low- and high-pulse frequencies of stimulus on seizure threshold and physiological responses to ECT. Twenty-four consenting inpatients prescribed ECT by the treating psychiatrist received bilateral ECT.

Membrane phospholipid abnormalities of basal ganglia in never-treated schizophrenia: a 31P magnetic resonance spectroscopy study.

Background: Studies in schizophrenia using in vivo (31)P magnetic resonance spectroscopy (MRS) have mostly focused on the association cortices, including the frontal and temporal lobes. Striatum has also been implicated in schizophrenia, although neuroleptic exposure in the patients is a potential confound limiting interpretation of earlier studies. We examined membrane phospholipid abnormality in the basal ganglia using (31)P MRS in neuroleptic-naive schizophrenia patients.

Neurological soft signs in never-treated schizophrenia.

Objective: Studies of Neurological Soft Signs (NSS) in schizophrenia are confounded by handedness, inconsistent methodology, and prior treatment with neuroleptics. The study objective is to examine NSS in never-treated schizophrenia.

Method: We examined the NSS in treatment-naïve schizophrenia patients (n = 21) and age, sex, education, and handedness matched normal controls (n = 21) using the modified Neurological Evaluation Scale with good inter-rater reliability.

Reduced Caudate Volume in Never-Treated Schizophrenia : Evidence for Neuro developmental Etiopathogenesis.

Background: Evidence suggests that caudate nucleus abnormalities have a role in schizophrenia. Structural brain imaging studies on caudate size in schizophrenia are inconclusive due to confounding factors.

Methods: In this study, caudate volume was measured on coronal Magnetic Resonance Images (I -mm) in consenting 15 never-treated schizophrenia (DSM-IV) patients and 15 age, sex, handedness, education and socioeconomic status matched controls using semi-automated Scion image software.

Does higher cardiovascular response to ECT predict early antidepressant effect?

Background: Effects of diencephalic seizure generalization during ECT, e.g., cardiovascular response, may be relevant in indexing its therapeutic potency.

Ect in neurological counditions.

It is a myth that electroconvulsive therapy (ECT) produces greater side effects and worsens the neurological condition when used in neurologically ill patients. With the advancement and sophistication in ECT practice standards and modification procedures, it can be safely administered either to treat selected neurological conditions or the co-morbid psychiatric illnesses without additional risks. However ECT should be administered only after thorough evaluation of risks and benefits in such individuals.

Age-at-onset and schizophrenia: reversed gender effect.

Objective: This study seeks an explanation for reversed gender effect on age-at-onset (AAO) in schizophrenia. The hypothesis is older AAO in males would be detected in a sample where higher infant mortality (IMR) prevailed.

Method: Case records of International Classification of Diseases-10 (ICD-10) schizophrenia patients from two states (n=70 each) with an IMR of 13 and 67 per thousand were reviewed and AAO was obtained by using the recorded age and duration of illness.

Merits of EEG monitoring during ect: a prospective study on 485 patients.

Eliciting cerebral seizure during electroconvulsive therapy (ECT) is essential for therapeutic purposes. When it exceeds beyond 120 seconds (Freeman, 1995) i.e.

Ect and t(2) relaxometry: a static walter proton magnetic resonance imaging study.

The aim of the study was to detect brain oedema with electroconvulsive therapy (ECT). Magnetic resonance imaging (MRI) T(2) relaxation time which is an indicator of brain water was measured one day prior to the first ECT and at two hours after second ECT in five depressive patients prescribed right unilateral (RUL) ECT. MRI T(2), relaxation time was measured in hippocampus (He) and thalamus (Th) bilaterally No significant change in T(2) relaxation time following ECT occurred in any of the four regions.

P300 in family studies of schizophrenia: review and critique.

The published studies using P300 event-related potential (ERP) as a vulnerability marker in schizophrenia have been summarized and reviewed. Several factors across sibling, offspring, and familial studies appear to contribute to the variegated findings with respect to the utility of P300 as a vulnerability marker for schizophrenia. These include how subject samples are defined in terms of their genetic loading for schizophrenia, sample size, ERP methodology, and the relationship of P300 measures to neuropsychological test outcomes.

Seizure threshold estimation by formula method: a prospective study in unilateral ECT.

Formula methods of estimating seizure threshold in bilateral electroconvulsive therapy (ECT) have been successful in 75% (at the first ECT) and 80% (at the sixth ECT) of treatments (Gangadhar et al., 1998). This study showed the same results for unilateral (UL) ECT patients.

Cardiovascular response during ECT: a cross-over study across stimulus conditions.

This study examined the effect of stimulus conditions on rate pressure product (RPP) during ECT. Seizure duration as well as baseline, ictal, and postictal RPP were recorded in 28 patients who received ECT under four stimulus conditions (unilateral threshold, unilateral suprathreshold, bilateral threshold, and bilateral suprathreshold). Seizure duration did not differ between the stimulus conditions.

Discontinuation of antidepressant drugs during electroconvulsive therapy: a controlled study.

Background: The concurrent use of antidepressant drugs with ECT is recommended by a recent ECT guideline. The study aimed to examine differential therapeutic and side effect responses when antidepressants are discontinued or not during ECT.

Methods: This study compared the effectiveness and side effect profile of unilateral ECT with antidepressant drugs (Group-1) or unilateral ECT with drug placebo (Group-2) in 30 major depressive disorder (DSM-IV) patients on antidepressants using a prospective randomised trial.

Antidepressant efficacy of Sudarshan Kriya Yoga (SKY) in melancholia: a randomized comparison with electroconvulsive therapy (ECT) and imipramine.

Background: Sudarshan Kriya Yoga (SKY) is a procedure that involves essentially rhythmic hyperventilation at different rates of breathing. The antidepressant efficacy of SKY was demonstrated in dysthymia in a prospective, open clinical trial. This study compared the relative antidepressant efficacy of SKY in melancholia with two of the current standard treatments, electroconvulsive therapy (ECT) and imipramine (IMN).

Motor seizure monitoring during electroconvulsive therapy.

Background: The occurrence of a seizure during electroconvulsive therapy (ECT) should be confirmed. Most clinicians use motor seizure monitoring alone and recent guidelines have not considered electroencephalogram (EEG) monitoring mandatory.

Aims: To examine the potential pitfalls of motor seizure monitoring.