Publications by authors named "Toby T Winton-Brown"

There are no well-validated treatments for functional seizures. While specialist psychotherapy is usually recommended, the evidence for its benefit is qualified, and it can be difficult to obtain. Given the association between hyperventilation and functional seizures we explored an alternative modality, breathing control training, in a multi-site open label pilot trial.

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Gender inequality across the world has been associated with a higher risk to mental health problems and lower academic achievement in women compared to men. We also know that the brain is shaped by nurturing and adverse socio-environmental experiences. Therefore, unequal exposure to harsher conditions for women compared to men in gender-unequal countries might be reflected in differences in their brain structure, and this could be the neural mechanism partly explaining women's worse outcomes in gender-unequal countries.

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Article Synopsis
  • The study aimed to understand differences in mental health profiles between patients with psychogenic nonepileptic seizures (PNES) and those with epileptic seizures (ES), focusing on various aspects of psychopathology.
  • Involving 261 patients, the research found that those with PNES reported significantly higher levels of childhood trauma, dissociation, and depression compared to the ES group, highlighting notable differences in their mental health.
  • Despite the observed differences, the individual psychometric measures were found to have limited diagnostic effectiveness, suggesting that a combined general psychopathology factor better explains the variations between the two groups.
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Objective: This study was undertaken to identify factors that predict discordance between the screening instruments Neurological Disorders Depression Inventory for Epilepsy (NDDI-E) and Generalized Anxiety Disorder scale (GAD-7), and diagnoses made by qualified psychiatrists among patients with seizure disorders. Importantly, this is not a validation study; rather, it investigates clinicodemographic predictors of discordance between screening tests and psychiatric assessment.

Methods: Adult patients admitted for inpatient video-electroencephalographic monitoring completed eight psychometric instruments, including the NDDI-E and GAD-7, and psychiatric assessment.

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Article Synopsis
  • Adverse events (AEs) from antiepileptic drugs (AEDs) can hinder proper dosing and patient compliance, leading to worse seizure control and increased health risks, which this study aimed to analyze using the Liverpool Adverse Events Profile (LAEP).
  • The study enrolled 311 adult patients to explore factors like gender, mood disorders, and AED polytherapy in relation to AEs, finding that depression and female sex were linked to higher AEs, while epilepsy patients reported fewer AEs than those with psychogenic nonepileptic seizures (PNES).
  • The findings highlight the significant connection between patient-reported AEs and psychiatric conditions, emphasizing the need for tailored management strategies in epilepsy treatment
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Migration is a major risk factor for schizophrenia but the neurochemical processes involved are unknown. One candidate mechanism is through elevations in striatal dopamine synthesis and release. The objective of this research was to determine whether striatal dopamine function is elevated in immigrants compared to nonimmigrants and the relationship with psychosis.

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Background: A key problem in the management of first episode psychosis is that patients are often reluctant to take antipsychotic medication, especially once their presenting symptoms have resolved. Clinicians may be tempted to trial a 'break in treatment' in such patients.

Aim: To assess the impact of interruptions in the antipsychotic treatment of first episode psychosis.

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Childhood adversity increases the risk of psychosis in adulthood. Theoretical and animal models suggest that this effect may be mediated by increased striatal dopamine neurotransmission. The primary objective of this study was to examine the relationship between adversity in childhood and striatal dopamine function in early adulthood.

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Disrupted salience processing is proposed as central in linking dysregulated dopamine function with psychotic symptoms. Several strands of evidence are now converging in support of this model. Animal studies show that midbrain dopamine neurons are activated by unexpected salient events.

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There is growing interest in the complex topology of human brain functional networks, often measured using resting-state functional MRI (fMRI). Here, we used a meta-analysis of the large primary literature that used fMRI or PET to measure task-related activation (>1,600 studies; 1985-2010). We estimated the similarity (Jaccard index) of the activation patterns across experimental tasks between each pair of 638 brain regions.

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Background: Using positron emission tomography (PET), we previously observed increases in 3,4-dihydroxy-6-[(18)F]fluoro-L-phenylalanine ((18)F-DOPA) uptake in the striatum of subjects at ultra-high risk (UHR) for psychosis, indicating elevated presynaptic dopamine synthesis capacity. The purpose of this study was to test if this finding would be replicated in a second UHR cohort.

Methods: (18)F-DOPA PET was used to estimate dopamine synthesis capacity in the striatum of an entirely new cohort of 26 individuals at UHR for psychosis (14 males, mean±SD age = 22.

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Although the effects of cannabis on perception are well documented, little is known about their neural basis or how these may contribute to the formation of psychotic symptoms. We used functional magnetic resonance imaging (fMRI) to assess the effects of Delta-9-tetrahydrocannabinol (THC) and cannabidiol (CBD) during visual and auditory processing in healthy volunteers. In total, 14 healthy volunteers were scanned on three occasions.

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Neuroimaging in psychiatry, and in schizophrenia in particular, moves ahead at a rapid pace delivering new insights into the nature of the illness and its intriguing symptoms via technologies such as MRI, fMRI, PET, and SPET scanning. How do these impact on understanding the patient in front of us? What do they mean for the busy clinician in clinic? We outline some of the recent findings in neuroimaging research of schizophrenia and consider their potential application in clinical practice.

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