Biomedical subjects

A Iwanami

Publications and source records attributed to A Iwanami.

At least 19 recordsLinked to original sources

PubMed2003

Voxel-based analysis of MRI reveals anterior cingulate gray-matter volume reduction in posttraumatic stress disorder due to terrorism.

MRI studies using the manual tracing method have shown a smaller-than-normal hippocampal volume in patients with posttraumatic stress disorder (PTSD). However, these studies have yielded inconsistent results, and brain structures other than the hippocampus have not been well investigated. A recently developed, fully automated method called voxel-based morphometry enables an exploration of structural changes throughout the brain by applying statistical parametric mapping to high-resolution MRI. Here we first used this technology in patients with PTSD. Participants were 9 victims of the Tokyo subway sarin attack with PTSD and 16 matched victims of the same traumatic event without PTSD. The voxel-based morphometry showed a significant gray-matter volume reduction in the left anterior cingulate cortex (ACC) in trauma survivors with PTSD compared with those without PTSD. The severity of the disorder was negatively correlated with the gray-matter volume of the left ACC in PTSD subjects. There were no significant differences in other gray-matter regions or any of the white-matter regions between two groups. The present study demonstrates evidence for structural abnormalities of ACC in patients with PTSD. Together with previous functional neuroimaging studies showing a dysfunction of this region, the present findings provide further support for the important role of ACC, which is pivotally involved in attention, emotional regulation, and conditioned fear, in the pathology of PTSD.

Adult↗

PubMed2003

Prescribing for inpatients with schizophrenia: an international multi-center comparative study.

BACKGROUND: This study compares prescription practices for acute inpatients with schizophrenia among six academic departments located in China, Japan, Hungary, and the U.S. METHODS: Prescription data for a sample of 429 inpatients from six academic departments were collected on a randomly chosen census day. All patients met criteria for schizophrenia according to DSM-IV and had a length of illness of at least two years. RESULTS: While patients at the different centers varied in their demographic and clinical characteristics, i. e., age, sex, and length of illness, a great variation in prescription patterns for antipsychotic and other psychotropic drugs among centers was observed even within the same country for all the variables studied (i. e., number and dose antipsychotics, atypical and depot antipsychotics, other psychotropic drugs, multiple antipsychotics, and daily dose) except antidepressant use. In most cases these differences persisted even after adjusting for demographic and clinical characteristics (age, sex, and length of illness) of the subjects. Antipsychotics were usually prescribed in divided daily doses in combination with one or more other psychotropic drugs, including anticholinergics, anticonvulsants, benzodiazepines, and non-benzodiazepine hypnotics. Anticholinergic use was more common with typical antipsychotics. Rates of atypical antipsychotic drug use were lowest in the Japanese center. The Japanese center had by far the highest mean daily dose of antipsychotics. CONCLUSIONS: The results indicate that prescription patterns in different centers do not follow any specific guidelines for the treatment of schizophrenia. The results also confirm previous findings that prescribing practices for schizophrenia vary greatly among centers and countries. A common prescribing pattern found was the use of atypical antipsychotic drugs in combination with psychotropic drugs, such as anticholinergics, hypnotics, anticonvulsants, and benzodiazepines, administered in multiple daily doses.

Adult↗

PubMed2002

1H-MR spectroscopy and gray matter volume of the anterior cingulate cortex in schizophrenia.

Schizophrenic and normal control subjects were examined using both H-magnetic resonance spectroscopy (MRS) and structural MR imaging, in order to accurately assess the partial volume within the spectroscopic volume of interest (VOI) in the anterior cingulate cortex. The gray matter volume within VOI correlated positively with the N-acetyl-aspartate (NAA) to choline (Cho) ratio in schizophrenics only, not in controls. Schizophrenic patients had a reduced NAA/Cho ratio and an elevated Cho/creatine ratio compared to controls after the partial volume effect was eliminated. There was a significant negative correlation between the NAA/Cho ratio and the severity of blunted affect symptom in schizophrenics. These results provide further support to the idea that the measures of H-MRS indicate not only neuronal loss but also neuronal dysfunction in schizophrenia.

Adult↗

PubMed2001

Brain lateralization for mismatch response to across- and within-category change of vowels.

Differences in hemispheric predominance between across- and within-category change perception of vowels were assessed using a whole-head magnetoencephalography. The magnetic mismatch responses (MMNm) to pure-tone and vowel within-category changes were significantly predominant in the right hemisphere; on the other hand, vowel across-category MMNm did not differ in power between hemispheres. The results suggest that both hemispheres are symmetrically activated in the preattentive across-category change perception of vowels, while the within-category change of a vowel is analyzed as the change in physical features of the stimuli, thus predominantly activating the right hemisphere. Thus, the relative contribution of the left auditory cortex in the preattentive speech processing may occur only at the level of perception of the vowel across-category change.

Acoustic Stimulation↗

PubMed2001

Impaired suppression of processing in schizophrenic patients suggested by ERPs obtained in a selective attention task.

In the present study, we focused on the ability of suppression of processing in schizophrenic patients, using event-related potentials (ERPs) recorded during a selective attention task. During the task, subjects were required to focus on one ear, counting deviant stimuli, those deviating in duration from a sequence of standard stimuli. We compared amplitude data of two positive components differing in latency elicited by standard stimuli, which reflect suppression of stimulus processing, between schizophrenic patients and normal controls. Significant between-group differences were obtained specifically in the right ear attended condition, suggesting impaired suppression of processing in schizophrenics mediated in the left hemisphere.

Adult↗

PubMed2001

Effects of risperidone on event-related potentials in schizophrenic patients.

In order to examine the effects of risperidone on cognitive impairment in schizophrenia, event-related potentials (ERPs) were recorded before and after switching from conventional neuroleptics to risperidone in schizophrenic patients. ERPs were recorded during two auditory discrimination tasks (an oddball task and a distraction task) in 10 medicated schizophrenic patients during conventional neuroleptic and risperidone treatments. The amplitudes and latencies of N 100 and P300 component were measured in ERPs for target stimuli in the oddball task and in ERPs for target and novel stimuli in the distraction task. Although N 100 amplitude and latency and P 300 amplitude did not change significantly after switching the drug compared to that during conventional neuroleptic treatment, P 300 latency for target stimuli shortened significantly during risperidone treatment in both tasks, accompanied by the shortening of the reaction time in the distraction task. The P 300 latency change did not correlate with the change of the severity of psychopathology. These findings suggest that risperidone may speed the information processing in schizophrenic patients, contributing to the improvement of cognitive functions.

Adult↗

PubMed2000

Psychophysiological correlates of social skills deficits in persons with schizophrenia.

Social skill deficits in schizophrenia profoundly affect patients' life-long outcome, although the profile of the underlying cognitive dysfunction still remains a matter of debate. In the present study, we investigated the relationship between social skills and event-related potentials (ERPs) in an auditory selective attention task, in addition to the neurocognitive indices obtained from the degraded-stimulus continuous performance test (CPT) and clinical indices, such as Brief Psychiatric Rating Scale (BRPS) and global assessment of function (GAF) scores. Social skills were assessed using a Japanese version of the structured role play test. Fourteen persons with schizophrenia participated in the study. Non-verbal skills showed a positive correlation with GAF, the performance level, N1 and N2b amplitude in the ERP task, and hit rate in the CPT, and a negative correlation with reaction time in the CPT. Verbal communication skills showed a positive correlation with GAF, the performance level and N2b amplitude in the ERP task, and hit rate in the CPT, and a negative correlation with reaction time in the CPT. Processing skills showed a positive correlation with the performance level and N1 amplitude in the ERP task and a negative correlation with reaction time in the CPT. These findings suggested that the social skill deficits of persons with schizophrenia were related to the vigilance level and controlled stimulus detection processing.

Adult↗

PubMed2000

Event-related potentials and thought disorder in schizophrenia.

We examined the relationship between event-related potentials and thought disorder in schizophrenia. The subjects were 29 chronic schizophrenic patients. Thought disorder was assessed using the Comprehensive Index of Positive Thought Disorder developed by Harrow and colleagues (Harrow and Quinlan, 1985; Marengo et al., 1986). Auditory event-related potentials were recorded during a standard oddball task. The P300 amplitude correlated negatively with the severity of the thought disorder. The P300 amplitude in the patients with thought disorder was significantly smaller than in the patients without thought disorder. These results suggest that a reduction in P300 amplitude is associated with a fundamental impairment of information processing in schizophrenic patients.

Adult↗

PubMed1999

Electrophysiological evidence for sequential activation of multiple brain regions during the auditory selective attention process in humans.

In an attempt to examine dynamic involvement of multiple brain regions in the auditory selective attention process, negative difference wave (Nd) generators were assessed using a high-resolution EEG system (128ch) and scalp current density (SCD) analysis. Ten normal volunteers participated in the study. Event-related potentials were recorded during a selective attention task. Sequential SCD mappings revealed that current sinks were located in the bilateral temporal regions at 160 ms subsequent to the onset of stimuli, shifting the dipole orientation more tangentially to the scalp at around 220 ms. Moreover, a current sink was demonstrated in the midfrontal region at around 320 ms. These findings confirm that different cortical regions are sequentially involved in the auditory selective attention process.

Adult↗

PubMed1999

Multiple generators in the auditory automatic discrimination process in humans.

To reveal the spatiotemporal characteristics of the auditory automatic discrimination process, mismatch negativity (MMN) generators were assessed with a high-resolution EEG system (128ch) and scalp current density (SCD) analysis. Ten normal volunteers participated in the study. Event-related potentials were recorded during a selective attention task. Sequential SCD mappings revealed that a current sink/source combination in the left temporal regions and a current sink in the right frontotemporal regions appeared around 200 msec irrespective of the ear of stimulation. Moreover, a parietal sink/source combination was demonstrated on the right hemisphere around 240 ms irrespective of the ear of stimulation. These findings demonstrate that the auditory automatic change detection process is, both spatially and temporally, a multiple-generated system.

Acoustic Stimulation↗

PubMed1999

P300 and disability of daily life in schizophrenia.

1. The relationship between the P300 component of event-related potentials and disability of daily life was examined in schizophrenia. The subjects were 26 chronic schizophrenic patients. 2. Disability of daily life was assessed by using the Life Assessment Scale for Mental Illness (LASMI). 3. Auditory event-related potentials were recorded during a standard oddball task. 3. P300 amplitude correlated negatively with general psychopathology scale of PANSS (r = -0.416) and Work of LASMI (r = -0.417). P300 latency did not correlate with any of PANSS or LASMI score. 4. These results indicate that P300 amplitude can be an index for disability of daily life in schizophrenia.

Activities of Daily Living↗

PubMed1999

Algorithms for the pharmacotherapy psychotic depression.

Psychotic depression is reported and requires different pharmacological treatment from other mood disorders, however, sufficient studies to guide us in selecting successful treatment strategies have not been performed. In this study, algorithm for the treatment of psychotic depression was developed by the Japan Psychopharmacology Algorithm Project. The following three issues are emphasized: (1) risk of suicide; (2) agitation; and (3) oral intake ability. When patients show a high risk of suicide and/or agitation, prompt treatment strategies, such as tricyclic antidepressant (TCA)/neuroleptics therapy or electroconvulsive therapy (ECT), are necessary. If patients show no suicidal risk without agitation, TCA therapy is recommended. ECT is recommended as the first choice when the symptoms are severe or when there is an inability of oral intake.

Affective Disorders, Psychotic↗

PubMed1999

Questionnaire survey on the prescribing practice of Japanese psychiatrists for mood disorders.

The answers to a questionnaire on the practical prescription in mood disorders from 298 Japanese psychiatrists was obtained. As the first-line treatment, a majority of respondents chose newer tricyclic agents (TCA) or non-TCA for moderate depression and older TCA for severe depression both with and without psychotic features. Combination therapy with antidepressants and anxiolytics was fairly popular in moderate depression, while antidepressant/neuroleptic combination was more common in severe psychotic depression. Sulpiride was the most favored drug for dysthymia. Although lithium was the most popular for bipolar mania, respondents were divided on the treatment of bipolar depression.

Anti-Anxiety Agents↗

PubMed1998

Decreased plasma cortisol level during alprazolam treatment of panic disorder: a case report.

1. Changes in the plasma cortisol level were reported in a male patient with panic disorder during the period of low-dose alprazolam treatment (mean 0.62 +/- 0.15 mg/day) compared with during the period of high-dose period (mean 1.08 +/- 0.28 mg/day). 2. The plasma cortisol level was significantly higher in the low-dose period (mean 13.90 +/- 3.35 micrograms/ml) than in the high-dose period (mean 9.06 +/- 2.75 micrograms/ml) although, paradoxically, the panic attack frequency was significantly lower in the low-dose period (mean 1.35 +/- 0.29/day) than in the high-dose period (mean 2.09 +/- 0.66/day). 3. Thus, the decreased plasma cortisol level during alprazolam treatment of panic disorder was suggested to be caused not by symptom alleviation due to alprazolam but by alprazolam administration itself.

Adult↗

PubMed1998

P3a of event-related potential in chronic methamphetamine dependence.

To investigate the psychophysiological features of methamphetamine (MAP) dependence, we recorded auditory event-related potentials (ERPs) in 15 patients with MAP dependence and in 15 age-matched normal controls. ERPs were recorded during a standard oddball task and a read task similar to those employed by Squires et al. (Squires NK, Squires KC, Hillyard SA [1975] Two varieties of long-latency positive waves evoked by unpredictable auditory stimuli in man. Electroenceph Clin Neurophysiol 38:387-401). The patients with MAP dependence showed reduced P3a amplitude and area in the read task and delayed P3b latency with normal P3b amplitude and area in the oddball task. These results suggest that central noradrenergic dysregulation may persist after the remission of acute psychotic symptoms in MAP psychosis and that chronic MAP dependence would produce impairment of the frontal cortex.

Acoustic Stimulation↗

PubMed1998

Event-related potentials during a selective attention task with short interstimulus intervals in patients with schizophrenia.

OBJECTIVE: To study selective attention in schizophrenia by examining event-related potentials during a dichotic listening task with short interstimulus intervals (ISIs). DESIGN: Prospective study. PARTICIPANTS: Twelve patients with schizophrenia in remission and 12 age-matched controls with no history of psychiatric or neurological illness. INTERVENTIONS: Participants were asked to push a button in response to target stimuli in either ear. OUTCOME MEASURES: Reaction time, correct response rate and results of electroencephalography recorded at 3 regions: mean segmental amplitudes between 0 and 200 ms and between 200 and 400 ms after stimuli and processing negativity (Nd), measured by the negative area during these periods. RESULTS: Distinct slow-positive potentials for unattended stimuli, which were elicited in a task with long ISIs in a previous report, did not emerge in either group in this study. Although the 2 groups did not differ significantly in terms of Nd area, in the controls the mean segmental amplitude for attended standard stimuli was significantly greater than that in the patients with schizophrenia. CONCLUSIONS: Impairment of selective attention in patients with schizophrenia is related to a lack of ability to focus attention on attended task-relevant stimuli during a selective attention task with short ISI.

Adult↗

PubMed1997

Behavioral and P3 amplitude enhancement in schizophrenia following feedback training.

In order to clarify the remediability of behavioral and electrophysiological abnormalities in schizophrenia, hit rate, reaction time, and P3 amplitude from auditory event-related potentials were evaluated before and after feedback training of a task in 14 schizophrenics and 12 age-matched normal controls. Although mean changes in the three indices due to the training were nonsignificant in both schizophrenic and normal control groups as a whole, the changes in hit rate and reaction time correlated significantly with the P3 amplitude change in the schizophrenic (r = 0.60 and -0.58, respectively) but not in the normal control group. The P3 amplitude change also correlated with the P3 amplitude before the training only in the schizophrenic group (r = -0.68), suggesting that the training was more effective for the schizophrenic patients with marked P3 amplitude reduction. The observed P3 amplitude increase due to training may represent an electrophysiological correlate of a remediable aspect of behavioral deficits in schizophrenics, which may underlie the effectiveness of nonpharmacological treatments.

Adult↗

PubMed1997

Auditory event-related potentials in panic disorder.

To investigate the psychophysiological features of panic disorder (PD), we recorded auditory event-related potentials (ERPs) in 12 patients with PD meeting the DSM-IV criteria and in 12 age-matched normal controls. The ERPs were recorded during a standard two-tone discrimination task (oddball task). The probabilities of the rare target (1200 Hz) and frequent non-target tones (1000 Hz) were 15 and 85%, respectively. The subjects were required to press a button in response to the rare target tones. Scalp electroencephalograms were recorded from Fz, Cz, Pz, C3, and C4. The State-Trait Anxiety Inventory and Manifest Anxiety Scale scores were assessed for clinical evaluation. Analysis of variance revealed that the N1 and N2 amplitudes for target tones and the N1 amplitude for non-target tones were significantly larger in the PD patients than those in the controls. The two groups did not differ significantly in P3 latency and amplitude. The larger N1 and N2 amplitudes in the PD patients are suggestive of alteration of early information processing in PD.

Adult↗