Drugs acting at the glycine site on the NMDA receptor as cognitive enhancers in patients with Alzheimer's disease.
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Alzheimer Disease↗
Biomedical subjects
F Kapczinski
Publications and source records attributed to F Kapczinski.
Cognitive impairments of alcoholic cirrhotic patients: correlation with endogenous benzodiazepine receptor ligands and increased affinity of platelet receptors.
OBJECTIVES: To determine whether differences in cognitive function between alcoholic and non-alcoholic cirrhotic patients relate to differences in endogenous ligands for the benzodiazepine receptor and/or benzodiazepine binding. METHODS: Seventeen grade-I hepatic encephalopathic patients (nine alcoholic, eight non-alcoholic) were compared with 10 matched controls on plasma concentrations of endogenous ligands for the neuronal benzodiazepine receptor, benzodiazepine binding in platelets, and performance on tests of cognitive function. RESULTS: Both groups of patients were impaired on verbal recall and on reaction time tasks compared with controls; alcoholic patients were also impaired on Reitan's trails test and digit cancellation. Four of the 17 patients had detectable concentrations of endogenous benzodiazepine ligands and they were more impaired than other patients on trails and cancellation tests. The groups did not differ in the density of benzodiazepine platelet receptors, but receptor affinity was higher in alcoholic patients than in controls; furthermore, receptor affinity correlated with the time to complete the cancellation task and with reaction time. CONCLUSION: Alcoholic cirrhotic patients may have enhanced concentrations of ligands for neuronal and peripheral benzodiazepine receptors and these may contribute to cognitive impairments in these patients.
Adult↗
Mild depression levels alter self-perceptions of future but not the recall of verbal information in elderly inpatients.
In order to determine the correlation of levels of symptoms of depression and rate of forgetting and perception of the future, a total of 68 elderly inpatients without Major Depression admitted to a general hospital were evaluated by: 1) the Montgomery-Asberg Depression Rating Scale (MADRS), 2) the Mini-Mental State Examination (MMSE), 3) a questionnaire on future self-perceptions (FSPQ), and 4) a test on the recall of verbal information to estimate the rate of forgetting. They were grouped according to the clinical prognosis of their disease (good, N = 48, 25 women, 23 men, age mean +/- SD, 68 +/- 6.64; poor, N = 20, 10 women, 10 men, age mean +/- SD, 69 +/- 6.68) which correlates with morbidity-mortality rates (low/high). There was no relationship between mild levels of signs and symptoms of depression and increased forgetting. However, levels of depression were negatively correlated to the score of future perceptions (B = -0.18, beta = -0.29, P = 0.032). Patients with diseases with good prognosis did not present different levels of depression, rates of forgetting or future expectations from those of patients with poor prognosis (high mortality rates). However, individuals with negative FSPQ scores showed significantly higher MADRS scores, independent of the type of disease. These data suggest that the modifications in the processing of information related to the future are present in clinical patients without Major Depression but they occur within a small range of very mild signs and symptoms of depression.
Aged↗
Differential effects of flumazenil in alcoholic and nonalcoholic cirrhotic patients.
Ligands to the benzodiazepine receptor (BZR) accumulate in hepatic encephalopathy; the benzodiazepine antagonist flumazenil can reverse some manifestations of this condition. This study was designed to explore the effects of flumazenil on cognitive function and anxiety levels in cirrhotic patients without hepatic encephalopathy. Twenty such patients--ten alcoholic, ten nonalcoholics--and ten normal volunteers matched for age and sex were randomly allocated to treatment order (flumazenil or placebo first) in a double-blind cross-over trial. Cognitive function was evaluated with a battery of psychological tests shown previously to be sensitive to the impairment induced by liver disease. Cirrhotic patients performed worse than controls on several tests: digit cancellation, digit symbol substitution, key tapping and Reitan's trail B test. Flumazenil did not reverse these cognitive impairments but it did induce anxiety in nonalcoholic cirrhotics. On one index of memory--delayed word recall--alcoholics performed worse than nonalcoholic cirrhotics. Flumazenil reversed this memory impairment in the alcoholic cirrhotic group. These results suggest that alcohol consumption induces changes at the BZR that are different from changes induced solely by liver impairment.
Adult↗
Flumazenil has an anxiolytic effect in simulated stress.
This study was designed to test whether or not flumazenil (1 mg IV) would change levels of anxiety induced by simulation of public speaking (PSS). Forty normal volunteers were randomly allocated in a parallel groups design to treatment with flumazenil or placebo (double-blind) and one of two stress conditions (PSS/control task). PSS increased anxiety and flumazenil antagonized this effect. The anxiolytic activity of flumazenil was particularly strong on anticipatory anxiety measures. The results were discussed in terms of the involvement of endogenous benzodiazepine-type ligands in the regulation of the human response to stress.
Adolescent↗
Observing countertransference in brief dynamic psychotherapy.
Six cases treated with Brief Dynamic Psychotherapy were studied. Initial countertransferential reactions were identified, and expectations were determined concerning the evolution of the patient-therapist relationship. The existence of a basic pattern of emotional response to the patient in the therapist throughout the treatment was observed, and the authors propose to denominate it countertransferential focus. Three clinical vignettes are reported.
Adult↗