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Biomedical subjects

J R Bustillo

Publications and source records attributed to J R Bustillo.

9 recordsLinked to original sources
PubMed2003

Predicting EEG responses using MEG sources in superior temporal gyrus reveals source asynchrony in patients with schizophrenia.

OBJECTIVE: An integrated analysis using Electroencephalography (EEG) and magnetoencephalography (MEG) is introduced to study abnormalities in early cortical responses to auditory stimuli in schizophrenia. METHODS: Auditory responses were recorded simultaneously using EEG and MEG from 20 patients with schizophrenia and 19 control subjects. Bilateral superior temporal gyrus (STG) sources and their time courses were obtained using MEG for the 30-100 ms post-stimulus interval. The MEG STG source time courses were used to predict the EEG signal at electrode Cz. RESULTS: In control subjects, the STG sources predicted the EEG Cz recording very well (97% variance explained). In schizophrenia patients, the STG sources accounted for substantially (86%) and significantly (P<0.0002) less variance. After MEG-derived STG activity was removed from the EEG Cz signal, the residual signal was dominated by 40 Hz activity, an indication that the remaining variance in EEG is probably contributed by other brain generators, rather than by random noise. CONCLUSIONS: Integrated MEG and EEG analysis can differentiate patients and controls, and suggests a basis for a well established abnormality in the cortical auditory response in schizophrenia, implicating a disorder of functional connectivity in the relationship between STG sources and other brain generators.

Acoustic Stimulation↗
PubMed2001

Effects of chronic haloperidol and clozapine treatments on frontal and caudate neurochemistry in schizophrenia.

N-Acetyl-aspartate (NAA), a marker of neuronal integrity, has been found to be reduced in frontal regions in schizophrenia. However, the impact of antipsychotic drug type on NAA has not been carefully evaluated. We studied outpatients with schizophrenia/schizoaffective disorders chronically treated with haloperidol or clozapine and normal controls with single-voxel 1H-MRS of the caudate nuclei and the left frontal lobe. Concentrations of NAA, choline containing compounds (Cho) and creatine plus phosphocreatine (Cre) were determined and corrected for the proportion of cerebrospinal fluid (CSF) in each voxel. The haloperidol-treated group had significantly lower CSF-uncorrected and CSF-corrected left frontal NAA than the normal controls, with the clozapine group having intermediate concentrations. The haloperidol-treated group had significantly lower CSF-uncorrected caudate NAA than the normal controls, but the three groups did not differ after correcting for CSF fraction. Performance times in the Grooved Pegboard, a measure of motor dexterity and proxy for parkinsonism, were correlated with CSF-uncorrected and CSF-corrected left frontal NAA. Demographic and illness-related variables were not related to NAA. Exposure to haloperidol-like drugs may in part account for the frontal NAA reductions previously reported in schizophrenia. Adjustment for proportion of voxel CSF should be considered in 1H-MRS studies.

Adolescent↗
PubMed2001

Proton magnetic resonance spectroscopy (H-MRS) studies of schizophrenia.

Proton magnetic resonance spectroscopy ((1)H-MRS) is a noninvasive technique that can quantify biochemical compounds in the brain. (1)H-MRS has been used to investigate neural structures implicated in the pathology of schizophrenia. The majority of research has revealed reduced N-acetylaspartate (NAA), an index of neuronal integrity, in frontal and temporal regions of medicated and chronically ill patients with schizophrenia. This review summarizes basic principles of (1)H-MRS, studies of frontal, temporal, subcortical, and cerebellar regions in schizophrenia. Technical and study design limitations are also discussed.

Aspartic Acid↗
PubMed1997

Visual information-processing impairments in deficit and nondeficit schizophrenia.

OBJECTIVE: Previous studies of covert visuospatial attention in schizophrenia suggest a subtle form of right hemispatial neglect in acutely ill patients but not in chronic, stable patients. Because of previous work documenting various visual information-processing abnormalities in deficit schizophrenia, the authors investigated whether the deficit/nondeficit categorization would help clarify the presence of visual attentional asymmetries in schizophrenia. METHOD: Performance on a covert visuospatial attention task was examined in clinically stable outpatients with schizophrenia (17 in a deficit subgroup and 28 in a nondeficit subgroup) and 25 normal subjects. Peripheral cue and central cue versions of the covert visuospatial attention task, at 100-, 200-, and 800-msec intervals between cue and target, were administered a week apart. RESULTS: The nondeficit patients exhibited a significant and abnormal asymmetry, with slower reaction time to targets presented in the right visual field than in the left visual field. This right visual field disadvantage was found with both versions of the task, but only at the 100-msec cue-target interval. The deficit patients were slowest in overall reaction time but, similar to the normal subjects, showed no asymmetry. CONCLUSIONS: The results are consistent with slower visual information processing in the left compared to the right cerebral hemisphere in nondeficit schizophrenia. This finding cannot be accounted for by differences between the deficit and nondeficit subgroups in demographic characteristics, chronicity, or medication effects, nor is it secondary to generalized cognitive impairment.

Adolescent↗
PubMed1996

The deficit syndrome in the DSM-IV Field Trial. Part II. Depressive episodes and persecutory beliefs.

Patients with the deficit syndrome are remarkable for their decrease in interest in social relationships, suggesting they have an abnormality in those brain regions controlling social behavior and social cognition. To further assess social behavior and social cognition in this group of patients, we examined the relationships among three aspects of the psychopathology: suspiciousness; major depressive episodes; and the deficit syndrome. These features of psychopathology were examined in two clinical samples: stable outpatients from a research clinic (the MPRC sample), and patients in the DSM-IV Field Trial. In both samples, patients with history of a depressive episode had more severe suspiciousness than those without such a history; other psychotic symptoms were not associated with depressive episodes. In the MPRC sample, patients with the deficit syndrome exhibited less severe suspiciousness than nondeficit patients; in the Field Trial sample, this same comparison had a nonsignificant trend in the same direction. In the Field Trial sample, patients with the deficit syndrome also had less severe delusions with a predominantly social content than did nondeficit patients. These findings suggest suspiciousness is a risk factor for major depression in schizophrenia, and that the decreased interests in social relationships exhibited by deficit syndrome patients is reflected in the content of their delusions.

Adult↗
PubMed1996

Differential effect of clozapine on weight: a controlled study.

OBJECTIVE: This study examined whether clozapine induces more weight gain than haloperidol and whether weight gain is related to clinical improvement. METHOD: The weight and symptoms of 39 outpatients with schizophrenia who were randomly assigned to double-blind treatment with either clozapine or haloperidol were assessed. The weight and symptoms of 33 of the patients who chose to take clozapine during a 1-year follow-up after the study ended were also assessed. RESULTS: The patients treated with clozapine gained significantly more weight over baseline (7%) than the haloperidol-treated patients (1%). Weight gain was not significantly correlated with improvements in either positive or negative symptoms. Fifty-eight percent of the patients followed for 1 year gained at least 10% over their baseline weight. CONCLUSIONS: Weight gain is an important side effect of clozapine and is unrelated to the drug's differential antipsychotic efficacy.

Ambulatory Care↗
PubMedDate not supplied

Schizophrenia: improving outcome.

Therapeutic advances over the last four decades have enabled most persons with schizophrenia to live in the community. Nevertheless, the majority will continue to experience various symptoms and to have social and cognitive disabilities. With the development of new medications and psychosocial interventions, outpatient status can no longer be viewed as a satisfactory final outcome. This article presents the current state of schizophrenia therapeutics in a variety of clinically relevant situations: first-episode psychosis, treatment-resistant psychosis, chronic, relapsing psychosis, continuous poor functioning, and chronic psychosis not responsive to pharmacotherapy. The first-line atypical antipsychotics should generally be used, mainly because of their comparatively benign side-effect profiles, and they should be given as early as possible in the illness. The clinician should not be quick to accept persistent psychosis; the second-line atypical clozapine should be tried early in the course of the disease in patients showing treatment resistance. For patients residing with their families, educational and supportive family interventions have an important effect on relapse prevention; for those who live on their own and suffer frequent relapses, Assertive Community Treatment may be helpful. Patients with psychosis that is not responsive to pharmacotherapy may benefit from specific modalities of cognitive-behavioral therapy currently being developed, while persons with persistent negative symptoms and limited social competence may find social-skills training useful. In addition, new programs of supported employment may enable some patients to maintain competitive employment.

Chronic Disease↗