Biomedical subjects

M J Portella

Publications and source records attributed to M J Portella.

7 recordsLinked to original sources

PubMed2004

No brain perfusion impairment at long-term follow-up in elderly patients treated with electroconvulsive therapy for major depression.

No functional neuroimaging study has previously assessed the long-term effects of electroconvulsive therapy (ECT) on brain perfusion. In this study, long-term follow-up brain perfusion in elderly patients treated with ECT for severe unipolar major depression was assessed. In 14 elderly major depressed patients who were ECT remitters, 22 elderly major depressed patients who were pharmacological treatment remitters and 25 age- and sex-matched healthy controls, a medication-free brain 9mTc-HMPAO-SPECT was performed after a minimum period of 12 months of euthymia and, in the case of the ECT remitters, at least 12 months after the last ECT session. Brain perfusion ratios in major depressed patients administered ECT were similar to those in major depressed patients receiving pharmacological treatment and in control subjects. This result suggests that elderly patients given ECT for severe unipolar major depression do not suffer brain perfusion abnormalities at long-term follow-up. Our study adds new evidence in favor of the safety of the ECT, particularly in elderly subjects.

Age Factors↗

PubMed2003

Residual cognitive impairment in late-life depression after a 12-month period follow-up.

OBJECTIVES: This study investigated cognitive impairment in late-life depression in a follow-up design. The main objective was to assess the most important cognitive domains implicated in late-life depression, in patients who underwent pharmacological treatment, in the acute phase and twelve months after. METHODS: Neuropsychological and clinical data were used from the baseline of patients and controls, to determine the cognitive impairment in the acute phase. Patients repeated the neuropsychological assessment at twelve months. RESULTS: There were significant differences between patients and controls at baseline. But in the patients there was no change over twelve months. There were no differences between remitted and non-remitted patients on neuropsychological scores. CONCLUSIONS: The cognitive impairment seen in the elderly depressed patients seems to be a trait characteristic of this mental disease, even when the depressive episode has remitted.

Aged↗

PubMed2003

Residual symptoms in elderly major depression remitters.

OBJECTIVE: To assess residual symptoms in severe geriatric major depression in remission, and to determine baseline clinical and sociodemographic predictors of residual symptoms in remitters. METHOD: A total of 108 elderly patients with unipolar major depression were evaluated and treated naturalistically for 9 months so as to record the predictors of residual symptoms in remitters. In order to reduce the likelihood of confusing residual symptoms with normal effects of age, 30 control subjects were also monitored. RESULTS: Seventy-nine patients (73.1%) were considered remitters and 82.3% of remitters showed residual symptoms. Medical burden, chronic stress and subjective social support were the only variables which predicted the severity of residual symptoms in remitters. CONCLUSION: Residual symptoms in elderly patients with major depression in remission should not only be attributed exclusively to intrinsic factors of the illness or the age of the individual patient, but also to external factors.

Aged↗

PubMedDate not supplied

[Selective alteration of the declarative memory systems in patients treated with a high number of electroconvulsive therapy sessions].

INTRODUCTION: The reversible electrochemical effects of electroconvulsive therapy (ECT) on specific areas of the brain enable the neuroanatomical bases of some cognitive functions to be studied. In research carried out on memory systems, a selective alteration of the declarative ones has been observed after treatment with ECT. Little work has been done to explore the differential alteration of the memory subsystems in patients with a high number of ECT sessions. AIM. To study the declarative and non declarative memory system in psychiatric patients submitted to maintenance ECT treatment, with a high number of previous ECT sessions. PATIENTS AND METHODS: 20 patients submitted to treatment with ECT (10 diagnosed as having depression and 10 with schizophrenia) and 20 controls, who were paired by age, sex and psychopathological diagnosis. For the evaluation of the declarative memory system, the Wechsler Memory Scale (WMS) logical memory test was used. The Hanoi Tower procedural test was employed to evaluate the non declarative system. RESULTS: Patients treated with ECT performed worse in the WMS logical memory test, but this was only significant in patients diagnosed as suffering from depression. No significant differences were observed in the Hanoi Tower test. CONCLUSIONS: A selective alteration of the declarative systems was observed in patients who had been treated with a high number of ECT sessions, while the non declarative memory systems remain unaffected.

Adolescent↗

PubMedDate not supplied

[Frontal lobe involvement in elderly major depression].

INTRODUCTION: It is acknowledged that major depression (MD) entails alterations in moods, physiological dysfunctions and cognitive dysfunctions. The neuropsychological profile of this mental disorder, however, is still unknown. Furthermore, in the nosological delimitation of depressive disorders there are different categories, which makes it still more difficult to establish the cognitive dysfunction of MD. Over the last few years, a great deal of effort has been aimed at establishing a neuropsychological profile of elderly major depression (EMD) as a distinct depressive disorder, since it also involves other variables such as the course and response to pharmacological treatment. AIMS. The objective of this study is to review the present state of the cognitive deficits in EMD and their possible neurobiological correlates. METHOD: From a search in the Medline database using the keywords elderly major depressive disorders , cognitive function , frontal lobes and prefrontal area , we selected studies that had been conducted over the last 10 years. CONCLUSIONS: Recent studies have found mnemonic deficits, together with an executive dysfunction in EMD. Bearing in mind the interactions between affection, motivation and cognitive function enables us to better understand the involvement of the fronto subcortical pathways in this disorder. Moreover, future research should centre on the pathways that connect the frontal lobes and, more specifically, those between the prefrontal dorsolateral area and practically the rest of the brain, since, from what can be observed in the findings obtained, the executive dysfunction could be due to a brain connection disorder

Aged↗

PubMedDate not supplied

[Assessment of frontal functions in psychiatric patients during maintenance electroconvulsive therapy].

INTRODUCTION: Previous studies on adverse cognitive effects of electroconvulsive therapy (ECT) have not found any significant alteration of the frontal functions after an acute treatment course. This study aims to assess frontal executive functions in psychiatric patients during maintenance electroconvulsive therapy (M-ECT). SUBJECTS AND METHODS: Thirty two patients treated with M-ECT and 29 psychiatric patients never treated with ECT were evaluated with neuropsychological tests that assessed the following frontal functions: work memory, planning, cognitive flexibility, attention, visuomotor velocity, verbal abstract reasoning and phonetic verbal fluency. RESULTS: Multivariate global analysis did not detect significant frontal function tests differences between both groups. The M-ECT group only scored significantly lower on the FAS test, a test that measures phonetic verbal fluency. A significant correlation between number of previous ECT sessions and performance in the FAS was found. CONCLUSIONS: The M-ECT patient group presented a phonetic verbal fluency alteration that may also be associated to the previous number of ECT sessions. No significant differences in the other frontal functions were detected.

Bipolar Disorder↗

PubMedDate not supplied

['Tower of London': mental planning, validity and the ceiling effect].

INTRODUCTION: The Tower of London (TL) is a neuropsychological test that is used to evaluate the capacity for planning. Different versions of the TL exist, including the classical version that presents certain psychometric problems (for example, the ceiling effect). AIMS: The aim of this study was to propose a new method of administering and correcting the classical version of the TL, thus increasing the mental resolution of the planning task through instruction, and varying the system of scoring in order to obtain a wider range of scores. PATIENTS AND METHODS: Two versions of the TL were administered to two independent, counterbalanced groups. One of them was the one designed by Krikorian and the other was the one proposed for this study. To compare the two versions, Porteus mazes were administered in each group as a criterion variable in the study of correlations. RESULTS: Both versions correlate with the Porteus mazes in a similar fashion. The variances found in each group are statistically different and the coefficient of covariance is clearly wider in the group that received the version proposed in this study. CONCLUSIONS: Changing the instruction for the mental resolution of planning tasks does not appear to alter the TL. The changes introduced in the correction and the system of scoring of the version proposed for this study present wider variance, which means that the ceiling effect has been overcome.

Adolescent↗