Biomedical subjects

Manel Salamero

Publications and source records attributed to Manel Salamero.

16 recordsLinked to original sources

PubMed2006

Cognitive remediation therapy for outpatients with chronic schizophrenia: a controlled and randomized study.

Cognitive Remediation Therapy (CRT) is a novel rehabilitation approach designed to improve neurocognitive abilities such as attention, memory and executive functioning. The aim of the present study is to evaluate the effect of CRT on neurocognition, and secondarily on symptomatology and psychosocial functioning. Cognitive Behavioural Therapy (CBT) was used as a control condition because it aims to improve emotional problems and positive symptoms, focusing on modification of maladaptive beliefs and schemas, but neurocognition is not targeted. A total of 40 chronic patients with DSM-IV schizophrenia disorder were randomly assigned for 4 months to one of two treatment groups: CRT or CBT. Repeated assessments were conducted before and after the treatments and at the end of a follow-up period of 6 months. Additionally, a method to establish reliable change was calculated from a separate sample of 20 schizophrenic patients who were under standard medication without any kind of psychological treatment. Results showed that CRT produced an overall improvement on neurocognition (Mean effect size=0.5), particularly in verbal and nonverbal memory, and executive function. CBT showed the expected treatment effect on general psychopathology (anxiety and depression) but produced only a slight non-specific improvement in neurocognition (Working Memory). Furthermore, patients receiving CRT showed improvement in social functioning, demonstrating that cognitive improvements are clinically meaningful. These gains were still present at the 6 month follow-up.

Adult↗

PubMed2006

Life events and inflammatory bowel disease relapse: a prospective study of patients enrolled in remission.

OBJECTIVES: The impact of life events in recurrence of inflammatory bowel disease (IBD) is unclear. We sought to determine whether stressful life events or the emotional impact of these events are associated with IBD relapses, hypothesizing that the exposure of life events among patients with inactive disease will increase the risk of subsequent relapses. METHODS: In this prospective study, 163 patients with inactive IBD, who had had at least one relapse in a 2-yr period before entry into the study, were enrolled. The Spanish version of the Social Readjustment Rating Scale (SRRS) (measuring life events), a measure of the emotional impact of these life events, and an IBD activity index were completed monthly up to the end of the study (maximum 11 months) or up to a relapse. Biological factors associated with an increased risk of relapse were identified in patients who relapsed. RESULTS: Fifty-one patients relapsed (32.9%), 104 remained in remission, and 8 dropped out. Multivariate Cox regression analysis with time dependent variables showed that the number of life events was not associated with the rate of relapse after adjustment for significant covariates on the subsequent month (hazard ratio = 0.88, 95% CI = 0.68-1.13, p = 0.33) or in the time-lagged analysis. The emotional impact of stressful events was also not associated with the risk of relapse. When patients who suffered a biological risk factor for relapsing were excluded in subsequent statistical analyses, similar results were obtained. CONCLUSIONS: Our results suggest that stressful life events do not trigger exacerbations in patients suffering from IBD.

Adolescent↗

PubMed2006

Cognitive impairment in bipolar II disorder.

BACKGROUND: Persistent impairments in neurocognitive function have been described in bipolar disorder. AIMS: To compare the cognitive performance of patients with bipolar II disorder with that of patients with bipolar I disorder and a healthy control group. METHOD: The study included 71 euthymic patients with bipolar disorder (38 bipolar I, 33 bipolar II), who were compared on clinical and neuropsychological variables (e.g. executive function, attention, verbal and visual memory) and contrasted with 35 healthy controls on cognitive performance. RESULTS: Compared with controls, both bipolar groups showed significant deficits in most cognitive tasks including working memory (DigitSpan Backwards, P=0.002) and attention (DigitSpan Forwards, P=0.005; Trail Making Test, P=0.001). Those with type II disorders had an intermediate level of performance between the bipolar I group and the control group in verbal memory (P<0.005) and executive functions (Stroop interference task, P=0.020). CONCLUSIONS: Cognitive impairment exists in both subtypes of bipolar disorder, although more so in the bipolar I group. The best predictors of poor psychosocial functioning in bipolar II disorder were subclinical depressive symptoms, early onset of illness and poor performance on a measure related to executive function.

Adult↗

PubMed2005

Neuropsychological tests with lateralizing value in patients with temporal lobe epilepsy: reconsidering material-specific theory.

PURPOSE: To assess the ability of neuropsychological tests to determine the side of seizure onset for preoperative assessment in patients with drug-resistant temporal lobe epilepsy. METHODS: Twenty-nine consecutive patients diagnosed with temporal lobe epilepsy (TLE), in whom the epileptogenic focus was clearly identified and localized to either the right or left hemisphere. Patients underwent a full neuropsychological assessment as part of their pre-surgical investigation, including the Boston Naming Test (BNT) and a variety of Wechsler Adult Intelligence Scale-Third Edition (WAIS-III) and Wechsler Memory Scale-Third Edition (WMS-III) subtests. Two multivariate analyses of variance were carried out to assess differences on memory and language measures between groups according to side of epileptogenic focus. Binary logistic regression analysis was performed to find the sets of tests that best predicted the side of seizure onset (determined by EEG and MRI). RESULTS: Memory multivariate analysis of variance failed to show significant differences between the right- and left-sided groups. Among language measures, only the BNT revealed significant differences between the groups. The neuropsychological measures that best predicted the side of seizure onset were the BNT and Visual Reproduction II. CONCLUSIONS: Language measures predict the side of seizure focus better than memory measures. The results of this study in a sample of drug-resistant temporal lobe epilepsy patients challenge the memory material-specific theory for the side of seizure focus.

Adult↗

PubMed2005

Executive function and nonverbal memory in obsessive-compulsive disorder.

It has been suggested that memory impairments found in obsessive-compulsive disorder (OCD) are mediated by organizational problems in encoding that are caused by primary executive dysfunction. Performance on different nonverbal memory and executive skills was tested in 68 subjects (35 non-depressed OCD sufferers and 33 healthy controls). Multiple regression models were performed to analyze the role of different cognitive variables, especially organizational encoding strategies in nonverbal memory. OCD patients performed significantly worse than controls in immediate nonverbal memory [Rey-Osterrieth Complex Figure Test (RCFT)] and on all the executive functions such as interference control (Stroop test), mental set shifting (Trail-Making Test), and organizational strategies (copy organization). As no differences were found in the memory of faces, where organizational strategies are minimal, it is possible to speculate that immediate nonverbal memory problems in OCD appear only when organizational strategies mediate the recalling process. Thus, memory deficits appear to have less to do with memory, per se, and more to do with the degree of organization necessary to effectively complete the task. Statistical analyses of mediation models showed the highest explanatory power for the organizational approach and demonstrated the mediation effect of organizational strategies in nonverbal impairment.

Adult↗

PubMed2005

Neuropsychological prediction of recovery in late-onset major depression.

OBJECTIVES: To assess antidepressant response in late-onset major depression in relation to neuropsychological domains: attention, memory and planning. METHODS: A neuropsychological battery was administered in 30 medication-free patients with late-onset major depression, who were then included in a 12-week antidepressant treatment regimen within a 12-month follow-up period. Logistic regression was used to define a predictive model of recovery. RESULTS: Eighteen patients were classed as remitters and seven as non-remitters. The 'indexrem' refers to the results of a logistic regression from verbal learning and planning and had a global predictive power of 84%. CONCLUSIONS: Our study suggests that the balance between verbal learning (memory) and planning (executive function)-both related to the dorsolateral prefrontal cortex-could predicts recovery.

Age of Onset↗

PubMed2004

Decrease of the platelet 5-HT2A receptor function by long-term imipramine treatment in endogenous depression.

BACKGROUND: Animal studies have found that many antidepressants induce decreases in both the density and the functional activity of the serotonin 2A (5-HT2A) receptor subtype. However, the extrapolation of findings to humans has been inconclusive. A physiological platelet response mediated by this receptor, the serotonin-amplified platelet aggregation, was measured to study whether long-term antidepressant treatment induces changes in 5-HT2A receptor functioning in endogenous depressed patients. METHOD: The percentage of serotonin-amplified platelet aggregation to adenosine diphosphate (ADP) was studied in 15 untreated patients with major depressive disorder (DSM-IV) with endogenous features (Newcastle scale). This index was used as an indirect measurement of the functional status of platelet 5-HT2A receptors. Aggregation studies were repeated once remission of the symptoms was achieved during treatment with imipramine (150-300 mg/day). A group of 15 concurrent normal subjects was used as a control. RESULTS: A statistically significant decrease (p = 0.038) in the percentage of serotonin-amplified platelet aggregation to ADP was observed when remission was achieved (after 145 +/- 27 days). CONCLUSIONS: The results showed a decrease in a platelet functional response mediated by 5-HT2A receptors following effective imipramine treatment, suggesting that desensitization or down-regulation of the 5-HT2A receptor function could be linked to the therapeutic effect of some antidepressants. The data also support the use of platelet aggregometry as a surrogate measurement of antidepressant action, particularly in intra-subject designs.

Adult↗

PubMed2004

Silent cerebral white matter lesions and cognitive function in middle-aged essential hypertensive patients.

BACKGROUND: An association between midlife blood pressure levels and late-life cognitive impairment has been reported. Hypertension is one of the most important factors related to the presence of cerebral white matter lesions, which is a prognostic factor for the development of cognitive impairment. Studies have shown a relationship between white matter lesions and cognitive decline in elderly hypertensive patients. The aim of the present study was to evaluate cognitive function in asymptomatic middle-aged hypertensive patients according to the presence or absence of white matter lesions. METHODS: Sixty never-treated essential hypertensive patients (38 men, 22 women), aged 50 to 60 years (mean age, 54.4 +/- 3.8 years), without clinical evidence of target organ damage, were studied. All patients underwent brain magnetic resonance imaging to establish the presence or absence of white matter lesions, using the Rotterdam criteria. Cognitive function was evaluated by a neuropsychologic test battery measuring attention, memory, intelligence, anxiety, and depression. RESULTS: Twenty-three hypertensive patients (38%) were found to have white matter lesions on brain resonance. These patients exhibited a significantly worse performance on digit span forward, a standardized measure of attention than hypertensives without white matter lesions (4.86 +/- 1.14 v 5.51 +/- 0.97; P =.027). Hypertensive patients with white matter lesions showed no differences on both visual and logical memory tests when compared with patients without lesions. CONCLUSIONS: We conclude that the presence of silent cerebral white matter lesions in middle-aged hypertensive patients is associated with a mild decline in basic attention.

Blood Pressure↗

PubMed2004

Absence of additional cognitive impairment in schizophrenia patients during maintenance electroconvulsive therapy.

This study examines the cognitive impairment profile of schizophrenia patients during maintenance electroconvulsive therapy (M-ECT). Ten schizophrenia patients treated with M-ECT and ten control patients matched for diagnosis, sex, and age who had never been treated with ECT were assessed with a comprehensive neuropsychological battery. M-ECT patients did not show a higher level of memory, attention, or frontal function impairment than the control group. The absence of additional memory dysfunction may favor the functional adaptation of these patients during M-ECT.

Adult↗

PubMed2004

Cognitive function across manic or hypomanic, depressed, and euthymic states in bipolar disorder.

OBJECTIVE: The study aims were to address neuropsychological functioning across different states of bipolar illness and to determine relationships among clinical features, neuropsychological performance, and psychosocial functioning. METHOD: Several domains of cognitive function were examined in 30 depressed bipolar patients (DSM-IV criteria for major depression, Hamilton Depression Rating Scale score > or = 17), 34 manic or hypomanic bipolar patients (DSM-IV criteria for manic or hypomanic episode, Young Mania Rating Scale score > or = 12), and 44 euthymic bipolar patients (6 months of remission, Hamilton depression scale score < or = 8, and Young Mania Rating Scale score < or = 6). The comparison group consisted of 30 healthy subjects without history of neurological or psychiatric disorders. A neuropsychological battery assessed executive function, attention, and verbal and visual memory. RESULTS: The three groups showed cognitive dysfunction in verbal memory and frontal executive tasks in relation to the comparison group. Low neuropsychological performance was associated with poor functional outcome. Impairment of verbal memory was related to the duration of illness and the numbers of previous manic episodes, hospitalizations, and suicide attempts. CONCLUSIONS: A poorer performance was observed in all bipolar groups regarding executive function and verbal memory in relation to the healthy comparison subjects. These cognitive difficulties, especially related to verbal memory, may help explain the impairment regarding daily functioning, even during remission. Further studies should focus on testing, whether optimizing prophylactic pharmacological treatment and psychoeducation might reduce cognitive impairment, and whether bipolar patients would benefit from neuropsychological rehabilitation in order to reduce the impact of cognitive impairment in their overall functioning.

Adult↗

PubMed2004

Cognitive status of psychiatric patients under maintenance electroconvulsive therapy: a one-year longitudinal study.

In recent years, maintenance electroconvulsive therapy (M-ECT) has been a common treatment within psychiatric practice. Little information is available regarding the cognitive risks of this treatment, however. In this study, twenty psychiatric outpatients were assessed during M-ECT and 1 year later on treatment. A comprehensive cognitive battery was administered, and a separate comparison group was used to calculate the Reliable Change Index. Global cognitive measures showed no significant difference in scores over time. Our results concur with those described in case reports and suggest that there is no significant association between cognitive decline and M-ECT.

Adult↗

PubMed2003

Cognitive mechanisms, psychosocial functioning, and neurocognitive rehabilitation in schizophrenia.

The aim of the present study is to test Brenner's model of cognitive functioning in schizophrenia. It is assumed that elementary cognitive disorders (attention and encoding) and complex cognitive disorders (recall, concept formation) reinforce each other. Cognitive disorders are supposed to cause detrimental effects on functional outcome. We used cognitive rehabilitation as a strategy to induce cognitive changes in 27 patients assigned to treatment groups following the cognitive modules of the Integrated Psychological Treatment (IPT). Ten schizophrenic patients without cognitive impairments worked as a control group. With only one minor conceptual change (replacing concept formation with executive function, a more comprehensive construct), we found that our data fitted with Brenner's model. A relationship has been found between neuropsychological improvements and higher levels of autonomy and social functioning. These findings have important implications not only for cognitive assessment but also for selecting targets in cognitive rehabilitation.

Activities of Daily Living↗

PubMed2003

Amygdalar atrophy in panic disorder patients detected by volumetric magnetic resonance imaging.

It has been suggested that the pathophysiology of panic disorder (PD) may involve abnormalities in several brain structures, including the amygdala. To date, however, no study has used quantitative structural neuroimaging techniques to examine amygdalar anatomy in this disorder. Volumetric magnetic resonance imaging (MRI) studies of the amygdalas, hippocampi, and temporal lobes were conducted in 12 drug-free, symptomatic PD patients (six females and six males), and 12 case-matched healthy comparison subjects. Volumetric MRI data were normalized for brain size. PD patients were found to have smaller left-sided and right-sided amygdalar volumes than controls. No differences were found in either hippocampi or temporal lobes. These findings provide new evidence of changes in amygdalar structure in PD and warrant further anatomical and MRI brain studies of patients with this disorder.

Adult↗

PubMed2002

[Spanish version of a scale for the assessment of mania: validity and reliability of the Young Mania Rating Scale].

BACKGROUND: The Young Mania Rating Scale is the most widely used tool for the assessment of the intensity of manic symptoms. Unfortunately, to date, there was no Spanish validated version available. This study validated the Spanish version of the YMRS. PATIENTS AND METHOD: A sample of 541 DSM-IV manic or hypomanic bipolar patients were recruited in 56 different psychiatric settings in Spain and assessed with the YMRS by 112 clinicians specifically trained in its use on days 1, 7, 14, 30, 45 and at 3 and 6 months. The mania subscale of the Clinical Global Impression for Bipolar Disorders was also performed in order to have a standard measure to compare our results. Feasibility, reliability, validity and sensitivity of the YMRS were analysed. RESULTS: The YMRS Spanish version showed reliability index of 0.88 (internal consistency) and 0.76 (test-retest reliability), and good internal validity and external (p < 0.001) when compared to the mania subscale of the Modified Clinical Global Impression. The results also showed good sensitivity and feasibility. CONCLUSIONS: The YMRS Spanish Version is a useful, valid and reliable tool for the assessment of manic symptoms.

Bipolar Disorder↗

PubMed2002

Platelet 5-HT2A-receptor-mediated induction of aggregation is not altered in major depression.

BACKGROUND: Studies of the 5-HT(2A) receptor subtype in major depression have focused on the density of these receptors in neuronal cells and platelets, showing an up-regulation secondary to a deficit in serotonergic activity in major depression. However, their functional state has often been disregarded. The aim of the study was to investigate whether depressed patients show abnormalities in the function of the 5-HT(2A) receptor pathway in platelets. METHOD: The percentage of serotonin-amplified platelet aggregation to adenosine diphosphate (ADP) was assessed in 30 untreated patients with major depressive disorder and in 15 controls. Since 5-HT(2A) platelet receptors mediate the serotonin-induced platelet aggregation response, this index was used as a measure of the functional status of the platelet 5-HT(2A) receptor pathway. RESULTS: There was no significant difference in the percentage of serotonin-amplified platelet aggregation to ADP between depressed patients and controls. No correlation with the severity of depression, as assessed by the Hamilton scale, was found. CONCLUSION: The results showed no consistent changes in the platelet aggregating responses to serotonin in the depressed patients. Therefore this study does not support the hypothesis of an alteration of the functional status of platelet 5-HT(2A) receptors in major depression.

Adenosine Diphosphate↗

PubMed2002

Reduced levels of creatine in the right medial temporal lobe region of panic disorder patients detected with (1)H magnetic resonance spectroscopy.

In vivo proton magnetic resonance spectroscopy ((1)H MRS) was used to study possible neurochemical abnormalities in drug-free, symptomatic panic disorder patients at rest. (1)H MRS was performed in 11 panic disorder patients and 11 healthy age- and sex-matched comparison subjects. Levels of brain metabolites were determined in the right medial temporal lobe region (encompassing the whole amygdala and part of the hippocampus) and in the medial prefrontal cortex on the basis of previous work with both structural and functional neuroimaging techniques. The concentration of creatine and phosphocreatine, metabolites involved in energy-dependent systems in brain, was significantly lower in the right medial temporal lobe region of panic disorder patients compared to healthy subjects. No significant differences between the two groups were observed in the medial prefrontal cortex. These results provide neurochemical evidence suggesting the involvement of the amygdalohippocampal region in the pathogenesis of panic disorder.

Adult↗