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Biomedical subjects

Shih-Jen Tsai

Publications and source records attributed to Shih-Jen Tsai.

At least 109 records · Page 6Linked to original sources
PubMed2003

Association of muscarinic m1 receptor genetic polymorphisms with psychiatric symptoms and cognitive function in schizophrenic patients.

OBJECTIVE: The cholinergic system is important in the search for the pathophysiology of schizophrenia due to its role in cognitive function, interaction with the dopamine system in brain regions relevant to schizophrenia, side effects of antipsychotic medication and potential antipsychotic effect of muscarinic receptor antagonists. This study investigated the association of type I muscarinic receptor (CHRM1) genetic polymorphisms with the clinical characteristics of chronic schizophrenic inpatients. METHODS: We determined the genotype of CHRM1 genetic polymorphisms in 243 schizophrenic patients hospitalized in chronic care wards. Psychotic symptoms were assessed using the Brief Psychiatric Rating Scale (BPRS), and cognitive function was assessed using the Folstein Mini-Mental Status Examination (MMSE) test. Sixty of the 243 subjects also completed the Wisconsin Card Sorting Test (WCST). RESULTS: There was a significant difference in the number of correct responses and the percentage of perseverative errors in the WCST in the CHRM1 C267A genotype group of schizophrenia patients. There was no significant association between age at onset, chlorpromazine equivalents, BPRS scores, MMSE or schizophrenia per se in patients with the CHRM1 C267A genotype. The full exon of the CHRM1 gene was screened out with single-strand conformation polymorphism, and 2 single nucleotide polymorphisms (C267A and C1353T) were identified in our patients and control subjects. These 2 single nucleotide polymorphisms were linked together without exception. CONCLUSION: This study demonstrated that in schizophrenic patients, the heterozygote group of CHRM1 C267A polymorphism (267C/A) had more correct responses and less perseverative errors on the WCST performance than the 267C/C homozygote group, implicating that this polymorphism may be related to prefrontal cortical function. Our results also suggested that the C267A polymorphism plays no major role in the susceptibility to and clinical manifestations of schizophrenia.

Adolescent↗
PubMed2003

Expression of cAMP response element-binding protein in major depression before and after antidepressant treatment.

Antidepressants usually take weeks to exert significant therapeutic effects. This lag phase is suggested to be due to neural plasticity, which may be mediated by the coupling of receptors to their respective intracellular signal transduction pathways. Phosphorylated cAMP response element-binding protein (CREB), a downstream target of the cAMP signaling pathway, has been reported to be a molecular state marker for the response to antidepressant treatment in patients with major depressive disorder (MDD). In order to explore the role of CREB expression in MDD, we used quantitative reverse transcriptase-polymerase chain reaction to quantify CREB messenger RNA of the peripheral lymphocytes obtained from 21 MDD patients, before and after antidepressant treatment, and 21 normal controls. The results revealed no significant difference of CREB expression between untreated MDD patients and normal controls. However, after 8 weeks of antidepressant treatment, CREB expression was significantly decreased in MDD patients (p = 0.025). The CREB change is not associated with the types of antidepressants and therapeutic response.

Adult↗
PubMed2003

Association study of a brain-derived neurotrophic-factor genetic polymorphism and mood disorders, age of onset and suicidal behavior.

Brain-derived neurotrophic factor (BDNF), a member of the neurotrophin growth factor family, has been implicated in both mood disorders and suicidal behavior. This study has examined the association between the BDNF gene Val66Met polymorphism and mood disorders, age of onset and suicidal behavior in a Chinese sample population. The genotype and allele frequencies for the BDNF gene Val66Met polymorphism did not differ comparing depression groups (total, bipolar disorder or major depression) and control subjects. Furthermore, it was not demonstrated that this BDNF polymorphism was associated with age of onset or suicidal history in our mood disorder patients. Based on these results, it seems reasonable to suggest that this polymorphism is unlikely to play a major role in the genetic susceptibility to mood disorders. Given the fact that the positive association between BDNF gene Val66Met polymorphism and bipolar disorder has only been demonstrated for a Caucasian population but not for a Japanese analog or our Chinese sample, it appears likely that this association is ethnicity dependent.

Adult↗
PubMed2003

Long-term glue sniffing: report of six cases.

OBJECTIVE: Glue is cheap and readily available, and is frequently misused, especially by adolescents. Long-term effects of regular use, in terms of the psychiatric symptoms and cognitive function, have rarely been reported, however. METHOD: We retrospectively reviewed the psychiatric symptoms and the results of cognitive tests for six long-term glue sniffers admitted to a psychiatric ward. RESULTS: Our results suggest that long-term abuse of these adhesive products is often associated with violent behavior and/or self-mutilation. Functional deterioration, characterized by impairment of intelligence, was noted for most of the patients, with some developing psychosis. CONCLUSIONS: Chronic glue sniffing may cause functional deterioration, and even psychosis. The associated violent behaviors in long-term glue sniffers also warrant caution.

Adolescent↗
PubMed2003

St. John's wort (Hypericum perforatum) as a treatment for premenstrual dysphoric disorder: case report.

Premenstrual dysphoric disorder (PMDD), a menstruous dysfunction, is characterized by profoundly depressed mood, and studies have shown that antidepressants are effective for PMDD. The authors describe a case of PMDD who was initially treated with selective serotonin reuptake inhibitors. Due to intolerable gastrointestinal side effects with selective serotonin reuptake inhibitors, St. John's wort (900 mg/day) was substituted and much improvement in PMDD symptoms was noted for at least five-month follow-up. The authors propose that St. John's wort could be an alternative medication for PMDD, especially for patients experiencing intolerable side effects with selective serotonin reuptake inhibitors.

Adult↗
PubMed2003

A double-blind, randomized, group-comparative study of the tolerability and efficacy of 6 weeks' treatment with mirtazapine or fluoxetine in depressed Chinese patients.

AIM: To compare the efficacy and tolerability of mirtazapine and fluoxetine treatment in a sample population consisting of Chinese patients suffering moderate-to-severe depression. METHOD: 133 patients with a diagnosis of major depressive episode (DSM-IV) and scoring 15 or more on the 17-item Hamilton Rating Scale for Depression (HAM-D) were randomly assigned to receive 6 weeks of treatment with either mirtazapine (15-45 mg/day) or fluoxetine (20-40 mg/day). Efficacy was assessed using the HAM-D and Clinical Global Impressions scale, with analyses performed on the intent-to-treat sample using the last-observation-carried-forward method. Safety analysis was based on the all-subjects-treated group. RESULTS: Mean daily doses were 34.1 mg for mirtazapine (N = 66) and 30.7 mg for fluoxetine (N = 66). Thirty patients in the mirtazapine group and 22 in the fluoxetine group dropped out. Both drugs proved equally effective for reduction of the overall symptoms of depression throughout the treatment period. At day 42, the mean reductions in HAM-D total score (compared with baseline) were 11.8 and 10.6 for the mirtazapine and fluoxetine groups, respectively; however, the changes were not statistically significant. Both treatments were well tolerated, with more nausea and influenza-like symptoms observed for the fluoxetine group, and greater weight increase and somnolence for the mirtazapine analog. CONCLUSION: Both mirtazapine and fluoxetine were indistinguishable in effectiveness for treatment of depressive symptoms, and both were well tolerated by our population of depressed Chinese patients. In line with analogous Western reports, the safety of mirtazapine and fluoxetine was comparable for our depressed Chinese patients; however, slightly different side effect profiles were noted for the 2 drugs in our study.

Adolescent↗
PubMed2003

Amisulpride versus risperidone in the treatment of schizophrenic patients: a double-blind pilot study in Taiwan.

BACKGROUND AND PURPOSE: The atypical antipsychotics, amisulpride and risperidone, have different receptor affinity characteristics. Although the relative efficacy of both drugs compared to conventional antipsychotics is well established, it remains unclear how the efficacy of amisulpride compares with risperidone. There have been no controlled studies comparing amisulpride to risperidone in Asian patients. The purpose of this study was to compare the efficacy and safety of amisulpride with that of risperidone in Taiwanese schizophrenic patients. METHODS: Patients with productive positive symptoms (n = 48) were enrolled into this double-blind, randomized pilot study for 6 weeks. Patients received either amisulpride (400-800 mg/day) or risperidone (4-8 mg/day). Positive and Negative Syndrome Scale (PANSS), Clinical Global Impression (CGI), Social and Occupational Functioning Assessment Scale (SOFAS), and patients' subjective responses to treatment were assessed during the trial period. Adverse events were recorded at each follow-up visit. RESULTS: At the end of the trial, the mean dosage was 630 +/- 134 mg/day and 6.88 +/- 1.54 mg/day for amisulpride and risperidone, respectively. There was no significant difference in the reduction of the PANSS total score (amisulpride -24.1 versus risperidone -28.4, p = 0.999), the PANSS positive subscale score (amisulpride -6.8 versus risperidone -8.3, p = 0.467), the PANSS negative subscale score (amisulpride -5.6 versus risperidone -6.4, p = 0.999), or the CGI score between the two groups. The extrapyramidal symptom ratings, the improvement in the SOFAS (amisulpride 11.1 versus risperidone 10.0) and the subjective response (amisulpride 82% versus risperidone 83%) were comparable. No serious adverse events were recorded in either treatment group. There was a statistically significant body weight gain in the risperidone group. In contrast, there was a statistically, though not clinically, significant reduction of blood pressure and heart rate in the amisulpride group. CONCLUSIONS: This study suggests that amisulpride is as effective as risperidone in the treatment of patients with schizophrenia. Both drugs were well tolerated, but had different side effect profiles.

Amisulpride↗
PubMed2002

Norepinephrine transporter and alpha(2c) adrenoceptor allelic variants and personality factors.

It has been suggested that reward dependence, as measured by the Tridimensional Personality Questionnaire (TPQ), is related to central noradrenergic activity, a proposition supported by two studies of urinary norepinephrine metabolite. In the current investigation, 190 normal young Han Chinese were examined, with genetic polymorphisms determined for the norepinephrine transporter (1287G/A) and the alpha(2c)-adrenoceptor (Del322-325) to test the association with TPQ personality traits. No significant association was demonstrated for these two polymorphisms and any of the TPQ personality-factor scores, including reward dependence and its subscales. Our negative findings suggest that the investigated polymorphisms of the norepinephrine transporter and the alpha(2c) adrenoceptor do not play a major role in the reward-dependence personality trait as assessed by TPQ.

Adult↗
PubMed2002

No association for D2 and D4 dopamine receptor polymorphisms and methamphetamine abuse in Chinese males.

The D2 and D4 dopamine receptors (DRD2 and DRD4) play major roles in the central effects of psychostimulants and in the reward system. Previous studies, although not all, have demonstrated associations between the DRD2 TaqI and the DRD4 exon III variable number tandem repeat (VNTR) polymorphisms and substance dependence. For this study, we have investigated the associations between these two polymorphisms and methamphetamine (MAP) dependence, as manifested in a Chinese-male sample population. No significant difference was demonstrated for genotype or allele frequency when comparing MAP-dependent and control cases for the DRD2 TaqI and the DRD4 gene exon III VNTR polymorphisms, suggesting that these two polymorphisms do not play major roles in MAP dependence for our sample of Chinese males.

Amphetamine-Related Disorders↗
PubMed2002

Serotonin transporter genetic polymorphisms and harm avoidance in the Chinese.

The association for the harm avoidance (HA) dimension, as assessed by the Tridimensional Personality Questionnaire (TPQ), and the serotonin-transporter genetic polymorphisms has been investigated with controversial results. The aim of the present study was to replicate this investigation and to establish the association for a Chinese population. Two polymorphisms of the serotonin transporter (5HTT-LPR, serotonin transporter-linked polymorphism region; 5HTT-VNTR, variable number tandem repeat polymorphism in intron 2 of the serotonin transporter gene) were determined for 192 healthy Han Chinese who had completed the TPQ. No significant differences were demonstrated for TPQ HA scores, including the sub-scales, for subjects with different 5HTT-LPR genotypes. A significantly higher HA2 sub-score was demonstrated for subjects carrying the 10-12 5HTT-VNTR genotype, however, compared with those from the 12-12 genotype group, for the male population (P = 0.007). Our findings suggest that the 5HTT genetic polymorphism may be associated with HA scores; however, the effect is influenced by ethnicity and gender.

Asian People↗
PubMed2002

Genetic variant of the histamine-1 receptor (glu349asp) and body weight change during clozapine treatment.

Clozapine treatment frequently causes body weight gain that may impair health and may affect patient compliance. While the histamine-1 (H1) receptor may play a major role in the mechanism of the clozapine-induced body weight change, we tested the relationship between the genetic variant (Glu349Asp) of the H1 receptor and the clozapine-induced body weight change. Eighty-eight schizophrenic patients treated with clozapine were included in this study. Analysis of body weight change after 4 months of clozapine treatment showed no relationship with the H1 genotype. Further exploration of the other H1 genotypes and the antipsychotic-induced body weight change may help in the understanding of the mechanisms of antipsychotic-induced body weight gain and in the choice of patient's antipsychotic regimens.

Adolescent↗
PubMed2002

Study of the association between Alzheimer's disease and angiotensin-converting enzyme gene polymorphism using DNA from lymphocytes.

Angiotensin-converting enzyme (ACE) may play a role in cognition and memory. A recent study found that a 287-bp insertion/deletion (I/D) polymorphism of the ACE gene is associated with susceptibility to Alzheimer's disease (AD). However, this finding has not been replicated by all studies. These discrepancies may be due to the difference in ethnic background. Therefore, we investigated the possibility of such an association in 173 AD patients and 286 normal controls from a Chinese population. We found that there is an increased frequency of the ACE I allele in AD patients and the odds ratio for bearers of the I allele was 2.88. Our findings further support previous reports of an association between ACE polymorphism and AD. The implication of the ACE I/D polymorphism in the pathogenesis of AD warrants further exploration.

Adult↗
PubMed2002

Association analysis for the genetic variants of the NMDA receptor subunit 2b and Alzheimer's disease.

N-methyl-D-aspartate (NMDA) receptor dysfunction has been implicated in the pathogenesis of Alzheimer's disease (AD). The NMDA receptor is composed of several subunits, of which the receptor 2b subunit (NR2b) is of particular significance for AD. Abundant in the hippocampus of normal subjects, reductions in NR2b have been demonstrated in the hippocampus and entorhinal cortex of AD patients. In this study, we tested the hypothesis that the allelic variant (C2664T) of the NR2b confers susceptibility to AD using a sample population of 132 AD patients and 114 normal controls. The distribution of the NR2b genotypes (p = 0.600) and alleles (p = 0.652) did not differ significantly between AD patients and controls, however, suggesting that it is unlikely that the NR2b C2664T polymorphism plays a substantial role in conferring susceptibility to AD. We propose that other genetic variations of the NMDA subunits, relating either to AD or to the therapeutic response for NMDA partial agonists, may need further investigation.

Aged↗
PubMed2002

Dopamine D2 receptor and N-methyl-D-aspartate receptor 2B subunit genetic variants and intelligence.

The dopaminergic and glutamate systems have been implicated in cognitive function. We tested the associations between the dopamine D2 receptor (DRD2) and N-methyl-D-aspartate receptor 2B subunit (GRIN2B) gene variants and intelligence quotient (IQ). Subjects with the DRD2 A1/A1 genotype had a significantly higher mean performance IQ than A2/A2 carriers, while no significant differences in IQ scores were determined for the three GRIN2B genotype groups. These results suggest that genetic variants of the DRD2 gene may play a role in cognitive function. Considering the major role played by the dopaminergic system in general cognitive function, genetic variants of the dopamine receptors and those involved in metabolism and modulation of reuptake should be tested to improve gene-based prediction of general cognitive function.

Adult↗
PubMed2002

Association for serotonin transporter gene variable number tandem repeat polymorphism and schizophrenic disorders.

In contrast with two previous western reports, a recent study on a Chinese population found an association for allele 12 of the variable number tandem repeat (VNTR) in the second intron of the serotonin transporter (5-HTT) gene and schizophrenic disorders. We have replicated this finding for a Chinese population in Taiwan (114 schizophrenic patients and 127 controls), demonstrating a modest but significant statistical association for the 5-HTT-VNTR allele 12 and schizophrenic patients (one-sided p = 0.043). This positive finding further supports the proposition that the 5-HTT-VNTR allele 12 is a risk factor for schizophrenic disorders in Chinese populations, although the effect is weak.

Adult↗
PubMed2002

Smoking in chronic schizophrenic inpatients in taiwan.

OBJECTIVE: This study investigated the prevalence of smoking and its association with the clinical characteristics of Chinese inpatients with chronic schizophrenia. METHOD: Schizophrenic patients hospitalized in chronic wards were assessed using Brief Psychiatric Rating Scale (BPRS), Abnormal Involuntary Movements Scale (AIMS) and Folstein Mini-Mental Status Examination (MMSE) testing. RESULTS: Of 257 patients, 105 smoked and 4 had ceased. Males exhibited a higher prevalence of smoking than females (p < 0.001). Smoking was not significantly associated with age at onset (AAO), chlorpromazine equivalents, MMSE, AIMS, BPRS positive symptom subscale, BPRS negative symptom subscale or total BPRS scores. Smokers had higher BPRS general subscales. CONCLUSION: Compared to the general population, smoking prevalence was slightly higher in schizophrenic males, double in schizophrenic females, but no difference in refractory schizophrenic clozapine users. Smoking did not affect patient AAO or daily antipsychotic dose. Patients with a higher BPRS general subscale may smoke to relieve affective symptoms.

Adult↗