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Biomedical subjects

T Marcos

Publications and source records attributed to T Marcos.

At least 19 recordsLinked to original sources
PubMed2004

Neuropsychological markers of dementia in patients with memory complaints.

OBJECTIVES: To identify neuropsychological markers able to predict evolution towards dementia, through the detection of differential neuropsychological characteristics in a group of subjects complaining of memory loss, in a longitudinal, two-year follow-up study. METHODS: Longitudinal and retrospective comparisons of neuropsychological performance in: (a) subjects complaining of memory loss who, after a two-year period, met neurological and clinical diagnostic criteria for probable AD, and (b) subjects from the same group who did not progress towards dementia. A sample of 43 subjects were administered a comprehensive neuropsychological battery evaluating orientation, logical-verbal and visuoperceptive reasoning, immediate and delayed verbal and visual memory, attention, learning, executive functions and semantic and phonemic verbal fluency. RESULTS: Of the 43 subjects evaluated and then re-evaluated two years later, ten (23%) progressed to dementia according to the NINCS-ADRDA criteria for probable Alzheimer's disease. The neuropsychological performance of the rest of the subjects (n=33) over the two examinations was stable. In the retrospective analysis the principal differences between the two groups were found in the intensity of the initial memory deficits (WMS-R) and in the impairment of other cognitive areas in the dementia group: formation of concepts, vocabulary and similarities (WAIS), learning (WMS-R) and several executive functions. CONCLUSIONS: The deficits in cognitive areas other than memory are significant in subjects with memory complaints who progress towards dementia within two years. Memory complaints represent a risk factor that is at least as important as actual memory loss. Recent proposals for adding descriptive labels to the diagnosis of Mild Cognitive Impairment (MCI) in order to reflect the neuropsychological functions impaired in addition to memory (Petersen, 2001a), may be decisive from the prognostic viewpoint.

Aged↗
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↗
PubMed2001

Frontal cerebral perfusion dysfunction in elderly late-onset major depression assessed by 99MTC-HMPAO SPECT.

Baseline regional cerebral blood flow of thirty unmedicated late-onset unipolar major depressed patients over the age of 60 years and 20 sex-, age-, and vascular risk factor-matched healthy controls was imaged with single photon emission computed tomography, using technetium-99m hexamethylpropylene amine oxime as a tracer. To avoid errors of diagnosis--in particular, confusion between major depression and organic cognitive impairment--only treatment responders were included in the final sample. Statistically significant differences were observed in both left and right anterior frontal regions, with reduced uptake in depressed patients; these differences were more pronounced in the left hemisphere. Among patients, there was no correlation between regional cerebral blood flow and the severity of baseline symptoms. Our results support the hypothesis that certain neuroanatomic regions of the central nervous system may be functionally involved in elderly unipolar major depression, particularly in the late-onset subgroup.

Aged↗
PubMed2001

Subtyping of panic disorder patients with bradycardia.

PURPOSE: Since clinical practice suggests that panic disorder may not be a homogeneous condition, a study was carried out to test the possible existence of different groups or subgroups of panic patients. SUBJECTS AND METHODS: Thirty-two panic patients (DSM-III-R) underwent lactate challenge in our laboratory and were assessed for heart rate, blood pressure, sweating and Acute Panic Inventory. RESULTS: During the lactate challenge, patients complaining mainly of 'cardiorespiratory' symptoms (N = 12) showed tachycardia and localized sweating. Conversely, patients complaining mainly of 'pseudoneurological' symptoms (N = 16) showed bradycardia and generalized sweating. In both groups, Acute Panic Inventory scores were significantly higher during than before the panic attack, but the distribution of the scores was markedly different. DISCUSSION AND CONCLUSION: The results suggest that panic disorder may be a heterogeneous condition. Implications of these results to other phobic disorders, to Klein's false suffocation alarm theory and to the 'extended amygdala model' are discussed.

Acute Disease↗
PubMed2001

Citalopram versus nortriptyline in late-life depression: a 12-week randomized single-blind study.

OBJECTIVE: The aim of this single-blind study was to examine the efficacy and tolerability of citalopram compared to nortriptyline in moderate to severe major depressive patients aged 60 years or over. METHOD: In- and out-patients (N=58) with unipolar major depression were randomized to 12-week flexible dose treatment with nortriptyline or citalopram. RESULTS: No significant differences between the number of drop-outs in either group were observed, but the autonomic side-effects were significantly higher for nortriptyline than for citalopram. A significantly higher remission rate to nortriptyline than to citalopram was demonstrated, particularly if severe patients (endogenous or psychotic patients) were assessed. CONCLUSION: The remission rate to a therapeutic plasma level of nortriptyline appears to be higher than the remission rate to a standard dose of citalopram in a group of elderly major depressed patients, especially those with endogenous or psychotic features. On the other hand, citalopram appears to be better tolerated.

Age of Onset↗
PubMed2000

[Neuropsychological pattern of cognitive impairment in Alzheimer type dementia and vascular dementia].

BACKGROUND: Cummings et al, 1987, hypothesized that Alzheimer dementia type (ADT) patients would present poorer performances than vascular dementia (VD) patients on the neuropsychological tests that mainly involve cortical neurological structures, and that VD would perform worse on tests that mainly involve subcortical structures. The main purpose of the research was to identify a cognitive impairment pattern that discriminates the type of dementia in the initial stages. METHOD: Two groups of patients, one affected by mild ADT (n = 30) and the other by multi-infarct dementia (VD, n = 30) were given a neuropsychological battery. The battery was composed by Temporal Orientation (Benton et al.); Vocabulary, Similarities, Digits, Coding and Kohs (WAIS) of Wechsler; the Colour-Form Test of Weigh; the Trail Making Test (A and B) (Halstead-Reitan Neuropsychological Battery); Tapping (McQuarrie); Logical Memory, Visual Memory and Paired Association (Wechsler Memory Scale) of Wechsler; Delayed Memory (Russell). The two groups were similar in age and socio-cultural features. The z-score and its statistical significance on the Mann-Whitney test were made and we performed an exploratory discriminant analysis to the classification. RESULTS: In general, results were poorer in the ADT group. But we detected no significant differences in the tests, although some test (Immediate Visual Memory and Kohs' Blocks) almost reached significance. The discriminant analysis reached a classification of the 67% of the subjects into the ADT group and the 70% of the subjects into the VD group. CONCLUSIONS: In the initial stages of dementia it is difficult to differentiate between a cortical pattern of cognitive impairment in ADT and a subcortical pattern in VD, a distinction that the other researchers have reported. When complex tests were used the performance depended on the coordination of multiple related systems. These findings are in agreement with the holistic models of higher mental functions.

Aged↗
PubMed2000

Analysis of the polymorphic (GT)(n) repeat at the dopamine beta-hydroxylase gene in Spanish patients affected by schizophrenia.

The presence of a polymorphic (GT)(n) repeat, a microsatellite repeat, at the human dopamine beta-hydroxylase (DBH) gene had been previously investigated in healthy people and in schizophrenic patients. The different DBH genotypes had been found to be associated to different DBH biochemical function, but no differences were found in the allelic and genotype frequencies between schizophrenic and control groups. To further clarify the potential involvement of the variation at the DBH gene in schizophrenia we have studied the DBH (GT)(n) repeat in a sample of 47 Spanish schizophrenic patients, in their healthy relatives (n = 72), and in a control population (n = 74). We have been able to identify five different variants of the DBH gene (A1, A2, A3, A4, A5) in the different groups. Subsequent statistical analysis revealed that the genotypes as well as the allele frequencies did not differ significantly among schizophrenic patients and the control population. Interestingly, the allelic variant A2 and the genotype A4/A2 were significantly more frequent in schizophrenic patients as compared with their healthy relatives. However, the association of the A2 allele with schizophrenia was not supported by the haplotype relative risk analysis of transmitted versus nontransmitted alleles. Therefore, although it will be important to extend the present analysis in a larger sample of schizophrenic patients and controls, our results suggest that the (GT)(n) does not seem to play a major role in the genetics of schizophrenia at least in this group of Spanish schizophrenic patients. Am. J. Med. Genet. (Neuropsychiatr. Genet.) 96:88-92, 2000.

Alleles↗
PubMed1995

[Delirium in an elderly population admitted at a general hospital].

BACKGROUND: Delirium is an organic mental disorder frequently seen in elderly patients admitted to hospital for medical or surgical diseases. The prevalence, triggering factors, the relationship with prior existence of dementia and the evolution of delirium were studied. METHODS: One hundred eight elderly patients admitted to the Internal Medicine, General Surgery and Traumatology Departments of the Hospital Clínic i Provincial in Barcelona, Spain were randomly selected with clinical evaluation being performed following the DSM-III-R diagnostic criteria. Likewise a structured clinical interview (CAMDEX) was carried out, and the establishment of delirium, the possible causes and its evolution were evaluated. RESULTS: Eighteen of the elderly patients studied presented delirium at some time during hospital stay. Of these patients 15 had previously been clinically diagnosed with dementia. These patients did not require longer hospital stay than those not presenting dementia. The most frequent etiology was surgery and fever due to an infectious process. In addition to etiologic treatment, 12 of the patients also received symptomatic treatment with a neuroleptic drug (haloperidol). CONCLUSIONS: Most of the elderly who have presented delirium admitted in a general hospital had been diagnosed with dementia during hospital stay thus indicating the high comorbidity of the two entities. In many cases it is important to carry out symptomatic in addition to etiologic treatment to achieve rapid reversibility of the disorder.

Aged↗
PubMed1995

Affective disorders, social support, and health status in geriatric patients in a general hospital.

A randomized-sample taken from all elderly patients aged 70 years and over hospitalized for medical/surgical disorders was studied (N = 108) to determine the influence of health problems and social support on depression. According to DSM-III-R diagnostic criteria, 50.9% had psychiatric disorders and 15.7% had affective disorders. In the total sample, depressive symptoms significantly correlated with the existence of health problems and lack of social support, but independently considered, these variables did not have a significant influence on diagnoses of depressive disorders.

Adjustment Disorders↗
PubMed1994

Cognitive dysfunctions in recovered melancholic patients.

Cognitive dysfunctions were studied in symptom-free patients suffering from Recurrent Depressive Disorder with melancholia. Their performances on a standard neuropsychological battery were compared with those of a healthy sample matched for age and educational level. Statistically significant differences were found in Immediate Visual Memory, Delayed Logical and Visual Memory, Paired Learning and Block Design. Results seem to indicate that the cognitive disfunctions are not likely to be only mnesic. All these data suggest that these disfunctions found in some melancholic depressives could not be state-dependent.

Adult↗
PubMed1994

Factorial study of the BDI in pregnant women.

This study was carried out to investigate the significance of Beck Depression Inventory (BDI) scores and the influence of somatic items in a non-psychiatric population presenting with somatic complaints. Internal consistency, item frequency, factor dimensions, and correlation with Eysenck's 'N' were analysed in a sample of 882 non-psychiatric pregnant women. The BDI showed a high level of internal consistency (Cronbach alpha coefficient was 0.85). Factor analysis yielded two major factors. Low BDI scores were determined mainly by items related to somatic complaints or decreased activity without unequivocal depressive content. In contrast, it was unambiguous depressive items that were endorsed in high scores, and these showed higher correlations with neuroticism. It is concluded that in non-psychiatric populations the BDI may measure conditions other than depression and that low or medium range scores should not be interpreted as indicators of mild depressive symptomatology.

Adolescent↗
PubMed1992

Factor study of the Geriatric Depression Scale.

A sample of 234 people between the ages of 60 and 95 was studied using the Brink-Yesavage Geriatric Depression Scale (GDS). The GDS has good concurrent validity with the Hamilton Rating Scale for Depression with the Melancholia Scale (r = 0.77), which confirms the clinical utility of this scale. A factor analysis of principal components with an oblimin rotation was performed. The results obtained imply that structural validation cannot be made in relation to Beck's cognitive model of depression. It can be concluded that the elimination of the somatic items does not add any theoretical correspondence with the model, as the factors tend to group the various items into one dimension.

Aged↗
PubMed1992

Clomipramine versus phenelzine in obsessive-compulsive disorder. A controlled clinical trial.

A double-blind clinical trial of clomipramine versus phenelzine was carried out on 30 patients suffering from DSM-III obsessive-compulsive disorder. The study period was 12 weeks, and the maximum doses used (from the fifth week on) were 225 mg/day for clomipramine (14 patients) and 75 mg/day for phenelzine (12 patients); four patients dropped out. Obsessive symptoms improved significantly in both drug groups, but there was no significant difference between groups. Depressive symptoms improved before obsessive ones.

Adult↗
PubMed1990

Factor study of the Hamilton Rating Scale for Depression and the Bech Melancholia Scale.

In this study, a sample (n = 234) of elderly people between the ages of 60 and 95 was evaluated. Items from the Hamilton Rating Scale for Depression and the Bech-Rafaelsen Melancholia Scale were factorialized using the oblique rotation method oblimin. Three clinically significant factors were obtained, accounting for 41% of variance. The first was interpreted as a dimension of inhibition and melancholic depression; the second, insomnia; and the third, somatic and psychic anxiety. It is concluded that the set of items on both scales increases the capacity for evaluating melancholic aspects of depression. In the interpretation of factor analysis, the possible artifact represented by the repetition of similar items must be kept in mind. Despite the loss of simplicity oblique rotation implies, it is considered preferable to orthogonal rotation since it allows for a greater congruity with clinical situations.

Aged↗
PubMed1987

Ventricular enlargement and neuropsychological testing in schizophrenia.

The Ventricular Brain Ratio was computed in a group of 42 young chronic schizophrenics (age range: 17-45). The patients also completed a battery of neuropsychological tests: four WAIS subscales, the Benton test and the Trail Making Test. Although patients as a whole showed the expected ventricular enlargement and neuropsychological impairment when compared to control groups, no correlation was found between the two measures. These results are inconsistent with previous work on the same topic that hypothesized the association of both parameters. Some tentative explanations for these conflicting results are given.

Adolescent↗