[Psychiatric rehabilitation--a report from Wakayama].
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Biomedical subjects
Publications and source records attributed to Y Momotani.
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A power spectral analysis was performed on occipital EEGs recorded from 36 Down Syndrome (DS) subjects aged 15 to 54 and compared with two control groups; 47 healthy volunteers (Control) and 42 mentally retarded people without DS (MR). The frequencies of occipital alpha rhythms of DS showed a significant inverse correlation with chronological age, while Control and MR did not. The average frequencies of DS were significantly low even in the youngest age-group in comparison with those of Control, and also decreased in the age-groups of 35 and older compared with MR. It was considered that a slowing of alpha rhythm was a manifestation of premature aging that occurred in the underdeveloped brains of DS.
In the present study, we investigated the neurological mechanism of commonly known specific or unnatural postures in schizophrenic patients. Using a gravimeter, body sway studied in 26 chronic schizophrenic patients, 10 schizoaffective disorder patients and 21 normal subjects. During eye fixation at a target while keeping an upright posture, schizophrenic patients presented a larger gravimetric area than the normal subjects and the patients with schizoaffective disorder. There was a negative correlation (r = -0.509) between the standard deviation of the sway gravimetric area during fixation and the dose of neuroleptics in schizophrenic patients, but no correlation was found in patients with schizoaffective disorder (r = -0.01), although they took neuroleptics in a similar regimen to that for the schizophrenics. There was no correlation between the standard deviation of the sway gravimetric area during fixation and the duration of illness. There was also no correlation between the former and the amplitude ratio of saccades during smooth pursuit eye movements. When horizontal eye movements pursuing the target were loaded in this experiment, both the normal subjects and the patients with schizoaffective disorder showed a decrease in a loaded gravimetric area and a tendency towards postural stabilization. However, schizophrenic patients having higher SANS scores (Andreasen) presented an increase in gravimetric area. This suggests that schizophrenic patients with higher SANS score may have organic cerebellar changes related to impairment of the mechanism of visual and postural coordinations.
The overall effect of zotepine was a "slightly improved" or better response in 20 patients (64.5%), "unchanged" in 10 (32.3%) and "worsened" in 1 (3.2%). Zotepine exhibited some degree of improvement in 54.5% of patients unresponsive to prior drugs. The onset of effect of zotepine was within one month in 19 patients. The improvement rate in the hebephrenic type (66.7%) was almost the same as in the paranoid type. The improvement rate classified by psychopathology was highest for hypobulia, followed by restlessness-excitement and hallucination, depressive mood, hypochondria and delusion. The side-effects were subjective complaints, such as general fatigue, dryness of mouth, sleepiness or fainting in a small number of cases. There was a slight increase in S-GPT in one patient and a slightly increased blood platelet count, also in one patient. Serial EEG changes associated with zotepine studied in another 17 chronic schizophrenics could be classified into three groups: those with increased slow waves, those with enhanced alpha waves and those with unchanged EEGs. There was a positive correlation between the incidence of slow waves and higher plasma levels of zotepine.
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