The Journal of neuropsychiatry and clinical neurosciences
-
J Neuropsychiatry Clin Neurosci · Jan 2011
Randomized Controlled TrialTheta-patterned, frequency-modulated priming stimulation enhances low-frequency, right prefrontal cortex repetitive transcranial magnetic stimulation (rTMS) in depression: a randomized, sham-controlled study.
Efficacy of repetitive, transcranial magnetic stimulation (rTMS) has been found in depression; however, doubt still remains about its effectiveness in clinical practice. In this context, results are being explored. The authors, describing new techniques to improve response rates to rTMS treatment, compared the efficacy of adjuvant, frequency-modulated, active-priming rTMS with sham-priming stimulation in the theta range in patients with moderate-to-severe depression receiving low-frequency rTMS. ⋯ For SIGH-D scores, there was significant improvement in the active group over time. Stepwise linear-regression analysis showed that age at onset significantly predicted SIGH-D scores after the 5th rTMS session in the active-priming group. Pre-stimulation with frequency-modulated priming stimulation in the theta range has greater antidepressant effect than low-frequency stimulation alone.
-
J Neuropsychiatry Clin Neurosci · Jan 2011
Sleep disturbance after mild traumatic brain injury: indicator of injury?
Mild traumatic brain injury (mTBI) is a complex entity with no known objective diagnostic markers. To test the hypothesis that sleep disturbances in the acute mTBI period can serve as an indicator of brain injury, the authors compared sleep polysomnograms (PSG) and sleep EEG power spectra (PS) data in seven mTBI subjects with seven age- and race-matched healthy-control subjects. The two groups differed significantly on PS measures, suggesting that mTBI can result in a disruption of sleep microarchitecture and, in theory, could be of use as a marker for brain injury. These pilot findings need to be replicated on larger samples.
-
J Neuropsychiatry Clin Neurosci · Jan 2011
Phenomenological and neuropsychological profile across motor variants of delirium in a palliative-care unit.
Studies using composite measurement of cognition suggest that cognitive performance is similar across motor variants of delirium. The authors assessed neuropsychological and symptom profiles in 100 consecutive cases of DSM-IV delirium allocated to motor subtypes in a palliative-care unit: Hypoactive (N=33), Hyperactive (N=18), Mixed (N=26), and No-Alteration motor groups (N=23). ⋯ Most patients (70%) with no motor alteration had DRS-R-98 scores in the mild or subsyndromal range even though they met DSM-IV criteria. Motor variants in delirium have similar cognitive profiles, but mixed cases differ in expression of several noncognitive features.
-
J Neuropsychiatry Clin Neurosci · Jan 2010
Relationship between cognitive status at admission and incident delirium in older medical inpatients.
To evaluate the relationship between cognitive status and incident delirium, 291 geriatric patients on internal medicine wards were evaluated on admission with the Mini-Mental State Examination (MMSE) and Confusion Assessment Method-Spanish. Those with incident delirium were assessed using the Delirium Rating Scale-Revised-98 (DRS-R98). ⋯ Optimal MMSE cutoff score from receiver-operating characteristic curve analysis was 24.5. Even mild cognitive deficits increase delirium risk and severity.