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Objective:To investigate regional homogeneity(ReHo)and whole brain functional connectivity(FC)in patients with mild cognitive impairment(MCI), and to explore the mechanisms of MCI in the resting state.Methods:Resting-state functional magnetic resonance imaging(RS-fMRI)was performed on 24 patients with MCI and 30 age, gender and nationality-matched normal controls.Abnormal brain areas in the MCI group were screened and analyzed by using the DPARSFA2.3 and SPM8 software programs.Whole brain FC analysis was performed with the posterior cingulate cortex(PCC)/precuneus as the seed points.Results:Compared with the control group, MCI subjects displayed higher ReHo values in the frontal-middle-Left, precentral-Left, postcentral-Left, rolandic-opercular-Left, and frontal-inferior-opercular-Left and lower ReHo values in the temporal-superior-right, temporal-middle-right, postcentral-right, and temporal -pole -superior -right(Voxel level, Alphasim correction, P<0.05). Whole brain FC analysis showed greater functional connectivity of PCC/precuneus with fusiform-right, thalamus-right, lingual-right and parahippocampal-right in subjects with MCI, and less functional connectivity of the PCC/precuneus with temporal-middle-Left, angular-Left, temporal-superior-Left and occipital-middle-Left in subjects with MCI(Voxel level, Alphasim correction, P<0.05). Conclusions:Abnormalities of the default mode network may be associated with the onset of MCI, and abnormalities in posterior cingulate/precuneus connectivity may be helpful in finding imaging evidence with high sensitivity to MCI.
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Objective:To investigate the mechanism of subjective cognitive decline(SCD)in resting-state by using regional homogeneity(ReHo)and functional connectivity(FC)in SCD patients.Methods:Resting-state functional magnetic resonance imaging(RS-fMRI)was performed in 25 SCD patients and 30 normal controls matched by sex, education and nationality.DPARSFA2.3 and SPM8 software were used to analyze and screen the brain areas with abnormal ReHo values in SCD group, with the posterior cingulated(PCC)/paruneus as seed points for whole-brain FC analysis.Results:Compared with the normal control group, the SCD group showed that ReHo values of right occipital gyrus and left precuneus were increased, and ReHo values of right inferior temporal gyrus, right orbital inferior frontal gyrus and bilateral thalamus were decreased(Voxel level, Alphasim correction, P<0.05). Using PCC/ precuneus as seed voxels, the whole brain functional connectivity analysis showed that the functional connectivity with cerebelum Crus 2 R was increased, and the functional connectivity with right orbital inferior frontal gyrus, left inferior temporal gyrus and temporal pole was reduced(Voxel level, Alphasim correction, all P<0.05). Conclusions:Default mode network may play an important role in the mechanism of SCD, and abnormalities in brain areas may first occur in PCC/precuneus.
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Objective To compare the efficacy and safety of diazepam combined with olanzapine in treatment of agitation symptoms in patients with alcohol withdrawal delirium tremors( DT) . Methods Total-ly 60 inpatients with DT according to CCMD-3 were enrolled in a 7-day,with 30 patients in the diazepam group ( control group) and 30 patients in diazepam combined with olanzapine group ( research group) . The delirium rating scale( DRS-R-98) was used to evaluate the severity of the delirium symptoms. The positive and negative syndrome scale excited component( PANSS-EC) was used to assess the agitation symptoms. The treatment emergent symptom scale ( TESS) was used to assess the safety and the vital signs. Results There was no significant difference in the delirium recovery time between the two groups(M(QR):24 h(24 h)vs 24 h(6 h))(Z=-0. 45,P=0. 65). The PANSS-EC score in research group(17. 00±2. 67) was significant low-er than that in control group(19. 80±2. 43) at the 6 hours after treatment(t=4. 26,P<0. 01),but there were no significant difference between the two groups at the baseline,24 h,48 h and 72 h(P>0. 05) . One case of dizziness,2 cases of lethargy in the control group;1 case of nasal congestion,5 cases of drowsiness,3 cases of constipation, 3 cases of dry mouth, 1 case of abnormal liver function in the research group. Conclusion The combination of olanzapine with diazepam can not reduce the recovery time of DT,but can quickly improve the agitation behavior.
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Objective To explore the gray matter changes in aggressive patients with schizophrenia,and the relationship between the gray matter and aggression in patients.Methods Eighteen aggressive patients with schizophrenia (SZ1),18 age-and gender-matched un-aggressive patients with schizophrenia (SZ2) and 18 normal controls (NC) were enrolled in the study.Then a 3.0 T magnetic resonance imaging (MRI) scan was conducted for each participant.The voxel-based morphometry (VBM) approach and the Chinese version of Buss & Perry aggression questionnaire (B&P) were used to explore imaging data and to assess the aggression,respectively.Results Compared with NC,patients with schizophrenia showed changes in gray matter volume (GMV) in the frontal,temporal and the occipital lobes (P＜0.05,AlphaSim corrected).Compared with SZ2,SZ1 showed increased GMV in the right supramarginal gyrus,right postcentral gyms,bilateral insula and orbito-frontal gyri (P＜0.05,AlphaSim corrected).The GMV of the right insula,right postcentral gyms and right supramarginal grus were positively associated with B&P scores in patients with schizophrenia (P＜0.01,AlphaSim corrected),respectively.Conclusions These preliminary findings support that the aggression in schizophrenia is associated with GMV changes of brain regions in patients with schizophrenia.The right postcentral gyrus,the right insula and the right supramarginal gyrus may be involved in the neural mechanism of aggression in schizophrenia.
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Objective To explore the memory function and the effects of sleep on memory consolidation in patients with stable paranoid schizophrenia.Method Sixty patients with stable paranoid schizophrenia were randomly assigned into research group (n =30) and control group (n =30).30 healthy people were raised as a healthy control group.The polysomnography (PSG) was used for 10 hours of sleep monitoring in the research group and the healthy control group and the muhiple memory assessment scale(MMAS) was used to test the subjects memory before and after the sleep monitoring.Control group performed memory tests in equal length daytime.Pre-test and post-memory measurements were compared.Results The prememory test of three groups had significant statistical differences (F(2.87) =31.40,39.89;P＜0.01).Both the auditory verbal/picture memory conservation rate and recognition accuracy rate between research group and healthy controls had no statistically significance differences (P＞0.05).But compared with the control group,auditory verbal memory conservation rate ((62.64±9.06) ％ vs (43.00±9.73) ％,P＜0.01),recognition accuracy rate ((69.11±11.04)％ vs (61.78±11.67)％,P＜0.05),picture memory conservation rate((71.20±14.95) ％ vs (58.72 ± 16.19) ％,P＜ 0.01),recognition accuracy rate ((86.89 ± 8.02) ％ vs (78.89 ±12.63) ％,P＜0.01) of the research group showed statistical significance differences (P＜0.05).Both N2 (r=0.377,P＜0.05) and REM (r=0.436,P＜0.05) had positive correlation with recognition accuracy rate of auditory verbal memory in research group.Conclusion Stable paranoid schizophrenic patients have poorer memory function(auditory verbal words memory recall,picture memory recall) than healthy people.Sleep promotes the consolidation of memory in patients with schizophrenia.Both N2 and REM of patients with stable paranoid schizophrenic have positive correlation with recognition accuracy rate of auditory verbal memory.
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Objective To explore the effect of theta burst stimulation (TBS) paradigm of repetitive transcranial magnetic stimulation (rT-MS) on executive function in patients with chronic schizophrenia. Methods 60 patients meeting DSM-IV for chronic schizophrenia disor-ders criteria were enrolled. They were randomly divided into TBS group (n=30) and sham intervention group (n=30). They were assessed with digit span performance, space span performance and Wisconsin Card Sorting Test (WCST) before and 4 weeks after intervention. Re-sults After intervention, the forward score of digit span performance, the total score and forward score of space span performance increased (P0.05). There was significant difference in all the items be-tween 2 groups after intervention (P<0.05). Conclusion TBS paradigm of rTMS could improve the executive function in schizophrenic pa-tients.
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Objective To assess whether topiramate prevents body weight gain in patients with olanzapine .Methods The ran‐domized controlled trials(RCTs) about topiramate for prevention of weight gain with olanzapine from 1998 to 2013 were searched in the Cochrane Library ,Pubmed ,EMbase ,WanFang Data ,CNKI and VIP .Two reviewers independently screened the literatures ,ex‐tracted the data ,and evaluated the methodological quality .Then Meta‐analyses were conducted by using RevMan 5 .1 software .Re‐sults The total of 11 RCTs were included .Among the 549 patients were involved .The results of Meta‐analyses showed that the ef‐ficacy of the topiramate group was superior to that of the control group in lessen body mass with significant difference (MD= -3 .68 ,95% CI:-5 .16- -2 .19 ,Z=4 .86 ,P<0 .01) .Conclusion Topiramate addition therapy is effective in attenuating olanzapine‐induced weight gain .
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Objective To evaluate the effect of theta burst stimulation( TBS) paradigm of repetitive tran?scranial magnetic stimulation ( rTMS ) on the treatment of schizophrenia through assessing executive function. Methods 60 patients met with DSM?4 and ICD?10 for schizophrenia disorders criteria were enrolled in this study. The group was divided into theta burst stimulation group(research group, n=30) and sham intervention group ( control group, n=30) . The research group and control group were assessed with the Wisconsin card sorting test (WCST) and the go/no?go task by event?related potential(ERPs) before and after 4 weeks treatment. Each test results of all groups before and after treatment were compared with each other respectively. Results Regarding the WCST test,compared with the baseline,the post?rTMS state of the TBS group showed a decrease in the error selec?tion percentage((59.8±14.7)%),the preservative error number(55.3±18.0) and the preservative error percentage (71.3±12.6)%,but the percentage of conceptual level(71.3±12.6)% increased in the TBS group(P0.05).Conclusions The?ta burst stimulation paradigm of rTMS can improve the executive function in schizophrenic patients.
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Objective To compare the efficacy of amisulpride and other SGAs in treating the negative symptoms of Schizophrenia.Methods The randomized controlled trials (RCTs) about Schizophrenia treated with amisulpride and other SGAs from Jan 1995 to Mar 2013 were searched in The Pubmed,EMbase,Cochrane Library,WanFang Data,CNKI and VIP.Two reviewers independently screened the literatures,extracted the data,and evaluated the methodological quality.Than meta-analyses were conducted by using RevMan 5.1 and Stata 12.0 software.Results The totall3 RCTs were included.Among the 1814 patients involved.The results of meta-analyses showed that the score of PANSS-N was no significant differences between two groups (MD =-0.33,95％ CI:(-0.87,0.21),Z =1.20,P =0.23) ; and the score of SANS was no significant differences between two groups (MD =-0.21,95％ CI:(-1.51,1.50),Z =0.31,P =0.76).The side effects were more in other SGAs group than those in amisulpride group.Conclusion Amisulpride is as effective as other SGAs for the treatment of schizophrenia with predominantly negative symptoms,and it has more advantage than other SGAs in safety.
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BACKGROUND: The Childhood Experience of Care and Abuse Questionnaire (CECA.Q) compiled by the Institute of Psychiatry, University of London, has been verified to have good reliability and validity in the assessment of foreign community adults and patients with affective disorder,but the application of CECA.Q in China still needs verification of reliability and validity in various population.OBJECTIVE: To analyze the reliability and validity of CECA.Q in community population.DESIGN: The subjects were randomized selected; the principle for the analysis of scale reliability and validity was followed.SETTING: Mental Health Institute of Central South University.PARTICIPANTS: From September 2003 to February 2004, 608 adults were selected from two communities of Hunan Changsha city and Henan Xinxiang city as the common community population group, totally 608scales of CECA.Q were sent out, 8 invalid ones were excluded, and finally 600 subjects finished the investigation. Sixty adult inpatients with depressive disease were randomly selected from Henan Provincial Psychiatric Hospital as the depression group.METHODS: The common community population and patients with depressive disease were investigated with CECA.Q, which was a self-rating scale mainly to retrospectively survey whether the adults had suffered from physical, sexual or mental abuse in their childhood, and the mental abuse had two factors of antipathy and neglect, and each included 8 items. The answers for the items were quantified into 5 grades. The subjects evaluated whether their parents had given any abuse to them; the higher the score was, the greater the mental abuse they suffered. Of the community population, 40 cases were the positive samples with the history of physical and sexual abuse in childhood evaluated by CECA.Q, and they were then assessed with Bifulco provided childhood experience of care and abuse (CECA) together with 40 cases randomly selected from 560 samples with negative evaluation. A total of 100 cases in the community population were also evaluated with Zung self-rating depression scale (SDS), besides, 30 cases were retested with CECA.Q at 2 weeks after the first evaluation.MAIN OUTCOME MEASURES: The internal consistency, test-retest reliability, contents and criterion validity of CECA.Q were analyzed. RESULTS: Of the community population, 8 invalid questionnaires were excluded, and the other 600 cases entered the statistical analysis. ① Testretest reliability of CECA.Q: The Cronbach α coefficient for the mental abuse section was 0.87 (0.85 for maternal one, 0.83 for paternal one); including that of antipathy factor was 0.84 (0.80 for maternal one, 0.81 for paternal one), and that of neglect factor was 0.85 (0.84 for maternal one,.83 for paternal one. The test-retest reliability coefficient for mental abuse as 0.83 (0.81 for maternal one, 082 for paternal one), including that of antipathy was 0.81 (0.82 for maternal one, 0.70 for paternal one), and that f neglect was 0.79 (0.78 for maternal one, 0.75 for paternal one). The twice evaluations of physical and sexual abuse had good consistency (Kappa=0.78). ② Criterion validity of CECA.Q: The correlation coefficients of mental abuse, antipathy and neglect factors in CECA.Q with Zung SDS were 0.58, 0.55 and 0.60 respectively (P＜0.01). CECA.Q and CECA had good consistency in evaluating history of physical and sexual abuse, and the score of mental abuse in the depressive patients was higher than that in community population (P＜0.05).CONCLUSION: The CECA.Q shows acceptable reliability and validity in community population, and can be used as a self-rating measure for childhood abuse experience in China.
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BACKGROUND: At present, the internationally public recognition of childhood trauma questionnaire is the authorized version of Bernstein,American psychologist, in 1998.OBJECTIVE: To set up the scale of Chinese version of childhood trauma questionnaire with 28 items and analyze its reliability and validity.DESIGN: Community investigation was designed.SETTING: Mental Health Institute, Xiangya Second Hospital, Central South University.PARTICIPANTS: Totally 441 students from 8 classes were randomized from a countryside middle school of a city in Henan in October 2004.METHODS: A total of 441 students were measured with childhood trauma questionnaire and 93 of them were re-measured 2 months later. Childhood trauma questionnaire included 28 items and divided into 5 subscales,named emotional abuse, physical abuse, sexual abuse, emotional neglect and physical neglect. Five grades were adopted in each item, named 1 score: never; 2 scores: occasionally; 3 scores: sometimes; 4 scores: often;and 5 scores: always. Every subscale was varied from 5 to 25 scores, and the total results were in the range from 25 to 125 scores. It was to analyze the internal identical property, reliability of re-measuring, average correlation coefficient among items and correlation coefficient between total score and every subscale. And the analysis was carried on validation factors. MAIN OUTCOME MEASURES: Homogeneity reliability, re-measuring reliability and validity, absolute fit index, relative fit index and parsimony index of childhood trauma questionnaire were involved.RESULTS: Totally 441 pieces of questionnaire were distributed on the spot and 435 pieces of questionnaire with integral and regular answers were collected. Totally 93 pieces of questionnaire were delivered for the second evaluation 2 months later and 93 pieces with regular answers were collected. All of those were used for the evaluation of re-measuring reliability of such measuring table. ① Cronbach α coefficient was 0.64 in Chinese version of childhood trauma questionnaire of and re-measuring reliability was 0.75. Cronbach αcoefficient of every subscale was varied from 0. 16 to 0.65 and re-measuring reliability was in the range from 0.27 to 0.73. The correlation coefficient among items was varied from -0.20 to 0. 44; ②The correlation coefficient between total score and every subscale was varied from 0. 36 to 0.68 and the correlation coefficient among subscales was from-0.01 to 0.39; ③ Indexes of validation factor analysis:The load coefficient of physical neglect was varied from 0.09 to 0. 64 and that in 2 items was less than 0.20. Multiple correlation coefficient was varied from-0. 20 to 0. 82, X2/df was 2.48 and root mean square error of appr0ximation(RMSEA) was 0.06. Added indexes: IFI (0. 76), CFI (0.75) and TLI (0.72) .Parsimony index: PNFI (0.58) and PCFI (0. 67).CONCLUSION: Chinese version of childhood trauma questionnaire provides better reliability and validity. According to validation analysis, except physical neglect, every index tallies with psychometric standards. The results of analysis on normative pathways are satisfactory, which explains that the subscales of such measuring model provide good matching property and conception validity.
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0.05). But male students had higher scores in sexual abuse severity (5.92?2.22) and total abuse severity (30.27?6.8) than girls (5.55?1.34 and 28.87?6.07 respectively, P