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1.
Eur Arch Psychiatry Clin Neurosci ; 260(4): 351-8, 2010 Jun.
Article in English | MEDLINE | ID: mdl-19898735

ABSTRACT

Animal experiments have shown that early developmental lesions of the entorhinal cortex lead, after a prolonged interval, to an enhanced mesolimbic dopamine release and an increased locomotor activity in rats. Hence, disturbed shape of the entorhinal cortex might indicate maturational abnormalities relevant for psychotic symptoms in schizophrenia. We used an automated surface-based MRI method to perform a region of interest analysis of entorhinal cortical surface area, folding and thickness in 59 patients with schizophrenia and 59 healthy controls. We postulated the entorhinal cortical surface area, folding index, and thickness to be significantly smaller in patients with schizophrenia. Additionally, we expected the complexity of the entorhinal cortical shape to be associated with psychotic symptoms in schizophrenia. Our ROI analysis showed a significant thinner left entorhinal cortex. In addition, our data demonstrate a positive correlation between left entorhinal cortical surface area and folding index and severity of psychotic symptoms. In conclusion, we present new evidence for the involvement of the entorhinal cortex in the pathogenesis of schizophrenia. As cortical folding is a stable neuroanatomical parameter terminated in early neonatal stages, our data give reason to assume that the vulnerability to develop psychotic symptoms might be manifest at an early level of brain maturation.


Subject(s)
Entorhinal Cortex/pathology , Psychopathology/methods , Schizophrenia/pathology , Schizophrenic Psychology , Statistics as Topic , Adult , Brain Mapping , Case-Control Studies , Female , Functional Laterality , Humans , Image Processing, Computer-Assisted , Magnetic Resonance Imaging/methods , Male , Psychiatric Status Rating Scales , Young Adult
2.
J Sex Med ; 5(12): 2816-26, 2008 Dec.
Article in English | MEDLINE | ID: mdl-18466271

ABSTRACT

INTRODUCTION: Sexual dysfunction is a frequent side effect of antipsychotic treatment. Increased prolactin levels are believed to be responsible for this sexual impairment despite contradictory results. AIM: The primary objective of the present study was to examine the relationship between sexual dysfunction, subjective well-being and prolactin levels in patients with schizophrenia treated either with risperidone or quetiapine. The secondary objective was to explore the relationship between testosterone and the severity of positive and negative symptoms of schizophrenia in male patients. METHODS: In a 4-week nonrandomized open label observational study, 102 inpatients with schizophrenia were recruited. Sexual functioning, subjective well-being and endocrinological parameters were assessed as well as psychopathological characteristics. MAIN OUTCOME MEASURES: Two self-rating questionnaires concerned with sexual functioning ("Essener Fragebogen zur Sexualität") and Subjective Well-Being Under Neuroleptic Treatment Scale (SWN) were completed by the patients. Plasma levels of prolactin in male and female patients were measured. Furthermore, in male patients testosterone, luteinizing hormone (LH) and follicle-stimulating hormone (FSH) were determined. Positive and Negative Symptom Scale (PANSS) was applied. RESULTS: After 4 weeks, patients treated with quetiapine reported less severe sexual impairment, as well as lower PANSS negative and general score compared with patients treated with risperidone. Additionally, emotional regulation as measured with the SWN was higher in patients treated with quetiapine. Risperidone was significantly associated with elevated prolactin levels. Prolactin levels were not correlated either with sexual dysfunction or PANSS. However, in the group of patients treated risperidone, sexual impairment was significantly associated with the SWN subscale emotional regulation. CONCLUSIONS: Increased prolactin levels do not seem to be decisive for antipsychotic induced sexual dysfunction. Improvement of severity of illness and regaining the ability to regulate one's own emotion have positive influence on sexual functioning.


Subject(s)
Antipsychotic Agents/adverse effects , Dibenzothiazepines/adverse effects , Prolactin/blood , Risperidone/adverse effects , Schizophrenia/drug therapy , Schizophrenic Psychology , Sexual Dysfunction, Physiological/chemically induced , Adult , Antipsychotic Agents/therapeutic use , Arousal/drug effects , Dibenzothiazepines/therapeutic use , Erectile Dysfunction/blood , Erectile Dysfunction/chemically induced , Erectile Dysfunction/psychology , Female , Humans , Libido/drug effects , Male , Middle Aged , Orgasm/drug effects , Psychiatric Status Rating Scales , Quetiapine Fumarate , Risperidone/therapeutic use , Schizophrenia/blood , Sexual Dysfunction, Physiological/blood , Sexual Dysfunction, Physiological/psychology , Surveys and Questionnaires , Testosterone/blood
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