Effect of vitamin D deficiency on BMI in patients treated with Multi-acting Receptor Target Antipsychotics.

OBJECTIVES: Our aim was to examine the effect of vitamin D deficiency on BMI in patients treated with Multi-acting Receptor Target Antipsychotics (MARTA). METHODS: We measured serum 25-hydroxyvitamin D [25(OH)D] levels and body mass index (BMI) in patients with (≥1 months) and without long-term exposure to MARTA to evaluate the role of 25(OH)D deficiency on BMI. RESULTS: The BMI was significantly higher after long-term MARTA exposure in 25(OH)D-deficient patients than in non-deficient patients. No significant difference was found in antipsychotic exposure between the long-term MARTA exposure groups. The BMI was significantly higher in long-term MARTA exposure 25(OH)D-deficient patients than in 25(OH)D-deficient patients without long-term exposure. CONCLUSION: Vitamin D deficiency could be a risk factor for MARTA-induced weight gain. Further studies are necessary to replicate this finding.

Latent Schizencephaly With Psychotic Phenotype or Schizophrenia With Schizencephaly? A Case Report and Review of the Literature.

OBJECTIVES: Although schizencephaly belongs to the class of neurodevelopmental disorders, which are a well-known predisposing factor for psychosis, there is a lack of relevant studies and diagnostic guidelines on this relationship. METHOD: A case report of first-episode psychosis with persistent negative symptoms associated with schizencephaly is described and compared with 7 other cases found in the literature. RESULTS: We found perinatal pathology, cognitive deficit, and EEG abnormality in a patient with atypical initial symptoms of psychosis such as olfactory hallucinations. Abnormal EEG findings (left frontal spikes and frontal intermittent rhythmic delta activity) called for magnetic resonance imaging, which revealed left parieto-occipital closed-lip schizencephaly. The patient exhibited a partial response to low-dose amisulpride treatment. CONCLUSION: We conclude that schizencephaly in our patient was at first asymptomatic and later developed into clinically manifest schizophrenia-like disorder. Both magnetic resonance imaging and EEG were essential tools for establishing this diagnosis.

Relationship of ketamine's antidepressant and psychotomimetic effects in unipolar depression.

OBJECTIVES: Ketamine and other NMDA (N-methyl-D-aspartate) antagonists produce fast-acting antidepressant-like effects, although the underlying mechanism is unclear. Furthermore, high affinity NMDA antagonists such as ketamine are associated with psychotomimetic effects. To date the link between the antidepressant and psychotomimetic effects of ketamine has not been explored. We examined the relationship between the antidepressant and psychotomimetic effects of a single ketamine infusion in subjects diagnosed with major depressive disorder. METHODS: In a double-blind, cross-over, placebo-controlled, two weeks clinical trial we studied the effects of ketamine (0.54 mg/kg within 30 min) in a group of 27 hospitalized depressive patients. RESULTS: Higher intensity of psychotomimetic symptoms, measured using BPRS, during ketamine administration correlated with alleviation in mood ratings during the following week with maximum on day seven. Ketamine was superior to placebo in all visits (day 1, 4, and 7) assessed by MADRS with effect size (Cohen´s d) of 0.62, 0.57, and 0.44 respectively. There was no significant correlation between ketamine and nor-ketamine plasma levels and MADRS score change at any study time point. CONCLUSION: The substantial relationship between ketamine's antidepressant and psychotomimetic effects was found. This relationship could be mediated by the initial steps of ketamine's action, trough NMDA receptors, shared by both ketamine's clinical effects.

EEG source analysis in obsessive-compulsive disorder.

OBJECTIVE: The goal of this study was to assess the activity of intracortical EEG sources in patients with OCD. METHODS: We compared resting state EEG from 50 OCD patients and 50 matched controls using standardized low-resolution electromagnetic tomography (sLORETA) and normative independent component analysis (NICA). Data were analyzed with 1 Hz frequency resolution. Group ICA was used to separate seven independent components from the control group data. The resulting weights and norms served to derive the same components from the OCD group and to compare their power with controls. RESULTS: In OCD, sLORETA indicated low-frequency power excess (2-6 Hz) in the medial frontal cortex, whereas group ICA showed increased low-frequency power in a component reflecting the activity of subgenual anterior cingulate, adjacent limbic structures and to a lesser extent also of lateral frontal cortex. CONCLUSIONS: Both methods provided evidence for medial frontal hyperactivation in OCD. SIGNIFICANCE: Our study is the first to use normative ICA in a clinical sample and indicates its potential utility as a diagnostic tool. The findings provide consistent results based on EEG source localization in OCD and are of practical interest for therapeutic interventions.