Autism and Beauty: Neural Correlates of Aesthetic Experiences in Autism Spectrum Disorder.

OBJECTIVES: The purpose of this study was to investigate whether the neural activity of autism spectrum disorder (ASD) patients is different from that of normal individuals when performing aesthetic judgments. METHODS: We recruited typical ASD patients without savant skills (ASD group, n=17) and healthy controls (HC group, n=19) for an functional magnetic resonance imaging study. All subjects were scanned while performing aesthetic judgment tasks on two kinds of artwork (magnificent landscape images and fractal images). Differences in brain activation between the two groups were assessed by contrasting neural activity during the tasks. RESULTS: The aesthetic judgment score for all images was significantly lower in the ASD group than in the HC group. During the aesthetic judgment tasks, the ASD group showed less activation than the HC group in the anterior region of the superior frontal gyrus, and more activation in the temporoparietal area and insula, regardless of the type of images being judged. In addition, during the aesthetic judgment task for the fractal images, the ASD group exhibited greater neural activity in the amygdala and the posterior region of the middle/inferior temporal gyrus (Brodmann area 37) than the HC group. CONCLUSION: The results of this study suggest that the brain activation patterns associated with aesthetic experiences in ASD patients may differ from those of normal individuals.

Depression and self-concept in girls with perception of pubertal onset.

PURPOSE: Early pubertal timing in girls is associated with psychological and behavioral problems. This study aimed to evaluate the psychological features of girls who perceived breast development beginning by analyzing their depression levels and self-concept. METHODS: From March 2007 to December 2012, 93 girls were enrolled and assigned to a pre-8 (younger than 8 years, n=43) or post-8 (8 years and older, n=50) group according to the age at onset of perceived breast development, and their height, body weight, body mass index, bone age (BA), Tanner stage, and luteinizing hormone and follicle-stimulating hormone levels were examined. We investigated their psychological state with the Korean Children's Depression Inventory (CDI) and Piers-Harris Children's Self-Concept Scale (PHCSC) to evaluate depression levels and self-concept, respectively. RESULTS: The pre-8 group had a significantly greater height standard deviation score, (0.5±1.01 vs. 0.11±0.86, P = 0.048) and more advanced BA (2.07±1.02 years vs. 1.40±0.98 years, P = 0.004) compared to the post-8 group. There were no statistically significant intergroup differences for the CDI and PHCSC scores; however, the pre-8 group scored higher than the post-8 group in the physical appearance and attributes domain of the PHCSC (9.93±2.57 vs. 8.52±3.03, P = 0.017). CONCLUSION: The timing of perceived breast development among girls who thought puberty to begin did not affect depression levels and self-concept. There was no correlation between Tanner stage and depression levels and self-concept despite the perception of pubertal onset. The pre-8 group had a more positive view of their physical appearance than the post-8 group.

Characteristic time scales of electroencephalograms of narcoleptic patients and healthy controls.

Sleep electroencephalograms (EEGs) typically showed correlated fluctuations that became random-like oscillations beyond a characteristic time scale. To investigate this behavior quantitatively, the detrended fluctuation analysis (DFA) was applied to EEGs of 10 narcoleptic patients (22.0 ± 4.0 yrs; 6 males) and 8 healthy controls (24.0 ± 2.0 yrs; 5 males). The characteristic time scales of the narcoleptics and controls were estimated as 1.8 ± 0.7 and 4.4 ± 1.2s, respectively (significance level, p<0.01). We further performed DFA of the EEGs segmented into 30s epochs and found that the DFA scaling exponents increased in deep sleep stages. These results were verified with power spectrum and auto-correlation analysis, and reproduced by a mathematical model. We thus concluded that characteristics of EEGs of narcoleptic patients could be differentiated from those of healthy subjects, suggesting a potential application of DFA in diagnosing narcolepsy.

Psychometric validation of the Korean version of Structured Interview for Post-traumatic Stress Disorder (K-SIP).

For diagnosis and management of post-traumatic stress disorder (PTSD), the easily administered assessment tool is essential. Structured Interview for PTSD (SIP) is a validated, 17-item, simple measurement being used widely. We aimed to develop the Korean version of SIP (K-SIP) and investigated its psychometric properties. Ninety-three subjects with PTSD, 73 subjects with mood disorder or anxiety disorder as a psychiatric control group, and 88 subjects as a healthy control group were enrolled in this study. All subjects completed psychometric assessments that included the K-SIP, the Korean versions of the Clinician-Administered PTSD Scale (CAPS) and other assessment tools. The K-SIP presented good internal consistency (Cronbach's alpha=0.92) and test-retest reliability (r=0.87). K-SIP showed strong correlations with CAPS (r=0.72). Among three groups including PTSD patients, psychiatric controls, and normal controls, there were significant differences in the K-SIP total score. The potential cut-off total score of K-SIP was 20 with highest diagnostic efficiency (91.9%). At this point, the sensitivity and specificity were 95.5% and 88.4%, respectively. Our result showed that K-SIP had good reliability and validity. We expect that K-SIP will be used as a simple but structured instrument for assessment of PTSD.

Psychometric properties of the Korean version of the Short Post-Traumatic Stress Disorder Rating Interview (K-SPRINT).

AIMS: The Short Post-traumatic Stress Disorder (PTSD) Rating Interview (SPRINT) is a validated, eight-item, brief global assessment scale for PTSD. This report investigated the psychometric properties of the Korean version of the SPRINT (K-SPRINT). METHODS: Eighty-seven PTSD patients, 47 other psychiatric patients, and 63 healthy control subjects were enrolled in the study. All subjects completed a psychometric assessment package that included the K-SPRINT and the Korean versions of the Clinician-Administered PTSD Scale (CAPS), the Beck Depression Inventory (BDI), and the State Trait Anxiety Inventory (STAI). RESULTS: The K-SPRINT showed good internal consistency (Cronbach's alpha = 0.86) and test-retest reliability (r = 0.82). K-SPRINT showed moderatecorrelations with CAPS (r = 0.71). An exploratory factor analysis produced one K-SPRINT factor. The optimal diagnostic efficiency (91.9%) of the K-SPRINT was found at a total score of 15, at which point the sensitivity and specificity were 90.8% and 92.7%, respectively. CONCLUSIONS: The present findings demonstrate that the K-SPRINT had good psychometric properties and can be used as a reliable and valid instrument for the assessment of PTSD.

Activation of extracellular signal-regulated kinase signaling by chronic electroconvulsive shock in the rat frontal cortex.

The effects of chronic electroconvulsive shock (ECS), given daily for 1, 5 and 10 days, on the activation of extracellular signal-regulated kinase (ERK) were studied in the rat frontal cortex. The phosphorylation of MEK1/2 and ERK1/2 increased through 5 days of ECS. Thereafter, a plateau was achieved. The expression of brain-derived neurotrophic factor was continuously increased for 10 days. Our data show that the effect of ECS on ERK1/2 signaling is increased with chronic treatment.

The dysbindin gene (DTNBP1) and schizophrenia: no support for an association in the Korean population.

The dysbindin gene (DTNBP1) is located in chromosome 6p22.3, one of the regions of positive linkage for schizophrenia. A strong genetic association between DTNBP1 and schizophrenia has been replicated through many recent studies. In particular, dysbindin protein has been found to play a role in the glutamate neural transmission in the brain. In this study, we attempted to replicate the previously reported positive association between DTNBP1 and schizophrenia in the Korean population. Our sample included 194 patients with schizophrenia based on DSM-IV and 351 normal controls. We genotyped five SNPs including SNP A in promoter region of DTNBP1. The allele and genotype association were analyzed and the simulated haplotype was investigated as well. As the result, we could not find a significant association of DTNBP1 with schizophrenia in this Korean sample. Additional analysis of the subgroup of schizophrenia having familial loading of major psychiatric disorders did not show association, either. In summary, DTNBP1 is not likely to be a major susceptibility gene for schizophrenia in this Korean population. This result of no association also implies possible genetic heterogeneity of schizophrenia. Further studies with more dense SNPs of the whole gene sequence for various populations will be necessary to understand the genetic contribution of DTNBP1 for the development of schizophrenia.

Experience of maintaining clozapine medication in patients with 'red-alert zone' neutropenia: long-term follow-up results.

According to the recommended guidelines by Novartis, neutropenia in the range of a white blood cell count less than 3000 per mm, or an absolute neutrophil count (ANC) less than 1500 per mm, is classified as being in the 'red-alert zone' during clozapine treatment. If a patient's blood test result falls into this zone, immediate discontinuation of clozapine is recommended, and reinstitution is prohibited. However, in some patients, it is not entirely feasible to implement this standard guideline because of the lack of effective alternatives to clozapine treatment. Through retrospective chart reviews, five patients who had been maintained on clozapine treatment despite red-alert zone neutropenia were selected. The haematological and clinical courses of these patients were followed for more than 600 days and were compared with those of two control patients who discontinued clozapine due to neutropenia. In all five patients, no additional episodes of neutropenia occurred during the observation period despite continued clozapine treatment. However, three of them maintained a lower neutrophil count for the remaining observation period. Four patients responded favourably to clozapine treatment as judged by Clinical Global Impression score. Given the limitations of a retrospective chart review and the small number of patients, we cannot draw any definite conclusions. However, while the guidelines for the prevention of agranulocytosis should be generally followed, it may be that judicious continuation of clozapine treatment is less risk-prone than previously considered in selected cases where only a few feasible alternatives to clozapine are available. Moreover, there is an apparent necessity to develop new measures or methods that can differentiate between benign neutropenia and that leading to fatal agranulocytosis.

Repeated electroconvulsive shock treatment increases the expression of A kinase anchoring proteins in the rat hippocampus.

Electroconvulsive shock (ECS) is widely used in the treatment of psychiatric disorders, but its mode of action remains largely unknown. Thus, this study was performed to examine the effect of repeated ECS treatment on the expression of A kinase anchoring proteins (AKAPs) in the brain. Rats were treated with ECS daily for 10 days. The expression of AKAP protein was analyzed by Western blotting, and AKAP mRNA by real-time quantitative RT-PCR. Repeated ECS treatment for 10 days resulted in increases in the levels of the protein and mRNA of AKAP150, yotiao, and ezrin in the rat hippocampus. Thus, repeated ECS treatment is suggested to increase the reactivity of glutamatergic synapses by increasing the expressions of the AKAPs, which can recruit protein kinase A to glutamate receptors.

Electroconvulsive shock increases the phosphorylation of amphiphysin II in the rat cerebellum.

Amphiphysin II (Amph2) is known to undergo rapid dephosphorylation and phosphorylation at nerve terminals. After in vivo electroconvulsive shock (ECS) in the rat cerebellum, we found an electrophoretic mobility retardation of Amph2, which suggested an increased degree of phosphorylation above the non-stimulated level. This shifted signal was observed from 1 min, reached the maximum level at 5 min and extended beyond 2 h after ECS. The shifted band was markedly decreased by the phosphatase treatment. Pretreatment with cyclosporin A augmented the mobility retardation of Amph2 after ECS. Our results indicate that ECS induces the phosphorylation of Amph2 in the rat cerebellum.

A retrospective study of clozapine and electroencephalographic abnormalities in schizophrenic patients.

This study investigated the incidence and nature of clozapine-associated electroencephalographic (EEG) abnormalities and the relationship between EEG abnormality and clozapine dosage in Korean schizophrenic patients. Fifty schizophrenic patients with normal baseline EEG and with additional EEG record examined during clozapine treatment more than once were included. Thirty-one patients (62%) showed abnormal EEGs after clozapine treatment, and two of them had seizures. The majority of EEG abnormalities presented as nonspecific slow waves (SW). Spikes (or spike and wave complexes; SP) and frontal intermittent rhythmic delta activity (FIRDA) were relatively rarely observed. The probability of EEG abnormality was linearly dependent on the daily dose of clozapine and patient's age. Our results can be summarized as follows: (1) a substantial proportion of Korean patients treated with clozapine develops EEG abnormalities, and its incidence is comparable to the published results in Caucasian patients; (2) EEG abnormalities occurred in a dose-dependent manner; and (3) the occurrence of EEG abnormalities did not necessarily lead to future seizure development, except in a small number of cases.