Anatomical substrates of cognitive and clinical dimensions in first episode schizophrenia.

OBJECTIVE: To explore gray (GM) and white matter (WM) abnormalities and the relationships with neuropsychopathology in first-episode schizophrenia (FES). METHOD: Nineteen patients with first episode of non-affective psychosis and 18 controls underwent a magnetic resonance voxel-based morphometry. Additionally, WM fractional anisotropy (FA) was calculated. For correlative analysis, symptoms and neuropsychological performances were scored by PANSS and by a comprehensive neuropsychological assessment respectively. RESULTS: Patients showed significantly decreased volume of left temporal lobe and disarray of all major WM tracts. Disorganized PANSS factor was inversely related to left cerebellar GM volume (corrected P = 0.03) and to WM FA of the left cerebellum, inferior fronto-occipital fasciculi (IFOF), and inferior longitudinal fasciculi (corrected P < 0.05). PANSS negative factor was inversely related to FA in the IFOF and superior longitudinal fasciculi (corrected P < 0.05). Impairment in facial emotion identification showed associations with temporo-occipital GM volume decrease (corrected P = 0.003) and WM disarray of superior and middle temporal gyri, anterior thalamic radiation, and superior longitudinal fasciculi (corrected P < 0.05). Speed of processing and visual memory correlated with WM abnormalities in fronto-temporal tracts. CONCLUSION: These results confirm how the structural development of key brain regions is related to neuropsychopathological dysfunction in FES, consistently with a neurodevelopmentally derived misconnection syndrome.

Suicide among the elderly in Italy: a descriptive epidemiological study (1969 to 1994).

Data regarding the elderly suicide trend in Italy between 1969 and 1994 were analyzed from an epidemiological point of view in order to verify hypotheses on suicide risk factors in old age. The data were obtained from the National Register of the Institute of Health (Italy) and were standardized at 1971 for age and sex. For the purposes of the study, only data for people aged 70 years and over were considered. The elderly suicide rate increased from 274 per 1,000,000 in 1969 to 354.7 per 1,000,000 in 1994 in males and from 59.7 per 1,000,000 in 1969 to 82.1 per 1,000,000 in 1994 in females. In the three macroareas (northern, central, and southern regions, indicated as N, C, and S), it is possible to observe different trends. In both genders, N and C rates are the highest in Italy (tending to be similar), while S rates are lower and distinct from the others. The most marked increase was observed in the S male rate, whereas N and C rates show a remission after the rate increase in 1980. The most important finding to emerge from this study is the interruption in the tendency for suicide rates to increase in recent years (dating back to the mid-1980s) and the nonuniformity of the nationwide distribution of suicides.

Peduncular hallucinosis following a transoral odontoidectomy for cranio-vertebral junction malformation. A case report.

This is a case report of a sixty-two years old man suffering from a cranio-vertebral malformation whose dens epistrophei was removed through a transoral approach. During the postoperative course, he experienced a transient peduncular hallucinosis probably caused by surgical trauma on his brainstem. The possible physiopathological, etiopathological, clinical, and therapeutic aspects of this rare phenomenon are discussed.