The temporal unfolding of face processing in social anxiety disorder--a MEG study.

The current study is the first to use magnetoencephalography (MEG) to examine how individuals with social anxiety disorder (SAD) process emotional facial expressions (EFEs). We expected that, compared to healthy controls (HCs), participants with SAD will show an early (<200 ms post-stimulus) over-activation in the insula and the fusiform gyrus (FG, associated with the N170/M170 component), and later (>200 ms post-stimulus) over-activation in the dorsolateral prefrontal cortex (DLPFC). Individuals with SAD (n = 12) and healthy controls (HCs, n = 12) were presented with photographs of facial displays during MEG recording. As compared to the HC group, the SAD group showed a reduced M170 (right FG under-activation around 130-200 ms); early reduced activation in the right insula, and lower insular sensitivity to the type of EFE displayed. In addition, the SAD group showed a late over-activation in the right DLPFC. This unique EFE processing pattern in SAD suggests an early under-activation of cortical areas, possibly related to reduced emphasis on high spatial frequency information and greater early emphasis on low spatial frequency information. The late DLPFC over-activation in the SAD group may correlate to failures of cognitive control in this disorder. The importance of a temporal perspective for the understanding of facial processing in psychopathology is underlined.

A double-blind, randomized study of minocycline for the treatment of negative and cognitive symptoms in early-phase schizophrenia.

BACKGROUND: Current antipsychotics have only a limited effect on 2 core aspects of schizophrenia: negative symptoms and cognitive deficits. Minocycline is a second-generation tetracycline that has a beneficial effect in various neurologic disorders. Recent findings in animal models and human case reports suggest its potential for the treatment of schizophrenia. These findings may be linked to the effect of minocycline on the glutamatergic system, through inhibition of nitric oxide synthase and blocking of nitric oxide-induced neurotoxicity. Other proposed mechanisms of action include effects of minocycline on the dopaminergic system and its inhibition of microglial activation. OBJECTIVE: To examine the efficacy of minocycline as an add-on treatment for alleviating negative and cognitive symptoms in early-phase schizophrenia. METHOD: A longitudinal double-blind, randomized, placebo-controlled design was used, and patients were followed for 6 months from August 2003 to March 2007. Seventy early-phase schizophrenia patients (according to DSM-IV) were recruited and 54 were randomly allocated in a 2:1 ratio to minocycline 200 mg/d. All patients had been initiated on treatment with an atypical antipsychotic < or = 14 days prior to study entry (risperidone, olanzapine, quetiapine, or clozapine; 200-600 mg/d chlorpromazine-equivalent doses). Clinical, cognitive, and functional assessments were conducted, with the Scale for the Assessment of Negative Symptoms (SANS) as the primary outcome measure. RESULTS: Minocycline was well tolerated, with few adverse events. It showed a beneficial effect on negative symptoms and general outcome (evident in SANS, Clinical Global Impressions scale). A similar pattern was found for cognitive functioning, mainly in executive functions (working memory, cognitive shifting, and cognitive planning). CONCLUSIONS: Minocycline treatment was associated with improvement in negative symptoms and executive functioning, both related to frontal-lobe activity. Overall, the findings support the beneficial effect of minocycline add-on therapy in early-phase schizophrenia. TRIAL REGISTRATION: clinicaltrials.gov Identifier: NCT00733057.