Correlation Between Brain Activation Changes and Cognitive Improvement Following Cognitive Remediation Therapy in Schizophrenia: An Activation Likelihood Estimation Meta-analysis.

BACKGROUND: Several studies using functional magnetic resonance imaging (fMRI) and positron emission tomography (PET) have indicated that cognitive remediation therapy (CRT) might improve cognitive function by changing brain activations in patients with schizophrenia. However, the results were not consistent in these changed brain areas in different studies. The present activation likelihood estimation (ALE) meta-analysis was conducted to investigate whether cognitive function change was accompanied by the brain activation changes, and where the main areas most related to these changes were in schizophrenia patients after CRT. Analyses of whole-brain studies and whole-brain + region of interest (ROI) studies were compared to explore the effect of the different methodologies on the results. METHODS: A computerized systematic search was conducted to collect fMRI and PET studies on brain activation changes in schizophrenia patients from pre- to post-CRT. Nine studies using fMRI techniques were included in the meta-analysis. Ginger ALE 2.3.1 was used to perform meta-analysis across these imaging studies. RESULTS: The main areas with increased brain activation were in frontal and parietal lobe, including left medial frontal gyrus, left inferior frontal gyrus, right middle frontal gyrus, right postcentral gyrus, and inferior parietal lobule in patients after CRT, yet no decreased brain activation was found. Although similar increased activation brain areas were identified in ALE with or without ROI studies, analysis including ROI studies had a higher ALE value. CONCLUSIONS: The current findings suggest that CRT might improve the cognition of schizophrenia patients by increasing activations of the frontal and parietal lobe. In addition, it might provide more evidence to confirm results by including ROI studies in ALE meta-analysis.

[Association of psychosocial factors and platelet 5-HT with peptic ulcer].

OBJECTIVE: To scrutinize the association of psychosocial factors especially emotional factors with peptic ulcer. METHODS: Eighty-nine peptic ulcer patients and 50 normal controls were investigated by means of questionnaires for personality, alexithymia, social support, life events, and their platelet 5-HT levels were determined. RESULTS: By comparison with normal controls, the peptic ulcer patients had: (1) higher scores on the subscales such as Hs, D, Pt, Sc and Hy of personality; (2) Higher scores on HAMA, HAMD and Toronto alexithymia scale (TAS); (3) Significantly lower platelet 5-HT concentration. And in the ulcer patients who were not infected with HP (called HP negative), the area of their ulcer was found to have a positive correlation with HAMA and TAS scores (r=0.74, P<0.01; r=0.45, P<0.05). CONCLUSION: (1) There was a correlation between the onset of peptic ulcer and personality or manner of emotional expression. (2) There may be two subtypes of ulcer patients: one of it may be due to HP infection and the other may be more closely associated with negative emotion and manner of emotional expression; for the latter one, anxiolytics deserve to be included in the routine treatments.