Excessive weight gain after remission of depression in a schizophrenic patient treated with risperidone: case report

BACKGROUND: The use of atypical antipsychotics in schizophrenic patients has been associated with a risk of weight gain. Similarly, recovery from depression is often followed by improved appetite, greater food intake and potential increase in weight. CASE PRESENTATION: A Caucasian 33-year-old schizophrenic female patient was being treated with 6 mg/day of risperidone and 15 mg/day of clorazepate. She developed depressive symptomatology and 40 mg/day of fluoxetine was gradually added to her treatment regimen for about 9 months. After the remission of depression, and the discontinuation of fluoxetine, she experienced an increase in appetite and subsequently excessive weight gain of 52 kg. Re-administration of fluoxetine did not reverse the situation. The patient developed diabetes mellitus, which was successfully controlled with metformin 1700 mg/day. The addition at first of orlistat 360 mg/day and later of topiramate 200 mg/day has helped her to lose a significant part of the weight gained (30 kg). CONCLUSION: The case suggests a probable association between the remission of depressive symptomatology and weight gain in a schizophrenic patient

Variability in the decision process leading to saccades: A specific marker for schizophrenia?

In a previous study, deviance in the reaction time (RT) distribution of saccades for patients with schizophrenia was explained using an oculomotor decision model. Here, RTs of visually guided saccades in young healthy men, healthy children, older adults, patients with schizophrenia, and patients with obsessive compulsive disorder (OCD) were modeled to study the specificity of this decision process deviance for schizophrenia. The mean decision rate to saccade decreased with age in children and increased in older adults while the decision rate intrasubject variability (ISV) was not modulated by age. A significant increase in ISV of the decision rate was confirmed for patients with schizophrenia but not OCD compared to healthy controls. There was no effect of medication on model parameters in the OCD patient group. These results confirm the specificity of the deviance in a simple oculomotor decision process in schizophrenia. © 2014 Society for Psychophysiological Research

A review of neuroimaging findings of apathy in Alzheimer's disease

Background: Apathy is one of the most frequent behavioral and psychological signs and symptoms of dementia (BPSD) encountered in Alzheimer's disease (AD). There is a growing interest in the early diagnosis of apathetic elderly patients in the community since apathy has been associated with reduced daily functioning, caregiver distress, and poor outcome. The generalization of neuroimaging techniques might be able to offer help in this domain. Methods: Within this context we conducted an extensive electronic search from the databases included in the National Library of Medicine as well as PsychInfo and Google Scholar for neuroimaging findings of apathy in AD. Results: Neuroimaging findings lend support to the notion that frontal-subcortical networks are involved in the occurrence of apathy in AD. Conclusions: Longitudinal studies comparing patients and normal individuals might allow us to infer on the association between apathy and neurodegenerative diseases and what can brain imaging markers tell us about the characterization of this association, thus revealing disease patterns, helping to distinguish clinically distinct cognitive syndromes, and allowing predictions. Copyright © International Psychogeriatric Association 2013

The of effects of increasing memory load on the directional accuracy of pointing movements to remembered targets

The directional accuracy of pointing arm movements to remembered targets in conditions of increasing memory load was investigated using a modified version of the Sternberg's context-recall memory-scanning task. Series of 2, 3 or 4 targets (chosen randomly from a set of 16 targets around a central starting point in 2D space) were presented sequentially, followed by a cue target randomly selected from the series excluding the last one. The subject had to move to the location of the next target in the series. Correct movements were those that ended closer to the instructed target than any other target in the series while all other movements were considered as serial order errors. Increasing memory load resulted in a large decrease in the directional accuracy or equivalently in the directional information transmitted by the motor system. The constant directional error varied with target direction in a systematic fashion reproducing previous results and suggesting the same systematic distortion of the representation of direction in different memory delay tasks. The constant directional error was not altered by increasing memory load, contradicting our hypothesis that it might reflect a cognitive strategy for better remembering spatial locations in conditions of increasing uncertainty. Increasing memory load resulted in a linear increase of mean response time and variable directional error and a non-linear increase in the percentage of serial order errors. Also the percentage of serial order errors for the last presented target in the series was smaller (recency effect). The difference between serial order and directional spatial accuracy is supported by neurophysiological and functional anatomical evidence of working memory subsystems in the prefrontal cortex. © Springer-Verlag 2004