Visual and behavioral profiles of socially \u27at-risk\u27 juveniles

The aim of this investigation is to examine the prevalence of visual dysfunction, behavior problems, and co-existing conditions between the two in the socially at-risk juvenile population. A sample of 70 socially at risk juveniles was drawn from alternative classrooms in the public schools and a training facility for boys. A visual screening battery was administered on -site at each of the three facilities. The screening consisted of: acuity measurement, static retinoscopy, cover test, near point of convergence, stereo acuity, accommodative facility, mobility (DEM), visual-motor perception (Beery), and direct ophthalmoscopy. Behavior profiles were assessed by the classroom teacher utilizing the Child Behavior Check List (Achenbach). Failure was designated as any clinical score. All 70 subjects failed some area of visual function ranging from 0% in ocular disease to 70% in visual-motor perception to 7 1 % in refractive problems. All. subjects displayed some sort of clinically significant behavior problem ranging from 4% in somatic complaints to 27% who measured anxious/depressed. Co-existing conditions with \u27fail scores that were 20% congruent for boys were: refractive status: withdrawn/depressed; visual motor perception: anxious/depressed. Co-existing conditions with \u27fail\u27 scores that were 20% congruent for girls were: refractive status: delinquent behavior; accommodative facility: thought problems, attention problems, delinquent behavior; Visual motor perception: delinquent behavior. It was found that juveniles from alternative classrooms exhibit a high prevalence of visual dysfunction along with certain behavior problems. This study suggests that certain visual dysfunction might be viewed as relative risk factors in these behavior problems. No conclusion can be drawn as to cause and effect. However, one is tempted to speculate that juveniles with visual dysfunction will do less well meeting academic demands and hence become prime targets for alternative education

PSYCHOSIS IN HINDSIGHT: A COLLECTIVE RECOLLECTION OF THE ONSET OF PSYCHOSIS

poster abstractPsychotic disorders cause marked cognitive, perceptual, and social impairments and may lead to significant disability. Those affected with these illnesses may have great difficulty in educational, occupational, and social functioning; especially troubling is the fact that these illness often strike when those afflicted should be entering into some of the most productive years of their lives. The primary purpose of this study is to ascertain the perspective of subjects with psychotic disorders on the mental health system and treatment, stigmatization, social functioning, and symptom experience. This information will be of use in improving treatment engagement, compliance, and education of providers. Fifty subjects with nonaffective psychoses in each of two arms (new onset psychosis and chronic psychosis) will be enrolled and asked to complete a self-administered questionnaire. After subjects complete the questionnaire, investigators will review medical records to confirm subject age and diagnosis, compare subject report with symptomatology, and look for trends or topics of interest in comparing patient survey reports with medical records which may provide for useful insight upon further investigation

O12.3.Effects of Fingolimod, A Potent Anti-Inflammatory Agent, On Brain Structure, Function, And Symptoms in Schizophrenia

Background New medications with novel targets are needed for schizophrenia. Several lines of evidence indicate that inflammatory processes including aberrant lymphocytic activity may be related to the pathophysiology of this illness. These data suggest that agents with anti-inflammatory actions, including modulation of lymphocytes and their inflammatory substrates, may prove to be efficacious for schizophrenia. Fingolimod is a powerful anti-inflammatory agent that is used in the treatment of relapsing multiple sclerosis. It is a sphingosine-1-phosphate (S1P) receptor modulator that decreases circulating lymphocytes through sequestration in lymph tissues. In addition, evidence suggest that it stimulates oligodendrocytes and may enhance white matter integrity. The purpose of this study was to assess the effects of fingolimod in schizophrenia. Methods Subjects with schizophrenia (N=40) were recruited through the Indiana University Psychotic Disorders Programs and randomized 1:1 in a double-blind, eight-week clinical trial of fingolimod 0.5 mg/day and placebo. Circulating total lymphocytes were determined and effects were assessed on symptoms (PANSS), cognition (BACS), plasma cytokines, white matter integrity (DTI) and cortical connectivity (resting fMRI). Results Results revealed a significant decrease in lymphocytes in subjects taking fingolimod versus placebo (treatment x time; F = 61.2, p < 0.001). Fingolimod treated subjects had a mean maximal drop in lymphocytes from baseline of 79.2% with all fingolimod treated subjects experiencing decrements greater than 60%. There was a trend toward higher mean skeletal fractional anisotropy (FA) post-treatment in the fingolimod group. Within the fingolmiod group, there were significant or trend-level correlations between FA increase and decrease in lymphocytes in the genu and body of the corpus collosum and the right superior longitudinal fasciculus. There were also significant group-by-visit interactions in connectivity of left prefrontal cortical (PFC) seeds with clusters in the cerebellum, driven by higher PFC-cerebellum connectivity following fingolimod treatment. There were no improvements (treatment x time) in PANSS total (F = 0.66, p= 0.52), any of the PANSS subscales, or BACS composite score (F = 0.54, p = 0.44). Serious side effects were not observed, and a full safety report will be provided. Discussion Fingolimod produced a strong anti-inflammatory response with substantial reductions in circulating lymphocytes in all treated subjects. Brain effects were observed. However, this response was not accompanied by improvements in symptoms or cognition. These data suggest that fingolimod’s target of S1P modulation and robust anti-inflammatory warrant further investigation in schizophrenia

An evaluation of the Wii Nunchuk as an alternative assistive device for people with intellectual and physical disabilities using switch controlled software

Many people with intellectual disabilities also have physical difficulties which prevent them from using standard computer control devices. Custom made alternative devices for those with special needs can be expensive and the low unit turnover makes the prospect unattractive to potential manufacturers. One solution is to explore the potential of devices used in contemporary gaming technology, such as the Nintendo Wii. The Wii Nunchuk has the potential to replace joystick functions with the advantages of not being surface bound and easier for some individuals to grasp. This study evaluated the feasibility of using the Nunchuk by comparing its performance as a switch with the participant's usual switch. Twenty three volunteers aged between 17 and 21 with intellectual and physical disabilities completed a Single Switch Performance Test using the new device and their familiar device. For most functions of the switch, there was no significant difference between the participants' performance using the Nunchuck and their familiar device. Additional analysis found that some participants' performance did improve whilst using the Nunchuck, but this was not significantly related to physical or cognitive ability. Those whose performance was better with the Nunchuk were more likely to hold it in the conventional way than were those who had better performance with their familiar device. This merits it being offered as a possible alternative to currently available switches for those with physical difficulties affecting their grip

Functional neuroanatomical correlates of episodic memory impairment in early phase psychosis

Studies have demonstrated that episodic memory (EM) is often preferentially disrupted in schizophrenia. The neural substrates that mediate EM impairment in this illness are not fully understood. Several functional magnetic resonance imaging (fMRI) studies have employed EM probe tasks to elucidate the neural underpinnings of impairment, though results have been inconsistent. The majority of EM imaging studies have been conducted in chronic forms of schizophrenia with relatively few studies in early phase patients. Early phase schizophrenia studies are important because they may provide information regarding when EM deficits occur and address potential confounds more frequently observed in chronic populations. In this study, we assessed brain activation during the performance of visual scene encoding and recognition fMRI tasks in patients with earlyphase psychosis (n = 35) and age, sex, and race matched healthy control subjects (n = 20). Patients demonstrated significantly lower activation than controls in the right hippocampus and left fusiform gyrus during scene encoding and lower activation in the posterior cingulate, precuneus, and left middle temporal cortex during recognition of target scenes. Symptom levels were not related to the imaging findings, though better cognitive performance in patients was associated with greater right hippocampal activation during encoding. These results provide evidence of altered function in neuroanatomical circuitry subserving EM early in the course of psychotic illness, which may have implications for pathophysiological models of this illness