Effects of Paroxetine and Milnacipran on Pain Disorder

The outcomes of treatment for pain disorder are generally disappointing: symptoms are poorly controlled, they are seldom managed by experts, and they are often long standing. The aim of the present study was to compare the therapeutic effectiveness of paroxetine and milnacipran for outpatients with pain disorder. The study was performed on 43 consecutive outpatients with pain disorder diagnosed according to DSM-IV-TR criteria. Patients were treated with either antidepressant for 8 weeks. Pain was self-assessed using the Short-Form McGill Pain Questionnaire (SF-MPQ), the total Pain Rating Index (t-PRI), Present Pain Intensity (PPI), and visual analogue scale (VAS). In addition, pain was evaluated objectively using Pain Vision (a machine devised by NIPRO for semiquantitative measurements). Possible depressive symptoms were rated on the Hamilton Depression Scale (HAM-D) and the Zung Self-rating Depression Scale (SDS). Although VAS scores decreased significantly over the course of the 8-week trial in both the paroxetine- and milnacipran-treated groups (from 6.6 ± 2.3 to 4.8 ± 3.0 [P = 0.01] and from 7.5 ± 2.4 to 5.4 ± 3.3 [P = 0.03], respectively), the t-PRI decreased only in the paroxetine group (from 13.9 ± 10.1 to 7.6 ± 7.5; P = 0.01). The Pain Vision indicated a tendency for decreased pain in both groups, with no significant differences between them. There were no significant changes in the SDS in either group, but the HAM-D decreased significantly in the milnacipran-treated group (from 7.8 ± 4.0 to 6.7 ± 3.9; P = 0.04). The results of the present study suggest that both paroxetine (a selective serotonin re-uptake inhibitor) and milnacipran (a selective serotonin-noradrenaline re-uptake inhibitor) may decrease pain in individuals with pain disorder

Effect of Music on Emotions and Respiration

In the present study we investigated whether the emotional state induced by music can change respiratory rate (RR), tidal volume (VT), minute ventilation (VE), and end-tidal CO2concentration (ETCO2). In a pioneering study investigating the effect of music on respiration, the music of Stockhausen and Chopin was used. In the present study, we examined the effects of the same musical stimuli used in that study on respiration. Each stimulus (Stockhausen, Chopin, and silence) was delivered for 30 s and each stimulus was presented five times in random order. Subjects reported feeling uncomfortable listening to Stockhausen\u27s music, but comfortable during Chopin\u27s music and silence. The respiratory response during exposure to Stockhausen\u27s music was rapid and shallow breathing, resulting in an increase in RR. Although the RR was decreased during silence and Chopin\u27s music by Chopin compared with that during Stockhausen\u27s music, there was no significant difference in RR in response to Chopin\u27s music and Stockhausen\u27s music. Although subjects reported feeling comfortable while listening to Chopin\u27s music, the decrease in RR was not significant. The lack of a significant decrease in RR in response to Chopin\u27s music may be due to a mixture of various emotions that may be interconnected to physiological responses, and this higher processing may be peculiar to humans

Altered functional organization within the insular cortex in adult males with high-functioning autism spectrum disorder: evidence from connectivity-based parcellation

Determination of the optimal number of clusters based on VI and MI in intracalcarine cortex. The intracalcarine cortex was selected as a control region. The VI and MI values are shown for every clustering solution for k values ranging from 2 to 10. Arrows indicate either local minima of VI or local maxima of MI. Dashed lines denote the optimal number of solutions as determined using both VI and MI. The error bars denote standard errors of the mean for 100 repetitions of the split-half procedure (see the “Estimation of the optimal number of clusters” section). “n.s.” indicates no statistically significant difference between points. (PDF 334 kb

Resting-state functional connectivity-based biomarkers and functional MRI-based neurofeedback for psychiatric disorders: a challenge for developing theranostic biomarkers

Psychiatric research has been hampered by an explanatory gap between psychiatric symptoms and their neural underpinnings, which has resulted in poor treatment outcomes. This situation has prompted us to shift from symptom-based diagnosis to data-driven diagnosis, aiming to redefine psychiatric disorders as disorders of neural circuitry. Promising candidates for data-driven diagnosis include resting-state functional connectivity MRI (rs-fcMRI)-based biomarkers. Although biomarkers have been developed with the aim of diagnosing patients and predicting the efficacy of therapy, the focus has shifted to the identification of biomarkers that represent therapeutic targets, which would allow for more personalized treatment approaches. This type of biomarker (i.e., theranostic biomarker) is expected to elucidate the disease mechanism of psychiatric conditions and to offer an individualized neural circuit-based therapeutic target based on the neural cause of a condition. To this end, researchers have developed rs-fcMRI-based biomarkers and investigated a causal relationship between potential biomarkers and disease-specific behavior using functional MRI (fMRI)-based neurofeedback on functional connectivity. In this review, we introduce recent approach for creating a theranostic biomarker, which consists mainly of two parts: (i) developing an rs-fcMRI-based biomarker that can predict diagnosis and/or symptoms with high accuracy, and (ii) the introduction of a proof-of-concept study investigating the relationship between normalizing the biomarker and symptom changes using fMRI-based neurofeedback. In parallel with the introduction of recent studies, we review rs-fcMRI-based biomarker and fMRI-based neurofeedback, focusing on the technological improvements and limitations associated with clinical use.Comment: 46 pages, 5 figure

Atypical gaze patterns in children and adults with autism spectrum disorders dissociated from developmental changes in gaze behaviour

Eye tracking has been used to investigate gaze behaviours in individuals with autism spectrum disorder (ASD). However, traditional analysis has yet to find behavioural characteristics shared by both children and adults with ASD. To distinguish core ASD gaze behaviours from those that change with development, we examined temporo-spatial gaze patterns in children and adults with and without ASD while they viewed video clips. We summarized the gaze patterns of 104 participants using multidimensional scaling so that participants with similar gaze patterns would cluster together in a two-dimensional plane. Control participants clustered in the centre, reflecting a standard gaze behaviour, whereas participants with ASD were distributed around the periphery. Moreover, children and adults were separated on the plane, thereby showing a clear effect of development on gaze behaviours. Post hoc frame-by-frame analyses revealed the following findings: (i) both ASD groups shifted their gaze away from a speaker earlier than the control groups; (ii) both ASD groups showed a particular preference for letters; and (iii) typical infants preferred to watch the mouth rather than the eyes during speech, a preference that reversed with development. These results highlight the importance of taking the effect of development into account when addressing gaze behaviours characteristic of ASD

The right temporoparietal junction during a cooperation dilemma: An rTMS study

Cooperation enhances interpersonal communication and nurtures society. However, efforts to socially cooperate may often evoke conflict. Individuals may selfishly pursue a greater reward or success by exploiting the efforts of other individuals or taking unnecessary risk to oneself. Such a cooperation dilemma is highly prevalent in real life; thus, it has been studied in various disciplines. Although published functional magnetic resonance imaging studies have shown the involvement of the right temporoparietal junction (TPJ) in resolving a dilemma through cooperation, a causal relationship between the two has rarely been explored. Hence, we investigated this issue by combining repetitive transcranial magnetic stimulation with a priority game task (modified snowdrift game). In this game task, participants and opponent players jointly faced a problem whereby their collaboration was anticipated to defuse the situation. This conflicted with a choice in the participant's self-interest that was more rewarding but risky. We further included conditions with and without explicit social cues using figures describing elderly/pregnant passengers in the game opponent's car, and measured participants' prosocial traits to examine any cue-induced effect as well as the personality-cooperation relationship, respectively. The cooperation ratio was not statistically different in both the no-cue and with-cue conditions between the sham stimulation and inhibitory continuous theta burst stimulation (cTBS). However, after cTBS, in the no-cue condition, the strength of the association between cooperation ratio and empathy traits decreased significantly. These results add to our knowledge about the right TPJ's role in social cognition, which may be extraordinarily complex. This topic is deserving of further examination

Odor Detection and Recognition Ability in Patients with Alzheimer\u27s Disease

Alzheimer\u27s disease (AD) manifests early with prominent olfactory dysfunction. The olfactory symptoms appear long before cognitive impairment and other typical AD symptoms. Here, we tested odor detection and recognition acuity in AD patients and in age-matched controls to determine the relationships between olfactory test scores and anxiety level, cognitive function, and disease and therapy duration.We found that while AD patients had the same odor detection sensitivity as healthy subjects, most patients exhibited impaired odor recognition. AD patients had significantly lower cognitive function and trait anxiety scores than healthy subjects according to our assessments using the Mini-Mental State Examination (MMSE). Trait anxiety scores are thought to be lower in AD patients because of atrophy of the limbic system, particularly the amygdala (AMG). It has been reported that trait anxiety level is dependent on amygdala activity, therefore, the low activation of the AMG is linked to reduced trait anxiety in AD.However, we found that trait anxiety correlated positively with odor detection ability in AD patients. Although the function of the AMG is reduced in AD patients, it still contributes to odor detection in AD patients with high trait anxiety

An fMRI Study of an Abnormal Neurovascular Response in the Right Premotor Cortex during Inner Speech and the Relationship to Auditory Hallucinations in Patients with Schizophrenia

There is evidence for sensory and cognitive impairments at multiple levels in schizophrenia, which may be related to the clinical symptoms of the condition. Inner speech involves both auditory and language systems and dysfunction of inner speech and may be associated with auditory hallucinations in schizophrenia. We used functional magnetic resonance imaging to examine this association by measuring brain activation in 23 patients with schizophrenia and 23 healthy control individuals. The participants performed an auditory verbal working memory task that required inner speech in the form of subvocal rehearsal. The control participants showed prominent activation in the inferior frontal cortex (IFC), premotor cortex (PMC), superior temporal cortex (STC), and lateral parietal cortex (LPC) bilaterally, throughout the task. In contrast, patients with schizophrenia showed significant activation in STC bilaterally during encoding phase and in the IFC, PMC, STC, and LPC bilaterally during the recognition phase. A comparison between groups showed that controls had greater activation during rehearsal in the IFC, LPC, and PMC bilaterally than patients with schizophrenia. In the region-of-interest analysis, we observed a significant negative correlation between right PMC activation and Auditory Hallucination Rating Scale scores as well as the hallucination item in the Positive and Negative Syndrome Scale. These observations indicate that inner speech is impaired in schizophrenia and that the severity of auditory hallucinations is associated with abnormal activation in the right PMC during inner speech