Structural changes in the brain and the clinical image of neuropsychological functions in men with alcohol use disorders

Wydział Psychologii i KognitywistykiCelem badań własnych było: 1) ukazanie siły i kierunku związków między wskaźnikami używania alkoholu, zmianami strukturalnymi mózgu a obrazem klinicznym funkcji neuropsychologicznych, 2) ocena struktury temperamentu jako moderatora zależności między zmianami strukturalnymi mózgu a sprawnością praksji dynamicznej, funkcji poznawczych i wykonawczych oraz 3) weryfikacja założeń modelu neuropsychologicznego poalkoholowych zmian mózgu jak i przedstawienie specyfiki profilu zmian patologicznych i niepatologicznych w mózgu wśród mężczyzn z zaburzeniem używania alkoholu. W badaniu przesiewowym, neuroobrazowym (na 1.5T i 3T MRI) i neuropsychologicznym (rozszerzonym o pomiar struktury temperamentu) wzięło udział 103 mężczyzn z zaburzeniem używania alkoholu. Na podstawie tak zaprojektowanego badania między innymi zweryfikowano dwa główne modele neuropsychologicznych zmian strukturalnych mózgu w zaburzeniu używania alkoholu, które opierają się na założeniach teorii mikrogenetycznej Jasona W. Browna. Wśród mężczyzn z zaburzeniem używania alkoholu o niezharmonizowanej strukturze temperamentu zaobserwowano silniejszą zależność między zanikiem korowo-podkorowym mózgu a obniżoną sprawnością pamięci i uczenia. Ponadto, u 1/3 zbadanych mężczyzn odnotowano znaczne zaburzenia neuropsychologiczne oraz patologiczne zmiany w płatach czołowych i układzie komorowym mózgu a także dłuższy czas nadużywania alkoholu i większą ilość dziennego spożycia alkoholu. Uzyskane wyniki mogą okazać się istotne dla rozwoju neuropsychologii uzależnień, w szczególności w obszarze diagnozy i leczenia.The most important goals of the research were: (1) to verify the strength and direction of the relationships between alcohol consumption rate, structural changes to the brain, and the clinical image of neuropsychological functions; (2) to evaluate temperament structure as a moderator of the relationship between structural changes to the brain and the efficiency of dynamic praxia and cognitive and executive functions; (3) to verify the neuropsychological model of alcohol-induced brain changes, while comparing the specific profile of pathological and nonpathological brain changes resulting from alcohol use disorder. The screening, neuroimaging (by using 1.5T and 3T MRI), and neuropsychological examination (extended to measure temperament structure) included 103 men with alcohol use disorder. Among other things, the examination tested two main models of neuropsychological structural changes to the brain in alcohol use disorder, based on the main assumptions of Jason W. Brown’s microgenetic theory. Among men with alcohol use disorder with a nonharmonized temperament structure a stronger association was observed between brain atrophy and impaired memory and learning. Moreover, one-third of the examined men were characterized by neuropsychological disorders, pathological changes in the frontal lobes and the ventricular system, longer alcohol abuse history, and greater daily alcohol use. These results should contribute to the development of dependence neuropsychology, especially in the areas of diagnosis and treatment.Badanie sfinansowano ze środków Narodowego Programu Zdrowia na lata 2016-2020

Spatial distribution of white matter degenerative lesions and cognitive dysfunction in relapsing-remitting multiple sclerosis patients

Aim. The aim of this study was to assess degenerative lesion localisation in the course of relapsing-remitting multiple sclerosis (RRMS) and to identify the association between localisation and the frequency of T1-hypointense lesions (black holes) with cognitive dysfunction. We also searched for neuroradiological predictors of cognitive dysfunction in patients. The clinical rationale for the study was previous research, and our own findings suggest that lesion localisation plays an important role in cognitive performance and neurological disability of MS patients. Material and methods. Forty-two patients were included in the study. All subjects underwent neuropsychological examination using Raven’s Coloured Progressive Matrices, a naming task from the Brief Repeatable Battery of Neuropsychological Tests, and attention to detail tests. Magnetic resonance imaging (MRI) was acquired on 1.5 Tesla scanner and black holes were manually segmented on T1-weighted volumetric images using the FMRIB Software Library. Linear regression was applied to establish a relationship between black hole volume per lobe and cognitive parameters. Bonferroni correction of voxelwise analysis was used to correct for multiple comparisons. Results. The following associations between black hole volume and cognition were identified: frontal lobes black hole volume was associated with phonemic verbal fluency (t = –4.013, p < 0.001), parietal black hole volume was associated with attention (t = –3.776, p < 0.001), and parietal and temporal black hole volumes were associated with nonverbal intelligence (p < 0.001). The volume of parietal black holes was the best predictor of cognitive dysfunction. Conclusions. Our approach, including measurement of focal axonal loss based on T1-volumetric MRI sequence and brief neuropsychological assessment, might improve personalised diagnostic and therapeutic decisions in clinical practice

Bovine colostrum supplementation as a new perspective in depression and substance use disorder treatment: a randomized placebo-controlled study

IntroductionThis randomized, placebo-controlled, double-blind, parallel study aimed to evaluate the effect of 3-month supplementation of bovine colostrum (BOV-COL; 8x400 mg per day) on the outcomes of depression treatment in hospitalized patients with substance use disorder (SUD). The hypothesis is that BOV-COL supplementation as an add-on treatment results in favorable alternations in selected blood inflammatory markers or neurotransmitters, leading to better depression treatment outcomes compared with placebo (PLA).MethodsPatients with a Minnesota Multiphasic Personality Inventory-2 score ≥60 points were enrolled. Twenty-nine participants (n=18 in the BOV-COL group and n=11 in the PLA group) completed the protocol.ResultsThe mean Beck Depression Inventory-II score was significantly reduced after supplementation in both groups. However, the mean 17-point Hamilton Depression Rating Scale score was decreased in the BOV-COL group, but not in the PLA group. In the BOV-COL group, there was a reduction in interleukin (IL)-1, IL-6, IL-10, the IL-6:IL-10 ratio, IL-17, and tumor necrosis factor alpha (TNF-α), while in the PLA group only IL-6 decreased. Favorable alternations in the total count and differentials of white blood cell subsets were more pronounced in the BOV-COL. There were no changes in neurotransmitter concentrations.ConclusionsBOV-COL supplementation is a promising add-on therapy in patients with depression and SUD

Frontal and callosal white matter changes and their potential effects on neurocognitive functioning in alcohol addicts: a meta-analysis

This meta-analysis of published studies examines the fractional anisotropy coefficient of frontal and callosal microstructural abnormalities in alcohol addiction. Twelve articles (total Nalc = 230) were included. Eighteen of the examined data points concern changes in the corpus callosum, twenty-three point to alterations in frontal white matter tracts, and eleven described microstructural tracts having potential effects on cognitive functions such as short-term and working memory, decision making, selective attention, and visuospatial ability. The random effect models show a standardized mean difference in the particular fiber tracts in all studies: SMDall = 1.20, SMDcc = 1.26, SMDfwm = 1.17, SMDcog = 1.07. The heterogeneity ranges from very low (CC) to high (FWM). In summary, these results confirm and provide significant evidence that callosal and frontal microstructural abnormalities are present in the course of alcohol addiction. This findings also highlight the necessity to further examine patients’ cognitive functioning

The clinical image of memory, attention, and executive functions in a school-aged child with autoimmune epilepsy: A case study

The aim of this study was to identify specific aspects of the cognitive and socioemotional functioning of a school-age child with autoimmune-resistant epilepsy, and to provide a detailed explanation of the executive dysfunctions significant in this type of disorder. A battery of neuropsychological tests and clinical trials were used to neuropsychologically diagnose an eight-year-old girl. Data from an interview with the patient’s mother, observational data, and the results of previous psychological and medical tests were also taken account. Neuropsychological diagnosis was performed in line with the clinical–experimental and psychometric -test models. The patient’s current level of intellectual functions is below average. The patient obtained low results in tests examining executive functions, direct auditory memory, phonemic hearing, and visual–spatial organization. In comparison with children of her age group and with similar intelligence quotients, she obtained average results relating to tasks involving direct visual memory. No difficulty was seen in terms of semantic fluency, concentration, or persistence of the attention process. Executive dysfunctions are among the dominant disorders seen in clinical settings; these significantly hinder the systematic and orderly organization of the child’s learning process. Such difficulties in cognitive functioning, but also in emotional and social functioning, can significantly impede the normal development of the child

Structural changes in the brain and the clinical image of neuropsychological functions in men with alcohol use disorders

Wydział Psychologii i KognitywistykiCelem badań własnych było: 1) ukazanie siły i kierunku związków między wskaźnikami używania alkoholu, zmianami strukturalnymi mózgu a obrazem klinicznym funkcji neuropsychologicznych, 2) ocena struktury temperamentu jako moderatora zależności między zmianami strukturalnymi mózgu a sprawnością praksji dynamicznej, funkcji poznawczych i wykonawczych oraz 3) weryfikacja założeń modelu neuropsychologicznego poalkoholowych zmian mózgu jak i przedstawienie specyfiki profilu zmian patologicznych i niepatologicznych w mózgu wśród mężczyzn z zaburzeniem używania alkoholu. W badaniu przesiewowym, neuroobrazowym (na 1.5T i 3T MRI) i neuropsychologicznym (rozszerzonym o pomiar struktury temperamentu) wzięło udział 103 mężczyzn z zaburzeniem używania alkoholu. Na podstawie tak zaprojektowanego badania między innymi zweryfikowano dwa główne modele neuropsychologicznych zmian strukturalnych mózgu w zaburzeniu używania alkoholu, które opierają się na założeniach teorii mikrogenetycznej Jasona W. Browna. Wśród mężczyzn z zaburzeniem używania alkoholu o niezharmonizowanej strukturze temperamentu zaobserwowano silniejszą zależność między zanikiem korowo-podkorowym mózgu a obniżoną sprawnością pamięci i uczenia. Ponadto, u 1/3 zbadanych mężczyzn odnotowano znaczne zaburzenia neuropsychologiczne oraz patologiczne zmiany w płatach czołowych i układzie komorowym mózgu a także dłuższy czas nadużywania alkoholu i większą ilość dziennego spożycia alkoholu. Uzyskane wyniki mogą okazać się istotne dla rozwoju neuropsychologii uzależnień, w szczególności w obszarze diagnozy i leczenia.The most important goals of the research were: (1) to verify the strength and direction of the relationships between alcohol consumption rate, structural changes to the brain, and the clinical image of neuropsychological functions; (2) to evaluate temperament structure as a moderator of the relationship between structural changes to the brain and the efficiency of dynamic praxia and cognitive and executive functions; (3) to verify the neuropsychological model of alcohol-induced brain changes, while comparing the specific profile of pathological and nonpathological brain changes resulting from alcohol use disorder. The screening, neuroimaging (by using 1.5T and 3T MRI), and neuropsychological examination (extended to measure temperament structure) included 103 men with alcohol use disorder. Among other things, the examination tested two main models of neuropsychological structural changes to the brain in alcohol use disorder, based on the main assumptions of Jason W. Brown’s microgenetic theory. Among men with alcohol use disorder with a nonharmonized temperament structure a stronger association was observed between brain atrophy and impaired memory and learning. Moreover, one-third of the examined men were characterized by neuropsychological disorders, pathological changes in the frontal lobes and the ventricular system, longer alcohol abuse history, and greater daily alcohol use. These results should contribute to the development of dependence neuropsychology, especially in the areas of diagnosis and treatment.Badanie sfinansowano ze środków Narodowego Programu Zdrowia na lata 2016-2020

EFFECTS OF NEUROPSYCHOLOGICAL THERAPY IN A SCHOOL-AGED CHILD WITH AUTOIMMUNE DRUG-RESISTANT EPILEPSY: A CASE STUDY

The aim of this article is to present the effects of neuropsychological therapy of a school-aged child diagnosed with autoimmune drug-resistant epilepsy. Material and methods: A battery of neuropsychological and clinical tests, an interview with the patient’s mother, observational data, and the results of previous psychological and medical tests were used to provide a neuropsychological diagnosis of an 8-year-old girl. The diagnosis was performed twice: before and after a year of neuropsychological therapy. The therapy program was based on the assumptions of microgenetic symptom theory (Brown & Pąchalska 2003), which aims at improving intellectual, visuospatial, and executive functions, as well as improving the emotional - social processes. The patient’s intellectual functions significantly improved: in 2017, the quotient of fluid intelligence ranged from light intellectual disability to lower than average. Currently, the IQ ranges from lower than average to average. Improvements also took place in the following areas: motor and constructional praxis, capacity of direct auditory memory, visuomotor coordination, spatial orientation, visual searching, and some executive functions. Other cognitive processes did not change, while an increase in the difficulty in switching attention from one task to another was observed. Neuropsychological therapy conducted in accordance with the theoretical assumptions of neuropsychology proved effective. We consider that neuropsychological therapy should be continued while new goals are established

Disturbances in intentional action among patients with frontal lobes dysfunction from the self-regulatory point of view

Dysfunkcja w płatach czołowych doprowadza do pojawienia się szerokiego spektrum zaburzeń poznawczych i emocjonalno-motywacyjnych, zakłócając codzienne funkcjonowanie jednostki. Jednym z kluczowych deficytów są trudności w działaniu celowym, które mogą być ujmowane z perspektywy procesu samoregulacji. Badania wskazują również na zależności między zaburzeniem procesu samoregulacji a deficytami funkcji wykonawczych, samoświadomości czy samokrytycyzmu. Analizując proces samoregulacji, odwołano się do koncepcji Alberta Bandury, akcentując ważność działania celowego – ukierunkowanego na elastyczne modyfikowanie swojego zachowania, w tym świadomego i krytycznego korygowania trudności. W artykule przedstawiono również potencjalne źródła opisywanych trudności u osób z uszkodzeniem płatów czołowych, weryfikując dane dotyczące znaczenia zarówno mechanizmów obronnych, jak i neuropsychologicznych uwarunkowań

EVENT-RELATED POTENTIALS STUDIES OF PTSD AFTER INFECTION OF SARS-COV-2 AND NEUROCOVID-19

Coronavirus disease 19 (COVID-19) hospitalisation is a potentially traumatic experience, especially in severe cases. Furthermore, the unprecedented context of the SARS-CoV-2 pandemic, with the daily media bombardment about COVID-19 mortality, may have amplified its life-threatening perception also in patients with moderate infection. The purpose of our study was twofold: 1) to evaluate QEEG/ERPs shows of PTSD associated with severe infection SARS-CoV-2, and neuroCOVID-19, 2) to construct a neurofeedback protocol based on these indices to support the psychotherapy of the case study described herein. Patient N.C. 49, a frontline healthcare worker in the emergency services (an ambulance driver), became ill with Covid-19 on November 14, 2020. Initially, he lost his sense of smell (anosmia), of taste (ageusia), and had latent blinks (heterophila), headaches, and dizziness. After 10 days of illness, the patient had additionally a dry cough and a shortness of breath and he was hospitalized, sedated and mechanically ventilated for 24 days. After a few months he was diagnosed with PTSD (according to the DSM- 5 criteria) and referred to the Reintegration and Training Center of the Polish Neuropsychological Society for further diagnosis and treatment. It was found that the P3 GO and P3 NOGO waves were indeed less in his case (p < 0.01) when compared to the ERPs results of a health group of individuals of a similar age (n = 100), derived from the normative data bases of the Human Brain Index (HBI) in Switzerland. The ERPs wave pattern in our patient reflects the pattern appearing in patients with PTSD. The patient took part in 20 sessions of individually tailored anodal transcranial direct current stimulation (tDCS), with the excitatory stimulation of the left prefrontal cortex and inhibitory stimulation of the right prefrontal cortex which can reduce anxiety, as was proposed in the subject literature. Also, the neuromarker of PTSD obtained with the use of QEEG/ERPs was helpful in choosing the appropriate tDCS protocol. Neurostimulation with the use of tDCS was administered systematically, every day, 15-20 and 30-40 minutes for each session, for 20 days. He also received individual sessions of psychotherapy every day, 30-40 minutes for each session, for 20 day. After the treatment the patient improved and returned to his previous job as a frontline healthcare worker in the emergency services (an ambulance driver) in the fight against COVID-19. Detection of the PTSD neuromarker enabled the development of a proper tDCS protocol and the conduct of effective brain neurostimulation of a patient with PTSD. The proposed protocol of treatment, in combination with goal-oriented individual psychotherapy, offered to the patient, was effective in the reduction of PTSD. ERPs can be useful in the diagnosis of PTSD as well as in selecting an appropriate therapy protocol for these patients

Resources evaluation in patients with multiple sclerosis: A moderation effect of time since diagnosis

Multiple sclerosis significantly affects how patients maintain the resources they consider important. The aim of this paper is to describe the moderation effect of time since diagnosis on the evaluation of resources by patients with multiple sclerosis, on the basis of S.E. Hobfoll’s Conservation of Resources (COR) theory. The study was conducted using paper and pencil methods and involved 77 patients, of whom 32 received their diagnosis less than four years ago, and 45 more than four years ago. The patients’ resource evaluation was investigated using the Polish adaptation of the COR questionnaire. Patients who received their diagnosis more than four years ago were more likely to consider vital and spiritual resources to be more important. In patients diagnosed less than four years ago, the loss of economic, political, and vital resources was significant. It is shown moderation effect of time since diagnosis. The results may for the basis for further research