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Background Although remission is a priority target in psychosis, reported rates show a marked variation across studies and instability over time. Such variability, partly due to methodology, emphasizes the need to define the optimal assessment procedure, as well as to identify reliable predictors. This study aims to: 1. longitudinally compare remission status according to different criteria; 2. identify predictors of duration and stability. Methods 112 patients with schizophrenia or schizoaffective disorder underwent comprehensive clinical evaluations, with 24-month follow-up. Remission was assessed using three criteria: Remission in Schizophrenia Working Group (RSWG) vs Positive and Negative Syndrome Scale (PANSS) positive and negative scales (PANSS-PN) vs total score (PANSS-T). Kaplan-Meier survival analysis was used for longitudinal comparison, regression models to identify predictors of duration and stability. Results At enrolment 50% of patients were in remission according to RSWG, while only 23.2% reached the other criteria. PANSS-T cumulative remission rates showed the greatest stability. Stable remission according to RSWG criteria was predicted by negative symptoms, while no significant predictors emerged for PANSS-T. Remission duration was predicted by negative, positive and cognitive symptoms and treatment dosage for RSWG criteria, while for PANSS-T the predictors were cognitive symptoms and duration of illness. Conclusion Results are in line with previous literature on remission rates and further support the role of basal clinical predictors. In addition, this study shows that more stringent criteria are more stable over time, suggesting their predictive value and the relevance of their use to optimize evaluations also in clinical settings.

BACKGROUND Patients with bipolar disorder (BD) often have impairments in neurocognition, including affective processing and affective response inhibition. While studies suggest that cognitive control in general may decline with age in BD, less is known about age-related changes in response inhibition to emotionally salient information. METHODS 258 participants with BD and 54 healthy controls, ages 18-70, completed the Cambridge Neuropsychological Test Automated Battery (CANTAB) Affective Go/No-Go task to assess affective response inhibition to positive and negative valenced stimuli. We examined the relationship between BD and affective response inhibition (number of commission and omission errors and reaction time), as well as a potential moderating effect of age, using mixed effects linear regression models. RESULTS The BD group made more omission and commission errors overall than the control group (p

Introduction Anxiety is characterized by psychological, physiological, and cognitive complaints. Current treatments have significant limitations, and often overlook any potential benefits to common cognitive symptoms, notably attention and executive function issues. The current study aimed to investigate the use of transcranial direct current stimulation (tDCS) on both common anxiety symptoms and executive function abilities in a college aged sample. Method As this is one of the first large scale anxiety studies utilizing tDCS, participants were given a single session of tDCS (anodal, cathodal, or sham) for 20 min at 2 mA over the left dorsolateral prefrontal cortex (lDLPFC). Participants also completed a series of self-reported anxiety measures and measures of executive functioning (Rey-O Copy and Wisconsin Card Sorting Task). Results While there were no differences in anxiety between tDCS groups, a trend was noted demonstrating better performance on Rey-O Copy for the cathodal group. Anxiety increased pre to post for all groups. Conclusion Overall, results suggest that while anodal stimulation of the lDLPFC may benefit cognitive abilities for this population, targeting psychological symptoms of anxiety likely requires stimulation over other cortex, possibly right DLPFC. Further, the use of tDCS, whether active or sham, may be distressing to patients.

Purpose To investigate psychopathological reaction to traumatic stress, addressing in particular gender difference, in parental couples of children affected by epilepsy. Methods 50 mothers and 50 fathers, paired for one’s child, of children followed at the Pediatric Unit of a major Italian University Hospital with a diagnosis of epilepsy were enrolled, screened by means of the Semi-structured Clinical Interview for DSM-5 (SCID-5) and filled the Trauma and Loss Spectrum Self-Report (TALS-SR), an international instrument to evaluate post-traumatic stress symptomatology. Results 25 % of the total sample presented a diagnosis of PTSD with a statistically higher prevalence of mothers (36 % and 14 %, respectively; p = .021). Furthermore, 44 % (48 % mothers and 40 % fathers) presented a partial PTSD. Important gender differences emerged also for all cluster dimensions of the TALS-SR except for the Avoidance. Finally, the analysis of the single items of the TALS-SR evidenced that in mothers subgroup prevail cognitive symptoms of fear and sadness as well as somatic manifestations. Conclusions Our results point out the differences between mothers and fathers in trauma response and underline the need to develop gender targeted models of healthcare prevention and assistance.

Pain has well-established effects on attention. At present, parallel literatures exist that have examined the effects of experimentally induced pain and consider cognitive performance in patients with chronic pain states. However, no study to date as attempted to examine the combined or differing effects of these 2 manifestations of pain in a single study. Twenty-four participants with fibromyalgia (aged 43.00 ± 28.28 years) and 26 healthy controls (aged 36.07 ± 11.93 years) completed an n-back task, an attentional switching task, and a divided attention task, once during induced, moderately intense pressure pain, and once without induced pain. Pain induction had selective effects on the n-back task and an overall decrease in accuracy on the attentional switching task. Conversely, patients with fibromyalgia were selectively impaired in performance on the divided attention task. These data therefore suggest that the effects of pain are not summative and rather that the mechanisms that underlie the negative effects of pain on performance in acute and chronic states may differ. More research is needed to examine these mechanisms and how these negative effects can be ameliorated to treat cognitive symptoms in pain. PERSPECTIVE: This article presents a study to examine the effects of an acute, induced pain model on cognitive performance in both patients with fibromyalgia and healthy control populations. We established that the effects of acute and chronic pain on attention are different, suggesting that different models need to be developed to understand these phenomena.

Maternal immune activation induced by Poly(I:C) administration is one of the most commonly used animal models of schizophrenia at present. Previous work from our team has demonstrated that some, but not all of the features often reported for maternal immune activation exposure in rodents can be observed in rats exposed to maternal immune activation at mid or late gestation. To determine whether previous findings in our laboratory were due to these time points simply being less sensitive neurodevelopmental periods for rats with regard to maternal immune activation effects, we aimed to investigate whether maternal immune activation at an often-reported sensitive period (mid-late gestation, day 14) resulted in more behavioural features reflective of face validity for schizophrenia. We examined the behavioural outcomes of mid-late maternal immune activation on a battery of behavioural tests aimed at assessing validity for positive, negative and cognitive symptoms of schizophrenia. We found that rats exposed to maternal immune activation, compared to controls, exhibited enhanced sensitivity to the locomotor-stimulating effects of amphetamine and reduced exploration of novel objects. These findings present a unique profile of effects, different to what has already been established for the same time point in rats, and different to what we had found at earlier and later time points. This work, among others in the literature, highlights the varying nature of models of maternal immune activation and we submit that it is essential for laboratories to characterise their models of maternal immune activation on behaviour rather than assuming that the effects from one laboratory apply in their own.

Cognitive symptoms of Parkinson's disease (PD) have been long underestimated, but are some of the most disabling non-motor features of the disease. In order to establish signs that allow for earlier detection of cognitive decline in PD, the concept of `subjective cognitive decline´ (SCD) has gained a growing interest. SCD refers to patients who report a decline in subjective cognitive capacities, while their results on neuropsychological tests are within the normal performance range, indicating adequate cognitive functions. The aim of this review was to evaluate the concept of SCD in PD and give an overview of the current research. A systematic literature search in PubMed was performed to identify articles published before December 2020. We included 18 studies with a total of n = 2,654 patients. While there is currently no consensus on research or clinical criteria for SCD in PD, this review presents the accumulated evidence for SCD in PD patients and supports the importance of early identification of cognitive deficits, due to the relatively high prevalence for SCD in PD and the added risk of future cognitive impairment it entails. The publications included in this review indicate that SCD may be part of the PD spectrum but further research is needed. Expanding research on SCD in PD will allow for earlier detection of cognitive impairment and may be considered for a preventive intervention.

Recent work has suggested that anxiety restricts working memory capacity, which may underlie a wide range of cognitive symptoms in anxiety. However, previous literature on the anxiety-visual working memory association yielded mixed results, with some studies demonstrating an anxiety-related increase in visual working memory capacity. In an attempt to gain a more thorough understanding of the relationship between anxiety and visual working memory maintenance function, the current study examined the influence of trait anxiety on visual working memory capacity and resolution for negative, positive, and neutral faces in a large unselected sample, by conducting two different experiments. Experiment 1 used a change-detection task to estimate visual working memory capacity, while Experiment 2 used a modified time-delay estimation task to measure memory precision. Hierarchical linear modeling was used to analyze the relationship between trait anxiety, emotional valence, and visual working memory. Results showed that trait anxiety was associated with decreased visual working memory capacity for faces in a valence-independent manner, whereas anxiety-related change in visual working memory resolution was not significant. This pattern of results was discussed in light of the theories of anxiety and visual working memory.

Resumen Tanto la demencia como la depresion son frecuentes y condicionan un grave impacto en el paciente y su entorno. Ante la sospecha de deterioro cognitivo, es necesario: confirmar el diagnostico de demencia (afectacion de una o mas funciones superiores con repercusion en el funcionamiento global), realizar un adecuado diagnostico diferencial, clasificar y estadificar la demencia y valorar los sintomas no cognitivos. Se debe considerar la presencia de enfermedades cronicas, el deterioro funcional, el consumo elevado de farmacos o los problemas del entorno sociofamiliar concomitantes. Se recomienda el tratamiento con inhibidores de la acetil-colinesterasa y/o memantina cuando esten indicados, junto con terapias no farmacologicas. En la depresion del mayor es mas comun la irritabilidad, la ansiedad y los sintomas cognitivos. Se asocia a comorbilidad y/o deterioro cognitivo. La relacion entre depresion y enfermedad medica es bidireccional: problemas medicos como el dolor cronico predisponen a la depresion, y la depresion esta asociada con peor un pronostico para otras enfermedades. El tratamiento de la depresion en los ancianos es tan eficaz como en el resto de la poblacion, y es fundamental su deteccion y correcto diagnostico. Dementia and depression are both common and have a major impact on the patient and their environment. If cognitive impairment is suspected, it is necessary to confirm the diagnosis of dementia (impairment of one or more cognitive higher functions affecting overall functioning), to make an appropriate differential diagnosis, to classify and stage the dementia, and to assess non-cognitive symptoms. The presence of chronic disease, functional impairment, high drug consumption and concomitant social and family problems should be considered. Treatment is recommended with acetylcholinesterase and/or memantine when indicated, along with non-pharmacological therapies. Irritability, anxiety and cognitive symptoms are more common in depressed elderly patients. The relationship between depression and medical disease is two-way: medical problems such as chronic pain predispose to depression, and depression is associated with a poorer prognosis for other diseases. Treatment of depression in the elderly is as effective as in the rest of the population, and its detection and correct diagnosis is essential.

Psychiatric and neurologic disorders are often characterized by both neuroinflammation and cognitive dysfunction. To date, however, the relationship between neuroinflammation and cognitive dysfunction remains understudied in humans. Preclinical research indicates that experimental induction of neuroinflammation reliably impairs memory processes. In this paradigm development study, we translated those robust preclinical findings to humans using positron emission tomography (PET) imaging with [(11)C]PBR28, a marker of microglia, and lipopolysaccharide (LPS), a potent neuroimmune stimulus. In a sample of 18 healthy adults, we confirmed our previous findings that LPS administration increased whole-brain [(11)C]PBR28 availability by 3150%, demonstrating a robust neuroimmune response (Cohen’s ds>1.6). We now show that LPS specifically impaired verbal learning and recall, hippocampal memory processes, by 11% and 22%, respectively (Cohen’s ds>0.9), but did not alter attention, motor, or executive processes. The LPS-induced increase in [(11)C]PBR28 binding was correlated with significantly greater decrements in verbal learning performance in the hippocampus (r=−0.52, p=.028), putamen (r=−0.50, p=.04), and thalamus (r=−0.55, p=.02). This experimental paradigm may be useful in investigating mechanistic relationships between neuroinflammatory signaling and cognitive dysfunction in psychiatric and neurologic disorders. It may also provide a direct approach to evaluate medications designed to rescue cognitive deficits associated with neuroinflammatory dysfunction.

After discovering that addictive drugs alter adult neurogenesis, the potential role of adult-born hippocampal neurons in drug addiction has become a promising research field, in which cocaine is the most frequently investigated drug. Although a substantial amount of pre-clinical evidence has accumulated, additional studies are required to reveal the mechanisms by which cocaine modulates adult hippocampal neurogenesis (AHN) and determine whether these adult-born neurons have a role in cocaine-related behaviors, such as cocaine-mediated cognitive symptoms. First, this review will summarize the cocaine-induced alterations in a number of neurobiological factors (neurotransmitters, neurotrophins, glucocorticoids, inflammatory mediators) that likely regulate both hippocampal-dependent learning and adult hippocampal neurogenesis after cocaine exposure. A separate section will provide a detailed review of the available literature that challenges the common view that cocaine reduces adult hippocampal neurogenesis. In fact, cocaine has a short-term anti-proliferative role, but the young adult-born neurons are apparently spared, or even enhanced, following certain cocaine protocols. Thus, we will try to reconcile this evidence with the hippocampal-dependent cognitive symptoms that are typically observed in cocaine addicts, and we will propose new directions for future studies to test the relevant hypothesis. Based on the evidence presented here, the regulation of adult hippocampal neurogenesis might be one of the many mechanisms by which cocaine sculpts hippocampus-dependent learning.

Schizophrenia is a severe mental illness that causes major functional impairment. Current pharmacologic treatments are inadequate, particularly for addressing negative and cognitive symptoms of the disorder. Oxytocin, a neuropeptide known to moderate social behaviors, has been investigated as a potential therapeutic for schizophrenia in recent years. Results have been decidedly mixed, leading to controversy regarding oxytocin's utility. In this review, we outline several considerations for interpreting the extant literature and propose a focused agenda for future work that builds on the most compelling findings regarding oxytocin effects in schizophrenia to date. Specifically, we examine underlying causes of heterogeneity in randomized clinical trials (RCTs) conducted thus far and highlight the complexity of the human oxytocin system. We then review evidence of oxytocin's effects on specific deficits in schizophrenia, arguing for further study using objective, precise outcome measures in order to determine whether oxytocin has the potential to improve functional impairment in schizophrenia.

Neuropsychiatric symptoms (NPS) are frequent in dementia. These symptoms are also present in patients with mild cognitive impairment (MCI) and can even constitute the first manifestations of a neurodegenerative process, preceding the development of cognitive symptoms. The presence of NPS is associated with higher rates of conversion to dementia in healthy persons and patients with MCI. Recognizing the importance of NPS, the Alzheimer Association created a working group that has designed the ISTAART criteria for mild behavioral impairment (MBI), including the following areas of assessment: motivation, affect, impulse control, social appropriateness and thoughts/perception. The ISTAART criteria allow identification of NPS to prospectively assess the risk of a person developing dementia. The Mild Behavioral Impairment-Checklist (MBI-C) has subsequently been developed, which allows the MBI construct to be specifically assessed by quantifying the distinct symptoms, thus enhancing the clinical utility of this construct in clinical practice and research.

Introduction Depressive symptoms are experienced by up to 50% of individuals diagnosed with Multiple Sclerosis (MS). Furthermore, depressive symptoms are sometimes experienced differently for females and males in the general population, but it is unclear if this is true for people with Relapsing-Remitting MS (RRMS). The current study aimed to investigate whether there are differences between females and males with RRMS in overall depression scores as well as the types of depressive symptoms reported (somatic or cognitive). Method Demographic and Beck Depression Inventory, 2nd edition (BDI-II) raw scores for females and males with RRMS were downloaded with permission from the Multiple Sclerosis Outcome Assessments Consortium (MSOAC) Placebo database. A total of 494 individuals (n=354 females) with RRMS were included in analyses. Non-parametric Wilcoxon rank-sum tests were used to compare BDI-II Total Scores, Somatic Scores, and Cognitive Scores between females and males with RRMS. Results Females reported significantly greater overall symptoms of depression compared to males. Furthermore, females endorsed significantly greater somatic symptoms than males. There were no significant differences in females’ reports of cognitive symptoms compared to males. Conclusions Depressive symptoms in RRMS are experienced differently for females and males. Females with RRMS report higher levels of overall depression and somatic depressive symptoms compared to males with RRMS; this knowledge may help inform best strategies for treatment planning. Future studies should investigate depressive symptoms in females and males with progressive forms of MS, and track symptom changes longitudinally.

Introduction: The aim of the present study is to analyse the influence that motor and non-motor symptoms have on the quality of life (QoL) of patients with Parkinson's disease (PD), and to study the relationship between the two types of symptoms. Material and methods: This cross-sectional study included 103 patients with PD (55 men and 48 women). Quality of life was measured on the PDQ-39 scale. The UPDRS scale (I-IV) was also used, and different items were grouped to analyse the presence of tremor, rigidity, bradykinesia, and axial symptoms. The non-motor symptoms scale (NMSS) was administered to assess non-motor symptoms. We performed correlation analyses between different scales to analyse the influence of motor and non-motor symptoms on QoL. Results: Correlations were observed between the PDQ-39 summary index (PDQ39 SI) and the NMSS (correlation coefficient [cc], 0.56; P

The belief that latent toxoplasmosis is asymptomatic has been questioned, in particular due to the repeated highlighted link between the Toxoplasma gondii infection and an increased incidence of schizophrenia. However, to understand this relationship, the effect of infection with Toxoplasma gondii on the severity of schizophrenia has been poorly studied. Our work focused on comparing the prevalence of Toxoplasma infection between schizophrenic patients and healthy controls, as well as comparing the clinical features and the demographic characteristics between Toxoplasma-seronegative and Toxoplasma-seropositive patients with schizophrenia. The rate of IgG antibody in the schizophrenia patients was 74.8% compared 53.8% in controls. Patients with schizophrenia had a significantly higher mean of serum IgG antibodies to T. gondii compared to controls. The seropositive male patients had a higher age of disease onset, a higher BPRS score, a greater negative PANSS score and a lower GAF score than the seronegative male patients. These results suggest a higher severity of clinical symptoms in the male patients with schizophrenia. This study provides further evidence to the hypothesis that exposure to Toxoplasma may be a risk factor for schizophrenia. Moreover, toxoplasmosis in men with schizophrenia may lead to more severe negative and cognitive symptoms and a less favorable course of schizophrenia.

A well-established body of literature supports the role of physical activity in maintaining mental health. Conversely, lack of physical activity has been associated with adverse mental health outcomes, such as posttraumatic stress disorder (PTSD) and high anxiety sensitivity. Emerging research has investigated and found promising support for aerobic exercise in reducing symptoms of PTSD and anxiety sensitivity through exposure to feared bodily sensations; however, little is known regarding whether factors such as cardiorespiratory fitness predict who will most benefit from such interventions. We explored the role of cardiorespiratory fitness in predicting reductions in PTSD symptoms and anxiety sensitivity following aerobic exercise. Thirty-two individuals from a previously published trial (Fetzner & Asmundson, 2015) were enrolled in a 2-week aerobic exercise program consisting of six sessions of moderate to vigorous intensity stationary cycling and were assessed for cardiorespiratory fitness. Results suggested that aerobic exercise was generally effective in reducing symptoms of PTSD and anxiety sensitivity, regardless of individuals' fitness levels; however, individuals with lower pre-treatment levels of cardiorespiratory fitness experienced greater reductions in avoidance and hyperarousal symptoms of PTSD, as well as total, physical, and social symptoms of anxiety sensitivity. With the exception of re-experiencing symptoms of PTSD and cognitive symptoms of anxiety sensitivity, symptom reduction generally decelerated or returned toward pre-treatment levels following post-treatment. Aerobic exercise may be particularly effective in targeting specific symptoms related to PTSD and anxiety sensitivity in individuals with lower levels of cardiorespiratory fitness and sustained physical activity may be required to maximize maintenance of treatment gains. (C) 2015 Elsevier Ltd. All rights reserved.

Background Attention-deficit/hyperactivity disorder (ADHD) stands out as the most prevalent neurodevelopmental disorder of childhood, with global prevalence ranging from 3.4% to 7•2%. Its cognitive symptoms result from the combination of complex etiological processes encompassing genetic and environmental components. Available therapeutic approaches are associated with significant challenges such as modest efficacy or side effects. Transcranial direct current stimulation (tDCS) is a promising tool for enhancing cognitive performance in neuropsychiatric disorders. Trials investigating its applicability in ADHD have showed propitious, however, still preliminary findings. Methods We performed a systemic review by searching on Medline, Cochrane Library, Web of Science, ScienceDirect and Embase using the descriptors: “attention-deficit/hyperactivity disorder” or “ADHD”; and “transcranial direct current stimulation” or “tDCS”; following PRISMA guidelines. Results A total of 383 articles were identified. After removing duplicates, 45 studies were assessed for eligibility, and after careful review, 11 manuscripts applying tDCS in ADHD were included. Significant improvements in attention, inhibitory control and working memory were reported, in addition to increased brain connectivity following use of active tDCS. Limitations The main limitation was the small number of trials investigating use of tDCS in ADHD. Study methods and outcome measures were quite variable, and generally did not include long-term follow-up. Conclusions Although the extent literature indicates promising findings, the available data remains highly preliminary. Further trials evaluating the efficacy of tDCS for ADHD, with longer follow-up, are necessary. These studies will be needed to determine the optimal protocol for clinical efficacy.

Depression is a serious mental illness. The symptoms associated with depression are both behavioral (in appetite, energy level, sleep) and cognitive (in interests, mood, concentration). Currently, survey instruments are commonly used to keep track of depression symptoms, which are burdensome and difficult to execute on a continuous basis. In this paper, we explore the feasibility of predicting all major categories of depressive symptoms automatically using smartphone data. Specifically, we consider two types of smartphone data, one collected passively on smartphones (through an app running on the phones) and the other collected from an institution's WiFi infrastructure (that does not require direct data capture on the phones), and construct a family of machine learning based models for the prediction. Both scenarios require no efforts from the users, and can provide objective assessment on depressive symptoms. Using smartphone data collected from 182 college students in a two-phase study, our results demonstrate that smartphone data can be used to predict both behavioral and cognitive symptoms effectively, with F 1 score as high as 0.86. Our study makes a significant step forward over existing studies that only focus on predicting overall depression status (i.e., whether one is depressed or not).

This study aimed to obtain University of California San Diego Performance-based Skill Assessment (UPSA) cut-off scores for the purpose of severity classification and to expand the clinical utility of the UPSA for the evaluation of cognitive function in patients with schizophrenia. In total, 191 patients with schizophrenia were recruited. The UPSA, Positive and Negative Symptom Scale (PANSS), Clinical Global Impression-Schizophrenia Scale (CGI-SCH), and Global Assessment Functioning Scale (GAF) were used for the evaluation. The cognitive symptoms item of the CGI-SCH was used as a reference and the subjects were divided into three groups: mild, moderate, and severe. The sensitivity and specificity of the UPSA were analyzed by receiver operating characteristic curves. There were significant differences in the UPSA, CGI-SCH, PANSS, and GAF scores among the groups. In the mild and moderate groups, a UPSA score of 59 was identified as the optimal cut-off score, and a score of 41 was identified as the optimal cut-off score in the moderate and severe groups. Severity can be classified using the UPSA score as follows: ≥ 60 for mild, 41–59 for moderate, and ≤ 40 for severe. The UPSA could be used to assess the degree of daily living dysfunction in patients with schizophrenia.

NMDA receptors (NMDAR) are important in the formation of activitydependent connections in the brain. In sensory pathways, NMDAR disruption during discrete developmental periods has enduring effects on wiring and function. Yet, it is not clear whether NMDAR-limited critical periods exist for higher-order circuits governing mood and cognition. This question is urgent for neurodevelopmental disorders, like schizophrenia, that have NMDAR hypofunction and treatment-resistant cognitive symptoms. As proof of concept, we developed a novel mouse model where developmental NMDAR deficits can be ameliorated by inducible Cre recombinase. Rescue of NMDARs in either adolescence or adulthood yields surprisingly strong improvements in higher-order behavior. Similar levels of behavioral plasticity are observed regardless of intervention age, with degree of plasticity dependent on the specific behavioral circuit. These results reveal higher-order brain function as amenable to treatment in adulthood and identify NMDAR as a key target for cognitive dysfunction.

The spontaneously hypertensive rat (SHR) is a commonly used and well-studied rodent model of attention deficit hyperactivity disorder (ADHD). Sex differences in the cognitive symptoms of ADHD are reported. However, the female SHR rat is much less studied than its male counterpart. The goal of the current study was to assess the validity of the SHR rodent model of ADHD by examining attentional performance, inhibitory control, and hyperactivity in both male and female SHR rats. Adult SHR and control Wistar–Kyoto rats were trained on the 5-choice serial reaction time task, a self-paced test of attention and inhibitory control. This task requires animals to identify the location of a brief light stimulus among five possible locations under several challenging conditions. Analyses of percent correct revealed that attentional performance in SHR females was not significantly different from control females, whereas attentional performance in SHR males was significantly different from control males. Analyses of the number of premature responses revealed that SHR rats made more inhibitory control errors than did control rats and that this decrease in inhibitory control was present in both SHR males and females. Analyses of activity in the open field revealed that SHR rats were more hyperactive than were control rats and that this increased hyperactivity was present in both SHR males and females. The current findings have implications for the study of sex differences in ADHD and for the use of SHR rats as a model of ADHD in females.

The symptoms of schizophrenia are evaluated in three general categories: positive, negative and cognitive symptoms. Disruption of prepulse inhibition (PPI) of the acoustic startle reflex is commonly used to model positive and cognitive symptoms in experimental animals. On the other hand, deficient social interaction (SI) is a common model of negative symptoms. Here we tested whether PPI provides information about negative symptoms by using a SI test. Baseline PPI and its relation with anxiety-like behavior were also examined with elevated plus maze (EPM) test. In the first experiment, baseline PPI levels of 30 Wistar rats were measured and animals with the highest 1/3 and the lowest 1/3 of PPI scores were respectively assigned in high-inhibitory (HI) and low-inhibitory (LI) groups. Subsequently, rats in the HI and LI groups were paired with animals from the same group and tested for SI. In the second experiment, another batch of animals was assigned to HI and LI groups and they were investigated in the EPM test. The results demonstrate a significant difference between the PPI values of HI and LI groups. Both the SI time and the moving distance of LI rats were significantly lower, and the average distance between rat pairs was significantly longer than HI rats. In the EPM test LI and HI rats showed similar levels of anxiety-like behaviors, however our results imply that performance of the rats in the SI test is related to baseline PPI levels. Thus PPI test can provide predictive information about the outcome of animal models for negative symptoms in rats. (C) 2014 Elsevier Ireland Ltd. All rights reserved.

Virtually all patients with heart failure experience multiple symptoms simultaneously, yet clinicians and researchers usually consider symptoms in isolation. Recognizing and responding early to escalating symptoms is essential to preventing hospitalizations in heart failure, yet patients have considerable difficulty recognizing symptoms. Identification of symptom clusters could improve symptom recognition, but cultural differences may be present that must be considered.To identify and compare symptom clusters in heart failure patients from the United States, Europe and Asia.Cross-sectional, observational study.In- and out-patient settings in three regions of the world: Asia (i.e., China and Taiwan); Europe (i.e., the Netherlands and Sweden); and the United States.A total of 720 patients with confirmed heart failure. Propensity scoring using New York Heart Association Classification was used to match participants from each of the three regions.Symptoms were identified using the Minnesota Living with Heart Failure Questionnaire. To identify symptom clusters we used cluster analysis with the hierarchical cluster agglomerative approach. We used the Euclidean distance to measure the similarity of variables. Proximity between groups of variables was measured using Ward's method. The resulting clusters were displayed with dendrograms, which show the proximity of variables to each other on the basis of semi-partial R-squared scores.There was a core group of symptoms that formed two comparable clusters across the countries. Dyspnea, difficulty in walking or climbing, fatigue/increased need to rest, and fatigue/low energy were grouped into a cluster, which was labeled as a physical capacity symptom cluster. Worrying, feeling depressed, and cognitive problems were grouped into a cluster, which was labeled as an emotional/cognitive symptom cluster. The symptoms of edema and trouble sleeping were variable among the countries and fell into different clusters.Despite the diversity in cultures studied, we found that symptoms clustered similarly among the cultural groups. Identification of similar symptoms clusters among patients with heart failure may improve symptom recognition in both patients and healthcare providers.

The wide range of psychological and cognitive symptoms associated with schizophrenia can often affect the level of independence that individuals with schizophrenia can achieve in their lives. Prospective memory (PM), or memory associated with future intentions, has been proposed as a useful indicator of select independent living skills. Currently, there is limited research with regards to prospective memory in schizophrenia. The current review systematically summarizes the literature focusing on prospective memory in schizophrenia and concludes that individuals with schizophrenia exhibited both an impairment in PM when compared to healthy controls and a general lack of awareness regarding these deficits. The existing research also suggests that PM deficits are not related to chronicity of illness or medications associated with schizophrenia. Limited findings suggest that PM deficits in individuals with schizophrenia may be associated with the ability to live independently and instrumental activities of daily living.

Negative symptoms have long been recognized as a central feature of the phenomenology of schizophrenia, dating back to the early descriptions by Kraepelin and Bleuler. Over the ensuing century, there have been important clarifications and reconceptualizations regarding the phenomenology of negative symptoms in schizophrenia. This review explores these developments, including the delineation of two underlying subdomains of negative symptoms - amotivation (i.e., avolition/apathy and asociality) and diminished expression (i.e., poverty of speech and affective flattening). Further, advances in our understanding of specific motivational and hedonic deficits seen in schizophrenia are explored. The findings that negative symptoms stand apart from depressive and cognitive symptoms in schizophrenia are also discussed. In terms of the predictors of functional outcomes in schizophrenia, we explore both the direct role of negative symptoms in this regard, as well as their indirect role through cognition. We then broaden our examination of negative symptoms to related disorders across the schizophrenia spectrum, as well as to other neuropsychiatric illnesses, where negative symptoms have been increasingly recognized. We explore the differential characteristics of negative symptoms across these illnesses, and their relevance to functional outcomes. This transdiagnostic presence and relevance of negative symptoms highlights the need for continued exploration of their phenomenology and neurobiology as we move to develop effective interventions to address these debilitating symptoms and improve functional outcomes.

A recent paper published in JAMA reported on a case-series of 21 people with cognitive complaints compatible with post-concussive symptoms (Swanson et al., 2018). These individuals were US government personnel who had been working in Havana, Cuba, and the proposed cause of their symptoms was unusual auditory phenomena of an unknown origin.

Major Depressive Disorder is a frequent cause of morbidity worldwide. Depression and pain disorders/symptoms are common co-morbidities. The current definitions of depression mention pain but they describe it as a secondary or uncommon symptom. This emphasis on affective symptoms may contribute to under-recognition of pain and other physical symptoms in patients with depression. The differing patterns of symptoms of depression, both over life time and within different cultures may reflect various mechanisms, cultural and economical. Therefore, we aimed to focus on painful/somatic symptoms of depression in studies reported from Turkey both in native and in migrant populations and compare the results with studies reported from other Asian and European countries. As a result, we have found that somatic symptoms are a prominent feature of Asian populations with depression, including Turkey, but that the latter also tend to report cognitive symptoms similar to Western populations with depression. The relationship of pain and somatic symptoms with depression may be complex. Further studies are needed to explain the co-morbidity of pain and depression.

Effective treatment of the cognitive symptoms of schizophrenia has remained an elusive goal. Despite the intense focus on treatments acting at or via cholinergic mechanisms, little remains known about the dynamic cholinergic abnormalities that contribute to the manifestation of the cognitive symptoms in patients. Evidence from basic neuroscientific and psychopharmacological investigations assists in proposing detailed cholinergic mechanisms and treatment targets for enhancement of attentional performance. Dynamic, cognitive performance-dependent abnormalities in cholinergic activity have been observed in animal models of the disorder and serve to further refine such proposals. Finally, the potential usefulness of individual groups of cholinergic drugs and important issues concerning the interactions between pro-cholinergic and antipsychotic treatments are addressed. The limited evidence available from patient studies and animal models indicates pressing research needs in order to guide the development of cholinergic treatments of the cognitive symptoms of schizophrenia.

In addition to positive, negative, aggressive and cognitive symptoms, patients with schizophrenia often exhibit affective disorders, including depression and anxiety. Affective symptoms in schizophrenia can be particularly disturbing for patients with schizophrenia, increasing the risk of suicide and diminishing quality of life. The following review examines the prevalence, etiology and treatment of affective symptoms, particularly depression, in patients with schizophrenia.

Elevated brain iron content, which has been observed in late-stage human Alzheimer's disease, is a potential target for early diagnosis. However, the time course for iron accumulation is currently unclear. Using the PSAPP mouse model of amyloid plaque formation, we conducted a time course study of metal ion content and distribution [iron (Fe), copper (Cu), and zinc (Zn)] in the cortex and hippocampus using X-ray fluorescence microscopy (XFM). We found that iron in the cortex was 34% higher than age-matched controls at an early stage, corresponding to the commencement of plaque formation. The elevated iron was not associated with the amyloid plaques. Interestingly, none of the metal ions were elevated in the amyloid plaques until the latest time point (56 weeks), where only the Zn content was significantly elevated by 38%. Since neuropathological changes in human Alzheimer's disease are presumed to occur years before the first cognitive symptoms appear, quantification of brain iron content could be a powerful marker for early diagnosis of Alzheimer's disease.

Background Schizophrenia is associated with neuropsychological deficits that have been linked to poor functional outcome. To address this problem, pharmacologic and behavioral treatments are being developed for cognitive impairments, but they will not be well utilized if people with schizophrenia do not perceive a need for treatment. Aims This study compared whether people with schizophrenia have a similar degree of insight into neuro-cognitive symptoms as clinical symptoms, and whether neuro-cognitive and clinical symptoms are similarly related to degree of insight into these two aspects of the illness. Method Seventy-one patients with schizophrenia were administered measures of clinical and neuro-cognitive status as well as clinician rated measures of insight into clinical and neuro-cognitive symptoms. Results Patients had significantly less insight into their neuro-cognitive symptoms than their clinical symptoms. On average, patients had good insight into clinical symptoms and partial insight into neuro-cognitive symptoms. Neuropsychological variables were related to insight into clinical symptoms, but not insight into neuro-cognition. Clinical variables were not significantly related to either type of insight. Conclusions Insight is not a unitary concept and the differences between awareness of neuro-cognition and awareness of clinical symptoms suggest that they have to be addressed separately in treatment. Specific education about cognitive symptoms may be necessary to improve awareness of this aspect of the schizophrenia.

The purpose of the present study was to explore cognitive symptoms of personality disorder traits by means of Baddeley’s working memory model. Forty-nine college students were tested for personality disorder traits with the Coolidge Axis II Inventory, and they were given measures assessing executive control, working memory, including general working memory capacity (Operation-Word Span), phonological storage capacity (digits forwards and digits backwards), and three other Wechsler Adult Intelligence Scale subtests. The results indicated that the 14 personality disorder scales had strong positive correlations with a measure of executive function deficits. Among measures of working memory capacity, the Digits Backwards subtest appeared to be the strongest predictor (negatively) of personality disorders according to multiple regressions. It was concluded that personality disorders may express themselves in cognitive ways that are reflected in measures of executive control, working memory capacity, and phonological storage capacity. Directions for further research are offered.

A wide range of central and peripheral nervous system disorders occur in patients with primary Sjögren's syndrome (pSS), although the true prevalence is an aspect which has been and remains controversial. Under-recognition of pSS and lack of consensus regarding criteria contribute to the uncertainty regarding the extent of neuropsychiatric involvement. A relatively high rate of affective and cognitive symptoms, as well as abnormal fatigue and poorly characterized pain, are features of pSS that contribute to diminishing health quality in the pSS population. This article describes the neurologic complications and controversies that surround the neurologic syndromes associated with pSS and reviews the current literature on potential immunopathogenetic mechanisms and therapy.