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Background: Identification of the biological markers of anorexia nervosa (AN) is crucial for the development of new treatments. We aimed to determine whether AN is associated with disturbances in the nonconscious neural processing of innate signals of emotion and whether these disturbances persist after weight gain. Methods: In a retest design, 28 adolescent females with AN were tested at first admission to hospital and again after they had gained weight. Matched healthy control participants were tested at the same times. We assessed emotion-elicited event-related potentials (ERPs) during overt and covert presentation of emotion expressions, scores on an emotion-identification behavioural task, and symptom measures. We performed between and within group analyses. Results: Individuals with AN had a marked alteration in ERPs relative to healthy controls. Irrespective of the form of stimulus, early and late ERP components were significantly reduced in AN patients at baseline (when underweight) and on retest (after weight gain), especially in the temporo-occipital regions, suggesting a persistent disruption of the early automatic appraisal of salient emotional signals. Limitations: This study could have been improved with a longer standardized retest interval. Conclusion: There is likely a core, generic disturbance in AN in the early 'automatic' neural processing of emotion irrespective of weight or nutritional status. New innovative emotion-based psychologic or pharmacologic treatments targeting these nonconscious processes may prove beneficial., Introduction Anorexia nervosa (AN) is an eating disorder characterized by low body weight, an intense fear of weight gain, body image distortion and a disruption of menstrual function. (1) There [...]

Background: Schizophrenia may be understood as a disorder of neural synchrony. There is also increasing evidence that emotional and social cognitive impairments are central to this disorder. In patients with first-episode schizophrenia, we examined whether emotion perception is associated with disruptions to high-frequency (40 Hz) gamma synchrony and whether these disruptions predict selfregulatory adaptive compensations reflected in social cognitive behaviours. Methods: We obtained electroencephalography recordings from 28 patients with first-episode schizophrenia and matched healthy controls during perception of facial emotion under both conscious and nonconscious conditions. We extracted gamma-band synchrony from the electroencephalogram. We also used behavioural measures of emotion identification, emotional intelligence, negativity bias and social function, along with ratings of first-episode schizophrenia symptoms. We analyzed group differences and predicted social cognition to assess the potential contribution of medication. Results: Within 200 ms poststimulus, patients with first-episode schizophrenia showed alterations in gamma synchrony during both conscious and nonconscious emotion perception. Stimulus-locked synchrony was reduced in patients, particularly over the temporal cortex, whereas complementary enhancements in absolute gamma synchrony (independent of stimuli) were more distributed over temporal and left parieto-occipital regions. This pattern of altered synchrony predicted poor performance on each measure of social cognition among these patients. Medication dosage did not correlate significantly with either gamma synchrony or behavioural measures in this group. Limitations: Limitations to our study include the lack of comparison between medicated and unmedicated patients or between types of medication. Conclusion: These findings suggest that disruptions in integrative processing of motivationally important stimuli show promise as a potential biological marker of social cognitive impairments, present from the first episode of schizophrenia, and their outcomes., Introduction The term "schizophrenia" was initially used to refer to a "splitting of the psychic functions." (1) Recent formulations have a similar emphasis on schizophrenia as a disconnection syndrome. (2-6) [...]

Background: Although schizophrenia has been characterized by disruptions to neural synchrony, it remains unknown whether these disturbances are related to symptoms and loss of grey matter. We examined relations between 40 Hz Gamma band synchrony and grey matter in patients with schizophrenia at first episode and after 2.5 years. Methods: From an initial recruitment of 35 medicated patients with a first episode of schizophrenia, 25 patients completed clinical and oddball task-elicited Gamma synchrony within 3 months of health service contact and again after 2.5 years, 23 completed magnetic resonance imaging (MRI) at these time points, and 13 completed all sessions. We compared patients with 35 matched healthy controls. We identified early (0-150 ms) and late (250-500 ms) peaks in Gamma synchrony locked to oddball targets, and we analyzed MRI data using voxel-based morphometry. We evaluated group and test-retest differences using repeated-measures analyses of variance. Results: Compared with controls, at first contact, patients with a first episode of schizophrenia showed a disruption to the laterality of early Gamma synchrony and global reduction in late Gamma synchrony, with a corresponding loss of fronto-temporal-parietal grey matter. Gamma synchrony was increased at follow-up among patients with a first episode of schizophrenia. It related negatively to further loss of grey matter, but positively to improvement in reality distortion symptoms. These relations could not be explained by medication dose. Limitations: Our study did not include unmedicated patients or normative follow-up testing. Conclusion: Gamma synchrony may track the progression of schizophrenia from first episode. An increase in Gamma synchrony over time might reflect an attempt to adapt to a progressive loss of cortical grey matter and associated changes in cognitive and emotional function. Contexte: Bien que l'on ait caracterise la schizophrenie comme presentant des dereglements de la synchronisation neuronale, on ignore encore s'il y a un lien entre ces dereglements, les symptomes et la perte de matiere grise. Nous avons examine les liens entre la synchronisation oscillatoire a 40 Hz (gamma) et la matiere grise chez des patients atteints de schizophrenie, au moment de leur premier episode et apres 2,5 ans. Methodes : Nous avons recrute initialement 35 patients traites pharmacologiquement pour un premier episode de schizophrenie. De ce nombre, 25 patients ont subi des tests de synchronisation oscillatoire Gamma suscitee par l'execution d'une tache clinique et d'une tache inhabituelle (protocole oddball), dans les 3 mois suivant leur premiere prise de contact avec les services de sante et a nouveau apres 2,5 ans; 23 patients ont subi un test d'imagerie par resonance magnetique (IRM) lors de ces etapes et 13 ont subi tous les tests prevus. Nous avons compare les patients a 35 temoins assortis en bonne sante. Nous avons repere les pics precoces (0-150 ms) et tardifs (250-500 ms) de synchronisation gamma correspondant aux cibles du protocole oddball et nous avons analyse les resultats des IRM par morphometrie voxel a voxel. Nous avons evalue les differences entre les groupes et les differences test-retest a l'aide d'une analyse de variance appliquee aux mesures repetees. Resultats : Comparativement aux temoins, lors du premier contact avec les services de sante, les patients atteints d'un premier episode de schizophrenie ont montre un dereglement de la lateralite de la synchronisation gamma precoce et une reduction globale de la synchronisation gamma tardive, avec perte correspondante de matiere grise fronto-temporo-parietale. Au moment du suivi, la synchronisation gamma a paru amplifiee chez les patients atteints d'un premier episode de schizophrenie. Ce phenomene a ete negativement relie a une perte accrue de matiere grise, mais positivement relie a une amelioration des symptomes de distorsion de la realite. Ces liens n'ont pu etre expliques par la dose de medicament. Limites : Notre etude n'incluait aucun patient qui ne prenait pas de medicaments et ne prevoyait pas l'application de tests de suivi normatifs. Conclusion: La synchronisation gamma pourrait permettre de suivre la progression de la schizophrenie a partir d'un premier episode. Une accentuation progressive de la synchronisation gamma pourrait traduire une tentative d'adaptation a la perte graduelle de matiere grise corticale et aux anomalies des fonctions cognitives et emotionnelles qui s'ensuivent., Introduction The term "schizophrenia" was initially used by Bleuler (1) to refer to a disease process that produces a "splitting of the psychic functions." (2) Recent formulations have also focused [...]

Objective: Posttraumatic stress disorder (PTSD) involves deficits in information processing that may reflect hypervigilence and deficient inhibitory control. To date, however, no PTSD neuroimaging study has directly examined PTSD-related changes [...]

Objective: Symptoms of borderline personality disorder (BPD) may reflect distinct breakdowns in the integration of posterior and frontal brain networks. We used a high temporal resolution measure (40-Hz gamma phase [...]

Abstract Background Clinically useful treatment moderators of Major Depressive Disorder (MDD) have not yet been identified, though some baseline predictors of treatment outcome have been proposed. The aim of iSPOT-D is to identify pretreatment measures that predict or moderate MDD treatment response or remission to escitalopram, sertraline or venlafaxine; and develop a model that incorporates multiple predictors and moderators. Methods/Design The International Study to Predict Optimized Treatment - in Depression (iSPOT-D) is a multi-centre, international, randomized, prospective, open-label trial. It is enrolling 2016 MDD outpatients (ages 18-65) from primary or specialty care practices (672 per treatment arm; 672 age-, sex- and education-matched healthy controls). Study-eligible patients are antidepressant medication (ADM) naïve or willing to undergo a one-week wash-out of any non-protocol ADM, and cannot have had an inadequate response to protocol ADM. Baseline assessments include symptoms; distress; daily function; cognitive performance; electroencephalogram and event-related potentials; heart rate and genetic measures. A subset of these baseline assessments are repeated after eight weeks of treatment. Outcomes include the 17-item Hamilton Rating Scale for Depression (primary) and self-reported depressive symptoms, social functioning, quality of life, emotional regulation, and side-effect burden (secondary). Participants may then enter a naturalistic telephone follow-up at weeks 12, 16, 24 and 52. The first half of the sample will be used to identify potential predictors and moderators, and the second half to replicate and confirm. Discussion First enrolment was in December 2008, and is ongoing. iSPOT-D evaluates clinical and biological predictors of treatment response in the largest known sample of MDD collected worldwide. Trial registration International Study to Predict Optimised Treatment - in Depression (iSPOT-D) ClinicalTrials.gov Identifier: NCT00693849 URL: http://clinicaltrials.gov/ct2/show/NCT00693849?term=International+Study+to+Predict+Optimized+Treatment+for+Depression&rank=1

Purpose: To evaluate the performance of a cognitive and emotional test battery in a representative sample of depressed outpatients to inform likelihood of remission over 8 weeks of treatment with each of three common antidepressant medications. Patients and methods: Outpatients 18-65 years old with nonpsychotic major depressive disorder (17 sites) were randomized to escitalopram, sertraline or venlafaxine-XR (extended release). Participants scored ≥12 on the baseline 16-item Quick Inventory of Depressive Symptomatology - Self-Report and completed 8 weeks of treatment. The baseline test battery measured cognitive and emotional status. Exploratory multivariate logistic regression models predicting remission (16-item Quick Inventory of Depressive Symptomatology - Self-Report score #5 at 8 weeks) were developed independently for each medication in subgroups stratified by age, sex, or cognitive and emotional test performance. The model with the highest crossvalidated accuracy determined the participant proportion in each arm for whom remission could be predicted with an accuracy ≥10% above chance. The proportion for whom a prediction could be made with very high certainty (positive predictive value and negative predictive value exceeding 80%) was calculated by incrementally increasing test battery thresholds to predict remission/non-remission. Results: The test battery, individually developed for each medication, improved identification of remitting and non-remitting participants by ≥10% beyond chance for 243 of 467 participants. The overall remission rates were escitalopram: 40.8%, sertraline: 30.3%, and venlafaxine-XR: 31.1%. Within this subset for whom prediction exceeded chance, test battery thresholds established a negative predictive value of ≥80%, which identified 40.9% of participants not remitting on escitalopram, 77.1% of participants not remitting on sertraline, and 38.7% of participants not remitting on venlafaxine-XR (all including 20% false negatives). Conclusion: The test battery identified about 50% of each medication group as being ≥10% more or less likely to remit than by chance, and identified about 38% of individuals who did not remit with ≥80% certainty. Clinicians might choose to avoid this specific medication in these particular patients. [ABSTRACT FROM AUTHOR]