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Background Lambert-Eaton Myasthenic Syndrome is an autoimmune neuromuscular junction disorder characterized by proximal weakness, autonomic dysfunction and areflexia associated with antibodies against voltage-gated calcium channels. Psychotic symptoms can take place in many auto-immune neurological disorders, but their occurrence in myasthenic syndromes has rarely been observed.Case presentation : We report a case of a 21-year-old female with primary autoimmune Lambert-Eaton Myasthenic Syndrome due to anti-voltage-gated calcium channels antibodies subtype P/Q, who developed psychotic symptoms 3 years after motor symptoms onset. With monthly administration, these symptoms improved after every cycle of Intravenous Immunoglobulin therapy. Different causes of reversible psychosis were excluded, such as autoimmune encephalitis. Owing to muscle strength worsening and psychotic episodes, the patient was put on several treatments including one admission to a Neurology unit.Conclusions This is, to our knowledge, the first described case of a psychotic syndrome associated with Lambert-Eaton Myasthenic Syndrome. We speculate that voltage-gated calcium channel antibodies could have a role in the development of mental symptoms, however further hypotheses are discussed.

Background and hypothesis Recovery from psychosis is a complex phenomenon determined by an array of variables mutually impacting each other in a manner that is not fully understood. The aim of this study is to perform an approximated replication of a previous network analysis study investigating how different clinical aspects—covering psychopathology, cognition, personal resources, functional capacity, and real-life functioning—are interrelated in the context of schizophrenia-spectrum disorders. Study design A sample of 843 subjects from a multisite cohort study, with the diagnosis of a schizophrenia-spectrum disorder, was used to estimate a network comprising 27 variables. The connectivity and relative importance of the variables was examined through network analysis. We used a quantitative and qualitative approach to infer replication quality. Study results Functional capacity and real-life functioning were central and bridged different domains of the network, in line with the replicated study. Neurocognition, interpersonal relationships, and avolition were also key elements of the network, in close relation to aspects of functioning. Despite significant methodological differences, the current study could substantially replicate previous findings. Conclusions Results solidify the network analysis approach in the context of mental disorders and further inform future studies about key variables in the context of recovery from psychotic disorders.

Background Schizophrenia spectrum disorders are complex syndromes involving multiple clinical manifestations. Besides psychopathological symptoms, cognitive and motor alterations are also highly relevant in the context of the comprehension, assessment, and treatment of these disorders. Moreover, these three domains of clinical manifestations display complex reciprocal interactions that require further characterization. This work aims to use network analysis to investigate the associations between cognitive, motor, and psychopathological alterations in schizophrenia spectrum disorders. This approach might prove to be advantageous in identifying key variables for the assessment and treatment of these disorders. Methods A sample of 732 patients with schizophrenia spectrum disorders from a multi-site cohort study was included in the analysis. We estimated a network using a regularized Gaussian Graphical Model and conducted network stability analyses. Twenty-six nodes were included, encompassing items from the Positive and Negative Syndrome Scale, multiple neuropsychological tests, and clinician-assessed extrapyramidal symptoms’ scores. The results were further explored with centrality analyses and network comparisons between subgroups defined according to illness duration and remission status. Results We found that the estimated network was densely interconnected. Furthermore, nodes representing symptoms of disorganization were very central and, therefore, pivotal in connecting other psychopathological symptoms to cognitive and motor alterations. The estimated network for the subgroup of patients in remission showed a more sparse density and a different structure from the network of non-remitted patients. Discussion In conclusion, in the context of a broader representation of schizophrenia spectrum disorders’ manifestations, our results of a network analysis confirm a close association between different symptom domains and unveil a highly influential role of disorganization symptoms. Moreover, structural differences in networks occur according to remission status. These results are relevant for research in nosology, clinical assessment, and treatment approaches.

We explored the adherence to a home-delivered, computer-based, cognitive remediation protocol in a first-episode psychosis outpatient cohort. Seventeen patients underwent a cognitive training protocol for 6 months using an online platform accessible from their home under the supervision of a qualified neuropsychologist. Neuropsychological, psychopathological, and functional data were collected at baseline and postintervention, whereas qualitative appraisal of the intervention was assessed monthly. Overall, participants' evaluation of the program was positive. This was reflected in a good adherence rate with 12 (70%) of 17 patients completing 80% of the prescribed sessions. Exploratory analysis revealed significant improvements in sustained attention (p = 0.020) and verbal memory (p = 0.018). A decrease in negative symptoms and an improvement on the Clinical Global Impression were also found (p = 0.009). We believe these are encouraging results to further explore the adopted delivery approach, which could facilitate access to cognitive training earlier and to a larger group of patients.