Numerous studies indicate impaired reward-related learning in individuals with schizophrenia, with various factors such as illness duration, medication, disease severity, and level of analysis (behavioral or neurophysiological data) potentially confounding the results. Patients with schizophrenia who are treated with second-generation antipsychotics have been found to have a less affected reward system. However, this finding does not explain the neural dysfunctions observed in previous studies. This study aimed to address the open question of whether the less impaired reward-related behavior is associated with unimpaired task-related functional connectivity or altered task-related functional connectivity.
Aims: The loudness dependence of auditory evoked potentials (LD) has been suggested as a marker of central monoaminergic function. A strong LD is associated with a reduction of central serotonergic activity and a favorable response to serotonergic agents in patients with depression. In combined neurophysiological and nuclear imaging studies the LD was correlated with both central serotonin and dopamine transporter availability. Aim of this study was to investigate the long-term effects of serotonergic versus noradrenergic antidepressants on LD in patients with depression.
Dichotic listening (DL) has been extensively used as a task to investigate auditory processing and hemispheric lateralisation in humans. According to the "callosal relay model," the typical finding of a right ear advantage (REA) occurs because the information coming from the right ear has direct access to the left dominant hemisphere while the information coming from the left ear has to cross via the corpus callosum. The underlying neuroanatomical correlates and neurophysiological mechanisms have been described using diffusion tensor imaging (DTI) and lagged phase synchronization (LPS) of the interhemispheric auditory pathway. During the non-forced condition of DL, functional connectivity (LPS) of interhemispheric gamma-band coupling has been described as a relevant mechanism related to auditory perception in DL. In this study, we aimed to extend the previous results by exploring the effects of top-down modulation of DL (forced-attention condition) on interhemispheric gamma-band LPS.
Introduction: Despite the progress in antipsychotic treatment, modern antipsychotic medication is still associated with side effects, reduced compliance, drug discontinuation and insufficient effects on negative and cognitive symptoms. Sertindole is an antipsychotic compound, with high affinity for dopamine D2, serotonin 5-HT2A, 5-HT2C and α1-adrenergic receptors, which has been reintroduced in the market after extended re-evaluation of its safety and risk–benefit profile. Areas covered: Sertindole's pharmacological profile, pharmacokinetics, neuophysiological properties, efficacy on positive, negative and cognitive symptoms and safety issues are covered in this article, based on a literature review from 1990 to 2012. Expert opinion: Based on five double-blind, randomized, placebo-, haloperidol- or risperidone-controlled studies in patients with schizophrenia, sertindole shows a comparable efficacy with haloperidol and risperidone on positive symptoms, while the effect on negative symptoms seems to be superior. Sertindole is generally well tolerated, but is associated with a dose-related QTc interval prolongation (+22 ms). Risk factors for drug-induced arrhythmia, such as cardiac diseases, congenital long QT syndrome, prolongated QTc at baseline, etc. and drug interactions should be considered before prescribing sertindole. To minimize cardiovascular risk, regular ECG recording is required. Sertindole can be an important second-line option for the treatment of schizophrenia for patients intolerant to at least one other antipsychotic. Further comparison with other SGAs and investigations on subgroups (e.g., children, elderly, first-episode, treatment-refractory patients, etc.) are still needed for a precise understanding of the therapeutic benefits and its role in schizophrenia therapy.
Patients with phobic postural vertigo (PPV) show symptoms similar to anxiety disorders. Anticipatory anxiety (AA) is a very common phenomena in those disorders. The aim of this study was the investigation of AA-associated functional responses in PPV patients compared to healthy controls (HC). For that purpose in fMRI, AA was provoked in participants due to anticipation of the cholecystokinin-tetrapeptide (CCK-4) injection, which is known to induce panic attacks. 15 PPV patients and 15 gender and age matched HC underwent the challenge. Participants did not know the exact time point of the injection in order to separate the anticipatory and CCK-4 induced anxiety. Additionally psychiatric and somatic symptoms were assessed. Healthy controls showed functional responses mainly in fronto-temporal regions. PPV patients revealed pronounced BOLD responses e. g. in the Insula, Amygdala, anterior cingulate cortex, gyrus temporalis superior and cuneus. Subjective ratings indicated that AA was associated with increased anxiety in patients than in HC. Furthermore significantly increased depression scores were demonstrated in patients. In PPV patients anticipatory anxiety led to pronounced BOLD responses in brain regions which play a central role in anxiety and cognition in fear-related processes. These neuronal responses were more pronounced than in healthy subjects. Given this fact these findings could provide evidence for common aspects of phobic postural vertigo and anxiety disorders.
