Search Results (4)

The review brings together a wealth of case studies, both from the authors’ patients and from the literature, about people whose bodies do not feel as they really should. Body parts suddenly become longer or shorter, heavier or lighter and there may be a loss of body control to the point where individuals feel as if they no longer have a body at all. The article differentiates by type of causes: mental disorders (e.g., psychosis), the influence of drugs on body perception and neurological causes. Depending on the type of body change, examples are given from the categories of sexually toned changes in body perception, out-of-body experiences and near-death experiences. Since there are countless types of body image disorders, the article is limited to a selective selection of the most interesting and sometimes obscure deviations. Full article

Schizophrenia is a debilitating mental illness which involves three groups of symptoms, i.e., positive, negative and cognitive, and has major public health implications. According to various sources, it affects up to 1% of the population. The pathomechanism of schizophrenia is not fully understood and current antipsychotics are characterized by severe limitations. Firstly, these treatments are efficient for about half of patients only. Secondly, they ameliorate mainly positive symptoms (e.g., hallucinations and thought disorders which are the core of the disease) but negative (e.g., flat affect and social withdrawal) and cognitive (e.g., learning and attention disorders) symptoms remain untreated. Thirdly, they involve severe neurological and metabolic side effects and may lead to sexual dysfunction or agranulocytosis (clozapine). It is generally agreed that the interactions of antipsychotics with various neurotransmitter receptors are responsible for their effects to treat schizophrenia symptoms. In particular, several G protein-coupled receptors (GPCRs), mainly dopamine, serotonin and adrenaline receptors, are traditional molecular targets for antipsychotics. Comprehensive research on GPCRs resulted in the exploration of novel important signaling mechanisms of GPCRs which are crucial for drug discovery: intentionally non-selective multi-target compounds, allosteric modulators, functionally selective compounds and receptor oligomerization. In this review, we cover current hypotheses of schizophrenia, involving different neurotransmitter systems, discuss available treatments and present novel concepts in schizophrenia and its treatment, involving mainly novel mechanisms of GPCRs signaling. Full article

The present study assessed problems in Japanese prisoners (inmates) who abused methamphetamine. Fifty-two male inmates were assessed in 2005–2007 using the Addiction Severity Index-Japanese version and compared with 55 male methamphetamine abusers in hospitals and recovery centers. The χ² and Mann-Whitney-Wilcoxon tests showed that the inmates had a significantly lower education level, more frequently had full-time jobs, had more experience living with a sexual partner, and more frequently had a history of juvenile delinquency and criminal records than patients. Although psychiatric symptoms, such as depression, anxiety, and hallucinations, were not common among inmates, suicidal behavior and trouble controlling violence were common in both groups. Full article

The last 15 years have seen the progressive introduction of deep-brain stimulation (DBS) for the treatment of Parkinson’s disease. This advance has been possible thanks to better understanding of the organisation of the basal ganglia with parallel segregated loops involved in the control of movement, behaviour, mood and cognition that interact through interneurons or collateral projections. Deep-brain stimulation, which allows by stimulation adjustments to optimise the benefit/side effect ratio, has made possible bilateral treatments needed for treating Parkinson’s disease, while former available lesions were contraindicated because of the substantial side effects they produced. Thalamic ventral intermediate nucleus was the first target. It affects the cerebello-thalamo-cortical pathway and is mainly effective on tremor with little benefit on the other signs of Parkinson’s disease. For Parkinson’s disease it has progressively completely been replaced by the two other targets and is currently mainly used to treat medication-resistant essential tremor. Internal posterior part of globus pallidus acts on the common output nucleus of the basal ganglia loops. It has been proven very effective for treating motor fluctuations, mainly dyskinesia. Its effects on motor signs of Parkinson’s disease are moderate and variably observed probably secondary to the organization of this relatively large nucleus, with deep-brain stimulation effects depending upon precise localisation. Globus pallidus deep-brain stimulation does not allow antiparkinsonian medication reduction, in contrast to subthalamic deep-brain stimulation, but necessitates a progressive increase of drugs, with some decrease in efficacy with time. Globus pallidus being very effective on dyskinesia is currently rather used to treat other movement disorders, e.g. dystonia. Subthalamic deep-brain stimulation has become the main target for treating Parkinson’s disease. It is acting on the indirect pathway, correcting the subthalamic hyperactivity secondary to disinhibition following dopamine depletion in Parkinson’s disease. Subthalamic deep-brain stimulation improves the four major signs of Parkinson’s disease, with effects mimicking levodopa: response to levodopa challenge being one of the best predictive parameters of the response to subthalamic deep-brain stimulation. This treatment allows substantial antiparkinsonian drug reduction. The latter is the main responsible for dyskinesia reduction observed after subthalamic deep-brain stimulation. Subthalamic deepbrain stimulation effects are maintained for at least 5 years although increase in axial signs and dementia is observed with Parkinson’s disease progression. Beside the motor effects, deep-brain stimulation may induce acute or chronic neuro-behavioural changes. The former is probably secondary to direct effect on structures adjacent to the targeted nuclei or involvement of parallel basal ganglia circuitry. The latter, which develops over months or years, is possibly also related to medication changes, neuronal plasticity following deep-brain stimulation, adaptation difficulties and dramatic socio-familial modification induced by the motor effects of deep-brain stimulation. Depression, apathy, anxiety, mania, pathological gambling, sexual behaviours and hallucinations have all been described following deep-brain stimulation. These changes, which underline the importance of basal ganglia circuitry in mood and behaviour, may have severe consequences including suicides. If the acute effects can usually easily be corrected by deep-brain stimulation tuning, the chronic modifications need to be detected and often necessitate a multidisciplinary approach. This careful multidisciplinary (neurologist, neuropsy-chologist, neurosurgeon, psychiatrist) collaboration is important not only for the selection but also for the follow-up of Parkinson’s disease patients treated by deep-brain stimulation. Full article