- Publikační typ
- abstrakt z konference MeSH
We report on the case of a 46-year-old woman with generalized anxiety disorder, paranoid personality disorder, and mild reduction in glomerular filtration rate (GFR). She was treated with pregabalin, trazodone, hydroxyzine, and clonazepam before hospital admission. Pharmacotherapy for the patient was changed during her first week in the hospital. Dosing of hydroxyzine and clonazepam was gradually decreased, and then these two drugs were withdrawn. Treatment with amisulpride was started on the fourth day after admission, and amisulpride serum levels were then measured three times as a part of therapeutic drug monitoring (TDM). The serum concentration of amisulpride detected during concurrent use of trazodone and pregabalin was approximately twice the therapeutic range for amisulpride. When the dose of pregabalin was reduced by half, the serum concentration of amisulpride decreased to therapeutic serum levels. We hypothesize that an interaction between amisulpride and pregabalin was responsible for the increased amisulpride concentration since both drugs are almost exclusively excreted from the body by the renal route. Pregabalin-amisulpride interaction might also be influenced by concomitant therapy with trazodone or a mild reduction in GFR. However, we only have clinical evidence for an interaction between amisulpride and pregabalin because after we halved the dose of pregabalin, the amisulpride concentration decreased, and the C/D ratio normalized. This could be helpful information for psychiatrists in order to avoid drug-drug interactions between amisulpride and pregabalin. We recommend TDM of amisulpride in patients treated concomitantly with other drugs eliminated mainly by the kidneys.
- Publikační typ
- kazuistiky MeSH
INTRODUCTION: Tinnitus is an intrusive and chronic illness affecting a significant portion of the population, decreasing affected individuals' quality of life and socioeconomic functioning. Transcranial Direct Current Stimulation (tDCS) is a non-invasive neuromodulatory method utilizing weak electrical currents to elicit short and long-term central nervous system changes. Several studies have proven its effect on tinnitus. We aimed to broaden the knowledge and provide data on the effect and its retention. METHODS: In the randomized, double-blinded, sham-controlled trial, 39 patients (active n = 19, sham n = 20) underwent bifrontal tDCS (anode over right dorsolateral prefrontal cortex (DLPFC), cathode left DLPFC, current of 1.5 mA, 20 min, 6 sessions in 2 weeks). Tinnitus Functional Index (TFI), Iowa Tinnitus Handicap Questionnaire (ITHQ), Beck Anxiety Inventory (BAI), Zung Self-Rating Depression Scale (SDS), and WHO-Quality of Life-BREF were employed in 4 evaluation points, including the follow-ups of 6 weeks and 6 months. RESULTS: We reached a delayed, significant long-term improvement (p < 0.05) in auditory difficulties associated with tinnitus and noticed it even after 6 months compared to placebo. We also reached a short-term, negative effect in the psychological domain of WHO-Quality of Life-BREF (p < 0.05). Not all subdomains of TFI and ITHQ reached statistical significance during the data analysis, even though specific positive trends were noticed. CONCLUSION: We proved partial, positive, long-term effects of tDCS on tinnitus and short-term, negative, transient effect on a specific aspect of the general quality of life. We expanded upon the results of previous trials and provided data concerning the longevity and the precise effect of multiple sessions, bifrontal DLPFC tDCS. Our sample size (n = 39) was limited, which might have contributed to the lesser statistical power of the analyzed items. CLINICAL TRIAL REGISTRATION: [www.ClinicalTrials.gov], identifier [NCT05437185].
- Publikační typ
- časopisecké články MeSH
Syndrom bludné misidentifikace je zastřešujícím pojmem pro chybné určování totožnosti zejména osob, ale i míst, předmětů či událostí, často doprovázené bludným přesvědčením o jejich proměně či existenci dvojníků. Mezi nejčastější fenomény řazené k této skupině patří Capgrasův a Fregoliho syndrom. Článek poskytuje stručný souhrn dosavadních informací o daných syndromech, prezentuje dvě kazuistiky pacientek hospitalizovaných na oddělení pro léčbu psychotických poruch na jaře roku 2021 a diskutuje možné klinicko-neurobiologické implikace získaných poznatků
Delusional misidentification syndrome is an umbrella term for disorders of identification of predominantly persons, but also places, objects or events, accompanied particularly by delusional belief in the existence of doppelgängers, with Capgras and Fregoli syndromes amongst the most common phenomena within the syndrome. Following article provides a brief summary of current knowledge on these conditions along with two case reports of patients treated in our ward during spring 2021 and discussion of possible clinical and neurobiological implications.
- Klíčová slova
- Delusional misidentification syndrome, Syndrom bludné misidentifikace,
- MeSH
- antipsychotika aplikace a dávkování MeSH
- bludy MeSH
- Capgrasův syndrom * diagnostické zobrazování diagnóza farmakoterapie MeSH
- diferenciální diagnóza MeSH
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- neurokognitivní poruchy diagnóza farmakoterapie MeSH
- olanzapin aplikace a dávkování MeSH
- paliperidon palmitát aplikace a dávkování MeSH
- schizofrenie a poruchy s psychotickými rysy diagnóza farmakoterapie MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- ženské pohlaví MeSH
- Publikační typ
- kazuistiky MeSH
- přehledy MeSH
- Publikační typ
- abstrakt z konference MeSH
- Publikační typ
- abstrakt z konference MeSH
Increased frontal midline theta activity generated by the anterior cingulate cortex (ACC) is induced by conflict processing in the medial frontal cortex (MFC). There is evidence that theta band transcranial alternating current stimulation (θ-tACS) modulates ACC function and alters inhibitory control performance during neuromodulation. Multi-electric (256 electrodes) high definition θ-tACS (HD θ-tACS) using computational modeling based on individual MRI allows precise neuromodulation targeting of the ACC via the medial prefrontal cortex (mPFC), and optimizes the required current density with a minimum impact on the rest of the brain. We therefore tested whether the individualized electrode montage of HD θ-tACS with the current flow targeted to the mPFC-ACC compared with a fixed montage (non-individualized) induces a higher post-modulatory effect on inhibitory control. Twenty healthy subjects were randomly assigned to a sequence of three HD θ-tACS conditions (individualized mPFC-ACC targeting; non-individualized MFC targeting; and a sham) in a double-blind cross-over study. Changes in the Visual Simon Task, Stop Signal Task, CPT III, and Stroop test were assessed before and after each session. Compared with non-individualized θ-tACS, the individualized HD θ-tACS significantly increased the number of interference words and the interference score in the Stroop test. The changes in the non-verbal cognitive tests did not induce a parallel effect. This is the first study to examine the influence of individualized HD θ-tACS targeted to the ACC on inhibitory control performance. The proposed algorithm represents a well-tolerated method that helps to improve the specificity of neuromodulation targeting of the ACC.
- Publikační typ
- časopisecké články MeSH
- MeSH
- antikonvulziva terapeutické užití MeSH
- bipolární porucha * terapie MeSH
- deprese etiologie terapie MeSH
- elektrokonvulzívní terapie * metody škodlivé účinky statistika a číselné údaje MeSH
- klinická studie jako téma MeSH
- kognitivní poruchy etiologie komplikace MeSH
- lidé MeSH
- lithium terapeutické užití MeSH
- mánie etiologie MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- práce podpořená grantem MeSH
Over the past decade, theta-burst stimulation (TBS) has become a focus of interest in neurostimulatory research. Compared to conventional repetitive transcranial magnetic stimulation (rTMS), TBS produces more robust changes in cortical excitability (CE). There is also some evidence of an analgesic effect of the method. Previously published studies have suggested that different TBS parameters elicit opposite effects of TBS on CE. While intermittent TBS (iTBS) facilitates CE, continuous TBS (cTBS) attenuates it. However, prolonged TBS (pTBS) with twice the number of stimuli produces the opposite effect. In a double-blind, placebo-controlled, cross-over study with healthy subjects (n = 24), we investigated the effects of various pTBS (cTBS, iTBS, and placebo TBS) over the right motor cortex on CE and pain perception. Changes in resting motor thresholds (RMTs) and absolute motor-evoked potential (MEP) amplitudes were assessed before and at two time-points (0-5 min; 40-45 min) after pTBS. Tactile and thermal pain thresholds were measured before and 5 min after application. Compared to the placebo, prolonged cTBS (pcTBS) transiently increased MEP amplitudes, while no significant changes were found after prolonged iTBS. However, the facilitation of CE after pcTBS did not induce a parallel analgesic effect. We confirmed that pcTBS with twice the duration converts the conventional inhibitory effect into a facilitatory one. Despite the short-term boost of CE following pcTBS, a corresponding analgesic effect was not demonstrated. Therefore, the results indicate a more complex regulation of pain, which cannot be explained entirely by the modulation of excitability.
- Publikační typ
- časopisecké články MeSH
- Publikační typ
- abstrakt z konference MeSH
