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Cureus Feb 2024Delusional infestation (DI) is characterized by delusions of being infested by small microorganisms or even inanimate objects without any medical or microbiological...
Delusional infestation (DI) is characterized by delusions of being infested by small microorganisms or even inanimate objects without any medical or microbiological evidence. The pathophysiology of DI is not well understood, and there are two types of DI: the primary form, where there is no underlying cause, and the secondary form, which is related to an associated psychiatric disorder, medical condition, or substance use. DI in Parkinson's disease (PD) is rarely reported, and most published cases are due to antiparkinsonian drugs. Piribedil is a dopaminergic agonist used for the symptomatic treatment of PD either as monotherapy or as adjuvant therapy with other antiparkinsonian treatments. We report the case of an 81-year-old man followed for PD at our institution who developed DI after piribedil dose escalation. When DI is secondary to an antiparkinsonian drug, the treatment of choice is based on withdrawing the implicated drug.
PubMed: 38449964
DOI: 10.7759/cureus.53631 -
BMC Neurology Mar 2024Neuropsychiatric symptoms and delusions are highly prevalent among people with dementia. However, multiple roots of neurobiological bases and shared neural basis of...
BACKGROUND
Neuropsychiatric symptoms and delusions are highly prevalent among people with dementia. However, multiple roots of neurobiological bases and shared neural basis of delusion and cognitive function remain to be characterized. By utilizing a fine-grained multivariable approach, we investigated distinct neuroanatomical correlates of delusion symptoms across a large population of dementing illnesses.
METHODS
In this study, 750 older adults with mild cognitive impairment and Alzheimer's disease completed brain structural imaging and neuropsychological assessment. We utilized principal component analysis followed by varimax rotation to identify the distinct multivariate correlates of cortical thinning patterns. Five of the cognitive domains were assessed whether the general cognitive abilities mediate the association between cortical thickness and delusion.
RESULTS
The result showed that distributed thickness patterns of temporal and ventral insular cortex (component 2), inferior and lateral prefrontal cortex (component 1), and somatosensory-visual cortex (component 5) showed negative correlations with delusions. Subsequent mediation analysis showed that component 1 and 2, which comprises inferior frontal, anterior insula, and superior temporal regional thickness accounted for delusion largely through lower cognitive functions. Specifically, executive control function assessed with the Trail Making Test mediated the relationship between two cortical thickness patterns and delusions.
DISCUSSION
Our findings suggest that multiple distinct subsets of brain regions underlie the delusions among older adults with cognitive impairment. Moreover, a neural loss may affect the occurrence of delusion in dementia largely due to impaired general cognitive abilities.
Topics: Humans; Aged; Alzheimer Disease; Delusions; Cognitive Dysfunction; Cognition; Brain
PubMed: 38448803
DOI: 10.1186/s12883-024-03568-5 -
Journal of Multidisciplinary Healthcare 2024Historically, humanity has suffered and endured deadly pandemics of varying mortality rates. Irrefutably, research shows that the outbreak of pandemics is flooded by... (Review)
Review
Historically, humanity has suffered and endured deadly pandemics of varying mortality rates. Irrefutably, research shows that the outbreak of pandemics is flooded by mythical and fallacious information among the public, hence stifling the prevention, treatment, and management of diseases. This paper focused on comparing selected aspects of the two pandemics, that is, HIV/AIDS and Coronavirus. This comparative analysis is important for drawing informative lessons for effective response and management of pandemics in the future. Through a literature review analysis, the paper established that both pandemics have more similarities than distinctions. The etiology and epidemiology of the diseases assume a similar cascading trajectory; the public health information about the diseases is characterized by myths, conspiracy theories, illusions, and delusions from the public. The myths associated with pandemics prevail around causation, disease transmission, and cure. The pandemics present economic paradoxes, though arguably the negatives outdo the positives. There is a need for the governments and international health custodians to be richly prepared for the pandemics in the future. This implies having special budgetary allocations for possible pandemic outbreaks, investing in vaccine development and disease surveillance, and training and skilling personnel in all social-health-related sectors.
PubMed: 38445068
DOI: 10.2147/JMDH.S440243 -
ELife Mar 2024In children, psychotic-like experiences (PLEs) are related to risk of psychosis, schizophrenia, and other mental disorders. Maladaptive cognitive functioning, influenced...
In children, psychotic-like experiences (PLEs) are related to risk of psychosis, schizophrenia, and other mental disorders. Maladaptive cognitive functioning, influenced by genetic and environmental factors, is hypothesized to mediate the relationship between these factors and childhood PLEs. Using large-scale longitudinal data, we tested the relationships of genetic and environmental factors (such as familial and neighborhood environment) with cognitive intelligence and their relationships with current and future PLEs in children. We leveraged large-scale multimodal data of 6,602 children from the Adolescent Brain and Cognitive Development Study. Linear mixed model and a novel structural equation modeling (SEM) method that allows estimation of both components and factors were used to estimate the joint effects of cognitive phenotypes polygenic scores (PGSs), familial and neighborhood socioeconomic status (SES), and supportive environment on NIH Toolbox cognitive intelligence and PLEs. We adjusted for ethnicity (genetically defined), schizophrenia PGS, and additionally unobserved confounders (using computational confound modeling). Our findings indicate that lower cognitive intelligence and higher PLEs are significantly associated with lower PGSs for cognitive phenotypes, lower familial SES, lower neighborhood SES, and less supportive environments. Specifically, cognitive intelligence mediates the effects of these factors on PLEs, with supportive parenting and positive school environments showing the strongest impact on reducing PLEs. This study underscores the influence of genetic and environmental factors on PLEs through their effects on cognitive intelligence. Our findings have policy implications in that improving school and family environments and promoting local economic development may enhance cognitive and mental health in children.
Topics: Adolescent; Child; Humans; Mental Disorders; Psychotic Disorders; Mental Health; Cognition; Intelligence
PubMed: 38441539
DOI: 10.7554/eLife.88117 -
Ecology and Evolution Mar 2024During the last 50 years, a group of ecologists has repeatedly used Popper's falsificationism in normative claims concerning how research in ecology should be... (Review)
Review
During the last 50 years, a group of ecologists has repeatedly used Popper's falsificationism in normative claims concerning how research in ecology should be conducted and/or how ecology should be corrected. Other ecologists seem to be dissatisfied with these criticisms. Nevertheless, they have not provided systematic analyses of how and why the Popperian criticisms of ecology fail. I have two aims in this article First, I show how so-called Popperian ecologists have not only failed to use but have misused - if not abused - Popper in their criticisms of ecology. That is, the Popperian criticisms of ecology lack the justification the critics claim it has. Second, I claim that Popper's falsificationism is an unsuitable philosophy of science for ecology. In other words, ecology should not be criticized nor evaluated from the Popperian perspective in the first place.
PubMed: 38435009
DOI: 10.1002/ece3.11106 -
Journal of Clinical Neurology (Seoul,... Mar 2024Neurological diseases often manifest with neuropsychiatric symptoms such as depression, emotional incontinence, anger, apathy and fatigue. In addition, affected patients... (Review)
Review
Neurological diseases often manifest with neuropsychiatric symptoms such as depression, emotional incontinence, anger, apathy and fatigue. In addition, affected patients may also experience psychotic symptoms such as hallucinations and delusions. Various factors contribute to the development of psychotic symptoms, and the mechanisms of psychosis are similar, but still differ among various neurological diseases. Although psychotic symptoms are uncommon, and have been less well investigated, they may annoy patients and their families as well as impair the patients' quality of life and increase the caregiver burden. Therefore, we need to appropriately identify and treat these psychotic symptoms in patients with neurological diseases.
PubMed: 38433485
DOI: 10.3988/jcn.2023.0501 -
Journal of Alzheimer's Disease : JAD 2024Pimavanserin, a 5-HT2A receptor inverse agonist/antagonist, is the only medication approved by the FDA for the treatment of hallucinations and delusions associated with... (Randomized Controlled Trial)
Randomized Controlled Trial
BACKGROUND
Pimavanserin, a 5-HT2A receptor inverse agonist/antagonist, is the only medication approved by the FDA for the treatment of hallucinations and delusions associated with Parkinson's disease psychosis (PDP). Further expanding knowledge of the safety profile of pimavanserin in PDP and neurodegenerative diseases (NDD) such as Alzheimer's disease is of great interest for informing its use in patients with PDP (with or without dementia), given this population is highly sensitive to adverse effects following antipsychotic use.
OBJECTIVE
This trial evaluated the effects of pimavanserin compared to placebo in frail older adults and elderly patients with neuropsychiatric symptoms related to NDD, such as hallucinations and delusions, to better understand the safety of pimavanserin in this population.
METHODS
This was a phase 3b, 8-week treatment (study duration of up to 16 weeks), multicenter, randomized, double-blind, placebo-controlled, two-arm parallel-group trial (NCT03575052). The primary endpoint was safety and tolerability, measured by treatment-emergent adverse events (TEAEs). Secondary safety endpoints were change from baseline in motor and cognitive function; exploratory endpoints included suicidality, sleep quality, and neuropsychiatric symptoms.
RESULTS
Incidences of TEAEs were similar between treatment groups; 29.8% reported ≥1 TEAE (pimavanserin: 30.4%; placebo: 29.3%), and 1.8% reported serious TEAEs (pimavanserin: 2.0%; placebo: 1.5%). Pimavanserin did not impact motor- or cognitive-related function.
CONCLUSIONS
Pimavanserin was well tolerated and not associated with motor or cognitive impairment. Together, these findings highlight the manageable and generally favorable safety profile of pimavanserin in patients with NDD, contributing to our knowledge on the safety of pimavanserin as it generalizes to patients with PDP.
Topics: Aged; Humans; Antipsychotic Agents; Drug Inverse Agonism; Hallucinations; Neurodegenerative Diseases; Piperidines; Psychotic Disorders; Urea
PubMed: 38427485
DOI: 10.3233/JAD-231167 -
NeuroImage. Clinical 2024Psychosis (including symptoms of delusions, hallucinations, and disorganized conduct/speech) is a main feature of schizophrenia and is frequently present in other major...
Psychosis (including symptoms of delusions, hallucinations, and disorganized conduct/speech) is a main feature of schizophrenia and is frequently present in other major psychiatric illnesses. Studies in individuals with first-episode (FEP) and early psychosis (EP) have the potential to interpret aberrant connectivity associated with psychosis during a period with minimal influence from medication and other confounds. The current study uses a data-driven whole-brain approach to examine patterns of aberrant functional network connectivity (FNC) in a multi-site dataset comprising resting-state functional magnetic resonance images (rs-fMRI) from 117 individuals with FEP or EP and 130 individuals without a psychiatric disorder, as controls. Accounting for age, sex, race, head motion, and multiple imaging sites, differences in FNC were identified between psychosis and control participants in cortical (namely the inferior frontal gyrus, superior medial frontal gyrus, postcentral gyrus, supplementary motor area, posterior cingulate cortex, and superior and middle temporal gyri), subcortical (the caudate, thalamus, subthalamus, and hippocampus), and cerebellar regions. The prominent pattern of reduced cerebellar connectivity in psychosis is especially noteworthy, as most studies focus on cortical and subcortical regions, neglecting the cerebellum. The dysconnectivity reported here may indicate disruptions in cortical-subcortical-cerebellar circuitry involved in rudimentary cognitive functions which may serve as reliable correlates of psychosis.
Topics: Humans; Magnetic Resonance Imaging; Psychotic Disorders; Brain; Schizophrenia; Cerebellum; Brain Mapping
PubMed: 38422833
DOI: 10.1016/j.nicl.2024.103584 -
Frontiers in Cellular Neuroscience 2024Schizophrenia is a complex and severe mental disorder that affects approximately 1% of the global population. It is characterized by a wide range of symptoms, including...
Schizophrenia is a complex and severe mental disorder that affects approximately 1% of the global population. It is characterized by a wide range of symptoms, including delusions, hallucinations, disorganized speech and behavior, and cognitive impairment. Recent research has suggested that the immune system dysregulation may play a significant role in the pathogenesis of schizophrenia, and glial cells, such as astroglia and microglia known to be involved in neuroinflammation and immune regulation, have emerged as potential players in this process. The aim of this systematic review is to summarize the glial hallmarks of schizophrenia, choosing as cellular candidate the astroglia and microglia, and focusing also on disease-associated psychological (cognitive and emotional) changes. We conducted a systematic review following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. We searched PubMed, Scopus, and Web of Science for articles that investigated the differences in astroglia and microglia in patients with schizophrenia, published in the last 5 years. The present systematic review indicates that changes in the density, morphology, and functioning of astroglia and microglia may be involved in the development of schizophrenia. The glial alterations may contribute to the pathogenesis of schizophrenia by dysregulating neurotransmission and immune responses, worsening cognitive capabilities. The complex interplay of astroglial and microglial activation, genetic/epigenetic variations, and cognitive assessments underscores the intricate relationship between biological mechanisms, symptomatology, and cognitive functioning in schizophrenia.
PubMed: 38419655
DOI: 10.3389/fncel.2024.1358450