Journal of Neuropsychiatry and Clinical Neurosciences最新文献

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Refining Research Diagnostic Criteria for Catatonia Among Delirium, Medical, Affective, and Psychosis Patient Groups. 在谵妄、内科、情感和精神病患者群体中完善紧张症的研究诊断标准。
IF 2.4 4区 医学
Journal of Neuropsychiatry and Clinical Neurosciences Pub Date : 2024-10-10 DOI: 10.1176/appi.neuropsych.20230100
Paula T Trzepacz, José G Franco, Subho Chakrabarti, Abhishek Ghosh, Swapnajeet Sahoo, Rahul Chakravarty, Sandeep Grover
{"title":"Refining Research Diagnostic Criteria for Catatonia Among Delirium, Medical, Affective, and Psychosis Patient Groups.","authors":"Paula T Trzepacz, José G Franco, Subho Chakrabarti, Abhishek Ghosh, Swapnajeet Sahoo, Rahul Chakravarty, Sandeep Grover","doi":"10.1176/appi.neuropsych.20230100","DOIUrl":"https://doi.org/10.1176/appi.neuropsych.20230100","url":null,"abstract":"<p><strong>Objective: </strong>The authors proposed catatonia diagnostic criteria that require the presence of three neuropsychiatric symptom clusters, rated over 24 hours; this system differs from other symptom clustering proposals and is intended to increase diagnostic rigor over Bush-Francis Catatonia Rating Scale (BFCRS) or DSM-5 criteria.</p><p><strong>Methods: </strong>By applying new BFCRS item score thresholds, symptoms were clustered into three categories to comprise the Research Diagnostic Criteria for Catatonia (RDCC): akinesia (criterion A), unusual motor signs (criterion B), and behavioral signs (criterion C). RDCC symptom clusters were analyzed in four prospectively evaluated patient groups (delirium, medical, affective, and psychosis) (N=341).</p><p><strong>Results: </strong>Use of the RDCC, compared with the DSM-5-TR and BFCRS, resulted in far fewer diagnoses of catatonia in the four patient groups: medical, N=1 out of 42 (2%); affective, N=1 out of 45 (2%); psychosis, N=3 out of 53 (6%); and delirium, N=0 out of 201. Permutations of the RDCC with more relaxed criteria were assessed, requiring either symptom thresholds or numbers of symptoms to meet criteria, resulting in catatonia rate gradations between those obtained with the RDCC and those obtained with current systems. The Cochrane Q test found that the DSM-5-TR was not dissimilar to the RDCC, if fulfilling numerical thresholds for criteria A-C, although any level of symptom severity was allowed. Confirmatory factor analysis with three goodness-of-fit indexes validated the RDCC.</p><p><strong>Conclusions: </strong>The RDCC requires akinetic symptoms on the basis of literature demonstrating their high BFCRS prevalence and exploratory factor analysis co-loadings, plus symptoms from unusual motor and behavioral signs. Compared with current lenient diagnostic approaches, having the symptoms required by the RDCC produced lower catatonia rates in the psychosis, affective, and medical groups and revealed no patients with catatonia in the delirium group. Subdividing DSM-5-TR symptoms into several different criteria may improve diagnosis. RDCC symptom clusters are both research data-based and amenable to further research for validation.</p>","PeriodicalId":16559,"journal":{"name":"Journal of Neuropsychiatry and Clinical Neurosciences","volume":" ","pages":"appineuropsych20230100"},"PeriodicalIF":2.4,"publicationDate":"2024-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142391161","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
An 11-Fold Higher Risk of Incident Mild Cognitive Impairment With Hispanic Ethnicity and Baseline Neuropsychiatric Symptoms. 西班牙裔和基线神经精神症状引发轻度认知障碍的风险高出 11 倍。
IF 2.4 4区 医学
Journal of Neuropsychiatry and Clinical Neurosciences Pub Date : 2024-08-22 DOI: 10.1176/appi.neuropsych.20230180
Ricardo Salazar, Alok K Dwivedi, Luis A Alvarado, Michael Escamilla
{"title":"An 11-Fold Higher Risk of Incident Mild Cognitive Impairment With Hispanic Ethnicity and Baseline Neuropsychiatric Symptoms.","authors":"Ricardo Salazar, Alok K Dwivedi, Luis A Alvarado, Michael Escamilla","doi":"10.1176/appi.neuropsych.20230180","DOIUrl":"https://doi.org/10.1176/appi.neuropsych.20230180","url":null,"abstract":"<p><strong>Objective: </strong>Neuropsychiatric symptoms (NPSs) have been linked to cognitive decline. This study explored ethnic differences and the effects of baseline NPSs on incident mild cognitive impairment (MCI) among 386 Hispanic and non-Hispanic participants from the Texas Harris Alzheimer's Research Study.</p><p><strong>Methods: </strong>Data on NPSs from the Neuropsychiatric Inventory Questionnaire were available for all participants. Cox proportional hazards regression models were used to estimate the effect of ≥1 NPS at baseline and Hispanic ethnicity on incident MCI over a 7-year follow-up period.</p><p><strong>Results: </strong>NPSs at baseline were associated with incident MCI for Hispanic participants but not non-Hispanic participants. Being Hispanic with at least one NPS at baseline had an 11-times higher risk of incident MCI.</p><p><strong>Conclusions: </strong>The Hispanic participants converted to MCI to a greater extent than the non-Hispanic participants. Only depressive symptoms increased the risk of MCI among non-Hispanics. Being of Hispanic ethnicity and having NPSs appeared to jointly increase the risk of progressing to MCI. To better understand the Alzheimer's disease continuum, further studies should explore other cultural, genetic, and medical risk factors influencing disease progression. Our findings strongly suggest the need to incorporate NPSs as outcomes of disease progression in future clinical trials involving Hispanic participants.</p>","PeriodicalId":16559,"journal":{"name":"Journal of Neuropsychiatry and Clinical Neurosciences","volume":" ","pages":"appineuropsych20230180"},"PeriodicalIF":2.4,"publicationDate":"2024-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142017719","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Race-Ethnicity, Rurality, and Age in Prospective Preferences and Concerns Regarding Closed-Loop Implanted Neural Devices. 种族-民族、乡村和年龄对闭环植入式神经设备的前瞻性偏好和关注。
IF 2.4 4区 医学
Journal of Neuropsychiatry and Clinical Neurosciences Pub Date : 2024-08-22 DOI: 10.1176/appi.neuropsych.20230190
Bryan B Chen, Tobias Haeusermann, Abraham Dada, Roy H Hamilton, Jennifer E James, Kristina Celeste Fong, Daniel Dohan, Winston Chiong
{"title":"Race-Ethnicity, Rurality, and Age in Prospective Preferences and Concerns Regarding Closed-Loop Implanted Neural Devices.","authors":"Bryan B Chen, Tobias Haeusermann, Abraham Dada, Roy H Hamilton, Jennifer E James, Kristina Celeste Fong, Daniel Dohan, Winston Chiong","doi":"10.1176/appi.neuropsych.20230190","DOIUrl":"10.1176/appi.neuropsych.20230190","url":null,"abstract":"<p><strong>Objective: </strong>Responsive and human-centered neurotechnology development requires attention to public perceptions, particularly among groups underserved by existing treatments.</p><p><strong>Methods: </strong>The authors conducted a preregistered nationally representative survey (https://osf.io/ej9h2) using the NORC at the University of Chicago AmeriSpeak panel. One vignette compared an implanted neural device with surgical resection in a scenario involving epilepsy, and another compared an implanted neural device with medications in a scenario involving mood disorders. The survey also contained questions about respondents' confidence that a device would be available if needed and confidence that enough research has been conducted among people like themselves. Responses were entered into nested survey-weighted logistic regression models, including a base demographic model (to test the overall effect of demographic factors) and an adjusted model that also included socioeconomic, religious and political, and health care access predictors.</p><p><strong>Results: </strong>A total of 1,047 adults responded to the survey, which oversampled Black non-Hispanic (N=214), Hispanic (N=210), and rural (N=219) Americans. In the base demographic model, older Americans were more likely to prefer an implanted device in the two scenarios, and non-Hispanic Black Americans were less likely than non-Hispanic White Americans to prefer a device; rural Americans were less confident than urban or suburban Americans in having access, and non-Hispanic Black and rural Americans were less confident that enough research has been conducted among people like themselves. In adjusted models, income was a key mediator, partially explaining the effect of age and the contrast between Black and White non-Hispanic respondents on preferences for a device in the epilepsy scenario and fully explaining the effect of rurality on confidence in access.</p><p><strong>Conclusions: </strong>Demographic differences in prospective preferences and concerns highlight the importance of including members of underserved communities in neurotechnology development.</p>","PeriodicalId":16559,"journal":{"name":"Journal of Neuropsychiatry and Clinical Neurosciences","volume":" ","pages":"appineuropsych20230190"},"PeriodicalIF":2.4,"publicationDate":"2024-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142017720","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Cognitive Performance Between Latino and White Non-Latino Individuals With Parkinson's Disease. 拉美裔与非拉美裔白人帕金森病患者的认知表现。
IF 2.4 4区 医学
Journal of Neuropsychiatry and Clinical Neurosciences Pub Date : 2024-08-08 DOI: 10.1176/appi.neuropsych.20240006
Yenny Valenzuela, Kenya Luna, Ruth Uribe-Kirby, Alejandra Pawlak, Lauren Pitman, Priscilla Cuellar-Rocha, Guadalupe Romero Lucatero, Maria M Santos, Jacob D Jones
{"title":"Cognitive Performance Between Latino and White Non-Latino Individuals With Parkinson's Disease.","authors":"Yenny Valenzuela, Kenya Luna, Ruth Uribe-Kirby, Alejandra Pawlak, Lauren Pitman, Priscilla Cuellar-Rocha, Guadalupe Romero Lucatero, Maria M Santos, Jacob D Jones","doi":"10.1176/appi.neuropsych.20240006","DOIUrl":"10.1176/appi.neuropsych.20240006","url":null,"abstract":"<p><strong>Objective: </strong>Cognitive impairment is a common nonmotor symptom in Parkinson's disease (PD). Individuals of Latino background are traditionally underrepresented in research on PD. Despite the fact that Latinos comprise 18% of the U.S. population, they commonly make up less than 5% of samples in studies of PD. Emerging evidence suggests that Latino individuals with PD may experience disparities relative to White non-Latinos in terms of having more severe motor symptoms, more severe depressive symptoms, and worse health-related quality of life. The purpose of the present study was to investigate differences in cognitive performance between Latino and White non-Latino individuals with PD and examine correlates of cognitive performance.</p><p><strong>Methods: </strong>Data were obtained from the Parkinson's Progression Markers Initiative. Participants included 60 Latino individuals with PD and 1,009 White non-Latino individuals with PD, all of whom were followed annually for up to 5 years. Participants completed neuropsychological tests of attention and working memory, processing speed, visuospatial functioning, verbal fluency, and immediate and delayed memory and recall.</p><p><strong>Results: </strong>Relative to White non-Latino individuals with PD, Latino individuals with PD had significantly lower scores on the global measure of cognitive functioning, a test of processing speed, and tests of working memory and attention. Years of education was the strongest correlate of performance in these three cognitive domains among individuals in the Latino group.</p><p><strong>Conclusions: </strong>These findings provide initial evidence of disparities in cognitive functioning among Latino individuals with PD. Educational disadvantages may be one potential driver of these disparities.</p>","PeriodicalId":16559,"journal":{"name":"Journal of Neuropsychiatry and Clinical Neurosciences","volume":" ","pages":"appineuropsych20240006"},"PeriodicalIF":2.4,"publicationDate":"2024-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141902021","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Psychiatric Manifestations in Early to Middle Stages of Fragile X-Associated Tremor-Ataxia Syndrome (FXTAS). 脆性 X 相关震颤共济失调综合征(FXTAS)早中期的精神表现。
IF 2.4 4区 医学
Journal of Neuropsychiatry and Clinical Neurosciences Pub Date : 2024-08-08 DOI: 10.1176/appi.neuropsych.20230215
Mei Hung Chi, James A Bourgeois, Ellery Santos, Kyoungmi Kim, Matt Dominic Ponzini, Guadalupe Mendoza, Andrea Schneider, David Hessl, Flora Tassone, Randi J Hagerman
{"title":"Psychiatric Manifestations in Early to Middle Stages of Fragile X-Associated Tremor-Ataxia Syndrome (FXTAS).","authors":"Mei Hung Chi, James A Bourgeois, Ellery Santos, Kyoungmi Kim, Matt Dominic Ponzini, Guadalupe Mendoza, Andrea Schneider, David Hessl, Flora Tassone, Randi J Hagerman","doi":"10.1176/appi.neuropsych.20230215","DOIUrl":"10.1176/appi.neuropsych.20230215","url":null,"abstract":"<p><strong>Objective: </strong>The purpose of the present study was to assess the psychiatric manifestations of early to middle stages of fragile X-associated tremor-ataxia syndrome (FXTAS) and their relationship with executive function and <i>FMR1</i> cytosine-guanine-guanine (CGG) repeat numbers across genders.</p><p><strong>Methods: </strong>Cross-sectional data from 100 participants (62 men, 38 women; mean±SD age=67.11±7.90 years) with FXTAS stage 1, 2, or 3 were analyzed, including demographic information, cognitive measures, psychiatric assessments (Symptom Checklist-90-Revised and Behavioral Dyscontrol Scale-II [BDS-II]), and CGG repeat number.</p><p><strong>Results: </strong>Participants with FXTAS stage 3 exhibited significantly worse psychiatric outcomes compared with participants with either stage 1 or 2, with distinct gender-related differences. Men showed differences in anxiety and hostility between stage 3 and combined stages 1 and 2, whereas women exhibited differences in anxiety, depression, interpersonal sensitivity, obsessive-compulsive symptoms, and somatization, as well as in the Global Severity Index, the Positive Symptom Distress Index, and the Positive Symptom Total. Among male participants, negative correlations were observed between BDS-II total scores and obsessive-compulsive symptoms, as well as between anxiety and CGG repeat number.</p><p><strong>Conclusions: </strong>These findings suggest that even at early FXTAS stages, patients have significant cognitive and other psychiatric symptoms, with notable gender-specific differences. This study underscores the clinical and prognostic relevance of comorbid psychiatric conditions in FXTAS, highlighting the need for early intervention and targeted support for individuals with relatively mild motor deficits.</p>","PeriodicalId":16559,"journal":{"name":"Journal of Neuropsychiatry and Clinical Neurosciences","volume":" ","pages":"appineuropsych20230215"},"PeriodicalIF":2.4,"publicationDate":"2024-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141902022","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Relationship Between Posttraumatic Headache and Depression After Mild Traumatic Brain Injury. 轻度脑外伤后创伤后头痛与抑郁之间的关系。
IF 2.4 4区 医学
Journal of Neuropsychiatry and Clinical Neurosciences Pub Date : 2024-08-08 DOI: 10.1176/appi.neuropsych.20230143
Marissa L Beal, Kevin J Psoter, Kathleen T Bechtold, Veeran Nagpaul, Matthew E Peters, Vani Rao, Timothy E Van Meter, Hayley Falk, Frederick K Korley, Durga Roy
{"title":"Relationship Between Posttraumatic Headache and Depression After Mild Traumatic Brain Injury.","authors":"Marissa L Beal, Kevin J Psoter, Kathleen T Bechtold, Veeran Nagpaul, Matthew E Peters, Vani Rao, Timothy E Van Meter, Hayley Falk, Frederick K Korley, Durga Roy","doi":"10.1176/appi.neuropsych.20230143","DOIUrl":"https://doi.org/10.1176/appi.neuropsych.20230143","url":null,"abstract":"<p><strong>Objectives: </strong>Mild traumatic brain injury (mTBI) can lead to psychiatric and somatic symptoms for some patients, including posttraumatic headache (PTH) and depression. This study attempted to further establish the relationship between PTH and depression following mTBI and investigate whether the presence of PTH immediately following injury can identify patients at risk for developing depressive symptoms up to 6 months later.</p><p><strong>Methods: </strong>This study was a secondary analysis of data from Head Injury Serum Markers for Assessing Response to Trauma (HeadSMART), a prospective study of adult patients in the emergency department with head injury. Participants included 265 patients who met criteria for mTBI and completed the Rivermead Post-Concussion Symptoms Questionnaire, to identify PTH within 24 hours after injury, and the Patient Health Questionnaire-9, to assess depressive symptoms during follow-up. Measures were completed at the initial visit immediately after the injury in the emergency department and at 1-, 3-, and 6-month follow-up visits.</p><p><strong>Results: </strong>Patients with acute PTH (aPTH) at time of injury were more likely to report PTH at 1, 3, and 6 months. They also had more severe depressive symptoms and a greater likelihood of clinically significant depression at all time points.</p><p><strong>Conclusions: </strong>Patients with aPTH within 24 hours after injury were more likely to report continued symptoms of PTH and clinically significant depression at 1, 3, and 6 months. These findings provide support for using the presence of aPTH in the emergency department following mTBI as an indicator for monitoring persistent PTH and depressive symptoms in the postacute recovery period.</p>","PeriodicalId":16559,"journal":{"name":"Journal of Neuropsychiatry and Clinical Neurosciences","volume":" ","pages":"appineuropsych20230143"},"PeriodicalIF":2.4,"publicationDate":"2024-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141902023","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Quetiapine, Clozapine, and Pimavanserin Treatment Response in Monogenic Parkinson's Disease Psychosis: A Systematic Review. 喹硫平、氯氮平和皮马凡瑟林对单基因帕金森病精神病的治疗反应:系统回顾
IF 2.4 4区 医学
Journal of Neuropsychiatry and Clinical Neurosciences Pub Date : 2024-07-22 DOI: 10.1176/appi.neuropsych.20230231
Mark Ainsley Colijn
{"title":"Quetiapine, Clozapine, and Pimavanserin Treatment Response in Monogenic Parkinson's Disease Psychosis: A Systematic Review.","authors":"Mark Ainsley Colijn","doi":"10.1176/appi.neuropsych.20230231","DOIUrl":"https://doi.org/10.1176/appi.neuropsych.20230231","url":null,"abstract":"<p><p>Psychotic symptoms frequently occur in idiopathic Parkinson's disease (PD) and often require treatment with antipsychotic therapy. Most antipsychotics have the potential to worsen the motor symptoms of PD; quetiapine, clozapine, and pimavanserin are commonly used for the treatment of idiopathic PD because these medications tend to be comparatively well tolerated. Although psychotic symptoms may also occur in monogenic forms of PD, no reviews have focused on the use of antipsychotic medications in this context. The objective of the present systematic review was to characterize the effectiveness and tolerability of quetiapine, clozapine, and pimavanserin in monogenic PD-associated psychosis. A literature search was performed with PubMed, Scopus, and Embase. The search yielded 24 eligible articles describing 30 individuals, although treatment response with respect to psychotic symptoms was described in only 11 cases; of these, six individuals experienced symptomatic improvement or remission (four with clozapine and two with quetiapine), two exhibited a poor therapeutic response (one to clozapine and one to quetiapine), and the other three responded initially to antipsychotic therapy before experiencing a recurrence of symptoms. The use of quetiapine and clozapine in <i>GBA</i> variant-associated PD is briefly reviewed separately. Notably, no reports of pimavanserin therapy were identified. In keeping with the idiopathic PD literature, relatively low doses of medication were used in most cases. Lastly, side effects were rarely reported. Although quetiapine and particularly clozapine may be effective and well tolerated in the treatment of monogenic PD psychosis, this review highlights the paucity of available evidence to guide clinical decision making in this context.</p>","PeriodicalId":16559,"journal":{"name":"Journal of Neuropsychiatry and Clinical Neurosciences","volume":" ","pages":"0"},"PeriodicalIF":2.4,"publicationDate":"2024-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141734404","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Functional Neurological Disorders Among Patients With Tremor. 震颤患者的功能性神经紊乱
IF 2.4 4区 医学
Journal of Neuropsychiatry and Clinical Neurosciences Pub Date : 2024-07-22 DOI: 10.1176/appi.neuropsych.20230126
José Fidel Baizabal-Carvallo, Marlene Alonso-Juarez, Joseph Jankovic
{"title":"Functional Neurological Disorders Among Patients With Tremor.","authors":"José Fidel Baizabal-Carvallo, Marlene Alonso-Juarez, Joseph Jankovic","doi":"10.1176/appi.neuropsych.20230126","DOIUrl":"https://doi.org/10.1176/appi.neuropsych.20230126","url":null,"abstract":"<p><strong>Objective: </strong>Functional neurological disorders (FNDs) are increasingly recognized in the general population and neurology clinics, and there is evidence that patients with neurological disorders are more likely to have a FND. This study was designed to identify the clinical features of FNDs among patients with movement disorders when the two disorders coexist.</p><p><strong>Methods: </strong>The clinical histories and video recordings of 150 consecutive patients with tremors were examined: the types of tremor included essential tremor; essential tremor plus; dystonic tremor; tremor associated with dystonia; and drug-induced, myoclonic, orthostatic, task-specific, parkinsonian, Holmes, and unclassified tremor. Using criteria for \"possible\" and \"probable\" coexistent FND, clinical features that helped differentiate between functional and other neurological tremors were identified.</p><p><strong>Results: </strong>There were 27 (18%) patients with functional manifestations, and 17 (11% of full sample) of these patients had signs suggestive of comorbid functional tremor. Patients with comorbid functional manifestations were younger at presentation, and these patients had greater severity of tremor, particularly upper limb postural tremor. Functional manifestations were not more commonly observed among patients with any particular type of tremor, except for patients with Holmes tremor, who were more likely to have comorbid functional neurological manifestations.</p><p><strong>Conclusions: </strong>About 18% of patients with diverse types of tremors also had comorbid functional neurological manifestations. Of the coexistent FNDs, functional tremor was the most common. Patients with co-occurring functional and other neurological tremors presented for evaluation at a younger age and had greater severity of arm tremor than those without comorbid functional neurological manifestations.</p>","PeriodicalId":16559,"journal":{"name":"Journal of Neuropsychiatry and Clinical Neurosciences","volume":" ","pages":"appineuropsych20230126"},"PeriodicalIF":2.4,"publicationDate":"2024-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141734403","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Characterizing Neurobehavioral Dysregulation Among Former American Football Players: Findings From the DIAGNOSE CTE Research Project. 前美式橄榄球运动员神经行为失调的特征:DIAGNOSE CTE 研究项目的发现。
IF 2.4 4区 医学
Journal of Neuropsychiatry and Clinical Neurosciences Pub Date : 2024-07-22 DOI: 10.1176/appi.neuropsych.20230133
Surya V Pulukuri, Tessa R Fagle, Diana Trujillo-Rodriguez, Suzan van Amerongen, Charles Bernick, Yonas E Geda, Jennifer V Wethe, Elaine R Peskind, Douglas I Katz, Michael L Alosco, Joseph N Palmisano, Yorghos Tripodis, Charles H Adler, Laura J Balcer, Eric M Reiman, Martha E Shenton, Jeffrey L Cummings, Robert A Stern
{"title":"Characterizing Neurobehavioral Dysregulation Among Former American Football Players: Findings From the DIAGNOSE CTE Research Project.","authors":"Surya V Pulukuri, Tessa R Fagle, Diana Trujillo-Rodriguez, Suzan van Amerongen, Charles Bernick, Yonas E Geda, Jennifer V Wethe, Elaine R Peskind, Douglas I Katz, Michael L Alosco, Joseph N Palmisano, Yorghos Tripodis, Charles H Adler, Laura J Balcer, Eric M Reiman, Martha E Shenton, Jeffrey L Cummings, Robert A Stern","doi":"10.1176/appi.neuropsych.20230133","DOIUrl":"10.1176/appi.neuropsych.20230133","url":null,"abstract":"<p><strong>Objective: </strong>Neurobehavioral dysregulation (NBD), a core clinical feature of traumatic encephalopathy syndrome, encompasses neuropsychiatric symptoms reported among individuals with a history of repetitive head impact exposure, including contact sport athletes. The objective of this study was to examine the construct and subconstructs of NBD through a series of factor and cluster analyses.</p><p><strong>Methods: </strong>Six clinician-scientists selected self-report questionnaire items relevant to NBD from seven available neuropsychiatric scales through a blinded voting process. These items were subjected to confirmatory factor analyses in a sample of 178 former college and professional American football players and 60 asymptomatic individuals without a history of repetitive head impact exposure. All participants were enrolled in the Diagnostics, Imaging, and Genetics Network for the Objective Study and Evaluation of Chronic Traumatic Encephalopathy Research Project. Factor scores were generated on the basis of the optimal expert-informed model for NBD. Construct validity was assessed with neuropsychiatric scales not included in generation of the factor scores. Cluster analyses with NBD factor scores were used to examine symptom profiles.</p><p><strong>Results: </strong>Factor analyses confirmed that NBD was composed of four subconstructs: explosivity, emotional dyscontrol, impulsivity, and affective lability. Cluster analyses indicated four distinct symptom profiles of NBD in this group of former football players: asymptomatic (N=80, 45%), short fuse (N=33, 19%), high affective lability (N=34, 19%), and high NBD (N=31, 17%).</p><p><strong>Conclusions: </strong>These findings characterize NBD as a multifaceted clinical construct with a heterogeneous presentation, providing a foundation for empirical work on the diagnostic criteria for traumatic encephalopathy syndrome and research on the neurobiological underpinnings of NBD.</p>","PeriodicalId":16559,"journal":{"name":"Journal of Neuropsychiatry and Clinical Neurosciences","volume":" ","pages":"appineuropsych20230133"},"PeriodicalIF":2.4,"publicationDate":"2024-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141734402","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Dementia With Lewy Bodies Phenocopy in a Case of RT-QuIC-Negative Creutzfeldt-Jakob Disease: Implications of Functional Anatomy. RT-QuIC 阴性克雅氏病病例中的路易体痴呆表型:功能解剖学的意义。
IF 2.4 4区 医学
Journal of Neuropsychiatry and Clinical Neurosciences Pub Date : 2024-07-11 DOI: 10.1176/appi.neuropsych.20230205
Molly K Wiggins, Emily P Pharr, Jennifer L Wood, Suzanne Craft, William T Harrison, James R Bateman
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