This study aimed to investigate the association between atrophy in the prefrontal cortex with executive function and verbal fluency in elderly male and female patients poststroke. Thirty elderly female patients with n...This study aimed to investigate the association between atrophy in the prefrontal cortex with executive function and verbal fluency in elderly male and female patients poststroke. Thirty elderly female patients with non-aphasic ischemic stroke aged -〉 60 years and 30 age-matched non-aphasic male patients with ischemic stroke were recruited. Automatic magnetic resonance imaging segmentation was used to assess the volume of the whole prefrontal cortex, along with its subdivisions： anterior cingulate cortex, orbitofrontal cortex and dorsolateral prefrontal cortex. The Semantic Verbal Fluency Test was administered at 3 and 15 months poststroke. At 3 months poststroke, left dorsolateral prefrontal cortex volume was significantly correlated with Verbal Fluency Test score in female patients only （partial coefficient = 0.453, P = 0.045）, after controlling for age, education, diabetes, neurological deficit, white matter lesions volume, as well as the location and volume of infarcts. At 15 months poststroke, there remained a significant association between the left dorsolateral prefrontal cortex volume and Verbal Fluency Test （partial coefficient = 0.661, P = 0.001） and between the left prefrontal cortex volume and Verbal Fluency Test （partial coefficient = 0.573, P = 0.004） in female patients after the same adjustments. These findings indicate that atrophy of the left dorsolateral prefrontal cortex contributes to the impairment of verbal fluency in elderly female patients with stroke. Sex differences may be present in the neuropsychological mechanisms of verbal fluency impairment in patients with stroke.展开更多
Objective: Sleep dysfunctions are common in schizophrenia, yet few evidence-based guidelines exist for the detection, diagnosis and management of sleep disturbances in this disorder. This critical review paper sought ...Objective: Sleep dysfunctions are common in schizophrenia, yet few evidence-based guidelines exist for the detection, diagnosis and management of sleep disturbances in this disorder. This critical review paper sought to increase awareness amongst mental health clinicians of sleep problems in schizophrenia, promote better identification of sleep problems, and help clinicians make more informed decisions about integrated treatment plans. Specifically, we examined the following key questions: 1) Which sleep problems occur in schizophrenia? 2) What evidence exists regarding the impact of poor sleep? 3) What are the underlying mechanisms of sleep problems in schizophrenia? 4) How can this information be used by clinicians to design a more complete treatment plan? Data Sources and study selection: We conducted a non-systematic review of studies that have shaped our current understanding of sleep in schizophrenia (n = 65). Data sources included PubMed, Medline, and cross-referencing. Results: Sleep disorders are pervasive and broad-ranging in people with schizophrenia, and are associated with substantial burden. An integrated model is proposed whereby a combination of highly interactive factors comprising genetic and neurobiological vulnerabilities, and behavioural and environmental factors, interact to cause sleep abnormalities. However, prospective and rigorous studies of sleep in schizophrenia are lacking. Conclusion: Patients often do not receive optimal care because sleep problems are rarely diagnosed, and treatments plans are incompletely formulated. A better understanding of sleep problems in schizophrenia will lead to increased treatment options, and a more positive clinical outcome.展开更多
基金supported by the Research Grants Council of the Hong Kong SAR,No. 452906
文摘This study aimed to investigate the association between atrophy in the prefrontal cortex with executive function and verbal fluency in elderly male and female patients poststroke. Thirty elderly female patients with non-aphasic ischemic stroke aged -〉 60 years and 30 age-matched non-aphasic male patients with ischemic stroke were recruited. Automatic magnetic resonance imaging segmentation was used to assess the volume of the whole prefrontal cortex, along with its subdivisions： anterior cingulate cortex, orbitofrontal cortex and dorsolateral prefrontal cortex. The Semantic Verbal Fluency Test was administered at 3 and 15 months poststroke. At 3 months poststroke, left dorsolateral prefrontal cortex volume was significantly correlated with Verbal Fluency Test score in female patients only （partial coefficient = 0.453, P = 0.045）, after controlling for age, education, diabetes, neurological deficit, white matter lesions volume, as well as the location and volume of infarcts. At 15 months poststroke, there remained a significant association between the left dorsolateral prefrontal cortex volume and Verbal Fluency Test （partial coefficient = 0.661, P = 0.001） and between the left prefrontal cortex volume and Verbal Fluency Test （partial coefficient = 0.573, P = 0.004） in female patients after the same adjustments. These findings indicate that atrophy of the left dorsolateral prefrontal cortex contributes to the impairment of verbal fluency in elderly female patients with stroke. Sex differences may be present in the neuropsychological mechanisms of verbal fluency impairment in patients with stroke.
基金supported by the University of Macao(SRG2014-00019-FHSMYRG2015-00230-FHS+4 种基金MYRG2016-00005-FHS)the Affiliated Brain Hospital of Guangzhou Medical University(2016YFC09063022014Y2-001052015BAI13B02)Science and Technology Department of Guangdong Province major science and technology(2016B010108003)
文摘Objective: Sleep dysfunctions are common in schizophrenia, yet few evidence-based guidelines exist for the detection, diagnosis and management of sleep disturbances in this disorder. This critical review paper sought to increase awareness amongst mental health clinicians of sleep problems in schizophrenia, promote better identification of sleep problems, and help clinicians make more informed decisions about integrated treatment plans. Specifically, we examined the following key questions: 1) Which sleep problems occur in schizophrenia? 2) What evidence exists regarding the impact of poor sleep? 3) What are the underlying mechanisms of sleep problems in schizophrenia? 4) How can this information be used by clinicians to design a more complete treatment plan? Data Sources and study selection: We conducted a non-systematic review of studies that have shaped our current understanding of sleep in schizophrenia (n = 65). Data sources included PubMed, Medline, and cross-referencing. Results: Sleep disorders are pervasive and broad-ranging in people with schizophrenia, and are associated with substantial burden. An integrated model is proposed whereby a combination of highly interactive factors comprising genetic and neurobiological vulnerabilities, and behavioural and environmental factors, interact to cause sleep abnormalities. However, prospective and rigorous studies of sleep in schizophrenia are lacking. Conclusion: Patients often do not receive optimal care because sleep problems are rarely diagnosed, and treatments plans are incompletely formulated. A better understanding of sleep problems in schizophrenia will lead to increased treatment options, and a more positive clinical outcome.
