Publications by authors named "Rogelio Luque"

11 Publications

  • Page 1 of 1

Association between cerebral metabolic and structural abnormalities and cognitive performance in schizophrenia.

Psychiatry Res 2009 Aug 25;173(2):88-93. Epub 2009 Jun 25.

Dept of Psychiatry, Hospital Universitario, Salamanca, Spain.

The possible association in schizophrenia between frontal abnormalities, such as hypofrontality and frontal grey matter (GM) deficits, and neuropsychological deficits is not yet well defined. Our objective was to study such an association and to clarify the cognitive relevance of metabolic and anatomical variability across schizophrenia patients. To do so, we studied dorsolateral prefrontal (DLPF) metabolism during an attention test using fluoro-deoxy-glucose positron emission tomography and DLPF structure with magnetic resonance imaging (MRI) in 22 schizophrenia patients [9 neuroleptic-naïve (NN) first episodes]. These patients also underwent a comprehensive battery of neuropsychological tests aimed at evaluating global intelligence and the proposed domains of cognitive alteration in schizophrenia, i.e., attention, visual and verbal learning and memory, working memory, problem solving and processing speed. The metabolic activity in the right DLPF region was significantly and directly related to processing speed, and a measure of structural deficit in the same area was directly related to working memory scores. In the NN group studied alone, these associations were replicated. We may conclude that hypofrontality during cognitive activation, and the degree of DLPF structural deficit may be associated to a particular profile of cognitive deficit, including lower processing speed and working memory capacity.
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http://dx.doi.org/10.1016/j.pscychresns.2008.09.009DOI Listing
August 2009

Biochemical changes in the cingulum in patients with schizophrenia and chronic bipolar disorder.

Eur Arch Psychiatry Clin Neurosci 2008 Oct 24;258(7):394-401. Epub 2008 Apr 24.

Department of Psychiatry, Complejo Hospitalario, Carretera Bailén-Motril sn, Jaén, CP 23009, Spain.

Biochemical changes have been reported in vivo in the brain in schizophrenia patients using 1H-magnetic resonance spectroscopy (MRS). The aim of this study was to assess the specificity of biochemical changes occurring in schizophrenia patients, in a direct comparison with bipolar disorder patients. Fourteen patients with chronic paranoid schizophrenia, 17 euthymic type I bipolar patients with no previous history of psychotic symptoms and 15 healthy controls were included, most of them were female. They underwent a study with MRS: proton spectra were acquired using a Signa 1.5 T CVI scanner, with a localised single voxel PRESS sequence. N-acetyl aspartate (NAA), Creatine (Cr), and Choline (Cho) metabolite resonance intensities were all quantified in the cingulum, a region of interest in schizophrenia and bipolar disorder. Schizophrenia patients showed a significantly higher Cho/Cre as well as lower NAA/Cho ratios as compared with controls and bipolar patients. No significant differences were found among the three groups as regards NAA/Cre levels. These data are consistent with an increase in the concentration of choline in the cingulum in chronic schizophrenia, at least in this predominantly female group. Such an increase seems to be more intense than in psychosis-free bipolar disorder patients.
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http://dx.doi.org/10.1007/s00406-008-0808-9DOI Listing
October 2008

Cotard's syndrome in adolescents and young adults is associated with an increased risk of bipolar disorder.

Bipolar Disord 2007 Sep;9(6):665-8

Department of Child and Adolescent Psychiatry, Comportement et Cognition, Université Pierre et Marie Curie, Assistance Publique, Hopitaux de Paris, Hôpital Pitié-Salpétrière, Paris, France.

Objectives: To assess the effect of age at onset on the phenomenology of Cotard's syndrome (CS) as a recent study reported a high rate of occurrence of bipolar disorder (BD) in adolescents and young adults with CS followed up for > or =2 years.

Methods: We reviewed all cases of CS reported since it was first described. A statistical analysis was carried out to determine the effect of age at onset on CS phenomenology.

Results: We found 138 cases including 21 cases aged 25 years or younger. In these younger CS patients, BD was more frequent, and the risk of associated BD was increased nine times (p < 0.0001). Within the BD sub-group (n = 27), admixture analysis identified two sub-groups with mean ages at onset of 18.7 years [standard deviation (SD) = 3.2] and 50.5 years (SD = 11.7).

Conclusions: Young people with CS should be monitored carefully for the onset of BD, and families should be educated about this risk. Treatment with mood stabilizers can be helpful for those who develop BD. Within BD associated with CS, early versus late onset should be distinguished.
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http://dx.doi.org/10.1111/j.1399-5618.2007.00420.xDOI Listing
September 2007

No association between dorsolateral prefrontal gray matter deficit and N-acetyl aspartate ratios in schizophrenia.

Neuropsychobiology 2006 17;54(3):171-8. Epub 2007 Jan 17.

Department of Psychiatry, Hospital Universitario, Salamanca, Spain.

The cellular substrates of cortical volume deficit in schizophrenia are unclear. We may hypothesize that, if that deficit was related to a decrease in the amount in neuronal tissue, it should correlate with N-acetyl aspartate levels. We studied a group of 34 schizophrenia patients (of them, 17 first episodes) with both structural and spectroscopic magnetic resonance (MR). Using the data of 50 controls, we were able to calculate for each case residuals of gray matter and cortical cerebrospinal fluid (CSF) in the dorsolateral prefrontal (DLPF) region, representing the deviation from the expected values in normals, given individual intracranial volume and age. Although our patients showed a significant deficit in gray matter and excess in cortical CSF in the DLPF region, that deficit was unrelated to N-acetyl aspartate levels. This was also true for the chronic and first episode groups analyzed separately. These results do not support a neuronal tissue deficit as contributing to the cortical volume deficit in schizophrenia, at least in the DLPF region.
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http://dx.doi.org/10.1159/000098653DOI Listing
May 2007

Depersonalization in psychiatric patients: a transcultural study.

J Nerv Ment Dis 2006 May;194(5):356-61

Depersonalization Research Unit, Institute of Psychiatry, King's College, London, UK.

There is evidence suggesting that the prevalence of depersonalization in psychiatric patients can vary across cultures. To explore the possible influence of culture on the prevalence of depersonalization, we compared psychiatric inpatient samples from the United Kingdom (N = 31), Spain (N = 68), and Colombia (N = 41) on standardized and validated self-rating measures of dissociation and depersonalization: the Cambridge Depersonalization Scale and the Dissociative Experiences Scale (DES). Colombian patients were found to have lower global scores on the Cambridge Depersonalization Scale and the DES and all its subscales, with the exception of DES-Absorption. No differences were found for measures of depression or anxiety. These findings seem to support the view that depersonalization is susceptible to cultural influences. Attention is drawn to the potential relevance of the sociological dimension "individualism-collectivism" on the experience of the self, and it is proposed that cultures characterized by high individualism may confer vulnerability to depersonalization experiences.
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http://dx.doi.org/10.1097/01.nmd.0000218071.32072.74DOI Listing
May 2006

Cotard's syndrome in adolescents and young adults: a possible onset of bipolar disorder requiring a mood stabilizer?

J Child Adolesc Psychopharmacol 2005 Aug;15(4):706-11

Department of Psychiatry, AP-HP, Hôpital Saint Antoine, Paris, France.

This paper reviews all reports of Cotard's syndrome (délire de négation) in adolescents and young adults and summarizes four consecutive cases seen at our institution during the past 10 years. Cotard's syndrome occurs infrequently in young people (19 cases have been reported so far, including a 15-year-old boy who died at hospital) but appears to be a severe syndrome in adolescents of both genders. Ten patients received electroconvulsive therapy (ECT) despite their young age. Among the 14 cases reported with at least a 2-year follow-up, 13 patients (93%; 11 female) exhibited a bipolar outcome. The use of mood stabilizers should be considered in this rare, but potentially severe, condition.
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http://dx.doi.org/10.1089/cap.2005.15.706DOI Listing
August 2005

Dorsolateral prefrontal and superior temporal volume deficits in first-episode psychoses that evolve into schizophrenia.

Eur Arch Psychiatry Clin Neurosci 2006 Mar 14;256(2):106-11. Epub 2005 Sep 14.

Dept. of Psychiatry, Hospital Clínico de Salamanca, Paseo de San Vicente, 58-182, 37007, Salamanca, Spain.

Regions with a likely involvement in schizophrenia may differ between patients with first-episodes of psychosis respectively with and without evolution into schizophrenia following the initial episode. We have used magnetic resonance imaging (MRI) to assess the volumes of dorsolateral prefrontal (DLPF) and superior temporal gyrus (STG) in a group of 37 first-episode psychotic patients. After an initial MRI study performed by the time of the first episode, the subjects were followed for two years. After this period 22 cases were diagnosed with schizophrenia, while the other 15 did not show clinical evidence for this illness. A Talairach-based tool was used for segmentation and volumetry of the MRI scans. A group of 44 healthy controls was used for comparison and, using lineal regression, to control for the normal effects of age and intracranial volume on the regional parameters of the patients. By the time of their first episode, patients with schizophrenia had significantly less grey matter in the right DLPF and STG regions as compared to both controls and FE without schizophrenia. Nevertheless, these parameters could not predict final diagnosis in a discriminant analysis model. Our findings indicate that subtle structural defects are already found by the time of the first psychotic break in schizophrenia, although clinical implications for these differences seem unclear.
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http://dx.doi.org/10.1007/s00406-005-0615-5DOI Listing
March 2006

Anatomical and functional cerebral variables associated with basal symptoms but not risperidone response in minimally treated schizophrenia.

Psychiatry Res 2003 Nov;124(3):163-75

Department of Psychiatry, Hospital Doce de Octubre, Avda. de Cordoba Km 5.4, 28041 Madrid, Spain.

In schizophrenia, structural and functional cerebral variables show an unclear association with clinical features and their value as predictors of response to a typical antipsychotic agents has yet to be determined. The goal of this study was to investigate the relationships between clinical variables (baseline syndromes and response to risperidone) and anatomo-functional brain variables. We studied 19 minimally treated patients with schizophrenia of recent onset using magnetic resonance imaging (MRI) and fluorodeoxyglucose positron emission tomography (FDG-PET) under resting conditions. The following brain variables were studied: volume of the cerebrospinal fluid (CSF) and gray matter (GM) of the dorsolateral prefrontal cortex (DLPFC) and temporal lobe; hippocampal metabolic activity and volume; and metabolic activity of the DLPFC, temporal lobe, putamen and caudate. Anatomical volume measurements were corrected for age and intracranial size using regression parameters determined from a matched sample of control subjects. Using stepwise multiple regression, we assessed the relation between these brain measures and basal scores of symptom dimensions (positive, disorganization, negative and total), as well as their change in response to risperidone. We found that positive and disorganization symptoms improved with risperidone treatment and that hippocampal metabolism, DLPFC CSF volume, and temporal CSF volume predicted baseline symptoms. However, none of the brain measures predicted response to treatment. We conclude that there is evidence of a significant association between basal symptoms and DLPFC atrophy and limbic hyperactivity at rest in recent-onset schizophrenic patients.
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http://dx.doi.org/10.1016/s0925-4927(03)00107-0DOI Listing
November 2003

Anatomical and functional brain variables associated with clozapine response in treatment-resistant schizophrenia.

Psychiatry Res 2003 Nov;124(3):153-61

Department of Psychiatry, Hospital Doce de Octubre, Edificio de Medicina Comunitaria, Avda de Córdoba, km 5.4, 28041 Madrid, Spain.

Clozapine alleviates the symptoms of a significant proportion of treatment-resistant schizophrenic patients. Previous studies suggest that the response to clozapine may be associated with prefrontal and temporal anatomy as well as with prefrontal, basal ganglia and thalamic metabolism. A sample of 25 treatment-resistant (TR) schizophrenic patients underwent magnetic resonance imaging (MRI) and 18F-deoxyglucose positron emission tomography (PET) before and after treatment with clozapine. We investigated the association between changes in positive, disorganized, and negative schizophrenic syndromes with clozapine treatment and a set of cerebral variables that included total intracranial volume (ICV); hippocampal, dorsolateral prefrontal (DLPF) and temporal gray-matter volume and metabolism; and metabolic activity of the thalamus, pallidum/putamen, and caudate head. Improvement in positive symptoms with clozapine was directly related to temporal gray-matter volume, whereas improvement of disorganization symptoms was inversely related to ICV and hippocampal volume. Patients with high baseline DLPF cortical volume and metabolic activity were more likely to experience improvement in their negative symptoms. We conclude that clinical improvement with clozapine may be related with the anatomy and metabolic activity of specific brain areas, with the structural integrity of the DLPF and temporal regions showing the maximum predictive capacity.
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http://dx.doi.org/10.1016/s0925-4927(03)00108-2DOI Listing
November 2003

Multimodal neuroimaging studies and neurodevelopment and neurodegeneration hypotheses of schizophrenia.

Neurotox Res 2002 Aug-Sep;4(5-6):437-451

Dept of Psychiatry, Hospital 12 de Octubre, Edificio de Medicina Comunitaria, Avda de Córdoba, km 5.4, 28041, Madrid, Spain.

The interpretation of the huge number of results in schizophrenia research using neuroimaging is uncertain. However, the simultaneous use of complimentary data obtained with these techniques may yield more relevant information in this regard. In this paper we present a series of studies performed by our group in two schizophrenic samples with the use of structural (magnetic resonance imaging, MRI), functional [glucose positron emission tomography (PET) and N-acetyl-aspartate (NAA) magnetic resonance spectrocopy] and neurophysiological techniques (the P300 event-related potential). Transversal and longitudinal measurements were performed.The integrated vision of the results so obtained allows us to propose the hypothesis of a neurodevelopmentally determined state of prefrontal disinihibition, in which the degree of atrophy would directly relate to the metabolic rate. This state would already be present in the first stages of illness and could have neurotoxic consequences in the long term. This would explain the findings of an association between sulcal cerebrospinal fluid (CSF) and illness duration and decreased NAA levels in chronic but not in recent-onset cases. The prefrotnal disinhibition would overstimulate the limbic system and the hippocampus would become overactivated, the metabolic rate at this level being inversely related to P300 amplitude. Clozapine showed a more selective and intense action on that hyperactive metabolic tone than haloperidol.
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http://dx.doi.org/10.1080/10298420290031397DOI Listing
May 2003

Association between relative temporal and prefrontal sulcal cerebrospinal fluid and illness duration in schizophrenia.

Schizophr Res 2002 Dec;58(2-3):305-12

Department of Psychiatry, Hospital Doce de Octubre, Edificio de Medicina Comunitaria, Avda de Córdoba, km 5.4, 28041, Madrid, Spain.

Changes in sulcal cerebrospinal fluid (CSF) volume have been related to the neurodegeneration hypothesis in schizophrenia. Fifty-three (24 neuroleptic-naive) schizophrenics and a control group (n=26) were studied with MRI to assess regional sulcal CSF values relative to the total volume of brain lobes (prefrontal, orbital, temporal, parietal, and occipital). Segmentation of brain structures was performed using an automatic Talairach-based method. Relative CSF volumes were adjusted for age by means of linear regression from normal subjects; the corrected values were used to assess their relationship with illness duration and age of onset (AOS). The volume of sulcal CSF on prefrontal and temporal lobes (bilateral) was significantly greater in schizophrenic patients and showed a significant positive correlation with illness duration not found in the other regions studied. No significant association between CSF volumes and AOS was found in any region. Our findings support the existence of a degenerative process in schizophrenia located in prefrontal and temporal areas.
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http://dx.doi.org/10.1016/s0920-9964(02)00166-4DOI Listing
December 2002
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