Vitamin D-Resistant Rickets Type II-A, Basal Ganglia Calcification, and Catatonia: A Casual or Causal Relationship?

Background: Vitamin D-resistant rickets type-IIA (VDRR-IIA) is a rare, congenital, metabolic disorder characterized by hypocalcemia, rickets, and alopecia. There are reports correlating calcium-metabolic disorders with basal ganglia calcification (BGC) and neuropsychiatric symptoms. Objective: The authors document and discuss the relationships of these phenomena. Method: The authors describe a patient born with VDRR-IIA who subsequently developed BGC at age 15, and catatonic symptoms of progressive severity at age 16. Results: There appeared to be a positive correlation between the severity of BGC and neuropsychiatric symptoms. Discussion: This is the first time VDRR-IIA, BGC, and catatonia have been reported in a patient, and the authors discuss the relationship among the conditions. (Psychosomatics 2009; 50: 420-424)

Catatonia due to systemic lupus erythematosus

Objectives Discuss neuropsychiatric aspects and differential diagnosis of catatonic syndrome secondary to systemic lupus erythematosus (SLE) in a pediatric patient. Methods Single case report. Result A 13-year-old male, after two months diagnosed with SLE, started to present psychotic symptoms (behavioral changes, hallucinations and delusions) that evolved into intense catatonia. During hospitalization, neuroimaging, biochemical and serological tests for differential diagnosis with metabolic encephalopathy, neurological tumors and neuroinfections, among other tests, were performed. The possibility of neuroleptic malignant syndrome, steroid-induced psychosis and catatonia was also evaluated. A complete reversal of catatonia was achieved after using benzodiazepines in high doses, associated with immunosuppressive therapy for lupus, which speaks in favor of catatonia secondary to autoimmune encephalitis due to lupus. Conclusion Although catatonia rarely is the initial clinical presentation of SLE, the delay in recognizing the syndrome can be risky, having a negative impact on prognosis. Benzodiazepines have an important role in the catatonia resolution, especially when associated with parallel specific organic base cause treatment. The use of neuroleptics should be avoided for the duration of the catatonic syndrome as it may cause clinical deterioration.

Electroconvulsive therapy and anticoagulation after pulmonary embolism: a case report

Introduction Electroconvulsive therapy (ECT) is considered the most effective treatment for catatonia regardless its underlying condition. The rigid fixed posture and immobility observed in catatonia may lead to several clinical complications, of which, pulmonary embolism (PE) is one of the most severe. The rapid improvement of the psychiatric condition in catatonia-related PE is essential, since immobility favors the occurrence of new thromboembolic events and further complications. In that scenario, ECT should be considered, based on a risk-benefit analysis, aiming at the faster resolution of the catatonia. Methods Case report and literature review. Results A 66-years-old woman admitted to the psychiatric ward with catatonia due to a depressive episode presented bilateral PE. Clinically stable, but still severely depressed after a trial of antidepressants, she was treated with ECT in the course of full anticoagulation with enoxaparin. After five ECT sessions, her mood was significantly better and she was walking and eating spontaneously. She did not present complications related either to PE or to anticoagulation. After the eighth ECT session, she evolved with hypomania, which was managed with oral medication adjustments. The patient was completely euthymic at discharge. Conclusion The case we presented provides further evidence to the anecdotal case reports on the safety of ECT in the course of concomitant full anticoagulant therapy after PE, and illustrates how, with the proper precautions, the benefits of ECT in such condition might outweigh its risks.

L'obra filològica d'Antoni de Bastero i Lledó. Edició de la Història de la llengua catalana

S'estudia l'obra filològica d' Antoni de Bastero i Lledó (1675-1737), des d'una perspectiva de conjunt, per tal de concretar I'activitat d'aquest estudiós en els camps de la lingüística, la filologia o la crítica literària, i fer-ne una valoració adequada als coneixements actuals sobre I'exercici d'aquestes disciplines durant la primera meitat del segle XVIII. La tesi inclou un estudi biogràfic, absolutament necessari per establir moltes de les circumstancies vitals del canonge Bastero, que ens resultaven obscures i que són decisives per explicar el propi interès per la filologia, les relacions amb determinats cercles acadèmics, la datació aproximada dels diversos projectes iniciats, la interpretació correcta de la seva activitat. S'inclou, així mateix, un catàleg exhaustiu de tots els manuscrits conservats d'Antoni de Bastero i que tenen alguna relació amb el seu treball filològic. En total es tenen en compte 69 volums manuscrits, actualment escampats per diversos arxius i biblioteques de Barcelona i Girona, alguns dels quals eren fins ara desconeguts. D'aquests 69 volums, 48 contenen pròpiament obres de Bastero o altres materials publicables, i la resta són materials de treball. En conseqüència, l' obra filològica del canonge es pot concretar en: la producció d'una gramàtica italiana i d'una gramàtica francesa, en català, que va deixar inacabades; la realització de La Crusca provenzale, un magne diccionari etimològic i d'autoritats que recull una gran quantitat d'hipotètics provençalismes italians -només es va publicar el primer volum d'aquesta obra a Roma, l'any 1724, però n'he localitzat pràcticament tot el contingut; l'elaboració d'una extensa antologia de poesies trobadoresques, copiades amb gran rigor d'alguns còdexs de la Biblioteca Vaticana; el plantejament d'una Història de llengua catalana, que havia de ser una gran compilació dels mèrits i les excel·lències d'aquesta llengua -que l'autor identifica amb la provençal- i la seva literatura, i que es va poder desenvolupar nomes de forma parcial. Precisament, la part central de la tesi l'ocupa l'estudi particular i l'edició crítica de les parts redactades d'aquesta obra, que suposa la concreció de la particular percepció lingüística i literària que Bastero havia anat perfilant al llarg dels seus anys d'estudi. Es tracta d'una edició molt complexa, perquè l'obra ens ha arribat només en un esborrany, que presenta múltiples correccions i esmenes i evidencia diferents estadis redaccionals; els manuscrits inclouen, així mateix, nombrosos papers amb anotacions o fragments que, o no pertanyen al cos de l'obra, o bé s'han hagut de resituar en el lloc que els correspon. EI resultat és, tanmateix, un text prou coherent que comprèn quasi la totalitat del Llibre primer -sobre l'origen, el naixement i els diversos noms de la llengua, i sobre el nom de Catalunya- i un capítol del Llibre tercer -sobre la primitiva extensió del català per tot Espanya. EI més rellevant d'aquesta obra és el fet que s'hi basteix una original teoria sobre la formació de les diverses llengües romàniques que té el català com a eix central -proposa la identificació del català provençal amb la lingua romana dels documents alt medievals, en una operació que s'avança quasi cent anys a François Raynouard, que propugnava això mateix, referint-se nomes al provençal, amb un àmplia aprovació de la comunitat científica del seu temps. Destaquen també un excepcional rigor històric i documental, i una notable sensibilitat vers l'oralitat lingüística, que és objecte d'algunes anotacions ben interessants. Tanquen la tesi un seguit d'annexos documentals on es transcriuen diversos documents relacionats amb els aspectes tractats anteriorment.

Identificação dos princípios ativos presentes no extrato etanólico de cereus jamacaru e avaliação em ratos dos possíveis efeitos tóxicos e/ou comportamentais da exposição prolongada

Conselho Nacional de Desenvolvimento Científico e Tecnológico

Aplicação de análise de sobrevivência no estudo da imobilidade tônica e do comportamento de reintegração social de perdizes (Rhynchotus rufescens)

Pós-graduação em Genética e Melhoramento Animal - FCAV

Motor symptoms and schizophrenia

Classical schizophrenia literature reports motor symptoms as characteristic of the disorder. After the introduction of neuroleptic drugs, the existence of genuine motor disorders was challenged. Renewed interest arose as symptoms were found in never-medicated patients. Reports focused on abnormal involuntary movements, parkinsonism, neurological soft signs, catatonia, negative symptoms, or psychomotor slowing. Since these syndromes refer to different concepts, however, the definitions are not congruent and the symptoms overlap. The prevalence rates of motor symptoms in schizophrenia are surprisingly high, and recent studies indicate a possible pathobiology. In particular, the development and maturation of the human motor system appears to be closely linked to the emergence of motor symptoms observed in schizophrenia. Post-mortem and neuroimaging results demonstrated aberrant structure and function of premotor and motor cortices, basal ganglia, thalamus, and the connecting white matter tracts. Animal models have focused on aberrant neurotransmission and genetic contributions. Findings of localized abnormal oligodendrocyte function and myelination point to the special role of the white matter in schizophrenia, and recent studies specifically found an association between motor abnormalities and white matter structure in schizophrenia. This review of the literature supports the idea that motor symptoms are closely related to the neurodevelopmental disturbances of schizophrenia and a distinct syndromal dimension with its own pathophysiology.

Dysfunctions of the motor system in schizophrenia

Objective: Schizophrenia patients suffer from a variety of motor symptoms, including parkinsonism, catatonia, neurological soft signs, abnormal involuntary movements and psychomotor slowing. Methods: Literature review of prevalence rates and presentation of own results. Results: Parkinsonism and abnormal involuntary movements are intrinsic to schizophrenia, but may also be evoked by antipsychotic treatment. Reduced motor activity is associated with negative symptoms, catatonia and psychomotor slowing. Furthermore, 40 % of schizophrenia patients are impaired in gesture performance, which is related to executive and basic motor function. Mild motor disturbances are found in the majority of patients, while severe dysfunctions are limited to a minority. Our neuroimaging studies suggest that hypokinesia is caused by defective cortico-subcortical motor loops in schizophrenia. Taken together, a dimensional approach to schizophrenia motor symptoms seems promising. A purely descriptive assessment of motor signs is preferred over theoryladen categorization. Using objective motor parameters allows finding neural correlates of abnormal motor behaviour. Conclusion: The motor dimension of schizophrenia is linked to distinct disturbances in the cerebral motor system. Targeted modification of the defective motor system might become a relevant treatment option in patients suffering from schizophrenia with predominant motor features.

Psychotische Störungen im DSM-5

This article provides an overview of the main changes in the chapter "Schizophrenia Spectrum and Other Psychotic Disorders" from DSM-IV-TR to DSM-5, which, once again, does not make allowance for potential characteristics of children and adolescents. Changes in the main text include abandoning the classical subtypes of Schizophrenia as well as of the special significance of Schneider's first-rank symptoms, resulting in the general requirement of two key features (one having to be a positive symptom) in the definition of Schizophrenia and the allowance for bizarre contents in Delusional Disorders. Further introduced are the diagnosis of a delusional obsessive-compulsive/body dysmorphic disorder exclusively as Obsessive-Compulsive Disorder, the specification of affective episodes in Schizoaffective Disorder, and the formulation of a distinct subchapter "Catatonia" for the assessment of catatonic features in the context of several disorders. In Section III (Emerging Measures and Models) there is a recommendation for a dimensional description of psychoses. A likely source of confusion lies in the double introduction of an "Attenuated Psychosis Syndrome." On the one hand, a vague description is provided among "Other Specified Schizophrenia Spectrum and Other Psychotic Disorders" in the main text; on the other hand, there is a precise definition in Section III as a "Condition for Further Study." There is some cause to worry that this vague introduction of the attenuated psychosis syndrome in the main text might indeed open the floodgates to an overdiagnosis of subthreshold psychotic symptoms and their early pharmacological treatment.

Psychomotor symptoms of schizophrenia map on the cerebral motor circuit

Schizophrenia is a devastating disorder thought to result mainly from cerebral pathology. Neuroimaging studies have provided a wealth of findings of brain dysfunction in schizophrenia. However, we are still far from understanding how particular symptoms can result from aberrant brain function. In this context, the high prevalence of motor symptoms in schizophrenia such as catatonia, neurological soft signs, parkinsonism, and abnormal involuntary movements is of particular interest. Here, the neuroimaging correlates of these motor symptoms are reviewed. For all investigated motor symptoms, neural correlates were found within the cerebral motor system. However, only a limited set of results exists for hypokinesia and neurological soft signs, while catatonia, abnormal involuntary movements and parkinsonian signs still remain understudied with neuroimaging methods. Soft signs have been associated with altered brain structure and function in cortical premotor and motor areas as well as cerebellum and thalamus. Hypokinesia is suggested to result from insufficient interaction of thalamocortical loops within the motor system. Future studies are needed to address the neural correlates of motor abnormalities in prodromal states, changes during the course of the illness, and the specific pathophysiology of catatonia, dyskinesia and parkinsonism in schizophrenia.