Progress in neuro-psychopharmacology & biological psychiatry
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Prog. Neuropsychopharmacol. Biol. Psychiatry · Jul 2017
Randomized Controlled TrialTranscranial direct current stimulation can enhance working memory in Huntington's disease.
Transcranial direct current stimulation (tDCS) combined with a cognitive task can enhance targeted aspects of cognitive functioning in clinical populations. The movement disorder Huntington's disease (HD) is associated with progressive cognitive impairment. Deficits in working memory (WM) can be apparent early in the disease and impact functional capacity. ⋯ Participants exhibited an increase in WM span on the digit re-ordering span task from pre- to post-stimulation after tDCS, but not after sham stimulation. Gains in WM were positively related to motor symptom ratings and negatively associated with verbal fluency scores. Patients with more severe motor symptoms showed greatest improvement, suggesting that motor symptom ratings may help identify patients who are most likely to benefit from tDCS.
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Prog. Neuropsychopharmacol. Biol. Psychiatry · Apr 2019
ReviewTranslational machine learning for psychiatric neuroimaging.
Despite its initial promise, neuroimaging has not been widely translated into clinical psychiatry to assist in the prediction of diagnoses, prognoses, and optimal therapeutic strategies. Machine learning approaches may enhance the translational potential of neuroimaging because they specifically focus on overcoming biases by optimizing the generalizability of pipelines that measure complex brain patterns to predict targets at a single-subject level. ⋯ Promising initial results are then balanced by the description of limitations that should be considered in order to interpret existing research and maximize the possibility of future translation. Future directions are then presented in order to inspire further research and progress the field towards clinical translation.
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Alzheimer's disease (AD) is the most common form of dementia and remains a growing worldwide health problem. As life expectancy continues to increase, the number of AD patients presenting for surgery and anesthesia will steadily rise. The etiology of sporadic AD is thought to be multifactorial, with environmental, biological and genetic factors interacting together to influence AD pathogenesis. ⋯ Tau pathology is important in AD as it correlates very well with cognitive dysfunction. Lately, several studies have begun to elucidate the mechanisms by which anesthetic exposure might affect the phosphorylation, aggregation and function of this microtubule-associated protein. Here, we specifically review the literature detailing the impact of anesthetic administration on aberrant tau hyperphosphorylation as well as the subsequent development of neurofibrillary pathology and degeneration.
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Prog. Neuropsychopharmacol. Biol. Psychiatry · Dec 2015
ReviewTargeting drug sensitivity predictors: New potential strategies to improve pharmacotherapy of human brain disorders.
One of the main challenges in medicine is the lack of efficient drug therapies for common human disorders. For example, although depressed patients receive powerful antidepressants, many often remain resistant to psychopharmacotherapy. ⋯ Here, we apply the concept of endophenotypes and their interplay to drug action and sensitivity. Based on these analyses, we postulate that novel drugs may be developed by targeting specific molecular pathways that integrate drug targets with drug sensitivity predictors.
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Prog. Neuropsychopharmacol. Biol. Psychiatry · Oct 2016
ReviewTreatment-refractory substance use disorder: Focus on alcohol, opioids, and cocaine.
Substance use disorders are common, but only a small minority of patients receive adequate treatment. Although psychosocial therapies are effective, relapse is common. This review focusses on novel pharmacological and other treatments for patients with alcohol, opioid, or cocaine use disorders who do not respond to conventional treatments. ⋯ To date, no pharmacological treatment has been approved for cocaine addiction; however, 3 potential pharmacological treatments are being studied, disulfiram, methylphenidate, and modafinil. Pharmacogenetic approaches may help to optimize treatment response in otherwise treatment-refractory patients and to identify which patients are more likely to respond to treatment, and neuromodulation techniques such as repeated transcranial magnetic stimulation and deep brain stimulation also may play a role in the treatment of substance use disorders. Although no magic bullet is in sight for treatment-refractory patients, some novel medications and brain stimulation techniques have the potential to enrich treatment options at least for some patients.