The Journal of neuropsychiatry and clinical neurosciences
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J Neuropsychiatry Clin Neurosci · Jan 2007
ReviewRecent neuroimaging techniques in mild traumatic brain injury.
Mild traumatic brain injury (TBI) is characterized by acute physiological changes that result in at least some acute cognitive difficulties and typically resolve by 3 months postinjury. Because the majority of mild TBI patients have normal structural magnetic resonance imaging (MRI)/computed tomography (CT) scans, there is increasing attention directed at finding objective physiological correlates of persistent cognitive and neuropsychiatric symptoms through experimental neuroimaging techniques. The authors review studies utilizing these techniques in patients with mild TBI; these techniques may provide more sensitive assessment of structural and functional abnormalities following mild TBI. Particular promise is evident with fMRI, PET, and SPECT scanning, as demonstrated by associations between brain activation and clinical outcomes.
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J Neuropsychiatry Clin Neurosci · Jan 2007
Cumulative Exposure to General anesthesias and cognitive dysfunction at age 75 in the Vienna Transdanube Aging "VITA" study.
Some reports have described general anesthesias as a risk factor for dementia in the elderly. The authors investigated whether the number of general anesthesias during a lifetime was associated with cognitive functioning in the community-based age cohort of a geographical area of Vienna. ⋯ The number of general anesthesias was not associated with extensive psychometric data. Cognitive dysfunction at age 75 was significantly associated with level of education, a history of major head trauma, and having lived in a rural environment during childhood.
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J Neuropsychiatry Clin Neurosci · Jan 2007
Mood-elevating effects of opioid analgesics in patients with bipolar disorder.
Opioids can have mood-elevating effects in healthy subjects and have been used successfully to treat refractory depressed patients. A few case reports indicate that opioid analgesics can induce mania. ⋯ None of the comparison subjects reported a significant mood reaction from opioid analgesics. These results indicate that opioid analgesics can have an important mood-altering effect on patients with known bipolar disorder.
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J Neuropsychiatry Clin Neurosci · Jan 2006
Comparative StudyPosttraumatic stress disorder symptoms during the first six months after traumatic brain injury.
Controversy exists regarding the rate and risk factors for posttraumatic stress disorder (PTSD) following traumatic brain injury (TBI). The authors determined the rate and phenomenology of PTSD symptoms in the 6 months after TBI by conducting a prospective cohort study of 124 subjects who completed the PTSD Checklist-Civilian Version. The cumulative incidence of meeting PTSD symptom criteria at 6 months was 11% and full criteria 5.6%. ⋯ Eighty-six percent had another psychiatric disorder and 29% a history of PTSD. Symptoms were associated with not completing high school, assault, recalling being terrified or helpless, and positive toxicology. PTSD after TBI is rare and the relation to risk factors and comorbidities must be examined.