多巴胺D3受体基因多态性与精神分裂症患者迟发性运动障碍的关联分析

目的　观察广州地区汉族伴或不伴迟发性运动障碍 (TD)的精神分裂症患者多巴胺D3受体 (DRD3)基因Ser 9 Gly多态性分布 ,探讨DRD3基因Ser 9 Gly多态性与TD发生的关系。方法对 1 4 0例精神分裂症患者采用不自主运动评定量表 (AIMS)进行评定 ,其中 53例伴TD ,87例不伴TD。应用聚合酶链反应和限制性内切酶长度多态性方法 ,检测 1 4 0例患者的DRD3基因Ser 9 Gly多态性 ,并对DRD3各等位基因及基因型与精神分裂症患者的TD表型进行关联分析。结果　 (1 )TD组与无TD组患者基因型总体分布的差异无显著性 (χ2 =5 6 ,υ =2 ,P >0 0 5) ,等位基因频数分布的差异有显著性 (χ2 =5 1 1 ,υ =1 ,P <0 0 5)。 (2 )按性别分组后 ,在男性患者中 ,伴TD患者较不伴TD患者 1 / 1基因型和等位基因 1频率的差异有显著性 (χ2 =5 2 4 ,χ2 =5 0 6 ,P <0 0 5) ,等位基因 2的差异有显著性 (χ2 =5 0 6 ,P <0 0 5)。在女性患者中 ,DRD3各基因型及等位基因的频率的差异均无显著性 (P >0 0 5)。结论　DRD3基因Ser 9 Gly多态性可能与精神分裂症尤其是男性患者的TD关联     

多巴胺D3受体基因多态性与精神分裂症

目的:探讨沈阳地区汉族人群中多巴胺D3受体基因(DRD3)第一外显子第9密码子A→G单核苷酸置换多态性(Ser9Gly多态)与精神分裂症的关联。方法:采用聚合酶链反应-限制性内切酶片断长度多态性(PCR-RFLP)技术对70例精神分裂症患者、94名健康对照者进行基因分型鉴定。比较患者组与对照组DRD3多态性分布频率、精神分裂症早发组与非早发组基因分布频率差异,并与其他国家人群进行比较。结果:患者组与对照组之间等位基因分布无明显差异,早发组与非早发组亦未发现明显差异,而该位点等位基因分布频率与巴西、英国人群有明显差异。结论:研究人群中未发现DRD3基因Ser9Gly多态与精神分裂症存在明显关联。     

精神分裂症与儿茶酚邻位甲基转移酶基因多态性的关联分析

目的：探讨精神分裂症与儿茶酚邻位甲基转移酶（COMT）基因Val158Met多态性的关系。方法：采用聚合酶链反应技术检测符合诊断 标准的476例精神分裂症患者（病例组）和207例名正常对照者（对照组）的COMT基因Val158Met多态性，并进行关联分析，结果：（1）病例组与对照组基因型及等位基因分布频率的差异无显著性（P＞0．05）；（2）首次起病以阳性症状为主的患者Val158Val基因型（56．5％）高于非阳性症状为主型者（45．5％；P＝0．07）；（3）在男性患者中，不吸烟患者的Met 158Met基因型分布频率（11．9％）高于吸烟患者（4．1％；P＜0．05），OR＝3．137）；两者等基因分布的差异无显著性（P＞0．05）。结论：COMT基因多态性可能与精神分裂症某些临床特点存在关联。     

多巴胺D3受体基因多态性与精神分裂症亚型及利培酮疗效相关性分析

目的探讨多巴胺D3受体(dopamine D3 receptor,DRD3)基因第一外显子丝氨酸9甘氨酸(Ser9Gly)多态性与精神分裂症临床亚型、药物疗效的关联.方法 241 例汉族首发精神分裂症患者,采用限制性片段长度多态性(restriction fragment length polymorphism,RFLP)技术测定基因型.分析判断基因多态性与精神分裂症的临床亚型、药物疗效的关联. 结果精神分裂症各亚型Ser9Gly等位基因分布存在显著性差异(p <0.05).利培酮疗效不同的患者间Ser9Gly等位基因多态性均无显著性差异. 结论 DRD3受体基因第一外显子Ser9Gly多态性可能与精神分裂症亚型相关,而与患者对药物的反应不相关.     

多巴胺D3受体Ser9Gly多态性与精神分裂症的关联研究

目的:探讨多巴胺D_3受体(DRD3)基因Ser9Gly(第9密码子丝氨酸被甘氨酸替代)多态性与精神分裂症的相关性。方法:采用聚合酶链反应(PCR),基因扩增的限制性片段长度多态性(Amp-RFLP)方法对精神分裂症56个先证者及其父母组成的核心家系进行检测,并对DRD3基因分型,精神分裂症的DRD3基因Ser9Gly多态性运用传递不平衡(TDT)检验。结果:精神分裂症与DRD3基因无显著关联(TDT值为0.388,P>0.05)。结论:DRD3基因Ser9Gly可能在中国汉族精神分裂症发病机制中不起主要作用。     

多巴胺D_3受体基因多态性与精神分裂症临床表型

目的：探讨多巴胺D3受体（DRD3）基因多态性与精神分裂症临床表型的关系。方法：对73个精神分裂症核心家系83例精神分裂症患者（患者组）及其146名父母（父母组）应用聚合酶链反应、限制性内切酶消化方法、琼脂糖凝胶电泳结合紫外凝胶成像系统检测DRD3基因中的3个位点（Ser9Gly、Ala38Thr和-205A/G）的多态性;采用阳性与阴性症状量表（PANSS）评定精神分裂症临床表型。结果：两组DRD3基因中3个位点的基因型分布及等位基因的频率分布差异无显著性;但在患者组中,对Ser9Gly位点3种基因型（Ser9Ser、Ser9Gly和Gly9Gly）进行分组比较时,Gly9Gly组的PANSS抑郁因子评分明显高于Ser9Ser组和Ser9Gly组,3组间比较,差异有显著性（P=0.042）。对Ala38Thr位点3种基因型（Ala38Ala、Ala38Thr和Thr38Thr）进行分组比较,PANSS总分及各因子分在Ala38Ala、Ala38Thr和Thr38Thr组间差异均无显著性。对-205A/G位点3种基因型（A/A、A/G和G/G）进行分组比较,G/G组的PANSS反应缺乏因子评分明显高于A/A组和A/G组,3组间比较,差异有显著性（P=0.048）。结论：DRD3基因变异可能与精神分裂症的病理症状有关。     

精神分裂症与5—HT2A受体基因相关联

目的：探讨中国汉族人群精神分裂症与5－HT2A受体基因T102C多态性之间的关系。方法：选择精神分裂症患者286例,按病期分一般组和慢性组;以291例正常人对照,也按现年龄相应地分为一般对照组和慢性对照组,分生物学技术采用PCR扩增及MSPI内切酶酶切技术,检测各组研究对象的5－HT2A受体基因的基因型和等位基因的频率分布,结果：一般组精神分裂症患者5－HT2A受体基因A2／A2型频率及A2等位基因频率均显著高于对照组（ZA2／A2＝2．97,P＜0．05;ZA2＝2．19,P＜0．05）。经关联分析,其OR值分别为2．35（P＜0．05）和1．45（P＜0．05）。结论：提示中国汉族人群中5－HT2A受体基因多态性可能与精神分裂症呈正关联,而与慢性精神分裂症无关联。     

短暂性脑缺血发作与晚期糖基化终末产物受体基因Gly82Ser多态的关联

目的探讨晚期糖基化终末产物受体（receptor of advanced glycaton end products,RAGE）基因Gly82Ser多态与短暂性脑缺血发作（TIA）的关系。方法130例TIA患者按是否合并糖尿病分为单纯性TIA组60例，TIA合并糖尿病组（糖尿病＆TIA）70例，健康对照组66名，应用聚合酶链反应一限制性片段长度多态性（PCR—RFLP）方法检测RAGE基因Gly82Ser外显子3内82位点基因型，比较各组基因型频率和等位基因频率。结果共检测到3种基因型GG、GS及ss，糖尿病＆TIA、单纯TIA及健康对照3组患者RAGE基因杂合子基因型（GS）频率分别为62．9％、53．3％和43．9％，糖尿病＆TIA组明显高于对照组（OR2．036，95％CI1．0214．062，P=0．042）；而单纯TIA组与对照组之间差异无统计学意义（OR1．299，95％C10．644—2．618，P=0．465）；3组等位基因S频率分别为34．3％、28．3％和26．5％，3组之间差异均无统计学意义。结论TIA＆糖尿病患者RAGE基因Gly82Ser基因型（Gs）增多，Gly82Ser的多态可能是糖尿病＆TIA患者的危险因素，未发现其与单纯性TIA有关。     

多巴胺D5受体基因多态性与精神分裂症的关联研究

目的　探讨昆明地区汉族人群多巴胺D5受体 (DRD5 )基因多态性与精神分裂症的关系。方法　对 79例精神分裂症患者 (患者组 )和 75名正常对照者 (对照组 )采用聚合酶链反应 (PCR)扩增DRD5基因二核苷酸多态性片段 ,并通过聚丙烯酰胺凝胶电泳对PCR扩增产物进行多态性分型鉴定。比较患者组与对照组DRD5基因各等位基因分布频率。结果　 ( 1)患者组与对照组之间等位基因分布的差异无显著性 ( χ2 =12 2 6 ,P >0 0 5 )。 ( 2 )女性患者比男性患者及对照组 14 0bp等位基因有更高的分布频率 ;与男性患者比较 ,相对危险度 (RR) =2 73( χ2 =5 33,P <0 0 5 ) ;与对照组比较 ,RR =2 0 1( χ2 =4 5 9,P <0 0 5 )。结论　未发现汉族人群中DRD5基因多态性与精神分裂症存在明显关联 ,但该基因多态性可能影响不同性别间的疾病易感性     

多巴胺D3受体基因Ser9Gly多态性与阿立哌唑及利培酮治疗效应的关联研究

目的比较阿立哌唑与利培酮治疗女性首发精神分裂症患者的疗效和血浆催乳素水平变化及其与多巴胺D3受体(DRD3)基因Ser9Gly(rs6280)多态性的关联。方法选择完成8周阿立哌唑或利培酮治疗的女性首发精神分裂症患者各60例,于治疗前和治疗8周后分别评测阳性与阴性症状量表(positive and negativesymptom scale,PANSS)。采用放射免疫法检测血浆催乳素水平,DNA测序技术检测DRD3基因Ser9Gly多态性,分析DRD3基因Ser9Gly多态性与两药疗效及血浆催乳素变化的关联。结果治疗8周后,两组PANSS减分率的差异无统计学意义[(59.79±23.48)vs.(63.30±22.66),P>0.05],但利培酮组血浆催乳素的变化值高于阿立哌唑组[(26.92±9.48)vs.(-25.25±8.07),P<0.05]。利培酮组中C等位基因携带者的血浆催乳素的增加明显高于未携带者[(52.48±27.01)ng/mL vs(36.07±17.46),P<0.05];而阿立哌唑组中未见此差异[(-23.27±8.36)vs.TT(-26.05±8.11),P>0.05]。两组8周后PANSS减分率(%)与DRD3基因Ser9Gly的差异均无统计学意义:阿立哌唑组[CC+CT(57.83±19.94)vs.TT(56.84±18.46),P>0.05];利培酮组[CC+CT(53.94±21.08)vs.TT(60.38±19.37),P>0.05]。结论阿立哌唑治疗女性首发精神分裂症疗效与利培酮相当,但引起血浆催乳素水平变化的幅度较小;利培酮引起血浆催乳素水平增加可能与DRD3基因Ser9Gly多态性有关联。     

Classification of methods in transcranial Electrical Stimulation (tES) and evolving strategy from historical approaches to contemporary innovations

Transcranial Electrical Stimulation (tES) encompasses all methods of non-invasive current application to the brain used in research and clinical practice. We present the first comprehensive and technical review, explaining the evolution of tES in both terminology and dosage over the past 100 years of research to present day. Current transcranial Pulsed Current Stimulation (tPCS) approaches such as Cranial Electrotherapy Stimulation (CES) descended from Electrosleep (ES) through Cranial Electro-stimulation Therapy (CET), Transcerebral Electrotherapy (TCET), and NeuroElectric Therapy (NET) while others like Transcutaneous Cranial Electrical Stimulation (TCES) descended from Electroanesthesia (EA) through Limoge, and Interferential Stimulation. Prior to a contemporary resurgence in interest, variations of transcranial Direct Current Stimulation were explored intermittently, including Polarizing current, Galvanic Vestibular Stimulation (GVS), and Transcranial Micropolarization. The development of these approaches alongside Electroconvulsive Therapy (ECT) and pharmacological developments are considered. Both the roots and unique features of contemporary approaches such as transcranial Alternating Current Stimulation (tACS) and transcranial Random Noise Stimulation (tRNS) are discussed. Trends and incremental developments in electrode montage and waveform spanning decades are presented leading to the present day. Commercial devices, seminal conferences, and regulatory decisions are noted. We conclude with six rules on how increasing medical and technological sophistication may now be leveraged for broader success and adoption of tES.     

Neonatal Seizures: Problems in Diagnosis and Classification

Summary: The clinical identification of neonatal seizures is critical for the recognition of brain dysfunction; however, diagnosis is often difficult because of the poorly organized and varied nature of these behaviors. Current classification systems are limited in their ability to communicate motor, autonomic, and electroencephalo-graphic features of seizures precisely and to provide a basis for uniform effective diagnosis, therapy, and determination of prognosis. Recent investigations of neonates, utilizing bedside electroencephalographic/polygraphic/ video monitoring techniques, have provided the basis for improved diagnosis and classification of seizures in the newborn. These studies have demonstrated that not all clinical phenomena currently considered to be seizures require electrocortical epileptiform activity for their initiation or elaboration. In addition, the specific clinical character of the phenomena considered to be seizures, the clinical state of the infant, and the character of the EEG indicate the probable pathophysiological mechanisms involved and suggest probable etiologies, prognosis, and therapy. Similarities between animal models that demonstrate reflex physiology and neonates with motor automatisms and tonic posturing suggest that these clinical behaviors may not be epileptic in origin but, rather, primitive movements of progression and posture mediated by brainstem mechanisms. Although not all clinical behaviors currently considered to be neonatal seizures may have similar pathophysiological mechanisms, they are clinically significant because they all indicate brain dysfunction.     

Valproate Monotherapy in the Management of Generalized and Partial Seizures

Summary: For decades, therapeutic tradition has promoted the concept of polypharmacy in the management of epilepsy. In recent years, however, studies have shown that, for most patients, monotherapy can provide comparable or better seizure control than administration of multiple anticonvulsants, while diminishing the potential for adverse reactions, drug interactions, and poor compliance. Valproate is an important monotherapeutic agent that is highly effective in the control of idiopathic primary and secondarily generalized epilepsies, and partial seizures that do not generalize. Comparative studies have found that valproate is at least as effective as phenytoin and carbamazepine in the treatment of generalized and partial seizures. Given the similar efficacy, other factors such as pharmacokinetics and side effects may therefore determine anticonvulsant selection for monotherapy.     

Un nouveau cadre conceptuel de travail pour la psychiatrie

In an attempt to place psychiatric thinking and the training of future psychiatrists more centrally into the context of modern biology, the author outlines the beginnings of a new intellectual framework for psychiatry that derives from current biological thinking about the relationship of mind to brain. The purpose of this framework is twofold. First, it is designed to emphasize that the professional requirements for future psychiatrists will demand a greater knowledge of the structure and functioning of the brain than is currently available in most training programs. Second, it is designed to illustrate that the unique domain which psychiatry occupies within academic medicine, the analysis of the interaction between social and biological determinants of behavior, can best be studied by also having a full understanding of the biological components of behavior.     

Clobazam for Treatment of Intractable Epilepsy: A Critical Assessment

Summary: Clobazam (CLB), a 1,5-benzodiazepine, is a remarkably effective add-on drug for individual patients with refractory partial epilepsy. CLB has an excellent safety record. As with all benzodiazepines used for treating epilepsy, sedation and withdrawal effects, together with the development of tolerance, limit its usefulness. Recent efforts to prevent or reverse tolerance with intermittent administration of CLB or periodic injection of a benzodiazepine antagonist, flumazenil, are encouraging and justify further investigations.     

La passion de Torquemada et le terrorisme islamique : quelques points de comparaison

This original research compares the doctrinal, psychopathological and operational standpoints of the 15th century Spanish Inquisition (Torquemada) with those of radical Islamism from 1988 to 2005 (Al-Qaeda). The following are reviewed: (a) the main texts codifying the procedure for conducting the criminal investigation of a Holy Office trial (Directorium inquisitorum); (b) the life and work of the grand inquisitor Tomás de Torquemada (1420–1498); (c) the psychopathological relations between passion (passionate psychoses, passionate idealism, paranoid personality) and fanaticism; (d) “the madmen, the enlightened and the criminals” of Islamic terrorism; (e) the cognitive and emotional motives for engagement in the jihadist radicalization of young people; (f) the common principles of monotheistic fanaticism (Inquisition, Al-Qaeda) and the particular dogmas of Islamic terrorism in our time; (g) the operating modes of the Inquisition and the Jihadist holy war. The author concludes that the rigour and seriousness of the inquisitorial judicial procedure, which was precise, individual and personalized, contrasts with the revolutionary pamphlets of Al-Qaeda, which only provide broad guidelines for the modus operandi of the fight against infidels, who are usually random victims.     

Claustration et collectionnisme : réflexions à propos d’un cas de syndrome de Diogène avec vols kleptomaniaques et vengeurs

Social withdrawal is a pathognomonic behaviour that is consistently associated with mental illnesses. Compulsive hoarding can also be interpreted as a pathological behaviour, even when it does not involve kleptomania. Diogenes syndrome (DS) was first described in 1975, and is characterized by both behaviours - social withdrawal and compulsive hoarding. Even though it is often the manifestation of a psychiatric condition, its aetiology is diverse. The most frequent ones are however: dementia, schizophrenia and mental retardation. In this study, we describe an atypical case presenting with DS. Il consists of a young man, seen in a forensic setting, who had been diagnosed with kleptomania in the past, presents with compulsive hoarding, and whose recent thefts were fuelled by revenge. Finally, to our knowledge, the way social withdrawal is viewed is seldom taken into account. We analyse its implication on social withdrawal.     

Neurological soft signs and schizophrenia: a review of current knowledge

Schizophrenia is a frequent and disabling disorder emerging during adolescence or early adulthood. The identification of underlying processes has been hampered by the complex clinical expression and the probable etiological heterogeneity. The frequency of neurological soft signs (NSS) in patients with schizophrenia and their presence early in life (during the first two years) in high risk subjects support the hypothesis that schizophrenia is a "brain disease" reflecting pre- or perinatal insults during development. The growing interest for NSS has lead to multiple studies that are often difficult to compare. The objective of this review is to summarize the current knowledge on NSS, methodological issues and the future perspectives.     

Lacan, lecteur de Minkowski : l'approche structurale

The notion of structure occupies a predominant place in the theory of Lacan. He indicates that was developed from the work of Minkowski. In fact, through his phenomeno-structural approach, Minkowski does not limit himself to purely observable phenomena, but attempts to determine the underlying structure. He refers to the comprehensive phenomenology and psychopathology, and this method provides him with clinical finesse and another means of determining a diagnosis. Thus Lacan has used this as a basis for his approach to structure to develop a theory regarding the individual. This implies that the structure of the individual is based on his relation to language. From this concept, he then develops the clinical structures of neurosis, psychosis, and perversion. These structural landmarks also have an effect on the course of treatment.