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Iftimovici A, Chaumette B, Duchesnay E, Krebs MO. Brain anomalies in early psychosis: From secondary to primary psychosis. Neurosci Biobehav Rev 2022; 138:104716. [PMID: 35661683 DOI: 10.1016/j.neubiorev.2022.104716] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Revised: 03/12/2022] [Accepted: 05/25/2022] [Indexed: 10/18/2022]
Abstract
Brain anomalies are frequently found in early psychoses. Although they may remain undetected for many years, their interpretation is critical for differential diagnosis. In secondary psychoses, their identification may allow specific management. They may also shed light on various pathophysiological aspects of primary psychoses. Here we reviewed cases of secondary psychoses associated with brain anomalies, reported over a 20-year period in adolescents and young adults aged 13-30 years old. We considered age at first psychotic symptoms, relevant medical history, the nature of psychiatric symptoms, clinical red flags, the nature of the brain anomaly reported, and the underlying disease. We discuss the relevance of each brain area in light of normal brain function, recent case-control studies, and postulated pathophysiology. We show that anomalies in all regions, whether diffuse, multifocal, or highly localized, may lead to psychosis, without necessarily being associated with non-psychiatric symptoms. This underlines the interest of neuroimaging in the initial workup, and supports the hypothesis of psychosis as a global network dysfunction that involves many different regions.
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Affiliation(s)
- Anton Iftimovici
- Université Paris Cité, Institute of Psychiatry and Neuroscience of Paris (IPNP), INSERM U1266, GDR 3557-Institut de Psychiatrie, Paris, France; NeuroSpin, Atomic Energy Commission, Gif-sur Yvette, France; GHU Paris Psychiatrie et Neurosciences, Paris, France.
| | - Boris Chaumette
- Université Paris Cité, Institute of Psychiatry and Neuroscience of Paris (IPNP), INSERM U1266, GDR 3557-Institut de Psychiatrie, Paris, France; GHU Paris Psychiatrie et Neurosciences, Paris, France
| | | | - Marie-Odile Krebs
- Université Paris Cité, Institute of Psychiatry and Neuroscience of Paris (IPNP), INSERM U1266, GDR 3557-Institut de Psychiatrie, Paris, France; GHU Paris Psychiatrie et Neurosciences, Paris, France
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Mental disorders in neurological diseases. Can symptoms of bipolar disorder be the first manifestation of X-linked adenoleukodystrophy? A case report. CURRENT PROBLEMS OF PSYCHIATRY 2020. [DOI: 10.2478/cpp-2020-0011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Abstract
Background: X-linked adrenoleukodystrophy (X-ALD) is an inherited metabolic disease which causes demyelination of the white matter of the brain. The symptoms include mental impairment, progressive paresis, impaired motor coordination, and epileptic seizures. Diagnosis is established mainly by genetic testing. Currently, the recommended treatment is haematopoietic stem cell transplantation (HSCT).
Goal: The aim of the study was to present the case of a patient suffering from X-ALD, who developed symptoms of bipolar disorder in the initial phase of the disease prior to the onset of characteristic neurological symptoms.
Case presentation: In 2015, a 33-year-old patient was admitted to a psychiatric department due to aggressive behaviour he showed towards his wife and other family members. He had been treated for a depressive episode in 2005, and for a manic episode without psychotic symptoms earlier in 2015. During the successive psychiatric hospitalizations, in addition to psychopathological symptoms, the patient had been observed to have neurological symptoms, which included progressive paraparesis and ataxia. In 2018, based on imaging and genetic tests, the patient was diagnosed with X-ALD. The patient’s condition gradually deteriorated; with time, he was unable to move on his own. During a hospital stay in 2019, he was transferred to an internal medicine department due to a progressive urinary tract infection, which, however, could not be controlled, and the patient died.
Conclusions:
1. X-ALD is a rare metabolic illness. In the early stages of the disease, various psychopathological symptoms, including affective disorders, are observed.
2. Early initiation of adequate treatment increases the chances of extending the patient’s life.
3. In the present case, the patient did not die due to the underlying disease, but due to causes typical of bed-bound patients, i.e. complications of progressing infection.
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Accogli A, Brais B, Tampieri D, La Piana R. Long-Standing Psychiatric Features as the Only Clinical Presentation of Vanishing White Matter Disease. J Neuropsychiatry Clin Neurosci 2020; 31:276-279. [PMID: 31046592 DOI: 10.1176/appi.neuropsych.18110279] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Affiliation(s)
- Andrea Accogli
- The Departments of Neurology and Neurosurgery and Pediatrics, McGill University, Montreal (Accogli); DINOGMI-Università di Genova, Italy (Accogli); IRCCS Ospedale Policlinico San Martino, Genova, Italy (Accogli); the Laboratory of Neurogenetics of Motion, Montreal Neurological Institute, McGill University, Montreal (Brais, La Piana); the Department of Human Genetics, McGill University, Montreal (Brais); the Department of Diagnostic Radiology, Kingston General Hospital, Queen's University, Kingston, Ontario, Canada (Tampieri); and the Department of Neuroradiology, Montreal Neurological Hospital and Institute, McGill University, Montreal (La Piana)
| | - Bernard Brais
- The Departments of Neurology and Neurosurgery and Pediatrics, McGill University, Montreal (Accogli); DINOGMI-Università di Genova, Italy (Accogli); IRCCS Ospedale Policlinico San Martino, Genova, Italy (Accogli); the Laboratory of Neurogenetics of Motion, Montreal Neurological Institute, McGill University, Montreal (Brais, La Piana); the Department of Human Genetics, McGill University, Montreal (Brais); the Department of Diagnostic Radiology, Kingston General Hospital, Queen's University, Kingston, Ontario, Canada (Tampieri); and the Department of Neuroradiology, Montreal Neurological Hospital and Institute, McGill University, Montreal (La Piana)
| | - Donatella Tampieri
- The Departments of Neurology and Neurosurgery and Pediatrics, McGill University, Montreal (Accogli); DINOGMI-Università di Genova, Italy (Accogli); IRCCS Ospedale Policlinico San Martino, Genova, Italy (Accogli); the Laboratory of Neurogenetics of Motion, Montreal Neurological Institute, McGill University, Montreal (Brais, La Piana); the Department of Human Genetics, McGill University, Montreal (Brais); the Department of Diagnostic Radiology, Kingston General Hospital, Queen's University, Kingston, Ontario, Canada (Tampieri); and the Department of Neuroradiology, Montreal Neurological Hospital and Institute, McGill University, Montreal (La Piana)
| | - Roberta La Piana
- The Departments of Neurology and Neurosurgery and Pediatrics, McGill University, Montreal (Accogli); DINOGMI-Università di Genova, Italy (Accogli); IRCCS Ospedale Policlinico San Martino, Genova, Italy (Accogli); the Laboratory of Neurogenetics of Motion, Montreal Neurological Institute, McGill University, Montreal (Brais, La Piana); the Department of Human Genetics, McGill University, Montreal (Brais); the Department of Diagnostic Radiology, Kingston General Hospital, Queen's University, Kingston, Ontario, Canada (Tampieri); and the Department of Neuroradiology, Montreal Neurological Hospital and Institute, McGill University, Montreal (La Piana)
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Meher RK, Aghoram R, Nair PP. Adrenoleukodystrophy presenting as glue sniffing. BMJ Case Rep 2020; 13:13/3/e233036. [PMID: 32169980 DOI: 10.1136/bcr-2019-233036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Adrenoleukodystrophy classically presents in childhood with bronze skin, spastic tetraparesis, dysphagia, behavioural abnormalities and adrenal insufficiency. However, atypical presentations are known. Here we report an adolescent with adrenoleukodystrophy who first sought medical attention for glue sniffing.
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Affiliation(s)
- Rajesh Kumar Meher
- Neurology, Jawaharlal Institute of Postgraduate Medical Education & Research (JIPMER), Puducherry, India
| | - Rajeswari Aghoram
- Neurology, Jawaharlal Institute of Postgraduate Medical Education & Research (JIPMER), Puducherry, India
| | - Pradeep Pankajakshan Nair
- Neurology, Jawaharlal Institute of Postgraduate Medical Education & Research (JIPMER), Puducherry, India
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