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O'Donoghue B, Allott K, Harrigan S, Scalzo F, Ward J, Mallawaarachchi S, Whitson S, Baldwin L, Graham J, Mullen E, MacNeil C, Alexander D, Wood SJ, Berk M, Alvarez‐Jimenez M, Thompson A, Fornito A, Yuen HP, Nelson B, Francey SM, McGorry P. Isolating the impact of antipsychotic medication on metabolic health: Secondary analysis of a randomized controlled trial of antipsychotic medication versus placebo in antipsychotic medication naïve first-episode psychosis (the STAGES study). Early Interv Psychiatry 2023; 17:597-607. [PMID: 36196478 PMCID: PMC10947230 DOI: 10.1111/eip.13353] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Revised: 07/21/2022] [Accepted: 08/29/2022] [Indexed: 11/30/2022]
Abstract
BACKGROUND Cardiovascular and metabolic diseases are the leading contributors to the early mortality associated with psychotic disorders. To date, it has not been possible to disentangle the effect of medication and non-medication factors on the physical health of people with a first episode of psychosis (FEP). This study aimed to isolate the effects of antipsychotic medication on anthropometric measurements, fasting glucose and lipids. METHODS This study utilized data from a triple-blind randomized placebo-controlled trial comparing two groups of antipsychotic-naïve young people with a FEP who were randomized to receive a second-generation antipsychotic medication (FEP-medication group) or placebo (FEP-placebo group) for 6 months. Twenty-seven control participants were also recruited. RESULTS Eighty-one participants commenced the trial; 69.1% completed at least 3 months of the intervention and 33.3% completed the full 6 months. The FEP-placebo group gained a mean of 2.4 kg (±4.9) compared to 1.1 kg (±4.9) in the control participants (t = 0.76, p = .45). After controlling for multiple analyses, there was no difference in blood pressure, waist circumference or heart rate between the FEP-placebo group and controls. After 6 months, the FEP medication group had gained 4.1 kg (±4.5), higher than those receiving placebo but not statistically significant (t = 0.8, p = .44). There were no differences in fasting glucose or lipids between the FEP groups after 3 months. CONCLUSIONS While limited by small numbers and high attrition, these findings indicate that some of the metabolic complications observed in psychotic disorders could be attributable to factors other than medication. This emphasizes the need to deliver physical health interventions early in the course of FEP.
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Hashimoto T, Kunieda T, Honda T, Scalzo F, Ali L, Hinman J, Rao N, Nour M, Bahr-Hosseini M, Saver J, Raychev R, Liebeskind D. Reduced Leukoaraiosis, Noncardiac Embolic Stroke Etiology, and Shorter Thrombus Length Indicate Good Leptomeningeal Collateral Flow in Embolic Large-Vessel Occlusion. AJNR Am J Neuroradiol 2022; 43:63-69. [PMID: 34794948 PMCID: PMC8757540 DOI: 10.3174/ajnr.a7360] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Accepted: 09/20/2021] [Indexed: 01/03/2023]
Abstract
BACKGROUND AND PURPOSE Acute leptomeningeal collateral flow is vital for maintaining perfusion to penumbral tissue in acute ischemic stroke caused by large-vessel occlusion. In this study, we aimed to investigate the clinically available indicators of leptomeningeal collateral variability in embolic large-vessel occlusion. MATERIALS AND METHODS Among prospectively registered consecutive patients with acute embolic anterior circulation large-vessel occlusion treated with thrombectomy, we analyzed 108 patients admitted from January 2015 to December 2019 who underwent evaluation of leptomeningeal collateral status on pretreatment CTA. Clinical characteristics, extent of leukoaraiosis on MR imaging, embolic stroke subtype, time of imaging, occlusive thrombus characteristics, presenting stroke severity, and clinical outcome were collected. The clinical indicators of good collateral status (>50% collateral filling of the occluded territory) were analyzed using multivariate logistic regression analysis. RESULTS Good collateral status was present in 67 patients (62%) and associated with independent functional outcomes at 3 months. Reduced leukoaraiosis (total Fazekas score, 0-2) was positively related to good collateral status (OR, 9.57; 95% CI, 2.49-47.75), while the cardioembolic stroke mechanism was inversely related to good collateral status (OR, 0.17; 95% CI, 0.02-0.87). In 82 patients with cardioembolic stroke, shorter thrombus length (OR, 0.91 per millimeter increase; 95% CI, 0.82-0.99) and reduced leukoaraiosis (OR, 5.79; 95% CI, 1.40-29.61) were independently related to good collateral status. CONCLUSIONS Among patients with embolic large-vessel occlusion, reduced leukoaraiosis, noncardiac embolism mechanisms including embolisms of arterial or undetermined origin, and shorter thrombus length in cardioembolism are indicators of good collateral flow.
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Affiliation(s)
- T. Hashimoto
- From the Department of Neurology and Comprehensive Stroke Center, University of California, Los Angeles, Los Angeles, California
| | - T. Kunieda
- From the Department of Neurology and Comprehensive Stroke Center, University of California, Los Angeles, Los Angeles, California
| | - T. Honda
- From the Department of Neurology and Comprehensive Stroke Center, University of California, Los Angeles, Los Angeles, California
| | - F. Scalzo
- From the Department of Neurology and Comprehensive Stroke Center, University of California, Los Angeles, Los Angeles, California
| | - L. Ali
- From the Department of Neurology and Comprehensive Stroke Center, University of California, Los Angeles, Los Angeles, California
| | - J.D. Hinman
- From the Department of Neurology and Comprehensive Stroke Center, University of California, Los Angeles, Los Angeles, California
| | - N.M. Rao
- From the Department of Neurology and Comprehensive Stroke Center, University of California, Los Angeles, Los Angeles, California
| | - M. Nour
- From the Department of Neurology and Comprehensive Stroke Center, University of California, Los Angeles, Los Angeles, California
| | - M. Bahr-Hosseini
- From the Department of Neurology and Comprehensive Stroke Center, University of California, Los Angeles, Los Angeles, California
| | - J.L. Saver
- From the Department of Neurology and Comprehensive Stroke Center, University of California, Los Angeles, Los Angeles, California
| | - R. Raychev
- From the Department of Neurology and Comprehensive Stroke Center, University of California, Los Angeles, Los Angeles, California
| | - D. Liebeskind
- From the Department of Neurology and Comprehensive Stroke Center, University of California, Los Angeles, Los Angeles, California
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Yoshie T, Yu Y, Jiang H, Honda T, Trieu H, Scalzo F, Saver JL, Liebeskind DS. Perfusion Parameter Thresholds That Discriminate Ischemic Core Vary with Time from Onset in Acute Ischemic Stroke. AJNR Am J Neuroradiol 2020; 41:1809-1815. [PMID: 32855193 DOI: 10.3174/ajnr.a6744] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2020] [Accepted: 06/29/2020] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE When mapping the ischemic core and penumbra in patients with acute ischemic stroke using perfusion imaging, the core is currently delineated by applying the same threshold value for relative CBF at all time points from onset to imaging. We investigated whether the degree of perfusion abnormality and optimal perfusion parameter thresholds for defining ischemic core vary with time from onset to imaging. MATERIALS AND METHODS In a prospectively maintained registry, consecutive patients were analyzed who had ICA or M1 occlusion, baseline perfusion and diffusion MR imaging, treatment with IV tPA and/or endovascular thrombectomy, and a witnessed, well-documented time of onset. Ten superficial and deep MCA ROIs were analyzed in ADC and perfusion-weighted images. RESULTS Among the 66 patients meeting entry criteria, onset-to-imaging time was 162 minutes (range, 94-326 minutes). Of the 660 ROIs analyzed, 164 (24.8%) showed severely or moderately reduced ADC (ADC ≤ 620, ischemic core), and 496 (75.2%), mildly reduced or normal ADC (ADC > 620). In ischemic core ADC regions, longer onset-to-imaging times were associated with more highly abnormal perfusion parameters-relative CBF: Spearman correlation, r = -0.22, P = .005; relative CBV: r = -0.41, P < .001; MTT: - r = -0.29, P < .001; and time-to-maximum: r = 0.35, P < .001. As onset-to-imaging times increased, the best cutoff values for relative CBF and relative CBV to discriminate core from noncore tissue became progressively lower and overall accuracy of the core tissue definition increased. CONCLUSIONS Perfusion abnormalities in ischemic core regions become progressively more abnormal with longer intervals from onset to imaging. Perfusion parameter value thresholds that best delineate ischemic core are more severely abnormal and have higher accuracy with longer onset-to-imaging times.
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Affiliation(s)
- T Yoshie
- From the Department of Neurology (T.Y., Y.Y., H.J., T.H., H.T., F.S., J.L.S., D.S.L.), David Geffen School of Medicine at University of California, Los Angeles, Los Angeles, California
- Department of Neurology and Neuro Endovascular Therapy (T.Y.), St. Marianna University Toyoko Hospital, Kanagawa, Japan
| | - Y Yu
- From the Department of Neurology (T.Y., Y.Y., H.J., T.H., H.T., F.S., J.L.S., D.S.L.), David Geffen School of Medicine at University of California, Los Angeles, Los Angeles, California
| | - H Jiang
- From the Department of Neurology (T.Y., Y.Y., H.J., T.H., H.T., F.S., J.L.S., D.S.L.), David Geffen School of Medicine at University of California, Los Angeles, Los Angeles, California
- Department of Neurology (H.J.), the First Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China
| | - T Honda
- From the Department of Neurology (T.Y., Y.Y., H.J., T.H., H.T., F.S., J.L.S., D.S.L.), David Geffen School of Medicine at University of California, Los Angeles, Los Angeles, California
| | - H Trieu
- From the Department of Neurology (T.Y., Y.Y., H.J., T.H., H.T., F.S., J.L.S., D.S.L.), David Geffen School of Medicine at University of California, Los Angeles, Los Angeles, California
| | - F Scalzo
- From the Department of Neurology (T.Y., Y.Y., H.J., T.H., H.T., F.S., J.L.S., D.S.L.), David Geffen School of Medicine at University of California, Los Angeles, Los Angeles, California
| | - J L Saver
- From the Department of Neurology (T.Y., Y.Y., H.J., T.H., H.T., F.S., J.L.S., D.S.L.), David Geffen School of Medicine at University of California, Los Angeles, Los Angeles, California
| | - D S Liebeskind
- From the Department of Neurology (T.Y., Y.Y., H.J., T.H., H.T., F.S., J.L.S., D.S.L.), David Geffen School of Medicine at University of California, Los Angeles, Los Angeles, California
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Yu YN, Liu MW, Villablanca JP, Li ML, Xu YY, Gao S, Feng F, Liebeskind DS, Scalzo F, Xu WH. Middle Cerebral Artery Plaque Hyperintensity on T2-Weighted Vessel Wall Imaging Is Associated with Ischemic Stroke. AJNR Am J Neuroradiol 2019; 40:1886-1892. [PMID: 31624115 DOI: 10.3174/ajnr.a6260] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2019] [Accepted: 08/27/2019] [Indexed: 01/09/2023]
Abstract
BACKGROUND AND PURPOSE Vessel wall imaging can identify intracranial atherosclerotic plaque and give clues about its components. We aimed to investigate whether the plaque hyperintensity in the middle cerebral artery on T2-weighted vessel wall imaging is associated with ischemic stroke. MATERIALS AND METHODS We retrospectively reviewed our institutional vessel wall MR imaging data base. Patients with an acute ischemic stroke within 7-day onset in the MCA territory were enrolled. Patients with stroke and stenotic MCA plaque (stenosis degree, ≥50%) were included for analysis. Ipsilateral MCA plaque was defined as symptomatic, and contralateral plaque, as asymptomatic. Plaque was manually delineated on T2-weighted vessel wall imaging. The plaque signal was normalized to the ipsilateral muscle signal. The thresholds and volume of normalized plaque signal were investigated using logistic regression and receiver operating characteristic analysis to determine the association between normalized plaque signal and stroke. RESULTS One hundred eight stenotic MCAs were analyzed (from 88 patients, 66 men; mean age, 58 ± 15 years), including 72 symptomatic and 36 asymptomatic MCA plaques. Symptomatic MCA plaque showed larger plaque hyperintensity volume compared with asymptomatic MCA plaque. The logistic regression model incorporating stenosis degree, remodeling ratio, and normalized plaque signal 1.3-1.4 (OR, 6.25; 95% CI, 1.90-20.57) had a higher area under curve in differentiating symptomatic/asymptomatic MCA plaque, compared with a model with only stenosis degree and remodeling ratio (area under curve, 0.884 versus 0.806; P =.008). CONCLUSIONS The MCA plaque hyperintensity on T2-weighted vessel wall imaging is independently associated with ischemic stroke and adds value to symptomatic MCA plaque classification. Measuring the normalized signal intensity may serve as a practical and integrative approach to the analysis of intracranial atherosclerotic plaque.
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Affiliation(s)
- Y-N Yu
- From the Departments of Neurology (Y.-N.Y., Y.-Y.X., S.G., W.-H.X.)
| | - M-W Liu
- Neurovascular Imaging Research Core and UCLA Stroke Center (M.-W.L., D.S.L., F.S.), Los Angeles, California
| | | | - M-L Li
- Radiology (M.-L.L., F.F.), Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China
| | - Y-Y Xu
- From the Departments of Neurology (Y.-N.Y., Y.-Y.X., S.G., W.-H.X.)
| | - S Gao
- From the Departments of Neurology (Y.-N.Y., Y.-Y.X., S.G., W.-H.X.)
| | - F Feng
- Radiology (M.-L.L., F.F.), Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China
| | - D S Liebeskind
- Neurovascular Imaging Research Core and UCLA Stroke Center (M.-W.L., D.S.L., F.S.), Los Angeles, California
| | - F Scalzo
- Neurovascular Imaging Research Core and UCLA Stroke Center (M.-W.L., D.S.L., F.S.), Los Angeles, California
| | - W-H Xu
- From the Departments of Neurology (Y.-N.Y., Y.-Y.X., S.G., W.-H.X.)
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Abstract
Co-occurring substance misuse and borderline personality disorder (BPD) in adults is associated with more severe dysfunction and poorer prognosis than BPD alone. However, it is unknown to what extent substance use in youth with BPD is normative for this age group or pathological. This study compared substance use in 117 help-seeking youth (aged 15-25 years) with their first presentation for treatment of BPD, with an epidemiological general population sample and with healthy, age- and gender-matched controls. Established instruments were used to diagnose BPD and assess substance use. Alcohol dependence, daily tobacco use, and use of illicit substances in the past month were between four and nine times more prevalent in the BPD group than in the general population. Similarly, the prevalence of substance use was disproportionately higher in youth with BPD than in matched controls. The findings indicate a non-normative, alarmingly high rate of substance use among youth with BPD.
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Affiliation(s)
- Franco Scalzo
- Melbourne School of Psychological Sciences, University of Melbourne, Australia
| | - Carol A Hulbert
- Melbourne School of Psychological Sciences, University of Melbourne, Australia
| | - Jennifer K Betts
- Orygen, The National Centre of Excellence in Youth Mental Health, Melbourne, Australia.,Centre for Youth Mental Health, University of Melbourne
| | - Sue M Cotton
- Orygen, The National Centre of Excellence in Youth Mental Health, Melbourne, Australia.,Centre for Youth Mental Health, University of Melbourne
| | - Andrew M Chanen
- Orygen, The National Centre of Excellence in Youth Mental Health, Melbourne, Australia.,Centre for Youth Mental Health, University of Melbourne
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Scalzo F, Hulbert CA, Betts JK, Cotton SM, Chanen AM. Predictors of substance use in youth with borderline personality disorder. ACTA ACUST UNITED AC 2018. [DOI: 10.1037/per0000257] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Chien A, Xu M, Yokota H, Scalzo F, Morimoto E, Salamon N. Nonsphericity Index and Size Ratio Identify Morphologic Differences between Growing and Stable Aneurysms in a Longitudinal Study of 93 Cases. AJNR Am J Neuroradiol 2018; 39:500-506. [PMID: 29371255 DOI: 10.3174/ajnr.a5531] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2017] [Accepted: 11/13/2017] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE Recent studies have strongly associated intracranial aneurysm growth with increased risk of rupture. Identifying aneurysms that are likely to grow would be beneficial to plan more effective monitoring and intervention strategies. Our hypothesis is that for unruptured intracranial aneurysms of similar size, morphologic characteristics differ between aneurysms that continue to grow and those that do not. MATERIALS AND METHODS From aneurysms in our medical center with follow-up imaging dates in 2015, ninety-three intracranial aneurysms (23 growing, 70 stable) were selected. All CTA images for the aneurysm diagnosis and follow-up were collected, a total of 348 3D imaging studies. Aneurysm 3D geometry for each imaging study was reconstructed, and morphologic characteristics, including volume, surface area, nonsphericity index, aspect ratio, and size ratio were calculated. RESULTS Morphologic characteristics were found to differ between growing and stable groups. For aneurysms of <3 mm, nonsphericity index (P < .001); 3-5 mm, nonsphericity index (P < .001); 5-7 mm, size ratio (P = .003); >7 mm, volume (P < .001); surface area (P < .001); and nonsphericity index (P = .002) were significant. Within the anterior communicating artery, the nonsphericity index (P = .008) and, within the posterior communicating artery, size ratio (P = .004) were significant. The nonsphericity index receiver operating characteristic area under the curve was 0.721 for discriminating growing and stable cases on the basis of initial images. CONCLUSIONS Among aneurysms with similar sizes, morphologic characteristics appear to differ between those that are growing and those that are stable. The nonsphericity index, in particular, was found to be higher among growing aneurysms. The size ratio was found to be the second most significant parameter associated with growth.
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Affiliation(s)
- A Chien
- From the Departments of Radiological Science (A.C., M.X., H.Y., E.M., N.S.)
| | - M Xu
- From the Departments of Radiological Science (A.C., M.X., H.Y., E.M., N.S.)
| | - H Yokota
- From the Departments of Radiological Science (A.C., M.X., H.Y., E.M., N.S.)
| | - F Scalzo
- Neurology (F.S.), David Geffen School of Medicine at the University of California, Los Angeles, Los Angeles, California
| | - E Morimoto
- From the Departments of Radiological Science (A.C., M.X., H.Y., E.M., N.S.)
| | - N Salamon
- From the Departments of Radiological Science (A.C., M.X., H.Y., E.M., N.S.)
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Abstract
Co-occurring substance misuse and borderline personality disorder (BPD) in adults is associated with more severe dysfunction and poorer prognosis than BPD alone. However, it is unknown to what extent substance use in youth with BPD is normative for this age group or pathological. This study compared substance use in 117 help-seeking youth (aged 15-25 years) with their first presentation for treatment of BPD, with an epidemiological general population sample and with healthy age- and gender-matched controls. Established instruments were used to diagnose BPD and assess substance use. Alcohol dependence, daily tobacco use, and use of illicit substances in the past month were between four and nine times more prevalent in the BPD group than in the general population. Similarly, the prevalence of substance use was disproportionately higher in youth with BPD than in matched controls. The findings indicate a non-normative, alarmingly high rate of substance use among youth with BPD.
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Affiliation(s)
| | | | - Jennifer K Betts
- University of Melbourne, Melbourne, Australia
- Orygen, The National Centre of Excellence in Youth Mental Health, Melbourne, Australia
| | - Sue M Cotton
- University of Melbourne, Melbourne, Australia
- Orygen, The National Centre of Excellence in Youth Mental Health, Melbourne, Australia
| | - Andrew M Chanen
- University of Melbourne, Melbourne, Australia
- Orygen, The National Centre of Excellence in Youth Mental Health, Melbourne, Australia
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Scalzo F, O'Connor DA, Orr C, Murphy K, Hester R. Attention Diversion Improves Response Inhibition of Immediate Reward, But Only When it Is Beneficial: An fMRI Study. Front Hum Neurosci 2016; 10:429. [PMID: 27616988 PMCID: PMC5000576 DOI: 10.3389/fnhum.2016.00429] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2016] [Accepted: 08/10/2016] [Indexed: 11/13/2022] Open
Abstract
Deficits of self-control are associated with a number of mental state disorders. The ability to direct attention away from an alluring stimulus appears to aid inhibition of an impulsive response. However, further functional imaging research is required to assess the impact of shifts in attention on self-regulating processes. We varied the level of attentional disengagement in an functional magnetic resonance imaging (fMRI)-based Go/No-go task to probe whether diversion of attention away from alluring stimuli facilitates response inhibition. We used the attention-grabbing characteristic of faces to exogenously direct attention away from stimuli and investigated the relative importance of attention and response inhibition mechanisms under different delayed reward scenarios [i.e., where forgoing an immediate reward ($1) led to a higher ($10) or no payoff in the future]. We found that diverting attention improved response inhibition performance, but only when resistance to an alluring stimulus led to delayed reward. Region of interest analyses indicated significant increased activity in posterior right inferior frontal gyrus during successful No-go trials for delayed reward trials compared to no delayed reward trials, and significant reduction in activity in the superior temporal gyri and left caudate in contexts of high attentional diversion. Our findings imply that strategies that increase the perceived benefits of response inhibition might assist individuals in abstaining from problematic impulsive behaviors.
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Affiliation(s)
- Franco Scalzo
- Melbourne School of Psychological Sciences, University of Melbourne Melbourne, VIC, Australia
| | - David A O'Connor
- Melbourne School of Psychological Sciences, University of MelbourneMelbourne, VIC, Australia; Cognitive Neuroscience Centre, Reward and Decision-Making Group, Centre National pour la Recherche ScientifiqueLyon, France
| | - Catherine Orr
- Melbourne School of Psychological Sciences, University of MelbourneMelbourne, VIC, Australia; Departments of Psychiatry and Psychology, University of VermontBurlington, VT, USA
| | - Kevin Murphy
- Cardiff University Brain Research Imaging Centre, School of Psychology, Cardiff University Cardiff, UK
| | - Robert Hester
- Melbourne School of Psychological Sciences, University of Melbourne Melbourne, VIC, Australia
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Scalzo F. Developmental effects of phencyclidine and MK-801 on monoamines in rats. Neurotoxicol Teratol 1995. [DOI: 10.1016/0892-0362(95)93390-l] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Zimatore G, Riccio S, Saccà N, Scalzo F, Vero R. [Sinus arrest caused by clonidine during treatment of chronic opiate poisoning]. Clin Ter 1985; 113:261-5. [PMID: 4017505] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
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