[Frequency of single nucleotide polymorphisms and alpha-synuclein haplotypes associated with sporadic Parkinson's disease in the Mexican population]

INTRODUCTION

Parkinson's disease (PD) is a common neurodegenerative disease which begins in adulthood. Its incidence in Mexico is estimated to be 40-50 cases per 100,000 inhabitants/year and is the fourth reason for medical care in the National Institute of Neurology and Neurosurgery. The protein alpha-synuclein, SNCA, plays a key role in the pathology of PD, and its polymorphisms have been associated with an increased risk of developing the disease.

AIM

To evaluate the risk of PD represented by the polymorphisms rs2619364, rs2619363, rs2736990, rs7684318, rs17016074, rs356219, rs356220 and rs356203 of SNCA in a sample of Mexican subjects.

SUBJECTS AND METHODS

Altogether 171 patients diagnosed with PD and 171 gender- and age-paired controls were assessed by means of real-time polymerase chain reaction, and a statistical analysis was performed to determine the association between the polymorphisms and the disease.

RESULTS

The SNCA variants rs356220, rs356203, rs7684318 and rs2736990 were associated with the disease and form two haplotypes with a high risk of developing sporadic PD in the Mexican population.

CONCLUSIONS

Variations in SNCA are a risk factor for the development of PD and can act as specific genetic biomarkers as a diagnostic support tool in sporadic PD for Mexican mestizo patients.

The beneficial effects of combining pharmacological and psychosocial treatment on remission and functional outcome in outpatients with schizophrenia

OBJECTIVE

The effects of pharmacological and psychosocial treatment on remission and the functional outcome in outpatients with schizophrenia were evaluated. Remission was assessed according to the criteria proposed by the Remission in Schizophrenia Working group and psychosocial functioning according to the Global Assessment of Functioning with a score > 60. Functional outcome was the result of these two variables.

METHOD

One hundred fifty two patients were randomized to receive either, antipsychotic treatment as usual (TAU) or social skills training and family psychoeducation in addition to TAU. A final sample of 119 patients: n = 68 in the social skills training group, and n = 51 in the TAU group completed the study protocol. Patients were assessed at baseline and at 6-month follow-up.

RESULTS

At the end of the study, 80% of the patients fulfilled the criteria for symptomatic remission: 62 patients (91.2%) in the social skills training group in contrast to 34 patients (66.7%) in the TAU group. Functional improvement criteria were accomplished by 41 patients (34.5%) at the endpoint of the study. Forty of these patients (58.8%) belonged to social skills training and one patient to customary treatment (χ(2) = 41.7, df 1, p < 0.001) and when criteria for symptomatic remission and functional improvement were combined, 39 patients (97.5%) of the social skills training group and one patient (1.9%) of the customary treatment group achieved functional outcome.

CONCLUSION

The results emphasize the need for psychosocial interventions as conjoint to pharmacological treatment to improve functional outcome in schizophrenia patients.

Effects of mirtazapine on the sleep wake rhythm of geriatric patients with major depression: an exploratory study with actigraphy

INTRODUCTION

Major depression and insomnia are among the most frequent neuropsychiatric syndromes in the geriatric population. Although most SSRI antidepressants affect sleep continuity, mirtazapine has been found to improve sleep continuity in patients with depression. The aim of the present study was to assess by actigraphic recordings changes in sleep patterns of geriatric patients with major depression before and during treatment with mirtazapine (30 mg).

METHODS

Patients aged 60 years or more with major depressive disorder were recruited at the outpatient service of a specialized mental health centre. Severity of depression was rated with the Montgomery-Asberg depression rating scale and subjective perception of sleep was assessed with the Pittsburgh sleep quality index (PSQI). Actigraphic parameters were registered 4 days before the onset of mirtazapine treatment (patients were drug free in this period of time) and recorded at day 60 of treatment with mirtazapine.

RESULTS

A significant decrease was observed in the sleep fragmentation index. While a significant improvement was observed in the subjective assessment of quality after treatment with mirtazapine, actigraphic measures of sleep parameters did not show changes in line with mirtazapine treatment.

DISCUSSION

Mirtazapine produces minimal changes on actigraphic measures in the sleep of elderly outpatients. Sleep produced by mirtazapine indicates a more pronounced effect in ≥ 80-year-old patients. This differential response should be considered during treatment of this clinical population.

Reliability study of the translation into Spanish of the PRIME Screen Questionnaire for Prodromic Symtoms

INTRODUCTION

A fundamental precondition for early intervention in schizophrenia is accurate detection of prodromal states, that is, sign and symptom constellations that predict the onset of psychosis in persons with no prior background. Several structured interviews have been designed for the detection of prodromal subjects.

OBJECTIVE

To translate and determine the reliability of the PRIME Screen in an adolescent community sample in México City.

METHOD

A total of 532 adolescents of a technical-industrial educational center of México City were included for the study. All the subjects were administered the PRIME Screen Questionnaire of Prodromal Symptoms.

RESULTS

A total of 98 subjects (18.4%) reported one or more prodromal symptoms. The results of the factorial analysis showed that the PRIME Screen questionnaire is conformed by three factors that explained 59.3% of the variance. Internal consistency of the instrument was of 0.88.

DISCUSSION

Our results on the exploratory factor analysis show that the items of the questionnaire are grouped into three main areas called: a) alteration of setting; b) sensorial-perceptual abnormalities, and c) alterations of self-skills. The Prodromal Symptoms Screen Questionnaire is an instrument with adequate clinimetric behavior that may be effective to conduct community-wide screening of adolescents for prodromal symptoms.

Lack of association of apolipoprotein E polymorphism in obsessive-compulsive disorder

Obsessive-compulsive disorder (OCD) could be considered a neurodevelopmental disorder, from several lines of evidence. One of the most widely studied genes in these disorders is the apolipoprotein E gene, particularly allele 4. We analyzed for association among patients with OCD versus normal controls and cognitively impaired patients. There were no significant differences between OCD probands compared with population controls. However, the cognitively impaired group showed a higher frequency of allele apolipoprotein E gene compared with normal controls and patients with OCD.