Epidemiological studies suggested that elevated plasma homocysteine (Hcy) is associated with an increased risk of depression and cerebrovascular disease (CVD). There were few published reports of Hcy levels and methylenetetrahydrofolate reductase (MTHFR) C677T genotype in geriatric depression.

To investigate the relationship among plasma Hcy level, MTHFR C677T polymorphism and geriatric depression in the Chinese population.

The plasma Hcy level measured by capillary electrophoresis with ultraviolet detection and the C667T polymorphism of MTHFR detected using polymerase chain reaction-restriction fragment length polymorphism assay were determined in 116 patients with geriatric depression and in 80 healthy controls.

The plasma Hcy level in the patients with geriatric depression was significantly higher than that in controls (p < 0.001). The age of first episode and comorbid CVD were significantly correlated with plasma Hcy levels in geriatric patients (p = 0.014 and 0.008, respectively). The Hamilton Rating Scale for Depression total score and plasma Hcy level at baseline showed no significant correlation in the patients (r = −0.111, p = 0.397). There were no significant differences in the MTHFR C677T polymorphism genotypes and alleles between the patients and the healthy controls (p = 0.654 and 0.573, respectively).

The elevated plasma Hcy level is a risk factor for geriatric depression. MTHFR C667T genotype is not associated with geriatric depression in the Chinese population.

Constitute hypothesis for origin of supernumerary phantom limb (SPL) after stroke.

Single case description, review of literature and formulation of hypothesis.

A 59-year-old lady was evaluated for complaints of left-sided hemiparesis and extra limbs attached to her left shoulder for the past 7 months. Neuropsychological assessment revealed left hemineglect with SPL, and profile suggested bilateral frontal, right parietotemporal and basal ganglia involvement. Magnetic resonance imaging brain scan showed gliotic cavity secondary to the old haematoma in right putamen with white matter changes in the right frontoparietotemporal lobes.

The conceptual framework of body schema can be used to classify many of the neurological disorders of body representation. Generation of SPL comes under the subtype of pathology of updating among the disorders of body schema. The continuous updating allows the body schema to modulate perceptual processing of objects according to their position in space. Brain areas classified as parts of motor system can, under pathological conditions (haemorrhage), influence body perception. So, when she used to move her arm, the representation of the estimated position was not updated by the motor commands. Sensory and motor information therefore becomes discrepant, and failure to integrate these two sources of information leads to loss of normal coherence, and the perceived shape of the body was altered by adding a SPL to accommodate the discrepancy.

Magnetic resonance spectroscopy (MRS) is a non-invasive in vivo method used to quantify metabolites that are relevant to a wide range of brain processes. This paper briefly describes neuroimaging using MRS and provides a systematic review of its application to anxiety disorders.

A literature review was performed in the PubMed, Lilacs and Scielo databases using the keywords spectroscopy and anxiety disorder. References of selected articles were also hand-searched for additional citations.

Recent studies have shown that there are significant metabolic differences between patients with anxiety disorders and healthy controls in various regions of the brain. Changes were mainly found in N-acetylaspartate, which is associated with neuronal viability, but some of them were also seen in creatine, a substance that is thought to be relatively constant among individuals with different pathological conditions.

MRS is a sophisticated neuroimaging technique that has provided useful insights into the biochemical and neurobiological basis of many anxiety disorders. Nevertheless, its utilization in some anxiety disorders is still modest, particularly social phobia and generalised anxiety. Although it is an extremely useful advance in neuroimaging, further research in other brain areas and patient populations is highly advisable.

The aim of this review is to provide an overview of the fundamental features of the neurosphere assay (NSA), which was initially described in 1992, and has since been used not only to detect the presence of stem cells in embryonic and adult mammalian neural tissues, but also to study their characteristics in vitro. Implicit in this review is a detailed examination of the limitations of the NSA, and how this assay is most accurately and appropriately used. Finally we will point out criteria that should be challenged to design alternative ways to overcome the limits of this assay.

NSA is used to isolate putative neural stem cells (NSCs) from the central nervous system (CNS) and to demonstrate the critical stem cell attributes of proliferation, extensive self-renewal and the ability to give rise to a large number of differentiated and functional progeny. Nevertheless, the capability of neural progenitor cells to form neurospheres precludes its utilisation to accurately quantify bona fide stem cell frequency based simply on neurosphere numbers. New culture conditions are needed to be able to distinguish the activity of progenitor cells from stem cells.

A commonly used, and arguably misused, methodology, the NSA has provided a wealth of information on precursor activity of cells derived from the embryonic through to the aged CNS. Importantly, the NSA has contributed to the demise of the ‘no new neurogenesis’ dogma, and the beginning of a new era of CNS regenerative medicine. Nevertheless, the interpretations arising from the utilisation of the NSA need to take into consideration its limits, so as not to be used beyond its specificity and sensitivity.

To review the literature comparing electroconvulsive therapy (ECT) and transcranial magnetic stimulation (TMS) for major depression.

Data from the six randomised, prospective studies were agglutinated into one data set. Special attention was given to the methods of both TMS and ECT as well as data pertaining to differential outcomes in subgroups such as psychotic depressives and the elderly.

There is a highly significant advantage for ECT in the prospective, randomised trials. The two non-randomised, retrospective comparative trials found the treatments to be equal in one study and superior for ECT in another. However, sample sizes are small in these studies, and both TMS and ECT may have been used suboptimally. Furthermore, the possibilities of differential efficacy of ECT or TMS for psychotic depressives or as a function of age have yet to be fully explored.

The data to date do not support the contention that TMS is equivalent in efficacy to ECT. It is recommended that a large-scale trial be undertaken using aggressive forms of both TMS and ECT with sample sizes sufficiently large to detect effects of moderating variables such as age and psychosis status.

Prefrontal and/or temporo-limbic abnormalities associated with antisocial personality disorder (APD), high psychopathy scores and violent behaviours can readily be evaluated by neuroimaging methods.

In this study, we compared the brain metabolites in adult male military conscripts with APD, high psychopathy scores and serious violent crimes (n = 15) with age- and educational-level-matched healthy controls (n = 15) by means of magnetic resonance spectroscopy.

All cases were diagnosed by means of the Diagnostic Statistical Manual-IV APD module of the Structured Clinical Interview for DSM III-R Axis II Disorders (SCID-II) semistructured questionnaire in Turkish. The psychopathy scores were evaluated by means of the Hare Psychopathy Checklist-Revised translated into Turkish (PCL-R). PCL-R is a 20-item, reliable and valid instrument for assessment of psychopathy, both in categorical and dimensional natures. All patients had a total score of 29 (of possible 40) or higher from PCL-R, indicating a high degree of psychopathy.

Our results showed no significant differences in ratio of N-acetyl aspartate (NAA), creatine (Cr) and choline-related compounds in the right dorsolateral prefrontal cortex, anterior cingulate cortex (ACC) and amygdala–hippocampus regions of cases compared with controls. ACC NAA/Cr was significantly negatively correlated with both the PCL-R total score and the PCL-R factor I score (interpersonal/affective problems) among the cases.

As ACC plays an important role in decision-making and emotional information processing, we postulate that the lower NAA/Cr ratio, suggesting impaired neural integrity, may increase the severity of interpersonal/affective problems of the psychopathy factor in male subjects exhibiting APD, high psychopathy overall scores and violent crimes.

A prevailing belief is that opioids tend not to impair cognitive performance in opioid-dependent users. However, the impact of heroin abuse on verbal memory, especially on working memory, is not well studied and the results available are inconsistent.

This study was carried out to test the hypothesis that abstinent heroin abusers have intact working memory capacity.

N-back task and backward digit span task were used to measure the verbal working memory capacity in 28 abstinent heroin abusers and 25 controls matched for age, education level and gender. Forward digit span task was used as a control task to measure short-term memory capacity.

Compared with the control subjects, heroin abusers showed normal backward/forward digit spans but significant performance impairment in the n-back task.

Abstinent heroin abusers have intact short-term memory capacity but impaired verbal working memory capacity.

The purpose of this study was to explore whether memory deficits in schizophrenia are attributable to poor organisation/encoding during initial learning vs. memory decay.

Subjects included geriatric schizophrenia/schizoaffective disorders [SSD; n = 37; age = 59.92 (55–74); education = 11.70 (7–18)]; frontotemporal dementia [FTD; n = 41; age = 76.59 (64–83); education = 14.61 (12–20)] and geriatric controls [n = 107; age = 70.97 (55–93); education = 13.76 (6–20)]. Subjects were administered the Wechsler Memory Scale, Third Edition and discrepancy scores between immediate and delayed subtests/indices were used to explore possible differences between groups in pattern of impairment.

Significant differences were found between groups on age/education and these variables were related to several outcome measures. Gender was not related to diagnostic group and there were no gender differences on study variables. There were differences between the SSD subjects on several variables, with the schizoaffective subjects performing worse despite equivalence on global cognitive function, living status and chronicity. Seven one-way between-subjects ANCOVAs compared groups on discrepancy scores. Results failed to suggest differences between groups on immediate-delayed memory discrepancy scores (p> 0.05). Subsequent analyses revealed differences in percentage retention scores between SSD and FTD on the faces subtest (p = 0.040), with SSD retaining greater information over time.

Results failed to show distinctions between groups on pattern of memory impairment when using discrepancy comparisons. However, an analysis examining percentage retention scores revealed better maintenance of non-contextual visual information over time in SSD. Findings may suggest deficits in immediate encoding rather than memory decay for some types of memory ability among geriatric SSD. Our failure to document group differences when using discrepancy comparisons may be attributable to relative similarity in pattern between groups or the limited sensitivity of this technique.

To provide a comprehensive review and evaluation of the literature pertaining to the psychiatric sequelae of deep brain stimulation (DBS) of the subthalamic nucleus (STN) in patients with Parkinson’s disease (PD).

A structured search of the EMBASE, PsychINFO and MEDLINE databases was performed on articles published since the first use of STN DBS in 1993 for PD until March 2007. Non-human studies were excluded, along with studies reporting on unilateral DBS and studies reporting on the use of STN DBS for indications other than idiopathic PD. Ninety-seven articles were selected for inclusion in the review.

Patients with advanced PD have a high rate of psychiatric morbidity. STN DBS has been shown to be an effective treatment for the control of motor symptoms in advanced PD. Neurobehavioural side-effects are, however, relatively common following STN DBS. Side-effects include impaired executive function and verbal fluency, depression, hypomania, apathy, postoperative delirium, anxiety disorders and psychotic symptoms, especially hallucinations. The alteration in dopaminergic medication following surgery as well as the direct effect of STN stimulation both appear to contribute to the short-term and long-term postoperative psychiatric complications. Methodological issues that limit the applicability of the current literature in this field are highlighted.

STN DBS is an effective treatment for the motor symptoms of advanced PD. However, further research is needed to assess the extent to which STN DBS contributes to or exacerbates psychiatric morbidity over and above that associated with advanced PD. Careful neuropsychiatric evaluation and monitoring are required in this patient group.