Justyna Morylowska-Topolska

Introduction: Parkinson’s disease is a neurodegenerative disease that is often accompanied by disorders such as depression, psychotic disorders, cognitive disorders, anxiety disorders, sleep disorders, impulse control disorders. The aim of the study was to review the literature and present the characteristics of neuropsychiatric disorders occurring in people suffering from Parkinson’s disease, with the specification of the above-mentioned disorders. Material and method: The literature available on the PubMed platform from 1986 to 2022 was reviewed using the following keywords: Parkinson’s disease, depression, anxiety disorders, psychotic disorders, sleep disorders, cognitive disorders, impulse control disorders. Original studies, reviews, meta-analyzes and internet sources were analyzed. Results: The above-mentioned neuropsychiatric disorders appear with different frequency among people suffering from Parkinson’s disease and occur at different times of its duration or even precede its onset for many years. The non-motor symptoms in the form of depressed mood, energy loss or changes in the rhythm of the day may result in a delay of appropriate therapy and thus in complications. Neuropathological changes in the course of Parkinson’s disease as well as dopaminergic drugs used in its therapy influence the development of neuropsychiatric disorders. Conclusions: In order to avoid misdiagnosis, practitioners should use, e.g. scales intended for patients with Parkinson’s disease. To prevent the consequences of the aforementioned disease entities, methods of early diagnosis, determination of risk factors and standardization of the treatment process must be determined. Consistent care for patients with Parkinson’s disease is significant, not only in the neurological field, but also in the psychiatric one.

There is an increasing amount of evidence which links the pathogenesis of irritable bowel syndrome (IBS) with food IgG hyperreactivity. Some authors have suggested that food IgG hyperreactivity could be also involved in the pathophysiology of major depressive disorder (MDD). The aim of this study was to compare levels of serum IgG against 39 selected food antigens between three groups of participants: patients with MDD (MDD group), patients with IBS (IBS group) and healthy controls (HC group). The study included 65 participants (22 in the MDD group, 22 in the IBS group and 21 in the HC group). Serum IgG levels were examined using enzyme-linked immunosorbent assay (ELISA). Medical records, clinical data and laboratory results were collected for the analysis. IgG food hyperreactivity (interpreted as an average of levels of IgG antibodies above 7.5 µg/mL) was detected in 28 (43%) participants, including 14 (64%) from the MDD group, ten (46%) from the IBS group and four (19%) from the HC group. We found differences between extreme IgG levels in MDD versus HC groups and in IBS versus HC groups. Patients with MDD had significantly higher serum levels of total IgG antibodies and IgG against celery, garlic and gluten compared with healthy controls. The MDD group also had higher serum IgG levels against gluten compared with the IBS group. Our results suggest dissimilarity in immune responses against food proteins between the examined groups, with the highest immunoreactivity in the MDD group. Further studies are needed to repeat and confirm these results in bigger cohorts and also examine clinical utility of IgG-based elimination diet in patients with MDD and IBS.

G protein-coupled receptors (GPCRs) constitute a family of transmembrane proteins that mediate many cellular processes. GPR120/FFAR4, a receptor from this family that is activated by fatty acids, has received considerable attention recently. This paper presents a literature review concerning the role of GPR120 and its mechanism of action in animal and human studies as well as the potential use of GPR120 for the treatment of chronic diseases. Two electronic databases – Medline and Google Scholar – were searched for available studies addressing the review topic that were written in English and published from 2000 to June 2017. The following key terms were used in the search: GPR120, FFA4, GPR120 agonist, PUFAs, EPA, DHA, adipocyte, obesity, hyperlipidemia, inflammation, cancer, diabetes, insulin resistance, taste, atherogenesis, hepatis, central nervous system. In humans, GPR120 expression is expressed in macrophages, eosinophils, and adipose tissue, in cells of the tongue, liver, lungs, small and large intestine, gastric mucosa, and pancreas, in the central nervous system and placental microvilli. Medium- and long-chain fatty acids act as ligands for the receptor. Through the internalization of beta-arrestin-2 complex and the inhibition of NF-κB, GPR120 mediates the activation of the cell’s anti-inflammatory mechanisms. The receptor is also involved in the maturation of adipocytes, the modulation of insulin signalling pathways, the regulation of glucose metabolism, and the secretion of intestinal hormones. GPR120 is a promising target for the treatment of numerous diseases, whose pathophysiology is associated with low-grade inflammation. As a result of intensive searches, a likely group of synthetic agonists of the receptor was determined with potential therapeutic applications in conditions such as obesity, impaired carbohydrate metabolism, inflammatory bowel diseases, cancer, mental disorders.

Aims: Patients with schizophrenia (SCH) show impaired verbal and non-verbal fluency. However, these individuals’ fluctuations in words or designs generation efficiency over time, a phenomenon that may significantly affect fluency, have never been studied. Thus, the aim of this research was to investigate if individuals with SCH may present with alternations in the dynamics of the information production and its control as well as to test if the potential abnormalities in this regard might affect these patients’ overall performance on both verbal and non-verbal fluency tasks. Method: Forty-four patients with SCH and 40 healthy controls (HC) completed both verbal (phonological, semantic) and non-verbal fluency tests. To analyse processing efficiency changes over time, the period in which subjects had to generate words or designs (60 s) has been divided into 15-s sections. Results: In comparison to HCs, individuals with SCH obtained significantly lower total scores for all fluency measures. Furthermore, group differences in the dynamics of the test performance also emerged, with SCH patients having a significantly worse production during the initial 15 s of each fluency task. Additionally, the initial production deficiency seen in patients with SCH has accounted for these individuals’ total performance. Moreover, comparisons of errors distribution over time during the phonemic and figural fluency performance also revealed differences, suggesting there was a rapid depletion in maintaining of cognitive control in the SCH sample. Conclusions: Inefficient fluency in SCH may arise from a more general initiation deficits that may partly account for these patients’ cognitive problems.

[b]Background: [/b]Contemporary research on the neurobiological determinants of schizophrenia is focused on the role of white matter abnormalities, studied mainly at the cellular level using Diffusion Tensor Imaging. At the same time, there are few reports on the effects of white matter damage that can be visualized in a typical MRI scan, on the brain function of schizophrenic patients. The aim of this study was to identify the specific features of the neuropsychological and neurophysiological functioning of a female patient with first-onset schizophrenia and comorbid white matter damage, which discriminated her from a healthy control and from a patient with an identical psychiatric diagnosis, but having no structural brain changes seen in an MRI scan. Identification of those features may help understand the role of subcortical brain dysfunctions in the aetiology and clinical picture of schizophrenia. [b]Case study:[/b]The investigation encompassed clinical, neuropsychological and neurophysiological assessment of two schizophrenic patients, of whom one had comorbid white matter damage imaged by structural MRI, and a healthy control. A number of areas of cognitive functioning were examined, including the speed of information processing and executive and memory functions. The study was conducted using EEG coherence analysis, power spectral density, and energy evaluation of neuronal activity with the Matching Pursuit algorithm.[b]Results: [/b]The study showed that, despite the fact that there were no differences in the psychopathological pictures of the schizophrenic patients, the neuropsychological and neurophysiological differences between them were substantial and related to the profile of cognitive impairments and the specific features of the brain function of the patient with abnormalities in the white matter: that patient’s EEG showed discoherence in the anterior part of the brain, reduced diversity of the dominant frequency of neuronal activity, and pathologically increased energy parameters for low-frequency bands. [b]Conclusions: [/b]Comorbidity of white matter damage with schizophrenia has a potentially significant effect on cerebral activity giving rise to specific information processing deficits. Further research in this area should be conducted with a view to determining biomarkers of mental diseases and improving the validity of clinical psychiatric diagnosis.

A high performance liquid chromatography (HPLC) method for simultaneous analysis of venlafaxine and its major metabolite 0-desmethylvenlafaxine and vilazodone and its methabolite M10 have been devel- oped and validated. Chromatography was performed on the Phenyl-Hexyl column with mobile phase containing methanol, acetate buffer at pH 3.5 and diethylamine. The application of stationary phase with 7r-7c moieties and mobile phase containing diethylamine as silanol blocker lets to obtain double protection against silanols and thus very high theoretical plate numbers were obtained. The good separation selectivity, good peaks' symmetry and very high systems efficiency for all investigated compounds were obtained in applied chromatographic system. The method is very efficient and suitable for the analysis of investigated drugs and their metabolites in human serum for patients' pharmacotherapy control.

Cel pracy: Celem badania było poszukiwanie czynników związanych z większym nasileniem objawów lęku i depresji w grupie kobiet doświadczających przemocy w związku intymnym.Metoda: Badanie przeprowadzono w sześciu losowo dobranych ośrodkach Podstawowej Opieki Zdrowotnej w województwie lubelskim. Zastosowano Szpitalną Skalę Lęku i Depresji (HADS) oraz ustrukturyzowany kwestionariusz konstrukcji własnej. Do badania włączono 350 zgłaszających się kolejno do lekarza rodzinnego kobiet. Od 200 z nich uzyskano kompletnie uzupełniony zestaw narzędzi badawczych. Doświadczenie przemocy w związku intymnym potwierdziły 102 (51%) kobiety, które stanowiły właściwą grupę badaną. Zastosowano metodę regresji wielorakiej postępującej wstecznie do stworzenia czterofazowych modeli związku między różnego typu niezależnymi zmiennymi a występowaniem objawów lęku i depresji u kobiet doświadczających przemocy w związku.Wyniki: 68% badanych uzyskało pozytywny wynik w podskali lęku, a 56% pozytywny wynik w podskali depresji HADS. Zamieszkiwanie na wsi lub w małym mieście było związane z istotnie wyższymi wynikami w podskali lęku (b=−1,18, p=0,003), ale nie z wynikami w podskali depresji HADS. Rozpoznanie somatycznej choroby przewlekłej (b=2,42, p=0,013; b=2,86, p=0,015), status bezrobotnego (b=0,58, p=0,024; b=0,69, p=0,008), oraz doświadczanie przemocy ekonomicznej (b=3,97, p<0,001; b=3,88, p=0,001) było związane z uzyskaniem wyższych wyników w obu podskalach HADS. Otrzymywanie pomocy finansowej (b=2,67, p=0,002; b=2,68, p=0,003) okazało się czynnikiem protekcyjnym zarówno dla wystąpienia objawów depresji jak i lęku w badanej grupie. Doświadczanie przemocy fizycznej wiązało się z uzyskiwaniem wyższych wyników w podskali depresji (b=3,09, p=0,005), ale nie podskali lęku HADS.Wnioski: Rodzaj doznawanej przemocy i czynniki socjoekonomiczne silniej niż zmienne demograficzne wiązały się nasileniem objawów lęku i depresji u kobiet doświadczających przemocy w związkach intymnych

Kynurenic acid (KYNA) is a neuroactive metabolite of tryptophan formed in the brain and in the periphery, known to block ionotropic glutamate receptors and α7 nicotinic receptors, and to act as a ligand of G protein-coupled GPR35 receptors and human aryl hydrocarbon (AHR) receptors. KYNA seems to modulate a number of mechanisms involved in the pathogenesis of schizophrenia including dopaminergic transmission in mesolimbic and mesocortical areas or glutamatemediated neurotransmission. The kynurenine hypothesis of schizophrenia links the occurrence of positive and negative symptoms of schizophrenia and cognitive impairments characteristic for the disease with the disturbances of kynurenine pathway function. Available data suggest that antipsychotic drugs may restore balance among kynurenine pathway metabolites, and that co-administration of glycine with antipsychotics may reduce extrapyramidal symptoms in patients suffering from schizophrenia. Central level of KYNA may increase in the course of inflammation, which is consistent with the inflammatory hypothesis of schizophrenia. Alterations of immune response and disturbed functioning of kynurenine pathway may lead to disproportion between neuroprotective and neurotoxic mechanisms in the brain. Currently, intense research efforts are focused on the role of kynurenine pathway metabolites in pathogenesis of schizophrenia, their association with the response to antipsychotic treatment, and search for novel medications modulating the function of kynurenine pathway.

Pomiędzy objawami tak pozornie od siebie odrębnych zaburzeń psychicznych jakimi są schizofrenia oraz jadłowstręt psychiczny istnieją różnego typu zależności. W artykule dokonano przeglądu literatury i podsumowano poglądy różnych autorów na temat powiązań tych dwóch zaburzeń. Objawy anoreksji mogą 1) poprzedzać wystąpienie psychozy, 2) pojawiać się w jej aktywnej fazie lub też rzadziej występować w okresie remisji, ale także z drugiej strony 3) w przebiegu jadłowstrętu psychicznego mogą okresowo pojawić się objawy psychotyczne. Gdy anoreksja wyprzedza ujawnienie się psychozy, możemy traktować objawy anoreksji jako składową fazy prodromalnej. Inną możliwością współistnienia psychozy (np. schizofrenii) z anoreksją jest sytuacja, gdy zespół zaburzeń odżywiania się pojawia się w tym samym czasie co pełnoobjawowy zespół psychotyczny. W przypadku zaś, jednoczasowego występowania objawów obu zaburzeń trudno często rozróżnić, czy jest to schizofrenia, w przebiegu której na podłożu psychotycznym pojawiają się objawy anoreksji, czy też anoreksja podczas której ujawniają się objawy psychotyczne, najczęściej wówczas tematycznie związane z odżywianiem się. Opublikowane do tej pory doniesienia, głownie opisy przypadków, wskazują na złożoną naturę wzajemnych związków schizofrenii i jadłowstrętu psychicznego. Konieczne są dalsze badania, które pomogłyby ostatecznie wyjaśnić powiązania zaburzeń psychotycznych z jadłowstrętem psychicznym, co umożliwiłoby stosowanie skuteczniejszego leczenia w tej grupie pacjentów.

The number of diagnoses of Autism Spectrum Disorders (ASD) is on the rise, which encourages the search for their causes spurs researchers to study co-occurrence of ASD with other diseases and disorders. This study aims at highlighting the importance of the clinical problem of autism spectrum disorders and its comorbidity with epilepsy. This is one of the most common co-morbidities happening to children. Regarding the psychopathological symptoms, it needs emphasizing that both in case of an isolated ASD and epilepsy itself, the accompanying psychiatric symptoms are confirmed. The research conducted so far also shows that in the course of epilepsy in the child / youth, mental health problems are often revealed, particularly depression and anxiety disorders. Episodes of depression and anxiety disorders are also mentioned as the most common comorbid psychopathological symptoms associated with ASD. An accurate and rapid diagnosis of epilepsy can improve the functioning of the child in the family environment and can improve communication skills. It is also important for the overall intellectual and psychological development. Making a correct diagnosis of the problem is equally crucial as choosing the right methods of medical and psychological care. Moreover,, it determines the early use of adequate, safe and effective forms of treatment.