Gábor Csukly

Semmelweis University | SOTE · Department of Psychiatry and Psychotherapy

A dementiában szenvedő betegek kezelése, gondozása komplex feladat, amely az egészségügyi alap- és szakellátás mellett a szociális ellátórendszer és a szakápolási szolgálatok együttműködése által valósulhat meg. A háziorvos kulcsszereplő a dementia kialakulásának megelőzésében, szűrésében, kezelésében és gondozásában is. Célunk a korszerű dementiae...

Background Treatment effects of conventional approaches with antipsychotics or psychosocial interventions are limited when it comes to reducing negative and cognitive symptoms in schizophrenia. While there is emerging clinical evidence that new, augmented protocols based on theta-burst stimulation can increase rTMS efficacy dramatically in depressi...

Background: Mood instability and risk-taking are hallmarks of borderline personality disorder (BPD). Schema modes are combinations of self-reflective evaluations, negative emotional states, and destructive coping strategies common in BPD. When activated, they can push patients with BPD into emotional turmoil and a dissociative state of mind. Our k...

A large number of trials have supported the functional significance of Theory of Mind (ToM) impairment in schizophrenia. However, the nature and the extent of the impairment are still unclear. Reviews on the topic suggest that, in many cases, studies use only one tool to assess the levels of difficulty in the field, limiting the validity of the mea...

Mild cognitive impairment (MCI) is the prodromal phase of dementia, and it is highly underdiagnosed in the community. We aimed to develop an automated, rapid (< 5 min), electronic screening tool for the recognition of MCI based on hand movement analysis. Sixty-eight individuals participated in our study, 46 healthy controls and 22 patients with cli...

Background In recent years, a growing body of literature has supported the core nature and functional significance of Theory of Mind (ToM) deficit in schizophrenia. These findings have made ToM impairment a promising treatment target. However, despite the encouraging results, its complexity makes it difficult to develop new interventions and even t...

Introduction Meta-analyses suggest that patients with schizophrenia show deficit in working memory – both verbal and visual – and are more distractible. Working memory disturbances are even regarded as the central deficit in schizophrenia by some researchers. Theta synchronization (especially over fronto-central areas) is related to cognitive contr...

Introduction While decreased alpha-band functional connectivity (FC) and changes in network topology have been reported in Alzheimer’s disease, it is not yet entirely known whether these differences mark cognitive decline in the early stages of the disease. Objectives Our study aimed to analyze EEG FC and network differences in the alpha frequency...

Introduction Magnocellular deficit in visual perception and impaired emotion recognition are core features of schizophrenia, however their relationship and the neurobiological underpinnings are still unclear. Objectives The aim of our research was to investigate the oscillatory background of perception and emotion recognition in schizophrenia and...

Introduction First episode psychosis (FEP) programs target the first 3-5 years after the first manifestation of a psychotic episode. Although follow-up results after 10-15 years are mixed, reported results of the first 5-10 years are promising in improving relapse prevention, functional outcomes and reducing mental health care costs, compared to tr...

Introduction: Elderly population is the most vulnerable group of the COVID-19 pandemic, since they often live with chronic diseases. Objective: The goal of our research is to analyze the direct and indirect effects of the pandemic on the Hungarian population over 60 years of age. Method: We collected data using the authentic Hungarian translat...

Amnestic-type mild cognitive impairment (a-MCI) represents the prodromal phase of Alzheimer's disease associated with a high conversion rate to dementia and serves as a potential golden period for interventions. In our study, we analyzed the role of visuospatial (VS) functions and networks in the recognition of a-MCI. We examined 78 participants (3...

Objective: Memory deficits are frequent among patients with epilepsies affecting the temporal lobe. Hippocampal interictal epileptic discharges (hIED), the presumed epileptic exaggeration of sharp wave-ripples (SWR) are known to contribute to memory dysfunctions, but the potential underlying mechanism is unknown. The precise temporal coordination...

Autism spectrum disorder (ASD) and schizophrenia (SCZ) are diagnostically demarcated disorders, yet overlapping pathological functioning is reported at several levels of organisation starting from brain circuitry to behaviour, complicating diagnostic differentiation. In particular, what the two disorders seem to share is anomalous minimal self expe...

Background: The World Wide Web along with online social media has significantly changed the dynamics of communication. Information is easier and faster to access, but at the same time the relevance of the content often remains questionable, often confronting users with half-truths and untruths. Information consumption patterns have also changed a...

Objective Patients with schizophrenia are characterized by compromised working memory (WM) performance and increased distractibility. Theta synchronization (especially over the frontal midline areas) is related to cognitive control and executive processes during WM encoding and retention. Alpha event-related desynchronization (ERD) is associated wi...

Background: While decreased alpha and beta-band functional connectivity (FC) and changes in network topology have been reported in Alzheimer’s disease, it is not yet entirely known whether these differences can mark cognitive decline in the early stages of the disease. Our study aimed to analyze electroencephalography (EEG) FC and network differenc...

It is a widely held assumption that the brain performs perceptual inference by combining sensory information with prior expectations, weighted by their uncertainty. A distinction can be made between higher- and lower-level priors, which can be manipulated with associative learning and sensory priming, respectively. Here, we simultaneously investiga...

Objective While many studies suggest that patients with Alzheimer’s disease have a higher chance for developing epileptic seizures, only a few studies are available examining independent epileptic discharges. The major aims of our study were to determine the prevalence of SEA in AD compared to healthy elderly controls with the hypothesis that SEA i...

Introduction: Alterations in narrow-band spectral power of electroencephalography (EEG) recordings are commonly reported in patients with schizophrenia (SZ). It is well established however that electrophysiological signals comprise a broadband scale-free (or fractal) component generated by mechanisms different from those producing oscillatory neur...

Background: It is a widely held assumption that the brain performs perceptual inference by combining sensory information with prior expectations, all being weighted by their uncertainty. Perception of ambiguous stimuli is influenced by higher- and lower-level priors, which can be manipulated with associative learning and sensory priming, respective...

Clozapine is effective in treatment-resistant schizophrenia; however, adverse effects often result in discontinuation of clozapine therapy. Many of the side-effects are associated with pharmacokinetic variations; therefore, the expression of major clozapine-metabolizing enzymes (CYP1A2, CYP3A4) in patients may predict development of adverse effects...

Focusing attention on relevant information while ignoring distracting stimuli is essential to the efficacy of working memory. Alpha- and theta-band oscillations have been linked to the inhibition of anticipated and attentionally avoidable distractors. However, the neurophysiological background of the rejection of task-irrelevant stimuli appearing i...

Background Schizophrenia (SZ) is a complex disorder characterized by a range of behavioral and cognitive symptoms as well as structural and functional alterations in multiple cortical and subcortical structures. SZ is associated with reduced functional network connectivity involving core regions such as the anterior cingulate cortex (ACC) and the t...

The efficacy of aripiprazole therapy and the risk of adverse reactions are influenced by substantial inter-individual variability in aripiprazole metabolizing capacity. In vitro studies assigned the potential role in aripiprazole metabolism to CYP2D6 and CYP3A enzymes; therefore, the association between the steady-state aripiprazole plasma concentr...

1. Köszöntés (Karvaly Gellért) – 1 perc 2. Bevezető (Bitter István, Vásárhelyi Barna) – 3 perc 3. A terápiás gyógyszerszint monitorozás Semmelweis Egyetemen elérhető új vizsgálati környezete (Karvaly Gellért) – 8 perc 4. A gyógyszerszint monitorozás és a pszichiátriai terápia (költség)hatékonyságának kapcsolata (Vásárhelyi Barna) – 4 perc 5. Klinik...

Background: Perrault syndrome is a genetically heterogenous, very rare disease, characterized clinically by sensorineural hearing loss, ovarian dysfunction and neurological symptoms. We present the case of a 33 years old female patient with TWNK-associated Perrault syndrome. The TWNK gene is coding the mitochondrial protein Twinkle and currently t...

While impaired facial emotion recognition and magnocellular deficits in visual perception are core features of schizophrenia, their relationship is still unclear. Our aim was to analyze the oscillatory background of these processes and to investigate the connection between the magnocellular pathway deficit and the abnormal facial affect processing....

Previous studies that aimed to support emotion recognition deficits and alexithymia in B cluster personality disorders have mainly focused on borderline personality disorder (BPD), and resulted in mixed findings. In our study we examine emotion recognition and alexithymia in patients with histrionic (HPD), narcissistic (NPD) and borderline (BPD) pe...

Background: Alzheimer's disease (AD) is the primary cause of cognitive decline. A growing body of evidence suggests that AD patients have a higher risk to develop epileptic seizures; however, results are contradictory due to different methodological approaches of previous studies. Objective: We aimed to identify the prevalence, semiology, and ri...

Mild cognitive impairment (MCI) refers to a measurable deficit in cognition in the absence of dementia or impairment in activities of daily living. Working memory impairment is among the earliest signs of MCI. Oscillatory analysis of working memory might be a potential tool for identifying patients at increased risk of developing dementia. Our stud...

Here we critically review studies that used electroencephalography (EEG) or event-related potential (ERP) indices as a biomarker of Alzheimer's disease. In the first part we overview studies that relied on visual inspection of EEG traces and spectral characteristics of EEG. Second, we survey analysis methods motivated by dynamical systems theory (D...

Background Schizophrenia has a negative effect on the activity of the temporal and prefrontal cortices in the processing of emotional facial expressions. However no previous research focused on the evaluation of mixed emotions in schizophrenia, albeit they are frequently expressed in everyday situations and negative emotions are frequently expresse...

Background: Genetic polymorphisms of drug metabolizing enzymes can substantially modify the pharmacokinetics of a drug and eventually its efficacy or toxicity; however, inferring a patient's drug metabolizing capacity merely from his or her genotype can lead to false prediction. Non-genetic host factors (age, sex, disease states) and environmental...

Mild cognitive impairment (MCI) gained a lot of interest recently, especially that the conversion rate to Alzheimer Disease (AD) in the amnestic subtype (aMCI) is higher than in the non-amnestic subtype (naMCI). We aimed to determine whether and how diffusion-weighted MRI (DWI) using the diffusion tensor model (DTI) can differentiate MCI subtypes f...

Background The atypical antipsychotic clozapine is effective in treatment-resistant schizophrenia; however, the success or failure of clozapine therapy is substantially affected by the variables that impact the clozapine blood concentration. Thus, elucidating the inter-individual differences in clozapine pharmacokinetics can facilitate the personal...

Structural brain changes underlying mild cognitive impairment (MCI) have been well-researched, but most previous studies required subjective cognitive complaints (SCC) as a diagnostic criterion, diagnosed MCI based on a single screening test or lacked analyses in relation to neuropsychological impairment. This longitudinal voxel-based morphometry s...

Background: The shortcomings of clonazepam therapy include tolerance, withdrawal symptoms and adverse effects, such as drowsiness, dizziness and confusion leading to increased risk of falls. Inter-individual variability in the incidence of adverse events in patients partly originates from the differences in clonazepam metabolism due to genetic and...

Introduction: While amnestic mild cognitive impairment (aMCI) and non-amnestic mild cognitive impairment (naMCI) are theoretically different entities, only a few investigations studied the structural brain differences between these subtypes of mild cognitive impairment. The aim of the study was to find the structural differences between aMCI and n...

Empirical data from previous investigations showed that emotion processing is reflected in beta, and especially in low beta event related desynchronization (ERD) (i.e. a decrease in low beta power). While recognition of social information and emotion processing are impaired in schizophrenia, no previous study analyzed induced and evoked beta oscill...

Due to population aging, old age cognitive deficit is becoming a mass-phenomenon. Dementia, its most severe variant, is chronic, progressive, long lasting and, so far, incurable. The early sign of a higher risk for a pathological decrease in cognition is called Mild Cognitive Impairment (MCI). Early detection of MCI is crucial for providing cost-ef...

It is anticipated that current and future preventive therapies will likely be more effective in the early stages of dementia, when everyday functioning is not affected. Accordingly the early identification of people at risk is particularly important. In most cases, when subjects visit an expert and are examined using neuropsychological tests, the d...

As society is aging, an increasing number of elderly people is affected by cognitive problems. Early detection of mild cognitive impairment (MCI) is crucial for slowing down deterioration at an early stage. Improving detection would allow aging in place and thus more cost effective care. However, detection usually occurs too late. Clinical tests ar...

Background: At present 34 million people live with Alzheimer's disease around the world. This figure is expected to triple in the next 40 years. The major cause of this increase is the well-known aging of the society in Europe and in the US as well. Aims and methods: In this paper we review the results of the last 10 years, and discuss those pha...

The authors examined social decision-making strategies in borderline personality disorder (BPD) using the Ultimatum Game (UG). They sought to extend previous findings by investigating altruistic punishment, a behavior that increases group cooperation in the long term. They tested the effect of the proposer's facial expression on responses. BPD pati...

Disturbed interpersonal relationships specific to borderline personality disorder (BPD) suggest biased processing of social information. The goal of this study was to examine alterations in mental state decoding (MSD) and their associations with early maladaptive schemas (EMS) that may lead to the misinterpretation of incoming information. In addit...

Growing evidence suggests that abnormalities in the synchronized oscillatory activity of neurons in schizophrenia may lead to impaired neural activation and temporal coding and thus lead to neurocognitive dysfunctions, such as deficits in facial affect recognition. To gain an insight into the neurobiological processes linked to facial affect recogn...

Gender identity disorder (GID) refers to transsexual individuals who feel that their assigned biological gender is incongruent with their gender identity and this cannot be explained by any physical intersex condition. There is growing scientific interest in the last decades in studying the neuroanatomy and brain functions of transsexual individual...

Mismatch negativity (MMN) is an event-related potential (ERP) measure of preattentional sensory processing. While deficits in the auditory MMN are robust electrophysiological findings in schizophrenia, little is known about visual mismatch response and its association with social cognitive functions such as emotion recognition in schizophrenia. Our...

Objective: Paired Associates Learning (PAL) test assesses brain functions in those brain regions affected earliest by Alzheimer's dementia. The aim of the present study was to assess the usability of our implementation of the PAL test for screening mild cognitive impairment. Methodology: Based on Petersen criteria, 14 out of the 63 subjects were...

Emotional expressions are important acts of communication, and impairment in facial emotion recognition has been shown to be related to impairments in social cognition in schizophrenia. We used an event-related potential (ERP) paradigm to identify and delineate the temporal characteristics in the electrophysiological cascade related to fearful faci...

To investigate whether people with schizophrenia experience discrimination when using health care services. A cross-sectional survey in 27 countries in centres affiliated to the INDIGO Research Network, using face-to-face interviews with 777 participants with schizophrenia (62% male and 38% female). We analysed the data related to health issues, in...

BACKGROUND: Depression is the third leading contributor to the worldwide burden of disease. We assessed the nature and severity of experienced and anticipated discrimination reported by adults with major depressive disorder worldwide. Moreover, we investigated whether experienced discrimination is related to clinical history, provision of health ca...

A new illegal psychotropic substance appeared in Hungary during the first months of 2011. Acutely hospitalized patients with psychosis disclosed using a new type of designer drug, previously unknown to clinicians. As the new drug became better known, the cases with acute intoxication were often also transported to toxicology departments. In this st...

The ability to read faces is a basic component of social cognition, and has gained considerable interest over the past decades in schizophrenia research. It has been shown to be closely related to psychosocial functioning and quality of life in schizophrenia. Use of event-related potential (ERP) paradigms to measure neural activity during emotion p...

Objective: Psychosocial stressors are consistently associated with antenatal anxiety and depression, while the impact of cortisol has proved inconsistent. Most studies have focused either on psychological or physiological stress indices. We investigated both subjective and endocrinologic indices of distress in the same subjects. Study design: We...

BACKGROUND: Birth season has well-known effects on neuropsychiatric disorders, and may also influence genotype distribution by possibly influencing chance of conception via parental idiosyncratic conception patterns or survival of foetuses or infants. The 5-HTTLPR is associated with phenomena including affective temperaments or suicide which are al...

Facial emotions express our internal states and are fundamental in social interactions. Here we explore whether the repetition of unattended facial emotions builds up a predictive representation of frequently encountered emotions in the visual system. Participants (n=24) were presented peripherally with facial stimuli expressing emotions while they...

Introduction While deficits in facial emotion recognition in schizophrenia have consistently been shown, the underlying neuronal mechanisms remain unclear. Electrophysiological measures, such as event-related brain potentials related to facial emotion recognition yield insight into the time course of recognizing emotional faces. Objectives In our...

Introduction Impaired social cognition is a characteristic feature of schizophrenia, which is associated with the level of community functioning. Socioeconomic games are well-established in behavioral economy and widely used to examine decision-making strategies. They can also provide a useful method in the investigation of social decision-making i...