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An objective diagnostic decision support for schizophrenia
... Algunos estudios han evidenciado que los pacientes que tienen esquizofrenia podrían procesar los estímulos acústicos de una manera inusual o alterada a nivel del tallo cerebral [22][23][24][25][26][27][28][29][30][31][32] . ...
... Contradictoriamente, algunos estudios han obtenido resultados normales 24,25 , mientras otros han detectado alteraciones, como, por ejemplo: ausencia de ondas, aumento de latencias, disminución de amplitudes, e incluso ausencia total de respuestas [26][27][28][29] . Curiosamente, se han asociado ABR anormales con la presencia de alucinaciones auditivas 28 , un síntoma distintivo en la mayor parte de los pacientes esquizofrénicos 30 . Esta heterogeneidad en los resultados puede ser explicada, en parte, por diferencias en los criterios de selección de pacientes (subtipos, tipos de síntomas predominantes, medicación, etc.), muestras pequeñas y variaciones técnicas 33,34 . ...
La esquizofrenia es un trastorno mental crónico que afecta aproximadamente al 1% de la población mundial. Diagnosticar este trastorno se puede tornar difícil debido a que los criterios diagnósticos son complejos y sus síntomas se pueden presentar en una gran variedad de formas. Por lo tanto, se hace necesario contar con herramientas que ayuden a los médicos en su esfuerzo por diagnosticar este trastorno rápida y objetivamente. Algunos estudios han mostrado que estos pacientes podrían procesar los estímulos acústicos de una manera alterada a nivel subcortical. Sin embargo, a pesar de la abundante evidencia neurofisiológica sobre esta disfunción, los resultados aún son equívocos. En este trabajo se realiza una revisión exhaustiva de la literatura donde se abordan los resultados de los diferentes estudios neurofisiológicos publicados sobre el tema, así como las posibles causas de sus diferencias. Y por último, se analizan futuras técnicas, así como el impacto que tendrían en la práctica clínica en caso de ser validadas.
... Problems of the forecast in schizophrenia, and in particular -the formation and severity of negative symptoms during its long-term course remains the key to the clinical study of this disease. The prognosis as the quintessence of clinical research (if we take into account the lack of reliable knowledge about the pathogenesis of schizophrenia), underlies the entire strategy of treatment and rehabilitation of patients with severe mental disorders [1,2]. ...
In our work, we propose one of the options for a prognostic criterion, which at the beginning of the disease can provide sufficient evidence to predict the form and severity of negative symptoms in schizophrenia. Aim. To investigate the influence of the presence of ear on music on the degree of severity of deficiency symptoms in paranoid schizophrenia. The study was conducted on the basis of the third clinical department of the Lviv Regional Clinical Psychiatric Hospital for the period of 2015. 40 patients with paranoid form of schizophrenia, aged 18 to 35, were examined, of which: group I – 20 patients with advanced ear on music (average age 28.60±1.01 years) and group II – 20 patients with no ear on music (average age 27.30±1.15 years). The main methods of studying the observation groups were: clinical-psychopathological, pathopsychological, and statistical. The pathopsychological study of the evaluation of negative symptoms was conducted using the "Qualitative Assessment Scale for Positivity, Negative and General Psychopathological Syndromes" (PANSS – Positive and Negative Syndrome Scale), namely, its PANSS-NS subscale. Comparison of the probability of the difference between the average indices of unrelated groups was carried out using the Mann-Whitney method, comparing the relative parameters of the distribution structure by the xi-square criterion. Analysis of the results of the study shows that in patients with developed ear on music, the level of deficiency symptoms of negative symptoms under the PANSS-NS subclass is 2.2 times lower (p <0.01) than in patients with no developed ear on music: 2.04±0.14 against 4.46±0.17 points, respectively. Comparing the key indicators of the PANSS-NS subscale in patients with paranoid schizophrenia with advanced ear on music, it was found that the manifestations of "Violations of abstract thinking" (N5 – 2.35±0.15 points), "Violation of spontaneity and smoothness in the conversation" (N6 – 2.30±0.15 points) and "Stereotyped thinking" (N7 – 2.20±0.16 points). All these negative symptoms were in patients with muscular earache with significantly lower scores: from lack of severity (1 point) to weakness (3 points). The lack of expressiveness (1 point) was most common in N4 "Passive-apathy social strangeness " - 35.00±10.67 % of patients, very weak severity (2 points) - for N1 "Blurred passion" - 75.00±9.68 % of patients (p <0.05 with the proportion of negative symptoms 1 and 3 points), weakness (3 points) - for N5 – 45.00±11.12 % of patients (p <0.05 with the proportion of negative symptoms 1 point ) The highest proportion (70.00±10.25 %, p <0.05 with a share of negative symptoms of 6 points) of patients with paranoid schizophrenia without ear on music had a high severity (5 points) of rigidity and stereotyping of thinking (N7). The obtained data prove the influence of the factor of the presence of ear on music on deficit syndrome, as well as on the forms and degree of severity of negative symptoms in paranoid schizophrenia.
... Prior studies have suggested that patients suffering from schizophrenia and ADHD may process certain sound stimuli in the brainstem in an unusual or aberrant manner [3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20]. Some studies have suggested that when these patient groups have been examined with brainstem audiometry, the resulting brainstem audiograms have displayed illness-specific aberrations [9,14,17,21]. ...
Psychiatric disorders, such as schizophrenia, attention deficit hyperactivity disorder (ADHD), and bipolar disorder, may sometimes be difficult to diagnose. There is a great need for a valid and reliable diagnostic tool to aid clinicians in arriving at the diagnoses in a timely and accurate manner. Prior studies have suggested that patients suffering from schizophrenia and ADHD may process certain sound stimuli in the brainstem in an unusual manner. When these patient groups have been examined with the electrophysiological method of brainstem audiometry, some studies have found illness-specific aberrations. Such aberrations may also exist for patients suffering from bipolar disorder.
In this study, we will examine whether the method of brainstem audiometry can be used as a diagnostic tool for patients suffering from schizophrenia, ADHD, and bipolar disorder.
The method includes three steps: (1) auditory stimulation with specific sound stimuli, (2) simultaneous measurement of brainstem activity, and (3) automated interpretation of the resulting brain stem audiograms with data-based signal analysis. We will compare three groups of 12 individuals with confirmed diagnoses of schizophrenia, ADHD, or bipolar disorder with 12 healthy subjects under blinded conditions for a total of 48 participants. The extent to which the method can be used to reach the correct diagnosis will be investigated.
The project is now in a recruiting phase. When all patients and controls have been recruited and the measurements have been performed, the data will be analyzed according to a previously arranged algorithm. We expect the recruiting phase and measurements to be completed in early 2015, the analyses to be performed in mid-2015, and the results of the study to be published in early 2016.
If the results support previous findings, this will lend strength to the idea that brainstem audiometry can offer objective diagnostic support for patients suffering from schizophrenia, ADHD, and bipolar disorder. A positive result from the study could imply that brainstem audiometry could become an important supportive tool for clinicians in their efforts to diagnose patients with these disorders in a timely and accurate manner.
ClinicalTrials.gov NCT01629355; https://clinicaltrials.gov/ct2/show/NCT01629355 (Archived by WebCite at http://www.webcitation.org/6VBfTwx5H).
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