NEUROPSYCHOLOGICAL, ANATOMICAL, AND PHYSIOLOGICAL CORRELATES OF MOOD DISORDERS

神经心理测试显示，患有情感疾病的患者 在霍尔斯特德类别测试和识别中的表现受损 面部情感表达，与未受损的言语 情绪识别任务。面部情绪识别中的障碍 是与国家有关的；即在表达过程中比“好的-- 发作之间的间隔。患者也报告生活障碍 在日常生活的任务和活动中，包括视觉空间 加工，但不是那些处于口头模式的人。神经细胞的基质 这些缺陷正在由各种不同的 技术包括利用015血流研究对患者进行测试 使用正电子发射计算机断层扫描方法(见MH 02636-02BPB和MH 02638-02BPB)。早些时候 CAT扫描研究显示，情感性心绞痛患者的VBR增加 疾病与病程无关，但与 年龄、皮质醇高分泌的测量与霍尔斯特德的损害 类别测试。最近的核磁共振研究显示面积和体积减小 情感性疾病受试者与对照组的颞叶。 在T2的BP-I患者中观察到了脑室周围的异常 加权扫描；这些发现与增加的 双相I型患者的脑脊液蛋白也是如此。前额的证据 原发性高血压患者的PET扫描结果显示代谢低下 情感障碍以及与癫痫相关的抑郁。这 与汉密尔顿抑郁量表评定的抑郁症严重程度相关 比例。颞骨和顶骨的改变也很明显。前额 低代谢预测对尼莫地平(和安非他酮)的反应 门诊患者的文拉法辛)，特别是在临时性的多动症 脑叶，与卡马西平的反应有关。我们希望看到 神经心理特征是否也能预测锂的反应 还有这些特工。像这些患有癫痫的情感病人 发作性精神感觉症状的高发率 初步证据表明，这与急性发作无关 卡马西平的抗抑郁或抗躁狂反应， 矛盾的是对卡马西平的长期反应较差- 定期预防。

Neuropsychological testing has revealed that affectively ill patients have impaired performance on the Halstead Category Test and recognition of facial emotional expression, in contrast with unimpaired verbal emotion recognition tasks. The impairment in facial emotion recognition is state-related; i.e., more profound during expression than the "well- interval" between episodes. Patients also report lifetime disturbances in tasks and activities of daily living including visual spatial processing, but not those in the verbal mode. The neural substrates of these deficits are being systematically explored by a variety of techniques including testing patients utilizing 015 blood flow studies with PET methodology (see MH 02636-02 BPB and MH 02638-02 BPB). Earlier CAT scan studies have revealed increased VBR in patients with affective disorders unrelated to the course of illness, but positively related to age, measures of cortisol hypersecretion, and impairment on the Halstead Category Test. More recent MRI studies suggest decreased area and volume of the temporal lobe in affectively ill subjects compared with controls. Periventricular abnormalities have been observed in BP-I patients on T2 weighted scans; these findings are of interest in relation to increased CSF protein in bipolar-I patients as well. Evidence of frontal hypometabolism is revealed on PET scan studies in patients with primary affective disorders as well as depression associated with epilepsy. This correlated with severity of depression rated on the Hamilton Depression Scale. Temporal and parietal alterations are also evident. Frontal hypometabolism predicts response to nimodipine (and bupropion or venlafaxine in outpatients), hyperactivity, particularly in temporal lobes, is associated with response to carbamazepine. We wish to see whether neuropsychological profiles can also predict response to lithium and these agents. Affectively ill patients like these with epilepsy have a high incidence of paroxysmal psychosensory symptoms during their episodes; preliminary evidence suggests that this is unrelated to acute antidepressant or antimanic response to carbamazepine, and is paradoxically associated with a poorer response to carbamazepine in long- term prophylaxis.