Many research groups have used neuroimaging techniques in order to investigate brain abnormalities in patients with Anorexia Nervosa (AN). The results of structural studies, which utilised CT scan and MRI, have revealed both global brain abnormalities and region-specific brain abnormalities. The central disturbance in AN is that of a distorted body image and food refusal. The purpose of the present study was to analyze structural neuroimaging studies in order to revel the possible existence of a neural basis of AN symptoms.

Published reports from refereed journals of the last twenty years are collected, analyzed and synthesized into a summary of the most significant neuroimaging findings. We used as keywords “anorexia”, “neuroimaging”, “MRI”, “CT”, “manual measurement”, “voxel based morphometry” differently matched together.

Structural studies have showed total decreases in both gray matter (GM) and white matter (WM), with an increase in cerebrospinal fluid (CSF). Several structural follow-up studies reported that GM, WM and CSF abnormalities are fully reversible after recovery, whilst other authors reported that GM decreases persists after recovery. Region-specific structural studies have principally revealed a decrease in extrastriate body area, precuneus, parietal lobe and, following recovery, the anterior cingulate cortex.

These results showed a global GM vulnerability in AN patients and that the specific GM regions affected are principally involved in the processing of body-image and mental images, and in the regulation of hunger and satiation. Although these results are still under debate, findings suggest that AN symptoms could have a neural substrate.

To assess the frequency of silent brain infarcts and cerebral cortical atrophy in male alcohol dependant psychiatric patients in post war Bosnia and Herzegovina (BH).

We analyzed twenty male alcohol dependant patients who were treated in the Department of Psychiatry in University Clinical Centre Tuzla during one year period (July 2007-July 2008), and to whom Computerized Tomography (CT) scan of neuro-cranium were done, according to age, war engagement, brain trauma, employment, smoking and presence of silent strokes and cerebral cortical atrophy. The results were analyzed using descriptive statistics.

Average age of the group of patients studied was 48.8±6.0 years, and 13/20 was hospitalized for the first time. Eleven of 20 were engaged as soldiers during the 1992-95 war in BH. Four of them were wounded and two of them had air-blast injury and head stroke without concussion. Fourteen of twenty were unemployed, and two of them were retired. Only one was admitted with alcoholic delirium. Eleven of twenty were cigarette smokers. Half of them had CT objectified silent stroke, and sixteen of twenty had generalized brain cortical atrophy. Brain cortical atrophy was significantly negatively associated with war engagement, while silent stroke were positively associated with age of patients.

Brain cortical atrophy and silent brain stroke are frequent findings in computerized tomography of the brain in psychiatric patients with alcohol dependency.

The aim of the study was to assess the frontal cortex functioning in schizophrenics and patients with paraphilia using CNV analysis in antisaccade paradigm.

9 paranoid schizophrenics, 13 patients with stereotyped forms of paraphilia, and 10 healthy subjects performed horizontal antisaccades. All participants were right-handed males. EEG was recorded from 19 sites. Mean amplitudes of slow negative potentials time-locked to peripheral target (CNV) were analyzed over two intervals: 1000-800 ms (early CNV), and 200-0 ms (late CNV) before peripheral target. Fixation period was 1200-1400 ms.

Significant increase of errors was revealed in patients with schizophrenia (13,6±4,4%) and parafilia (12,4±2,8%) compared to controls (4,1±1,0%). The significant between-group differences were obtained for the amplitude of early CNV, related to cognitive aspects of preparatory set. Bilateral frontal-central-parietal distribution of early CNV with a maximal amplitude at the saggital sites (Fz, Cz) was observed in control subjects. Significant decline of the CNV amplitude most pronounced in the saggital frontal region (Fz) was found in schizophrenics compared to controls. In patients with paraphilia the negativity zone didn't include central and parietal regions, but CNV amplitude at frontal sites didn't differ from control values.

The obtained results demonstrate that poor antisaccade performance was associated with different neural mechanisms in patients with schizophrenia and paraphilia.

The deficit of frontal activation was found in schizophrenic patients. Lack of the activation of central-parietal region in paraphilia group may reflect dysturbed interaction between cortical and subcortical systems involved in the executive regulation of behavior.

We wished to examine whether patterns of neural engagement during emotional processing could distinguish patients with Bipolar Disorder (BD) from their relatives with Major Depressive Disorder (MDD) and their psychiatrically healthy relatives.

Functional magnetic resonance imaging (fMRI) data were collected during a sad facial affect recognition task from 41 remitted BD patients, 40 of their first degree relatives (15 of whom had MDD) and 51 healthy controls. Data were analysed in SPM5.

1. A) Compared to controls, all individuals with genetic predisposition to BD showed increased activation in temporal lobe regions.

2. B) Compared to BD patients, MDD relatives had reduced activation in the left posterior cingulate (BA31) and the orbitofrontal cortex (BA11)

3. C) Compared to their healthy relatives, BD patients showed increased activation in somatosensory cortices bilaterally (BA3 and BA5) and in the posterior cingulate gyrus (BA30) on the left and reduced activation in the right cerebellum and the right inferior frontal gyrus (BA47).

4. D) Compared to their healthy relatives, MDD relatives showed reduced activation in the left superior frontal gyrus (BA10).

Our results suggest that:

1. (a) genetic predisposition to BD was associated with increased activation in distal nodes of the ventral visual pathway within the temporal lobe

2. (b) disease expression for mood disorders was associated with reduced neural responses in the PFC

3. (c) resilience in healthy relatives was associated with enhanced PFC engagement

4. (d) loci identified showed partial specificity for different clinical phenotypes indicative of partially segregated processes underpinning disease and resilience for mood disorders.

It is well known that brain activity associated with Go/NoGo tasks differed for normal children and those with ADHD, anxiety disorders, etc. Here, EEG mapping is used to study brain activity associated with Go/NoGo tasks in two populations of young healthy Brazilian (Fig. 1A) and German (Fig. 1B) children (4-6 year old).

Children (N=30) performed a child-oriented go-nogo task at the computer. We determined the entropy of the correlations between the EEG signal recorded by each electrode (10/20 system in Brazil, extended 10/20 system in Germany) as proposed elsewhere (Rocha et al. 2005) for 1000 ms epochs after the beginning of each trial.

Fig. 1

Factor Brain Mappings associated with solving Go/NoGo tasks in Brazilian (A) and German (B) children

Factor Analysis showed that the calculated entropy covaried among the frontal electrodes (Pattern F1); centro-temporal electrodes (Pattern F2) and the parieto-occiptal electrodes (Pattern F2) covariation in the two populations despite the different EEG recording systems.

Our spatial EEG approach revealed a Go/NoGo brain activity pattern similar to that recorded by adults in fMRI. In addition, the results were similar for two different populations of children and for two different recording systems. The EEG technology demonstrated here reliabl, cross cultural and cross technical robustness, when investigating young children from different cultures.

Attention is hypothesized to increase the brain's functional connectivity measured as EEG coherence between brain areas. Is this true for different types of attention compared to no-task resting?

In 25 healthy, meditation-naïve, right-handed, male students 58-channel EEG was recorded during three conditions of 5 minutes each with closed eyes in randomized order: (1) resting [3 runs], (2) mental arithmetic [2 runs], and (3) breath counting, a meditation initiation technique [2 runs]. For the 8 EEG frequency bands, the artifacted EEG was recomputed into sLORETA intracerebral current densities. To avoid localization ambiguities, we computed EEG coherence between sLORETA areas. To avoid effects of volume conduction, we computed intracerebral `lagged coherence' connectivity between sLORETA current densities in 19 areas. Averaged resting runs were compared to those breath counting and arithmetic runs of which participants post-hoc reported that their concentration was best.

Paired t-tests between conditions yielded differences of coherence at p< 0.1 (corrected for multiple testing) for 5 EEG frequency bands (delta, theta, alpha1, alpha2, beta3) [number of connections in brackets]: coherence was lower in breath counting than arithmetic (delta, beta3 [1,1]). Coherence was lower in resting than arithmetic (alpha2 [1]), but higher in resting than breath counting (theta, alpha1, alpha2, beta3 [2,1,1,1]).

Attention to breath counting showed lowest, to arithmetic highest demands on intracerebral functional connectivity. Breath counting and mental arithmetic induce mental states whose inter-area connectivity differs in opposite directions from resting. The results do not support a global hypothesis of increased coherence during attention.

Cocaine use is related to several cardiovascular conditions. Vasoconstriction seems to be particularly harmful to the brain.

To evaluate the relationship between the pattern of cocaine use and cerebral perfusion among cocaine addicts.

A sample of 30 cocaine addicts was studied using 99 m-Tc-HMPAO SPECT (single photon emission computed tomography with injection of 99 m-Tc-hexametilpropilenoamina-oxime). Their cerebral perfusion pattern was then compared with their pattern of cocaine use.

Eighty percent of the sample presented some degree of impairment in brain perfusion, either focal or diffuse. There was no difference between sniffers and crack smokers regarding their perfusion patterns. No relationship could be established between the severity of SPECT abnormalities and the amount of drug consumption or the duration of abstinence. However, duration of cocaine use did correlate with the severity of cerebral perfusion (Spearman correlation coefficient: r = 0.45, p < 0.05).

This study documents the high frequency of cerebral functional impairment in cocaine addicts and establishes the relationship between duration of cocaine exposure and severity of perfusion abnormalities.

Diffusion tensor imaging (DTI) is a relatively new imaging technique that is being increasingly used in different types of psychiatric patologies to characterize white matter microstructural organization in this kind of disorders. In the present study we use DTI to explore the structure of the white matter of borderline personality disorder (BPD) patients, using a novel voxel-based approach, tract-based spatial statistics (TBSS), to analyze the data.

DTI was performed in a 1.5T MRI unit in 9 young male patients with a DSM-IV defined BPD and 14 healthy male control subjects (no significant age difference between groups).Voxel wise analysis was performed using TBSS (diffusion toolbox of FSL- functional MRI Software Library) to localize regions of white matter showing significant changes of fractional anisotropy (FA). Additional high resolution three dimensional datasets were also acquired and normalised white matter volume was estimated with SIENAX (part of FSL).

The TBSS analysis revealed a statistically significant decrease in FA at the anterior part of the body and the genu of the corpus callosum and frontal white matter. This finding is consistent with previously reported findings of subtle prefrontal white matter abnormalities in BPD.

Significant white matter tract alterations in patients with BPD where observed in frontal regions involved in emotional, behavioural and cognitive regulation, and these abnormalities may be linked to key aspects of psychopatology in these patients.

Continuous arterial spin labelling (cASL) is a non-invasive magnetic resonance imaging method increasingly used to study human brain function and perfusion physiology.

In this study, we investigated distinct patterns of cerebral blood flow (CBF) in MDD patients by means of resting state cASL.

11 healthy controls and 11 patients with MDD according to DSM-IV criteria were included. The individual cASL images underwent data preprocessing steps including the generation of perfusion-weighted images, followed by conversion to quantified CBF. An analysis of temporally coherent CBF patterns was performed using a spatial Independent Component Analysis.

Both groups showed distinct blood flow patterns in a medial frontoparietal and lateral temporal component (“default mode” network), a medial temporal and anterior cingulate component (“limbic” network) and bilateral prefrontal and parietal component (“cognitive” network). Within the “limbic” network, MDD patients showed a pattern of increased CBF in the bilateral ventrolateral prefrontal, cingulate, striatal and hippocampal regions. Within the “cognitive” network, MDD patients showed a pattern of increased CBF in left dorsolateral prefrontal and the inferior parietal areas. Decreased perfusion in MDD patients was found in the right precuneus, the right inferior parietal cortex, the left posterior cingulate and the left lateral temporal cortex.

These preliminary data demonstrate the sensitivity of cASL techniques for detecting resting state CBF changes in MDD patients. Thus, cASL studies in MDD could provide valuable information with regard to neurobiologically characterized endophenotypes, while resting state CBF measures could serve as objective predictors of treatment response in future studies.

Heart disease mortality rates in persons with schizophrenia and bipolar disorder are greatly increased, compared to the general population. The objective was to assess the development during the period 1994 to 2006 of the heart disease mortality gap between persons with schizophrenia, bipolar disorder or other psychiatric disorders and the general population, evaluated in the light of rates of somatic hospitalization and invasive heart disease procedures.

Survival analysis was used to analyze heart disease mortality and somatic care trends in a cohort of all persons residing in Denmark.

Heart disease mortality in persons with schizophrenia remained on a high and stable level throughout the follow-up period, whereas cohort members without psychiatric disorders had declining heart disease mortality. The result is an increasing mortality gap with a significant mortality rate ratio trend equalling 1.12 with 95% CI (1.08, 1.15) for every second year. This was not the case for persons with bipolar disorder or other psychiatric disorders. Somatic hospitalization and invasive procedure were on a low level throughout the entire period, among persons with schizophrenia.

The reason for the widening of the mortality gap between persons with schizophrenia and the rest of the cohort members can be partly explained by the lack of improvement in treatment procedures, which is illustrated by the very low rates of invasive cardiac procedures. However, other reasons, such as antipsychotic-induced weight gain and difficulty following such advice as to stop smoking can also be part of the explanation.

To assess the efficacy of escitalopram, a selective inhibitor of serotonin reuptake, in the treatment of patients with fibromyalgia.

Ten patients with fibromyalgia were assessed prior to and after treatment with fixed-dose escitalopram 10 mg/d. Before initiation of pharmacotherapy, patients were interviewed with the Structured Clinical Interview for Axis I disorders in the Diagnostic and Statistical Manual of Mental Disorders, 4th edition. The study lasted for 12 weeks, and patients were evaluated in weeks 4, 8 and 12. The primary outcome measures were the Fibromyalgia Impact Questionnaire (FIQ) total score and pain score. The anxiety and depression levels of the patients were measured with the Beck Depression, the Beck Anxiety, the Hamilton Anxiety, and the Hamilton Depression scales.

There was a significant improvement in the mean intensity of pain (P< 0.01) and in the disability caused by fibromyalgia (P< 0.01) from baseline to week 12 of treatment. The depression and anxiety scores also decreased significantly from baseline to week 12. The improvement in the FIQ scores did not correlate with the decrease of scores in both patient- and physician-rated depression and anxiety inventories. Change in pain scores also was not correlated with the change in depression and anxiety scores.

Escitalopram was quite promising in alleviating the pain and disability associated with fibromyalgia. This effect seems to be independent of its anxiolytic and antidepressant properties.

Islam is being practiced in Chechnya. There are data about alcohol abuse of a certain part of the population in the Muslim countries contrary to religious interdictions. Alcoholic psychoses reflect level of alcohol abuse among the population. The purpose of the present research was to reveal interrelation between dynamics of alcohol abuse, alcoholic psychoses, social changes during the different periods: the period of operations, the postmilitary period and that of active social restoration.

392 case records of patients with psychoses from 2002 till 2008 inclusively are studied. The age, duration and kinds of psychoses, rates of formation of dependence on alcohol advanced in years, average stay of the patient on a cot were estimated. The relation of the population to alcohol was established by questioning of 4,500 persons. All data were compared with the number of patients delivered in a drunken state for the same years. Processing was made by program SPSS 12.0 Windows

Average stay on a cot annually decreased from 38,09 till 18,27 days. Duration of psychoses has decreased from 8,52 to 4,24. Fluctuation of number of the hospitalized patients had a correlation with the social phenomena in a society. In the process of normalization of situation in the republic the ratio of number of alcoholic psychoses to total number of hospitalized alcoholic patients decreases. The interrogated majority's attitude to alcohol abuse is negative.

There is a direct interrelation between the level of social stress, alcoholic psychoses, seriousness of their course and alcoholism growth.

Our study concerned 100 medical and paramedical staffs practicing in the HEDI CHAKER HOSPITAL, Sfax

A structured questionnaire was used to collect socio-demographic, somatic, psychiatric and the tobacco consumption data.

We also used Hospital-Anxiety and Depression Scale (HADS) and Rosenberg's self-esteem scale.

The population was consisted of 100 staffs of the health, distributed in two groups

Group 1 (n = 50), regular or occasional smokers

Group 2 (n = 50), no-smoking witnesses

The mean age was 30 years. Sex-ratio (H/F) was 1.

The smokers were single in 60%. They began to smoke in an average age of 16 years. Their motivations to smoke were mainly: curiosity (44%), decreasing stress (28%), searching pleasure (16%) and doing as the others (12%).

The smokers, compared with witnesses, consumed more alcohol and reported more stress factors (divorce of the parents, the frequent quarrels in the family, financial difficulties).

In our study, low self-esteem and anxiety were statistically correlated to the tobacco consumption (p=0.00).

It emerges from this work that the addiction to smoking in the medical and paramedical staff is frequently associated with traumatic events, anxious disorder and low self-esteem.

These shares will promote to inform our population for possibility of psychiatrical science and practice, to form normal relation for psychic patients, to pay the attention of power and public for questions of mental health of population and to consolidate mental health of nation.