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Altered thalamic subregion functional networks in patients with treatment-resistant schizophrenia

World Journal of Psychiatry 2022年第5期12卷 693-707页

作者： Woo-Sung Kim Jie Shen Uyanga Tsogt Soyolsaikhan Odkhuu Young-Chul Chung Department of Psychiatry Jeonbuk National UniversityJeon-ju 54907South Korea

BACKGROUND The thalamus plays a key role in filtering information and has extensive interconnectivity with other brain regions.A large body of evidence points to impaired functional connectivity(FC)of the thalamocortical pathway in ***,the functional network of the thalamic subregions has not been investigated in patients with treatment-resistant schizophrenia(TRS).AIM To identify the neural mechanisms underlying TRS,we investigated FC of thalamic sub-regions with cortical networks and voxels,and the associations of this FC with clinical *** hypothesized that the FC of thalamic subregions with cortical networks and voxels would differ between TRS patients and *** In total,50 patients with TRS and 61 healthy controls(HCs)matched for age,sex,and education underwent resting-state functional magnetic resonance imaging(rs-fMRI)and clinical *** on the rs-fMRI data,we conducted a FC analysis between thalamic subregions and cortical functional networks and voxels,and within thalamic subregions and cortical functional networks,in the patients with TRS.A functional parcellation atlas was used to segment the thalamus into nine *** between altered FC and TRS symptoms were *** We found differences in FC within thalamic subregions and cortical functional networks between patients with TRS and *** addition,increased FC was observed between thalamic subregions and the sensorimotor cortex,frontal medial cortex,and lingual *** abnormalities were associated with the pathophysiology of *** Our findings suggest that disrupted FC within thalamic subregions and cortical functional networks,and within the thalamocortical pathway,has potential as a marker for *** findings also improve our understanding of the relationship between the thalamocortical pathway and TRS symptoms.

关键词： treatment-resistant schizophrenia Thalamus Rs-fMRI Functional connectivity Thalamocortical pathway

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Difference between treatment-resistant schizophrenia and clozapineresistant schizophrenia

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World Journal of Psychiatry 2022年第8期12卷 1102-1104页

作者： Ping-Tao Tseng Mu-Hong Chen Chih-Sung Liang Institute of Biomedical Sciences National Sun Yat-Sen UniversityKaohsiung 804Taiwan Department of Psychiatry Taipei Veterans General HospitalTaipei 112Taiwan Department of Psychiatry Beitou BranchTri-Service General HospitalNational Defense Medical CenterTaipei 112Taiwan

We read the impressive review article“Clozapine resistant schizophrenia:Newer avenues of management”with great enthusiasm and *** author believes that preventing clozapine resistance from developing may be the most effective treatment strategy for patients with clozapine-resistant schizophrenia(CRS),and optimizing clozapine treatment is a key *** the differences between treatment-resistant schizophrenia and CRS is important for studies addressing treatment strategies for these difficult-to-treat populations.

关键词： treatment-resistant schizophrenia Clozapine Clozapine-resistant schizophrenia Ultra-resistant schizophrenia Ultra-treatment-resistant schizophrenia Superrefractory schizophrenia

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Case Reports: treatment-resistant schizophrenia with Severe Type 2 Diabetes Mellitus Treated with Clozapine

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Open Journal of Psychiatry 2016年第1期6卷 61-64页

作者： Junji Gon Shinji Sakamoto Manabu Takaki Department of Neuropsychiatry Okayama University Graduate School of Medicine Okayama Japan

Objective: Clozapine is regarded as the most effective drug for treatment of schizophrenia but has complex adverse effects associated with hyperglycemia and diabetes mellitus. Method: We report that clozapine was very effective to treat positive, negative, and cognitive symptoms and well tolerated to a treatment-resistant schizophrenia patient with severe type 2 diabetes mellitus (DM) under cautious blood-sugar monitoring. Results: Clozapine itself and discontinuation of other psychotropic and anticholinergic agents after switching may improve cognitive function and adherence to the treatment regimens for schizophrenia and DM. Conclusion: Clozapine can be administered to treatment-resistant schizophrenia patients even with severe DM with caution.

关键词： Clozapine treatment-resistant schizophrenia Type 2 Diabetes Mellitus Brief Assessment of Cognition in schizophrenia Japanese Version

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Low-dose clozapine-related seizure: A case report and literature review

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World Journal of Clinical Cases 2021年第20期9卷 5611-5620页

作者： Dan-Sheng Le Heng Su Zheng-Luan Liao En-Yan Yu The Second Clinical Medical College Zhejiang Chinese Medicine UniversityHangzhou 310051Zhejiang ProvinceChina Department of Psychiatry Zhejiang Provincial People’s HospitalHangzhou 310000Zhejiang ProvinceChina Department of Psychiatry The Cancer Hospital of the University of Chinese Academy of Sciences(Zhejiang Cancer Hospital)Institute of Basic Medicine and CancerChinese Academy of SciencesHangzhou 310022Zhejiang ProvinceChina

BACKGROUND treatment-resistant schizophrenia is a severe form of schizophrenia characterized by poor response to at least two antipsychotic drugs and is typically treated with ***,clozapine lowers the epileptic threshold,leading to seizures,which are severe side effects of antipsychotics that result in multiple ***-related seizures are generally considered to be dose-dependent and especially rare in the low-dose(150-300 mg/d)clozapine treated *** to clinical rarity,little is known about its clinical characteristics and *** SUMMARY A 62-year-old Chinese man with a 40-year history of treatment-resistant schizophrenia presented to the Emergency Department with symptoms of myoclonus,consciousness disturbance and vomiting after taking 125 mg *** admission,the patient had a suddenly generalized tonic-clonic seizure lasting for about half a minute with persistent disturbance of consciousness,fever,cough and bloody sputum,which was considered to be low-dose clozapine-related *** antiepileptic and multiple anti-infection treatments,the patient was discharged without epileptic or psychotic *** Our aim is to highlight the early prevention and optimal treatment of clozapine related seizure through case analysis and literature review.

关键词： Seizure treatment-resistant schizophrenia Antipsychotic Antiepileptic Electroconvulsive therapy Case report

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