Open Access Short Research Article

Gamma Transcranial Alternating Current Stimulation Improves Craving and Cognition in Patients with Alcohol Use Disorder: An Open Label Pilot Study

Nikolas Haller, Ulrike Kumpf, Gabi Koller, Frank Padberg, Ulrich Palm

International Neuropsychiatric Disease Journal, Page 37-50
DOI: 10.9734/indj/2022/v17i430211

Objective: Alcohol use disorder (AUD) is one of the most common psychiatric disorders worldwide. It often shows a chronic course, and pharmacological treatment is rather ineffective for maintaining abstinence. New non-invasive brain stimulation techniques could help to improve AUD symptoms by rebalancing and synchronizing the disturbed prefrontal brain function and thus reduce craving. This study aims at evaluating the use of gamma transcranial alternating current stimulation to improve clinical und neuropsychological symptoms in patients with AUD.

Methods: In this small open label study, six patients suffering from AUD for several years underwent treatment with prefrontal gamma transcranial alternating current stimulation for 10 min twice daily respectively 20 min once per day for 10 days. Clinical and neuropsychological tests as well as craving were assessed over the course of treatment.

Results: Scores of the Alcohol Craving Questionnaire decreased in all patients and cognitive functions assessed by word fluency and computer-based n-back test improved.

Conclusions: This new non-invasive brain stimulation technique could be of interest in treating craving symptoms and in maintaining abstinence.

Open Access Original Research Article

Early Detection of White Matter Changes with Cognitive Decline in Parkinson's Patients

Shimaa Ahmed Ibrahim Elgamal, Maha Hazem Khalil, Omar Abd-Elsalam Ahmed, Adel Galal El-Badrawy, Ahmed Esmael, Shady Khalil El-Rashedy, Tamer Mohamed Ebrahim Belal

International Neuropsychiatric Disease Journal, Page 8-17
DOI: 10.9734/indj/2022/v17i430208

Objective: The aim of this study was to detect changes in white matter in patients with Parkinson's disease applied by diffusion tensor imaging to predict cognitive impairment.

Methods: Montreal cognitive assessment was applied to 50 Parkinson's disease patients to confirm cognitive decline (M: F = 41:9; age: 62.72±9.07 years) and to 20 Parkinson's disease patients with no cognitive impairment as a control (M: F =13:7; age 58.95±11.22). All patients underwent disease severity testing by using Modified Hoehn and Yahr Scale, Unified Parkinson disease rating scale and Diffusion tensor imaging (DTI) for the corpus callosum and cingulum including their involved parts to define affected tracts.

Results: In PD with cognitive impairment subjects, the cognitive affection correlated with abnormal DTI parameters of the corpus callosum and cingulum. There were FA or MD differences in both the corpus callosum and cingulum pathways. These findings were independent of age, sex and total white matter volume.

Conclusion: Patients with Parkinson's disease associated with cognition decline are detected by tractography changes of the corpus callosum and cingulum.

Open Access Original Research Article

The Efficacy of an Oral Diazepam Based Protocol in Improving Care and Reducing Duration of Hospitalization in Alcohol Withdrawal

John Chronakos, Aashutosh Ramakar, Rutvik Shah, Ahmad Alharbi, Rahila Ogunnaike, Eman Hurissi

International Neuropsychiatric Disease Journal, Page 18-24
DOI: 10.9734/indj/2022/v17i430209

Background: Complications from alcohol abuse are the fourth leading preventable cause of death in the United States. Hospital length of stay (LOS) for patients experiencing alcohol withdrawal syndrome (AWS) has become of particular concern and effective treatment protocols are needed. 

Objective: At Danbury Hospital, a 371-bed community hospital in Danbury, Connecticut, the average LOS for AWS was historically nine days. We therefore designed a protocol for the treatment of AWS to provide effective treatment and thereby reduce LOS.

Design: Our study was a single centre, retrospective observational study of patients who were admitted to Danbury Hospital with a diagnosis of AWS.

Setting:  Danbury Hospital.

Subjects and Methods: A total of 307 patients were included in this study. All patients 18 years and older admitted to Danbury Hospital between June 2015 and December 2016, with a primary diagnosis of AWS were included. A loading dose regimen was used whereby 20mg of oral Diazepam was given hourly for a total of eight doses within the first 24 hours until clinical improvement or mild sedation was achieved. The comparison group consisted of patients treated with a symptom-triggered regimen using Lorazepam.

We compared the primary outcome of LOS and secondary outcomes including need for transfer to a critical care unit, restraint use for aggressive behaviour related to withdrawal, the need for a safety companion, and the need for Psychiatry consultation between the two groups.

Main Outcome Measures:  Hospital length of stay for patients experiencing alcohol withdrawal syndrome.

Results: In the Diazepam group versus the comparison group, LOS was reduced to about four days, and fewer Psychiatry consultations were needed. 

Conclusion: We conclude that a loading dose regimen of Diazepam may be used to safely reduce LOS in AWS patients.

Open Access Original Research Article

Prevalence of Depression, Problematic Drinking and their Correlates among University Students in Southwest Nigeria

Taiwo Alatishe, Olaitan Oladele, Babatunde Suleiman, Adeoye Oyewole, Samson Ojedokun, Taiwo Oloyede, Olanike Oladibu

International Neuropsychiatric Disease Journal, Page 25-36
DOI: 10.9734/indj/2022/v17i430210

Aim: To determine the prevalence and correlations of depression and problematic drinking among undergraduates in a Nigerian University.

Study Design: The study design was a descriptive cross-sectional survey

Methodology: The study was conducted among 412 full-time undergraduates of LAUTECH, 18 years and above and apparently well without previous history of mental illness. Alcohol Use Disorder Identification Test (AUDIT) and Patient Health Questionnaire-9 (PHQ-9) are instruments used for the study. Data analysis was done with the statistical package for social sciences version 21.

Results: Approximately half (49.5%) of the respondents were depressed and 20.4% of them had major depression. The prevalence of problematic alcohol use in the study population was 10.4% mostly among males. There was no significant association between depression, alcohol use and problematic alcohol use (χ2 = 1.125, df = 1, P-value = 0.289) in the study sample.

Conclusion: The increasing prevalence of depression and problematic drinking among university students is worrisome as this will not only adversely impact their academic performance but future productivity and the risk of other psychosocial and health problems.

Open Access Review Article

Extrapyramidal Symptoms and Novel Antipsychotic Drugs

M. O. Nwokike, S. I. Ghasi, A. O. Ogbonna, M. N. Ezenwaeze, A. C. Ezinwa

International Neuropsychiatric Disease Journal, Page 1-7
DOI: 10.9734/indj/2022/v17i430207

One of the challenges of antipsychotic medication is the occurrence of Extrapyramidal Symptoms. These cannot be easily eliminated considering the pathophysiology of schizophrenia and the established mechanism of action of classical antipsychotics. The antipsychotics help improve symptoms of schizophrenia by binding to dopamine receptors in the central nervous system and blocking dopamine. This prevents the basal ganglia from getting enough dopamine. Many drugs used in the treatment of mental disorders such as the neuroleptics and antidepressants adversely affect extrapyramidal system function, resulting in symptoms such as tremors and muscle rigidity collectively known as extrapyramidal symptoms. Treatment generally involves lowering the dose or trying a different antipsychotic but drugs may also be used specifically to treat symptoms. This review examines the attempt to eliminate extrapyramidal symptoms by generations of antipsychotic medications and their comparative efficacy in the treatment of schizophrenia. A wide internet search was carried out using keywords and phrases that include; Antipsychotics, Typical Antipsychotics, Atypical Antipsychotics, Dopaminergic, Extrapyramidal symptoms, comparative efficacy of Antipsychotics and Adverse Effect of Antipsychotics. This will further reinforce knowledge and prescription patterns for antipsychotic medications.