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Article: More than words: Speech production in first-episode psychosis predicts later social and vocational functioning.

Mackinley, Michael / Limongi, Roberto / Silva, Angélica María / Richard, Julie / Subramanian, Priya / Ganjavi, Hooman / Palaniyappan, Lena

Frontiers in psychiatry

2023 Volume 14, Page(s) 1144281

Abstract: Background: Several disturbances in speech are present in psychosis; however, the relationship between these disturbances during the first-episode of psychosis (FEP) and later vocational functioning is unclear. Demonstrating this relationship is ... ...

Abstract	Background: Several disturbances in speech are present in psychosis; however, the relationship between these disturbances during the first-episode of psychosis (FEP) and later vocational functioning is unclear. Demonstrating this relationship is critical if we expect speech and communication deficits to emerge as targets for early intervention. Method: We analyzed three 1-min speech samples using automated speech analysis and Bayes networks in an antipsychotic-naive sample of 39 FEP patients and followed them longitudinally to determine their vocational status (engaged or not engaged in employment education or training-EET vs. NEET) after 6-12 months of treatment. Five baseline linguistic variables with prior evidence of clinical relevance (total and acausal connectives use, pronoun use, analytic thinking, and total words uttered in a limited period) were included in a Bayes network along with follow-up NEET status and Social and Occupational Functioning Assessment Scale (SOFAS) scores to determine dependencies among these variables. We also included clinical (Positive and Negative Syndrome Scale 8-item version (PANSS-8)), social (parental socioeconomic status), and cognitive features (processing speed) at the time of presentation as covariates. Results: The Bayes network revealed that only total words spoken at the baseline assessment were directly associated with later NEET status and had an indirect association with SOFAS, with a second set of dependencies emerging among the remaining linguistic variables. The primary (speech-only) model outperformed models including parental socioeconomic status, processing speed or both as latent variables. Conclusion: Impoverished speech, even at subclinical levels, may hold prognostic value for functional outcomes and warrant consideration when providing measurement based care for first-episode psychosis.
Language	English
Publishing date	2023-04-14
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2564218-2
ISSN	1664-0640
ISSN	1664-0640
DOI	10.3389/fpsyt.2023.1144281
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Article: Relationship between Freezing of Gait and Anxiety in Parkinson's Disease Patients: A Systemic Literature Review.

Witt, Ivan / Ganjavi, Hooman / MacDonald, Penny

Parkinson's disease

2019 Volume 2019, Page(s) 6836082

Abstract: Freezing of gait (FOG) is experienced by a significant number of patients with Parkinson's disease (PD). The pathophysiology of this disabling motor symptom remains unclear, and there are no effective therapies. Anxiety has previously been posited as a ... ...

Abstract	Freezing of gait (FOG) is experienced by a significant number of patients with Parkinson's disease (PD). The pathophysiology of this disabling motor symptom remains unclear, and there are no effective therapies. Anxiety has previously been posited as a contributing factor to gait freezing. There have been few studies directly investigating this topic, and a comprehensive literature review is lacking. The objective of this paper was to systematically review the evidence associating anxiety with the presence, severity, and progression of FOG in PD patients. The PubMed, EMBASE, and PsycINFO databases were searched up to September 19, 2018, for English-language, peer-reviewed articles that explored anxiety and FOG as outcome measures in a PD population base. Review articles, case reports, and articles that assessed gait disorders other than FOG were excluded, yielding a total of 26 articles in the final analysis. Of these 26 studies, 16 had a significant relationship between anxiety outcome measure and either presence or severity of FOG. There was great variability among studies in terms of outcome measures for both FOG and anxiety. Despite this heterogeneity, most studies relate anxiety and FOG. Standardized, high-validity outcome measures of anxiety and FOG are needed. Future exploration should aim to clarify the role of anxiety in FOG as a causal factor, pathophysiological marker, and manifestation of a common pathophysiological process versus a consequence of FOG itself. Clarifying the relationship between anxiety and FOG could reveal anxiety reduction as a therapy for FOG.
Language	English
Publishing date	2019-07-24
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	2573854-9
ISSN	2042-0080 ; 2090-8083
ISSN (online)	2042-0080
ISSN	2090-8083
DOI	10.1155/2019/6836082
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Article ; Online: Levodopa has mood-enhancing effects in healthy elderly adults.

Vo, Andrew / Ganjavi, Hooman / MacDonald, Penny A

International journal of geriatric psychiatry

2018 Volume 33, Issue 4, Page(s) 674–675

MeSH term(s)	Affect/drug effects ; Aged ; Antiparkinson Agents/pharmacology ; Antiparkinson Agents/therapeutic use ; Anxiety/drug therapy ; Apathy/drug effects ; Female ; Humans ; Levodopa/pharmacology ; Levodopa/therapeutic use ; Male ; Middle Aged ; Parkinson Disease/drug therapy ; Parkinson Disease/psychology
Chemical Substances	Antiparkinson Agents ; Levodopa (46627O600J)
Language	English
Publishing date	2018-04-18
Publishing country	England
Document type	Letter ; Research Support, Non-U.S. Gov't
ZDB-ID	806736-3
ISSN	1099-1166 ; 0885-6230
ISSN (online)	1099-1166
ISSN	0885-6230
DOI	10.1002/gps.4824
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Article ; Online: Subregional analysis of striatum iron in Parkinson's disease and rapid eye movement sleep behaviour disorder.

Alushaj, Erind / Hemachandra, Dimuthu / Kuurstra, Alan / Menon, Ravi S / Ganjavi, Hooman / Sharma, Manas / Kashgari, Alia / Barr, Jennifer / Reisman, William / Khan, Ali R / MacDonald, Penny A

NeuroImage. Clinical

2023 Volume 40, Page(s) 103519

Abstract: The loss of dopamine in the striatum underlies motor symptoms of Parkinson's disease (PD). Rapid eye movement sleep behaviour disorder (RBD) is considered prodromal PD and has shown similar neural changes in the striatum. Alterations in brain iron ... ...

Abstract	The loss of dopamine in the striatum underlies motor symptoms of Parkinson's disease (PD). Rapid eye movement sleep behaviour disorder (RBD) is considered prodromal PD and has shown similar neural changes in the striatum. Alterations in brain iron suggest neurodegeneration; however, the literature on striatal iron has been inconsistent in PD and scant in RBD. Toward clarifying pathophysiological changes in PD and RBD, and uncovering possible biomarkers, we imaged 26 early-stage PD patients, 16 RBD patients, and 39 age-matched healthy controls with 3 T MRI. We compared mean susceptibility using quantitative susceptibility mapping (QSM) in the standard striatum (caudate, putamen, and nucleus accumbens) and tractography-parcellated striatum. Diffusion MRI permitted parcellation of the striatum into seven subregions based on the cortical areas of maximal connectivity from the Tziortzi atlas. No significant differences in mean susceptibility were found in the standard striatum anatomy. For the parcellated striatum, the caudal motor subregion, the most affected region in PD, showed lower iron levels compared to healthy controls. Receiver operating characteristic curves using mean susceptibility in the caudal motor striatum showed a good diagnostic accuracy of 0.80 when classifying early-stage PD from healthy controls. This study highlights that tractography-based parcellation of the striatum could enhance sensitivity to changes in iron levels, which have not been consistent in the PD literature. The decreased caudal motor striatum iron was sufficiently sensitive to PD, but not RBD. QSM in the striatum could contribute to development of a multivariate or multimodal biomarker of early-stage PD, but further work in larger datasets is needed to confirm its utility in prodromal groups.
MeSH term(s)	Humans ; REM Sleep Behavior Disorder/diagnostic imaging ; Parkinson Disease/diagnostic imaging ; Iron ; Corpus Striatum/diagnostic imaging ; Brain
Chemical Substances	Iron (E1UOL152H7)
Language	English
Publishing date	2023-09-28
Publishing country	Netherlands
Document type	Journal Article
ZDB-ID	2701571-3
ISSN	2213-1582 ; 2213-1582
ISSN (online)	2213-1582
ISSN	2213-1582
DOI	10.1016/j.nicl.2023.103519
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Article: Striatum-Mediated Deficits in Stimulus-Response Learning and Decision-Making in OCD.

Hiebert, Nole M / Lawrence, Marc R / Ganjavi, Hooman / Watling, Mark / Owen, Adrian M / Seergobin, Ken N / MacDonald, Penny A

Frontiers in psychiatry

2020 Volume 11, Page(s) 13

Abstract: Obsessive compulsive disorder (OCD) is a prevalent psychiatric disorder characterized by obsessions and compulsions. Studies investigating symptomatology and cognitive deficits in OCD frequently implicate the striatum. The aim of this study was to ... ...

Abstract	Obsessive compulsive disorder (OCD) is a prevalent psychiatric disorder characterized by obsessions and compulsions. Studies investigating symptomatology and cognitive deficits in OCD frequently implicate the striatum. The aim of this study was to explore striatum-mediated cognitive deficits in patients with OCD as they complete a stimulus-response learning task previously shown to differentially rely on the dorsal (DS) and ventral striatum (VS). We hypothesized that patients with OCD will show both impaired decision-making and learning, coupled with reduced task-relevant activity in DS and VS, respectively, compared to healthy controls. We found that patients with OCD (n = 14) exhibited decision-making deficits and learned associations slower compared to healthy age-matched controls (n = 16). Along with these behavioral deficits, OCD patients had reduced task-relevant activity in DS and VS, compared to controls. This study reveals that responses in DS and VS are altered in OCD, and sheds light on the cognitive deficits and symptoms experienced by patients with OCD.
Language	English
Publishing date	2020-02-05
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2564218-2
ISSN	1664-0640
ISSN	1664-0640
DOI	10.3389/fpsyt.2020.00013
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Article ; Online: ON-OFF Effects of Dopaminergic Therapy on Psychiatric Symptoms in Parkinson's Disease.

Ganjavi, Hooman / MacDonald, Penny A

The Journal of neuropsychiatry and clinical neurosciences

2015 Volume 27, Issue 2, Page(s) e134–9

Abstract: Psychiatric manifestations of Parkinson's disease (PD) are a cause of significant disability and the impact of dopaminergic medications is unclear. Using standardized rating scales, the authors tested the hypothesis that anxiety, depression, and apathy ... ...

Abstract	Psychiatric manifestations of Parkinson's disease (PD) are a cause of significant disability and the impact of dopaminergic medications is unclear. Using standardized rating scales, the authors tested the hypothesis that anxiety, depression, and apathy vary in the ON versus OFF states in PD in 33 PD patients and 29 healthy age- and education-matched controls. PD patients had significantly higher anxiety, depression, and apathy scores than control participants, regardless of ON-OFF state. Anxiety scores were higher in PD patients on relative to off dopaminergic medication. The ON-OFF difference in anxiety related to degree of improvement in motor function but not illness duration.
MeSH term(s)	Aged ; Analysis of Variance ; Antipsychotic Agents/therapeutic use ; Case-Control Studies ; Dopamine Agents/therapeutic use ; Female ; Humans ; Male ; Middle Aged ; Parkinson Disease/complications ; Psychiatric Status Rating Scales ; Psychotic Disorders/drug therapy ; Psychotic Disorders/etiology
Chemical Substances	Antipsychotic Agents ; Dopamine Agents
Language	English
Publishing date	2015
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	1036340-3
ISSN	1545-7222 ; 0895-0172
ISSN (online)	1545-7222
ISSN	0895-0172
DOI	10.1176/appi.neuropsych.14030055
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Zs.A 2633: Show issues

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ab Jg. 2022: Lesesaal (EG)

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Article ; Online: Dorsal striatum does not mediate feedback-based, stimulus-response learning: An event-related fMRI study in patients with Parkinson's disease tested on and off dopaminergic therapy.

Hiebert, Nole M / Owen, Adrian M / Ganjavi, Hooman / Mendonça, Daniel / Jenkins, Mary E / Seergobin, Ken N / MacDonald, Penny A

NeuroImage

2018 Volume 185, Page(s) 455–470

Abstract: Learning associations between stimuli and responses is essential to everyday life. Dorsal striatum (DS) has long been implicated in stimulus-response learning, though recent results challenge this contention. We have proposed that discrepant findings ... ...

Abstract	Learning associations between stimuli and responses is essential to everyday life. Dorsal striatum (DS) has long been implicated in stimulus-response learning, though recent results challenge this contention. We have proposed that discrepant findings arise because stimulus-response learning methodology generally confounds learning and response selection processes. In 19 patients with Parkinson's disease (PD) and 18 age-matched controls, we found that dopaminergic therapy decreased the efficiency of stimulus-response learning, with corresponding attenuation of ventral striatum (VS) activation. In contrast, exogenous dopamine improved response selection accuracy related to enhanced DS BOLD signal. Contrasts between PD patients and controls fully support these within-subject patterns. These double dissociations in terms of behaviour and neural activity related to VS and DS in PD and in response to dopaminergic therapy, strongly refute the view that DS mediates stimulus-response learning through feedback. Our findings integrate with a growing literature favouring a role for DS in decision making rather than learning, and unite two literature that have been evolving independently.
MeSH term(s)	Aged ; Antiparkinson Agents/therapeutic use ; Association Learning/drug effects ; Association Learning/physiology ; Brain Mapping/methods ; Corpus Striatum/drug effects ; Corpus Striatum/physiopathology ; Decision Making/drug effects ; Decision Making/physiology ; Evoked Potentials/drug effects ; Evoked Potentials/physiology ; Female ; Formative Feedback ; Humans ; Levodopa/therapeutic use ; Magnetic Resonance Imaging ; Male ; Parkinson Disease/drug therapy ; Parkinson Disease/physiopathology ; Parkinson Disease/psychology
Chemical Substances	Antiparkinson Agents ; Levodopa (46627O600J)
Language	English
Publishing date	2018-10-27
Publishing country	United States
Document type	Journal Article ; Randomized Controlled Trial ; Research Support, Non-U.S. Gov't
ZDB-ID	1147767-2
ISSN	1095-9572 ; 1053-8119
ISSN (online)	1095-9572
ISSN	1053-8119
DOI	10.1016/j.neuroimage.2018.10.045
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Zs.MO 7: Show issues

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Article ; Online: A fourth case of Feingold syndrome type 2: psychiatric presentation and management.

Ganjavi, Hooman / Siu, Victoria Mok / Speevak, Marsha / MacDonald, Penny Anne

BMJ case reports

2014 Volume 2014

Abstract: Feingold syndrome (FGLDS1) is an autosomal dominant disorder caused by mutations in the MYCN oncogene on the short arm of chromosome 2 (2p24.1). It is characterised by microcephaly, digital abnormalities, oesophageal and duodenal atresias, and often ... ...

Abstract	Feingold syndrome (FGLDS1) is an autosomal dominant disorder caused by mutations in the MYCN oncogene on the short arm of chromosome 2 (2p24.1). It is characterised by microcephaly, digital abnormalities, oesophageal and duodenal atresias, and often learning disability or mental retardation. In 2011, individuals sharing the skeletal abnormalities of FGLDS1 but lacking mutations in MYCN, were found to harbour hemizygous deletions of the MIR17HG gene on chromosome 13q31.3. These individuals share many of the characteristics of FGLDS1 except for gastrointestinal atresia. The condition was termed Feingold syndrome type 2 (FGLDS2). We describe the presentation and management of a fourth known case of FGLDS2 in an 18-year-old girl with microcephaly, short stature, mildly dysmorphic features, digital malformations and significant cognitive and psychiatric symptoms. Comparative genomic hybridisation array testing confirmed a 7.4 Mb microdeletion in chromosome region 13q31.1q.31.3 corresponding to the MIR17HG gene.
MeSH term(s)	Adolescent ; Antipsychotic Agents/therapeutic use ; Anxiety Disorders/complications ; Anxiety Disorders/diagnosis ; Anxiety Disorders/drug therapy ; Eyelids/abnormalities ; Female ; Follow-Up Studies ; Humans ; Intellectual Disability/complications ; Intellectual Disability/diagnosis ; Intellectual Disability/therapy ; Limb Deformities, Congenital/complications ; Limb Deformities, Congenital/diagnosis ; Limb Deformities, Congenital/therapy ; Microcephaly/complications ; Microcephaly/diagnosis ; Microcephaly/therapy ; Mood Disorders/complications ; Mood Disorders/diagnosis ; Mood Disorders/drug therapy ; Obsessive-Compulsive Disorder/complications ; Obsessive-Compulsive Disorder/diagnosis ; Obsessive-Compulsive Disorder/drug therapy ; Rare Diseases ; Risk Assessment ; Severity of Illness Index ; Tracheoesophageal Fistula/complications ; Tracheoesophageal Fistula/diagnosis ; Tracheoesophageal Fistula/therapy
Chemical Substances	Antipsychotic Agents
Language	English
Publishing date	2014-11-12
Publishing country	England
Document type	Case Reports ; Journal Article ; Review
ISSN	1757-790X
ISSN (online)	1757-790X
DOI	10.1136/bcr-2014-207501
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Article ; Online: Burning pain secondary to clozapine use: a case report.

Linton, Bradley / Fu, Rachel / MacDonald, Penny A / Ganjavi, Hooman

BMC psychiatry

2014 Volume 14, Page(s) 299

Abstract: Background: The first of the atypical antipsychotics introduced in the 1970s, clozapine remains the most efficacious neuroleptic to this day. However, serious and potentially fatal side effects have necessitated careful regular monitoring among ... ...

Abstract	Background: The first of the atypical antipsychotics introduced in the 1970s, clozapine remains the most efficacious neuroleptic to this day. However, serious and potentially fatal side effects have necessitated careful regular monitoring among prescribing clinicians. Some adverse effects (e.g. ischaemic bowel) remain under recognized, while newly identified adverse effects continue to be described in the literature. Case presentation: In this report, we describe a healthy 43-year old Caucasian male who experienced onset of a full body deep burning pain several months after the onset of treatment with clozapine. The pain worsened over time, ceased with cessation of treatment, and returned soon after the patient was rechallenged. Conclusion: We describe an unusual adverse effect from clozapine treatment that has not been described elsewhere to our knowledge. We present the time course of the pain symptom, relationship to dose, associated laboratory results, and ultimately how it was dealt with and how it improved for the benefit of clinicians who may encounter it in the future.
MeSH term(s)	Adult ; Antipsychotic Agents/adverse effects ; Antipsychotic Agents/therapeutic use ; Clozapine/adverse effects ; Clozapine/therapeutic use ; Depressive Disorder, Major/drug therapy ; Humans ; Male ; Pain/chemically induced ; Psychotic Disorders/drug therapy
Chemical Substances	Antipsychotic Agents ; Clozapine (J60AR2IKIC)
Language	English
Publishing date	2014-10-23
Publishing country	England
Document type	Case Reports ; Journal Article
ISSN	1471-244X
ISSN (online)	1471-244X
DOI	10.1186/s12888-014-0299-3
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Article: Assessing trauma in a transcultural context: challenges in mental health care with immigrants and refugees.

Wylie, Lloy / Van Meyel, Rita / Harder, Heather / Sukhera, Javeed / Luc, Cathy / Ganjavi, Hooman / Elfakhani, Mohamad / Wardrop, Nancy

Public health reviews

2018 Volume 39, Page(s) 22

Abstract: The growing numbers of refugees and immigrants from conflict-prone areas settling throughout the world bring several challenges for those working in the mental health care system. Immigrants and refugees of all ages arrive with complex and nuanced mental ...

Abstract	The growing numbers of refugees and immigrants from conflict-prone areas settling throughout the world bring several challenges for those working in the mental health care system. Immigrants and refugees of all ages arrive with complex and nuanced mental health histories of war, torture, and strenuous migration journeys. Many of the challenges of addressing the health care needs for this growing population of immigrants and refugees are often unfamiliar, and thus practices to address these challenges are not yet routine for care providers and health care organizations. In particular, complex trauma can make mental health assessments difficult for health care organizations or care providers with limited experience and training in transcultural or trauma-informed care. Using a transcultural approach can improve assessment and screening processes, leading to more effective and high-quality care for immigrant and refugee families experiencing mental health disorders. This paper presents findings from an assessment of current mental health services focusing on current practices and experiences with immigrant and refugee patients and families. The difficulties in developing shared understandings about mental health can hinder the therapeutic process; therefore, it is imperative to ensure an effective assessment right from the beginning, yet there is limited use of existing cultural formulation tools from the DSM-IV or DSM-5. The paper outlines current practices, approaches, challenges, and recommendations shared by mental health care providers and program leaders in addressing the mental health care needs of immigrants and refugees. The results from this study demonstrate that there are many challenges and inconsistencies in providing transcultural, trauma-informed care. Respondents emphasized the need for a thorough yet flexible and adaptive approach that allows for an exploration of differences in cultural interpretations of mental health. Our study concluded that ensuring a mindful, reflexive, transcultural, and trauma-informed health care workforce, and a learning environment to support staff with education, resources, and tools will improve the health care experiences of immigrants and refugees in the mental health care system.
Language	English
Publishing date	2018-08-22
Publishing country	England
Document type	Journal Article ; Review
ZDB-ID	217531-9
ISSN	2107-6952 ; 0301-0422
ISSN (online)	2107-6952
ISSN	0301-0422
DOI	10.1186/s40985-018-0102-y
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