Faculty Bibliography

OBJECTIVES: The aim of the present study was to systematically evaluate the prodrome to mania in youth. METHODS: New-onset/worsening symptoms/signs of >/= moderate severity preceding first mania were systematically assessed in 52 youth (16.2 +/- 2.8 years) with a research diagnosis of bipolar I disorder (BD-I). Youth and/or caregivers underwent semi-structured interviews, using the Bipolar Prodrome Symptom Scale-Retrospective. RESULTS: The mania prodrome was reported to start gradually in most youth (88.5%), with either slow (59.6%) or rapid (28.8%) deterioration, while a rapid-onset-and-deterioration prodrome was rare (11.5%). The manic prodrome, conservatively defined as requiring >/= 3 symptoms, lasted 10.3 +/- 14.4 months [95% confidence interval (CI): 6.3-14.4], being present for >/= 4 months in 65.4% of subjects. Among prodromal symptoms reported in >/= 50% of youth, three were subthreshold manic in nature (irritability: 61.5%, racing thoughts: 59.6%, increased energy/activity: 50.0%), two were nonspecific (decreased school/work functioning: 65.4%, mood swings/lability: 57.7%), and one each was depressive (depressed mood: 53.8%) or subthreshold manic/depressive (inattention: 51.9%). A decreasing number of youth had >/= 1 (84.6%), >/= 2 (48.1%), or >/= 3 (26.9%) 'specific' subthreshold mania symptoms (i.e., elation, grandiosity, decreased need for sleep, racing thoughts, or hypersexuality), lasting 9.5 +/- 14.9 months (95% CI: 5.0-14.0), 3.5 +/- 3.5 months (95% CI: 2.0-4.9), and 3.0 +/- 3.2 months (95% CI: 1.0-5.0) for >/= 1, >/= 2, or >/= 3 specific symptoms, respectively. CONCLUSIONS: In youth with BD-I, a relatively long, predominantly slow-onset mania prodrome appears to be common, including subthreshold manic and depressive psychopathology symptoms. This suggests that early clinical identification and intervention may be feasible in bipolar disorder. Identifying biological markers associated with clinical symptoms of impending mania may help to increase chances for early detection and prevention before full mania.

Reviews the book, Essentials of Autism Spectrum Disorders Evaluation and Assessment by Celine A. Saulnier and Pamela E. Ventola (see record 2012-17480-000). This book is really designed to help busy mental health professionals quickly acquire the knowledge and references they need to make optimal use of the major psychological assessment tests or test results for patients with autism spectrum disorders (ASD). Different parts in the book are devoted to a particular field, and they use an easy-to-follow format for rapid reference. The first part of the book describing the spectrum disorders in detail and the differences among the various diagnoses, and also explains the DSM change in Asperger's syndrome. Another part of the book clearly lays out a lot of the basic types of assessments for developmental, cognitive, behavioral, and neuropsychological profiles, and explains briefly and smoothly the purpose of each of these categories. Overall, the book is an ideal addition to a busy clinical practice, as an informative and easy-to-read book for clinicians or student clinicians who assess or work with children with ASD, and a useful supplement to any arsenal of books on assessment.

The timing of olfactory behavioral decisions may provide an important source of information about how the human olfactory-perceptual system is organized. This review integrates results from olfactory response-time (RT) measurements from a perspective of mental chronometry. Based on these findings, a new cascade model of human olfaction is presented. Results show that main perceptual decisions are executed with high accuracy within about 1~s of sniff onset. The cascade model proposes the existence of distinct processing stages within this brief time-window. According to the cascade model, different perceptual features become accessible to the perceiver at different time-points, and the output of earlier processing stages provides the input for later processing stages. The olfactory cascade starts with detecting the odor, which is followed by establishing an odor object. The odor object, in turn, triggers systems for determining odor valence and edibility. Evidence for the cascade model comes from studies showing that RTs for odor valence and edibility assessment are predicted by the shorter RTs needed to establish the odor object. Challenges for future research include innovative task designs for olfactory RT experiments and the integration of the behavioral processing sequence into the underlying cortical processes using complementary RT measures and neuroimaging methods.

Odors are surprisingly difficult to name, but the mechanism underlying this phenomenon is poorly understood. In experiments using event-related potentials (ERPs) and functional magnetic resonance imaging (fMRI), we investigated the physiological basis of odor naming with a paradigm where olfactory and visual object cues were followed by target words that either matched or mismatched the cue. We hypothesized that word processing would not only be affected by its semantic congruency with the preceding cue, but would also depend on the cue modality (olfactory or visual). Performance was slower and less precise when linking a word to its corresponding odor than to its picture. The ERP index of semantic incongruity (N400), reflected in the comparison of nonmatching versus matching target words, was more constrained to posterior electrode sites and lasted longer on odor-cue (vs picture-cue) trials. In parallel, fMRI cross-adaptation in the right orbitofrontal cortex (OFC) and the left anterior temporal lobe (ATL) was observed in response to words when preceded by matching olfactory cues, but not by matching visual cues. Time-series plots demonstrated increased fMRI activity in OFC and ATL at the onset of the odor cue itself, followed by response habituation after processing of a matching (vs nonmatching) target word, suggesting that predictive perceptual representations in these regions are already established before delivery and deliberation of the target word. Together, our findings underscore the modality-specific anatomy and physiology of object identification in the human brain.

We examined whether conversion to dementia can be predicted by self-reported olfactory impairment and/or by an inability to identify odors. Common forms of dementia involve an impaired sense of smell, and poor olfactory performance predicts cognitive decline among the elderly. We followed a sample of 1529 participants, who were within a normal range of overall cognitive function at baseline, over a 10-year period during which 159 were classified as having a dementia disorder. Dementia conversion was predicted from demographic variables, Mini-Mental State Examination score, and olfactory assessments. Self-reported olfactory impairment emerged as an independent predictor of dementia. After adjusting for effects of other predictors, individuals who rated their olfactory sensitivity as "worse than normal" were more likely to convert to dementia than those who reported normal olfactory sensitivity (odds ratio [OR] = 2.17; 95% confidence interval [CI] [1.40, 3.37]). Additionally, low scores on an odor identification test also predicted conversion to dementia (OR per 1 point increase = 0.89; 95% CI [0.81, 0.98]), but these two effects were additive. We suggest that assessing subjective olfactory complaints might supplement other assessments when evaluating the risk of conversion to dementia. Future studies should investigate which combination of olfactory assessments is most useful in predicting dementia conversion.

The aim of this study was to investigate the temporal abilities of children treated by surgery for a malignant tumor in the cerebellum, both in the perception and the production of rhythm. Children with a diagnosed medulloblastoma and age-matched control children were tested in a rhythm discrimination task and a sensorimotor synchronization task. Their motor and cognitive capabilities were also assessed through a battery of age-adapted neuropsychological tests. The results did not show any significant difference in performance between groups for the discrimination task. On the contrary, children with cerebellar lesions produced longer and more variable inter-tap intervals (ITI) in their spontaneous motor tempo (SMT) than did the control children. However, the length and, to a lesser extent, the variability of their SMT decreased after a synchronization phase, when they had been instructed to tap in synchrony with a beep. During the synchronization task, the children with medulloblastoma succeeded to modify the length of their ITI in response to an auditory rhythm, although with better success when the inter-stimuli intervals (ISI) were shorter than when they were longer than the ITIs of their own SMT. Correlational analyses revealed that children's poorer synchronization performance was related to lower scores in neuropsychological tests assessing motor dexterity and processing speed.

Pavlovian conditioning is the reference paradigm for the study of associative learning based on the programmed relation of two stimuli, the conditioned stimulus (CS) and the unconditioned stimulus (US). Some authors believe that learning the CS-US interval is a co-requisite of or a pre-requisite to learning the CS-US association. There is a substantial literature showing that the amygdala is a critical player in Pavlovian conditioning, with both aversive and appetitive USs. We review a sparse but growing body of literature suggesting that the amygdala may also participate in processing the timing of the CS-US interval. We discuss whether the amygdala, in particular its central, basal and lateral nuclei, in concert with the network it belongs to, may play a role in learning the CS-US interval. We also suggest new and dedicated strategies that would result in better knowledge of the neural mechanisms underlying the learning of the CS-US time interval in isolation from the CS-US association.

Humans and animals encode and store in memory elapsed intervals as evidenced through their temporal expectancies. However, there are very few experimental studies on long-term memory of duration. The aim of this original study was to examine the consolidation process for duration and its effect on time judgement. In our study, memory of duration was tested in humans with a temporal generalization task. Consolidation was assessed by means of a 15-min nontemporal interference task introduced at different delays after the initial learning of a 4-s standard duration. The results showed that (a) when tested 24 hours after the learning phase, memory of the 4-s duration was disrupted (less precision and lengthening effect) if the interference task was introduced 30-45 min after learning; (b) no disruption was observed when memory was tested immediately after the interference task; and (c) there was a temporal gradient of the disruptive interference effect within the first hour after learning. Overall, these results fulfil the key criteria for the inference of a synaptic/cellular consolidation process and thus demonstrate that, as is the case for other memories, memory of duration undergoes a consolidation process that lasts at least one hour.