Eva María Sánchez Morla - Academia.edu (original) (raw)

Papers by Eva María Sánchez Morla

Acta Neuropsychiatrica, Oct 1, 2011

Objective: Varenicline has been associated with psychiatric side effects, and cases with psychoti... more Objective: Varenicline has been associated with psychiatric side effects, and cases with psychotic symptoms during treatment have been reported, few of them after the withdrawal. We describe a case with no current or previous medical or psychiatric history. Method: A single case report. Results: The patient without previous psychiatric pathology, following the withdrawal of treatment with varenicline, experiences delirium and behavioural disturbances. There was a remission of symptoms after 3 weeks of treatment with risperidone. Conclusion: Discontinuation of treatment with varenicline due to poor tolerance for side effects (nausea and insomnia) could trigger psychotic symptoms in subjects with no personal or family psychiatric history.

Psychiatry Research-neuroimaging, Oct 1, 2009

Few studies have compared neurocognitive performance in euthymic patients with bipolar disorder (... more Few studies have compared neurocognitive performance in euthymic patients with bipolar disorder (BD), stabilized patients with schizophrenia (SC) and normal controls (NC) using a comprehensive neuropsychological battery, and those that have been conducted have yielded discrepant results. We evaluated the neurocognitive profile shown by 73 euthymic patients with BD, 89 stabilized patients with SC and 67 NC. All participants completed a cognitive battery in which the domains evaluated were executive functioning, sustained attention, and verbal and visual memory. Individuals with BD were administered the Quality of Life Scale (QLS). Patients with BD manifested dysfunction in executive functioning (moderate-to-large effect size), sustained attention (moderate effect size) and verbal/visual memory (large effect size) compared with NC. Verbal memory deficit in patients with BD was related to poor functional outcome on the QLS and Global Assessment of Functioning (GAF). Patients with BD performed significantly better than patients with SC on the Trail Making Test (TMT) part B, backward digit span, and California Verbal Learning Test (CVLT) learning trials. Other neuropsychological measures showed no significant differences between the two patient groups. These findings support the notion that euthymic BD patients suffer from an extensive neurocognitive deficit that affects all cognitive domains and is qualitatively similar to that in SC patients. Persistent verbal memory impairment in BD has clinical relevance because it is associated with poor psychosocial function.

Sensors, 2019

As multiple sclerosis (MS) usually affects the visual pathway, visual electrophysiological tests ... more As multiple sclerosis (MS) usually affects the visual pathway, visual electrophysiological tests can be used to diagnose it. The objective of this paper is to research methods for processing multifocal electroretinogram (mfERG) recordings to improve the capacity to diagnose MS. MfERG recordings from 15 early-stage MS patients without a history of optic neuritis and from 6 control subjects were examined. A normative database was built from the control subject signals. The mfERG recordings were filtered using empirical mode decomposition (EMD). The correlation with the signals in a normative database was used as the classification feature. Using EMD-based filtering and performance correlation, the mean area under the curve (AUC) value was 0.90. The greatest discriminant capacity was obtained in ring 4 and in the inferior nasal quadrant (AUC values of 0.96 and 0.94, respectively). Our results suggest that the combination of filtering mfERG recordings using EMD and calculating the corre...

Biomedical Signal Processing and Control, 2015

Abstract The multifocal visual evoked potential (mfVEP) test measures the potentials obtained by ... more Abstract The multifocal visual evoked potential (mfVEP) test measures the potentials obtained by simultaneous stimulation of multiple areas of the visual field. The principal mfVEP signal characteristics analysed are intensity and latency. A new parameter named Percentage of Energy (PoE) based on energy distribution along the recording is defined to evaluate (mfVEP) response intensity. mfVEP signals from controls and subjects classified according to the risk of developed Multiple Scleroris (MS) are used: 24 control, 15 Radiologically Isolated Syndrome (RIS), 28 Clinically Isolated Syndrome (CIS) and 28 MS diagnosed. Eyes from CIS and MS groups have been classified in neuritis optic eyes (NO) and no affected by neuritis optics eyes (nON). mfVEP signals intensity are analysed using the classic signal-to-noise (SNR) ratio and the PoE parameter. Index on discrimination between controls and different groups of diagnosed patients based on area under the curve are calculated using SNR and PoE. Lastly reproducibility test of SNR and PoE are analysed. The mean values of coefficient of variability ( C v ) for all the subjects are C VSRN = 0.34 and C VPOE = 0.17 ( p SNR = 0.79 to AUC POE = 0.83 ( p In conclusion, the PoE parameter presents advantages over the SNR parameter when characterizing mfVEP signal amplitude.

Journal of Personalized Medicine, 2021

Background: The aim of this study is to explore an objective approach that aids the diagnosis of ... more Background: The aim of this study is to explore an objective approach that aids the diagnosis of bipolar disorder (BD), based on optical coherence tomography (OCT) data which are analyzed using artificial intelligence. Methods: Structural analyses of nine layers of the retina were analyzed in 17 type I BD patients and 42 controls, according to the areas defined by the Early Treatment Diabetic Retinopathy Study (ETDRS) chart. The most discriminating variables made up the feature vector of several automatic classifiers: Gaussian Naive Bayes, K-nearest neighbors and support vector machines. Results: BD patients presented retinal thinning affecting most layers, compared to controls. The retinal thickness of the parafoveolar area showed a high capacity to discriminate BD subjects from healthy individuals, specifically for the ganglion cell (area under the curve (AUC) = 0.82) and internal plexiform (AUC = 0.83) layers. The best classifier showed an accuracy of 0.95 for classifying BD vers...

Revista de Psiquiatría y Salud Mental, 2021

Schizophrenia Research, 2020

Documenta Ophthalmologica, 2019

Purpose To propose a new method of identifying clusters in multifocal electrophysiology (multifoc... more Purpose To propose a new method of identifying clusters in multifocal electrophysiology (multifocal electroretinogram: mfERG; multifocal visual-evoked potential: mfVEP) that conserve the maximum capacity to discriminate between patients and control subjects. Methods The theoretical framework proposed creates arbitrary N-size clusters of sectors. The capacity to discriminate between patients and control subjects is assessed by analysing the area under the receiver operator characteristic curve (AUC). As proof of concept, the method is validated using mfERG recordings taken from both eyes of control subjects (n = 6) and from patients with multiple sclerosis (n = 15). Results Considering the amplitude of wave P1 as the analysis parameter, the maximum value of AUC = 0.7042 is obtained with N = 9 sectors. Taking into account the AUC of the amplitudes and latencies of waves N1 and P1, the maximum value of the AUC = 0.6917 with N = 8 clustered sectors. The greatest discriminant capacity is...

Psychiatry Research, 2018

This is a PDF file of an unedited manuscript that has been accepted for publication. As a service... more This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. Highlights  The presence of emotional contexts (positive or negative) triggers a bias towards misattributions of negative emotions to neutral faces in patients with schizophrenia.  However, in the presence of neutral contexts responses of patients and controls did not differ.  Patients and controls provided identical ratings of valence to faces and contexts.  These results provide new evidence on the role of contextual modulation of emotion recognition in schizophrenia that might be used to inform improved intervention programs in the domain of social cognition.

Schizophrenia Research, 2012

Background: Carpenter et al. (1985) proposed a subtype of schizophrenia characterized by primary ... more Background: Carpenter et al. (1985) proposed a subtype of schizophrenia characterized by primary and enduring negative symptoms named deficit schizophrenia (DS) which is distinct from other forms of schizophrenia (nondeficit schizophrenia, NDS). The deficit syndrome represents an attempt to find homogeneous clinical samples of patients diagnosed with schizophrenia (Carpenter et al., 1988). The aim of this study is to examine longitudinal course of neurocognitive and functional performance in a sample of schizophrenia patients classified as DS and NDS. Methods: Ninety-one outpatients with schizophrenia (DSM-IV/SCID), stabilized as described elsewhere (Sánchez-Morla et al., 2009a), were classified as deficit and non-deficit syndrome using the Spanish version of the Schedule for the Deficit Syndrome (SDS) (Bernardo et al., 2007). Forty healthy controls (SCID version non-patients) were also assessed. Patient and control groups were evaluated at baseline (EV1) and 5 years later (EV2).

Documenta Ophthalmologica, 2014

Purpose The purpose of the study is to present a method (Selfcorr) by which to measure intersessi... more Purpose The purpose of the study is to present a method (Selfcorr) by which to measure intersession latency differences between multifocal VEP (mfVEP) signals. Methods The authors compared the intersession latency difference obtained using a correlation method (Selfcorr) against that obtained using a Template method. While the Template method cross-correlates the subject's signals with a reference database, the Selfcorr method cross-correlates traces across subsequent recordings taken from the same subject. Results The variation in latency between intersession signals was 0.8 ± 13.6 and 0.5 ± 5.0 ms for the Template and Selfcorr methods, respectively, with a coefficient of variability C V_TEMPLATE = 15.83 and C V_SELFCORR = 5.68 (n = 18, p = 0.0002, Wilcoxon). The number of analyzable sectors with the Template and Selfcorr methods was 36.7 ± 8.5 and 45.3 ± 8.7, respectively (p = 0.0001, paired t test, two tailed). Conclusions The Selfcorr method produces smaller intersession mfVEP delays and variability over time than the Template method.

Schizophrenia bulletin, 2012

NR4A2 (nuclear receptor subfamily 4 group A member 2) or Nurr1 is a transcription factor implied ... more NR4A2 (nuclear receptor subfamily 4 group A member 2) or Nurr1 is a transcription factor implied in the differentiation, maturation, and survival of dopaminergic neurons. It also has a role in the expression of several proteins that are necessary for the synthesis and regulation of dopamine (DA), such as tyrosine hidroxilase, dopamine transporter, vesicular monoamine transporter 2, and cRET. DA is an important neurotransmitter in attentional pathways. Our aim was to evaluate the influence of NR4A2 gene in the performance of schizophrenia (SZ) patients and healthy subjects on a sustained attention task. For this study, we collected 188 SZ subjects (Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition) and 100 control individuals. We genotyped 5 tag SNPs in NR4A2 gene: rs1150143 (C/G), rs1150144 (A/G), rs834830 (A/G), rs1466408 (T/A), and rs707132 (A/G). We also analyzed the influence of its haplotypes (frequency >5%). To examine sustained attention, all the indivi...

Journal of affective disorders, Nov 8, 2017

It has been suggested that patients with bipolar disorder with psychotic symptoms (BD-P) have lar... more It has been suggested that patients with bipolar disorder with psychotic symptoms (BD-P) have larger neurocognitive impairment than patients with bipolar disorder without a history of psychotic symptoms (BD-NP). The objective of this study was to compare neurocognitive performance of BD-P and BD-NP relative to a group of patients with schizophrenia (SZ), and healthy controls (HC). Neurocognitive function was examined in 100 subjects with bipolar I disorder (50 BD-P, 50 BD-NP), 50 SZ, and 51 HC. All patients with BD fulfilled criteria for euthymia, while all SZ patients were stabilised for at least the previous 3 months. Patients with BD-P and BD-NP performed worse than HC in all neurocognitive measures, except for sustained attention. Differences between BD-P and BD-NP were subtle and circumscribed to the working memory domain (effect size: 0.29). SZ performed worse than BD-NP in the neurocognitive composite index (NCI) and in the working memory domain. There were no differences bet...

International Journal of Clinical and Health Psychology

The multifocal visual-evoked-potential (mfVEP) signals are filtered using the Wiener filter combi... more The multifocal visual-evoked-potential (mfVEP) signals are filtered using the Wiener filter combined with a Fast Fourier Transform and their signal-to-noise ratios are compared against those of unfiltered signals (RAW data) and those of signals filtered using the traditional method (FFT data). The Wiener filter improves the original signals' SNR by 37.49%, while the FFT improves the SNR by 20.41%. This gain is achieved by selecting the best channel in each sector of the visual field. In conclusion, filtering using the Wienerś method improves the quality of mfVEP signal pre-processing when compared against the original signals, or against filtering using the FFT.

Journal of Affective Disorders

BACKGROUND Functional impairment is commonly encountered among patients with bipolar disorder (BD... more BACKGROUND Functional impairment is commonly encountered among patients with bipolar disorder (BD) during periods of remission. The distribution of the impairment of the functional outcome is heterogeneous. The objective of this current investigation was to identify neurocognitive and clinical predictors of psychosocial functioning in a sample of patients with BD. METHODS Seventy-six patients (59.2% females) and 40 healthy controls (50% females), aged 18 to 55 years, were assessed using a comprehensive neurocognitive battery (six neurocognitive domains), and the Functioning Assessment Short Test (FAST), at baseline and after a 5-year follow-up. Stepwise regression models were used to identify predictor variables related to psychosocial functioning. RESULTS The number of hospitalizations during the follow-up, the change occurred in the neurocognitive composite index (NCI change), and NCI at baseline explained 30.8% of the variance of functioning. The number of hospitalizations during the follow-up was the variable that explained a greater percentage of the variance (16.9%). Verbal memory at baseline and the change in sustained attention during the follow-up explained 10% and 5.9% of the variance of the psychosocial functioning, respectively. LIMITATIONS The interval of 5 years between the two assessments could be too short to detect a possible progression in functional outcome for the overall sample. CONCLUSIONS The clinical course during the follow-up is the factor that has a greater impact on psychosocial functioning in patients with BD. Thus, the interventions aimed to promote prevention of relapses should be considered as essential for avoiding functional impairment in these patients.

Sensors

The purpose of this paper is to evaluate the feasibility of diagnosing multiple sclerosis (MS) us... more The purpose of this paper is to evaluate the feasibility of diagnosing multiple sclerosis (MS) using optical coherence tomography (OCT) data and a support vector machine (SVM) as an automatic classifier. Forty-eight MS patients without symptoms of optic neuritis and forty-eight healthy control subjects were selected. Swept-source optical coherence tomography (SS-OCT) was performed using a DRI (deep-range imaging) Triton OCT device (Topcon Corp., Tokyo, Japan). Mean values (right and left eye) for macular thickness (retinal and choroidal layers) and peripapillary area (retinal nerve fibre layer, retinal, ganglion cell layer—GCL, and choroidal layers) were compared between both groups. Based on the analysis of the area under the receiver operator characteristic curve (AUC), the 3 variables with the greatest discriminant capacity were selected to form the feature vector. A SVM was used as an automatic classifier, obtaining the confusion matrix using leave-one-out cross-validation. Clas...

European Archives of Psychiatry and Clinical Neuroscience

We aimed to examine the trajectory of psychosocial functioning in a sample of euthymic patients w... more We aimed to examine the trajectory of psychosocial functioning in a sample of euthymic patients with bipolar disorder (BD) throughout a 5-year follow-up. Ninety-nine euthymic bipolar patients and 40 healthy controls (HC) were included. A neurocognitive assessment (17 neurocognitive measures grouped in 6 domains) was carried out at baseline. The split version of the Global Assessment of Functioning scale (GAF-F) and the Functioning Assessment Short Test (FAST) were used to examine psychosocial functioning at baseline (T1), and after a 5-year follow-up (T2). The statistical analysis was performed through repeated measures ANOVA and hierarchical cluster analysis based on the GAF-F and the FAST scores at T1 and T2. Eighty-seven patients (87.9%) were evaluated at T2. The cluster analysis identified two groups of patients. The first group included 44 patients (50.6%) who did not show a progression of the functional impairment (BD-NPI). The second cluster, which included 43 patients (49.4%), was characterized by a progression of the functional impairment (BD-PI). The BD-PI had a higher number of relapses and a higher number of hospitalizations during the follow-up period, as well as worse neurocognitive functioning than the BD-NPI. The repeated measures ANOVA confirmed that the psychosocial performance of BD-NPI is stable while there was a progression of the functional deterioration in BD-PI. The trajectory of the psychosocial functioning of patients with BD is not homogeneous. Our results suggest that in at least one subset of patients with BD, which might account for half of the patients, the disease has a progressive course.

Schizophrenia Research

The objective of the study was to examine the cognitive profile of Spanish patients with a first ... more The objective of the study was to examine the cognitive profile of Spanish patients with a first episode of schizophrenia (FESz) and to compare that to the profile of patients with a chronic schizophrenia (CSz) and non-psychiatric (NP) control subjects. The study included 106 FESz, 293 CSz, and 210 NP, assessed with the Spanish version of the MATRICS Consensus Cognitive Battery (MCCB). The MCCB cognitive profile in a Spanish sample of FESz was similar to the cognitive profile of CSz with some discrepancies in select domains. The scores of both patient samples were about 1-2 SD below the scores of non-psychiatric control subjects.

Revista de Psiquiatría y Salud Mental (English Edition)

Antipsychotics are an essential component in the treatment of schizophrenia. Long-acting injectab... more Antipsychotics are an essential component in the treatment of schizophrenia. Long-acting injectable formulations (LAI) arose to improve adherence with the associated potential of reducing the risk of relapse. The objective of this article is to analyze the use of LAI antipsychotics in Spain, which is similar to other European countries but with a predominance of the use of second generation LAI, to discuss the possible causes of prescribing differences with respect to other countries (including organizational aspects, attitudes of psychiatrists, patients and family members, and clinical practice guidelines), and to discuss their use in acute psychiatric units, first episode, and in children and adolescents. In our view, while it is necessary to increase existing evidence regarding the advantages of LAI antipsychotics and the differentiation between LAI antipsychotics currently available, their use will likely continue to grow driven by clinical experience.