Our preliminary study demonstrated the efficacy of pharmacotherapy augmentation by TSD and SPA in half of the patients with TRD. The main biochemical factors related to clinical response included status of cortisol and increase in IL-10 and IL-1β levels.

BackgroundCognitive deficits occur in most patients with affective disorders. The role of neurotrophic factors (e.g., BDNF) as modulators of brain plasticity affecting neurocognitive abilities has been emphasized. Neurotrophin concentrations may change under the influence of various interventions, including physical activity. Selected studies have shown that cognitive function may also be affected by exercise.AimThe aim of the study was to determine whether physical activity changes the concentration of neurotrophins and their receptors in patients with an episode of depression. It was also examined how one session of aerobic exercise affects cognitive control.MethodsThe study included 41 participants. The subjects were asked to exercise on a cycloergometer for 40 min with individually selected exercise loads (70% VO2max). Before and shortly after the exercise blood samples were acquired to perform blood assays (proBDNF, BDNF, TrkB, NGFR). The participants also performed a Stroop test twice—before the exercise and 10 min after its cessation.ResultsThe single bout of physical exercise did not cause any significant changes in the concentration of neurotrophic factors. The SCWT results: both the mean reading time (29.3 s vs. 47.8 s) and the color naming time (36.7 s vs. 50.7 s) increased. The patients made more mistakes after physical exercise, both in part A (0.2 vs. 1.5) and B (0.6 vs. 1.5). The so-called interference effect decreased—the difference between naming and reading times was smaller after exercise (6.2 s vs. 2.4 s). No significant correlations were found between the concentrations of the studied neurotrophic factors and the Stroop test results.ConclusionsThe results did not confirm changes in neurotrophin concentration under the influence of a single session of physical activity. The shortening of the interference time after exercise may be caused by practice effects. A significant limitation of the study is the use of the Stroop test twice in short intervals.

Anorexia nervosa (AN) is a widespread, metabo-psychiatric disorder with high relapse rates, comorbidity, and mortality. Many regulatory proteins and neurohormones studied to date play essential roles in the etiopathogenesis of eating disorders and the maintenance of psychopathological symptoms. Nevertheless, the regulatory and pathophysiological mechanisms of AN are still poorly understood. In the presented study, the plasma levels of apelin-13 (APE-13) and asprosin (ASP), as well as carbohydrate metabolism parameters and psychometric parameters, were evaluated in low-weight adolescent female patients with AN (AN1), after partial weight normalization (AN2) and in an age-matched healthy control group (CG) were evaluated. APE-13 levels were higher in the AN1 group than in the post-realimentation and the CG group. APE-13 levels were independent of insulin and glucose levels. Plasma ASP levels increased with increasing body weight in patients with AN, correlating with the severity of eating disorder symptoms in emaciation. The presented data suggest that APE-13 and ASP may be AN’s biomarkers-regulation of eating behavior by APE-13 and ASP, the close relationship between them and emotional behavior, and changes in neurohormone levels in patients with eating and affective disorders seem to support these hypotheses. Moreover, their plasma levels seem to be related to the severity of psychopathological symptoms of eating disorders.

Purpose: Limbic encephalitis is a clinical syndrome of various aetiologies: viral (the most often herpes simplex virus), associated with autoimmune diseases as well as a paraneoplastic syndrome (most commonly in the case of small cell lung carcinoma). This disease was first described by English neurologists and neuropathologists in 1960. Case description: The case provided below shows a 46-year-old female suffering from autoimmune limbic encephalitis with anti-NMDAR antibodies (anti-N-methyl-D-aspartate receptor antibodies) in the course of paraneoplastic syndrome, which was linked with ovarian tumour, i.e. teratocarcinoma mature (teratoma adultum ovaris). Considering previously unknown primary cancer, correct laboratory tests, imaging results and many psychopathological symptoms, the initial diagnosis was correlated with mental disorders. Soon, the symptoms of respiratory distress appeared in the deteriorating mental condition of the patient. Therefore, sedation and mechanical ventilation were necessary to implement. Comment: Quick verification of diagnosis, active neurological and oncological examinations and causal treatment led to full recovery of the patient. Key words: limbic encephalitis, anti-NMDAR antibodies, paraneoplastic syndrome. StreszczenieCel: Limbiczne zapalenie mózgu to zespół objawów kliniczno-patologicznych o różnorodnej etiologii: wirusowej (najczęściej wirus opryszczki pospolitej), autoimmunologicznej, a także o charakterze zespołu paranowotworowego (najczęściej w przebiegu raka drobnokomórkowego płuc). Po raz pierwszy ta jednostka chorobowa została opisana przez angielskich neurologów i neuropatologów w 1960 r. Opis przypadku: W pracy przedstawiono przypadek 46-letniej pacjentki z autoimmunologicznym limbicznym zapaleniem mózgu z przeciwciałami anty-NMDAR (anti-N-methyl-D-aspartate receptor) w przebiegu zespołu paranowotworowego, który był związany z guzem jajnika -potworniakiem dojrzałym (łac. teratoma adultum ovarii). Przy obecności nasilonych objawów psychiatrycznych oraz w większości prawidłowych wyników badań laboratoryjnych i obrazowych początkowo rozpoznanie wiązano z zaburzeniami psychicznymi. W krótkim czasie do pogarszającego się stanu psychicznego dołączyły objawy niewydolności oddechowej. Konieczne było zastosowanie sedacji i mechanicznej wentylacji chorej. Komentarz: Szybka weryfikacja rozpoznania, aktywna diagnostyka neurologiczna i onkologiczna oraz wdrożenie leczenia przyczynowego pozwoliły na pełny powrót pacjentki do zdrowia. Słowa kluczowe: limbiczne zapalenie mózgu, przeciwciała anty-NMDAR, zespół paranowotworowy.

Opis przypadku/Case report S t r e s z c z e n i e Limbiczne zapalenie mózgu (LE) jest jednostką chorobową znaną od 1960 r. Obecnie wyróżnia się przypadki na tle infekcyjnym i nieinfekcyjnym, a w drugiej grupie znajdują się zapalenia o etiologii paranowotworowej i nieparanowotworowej związane z występowa-niem przeciwciał w surowicy krwi i płynie mózgowo--rdzeniowym. Na charakterystyczny zespół objawów występujących w LE składają się zaburzenia funkcji poznawczych, zaburzenia psychiczne i napady drgawkowe. Początek choroby ma ostry lub podostry przebieg. W diagnostyce istotną rolę odgrywają badania elektroencefalograficzne (EEG) i serologiczne oraz badanie głowy metodą rezonansu magnetycznego (MR). Podtyp LE z przeciwciałami skierowanymi przeciwko receptorom NMDA został opisany w 2007 r. Jest prawdopodobnie najczęściej występującym rodzajem LE. Artykuł opisuje 57-letniego chorego, u którego od 4 lat występowały zaburzenia pamięci, nadmierna senność i zaburzenia psychiczne. W badaniu EEG obserwowano nieprawidłowy zapis. Przeprowadzone badanie metodą rezonansu magnetycznego nie wykazało obecności zmian typowych dla LE. Ostatecznie obecność przeciwciał anty-NMDA i obraz kliniczny zadecydowały o diagnozie LE i podjęciu leczenia tej choroby.Słowa kluczowe: limbiczne zapalenie mózgu, przeciwciała anty-NMDA. A b s t r a c tLimbic encephalitis (LE) is a disease known since 1960. At present, infectious and non-infectious cases are distinguished, and in the latter group paraneoplastic and non-paraneoplastic cases may be observed. Both are associated with the presence of an antibodies in serum and cerebrospinal fluid. A characteristic syndrome in LE is characterised by cognitive impairments, psychiatric disorders, and seizures. The onset of the disease is acute or subacute. EEG, and serologic and magnetic resonance imaging studies are important in diagnostics. The LE subtype with anti-NMDA receptors was described in 2007. It is probably the most common type of LE. This article describes a 57-year-old patient with a four-year history of memory disorders, sleep disturbance, and psychiatric symptoms. EEG abnormalities were observed, but MRI did not demonstrate the presence of lesions typical of LE. Finally, the presence of anti-NMDA antibodies and clinical picture led to the diagnosis of LE and its treatment.

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