Meditation practice alters intrinsic resting-state functional connectivity (rsFC) in the default mode network (DMN). However, little is known regarding the effects of meditation on other resting-state networks. The aim of current study was to investigate the effects of meditation experience and meditation-state functional connectivity (msFC) on multiple resting-state networks (RSNs). Meditation practitioners (MPs) performed two 5-minute scans, one during rest, one while meditating. A meditation naïve control group (CG) underwent one resting-state scan. Exploratory regression analyses of the relations between years of meditation practice and rsFC and msFC were conducted. During resting-state, MP as compared to CG exhibited greater rsFC within the Dorsal Attention Network (DAN). Among MP, meditation, as compared to rest, strengthened FC between the DAN and DMN and Salience network whereas it decreased FC between the DAN, dorsal medial PFC, and insula. Regression analyses revealed positive correlations between the number of years of meditation experience and msFC between DAN, thalamus, and anterior parietal sulcus, whereas negative correlations between DAN, lateral and superior parietal, and insula. These findings suggest that the practice of meditation strengthens FC within the DAN as well as strengthens the coupling between distributed networks that are involved in attention, self-referential processes, and affective response.

SUMMARYBoth neuroleptic and non-neuroleptic medications are widely used to treat symptomatic behaviors in dementia patients. There is a substantial body of literature suggesting that neuroleptics are modestly effective in treating these symptoms, but the magnitude of their effect is limited. Non-neuroleptic medications such as anticonvulsants and antidepressants have been advocated as useful in treating certain symptoms but have not been as well studied. This article critically reviews the published evidence for the effectiveness of selected non-neuroleptic medications in treating behavioral symptoms in elderly dementia patients, especially those with possible Alzheimer's disease. The medications reviewed include lithium, b-adrenergic blockers, trazodone, carbamazepine, buspirone, 1-deprenyl, and serotonin uptake blockers, reflecting the point of view that pharmacological approaches to the problem of agitation in dementia have included a variety of psychotropic medications. Most of these medications were not tried specifically with Alzheimer's disease patients, however, but in patients with various organic mental syndromes. The literature consists almost entirely of clinical series and case reports, making interpretations of the efficacy of individual medications difficult. With the singular exception of the serotonin uptake blocker citalopram, the few placebo-controlled studies are of small sample sizes, showing at best very modest efficacy for the study medication. Despite their widespread use, there is very little published empirical evidence for the effectiveness of these novel treatments for treating behavioral symptoms in elderly dementia patients.KEY worms-Agitation, dementia, management, non-neuroleptic medications.Agitation and other symptomatic behaviors remain principal problems in the clinical management of elderly patients with Alzheimer's disease and other dementia. Disruptive symptoms such as agitation, outbursts, violence, sleep disturbance, motor restlessness, delusion, hallucinations and misidentifications each occur in approximately one-third of various AD patient samples, with the majority of patients showing at least one symptom (Leuchter and Spar, 1985;Mayeux et al., 1985a;Reisberg et al., 1987). Between 50 and 75% of AD patients show significant disruptive behavior at some time during their illness (Rovner et al., 1990;Rubin, 1987).The consequences of agitated behaviors in dementia patients-regardless of the etiology-

Sixty-seven psychiatrists who were employed in state hospitals in Texas were surveyed about their attitudes toward use of electroconvulsive therapy (ECT) and the laws and regulations associated with its use. The majority of respondents agreed with accepted professional guidelines on ECT usage and had a positive attitude toward ECT treatment. However, the number of referrals for ECT by these psychiatrists was low, perhaps due to the view that Texas laws and policies about ECT are restrictive and limiting to patient care. The majority of respondents indicated that more professional education about laws and policies related to ECT is needed.

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