Shamil U. Abbasy, United States of America
RUSH University Medical Center PsychiatryAuthor Of 1 Presentation
Modulating effects of distinct NMDA receptors that may support the concept of a distinct neuro-biologic network of affective regulation nascent to the Cerebellum. - EPV0772
Abstract
Introduction
The concept of a Cognitive Cerebellar Affective Syndrome has become accepted potential sequelae for patients that have traumatic bain injuries and lesions that affect the cerebellum. The involvement of the cerebellum in gross motor and movement disorders is well established; however, its role in affective processes has recently become more evident and continues to be an area of opportunity in psychiatry for further charaterization.
Objectives
The possibility that a similar psyhciatric presentation such as Cognitive Cerebelar Affective Syndrome may exist without specific brain insult.
Methods
We present a case of a 17 year old male with a congenital malformation of the cerebelar vermis and hypoplasia of the corpus callosum who had deficits across multiple cognitive and affective domains including visual-spatial and verbal/semantic deficits, with affective instability that was suggestive of Cognitive Cerebellar Affective Syndrome. It refactory to standard treatment but had a robust response to an NMDA antagonist.
Results
The patient was started on memantine 10mg BID over the course of two weeks. The patient tolerated the medication without any adverse effects. Over the course of four weeks the patient demonstrated near remission of emotional/behavioral disturbance that was previously refractory to treatment.
Conclusions
This case report and review of the literature provided evidence to suggest that congenital malformations of the cerebellum may manifest with dysregulated affective symptoms similar to patients with Cognitive Cerebellar Affective Syndrome, which are responsive to NMDA receptor antagonists. The difference in the binding affinities of the NMDA receptor may account for positive response to NMDA agonist observed in this patient.
Presenter of 1 Presentation
Modulating effects of distinct NMDA receptors that may support the concept of a distinct neuro-biologic network of affective regulation nascent to the Cerebellum. - EPV0772
Abstract
Introduction
The concept of a Cognitive Cerebellar Affective Syndrome has become accepted potential sequelae for patients that have traumatic bain injuries and lesions that affect the cerebellum. The involvement of the cerebellum in gross motor and movement disorders is well established; however, its role in affective processes has recently become more evident and continues to be an area of opportunity in psychiatry for further charaterization.
Objectives
The possibility that a similar psyhciatric presentation such as Cognitive Cerebelar Affective Syndrome may exist without specific brain insult.
Methods
We present a case of a 17 year old male with a congenital malformation of the cerebelar vermis and hypoplasia of the corpus callosum who had deficits across multiple cognitive and affective domains including visual-spatial and verbal/semantic deficits, with affective instability that was suggestive of Cognitive Cerebellar Affective Syndrome. It refactory to standard treatment but had a robust response to an NMDA antagonist.
Results
The patient was started on memantine 10mg BID over the course of two weeks. The patient tolerated the medication without any adverse effects. Over the course of four weeks the patient demonstrated near remission of emotional/behavioral disturbance that was previously refractory to treatment.
Conclusions
This case report and review of the literature provided evidence to suggest that congenital malformations of the cerebellum may manifest with dysregulated affective symptoms similar to patients with Cognitive Cerebellar Affective Syndrome, which are responsive to NMDA receptor antagonists. The difference in the binding affinities of the NMDA receptor may account for positive response to NMDA agonist observed in this patient.