EEG Features in Manic-Paraphrenic and Manic-Delusional Conditions in Patients with Paroxysmal Endogenous Psychoses

Background: the study of psychopathological and neurobiological features of psychotic states, in particular, manic-delusional and manic-paraphrenic ones, in the framework of paroxysmal endogenous psychoses, is relevant to clarify the diagnosis and individual prognosis of the disease. Quantitative EEG parameters allow objective assessment of the brain functional state in these patients, and clarify the neurophysiological mechanisms underlying the features of the syndromal structure of psychotic states.

Objective: to evaluate the amplitude-frequency and spatial characteristics of the EEG in patients with paroxysmal endogenous psychosis with manic-paraphrenic and manic-delusional conditions.

Patients and methods: 73 inpatient women aged from 18 to 55 years with manifest manic-paraphrenic and manic-delusional conditions in the structure of paroxysmal endogenous psychoses (F20.01, F20.02, F25.0, F30.2, F31.2 according to ICD-10) participated in a multidisciplinary study, Three groups were formed taking into account the peculiarities of the affective component of the syndrome and the mechanism of delusions: the 1st group (28 patients) with affective dominance of acute sensory delusion, the 2nd group (31 patients) with non-systematiting interpretative delusion, the 3rd group (14 patients) with manic delusion states with a dominance of visual-figurative delusions of imagination. Clinical psychopathological, psychometric, and neurophysiological methods were used. Evaluation of the mental state of patients was carried out using the YMRS and PANSS scales, and the brain functional state — using multi-channel recording and spectral analysis of the resting EEG. The correlation analysis method determined the relationships between clinical evaluations and EEG parameters.

Results: the features of the EEG spectral power parameters and topography were revealed. Their correlations with clinical evaluations by the YMRS and PANSS scales significantly differed in the three groups of patients. It has been stated that they are caused by the different degree of hypofrontality and of the level of the brain stem structures activation. Perhaps these factors determine the characteristics of the psychopathic structure of manic-paraphrenic and manic-delusional conditions.

Conclusions: the EEG quantitative characteristics and the structure of their relationshipswith clinical parameters differ in three clinically separated groups of patients with manic-paraphrenic and manic-delusional conditions indicate differences in the functional organization of the brain, mediating the clinical and psychopathological structure of syndromes, and confirm thevalidity of their typological division.

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