The Chronicle of Neurology & Psychiatry June 2016; 19(3)

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Canada’s National Newspaper of the CNS Sciences n June 2016 n The Chronicle is committed to maintaining leadership in environmentally sustainable policies, and to encouraging the adoption of “greenaware” practices in healthcare. We invite your comments via e-mail, at:

Editorial: ACP guidelines provokes thought ..........................3 Motivational deficits in MDD linked to functional impairments ......6 Modifiable factors to help reduce smoking during pregnancy ......11

Perinatal stroke hemiparesis: exploring rTMS, constraint Stroke

n Adding rTMS, CIMT to therapy improved outcomes

Adults with

by Emily Innes-Leroux,

Associate Editor, The Chronicle





transcranial magnetic stimulation (rtMS), or constraint-induced movement therapy (CiMt), or both, to intensive therapy for children with stroke-induced hemiparetic cerebral palsy has been found to increase the chances of clinically significant improvement compared to children who received only intensive therapy. in a factorial-design, blinded, randomized controlled trial, published online ahead of print in the journal DDiNg rePetitive



Neurology (Mar. 30, 2016), lead author Dr. Adam Kirton and colleagues assessed rtMS and CiMt effects in hemiparetic children aged six to 19 years with Mri-confirmed perinatal stroke. All participants (45) completed a two-week, goal-directed, peer-supported motor learning camp and were randomized to receive daily rtMS, CiMt, both, or neither. the primary outcomes were the Assisting Hand Assessment and the Canadian Occupational Performance Measure at baseline, one week,

—please turn to page 8

Light therapy as non-seasonal MDD treatment Depression

please turn to page 12

Schizophrenia associated with CVD

Light therapy, both as monotherapy and in combination with fluoxetine, appears to be efficacious and well tolerated for the treatment of adults with non-seasonal major depressive disorder (MDD), according to a study published in JAMA Psychiatry (Jan. 2016; 73(1):56–63). —See page 7


n Consensus guidelines needed for early detection of CVD by Lynn Bradshaw, Senior Editor, The Chronicle

(CvD) among people with schizophrenia needs more serious attention from clinicians and researchers, according to the authors of a literature review published in the Asian Journal of Psychiatry (feb. 2016; 19:28–36). “it has been observed that mortality risk in people with schizophrenia is quite higher than the general population,” said the corresponding author of the report, Dr. tanvir turin Chowdhury. —please turn to page 14 He COMOrbiDity Of CArDiOvASCuLAr DiSeASe


This issue’s Chronicle Vitae profiles Dr. James Rutka, a neurosurgeon who was recently appointed as an officer of the Order of Canada for his contributions to advancing treatment for pediatric brain tumours. See page 18