Experimental irradiation conditions.
\r\n\t
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His previous appointment was as researcher in School of Civil & Environmental Engineering of Nanyang Technological University of Singapore where he studied for his PhD during 2008-2011. His research is predominantly focused on hydrological modeling and flood forecasting using artificial intelligence techniques. Most recently, he has been also involved in research projects dealing with sustainable urban water management. To date, he has published over 50 articles in reputable journals and international conference proceedings. He has supervised several PhD and Master students and won the Supervisor of the Year Award in Monash University Malaysia in 2017. 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Venkateswarlu",coverURL:"https://cdn.intechopen.com/books/images_new/371.jpg",editedByType:"Edited by",editors:[{id:"58592",title:"Dr.",name:"Arun",surname:"Shanker",slug:"arun-shanker",fullName:"Arun Shanker"}],productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"878",title:"Phytochemicals",subtitle:"A Global Perspective of Their Role in Nutrition and Health",isOpenForSubmission:!1,hash:"ec77671f63975ef2d16192897deb6835",slug:"phytochemicals-a-global-perspective-of-their-role-in-nutrition-and-health",bookSignature:"Venketeshwer Rao",coverURL:"https://cdn.intechopen.com/books/images_new/878.jpg",editedByType:"Edited by",editors:[{id:"82663",title:"Dr.",name:"Venketeshwer",surname:"Rao",slug:"venketeshwer-rao",fullName:"Venketeshwer Rao"}],productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"4816",title:"Face Recognition",subtitle:null,isOpenForSubmission:!1,hash:"146063b5359146b7718ea86bad47c8eb",slug:"face_recognition",bookSignature:"Kresimir Delac and Mislav Grgic",coverURL:"https://cdn.intechopen.com/books/images_new/4816.jpg",editedByType:"Edited by",editors:[{id:"528",title:"Dr.",name:"Kresimir",surname:"Delac",slug:"kresimir-delac",fullName:"Kresimir Delac"}],productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}}]},chapter:{item:{type:"chapter",id:"60825",title:"Colombian Neutron Activation Analysis Laboratory (CNAAL): Applications and Development Using the Nuclear Research Reactor IAN-R1",doi:"10.5772/intechopen.74395",slug:"colombian-neutron-activation-analysis-laboratory-cnaal-applications-and-development-using-the-nuclea",body:'The Colombian Neutron Activation Analysis Laboratory (CNAAL) is a facility used for qualitative and quantitative nondestructive chemical multielemental analysis by activating samples at the Nuclear Research Reactor IAN-R1 and analyzing their decay products using Gamma Spectrometry. Neutron activation analysis (NAA) in Colombia started at the Institute of Nuclear Affairs (IAN) when the nuclear reactor research IAN-R1 first achieved criticality in 1965. This technique has been used for over 30 years mainly for elemental analysis with applications in geology, hydrology, environmental and forensic sciences. In 1998, the Colombian government closed down the Reactor and the country’s nuclear development fell behind other Latin American countries who also began their nuclear research applications in the 1960s.
The onset of NAA in Colombia began in the mid-1950s, not long after the United States President Dwight D. Eisenhower gave his atoms for peace speech at the United Nations General Assembly on December 8, 1953. The Atoms for peace program served as shorthand for a number of programs intended to spread the peaceful uses of nuclear physics around the world and demonstrating its usefulness in the fields of medicine and energy generation. In 1955, the Colombian Institute of Nuclear Affairs (ICAN) was created, but it was not until 1957 that the Radioactive Analysis Laboratory was built as part of the ICAN chemistry program [1], being the predecessor of the current Neutron Activation Analysis Laboratory. This laboratory had basic instrumentation for personnel training purposes and was used for radiometric analysis by low-resolution gamma spectrometry using scintillation detectors like NaI(Tl) and single-channel systems.
Colombia was admitted to the International Atomic Energy Agency (IAEA) in the year 1960 and in 1964 began the construction of the dome building where the nuclear reactor stands today, later that same year the country received nuclear fuel manufactured in the United States as a donation by the American government. On January 20, 1965, the nuclear reactor achieved its first criticality (Figure 1) and operated at 10 kW during its first months [2].
Nuclear reactor start-up by Colombian president Guillermo León Valencia (1965).
In 1965, the first NAA samples were irradiated for elemental analysis [3], and the results were published 2 years later in 1967. Many scientific papers were published during this time, out of which two were of particular interest: the determination of inorganic iodine in samples of urine and the determination of trace amounts of selenium and tellurium in sulfur samples [4, 5]. The year 1971 witnessed the arrival of the first high-resolution Gamma Spectrometry System consisting of a germanium-lithium detector coupled to a multichannel analyzer (Figure 2). During this year, research focused on petrochemical analysis with the determination of vanadium in oil samples followed by the irradiation of food samples to determine nitrogen content in cereals.
Neutron activation analysis instrumentation, Ge-li detection system (1971).
Due to the boom in radioactive mineral exploration activities, the then Institute of Nuclear Affairs promoted a program for the quantitative evaluation of uranium and thorium in Colombia, for which Neutron Activation Analysis was used for the study of radioactive minerals and elemental determination in geological samples [1, 6]. Given the increased demand for this type of analysis and the interest from different companies on radioactive mineral exploration in the Colombian territory, a similar nuclear technique was implemented at the time which helped improve the precision of analysis: delayed neutron counting (DNC) (Figure 3). Delayed neutrons are emitted after nuclear fission events by one of the fission products sometime after the fission process [7].
U/Th analysis by DNC (1974).
As of 1973 and thanks to the support offered by the French Government, NAA was implemented as an alternative to conventional analytical methods for the determination of small quantities of precious metals such as gold, silver, platinum and palladium, among others [8]. For 12 years, from 1975 to 1986, the NAA technique reached its stage of the greatest development and was used as standard for elemental analysis. Thanks to the support given by the IAEA, the country received funds to upgrade its NAA laboratory due to the potential growth of users demanding this type of analysis (Figure 4). During this period, the use of NAA in Forensic Sciences was also introduced.
NAA instrumentation (1976).
From 1986 to 1989, work focused on improving procedures and methodologies in the application of NAA for mineral resource exploration and studies of sediments and water pollution [9, 10, 11]. From 1987 to 1990, there was a drastic decrease in workload (Figure 5) due to an upgrade at the nuclear reactor.
Irradiated samples from 1980 to 1990 [12].
Once the reactor was up and running, the laboratory continued its routine analysis, providing services to internal projects as well as to external clients. NAA was used mainly for mining companies and special forensic studies (Figure 6) [9]. In 1992, the laboratory was moved to a new space, which was built as an annex to the Reactor’s Building with the sole purpose of installing a pneumatic transfer system that would allow for the measurement of short-lived radionuclides (with average half-lives of the order of minutes and seconds).
NAA laboratory (1989).
In September 1994, the nuclear reactor went into an extended shutdown period due to modernization of its instrumentation and control systems as well as conversion from highly-enriched uranium (HEU) fuel to low-enriched uranium (LEU) TRIGA fuel. Process took place from 1995 to 1997.
In spite of the liquidation in 1997 of the Institute of Nuclear Sciences and Alternative Energies (Formerly Institute of Nuclear Affairs), the nuclear reactor still operated with its new TRIGA fuel and was utilized for the analysis of forensic samples needed by the Police Department for the determination of barium, antimony and copper. During the first quarter of 1998, forensic samples were analyzed for the determination of mercury in hair, but due to the closure of the institute, the Reactor was shut down on March 31 that same year [3]. This series of events halted the operational experience that the NAA Laboratory had built for about 32 years (Figure 7).
Gamma spectrometry system (1997).
It was not until 2005 that the Colombian Government decided to restart its Nuclear Program and began training personnel at the Reactor and associated nuclear laboratories. In May 2006 with support from the IAEA, the NAA technique was finally resumed, and tests were performed for the two Gamma Spectrometry Systems available at the time. One system equipped with a NaI(Tl) scintillation detector and the other with a Canberra 7229P HPGe semiconductor detector.
However, the NAA laboratory formally resumed activities in 2009, when the authorization for radioactive material handling was granted by the National Regulatory Authority. Several expert missions were received for training of new personnel. The first objective of the Laboratory in this new stage was to provide the service of multielement analysis of geological samples, for which the relative method (comparator method in the literature) is used through certified reference materials (CRM) [13, 14]. Figure 8 shows the state of the laboratory in 2009.
NAA laboratory (2009).
During the years of 2013 and 2015, the gamma spectrometry systems were modernized with High-Purity Germanium (HPGe) Canberra® detectors (Figure 9), an automated positioning system was also installed in the laboratory, making it unique in Latin America. IAEA experts have been continuously assisting on the validation for the test method and neutron flux characterization of the core. Today, thanks to the support given by the IAEA, the nuclear reactor and NAA laboratory have some of the most modern installations in Latin America with strong future prospectives in various fields of science.
NAA laboratory (2017).
Neutron activation analysis is a multielemental chemical analytical technique based on neutrons generated by the nuclear reactor to create radioactive isotopes from stable isotopes in a sample material. The technique relies on excitation by neutrons so that the treated sample emits gamma-rays, and this radiation is then analyzed enabling the user to detect, identify and measure the presence of radioactivity in natural or man-made sources. The main use for the laboratory is to complement the conventional analytical techniques adopted in the institute, especially for those elements whose routine determination may require costly procedures with high environmental impact due to their nature and complexity. This type of analysis is used for the elaboration of a national geochemical map, which is essential for mineral exploration in the territory.
In 2009, not long after restarting the IAN-R1 Research Reactor, the laboratory was re-established at the Colombian Geological Survey, serving the country once again as a key player in the determination of elemental composition in geological matrices. Samples are irradiated under appropriate safety conditions following national regulations, which are lined up to the International Atomic Energy Agency (IAEA) and International Commission on Radiation Protection (ICRP) guides and scientific publications.
From 2016 to 2017, the delayed neutron counting technique was re-established for the determination of uranium and thorium in resource exploration projects due to the sensitivity of the technique, which is lower than 1 μg/kg and can be used to analyze materials with high uranium content (including U3O8) and enrichment of 235U [15].
The scientific staff are qualified and trained with several years of experience and extensive operational knowledge in the management of radioactive material, radiation protection, qualitative and quantitative chemical analysis, waste management, isotope applications and nuclear energy applications.
A brief description of the rooms that make up the CNAAL is given in the following sections.
This room has the necessary infrastructure and equipment for the preparation and adaptation of samples. A Niton XL3t GOLDD portable X-ray fluorescence analyzer, which is used for the preliminary characterization of the samples, a homogenizer mill, three analytical balances, a tablet press and a bag sealer. Reference materials and standards are properly stored under controlled conditions in this room.
This room is where the samples are sent into and out of the core if the pneumatic transfer system is to be used. The systems console and Port No. 1 are located here. There is a gas and vapor extraction cabin with a 1.5 cm thick shielded port used to receive irradiated material from the reactor, and there is also a leaded glass which protects the staff from radiation exposure from the samples (Figures 10 and 11). Verification sources used for radiation monitors and calibration of gamma spectrometers are also stored in this room.
Gas extraction cabin.
Shielded port for sample transfer.
The Gamma Spectrometry Systems used in the detection and quantification of the gamma-rays emitted by the activated samples after irradiation are located in two different rooms. A HPGe Canberra GC-1020 detector, a Canberra 2002CSL pre-amplifier and the InSpector 2000 multichannel module are located in the first room.
The second room (Figure 12) has four HPGe detectors. Two Canberra GC-3018 detectors with 30% efficiency and energy resolution of 1.8 keV at 1.33 MeV at full-width at half-maximum (FWHM), and two GC-7020 units with 70% efficiency and energy resolution of 2.0 keV at 1.33 MeV (FWHM); each detector comes with its respective shielding, a LYNX® digital signal analyzer and is controlled by the Canberra’s Genie2000 v.3.3 software. There is also an automated positioning system that uses a robotic arm to automatically place the samples in each of the four HPGe detectors and reads the gamma spectra during the time it is programmed; this system was designed for radiological protection purposes.
Gamma spectrometry – Room 2.
he room assigned for delayed neutron counting consists of a console and Port No. 2 of the pneumatic transfer system, one ton of paraffin shield which sits on top of 20 cm thick concrete blocks, a geometric arrangement of eight proportional BF3 counters and its associated electronic instrumentation for neutron counting and determination of uranium and thorium in geological, environmental and forensic matrices. There is a central hole in the paraffin shield were samples are placed for reading, and there is also a manual mechanism for sample extraction once readings are done (Figure 13).
Delayed neutron instrumentation.
The radioactive material decay room is a space with lead and concrete shields needed to store activated samples for decay. It has two cylindrical lead containers with 6 cm thick walls for the storage of radioactive waste and two compartments made out of 15 cm thick concrete blocks for the storage of samples according to their half-life (Figure 14). Activated samples are temporarily stored in this room until the exemption levels are reached [16].
Concrete shielding in decay room.
The pneumatic transfer system allows for the rapid exchange of samples between the neutron activation room, the delayed neutron counting room and the nuclear reactor. Its master control is located in the Reactor’s console room and without authorization from the reactor’s personnel, it is not possible to send samples for irradiation, and this results in a redundancy in the safety of the sample positioning system.
This system consists of two compressors: flow diverters, two controls to send and receive samples (Figure 15) and a high-density polyethylene duct. The samples enter directly into one of the two aluminum terminals located in the core (positions D3 and C4), where the highest neutron flux can be found. It has the advantage to transfer activated samples to different areas speeds of 15 m/s, being an important aspect in the radiological protection of the personnel. This system is equipped with “air cushion” braking mechanisms to avoid violent crashes against the system ports.
Pneumatic transfer system controls.
The systems control unit includes a digital counter which can be set up for times between 30 s and 4 h. This unit controls the automatic valves to open and cut the air pressure at the right time. Since it is a complex pneumatic system with two receiving stations and two in-core terminal positions, there are diverters operated remotely from the control unit, which allows for the selection of irradiation positions and terminal stations where samples are received.
Due to the production of Ar41 during activation, terminal ports in the laboratory rooms are located inside extraction cabins with filters for radionuclides, preventing the inhalation of the radioactive gas by the operators.
The Colombian Geological Survey serves the country by providing reliable scientific data through research into basic and applied subsoil geo-sciences; evaluating and monitoring threats of geological origin; exploring and monitoring petroleum resources, minerals and groundwater; the ability to study the elemental composition of samples such as rocks, soils, sediments, minerals, water and gases is a major asset. Collected samples are often taken to different laboratories for a variety of analyses if required by the research being conducted. Several analytical techniques ranging from Gravimetric Analysis and Atomic Absorption Spectrometry, to X-ray Fluorescence, Inductively Coupled Plasma Mass Spectrometry (ICP-MS), and Neutron Activation Analysis among others are available at the Colombian Geological Survey.
Geological materials analyzed by NAA need to be previously dried at room temperature, crushed, pulverized and sieved to a particle size of 150 μm (100 mesh, Figure 16). Once the sample is received (~ 50 g), moisture content needs to be determined in order to make future corrections referencing the dried sample. Samples are homogenized, weighed (0.250 ± 0.001 g), pressed and encapsulated in plastic hermetically sealed polyethylene vials.
Sample preparation process: (a) drying (b) grinding and (c) screening.
Samples for long-lived element activation (days to years) are placed at the periphery of the core and vials with samples are arranged in racks as shown in the following diagram (Figure 17). These racks are placed in vacuum-sealed Ziploc bags before irradiation in the G3-G4 positions (Figure 18).
Rack sample configuration (left) neutron flux monitors attached to vials (right).
Reactor core schematic (IAN-R1).
The following elements can be determined after a 4-h irradiation operating at 30 kW: Sm, Lu, U, La, Nd, Eu, Hf, Ce, Yb, As, Sb, Ba, Br, Cd, Gd, Ga, Ho, Mo, W, Th, Cr, Cs, Sc, Ir, Ni, Se, Ag, Ta, Tb, Tm, Rb, Fe, Co, Zn, Zr. The neutron flux is measured by 5 mg Al + 0.1% Au rectangular foils as previously shown in Figure 17. Measurement required to obtain the correction factor fφ. Samples for short-lived element activation (seconds to a few hours) are irradiated inside the core at positions D3 or C4 (Figure 18). These samples are encapsulated in cylindrical pressure-sealed polyethylene containers, packed in pairs into rabbits (polyethylene vials) and transferred into the core by the pneumatic transfer system.
Sample irradiation in these rabbits ranges from 40 s at 5 kW for the analysis of uranium and thorium using delayed neutron counting techniques and up to 5 min at 30 kW for the analysis of short-lived elements (Al, Ca, Mg, Ti, V, Dy, Mn, K and Na).
The IAN-R1 nuclear reactor was built by the Lockheed Western Export Company and was commissioned in 1965 as a graphite-reflected pool-type research reactor, cooled by natural convection with light water. The current core consists of 50 fuel elements made of U-ZrH1.6 enriched up to 19.75%. The reactor is licensed by the Ministry of Mines and Energy (Nuclear Regulatory Body) to operate at the maximum steady-state power of 30 kW, and it is located inside a cylindrical tank made of carbon steel 6 × 10−3 m thick, 5.25 m tall and 2 m in diameter with capacity to store up to 16 m3 of water.
The nuclear reactor’s instrumentation and control systems were fully upgraded during 2012 and 2013 (Figure 19) by National Institute of Nuclear Research (ININ, México), in 2016 a new automated pneumatic transfer system (Figure 20) was installed, replacing the original system installed in 1997. This system opened up two irradiation positions inside the core, remotely controlled from ports 1 and 2 located in the neutron activation and delayed neutron counting rooms, respectively.
Nuclear research reactor IAN-R1.
Rack with samples for irradiation.
Additionally, there is a peripheral pneumatic transfer system that was part of the original design (1965) and is used to irradiate samples in a position adjacent to the core (Position A6). This old system was used from 1968 to 1992 for radioisotope production (24Na, 32P, 82Br, 198Au and 99Mo) [17].
The rack containing the flux monitors and samples is positioned in the middle of the frontal face of the core, irradiated during 4 h at 30 kW (Figure 20) and subjected to a thermal neutron flux of around 2.3 × 1011 neutrons cm−2 s−1.
Table 1 presents a summary of the experimental conditions used for the analysis of short-, medium- and long-lived elements.
Characteristic | Value/description | |
---|---|---|
Pneumatic transfer system | Rack system | |
Method | Direct comparator | Direct comparator |
Measurand | Mass fraction | Mass fraction |
Sample/comparator (mass) | 0.250 ± 0.001 g | 0.200 ± 0.001 g |
Reactor power | 20–30 kW | 30 kW |
Irradiation position | D3 or C4 | G3-G4 |
Irradiation time | 1–5 min | 4 h |
Flux monitor | Al + 0.1% Au 0.5 mg | Al + 0.1% Au 0.5 mg |
Decay time 1 | 5 min | 3–7 days |
Reading time 1 | 5 min | 3 h |
Reading 1 geometry | 50 mm | 30 mm |
Decay time 2 | 60 min | 21–28 days |
Reading time 2 | 10 min | 4 h |
Reading 2 geometry | 10 mm | 15 mm |
Photon energy (keV) | Nuclide dependent | Nuclide dependent |
Experimental irradiation conditions.
Automation allows greater control of counting geometries, less error in positioning, increased productivity in the analyses, increased control and quality assurance of the analytical data and decreased doses received by the staff [18].
The automated system developed in the NAA laboratory fulfills the following objectives: Programming of analysis sequences, opening and closing of shields for sample positioning in the detector, and communication with the software for data acquisition. This has improved productivity by enabling 24/7 operation, and as a side benefit there is also less exposure to ionizing radiation.
This system is based on electromechanical components that can handle up to 64 sample readings in the same sequence of analysis, for which each step includes the collection of the sample from a sample rack, the positioning of the sample in the detector, data acquisition at pre-defined reading times, and the return of the sample to the rack where the other samples are located.
All of this is possible by means of a high precision positioning system based on linear actuators. The system is controlled by a human machine interface (HMI) where execution commands can be programmed. Figures 21–24 show how everything is set up.
Positioning system: 1. Detector A; 2. X-axis linear actuator; 3. Sample rack (64 positions); 4. Detector B; 5. Y-axis linear actuator; 6. Z-axis linear actuator; 7. Detector C; 8. Detector D; 9. Control panel.
Positioning system: 1. HMI; 2. Emergency stop; 3. System status; 4. Electronic components; 5. Power control.
Positioning system: 1. Electric motor to open/close shielding; 2. Shield sensor for opening; 3. Shield sensor for closing; 4. Emergency stop; 5. Sample gripper; 6. Detector sample support; 7. Actuator motion limit sensor.
Positioning system.
In principle, the presence of personnel in the gamma spectrometry room is limited while the positioning system is in operation. However, shielding for the sample rack is to be installed in the near future for radiological protection purposes.
Precision is determined by servomotors that provide the movement, which have a resolution of 1,048,576 pulses/revolution per axis. Coupled to the previously described servomotors, there are linear belt actuators (Accuracy ±1.0 mm) with their respective guides for alignment and friction reduction throughout the working area.
The system has two spatial adjustment options, point-to-point which displays the 64 positions of the sample rack and the 4 detector positions; and also single-point which is used to correct a common mismatch in all points using the point-to-point option, defining the first position of the rack, and allowing for the automatic adjustment of all the other positions. Both of these options are password protected for security reasons.
The point-to-point adjustment option must be used to change the counting geometry on the detectors, which must be performed prior to the execution of the sequences as required by the operators.
This positioning system greatly reduces manual efforts during the analysis of radioactive samples; the only manipulation required by our staff is the setup of the 64 samples in the rack. The idea of the use of this rack is minimizing Radiation Exposure, and thus enhancing the safety and well-being of personnel.
In order to offer a quality service, the laboratory has made important updates in its instrumentation; acquiring four state-of-the-art HPGe Canberra Detectors for the measurement of gamma radiation and a novel sample positioning system.
The NAA relative method uses gamma radiation emitted by the radioactive nuclei from activated samples and compares it to the radiation emitted by a reference material with similar characteristics.
The characteristic gamma energies of each radionuclide are measured using one of the four solid-state semiconductor detectors (GC-3018 and GC-7020) coupled to LYNX® digital signal analysers controlled by the Canberra’s Genie 2000 (v3.3) software. Each of these systems is calibrated weekly in energy, and its efficiency is checked monthly using a gamma check source kit consisting of 241Am, 22Na, 133Ba, 137Cs, 155Eu and 60Co electro-deposited point sources.
Depending on the irradiation, system used (Table 1), and once pre-determined decay times are reached, radiation measurement is performed by using one of the HPGe detectors [19].
Radiation measurement by samples coming from the pneumatic system is performed in some of the less efficient detectors (GC-1020 or GC-3018, depending upon availability). For complete analysis, two readings are carried out: the first, after 5 min of decay, positioning the vials individually at a distance of 50 mm from the detector and reading the corresponding spectra for 5 min. The second reading is done after the activity decays for an hour, at a distance of 10 mm and the spectra is read for 10 min. On the other hand, samples not going through the pneumatic transfer system are analyzed as follows: a first reading is done after a 4-day decay on one of the GC-3018 detectors, positioning the vials individually at a distance of 30 mm from the detector and reading the spectra for 3 h. A second reading is then performed after 21 days of decay on the higher efficiency GC-7020 detectors at a distance of 15 mm and the spectra is read for 4 h.
Flux monitors used during sample activation for flux corrections are also analyzed by gamma spectrometry on one of the GC-3018 detectors at a distance of 50 mm for 60 min. The samples obtained its corresponding gamma spectrum (Figures 25 and 26).
Detection geometry for check source verification.
Gamma spectra from soil sample irradiated for 4 h at 30 kW and a 5-day decay.
The elemental determination in the NAA is done by using the relative calibration (direct comparator method) [20]. This method uses a sample with known mass of the elements of interest (comparator or standard) and an unknown sample which is irradiated simultaneously. Taking into account that the amount of radiation emitted from the activation of the sample is proportional to the neutron flux, and this in turn to the mass of the irradiated element, it is found that the ratio between the mass fraction of the element x and the amounts of influence is given by:
The subscripts indicate parameters for the unknown sample and the comparator or standard. That is, the mass fraction of the unknown sample of the element (measurand) and the mass fraction of the element in the reference material. W is the total mass of the samples. The number of net counts of the energy of interest (keV) and the counting time of the gamma radiation are decay correction factors of the peak; this factors are used to obtain the neutron flux correction factor, which quantify the gradient of the flux between the irradiation position of the sample and the comparator.
The neutron flux correction factor is determined as the ratio between the flux measured with the 0.1% Au-Al flux monitors at the sample position and that of the comparator. The neutron flux is proportional to the number of counts in energy range of 198Au and depends on other factors such as the neutron capture cross-section, isotope abundance, irradiation time, 198Au half-life, detection efficiency, and number of accounts for the emission energy of the radioactive isotope. Taking the relationship between the flux readings, all the terms except for the number of counts registered for the monitor at the sample position and for the monitor at the comparators position are canceled, obtaining:
This relationship is fulfilled, assuming that the irradiation conditions and counting geometries are similar.
In compliance with national regulations, the Neutron Activation Analysis Laboratory has developed a simple scheme for the safe management of activated samples once they are no longer needed. These procedures are authorized and monitored by the National Nuclear Authority (Ministry of Mines and Energy). The aim of radioactive waste management is to isolate and apply protective measures to this type of waste so that there are no foreseeable future human health risks and/or negative effects on the environment.
Most of the radioactive waste corresponds to plastic materials (vials, racks, bags, tapes, etc.), as well as flux monitors and samples activated during irradiation, and also elements used in the decontamination of working areas (gloves, paper towels, plastic bags, etc.). Most of the waste is classified into three categories: Group 1 – Exempt Waste (EW), Group 2 – Very Short-Lived Waste (VSLW) and Group 3 – Very Low Level Waste (VLLW) [16].
The NAA Lab has a decay room for the temporary storage of VSLW, equipped with the necessary shielding and equipment for its safe handling. The room is locked and permanently monitored, admission is restricted to non-operating personnel, unless authorized otherwise. The stored waste is properly labeled and grouped into packages each workweek.
In order to classify and monitor temporarily stored waste, packages are analyzed by gamma spectrometry. Each package is analyzed separately in the GC-7020 detector at a reading geometry of 10 mm during 4 h, determining the activity of each of the radionuclides present.
Radioactive waste is discharged as conventional waste only when its activity reaches acceptable levels established by national regulations, with previous knowledge and consent of the Regulatory Authority. Procedures for the Management of Radioactive Waste are lined up with technical and administrative requirements established by national regulations. The following schematic allows for the safe management of radioactive samples and activated materials generated during practice.
Minimization: Only materials and samples directly linked to national projects are irradiated in order to generate useful information for the economic and social development of the country.
Segregation: Separating waste generated during short and long irradiations and that collected during decontamination activities.
Pre-treatment: Waste package preparation, 16–20 samples per package.
Classification: By activity concentration and half-lives of nuclides present in the sample.
Characterization: Classification and monitoring of temporarily store waste are performed by Gamma Spectrometric analysis of the packages generated each workweek. Every package is analyzed separately in Canberra HPGe GC-7020 detectors, at a reading geometry of 10 mm during 4 h, these reading are then analyzed and the activity of each radionuclide present is determined.
Storage: The NAA Lab has a decay room for the temporary storage of VSLW, equipped with the necessary shielding and equipment for its safe handling. The room is locked and permanently monitored, admission is restricted to non-operating personnel, unless authorized otherwise. The stored waste is properly labeled and grouped into packages each workweek.
As part of the validation process for NAA using HPGe detectors and future accreditation of the laboratory under ISO/IEC 17025:2005 [21], the technique has been validated for the determination of rare earths such as La and Ce, and elements of interest such as U and Th in geological matrices. The following parameters were taken into account: selectivity, linearity, reproducibility, limits of detection and quantification, robustness and uncertainty estimation.
This process included the evaluation of detection limits and quantification of gamma radiation spectra obtained, according to the statistical criterion of Currie [22]. The following results show element concentrations in the sample in units of mg/kg. Ba: 129, Ce: 1.37, Co: 0.20, Cs: 0.29, La: 0.11, Rb: 10.06, Sb: 0.054, Sc: 0.024, Th: 0.27, U: 0.2. These results were comparable to those reported by other laboratories, thus demonstrating the competence of the NAA Laboratory on multielemental analysis in geological matrices.
Certified reference materials (rocks, soils, sediments and coals) are used as comparators for the implementation of the technique, and they serve as a basis to compare known quantities of an element with fractions of elements in the sample. Internal standards are used for routine control of the method, and these standards are geological materials with known concentrations reported by other laboratories worldwide that use NAA or other analytical techniques, these standards are evaluated under the same analytical conditions of the problem samples.
For the determination of uncertainty, the steps recommended in the Reference Guides [23, 24] were followed. First, the measurand was defined, establishing its relation with influence quantities and identifying them. Identifying those with greater contribution were evaluated according to their type: A or B. Finally, the combined uncertainty and the expanded uncertainties are quantified.
The uncertainty estimation was done following the bottom-up approach. The procedure consisted of establishing the measurand, identifying and quantifying the sources of uncertainty and finally determining the combined and extended uncertainties. The sample’s mass, standard’s mass, neutron flux gradient, counting geometry differences, and sample count statistics were evaluated as sources of uncertainty. Sample and standard count statistics as well as differences in irradiation geometry were identified as the main contributors to the uncertainty [25, 26]. The combined relative uncertainty for the studied elements oscillates between 2 and 8% (Table 2).
Element | Isotope | Half-life (days) | Energy 1 (keV) | Energy 2 (keV) | LOD (mg/kg) | Precision (%) | Veracity (%) | Uncertainty (%) |
---|---|---|---|---|---|---|---|---|
La | La-140 | 1.68 | 1596.2 | 487.0 | 0.11 | 6.1 | 97.4 | 4.0 |
Sb | Sb-122 | 2.72 | 692.8 | – | 0.05 | 9.5 | 103 | 1.9 |
U | Np-239 | 2.36 | 106.1 | 228.2 | 0.25 | 6.9 | 100 | 8.9 |
Ba | Ba-131 | 11.5 | 216.1 | 496.3 | 129 | 5.1 | 96.1 | 8.8 |
Ce | Ce-141 | 32.5 | 145.4 | – | 1.37 | 2.8 | 101 | 9.9 |
Co | Co-60 | 1925 | 1173.2 | 1332.5 | 0.20 | 3.2 | 95.6 | 5.8 |
Cs | Cs-134 | 754 | 604.7 | 795.9 | 0.29 | 2.1 | 103 | 6.9 |
Rb | Rb-86 | 18.6 | 1076.6 | – | 10.1 | 5.8 | 95.9 | 6.7 |
Sc | Sc-46 | 83.8 | 889.3 | 1120.5 | 0.02 | 3.5 | 98.3 | 6.2 |
Th | Pa-233 | 27.0 | 312.2 | – | 0.27 | 3.3 | 97.6 | 8.3 |
Multi-elemental validation results.
The results of the evaluation of performance: limits of detection, intermediate precision, robustness, veracity and uncertainty, meet the requirements established for the test method; establishing a line of work toward further validation of more elements and offering the scientific community a proven method according to international standards [27].
As part of the application for the accreditation process under the ISO/IEC-17043 standard [29], and the need for constant validation in performance and quality assurance, the laboratory participates in annual IAEA-WEPAL (Wageningen Evaluating Programmes for Analytical Laboratories) Proficiency Tests and Inter-laboratory Comparisons, obtaining excellent results and positioning its metrological competence, this being a major step toward accreditation under ISO/IEC 17025 [21].
The Colombian Laboratory for Neutron Activation Analysis, CNAAL, is an installation oriented to the generation of high-quality analytical data that contribute to the geoscientific knowledge of the national territory, represented in the characterization of our valuable mineral and hydrocarbon resources. This potential of CNAAL’s analytical technique can now be applied in vast areas of the country, which for decades were the scene of a long, costly and painful armed conflict, which ended in 2016 with the signing of the Peace Agreements between the Colombian State and the FARC guerrillas, the oldest in our continent.
Our laboratory has focused its analytical capabilities on the exploration of rare earth elements, which according to the OECD study [30] present a relatively favorable scenario for the search for these strategic minerals that present a greater supply risk taking into account its typical scarcity.
Rare earth elements (REEs) are central in information and communications technologies and green technologies, which is one of many reasons that justify studies in this area. In this way also, OECD’s Cost of Inaction and Resource Scarcity; Consequences for Long-term Economic Growth (CIRCLE) Project “…aims at identifying how feedback from poor environmental quality, climate change and natural resource scarcity are likely to affect economic growth in the coming decades” [28].
Additionally, the characteristic mobility of REE is useful for the study of petrogenetic processes and the study of the geochemical cycle of uranium and other associated energy minerals.
Other applications planned for neutron activation analysis technique are related to: advances in the validation of analytical methods to determine elements, quality assurance by ISO/IEC 17025, continue with successful participation in the IAEA – WEPAL proficiency test and promotes future developments to generate impact researches on selected topics on geological materials characterization (rocks, soils, sediments, minerals and hydrocarbons), forensic sciences (element traces in crime scenes), archeometry (studies of provenance of bones, paintings, pottery, coins) and environmental sciences (mobility and accumulation of eco-toxic elements in humans, from technological and industrial processes and evaluation of environmental impacts in the biotic components), among others. In order to consolidate the credibility of our results, the LAAN has participated in a series of intercomparison exercises whose results have been improved to date.
Recent advances in the characterization of the neutron flux (thermal and epithermal) of the modern Colombian nuclear reactor IAN-R1 (upgraded in 2015), allow the CNAAL a window of opportunity for the implementation of the “k0 – NAA method”, to improve the analytical capabilities of the laboratory, placing it at the level of other facilities of similar characteristics in other countries [29].
The Colombian Neutron Activation Analysis Laboratory and the Nuclear Research Reactor IAN-R1 area singular scientific and technological facilities in our country, located at the Colombian Geological Survey (Servicio Geológico Colombiano). CNAAL plays an exceptional role oriented to cover technical topics in sustainable exploitation of mineral resources and hydrocarbons, developments in nuclear sciences and researches in environmental and forensic sciences. At this point, the laboratory is available to the entire scientific and academic community of the country and recently upgrading of the Nuclear Research Reactor IAN-R1 (2014), also contributes to these national goals.
The CNAAL has state-of-the-art technology and competent personnel, which allows it to expand the coverage of research services in the country, through the Neutron Activation analysis in the execution and development of research projects.
Special mention is offered to the International Atomic Energy Agency – IAEA for its permanent support to CNAAL, represented in technical assistance, expert missions, equipments and spare parts, trainings and scientific visits in order to strengthen our scientific capacities. Thanks are due to Mr. Peter Bode (TU-Delft) for his invaluable assistance. Acknowledgement is made to Mr. Oscar Paredes Zapata, General Director of Colombian Geological Survey, for his assistance. The authors also thank to Mr. Fernando Mosos, Technical Director of Nuclear Affairs Division for his support.
In delusional misidentification syndromes (DMSs), the individual everlastingly misidentifies persons, places, objects, or events. Capgras syndrome (CS) is the most common in the umbrella term DMS [1, 2]. Perhaps the best known form of DMS is the Capgras syndrome, originally described by Dr. Joseph Capgras and his colleague, J. Reboul-Lachaux, in the early twentieth century [3]. They first encounter this impressive phenomenon when their patient Madame M. insisted that all her friends, family, relatives, and neighbors were being replaced or constantly misperceived as being an imposter [4]. The term l’illusion des sosies (the illusion of doubles) was used to describe the case of a woman who strongly believes that various “doubles” had taken the place of people she knew [3]. It is an essential feature of the Capgras syndrome, the denial of identity of known persons and the delusional belief that this person has been substituted by a double [5].
CS is characterized by the delusional denial of identity of a significant other and the belief that they have been replaced by a double. Some patients with CS may deny the identity of the actual spouse and claim that there are two spouses, the actual and the imposter [6]. Therefore there are four conditions in patient with CS: the person is recognized, and the patient affirms the resemblance of the double to the misidentified significant other; no identity is attributed to the double, who has neither name nor existence; the double is an imposter, pretending to be the original they are replacing; the original has disappeared, his/her absence remaining unquestioned [7].
The rareness of CS, as well as its impressive clinical manifestation as a colorful syndrome, has caused most publications to present case descriptions as scientific curiosities [8, 9]. CS has also attracted the attention of novelists in fictional literature. Dostoevsky provided a dramatic description of the phenomenon in his novel, The Possessed [6]. Sociocultural factors essentially shape the phenomena and thus mightily influence the establishment of definitions of this disorder [11]. Therefore, it may be necessary to mention. The meaning given to the terms ‘change’ and ‘transformation’ of physical identity has been called ‘incarnations’ or ‘possessions’ of other bodies in some cultures [11]. Possessions by an evil spirit have early origins within Paganism, Wicca, Haitian voodoo, Buddhism, Hinduism, Judaism, and Christianity [12]. There is a belief in some countries that people can be possessed by Satan and made to act in strange, immoral, and antisocial ways. In the United States, among European-American Catholics, there exists a belief that demons may possess a person. Possessing demons are presumed to cause experiences of proscribed feelings, thoughts, or behaviors in the person. Occasionally, solutions involve exorcism rituals [13].
It is generally being reported as single case studies in the literature. Although an uncommon psychiatric disorder, Capgras delusion has been central to the development of theories of delusions [6]. It is not dealt with particularly in the DSM-5 and may be classified as delusional disorder, suiting either the persecutory or the unspecified type [14]. With no consensual clinical criteria for this syndrome, it is usual to refer to their original description [7]. The basic manifestation was a false belief that real and familiar persons or oneself is replaced by strange, malicious imposters [15]. In fact, CS is a ‘hypoidentification’ of a person closely related to the patient [6]. CS is more frequent in women than men, with a sex ratio of approximately 2:1, but this result was not found across all studies [7]. Only a few reports have described this syndrome in patients during childhood [16].
The remarkable feature of Capgras delusion is that patients are able to recognize the close relation, the related person’s face, but deny his or her identity and often use subtle misperceived differences in behaviour, personality, or physical appearance to distinguish between him or her and the imagined impersonator [17, 18]. Patients with CS find ways to defend their irrational beliefs [4]. Generally, the patients support their conviction in revealing detail. This sign may be a habit or a personality trait; small misperceived differences, for instance, in physical appearance and behaviour, may vary over time [7]. And these are frequently used to distinguish the imposter from the loved one [19]. Surprisingly, patients may show implicit or explicit awareness of their true situation [6]. Some research suggests that a considerable number of patients with CS have some awareness of the bizarre nature of the misidentification delusions and therefore tend not to report them, especially during initial interviews when they are less likely to be confident with the clinician [20].
Common to all DMS is the delusional denial of identity of objects having affective significance for the patient, and it is exceptional for there to be only one imposter, but these objects are limited in number. CS may be associated with other DMSs, and these frequently evolve from one another because of this relation and similarity [7, 21].
It sometimes occurs isolated, hereby justifying its autonomy as a ‘delusion’ [7]. CS may be accompanied by other delusions and thus may rarely exemplify a ‘monothematic’ delusion [6]. Erotomanic delusions and delusional jealousy [i.e., Othello jealousy] were identified in 9.1% and 6.4% of patients with CS, respectively [22, 23]. However, delusional misidentification syndromes uncommonly appear independent of comorbid pathology [24].
The absence of consensual clinical criteria makes the epidemiological data uncertain [7]. Thus, the prevalence of CS may be underrated. More than half of the patients of the registered cases suffered from mental disorders without any organic association, among which schizophrenia spectrum disorders were diagnosed in 6 of 10 patients with CS [22, 23]. The Capgras delusion has been reported in association with other psychiatric disorders in 60–75% of cases and in organic illnesses in 25–40% of cases [24]. The Capgras delusion has usually been recognized in the contextual relationship of psychiatric disorders and often occurs in conjunction with paranoia, derealization, and depersonalization [6]. The Capgras syndrome may represent a delusional evolution of the phenomena of depersonalization and derealization [25]. Nonspecific, derealization-depersonalization experiences are frequent, especially in psychotic disorders, and are considered a significant core symptom of CS [7]. Studies on the prevalence of this disease or comorbid disease show differences. A study has found that the prevalence of DMS in psychiatric populations was less than 1% [15]. Another study has found that its prevalence in all psychiatric inpatients is 1.3–4.1% [26]. It is around 3% for hospitalized psychotic patients [18]. In a recent prospective study of patients hospitalized for a first psychotic episode, it was found that CS was diagnosed approximately 1 in 10 of patients. The prevalence was maximal among patients presenting schizophreniform psychosis 50%, brief psychosis 34.8%, and unspecified psychosis 23.9%, and the prevalence was moderate for a major depressive episode 15%, schizophrenia 11%, or delusional disorders 11% [15]. The most common psychiatric diagnoses in CS have been paranoid schizophrenia, schizoaffective disorder, and bipolar affective disorder [24]. CS has been linked with multiple pathologies. It has been described in psychiatric as well as organic disorders. In the last few decades, reports have increasingly stressed the aetiologic importance of heterogeneity of conditions that have been found in the patients with misidentification syndromes like the Capgras delusion, including cerebrovascular disease, post-traumatic encephalopathy, temporal lobe epilepsy, postencephalitic Parkinsonism, viral encephalitis, migraine, vitamin B12 deficiency, hepatic encephalopathy, chronic alcoholism, hypothyroidism, pseudohypoparathyroidism, and dementia [24]. Schizophrenia remains the most common co-occurring mental disorder associated with case reports of Capgras delusion [26, 27]. Also, family history of psychosis is reportedly present in half of CS patients [21]. Medications and drug toxicity have also been reported to cause CS [28].
Since initial reports of CS involved patients with psychiatric illness, their close relations, and how they interacted with each other, early explanations of the delusion were predominately psychodynamic interpretations. There are several psychodynamic approaches. Consequently, these explanations included suggestions that CS might develop out of Oedipal issues in women as a defence against hostility or incestuous, guilty desires, or out of hidden homosexuality in men. Later attempts to account for CS resulted in hypotheses of anxiety-induced regression of cognitive and emotional functioning, pathological splitting of internalized object representations, insufficiently repressed conflicting or ambivalent feelings toward the implicated person, and the projection of negative emotions that come to light from these conflicting feelings [18]. In the psychodynamic theory, it is supposed that the delusion is a way in which the patient copes with the ambivalent emotions that he feels toward the close family member who is duplicated [16]. There are several explanations brought about by psychodynamic approaches of misidentification syndromes. Premorbid psychopathology, motivation, and loss of ego functions may be important in determining which vulnerable patients develop CS [6].
Capgras delusion can occur due to ‘spatial disorientation, anatomic disconnection, memory and executive process impairment, and loss of ego’ [4]. While psychodynamic theories consist of ambivalence theory, depersonalization theory, and regression theory, neurocognitive hypotheses focus on right hemispheric dysfunction, face-recognition processing abnormalities, and focal structural cerebral abnormalities [29]. There are two components of the visual recognition of a familiar face, one of which is responsible for conscious recognition of the face and the remembrance of associated semantic information, while the other is responsible for the limbic-mediated emotional arousal including the feeling of familiarity that accompanies the conscious recognition of a known face [9].
Despite the sharp increase in the number of published cases accompanied by various suggestions regarding an organic etiology, to accurately explain the delusion, it is necessary to embrace the psychodynamic as well as the organic. Even if a specific neuropsychological lesion is found in the end, the psychodynamics of the individual will still be pertinent and remain substantial [10]. An association between CS and depersonalization has been thought to exist onward the time when the disorder was first described. Some authors put forward that depersonalization may be the basis of the disorder which may develop in some individuals. CS can be evaluated as a disorder of ego function which permeates the entire personality [10]. Some authors postulated that cerebral dysfunction leads to feelings of derealization and depersonalization which in turn may develop into Capgras’ syndrome in the presence of paranoid ideation [10].
The psychodynamic conception of the Capgras phenomenon is basically a love-hate conflict that is resolved by reflecting ambivalent feelings onto a fictitious double [10]. On the one hand, there are a long-standing love and on the other hand a visible hatred. In those cases when it occurs, it is very substantial that before the onset of the delusion of doubles, the patient shows an increased love and sexual desire toward the object. This overreaction results from a desire for reassurance regarding the love of the object and fear of losing it simultaneously. Theories suggested that CS could arise out of an Electra complex and incest desires, Oedipal problems, and latent homosexuality. Personality disintegration coupled with an evolutionary regression to more primitive modes of cognitive and emotional functioning; division of internalized object representations; ambivalent feelings toward a familiar other that are not sufficiently suppressed; and the feelings of anxiety, guilt, and anger resulting from this struggle are reflected onto imagined imposter [21]. Instead of approving these demands, the object becomes even more repulsed and is unable to cover up these feelings that clearly aggravate the situation, and a vicious circle is established [10].
Usually, we do not strive for facial recognition. The ability to identify people who we met before is a headstone of our social interactions. Face recognition is a multistage process ending with the identification of a person. Prosopagnosia is defined as loss of familiarity to previously known faces and the inability to learn to recognize new faces. Although these patients fail to recognize faces, they are still able to show affective responses to these faces [30, 31]. Several studies have suggested that CS represents a ‘mirror image’ of prosopagnosia, thus suggesting different neural circuits for facial processing: a cognitive circuit (impaired in prosopagnosia) and an affective circuit (impaired in CS). In the affective circuit, the ventral route from the visual centers to the temporal lobes may be protected, also active in conscious face recognition; however, the dorsal visual track that gives the face its emotional significance is damaged. A brief disruption of the ventral visual pathway leads to prosopagnosia, whereas damage to the dorsal visual areas leads to an impaired sense of familiarity for known faces, as in CS [9, 18, 30, 32]. While the ability to identify that person is intact, patient with CS probably has a brain lesion that interferes with the patient’s ability to sense a familiarity toward the significant other [16]. It has been suggested that the impairment seen in the Capgras delusion was linked to a disruption of pathways connecting face-sensitive regions to limbic cortex, which is involved in the accompanying emotional response [30]. Perhaps arising from the conflicting experience of recognizing a known face without any accompanying affective reaction, the patient can understand that the absence of this emotional arousal is to establish the belief that the person he is looking at is an imposter [9, 33]. In another connectivity study, posterior coupled with anterior right hemisphere dysfunction may have involved in the emergence of Capgras delusion [34]. Also, it has been suggested that CS results from the disconnection of the face processing regions in the inferior temporal lobe from structures in the limbic system, especially the amygdala, which is very important in assigning emotional value to familiar faces [34]. Common to the CS is a fixed false belief but infrequently transient [35]. However, anatomical disconnection models fail to efficiently consider the transient nature of the misidentification episodes [34]. Therefore, it has been suggested that CS may be associated with the ‘kindling of subcortical structures’. Kindling refers to repeated subthreshold stimuli which may result in psychomotor outbursts or overt seizure activity [34]. Autonomic responses and eye movements are involved in face perception which may cause the patient believe that the person has been replaced by an imposter. Studies on patient with CS like other psychiatric disorders have shown abnormal scan paths to facial stimuli or abnormal skin conductance response (SCR) in face processing tasks [30, 33]. The absence of identity recognition, accompanied by a lack of SCR, stimulates the patient to explore unfamiliar faces, and identity recognition of familiar faces leads to a more detailed exploration in the eye region, and it results in gaze avoidance of the eye region [33]. Vision is important in accessing reserved knowledge in the etiology of CS. However, surprisingly CS has also been reported in a number of blind patients which suggests that it cannot have an exclusively visual basis [34]. Some theories assume that two deficits are necessary for delusions to occur in the case of Capgras delusion like other DMSs [32, 36]. This is also called ‘two-hit’ process [21]. The first one, the brain’s ability to attach emotional emphasis, may be the lack of autonomic arousal which leads to the abductive inference that the person is an imposter [30]. The other deficit is an impaired ability to reassess beliefs [the global consistency-checking mechanism] which prevents the rejection of the bizarre belief. The second deficit leads to the persistence of that abnormal perception as a delusion resistant to reasoning, also related to the right anterior cortex of the second deficit [9, 30, 32, 36].
Neuropsychological deficits in patient with CS were reported across multiple cognitive domains, including memory, executive functioning, and visuospatial processing. These studies suggest that memory was statistically more likely to be impaired than other cognitive domains. Therefore, the memory may be playing an important role in the development of these delusions [32]. The existence of confabulations may have a role in prognosis and predicted significantly longer delusion duration, once more supporting the importance of memory impairment in patients with CS [32]. To mention a little more about the confabulation, some authors are focusing on confabulation in these patients because they are thought to be confabulation and delusion are closely related. When asked how they can explain their beliefs, Capgras patients will often confabulate. Confabulation is a kind of false memory that occurs when patients produce stories that fill in gaps in their memories, whereas a delusion is a mental state, typically thought of as a belief. Confabulation and delusion cannot be completely the same [37, 38]. Some researchers suggested that CS comes out when right hemisphere dysfunction causes a memory disconnection that leads to a failure to put new information together with representations about a significant individual and to keep in reserved over time [18]. Against all of these, although many patients have subtle deficits in face recognition and memory for faces, they do not have difficulty in recognizing faces in everyday life [1, 2]. CS is distinguished by its delusional mechanism: it is neither a hallucination nor an illusion—the object is correctly recognized in its appearance. CS is not a memory disorder. The person is correctly recognized; people are memorized [7]. Language deficits may not be absent, because of the right hemispherical dominance of the lesions [32].
In 1971 a case of Capgras was described in a young man following a head injury, with no previous history of psychiatric disorder. Since then, many patients with CS have undergone more thorough neurological investigations [10]. Identification disorders like CS are very frequent in neurodegenerative diseases [7]. Regarding the organic conditions that occur in Capgras delusion, this appears mainly in various types of dementia like Alzheimer, Lewy bodies, and Parkinson [39]. The prevalence of CS in Lewy body dementia may be as high as 25% and 10% in Alzheimer-type dementia. Identification disorders are much rarer in other types of dementia, especially those associated with Parkinson’s disease [7]. Nearly half of the cases in CS were associated with neurocognitive disorders, such as delirium, traumatic brain encephalopathy, cerebrovascular disease, dementia, meningioma, encephalitis, and multiple sclerosis [22, 23]. Although there is usually a delay in the presentation of Capgras delusion after cerebral events, there are also such cases of immediate presentation [31]. Psychotic disorders with CS tend to present in the late teens and early twenties. It reflects the long mean duration of the delusion in the functional group [27]. Those with neurological disorder associated with the onset of the delusion had a mean age of 60, in keeping with their presentation in middle to late adulthood, especially as Capgras delusion in dementia tends to occur in the later stages [27]. Therefore all individuals with Capgras should be examined for organic pathology [9]. In a literature review of patients with CS who had associated organic factors, there are several single case reports in patients with Capgras delusion which suggest structural and metabolic anomalies in mostly right-sided frontal, temporal, or parietal brain regions. But most of CS patients had bilateral lesions although, for those with unilateral lesions, right hemisphere lesions were much more likely [30]. Some studies give emphasis to the presence of two lesion sites, one in right frontal and the other in right temporal cortex [30]. The identity of the imposter is significantly associated with the reported underlying etiology. Capgras’ delusion is reportedly due to functional psychiatric disorder, which is more likely to view their parent as an imposter, whereas the spouse is involved in those with suspected neurological etiology. There may be mentioned two reasons. The first one is may be because of the different mean age for the groups. The age of onset of Capgras delusion is different between those with organic disorders and those with neurological disorders [27]. The other reason is about Capgras delusion’s feature. Capgras delusion is the phenomenon mostly specific to close relatives. This supports the role of intimacy [9, 27]. Selectivity for familiar persons is essential, though sometimes relative, and the syndrome can extend to persons who are simply known or famous [7]. Against this, the frequency with which strangers and multiple imposters are implicated in all cases of Capgras delusion can be up to 39% [27]. Multiple imposters are significantly more likely to occur in functional cases, while the involvement of inanimate objects would seem to suggest organic etiology [27]. The neuropsychological findings discussed may lead to some account of the possible mechanisms by which an abnormal experience may be generated in a subset of Capgras patients, but some researchers do not think in itself account for the formation of delusional belief [40]. Consequently, the explanation may offer a useful, helpful analysis of a certain step in the pathology of the CS in a subgroup of more neurological patients but could be unlikely to enlighten about delusions more generally or those with Capgras in the context of a functional psychosis such as schizophrenia or bipolar disorder [40].
The term CS does not demonstrate a well-defined mental disorder. Over the years various studies have suggested psychodynamic and neurophysiological interpretations for CS, and various aetiologies have been recommended for the condition’s development [16, 18, 29].
Although frequently seen in psychotic cases, Capgras has also been associated with neurological disorders suggesting that the syndrome has an organic basis [15]. According to a study, CS patients were classified into groups according to whether or not they had evidence of neurological disorder. Some of the patients identified as having no neurological lesion might be found to have organic brain disease with more sophisticated imaging techniques or at post-mortem evaluation [41]. In another study, approximately one in five of patients with CS presented with organic mental disorders [1, 2]. Multiple hypotheses have been put forth regarding the underlying pathophysiology of CS. Some areas of the brain are responsible for the etiology of this disease. Results of structural and neuroimaging studies of CS provide support for an organic etiology [18]. Multiple studies and reports have remarked on CS in the setting of various neurological and neurodegenerative diseases [42]. There is a study that found more widespread bilateral frontal and temporal cortex atrophy in schizophrenia patients with CS than schizophrenia patients without the syndrome by using computerized tomography (CT) [18]. Likewise other studies using CT found global brain atrophy in combination with right hemisphere lesions in patients with dementia. There is also reported that positron emission tomography [PET] demonstrated abnormal brain glucose metabolism in paralimbic structures and temporal lobes of patients with Alzheimer’s dementia comorbid with CS and other subcategories of delusional misidentification syndromes [18]. Numerous neuropsychological researches support an association between CS and right frontal and temporal lobe abnormalities, and also many study reports indicate that patients with CS tend to have inferior scores on neuropsychological tests of frontal lobe function [18]. Even though less well documented, regions of the prefrontal cortex are also associated within facial processing: projections from the face processing areas in the right ventromedial occipitotemporal regions to the ventromedial prefrontal cortex via the uncinate fasciculus as well as limbic-thalamic pathways are well established [34].
Some people with schizophrenia exhibit this syndrome, but it is not related directly to schizophrenia itself; there are people with schizophrenia who do not exhibit CS, as well as people with CS who do not exhibit schizophrenia. The mean age of schizophrenic patients with Capgras syndrome is older than the age at which schizophrenia alone is usually expected to occur. When brain abnormalities of people with schizophrenia affect certain areas, CS and schizophrenia will occur concurrently. Capgras delusion and schizophrenia seem to be statistically related, at least in the case of the paranoid subtype of schizophrenia. It has been claimed that right hemisphere damage is a characteristic of schizophrenia; perhaps the imperfect evaluation of beliefs, which we have suggested, occurs as an outcome of damage to a particular area of the right frontal lobe, which is necessary for the occurrence even of the persecutory and grandiose delusions that are common in paranoid schizophrenia. Accounting the association of Capgras delusion with paranoid schizophrenia, the same neuropsychological deterioration of belief assessment is required for both, and in cases of patients with persecutory or grandiose delusions where the neuropathology also has affected the track from face recognition to the autonomic nervous system, Capgras delusion will also be existing [43, 44]. CS in paranoid schizophrenia may improve with successful treatment. But recurrence of illness may be accompanied by a return of delusional material [44].
It is important to note that the Capgras delusion can be either a primary condition that is part of a ‘mental illness’ or a secondary condition that is the direct result of an organic disease of the brain. Also, the primary and secondary versions differ significantly in their presentation. In primary Capgras syndrome, the patient is more likely to be furious or violent toward the imposter. In secondary CS, the imposters do not change over time. This is different from the situation in schizophrenia where the delusions can vary [45]. The mean age of onset of the delusion was earlier in primary Capgras (mean age 32 years) than in secondary Capgras (mean age 48.5 years). Primary cases are more likely to have a subtle onset which evolved gradually, whereas secondary cases are more likely to have sudden-onset delusions. Primary cases show associated psychotic symptoms, particularly paranoid thought, whereas psychotic symptoms are not very often of the secondary cases. The patients with CS without apparent organic cerebral dysfunction were more likely to have experienced other psychiatric symptoms prior to the onset of the Capgras delusion than those with organic cerebral dysfunction [41]. Patients with neurological impairments were more likely to regard the misidentification as benign or as due to illusory, whereas patients without evidence of neurological basis were more likely to appraise the delusions as being threatening [41]. Thus, hostility and violence are seen much more frequently in those patients diagnosed as schizophrenic than in other patients [46].
Acting on delusions is a crucial clinical issue. There is a positive relationship between delusions and serious violent acts. Although the pathway from delusions to violent outcomes is not direct, the risk is greatly increased when symptoms are acute, especially at the time of initial presentation and if not treated [20]. And the risk also can be changed according to the etiology of delusions. There is a requirement to be concerned about the patient’s tendency for violence and to evaluate for it thoroughly in Capgras delusion [45]. In patients with CS of an organic nature, violence may be associated with few or no affective manifestations (e.g., hostility, aggression, and auditory hallucinations), and may not be associated with paranoid elements [7]. Delusional symptoms in CS such as persecutory thoughts, threat-control symptoms, command auditory and/or visual hallucinations, and hallucinations of threatening content have all demonstrated to be significant predictors of violence act and aggressive behaviour [29]. If the patients are married, divorced, or separated, the most frequent doubles are the spouse. If the patients are single, the most frequent doubles are the siblings [20]. It should be noted that healthcare professionals may become the objects of delusional misidentification [42]. Because the double is usually assumed to have malicious, the CS could be characterized by hostility toward misidentified objects, and, later, it can lead to physical harm to others [20]. The assault associated with CS, the tendency to violence, cannot be attributed purely to the delusion’s existence. Other factors are presumably to affect the possibility of violent act. A significantly higher tendency for interpersonal violence are men disclosed among male subjects, average age at 40 years old, with a history of aggressive behaviour and substance abuse; social withdrawal prior to the violent act is common, and the violence is usually well planned [20, 22, 23]. Persecutory paranoid motivations have been implicated as a key factor in acts of violence toward family members who constitute the majority of victims in CS [29]. Physical violence was expressed by 58.2% of patients with CS and 62.5% of patients with CS engaged in acts of interpersonal violence toward their close family members and caregivers [22, 23]. Mothers and spouses were the most frequently attacked group of relatives, respectively. Also, it was found that 1 of 10 Capgras patients attempted homicide [22, 23]. Most of the perpetrators were males suffering from mental disorders without organic association. A higher incidence of self-harm and suicide attempts, which is about 1 in 10 of patients with CS, was detected among females even in patients with psychiatric disorders and in patients with neurodegenerative disorders [22, 23]. Although in the usual cases, the misidentified object is a person, hence justifying the title of delusional identification of people, the CS is not restricted to person misidentification but can also involve other living or lifeless objects [7, 20]. Physical violence against objects was also common, such as setting fire to one else’s estate [22, 23].
The differential diagnosis of patients who suffered CS is crucial. It is substantial to rule out the presence of brain disease in every patient with Capgras delusion [45]. Many patients with CS also present with medical illnesses of organic etiologies, associated with delusional misidentification; these patients may respond well to treatment of the medical condition underlying the onset of CS [47]. The syndrome should be differentiated from the quite common false recognitions which occur in confusional states and the transient misidentifications encountered in mania [8]. For this purpose, ending with a complete mental status examination, as well as thorough testing of cognition, is important. Neuropsychological testing and neuroimaging are often indicated. Clinicians should clarify the nature of the underlying psychiatric illness [45].
Low platelet monoamine oxidase (MAO) activity is a biochemical abnormality which is present in some psychiatric disease. Some authors suggested that the low platelet MAO activity might be proposed as a potential biochemical marker of CS. It is also thought that reduced monoamine oxidase activity in primary psychiatric patients with CS may give a piece of information to the pathogenetic mechanism underlying the reported cases of CS in organic patients without a primary behavioral disorder. However, study results show that platelet monoamine oxidase activity in patients with delusional misidentifications did not differ notably from that of schizophrenia and nonpsychiatric controls [41, 48].
The key features currently considered to be critical to the development of the Capgras delusion are as follows:
There is an abnormal perceptual experience that is a prerequisite for the delusion.
This perceptual experience is accompanied by a paranoid which leads to misattribution of the abnormal perceptual experience.
The loss of normal response to known faces occurs in the context of more generalized derealization-depersonalization [41].
Delusion in CS should be treated timely because it can cause a dangerous condition [42]. However, there are no guidelines to assist clinicians to care for patients presenting with CS in selecting complementary examinations to be performed or in selecting treatment [7]. Likewise, the symptoms of DMS are very refractory to treatment despite various interventions including psychotherapy and pharmacotherapy approaches [20]. The CS like other DMSs is known to develop similar to the comorbid disorder that they accompany, disappearing after remission even though it is not unusual for them to continue after the disappearance of the comorbid disorder [7]. Thus, treatment of the underlying neurological or psychiatric conditions may not lead to remission of CS [28]. The presence of depersonalization, derealization or visual-perceptual disturbances, and other comorbidities may influence the treatment of CS [47]. The syndrome has been linked to dopaminergic overactivity, and serotonin abnormality has been implicated in some but not all studies. Similarly, reduced platelet monoamine oxidase activity has been noted by some but not by others [18]. According to the results of the case studies in the literature, CS patients are sometimes responsive to typical and atypical antipsychotics such as olanzapine, risperidone, quetiapine, sulpiride, trifluoperazine, and pimozide [20]. Pharmacological treatment of CS is based on antipsychotics, antidepressants, anticonvulsant, and benzodiazepines considering patient needs and characteristics, but no control trials are available [49]. In the literature, there have been reported cases with a diagnosis of organic or functional delusional disorder associated with CS whose DMS responded well to pimozide that is well known for the treatment of monosymptomatic delusional disorders [49]. Experience with the new generation of atypical antipsychotics for the treatment of CS is quite limited. Although for patients manifesting any psychotic disorder, atypical antipsychotics are usually recommended because of the reduced risk of adverse effects [6, 47]. A crucial point of a case report is the positive outcome in response to antipsychotic medication [olanzapine] [49]. The combination of antipsychotic drug therapy and selective serotonin reuptake inhibitor (SSRI) may produce a positive outcome in patients with CS [16].
A case report also suggested the use of clorazepate which is benzodiazepine. In this case report, in addition to the antipsychotic properties of clorazepate, its anticonvulsant properties were also utilized in CS patient with the suggestion of some researches that found an over 90% incidence of electroencephalographic abnormalities in CS patients [27]. According to the results of the case studies, it showed a positive outcome in a patient with CS after treatment with mirtazapine that is also a serotonin 2A receptor antagonist, which could potentially afford its antipsychotic effects resulting in significantly decreasing the symptoms of CS [20, 28].
With patients who have progressive dementia, such as dementia with Lewy bodies, in which misidentification syndromes are common occurred, cholinesterase inhibitors have demonstrated benefit to reduce psychiatric symptoms [6].
Electroconvulsive therapy (ECT) has been reported to benefit either alone or in conjunction with antipsychotics, mood stabilizer, or antidepressant medication in patients with CS. It has been suggested that ECT provides permanent effective control of CS [42, 47, 49].
Psychotherapy may be beneficial in the treatment of selected patients with CS in order to reform the patient’s relationship with his family. The psychoanalytic theories show that the emotions which the patient experiences in regard to the people with whom he is confronted are transferred to the imposters, and therefore, in this way from a safe delusional distance, the patient gives himself to refuse them without guilt, sometimes manifesting an aggressive behaviour toward them [22, 23]. It has been shown that group psychotherapy may also be beneficial by becoming less prone to feel hostile toward others, thereby weakening the delusional misidentification process for psychotic patients with DMS [40]. Cognitive behavioural therapy (CBT) may be a utilized form of psychotherapy intervention in some cases by assisting the patient to overcome the delusional beliefs [22, 23].
It is quite common in cases of delusion for his/her family members of the deluded person to be concerned about the delusion and to try to get rid of it by constantly challenging it [43]. It may be beneficial to know that just as an impairment in the interpersonal relationship between the patient and the object may occur before the onset of the delusion, an amelioration in this relationship is an essential factor in the amelioration of symptoms. Therefore treatment must include helping the partner or person implicated to gain insight and perhaps change their attitude toward the patient [10].
CS is a different neuropsychiatric symptom of interest to researchers over the past century. No approved questionnaires focus on CS. While noting that the Capgras syndrome has no formal place in recognized diagnostic systems, it should be emphasized that this is of significance. It is crucial to keep them in mind as a possibility and to pursue any possible clues. Capgras delusion is a complex psychopathological phenomenon that presents in a wide range of psychiatric and neurological disorders with differing patterns dependent on the main etiology. Misidentifications in CS are fixed false beliefs and, therefore, represent true delusions. Even if when patients are confronted over and over with the illogical nature of the delusion, they keep their beliefs. Specific questions and interventions may assist to clinicians in successfully identifying patients with CS. In a series of interviews with these patients, some focus on identifying CS, rather than a single interview which is likely to increase the detection of the delusional misidentification. The clinician should always be mindful of the risk of aggression and homicide in CS.
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