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Wisner KM, Chiappelli J, Savransky A, Fisseha F, Rowland LM, Kochunov P, Hong LE. Cingulum and abnormal psychological stress response in schizophrenia. Brain Imaging Behav 2021; 14:548-561. [PMID: 31123971 DOI: 10.1007/s11682-019-00120-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Stress is implicated in many aspects of schizophrenia, including heightened distress intolerance. We examined how affect and microstructure of major brain tracts involved in regulating affect may contribute to distress intolerance in schizophrenia. Patients with schizophrenia spectrum disorders (n = 78) and community controls (n = 95) completed diffusion weighted imaging and performed psychological stress tasks. Subjective affect was collected pre and post stressors. Individuals who did not persist during one or both stress tasks were considered distress intolerant (DI), and otherwise distress tolerant (DT). Fractional anisotropy (FA) of the dorsal cingulum showed a significant diagnosis x DT/DI phenotype interaction (p = 0.003). Post-hoc tests showed dorsal cingulum FA was significantly lower in DI patients compared with DI controls (p < 0.001), but not different between DT groups (p = 0.27). Regarding affect responses to stress, irritability showed the largest stress-related change (p < 0.001), but irritability changes were significantly reduced in DI patients compared to DI controls (p = 0.006). The relationship between irritability change and performance errors also differed among patients (ρ = -0.29, p = 0.011) and controls (ρ = 0.21, p = 0.042). Further modeling highlighted the explanatory power of dorsal cingulum for predicting DI even after performance and irritability were taken into account. Distress intolerance during psychological stress exposure is related to microstructural properties of the dorsal cingulum, a key structure for cognitive control and emotion regulation. In schizophrenia, the affective response to psychological stressors is abnormal, and distress intolerant patients had significantly reduced dorsal cingulum FA compared to distress intolerant controls. The findings provide new insight regarding distress intolerance in schizophrenia.
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Affiliation(s)
- Krista M Wisner
- Department of Psychiatry, Maryland Psychiatric Research Center, University of Maryland School of Medicine, P.O. Box 21247, Baltimore, MD, 21228, USA.
| | - Joshua Chiappelli
- Department of Psychiatry, Maryland Psychiatric Research Center, University of Maryland School of Medicine, P.O. Box 21247, Baltimore, MD, 21228, USA
| | - Anya Savransky
- Department of Psychiatry, Maryland Psychiatric Research Center, University of Maryland School of Medicine, P.O. Box 21247, Baltimore, MD, 21228, USA
| | - Feven Fisseha
- Department of Psychiatry, Maryland Psychiatric Research Center, University of Maryland School of Medicine, P.O. Box 21247, Baltimore, MD, 21228, USA
| | - Laura M Rowland
- Department of Psychiatry, Maryland Psychiatric Research Center, University of Maryland School of Medicine, P.O. Box 21247, Baltimore, MD, 21228, USA
| | - Peter Kochunov
- Department of Psychiatry, Maryland Psychiatric Research Center, University of Maryland School of Medicine, P.O. Box 21247, Baltimore, MD, 21228, USA
| | - L Elliot Hong
- Department of Psychiatry, Maryland Psychiatric Research Center, University of Maryland School of Medicine, P.O. Box 21247, Baltimore, MD, 21228, USA
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Sonnenschein SF, Grace AA. Emerging therapeutic targets for schizophrenia: a framework for novel treatment strategies for psychosis. Expert Opin Ther Targets 2021; 25:15-26. [PMID: 33170748 PMCID: PMC7855878 DOI: 10.1080/14728222.2021.1849144] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2020] [Accepted: 11/05/2020] [Indexed: 01/10/2023]
Abstract
Introduction: Antipsychotic drugs are central to the treatment of schizophrenia, but their limitations necessitate improved treatment strategies. Multiple lines of research have implicated glutamatergic dysfunction in the hippocampus as an early source of pathophysiology in schizophrenia. Novel compounds have been designed to treat glutamatergic dysfunction, but they have produced inconsistent results in clinical trials. Areas covered: This review discusses how the hippocampus is thought to drive psychotic symptoms through its influence on the dopamine system. It offers the reader an evaluation of proposed treatment strategies including direct modulation of GABA or glutamate neurotransmission or reducing the deleterious impact of stress on circuit development. Finally, we offer a perspective on aspects of future research that will advance our knowledge and may create new therapeutic opportunities. PubMed was searched for relevant literature between 2010 and 2020 and related studies. Expert opinion: Targeting aberrant excitatory-inhibitory neurotransmission in the hippocampus and its related circuits has the potential to alleviate symptoms and reduce the risk of transition to psychosis if implemented as an early intervention. Longitudinal multimodal brain imaging combined with mechanistic theories generated from animal models can be used to better understand the progression of hippocampal-dopamine circuit dysfunction and heterogeneity in treatment response.
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Affiliation(s)
| | - Anthony A. Grace
- Departments of Neuroscience, Psychiatry and Psychology, University of Pittsburgh, Pittsburgh, PA, USA
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Baselmans BML, Yengo L, van Rheenen W, Wray NR. Risk in Relatives, Heritability, SNP-Based Heritability, and Genetic Correlations in Psychiatric Disorders: A Review. Biol Psychiatry 2021; 89:11-19. [PMID: 32736793 DOI: 10.1016/j.biopsych.2020.05.034] [Citation(s) in RCA: 33] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2020] [Revised: 05/14/2020] [Accepted: 05/27/2020] [Indexed: 12/19/2022]
Abstract
The genetic contribution to psychiatric disorders is observed through the increased rates of disorders in the relatives of those diagnosed with disorders. These increased rates are observed to be nonspecific; for example, children of those with schizophrenia have increased rates of schizophrenia but also a broad range of other psychiatric diagnoses. While many factors contribute to risk, epidemiological evidence suggests that the genetic contribution carries the highest risk burden. The patterns of inheritance are consistent with a polygenic architecture of many contributing risk loci. The genetic studies of the past decade have provided empirical evidence identifying thousands of DNA variants associated with psychiatric disorders. Here, we describe how these latest results are consistent with observations from epidemiology. We provide an R tool (CHARRGe) to calculate genetic parameters from epidemiological parameters and vice versa. We discuss how the single nucleotide polymorphism-based estimates of heritability and genetic correlation relate to those estimated from family records.
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Affiliation(s)
- Bart M L Baselmans
- Institute for Molecular Bioscience, The University of Queensland, Brisbane, Queensland, Australia
| | - Loïc Yengo
- Institute for Molecular Bioscience, The University of Queensland, Brisbane, Queensland, Australia
| | - Wouter van Rheenen
- Department of Neurology, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, Netherlands
| | - Naomi R Wray
- Institute for Molecular Bioscience, The University of Queensland, Brisbane, Queensland, Australia; Queensland Brain Institute, The University of Queensland, Brisbane, Queensland, Australia.
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Quidé Y, Tozzi L, Corcoran M, Cannon DM, Dauvermann MR. The Impact of Childhood Trauma on Developing Bipolar Disorder: Current Understanding and Ensuring Continued Progress. Neuropsychiatr Dis Treat 2020; 16:3095-3115. [PMID: 33364762 PMCID: PMC7751794 DOI: 10.2147/ndt.s285540] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2020] [Accepted: 11/18/2020] [Indexed: 12/12/2022] Open
Abstract
Childhood trauma (CT) has been repeatedly linked to earlier onset and greater severity of bipolar disorder (BD) in adulthood. However, such knowledge is mostly based on retrospective and cross-sectional studies in adults with BD. The first objective of this selective review is to characterize the short-term effects of CT in the development of BD by focusing on studies in young people. The second objective is to describe the longer-term consequences of CT by considering studies with adult participants. This review first outlines the most prominent hypotheses linking CT exposure and the onset of BD. Then, it summarizes the psychological and biological risk factors implicated in the development of BD, followed by a discussion of original studies that investigated the role of CT in young people with early-onset BD, youths at increased risk of developing BD, or young people with BD with a focus on subclinical and clinical outcome measures. The review considers additional biological and psychological factors associated with a negative impact of CT on the long-term course of BD in later adulthood. Finally, we discuss how the integration of information of CT can improve ongoing early identification of BD and mitigate severe clinical expression in later adulthood.
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Affiliation(s)
- Yann Quidé
- School of Psychiatry, University of New South Wales (UNSW), Sydney, NSW, Australia
- Neuroscience Research Australia, Randwick, NSW, Australia
| | - Leonardo Tozzi
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, USA
| | - Mark Corcoran
- School of Psychology, National University of Ireland Galway, Galway, Ireland
| | - Dara M Cannon
- Centre for Neuroimaging & Cognitive Genomics (NICOG), Clinical Neuroimaging Laboratory, NCBES Galway Neuroscience Centre, School of Medicine, National University of Ireland Galway, Galway, Ireland
| | - Maria R Dauvermann
- Department of Psychiatry, University of Cambridge, Cambridge, UK
- McGovern Institute for Brain Research, Massachusetts Institute of Technology, Cambridge, MA, USA
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Pries LK, van Os J, ten Have M, de Graaf R, van Dorsselaer S, Bak M, Lin BD, van Eijk KR, Kenis G, Richards A, O’Donovan MC, Luykx JJ, Rutten BPF, Guloksuz S. Association of Recent Stressful Life Events With Mental and Physical Health in the Context of Genomic and Exposomic Liability for Schizophrenia. JAMA Psychiatry 2020; 77:1296-1304. [PMID: 32805017 PMCID: PMC7711318 DOI: 10.1001/jamapsychiatry.2020.2304] [Citation(s) in RCA: 37] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2020] [Accepted: 06/01/2020] [Indexed: 12/23/2022]
Abstract
Importance Both adulthood stressful life events (SLEs) and liability for schizophrenia have been associated with poor mental and physical health in the general population, but their interaction remains to be elucidated to improve population-based health outcomes. Objective To test whether recent SLEs interact with genetic and environmental liability for schizophrenia in models of mental and physical health. Design, Setting, and Participants The Netherlands Mental Health Survey and Incidence Study-2 is a population-based prospective cohort study designed to investigate the prevalence, incidence, course, and consequences of mental disorders in the Dutch general population. Participants were enrolled from November 5, 2007, to July 31, 2009, and followed up with 3 assessments during 9 years. Follow-up was completed on June 19, 2018, and data were analyzed from September 1 to November 1, 2019. Exposures Recent SLEs assessed at each wave and aggregate scores of genetic and environmental liability for schizophrenia: polygenic risk score for schizophrenia (PRS-SCZ) trained using the Psychiatric Genomics Consortium analysis results and exposome score for schizophrenia (ES-SCZ) trained using an independent data set. Main Outcomes and Measures Independent and interacting associations of SLEs with ES-SCZ and PRS-SCZ on mental and physical health assessed at each wave using regression coefficients. Results Of the 6646 participants included at baseline, the mean (SD) age was 44.26 (12.54) years, and 3672 (55.25%) were female. The SLEs were associated with poorer physical health (B = -3.22 [95% CI, -3.66 to -2.79]) and mental health (B = -3.68 [95% CI, -4.05 to -3.32]). Genetic and environmental liability for schizophrenia was associated with poorer mental health (ES-SCZ: B = -3.07 [95% CI, -3.35 to -2.79]; PRS-SCZ: B = -0.93 [95% CI, -1.31 to -0.54]). Environmental liability was also associated with poorer physical health (B = -3.19 [95% CI, -3.56 to -2.82]). The interaction model showed that ES-SCZ moderated the association of SLEs with mental (B = -1.08 [95% CI, -1.47 to -0.69]) and physical health (B = -0.64 [95% CI, -1.11 to -0.17]), whereas PRS-SCZ did not. Several sensitivity analyses confirmed these results. Conclusions and Relevance In this study, schizophrenia liability was associated with broad mental health outcomes at the population level. Consistent with the diathesis-stress model, exposure to SLEs, particularly in individuals with high environmental liability for schizophrenia, was associated with poorer health. These findings underline the importance of modifiable environmental factors during the life span for population-based mental health outcomes.
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Affiliation(s)
- Lotta-Katrin Pries
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University Medical Center, Maastricht, the Netherlands
| | - Jim van Os
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University Medical Center, Maastricht, the Netherlands
- Department of Psychiatry, UMC (University Medical Center) Utrecht Brain Center, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, United Kingdom
| | - Margreet ten Have
- Department of Epidemiology, Netherlands Institute of Mental Health and Addiction, Utrecht, the Netherlands
| | - Ron de Graaf
- Department of Epidemiology, Netherlands Institute of Mental Health and Addiction, Utrecht, the Netherlands
| | - Saskia van Dorsselaer
- Department of Epidemiology, Netherlands Institute of Mental Health and Addiction, Utrecht, the Netherlands
| | - Maarten Bak
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University Medical Center, Maastricht, the Netherlands
- Flexible Assertive Community Treatment, Mondriaan Mental Health, Maastricht, the Netherlands
| | - Bochao D. Lin
- Department of Translational Neuroscience, UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands
| | - Kristel R. van Eijk
- Department of Neurology, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Gunter Kenis
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University Medical Center, Maastricht, the Netherlands
| | - Alexander Richards
- MRC (Medical Research Council) Center for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, United Kingdom
| | - Michael C. O’Donovan
- MRC (Medical Research Council) Center for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, United Kingdom
| | - Jurjen J. Luykx
- Department of Psychiatry, UMC (University Medical Center) Utrecht Brain Center, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands
- Department of Translational Neuroscience, UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands
- GGNet Mental Health, Apeldoorn, the Netherlands
| | - Bart P. F. Rutten
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University Medical Center, Maastricht, the Netherlands
| | - Sinan Guloksuz
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University Medical Center, Maastricht, the Netherlands
- Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut
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56
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Educational Response to a Student with Psychosis at the Secondary Level: A Non-Experimental Single-Case Study. Eur J Investig Health Psychol Educ 2020; 10:1080-1094. [PMID: 34542437 PMCID: PMC8314312 DOI: 10.3390/ejihpe10040076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2020] [Revised: 11/09/2020] [Accepted: 11/21/2020] [Indexed: 11/17/2022] Open
Abstract
Students with psychosis in school within the ordinary education system are a reality in the classroom. To study their correct adaptation at school, it is necessary to consider numerous factors such as the personal characteristics of the student, environmental variables, educational measures put in place as well as emotional and cognitive aspects. The aim of this research was to monitor the teaching-learning process of a student diagnosed with psychosis and enrolled in a public school at the secondary level in the ordinary modality with support during an academic year, with the usual resources provided by a guidance department to assess the impact of the educational measures and plans on his emotional and academic fields. This was a single case study in which both qualitative and quantitative information was collected (N = 1). The participant was a student with special needs at the secondary level. An analysis of the results of psychometric tests, plan for diversity, observational analysis, academic file, scholastic history, and multiple interviews were carried out. The findings show how the educational curriculum can be adapted to improve the competences of a student with psychosis by encouraging an increase in social abilities and potential cognitive abilities through the counseling department. The conclusions of this research can provide a guideline for comparison of different educational systems, paying greater attention to the development of emotional aspects, and opting for inclusive measures. In this line, this study shows that students with psychosis can share classrooms and studies with their peers, thus fulfilling the principle of educational inclusion.
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57
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Misiak B, Karpiński P, Szmida E, Grąźlewski T, Jabłoński M, Cyranka K, Rymaszewska J, Piotrowski P, Kotowicz K, Frydecka D. Adverse Childhood Experiences and Methylation of the FKBP5 Gene in Patients with Psychotic Disorders. J Clin Med 2020; 9:jcm9123792. [PMID: 33255215 PMCID: PMC7759816 DOI: 10.3390/jcm9123792] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Revised: 11/15/2020] [Accepted: 11/19/2020] [Indexed: 01/07/2023] Open
Abstract
Altered methylation of the FKBP5 gene has been observed in various mental disorders and attributed to the effects of adverse childhood experiences (ACEs). However, the level of FKBP5 methylation has not been investigated in patients with psychotic disorders. Therefore, in this study we aimed to determine the FKBP5 methylation in patients with psychosis and controls, taking into account the effects of ACEs. Participants were 85 patients with psychotic disorders, including first-episode psychosis (FEP) patients and acutely relapsed schizophrenia (SCZ-AR) patients, as well as 56 controls. The level of four CpG sites at the FKBP5 gene was determined in the peripheral blood leukocytes using pyrosequencing. After controlling for potential confounding factors, the level of FKBP5 methylation at one out of four tested CpG sites was significantly lower in FEP patients compared to other groups of participants. Significant main effects of parental antipathy and sexual abuse on the level of FKBP5 methylation were observed at the differentially methylated CpG site. Participants reporting this category of ACEs had significantly lower levels of FKBP5 methylation at this CpG site. Lower levels of FKBP5 methylation were associated with better cognitive performance and higher functional capacity in patients with psychosis. In controls, lower methylation of FKBP5 was related to worse performance of immediate memory and language skills. Our findings suggest that hypomethylation of the FKBP5 appears at early stages of psychosis and might be associated with a history of ACEs as well as less severe clinical manifestation.
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Affiliation(s)
- Błażej Misiak
- Department of Psychiatry, Wroclaw Medical University, Pasteura 10 Street, 50-367 Wroclaw, Poland; (J.R.); (P.P.); (K.K.); (D.F.)
- Correspondence:
| | - Paweł Karpiński
- Department of Genetics, Wroclaw Medical University, Marcinkowskiego 1 Street, 50-368 Wroclaw, Poland; (P.K.); (E.S.)
- Laboratory of Genomics & Bioinformatics, Institute of Immunology and Experimental Therapy, Polish Academy of Sciences, Weigla 12 Street, 53-114 Wroclaw, Poland
| | - Elżbieta Szmida
- Department of Genetics, Wroclaw Medical University, Marcinkowskiego 1 Street, 50-368 Wroclaw, Poland; (P.K.); (E.S.)
| | - Tomasz Grąźlewski
- Department of Psychiatry, Pomeranian Medical University, Broniewskiego 26 Street, 71-460 Szczecin, Poland; (T.G.); (M.J.)
| | - Marcin Jabłoński
- Department of Psychiatry, Pomeranian Medical University, Broniewskiego 26 Street, 71-460 Szczecin, Poland; (T.G.); (M.J.)
| | - Katarzyna Cyranka
- Department of Psychiatry, Jagiellonian University, Kopernika 21a Street, 31-501 Cracow, Poland;
| | - Joanna Rymaszewska
- Department of Psychiatry, Wroclaw Medical University, Pasteura 10 Street, 50-367 Wroclaw, Poland; (J.R.); (P.P.); (K.K.); (D.F.)
| | - Patryk Piotrowski
- Department of Psychiatry, Wroclaw Medical University, Pasteura 10 Street, 50-367 Wroclaw, Poland; (J.R.); (P.P.); (K.K.); (D.F.)
| | - Kamila Kotowicz
- Department of Psychiatry, Wroclaw Medical University, Pasteura 10 Street, 50-367 Wroclaw, Poland; (J.R.); (P.P.); (K.K.); (D.F.)
| | - Dorota Frydecka
- Department of Psychiatry, Wroclaw Medical University, Pasteura 10 Street, 50-367 Wroclaw, Poland; (J.R.); (P.P.); (K.K.); (D.F.)
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EEG Microstates and Psychosocial Stress During an Exchange Year. Brain Topogr 2020; 34:117-120. [PMID: 33169276 PMCID: PMC7892813 DOI: 10.1007/s10548-020-00806-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Accepted: 10/26/2020] [Indexed: 11/19/2022]
Abstract
The well-known stress vulnerability model of psychosis assumes that psychotic episodes result from the coincidence of individual trait dispositions and triggering stressors. We thus hypothesized that a transient psychosocial stressor would not only increase the number of and stress caused by psychosis-like symptoms (like delusion-like symptoms or auditory hallucinations) in healthy subjects but also elicit changes in EEG microstates that have been related to the presence of psychotic symptoms in patients with schizophrenia. Considering a radical change of one’s psychosocial environment as a significant stressor, we analyzed psychotic symptoms and EEG microstate data in teenage exchange-students at an early and a later phase of their stay. The subjects experienced a small and transient, but significant increase of stress by psychosis-like symptoms. These changes in mental state were associated with increases in microstate class A, which has previously been related to unspecific stress. microstate classes C and D, which have consistently been found to be altered in patients with psychosis, were found unaffected by the time of the recording and the subjective stress experiences. Therefore, we conclude that microstate class A appears to be a psychosis independent and rather general correlate of psychosocial stress, whereas changes in microstate classes C and D seem to be more specifically tied to the presence of psychotic symptoms.
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The mGluR2/3 agonist pomaglumetad methionil normalizes aberrant dopamine neuron activity via action in the ventral hippocampus. Neuropsychopharmacology 2020; 45:2106-2113. [PMID: 32663839 PMCID: PMC7547679 DOI: 10.1038/s41386-020-0764-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2020] [Revised: 05/27/2020] [Accepted: 07/08/2020] [Indexed: 11/09/2022]
Abstract
The group 2 metabotropic glutamate receptor (mGluR2/3) agonist, pomaglumetad methionil (POM), showed promise as a novel antipsychotic in preclinical research but failed to show efficacy in clinical trials, though it has been suggested that it may be effective in certain patient populations. Although previous studies have shown that mGluR2/3 agonists have no effect on dopamine (DA) in wild type rats, we used the methylzoxymethanol acetate (MAM) model to determine whether POM may indirectly normalize DA neuron activity in a model representative of the hyperdopaminergic state thought to underlie psychosis, compared to SAL rats, using in vivo, anesthetized, electrophysiological recordings. POM dose-dependently reduced the number of spontaneously active DA neurons in the VTA of MAM rats to control levels without affecting DA firing in SAL rats, which persisted following 14d repeated treatment with POM. In female MAM rats, POM significantly reduced DA neuron population activity only during proestrous and estrous stages. MAM rats also demonstrated dose-dependent improvement in novel object recognition following acute POM, which was not observed in SAL rats. Similar to the MAM rats, DA neuron population activity was increased in a hippocampal-dependent manner following acute restraint stress. Administration of POM prior to 2 h restraint stress prevented the restraint-induced increase in DA neuron population activity, and this effect was blocked by pretreatment with an mGluR2/3 antagonist. Thus, the ability of POM to reduce the hyperdopaminergic activity in both MAM rats and in wild type rats following restraint stress suggests that it can indirectly regulate DA neuron activity, which may underlie its potential therapeutic effects.
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60
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Modulation of cognition and neuronal plasticity in gain- and loss-of-function mouse models of the schizophrenia risk gene Tcf4. Transl Psychiatry 2020; 10:343. [PMID: 33037178 PMCID: PMC7547694 DOI: 10.1038/s41398-020-01026-7] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2020] [Revised: 08/12/2020] [Accepted: 08/21/2020] [Indexed: 12/16/2022] Open
Abstract
The transcription factor TCF4 was confirmed in several large genome-wide association studies as one of the most significant schizophrenia (SZ) susceptibility genes. Transgenic mice moderately overexpressing Tcf4 in forebrain (Tcf4tg) display deficits in fear memory and sensorimotor gating. As second hit, we exposed Tcf4tg animals to isolation rearing (IR), chronic social defeat (SD), enriched environment (EE), or handling control (HC) conditions and examined mice with heterozygous deletion of the exon 4 (Tcf4Ex4δ+/-) to unravel gene-dosage effects. We applied multivariate statistics for behavioral profiling and demonstrate that IR and SD cause strong cognitive deficits of Tcf4tg mice, whereas EE masked the genetic vulnerability. We observed enhanced long-term depression in Tcf4tg mice and enhanced long-term potentiation in Tcf4Ex4δ+/- mice indicating specific gene-dosage effects. Tcf4tg mice showed higher density of immature spines during development as assessed by STED nanoscopy and proteomic analyses of synaptosomes revealed concurrently increased levels of proteins involved in synaptic function and metabolic pathways. We conclude that environmental stress and Tcf4 misexpression precipitate cognitive deficits in 2-hit mouse models of relevance for schizophrenia.
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Tryon VL, Garman HD, Loewy RL, Niendam TA. Links Between Human and Animal Models of Trauma and Psychosis: A Narrative Review. BIOLOGICAL PSYCHIATRY: COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2020; 6:154-165. [PMID: 33309566 DOI: 10.1016/j.bpsc.2020.09.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Revised: 09/08/2020] [Accepted: 09/16/2020] [Indexed: 11/26/2022]
Abstract
Traumatic experiences during development are associated with an increased risk of developing psychosis. Individuals with psychosis also report a higher rate of past trauma than healthy control subjects and worse outcomes than those who do not have these experiences. It is thought that traumatic experiences negatively impact specific neurobiological processes to confer this increased risk, and that systems affected by trauma are similarly changed in individuals with psychosis. Examining animal models of psychosis and the shared neurobiological changes in response to stressors can offer valuable insight into biological mechanisms that mediate symptoms and targets for intervention. This targeted review highlights a subset of models of psychosis across humans and animals, examines the similarities with the brain's response to stress and traumatic events, and discusses how these models may interact. Suggestions for future research are described.
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Affiliation(s)
- Valerie L Tryon
- Department of Psychiatry and Behavioral Sciences, University of California, Davis, Davis
| | - Heather D Garman
- Department of Psychiatry, Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, California
| | - Rachel L Loewy
- Department of Psychiatry, Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, California
| | - Tara A Niendam
- Department of Psychiatry and Behavioral Sciences, University of California, Davis, Davis.
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Eck SR, Xu SJ, Telenson A, Duggan MR, Cole R, Wicks B, Bergmann J, Lefebo H, Shore M, Shepard KA, Akins MR, Parikh V, Heller EA, Bangasser DA. Stress Regulation of Sustained Attention and the Cholinergic Attention System. Biol Psychiatry 2020; 88:566-575. [PMID: 32600739 PMCID: PMC7487022 DOI: 10.1016/j.biopsych.2020.04.013] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2019] [Revised: 04/19/2020] [Accepted: 04/20/2020] [Indexed: 11/24/2022]
Abstract
BACKGROUND Stress exacerbates symptoms of schizophrenia and attention-deficit/hyperactivity disorder, which are characterized by impairments in sustained attention. Yet how stress regulates attention remains largely unexplored. We investigated whether a 6-day variable stressor altered sustained attention and the cholinergic attention system in male and female rats. METHODS Sustained attention was tested with the sustained attention task. Successful performance on the sustained attention task relies on the release of acetylcholine (ACh) into the cortex from cholinergic neurons in the nucleus basalis of Meynert (NBM). Thus, we evaluated whether variable stress (VS) altered the morphology of these neurons with a novel approach using a Cre-dependent virus in genetically modified ChAT::Cre rats, a species used for this manipulation only. Next, electrochemical recordings measured cortical ACh following VS. Finally, we used RNA sequencing to identify VS-induced transcriptional changes in the NBM. RESULTS VS impaired attentional performance in the sustained attention task and increased the dendritic complexity of NBM cholinergic neurons in both sexes. NBM cholinergic neurons are mainly under inhibitory control, so this morphological change could increase inhibition on these neurons, reducing downstream ACh release to impair attention. Indeed, VS decreased ACh release in the prefrontal cortex of male rats. Quantification of global transcriptional changes revealed that although VS induced many sex-specific changes in gene expression, it increased several signaling molecules in both sexes. CONCLUSIONS These studies suggest that VS impairs attention by inducing molecular and morphological changes in the NBM. Identifying mechanisms by which stress regulates attention may guide the development of novel treatments for psychiatric disorders with attention deficits.
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Affiliation(s)
- Samantha R Eck
- Department of Psychology and Neuroscience Program, Temple University, Philadelphia, Pennsylvania
| | - Song-Jun Xu
- Penn Epigenetics Institute, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania
| | - Alexander Telenson
- Department of Psychology and Neuroscience Program, Temple University, Philadelphia, Pennsylvania
| | - Michael R Duggan
- Department of Psychology and Neuroscience Program, Temple University, Philadelphia, Pennsylvania
| | - Robert Cole
- Department of Psychology and Neuroscience Program, Temple University, Philadelphia, Pennsylvania
| | - Brittany Wicks
- Department of Psychology and Neuroscience Program, Temple University, Philadelphia, Pennsylvania
| | - Joy Bergmann
- Department of Psychology and Neuroscience Program, Temple University, Philadelphia, Pennsylvania
| | - Hanna Lefebo
- Department of Psychology and Neuroscience Program, Temple University, Philadelphia, Pennsylvania
| | - Marni Shore
- Department of Psychology and Neuroscience Program, Temple University, Philadelphia, Pennsylvania
| | | | - Michael R Akins
- Department of Biology, Drexel University, Philadelphia, Pennsylvania
| | - Vinay Parikh
- Department of Psychology and Neuroscience Program, Temple University, Philadelphia, Pennsylvania
| | - Elizabeth A Heller
- Penn Epigenetics Institute, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania
| | - Debra A Bangasser
- Department of Psychology and Neuroscience Program, Temple University, Philadelphia, Pennsylvania.
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63
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Wesselhoeft R, Davidsen K, Sibbersen C, Kyhl H, Talati A, Andersen MS, Bilenberg N. Maternal prenatal stress and postnatal depressive symptoms: discrepancy between mother and teacher reports of toddler psychological problems. Soc Psychiatry Psychiatr Epidemiol 2020; 56:559-570. [PMID: 32995941 PMCID: PMC8005495 DOI: 10.1007/s00127-020-01964-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2019] [Accepted: 09/23/2020] [Indexed: 01/30/2023]
Abstract
PURPOSE Maternal prenatal stress and postnatal depression are reported to increase the risk for early offspring psychological problems. We examined whether these two stressors predicted toddler emotional or behavioral problems based on the mother and teacher reports, respectively. METHODS A longitudinal study within the Odense Child Cohort (OCC). Prenatal stress was assessed (gestation week 28) using Cohen's Perceived Stress Scale (PSS). Depressive symptoms were assessed (3 months after birth) using the Edinburgh Postnatal Depression Scale (EPDS). Behavioral and emotional problems were assessed by mothers using the preschool version of Child Behaviour Checklist (CBCL) and by teachers using the caregiver-teacher report form (CTR-F). RESULTS N = 1302 mother-child dyads were included. CBCL (N = 1302) was collected at 29 months (SD 5.3) and C-TRF (N = 989) at 32.6 months (SD 6.9). N = 70 mothers (5.4%) were at high risk for postnatal depression (EPDS score > 12). Generalized additive models showed that prenatal stress (increase of + 1 on PSS-10 total score) predicted an increase in CBCL (+ 0.011) and C-TRF (+ 0.015) total scores. Postnatal depressive symptoms (increase of + 1 on EPDS total score) only predicted an increase in CBCL total score (+ 0.026). CONCLUSION Prenatal maternal stress was a significant predictor of both mother and teacher reported toddler emotional and behavioral problems, although effect sizes were small. Postnatal depressive symptoms were associated with increased maternal (but not teacher) reporting of toddler problems. Mothers reported more toddler psychological problems than teachers, and the mother-teacher discrepancy was positively correlated to maternal postnatal depressive symptoms.
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Affiliation(s)
- R Wesselhoeft
- Research Unit of Child and Adolescent Mental Health, Institute for Clinical Research, Mental Health Services in the Region of Southern Denmark, University of Southern Denmark, Odense, Denmark.
- Clinical Pharmacology and Pharmacy, Department of Public Health, University of Southern Denmark, Odense, Denmark.
| | - K Davidsen
- Research Unit of Child and Adolescent Mental Health, Institute for Clinical Research, Mental Health Services in the Region of Southern Denmark, University of Southern Denmark, Odense, Denmark
- Department of Psychology, University of Southern Denmark, Odense, Denmark
| | - C Sibbersen
- Research Unit of E-Mental Health, Mental Health Services in the Region of Southern Denmark, Odense, Denmark
| | - H Kyhl
- Hans Christian Andersen Children's Hospital, University of Southern Denmark and Odense Patient Data Explorative Network (OPEN), Odense, Denmark
| | - A Talati
- Division of Epidemiology, Department of Psychiatry, New York State Psychiatric Institute, Columbia University, New York, USA
| | - M S Andersen
- Department of Endocrinology, Odense University Hospital, Odense, Denmark
| | - N Bilenberg
- Research Unit of Child and Adolescent Mental Health, Institute for Clinical Research, Mental Health Services in the Region of Southern Denmark, University of Southern Denmark, Odense, Denmark
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64
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Söder E, Krkovic K, Lincoln TM. The relevance of chronic stress for the acute stress reaction in people at elevated risk for psychosis. Psychoneuroendocrinology 2020; 119:104684. [PMID: 32512251 DOI: 10.1016/j.psyneuen.2020.104684] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2019] [Revised: 04/07/2020] [Accepted: 04/07/2020] [Indexed: 12/25/2022]
Abstract
BACKGROUND Theoretical models and empirical evidence suggest that alterations of the acute stress reaction are a vulnerability indicator of psychosis. However, more studies are needed that use laboratory stressors and a multimodal assessment of the stress reaction. Furthermore, it needs to be clarified whether alterations of the acute stress reaction result from the chronic stress level. METHODS We recruited participants at familial (n = 32) and symptomatic risk (n = 43) for psychosis and a low-risk control group (n = 35). We assessed their chronic stress levels (self-report, hair cortisol concentrations) and self-reported (subjective, affective, paranoia) as well as physiological (heart rate, skin conductance level, cortisol) reactions to the Trier Social Stress Test. RESULTS The groups did not differ in their acute stress reaction but both at-risk groups showed higher levels of self-reported chronic stress. Chronic stress predicted changes in negative affect, paranoia and skin conductance level in the total sample. CONCLUSIONS We could not confirm that alterations of the acute stress reaction are an early vulnerability indicator of psychosis and conclude that they might develop at a later time-point on the trajectory to psychosis. The high chronic stress level of the at-risk groups might constitute an intermediate state that increases the likelihood of altered stress reactions in later risk stages. To test this, future work needs to investigate the temporal order between chronic stress levels, acute stress reactions and symptom development across the psychosis continuum.
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Affiliation(s)
- Eveline Söder
- Universität Hamburg, Clinical Psychology and Psychotherapy, Institute of Psychology, Von-Melle-Park 5, 20146 Hamburg, Germany.
| | - Katarina Krkovic
- Universität Hamburg, Clinical Psychology and Psychotherapy, Institute of Psychology, Von-Melle-Park 5, 20146 Hamburg, Germany
| | - Tania M Lincoln
- Universität Hamburg, Clinical Psychology and Psychotherapy, Institute of Psychology, Von-Melle-Park 5, 20146 Hamburg, Germany
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65
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Quadt L, Esposito G, Critchley HD, Garfinkel SN. Brain-body interactions underlying the association of loneliness with mental and physical health. Neurosci Biobehav Rev 2020; 116:283-300. [DOI: 10.1016/j.neubiorev.2020.06.015] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2019] [Revised: 05/31/2020] [Accepted: 06/10/2020] [Indexed: 12/14/2022]
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66
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Comer AL, Carrier M, Tremblay MÈ, Cruz-Martín A. The Inflamed Brain in Schizophrenia: The Convergence of Genetic and Environmental Risk Factors That Lead to Uncontrolled Neuroinflammation. Front Cell Neurosci 2020; 14:274. [PMID: 33061891 PMCID: PMC7518314 DOI: 10.3389/fncel.2020.00274] [Citation(s) in RCA: 103] [Impact Index Per Article: 25.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Accepted: 08/03/2020] [Indexed: 12/12/2022] Open
Abstract
Schizophrenia is a disorder with a heterogeneous etiology involving complex interplay between genetic and environmental risk factors. The immune system is now known to play vital roles in nervous system function and pathology through regulating neuronal and glial development, synaptic plasticity, and behavior. In this regard, the immune system is positioned as a common link between the seemingly diverse genetic and environmental risk factors for schizophrenia. Synthesizing information about how the immune-brain axis is affected by multiple factors and how these factors might interact in schizophrenia is necessary to better understand the pathogenesis of this disease. Such knowledge will aid in the development of more translatable animal models that may lead to effective therapeutic interventions. Here, we provide an overview of the genetic risk factors for schizophrenia that modulate immune function. We also explore environmental factors for schizophrenia including exposure to pollution, gut dysbiosis, maternal immune activation and early-life stress, and how the consequences of these risk factors are linked to microglial function and dysfunction. We also propose that morphological and signaling deficits of the blood-brain barrier, as observed in some individuals with schizophrenia, can act as a gateway between peripheral and central nervous system inflammation, thus affecting microglia in their essential functions. Finally, we describe the diverse roles that microglia play in response to neuroinflammation and their impact on brain development and homeostasis, as well as schizophrenia pathophysiology.
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Affiliation(s)
- Ashley L. Comer
- Graduate Program for Neuroscience, Boston University, Boston, MA, United States
- Department of Biology, Boston University, Boston, MA, United States
- Neurophotonics Center, Boston University, Boston, MA, United States
- Center for Systems Neuroscience, Boston University, Boston, MA, United States
| | - Micaël Carrier
- Axe Neurosciences, Centre de Recherche du CHU de Québec, Université Laval, Québec City, QC, Canada
| | - Marie-Ève Tremblay
- Axe Neurosciences, Centre de Recherche du CHU de Québec, Université Laval, Québec City, QC, Canada
- Division of Medical Sciences, University of Victoria, Victoria, BC, Canada
- Department of Biochemistry and Molecular Biology, The University of British Columbia, Vancouver, BC, Canada
| | - Alberto Cruz-Martín
- Graduate Program for Neuroscience, Boston University, Boston, MA, United States
- Department of Biology, Boston University, Boston, MA, United States
- Neurophotonics Center, Boston University, Boston, MA, United States
- Center for Systems Neuroscience, Boston University, Boston, MA, United States
- Department of Pharmacology and Experimental Therapeutics, Boston University, Boston, MA, United States
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67
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Sonnenschein SF, Gomes FV, Grace AA. Dysregulation of Midbrain Dopamine System and the Pathophysiology of Schizophrenia. Front Psychiatry 2020; 11:613. [PMID: 32719622 PMCID: PMC7350524 DOI: 10.3389/fpsyt.2020.00613] [Citation(s) in RCA: 65] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2020] [Accepted: 06/12/2020] [Indexed: 11/25/2022] Open
Abstract
Dysregulation of the dopamine system is central to many models of the pathophysiology of psychosis in schizophrenia. However, emerging evidence suggests that this dysregulation is driven by the disruption of upstream circuits that provide afferent control of midbrain dopamine neurons. Furthermore, stress can profoundly disrupt this regulatory circuit, particularly when it is presented at critical vulnerable prepubertal time points. This review will discuss the dopamine system and the circuits that regulate it, focusing on the hippocampus, medial prefrontal cortex, thalamic nuclei, and medial septum, and the impact of stress. A greater understanding of the regulation of the dopamine system and its disruption in schizophrenia may provide a more complete neurobiological framework to interpret clinical findings and develop novel treatments.
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Affiliation(s)
- Susan F Sonnenschein
- Departments of Neuroscience, Psychiatry and Psychology, University of Pittsburgh, Pittsburgh, PA, United States
| | - Felipe V Gomes
- Department of Pharmacology, Ribeirao Preto Medical School, University of Sao Paulo, Ribeirao Preto, Brazil
| | - Anthony A Grace
- Departments of Neuroscience, Psychiatry and Psychology, University of Pittsburgh, Pittsburgh, PA, United States
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68
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Corcoran M, Hawkins EL, O'Hora D, Whalley HC, Hall J, Lawrie SM, Dauvermann MR. Are working memory and glutamate concentrations involved in early-life stress and severity of psychosis? Brain Behav 2020; 10:e01616. [PMID: 32385970 PMCID: PMC7303391 DOI: 10.1002/brb3.1616] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2019] [Revised: 02/18/2020] [Accepted: 03/10/2020] [Indexed: 12/21/2022] Open
Abstract
OBJECTIVE Occurrences of early-life stress (ELS) are associated with the severity of psychotic symptoms and working memory (WM) deficits in patients with psychosis (PSY). This study investigated potential mediation roles of WM behavioral performance and glutamate concentrations in prefrontal brain regions on the association between ELS and psychotic symptom severity in PSY. METHOD Forty-seven patients with PSY (established schizophrenia, n = 30; bipolar disorder, n = 17) completed measures of psychotic symptom severity. In addition, data on ELS and WM performance were collected in both patients with PSY and healthy controls (HC; n = 41). Resting-state glutamate concentrations in the bilateral dorsolateral prefrontal cortex (DLPFC) and anterior cingulate cortex (ACC) were also assessed with proton magnetic resonance spectroscopy for both PSY and HC groups. t tests, analyses of variance, and regression analyses were utilized. RESULTS Participants with PSY reported significantly more ELS occurrences and showed poorer WM performance than HC. Furthermore, individuals with PSY displayed lower glutamate concentrations in the left DLPFC than HC. Neither ELS nor WM performance were predictive of severity of psychotic symptoms in participants with PSY. However, we found a significant negative correlation between glutamate concentrations in the left DLPFC and ELS occurrence in HC only. CONCLUSION In individuals with PSY, the current study found no evidence that the association between ELS and psychotic symptoms is mediated by WM performance or prefrontal glutamate concentrations. In HC, the association between ELS experience and glutamate concentrations may indicate a neurometabolite effect of ELS that is independent of an illness effect in psychosis.
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Affiliation(s)
- Mark Corcoran
- School of Psychology, National University of Ireland Galway, Galway, Ireland
| | - Emma L Hawkins
- Division of Psychiatry, University of Edinburgh, Edinburgh, UK
| | - Denis O'Hora
- School of Psychology, National University of Ireland Galway, Galway, Ireland
| | | | - Jeremy Hall
- Neuroscience and Mental Health Research Institute, Cardiff University School of Medicine, Cardiff, UK
| | | | - Maria R Dauvermann
- School of Psychology, National University of Ireland Galway, Galway, Ireland.,McGovern Institute for Brain Research, Massachusetts Institute of Technology, Cambridge, MA, USA.,Department of Psychiatry, University of Cambridge, Cambridge, UK
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69
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Mazzelli M, Maj C, Mariani N, Mora C, Begni V, Pariante CM, Riva MA, Cattaneo A, Cattane N. The Long-Term Effects of Early Life Stress on the Modulation of miR-19 Levels. Front Psychiatry 2020; 11:389. [PMID: 32499725 PMCID: PMC7243913 DOI: 10.3389/fpsyt.2020.00389] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/31/2019] [Accepted: 04/17/2020] [Indexed: 12/31/2022] Open
Abstract
MicroRNAs (miRNAs), one of the major small non-coding RNA classes, have been proposed as regulatory molecules in neurodevelopment and stress response. Although alterations in miRNAs profiles have been implicated in several psychiatric and neurodevelopmental disorders, the contribution of individual miRNAs in brain development and function is still unknown. Recent studies have identified miR-19 as a key regulator of brain trajectories, since it drives the differentiation of neural stem cells into mature neurons. However, no findings are available on how vulnerability factors for these disorders, such as early life stress (ELS), can modulate the expression of miR-19 and its target genes. To reach our aim, we investigated miR-19 modulation in human hippocampal progenitor stem cells (HPCs) treated with cortisol during 3 days of proliferation and harvested immediately after the end of the treatment or after 20 days of differentiation into mature neurons. We also analyzed the long-term expression changes of miR-19 and of its validated target genes, involved in neurodevelopment and inflammation, in the hippocampus of adult rats exposed or not to prenatal stress (PNS). Interestingly, we observed a significant downregulation of miR-19 levels both in proliferating (FC = −1.59, p-value = 0.022 for miR-19a; FC = −1.79, p-value = 0.016 for miR-19b) as well as differentiated HPCs (FC = −1.28, p-value = 0.065 for miR-19a; FC = −1.75, p-value = 0.047 for miR-19b) treated with cortisol. Similarly, we found a long-term decrease of miR-19 levels in the hippocampus of adult PNS rats (FC = −1.35, p-value = 0.025 for miR-19a; FC = −1.43, p-value = 0.032 for miR-19b). Among all the validated target genes, we observed a significant increase of NRCAM (FC = 1.20, p-value = 0.027), IL4R (FC = 1.26, p-value = 0.046), and RAPGEF2 (FC = 1.23, p-value = 0.020).We suggest that ELS can cause a long-term downregulation of miR-19 levels, which may be responsible of alterations in neurodevelopmental pathways and in immune/inflammatory processes, leading to an enhanced risk for mental disorders later in life. Intervention strategies targeting miR-19 may prevent alterations in these pathways, reducing the ELS-related effects.
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Affiliation(s)
- Monica Mazzelli
- Biological Psychiatry Unit, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Carlo Maj
- Institute for Genomic Statistics and Bioinformatics, University Hospital, Bonn, Germany
| | - Nicole Mariani
- Stress, Psychiatry and Immunology Laboratory, Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Cristina Mora
- Biological Psychiatry Unit, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Veronica Begni
- Department of Pharmacological and Biomolecular Sciences, University of Milan, Milan, Italy
| | - Carmine M Pariante
- Stress, Psychiatry and Immunology Laboratory, Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Marco A Riva
- Department of Pharmacological and Biomolecular Sciences, University of Milan, Milan, Italy
| | - Annamaria Cattaneo
- Biological Psychiatry Unit, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Nadia Cattane
- Biological Psychiatry Unit, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
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70
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Cristóbal-Narváez P, Sheinbaum T, Rosa A, de Castro-Catala M, Domínguez-Martínez T, Kwapil TR, Barrantes-Vidal N. Interaction of both positive and negative daily-life experiences with FKBP5 haplotype on psychosis risk. Eur Psychiatry 2020; 63:e11. [PMID: 32093798 PMCID: PMC7315877 DOI: 10.1192/j.eurpsy.2019.4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
Background. There is limited research on the interaction of both positive and negative daily-life environments with stress-related genetic variants on psychotic experiences (PEs) and negative affect (NA) across the extended psychosis phenotype. This study examined whether the FK506 binding protein 51 (FKBP5) variability moderates the association of positive and negative experiences in the moment with PEs and NA in participants with incipient psychosis and their nonclinical counterparts. Methods. A total of 233 nonclinical and 86 incipient psychosis participants were prompted for a 1-week period to assess their day-to-day experiences. Participants were genotyped for four FKBP5 single nucleotide polymorphisms (rs3800373, rs9296158, rs1360780, and rs9470080). Results. Multilevel analyses indicated that, unlike the risk haplotype, the protective FKBP5 haplotype moderated all the associations of positive experiences with diminished PEs and NA in incipient psychosis compared with nonclinical group. Conclusions. Participants with incipient psychosis showed symptomatic improvement when reporting positive appraisals in the interpersonal domain, which suggests that these act as a powerful coping mechanism. The fact that this occurred in daily-life underscores the clinical significance of this finding and pinpoints the importance of identifying protective mechanisms. In addition, results seem to concur with the vantage sensitivity model of gene–environment interaction, which poses that certain genetic variants may enhance the likelihood of benefiting from positive exposures.
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Affiliation(s)
- Paula Cristóbal-Narváez
- Parc Sanitari Sant Joan de Déu, Institut de Recerca Sant Joan de Déu, Barcelona, Spain.,Centre for Biomedical Research Network on Mental Health (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
| | - Tamara Sheinbaum
- Department of Psychology, University of Southern California, Los Angeles, California, USA
| | - Araceli Rosa
- Centre for Biomedical Research Network on Mental Health (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain.,Secció de Zoologia i Antropologia, Departament de Biologia Evolutiva, Ecologia i Ciències Ambientals, Facultat de Biologia, Universitat de Barcelona (UB), Barcelona, Spain.,Institut de Biomedicina de la Universitat de Barcelona (IBUB), Barcelona, Spain
| | - Marta de Castro-Catala
- Secció de Zoologia i Antropologia, Departament de Biologia Evolutiva, Ecologia i Ciències Ambientals, Facultat de Biologia, Universitat de Barcelona (UB), Barcelona, Spain.,Institut de Biomedicina de la Universitat de Barcelona (IBUB), Barcelona, Spain
| | - Tecelli Domínguez-Martínez
- Centro de Investigación en Salud Mental Global, Dirección de Investigaciones Epidemiológicas y Psicosociales, Instituto Nacional de Psiquiatría 'Ramon de la Fuente Muñiz', México
| | - Thomas R Kwapil
- Department of Psychology, University of Illinois at Urbana-Champaign , Champaign, Illinois, USA
| | - Neus Barrantes-Vidal
- Centre for Biomedical Research Network on Mental Health (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain.,Departament de Psicologia Clínica i de la Salut, Universitat Autònoma de Barcelona (UAB), Barcelona, Spain.,Sant Pere Claver-Fundació Sanitària, Barcelona, Spain
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71
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Atypical lateralization in neurodevelopmental and psychiatric disorders: What is the role of stress? Cortex 2020; 125:215-232. [PMID: 32035318 DOI: 10.1016/j.cortex.2019.12.019] [Citation(s) in RCA: 64] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2019] [Revised: 11/07/2019] [Accepted: 12/23/2019] [Indexed: 02/08/2023]
Abstract
Hemispheric asymmetries are a major organizational principle of the human brain. In different neurodevelopmental and psychiatric disorders, like schizophrenia, autism spectrum disorders, depression, dyslexia and posttraumatic stress disorder, functional and/or structural hemispheric asymmetries are altered compared to healthy controls. The question, why these disorders all share the common characteristic of altered hemispheric asymmetries despite vastly different etiologies and symptoms remains one of the unsolved mysteries of laterality research. This review is aimed at reviewing potential reasons for why atypical lateralization is so common in many neurodevelopmental and psychiatric disorders. To this end, we review the evidence for overlaps in the genetic and non-genetic factors involved in the ontogenesis of different disorders and hemispheric asymmetries. While there is evidence for genetic overlap between different disorders, only few asymmetry-related loci have also been linked to disorders and importantly, those effects are mostly specific to single disorders. However, there is evidence for shared non-genetic influences between disorders and hemispheric asymmetries. Most neurodevelopmental and psychiatric disorders show alterations in the hypothalamic-pituitary adrenocortical (HPA) axis and maternal as well as early life stress have been implicated in their etiology. Stress has also been suggested to affect hemispheric asymmetries. We propose a model in which early life stress as well as chronic stress not only increases the risk for psychiatric and neurodevelopmental disorders but also changes structural and functional hemispheric asymmetries leading to the aberrant lateralization patterns seen in these disorders. Thus, pathology-related changes in hemispheric asymmetries are not a factor causing disorders, but rather a different phenotype that is affected by partly overlapping ontogenetic factors, primarily stress.
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72
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Ayesa-Arriola R, Setién-Suero E, Marques-Feixa L, Neergaard K, Butjosa A, Vázquez-Bourgon J, Fañanás L, Crespo-Facorro B. The synergetic effect of childhood trauma and recent stressful events in psychosis: associated neurocognitive dysfunction. Acta Psychiatr Scand 2020; 141:43-51. [PMID: 31618440 DOI: 10.1111/acps.13114] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/13/2019] [Indexed: 12/11/2022]
Abstract
BACKGROUND A higher incidence of childhood trauma (CT) has been reported in first episode of psychosis (FEP). There is, however, a lack of knowledge about the synergetic effect between CT and recent stressful events (RSE). METHODS Information on specific types of CT (under 17 years) and RSE (within the past 3 years) was available for 290 FEP patients and 52 healthy controls (HC). Cognitive function at baseline was assessed through a comprehensive neuropsychological test battery. RESULTS While 45.2% of FEP patients and 25% of HC reported at least one CT event, 62.7% of FEP and 21.2% of HC reported an RSE. Meanwhile, 36.2% of FEP patients and 9.6% of HC encountered both childhood and recent stressful events. The patients that just reported CT showed normality in all but the verbal memory cognitive domain; those with additive CT and RSE presented worse general cognitive function, specifically on working memory, processing speed, and executive function. RSE and general cognitive dysfunction were significant determinants of psychosis onset. CONCLUSIONS These results support a synergetic influence of trauma and stressful events on brain function and allow a better understanding of mediators for psychotic disorders useful in the design of specific strategies based on stress-targeted therapies.
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Affiliation(s)
- R Ayesa-Arriola
- Department of Psychiatry, Marqués de Valdecilla University Hospital, IDIVAL, School of Medicine, University of Cantabria, Santander, Spain.,CIBERSAM, Centro Investigación Biomédica en Red Salud Mental, Madrid, Spain
| | - E Setién-Suero
- Department of Psychiatry, Marqués de Valdecilla University Hospital, IDIVAL, School of Medicine, University of Cantabria, Santander, Spain.,CIBERSAM, Centro Investigación Biomédica en Red Salud Mental, Madrid, Spain
| | - L Marques-Feixa
- CIBERSAM, Centro Investigación Biomédica en Red Salud Mental, Madrid, Spain.,Department of Evolutionary Biology, Ecology and Environmental Sciences, Faculty of Biology, University of Barcelona, Barcelona, Spain
| | - K Neergaard
- Laboratoire Parole et Langage, Aix-Marseille University, Aix-en-Provence, France
| | - A Butjosa
- CIBERSAM, Centro Investigación Biomédica en Red Salud Mental, Madrid, Spain.,Parc Sanitari Sant Joan de Déu, Institut de Recerca Sant Joan de Déu, Sant Boi de Llobregat, Barcelona, Spain
| | - J Vázquez-Bourgon
- Department of Psychiatry, Marqués de Valdecilla University Hospital, IDIVAL, School of Medicine, University of Cantabria, Santander, Spain.,CIBERSAM, Centro Investigación Biomédica en Red Salud Mental, Madrid, Spain
| | - L Fañanás
- CIBERSAM, Centro Investigación Biomédica en Red Salud Mental, Madrid, Spain.,Department of Evolutionary Biology, Ecology and Environmental Sciences, Faculty of Biology, University of Barcelona, Barcelona, Spain
| | - B Crespo-Facorro
- Department of Psychiatry, Marqués de Valdecilla University Hospital, IDIVAL, School of Medicine, University of Cantabria, Santander, Spain.,CIBERSAM, Centro Investigación Biomédica en Red Salud Mental, Madrid, Spain
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73
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Yang F, Cao X, Sun X, Wen H, Qiu J, Xiao H. Hair Cortisol Is Associated With Social Support and Symptoms in Schizophrenia. Front Psychiatry 2020; 11:572656. [PMID: 33192700 PMCID: PMC7541838 DOI: 10.3389/fpsyt.2020.572656] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Accepted: 09/07/2020] [Indexed: 11/23/2022] Open
Abstract
INTRODUCTION Psychosocial stressors may worsen psychotic symptoms in schizophrenia, while social support could protect against the effects of stress in schizophrenia. Hypothalamus-pituitary-adrenal axis dysfunction has been associated with schizophrenia. Hair cortisol concentrations (HCC) allow assessment of cumulative cortisol secretion over the preceding 3 months. The relationship between HCC, psychosocial stressors, social support, and the clinical characteristics of schizophrenia needs to be explored. METHODS One hundred nine schizophrenia patients and 86 healthy controls between the ages of 18 and 60 were enrolled in the study. Three-centimeter samples of hair were collected from the scalp and HCC were measured using ELISA kits. Linear regression and factor analysis were employed to examine the relationship between HCC, childhood trauma, the number of stressful life events (SLE), the amount of social support in the 3 months prior to the hair cortisol assessment and clinical characteristics of schizophrenia. RESULTS Schizophrenia patients experience more SLE in their lifetime, receive less social support, and have lower HCC in the recent 3 months compared to healthy controls. In the schizophrenia patients, HCC are positively associated with the amount of social support and negatively associated with the severity of delusions. The interaction between social support and SLE predicts decreased HCC. Factor analysis shows that a subgroup of schizophrenia patients who experience childhood trauma and SLE are characterized by decreased HCC. CONCLUSIONS Findings indicate social support could be a moderator for the relationship between SLE and HCC which may attenuate the effects of SLE in schizophrenia.
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Affiliation(s)
- Fuzhong Yang
- Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Xinyi Cao
- Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Xiujia Sun
- Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Hui Wen
- Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Jianyin Qiu
- Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Hua Xiao
- State Key Laboratory of Microbial Metabolism, Joint International Research Laboratory of Metabolic & Developmental Sciences, School of Life Sciences and Biotechnology, Shanghai Jiao Tong University, Shanghai, China
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74
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Abstract
Since its earliest conceptualization, schizophrenia has been considered a disorder of "young men." Contemporary research suggests that there are sex differences in schizophrenia that are both transdiagnostic and representative of general sex/gender differences across the psychopathology spectrum. This chapter selectively summarizes representative sex/gender differences in clinical expression, epidemiology, risk factors, treatment, as well as course and outcome in schizophrenia. The consistent sex differences found, such as onset age, generic brain anomalies, and hormonal involvement, are not specific to schizophrenia or necessarily to psychopathology. It is suggested that in working with those diagnosed as meeting the current criteria for schizophrenia, clinicians adopt a transdiagnostic framework informed by sex and gender role processes.
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Affiliation(s)
- Richard Lewine
- Department of Psychological and Brain Sciences, University of Louisville, Louisville, KY, United States.
| | - Mara Hart
- Department of Psychiatry, Worcester Recovery Center and Hospital, Worcester, MA, United States
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75
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Cherian K, Schatzberg AF, Keller J. HPA axis in psychotic major depression and schizophrenia spectrum disorders: Cortisol, clinical symptomatology, and cognition. Schizophr Res 2019; 213:72-79. [PMID: 31307859 DOI: 10.1016/j.schres.2019.07.003] [Citation(s) in RCA: 46] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2018] [Revised: 06/30/2019] [Accepted: 07/02/2019] [Indexed: 01/09/2023]
Abstract
The Hypothalamic Pituitary Adrenal (HPA) axis has been implicated in the pathophysiology of a variety of mood and cognitive disorders. Neuroendocrine studies have demonstrated HPA axis overactivity in major depression, a relationship of HPA axis activity to cognitive performance, and a potential role of HPA axis genetic variation in cognition. In schizophrenia differential HPA activity has been found, including higher rates of non-suppression to dexamethasone challenge and higher salivary cortisol levels, which have been a premonitory risk factor for conversion to psychosis in adolescents at risk for developing schizophrenia. The present study investigated the simultaneous roles HPA axis activity and clinical symptomatology play in poor cognitive performance. Patients with major depression with psychosis (PMD) or schizophrenia spectrum disorder (SCZ) and healthy controls (HC) were studied. All participants underwent a diagnostic interview and psychiatric ratings, a comprehensive neuropsychological battery, and overnight hourly blood sampling for cortisol. Cognitive performance did not differ between the clinical groups, though they both performed more poorly than the HC's across a variety of cognitive domains. Across all subjects, cognitive performance was negatively correlated with higher cortisol, and PMD patients had higher evening cortisol levels than did SCZ and HCs. Cortisol and clinical symptoms, as well as age, sex, and antipsychotic use predicted cognitive performance. Diathesis stress models and their links to symptomatology, cognition, and HPA function are discussed.
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Affiliation(s)
- Kirsten Cherian
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, United States of America; Palo Alto University, United States of America
| | - Alan F Schatzberg
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, United States of America
| | - Jennifer Keller
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, United States of America.
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76
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Aghamaleki-Sarvestani Z, Vousooghi N, Tabrizi M, Alipour ME, Alaghband-Rad J, Mostafavi-Abdolmaleky H, Zarindast MR. Catechol-O-methyltransferase gene expression in stress-induced and non-stress induced schizophrenia. Psychiatr Genet 2019; 30:10-18. [PMID: 31568068 DOI: 10.1097/ypg.0000000000000243] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
INTRODUCTION As schizophrenia is a complex mental disorder and the outcome of gene-gene-environmental interactions, there are different possible pathophysiological mechanisms in different schizophrenia subtypes corresponding to various risk factors. This study was aimed at examining the impact of one of the most likely interactions, that is, 'dopamine and stress', in schizophrenia pathogenesis. METHODS Here, we investigated the interaction between 'war-related psychological trauma' without brain trauma and catechol-O-methyltransferase gene. Using real-time PCR analysis we measured catechol-O-methyltransferase gene expression level in the blood cells of 66 male subjects in four groups, namely veteran schizophrenia patients as 'stress-exposed schizophrenia' (S-schizophrenia), their healthy brothers as 'their genetically closest relatives' (S-siblings), schizophrenia patients without any history of significant stress as 'non-stress-exposed schizophrenia' (NoS-schizophrenia), and the control group. The results were analyzed by Relative Expression Software Tool 2009 software. RESULTS The catechol-O-methyltransferase gene expression was not significantly different between the S-schizophrenia and NoS-schizophrenia groups. However, compared to the control group, the catechol-O-methyltransferase expression was significantly decreased in three groups of S-schizophrenia, their healthy siblings, and NoS-schizophrenia patients. CONCLUSION This data supports that reduced blood catechol-O-methyltransferase expression, which may be associated with higher dopamine level, is involved both in stress-induced and non-stress-induced schizophrenia.
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Affiliation(s)
| | - Nasim Vousooghi
- Department of Neuroscience and addiction studies, School of Advanced Technologies in Medicine.,Research Center for Cognitive and Behavioral Sciences
| | | | - Mohammad Esmaeil Alipour
- Department of Neuroscience and addiction studies, School of Advanced Technologies in Medicine.,Janbazan Medical and Engineering Research Center
| | | | - Hamid Mostafavi-Abdolmaleky
- Department of Psychiatry, Iran University of Medical Center, Tehran, Iran.,Department of Medicine (Biomedical Genetics), Boston University School of Medicine, Boston, Massachusetts, USA
| | - Mohammad Reza Zarindast
- Department of Neuroscience and addiction studies, School of Advanced Technologies in Medicine.,Iranian National Center for Addiction Studies, Tehran University of Medical Sciences.,Department of Pharmacology, School of Medicine
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77
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Uncharted Waters: Treating Trauma Symptoms in the Context of Early Psychosis. J Clin Med 2019; 8:jcm8091456. [PMID: 31547447 PMCID: PMC6780072 DOI: 10.3390/jcm8091456] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2019] [Revised: 09/05/2019] [Accepted: 09/08/2019] [Indexed: 12/27/2022] Open
Abstract
Psychosis is conceptualized in a neurodevelopmental vulnerability-stress framework, and childhood trauma is one environmental factor that can lead to psychotic symptoms and the development of psychotic disorders. Higher rates of trauma are associated with higher psychosis risk and greater symptom frequency and severity, resulting in increased hospitalization rates and demand on outpatient primary care and mental health services. Despite an estimated 70% of individuals in the early stages of psychosis reporting a history of experiencing traumatic events, trauma effects (post-traumatic anxiety or depressive symptoms) are often overlooked in psychosis treatment and current interventions typically do not target commonly comorbid post-traumatic stress symptoms. We presented a protocol for Trauma-Integrated Cognitive Behavioral Therapy for Psychosis (TI-CBTp), an approach to treating post-traumatic stress symptoms in the context of early psychosis care. We provided a brief summary of TI-CBTp as implemented in the context of Coordinated Specialty Care and presented preliminary data supporting the use of TI-CBTp in early psychosis care. The preliminary results suggest that individuals with comorbid psychosis and post-traumatic stress symptoms can be appropriately and safely treated using TI-CBTp within Coordinated Specialty Care.
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78
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van Duin EDA, Vaessen T, Kasanova Z, Viechtbauer W, Reininghaus U, Saalbrink P, Vingerhoets C, Hernaus D, Booij J, Swillen A, Vorstman J, van Amelsvoort T, Myin-Germeys I. Lower cortisol levels and attenuated cortisol reactivity to daily-life stressors in adults with 22q11.2 deletion syndrome. Psychoneuroendocrinology 2019; 106:85-94. [PMID: 30959234 DOI: 10.1016/j.psyneuen.2019.03.023] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2018] [Revised: 01/25/2019] [Accepted: 03/21/2019] [Indexed: 12/13/2022]
Abstract
BACKGROUND 22q11.2 deletion syndrome (22q11DS) is a genetic disorder associated with neurodevelopmental, anxiety and mood disorders, as well as an increased risk for developing psychosis. Cortisol levels and stress reactivity reflect hypothalamic-pituitary-adrenal (HPA)-axis activity, and are believed to be altered in individuals that often experience daily-life stress, depression, and psychotic symptoms. However, it is unknown whether individuals with 22q11DS display an altered stress reactivity. METHODS We included 27 adults with 22q11DS (mean age: 34.1 years, 67% female) and 24 age and sex-matched healthy controls (HC; mean age: 39.9 years, 71% female) into an experience sampling study. Throughout 6 consecutive days, we measured participants' subjective stress related to current activity and at the same time collected salivary cortisol samples. Multilevel regression models were used to analyze cortisol reactivity to activity-related stress. RESULTS Diurnal cortisol levels were significantly lower in the 22q11DS group compared to HCs (B=-1.03, p < 0.001). 22q11DS adults displayed significantly attenuated cortisol reactivity to activity-related stress compared to HCs (B = -0.04, p = 0.026). Post-hoc exploratory analysis revealed that these results were independent from 22q11DS psychiatric diagnosis or medication use. CONCLUSION These results indicate that adults with 22q11DS have lower cortisol levels and attenuated cortisol response to daily stress, possibly resulting from an increased sensitization of the HPA-axis. This suggests that alterations in HPA-axis functioning, previously reported in several psychiatric disorders including post-traumatic stress disorder (PTSD), psychotic disorder, and mood disorder, also appear to be present in adults with 22q11DS.
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Affiliation(s)
- Esther D A van Duin
- Department of Psychiatry & Neuropsychology, Maastricht University, Maastricht, the Netherlands; Department of Radiology and Nuclear Medicine, Amsterdam University Medical Centers, location Academic Medical Center, Amsterdam, the Netherlands
| | - Thomas Vaessen
- Center for Contextual Psychiatry, Department of Neurosciences, KU Leuven, Leuven, Belgium.
| | - Zuzana Kasanova
- Center for Contextual Psychiatry, Department of Neurosciences, KU Leuven, Leuven, Belgium
| | - Wolfgang Viechtbauer
- Department of Psychiatry & Neuropsychology, Maastricht University, Maastricht, the Netherlands
| | - Ulrich Reininghaus
- Department of Psychiatry & Neuropsychology, Maastricht University, Maastricht, the Netherlands; Centre for Epidemiology and Public Health, Health Service and Population Research Department, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Peter Saalbrink
- Department of Psychiatry & Neuropsychology, Maastricht University, Maastricht, the Netherlands
| | - Claudia Vingerhoets
- Department of Psychiatry & Neuropsychology, Maastricht University, Maastricht, the Netherlands; Department of Radiology and Nuclear Medicine, Amsterdam University Medical Centers, location Academic Medical Center, Amsterdam, the Netherlands
| | - Dennis Hernaus
- Department of Psychiatry & Neuropsychology, Maastricht University, Maastricht, the Netherlands
| | - Jan Booij
- Department of Radiology and Nuclear Medicine, Amsterdam University Medical Centers, location Academic Medical Center, Amsterdam, the Netherlands
| | - Ann Swillen
- Department of Human Genetics, KU Leuven - Leuven University, Leuven, Belgium; Center for Human Genetics, Hospital Gasthuisberg, Leuven, Belgium
| | - Jacob Vorstman
- Department of Psychiatry, The Hospital for Sick Children and University of Toronto, Toronto, ON, Canada; Program in Genetics and Genome Biology, Research Institute, The Hospital for Sick Children, Toronto, ON, Canada
| | - Thérèse van Amelsvoort
- Department of Psychiatry & Neuropsychology, Maastricht University, Maastricht, the Netherlands
| | - Inez Myin-Germeys
- Center for Contextual Psychiatry, Department of Neurosciences, KU Leuven, Leuven, Belgium
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Insights on current and novel antipsychotic mechanisms from the MAM model of schizophrenia. Neuropharmacology 2019; 163:107632. [PMID: 31077730 DOI: 10.1016/j.neuropharm.2019.05.009] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2018] [Revised: 04/25/2019] [Accepted: 05/07/2019] [Indexed: 12/18/2022]
Abstract
Current antipsychotic drugs (APDs) act on D2 receptors, and preclinical studies demonstrate that repeated D2 antagonist administration downregulates spontaneously active DA neurons by producing overexcitation-induced inactivation of firing (depolarization block). Animal models of schizophrenia based on the gestational MAM administration produces offspring with adult phenotypes consistent with schizophrenia, including ventral hippocampal hyperactivity and a DA neuron overactivity. The MAM model reveals that APDs act differently in a hyperdopamineregic system compared to a normal one, including rapid onset of depolarization block in response to acute D2 antagonist administration and downregulation of DA neuron population activity following acute and repeated D2 partial agonist administration, none of which are observed in normal rats. Novel target compounds have been developed based on the theory that glutamatergic dysfunction is central to schizophrenia pathology. Despite showing promise in preclinical research, none of the novel drugs succeeded in clinical trials. However, preclinical research is generally performed in normal, drug-naïve rats, whereas models with disease-relevant pathology and prior APD exposure may improve the predictive validity of preclinical research. Indeed, in MAM rats, chronic D2 antagonist treatment leads to persistent DA supersensitivity that interferes with the response to drugs that target upstream pathology. Moreover, MAM rats revealed that the peri-pubertal period is a stress-sensitive window that can be targeted to prevent the development of MAM pathology in adulthood. Neurodevelopmental models, such as the MAM model, can thus be used to test potential pharmacotherapies that may be able to treat schizophrenia in early stages of the disease. This article is part of the issue entitled 'Special Issue on Antipsychotics'.
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80
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Labad J. The role of cortisol and prolactin in the pathogenesis and clinical expression of psychotic disorders. Psychoneuroendocrinology 2019; 102:24-36. [PMID: 30503781 DOI: 10.1016/j.psyneuen.2018.11.028] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2018] [Revised: 11/19/2018] [Accepted: 11/21/2018] [Indexed: 02/03/2023]
Abstract
For many years, the study of the psychotic phenotpe and approach to treatment of schizophrenia has been focused on positive psychotic symptoms, although the functional outcome is more clearly associated with negative and cognitive symptoms. Recently, there has been a growing interest in identifying biomarkers associated with these symptoms at early stages of the illness, including the risk of psychosis in vulnerable individuals (at-risk mental states [ARMS]). In this paper, the role of cortisol and prolactin in the clinical expression of psychosis will be reviewed. In examination of the role of these hormones and the risk of developing a psychotic disorder in ARMS individuals, previous studies have suggested potential roles for both cortisol and prolactin. The study of cognitive abilities in recent-onset psychotic patients has suggested that affected cognitive domains differ depending upon the studied hormones: cortisol (processing speed, verbal and working memory) and prolactin (processing speed), with several studies suggesting that there are sex-differences in these associations. All of these results suggest that both cortisol and prolactin contribute to the pathogenesis and clinical expression of psychotic disorders.
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Affiliation(s)
- Javier Labad
- Department of Mental Health, Parc Taulí Hospital Universitari, Institut d'Investigació Sanitària Parc Taulí (I3PT), Translational Neuroscience Unit, Universitat Autònoma de Barcelona (UAB), CIBERSAM. Sabadell, Barcelona, Spain.
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81
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Popovic D, Schmitt A, Kaurani L, Senner F, Papiol S, Malchow B, Fischer A, Schulze TG, Koutsouleris N, Falkai P. Childhood Trauma in Schizophrenia: Current Findings and Research Perspectives. Front Neurosci 2019; 13:274. [PMID: 30983960 PMCID: PMC6448042 DOI: 10.3389/fnins.2019.00274] [Citation(s) in RCA: 85] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2018] [Accepted: 03/07/2019] [Indexed: 01/09/2023] Open
Abstract
Schizophrenia is a severe neuropsychiatric disorder with persistence of symptoms throughout adult life in most of the affected patients. This unfavorable course is associated with multiple episodes and residual symptoms, mainly negative symptoms and cognitive deficits. The neural diathesis-stress model proposes that psychosocial stress acts on a pre-existing vulnerability and thus triggers the symptoms of schizophrenia. Childhood trauma is a severe form of stress that renders individuals more vulnerable to developing schizophrenia; neurobiological effects of such trauma on the endocrine system and epigenetic mechanisms are discussed. Childhood trauma is associated with impaired working memory, executive function, verbal learning, and attention in schizophrenia patients, including those at ultra-high risk to develop psychosis. In these patients, higher levels of childhood trauma were correlated with higher levels of attenuated positive symptoms, general symptoms, and depressive symptoms; lower levels of global functioning; and poorer cognitive performance in visual episodic memory end executive functions. In this review, we discuss effects of specific gene variants that interact with childhood trauma in patients with schizophrenia and describe new findings on the brain structural and functional level. Additive effects between childhood trauma and brain-derived neurotrophic factor methionine carriers on volume loss of the hippocampal subregions cornu ammonis (CA)4/dentate gyrus and CA2/3 have been reported in schizophrenia patients. A functional magnetic resonance imaging study showed that childhood trauma exposure resulted in aberrant function of parietal areas involved in working memory and of visual cortical areas involved in attention. In a theory of mind task reflecting social cognition, childhood trauma was associated with activation of the posterior cingulate gyrus, precuneus, and dorsomedial prefrontal cortex in patients with schizophrenia. In addition, decreased connectivity was shown between the posterior cingulate/precuneus region and the amygdala in patients with high levels of physical neglect and sexual abuse during childhood, suggesting that disturbances in specific brain networks underlie cognitive abilities. Finally, we discuss some of the questionnaires that are commonly used to assess childhood trauma and outline possibilities to use recent biostatistical methods, such as machine learning, to analyze the resulting datasets.
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Affiliation(s)
- David Popovic
- Department of Psychiatry and Psychotherapy, University Hospital, Ludwig Maximilian University of Munich, Munich, Germany.,International Max Planck Research School for Translational Psychiatry (IMPRS-TP), Munich, Germany
| | - Andrea Schmitt
- Department of Psychiatry and Psychotherapy, University Hospital, Ludwig Maximilian University of Munich, Munich, Germany.,Laboratory of Neuroscience (LIM27), Institute of Psychiatry, University of São Paulo, São Paulo, Brazil
| | - Lalit Kaurani
- German Center of Neurodegenerative Diseases, University of Göttingen, Göttingen, Germany
| | - Fanny Senner
- Department of Psychiatry and Psychotherapy, University Hospital, Ludwig Maximilian University of Munich, Munich, Germany.,Institute of Psychiatric Phenomics and Genomics, University Hospital, Ludwig Maximilian University of Munich, Munich, Germany
| | - Sergi Papiol
- Department of Psychiatry and Psychotherapy, University Hospital, Ludwig Maximilian University of Munich, Munich, Germany.,Institute of Psychiatric Phenomics and Genomics, University Hospital, Ludwig Maximilian University of Munich, Munich, Germany
| | - Berend Malchow
- Department of Psychiatry and Psychotherapy, University Hospital of Jena, Jena, Germany
| | - Andre Fischer
- German Center of Neurodegenerative Diseases, University of Göttingen, Göttingen, Germany
| | - Thomas G Schulze
- Institute of Psychiatric Phenomics and Genomics, University Hospital, Ludwig Maximilian University of Munich, Munich, Germany
| | - Nikolaos Koutsouleris
- Department of Psychiatry and Psychotherapy, University Hospital, Ludwig Maximilian University of Munich, Munich, Germany
| | - Peter Falkai
- Department of Psychiatry and Psychotherapy, University Hospital, Ludwig Maximilian University of Munich, Munich, Germany
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82
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Vlaskamp DRM, Bassett AS, Sullivan JE, Robblee J, Sadleir LG, Scheffer IE, Andrade DM. Schizophrenia is a later-onset feature of PCDH19
Girls Clustering Epilepsy. Epilepsia 2019; 60:429-440. [DOI: 10.1111/epi.14678] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2018] [Revised: 01/29/2019] [Accepted: 01/29/2019] [Indexed: 02/06/2023]
Affiliation(s)
- Danique R. M. Vlaskamp
- Department of Medicine; Epilepsy Research Centre; The University of Melbourne; Austin Health; Melbourne Victoria Australia
- Department of Neurology; University Medical Center Groningen; University of Groningen; Groningen The Netherlands
- Department of Genetics; University Medical Center Groningen; University of Groningen; Groningen The Netherlands
| | - Anne S. Bassett
- Clinical Genetics Research Program; Campbell Family Mental Health Research Institute; Centre for Addiction and Mental Health; Toronto Ontario Canada
- Department of Psychiatry; University of Toronto; Toronto Ontario Canada
- Dalglish Family 22q Clinic for Adults with 22q11.2 Deletion Syndrome; Toronto General Research Institute; University Health Network; Toronto Ontario Canada
| | - Joseph E. Sullivan
- Pediatric Epilepsy Center; Benioff Children's Hospital; University of California San Francisco; San Francisco California
| | - Jennifer Robblee
- Division of Neurology; Toronto Western Hospital; University of Toronto; Toronto Ontario Canada
| | - Lynette G. Sadleir
- Department of Paediatrics and Child Health; University of Otago; Wellington New Zealand
| | - Ingrid E. Scheffer
- Department of Medicine; Epilepsy Research Centre; The University of Melbourne; Austin Health; Melbourne Victoria Australia
- Department of Paediatrics; Royal Children's Hospital; The University of Melbourne; Victoria Australia
- The Florey Institute of Neurosciences and Mental Health; Melbourne Victoria Australia
| | - Danielle M. Andrade
- Division of Neurology; Toronto Western Hospital; University of Toronto; Toronto Ontario Canada
- Epilepsy Genetics Research Program; Krembil Neuroscience Centre; University of Toronto; Toronto Ontario Canada
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83
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Oh H, Waldman K, Stubbs B, Koyanagi A. Psychotic experiences in the context of mood and anxiety disorders and their associations with health outcomes among people of color in the United States. J Psychosom Res 2019; 118:27-33. [PMID: 30782351 DOI: 10.1016/j.jpsychores.2019.01.004] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2018] [Revised: 01/09/2019] [Accepted: 01/10/2019] [Indexed: 10/27/2022]
Abstract
BACKGROUND Psychotic experiences appear to increase risk for health outcomes above and beyond mood/anxiety disorders. However, existing studies that have found this association were conducted mostly in low- and middle-income countries, calling for more studies to explore the association in other contexts, such as the U.S., where people of color face considerable health disparities. MATERIALS/METHODS Data from the National Latino and Asian American Survey, and the National Survey of American Life were analyzed. After restricting the analytic sample to individuals with at least one mood or anxiety disorder (N = 2929), multivariable logistic regression was used to examine the associations between psychotic experiences and health outcomes, disabilities, and help-seeking behaviors, adjusting for socio-demographic characteristics and psychiatric disorders. RESULTS Among people of color with mood/anxiety disorders, 16.58% (n = 519) of the weighted analytic sample reported psychotic experiences. Psychotic experiences were associated with 1.75 times greater odds (95% CI: 1.24-2.47) for reporting a lifetime health condition, with varying odds depending on the specific conditions (e.g. arthritis, heart disease, ulcers, and asthma), and specific disabilities (e.g. cognition, mobility, social interaction, and time out of role). Psychotic experiences were associated with 1.66 times the odds of seeking any treatment (95% CI: 1.20-2.29), and the perceived need for help among people who did not seek treatment (e.g. feeling the need for treatment, being encouraged to seek treatment by others). CONCLUSIONS Mental health practitioners serving people of color who have mood/anxiety disorders should routinely screen for psychotic experiences, which may suggest health problems and disabilities that warrant integrated healthcare.
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Affiliation(s)
- Hans Oh
- University of Southern California, Suzanne Dworak-Peck School of Social Work, CA, USA.
| | - Kyle Waldman
- University of Southern California, Suzanne Dworak-Peck School of Social Work, CA, USA.
| | - Brendon Stubbs
- Physiotherapy Department, South London and Maudsley NHS Foundation Trust, Denmark Hill, London, United Kingdom; Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom; Faculty of Health, Social Care and Education, Anglia Ruskin University, Chelmsford, United Kingdom.
| | - Ai Koyanagi
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, Universitat de Barcelona, Fundació Sant Joan de Déu, Barcelona, Spain; Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain.
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84
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Raue S, Wedekind D, Wiltfang J, Schmidt U. The Role of Proopiomelanocortin and α-Melanocyte-Stimulating Hormone in the Metabolic Syndrome in Psychiatric Disorders: A Narrative Mini-Review. Front Psychiatry 2019; 10:834. [PMID: 31798479 PMCID: PMC6867997 DOI: 10.3389/fpsyt.2019.00834] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2019] [Accepted: 10/21/2019] [Indexed: 01/10/2023] Open
Abstract
The metabolic syndrome (MetS) comprises abdominal obesity, preclinical or full diabetes type 2, arterial hypertension, and dyslipidemia and affects a significant proportion of the general population with a remarkably higher prevalence in patients suffering from psychiatric disorders. However, studies exploring the pathogenetic link between MetS and psychiatric diseases are rare. Here, we aim to narrow this gap in knowledge by providing a narrative review on this topic that focuses on two psychiatric diseases, namely on schizophrenia and posttraumatic stress disorder (PTSD) since we assume them to be associated with two different main causalities of MetS: in schizophrenia, MetS evidently develops or aggravates in response to antipsychotic drug treatment while it assumingly develops in response to stress-induced endocrine and/or epigenetic alterations in PTSD. First, we compared the prevalences of MetS and associated pathologies (which we took from the latest meta-analyses) among different psychiatric disorders and were surprised that the prevalences of arterial hypertension and hyperglycemia in PTSD almost doubles those of the other psychiatric disorders. Next, we performed a literature search on the neurobiology of MetS and found numerous articles describing a role for proopiomelanocortin (POMC) in MetS. Thus, we concentrated further analysis on POMC and one of its downstream effector hormones, α-melanocyte-stimulating hormone (α-MSH). We found some evidence for a role of POMC in both PTSD and schizophrenia, in particular in antipsychotic-induced MetS, as well as for α-MSH in schizophrenia, but, surprisingly, no study on α-MSH in PTSD. Taken together, our synopsis reveals, first, a potential interaction between the POMC system and stress in the assumingly at least partially shared pathogenesis of psychiatric disorders and MetS, second, that modulation of the POMC system, in particular of the melanocortin 3 and 4 receptors, might be a promising target for the treatment of MetS and, third, that the DNA methylation status of POMC might speculatively be a promising biomarker for MetS in general and, possibly, in particular in the context of stress-related psychiatric conditions such as PTSD. To best of our knowledge, this is the first review on the role of the POMC system in MetS in psychiatric disorders.
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Affiliation(s)
- Stefan Raue
- Psychotrauma Treatment Unit & RG Stress Modulation of Neurodegeneration, Department of Psychiatry and Psychotherapy, University Medical Center Göttingen (UMG), Göttingen, Germany
| | - Dirk Wedekind
- Department of Psychiatry and Psychotherapy, Georg August University, University Medical Center Göttingen (UMG), Göttingen, Germany
| | - Jens Wiltfang
- Department of Psychiatry and Psychotherapy, Georg August University, University Medical Center Göttingen (UMG), Göttingen, Germany.,German Center for Neurodegenerative Diseases (DZNE), Göttingen, Germany.,Medical Sciences Department, iBiMED, University of Aveiro, Aveiro, Portugal
| | - Ulrike Schmidt
- Psychotrauma Treatment Unit & RG Stress Modulation of Neurodegeneration, Department of Psychiatry and Psychotherapy, University Medical Center Göttingen (UMG), Göttingen, Germany.,Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience (MHeNs), Maastricht University Medical Centre, Maastricht, Netherlands
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85
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Sex differences in stress reactivity in arousal and attention systems. Neuropsychopharmacology 2019; 44:129-139. [PMID: 30022063 PMCID: PMC6235989 DOI: 10.1038/s41386-018-0137-2] [Citation(s) in RCA: 86] [Impact Index Per Article: 17.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2018] [Revised: 05/21/2018] [Accepted: 06/15/2018] [Indexed: 01/04/2023]
Abstract
Women are more likely than men to suffer from psychiatric disorders with hyperarousal symptoms, including posttraumatic stress disorder (PTSD) and major depression. In contrast, women are less likely than men to be diagnosed with schizophrenia and attention deficit hyperactivity disorder (ADHD), which share attentional impairments as a feature. Stressful events exacerbate symptoms of the aforementioned disorders. Thus, researchers are examining whether sex differences in stress responses bias women and men towards different psychopathology. Here we review the preclinical literature suggesting that, compared to males, females are more vulnerable to stress-induced hyperarousal, while they are more resilient to stress-induced attention deficits. Specifically described are sex differences in receptors for the stress neuropeptide, corticotropin-releasing factor (CRF), that render the locus coeruleus arousal system of females more vulnerable to stress and less adaptable to CRF hypersecretion, a condition found in patients with PTSD and depression. Studies on the protective effects of ovarian hormones against CRF-induced deficits in sustained attention are also detailed. Importantly, we highlight how comparing males and females in preclinical studies can lead to the development of novel therapeutics to improve treatments for psychiatric disorders in both women and men.
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86
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Moya-Higueras J, Cuevas A, Marques-Feixa L, Mezquita L, Mayoral M, Fañanás L, Ortet G, Ibáñez MI. Recent Stressful Life Events (SLE) and Adolescent Mental Health: Initial Validation of the LEIA, a New Checklist for SLE Assessment According to Their Severity, Interpersonal, and Dependent Nature. Assessment 2018; 27:1777-1795. [PMID: 30539643 DOI: 10.1177/1073191118817648] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The main aim of the present study was to develop and validate a checklist for adolescents, the Life Events Inventory for Adolescents (LEIA), for screening stressful life events (SLEs) of different nature (major-minor, dependent-independent, and personal-interpersonal). The LEIA was administered together with another SLE checklist (Escala de Acontecimientos Vitales [Life Events Scale], EAV), and with measures of life satisfaction and externalizing and internalizing symptoms. The results showed that the kappa and the percentage agreement reliability indices were adequate. Regarding validity evidences, the correlations found between the LEIA and the EAV ranged from .65 to .69, and between the LEIA and the psychopathological symptoms ranged from .26 to .38. Specifically, major dependent noninterpersonal SLEs were the best predictors of externalizing psychopathology; while major independent noninterpersonal SLEs were the best predictors of internalizing symptoms and low life satisfaction. To conclude, the LEIA could be considered an adequate checklist to screen for SLEs in adolescents.
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Affiliation(s)
- Jorge Moya-Higueras
- Universitat de Lleida, Lleida, Spain.,Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
| | | | - Laia Marques-Feixa
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain.,Universitat de Barcelona, Barcelona, Spain
| | - Laura Mezquita
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain.,Universitat Jaume I, Castelló, Spain
| | - María Mayoral
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain.,Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Madrid, Spain
| | - Lourdes Fañanás
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain.,Universitat de Barcelona, Barcelona, Spain
| | - Generós Ortet
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain.,Universitat Jaume I, Castelló, Spain
| | - Manuel I Ibáñez
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain.,Universitat Jaume I, Castelló, Spain
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87
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Dauvermann MR, Donohoe G. The role of childhood trauma in cognitive performance in schizophrenia and bipolar disorder - A systematic review. SCHIZOPHRENIA RESEARCH-COGNITION 2018; 16:1-11. [PMID: 30581765 PMCID: PMC6293032 DOI: 10.1016/j.scog.2018.11.001] [Citation(s) in RCA: 43] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/27/2018] [Revised: 11/09/2018] [Accepted: 11/27/2018] [Indexed: 12/13/2022]
Abstract
Childhood trauma (CT) has repeatedly been associated with cognitive deficits in patients with psychosis but many inconsistencies have been reported so that the nature of the relationship remains unclear. The purpose of this review was to better characterize the contribution of CT to cognitive deficits by considering the type, severity and frequency of childhood traumatic events and their relationships with psychosis at all stages. Relevant studies were identified via electronic and manual literature searches and included original studies that investigated the relationship between CT and higher cognitive performance or social cognitive performance in patients with schizophrenia, bipolar disorder and psychosis at all stages of the illness stages (i.e. ultra-high risk, first episode or chronic phase). Overall, a majority of studies reported that patients who experienced CT displayed deficits in general cognitive ability compared to patients with psychosis without such a history. Associations between CT and other cognitive function were more mixed. When comparing patient groups, the association between CT and cognitive function was more inconsistent in patients with chronic schizophrenia than in healthy participants, ultra-high risk individuals, first-episode patients and patients with chronic bipolar disorder. In understanding the variability in the reported relationships between CT and cognition across study populations, we highlight the variety of questionnaires used and discuss the likelihood of there being differences in cognitive function based on specific stressors, severity and frequency. Finally, we consider future research steps that may shed light on psychobiological mechanisms underlying CT and cognitive performance in patients with psychosis.
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88
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Kasanova Z, Ceccarini J, Frank MJ, van Amelsvoort T, Booij J, Heinzel A, Mottaghy FM, Myin-Germeys I. Daily-life stress differentially impacts ventral striatal dopaminergic modulation of reward processing in first-degree relatives of individuals with psychosis. Eur Neuropsychopharmacol 2018; 28:1314-1324. [PMID: 30482598 DOI: 10.1016/j.euroneuro.2018.10.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2018] [Revised: 09/04/2018] [Accepted: 10/11/2018] [Indexed: 11/17/2022]
Abstract
Emerging evidence shows that stress can impair the ability to learn from and pursue rewards, which in turn has been linked to motivational impairments characteristic of the psychotic disorder. Ventral striatal dopaminergic neurotransmission has been found to modulate reward processing, and appears to be disrupted by exposure to stress. We investigated the hypothesis that stress experienced in the everyday life has a blunting effect on reward-induced dopamine release in the ventral striatum of 16 individuals at a familial risk for psychosis compared to 16 matched control subjects. Six days of ecological momentary assessments quantified the amount of daily-life stress prior to [18F]fallypride PET imaging while performing a probabilistic reinforcement learning task. Relative to the controls, individuals at a familial risk for psychosis who encountered more daily-life stress showed significantly diminished extent of reward-induced dopamine release in the right ventral striatum, as well as poorer performance on the reward task. These findings provide the first neuromolecular evidence for stress-related deregulation of reward processing in familial predisposition to psychosis. The implication of daily-life stress in compromised modulation of reward function may facilitate the design of targeted neuropharmacological and ecological interventions.
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Affiliation(s)
- Zuzana Kasanova
- Center for Contextual Psychiatry, Department of Neuroscience, KU Leuven - Leuven University, Kapucijnenvoer 33, blok i, Leuven, 3000, Belgium.
| | - Jenny Ceccarini
- Division of Nuclear Medicine and Molecular Imaging, Department of Imaging & Pathology, University Hospitals Leuven, Leuven, Belgium
| | - Michael J Frank
- Department of Cognitive, Linguistic and Psychological Sciences, Brown University, Providence, USA
| | - Thérèse van Amelsvoort
- Department of Psychiatry and Neuropsychology, Maastricht University, Maastricht, The Netherlands
| | - Jan Booij
- Department of Radiology and Nuclear Medicine, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Alexander Heinzel
- Department of Nuclear Medicine, University Hospital RWTH Aachen University, Aachen, Germany
| | - Felix M Mottaghy
- Department of Nuclear Medicine, University Hospital RWTH Aachen University, Aachen, Germany; Department of Nuclear Medicine and Radiology, Maastricht University Medical Center (MUMC+), Maastricht, The Netherlands
| | - Inez Myin-Germeys
- Center for Contextual Psychiatry, Department of Neuroscience, KU Leuven - Leuven University, Kapucijnenvoer 33, blok i, Leuven, 3000, Belgium
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89
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Elevated allostatic load early in the course of schizophrenia. Transl Psychiatry 2018; 8:246. [PMID: 30420620 PMCID: PMC6232085 DOI: 10.1038/s41398-018-0299-z] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2018] [Revised: 06/17/2018] [Accepted: 07/14/2018] [Indexed: 12/19/2022] Open
Abstract
Stress plays a significant role in schizophrenia from disease onset to exacerbation of psychotic symptoms. Allostatic load (AL) is a measure of cumulative stress to the organism. This study is an extension of our previous work on AL and its relationship to brain structures. Here, we further determined whether elevated AL is a function of illness chronicity, or if it is already present early in the course of schizophrenia. AL was compared in schizophrenia patients early in the illness (within 5 years of disease onset), patients with chronic schizophrenia (more than 5 years of illness), and two groups of healthy controls that were age-and sex-matched to the two patient groups. This work is presented with an expanded sample and includes about two-thirds of the participants who were previously reported. We found that patients with early psychosis had significantly elevated AL score compared with their age-matched controls (p = 0.005). Chronic course patients also had elevated AL compared with age-matched controls (p = 0.003). Immune and stress hormone AL subcomponents were nominally higher in early-stage patients compared with controls (p = 0.005 and 0.04, respectively). Greater AL was also associated with more severe positive psychotic symptoms in early-stage patients (r = 0.54, p = 0.01). Elevated levels of allostatic load are already present in the early years of the schizophrenia illness, particularly in patients with more severe psychotic symptoms. AL may be a useful evaluation for the need of early intervention on psychosomatic comorbidity.
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90
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Sommer O, Aug RL, Schmidt AJ, Heiser P, Schulz E, Vedder H, Clement HW. Hydrogen Sulfide Affects Radical Formation in the Hippocampus of LPS Treated Rats and the Effect of Antipsychotics on Hydrogen Sulfide Forming Enzymes in Human Cell Lines. Front Psychiatry 2018; 9:501. [PMID: 30386265 PMCID: PMC6198150 DOI: 10.3389/fpsyt.2018.00501] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2016] [Accepted: 09/24/2018] [Indexed: 12/19/2022] Open
Abstract
Objectives: Psychiatric disorders, such as schizophrenia and other neuroinflammatory diseases are accompanied by an increase in the oxidative stress and changes in the immune system and in the metabolic, hormonal and neurological components of the central nervous system (CNS). Hydrogen sulfide (H2S) is a gaseous molecule that is endogenously produced in the peripheral and central nervous system through cysteine by the following major H2S producing enzymes in the brain: cystathionine-γlyase (CSE), cystathionine ß-synthase (CBS) and 3-mercaptopyruvate sulfurtransferase (MPST). The physiological effects of H2S are broad, with antioxidative properties being a major role in the body. The aims of our investigation were to analyze the central nervous antioxidant, metabolic and neuronal effects in the hippocampus of the rat after inflammatory peripheral lipopolysaccharide (LPS) treatment; and to examine the effects of antipsychotics on the expression of these enzymes in human cell lines. Material and Methods: Male Lewis rats (250 g) received an i.p. LPS injection (1 mg/kg) 24 h before microdialysis experiments. Conscious rats were infused via these probes (1.5 μl/min) with a radical scavenger 1-hydroxy-3-methoxycarbonyl-2,2,5,5-tetramethylpyrrolidine (CMH) in Krebs-Ringer solution. Sodiumhydrogensulfide (NaHS, 10 μg/min) was infused after a 2- h baseline for 1 h. Corticosterone, glutamate, glucose and lactate were measured by Elisa. Reactive oxygen species (ROS) were detected by electron spin resonance spectroscopy (ESR). The impact of the antipsychotics haloperidol, clozapine, olanzapine and risperidone on the expression of genes encoding the key enzymes of H2S synthesis was studied at the human neuroblastoma SH-SY5Y and monocytic U-937 cell lines. The cells were incubated for 24 h with 30 μM antipsychotic following which mRNA levels were measured by polymerase chain reaction. Results: Microdialysate glucose and lactate levels dramatically increased in the hippocampus of LPS untreated rats by local application of NaHS. By contrast, in the LPS pretreated rats, there was no effect of NaHS infusion on glucose but a further significant increase in microdialysate lactate was found. It was LPS pretreatment alone that particularly enhanced lactate levels. There was a marked increase in hippocampal microdialysate glutamate levels after local NaHS infusion in LPS untreated animals. In LPS treated rats, no change was observed by NaHS, but LPS itself had the strongest effect on microdialysate glutamate levels. Microdialysate corticosterone levels were reduced by NaHS in both LPS pretreated and untreated rats. The formation of free radicals in the hippocampus significantly reduced in LPS pretreated rats, while in LPS untreated rats a significant increase was observed after NaHS infusion. In human SH-SY5Y and U-937 cells, all three major enzymes of H2S-Synthesis, namely cystathionine-γ-lyase, cystathione ß-synthase and 3-mercaptopyruvate sulfurtransferase, could be detected by PCR. The antipsychotics haloperidol, clozapine, olanzapine and risperidone affected all three enzymes in different ways; with haloperidol and risperidone showing major effects that led to reductions in CBS or CSE expression. Discussion: The local application of NaHS in the hippocampus of the rat strongly affected glucose, lactate and glutamate release. Contrastingly, in LPS pretreated rats, a decreased radical formation was the only effect found. H2S synthetizing enzymes may be involved in antipsychotic mechanisms, although no clear common mechanism could be found.
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Affiliation(s)
- Olaf Sommer
- Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, Albert-Ludwigs-University Freiburg, Freiburg, Germany
| | - Rosana L. Aug
- Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, Albert-Ludwigs-University Freiburg, Freiburg, Germany
| | - Andreas J. Schmidt
- Department of Psychiatry and Psychotherapy, Philipps-University, Marburg, Germany
| | - Philip Heiser
- Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, Albert-Ludwigs-University Freiburg, Freiburg, Germany
| | - Eberhard Schulz
- Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, Albert-Ludwigs-University Freiburg, Freiburg, Germany
| | - Helmut Vedder
- Department of Psychiatry and Psychotherapy, Philipps-University, Marburg, Germany
| | - Hans-Willi Clement
- Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, Albert-Ludwigs-University Freiburg, Freiburg, Germany
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91
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Armando M, Sandini C, Chambaz M, Schaer M, Schneider M, Eliez S. Coping Strategies Mediate the Effect of Stressful Life Events on Schizotypal Traits and Psychotic Symptoms in 22q11.2 Deletion Syndrome. Schizophr Bull 2018; 44:S525-S535. [PMID: 29548017 PMCID: PMC6188528 DOI: 10.1093/schbul/sby025] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Converging evidence suggests that psychosis emerges from the complex interaction of genetic and environmental factors. Stressful life events (SLEs) play a prominent role in combination with coping strategies and with a dysfunctional hypothalamus-pituitary-adrenal axis (HPAA). It has been proposed that the framework of schizotypy might help disentangle the interaction between genetic and environmental factors in the pathogenesis of psychosis. Similarly, 22q11.2 deletion syndrome (22q11DS) is considered as a genetic model of psychosis vulnerability. However, SLE and coping strategies remain largely unexplored in 22q11DS. Moreover, the HPAA has not been systematically investigated in this population. Here, we explored the correlation between SLE, emotional coping strategies, schizotypal personality traits, subthreshold psychotic symptoms in a sample of 43 healthy controls (HCs) compared with 59 individuals with 22q11DS. In the latter, we also explored the correlation with pituitary volume as estimated from structural magnetic resonance imaging. We found that SLE and negative coping strategies were correlated with schizotypal personality traits in both HCs and 22q11DS, and with psychotic symptoms in the 22q11DS group only, whereas reduced pituitary volume correlated with general psychopathology. Moreover, dysfunctional coping mediated the effect of SLE on schizotypal personality traits and psychotic symptoms in 22q11DS. Our findings recapitulate evidence in nonsyndromic patients and confirm the central role of stress and coping in the pathogenesis of psychosis. More broadly, they highlight the importance of environmental factors in the pathway to psychosis in 22q11DS, suggesting a strong rationale for the implementation of stress and particularly coping-oriented interventions in this population.
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Affiliation(s)
- Marco Armando
- Developmental Imaging and Psychopathology Lab, Department of Psychiatry, School of Medicine, University of Geneva, David Dufour, Geneva, Switzerland
| | - Corrado Sandini
- Developmental Imaging and Psychopathology Lab, Department of Psychiatry, School of Medicine, University of Geneva, David Dufour, Geneva, Switzerland
| | - Maelle Chambaz
- Developmental Imaging and Psychopathology Lab, Department of Psychiatry, School of Medicine, University of Geneva, David Dufour, Geneva, Switzerland
| | - Marie Schaer
- Developmental Imaging and Psychopathology Lab, Department of Psychiatry, School of Medicine, University of Geneva, David Dufour, Geneva, Switzerland
| | - Maude Schneider
- Developmental Imaging and Psychopathology Lab, Department of Psychiatry, School of Medicine, University of Geneva, David Dufour, Geneva, Switzerland
- Center for Contextual Psychiatry, Department of Neurosciences, KU Leuven, Leuven, Belgium
| | - Stephan Eliez
- Developmental Imaging and Psychopathology Lab, Department of Psychiatry, School of Medicine, University of Geneva, David Dufour, Geneva, Switzerland
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92
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Dantchev S, Zammit S, Wolke D. Sibling bullying in middle childhood and psychotic disorder at 18 years: a prospective cohort study. Psychol Med 2018; 48:2321-2328. [PMID: 29429415 DOI: 10.1017/s0033291717003841] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND Being bullied by a sibling has been recently identified as a potential risk factor for developing depression and self-harm. It is unknown whether this risk extends to other serious mental health problems such as psychosis. We investigated whether sibling bullying victimization or perpetration in middle childhood was prospectively associated with psychotic disorder in early adulthood. METHODS The current study investigated 6988 participants of the Avon Longitudinal Study of Parents and Children, a UK community-based birth cohort. Sibling bullying was reported at 12 years and psychotic disorder was assessed via a semi-structured interview at 18 years. RESULTS Involvement in sibling bullying was associated with psychotic disorder in a dose-response fashion, even after controlling for a range of confounders. Those involved several times a week were 2-3 times more likely to meet criteria for a psychotic disorder [odds ratio (OR); 95% confidence interval (CI)]: victimization (OR 2.74; CI 1.28-5.87); perpetration (OR 3.16; CI 1.35-7.41). Categorical analysis indicated that particularly victims (OR 3.10; CI 1.48-6.50) and bully-victims (OR 2.66; CI 1.24-5.69) were at increased risk of psychotic disorder. Involvement in both sibling and peer bullying had a dose-effect relationship with a psychotic disorder, with those victimized in both contexts having more than four times the odds for a psychotic disorder (OR 4.57; CI 1.73-12.07). CONCLUSION Parents and health professionals should be aware of the adverse long-term effects of sibling bullying.
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Affiliation(s)
- Slava Dantchev
- Department of Psychology,University of Warwick,Coventry,UK
| | - Stanley Zammit
- Division of Psychological Medicine and Clinical Neurosciences,Cardiff University,Cardiff,UK
| | - Dieter Wolke
- Department of Psychology,University of Warwick,Coventry,UK
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93
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Klaus K, Butler K, Gutierrez H, Durrant SJ, Pennington K. Interactive effects of early life stress and CACNA1C genotype on cortisol awakening response. Biol Psychol 2018; 136:22-28. [PMID: 29733866 DOI: 10.1016/j.biopsycho.2018.05.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2017] [Revised: 03/19/2018] [Accepted: 05/02/2018] [Indexed: 01/08/2023]
Abstract
The rs1006737 (A/G) single nucleotide polymorphism within the gene encoding the Cav1.2 subunit of the L-type voltage-dependent calcium channel (CACNA1C) has been strongly implicated in psychiatric disorders. In addition, calcium channels are sensitive to the effects of glucocorticoids and functional variation may contribute to altered stress responsivity. This study aimed to investigate the role of early life stress (ELS) and its interaction with CACNA1C rs1006737 in affecting the cortisol awakening response (CAR), an indicator of HPA-axis function. Salivary cortisol was measured in 103 healthy adult males (aged 21-63) on two consecutive days at awakening and 30 min later. The ELS measure investigated self-reported adverse life events prior to age 17. The results revealed a marginally significant main effect of CACNA1C, a significant main effect of ELS, and a significant genotype-by-ELS interaction on the CAR, whereby non-risk allele carriers (GG) who had experienced early adversity showed higher CAR compared to the other groups. Further exploratory analyses showed that this interaction may have arisen from individuals who had experienced ELS before adolescence (prior to age 13). This study is the first to provide evidence that the effect of ELS on CAR may be partially moderated via CACNA1C rs1006737 genotype, whereby the heightened CAR in the GG-ELS group may be an indicator of mental health resilience in response to ELS.
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Affiliation(s)
- K Klaus
- School of Psychology, University of Lincoln, Brayford Wharf, Lincoln, LN5 7AT, UK
| | - K Butler
- School of Psychology, University of Lincoln, Brayford Wharf, Lincoln, LN5 7AT, UK
| | - H Gutierrez
- School of Life Sciences, University of Lincoln, Brayford Pool, Lincoln, LN7 6TS, UK
| | - S J Durrant
- School of Psychology, University of Lincoln, Brayford Wharf, Lincoln, LN5 7AT, UK
| | - K Pennington
- School of Psychology, University of Lincoln, Brayford Wharf, Lincoln, LN5 7AT, UK.
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94
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Tadmor H, Golani I, Doron R, Kremer I, Shamir A. ErbB signaling antagonist ameliorates behavioral deficit induced by phencyclidine (PCP) in mice, without affecting metabolic syndrome markers. Prog Neuropsychopharmacol Biol Psychiatry 2018; 82:322-331. [PMID: 28818421 DOI: 10.1016/j.pnpbp.2017.08.010] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2017] [Revised: 07/26/2017] [Accepted: 08/13/2017] [Indexed: 12/18/2022]
Abstract
Schizophrenia is a severe syndrome that affects about 1% of the world population. Since the mid-1950s, antipsychotics have been used to treat schizophrenia with preference for treating positive symptoms; however, their tolerance level is low, there are numerous side effects, and only some patients respond to the treatment. Antipsychotic medications that are more effective, better tolerated, and with fewer adverse effects are urgently needed. Given the accumulating evidence of the role filled by the ErbB signaling network in the biology of the dopamine, GABA, and glutamate systems, and in the etiology of schizophrenia, we hypothesized that the ErbB network is a candidate for development of a novel agent through which various symptoms of schizophrenia and other psychiatric disorders might be treated. Herein, we studied, in mice, the capability of blocking the ErbB signaling, in comparison with the atypical antipsychotic drug clozapine, to counter schizophrenia-like behavior induced by acute and sub-chronic phencyclidine (PCP), and determined whether inhibition of the ErbB networks induced weight gain and affected social and exploratory behavior, and metabolic syndrome markers. We demonstrated that administration of the pan-ErbB inhibitor JNJ28871063 (JNJ) reduced the level of activity in the open field induced by an acute injection of PCP. Moreover, the ability of JNJ to attenuate the effect of PCP is as effective as clozapine. In addition and like clozapine, JNJ normalized social behavior impairment induced by sub-chronic PCP and stress. Adult JNJ-treated mice displayed normal sociability and exploratory behavior, and their serum cholesterol, LDL, and HDL levels were lower than in the saline-treated mice. Sub-chronic treatment did not affect weight gain, glucose levels, and the activity of hepatic enzymes catalase and SOD. These data suggest that treatment with JNJ attenuates abnormal behaviors induced by PCP, and has similar effects as the antipsychotic drug clozapine, with no adverse effects. Thus, the ErbB signaling can serve as a new starting point for non-dopaminergic-based drug development of schizophrenia.
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Affiliation(s)
- Hagar Tadmor
- Psychobiology Research Laboratory, Mazor Mental Health Center, Akko, Israel; Faculty of Medicine in the Galilee, Bar-Ilan University, Zefat, Israel
| | - Idit Golani
- Department of Biotechnology, ORT Braude College, Karmiel, Israel
| | - Ravid Doron
- Psychobiology Laboratory, School of Behavioral Sciences, The Academic College of Tel Aviv-Yaffo, Israel; Department of Education and Psychology, The Open University, Israel
| | - Ilana Kremer
- Psychobiology Research Laboratory, Mazor Mental Health Center, Akko, Israel; The Ruth and Bruce Rappaport Faculty of Medicine, Technion - Israel Institute of Technology, Haifa, Israel
| | - Alon Shamir
- Psychobiology Research Laboratory, Mazor Mental Health Center, Akko, Israel; The Ruth and Bruce Rappaport Faculty of Medicine, Technion - Israel Institute of Technology, Haifa, Israel.
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95
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Marballi KK, Gallitano AL. Immediate Early Genes Anchor a Biological Pathway of Proteins Required for Memory Formation, Long-Term Depression and Risk for Schizophrenia. Front Behav Neurosci 2018; 12:23. [PMID: 29520222 PMCID: PMC5827560 DOI: 10.3389/fnbeh.2018.00023] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2017] [Accepted: 01/29/2018] [Indexed: 01/02/2023] Open
Abstract
While the causes of myriad medical and infectious illnesses have been identified, the etiologies of neuropsychiatric illnesses remain elusive. This is due to two major obstacles. First, the risk for neuropsychiatric disorders, such as schizophrenia, is determined by both genetic and environmental factors. Second, numerous genes influence susceptibility for these illnesses. Genome-wide association studies have identified at least 108 genomic loci for schizophrenia, and more are expected to be published shortly. In addition, numerous biological processes contribute to the neuropathology underlying schizophrenia. These include immune dysfunction, synaptic and myelination deficits, vascular abnormalities, growth factor disruption, and N-methyl-D-aspartate receptor (NMDAR) hypofunction. However, the field of psychiatric genetics lacks a unifying model to explain how environment may interact with numerous genes to influence these various biological processes and cause schizophrenia. Here we describe a biological cascade of proteins that are activated in response to environmental stimuli such as stress, a schizophrenia risk factor. The central proteins in this pathway are critical mediators of memory formation and a particular form of hippocampal synaptic plasticity, long-term depression (LTD). Each of these proteins is also implicated in schizophrenia risk. In fact, the pathway includes four genes that map to the 108 loci associated with schizophrenia: GRIN2A, nuclear factor of activated T-cells (NFATc3), early growth response 1 (EGR1) and NGFI-A Binding Protein 2 (NAB2); each of which contains the "Index single nucleotide polymorphism (SNP)" (most SNP) at its respective locus. Environmental stimuli activate this biological pathway in neurons, resulting in induction of EGR immediate early genes: EGR1, EGR3 and NAB2. We hypothesize that dysfunction in any of the genes in this pathway disrupts the normal activation of Egrs in response to stress. This may result in insufficient electrophysiologic, immunologic, and neuroprotective, processes that these genes normally mediate. Continued adverse environmental experiences, over time, may thereby result in neuropathology that gives rise to the symptoms of schizophrenia. By combining multiple genes associated with schizophrenia susceptibility, in a functional cascade triggered by neuronal activity, the proposed biological pathway provides an explanation for both the polygenic and environmental influences that determine the complex etiology of this mental illness.
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Affiliation(s)
- Ketan K. Marballi
- Department of Basic Medical Sciences and Psychiatry, University of Arizona College of Medicine—Phoenix, Phoenix, AZ, United States
| | - Amelia L. Gallitano
- Department of Basic Medical Sciences and Psychiatry, University of Arizona College of Medicine—Phoenix, Phoenix, AZ, United States
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96
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Radua J, Ramella-Cravaro V, Ioannidis JPA, Reichenberg A, Phiphopthatsanee N, Amir T, Yenn Thoo H, Oliver D, Davies C, Morgan C, McGuire P, Murray RM, Fusar-Poli P. What causes psychosis? An umbrella review of risk and protective factors. World Psychiatry 2018; 17:49-66. [PMID: 29352556 PMCID: PMC5775150 DOI: 10.1002/wps.20490] [Citation(s) in RCA: 334] [Impact Index Per Article: 55.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Psychosis is a heterogeneous psychiatric condition for which a multitude of risk and protective factors have been suggested. This umbrella review aimed to classify the strength of evidence for the associations between each factor and psychotic disorders whilst controlling for several biases. The Web of Knowledge database was searched to identify systematic reviews and meta-analyses of observational studies which examined associations between socio-demographic, parental, perinatal, later factors or antecedents and psychotic disorders, and which included a comparison group of healthy controls, published from 1965 to January 31, 2017. The literature search and data extraction followed PRISMA and MOOSE guidelines. The association between each factor and ICD or DSM diagnoses of non-organic psychotic disorders was graded into convincing, highly suggestive, suggestive, weak, or non-significant according to a standardized classification based on: number of psychotic cases, random-effects p value, largest study 95% confidence interval, heterogeneity between studies, 95% prediction interval, small study effect, and excess significance bias. In order to assess evidence for temporality of association, we also conducted sensitivity analyses restricted to data from prospective studies. Fifty-five meta-analyses or systematic reviews were included in the umbrella review, corresponding to 683 individual studies and 170 putative risk or protective factors for psychotic disorders. Only the ultra-high-risk state for psychosis (odds ratio, OR=9.32, 95% CI: 4.91-17.72) and Black-Caribbean ethnicity in England (OR=4.87, 95% CI: 3.96-6.00) showed convincing evidence of association. Six factors were highly suggestive (ethnic minority in low ethnic density area, second generation immigrants, trait anhedonia, premorbid IQ, minor physical anomalies, and olfactory identification ability), and nine were suggestive (urbanicity, ethnic minority in high ethnic density area, first generation immigrants, North-African immigrants in Europe, winter/spring season of birth in Northern hemisphere, childhood social withdrawal, childhood trauma, Toxoplasma gondii IgG, and non-right handedness). When only prospective studies were considered, the evidence was convincing for ultra-high-risk state and suggestive for urbanicity only. In summary, this umbrella review found several factors to be associated with psychotic disorders with different levels of evidence. These risk or protective factors represent a starting point for further etiopathological research and for the improvement of the prediction of psychosis.
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Affiliation(s)
- Joaquim Radua
- Early Psychosis: Interventions & Clinical-detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
- FIDMAG Germanes Hospitalàries, CIBERSAM, Sant Boi de Llobregat, Spain
- Department of Clinical Neuroscience, Centre for Psychiatry Research, Karolinska Institutet, Stockholm, Sweden
| | - Valentina Ramella-Cravaro
- Early Psychosis: Interventions & Clinical-detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
- Department of Neurosciences, Psychology, Drug Research and Child Health, University of Florence, Florence, Italy
| | - John P A Ioannidis
- Department of Medicine, Stanford Prevention Research Center, Stanford, CA, USA
- Department of Health Research and Policy, Stanford University School of Medicine, Stanford, CA, USA
- Meta-Research Innovation Center at Stanford, Stanford University, Stanford, CA, USA
- Department of Statistics, Stanford University School of Humanities and Sciences, Stanford, CA, USA
| | - Abraham Reichenberg
- Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Preventive Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Frieman Brain Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Nacharin Phiphopthatsanee
- Early Psychosis: Interventions & Clinical-detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Taha Amir
- Early Psychosis: Interventions & Clinical-detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Hyi Yenn Thoo
- Early Psychosis: Interventions & Clinical-detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Dominic Oliver
- Early Psychosis: Interventions & Clinical-detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Cathy Davies
- Early Psychosis: Interventions & Clinical-detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Craig Morgan
- Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
- National Institute for Health Research (NIHR) Maudsley Biomedical Research Center, London, UK
| | - Philip McGuire
- Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
- National Institute for Health Research (NIHR) Maudsley Biomedical Research Center, London, UK
| | - Robin M Murray
- Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
- National Institute for Health Research (NIHR) Maudsley Biomedical Research Center, London, UK
| | - Paolo Fusar-Poli
- Early Psychosis: Interventions & Clinical-detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
- National Institute for Health Research (NIHR) Maudsley Biomedical Research Center, London, UK
- OASIS Service, South London and Maudsley NHS Foundation Trust, London, UK
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97
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Perceived social stress and symptom severity among help-seeking adolescents with versus without clinical high-risk for psychosis. Schizophr Res 2018. [PMID: 28629890 DOI: 10.1016/j.schres.2017.06.002] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Research suggests that social stress exposure influences illness presentation and course among youth at clinical high-risk (CHR) for psychosis, though less is known about the extent to which self-reported perceptions of social stress relate to the severity of positive symptoms. Importantly, despite the notion that youth at CHR are especially susceptible to elevations in positive symptoms under conditions of stress, no study has examined this presumption relative to other psychiatric groups. Extending previous work demonstrating that perceived social stress was higher in a CHR group than in a clinical group of non-CHR, help-seeking controls, the current study aimed to: (1) examine whether perceived social stress is related to the severity of attenuated positive symptoms in the full sample (N=110); and (2) determine whether CHR status moderates the stress-symptom relation. Exploratory analyses examined relations of perceived social stress to negative, disorganized, and general symptoms. Greater perceptions of social stress were associated with more severe positive symptoms in the entire sample; however, although positive symptoms and perceived social stress were higher in the CHR group, the strength of this relation was statistically indistinguishable across groups. No differential effect of perceived social stress was observed for any symptom domain. Results provide some support for the diathesis-stress model of psychosis, while also suggesting that social stress and symptomatology are related independent of clinical vulnerability to psychosis. Future research would benefit from longitudinal studies of stress-symptom relations across CHR and help-seeking control groups.
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98
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Tomas-Roig J, Piscitelli F, Gil V, Quintana E, Ramió-Torrentà LL, Del Río JA, Moore TP, Agbemenyah H, Salinas G, Pommerenke C, Lorenzen S, Beißbarth T, Hoyer-Fender S, Di Marzo V, Havemann-Reinecke U. Effects of repeated long-term psychosocial stress and acute cannabinoid exposure on mouse corticostriatal circuitries: Implications for neuropsychiatric disorders. CNS Neurosci Ther 2018; 24:528-538. [PMID: 29388323 PMCID: PMC5969305 DOI: 10.1111/cns.12810] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2017] [Revised: 01/02/2018] [Accepted: 01/04/2018] [Indexed: 01/04/2023] Open
Abstract
Introduction Vulnerability to psychiatric manifestations is achieved by the influence of genetic and environment including stress and cannabis consumption. Here, we used a psychosocial stress model based on resident‐intruder confrontations to study the brain corticostriatal‐function, since deregulation of corticostriatal circuitries has been reported in many psychiatric disorders. CB1 receptors are widely expressed in the central nervous system and particularly, in both cortex and striatum brain structures. Aims and methods The investigation presented here is addressed to assess the impact of repeated stress following acute cannabinoid exposure on behavior and corticostriatal brain physiology by assessing mice behavior, the concentration of endocannabinoid and endocannabinoid‐like molecules and changes in the transcriptome. Results Stressed animals urinated frequently; showed exacerbated scratching activity, lower striatal N‐arachidonylethanolamine (AEA) levels and higher cortical expression of cholinergic receptor nicotinic alpha 6. The cannabinoid agonist WIN55212.2 diminished locomotor activity while the inverse agonist increased the distance travelled in the center of the open field. Upon CB1 activation, N‐oleoylethanolamide and N‐palmitoylethanolamide, two AEA congeners that do not interact directly with cannabinoid receptors, were enhanced in the striatum. The co‐administration with both cannabinoids induced an up‐regulation of striatal FK506 binding protein 5. The inverse agonist in controls reversed the effects of WIN55212.2 on motor activity. When Rimonabant was injected under stress, the cortical levels of 2‐arachidonoylglycerol were maximum. The agonist and the antagonist influenced the cortical expression of cholinergic receptor nicotinic alpha 6 and serotonin transporter neurotransmitter type 4 in opposite directions, while their co‐administration tended to produce a null effect under stress. Conclusions The endocannabinoid system had a direct effect on serotoninergic neurotransmission and glucocorticoid signaling. Cholinergic receptor nicotinic alpha‐6 was shown to be deregulated in response to stress and following synthetic cannabinoid drugs thus could confer vulnerability to cannabis addiction and psychosis. Targeting the receptors of endocannabinoids and endocannabinoid‐like mediators might be a valuable option for treating stress‐related neuropsychiatric symptoms.
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Affiliation(s)
- Jordi Tomas-Roig
- Department of Psychiatry and Psychotherapy, University of Göttingen, Göttingen, Germany.,Center Nanoscale Microscopy and Molecular Physiology of the Brain (CNMPB), Göttingen, Germany.,Girona Neuroimmunology and Multiple Sclerosis Unit (UNIEMTG), Dr. Josep Trueta University Hospital and Neurodegeneration and Neuroinflammation Research Group, Girona Biomedical Research Institute (IDIBGI), Girona, Spain
| | - Fabiana Piscitelli
- Endocannabinoid Research Group, Institute of Biomolecular Chemistry, Consiglio Nazionale delle Ricerche, Pozzuoli, Italy
| | - Vanesa Gil
- Institute for Bioengineering of Catalonia (IBEC), The Barcelona Institute of Science and Technology, Centro de Investigación Biomédica en Red de Enfermedades Neurodegenerativas (CIBERNED), Barcelona, Spain.,Department of Cell Biology, Physiology and Immunology, Faculty of Biology, University of Barcelona, Barcelona, Spain
| | - Ester Quintana
- Girona Neuroimmunology and Multiple Sclerosis Unit (UNIEMTG), Dr. Josep Trueta University Hospital and Neurodegeneration and Neuroinflammation Research Group, Girona Biomedical Research Institute (IDIBGI), Girona, Spain
| | - Lluís L Ramió-Torrentà
- Girona Neuroimmunology and Multiple Sclerosis Unit (UNIEMTG), Dr. Josep Trueta University Hospital and Neurodegeneration and Neuroinflammation Research Group, Girona Biomedical Research Institute (IDIBGI), Girona, Spain
| | - Jose Antonio Del Río
- Institute for Bioengineering of Catalonia (IBEC), The Barcelona Institute of Science and Technology, Centro de Investigación Biomédica en Red de Enfermedades Neurodegenerativas (CIBERNED), Barcelona, Spain.,Department of Cell Biology, Physiology and Immunology, Faculty of Biology, University of Barcelona, Barcelona, Spain
| | - Timothy Patrick Moore
- Department of Psychiatry and Psychotherapy, University of Göttingen, Göttingen, Germany.,Center Nanoscale Microscopy and Molecular Physiology of the Brain (CNMPB), Göttingen, Germany.,Department of Child and Adolescent Psychiatry, University Hospital Münster, Münster, Germany
| | - Hope Agbemenyah
- Laboratory for Aging and Cognitive Diseases, European Neuroscience Institute, Goettingen, Germany
| | - Gabriela Salinas
- Department of Developmental Biochemistry, Georg-August-Universität Göttingen, Göttingen, Germany
| | - Claudia Pommerenke
- Department of Developmental Biochemistry, Georg-August-Universität Göttingen, Göttingen, Germany
| | - Stephan Lorenzen
- Department of Medical Statistics, University Medical Center Göttingen, Göttingen, Germany.,Department of Molecular Medicine, Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany
| | - Tim Beißbarth
- Department of Medical Statistics, University Medical Center Göttingen, Göttingen, Germany
| | - Sigrid Hoyer-Fender
- Johann-Friedrich-Blumenbach Institute for Zoology and Anthropology, Developmental Biology, Göttingen, Germany
| | - Vincenzo Di Marzo
- Endocannabinoid Research Group, Institute of Biomolecular Chemistry, Consiglio Nazionale delle Ricerche, Pozzuoli, Italy
| | - Ursula Havemann-Reinecke
- Department of Psychiatry and Psychotherapy, University of Göttingen, Göttingen, Germany.,Center Nanoscale Microscopy and Molecular Physiology of the Brain (CNMPB), Göttingen, Germany
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99
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Lim SI, Song KH, Yoo CH, Woo DC, Choe BY. High-fat diet-induced hyperglutamatergic activation of the hippocampus in mice: A proton magnetic resonance spectroscopy study at 9.4T. Neurochem Int 2017; 114:10-17. [PMID: 29274351 DOI: 10.1016/j.neuint.2017.12.007] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2017] [Revised: 12/11/2017] [Accepted: 12/18/2017] [Indexed: 12/28/2022]
Abstract
The aim of this study was to investigate the long-term neurochemical alterations in the hippocampus of mice fed a high-fat diet (HFD) while plasma leptin and corticosterone levels were monitored. Although metabolic disturbances induced by the excess intake of fat are assumed to cause depression, the relationship underlying dysfunctional adipose tissue, stress hormone release, and excitatory metabolism has not been fully understood yet. Four-week-old male C57BL/6 mice were separated into a HFD-fed group (n = 8) and low-fat diet-fed group (n = 8). Proton magnetic resonance spectroscopy was used to measure the long-term changes in neurochemicals in the hippocampus at 0, 5, and 10 weeks and blood samples were taken at the same time to assess plasma hormones levels. At the end of the experiment, magnetic resonance imaging was performed to quantify abdominal fat accumulation. At 10 weeks, corticosterone and leptin levels were significantly increased in the HFD group compared with the low-fat diet group. In addition, aspartate, glutamate, total choline, and N-acetylaspartic acid levels were significantly increased, but glutamine/glutamate ratios were substantially decreased at 10 weeks in the HFD group. These results were compatible with HFD-induced acute stress responses and changes in N-methyl-d-aspartate receptor-induced plasticity. These findings demonstrated that the long-term ingestion of a HFD induced hyperglutamatergic metabolism and altered glutamine-glutamate cycling. Therfore, it is suggested that hypothalamic-pituitary-adrenal dysfunction and hyperglutamatergic activation in the hippocampus resulting from the HFD.
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Affiliation(s)
- Song-I Lim
- Department of Biomedical Engineering, Research Institute of Biomedical Engineering, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea; Asan Institute for Life Sciences, Asan Medical Center, Seoul, Republic of Korea
| | - Kyu-Ho Song
- Department of Biomedical Engineering, Research Institute of Biomedical Engineering, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea; Asan Institute for Life Sciences, Asan Medical Center, Seoul, Republic of Korea
| | - Chi-Hyeon Yoo
- Department of Biomedical Engineering, Research Institute of Biomedical Engineering, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea; Asan Institute for Life Sciences, Asan Medical Center, Seoul, Republic of Korea
| | - Dong-Cheol Woo
- Asan Institute for Life Sciences, Asan Medical Center, Seoul, Republic of Korea
| | - Bo-Young Choe
- Department of Biomedical Engineering, Research Institute of Biomedical Engineering, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
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100
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Redman SL, Corcoran CM, Kimhy D, Malaspina D. Effects of early trauma on psychosis development in clinical high-risk individuals and stability of trauma assessment across studies: a review. ARCHIVES OF PSYCHOLOGY (CHICAGO, ILL.) 2017; 1:28. [PMID: 29400347 PMCID: PMC5791764] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Early trauma (ET), though broadly and inconsistently defined, has been repeatedly linked to numerous psychological disturbances, including various developmental stages of psychotic disorders. The prodromal phase of psychosis highlights a unique and relevant population that provides insight into the critical periods of psychosis development. As such, a relatively recent research focus on individuals at clinical high risk (CHR) for psychosis reveals robust associations of early life trauma exposures with prodromal symptoms and function in these cohorts. While prevalence rates of ET in CHR cohorts remain consistently high, methodological measures of traumatic experiences vary across studies, presenting potential problems for reliability and validity of results. This review aims to 1) highlight the existing evidence identifying associations of ET, of multiple forms, with both symptom severity and transition rates to psychosis in CHR individuals, 2) present data on the variability among trauma assessments and its implications for conclusions about its relationship with clinical variables, 3) describe cognitive deficits common in CHR cohorts, including perceptual and neurocognitive impairments, and their neural correlates, that may modify the relationship of ET to symptoms, and 4) propose future directions for standardization of trauma assessment in CHR cohorts to better understand its clinical and cognitive correlates.
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Affiliation(s)
- Samantha L. Redman
- Corresponding Author: Samantha Redman, Icahn School of Medicine at Mount Sinai, Department of Psychiatry, 53 E 96 Street, New York, NY 10128, phone: 212-659-8756,
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