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Zhilyaeva TV, Kasyanov ED, Semennov IV, Rukavishnikov GV, Piatoikina AS, Kostina OV, Verbitskaya EV, Mazo GE. Tetrahydrobiopterin deficiency in schizophrenia: Biochemical and clinical aspects. J Psychiatr Res 2022; 153:141-148. [PMID: 35816973 DOI: 10.1016/j.jpsychires.2022.07.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Revised: 04/26/2022] [Accepted: 07/04/2022] [Indexed: 10/17/2022]
Abstract
UNLABELLED It was reported that the levels of tetrahydrobiopterin (BH4) are reduced in schizophrenia. However, mechanisms of BH4 deficiency in schizophrenia had not been studied precisely. OBJECTIVE the search of the association between BH4 deficiency in schizophrenia and a range of biochemical and clinical parameters for the evaluation of the possible mechanisms of BH4 loss and its role in the development of the symptoms. METHODS 93 patients with schizophrenia and 60 healthy volunteers were randomly selected and evaluated with a biochemical examination of BH4, folate, cobalamin (B12), homocysteine, C-reactive protein (CRP), reduced glutathione (GSH) levels in the blood serum.Patients underwent standardized psychopathological examination. RESULTS In patients, the levels of BH4 and folate were lower (p = 0.001 and p = 0.054, respectively), and the levels of homocysteine were higher (p = 0.012) compared to the control group. BH4 levels directly moderately correlated with folate (ρ = 0.43; p = 0.0029) and B12 levels (ρ = 0.43; p = 0.0020) and inversely moderately correlated with homocysteine levels (ρ = -0.54; p = 0.00015) in patients. Cluster analysis identified schizophrenia biotype characterized by a deficiency of BH4, folate, B12, and hyperhomocysteinemia. The clinical characteristics of this biotype were not specific. CRP and GSH were higher in patients compared to controls, but their association with serum BH4 was not confirmed.
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Affiliation(s)
- T V Zhilyaeva
- Privolzhsky Research Medical University, Nizhny Novgorod, Russia; Bekhterev National Medical Research Center for Psychiatry and Neurology, St. Petersburg, Russia.
| | - E D Kasyanov
- Bekhterev National Medical Research Center for Psychiatry and Neurology, St. Petersburg, Russia
| | - I V Semennov
- Nizhny Novgorod Clinical Psychiatric Hospital No.1, Nizhny Novgorod, Russia
| | - G V Rukavishnikov
- Bekhterev National Medical Research Center for Psychiatry and Neurology, St. Petersburg, Russia
| | - A S Piatoikina
- Nizhny Novgorod Clinical Psychiatric Hospital No.1, Nizhny Novgorod, Russia
| | - O V Kostina
- Privolzhsky Research Medical University, Nizhny Novgorod, Russia
| | - E V Verbitskaya
- Pavlov First Saint Petersburg State Medical University, St. Petersburg, Russia
| | - G E Mazo
- Bekhterev National Medical Research Center for Psychiatry and Neurology, St. Petersburg, Russia
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Zhilyaeva T, Kasyanov E, Pyatoikina A, Blagonravova A, Mazo G. The association of serum folate levels with schizophrenia symptoms. Zh Nevrol Psikhiatr Im S S Korsakova 2022; 122:128-135. [DOI: 10.17116/jnevro2022122081128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Semennov IV, Zhilyaeva TV, Kasyanov ED, Mishanov GA, Chekanina OM, Blagonravova AS, Mazo GE. Association of tetrahydrobiopterin deficiency with disturbances in one-carbon metabolism in patients with schizophrenia. Schizophr Res 2021; 229:132-133. [PMID: 33234426 DOI: 10.1016/j.schres.2020.11.023] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Revised: 11/14/2020] [Accepted: 11/15/2020] [Indexed: 11/26/2022]
Affiliation(s)
- Ilya Vladimirovich Semennov
- Federal State Budgetary Educational Institution of Higher Education "Privolzhsky Research Medical University", Ministry of Health of the Russian Federation, 10/1 Minin and Pozharsky sq., Nizhny Novgorod 603005, Russia
| | - Tatyana Vladimirovna Zhilyaeva
- Federal State Budgetary Educational Institution of Higher Education "Privolzhsky Research Medical University", Ministry of Health of the Russian Federation, 10/1 Minin and Pozharsky sq., Nizhny Novgorod 603005, Russia.
| | - Evgeny Dmitrievich Kasyanov
- Federal State Budgetary Institution "Bekhterev National Medical Research Center for Psychiatry and Neurology", Ministry of Health of the Russian Federation, 3 Bekhtereva st., St. Petersburg 192019, Russia
| | - Georgy Aleksandrovich Mishanov
- Federal State Budgetary Educational Institution of Higher Education "Privolzhsky Research Medical University", Ministry of Health of the Russian Federation, 10/1 Minin and Pozharsky sq., Nizhny Novgorod 603005, Russia
| | - Oksana Mikhailovna Chekanina
- Federal State Budgetary Educational Institution of Higher Education "Privolzhsky Research Medical University", Ministry of Health of the Russian Federation, 10/1 Minin and Pozharsky sq., Nizhny Novgorod 603005, Russia
| | - Anna Sergeevna Blagonravova
- Federal State Budgetary Educational Institution of Higher Education "Privolzhsky Research Medical University", Ministry of Health of the Russian Federation, 10/1 Minin and Pozharsky sq., Nizhny Novgorod 603005, Russia
| | - Galina Elevna Mazo
- Federal State Budgetary Institution "Bekhterev National Medical Research Center for Psychiatry and Neurology", Ministry of Health of the Russian Federation, 3 Bekhtereva st., St. Petersburg 192019, Russia
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Huemer M, Diodato D, Schwahn B, Schiff M, Bandeira A, Benoist JF, Burlina A, Cerone R, Couce ML, Garcia-Cazorla A, la Marca G, Pasquini E, Vilarinho L, Weisfeld-Adams JD, Kožich V, Blom H, Baumgartner MR, Dionisi-Vici C. Guidelines for diagnosis and management of the cobalamin-related remethylation disorders cblC, cblD, cblE, cblF, cblG, cblJ and MTHFR deficiency. J Inherit Metab Dis 2017; 40:21-48. [PMID: 27905001 PMCID: PMC5203859 DOI: 10.1007/s10545-016-9991-4] [Citation(s) in RCA: 175] [Impact Index Per Article: 25.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2016] [Revised: 09/28/2016] [Accepted: 10/04/2016] [Indexed: 12/22/2022]
Abstract
BACKGROUND Remethylation defects are rare inherited disorders in which impaired remethylation of homocysteine to methionine leads to accumulation of homocysteine and perturbation of numerous methylation reactions. OBJECTIVE To summarise clinical and biochemical characteristics of these severe disorders and to provide guidelines on diagnosis and management. DATA SOURCES Review, evaluation and discussion of the medical literature (Medline, Cochrane databases) by a panel of experts on these rare diseases following the GRADE approach. KEY RECOMMENDATIONS We strongly recommend measuring plasma total homocysteine in any patient presenting with the combination of neurological and/or visual and/or haematological symptoms, subacute spinal cord degeneration, atypical haemolytic uraemic syndrome or unexplained vascular thrombosis. We strongly recommend to initiate treatment with parenteral hydroxocobalamin without delay in any suspected remethylation disorder; it significantly improves survival and incidence of severe complications. We strongly recommend betaine treatment in individuals with MTHFR deficiency; it improves the outcome and prevents disease when given early.
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Affiliation(s)
- Martina Huemer
- Division of Metabolism and Children's Research Center, University Childrens' Hospital Zürich, Zurich, Switzerland
- radiz - Rare Disease Initiative Zürich, Clinical Research Priority Program, University of Zürich, Zurich, Switzerland
- Department of Paediatrics, Landeskrankenhaus Bregenz, Bregenz, Austria
| | - Daria Diodato
- Division of Metabolism, Bambino Gesù Children's Research Hospital, Rome, Italy
| | - Bernd Schwahn
- Willink Biochemical Genetics Unit, Saint Mary's Hospital, Central Manchester University Hospitals NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, M13 9WL, UK
| | - Manuel Schiff
- Reference Center for Inborn Errors of Metabolism, Robert Debré University Hospital, APHP, Paris, France
- Inserm U1141, Robert Debré Hospital, Paris, France
- Université Paris-Diderot, Sorbonne Paris Cité, site Robert Debré, Paris, France
| | | | - Jean-Francois Benoist
- Reference Center for Inborn Errors of Metabolism, Robert Debré University Hospital, APHP, Paris, France
- Inserm U1141, Robert Debré Hospital, Paris, France
- Biochimie, faculté de pharmacie, Université Paris Sud, Paris, France
| | - Alberto Burlina
- Division of Inherited Metabolic Diseases, Department of Pediatrics, University Hospital Padova, Padova, Italy
| | - Roberto Cerone
- University Dept of Pediatrics, Giannina Gaslini Institute, Genoa, Italy
| | - Maria L Couce
- Congenital Metabolic Diseases Unit, Hospital Clínico Universitario de Santiago de Compostela, IDIS, CIBER, Compostela, Spain
| | - Angeles Garcia-Cazorla
- Department of Neurology, Neurometabolism Unit, and CIBERER (ISCIII), Hospital Sant Joan de Deu, Barcelona, Spain
| | - Giancarlo la Marca
- Department of Experimental and Clinical Biomedical Sciences, University of Florence, Firence, Italy
| | - Elisabetta Pasquini
- Metabolic and Newborn Screening Clinical Unit, Department of Neurosciences, A. Meyer Children's University Hospital, Florence, Italy
| | - Laura Vilarinho
- Newborn Screening, Metabolism & Genetics Unit, National Institute of Health, Porto, Portugal
| | - James D Weisfeld-Adams
- Section of Clinical Genetics and Metabolism, Department of Pediatrics, University of Colorado School of Medicine, Aurora, CO, USA
- Inherited Metabolic Diseases Clinic, Childrens Hospital Colorado, Aurora, CO, USA
| | - Viktor Kožich
- Institute of Inherited Metabolic Disorders, Charles University-First Faculty of Medicine and General University Hospital, Prague, Czech Republic
| | - Henk Blom
- Laboratory of Clinical Biochemistry and Metabolism, Center for Pediatrics and Adolescent Medicine University Hospital, Freiburg, Freiburg, Germany
| | - Matthias R Baumgartner
- Division of Metabolism and Children's Research Center, University Childrens' Hospital Zürich, Zurich, Switzerland.
- radiz - Rare Disease Initiative Zürich, Clinical Research Priority Program, University of Zürich, Zurich, Switzerland.
| | - Carlo Dionisi-Vici
- Division of Metabolism, Bambino Gesù Children's Research Hospital, Rome, Italy.
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Lower folate levels in schizophrenia: A meta-analysis. Psychiatry Res 2016; 245:1-7. [PMID: 27521746 DOI: 10.1016/j.psychres.2016.03.003] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/20/2015] [Revised: 03/01/2016] [Accepted: 03/02/2016] [Indexed: 11/23/2022]
Abstract
This meta-analysis aimed to estimate the association between folate level and schizophrenia in order to provide the evidence for the treatment of schizophrenia. Data were extracted from all the studies meeting our inclusion and exclusion criteria. The association between the folate level and schizophrenia was evaluated by the standardized mean difference (SMD) and 95% confidence interval (CI). The 20 published articles of our meta-analysis included 1463 (53.4%) cases and 1276 (46.6%) controls. The folate level was significantly lower in schizophrenia cases than in healthy controls. Subgroup analysis showed the folate level was lower in cases from Asia subgroup than in healthy controls. Sensitivity analysis showed that the current results were credible and reliable and the funnel plots indicated no publication bias in our meta-analysis. Our study indicates that schizophrenia patients may have lower folate levels. More epidemiological and laboratory studies are still needed to confirm whether it is necessary to supplement folate in schizophrenia patients.
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Kim TH, Moon SW. Serum homocysteine and folate levels in korean schizophrenic patients. Psychiatry Investig 2011; 8:134-40. [PMID: 21852990 PMCID: PMC3149108 DOI: 10.4306/pi.2011.8.2.134] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2010] [Revised: 11/25/2010] [Accepted: 12/17/2010] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE This study was conducted to confirm the results of the authors' previous research on schizophrenia manifesting high serum homocysteine and low folate levels. This study is anchored on a theory that a high serum homocysteine concentration affects schizophrenia by virtue of a neurotoxic mechanism, and on a report that some schizophrenia patients with high homocysteine levels benefited from high folate ingestion. METHODS The serum homocysteine, folate, and vitamin B(12) levels of 236 normal-control-group subjects and 234 schizophrenia subjects who met the diagnostic criteria based on DSM-IV-TR were compared. The homocysteine levels were measured via fluorescence polarization immunoassay, and the folate and vitamin B(12) levels were determined via radioimmunoassay. RESULTS The homocysteine levels of the patient group were significantly higher than those of the normal control group. The homocysteine level was more negatively correlated with the folate level in the schizophrenia group than in the control group. The percentages of female and male schizophrenia subjects manifesting high homocysteine levels were 33.8 and 51.5%, respectively. The percentage of schizophrenia subjects with low folate levels was 66.2%. In the low- and normal-folate-level groups, the patient group showed significantly higher homocysteine levels than the normal control group. The low-folate-level patient group particularly showed significantly higher homocysteine levels than the low-folate-level normal control group. CONCLUSION Some schizophrenia patients with high serum homocysteine levels may have the genetic defect of having low folate serum levels. In such cases, folate ingestion may be a good management modality for clinical improvement.
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Affiliation(s)
- Tae Ho Kim
- Department of Psychiatry, Research Institute of Medical Science, Konkuk University School of Medicine, Chungju, Korea
| | - Seok Woo Moon
- Department of Psychiatry, Research Institute of Medical Science, Konkuk University School of Medicine, Chungju, Korea
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Panula P, Sallinen V, Sundvik M, Kolehmainen J, Torkko V, Tiittula A, Moshnyakov M, Podlasz P. Modulatory Neurotransmitter Systems and Behavior: Towards Zebrafish Models of Neurodegenerative Diseases. Zebrafish 2006; 3:235-47. [DOI: 10.1089/zeb.2006.3.235] [Citation(s) in RCA: 199] [Impact Index Per Article: 11.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Affiliation(s)
- Pertti Panula
- Neuroscience Center, Institute of Biomedicine/Anatomy, University of Helsinki, Helsinki, Finland
| | - Ville Sallinen
- Neuroscience Center, Institute of Biomedicine/Anatomy, University of Helsinki, Helsinki, Finland
| | - Maria Sundvik
- Neuroscience Center, Institute of Biomedicine/Anatomy, University of Helsinki, Helsinki, Finland
| | - Juha Kolehmainen
- Neuroscience Center, Institute of Biomedicine/Anatomy, University of Helsinki, Helsinki, Finland
| | - Veera Torkko
- Neuroscience Center, Institute of Biomedicine/Anatomy, University of Helsinki, Helsinki, Finland
| | - Anu Tiittula
- Neuroscience Center, Institute of Biomedicine/Anatomy, University of Helsinki, Helsinki, Finland
| | - Maxim Moshnyakov
- Neuroscience Center, Institute of Biomedicine/Anatomy, University of Helsinki, Helsinki, Finland
| | - Piotr Podlasz
- Neuroscience Center, Institute of Biomedicine/Anatomy, University of Helsinki, Helsinki, Finland
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Lee YS, Han DH, Jeon CM, Lyoo IK, Na C, Chae SL, Cho SC. Serum homocysteine, folate level and methylenetetrahydrofolate reductase 677, 1298 gene polymorphism in Korean schizophrenic patients. Neuroreport 2006; 17:743-6. [PMID: 16641680 DOI: 10.1097/01.wnr.0000215777.99473.52] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
High homocysteine serum level has been regarded as one of the important factors that influence the development of schizophrenia. Genetic variations of methylenetetrahydrofolate reductase, which is a main enzyme reducing homocysteine level, are reported in schizophrenic patients. We measured the serum level of homocysteine/folate and methylenetetrahydrofolate reductase C677T/A1298C gene polymorphism in 235 patients with schizophrenia. Plasma homocysteine levels were higher and folate levels were lower in patients than in comparison subjects. Variations of C677T were more frequent in patients than in comparison subjects. Patients with the 677TT genotype showed higher homocysteine levels than patients with the CC and CT genotypes. These findings suggest that folate supplement may be beneficial to some schizophrenic patients with homocysteinemia due to the genetic defect of methylenetetrahydrofolate reductase.
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Affiliation(s)
- Young Sik Lee
- Department of Neuropsychiatry, College of Medicine, Chung-Ang University Medical Center, Seoul National University Hospital, Korea
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Sazci A, Ergul E, Kucukali I, Kara I, Kaya G. Association of the C677T and A1298C polymorphisms of methylenetetrahydrofolate reductase gene with schizophrenia: association is significant in men but not in women. Prog Neuropsychopharmacol Biol Psychiatry 2005; 29:1113-23. [PMID: 16084002 DOI: 10.1016/j.pnpbp.2005.06.022] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/17/2005] [Indexed: 11/24/2022]
Abstract
Schizophrenia is a complex and common psychiatric disorder with a polygenic inheritance. In our previous report, we showed an association between the methylenetetrahydrofolate reductase (MTHFR) gene C677T and A1298C polymorphisms and schizophrenia in patients from Bakirkoy in Istanbul, Turkey [Sazci, A., Ergul, E., Guzelhan, Y., Kaya, G., Kara, I., 2003. Methylenetetrahydrofolate reductase gene polymorphisms in patients with schizophrenia. Mol. Brain Res. 117, 104-107]. We wanted also independently to confirm this study in a gender-specific manner with schizophrenic patients from Erenkoy in Istanbul, Turkey. To investigate the role of the C677T and A1298C polymorphisms of methylenetetrahydrofolate reductase gene in schizophrenia in a gender-specific manner, we analyzed the genotypes of MTHFR677 and MTHFR1298 of 297 schizophrenic patients and 341 healthy controls, using a polymerase chain reaction restriction fragment length polymorphism method. The MTHFR 677T allele was significantly distributed (chi2=7.312; P=0.026), between schizophrenic patients and healthy controls. The T677T genotype was overrepresented in the total schizophrenic patients (OR=1.938; 95%CI=1.133-3.315; chi2=5.996; P=0.014). Similarly, the T677T/A1298A compound genotype was the most significant one in the total schizophrenic patients (OR=2.397; 95% CI=1.327-4.330; chi2=8.821; P=0.003). The C1298C genotype was overrepresented in the total schizophrenic patients (OR=1.706; 95%CI=1.014-2.870; chi2=4.126; P=0.042). Likewise, the C677C/C1298C compound genotype was significant in the total schizophrenic patients (OR=1.689; 95%CI=0.985-2.894; chi2=3.695; P=0.055). When schizophrenic patients and healthy controls were stratified according to gender difference, the T677T genotype and T677T/A1298A compound genotype were significantly overrepresented (OR=2.184; 95% CI=1.069-4.462; chi2=4.767; P=0.029; OR=2.748; 95% CI=1.215-6.214; chi2=6.301; P=0.012, respectively) in men schizophrenic patients. However, neither the MTHFR C677T nor the A1298C polymorphisms are associated with schizophrenia in women. In conclusion, the MTHFR 677T allele and T677T, C1298C genotypes, and T677T/A1298A, C677C/C1298C compound genotypes are genetic risk factors for schizophrenia in men but not in women in a gender-specific manner.
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Affiliation(s)
- Ali Sazci
- Department of Medical Biology and Genetics, Faculty of Medicine, University of Kocaeli, Derince, 41900, Kocaeli, Turkey.
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Abstract
The problem on integration and control of the various processes of the metazoan organism is a major challenge to the physiologist. The traditional research strategy in dealing with the problem is neuron-oriented and its roots extend back into the last century when knowledge of hormones was lacking. In the present article, the traditional strategy is analyzed in the light of available data and its logical basis is questioned. Different levels of communication are supposed to occur in the animal or human body. Circulating hormones are responsible for the highest level of communication that occurs between organs or tissues. The central concept in the article is that regulation of circulating hormones constitutes a higher level of control relative to regulation of intercellular hormones. This is regardless of whether the latter occurs in the nervous system or elsewhere. The approach is utilized in defining the mechanism that integrates and controls the part processes of the body. The mechanism is defined as endothelial; the vascular endothelial system is the controlling part and the nervous system is one of the subordinate parts. Thanks to the new approach, meaningful biological explanations of major psychiatric disorders are now possible.
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Rommelspacher H, Dufeu P, Schmidt LG. Harman and norharman in alcoholism: correlations with psychopathology and long-term changes. Alcohol Clin Exp Res 1996; 20:3-8. [PMID: 8651457 DOI: 10.1111/j.1530-0277.1996.tb01034.x] [Citation(s) in RCA: 22] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
In the search for mechanisms specific for alcoholism, it has become evident that beta-carbolines (BCs; e.g., harman and norharman) are compounds that may act on brain reward systems, thereby mediating an increase in voluntary ethanol (ETOH) drinking in animals. This study was undertaken to analyze relationships between these compounds and clinical variables (e.g., family history, personality data, and affect) in alcoholics and to trace the time course of blood concentrations in subjects abstaining from alcohol for at least 6 months. Nonalcoholics were investigated during sober and ETOH-loading conditions (1 g ETOH/kg body weight). Levels of harman were elevated in the chronically intoxicated alcoholics and correlated with the scores on the self-rating depression (SDS) and the self-rating anxiety (SAS) scales. The group of alcoholics with at least one alcoholic parent had higher levels than the group without such a history. Levels remained elevated for 6 months. Norharman levels were only slightly elevated on the day of admission. They were correlated to high harm avoidance and SDS scores. A family history of alcoholism and the severity of alcoholism as assessed by the number of ICD-10 criteria fulfilled were correlated with norharman levels. Long-term observation revealed elevated levels of norharman after 3 months of abstinence, but not after 6 months. The association of harman levels with anxiety and depression demonstrated in the present study suggests that alcoholics with high harman levels use alcoholic beverages as self-medication in an attempt to overcome possible anxiogenic/depressiogenic actions of harman. Norharman levels are less strongly associated with these mood states, but significantly correlated to harm avoidance tendencies. It has been suggested that the activity of the indolergic neurons is relatively high in individuals with a high harm avoidance score. Biosynthesis of norharman might be stimulated under these conditions (tryptamine serves as precursor).
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Affiliation(s)
- H Rommelspacher
- Department of Neuropsychopharmacology, Free University, Berlin, Germany
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Regland B, Johansson BV, Gottfries CG. Homocysteinemia and schizophrenia as a case of methylation deficiency. J Neural Transm (Vienna) 1994; 98:143-52. [PMID: 7734111 DOI: 10.1007/bf01277017] [Citation(s) in RCA: 42] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
A 27-year-old woman is described whose disorder meets the DSM-III-R criteria for a diagnosis of schizophrenia and who was found to have a significantly increased serum level of homocysteine. Repeatedly, she improved on frequent cobalamin injections and deteriorated in periods without treatment. The effects of prolonged weekly treatment appeared to diminish as time went on, suggesting that the abnormality was not wholly cobalamin-dependent. It was found that methylenetetrahydrofolate reductase (MR) activity in cultured skin fibroblasts was reduced to a magnitude that is found among people with heterozygous deficiency. A defect in MR activity indicates a deficiency in methyltetrahydrofolate (MTHF), with a consequent reduction of the remethylation of homocysteine to methionine. Thus, reduced methylation may explain the increased levels of homocysteine and the transient effects of cobalamin treatment in the patient. Theoretically, MTHF should be the optimal treatment for her. The case reported highlights the importance of assessing the serum homocysteine level in order to detect methylation deficiency in patients with schizophrenia.
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Affiliation(s)
- B Regland
- Department of Clinical Neuroscience, Mölndal Hospital, University of Göteborg, Sweden
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Turner AJ. Commentary: The roles of folate and pteridine derivatives in neurotransmitter metabolism. Biochem Pharmacol 1977; 26:1009-14. [PMID: 18148 DOI: 10.1016/0006-2952(77)90236-2] [Citation(s) in RCA: 22] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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