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Saglam Y, Ermis C, Tanyolac D, Oz A, Turan S, Korkmaz HA, Karacetin G. The association between plasma thyroxine levels and neurocognitive impairment in early-onset schizophrenia and other psychosis spectrum disorders. Prog Neuropsychopharmacol Biol Psychiatry 2024; 131:110940. [PMID: 38199488 DOI: 10.1016/j.pnpbp.2024.110940] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2023] [Revised: 01/01/2024] [Accepted: 01/06/2024] [Indexed: 01/12/2024]
Abstract
BACKGROUND/AIM Limited studies have delved into the association between thyroid hormones and neurocognition in schizophrenia. We aimed to evaluate the relationship between thyroid hormone levels and neurocognitive functions in patients with schizophrenia and other psychosis spectrum disorders (SSD). METHOD A total of 135 patients with early-onset SSD were included in the study. The participants underwent a cognitive assessment. Blood samples were collected to measure serum levels of thyroid-stimulating hormone (TSH), free thyroxine (fT4), and free triiodothyronine (fT3). Subgroup analyses were conducted based on the severity of the psychosis. FINDINGS The results revealed a significant association between fT4 levels and various cognitive domains, including processing speed, verbal fluency, working memory, verbal learning, verbal memory, and visual memory. However, serum TSH and fT3 levels exhibited no significant association with neurocognitive impairment in adjusted linear regression models. Specifically, the correlation between fT4 levels and global cognition was more pronounced in patients with higher scores. CONCLUSIONS Serum fT4 levels were associated with the performance across various cognitive domains in cases of early-onset psychotic disorders. This correlation was accentuated among patients with higher illness severity. Future studies could focus on the effects of specific pathways that can affect the course and progression of psychosis.
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Affiliation(s)
- Yesim Saglam
- Department of Child and Adolescent Psychiatry, University of Health Sciences, Bakirkoy Prof Dr Mazhar Osman Research and Training Hospital for Psychiatry, Neurology and Neurosurgery, Istanbul, Turkey.
| | - Cagatay Ermis
- Queen Silvia Children's Hospital, Department of Child Psychiatry, Gothenburg, Sweden
| | - Denizhan Tanyolac
- Department of Child and Adolescent Psychiatry, University of Health Sciences, Bakirkoy Prof Dr Mazhar Osman Research and Training Hospital for Psychiatry, Neurology and Neurosurgery, Istanbul, Turkey
| | - Ahmet Oz
- Department of Radiology, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Serkan Turan
- Bursa Uludağ University Faculty of Medicine Hospital, Child and Adolescent Psychiatry Clinic, Bursa, Turkey
| | - Huseyin Anil Korkmaz
- Izmir Dr. Behcet Uz Pediatric Medicine and Surgery Training and Research Hospital, Pediatric Endocrinology Clinic, Izmir, Turkey
| | - Gul Karacetin
- Department of Child and Adolescent Psychiatry, University of Health Sciences, Bakirkoy Prof Dr Mazhar Osman Research and Training Hospital for Psychiatry, Neurology and Neurosurgery, Istanbul, Turkey
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Hanif F, Amir Q, Washdev W. Effect of DIO2 Gene Polymorphism on Thyroid Hormone Levels and Its Correlation with the Severity of Schizophrenia in a Pakistani Population. Int J Mol Sci 2024; 25:1915. [PMID: 38339190 PMCID: PMC10855673 DOI: 10.3390/ijms25031915] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2024] [Revised: 01/10/2024] [Accepted: 01/16/2024] [Indexed: 02/12/2024] Open
Abstract
Low levels of triiodothyronine (T3) in the brain lead to increased dopamine receptor sensitivity, potentially resulting in schizophrenia. Iodothyronine deiodinase 2 (DIO2) is the only enzyme which converts tetraiodothyronine (T4) to T3 in the brain. DIO2 polymorphism of rs225014 results in the expression of non-functioning DIO2. Therefore, this study aimed to investigate the association of rs255014 with schizophrenia and its impact on thyroid hormone levels. This study included 150 schizophrenia cases and 150 controls. DNA was extracted from blood and subjected to PCR and amplicon sequencing. Serum thyroid profiles were determined using chemiluminescent magnetic microparticle immunoassay. Statistical analyses involved independent sample t-tests, Chi-square, and Pearson's correlation tests. The results revealed a higher frequency of the reference genotype (TT) in controls compared to cases (p < 0.05). However, rs225014 did not influence serum thyroid levels or the severity of schizophrenia (p > 0.05). Interestingly, control subjects exhibited significantly higher T3 levels (p < 0.001) than cases. Regardless of the genotype (TT or CC), the control group had higher mean T3 levels than the corresponding case group (p < 0.05). In conclusion, rs225014 is associated with schizophrenia and has no effect on serum thyroid hormone levels.
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Affiliation(s)
- Farina Hanif
- Department of Biochemistry, Dow International Medical College, Dow University of Health Sciences, Karachi 74200, Pakistan
| | - Quratulain Amir
- Dow Institute of Medical Technology, Dow University of Health Sciences, Karachi 74200, Pakistan;
| | - Washdev Washdev
- Dr. Abdul Qadeer Khan Institute of Behavioral Sciences, Dow University of Health Sciences, Karachi 74200, Pakistan;
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Gine-Serven E, Martinez-Ramirez M, Boix-Quintana E, Davi-Loscos E, Guanyabens N, Casado V, Muriana D, Torres-Rivas C, Cuesta M, Labad J. Association between free thyroxine levels and clinical phenotype in first-episode psychosis: a prospective observational study. PeerJ 2023; 11:e15347. [PMID: 37283900 PMCID: PMC10241168 DOI: 10.7717/peerj.15347] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Accepted: 04/13/2023] [Indexed: 06/08/2023] Open
Abstract
Aim To determine whether thyroid hormone levels are associated with a specific clinical phenotype in patients with first-episode psychosis (FEP). Methods Ninety-eight inpatients experiencing FEP and with less than 6 weeks of antipsychotic treatment were included in the study and were followed up for one year. Baseline psychiatric evaluation included assessment of prodromal symptoms, positive and negative symptoms, depressive symptoms, stressful life events and cycloid psychosis criteria. Thyroid function (thyroid-stimulating hormone (TSH) and free thyroxin (FT4)) was determined at admission. Partial correlation analysis was conducted to analyse the correlation between levels of TSH/FT4 and symptoms. Logistic regression was performed to explore the association between psychopathological symptoms, 12-month diagnoses and thyroid hormones while adjusting for covariates. Results Patients with prodromal symptomatology showed lower baseline FT4 levels (OR = 0.06; p = 0.018). The duration of untreated psychosis (DUP) was inversely associated with FT4 concentrations (r = - 0.243; p = 0.039). FEP patients with sudden onset of psychotic symptoms (criteria B, cycloid psychosis) showed higher FT4 levels at admission (OR = 10.49; p = 0.040). Patients diagnosed with affective psychotic disorders (BD or MDD) at the 12-month follow-up showed higher FT4 levels at admission than patients diagnosed with nonaffective psychosis (schizophrenia, schizoaffective) (OR = 8.57; p = 0.042). Conclusions Our study suggests that higher free-thyroxine levels are associated with a specific clinical phenotype of FEP patients (fewer prodromal symptoms, shorter DUP duration and sudden onset of psychosis) and with affective psychosis diagnoses at the 12-month follow-up.
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Affiliation(s)
- Eloi Gine-Serven
- Department of Mental Health, Hospital de Mataró, Consorci Sanitari del Maresme, Mataró, Spain
| | - Maria Martinez-Ramirez
- Department of Mental Health, Hospital de Mataró, Consorci Sanitari del Maresme, Mataró, Spain
| | - Ester Boix-Quintana
- Department of Mental Health, Hospital de Mataró, Consorci Sanitari del Maresme, Mataró, Spain
| | - Eva Davi-Loscos
- Department of Mental Health, Hospital de Mataró, Consorci Sanitari del Maresme, Mataró, Spain
| | - Nicolau Guanyabens
- Department of Neurology, Hospital de Mataró, Consorci Sanitari del Maresme, Mataró, Spain
| | - Virginia Casado
- Department of Neurology, Hospital de Mataró, Consorci Sanitari del Maresme, Mataró, Spain
| | - Desiree Muriana
- Department of Neurology, Hospital de Mataró, Consorci Sanitari del Maresme, Mataró, Spain
| | - Cristina Torres-Rivas
- Department of Mental Health, Hospital de Mataró, Consorci Sanitari del Maresme, Mataró, Spain
| | - M.J. Cuesta
- Department of Psychiatry, Complejo Hospitalario de Navarra, Pamplona, Spain
- IdiSNA, Navarra Institute for Health Research, Pamplona, Spain
| | - Javier Labad
- Department of Mental Health, Hospital de Mataró, Consorci Sanitari del Maresme, Mataró, Spain
- Translational Neuroscience Research Unit I3PT-INc-UAB, Institut de Innovació i Investigació Parc Taulí (I3PT), Institut de Neurociències, Universitat Autònoma de Barcelona, Barcelona, Spain
- Centro de Investigación en Red de Salud Mental (CIBERSAM), Madrid, Spain
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KAYA H, AYIK B. Şizofreni hastalarında TSH, fT3 ve fT4 düzeylerinin nörobilişsel belirtiler üzerine etkisi. CUKUROVA MEDICAL JOURNAL 2022. [DOI: 10.17826/cumj.1135374] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
Amaç: Bu çalışmamızda ötiroid psikoz hastalarında tiroid hormon düzeyleri ile pozitif, negatif, genel ve bilişsel belirtiler arasındaki ilişkiyi incelemeyi amaçladık.
Gereç ve Yöntem: Çalışmaya 33 şizofreni hastası dahil edildi. Katılımcıların sosyodemografik ve klinik verileri, Pozitif ve Negatif Belirtileri Değerlendirme Ölçeği (PANSS), İşlevselliğin Genel Değerlendirilmesi Ölçeği (IGD), Klinik Global İzlenim Ölçeği (KGI) skorları kaydedildi. İz sürme, Sözel Akıcılık Testi, İleri ve Geri Sayı Menzili ile Wisconsin Kart Sayma Testinden (WKST) oluşan bir nörobilişsel batarya uygulanan hastaların bilişsel performanslarının TSH, sT3 ve sT4 düzeyleri ile ilişkisi araştırıldı.
Bulgular: sT4 düzeyleri ile İz Sürme B (r=-,376; p=0,031) ve Sözel Akıcılık test (p=,355; p=0,043) performansları arasında anlamlı derecede ilişki saptandı. Linear regresyon modelinde sT3 düzeylerinin WKST- tamamlanan kategori sayısını (UB=1.680; p=0.029) anlamlı derecede yordadığı saptandı..
Sonuç: Çalışmamızın sonuçları sT3 ün özellikle yürütücü işlevler üzerinde sT4’e kıyasla daha belirleyici etkileri olduğunu düşündürmüştür. İleride yapılacak daha geniş katılımlı araştırmalar, bilişsel belirtilerin tedavisinde tiroid hormon replasmanının etkinliğini belirlemek açısından önemli görünmektedir.
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Affiliation(s)
| | - Batuhan AYIK
- UNIVERSITY OF HEALTH SCIENCES, İSTANBUL ERENKÖY APPLICATION AND RESEARCH CENTER FOR PSYCHIATRIC AND NERVE DISEASES
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Śmierciak N, Szwajca M, Popiela TJ, Bryll A, Karcz P, Donicz P, Turek A, Krzyściak W, Pilecki M. Redefining the Cut-Off Ranges for TSH Based on the Clinical Picture, Results of Neuroimaging and Laboratory Tests in Unsupervised Cluster Analysis as Individualized Diagnosis of Early Schizophrenia. J Pers Med 2022; 12:jpm12020247. [PMID: 35207735 PMCID: PMC8874519 DOI: 10.3390/jpm12020247] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Revised: 02/05/2022] [Accepted: 02/07/2022] [Indexed: 11/16/2022] Open
Abstract
Thyroid abnormalities, including mild forms of hypothyroidism and hyperthyroidism, are reported as risk factors for the development of a number of neuropsychiatric disorders, including schizophrenia. The diagnostic process still takes into account the extreme ranges of the accepted reference values for serum TSH since the concentration of free thyroxine in the serum does not change by definition. TSH mU/L cut-off values in psychiatric patients are currently clinically considered in the case of extremely high serum TSH levels (>4.0 mU/L). The results obtained in this study suggest that the clinically significant value has a lower TSH cut-off point with an upper limit of 2–2.5 mU/L. The criteria for the differential diagnosis of patients with schizophrenia, however, mainly take into account statutory reference ranges without a background related to the history of thyroid diseases in the family. The results indicate the need to lower the upper cut-off values for TSH among patients with early psychosis, which is related to the potential clinical significance of the obtained values both in the field of clinical evaluation and neuroimaging and laboratory evaluation parameters. The cut-off points obtained with the prior available knowledge coincided with the values established in the unsupervised clustering method, which further confirms the legitimacy of their use in the individualized diagnosis strategy of schizophrenia.
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Affiliation(s)
- Natalia Śmierciak
- Department of Child and Adolescent Psychiatry, Faculty of Medicine, Jagiellonian University Medical College, Kopernika 21a, 31-501 Krakow, Poland; (N.Ś.); (M.S.); (P.D.); (A.T.)
| | - Marta Szwajca
- Department of Child and Adolescent Psychiatry, Faculty of Medicine, Jagiellonian University Medical College, Kopernika 21a, 31-501 Krakow, Poland; (N.Ś.); (M.S.); (P.D.); (A.T.)
| | - Tadeusz J. Popiela
- Department of Radiology, Jagiellonian University Medical College, Kopernika 19, 31-501 Krakow, Poland;
- Correspondence: (T.J.P.); (W.K.); (M.P.)
| | - Amira Bryll
- Department of Radiology, Jagiellonian University Medical College, Kopernika 19, 31-501 Krakow, Poland;
| | - Paulina Karcz
- Department of Electroradiology, Jagiellonian University Medical College, Michałowskiego 12, 31-126 Krakow, Poland;
| | - Paulina Donicz
- Department of Child and Adolescent Psychiatry, Faculty of Medicine, Jagiellonian University Medical College, Kopernika 21a, 31-501 Krakow, Poland; (N.Ś.); (M.S.); (P.D.); (A.T.)
| | - Aleksander Turek
- Department of Child and Adolescent Psychiatry, Faculty of Medicine, Jagiellonian University Medical College, Kopernika 21a, 31-501 Krakow, Poland; (N.Ś.); (M.S.); (P.D.); (A.T.)
- Doctoral School of Medical and Health Sciences, Jagiellonian University Medical College, Łazarza 16, 31-530 Krakow, Poland
| | - Wirginia Krzyściak
- Department of Medical Diagnostics, Jagiellonian University Medical College, Medyczna 9, 30-688 Krakow, Poland
- Correspondence: (T.J.P.); (W.K.); (M.P.)
| | - Maciej Pilecki
- Department of Child and Adolescent Psychiatry, Faculty of Medicine, Jagiellonian University Medical College, Kopernika 21a, 31-501 Krakow, Poland; (N.Ś.); (M.S.); (P.D.); (A.T.)
- Correspondence: (T.J.P.); (W.K.); (M.P.)
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Zhang H, Yang S, Zhu W, Niu T, Wang Z, An K, Xie Z, Wang P, Huang X, Wang C, Shangguan H, Yuan Y, Wang S. Free Triiodothyronine Levels are Related to Executive Function and Scene Memory in Type 2 Diabetes Mellitus Patients Without Diagnosed Thyroid Diseases. Diabetes Metab Syndr Obes 2022; 15:1041-1050. [PMID: 35411164 PMCID: PMC8994555 DOI: 10.2147/dmso.s355656] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/24/2021] [Accepted: 03/15/2022] [Indexed: 11/23/2022] Open
Abstract
PURPOSE We aim to determine the role of free triiodothyronine (FT3), the main active ingredient of thyroid hormones (THs), in type 2 diabetes mellitus (T2DM) patients with mild cognitive impairment (MCI). PATIENTS AND METHODS A total of 255 T2DM patients without diagnosed thyroid diseases were recruited and divided into MCI group and healthy cognition group. Neuropsychological functions were observed by multidimensional cognitive function scales in including MoCA, Digit Span Test (DST), Verbal Fluency Test (VFT), Clock drawing test (CDT), Trail Making Test (TMT) A and B, Instantaneously Recalled Auditory Verbal Learning Test (AVLT-IR), Delayed Recalled Auditory Verbal Learning Test (AVLT-DR) and Logical Memory Test (LMT). Correlation and logistic regression analyses were performed to explore the association between FT3 and diabetic cognitive dysfunction. RESULTS Compared with 147 normal cognition patients, 108 MCI patients exhibited lower FT3 and higher HOMA-IR. FT3 level was not only positively correlated with MoCA scores, but DST, VFT and LMT, while negatively associated with TMTB. Furthermore, there is a negative association between FT3 and HOMA-IR. Logistic regression showed that decreased FT3 is a risk factor of MCI in T2DM patients. Although FT3 is not the risk factor of MCI after homeostasis model assessment of insulin resistance (HOMA-IR) was entered as an independent variable, lower FT3 is associated with VFT and LMT adjusted by age, education, BMI, DM duration, HBP duration, smoking, HbA1c and HOMA-IR. CONCLUSION Lower FT3 levels may involve in MCI, especially for executive function and scene memory in T2DM patients without diagnosed thyroid diseases.
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Affiliation(s)
- Haoqiang Zhang
- Department of Endocrinology, Affiliated Zhongda Hospital of Southeast University, Nanjing, People’s Republic of China
- School of Medicine, Southeast University, Nanjing, People’s Republic of China
- Department of Endocrinology, The First Affiliated Hospital of University of Science and Technology of China, Hefei, People’s Republic of China
| | - Shufang Yang
- School of Medicine, Southeast University, Nanjing, People’s Republic of China
- Department of Endocrinology, Taizhou People’s Hospital, Taizhou, People’s Republic of China
| | - Wenwen Zhu
- Department of Endocrinology, Affiliated Zhongda Hospital of Southeast University, Nanjing, People’s Republic of China
- School of Medicine, Southeast University, Nanjing, People’s Republic of China
| | - Tong Niu
- Department of Endocrinology, Affiliated Zhongda Hospital of Southeast University, Nanjing, People’s Republic of China
- School of Medicine, Southeast University, Nanjing, People’s Republic of China
| | - Zheng Wang
- Department of Endocrinology, Affiliated Zhongda Hospital of Southeast University, Nanjing, People’s Republic of China
- School of Medicine, Southeast University, Nanjing, People’s Republic of China
| | - Ke An
- Department of Endocrinology, Affiliated Zhongda Hospital of Southeast University, Nanjing, People’s Republic of China
- School of Medicine, Southeast University, Nanjing, People’s Republic of China
| | - Zuoling Xie
- Department of Endocrinology, Affiliated Zhongda Hospital of Southeast University, Nanjing, People’s Republic of China
- School of Medicine, Southeast University, Nanjing, People’s Republic of China
| | - Pin Wang
- School of Medicine, Southeast University, Nanjing, People’s Republic of China
| | - Xi Huang
- Department of Endocrinology, Affiliated Zhongda Hospital of Southeast University, Nanjing, People’s Republic of China
- School of Medicine, Southeast University, Nanjing, People’s Republic of China
| | - Chenchen Wang
- Department of Endocrinology, Affiliated Zhongda Hospital of Southeast University, Nanjing, People’s Republic of China
- School of Medicine, Southeast University, Nanjing, People’s Republic of China
| | - Haiyan Shangguan
- School of Medicine, Southeast University, Nanjing, People’s Republic of China
| | - Yang Yuan
- Department of Endocrinology, Affiliated Zhongda Hospital of Southeast University, Nanjing, People’s Republic of China
| | - Shaohua Wang
- Department of Endocrinology, Affiliated Zhongda Hospital of Southeast University, Nanjing, People’s Republic of China
- Correspondence: Shaohua Wang; Yang Yuan, Department of Endocrinology, Affiliated Zhongda Hospital of Southeast University, No. 87 Dingjiaqiao Road, Nanjing, 210009, People’s Republic of China, Tel +86-25-83262815; +86-13814003661, Fax +86-25-83285132, Email ;
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Thyroid hormones in persons with schizophrenia: A systematic review and meta-analysis. Prog Neuropsychopharmacol Biol Psychiatry 2021; 111:110402. [PMID: 34274416 DOI: 10.1016/j.pnpbp.2021.110402] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Revised: 07/09/2021] [Accepted: 07/12/2021] [Indexed: 01/14/2023]
Abstract
There is accumulating evidence that individuals with schizophrenia show altered levels of thyroid hormones. However, a qualitative and quantitative synthesis of findings in this field has not been performed so far. Therefore, we aimed to perform a systematic review and meta-analysis of studies investigating the levels of thyroid-stimulating hormone (TSH), free thyroxine (fT4), total thyroxine (tT4), free triiodothyronine (fT3) and total triiodothyronine (tT3) in multiple-episode schizophrenia (MES) and first-episode psychosis (FEP). Electronic databases were searched from their inception until 30th May 2020 by two independent reviewers. Random-effects meta-analyses and meta-regression analyses were performed. Altogether, 19 studies were included. Persons with FEP had significantly lower TSH levels (5 studies, g = -0.26, 95%CI: -0.47 to -0.06, p = 0.013, I2 = 21.3%), higher fT4 levels (3 studies, g = 0.58, 95%CI: 0.15-1.01, p = 0.008, I2 = 64.6%) and lower tT3 levels (2 studies, g = -0.60, 95%CI: -0.82 to -0.37, p < 0.001, I2 = 0%) compared to controls. Elevated TSH levels were found in persons with MES (13 studies, g = 0.20, 95%CI: 0.02-0.39, p = 0.031, I2 = 50.0%). Our findings imply that the levels of TSH might be decreased in persons with FEP and increased in those with MES. Other alterations need to be confirmed by additional studies. These findings imply the need to monitor the levels of TSH and thyroid hormones from the onset of psychosis.
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Ge F, Dong L, Zhu D, Lin X, Shi J, Xiao M. Comparison of Serum Triiodothyronine with Biomarkers for Alzheimer's Disease Continuum in Euthyroid Subjects. J Alzheimers Dis 2021; 85:605-614. [PMID: 34864671 DOI: 10.3233/jad-215092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Accumulating studies have implicated thyroid dysfunction in the pathogenesis of Alzheimer's disease (AD). OBJECTIVE This study aimed to explore the association between thyroid hormone (TH) levels and cerebrospinal fluid (CSF) biomarkers for AD continuum among euthyroid subjects. METHODS In all, 93 clinically euthyroid subjects with a cognitive decline were included in this prospective cross-sectional study and were divided into groups with abnormal AD biomarkers (belonging to the "Alzheimer's continuum"; A+ patients) and those with "normal AD biomarkers" or "non-AD pathological changes" (A-patients), according to the ATN research framework classification for AD. A partial correlation analysis of serum thyroid-stimulating hormone (TSH) or TH levels with CSF biomarkers was conducted. The predictor for A+ patients was analyzed via binary logistic regressions. Finally, the diagnostic significance of individual biochemical predictors for A+ patients was estimated via receiver operating characteristic curve analysis. RESULTS Serum total triiodothyronine (TT3) and free triiodothyronine (FT3) levels were found to affect the levels of CSF amyloid-β (Aβ)42 and the ratios of Aβ 42/40. Further, FT3 was found to be a significant predictor for A+ via binary logistic regression modeling. Moreover, FT3 showed a high diagnostic value for A+ in euthyroid subjects. CONCLUSION Even in a clinical euthyroid state, low serum FT3 and TT3 levels appear to be differentially associated with AD-specific CSF changes. These data indicate that serum FT3 is a strong candidate for differential diagnosis between AD continuum and non-AD dementia, which benefits the early diagnosis and effective management of preclinical and clinical AD patients.
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Affiliation(s)
- Feifei Ge
- Department of Neurology, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Lin Dong
- Department of Neurology, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Donglin Zhu
- Department of Neurology, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Xingjian Lin
- Department of Neurology, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Jingping Shi
- Department of Neurology, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Ming Xiao
- Jiangsu Province, Key Laboratory of Neurodegeneration, Nanjing Medical University, Nanjing, China
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Zhu Y, Ji H, Tao L, Cai Q, Wang F, Ji W, Li G, Fang Y. Functional Status of Hypothalamic-Pituitary-Thyroid and Hypothalamic-Pituitary-Adrenal Axes in Hospitalized Schizophrenics in Shanghai. Front Psychiatry 2020; 11:65. [PMID: 32174848 PMCID: PMC7056840 DOI: 10.3389/fpsyt.2020.00065] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2019] [Accepted: 01/24/2020] [Indexed: 12/22/2022] Open
Abstract
OBJECTIVE Neuroendocrine dysfunction is related to the pathogenesis of mental disorders, but conclusions from clinical research lack consistency. We aimed to investigate the neuroendocrinal pathophysiology and its correlation with clinical symptoms in patients with schizophrenia. METHODS The present cross-sectional study included 486 inpatients with schizophrenia admitted at a psychiatric hospital in Shanghai within one year, and 154 healthy controls (HC) matched on age and gender. The serum hemoconcentrations of thyroid-stimulating hormone (TSH), total triiodothyronine (TT3), total thyroxine (TT4), free triiodothyronine (FT3), free thyroxine (FT4), adrenocorticotrophic hormone (ACTH), and cortisol (COR) were measured via electrochemical luminescence immunoassay. Pathophysiological conversions of neuroendocrine were then associated with gender, age, age at onset, antipsychotic treatment using hierarchical multiple linear regression. RESULTS When compared to HC, the schizophrenia group showed elevated ACTH and COR levels and decreased TT3 and TT4 levels (p's < 0.05). First-episode patients showed lower TSH and higher FT3 and FT4 (p's < 0.05) compared to recurrent patients. Female patients showed higher TSH and lower TT3, FT3, and ACTH levels (p's < 0.05) compared to males. We observed the area under the curve (AUC) of the predictive model to distinguish between schizophrenia and HC to be 0.737 among total samples and between first-episode and recurrent schizophrenia to be 0.890 among subgroups. CONCLUSIONS Decreased TT3 and TT4 and elevated ACTH and COR levels appear to be associated with schizophrenia symptoms. The chronic recurrent trait of schizophrenia may cause long-term effects on FT3 and FT4 while changes in thyroid, and adrenal function as a result of mental disorder varied with gender. The pathophysiological parameters provide fair to good accuracy of these models.
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Affiliation(s)
- Yuncheng Zhu
- Clinical Research Center & Division of Mood Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Division of Psychiatry, Shanghai Changning Mental Health Center, Affiliated Greenland Hospital of Bio-X Institute, Shanghai Jiao Tong University, Shanghai, China
| | - Haifeng Ji
- Division of Psychiatry, Shanghai Changning Mental Health Center, Affiliated Greenland Hospital of Bio-X Institute, Shanghai Jiao Tong University, Shanghai, China
| | - Lily Tao
- Key Laboratory of Brain Functional Genomics (MOE & STCSM), Shanghai Changning-ECNU Mental Health Center, Institute of Cognitive Neuroscience, School of Psychology and Cognitive Science, East China Normal University, Shanghai, China
| | - Qing Cai
- Key Laboratory of Brain Functional Genomics (MOE & STCSM), Shanghai Changning-ECNU Mental Health Center, Institute of Cognitive Neuroscience, School of Psychology and Cognitive Science, East China Normal University, Shanghai, China
| | - Fang Wang
- Division of Psychiatry, Shanghai Yangpu Mental Health Center, Shanghai, China
| | - Weidong Ji
- Division of Psychiatry, Shanghai Changning Mental Health Center, Affiliated Greenland Hospital of Bio-X Institute, Shanghai Jiao Tong University, Shanghai, China
| | - Guohai Li
- Zhenjiang Mental Health Center, Zhenjiang, China
| | - Yiru Fang
- Clinical Research Center & Division of Mood Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,CAS Center for Excellence in Brain Science and Intelligence Technology, Shanghai, China.,Shanghai Key Laboratory of Psychotic Disorders, Shanghai, China
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10
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Estrada F, Crosas JM, Ahuir M, Pérez-Muñoz S, Zabala W, Aguayo R, Barbero JD, Montalvo I, Tost M, Llauradó L, Guardia A, Palao D, Monreal JA, Labad J. Free Thyroxine Concentrations Moderate the Response to a Cognitive Remediation Therapy in People With Early Psychosis: A Pilot Randomized Clinical Trial. Front Psychiatry 2020; 11:636. [PMID: 32733292 PMCID: PMC7358368 DOI: 10.3389/fpsyt.2020.00636] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Accepted: 06/18/2020] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION Cognitive deficits are a cause of functional disability in psychotic disorders. Cognitive remediation therapy (CRT) might be applied to improve these deficits. We conducted a pilot study to explore whether thyroid hormones might predict the response to CRT in patients with recent-onset psychosis (ROP). METHODS Twenty-eight stable ROP outpatients (9 women) were randomized to receive computerized CRT (N=14) or treatment as usual (TAU) (N=14), over three months. Both cognitive and thyroid functions were assessed at the baseline and after those three months to all patients. A full cognitive battery (CANTAB) was administered before and after the treatment. Serum levels of thyroid-stimulating hormone (TSH) and free thyroxine (FT4) were measured. FT4 concentrations were recoded into a dichotomic variable (FT4 group) based on the median of the sample (1.2 ng/dL). Data were analyzed on an intention-to-treat basis with linear mixed models. Afterwards, we offered CRT to all participants from the TAU group and seven enrolled CRT, reassessing them when finished. Secondary analyses were repeated in a sample of 14 participants who completed the CRT (either from the beginning or after the TAU period) and attended at least one third of the sessions. RESULTS The linear mixed models showed a significant time x CRT x FT4 group effect in two cognitive tasks dealing with executive functions and sustained attention (participants with higher FT4 concentrations worsened executive functions but improved sustained attention after CRT). In the secondary analysis including all patients assigned to CRT, higher FT4 concentrations were associated with a poorer response in verbal memory but a better response in spatial working memory. CONCLUSIONS Free thyroxine concentrations moderate the response to a CRT in patients with early psychosis.
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Affiliation(s)
- Francesc Estrada
- Department of Mental Health, Institut d'Investigació i Innovació Parc Taulí (I3PT), Parc Taulí Hospital Universitari, Sabadell, Spain.,Department of Psychiatry and Legal Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Josep Maria Crosas
- Department of Mental Health, Institut d'Investigació i Innovació Parc Taulí (I3PT), Parc Taulí Hospital Universitari, Sabadell, Spain.,Department of Psychiatry and Legal Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Maribel Ahuir
- Department of Mental Health, Institut d'Investigació i Innovació Parc Taulí (I3PT), Parc Taulí Hospital Universitari, Sabadell, Spain.,Department of Psychiatry and Legal Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Sara Pérez-Muñoz
- Department of Mental Health, Institut d'Investigació i Innovació Parc Taulí (I3PT), Parc Taulí Hospital Universitari, Sabadell, Spain.,Department of Psychiatry and Legal Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Wanda Zabala
- Department of Mental Health, Institut d'Investigació i Innovació Parc Taulí (I3PT), Parc Taulí Hospital Universitari, Sabadell, Spain.,Department of Psychiatry and Legal Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Raquel Aguayo
- Department of Mental Health, Institut d'Investigació i Innovació Parc Taulí (I3PT), Parc Taulí Hospital Universitari, Sabadell, Spain.,Department of Psychiatry and Legal Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Juan David Barbero
- Department of Mental Health, Institut d'Investigació i Innovació Parc Taulí (I3PT), Parc Taulí Hospital Universitari, Sabadell, Spain.,Department of Psychiatry and Legal Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Itziar Montalvo
- Department of Mental Health, Institut d'Investigació i Innovació Parc Taulí (I3PT), Parc Taulí Hospital Universitari, Sabadell, Spain.,Department of Psychiatry and Legal Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Meritxell Tost
- Department of Mental Health, Institut d'Investigació i Innovació Parc Taulí (I3PT), Parc Taulí Hospital Universitari, Sabadell, Spain.,Department of Psychiatry and Legal Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Laura Llauradó
- Department of Mental Health, Institut d'Investigació i Innovació Parc Taulí (I3PT), Parc Taulí Hospital Universitari, Sabadell, Spain.,Department of Psychiatry and Legal Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Armand Guardia
- Department of Mental Health, Institut d'Investigació i Innovació Parc Taulí (I3PT), Parc Taulí Hospital Universitari, Sabadell, Spain.,Department of Psychiatry and Legal Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Diego Palao
- Department of Mental Health, Institut d'Investigació i Innovació Parc Taulí (I3PT), Parc Taulí Hospital Universitari, Sabadell, Spain.,Department of Psychiatry and Legal Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Carlos III Health Institute, Madrid, Spain
| | - José Antonio Monreal
- Department of Mental Health, Institut d'Investigació i Innovació Parc Taulí (I3PT), Parc Taulí Hospital Universitari, Sabadell, Spain.,Department of Psychiatry and Legal Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Carlos III Health Institute, Madrid, Spain
| | - Javier Labad
- Department of Mental Health, Institut d'Investigació i Innovació Parc Taulí (I3PT), Parc Taulí Hospital Universitari, Sabadell, Spain.,Department of Psychiatry and Legal Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Carlos III Health Institute, Madrid, Spain
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11
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Tost M, Monreal JA, Armario A, Barbero JD, Cobo J, García-Rizo C, Bioque M, Usall J, Huerta-Ramos E, Soria V, Labad J. Targeting Hormones for Improving Cognition in Major Mood Disorders and Schizophrenia: Thyroid Hormones and Prolactin. Clin Drug Investig 2019; 40:1-14. [DOI: 10.1007/s40261-019-00854-w] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
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12
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de Assis GG, Gasanov EV. BDNF and Cortisol integrative system - Plasticity vs. degeneration: Implications of the Val66Met polymorphism. Front Neuroendocrinol 2019; 55:100784. [PMID: 31425696 DOI: 10.1016/j.yfrne.2019.100784] [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: 03/16/2019] [Revised: 08/12/2019] [Accepted: 08/14/2019] [Indexed: 12/12/2022]
Abstract
UNLABELLED BDNF is the neurotrophin mediating pro-neuronal survival and plasticity. Cortisol (COR), in turn, is engaged in the coordination of several processes in the brain homeostasis. Stress-responsive, both factors show an integrative role through their receptor's dynamics in neurophysiology. Furthermore, the Val66Met BDNF polymorphism may play a role in this mechanism. AIM to investigate BDNF-COR interaction in the human neurophysiology context. METHODS We collected all papers containing BDNF and COR parameters or showing COR analyses in genotyped individuals in a PubMed search - full description available on PROSPERO - CRD42016050206. DISCUSSION BDNF and COR perform distinct roles in the physiology of the brain whose systems are integrated by glucocorticoid receptors dynamics. The BDNF polymorphism appears to have an influence on individual COR responsivity to stress. BDNF and COR play complementary roles in the nervous system where COR is a regulator of positive/negative effects. Exercise positively regulates both factors, regardless of BDNF polymorphism.
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Affiliation(s)
- Gilmara Gomes de Assis
- Department of Applied Physiology, Mossakowski Medical Research Centre Polish Academy of Sciences, Warsaw, Poland; Lab. of Behavioral Endocrinology, Brain Institute, Federal University of Rio Grande do Norte, Natal, Brazil.
| | - Eugene V Gasanov
- Laboratory of Neurodegeneration, International Institute of Molecular and Cell Biology in Warsaw, Poland
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13
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Chen H, Wu Y, Huang G, He W, Lin S, Zhang X, He J. Low Tri-iodothyronine Syndrome Is Associated With Cognitive Impairment in Patients With Acute Ischemic Stroke: A Prospective Cohort Study. Am J Geriatr Psychiatry 2018; 26:1222-1230. [PMID: 30236902 DOI: 10.1016/j.jagp.2018.07.007] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2018] [Revised: 07/16/2018] [Accepted: 07/16/2018] [Indexed: 12/30/2022]
Abstract
OBJECTIVE Low tri-iodothyronine (T3) syndrome is a predictor of poor prognosis in patients with stroke. Poststroke cognitive impairment (PSCI) is a common and important complication after stroke. The association between low T3 syndrome and PSCI is unclear. We aimed to explore the potential relationship between low T3 syndrome and PSCI in the acute phase of ischemic stroke at a 1-month follow-up visit. METHODS In total, 314 ischemic stroke patients were consecutively enrolled in the study and followed up at 1 month. Thyroid hormones were measured within 24 hours after admission. Cognitive function was evaluated by the Mini-Mental State Exam (MMSE) 1 month after acute ischemic stroke. Cognitive impairment was defined as an MMSE score of less than 27. Cognitive impairment severity was categorized as severe, mild, or none (MMSE score <23, 23-26, or ≥27, respectively). RESULTS According to the MMSE score, 182 participants (58.0%) had cognitive impairment 1 month after stroke. Patients with low T3 syndrome were more prone to have cognitive impairment than patients with normal levels of T3 (p < 0.001). After adjusting for potential confounders in our logistic model, low T3 syndrome was independently associated with PSCI (odds ratio 4.319, 95% confidence interval 1.553-12.013, p = 0.005). CONCLUSION Low T3 syndrome in the acute phase of ischemic stroke was associated with a higher prevalence of 1-month PSCI, independently of established risk factors.
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Affiliation(s)
- Huijun Chen
- Department of Neurology, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, China
| | - Yuemin Wu
- Department of Neurology, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, China
| | - Guiqian Huang
- Department of Neurology, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, China
| | - Weilei He
- Department of Neurology, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, China
| | - Shasha Lin
- Department of Neurology, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, China
| | - Xingru Zhang
- Department of Neurology, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, China
| | - Jincai He
- Department of Neurology, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, China..
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14
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Labad J, Barbero JD, Gutiérrez-Zotes A, Montalvo I, Creus M, Cabezas Á, Solé M, Algora MJ, Garcia-Parés G, Vilella E. Free thyroxine levels are associated with cognitive changes in individuals with a first episode of psychosis: A prospective 1-year follow-up study. Schizophr Res 2016; 171:182-6. [PMID: 26805411 DOI: 10.1016/j.schres.2016.01.036] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2015] [Revised: 12/19/2015] [Accepted: 01/12/2016] [Indexed: 10/22/2022]
Abstract
The results of previous cross-sectional studies suggest that free thyroxine (FT4) levels are associated with cognitive abilities (particularly attention/vigilance) during the early stages of psychosis. We aimed to explore whether hypothalamic-pituitary-thyroid hormones predict cognitive changes in a 1-year longitudinal study following first episodes of psychosis (FEP). We studied 36 FEP patients and a control group of 50 healthy subjects (HS). Plasma levels of thyroid-stimulating hormone (TSH) and FT4 were measured. Cognitive assessment was performed with the MATRICS Cognitive Consensus Cognitive Battery (MCCB). FEP patients were assessed twice (baseline and after 1year), whereas HS were assessed only once. We compared cognitive changes at 1year between three groups based on baseline FT4 levels: 1) lowest quartile (Q1, FT4<1.16ng/dL); 2) medium quartiles (Q2-Q3, FT4 1.16-1.54ng/dL); and 3) highest quartile (Q4, FT4>1.54ng/dL). No differences in TSH or FT4 levels were found between HS and FEP patients. All participants had FT4 levels within the normal range. HS outperformed FEP patients in all cognitive tasks. In relation to the relationship between FT4 levels and cognitive changes, a U-shaped pattern was observed: FEP patients from the middle quartiles (Q2-Q3) improved in attention/vigilance, whereas both extreme quartiles (Q1 and Q4) showed a worsening in this cognitive domain over time. Patients with lower FT4 (Q1) showed poorer baseline attention; therefore, lower baseline FT4 levels predicted a poorer prognosis in terms of attention performance. Our study suggests that baseline FT4 levels are associated with changes in attention and vigilance performance over one year in FEP patients.
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Affiliation(s)
- J Labad
- Department of Psychiatry, Corporació Sanitària Parc Taulí, Universitat Autònoma de Barcelona, Sabadell, Barcelona, Spain.
| | - J D Barbero
- Department of Psychiatry, Corporació Sanitària Parc Taulí, Universitat Autònoma de Barcelona, Sabadell, Barcelona, Spain
| | - A Gutiérrez-Zotes
- Hospital Universitari Institut Pere Mata, IISPV, Universitat Rovira i Virgili, CIBERSAM, Reus, Spain
| | - I Montalvo
- Department of Psychiatry, Corporació Sanitària Parc Taulí, Universitat Autònoma de Barcelona, Sabadell, Barcelona, Spain
| | - M Creus
- Hospital Universitari Institut Pere Mata, IISPV, Universitat Rovira i Virgili, CIBERSAM, Reus, Spain
| | - Á Cabezas
- Hospital Universitari Institut Pere Mata, IISPV, Universitat Rovira i Virgili, CIBERSAM, Reus, Spain
| | - M Solé
- Hospital Universitari Institut Pere Mata, IISPV, Universitat Rovira i Virgili, CIBERSAM, Reus, Spain
| | - M J Algora
- Hospital Universitari Institut Pere Mata, IISPV, Universitat Rovira i Virgili, CIBERSAM, Reus, Spain
| | - G Garcia-Parés
- Department of Psychiatry, Hospital Nostra Senyora de Meritxell, Servei Andorrà d'Atenció Sanitària, Andorra
| | - E Vilella
- Hospital Universitari Institut Pere Mata, IISPV, Universitat Rovira i Virgili, CIBERSAM, Reus, Spain
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15
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Steibliene V, Bunevicius A, Savickas A, Prange AJ, Nemeroff CB, Bunevicius R. Triiodothyronine accelerates and enhances the antipsychotic effect of risperidone in acute schizophrenia. J Psychiatr Res 2016; 73:9-16. [PMID: 26679760 DOI: 10.1016/j.jpsychires.2015.11.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2015] [Revised: 11/09/2015] [Accepted: 11/13/2015] [Indexed: 12/26/2022]
Abstract
In acute psychotic schizophrenia patients we investigated if the combination of triiodothyronine (T3) plus risperidone was more effective when compared to risperidone monotherapy. Thirty-two in-patients meeting the DSM-IV-TR diagnostic criteria for schizophrenia and without thyroid disease received risperidone (flexibly adjusted dose for tolerability) and were randomized to additionally receive either T3 (25 μg daily; risperidone plus T3 group) or placebo (risperidone plus placebo group). Treatment lasted until meeting the response to treatment criteria defined as score of ≤ 3 on the Clinical Global Impression Severity and Improvement scales. Acute psychotic episode symptom severity was evaluated using the Brief Psychiatric Rating Scale (BPRS) at treatment initiation and at the final study assessment. Fourteen patients were randomized to receive risperidone plus T3 and eighteen to receive risperidone plus placebo. The time until treatment response was shorter in the risperidone plus T3 group relative to the risperidone plus placebo group (25.5 ± 4.4 days vs 32.2 ± 8.2 days, respectively; p = 0.001). Moreover, there was a greater reduction of BPRS-total score (p = 0.01) in the risperidone plus T3 group relative to the risperidone plus placebo group. Treatment with T3 was associated with shorter time to treatment response (β = -0.440, p = 0.022) and with greater improvement in BPRS score (β = 0.240, p = 0.053), independent of patients' gender, age, baseline BPRS score and mean risperidone dose. The study confirms that addition of T3 to risperidone was associated with accelerated and enhanced treatment response in acutely psychotic schizophrenic patients.
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Affiliation(s)
- Vesta Steibliene
- Clinic of Psychiatry, Lithuanian University of Health Sciences, Mickeviciaus str. 9, Kaunas, LT-44307, Lithuania.
| | - Adomas Bunevicius
- Laboratory of Clinical Research, Institute of Neurosciences, Lithuanian University of Health Sciences, Eiveniu str. 2, Kaunas, LT-50009, Lithuania.
| | - Arunas Savickas
- Department of Drug Technology and Social Pharmacy, Lithuanian University of Health Sciences, Mickeviciaus str. 9, LT-44307, Kaunas, Lithuania.
| | - Arthur J Prange
- Department of Psychiatry, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
| | - Charles B Nemeroff
- Department of Psychiatry and Behavioral Sciences, University of Miami Miller School of Medicine, 1120 Northwest 14 Street, Suite 1455, Miami, FL, 33136, USA.
| | - Robertas Bunevicius
- Behavioral Medicine Institute, Lithuanian University of Health Sciences, Vyduno str. 4, Palanga, LT-00135, Lithuania
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16
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Penadés R, García-Rizo C, Bioque M, González-Rodríguez A, Cabrera B, Mezquida G, Bernardo M. The search for new biomarkers for cognition in schizophrenia. SCHIZOPHRENIA RESEARCH-COGNITION 2015; 2:172-178. [PMID: 29114461 PMCID: PMC5609637 DOI: 10.1016/j.scog.2015.10.004] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
The search for biomarkers in cognition has been the focus of a large part of the research on patients suffering from schizophrenia. The scientific literature is heterogeneous, and few studies establishing an integrative model of pathogenesis and therapeutic response are available in this field. In this review, we aimed to summarize three essential aspects correlated with cognitive performance: 1) the relationship between inflammation and cognition in schizophrenia, 2) the role of prolactin in cognition, and 3) the association between cognition and neurotrophic factors, particularly brain-derived neurotrophic factor (BDNF). Several studies support the association of inflammatory markers with cognitive status in schizophrenia. In recent decades, the development of effective therapies for cognitive impairment in schizophrenia has focused on the search for anti-inflammatory and immunomodulatory medications. Conversely, the implications of prolactin and its functions in cognition, the transition to psychosis and the diagnosis and prognosis of schizophrenia have been established independent of antipsychotic treatment. With regard to neurotrophic factors, a recent study has correlated BDNF levels with cognitive recovery in schizophrenic patients treated with cognitive remediation. We conclude that although there is a diversity of biomarkers focused on cognitive function in schizophrenia, BDNF is the biomarker that has accumulated the vast majority of evidence in the current literature.
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Affiliation(s)
- Rafael Penadés
- Barcelona Clinic Schizophrenia Unit (BCSU).,Hospital Clínic Barcelona.,University of Barcelona.,Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS).,Centro de Investigación en Red de Salud Mental (CIBERSAM)
| | - Clemente García-Rizo
- Barcelona Clinic Schizophrenia Unit (BCSU).,Hospital Clínic Barcelona.,Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS).,Centro de Investigación en Red de Salud Mental (CIBERSAM)
| | - Miquel Bioque
- Barcelona Clinic Schizophrenia Unit (BCSU).,Hospital Clínic Barcelona.,Centro de Investigación en Red de Salud Mental (CIBERSAM)
| | | | - Bibiana Cabrera
- Barcelona Clinic Schizophrenia Unit (BCSU).,Centro de Investigación en Red de Salud Mental (CIBERSAM)
| | - Gisela Mezquida
- Barcelona Clinic Schizophrenia Unit (BCSU).,Centro de Investigación en Red de Salud Mental (CIBERSAM)
| | - Miquel Bernardo
- Barcelona Clinic Schizophrenia Unit (BCSU).,Hospital Clínic Barcelona.,University of Barcelona.,Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS).,Centro de Investigación en Red de Salud Mental (CIBERSAM)
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17
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Penadés R, Garcia-Rizo C, Bioque M, González-Rodríguez A, Cabrera B, Mezquida G, Bernardo M. Búsqueda De Nuevos Biomarcadores De La Cognición En Esquizofrenia. Schizophr Res Cogn 2015. [DOI: 10.1016/j.scog.2015.06.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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18
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Mahintamani T, Ram D, Mitra S. Inside the mind of poor Tom--A multidimensional approach to determine causes for redundant clothing in patients with schizophrenia. Psychiatry Res 2015; 227:219-23. [PMID: 25863820 DOI: 10.1016/j.psychres.2015.03.029] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2014] [Revised: 02/03/2015] [Accepted: 03/03/2015] [Indexed: 12/17/2022]
Abstract
Redundant clothing (RC) is a readily observable feature of schizophrenia. While abnormal thermoregulation, thyroid dysfunction and autonomic dysregulation have been postulated to account for RC, no identified factor yet conclusively explains this enigmatic behaviour. This study attempted to determine the cause(s) of RC in schizophrenia. Two groups of 20 age- and sex-matched patients with and without RC were studied. Socio-demographic and clinical characteristics were recorded, and patients were assessed for psychopathology (Positive and Negative Syndrome Scale (PANSS)), cognitive function (Schizophrenia Cognition Rating Scale (SCoRS)), and autonomic and thyroid function. Those with RC differed significantly from those without RC in education, occupation, marital status and duration of untreated psychosis (DUP). They were more disorganised, more withdrawn, and had significant affective impairment. The RC group also had significantly higher negative, general and total psychopathology scores on the Positive and Negative Syndrome Scale, significantly poorer cognitive function, greater autonomic dysfunction, and lower free T3 and free T4 concentrations. We propose that the dimension of RC could define a subgroup with poorer premorbid functioning and a longer DUP, in whom cognitive dysfunction and prominent negative symptoms coloured the manifestations of deranged thermoregulation secondary to lower thyroid hormone levels and autonomic dysfunction, ultimately resulting in redundant clothing.
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Affiliation(s)
- Tathagata Mahintamani
- Department of Psychiatry, Central Institute of Psychiatry, Kanke, Ranchi, Jharkhand 834006, India.
| | - Daya Ram
- Department of Psychiatry, Central Institute of Psychiatry, Kanke, Ranchi, Jharkhand 834006, India
| | - Sayantanava Mitra
- K.S. Mani Centre for Cognitive Neurosciences, Central Institute of Psychiatry, Kanke, Ranchi, Jharkhand 834006, India
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19
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Levothyroxine Augmentation in Clozapine Resistant Schizophrenia: A Case Report and Review. Case Rep Psychiatry 2015; 2015:678040. [PMID: 26078905 PMCID: PMC4442283 DOI: 10.1155/2015/678040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2015] [Revised: 04/27/2015] [Accepted: 04/30/2015] [Indexed: 11/29/2022] Open
Abstract
There are many reports that show different thyroid abnormalities in schizophrenia without clear establishment of their role in etiology and treatment outcome of schizophrenia. Among these reports, there are only a few that consider a role for thyroid hormones as augmenting agents in the treatment with antipsychotic drugs. This case report outlines symptom subsidence of a patient with clozapine refractory paranoid schizophrenia and normal thyroid function who added levothyroxine to clozapine and found that symptoms of psychosis returned once levothyroxine was discontinued. Although this observation needs to be confirmed in controlled clinical trials, we aimed to discuss possible hypothesized mechanisms underlying this observation.
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