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Sut E, Akgül Ö, Bora E. Minor physical anomalies in schizophrenia and first-degree relatives in comparison to healthy controls: A systematic review and meta-analysis. Eur Neuropsychopharmacol 2024; 86:55-64. [PMID: 38943776 DOI: 10.1016/j.euroneuro.2024.05.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2024] [Revised: 05/13/2024] [Accepted: 05/15/2024] [Indexed: 07/01/2024]
Abstract
Minor physical anomalies (MPAs) are anatomical variations that are markers of aberrant early neurodevelopment. Schizophrenia is associated with increased MPA frequency, however, the frequency and distribution of MPAs exhibit substantial heterogeneity in schizophrenia and are not exclusive to this disorder. MPAs at different localizations might represent different developmental origins and might be related to latent genetic predisposition or vulnerability to develop full-blown psychosis. Therefore, we conducted a thorough review of minor physical anomalies (MPAs) in schizophrenia (Sch) and first-degree relatives (SchRel). Analyzing 52 studies published from January 1980 to October 2023, the meta-analysis compared MPA scores between 3780 schizophrenia patients and 3871 controls, as well as 1415 SchRel and 1569 controls. The total MPA score was significantly increased in schizophrenia compared to controls (g = 0.78 [0.63-0.93], p<0.001). In regional MPA meta-analyses, effect sizes ranged from 0.56 to 0.78. The difference between SchRel and controls was moderate (g = 0.44 [0.28-0.61], p<0.001). When individual MPA items were analyzed separately, fine electric hair, malformed ear, asymmetrical ear, curved 5th finger were anomalies that were shared between both schizophrenia and SchRel. Also, direct comparisons of the frequency of MPAs in schizophrenia and their relatives were conducted. Additionally, the early age of onset of schizophrenia was associated with mouth anomalies (Z=-2.13, p = 0.03), and ear anomalies were associated with a higher percentage of males in the schizophrenia group (Z = 2.64, p = 0.008). These findings support the notion that different MPAs might be associated with genetic susceptibility as well as vulnerability to developing full-blown psychosis. Studies investigating clinical and neurobiological correlates of MPAs in schizophrenia might be helpful in characterizing subtypes of psychoses that are associated with different developmental processes.
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Affiliation(s)
- Ekin Sut
- Department of Child and Adolescent Psychiatry, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey.
| | - Özge Akgül
- Department of Psychology, Izmir Democracy University, Izmir, Turkey
| | - Emre Bora
- Department of Psychiatry, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey; Department of Neurosciences, Health Sciences Institute, Dokuz Eylul University, Izmir, Turkey; Melbourne Neuropsychiatry Centre, Department of Psychiatry, University of Melbourne and Melbourne Health, Carlton South, Victoria 3053, Australia
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Yasa Kostas R, Kostas K, MacPherson SE, Wolters MK. Semantic verbal fluency in native speakers of Turkish: a systematic review of category use, scoring metrics and normative data in healthy individuals. J Clin Exp Neuropsychol 2024; 46:272-301. [PMID: 38904178 DOI: 10.1080/13803395.2024.2331827] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Accepted: 03/07/2024] [Indexed: 06/22/2024]
Abstract
INTRODUCTION Semantic verbal fluency (SVF) is a widely used measure of frontal executive function and access to semantic memory. SVF scoring metrics include the number of unique words generated, perseverations, intrusions, semantic cluster size and switching between clusters, and scores vary depending on the language the test is administered in. In this paper, we review the existing normative data for Turkish, the main metrics used for scoring SVF data in Turkish, and the most frequently used categories. METHOD We conducted a systematic review of peer-reviewed papers using Medline, EMBASE, PsycInfo, Web of Science, and two Turkish databases, TR-Dizin and Yok-Tez. Included papers contained data on the SVF performance of healthy adult native speakers of Turkish, and reported the categories used. Versions of the SVF that required participants to alternate categories were excluded. We extracted and tabulated demographics, descriptions of groups, metrics used, categories used, and sources of normative data. Studies were assessed for level of detail in reporting findings. RESULTS 1400 studies were retrieved. After deduplication, abstract, full text screening, and merging of theses with their published versions, 121 studies were included. 114 studies used the semantic category "animal", followed by first names (N = 14, 12%). All studies reported word count. More complex measures were rare (perseverations: N = 12, 10%, clustering and switching: N = 5, 4%). Four of seven normative studies reported only word count, two also measured perseverations, and one reported category violations and perseverations. Two normative studies were published in English. CONCLUSIONS There is a lack of normative Turkish SVF data with more complex metrics, such as clustering and switching, and a lack of normative data published in English. Given the size of the Turkish diaspora, normative SVF data should include monolingual and bilingual speakers. Limitations include a restriction to key English and Turkish databases.
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Affiliation(s)
| | - Kahraman Kostas
- Department of Computer Science, Heriot-Watt University, Edinburgh, UK
| | - Sarah E MacPherson
- Human Cognitive Neuroscience, Department of Psychology, University of Edinburgh, Edinburgh, UK
| | - Maria K Wolters
- School of Informatics, University of Edinburgh, Edinburgh, UK
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Jeng SL, Tu MJ, Lin CW, Lin JJ, Tseng HH, Jang FL, Lu MK, Chen PS, Huang CC, Chang WH, Tan HP, Lin SH. Machine learning for prediction of schizophrenia based on identifying the primary and interaction effects of minor physical anomalies. J Psychiatr Res 2024; 172:108-118. [PMID: 38373372 DOI: 10.1016/j.jpsychires.2024.02.032] [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: 11/07/2023] [Revised: 02/08/2024] [Accepted: 02/13/2024] [Indexed: 02/21/2024]
Abstract
In the neurodevelopmental model of schizophrenia, minor physical anomalies (MPAs) are considered neurodevelopmental markers of schizophrenia. To date, there has been no research to evaluate the interaction between MPAs. Our study built and used a machine learning model to predict the risk of schizophrenia based on measurements of MPA items and to investigate the potential primary and interaction effects of MPAs. The study included 470 patients with schizophrenia and 354 healthy controls. The models used are classical statistical model, Logistic Regression (LR), and machine leaning models, Decision Tree (DT) and Random Forest (RF). We also plotted two-dimensional scatter diagrams and three-dimensional linear/quadratic discriminant analysis (LDA/QDA) graphs for comparison with the DT dendritic structure. We found that RF had the highest predictive power for schizophrenia (Full-training AUC = 0.97 and 5-fold cross-validation AUC = 0.75). We identified several primary MPAs, such as the mouth region, high palate, furrowed tongue, skull height and mouth width. Quantitative MPA analysis indicated that the higher skull height and the narrower mouth width, the higher the risk of schizophrenia. In the interaction, we further identified that skull height and mouth width, furrowed tongue and skull height, high palate and skull height, and high palate and furrowed tongue, showed significant two-item interactions with schizophrenia. A weak three-item interaction was found between high palate, skull height, and mouth width. In conclusion, we found that the two machine learning methods showed good predictive ability in assessing the risk of schizophrenia using the primary and interaction effects of MPAs.
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Affiliation(s)
- Shuen-Lin Jeng
- Department of Statistics, Institute of Data Science, and Center for Innovative FinTech Business Models, National Cheng Kung University, Tainan, Taiwan
| | - Ming-Jun Tu
- Department of Statistics, National Cheng Kung University, Tainan, Taiwan
| | - Chih-Wei Lin
- Department of Public Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Jin-Jia Lin
- Department of Psychiatry, Chi Mei Medical Center, Tainan, Taiwan
| | - Huai-Hsuan Tseng
- Department of Psychiatry, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Fong-Lin Jang
- Department of Psychiatry, Chi Mei Medical Center, Tainan, Taiwan
| | - Ming-Kun Lu
- Jianan Psychiatric Center, Ministry of Health and Welfare, Tainan, Taiwan
| | - Po-See Chen
- Department of Psychiatry, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Chih-Chun Huang
- Department of Psychiatry, National Cheng Kung University Hospital, Dou-Liou Branch, Yunlin, Taiwan
| | - Wei-Hung Chang
- Department of Psychiatry, National Cheng Kung University Hospital, Dou-Liou Branch, Yunlin, Taiwan
| | - Hung-Pin Tan
- Jianan Psychiatric Center, Ministry of Health and Welfare, Tainan, Taiwan
| | - Sheng-Hsiang Lin
- Department of Public Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Institute of Clinical Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Biostatistics Consulting Center, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
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Uğurpala C, Berberoğlu E, Özkan U, Genç SA, Tanrıverdi NÇ, İnhanlı D, Ali C, Üçok A. Minor physical anomalies may be related to treatment resistance in patients with schizophrenia. Asian J Psychiatr 2023; 88:103729. [PMID: 37633160 DOI: 10.1016/j.ajp.2023.103729] [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: 03/14/2023] [Revised: 08/03/2023] [Accepted: 08/09/2023] [Indexed: 08/28/2023]
Abstract
This study investigates the relationship between minor physical anomalies (MPA) and treatment resistance in schizophrenia (TRS). We evaluated 137 patients and 100 healthy controls by using a modified Waldrup MPA scale. Thirteen MPA items were found more frequently in the schizophrenia group than in the controls. The total MPA score was higher in TRS, and MPAs in the eye and mouth regions were more frequent in TRS (n = 57) than in non-TRS. Total MPA score was correlated to Brief Psychiatric Rating Scale-Expanded (BPRS-E) total and BPRS-positive scores in TRS. Our findings suggest that MPA might contribute to treatment resistance in schizophrenia.
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Affiliation(s)
- Can Uğurpala
- Vezirkopru State Hospital, Department of Psychiatry, Samsun, Turkey
| | - Ertuğ Berberoğlu
- Korkuteli State Hospital, State Hospital, Department of Psychiatry, Antalya, Turkey
| | | | | | | | - Damla İnhanlı
- Luleburgaz State Hospital, Department of Psychiatry, Turkey
| | - Chouda Ali
- Valeara MVZ Bottrop GmbH, Bottrop, Germany
| | - Alp Üçok
- Istanbul Faculty of Medicine, Istanbul University, Department of Psychiatry, Istanbul, Turkey.
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Sjoberg EA, Wilner RG, D'Souza A, Cole GG. The Stroop Task Sex Difference: Evolved Inhibition or Color Naming? ARCHIVES OF SEXUAL BEHAVIOR 2023; 52:315-323. [PMID: 36261735 PMCID: PMC9859918 DOI: 10.1007/s10508-022-02439-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/12/2020] [Revised: 09/27/2022] [Accepted: 09/27/2022] [Indexed: 05/21/2023]
Abstract
Previous research shows that women outperform men in the classic Stroop task, but it is not known why this difference occurs. There are currently two main hypotheses: (1) women have enhanced verbal abilities, and (2) women show greater inhibition. In two Stroop experiments, we examined the Inhibition hypothesis by adopting a procedure, often used in visual cognition paradigms, that induces a particular inhibitory component. So-called Negative Priming occurs when a distracting non-target stimulus on one trial becomes the target on the following trial. Results from our experiments showed that the degree to which this type of inhibition occurs within the Stroop effect is no different for men and women. This was the case irrespective of whether participants made a vocal response (Experiment 1; n = 64, 32 men and 32 women) or a manual response (Experiment 2; n = 64, 32 men and 32 women). These results do not therefore support the Inhibition hypothesis. We additionally review findings from a range of paradigms that can be seen as indexing the different components required for the Stroop task (e.g., distractor suppression). This review suggests that the sex effect is due to superior color naming ability in women.
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Affiliation(s)
- Espen A Sjoberg
- School of Health Sciences, Kristiania University College, Prinsens gate 7-9, 0152, Oslo, Norway.
| | - Raquel G Wilner
- Department of Linguistic, Literary and Aesthetic Studies, University of Bergen, Bergen, Norway
| | - Antonia D'Souza
- Centre for Brain Science, University of Essex, Colchester, UK
| | - Geoff G Cole
- Centre for Brain Science, University of Essex, Colchester, UK
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Wang XY, Lin JJ, Lu MK, Jang FL, Tseng HH, Chen PS, Chen PF, Chang WH, Huang CC, Lu KM, Tan HP, Lin SH. Development and validation of a web-based prediction tool on minor physical anomalies for schizophrenia. SCHIZOPHRENIA 2022; 8:4. [PMID: 35210439 PMCID: PMC8873231 DOI: 10.1038/s41537-021-00198-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/13/2021] [Accepted: 12/06/2021] [Indexed: 11/09/2022]
Abstract
AbstractIn support of the neurodevelopmental model of schizophrenia, minor physical anomalies (MPAs) have been suggested as biomarkers and potential pathophysiological significance for schizophrenia. However, an integrated, clinically useful tool that used qualitative and quantitative MPAs to visualize and predict schizophrenia risk while characterizing the degree of importance of MPA items was lacking. We recruited a training set and a validation set, including 463 schizophrenia patients and 281 healthy controls to conduct logistic regression and the least absolute shrinkage and selection operator (Lasso) regression to select the best parameters of MPAs and constructed nomograms. Two nomograms were built to show the weights of these predictors. In the logistic regression model, 11 out of a total of 68 parameters were identified as the best MPA items for distinguishing between patients with schizophrenia and controls, including hair whorls, epicanthus, adherent ear lobes, high palate, furrowed tongue, hyperconvex fingernails, a large gap between first and second toes, skull height, nasal width, mouth width, and palate width. The Lasso regression model included the same variables of the logistic regression model, except for nasal width, and further included two items (interpupillary distance and soft ears) to assess the risk of schizophrenia. The results of the validation dataset verified the efficacy of the nomograms with the area under the curve 0.84 and 0.85 in the logistic regression model and lasso regression model, respectively. This study provides an easy-to-use tool based on validated risk models of schizophrenia and reflects a divergence in development between schizophrenia patients and healthy controls (https://www.szprediction.net/).
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Varga E, Hajnal A, Soós A, Hegyi P, Kovács D, Farkas N, Szebényi J, Mikó A, Tényi T, Herold R. Minor Physical Anomalies in Bipolar Disorder-A Meta-Analysis. Front Psychiatry 2021; 12:598734. [PMID: 34220563 PMCID: PMC8242170 DOI: 10.3389/fpsyt.2021.598734] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Accepted: 05/05/2021] [Indexed: 01/27/2023] Open
Abstract
Introduction: Minor physical anomalies (MPAs) may reflect basic neurobiological features underlying bipolar disorders (BPD), as they are sensitive physical indicators of morphogenetic failure of the brain. Despite several researches about the presence of MPAs in BPD, the results are still controversial. Objectives: The aim of the present meta-analysis was to assess the standardized weighted mean effect sizes of MPAs in BPD and to examine if MPAs may be found predominantly in the head and/or facial regions in BPD patients compared to controls (HC). Methods: Four studies, involving 155 patients with BPD, and 187 HC, were involved in the analysis after searching the literature. For the investigation of MPAs in the peripheral (MPA-P) and in the head and facial regions (MPA-CF), two studies involving 121 BPD patients, and 133 HC passed the inclusion criteria. Results: The number of the MPAs in the BPD group was significantly higher compared to HC. Another important finding of the present study is that BPD patients' MPA-P scores do not significantly differ from those of the HC. In contrast, BPD patients' MPA-CF scores were found to be significantly higher compared to HC subjects. It is important to note that there was a low number of eligible publications included, which caused higher heterogeneity. Conclusions: Low quality of evidence suggests that MPAs are more common in patients with BPD than in HC and the higher rate of MPAs is found predominantly in the head and facial regions.
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Affiliation(s)
- Eszter Varga
- Department of Pediatrics, Medical School, University of Pécs, Pécs, Hungary
| | - András Hajnal
- Department of Psychiatry and Psychotherapy, Medical School, University of Pécs, Pécs, Hungary
| | - Alexandra Soós
- Institute for Translational Medicine, Medical School, University of Pécs, Pécs, Hungary
| | - Péter Hegyi
- Institute for Translational Medicine, Medical School, University of Pécs, Pécs, Hungary
| | - Dóra Kovács
- Institute for Translational Medicine, Medical School, University of Pécs, Pécs, Hungary
| | - Nelli Farkas
- Institute of Bioanalysis, Medical School, University of Pécs, Pécs, Hungary
| | - Júlia Szebényi
- Department of Dermatology, Venereology and Oncodermatology, Medical School, University of Pécs, Pécs, Hungary
| | - Alexandra Mikó
- Institute for Translational Medicine, Medical School, University of Pécs, Pécs, Hungary
| | - Tamás Tényi
- Department of Psychiatry and Psychotherapy, Medical School, University of Pécs, Pécs, Hungary
| | - Róbert Herold
- Department of Psychiatry and Psychotherapy, Medical School, University of Pécs, Pécs, Hungary
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Tsehay B, Shitie D. Minor Physical Anomalies Among Schizophrenic Patients as a Biomarker of Its Developmental Origin in Northwest Ethiopia. Neuropsychiatr Dis Treat 2020; 16:2491-2497. [PMID: 33149590 PMCID: PMC7604434 DOI: 10.2147/ndt.s275582] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Accepted: 10/23/2020] [Indexed: 11/23/2022] Open
Abstract
PURPOSE Although there are highly precise and advanced diagnostic methods, the etiology and pathophysiology of schizophrenia remain poorly understood. There are several theories about schizophrenia origin, among which the neurodevelopmental theory is widely accepted. Our study aimed to assess minor physical anomalies among schizophrenic patients as putative indices of its developmental origin in North West Ethiopia 2018-2019. PATIENTS AND METHODS Institutional-based comparative cross-sectional study design was conducted in Debre Markos comprehensive, specialized hospitals in 190 schizophrenic patients, 190 healthy controls, and 190 1st-degree relatives. Data were collected using standard methods, entered into EpiData version 3.1, and exported to SPSS version 24 for analysis. Descriptive data were analyzed using descriptive statistics, and discriminant function analysis was conducted and a value of 0.03 was taken as the cutoff point for prediction of group status of the study samples. RESULTS Five hundred seventy study samples, male 375 (65.8%), and female 195 (34.2%), were included in this study. The discriminate function 1 and 2 revealed a significant association between groups and all predictors, accounting for 83.5% and 16.5% of between-group variability, respectively. However, closer analysis of the structure matrix revealed longitudinally furrowed tongue, ≥Five palate ridges, high steeples palate, transversely and randomly furrowed tongue, protruding supraorbital ridge as significant predictors. CONCLUSION Depending on predictor variables in this study, minor physical anomalies can serve as a biomarker for early screening of schizophrenic patients and clue for its developmental origin.
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Affiliation(s)
- Binalfew Tsehay
- Department of Biomedical Sciences, Debre Markos University, Debre Markos, Ethiopia
| | - Desalegn Shitie
- Department of Biomedical Sciences, Debre Markos University, Debre Markos, Ethiopia
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Stephan-Otto C, Lombardini F, Núñez C, Senior C, Ochoa S, Usall J, Brébion G. Fluctuating asymmetry in patients with schizophrenia is related to hallucinations and thought disorganisation. Psychiatry Res 2020; 285:112816. [PMID: 32036154 DOI: 10.1016/j.psychres.2020.112816] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2019] [Revised: 01/21/2020] [Accepted: 01/25/2020] [Indexed: 11/26/2022]
Abstract
Fluctuating asymmetry represents the degree to which the right and left side of the body are asymmetrical, and is a sign of developmental instability. Higher levels of fluctuating asymmetry have been observed in individuals within the schizophrenia spectrum. We aimed to explore the associations of fluctuating asymmetry with psychotic and affective symptoms in schizophrenia patients, as well as with propensity to these symptoms in non-clinical individuals. A measure of morphological fluctuating asymmetry was calculated for 39 patients with schizophrenia and 60 healthy individuals, and a range of clinical and subclinical psychiatric symptoms was assessed. Regression analyses of the fluctuating asymmetry measure were conducted within each group. In the patient cohort, fluctuating asymmetry was significantly associated with the hallucination and thought disorganisation scores. T-test comparisons revealed that the patients presenting either hallucinations or thought disorganisation were significantly more asymmetrical than were the healthy individuals, while the patients without these key symptoms were equivalent to the healthy individuals. A positive association with the anxiety score emerged in a subsample of 36 healthy participants who were rated on affective symptoms. These findings suggest that fluctuating asymmetry may be an indicator of clinical hallucinations and thought disorganisation rather than an indicator of schizophrenia disease.
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Affiliation(s)
- Christian Stephan-Otto
- Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Spain; Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
| | | | - Christian Núñez
- Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Spain; Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Spain
| | - Carl Senior
- School of Life & Health Sciences, Aston University, Birmingham, UK; Research and Development Unit - Parc Sanitari Sant Joan de Déu, c/ Dr. Antoni Pujadas, 42, 08830 - Sant Boi de Llobregat, Barcelona, Spain
| | - Susana Ochoa
- Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Spain; Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
| | - Judith Usall
- Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Spain; Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
| | - Gildas Brébion
- Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Spain; Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain.
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Liu JY, Chen HY, Lin JJ, Lu MK, Tan HP, Jang FL, Lin SH. Alterations of plasma cytokine biomarkers for identifying age at onset of schizophrenia with neurological soft signs. Int J Med Sci 2020; 17:255-262. [PMID: 32038109 PMCID: PMC6990880 DOI: 10.7150/ijms.38891] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2019] [Accepted: 12/19/2019] [Indexed: 01/22/2023] Open
Abstract
Several studies have been suggested that immunity plays a part in neurodevelopment and schizophrenia pathogenesis. Early age of onset in schizophrenia is associated with genetic factors which affect neurodevelopment. This study aims to identify immune abnormalities associated with neurodevelopmental impairments in early-onset schizophrenia (EOS) and adult-onset schizophrenia (AOS) patients. We determined the plasma levels of six cytokines (IL-1β, IL-4, IL-6, IL-10, IL-12 and TNF-α) in schizophrenia patients and healthy controls. Measurements included neurological soft signs (NSS) to distinguish and subgroup those with neurodevelopmental impairments. The study included 210 schizophrenia patients, which were divided into 84 EOS and 126 AOS patients, as well as 122 healthy controls. We observed significant differences in levels of IL-4, IL-6 and IL-10 between EOS and AOS patients. The results demonstrated the area under ROC curve (AUC) of the IL-4 in EOS and healthy controls was 0.81. Moreover, these results indicated that AUC of the IL-4 and the combination of IL-4, IL-6 and IL-12 in EOS with NSS and healthy controls were 0.91 and 0.95. These cytokines are altered in EOS and schizophrenia patients with neurodevelopmental impairments and demonstrated good classification abilities. These findings manifested that both pro- and anti-inflammatory cytokines are contributed to the clinical and pathophysiological features of schizophrenia. Future works are expected to explore potential genetic effectors and predictors as well as therapeutic directions in personalized medicine for early-onset schizophrenia.
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Affiliation(s)
- Jia-Yun Liu
- Institute of Clinical Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan.,Department of Medical Research, Center for Medical Genetics, Changhua Christian Hospital, Changhua, Taiwan.,Department of Genomic Medicine, Center for Medical Genetics, Changhua Christian Hospital, Changhua, Taiwan
| | - Han-Yu Chen
- Institute of Clinical Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Jin-Jia Lin
- Department of Psychiatry, Chimei Medical Center, Tainan, Taiwan
| | - Ming-Kun Lu
- Department of Health, Jianan Mental Hospital, Tainan, Taiwan.,Department of Applied Life Science and Health, Chia Nan University of Pharmacy and Science, Tainan, Taiwan
| | - Hung-Pin Tan
- Department of Psychiatry, Kaohsiung Veterans General Hospital Tainan Branch, Tainan, Taiwan.,Department of Environmental and Occupational Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Fong-Lin Jang
- Department of Psychiatry, Chimei Medical Center, Tainan, Taiwan
| | - Sheng-Hsiang Lin
- Institute of Clinical Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan.,Department of Public Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan.,Biostatistics Consulting Center, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
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Risk Model Assessment in Early-Onset and Adult-Onset Schizophrenia Using Neurological Soft Signs. J Clin Med 2019; 8:jcm8091443. [PMID: 31514416 PMCID: PMC6781040 DOI: 10.3390/jcm8091443] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2019] [Revised: 08/25/2019] [Accepted: 09/09/2019] [Indexed: 11/17/2022] Open
Abstract
Age at onset is one of the most important clinical features of schizophrenia that could indicate greater genetic loadings. Neurological soft signs (NSS) are considered as a potential endophenotype for schizophrenia. However, the association between NSS and different age-onset schizophrenia still remains unclear. We aimed to compare risk model in patients with early-onset schizophrenia (EOS) and adult-onset schizophrenia (AOS) with NSS. This study included 262 schizophrenia patients, 177 unaffected first-degree relatives and 243 healthy controls. We estimated the discriminant abilities of NSS models for early-onset schizophrenia (onset age < 20) and adult-onset schizophrenia (onset age ≥ 20) using three data mining methods: artificial neural networks (ANN), decision trees (DT) and logistic regression (LR). We then assessed the magnitude of NSS performance in EOS and AOS families. For the four NSS subscales, the NSS performance were greater in EOS and AOS families compared with healthy individuals. More interestingly, there were significant differences found between patients' families and control group in the four subscales of NSS. These findings support the potential for neurodevelopmental markers to be used as schizophrenia vulnerability indicators. The NSS models had higher discriminant abilities for EOS than for AOS. NSS were more accurate in distinguishing EOS patients from healthy controls compared to AOS patients. Our results support the neurodevelopmental hypothesis that EOS has poorer performance of NSS than AOS. Hence, poorer NSS performance may be imply trait-related NSS feature in EOS.
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Social cognitions in siblings of patients with schizophrenia: a comparison with patients with schizophrenia and healthy controls - a cross-sectional study. Asian J Psychiatr 2019; 43:24-33. [PMID: 31078092 DOI: 10.1016/j.ajp.2019.04.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2018] [Revised: 03/04/2019] [Accepted: 04/22/2019] [Indexed: 12/24/2022]
Abstract
BACKGROUND There are limited number of studies which have evaluated social cognitive deficits among the siblings of patients with schizophrenia. AIM This study aimed to evaluate the social cognitive deficits and its correlates among siblings of patients with schizophrenia. METHODOLOGY Patients of schizophrenia (N = 34), their siblings (N = 34) and healthy control subjects (N = 31) matched for age, gender, education and intelligence quotient were evaluated on social cognition rating tools in Indian setting (SOCRATIS). Patients were additionally evaluated on Positive and Negative Symptom Scale (PANSS). Siblings were assessed on Comprehensive Assessment for at risk mental state (CAARMS) scale and Short Wisconsin Schizotypy scale. Neurocognitive test battery was applied to all the groups. RESULTS Patients with schizophrenia performed the worst and the healthy controls performed the best, with siblings falling intermediate on all the subtests of social cognition (except for externalizing bias and personalized bias) and neurocognition. There were negative correlation between some of the domains of social cognition and various domains of CAARMS. Higher level of schizotypy was associated with higher level of social cognitive deficits. CONCLUSION Social cognitive deficits can act as an important endophenotype for estimating the risk of schizophrenia in at risk siblings. Further, social cognitive deficits must be considered as important target for intervention among the at risk siblings to improve their outcome.
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Umesh S, Nizamie SH, Goyal N, Tikka S, Bose S. Social anhedonia and gamma band abnormalities as a composite/multivariate endophenotype for schizophrenia: a dense array EEG study. Early Interv Psychiatry 2018; 12:362-371. [PMID: 27001559 DOI: 10.1111/eip.12327] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2015] [Revised: 12/12/2015] [Accepted: 01/15/2016] [Indexed: 12/13/2022]
Abstract
AIM Social anhedonia and gamma band oscillations are proposed as a promising endophenotype for schizophrenia (SZ). The aim was to assess whether social anhedonia and spontaneous gamma band oscillations could be used as multivariate/composite endophenotypic measures for SZ. METHODS Sixty consented subjects, of which 20 remitted SZ patients, 20 unaffected siblings of patients with schizophrenia (US) and 20 healthy controls (HC) were recruited for the study. The Revised Social Anhedonia Scale, Temporal Experience of Pleasure Scale and the Schizotypal Personality Questionnaire assessed social anhedonia, temporal experience of pleasure and schizotypal features. All participants underwent awake, resting state 192-channel dense array electroencephalographic recording. Gamma spectral power and coherence were calculated. We performed chi-square test, one-way analysis of variance, Pearsons correlation coefficient and step-by-step linear discriminant functional analysis. RESULTS Social anhedonia was significantly higher and anticipatory aspects of pleasure were significantly lower in both SZ and US compared with HC. US scored significantly higher than HC in the Schizotypal Personality Questionnaire. Spectral power of high gamma band (>70 Hz) was significantly lower over the right temporo-parietal and midline regions in both SZ and US than HC. We accurately classified (85%) three groups when social anhedonia, high gamma band spectral power of midline, right frontal and right fronto-temporal interhemispheric gamma coherence were considered as composite measures rather than each variable representing independently. CONCLUSION We propose region-specific high gamma spectral 'power and coherence' and social anhedonia as composite/multivariate measures could be a useful measure in distinguishing schizophrenia patients and unaffected siblings from healthy controls.
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Affiliation(s)
- Shreekantiah Umesh
- KS Mani Centre for Cognitive Neurosciences and Department of Psychiatry, Central Institute of Psychiatry, Kanke, India
| | - S Haque Nizamie
- KS Mani Centre for Cognitive Neurosciences and Department of Psychiatry, Central Institute of Psychiatry, Kanke, India
| | - Nishant Goyal
- KS Mani Centre for Cognitive Neurosciences and Department of Psychiatry, Central Institute of Psychiatry, Kanke, India
| | - Saikrishna Tikka
- KS Mani Centre for Cognitive Neurosciences and Department of Psychiatry, Central Institute of Psychiatry, Kanke, India
| | - Swarnali Bose
- KS Mani Centre for Cognitive Neurosciences and Department of Psychiatry, Central Institute of Psychiatry, Kanke, India
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Hirjak D, Meyer-Lindenberg A, Kubera KM, Thomann PA, Wolf RC. Motor dysfunction as research domain in the period preceding manifest schizophrenia: A systematic review. Neurosci Biobehav Rev 2018; 87:87-105. [DOI: 10.1016/j.neubiorev.2018.01.011] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2017] [Revised: 01/08/2018] [Accepted: 01/21/2018] [Indexed: 12/13/2022]
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15
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Galindo L, Bergé D, Murray GK, Mané A, Bulbena A, Pérez V, Vilarroya O. Default Mode Network Aberrant Connectivity Associated with Neurological Soft Signs in Schizophrenia Patients and Unaffected Relatives. Front Psychiatry 2017; 8:298. [PMID: 29375404 PMCID: PMC5767074 DOI: 10.3389/fpsyt.2017.00298] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2017] [Accepted: 12/13/2017] [Indexed: 12/31/2022] Open
Abstract
Brain connectivity and neurological soft signs (NSS) are reportedly abnormal in schizophrenia and unaffected relatives, suggesting they might be useful neurobiological markers of the illness. NSS are discrete sensorimotor impairments thought to correspond to deviant brain development. Although NSS support the hypothesis that schizophrenia involves disruption in functional circuits involving several hetero modal association areas, little is known about the relationship between NSS and brain connectivity. We explored functional connectivity abnormalities of the default mode network (DMN) related to NSS in schizophrenia. A cross-sectional study was performed with 27 patients diagnosed with schizophrenia, 23 unaffected relatives who were unrelated to the schizophrenia subjects included in the study, and 35 healthy controls. Subjects underwent magnetic resonance imaging scans including a functional resting-state acquisition and NSS evaluation. Seed-to-voxel and independent component analyses were used to study brain connectivity. NSS scores were significantly different between groups, ranging from a higher to lower scores for patients, unaffected relatives, and healthy controls, respectively (analysis of variance effect of group F = 56.51, p < 0.001). The connectivity analysis revealed significant hyperconnectivity in the fusiform gyrus, insular and dorsolateral prefrontal cortices, inferior and middle frontal gyri, middle and superior temporal gyri, and posterior cingulate cortex [minimum p-family wise error (FWE) < 0.05 for all clusters] in patients with schizophrenia as compared with in controls. Also, unaffected relatives showed hyperconnectivity in relation to controls in the supramarginal association and dorsal posterior cingulate cortices (p-FWE < 0.05 for all clusters) in patients with schizophrenia as compared with in controls. Also, unaffected relatives showed hyperconnectivity in relation to controls in the supramarginal association and dorsal posterior cingulate cortices (p-FWE = 0.001) and in the anterior prefrontal cortex (42 voxels, p-FWE = 0.047). A negative correlation was found between left caudate connectivity and NSS [p-FWE = 0.044, cluster size (k) = 110 voxels]. These findings support the theory of widespread abnormal connectivity in schizophrenia, reinforcing DMN hyperconnectivity and NSS as neurobiological markers of schizophrenia. The results also indicate the caudate nucleus as the gateway to the motor consequences of abnormal DMN connectivity.
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Affiliation(s)
- Liliana Galindo
- Neuroimaging Research Group, Neuroscience, Institut Hospital del Mar d'Investigacions Mèdiques, Barcelona, Spain.,Department of Psychiatry, University of Cambridge, Cambridge, United Kingdom
| | - Daniel Bergé
- Neuroimaging Research Group, Neuroscience, Institut Hospital del Mar d'Investigacions Mèdiques, Barcelona, Spain.,Cognitive Neuroscience Research Group, Psychiatry and Forensic Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Salud Mental, Madrid, Spain
| | - Graham K Murray
- Department of Psychiatry, University of Cambridge, Cambridge, United Kingdom.,Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge, United Kingdom.,Institute of Behavioural and Clinical Neuroscience, University of Cambridge, Cambridge, United Kingdom
| | - Anna Mané
- Neuroimaging Research Group, Neuroscience, Institut Hospital del Mar d'Investigacions Mèdiques, Barcelona, Spain.,Cognitive Neuroscience Research Group, Psychiatry and Forensic Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Salud Mental, Madrid, Spain
| | - Antonio Bulbena
- Neuroimaging Research Group, Neuroscience, Institut Hospital del Mar d'Investigacions Mèdiques, Barcelona, Spain.,Cognitive Neuroscience Research Group, Psychiatry and Forensic Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Victor Pérez
- Neuroimaging Research Group, Neuroscience, Institut Hospital del Mar d'Investigacions Mèdiques, Barcelona, Spain.,Cognitive Neuroscience Research Group, Psychiatry and Forensic Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Salud Mental, Madrid, Spain
| | - Oscar Vilarroya
- Neuroimaging Research Group, Neuroscience, Institut Hospital del Mar d'Investigacions Mèdiques, Barcelona, Spain.,Cognitive Neuroscience Research Group, Psychiatry and Forensic Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
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16
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Association between coding single nucleotide polymorphisms in ADAMTS20 and schizophrenia in a Korean population. Psychiatry Res 2016; 246:332-334. [PMID: 27750115 DOI: 10.1016/j.psychres.2016.09.051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2016] [Revised: 08/25/2016] [Accepted: 09/27/2016] [Indexed: 10/20/2022]
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17
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Delice M, Gurbuz O, Oflezer C, Kurt E, Mandali G. Palate size and shape in schizophrenia. Psychiatry Res 2016; 244:273-8. [PMID: 27512914 DOI: 10.1016/j.psychres.2016.05.035] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2015] [Revised: 03/17/2016] [Accepted: 05/03/2016] [Indexed: 10/21/2022]
Abstract
The palate is considered typical of the structures in which schizophrenia-related minor physical anomalies may occur. In this study, we aimed to compare the dimensions and form of palate in patients with schizophrenia with nonpsychiatric controls in a blinded manner. Dental stone casts of 127 patients with schizophrenia and 127 controls were prepared from impressions of the maxillary dental arch. Palate dimensions were measured on the stone casts using a digital caliper and palatometer. Palate length did not differ significantly between the groups, but there was a significant difference in palate width and depth, which were significantly higher in the schizophrenia group. As a result of using multivariate analysis for assessing independent risk factors affecting patients with schizophrenia, furrowed palate shape, palate width, and ellipsoid maxillary dental arch shape were found to be significant. This study also revealed that patients with schizophrenia demonstrate certain gender-related predilections in the differences of palate parameters compared to same-sex controls. As the palate develops in conjunction with both the face and brain, our study findings can significantly contribute to the assumption that there might be structural abnormalities of the palate that could represent specific markers of embryological dysmorphogenesis underlying schizophrenia.
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Affiliation(s)
- Mehtap Delice
- Department of Psychiatry, Bakirkoy Training and Research Hospital for Psychiatry, Neurology and Neurosurgery, Istanbul, Turkey
| | - Ozlem Gurbuz
- Department of Prosthetic Dentistry, Bakirkoy Training and Research Hospital for Psychiatry, Neurology and Neurosurgery, Istanbul, Turkey.
| | - Ceyhan Oflezer
- Department of Anesthesiology, Bakirkoy Training and Research Hospital for Psychiatry, Neurology and Neurosurgery, Istanbul, Turkey
| | - Erhan Kurt
- Department of Psychiatry, Bakirkoy Training and Research Hospital for Psychiatry, Neurology and Neurosurgery, Istanbul, Turkey
| | - Gamze Mandali
- Department of Prosthetic Dentistry, Oral and Dental Health Hospital, Okmeydani, Istanbul, Turkey
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18
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Tsai IN, Lin JJ, Lu MK, Tan HP, Jang FL, Gan ST, Lin SH. Improving risk assessment and familial aggregation of age at onset in schizophrenia using minor physical anomalies and craniofacial measures. Medicine (Baltimore) 2016; 95:e4406. [PMID: 27472737 PMCID: PMC5265874 DOI: 10.1097/md.0000000000004406] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Age at onset is the most important feature of schizophrenia that could indicate its origin. Minor physical anomalies (MPAs) characterize potential marker indices of disturbances in early neurodevelopment. However, the association between MPAs and age at onset of schizophrenia is still unclear. We aimed to compare risk assessment and familial aggregation in patients with early-onset schizophrenia (EOS) and adult-onset schizophrenia (AOS) with MPAs and craniofacial measures.We estimated the risk assessment of MPAs among patients with EOS (n = 68), patients with AOS (n = 183), nonpsychotic relatives (n = 147), and healthy controls (n = 241) using 3 data-mining algorithms. In addition, we assessed the magnitude of familial aggregation of MPAs with respect to the age at onset of schizophrenia.The performance of EOS was superior to that of AOS, with discrimination accuracies of 89% and 76%, respectively. Combined MPA scores as the risk assessment were significantly higher in all schizophrenia subgroups and the nonpsychotic relatives of EOS patients than in the healthy controls. The recurrence risk ratio for familial aggregation of the MPA scores of EOS families (odds ratio 9.27) was substantially higher than that of AOS families (odds ratio 2.47).The results highlight that EOS improves risk assessment and has a severe magnitude of familial aggregation of MPAs. These findings indicate that EOS might result from a stronger genetic susceptibility to neurodevelopmental deficits.
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Affiliation(s)
- I-Ning Tsai
- Institute of Clinical Medicine, College of Medicine, National Cheng Kung University
| | - Jin-Jia Lin
- Department of Psychiatry, Chimei Medical Center
| | - Ming-Kun Lu
- Department of Health, Jianan Mental Hospital
- Department of Applied Life Science and Health, Chia Nan University of Pharmacy and Science
| | - Hung-Pin Tan
- Department of Psychiatry, Kaohsiung Veterans General Hospital Tainan Branch
- Department of Acupressure Technology, Chung Hwa University of Medical Technology
- Department of Environmental and Occupational Health, College of Medicine, National Cheng Kung University
| | | | - Shu-Ting Gan
- Institute of Clinical Medicine, College of Medicine, National Cheng Kung University
| | - Sheng-Hsiang Lin
- Institute of Clinical Medicine, College of Medicine, National Cheng Kung University
- Biostatistics Consulting Center, National Cheng Kung University Hospital, Tainan, Taiwan
- Correspondence: Sheng-Hsiang Lin, Institute of Clinical Medicine, College of Medicine, National Cheng Kung University, 138, Shengli Road, Tainan, Taiwan (e-mail: )
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19
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Demirel OF, Demirel A, Kadak MT, Emül M, Duran A. Neurological soft signs in antisocial men and relation with psychopathy. Psychiatry Res 2016; 240:248-252. [PMID: 27131626 DOI: 10.1016/j.psychres.2016.04.094] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2015] [Revised: 12/28/2015] [Accepted: 04/25/2016] [Indexed: 11/17/2022]
Abstract
Neurological soft signs (NSS) were studied in some axis-I disorders like schizophrenia, obsessive compulsive disorder, bipolar disorder, alcohol and substance abuse disorder. Aim of this study is detection of neurological soft signs in antisocial personality disorder and relation of these signs with psychopathy. The study was included 41 antisocial men and 41 healthy control subjects. Sociodemographic form, neurological evaluation scale and Hare psychopathy checklist was applied to the antisocial subjects, whereas sociodemographic form and neurological evaluation scale were applied to the controls. Antisocial men exhibited significiantly more NSS in total score and subgroups scales (p<0.05). It was shown that there was a significant association with psychopathy scores and NSS sequencing complex motor tasks (r=0.309; p=0.049) and NSS other tests subgroup scores (r=0.328; p=0.037). Similar relation was also observed in comparison between psychopathy subgroups. NSS accepted as being endophenotypes in schizophrenia, were also detected in antisocial group significantly more than controls in our study. Significant relationship between psychopathy and NSS may also hint the role of genetic mechanisms in personality development, though new extended studies with larger sample size are needed for clarification of this relationship.
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Affiliation(s)
- Omer Faruk Demirel
- Department of Psychiatry, Cerrahpaşa Faculty of Medicine, Istanbul University, Turkey.
| | - Aysegul Demirel
- Department of Psychiatry, Cerrahpaşa Faculty of Medicine, Istanbul University, Turkey
| | - Muhammed Tayyib Kadak
- Department of Child and Adolescent Psychiatry, Cerrahpaşa Faculty of Medicine, Istanbul University, Turkey
| | - Murat Emül
- Department of Psychiatry, Cerrahpaşa Faculty of Medicine, Istanbul University, Turkey
| | - Alaattin Duran
- Department of Psychiatry, Cerrahpaşa Faculty of Medicine, Istanbul University, Turkey
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20
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Galindo L, Pastoriza F, Bergé D, Mané A, Picado M, Bulbena A, Robledo P, Pérez V, Vilarroya O, Cloninger CR. Association between neurological soft signs, temperament and character in patients with schizophrenia and non-psychotic relatives. PeerJ 2016; 4:e1651. [PMID: 27168955 PMCID: PMC4860298 DOI: 10.7717/peerj.1651] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2015] [Accepted: 01/12/2016] [Indexed: 11/26/2022] Open
Abstract
The heritability of schizophrenia and most personality traits has been well established, but the role of personality in susceptibility to schizophrenia remains uncertain. The aim of this study was to test for an association between personality traits and Neurological Soft Signs (NSS), a well-known biological marker of schizophrenia, in non-psychotic relatives of patients with schizophrenia. For this purpose, we evaluated the NSS scale and personality measured by the Temperament and Character inventory (TCI-R) in three groups of subjects: 29 patients with schizophrenia, 24 unaffected relatives and 37 controls. The results showed that patients with schizophrenia were more asocial (higher harm avoidance and lower reward dependence), more perseverative (higher persistence), and more schizotypal (lower self-directedness and cooperativeness, higher self-transcendence). The unaffected relatives showed higher harm avoidance, lower self-directedness and cooperativeness than the healthy controls. Higher NSS scores and sub-scores were found in patients and non-psychotic relatives compared with the controls. Among all the patients, total NSS scores were positively correlated with harm avoidance but negatively correlated with novelty seeking and persistence. Total NSS were also correlated with low scores on self-directedness and cooperativeness, which are indicators of personality disorder. Our results show that susceptibility to NSS and to schizophrenia are both related to individual differences in the temperament and character features in non-psychotic relatives of patients with schizophrenia. High harm avoidance, low persistence, low self-directedness and low cooperativeness contribute to both the risk of NSS and schizophrenia. These findings highlight the value of using both assessments to study high risk populations.
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Affiliation(s)
- Liliana Galindo
- Neuropsychiatry and Addiction Institute, Parc de Salut Mar, Barcelona, Spain; Neurosciences Research Programme, Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain; Departament de Psiquiatria i Medicina Legal, Universitat Autónoma de Barcelona, Cerdanyola del Vallés, Spain; Red de Trastornos Adictivos, RETIC, Spain
| | - Francisco Pastoriza
- Neurosciences Research Programme, Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain; Departament de Psiquiatria i Medicina Legal, Universitat Autónoma de Barcelona, Cerdanyola del Vallés, Spain
| | - Daniel Bergé
- Neuropsychiatry and Addiction Institute, Parc de Salut Mar, Barcelona, Spain; Neurosciences Research Programme, Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain; Departament de Psiquiatria i Medicina Legal, Universitat Autónoma de Barcelona, Cerdanyola del Vallés, Spain; Neuropharmacology, Universitat Pompeu Fabra, Barcelona, Spain
| | - Anna Mané
- Neuropsychiatry and Addiction Institute, Parc de Salut Mar, Barcelona, Spain; Neurosciences Research Programme, Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM G21, Spain
| | - Marisol Picado
- Neurosciences Research Programme, Hospital del Mar Medical Research Institute (IMIM) , Barcelona , Spain
| | - Antonio Bulbena
- Neuropsychiatry and Addiction Institute, Parc de Salut Mar, Barcelona, Spain; Neurosciences Research Programme, Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain; Departament de Psiquiatria i Medicina Legal, Universitat Autónoma de Barcelona, Cerdanyola del Vallés, Spain; Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM G21, Spain
| | - Patricia Robledo
- Neurosciences Research Programme, Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain; Neuropharmacology, Universitat Pompeu Fabra, Barcelona, Spain
| | - Victor Pérez
- Neuropsychiatry and Addiction Institute, Parc de Salut Mar, Barcelona, Spain; Neurosciences Research Programme, Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain; Departament de Psiquiatria i Medicina Legal, Universitat Autónoma de Barcelona, Cerdanyola del Vallés, Spain; Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM G21, Spain
| | - Oscar Vilarroya
- Neurosciences Research Programme, Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain; Departament de Psiquiatria i Medicina Legal, Universitat Autónoma de Barcelona, Cerdanyola del Vallés, Spain
| | - Claude Robert Cloninger
- Department of Psychiatry and Genetics, Washington University in St. Louis , Saint Louis, MO , United States
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21
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Hajnal A, Csábi G, Herold R, Jeges S, Halmai T, Trixler D, Simon M, Tóth ÁL, Tényi T. Minor physical anomalies are more common among the first-degree unaffected relatives of schizophrenia patients - Results with the Méhes Scale. Psychiatry Res 2016; 237:224-8. [PMID: 26803362 DOI: 10.1016/j.psychres.2016.01.036] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2015] [Revised: 07/28/2015] [Accepted: 01/15/2016] [Indexed: 02/05/2023]
Abstract
Minor physical anomalies are external markers of abnormal brain development,so the more common appearance of these signs among the relatives of schizophrenia patients can confirm minor physical anomalies as intermediate phenotypes. The aim of the present study was to investigate the rate and topological profile of minor physical anomalies in the first-degree unaffected relatives of patients with schizophrenia compared to matched normal control subjects. Using a list of 57 minor physical anomalies (the Méhes Scale), 20 relatives of patients with the diagnosis of schizophrenia and as a comparison 20 matched normal control subjects were examined. Minor physical anomalies were more common in the head and mouth regions among the relatives of schizophrenia patients compared to normal controls. By the differentiation of minor malformations and phenogenetic variants, we have found that only phenogenetic variants were more common in the relatives of schizophrenia patients compared to the control group, however individual analyses showed, that one minor malformation (flat forehead) was more prevalent in the relative group. The results can promote the concept, that minor physical anomalies can be endophenotypic markers of the illness.
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Affiliation(s)
- András Hajnal
- Department of Psychiatry and Psychotherapy, University of Pécs, Faculty of Medicine, Rét u.2.H, 7623 Pécs, Hungary
| | - Györgyi Csábi
- Department of Pediatrics, University of Pécs, Faculty of Medicine, Pécs, Hungary
| | - Róbert Herold
- Department of Psychiatry and Psychotherapy, University of Pécs, Faculty of Medicine, Rét u.2.H, 7623 Pécs, Hungary
| | - Sára Jeges
- Institute of Nursing and Patients Care, Faculty of Health Sciences, University of Pécs, Hungary
| | - Tamás Halmai
- Department of Clinical and Theoretical Mental Health, Semmelweis University, Faculty of Medicine, Hungary
| | - Dániel Trixler
- Department of Psychiatry and Psychotherapy, University of Pécs, Faculty of Medicine, Rét u.2.H, 7623 Pécs, Hungary
| | - Maria Simon
- Department of Psychiatry and Psychotherapy, University of Pécs, Faculty of Medicine, Rét u.2.H, 7623 Pécs, Hungary
| | - Ákos Levente Tóth
- Institute of Physical Education and Sport Science, Faculty of Sciences, University of Pécs, Hungary
| | - Tamás Tényi
- Department of Psychiatry and Psychotherapy, University of Pécs, Faculty of Medicine, Rét u.2.H, 7623 Pécs, Hungary.
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22
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Mrad A, Wassim Krir M, Ajmi I, Gaha L, Mechri A. Neurological soft signs in euthymic bipolar I patients: A comparative study with healthy siblings and controls. Psychiatry Res 2016; 236:173-178. [PMID: 26775167 DOI: 10.1016/j.psychres.2015.11.047] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2015] [Revised: 07/28/2015] [Accepted: 11/27/2015] [Indexed: 10/22/2022]
Abstract
Neurological Soft Signs (NSS) are endophenotypic markers widely studied in schizophrenia and remain poorly evaluated in bipolar disorder. The aims of this paper were to determine the prevalence and scores of NSS in bipolar I patients, compared to healthy siblings and controls and to explore correlations with socio-demographic and clinical features of patients. This was a case-control study comparing 92 euthymic bipolar I patients, 44 of their healthy siblings and 60 control subjects. The neurological assessment was performed through the NSS scale validated by Krebs et al. (2000). Bipolar I patients were also assessed with the Bech-Rafaelsen Mania Scale (MAS), the Hamilton Depression Rating Scale (HDRS) and the Global Assessment of Functioning (GAF). The raters were not blinded to groups. The prevalence and the total score of NSS were significantly higher in bipolar I patients compared to their healthy siblings and controls. The sibling group had significantly higher NSS prevalence and total score than controls. No correlation was found between NSS total score and socio-demographic and clinical features of patients, except a negative correlation with the school level and the GAF score. In conclusion, bipolar I patients have motor and sensory signs, which are unrelated to their clinical features.
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Affiliation(s)
- Amel Mrad
- Research Laboratory "Vulnerability to Psychotic Disorders", Department of Psychiatry, Fattouma Bourguiba University Hospital, Monastir, Tunisia.
| | - Mohamed Wassim Krir
- Research Laboratory "Vulnerability to Psychotic Disorders", Department of Psychiatry, Fattouma Bourguiba University Hospital, Monastir, Tunisia
| | - Inès Ajmi
- Research Laboratory "Vulnerability to Psychotic Disorders", Department of Psychiatry, Fattouma Bourguiba University Hospital, Monastir, Tunisia
| | - Lotfi Gaha
- Research Laboratory "Vulnerability to Psychotic Disorders", Department of Psychiatry, Fattouma Bourguiba University Hospital, Monastir, Tunisia
| | - Anwar Mechri
- Research Laboratory "Vulnerability to Psychotic Disorders", Department of Psychiatry, Fattouma Bourguiba University Hospital, Monastir, Tunisia
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23
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Gong J, Xie J, Chen G, Zhang Y, Wang S. Neurological soft signs in children with attention deficit hyperactivity disorder: Their relationship to executive function and parental neurological soft signs. Psychiatry Res 2015; 228:77-82. [PMID: 25943836 DOI: 10.1016/j.psychres.2015.04.017] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2014] [Revised: 03/29/2015] [Accepted: 04/15/2015] [Indexed: 11/15/2022]
Abstract
The correlations between neurological soft signs (NSS) in children with attention deficit hyperactivity disorder (ADHD) and their executive function, symptoms of inattention, and hyperactivity-impulsivity and the NSS of their parents remain unclear. This study aimed to examine: (1) the prevalence of NSS in children with ADHD and their parents; (2) the correlation between the NSS of children with ADHD and the NSS of their parents; and (3) the correlation between the NSS of children with ADHD and their executive function and symptoms. NSS were assessed with the Cambridge Neurological Inventory (CNI) in 57 children with ADHD (and 80 parents) and 60 healthy children (and 75 parents). Executive function was measured with the Behavioral Rating Inventory of Executive Function (BRIEF). Children with ADHD and their parents had significantly higher NSS than normal children and their parents, respectively, and the NSS of children with ADHD were correlated more strongly with the NSS of their fathers than their mothers. No correlation was found between NSS and BRIEF executive function, but Disinhibition in children with ADHD was significantly correlated with hyperactivity-impulsivity symptoms. Paternal and maternal NSS provided different predictions for child NSS. It may be that NSS are more likely to be genetically transmitted by fathers.
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Affiliation(s)
- Jingbo Gong
- Department of Applied Psychology, Traditional Chinese Medicine University of Hunan, Changsha 410208, Hunan, China
| | - Jingtao Xie
- Department of Applied Psychology, Traditional Chinese Medicine University of Hunan, Changsha 410208, Hunan, China
| | - Gui Chen
- Department of Social Medicine and Health Management, School of Public Health, Central South University, Changsha, Hunan, China
| | - Yajie Zhang
- Department of Applied Psychology, Traditional Chinese Medicine University of Hunan, Changsha 410208, Hunan, China
| | - Suhong Wang
- Department of Neuroscience, The Third Affiliated Hospital of Soochow University, Juqian Road No. 185, Changzhou 213003, China.
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Lin AS, Chang SS, Lin SH, Peng YC, Hwu HG, Chen WJ. Minor physical anomalies and craniofacial measures in patients with treatment-resistant schizophrenia. Psychol Med 2015; 45:1839-1850. [PMID: 25515974 DOI: 10.1017/s0033291714002931] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND Schizophrenia patients have higher rates of minor physical anomalies (MPAs) than controls, particularly in the craniofacial region; this difference lends support to the neurodevelopmental model of schizophrenia. Whether MPAs are associated with treatment response in schizophrenia remains unknown. The aim of this case-control study was to investigate whether more MPAs and specific quantitative craniofacial features in patients with schizophrenia are associated with operationally defined treatment resistance. METHOD A comprehensive scale, consisting of both qualitatively measured MPAs and quantitative measurements of the head and face, was applied in 108 patients with treatment-resistant schizophrenia (TRS) and in 104 non-TRS patients. Treatment resistance was determined according to the criteria proposed by Conley & Kelly (2001; Biological Psychiatry 50, 898-911). RESULTS Our results revealed that patients with TRS had higher MPA scores in the mouth region than non-TRS patients, and the two groups also differed in four quantitative measurements (facial width, lower facial height, facial height, and length of the philtrum), after controlling for multiple comparisons using the false discovery rate. Among these dysmorphological measurements, three MPA item types (mouth MPA score, facial width, and lower facial height) and earlier disease onset were further demonstrated to have good discriminant validity in distinguishing TRS from non-TRS patients in a multivariable logistic regression analysis, with an area under the curve of 0.84 and a generalized R 2 of 0.32. CONCLUSIONS These findings suggest that certain MPAs and craniofacial features may serve as useful markers for identifying TRS at early stages of the illness.
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Affiliation(s)
- A-S Lin
- Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University,17 Xu-Zhou Road,Taipei 100,Taiwan
| | - S-S Chang
- Hong Kong Jockey Club Centre for Suicide Research and Prevention, University of Hong Kong,Hong Kong Special Administrative Region,People's Republic of China
| | - S-H Lin
- Institute of Clinical Medicine, College of Medicine, National Cheng Kung University,Tainan,Taiwan
| | - Y-C Peng
- Department of General Psychiatry,Bali Psychiatric Center, Ministry of Health and Welfare,New Taipei City,Taiwan
| | - H-G Hwu
- Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University,17 Xu-Zhou Road,Taipei 100,Taiwan
| | - W J Chen
- Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University,17 Xu-Zhou Road,Taipei 100,Taiwan
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Debnath M, Venkatasubramanian G, Berk M. Fetal programming of schizophrenia: select mechanisms. Neurosci Biobehav Rev 2015; 49:90-104. [PMID: 25496904 PMCID: PMC7112550 DOI: 10.1016/j.neubiorev.2014.12.003] [Citation(s) in RCA: 48] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2014] [Revised: 11/24/2014] [Accepted: 12/01/2014] [Indexed: 12/16/2022]
Abstract
Mounting evidence indicates that schizophrenia is associated with adverse intrauterine experiences. An adverse or suboptimal fetal environment can cause irreversible changes in brain that can subsequently exert long-lasting effects through resetting a diverse array of biological systems including endocrine, immune and nervous. It is evident from animal and imaging studies that subtle variations in the intrauterine environment can cause recognizable differences in brain structure and cognitive functions in the offspring. A wide variety of environmental factors may play a role in precipitating the emergent developmental dysregulation and the consequent evolution of psychiatric traits in early adulthood by inducing inflammatory, oxidative and nitrosative stress (IO&NS) pathways, mitochondrial dysfunction, apoptosis, and epigenetic dysregulation. However, the precise mechanisms behind such relationships and the specificity of the risk factors for schizophrenia remain exploratory. Considering the paucity of knowledge on fetal programming of schizophrenia, it is timely to consolidate the recent advances in the field and put forward an integrated overview of the mechanisms associated with fetal origin of schizophrenia.
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Affiliation(s)
- Monojit Debnath
- Department of Human Genetics, National Institute of Mental Health & Neurosciences, Bangalore 560029, India.
| | - Ganesan Venkatasubramanian
- Translational Psychiatry Laboratory, Neurobiology Research Centre and Department of Psychiatry, National Institute of Mental Health & Neurosciences, Hosur Road, Bangalore 560029, India
| | - Michael Berk
- IMPACT Strategic Research Centre, School of Medicine, Deakin University, Barwon Health, Geelong, Victoria, Australia; Department of Psychiatry, The Florey Institute of Neuroscience and Mental Health, and Orygen, The National Centre of Excellence in Youth Mental Health, University of Melbourne, Parkville, Australia
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Ambrosio-Gallardo F, Cruz-Fuentes C, Heinze-Martin G, Caraveo-Anduaga J, Cortés-Sotres J. Study of minor physical anomalies in complete nuclear Mexican families. Evidence of neurodevelopmental problems in schizophrenia. PLoS One 2015; 10:e0117080. [PMID: 25612094 PMCID: PMC4303412 DOI: 10.1371/journal.pone.0117080] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2014] [Accepted: 12/15/2014] [Indexed: 11/24/2022] Open
Abstract
Introduction Minor physical anomalies (MPA) are dysmorphic features that reflect deviations in early development, are morphological variants that appear during the first trimester of pregnancy and could be used as a marker of disease risk in susceptible people. The literature agrees that the number of MPA is higher in patients with schizophrenia compared with their relatives and healthy subjects. The purpose of this study is to compare the MPA, assessed using the Gourion Scale, in complete nuclear families (families with a member with schizophrenia and control families) by determining the MPA mean, concordance and heritability for the total score on the MPA Gourion Scale for each anomaly. Method The sample consisted of 60 families with at least one schizophrenic patient (284 members) and 61 control families (249 members). Results: The mean total score for the scale was 5.72 ± 2.3 MPA in the case of families with at least one schizophrenic patient and 1.8 ± 4.46 MPA for control families. The average for families of patients without considering the patient in the analysis was 5.59 ± 2.3 MPA; for patients, the mean was 6.14 ± 2.4 MPA. In the analysis by anomaly differences were found only in eleven anomalies found no evidence of heritability or concordance. Conclusions MPA occur more frequently in patients, but a pattern of low consistency between them persists. It is concluded that MPA could be a marker of neurodevelopmental problems, but it is not suitable to consider them a Gourion scale as endophenotype.
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Affiliation(s)
| | - Carlos Cruz-Fuentes
- Departamento de Genética, Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz, México City, Mexico
| | - Gerhard Heinze-Martin
- Departamento de Psiquiatría y Salud Mental, Facultad de Medicina, Universidad Autónoma de México, Mexico City, Mexico
| | - Jorge Caraveo-Anduaga
- Investigaciones Epidemiológicas y Sociales, Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz, México City, Mexico
| | - José Cortés-Sotres
- Departamento de Apoyo Académico, Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz, México City, Mexico
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Tikka SK, Nizamie SH, Goyal N, Pradhan N, Tikka DL, Katshu MZUH. Evaluation of spontaneous dense array gamma oscillatory activity and minor physical anomalies as a composite neurodevelopmental endophenotype in schizophrenia. Int J Dev Neurosci 2014; 40:43-51. [PMID: 25450528 DOI: 10.1016/j.ijdevneu.2014.11.002] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2014] [Revised: 10/14/2014] [Accepted: 11/09/2014] [Indexed: 12/15/2022] Open
Abstract
OBJECTIVE Minor physical anomalies (MPAs) and gamma oscillatory activity have been proposed as associated endophenotypes in schizophrenia. Combining these endophenotypes to create a composite endophenotype may help identify those at risk for schizophrenia better. The present study aims to investigate MPAs and gamma oscillatory activity in schizophrenia patients, their unaffected first degree relatives and healthy controls and appreciate whether they can be used together as a composite endophenotype. METHODS This was a cross sectional family study conducted at a tertiary care mental health setup. Ninety participants including schizophrenia patients, their first degree relatives and controls (thirty each) were assessed for MPAs on the Extended Waldrop Scale. All participants underwent an awake, resting 192-channel EEG recording. Spectral power and coherence in 30-100Hz gamma bands were estimated using Welch's averaged periodogram method. One-way ANOVA, chi square test were used for comparing socio-demographic-clinical variables. MANOVA supplemented by one-way ANOVAs (post hoc Tukey HSD) were done for comparison of spectral measures. Pearson's correlation, step-by-step linear discriminant functional and intra-familial correlation analysis were subsequently performed. RESULTS An endophenotype pattern of finding was found for MPAs in the craniofacial region, the total number of MPAs, spectral power in right temporal region on all bands and in the right parietal region in 50-70Hz and 70-100Hz gamma bands. The three groups were most accurately classified when MPA total score, right temporal 30-50Hz gamma power and right occipital 'intra hemispheric' 50-70Hz gamma coherence were considered together than when considered independently. Significant intra familial correlation was seen for MPA total score and right temporal gamma 30-50Hz power. CONCLUSION Composite evaluation of two developmentally linked markers i.e. MPAs and gamma spectral measures may prove useful in categorizing schizophrenia and identifying at-risk individuals.
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Affiliation(s)
- Sai Krishna Tikka
- KS Mani Center for Cognitive Neurosciences and Department of Psychiatry, Central Institute of Psychiatry, Kanke, Ranchi, Jharkhand 834006, India.
| | - S Haque Nizamie
- KS Mani Center for Cognitive Neurosciences and Department of Psychiatry, Central Institute of Psychiatry, Kanke, Ranchi, Jharkhand 834006, India
| | - Nishant Goyal
- KS Mani Center for Cognitive Neurosciences and Department of Psychiatry, Central Institute of Psychiatry, Kanke, Ranchi, Jharkhand 834006, India
| | - N Pradhan
- Department of Psychopharmacology, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka 560029, India
| | - Deyashini Lahiri Tikka
- Department of Clinical Psychology, Central Institute of Psychiatry, Kanke, Ranchi, Jharkhand 834006, India
| | - Mohammad Zia Ul Haq Katshu
- Division of Psychiatry and Applied Psychology, School of Medicine, University of Nottingham, NG7 2TU, United Kingdom
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Akabaliev VH, Sivkov ST, Mantarkov MY. Minor physical anomalies in schizophrenia and bipolar I disorder and the neurodevelopmental continuum of psychosis. Bipolar Disord 2014; 16:633-41. [PMID: 24798215 DOI: 10.1111/bdi.12211] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2011] [Accepted: 11/26/2013] [Indexed: 11/26/2022]
Abstract
OBJECTIVES Minor physical anomalies (MPAs) have been investigated by numerous studies in patients with schizophrenia in support of the neurodevelopmental hypothesis of the disorder, but have rarely been examined in patients with bipolar disorder or in direct comparisons between the two conditions. The main objective of the present study was to compare the prevalence of MPAs in psychiatrically healthy controls, patients with bipolar I disorder, and patients with schizophrenia. METHODS A slightly modified version of the Waldrop Physical Anomaly Scale was used to assess MPAs in psychiatrically healthy controls (n = 103), patients with bipolar I disorder (n = 61), and patients with schizophrenia (n = 128). RESULTS In five out of six topographic regions (mouth, feet, head, eyes, and ears) there was a pattern of lowest regional MPA scores in controls, intermediate in bipolar I disorder, and highest in schizophrenia. The cephalofacial composite score and the total MPA score showed the same pattern, with all between-group differences being statistically significant. Seven individual MPAs in the discriminant analysis model contributed independently to the prediction of the triple-dependent status of 'psychiatrically healthy control, bipolar I disorder patient, schizophrenia patient': high/arched palate, fine electric hair, large gap between first and second toes, third toe ≥ second toe, epicanthus, malformed ears, and furrowed tongue. CONCLUSIONS Our findings support the existence of a continuum of neurodevelopmental adversity within the clinical spectrum of psychosis, with bipolar I disorder occupying an intermediate position between psychiatric health and schizophrenia.
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Massuda R, Bücker J, Czepielewski LS, Narvaez JC, Pedrini M, Santos BT, Teixeira AS, Souza AL, Vasconcelos-Moreno MP, Vianna-Sulzbach M, Goi PD, Belmonte-de-Abreu P, Gama CS. Verbal memory impairment in healthy siblings of patients with schizophrenia. Schizophr Res 2013; 150:580-2. [PMID: 24035560 DOI: 10.1016/j.schres.2013.08.019] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2013] [Revised: 08/13/2013] [Accepted: 08/15/2013] [Indexed: 01/03/2023]
Abstract
Cognitive deficits have been recognized as a core feature of schizophrenia (SZ) and are present in most patients. Verbal memory (VM), working memory (WM), and executive function (EF) are domains commonly impaired in patients with SZ. These latter domains have been related to the genetic risk of the disorder characterizing as possible endophenotypes. In order to study neurocognitive endophenotypes in a Brazilian population with elevated genetic risks to develop SZ, we measured VM (Hopkins Verbal Learning Test Revised), WM (Letter-Number Sequencing and Digit Span) and EF (Stroop Test) in 90 subjects (45 unaffected siblings of patients with SZ and 45 matched healthy controls). No differences were found in EF and WM (Letter-Number Sequencing and Digit Span). However, in VM, siblings of patients performed worse than controls on the immediate recall and delayed recall. Our results suggest that VM impairment could be considered an endophenotype of SZ.
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Affiliation(s)
- Raffael Massuda
- Laboratory of Molecular Psychiatry, INCT for Translational Medicine, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.
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Levit-Binnun N, Davidovitch M, Golland Y. Sensory and motor secondary symptoms as indicators of brain vulnerability. J Neurodev Disord 2013; 5:26. [PMID: 24063566 PMCID: PMC3849186 DOI: 10.1186/1866-1955-5-26] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2013] [Accepted: 09/04/2013] [Indexed: 01/20/2023] Open
Abstract
In addition to the primary symptoms that distinguish one disorder from the next, clinicians have identified, yet largely overlooked, another set of symptoms that appear across many disorders, termed secondary symptoms. In the emerging era of systems neuroscience, which highlights that many disorders share common deficits in global network features, the nonspecific nature of secondary symptoms should attract attention. Herein we provide a scholarly review of the literature on a subset of secondary symptoms––sensory and motor. We demonstrate that their pattern of appearance––across a wide range of psychopathologies, much before the full-blown disorder appears, and in healthy individuals who display a variety of negative symptoms––resembles the pattern of appearance of network abnormalities. We propose that sensory and motor secondary symptoms can be important indicators of underlying network aberrations and thus of vulnerable brain states putting individuals at risk for psychopathology following extreme circumstances.
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Affiliation(s)
- Nava Levit-Binnun
- Interdisciplinary Center (IDC), Sagol Unit for Applied Neuroscience, School of Psychology, POB 167, Herzliya 46150, Israel.
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Lin Y, Ma X, Deng W, Han Y, Li M, Liu X, Loh EW, Li T. Minor physical anomalies in patients with schizophrenia in a Chinese population. Psychiatry Res 2012; 200:223-7. [PMID: 22884216 DOI: 10.1016/j.psychres.2012.07.022] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2012] [Revised: 06/15/2012] [Accepted: 07/13/2012] [Indexed: 02/05/2023]
Abstract
Studies have shown that minor physical anomalies (MPAs) may be associated with schizophrenia. However, it remains unclear whether any items of MPAs are more associated with schizophrenia than the others. We aimed to examine which specific MPAs are more associated with schizophrenia than others. A total of 154 patients with schizophrenia and 152 healthy controls were assessed using candidate MPAs items along with items from the Waldrop scale. Significant differences were found between the patients and controls in inner canthal distance, epicanthus, adherent ear lobe, cuspidal ear and length difference from section index to ring finger (2D:4D length difference) as well as gap between the first and the second toes. These six items were selected by the logistic regression model, which correctly classified 89.0% of patients with schizophrenia (sensitivity) and 96.7% of healthy controls (specificity). The overall classification success rate was 92.8%. MPAs are associated with neurodevelopment, especially 2D:4D associated with cerebral lateralisation. Hence, our present findings support that it is necessary to evaluate MPAs beyond the Waldrop scale, as some item, such as 2D:4D length difference may reflect the more detailed aberrant neurodevelopment of schizophrenia.
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Affiliation(s)
- Yin Lin
- The Psychiatric Laboratory & the Mental Health Center, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, China
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Mhalla A, Boussaïd N, Gassab L, Gaha L, Mechri A. [Minor neurological and physical anomalies in patients with first-episode psychosis]. Encephale 2012; 39:149-54. [PMID: 23095597 DOI: 10.1016/j.encep.2012.06.030] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2012] [Accepted: 06/27/2012] [Indexed: 10/27/2022]
Abstract
INTRODUCTION Over the last several decades, there has been an increasing number of neuroanatomical, neuroimaging, neurophysiological, and neuropsychological studies in search of structural, functional, and cognitive correlates of brain insult(s) that could ultimately lead to unravelling the pathophysiology of schizophrenia. A direct, easily administered, and inexpensive way of investigating brain dysfunction in schizophrenia is the study of neurological soft signs and minor physical anomalies, two putative indices of developmental abnormality. The study of these neurodevelopmental markers in the first-episode psychosis allows the detection of the neurodevelopmental abnormalities at the onset of psychosis. AIMS OF THE STUDY The objectives of our study were to determinate the prevalence, the scores, and the nature of neurological soft signs (NSS) and minor physical anomalies (MPA) in patients with first-episode psychosis and to explore the correlations between these neurodevelopmental markers and the demographic, clinical and therapeutic features. METHOD A cross-sectional study was carried-out on 61 patients (mean age: 28.9±9.4years; 86.9% were males), hospitalized for first-episode psychosis (DSM-IV-TR diagnosis of schizophrenia, schizophreniform disorder, brief psychotic disorder, delusional disorder, and psychotic disorder not otherwise specified). The evaluation procedure consisted of a retrospective assessment of the premorbid functioning by the Premorbid Functioning Scale (PAS) and the following clinical scales: Positive and Negative Symptoms Scale (PANSS), Clinical Global Impression (CGI) and Global Assessment of Functioning (GAF), the NSS scale of Krebs et al. (23 items exploring motor coordination, motor integrative function, sensory integration, involuntary movements or posture, quality of lateralization) and the MPA scale of Gourion et al. (41 items, exploring anomalies of face, eyes, ears, mouth, hands and feet). RESULTS The prevalence of NSS was 83.6% (cut-off point=9.5), with a mean total score of 15.3±6.7. The highest score was for the motor coordination. The prevalence of MPA was 62.7% (cut-off point=5), with a mean total score of 5.8±3.2. The most common MPA were the fine hair (50.8%), adherent earlobes (49.2%) and clinodactyly (31.1%). Correlations were found between the NSS total score and the Poor Premorbid Functioning (r=0.32, P=0.04), the PANSS total score (r=0.36, P=0.005), and the negative (r=0.45, P<0.001) and disorganization sub-scores (r=0.41, P=0.001), the CGI-severity of (r=0.30, P=0.02), the impairment functioning in the GAF (r=-0.26, P=0.04) and with extrapyramidal symptoms (r=0.52, P<0.001). However, no correlation was found between the NSS total scores, age, gender, the PANSS positive sub-score, the daily dosage of antipsychotics, the CGI-improvement score and the MPA total score. There was no correlation between MPA total score and demographic, clinical and therapeutic features of patients. Moreover, there was no correlation between the NSS or MPA scores and the short-term evolution (6months to 1year) towards schizophrenia. CONCLUSION These results confirm the data in the literature relating high NSS and MPA scores in patients with a first-episode psychosis. The NSS appear to characterize severe psychotic disorders with more negative and disorganization symptoms and poor social functioning and may be a prognostic indicator.
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Affiliation(s)
- A Mhalla
- Service de psychiatrie, CHU de Monastir, rue 1(er)-Juin, 5000 Monastir, Tunisie
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Xu T, Chan RCK, Compton MT. Minor physical anomalies in patients with schizophrenia, unaffected first-degree relatives, and healthy controls: a meta-analysis. PLoS One 2011; 6:e24129. [PMID: 21931654 PMCID: PMC3169582 DOI: 10.1371/journal.pone.0024129] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2011] [Accepted: 08/04/2011] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Minor physical anomalies (MPAs) have been found to be more prevalent in schizophrenia than control participants in numerous studies and may index a potential endophenotype for schizophrenia. AIM To quantitatively define the magnitude of the difference in total MPA scores between patients with schizophrenia and healthy controls; to determine the degree of manifestation in unaffected first-degree relatives compared to patients and controls; and to investigate the degree of sensitivity among individual MPA items. METHODS A systematic search was conducted on the literature pertaining to MPAs in patients with schizophrenia and unaffected relatives. Effect sizes (Cohen's d and odds ratios) and corresponding confidence intervals were combined using the Comprehensive Meta-Analysis software package. RESULTS A large difference was found when examining 14 studies comprising 1207 patients with schizophrenia and 1007 healthy controls (d = 0.95, 95% CI = 0.63, 1.27). Six studies involving relatives of individuals with schizophrenia showed a medium effect size (d = 0.45, 95% CI = 0.29,0.62) between patients and relatives, but a small and non-significant effect size (d = 0.32, 95% CI = -0.08, 0.73) between relatives and controls. The majority of MPAs items showed significant odds ratios (1.26-9.86) in comparing patients and controls. CONCLUSIONS The findings indicate that medium effect size of MPAs have been demonstrated in patients with schizophrenia as compared to healthy controls, and to a lesser extent in unaffected relatives. These findings are consistent with the idea that MPAs may represent a putative endophenotype for schizophrenia. However, more research including first-degree family members is warranted.
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Affiliation(s)
- Ting Xu
- Neuropsychology and Applied Cognitive Neuroscience Laboratory, Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China
- Graduate School, Chinese Academy of Sciences, Beijing, China
| | - Raymond C. K. Chan
- Neuropsychology and Applied Cognitive Neuroscience Laboratory, Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China
| | - Michael T. Compton
- Emory University School of Medicine, Department of Psychiatry and Behavioral Sciences, Atlanta, Georgia, United States of America
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