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Bahadir H, Yetįmoğlu N, Oflezer Ö, Erkiran M. Mandibular morphology in schizophrenia patients compared with non-psychiatric controls using digital panoramic radiography: a retrospective cross-sectional study from Istanbul, Türkiye. BMC Oral Health 2024; 24:1170. [PMID: 39363256 PMCID: PMC11448317 DOI: 10.1186/s12903-024-04942-y] [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: 07/13/2024] [Accepted: 09/23/2024] [Indexed: 10/05/2024] Open
Abstract
BACKGROUND Schizophrenia is a chronic severe mental disorder characterized by impairment in cognition, emotion, perception, and other aspects of behavior. In light of the association of craniofacial dysmorphology with schizophrenia, mandibular morphology may provide clues about the role of neurodevelopment in the pathophysiology of schizophrenia. This retrospective cross-sectional study aimed to compare the mandibular morphology of patients with schizophrenia with controls using digital panoramic radiography (DPR). METHODS 302 recorded diagnostic panoramic images obtained from 143 schizophrenia patients (98 males, 45 females), and 159 controls (73 males, 86 females), aged 18-45 years, were evaluated. Seven mandibular measurements consisting of ramus height, condylar height, gonial angle, antegonial angle, antegonial notch depth, ramal notch depth and bigonial width were measured from the DPRs in a double-blinded manner. Bivariate comparisons were carried out using the Independent t-test and Mann-Whitney U test. Logistic regression analysis was used for multivariate comparisons. RESULTS Linear measurements were higher while angular measurements were lower in schizophrenia patients. Regression analyses indicated that female patients had greater ramus height (OR = 1.243; P = 0.001), condylar height (OR = 1.463; P = 0.048) and bigonial width (OR = 1.082; P < 0.001); male patients had greater ramus heights (OR = 1.216; P = 0.001) and bigonial width (OR = 1.076; P < 0.001) as well as lower antegonial angle (OR = 0.908; P = 0.012) compared to their respective controls. CONCLUSION Quantitative differences in mandibular morphology in schizophrenia patients versus controls deserve attention and corroborate with the concept of abnormal neurodevelopment in schizophrenia.
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Affiliation(s)
- Hakan Bahadir
- Department of Radiology, Private Practice, Istanbul, Turkey
| | - Nihal Yetįmoğlu
- Department of of Oral and Maxillofacial Radiology, Faculty of Dentistry, Yeni Yuzyıl University, Istanbul, Turkey
| | - Özlem Oflezer
- Department of Prosthodontics, Hamidiye Faculty of Dental Medicine, University of Health Sciences, Istanbul, Turkey.
| | - Murat Erkiran
- Department of Psychiatry, Bakirkoy Prof. Mazhar Osman Training and Research Hospital for Psychiatry, Neurology and Neurosurgery, University of Health Sciences, Istanbul, Turkey
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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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Mishra V, Sharma S, Kulsreshtha V, Kumar V, Gurunani KC. Anthropometerical association of the craniofacial dysmorphology with schizophrenia. J Clin Diagn Res 2013; 6:1620-3. [PMID: 23373013 DOI: 10.7860/jcdr/2012/4685.2623] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2012] [Accepted: 10/22/2012] [Indexed: 11/24/2022]
Abstract
BACKGROUND Dysmorphology is more concentrated in the craniofacial region of Schizophrenic Patients. So, an early anthropometric assessment of the physical dimensions of the cranium and the face may indicate a potential clue of Schizophrenia. AIMS To study the craniofacial dysmorphology in schizophrenic patients and in healthy controls of the Agra region and to find out whether its evaluation could be used as a tool in the early diagnosis of schizophrenia. SETTING AND DESIGN This was a case-control, cross-sectional study. SUBJECTS AND METHODS Schizophrenic Patients well diagnosed by consultant psychiatrists on the basis of the DSM IV criteria of the S.N. Medical College Agra and the Institute of Mental health, Agra and healthy controls of Agra were selected for the study. The total facial height (trichion to gnathion), the upper facial height (trichion to subnasale) and the lower facial height (subnasale to gnathion) were measured among the various groups of patients and the controls. The mean data were statistically correlated by using the t test for the independent variables. RESULTS The total facial height (trichion to gnathion) was elongated in the Schizophrenic male patients as compared to the controls. When we compared the schizophrenic patients on the basis of the family history of schizophrenia, it was found that there was an elongation of the total facial height in the patients with a positive family history of schizophrenia as compared to the patients without a family history of schizophrenia. There was also a significant elongation of the upper facial height (trichion to subnasale ) in the schizophrenic male and female patients. CONCLUSIONS There was total facial elongation and upper facial region elongation in the schizophrenia patients as compared to the controls.
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Affiliation(s)
- Vivek Mishra
- Assistant professor, Department of Anatomy, All India Institute Of Medical Science , Rishikesh, India
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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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Distances between facial landmarks can be measured accurately with a new digital 3-dimensional video system. Am J Orthod Dentofacial Orthop 2010; 137:580.e1-580.e10; discussion 580-1. [PMID: 20451768 DOI: 10.1016/j.ajodo.2009.03.039] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2008] [Revised: 03/01/2009] [Accepted: 03/01/2009] [Indexed: 10/19/2022]
Abstract
INTRODUCTION The aim of this study was to investigate a new digital 3-dimensional infrared video system to determine its accuracy, precision, and validity in measuring facial distances. METHODS Bench experiments were performed by measuring the vertical and diagonal distances of chessboard squares of known length to determine the system's accuracy and precision. To test the system's validity, 16 healthy volunteers participated in this study. Vertical and horizontal distances of the face were measured electronically at rest, and on posed and aggressive smiles. All measurements were repeated after 8 weeks. Direct measurements of the intercanthal distance were obtained twice with calipers. RESULTS A minor systematic error was found in the bench experiments, with the highest absolute error of 0.227 +/- 0.39 mm. The analysis with this video system showed good reproducibility of all measured distances when the mean of 2 frames was used to compare distances. Digital measurements of the intercanthal distances showed high agreement with the clinically obtained values. CONCLUSIONS This digital video system can measure geometric distances in a 3-dimensional environment with high precision. Facial distances can be measured with good accuracy and precision, allowing applications in research and clinical practice.
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Compton MT, Walker EF. Physical manifestations of neurodevelopmental disruption: are minor physical anomalies part of the syndrome of schizophrenia? Schizophr Bull 2009; 35:425-36. [PMID: 18990714 PMCID: PMC2659308 DOI: 10.1093/schbul/sbn151] [Citation(s) in RCA: 64] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
The well-documented excess of minor physical anomalies (MPAs) among individuals with schizophrenia generally supports the neurodevelopmental model, which posits that both genetic and environmental factors contribute to structural and functional brain changes in the intrauterine and perinatal periods that predispose one to developing schizophrenia. This review synthesizes select areas of research findings on MPAs to address the question, Are MPAs part of the syndrome of schizophrenia? Although MPAs are not specific to schizophrenia, their presence in some patients indicates that aberrations in the development of the nervous system contribute to risk for the disorder. The broadly defined, heterogeneous MPA construct may be of limited value in further elucidating the specific pathophysiology of schizophrenia, though particular anomalies, such as those pertaining to nasal volumes, palatal abnormalities, or craniofacial morphology, may be informative. Given the availability of more sophisticated microarray technologies, and in light of recent findings on spontaneous mutations in patients with schizophrenia, it is possible that MPAs will prove to be useful in identifying etiologic subtypes and/or the loci of genetic risk factors. It remains to be determined whether MPAs-which, of course, are fixed markers present throughout childhood and adolescence well before the onset of the prodrome and psychosis-may have utility in terms of risk stratification for future preventive efforts. Taken together, research findings on MPAs indicate that these minor anomalies are indeed part of some schizophrenia syndromes, representing a stable systemic or physical set of manifestations of the underlying neurodevelopmental processes that lead to the illness.
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Affiliation(s)
- Michael T. Compton
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine,To whom correspondence should be addressed; Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, 49 Jesse Hill Jr Drive, SE, Room No. 333, Atlanta, GA 30303; tel: 404-778-1486, fax: 404-616-3241, e-mail:
| | - Elaine F. Walker
- Department of Psychology, Graduate School of Arts and Sciences of Emory University
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Compton MT, Bollini AM, McKenzie Mack L, Kryda AD, Rutland J, Weiss PS, Bercu Z, Esterberg ML, Walker EF. Neurological soft signs and minor physical anomalies in patients with schizophrenia and related disorders, their first-degree biological relatives, and non-psychiatric controls. Schizophr Res 2007; 94:64-73. [PMID: 17512173 DOI: 10.1016/j.schres.2007.04.002] [Citation(s) in RCA: 74] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2006] [Revised: 04/04/2007] [Accepted: 04/06/2007] [Indexed: 11/25/2022]
Abstract
BACKGROUND Subtle neurological impairments and inconsequential minor anomalies of the face and limbs are manifestations of neurodevelopmental and ontogenic abnormalities that are consistently found at higher rates in individuals with schizophrenia compared to healthy controls. Limited research has been conducted on these traits among biological relatives of patients with schizophrenia. This study hypothesized that the mean NSS score and the mean MPA score would be greater in patients than controls and that first-degree relatives would have intermediate scores. Furthermore, it was hypothesized that NSS scores and MPA scores would not be correlated. This study also explored correlations between patients' NSS and MPA scores and their relatives' respective scores and sought to replicate the finding that NSS are associated with negative and disorganized symptoms of schizophrenia, whereas MPAs are not. METHODS Patients with schizophrenia and related psychotic disorders (n=73), first-degree relatives (n=44), and non-psychiatric controls (n=54) were assessed. Measures included the Neurological Evaluation Scale, a structured examination for MPAs, and the Positive and Negative Syndrome Scale in patients. Analyses accounted for clustering within families. RESULTS Both NSS and MPAs were greater in patients than controls, and first-degree relatives had intermediate scores. Furthermore, NSS and MPA scores were independent in all three groups. Correlations were found between patients' and their relatives' scores on one NES subscale (sensory integration) and total MPA score and several MPA regions (eyes, ears, and hands). This study replicated previous findings that in patients with schizophrenia, NSS are associated with negative, disorganized, and other domains of symptoms. Associations between MPAs and symptoms were sparse and inconsistent. CONCLUSION These findings suggest that NSS and MPAs represent two quite distinct markers of risk for schizophrenia that may stem from genetic factors, as well as from environmental/developmental influences. Future research on multivariable risk prediction models may benefit from the use of somewhat independent risk markers or endophenotypes.
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Affiliation(s)
- Michael T Compton
- Emory University School of Medicine, Department of Psychiatry and Behavioral Sciences, 49 Jesse Hill Jr. Drive, S.E., Room #333, Atlanta, GA 30303, United States.
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