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Smith RC, Sershen H, Youssef M, Lajtha A, Jin H, Zhang M, Chen A, Guidotti A, Davis JM. Deficits in odor discrimination versus odor identification in patients with schizophrenia and negative correlations with GABAergic and DNA methyltransferase mRNAs in lymphocytes. Front Psychiatry 2023; 14:1115399. [PMID: 37056402 PMCID: PMC10088370 DOI: 10.3389/fpsyt.2023.1115399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2022] [Accepted: 03/02/2023] [Indexed: 04/15/2023] Open
Abstract
Introduction People with schizophrenia have been reported to show deficits in tests of olfactory function. DNA methylation and GABAergic input have been implicated in biochemical processes controlling odor in animal studies, but this has not been investigated in human studies. Methods In a study of measures of DNA methylation and GABAergic mRNAs in lymphocytes, we also measured odor identification and discrimination with the Sniffin' Sticks battery in 58 patients with chronic schizophrenia (CSZ) and 48 controls. mRNAs in lymphocytes were assessed by qPCR using TaqManTM probes. Cognition was assessed by the MATRICS battery (Measurement and Treatment Research to Improve Cognition in Schizophrenia) in CSZ and controls, and symptoms in CSZ were assessed by PANSS scale (Positive and Negative Symptom Scale). The relationships of odor deficits with mRNA, cognition, and symptoms were explored by correlation analysis. Variables which significantly differentiated CSZ from controls were explored by logistic regression. Results Overall, CSZ showed significantly (P≤.001) lower scores on odor discrimination compared to controls, with a moderate effect size, but no difference in odor identification. Deficits in odor discrimination, which has not been standardly assessed in many prior studies, strongly differentiated CSZ from controls. In logistic regression analysis, odor discrimination, but not odor identification, was a significant variable predicting schizophrenia versus control class membership. This is the first study to report relationship between odor deficits and DNA methylation and GABAergic mRNAs in blood cells of human subjects. There were negative correlations of odor identification with DNA methylation enzymes mRNAs and significant negative correlations with odor discrimination and GABAergic mRNAs. Lower odor scores were significantly associated with lower cognitive scores on the MATRICS battery in CSZ but not control subjects. In CSZ, lower odor scores were significantly associated with negative symptom scores, while higher odor identification scores were associated with PANNS Excitement factor. Discussion Odor discrimination was a more powerful variable than odor identification in discriminating CSZ from controls and should be used more regularly as an odor measure in studies of schizophrenia. The substantive meaning of the negative correlations of odor discrimination and GABAergic mRNA variables in peripheral lymphocytes of CSZ needs more investigation and comparison with results in neural tissue.
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Affiliation(s)
- Robert C. Smith
- Nathan Kline Institute for Psychiatric Research, Orangeburg, NY, United States
- Department of Psychiatry, NYU Grossman School of Medicine, New York, NY, United States
- *Correspondence: Robert C. Smith, ;
| | - Henry Sershen
- Nathan Kline Institute for Psychiatric Research, Orangeburg, NY, United States
- Department of Psychiatry, NYU Grossman School of Medicine, New York, NY, United States
| | - Mary Youssef
- Nathan Kline Institute for Psychiatric Research, Orangeburg, NY, United States
| | - Abel Lajtha
- Nathan Kline Institute for Psychiatric Research, Orangeburg, NY, United States
- Department of Psychiatry, NYU Grossman School of Medicine, New York, NY, United States
| | - Hua Jin
- Department of Psychiatry and VA San Diego Healthcare System, University of California San Diego, San Diego, CA, United States
| | - Mumei Zhang
- Columbia University Mailman School of Public Health, New York, NY, United States
| | - Anmei Chen
- Columbia University Mailman School of Public Health, New York, NY, United States
| | - Alessandro Guidotti
- Department of Psychiatry, Psychiatric Institute University of Illinois, Chicago, IL, United States
| | - John M. Davis
- Department of Psychiatry, Psychiatric Institute University of Illinois, Chicago, IL, United States
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Urban-Kowalczyk M, Strzelecki D, Śmigielski J, Kotlicka-Antczak M. Odor perception and hedonics in chronic schizophrenia and in first episode psychosis. Neuropsychiatr Dis Treat 2019; 15:647-654. [PMID: 30880989 PMCID: PMC6407904 DOI: 10.2147/ndt.s192523] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND AND PURPOSE The study evaluated olfactory performance and pleasantness rating of odors in patients with first episode psychosis (FEP) and chronic schizophrenia (SCH) with regard to the severity of psychopathological symptoms and plasma β-endorphin concentration. PATIENTS AND METHODS Twenty patients with FEP, 27 with SCH and 29 healthy individuals, were recruited to the research . The University of Pennsylvania Smell Identification Test (UPSIT), subjective odor hedonic judgment and plasma levels of β-endorphin (BE) assay were performed in all participants. RESULTS Individuals with SCH revealed higher BE concentration than other study groups (P=0.000). All patients identified pleasant odors poorer than controls, however, SCH made more identification errors (P=0.000) than those with FEP. Moreover, participants with FEP rated pleasant odors as more pleasant than individuals with chronic schizophrenia and healthy controls (P=0.009). Nevertheless, higher β-endorphin level was related with lower scores in pleasant odor identification (Rs=-0.452; P=0.046) and more severe psychotic symptoms in FEP sample. Chronic schizophrenia patients did not demonstrate any relationship between symptom severity, odor identification performance and β-endorphin concentration. No relationship was found between BE concentration and hedonic judgment of the presented odors among all study groups. Chronically ill subjects identified odors significantly more poorly than those with first episode psychosis. Deficits in identifying pleasant odors might not be the only potential risk factor for undergoing chronic, recurrent schizophrenia. All patients subjectively overrated pleasant odors. Those with SCH and more severe negative symptoms made significantly more identification errors. CONCLUSION The endogenous morphine system deregulation is observed in first episode psychosis as well as in chronic schizophrenia. In first episode schizophrenia higher beta-endorphin concentration is related to pleasant odor identification deficit.
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Affiliation(s)
| | - Dominik Strzelecki
- Department of Affective and Psychotic Disorders, Medical University of Łódź, Łódź, Poland,
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Tang SX, Moberg PJ, Yi JJ, Wiemken AS, Dress EM, Moore TM, Calkins ME, McDonald-McGinn DM, Zackai EH, Emanuel BS, Gur RC, Gur RE, Turetsky BI. Olfactory deficits and psychosis-spectrum symptoms in 22q11.2 deletion syndrome. Schizophr Res 2018; 202:113-119. [PMID: 30007867 PMCID: PMC6432914 DOI: 10.1016/j.schres.2018.07.012] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2017] [Revised: 05/18/2018] [Accepted: 07/02/2018] [Indexed: 11/28/2022]
Abstract
Olfactory functioning is a promising biomarker for psychosis in 22q11.2 deletion syndrome (22q11DS) but has not been well studied to date. This is a pilot effort to evaluate the potential for tests of olfactory functioning to contribute to risk and resilience prediction in 22q11DS, and is the first study to evaluate relationships among olfactory deficits, cognition and psychosis-spectrum symptoms. Odor identification and discrimination were evaluated in 32 individuals with 22q11DS and 110 healthy comparison subjects (HC). Individuals with 22q11DS also underwent cognitive testing with the Penn Computerized Neurocognitive Battery, which evaluates executive functioning, episodic memory, complex cognition, and social cognition. Positive, negative, disorganized and general psychosis-spectrum symptoms were rated according to the Scale of Prodromal Symptoms. Age-normalized scores were calculated for odor identification and discrimination based on normative data. Both odor identification (p < 0.001, Cohen's d = -2.15, 95% CI [-2.62, -1.68]) and discrimination (p < 0.001, Cohen's d = -1.81, 95% CI [-2.26, -1.35]) were significantly impaired in 22q11DS relative to HC. There were no sex differences in either group. Neither odor identification nor discrimination was correlated with overall cognition or any specific cognitive domain in 22q11DS. Impairment in odor discrimination was correlated with higher negative and overall psychosis-spectrum symptoms. There was no significant effect of catechol-O-methyltransferase Val(158)Met genotype or presence of velopharyngeal insufficiency on olfactory functioning. Olfactory deficits, particularly olfactory discrimination, are robust in 22q11DS and appear to be independent of cognitive deficits. They are also clinically relevant and related to psychosis-spectrum symptoms. Olfactory functioning appears to be a promising biomarker for psychosis in 22q11DS.
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Affiliation(s)
- Sunny X. Tang
- University of Pennsylvania, Perelman School of Medicine, Department of Psychiatry
| | - Paul J. Moberg
- University of Pennsylvania, Perelman School of Medicine, Department of Psychiatry
| | - James J. Yi
- University of Pennsylvania, Perelman School of Medicine, Department of Psychiatry,Children’s Hospital of Philadelphia, Department of Child and Adolescent Psychiatry
| | - Andrew S. Wiemken
- University of Pennsylvania, Perelman School of Medicine, Department of Psychiatry
| | - Erich M. Dress
- University of Pennsylvania, Perelman School of Medicine, Department of Psychiatry
| | - Tyler M. Moore
- University of Pennsylvania, Perelman School of Medicine, Department of Psychiatry
| | - Monica E. Calkins
- University of Pennsylvania, Perelman School of Medicine, Department of Psychiatry
| | - Donna M. McDonald-McGinn
- Children’s Hospital of Philadelphia, Division of Human Genetics,University of Pennsylvania, Perelman School of Medicine, Department of Pediatrics
| | - Elaine H. Zackai
- Children’s Hospital of Philadelphia, Division of Human Genetics,University of Pennsylvania, Perelman School of Medicine, Department of Pediatrics
| | - Beverly S. Emanuel
- Children’s Hospital of Philadelphia, Division of Human Genetics,University of Pennsylvania, Perelman School of Medicine, Department of Pediatrics
| | - Ruben C. Gur
- University of Pennsylvania, Perelman School of Medicine, Department of Psychiatry
| | - Raquel E. Gur
- University of Pennsylvania, Perelman School of Medicine, Department of Psychiatry,Children’s Hospital of Philadelphia, Department of Child and Adolescent Psychiatry
| | - Bruce I. Turetsky
- University of Pennsylvania, Perelman School of Medicine, Department of Psychiatry
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Takahashi T, Nakamura M, Sasabayashi D, Komori Y, Higuchi Y, Nishikawa Y, Nishiyama S, Itoh H, Masaoka Y, Suzuki M. Olfactory deficits in individuals at risk for psychosis and patients with schizophrenia: relationship with socio-cognitive functions and symptom severity. Eur Arch Psychiatry Clin Neurosci 2018; 268:689-698. [PMID: 29071372 DOI: 10.1007/s00406-017-0845-3] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2017] [Accepted: 10/19/2017] [Indexed: 01/18/2023]
Abstract
Odor identification deficits are well documented in patients with schizophrenia, but it remains unclear whether individuals at clinical high-risk for psychosis exhibit similar changes and whether their olfactory function is related to social/cognitive functions and symptomatology. In this study, we investigated odor detection sensitivity and identification ability in 32 individuals with at-risk mental state (ARMS), 59 schizophrenia patients, and 169 healthy controls using a T&T olfactometer. The ARMS and schizophrenia subjects were administered the Brief Assessment of Cognition in Schizophrenia (BACS), the Schizophrenia Cognition Rating Scale (SCoRS), and the Social and Occupational Functioning Assessment Scale (SOFAS) to assess their cognitive and social functions, and the Positive and Negative Syndrome Scale (PANSS) for clinical symptoms. Both the ARMS and schizophrenia subjects had lower odor identification ability when compared with healthy controls, while no significant difference was found in the odor detection sensitivity. The lower odor identification ability in the ARMS group correlated with the severity of negative symptoms and weakly correlated with lower performance on the BACS verbal fluency test. The olfactory measures of schizophrenia patients did not correlate with illness duration, medication, symptom severity, and social and cognitive functions. For the ARMS and schizophrenia groups, the olfactory measures did not correlate with the SOFAS and SCoRS scores. These findings suggest that high-risk subjects for psychosis already show odor identification deficits similar to those observed in schizophrenia patients, which probably reflect a biological trait related to vulnerability to psychosis.
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Affiliation(s)
- Tsutomu Takahashi
- Department of Neuropsychiatry University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, 2630 Sugitani, Toyama, 930-0194, Japan.
| | - Mihoko Nakamura
- Department of Neuropsychiatry University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, 2630 Sugitani, Toyama, 930-0194, Japan
| | - Daiki Sasabayashi
- Department of Neuropsychiatry University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, 2630 Sugitani, Toyama, 930-0194, Japan
| | - Yuko Komori
- Department of Neuropsychiatry University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, 2630 Sugitani, Toyama, 930-0194, Japan
| | - Yuko Higuchi
- Department of Neuropsychiatry University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, 2630 Sugitani, Toyama, 930-0194, Japan
| | - Yumiko Nishikawa
- Department of Neuropsychiatry University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, 2630 Sugitani, Toyama, 930-0194, Japan
| | - Shimako Nishiyama
- Department of Neuropsychiatry University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, 2630 Sugitani, Toyama, 930-0194, Japan
| | - Hiroko Itoh
- Department of Neuropsychiatry University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, 2630 Sugitani, Toyama, 930-0194, Japan
| | - Yuri Masaoka
- Department of Physiology, Showa University School of Medicine, Tokyo, Japan
| | - Michio Suzuki
- Department of Neuropsychiatry University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, 2630 Sugitani, Toyama, 930-0194, Japan
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Turetsky BI, Moberg PJ, Quarmley M, Dress E, Calkins ME, Ruparel K, Prabhakaran K, Gur RE, Roalf DR. Structural anomalies of the peripheral olfactory system in psychosis high-risk subjects. Schizophr Res 2018; 195:197-205. [PMID: 28974405 PMCID: PMC5878118 DOI: 10.1016/j.schres.2017.09.015] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2017] [Revised: 09/05/2017] [Accepted: 09/13/2017] [Indexed: 12/19/2022]
Abstract
BACKGROUND Olfactory impairments are prominent in both schizophrenia and the preceding at-risk state. Their presence prior to illness predicts poor functional outcome. In schizophrenia, these impairments reflect peripheral olfactory structural abnormalities, which are hypothesized to arise during early embryonic development. If this is correct, then similar structural anomalies should be apparent among clinical high-risk subjects. METHODS Thirty-nine clinical high-risk (CR) subjects (24M/15F) were compared to 36 low-risk (LR) subjects (19M/17F). Olfactory measures derived from 3T MRI scans included olfactory bulb volume, primary olfactory cortical gray matter volume, and the depth of the olfactory sulcus overlying the bulb. Additionally, nasal cavity volumes were assessed with acoustic rhinometry. RESULTS Male CR subjects exhibited bilateral reductions in olfactory bulb volume and abnormal asymmetries of the posterior nasal cavities and olfactory sulci (left reduced relative to right). Post-hoc contrasts also indicated reduced left, but not right, olfactory cortical gray matter volume. Female CRs had no significant abnormalities, although they exhibited similar trend effects. Left olfactory bulb volume correlated, across all CR subjects, with negative, but not positive, symptoms. In a classification analysis, with 80% target specificity, olfactory measurements distinguished male CR from male LR subjects with 93% sensitivity. Among females, the comparable sensitivity was 69%. CONCLUSION Psychosis-risk youths exhibit an array of sexually dimorphic and laterally asymmetric anomalies of the peripheral olfactory system. These are consistent with a developmental disruption primarily affecting male fetuses. These structural biomarkers may enhance the identification of at-risk subjects with poor prognosis, before their clinical trajectory is apparent.
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Affiliation(s)
- Bruce I. Turetsky
- Department of Psychiatry, Neuropsychiatry Division, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104,Smell and Taste Center, Department of Otorhinolaryngology: Head & Neck Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104
| | - Paul J. Moberg
- Department of Psychiatry, Neuropsychiatry Division, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104,Smell and Taste Center, Department of Otorhinolaryngology: Head & Neck Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104
| | - Megan Quarmley
- Department of Psychiatry, Neuropsychiatry Division, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104
| | - Erich Dress
- Department of Psychiatry, Neuropsychiatry Division, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104
| | - Monica E. Calkins
- Department of Psychiatry, Neuropsychiatry Division, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104
| | - Kosha Ruparel
- Department of Psychiatry, Neuropsychiatry Division, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104
| | - Karthik Prabhakaran
- Department of Psychiatry, Neuropsychiatry Division, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104
| | - Raquel E. Gur
- Department of Psychiatry, Neuropsychiatry Division, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104
| | - David R. Roalf
- Department of Psychiatry, Neuropsychiatry Division, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104
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6
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Abstract
BACKGROUND Though olfactory deficits are well-documented in schizophrenia, fewer studies have examined olfactory performance profiles across the psychosis spectrum. The current study examined odor identification, discrimination, and detection threshold performance in first-episode psychosis (FEP) patients diagnosed with schizophrenia, schizoaffective disorder, bipolar disorder with psychotic features, major depression with psychotic features, and other psychotic conditions. METHOD FEP patients (n = 97) and healthy adults (n = 98) completed birhinal assessments of odor identification, discrimination, and detection threshold sensitivity for lyral and citralva. Participants also completed measures of anticipatory pleasure, anhedonia, and empathy. Differences in olfactory performances were assessed between FEP patients and controls and within FEP subgroups. Sex-stratified post hoc analyses were employed for a complete analysis of sex differences. Relationships between self-report measures and olfactory scores were also examined. RESULTS Individuals with psychosis had poorer scores across all olfactory measures when compared to the control group. Within the psychosis cohort, patients with schizophrenia-associated psychosis had poorer odor identification, discrimination, and citralva detection threshold scores relative to controls. In schizophrenia patients, greater olfactory disturbance was associated with increased negative symptomatology, greater self-reported anhedonia, and lower self-reported anticipatory pleasure. Patients with mood-associated psychosis performed comparable to controls though men and women in this cohort showed differential olfactory profiles. CONCLUSIONS These findings indicate that olfactory deficits extend beyond measures of odor identification in FEP with greater deficits observed in schizophrenia-related subgroups of psychosis. Studies examining whether greater olfactory dysfunction confers greater risk for developing schizophrenia relative to other forms of psychosis are warranted.
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Affiliation(s)
- Vidyulata Kamath
- Department of Psychiatry and Behavioral Sciences, The Johns Hopkins University School of Medicine, Baltimore, MD
- To whom correspondence should be addressed; Division of Medical Psychology, The Johns Hopkins University School of Medicine, 600 N. Wolfe Street, Meyer 218, Baltimore, MD 21287-7218, US; tel: 410-614-6342, fax: 410-955-0504, e-mail:
| | - Patricia Lasutschinkow
- Department of Psychiatry and Behavioral Sciences, The Johns Hopkins University School of Medicine, Baltimore, MD
| | - Koko Ishizuka
- Department of Psychiatry and Behavioral Sciences, The Johns Hopkins University School of Medicine, Baltimore, MD
| | - Akira Sawa
- Department of Psychiatry and Behavioral Sciences, The Johns Hopkins University School of Medicine, Baltimore, MD
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Kazour F, Richa S, Desmidt T, Lemaire M, Atanasova B, El Hage W. Olfactory and gustatory functions in bipolar disorders: A systematic review. Neurosci Biobehav Rev 2017; 80:69-79. [DOI: 10.1016/j.neubiorev.2017.05.009] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2017] [Accepted: 05/09/2017] [Indexed: 01/01/2023]
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8
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Roalf DR, Quarmley M, Calkins ME, Satterthwaite TD, Ruparel K, Elliott MA, Moore TM, Gur RC, Gur RE, Moberg PJ, Turetsky BI. Temporal Lobe Volume Decrements in Psychosis Spectrum Youths. Schizophr Bull 2017; 43:601-610. [PMID: 27559077 PMCID: PMC5463880 DOI: 10.1093/schbul/sbw112] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Structural brain abnormalities have been amply demonstrated in schizophrenia. These include volume decrements in the perirhinal/entorhinal regions of the ventromedial temporal lobe, which comprise the primary olfactory cortex. Olfactory impairments, which are a hallmark of schizophrenia, precede the onset of illness, distinguish adolescents experiencing prodromal symptoms from healthy youths, and may predict the transition from the prodrome to frank psychosis. We therefore examined temporal lobe regional volumes in a large adolescent sample to determine if structural deficits in ventromedial temporal lobe areas were associated, not only with schizophrenia, but also with a heightened risk for psychosis. Seven temporal lobe regional volumes (amygdala [AM], hippocampus, inferior temporal gyrus, parahippocampal gyrus, superior temporal gyrus, temporal pole, and entorhinal cortex [EC]) were measured in 386 psychosis spectrum adolescents, 521 adolescents with other types of psychopathology, and 359 healthy adolescents from the Philadelphia Neurodevelopment Cohort. Total intracranial and left EC volumes, which were both smallest among the psychosis spectrum, were the only measures that distinguished all 3 groups. Left AM was also smaller in psychosis spectrum compared with healthy subjects. EC volume decrement was strongly correlated with impaired cognition and less robustly associated with heightened negative/disorganized symptoms. AM volume decrement correlated with positive symptoms (persecution/special abilities). Temporal lobe volumes classified psychosis spectrum youths with very high specificity but relatively low sensitivity. These MRI measures may therefore serve as important confirmatory biomarkers denoting a worrisome preclinical trajectory among at-risk youths, and the specific pattern of deficits may predict specific symptom profiles.
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Affiliation(s)
- David R. Roalf
- Department of Psychiatry, Neuropsychiatry Division, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Megan Quarmley
- Department of Psychiatry, Neuropsychiatry Division, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Monica E. Calkins
- Department of Psychiatry, Neuropsychiatry Division, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Theodore D. Satterthwaite
- Department of Psychiatry, Neuropsychiatry Division, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Kosha Ruparel
- Department of Psychiatry, Neuropsychiatry Division, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Mark A. Elliott
- Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Tyler M. Moore
- Department of Psychiatry, Neuropsychiatry Division, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Ruben C. Gur
- Department of Psychiatry, Neuropsychiatry Division, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA;,Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Raquel E. Gur
- Department of Psychiatry, Neuropsychiatry Division, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA;,Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Paul J. Moberg
- Department of Psychiatry, Neuropsychiatry Division, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA;,Smell and Taste Center, Department of Otorhinolaryngology—Head and Neck Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Bruce I. Turetsky
- Department of Psychiatry, Neuropsychiatry Division, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA;,Smell and Taste Center, Department of Otorhinolaryngology—Head and Neck Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
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Lin A, Brewer WJ, Yung AR, Nelson B, Pantelis C, Wood SJ. Olfactory identification deficits at identification as ultra-high risk for psychosis are associated with poor functional outcome. Schizophr Res 2015; 161:156-62. [PMID: 25476117 DOI: 10.1016/j.schres.2014.10.051] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2013] [Revised: 10/27/2014] [Accepted: 10/27/2014] [Indexed: 11/15/2022]
Abstract
BACKGROUND We have previously reported that olfactory identification (OI) deficits are a promising premorbid marker of transition from ultra-high risk (UHR) to schizophrenia, but not to psychotic illness more generally. Whether this remains the case at longer follow-up, and whether there is decline in OI ability are unclear. METHOD The University of Pennsylvania Smell Identification Test (UPSIT) was administered to 81 participants at baseline (identification of risk for psychosis) and 254 individuals at follow-up. Forty-nine participants underwent UPSIT assessment at both time points. UPSIT scores were investigated at an average of 7.08years after identification of risk in relation to transition to psychosis, a diagnosis of schizophrenia, and psychosocial/functional outcome. RESULTS UPSIT scores at baseline and follow-up did not differ between participants who transitioned to psychosis and those who did not. Similarly, there were no significant differences on UPSIT scores at baseline or follow-up between individuals with a diagnosis of schizophrenia and transitioned individuals without schizophrenia. Those with a poor functional outcome showed significantly lower baseline UPSIT scores than participants with good outcome. There was no significant association between functional outcome and follow-up UPSIT scores. There were no significant changes in UPSIT over time for any group. CONCLUSIONS These results suggest that impaired OI is not a good marker of the onset of psychosis and schizophrenia, but may differentiate UHR individuals who experience a poor functional outcome, regardless of transition status.
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Affiliation(s)
- A Lin
- Telethon Kids Institute, The University of Western Australia, Australia.
| | - W J Brewer
- Orygen Youth Health Research Centre, Centre for Youth Mental Health, University of Melbourne, Victoria, Australia
| | - A R Yung
- Orygen Youth Health Research Centre, Centre for Youth Mental Health, University of Melbourne, Victoria, Australia; Institute of Brain, Behaviour and Mental Health, University of Manchester, UK
| | - B Nelson
- Orygen Youth Health Research Centre, Centre for Youth Mental Health, University of Melbourne, Victoria, Australia
| | - C Pantelis
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, University of Melbourne and Melbourne Health, Victoria, Australia
| | - S J Wood
- Telethon Kids Institute, The University of Western Australia, Australia; Melbourne Neuropsychiatry Centre, Department of Psychiatry, University of Melbourne and Melbourne Health, Victoria, Australia
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Kayser J, Tenke CE, Kroppmann CJ, Alschuler DM, Ben-David S, Fekri S, Bruder GE, Corcoran CM. Olfaction in the psychosis prodrome: electrophysiological and behavioral measures of odor detection. Int J Psychophysiol 2013; 90:190-206. [PMID: 23856353 DOI: 10.1016/j.ijpsycho.2013.07.003] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2013] [Revised: 07/03/2013] [Accepted: 07/05/2013] [Indexed: 10/26/2022]
Abstract
Smell identification deficits (SIDs) are relatively specific to schizophrenia and its negative symptoms, and may predict transition to psychosis in clinical high-risk (CHR) individuals. Moreover, event-related potentials (ERPs) to odors are reduced in schizophrenia. This study examined whether CHR patients show SIDs and abnormal olfactory N1 and P2 potentials. ERPs (49 channels) were recorded from 21 CHR and 20 healthy participants (13 males/group; ages 13-27 years) during an odor detection task using three concentrations of hydrogen sulfide (H2S) or blank air presented unilaterally by a constant-flow olfactometer. Neuronal generator patterns underlying olfactory ERPs were identified and measured by principal components analysis (unrestricted Varimax) of reference-free current source densities (CSD). Replicating previous findings, CSD waveforms to H2S stimuli were characterized by an early N1 sink (345 ms, lateral-temporal) and a late P2 source (600 ms, mid-frontocentroparietal). N1 and P2 varied monotonically with odor intensity (strong > medium > weak) and did not differ across groups. Patients and controls also showed comparable odor detection and had normal odor identification and thresholds (Sniffin' Sticks). However, olfactory ERPs strongly reflected differences in odor intensity and detection in controls, but these associations were substantially weaker in patients. Moreover, severity of negative symptoms in patients was associated with reduced olfactory ERPs and poorer odor detection, identification and thresholds. Three patients who developed psychosis had poorer odor detection and thresholds, and marked reductions of N1 and P2. Thus, despite the lack of overall group differences, olfactory measures may be of utility in predicting transition to psychosis among CHR patients.
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Affiliation(s)
- Jürgen Kayser
- Department of Psychiatry, Columbia University College of Physicians & Surgeons, New York, NY, USA; Division of Cognitive Neuroscience, New York State Psychiatric Institute, New York, NY, USA.
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