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Smesny S, Berberich D, Gussew A, Schönfeld N, Langbein K, Walther M, Reichenbach JR. Alterations of neurometabolism in the dorsolateral prefrontal cortex and thalamus in transition to psychosis patients change under treatment as usual - A two years follow-up 1H/ 31P-MR-spectroscopy study. Schizophr Res 2021; 228:7-18. [PMID: 33429152 DOI: 10.1016/j.schres.2020.11.063] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2019] [Revised: 11/22/2020] [Accepted: 11/27/2020] [Indexed: 11/25/2022]
Abstract
BACKGROUND The ultra-high risk (UHR) paradigm allows early contact with patients developing acute psychosis and the study of treatment effects on the underlying pathology. METHODS 29 patients with first acute psychosis according to CAARMS criteria (transition patients, TP) (T0) and thereof 22 patients after two-year follow-up (mean 788 d) (T1) underwent 1H-/31P-MR spectroscopy of the prefrontal (DLPFC) and anterior midcingulate (aMCC) cortices and the thalamus. N-acetylaspartate (NAA), glutamate (Glu, Glx), energy (PCr, ATP) and phospholipid metabolites (PME, PDE) were compared to 27 healthy controls by ANCOVA and correlated with patients' symptom ratings (BPRS-E, SCL-90R). For longitudinal analysis, linear mixed model (LMM) and ANCOVA for repeated measures were used. RESULTS DLPFC: In patients, NAA and PME were decreased bilaterally and Glu on the left side at T0. Left-sided Glu and NAA (trend) and bilateral Glx increased during follow-up. Thalamus: In TP, bilateral NAA, left-sided Glu and right-sided Glx were decreased at T0; bilateral NAA and left-sided Glx increased during follow-up. aMCC: In TP, bilateral NAA, right-sided Glu, and bilateral PME and PDE were decreased, while left-sided PCr was increased at T0. No changes were observed during follow-up. CONCLUSION Regardless of the long-term diagnosis, the psychotic state of illness includes disturbed neuronal function in the DLPFC, thalamus and aMCC. Treatment-as-usual (TAU), including antipsychotic/antidepressant medication and supportive psychotherapy, had an effect on the thalamo-frontal area but not or less pronounced on the neurometabolic deficits of the aMCC.
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Affiliation(s)
- Stefan Smesny
- Department of Psychiatry, Jena University Hospital, Philosophenweg 3, D-07743 Jena, Germany.
| | - Diana Berberich
- Department of Psychiatry, Jena University Hospital, Philosophenweg 3, D-07743 Jena, Germany
| | - Alexander Gussew
- Department of Radiology, University Hospital Halle (Saale), Ernst-Grube-Str. 40, D-06120 Halle (Saale), Germany
| | - Nils Schönfeld
- Department of Psychiatry, Jena University Hospital, Philosophenweg 3, D-07743 Jena, Germany
| | - Kerstin Langbein
- Department of Psychiatry, Jena University Hospital, Philosophenweg 3, D-07743 Jena, Germany
| | - Mario Walther
- Jena University of Applied Sciences, Department of Fundamental Sciences, Carl-Zeiss-Promenade 2, D-07745 Jena, Germany
| | - Jürgen R Reichenbach
- Medical Physics Group, Department of Diagnostic and Interventional Radiology, Jena University Hospital, Philosophenweg 3, D-07740 Jena, Germany
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Prasad KM, Burgess AM, Keshavan MS, Nimgaonkar VL, Stanley JA. Neuropil pruning in Early-Course Schizophrenia: Immunological, Clinical, and Neurocognitive Correlates. BIOLOGICAL PSYCHIATRY. COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2016; 1:528-538. [PMID: 28255578 PMCID: PMC5328666 DOI: 10.1016/j.bpsc.2016.08.007] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
INTRODUCTION Neuropathological studies suggest neuropil reduction in schizophrenia. Altered synaptic pruning is proposed to underlie neuropil reduction. Underlying factors and clinical correlates of synaptic pruning are poorly understood. Using phosphorus magnetic resonance spectroscopy (31P MRS), it is feasible to assess membrane phospholipid (MPL) metabolites in the brain that specifically and sensitively reflect neuropil expansion (elevated MPL precursors) or contraction (elevated MPL catabolites). METHODS We examined MPL metabolites and their cognitive, clinical and immunologic correlates among 28 early-course schizophrenia individuals (illness duration 1.99±1.33 years; antipsychotic-naïve=18) and 21 controls. We acquired whole-brain multi-voxel 31P MRS data from 12 unique brain regions. Interleukin-6 and C-reactive protein (CRP) were assayed in the serum. Generalized linear mixed models examined case-control differences in MPL metabolites in these regions correcting for multiple testing. Partial correlations accounting for multiple tests examined the relationship of Interleukin-6 and CRP levels with MPL metabolite levels. RESULTS MPL catabolite levels were increased in the thalamus in schizophrenia compared to controls. Interleukin-6 and CRP levels did not show case-control differences. Interleukin-6 levels positively correlated with MPL catabolite levels in the thalamus after correcting for multiple tests. The left thalamus MPL catabolite levels correlated negatively with sustained attention (corrected p=0.039). DISCUSSION Elevated MPL catabolites in the thalamus suggest increased neuropil contraction that may be related to excessive synaptic pruning. The thalamic neuropil contraction is associated with Interleukin-6 levels suggesting central pathogenic mechanisms for the inflammatory mediators. Correlation of increased thalamic MPL catabolite levels with cognitive impairments suggests clinical correlates of neuropil contraction.
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Smesny S, Gussew A, Biesel NJ, Schack S, Walther M, Rzanny R, Milleit B, Gaser C, Sobanski T, Schultz CC, Amminger P, Hipler UC, Sauer H, Reichenbach JR. Glutamatergic dysfunction linked to energy and membrane lipid metabolism in frontal and anterior cingulate cortices of never treated first-episode schizophrenia patients. Schizophr Res 2015; 168:322-9. [PMID: 26255566 DOI: 10.1016/j.schres.2015.07.013] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2015] [Revised: 06/10/2015] [Accepted: 07/06/2015] [Indexed: 12/22/2022]
Abstract
BACKGROUND Glutamatergic dysfunction and altered membrane lipid and energy metabolism have been repeatedly demonstrated in the frontal/prefrontal and anterior cingulate cortex (ACC) in schizophrenia. Though having been already studied in animals, the presumed link between glutamatergic function and structural plasticity has not been investigated directly in the human brain yet. We measured glutamate (Glu), focal energy metabolism, and membrane phospholipid turnover to investigate main pathologies in those key brain regions of schizophrenia. METHODS (1)H- and (31)P-Chemical Shift Imaging (CSI) was combined in a single session to assess Glu and markers of energy (PCr, ATP) and membrane lipid (PME, PDE) metabolism in 31 neuroleptic-naïve first acute onset psychosis patients and 31 matched healthy controls. Multivariate analyses of covariance were used to assess disease effects on Glu and to investigate the impact of Glu alterations on phospholipid and energy metabolites. RESULTS Glu levels of patients were increased in the frontal and prefrontal cortex bilaterally and in the ACC. Higher Glu was associated with increased left frontal/prefrontal PME and right frontal/prefrontal PDE in patients, which was not observed in healthy controls. In contrast, higher Glu levels were associated with lower PCr or ATP values in the frontal/prefrontal cortex bilaterally and in the right ACC of controls. This was not observed in the right ACC and left frontal/prefrontal cortex of patients. CONCLUSION Frontal glutamatergic hyperactivity is disconnected from physiologically regulated energy metabolism and is associated with increased membrane breakdown in right and increased membrane restoration in left frontal and prefrontal cortical regions. As indicated by previous findings, this pathology is likely dynamic during the course of first acute illness and possibly associated with negative symptoms and cognitive impairment. Our findings underline the importance of further research on neuroprotective treatment options during the early acute or even better for the ultra-high risk state of psychotic illness.
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Affiliation(s)
- Stefan Smesny
- Department of Psychiatry, Jena University Hospital, Philosophenweg 3, D-07743 Jena, Germany.
| | - Alexander Gussew
- Medical Physics Group, Department of Diagnostic and Interventional Radiology, Jena University Hospital, Philosophenweg 3, D-07740 Jena, Germany
| | - Natalie Joan Biesel
- Department of Psychiatry, Jena University Hospital, Philosophenweg 3, D-07743 Jena, Germany
| | - Stephan Schack
- Department of Psychiatry, Jena University Hospital, Philosophenweg 3, D-07743 Jena, Germany
| | - Mario Walther
- Institute of Medical Statistics, Computer Sciences and Documentation (IMSID), Jena University Hospital, Friedrich-Schiller University Jena, Bachstraße 18, D-07743 Jena, Germany
| | - Reinhard Rzanny
- Medical Physics Group, Department of Diagnostic and Interventional Radiology, Jena University Hospital, Philosophenweg 3, D-07740 Jena, Germany
| | - Berko Milleit
- Department of Psychiatry, Jena University Hospital, Philosophenweg 3, D-07743 Jena, Germany; Department of Psychiatry, Thüringen-Kliniken "Georgius Agricola" GmbH Rainweg 68, D-07318 Saalfeld/Saale, Germany
| | - Christian Gaser
- Department of Psychiatry, Jena University Hospital, Philosophenweg 3, D-07743 Jena, Germany
| | - Thomas Sobanski
- Department of Psychiatry, Thüringen-Kliniken "Georgius Agricola" GmbH Rainweg 68, D-07318 Saalfeld/Saale, Germany
| | - Carl Christoph Schultz
- Department of Psychiatry, Jena University Hospital, Philosophenweg 3, D-07743 Jena, Germany
| | - Paul Amminger
- Department of Child and Adolescent Psychiatry, Medical University Vienna, Währingergürtel 18-20, A-1090 Vienna, Austria; Orygen Youth Health Research Centre, The University of Melbourne, Locked Bag 10, 35 Poplar Road Parkville, Victoria 3052, Melbourne, Australia
| | - Uta-Christina Hipler
- Department of Dermatology, Jena University Hospital, Erfurter Straße 35, D-07743 Jena, Germany
| | - Heinrich Sauer
- Department of Psychiatry, Jena University Hospital, Philosophenweg 3, D-07743 Jena, Germany
| | - Jürgen R Reichenbach
- Medical Physics Group, Department of Diagnostic and Interventional Radiology, Jena University Hospital, Philosophenweg 3, D-07740 Jena, Germany
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Yuksel C, Tegin C, O'Connor L, Du F, Ahat E, Cohen BM, Ongur D. Phosphorus magnetic resonance spectroscopy studies in schizophrenia. J Psychiatr Res 2015; 68:157-66. [PMID: 26228415 DOI: 10.1016/j.jpsychires.2015.06.014] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2015] [Revised: 06/15/2015] [Accepted: 06/18/2015] [Indexed: 12/26/2022]
Abstract
Phosphorus magnetic resonance spectroscopy ((31)P MRS) allows in vivo quantification of phosphorus metabolites that are considered to be related to membrane turnover and energy metabolism. In schizophrenia (SZ), (31)P MRS studies found several abnormalities in different brain regions suggesting that alterations in these pathways may be contributing to the pathophysiology. In this paper, we systematically reviewed the (31)P MRS studies in SZ published to date by taking patient characteristics, medication status and brain regions into account. Publications written in English were searched on http://www.ncbi.nlm.nih.gov/pubmed/, by using the keywords 'phosphomonoester', 'phosphodiester', 'ATP', 'phosphocreatine', 'phosphocholine', 'phosphoethanolamine','glycerophosphocholine', 'glycerophosphoethanolamine', 'pH', 'schizophrenia', and 'MRS'. Studies that measured (31)P metabolites in SZ patients were included. This search identified 52 studies. Reduced PME and elevated PDE reported in earlier studies were not replicated in several subsequent studies. One relatively consistent pattern was a decrease in PDE in chronic patients in the subcortical structures. There were no consistent patterns for the comparison of energy related phosphorus metabolites between patients and controls. Also, no consistent pattern emerged in studies seeking relationship between (31)P metabolites and antipsychotic use and other clinical variables. Despite emerging patterns, methodological heterogeneities and shortcomings in this literature likely obscure consistent patterns among studies. We conclude with recommendations to improve study designs and (31)P MRS methods in future studies. We also stress the significance of probing into the dynamic changes in energy metabolism, as this approach reveals abnormalities that are not visible to steady-state measurements.
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Affiliation(s)
- Cagri Yuksel
- McLean Hospital, 115 Mill Street, Belmont, MA, USA; Harvard Medical School, 25 Shattuck Street, Boston, MA, USA.
| | - Cuneyt Tegin
- University of Louisville, Department of Psychiatry, 323 E. Chestnut Street, Louisville, KY, USA.
| | | | - Fei Du
- McLean Hospital, 115 Mill Street, Belmont, MA, USA; Harvard Medical School, 25 Shattuck Street, Boston, MA, USA.
| | - Ezgi Ahat
- Istanbul University, Cerrahpasa School of Medicine. Kocamustafapaşa Cad. No:53, Istanbul, Turkey.
| | - Bruce M Cohen
- McLean Hospital, 115 Mill Street, Belmont, MA, USA; Harvard Medical School, 25 Shattuck Street, Boston, MA, USA.
| | - Dost Ongur
- McLean Hospital, 115 Mill Street, Belmont, MA, USA; Harvard Medical School, 25 Shattuck Street, Boston, MA, USA.
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Weber-Fahr W, Englisch S, Esser A, Tunc-Skarka N, Meyer-Lindenberg A, Ende G, Zink M. Altered phospholipid metabolism in schizophrenia: a phosphorus 31 nuclear magnetic resonance spectroscopy study. Psychiatry Res 2013; 214:365-73. [PMID: 24045051 DOI: 10.1016/j.pscychresns.2013.06.011] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2013] [Revised: 05/31/2013] [Accepted: 06/21/2013] [Indexed: 12/26/2022]
Abstract
Phospholipid (PL) metabolism is investigated by in vivo 31P magnetic resonance spectroscopy (MRS). Inconsistent alterations of phosphocholine (PC), phosphoethanolamine (PE), glycerophosphocholine (GPC) and glycerophosphoethanolamine (GPE) have been described in schizophrenia, which might be overcome by specific editing techniques. The selective refocused insensitive nuclei-enhanced polarization transfer (RINEPT) technique was applied in a cross-sectional study involving 11 schizophrenia spectrum disorder patients (SZP) on stable antipsychotic monotherapy and 15 matched control subjects. Metabolite signals were found to be modulated by cerebrospinal fluid (CSF) content and gray matter/brain matter ratio. Corrected metabolite concentrations of PC, GPC and PE differed between patients and controls in both subcortical and cortical regions, whereas antipsychotic medication exerted only small effects. Significant correlations were found between the severity of clinical symptoms and the assessed signals. In particular, psychotic symptoms correlated with PC levels in the cerebral cortex, depression with PC levels in the cerebellum and executive functioning with GPC in the insular and temporal cortices. In conclusion, after controlling for age and tissue composition, this investigation revealed alterations of metabolite levels in SZP and correlations with clinical properties. RINEPT 31P MRS should also be applied to at-risk-mental-state patients as well as drug-naïve and chronically treated schizophrenic patients in order to enhance the understanding of longitudinal alterations of PL metabolism in schizophrenia.
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Affiliation(s)
- Wolfgang Weber-Fahr
- Department of Neuroimaging, Central Institute of Mental Health, University of Heidelberg, Mannheim, Germany
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Narayanaswamy JC, Venkatasubramanian G, Gangadhar BN. Neuroimaging studies in schizophrenia: an overview of research from Asia. Int Rev Psychiatry 2012; 24:405-16. [PMID: 23057977 DOI: 10.3109/09540261.2012.704872] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Neuroimaging studies in schizophrenia help clarify the neural substrates underlying the pathogenesis of this neuropsychiatric disorder. Contemporary brain imaging in schizophrenia is predominated by magnetic resonance imaging (MRI)-based research approaches. This review focuses on the various imaging studies from India and their relevance to the understanding of brain abnormalities in schizophrenia. The existing studies are predominantly comprised of structural MRI reports involving region-of-interest and voxel-based morphometry approaches, magnetic resonance spectroscopy and single-photon emission computed tomography/positron emission tomography (SPECT/PET) studies. Most of these studies are significant in that they have evaluated antipsychotic-naïve schizophrenia patients--a relatively difficult population to obtain in contemporary research. Findings of these studies offer robust support to the existence of significant brain abnormalities at very early stages of the disorder. In addition, theoretically relevant relationships between these brain abnormalities and developmental aberrations suggest possible neurodevelopmental basis for these brain deficits.
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Affiliation(s)
- Janardhanan C Narayanaswamy
- Schizophrenia Clinic, Department of Psychiatry, Translational Psychiatry Laboratory, Neurobiology Research Centre, National Institute of Mental Health and Neurosciences, Bangalore, India
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Smesny S, Langbein K, Rzanny R, Gussew A, Burmeister HP, Reichenbach JR, Sauer H. Antipsychotic drug effects on left prefrontal phospholipid metabolism: a follow-up 31P-2D-CSI study of haloperidol and risperidone in acutely ill chronic schizophrenia patients. Schizophr Res 2012; 138:164-70. [PMID: 22516552 DOI: 10.1016/j.schres.2012.02.031] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2011] [Revised: 02/03/2012] [Accepted: 02/29/2012] [Indexed: 10/28/2022]
Abstract
INTRODUCTION ³¹Phosphorous magnetic resonance spectroscopy (2D chemical shift imaging, CSI) allows multiregional study of membrane phospholipids and high-energy phosphates in vivo. Increased membrane lipid turnover and impaired energy supply have repeatedly been shown in first-episode schizophrenia patients, and might be a target of drug actions other than dopamine receptors. Here, we explored differential metabolic effects of a typical vs. an atypical antipsychotic on brain phospholipids. METHODS We applied 2D-CSI MR spectroscopy in 17 recurrent-episode schizophrenia patients off antipsychotics at baseline and at follow-up after 6 weeks, during which 7 patients were treated with haloperidol (10-16 mg/d) and 10 with risperidone (4-6 mg/d). Psychopathology changes were assessed using PANSS, BPRS and CGI scores. RESULTS Follow-up analysis using repeated measure ANOVA revealed different effects of both antipsychotic agents: while risperidone generally increased metabolite levels, haloperidol showed a tendency to decrease them. This diverging effect was significant for ATP levels in the left lateral frontal cortex. Furthermore, risperidone increased ATP in the left dorsolateral prefrontal cortex, left anterior temporal cortex and left insular cortex, basal ganglia, and anterior cerebellum, along with left frontal and prefrontal increase of PCr, PDE and PME in these brain regions. CONCLUSION Risperidone seems to stimulate neuronal and synaptic phospholipid remodeling in left frontal and prefrontal regions, and to a lesser extent also in temporal and insular cortices. We discuss these effects with respect to clinical effects on negative and cognitive symptoms, as well as interaction of phospholipid metabolism with glutamatergic neurotransmission.
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Affiliation(s)
- Stefan Smesny
- Department of Psychiatry and Psychotherapy, Jena University Hospital, Friedrich-Schiller-University, Philosophenweg 3, D-07743 Jena, Germany.
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Progressive membrane phospholipid changes in first episode schizophrenia with high field magnetic resonance spectroscopy. Psychiatry Res 2012; 201:25-33. [PMID: 22284150 DOI: 10.1016/j.pscychresns.2011.06.017] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2010] [Revised: 06/24/2011] [Accepted: 06/29/2011] [Indexed: 12/22/2022]
Abstract
Patients with a first episode of schizophrenia generally have increased phospholipid membrane breakdown products within the brain, while findings in chronic patients have been inconsistent. In this study we examine progressive changes in phosphorus membrane metabolites in the same patient group through the early years of schizophrenia in brain regions associated with the disease. Sixteen never-treated and medicated first episode schizophrenic patients were assessed at 10 months and 52 months after diagnosis. Sixteen matched volunteers were assessed at baseline and after 35 months. Phospholipid membrane metabolism was assessed with phosphorous magnetic resonance spectroscopy in the thalamus, cerebellum, hippocampus, anterior/posterior cingulate, prefrontal cortex, parieto-occipital cortex, superior temporal gyrus and temporal pole. At 10 months, glycerophosphocholine was increased in the anterior cingulate in patients as compared to controls. Glycerophosphocholine was decreased in the anterior cingulate and increased in the posterior cingulate and left superior temporal gyrus; glycerophosphoethanolamine was decreased in the left thalamus and increased in the left hippocampus within patients over time. At 52 months, compared to controls phosphocholine was increased in the left thalamus and glycerophosphoethanolamine was increased in the left hippocampus. These results imply a gradual inclusion of brain regions in schizophrenia where an initial increase, followed by a decrease in phospholipid membrane metabolites was observed. This pattern, observed in the early years of schizophrenia, is consistent with excitotoxic neural membrane breakdown in these regions.
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Llewellyn S. If waking and dreaming consciousness became de-differentiated, would schizophrenia result? Conscious Cogn 2011; 20:1059-83. [PMID: 21498086 DOI: 10.1016/j.concog.2011.03.022] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2010] [Revised: 03/17/2011] [Accepted: 03/22/2011] [Indexed: 12/31/2022]
Abstract
If both waking and dreaming consciousness are functional, their de-differentiation would be doubly detrimental. Differentiation between waking and dreaming is achieved through neuromodulation. During dreaming, without external sensory data and with mesolimbic dopaminergic input, hyper-cholinergic input almost totally suppresses the aminergic system. During waking, with sensory gates open, aminergic modulation inhibits cholinergic and mesocortical dopaminergic suppresses mesolimbic. These neuromodulatory systems are reciprocally interactive and self-organizing. As a consequence of neuromodulatory reciprocity, phenomenologically, the self and the world that appear during dreaming differ from those that emerge during waking. As a result of self-organizing, the self and the world in both states are integrated. Some loss of self-organization would precipitate a degree of de-differentiation between waking and dreaming, resulting in a hybrid state which would be expressed heterogeneously, both neurobiologically and phenomenologically. As a consequence of progressive de-differentiation, certain identifiable psychiatric disorders may emerge. Ultimately, schizophrenia, a disorganized-fragmented self, may result.
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Affiliation(s)
- Sue Llewellyn
- Faculty of Humanities, The University of Manchester, Booth Street West, Manchester M15 6PB, UK.
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Jayakumar PN, Gangadhar BN, Venkatasubramanian G, Desai S, Velayudhan L, Subbakrishna D, Keshavan MS. High energy phosphate abnormalities normalize after antipsychotic treatment in schizophrenia: a longitudinal 31P MRS study of basal ganglia. Psychiatry Res 2010; 181:237-40. [PMID: 20153149 DOI: 10.1016/j.pscychresns.2009.10.010] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2009] [Revised: 08/30/2009] [Accepted: 10/16/2009] [Indexed: 11/26/2022]
Abstract
We reported increased high-energy phosphate metabolism in the basal ganglia of antipsychotic-naïve schizophrenia patients using (31)P Magnetic Resonance Spectroscopy (MRS). These patients were followed up for 1 year and and reassessed using (31)P MRS. Fourteen (8 males) patients with DSM-IV schizophrenia and 14 (11 males) healthy controls underwent (31)P MRS of sub-cortical structures (predominantly basal ganglia) twice (mean+/-S.D. interscan interval 1.15+/-0.17year) on a 1.5T scanner. Total scores on the Positive and Negative Syndrome Scale (PANSS) decreased significantly after treatment in schizophrenia patients. Patients had significantly lower mean PCr/ATP ratios than healthy controls at baseline but not during the follow-up. In patients, there was a significant positive correlation between the magnitude of improvement in PANSS total scores and the extent of change in the PCr/ATP ratio. Findings support the hypothesis that reduction of energy demand or induction of decreased energy-demanding processes might underlie the mechanism of action of antipsychotics in schizophrenia.
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Affiliation(s)
- Peruvumba N Jayakumar
- Department of Neuroimaging & Interventional Radiology, National Institute of Mental Health and Neurosciences, Bangalore, India
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Nuss P, Tessier C, Ferreri F, De Hert M, Peuskens J, Trugnan G, Masliah J, Wolf C. Abnormal transbilayer distribution of phospholipids in red blood cell membranes in schizophrenia. Psychiatry Res 2009; 169:91-6. [PMID: 19646766 DOI: 10.1016/j.psychres.2009.01.009] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2007] [Revised: 01/02/2009] [Accepted: 01/05/2009] [Indexed: 10/20/2022]
Abstract
Abnormalities in membrane lipids have been repeatedly reported in patients with schizophrenia. These abnormalities include decreased phosphatidylethanolamine (PE) and n-3 and n-6 polyunsaturated fatty acids in peripheral and brain cell membranes. The present study investigates the hypothesis of an overrepresentation of PE in the external leaflet of the red blood cell (RBC) membrane in patients with schizophrenia. The assumption was that this modification of PE asymmetrical distribution could explain the reported lipid membrane abnormalities. Phosphatidylethanolamine located in the external leaflet was specifically labeled in RBC membranes from 65 medicated patients with schizophrenia and 38 healthy controls. Labeled (external) and non-labeled (internal) PE and their respective fatty acid composition were analyzed by mass spectrometry. A significant increase in the percentage of external leaflet PE was found in RBC membranes in 63.1% of the patients. In this subgroup, a significant depletion of n-3 and n-6 polyunsaturated fatty acids from internally located PE was also observed. Age, sex and antipsychotic treatment were not associated with the transbilayer membrane distribution of PE. Potential mechanisms underlying these abnormalities may involve membrane phospholipid transporters or degradative enzymes involved in phospholipid metabolism. The anomaly described could characterize a subgroup among patients with schizophrenia.
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Affiliation(s)
- Philippe Nuss
- UPMC Univ Paris 06, UMR_S 538, CHU St Antoine, 27, rue de Chaligny, 75012 Paris, France.
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Konrad A, Winterer G. Disturbed structural connectivity in schizophrenia primary factor in pathology or epiphenomenon? Schizophr Bull 2008; 34:72-92. [PMID: 17485733 PMCID: PMC2632386 DOI: 10.1093/schbul/sbm034] [Citation(s) in RCA: 158] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Indirect evidence for disturbed structural connectivity of subcortical fiber tracts in schizophrenia has been obtained from functional neuroimaging and electrophysiologic studies. During the past few years, new structural imaging methods have become available. Diffusion tensor imaging and magnetization transfer imaging (MTI) have been used to investigate directly whether fiber tract abnormalities are indeed present in schizophrenia. To date, findings are inconsistent that may express problems related to methodological issues and sample size. Also, pathological processes detectable with these new techniques are not yet well understood. Nevertheless, with growing evidence of disturbed structural connectivity, myelination has been in the focus of postmortem investigations. Several studies have shown a significant reduction of oligodendroglial cells and ultrastructural alterations of myelin sheats in schizophrenia. There is also growing evidence for abnormal expression of myelin-related genes in schizophrenia: Neuregulin (NRG1) is important for oligodendrocyte development and function, and altered expression of erbB3, one of the NRG1 receptors, has been shown in schizophrenia patients. This is consistent with recent genetic studies suggesting that NRG1 may contribute to the genetic risk for schizophrenia. In conclusion, there is increasing evidence from multiple sides that structural connectivity might be pathologically changed in schizophrenia illness. Up to the present, however, it has not been possible to decide whether alterations of structural connectivity are intrinsically linked to the primary risk factors for schizophrenia or to secondary downstream effects (ie, degeneration of fibers secondarily caused by cortical neuronal dysfunction)-an issue that needs to be clarified by future research.
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Affiliation(s)
- Andreas Konrad
- Department of Psychiatry, Johannes Gutenberg-University, Mainz, Germany.
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Venkatasubramanian G. Schizophrenia is a disorder of aberrant neurodevelopment: A synthesis of evidence from clinical and structural, functional and neurochemical brain imaging studies. Indian J Psychiatry 2007; 49:244-9. [PMID: 20680135 PMCID: PMC2910346 DOI: 10.4103/0019-5545.37663] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Affiliation(s)
- Ganesan Venkatasubramanian
- Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore - 560 029, Karnataka, India
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Gangadhar BN, Jayakumar PN, Venkatasubramanian G, Janakiramaiah N, Keshavan MS. Developmental reflexes and 31P Magnetic Resonance Spectroscopy of basal ganglia in antipsychotic-naive schizophrenia. Prog Neuropsychopharmacol Biol Psychiatry 2006; 30:910-3. [PMID: 16569471 DOI: 10.1016/j.pnpbp.2006.02.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
The study examined the high energy-phosphate metabolism of basal ganglia in antipsychotic-naive schizophrenia patients with and without developmental reflexes in comparison to healthy subjects. Nineteen antipsychotic-naive schizophrenics of whom 11 had developmental reflexes and 26 age-sex-matched healthy subjects without developmental reflexes underwent in-vivo 2-D 31P Magnetic Resonance Spectroscopy of basal ganglia on a 1.5-T scanner. Mean age-at-onset of psychosis was significantly lower in patients with developmental reflexes. Mean PCr/Total ATP ratio in bilateral basal ganglia was lower in patients than healthy subjects. The ratio was the least in patients with developmental reflexes (F=10.7; df=2, 42; p<0.001). Schizophrenia patients with developmental reflexes had the lowest PCr/Total ATP ratio in basal ganglia indicating more severe metabolic abnormality. These patients had younger age-at-onset of psychosis. Together, this suggests neurodevelopmental etiopathogenesis in schizophrenia.
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Affiliation(s)
- Bangalore N Gangadhar
- Department of Psychiatry, National Institute of Mental Health and Neurosciences, Hosur road, Bangalore 560029, India.
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Ross BM, Hughes B, Kish SJ, Warsh JJ. Serum calcium-independent phospholipase A2 activity in bipolar affective disorder. Bipolar Disord 2006; 8:265-70. [PMID: 16696828 DOI: 10.1111/j.1399-5618.2006.00299.x] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
OBJECTIVE Phospholipases A2 (PLA2) are a family of enzymes involved in membrane phospholipid metabolism and cell signalling. The gene encoding one form, type VI calcium-independent phospholipase A2, is located in a region of DNA that may contain a gene important in the aetiology of psychosis. Moreover, the activity of calcium-independent PLA2 is reported to be elevated in the blood and brain of patients with schizophrenia. In this study we determined whether a similar change takes place in patients with bipolar disorder with and without a history of psychosis. METHODS Serum calcium-independent and -dependent PLA2 activities were determined in 24 patients with bipolar I disorder. RESULTS Serum calcium-independent and -dependent PLA2 activities in bipolar cases did not differ significantly from that in healthy volunteers (HVs). However, calcium-independent PLA2 activity was significantly (p < 0.05) higher in patients with a history of psychosis compared with those with no history of psychosis (by 55%) or to HVs (by 31%). CONCLUSIONS Our data suggest that a subset of bipolar I disorder patients with a history of psychosis have elevated calcium-independent PLA2 activity. Given that this enzyme activity is also increased in schizophrenia, elevated rates of phospholipid turnover mediated by the enzyme could represent a common biochemical feature of psychotic illness.
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Affiliation(s)
- Brian M Ross
- Northern Ontario School of Medicine, Lakehead University, Thunder Bay, ON, Canada.
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Penet MF, Laigle C, Fur YL, Confort-Gouny S, Heurteaux C, Cozzone PJ, Viola A. In vivo Characterization of Brain Morphometric and Metabolic Endophenotypes in Three Inbred Strains of Mice Using Magnetic Resonance Techniques. Behav Genet 2006; 36:732-44. [PMID: 16710778 DOI: 10.1007/s10519-006-9077-4] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
C57BL6J, FVB/N and 129/SvJ mice are commonly used as background strains to engineer genetic models of brain pathologies and psychiatric disorders. Magnetic resonance imaging (MRI) and spectroscopy provide alternative approaches to neuroanatomy, histology and neurohistochemistry for investigating the correlation between genes and brain neuroanatomy and neurometabolism in vivo. We used these techniques to non-invasively characterize the cerebral morphologic and metabolic endophenotypes of inbred mouse strains commonly used in neurological and behavioral research. We observed a great variability in the volume of ventricles and of structures involved in cognitive function (cerebellum and hippocampus) among these strains. In addition, distinct metabolic profiles were evidenced with variable levels of N-acetylaspartate, a neuronal marker, and of choline, a compound found in membranes and myelin. Besides, significant differences in high-energy phosphates and phospholipids were detected. Our findings demonstrate the great morphologic and metabolic heterogeneity among C57BL/ 6J, FVB/N and 129/SvJ mice. They emphasize the importance of selecting the appropriate genetic background for over-expressing or silencing a gene and provide some directions for modeling symptoms that characterize psychiatric disorders such as autism, schizophrenia and depression.
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Affiliation(s)
- Marie-France Penet
- Faculté de Médecine, Centre de Résonance Magnétique Biologique et Médicale, UMR CNRS 6612, Université de la Méditérranée, 27 Bd J. Moulin, Marseille 13005, France
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Current awareness in NMR in biomedicine. NMR IN BIOMEDICINE 2003; 16:510-517. [PMID: 14719526 DOI: 10.1002/nbm.806] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
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