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Zhu X, Chen D, Xiu M, Li S, Zhang XY. Serum BDNF levels, glycolipid metabolism in deficit schizophrenia: A case-control study. Asian J Psychiatr 2022; 69:103003. [PMID: 34999534 DOI: 10.1016/j.ajp.2022.103003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2021] [Revised: 12/13/2021] [Accepted: 01/01/2022] [Indexed: 12/12/2022]
Abstract
BACKGROUND Few studies have compared serum BDNF and glycolipid profiles in patients with deficit schizophrenia (DS) and non-deficit schizophrenia (NDS). We aimed to compare BDNF and glycolipid profiles between DS and NDS patients and healthy controls, and to investigate the relationship between BDNF, glycolipid profiles in DS and NDS patients. METHODS A total of 591 patients with chronic schizophrenia (SZ) and 238 healthy controls participated in this study. According to Proxy for the Deficit Syndrome Scale, SZ patients were divided into DS (n = 158) and NDS (n = 273) patients. Psychiatric symptoms were assessed using the Positive and Negative Syndrome Scale (PANSS). Serum BDNF levels were measured using enzyme-linked immunosorbent assay (ELISA). RESULTS BDNF levels were significantly lower in SZ patients than those in healthy controls (7.81 ± 2.98 ng/ml vs. 11.96 ± 2.29 ng/ml, P < 0.01). Furthermore, BDNF levels were lower in DS group than those in NDS group (P = 0.007, OR = 0.846, 95% CI = 0.750-0.955). Lower triglyceride levels were also an independent predictor for DS patients (P = 0.007, OR = 0.846, 95% CI = 0.750-0.955). Serum BDNF levels were negatively associated with the severity of deficit syndrome in SZ patients (β = -1.151, t = -2.559, P = 0.011). In DS group, triglycerides were associated with PANSS negative subscore (β = -0.262, t = -2.994, P = 0.003) and depressive factor subscore (β = 0.282, t = 2.146, P = 0.035). CONCLUSION Serum BDNF and triglycerides may be informative biomarkers of DS in SZ patients. The differences in glycolipid metabolism patterns between DS and NDS patients indicate that deficit syndrome is an independent endophenotype of SZ patients.
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Affiliation(s)
- Xu Zhu
- Department of Psychiatry and Psychology, College of Basic Medical Sciences, Tianjin Medical University, Tianjin 300070, China
| | - Dachun Chen
- Beijing HuiLongGuan Hospital, Peking University HuiLongGuan Clinical Medical School, Beijing, China
| | - Meihong Xiu
- Beijing HuiLongGuan Hospital, Peking University HuiLongGuan Clinical Medical School, Beijing, China
| | - Shen Li
- Department of Psychiatry and Psychology, College of Basic Medical Sciences, Tianjin Medical University, Tianjin 300070, China.
| | - Xiang Yang Zhang
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China; Department of Psychology, University of Chinese Academy of Sciences, Beijing, China.
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Liu L, Luo Y, Zhang G, Jin C, Zhou Z, Cheng Z, Yuan G. Correlation of DRD2 mRNA expression levels with deficit syndrome severity in chronic schizophrenia patients receiving clozapine treatment. Oncotarget 2017; 8:86515-86526. [PMID: 29156812 PMCID: PMC5689702 DOI: 10.18632/oncotarget.21230] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2017] [Accepted: 08/26/2017] [Indexed: 01/06/2023] Open
Abstract
Schizophrenia is a complex, severe, chronic psychiatric disorder, and the associated deficit syndrome is widely regarded as an important clinical aspect of schizophrenia. This study analyzed the relationship of deficit syndrome severity with the mRNA levels of members of signaling pathways that associate with the pathophysiology of schizophrenia, including the dopamine D2 receptor (DRD2), protein kinase B (AKT1), and phosphoinositide-3 kinase (PI3KCB), in peripheral blood leukocytes (PBLs) of 20 healthy controls and 19 chronic schizophrenia patients with long-term clozapine treatment. The DRD2 expression levels in chronic schizophrenia group were statistically higher than those in controls (t=2.168, p=0.037). Moreover, in chronic schizophrenia group, correlations were observed between the expression levels of DRD2 and PI3KCB (r=0.771, p<0.001), DRD2 and AKT1 (r=0.592, p=0.008), and PI3KCB and AKT1 (r=0.562, p=0.012) and between the DRD2 mRNA levels and the Proxy for the Deficit Syndrome score (r=0.511, p=0.025). In control group, the correlation between PI3KCB expression levels and DRD2 expression levels was only observed (r=0.782, p<0.001). In conclusion, a correlation was observed between increased deficit syndrome severity and elevated expression levels of DRD2 in PBLs of chronic schizophrenia patients receiving long-term clozapine treatment.
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Affiliation(s)
- Liang Liu
- Wuxi Mental Health Center, Nanjing Medical University, Wuxi, China
| | - Yin Luo
- Wuxi Mental Health Center, Nanjing Medical University, Wuxi, China
| | - Guofu Zhang
- Wuxi Mental Health Center, Nanjing Medical University, Wuxi, China
| | - Chunhui Jin
- Wuxi Mental Health Center, Nanjing Medical University, Wuxi, China
| | - Zhenhe Zhou
- Wuxi Mental Health Center, Nanjing Medical University, Wuxi, China
| | - Zaohuo Cheng
- Wuxi Mental Health Center, Nanjing Medical University, Wuxi, China
- Wuxi Tongren International Rehabilitation Hospital, Nanjing Medical University, Wuxi, China
| | - Guozhen Yuan
- Wuxi Mental Health Center, Nanjing Medical University, Wuxi, China
- Wuxi Tongren International Rehabilitation Hospital, Nanjing Medical University, Wuxi, China
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van de Kerkhof NWA, Fekkes D, van der Heijden FMMA, Egger JIM, Verhoeven WMA. Relationship between plasma homovanillic acid and outcome in patients with psychosis spectrum disorders. Neuropsychobiology 2016; 71:212-7. [PMID: 26279280 DOI: 10.1159/000431095] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2014] [Accepted: 05/04/2015] [Indexed: 11/19/2022]
Abstract
BACKGROUND Psychosis spectrum disorders, especially schizophrenia, have been linked to disturbed dopaminergic activity in the brain. Plasma homovanillic acid (pHVA) levels partly represent dopaminergic metabolism in the central nervous system. In the present study associations between (changes in) pHVA levels, symptom severity and symptomatic improvement in patients with psychoses were investigated. METHODS From a total of 80 patients, 58 fulfilled all inclusion criteria and their symptom profile and severity were assessed by means of the Comprehensive Assessment of Symptoms and History (CASH), the Positive and Negative Syndrome Scale (PANSS) and the Clinical Global Impression Scale for Severity and Improvement (CGI-S/CGI-I) at baseline and after 6 weeks of antipsychotic treatment. After inclusion, all patients were prescribed first- or second-generation antipsychotics by their treating psychiatrist. A total of 12 patients had first-episode psychosis (FEP). At both time points, pHVA levels were measured. Subsequently, pHVA levels were compared with an age-matched control sample and changes in pHVA levels (ΔpHVA) after treatment were associated with clinical parameters. RESULTS Before analyses, data were scrutinized for possible confounders, particularly gender, smoking, medication status (including antipsychotic class), and recent drug use. The pHVA levels in patients were not different from those in controls. Treatment resulted in a significant decrease of all parameters. Symptomatic improvement as well as ΔpHVA was most pronounced in FEP patients. CONCLUSION These findings show that patients with FEP have a more favourable outcome than non-FEP patients and that greater ΔpHVA also suggests that FEP patients still have the capacity to adjust dopaminergic neurotransmission.
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Affiliation(s)
- Nora W A van de Kerkhof
- Centre of Excellence for Neuropsychiatry, Vincent van Gogh Institute for Psychiatry, Venray, The Netherlands
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Galderisi S, Merlotti E, Mucci A. Neurobiological background of negative symptoms. Eur Arch Psychiatry Clin Neurosci 2015; 265:543-58. [PMID: 25797499 DOI: 10.1007/s00406-015-0590-4] [Citation(s) in RCA: 64] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2015] [Accepted: 03/15/2015] [Indexed: 01/29/2023]
Abstract
Studies investigating neurobiological bases of negative symptoms of schizophrenia failed to provide consistent findings, possibly due to the heterogeneity of this psychopathological construct. We tried to review the findings published to date investigating neurobiological abnormalities after reducing the heterogeneity of the negative symptoms construct. The literature in electronic databases as well as citations and major articles are reviewed with respect to the phenomenology, pathology, genetics and neurobiology of schizophrenia. We searched PubMed with the keywords "negative symptoms," "deficit schizophrenia," "persistent negative symptoms," "neurotransmissions," "neuroimaging" and "genetic." Additional articles were identified by manually checking the reference lists of the relevant publications. Publications in English were considered, and unpublished studies, conference abstracts and poster presentations were not included. Structural and functional imaging studies addressed the issue of neurobiological background of negative symptoms from several perspectives (considering them as a unitary construct, focusing on primary and/or persistent negative symptoms and, more recently, clustering them into factors), but produced discrepant findings. The examined studies provided evidence suggesting that even primary and persistent negative symptoms include different psychopathological constructs, probably reflecting the dysfunction of different neurobiological substrates. Furthermore, they suggest that complex alterations in multiple neurotransmitter systems and genetic variants might influence the expression of negative symptoms in schizophrenia. On the whole, the reviewed findings, representing the distillation of a large body of disparate data, suggest that further deconstruction of negative symptomatology into more elementary components is needed to gain insight into underlying neurobiological mechanisms.
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Affiliation(s)
- Silvana Galderisi
- Department of Psychiatry, Second University of Naples (SUN), L.go Madonna delle Grazie, 1, 80138, Naples, Italy.
| | - Eleonora Merlotti
- Department of Psychiatry, Second University of Naples (SUN), L.go Madonna delle Grazie, 1, 80138, Naples, Italy
| | - Armida Mucci
- Department of Psychiatry, Second University of Naples (SUN), L.go Madonna delle Grazie, 1, 80138, Naples, Italy
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Schizophrenia and bipolar disorder: The road from similarities and clinical heterogeneity to neurobiological types. Clin Chim Acta 2015; 449:49-59. [DOI: 10.1016/j.cca.2015.02.029] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2015] [Accepted: 02/13/2015] [Indexed: 01/06/2023]
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Cai HL, Fang PF, Li HD, Zhang XH, Hu L, Yang W, Ye HS. Abnormal plasma monoamine metabolism in schizophrenia and its correlation with clinical responses to risperidone treatment. Psychiatry Res 2011; 188:197-202. [PMID: 21146875 DOI: 10.1016/j.psychres.2010.11.003] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2010] [Revised: 10/29/2010] [Accepted: 11/01/2010] [Indexed: 11/26/2022]
Abstract
Abnormalities in plasma monoamine metabolism reflect partly the illness of schizophrenia and sometimes the symptoms. Such studies have been repeatedly reported but have rarely taken both metabolites and parent amines or inter-amine activity ratios into account. In this study, the monoamines, their metabolites, turnovers and between-metabolite ratios in plasma were measured longitudinally in 32 schizophrenic patients treated with risperidone for 6 weeks, to examine possible biochemical alterations in schizophrenia, and to examine the association between treatment responses and psychopathology assessed according to the Positive and Negative Syndrome Scale (PANSS). The results showed lower level of plasma 3,4-dihydroxyphenylacetic acid (DOPAC) in relapsed versus first-episode schizophrenic patients, higher norepinephrine (NE) turnover rate (TR) in undifferentiated in comparison to paranoid schizophrenic patients and relatively higher metabolic activity of dopamine (DA) to serotonin (5-HT) in first-episode versus relapsed schizophrenic patients. Risperidone treatment induced a decrement of plasma DA levels and increments of plasma DOPAC and DA TR in the total group of schizophrenic patients. The turnover rate of 5-HT was was reduced in undifferentiated and relapsed subgroups of schizophrenic patients. The linkages between 5-HT TR, DA/NE relative activity and clinical symptomatology were also identified. These findings are consistent with an involvement of these systems in the pathogenesis of schizophrenia as well as in the responses to treatment, and the usefulness of certain biochemical indices as markers for subgrouping.
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Affiliation(s)
- Hua-Lin Cai
- Clinical Pharmacy and Pharmacology Research Institute, Second Xiangya Hospital, Central South University, Changsha, China
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7
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Nkam I, Bocca ML, Denise P, Paoletti X, Dollfus S, Levillain D, Thibaut F. Impaired smooth pursuit in schizophrenia results from prediction impairment only. Biol Psychiatry 2010; 67:992-7. [PMID: 20110087 DOI: 10.1016/j.biopsych.2009.11.029] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2008] [Revised: 10/12/2009] [Accepted: 11/18/2009] [Indexed: 11/27/2022]
Abstract
BACKGROUND Oculomotor abnormality is one of the endophenotypes in schizophrenia. The predictive component of smooth pursuit can be studied by comparing the gain, i.e., the ratio of smooth eye position to target position, during predictable (pure sinusoidal) and unpredictable (pseudorandom) target motions. The aim of this experiment was to study predictive and nonpredictive components of smooth pursuit in two groups of schizophrenia patients compared with control subjects. METHODS Fifty-one schizophrenia patients (40 nondeficit and 11 deficit) and 21 control subjects were studied. During a predictable task, subjects were asked to track a sinusoidal target (.4 Hz). For the unpredictable task, the pseudorandom target motion consisted of five superimposed sinusoidal waveforms (.1, .2, .4, .6, and .8 Hz). The smooth eye position (eye position without saccades), gain, and phase were calculated for each frequency in each participant and for both tasks. RESULTS The mean sinusoidal smooth eye position gain was significantly lower in patients than in control subjects with no significant difference between deficit and nondeficit patients. During the pseudorandom task, all groups had a similar gain at .4 Hz. CONCLUSIONS Our study reveals that patients have a normal nonpredictive component of smooth pursuit, regardless of their level of negative symptoms. In contrast, the predictive mechanisms involved in eye pursuit were impaired in schizophrenia patients. These results indicate that poor pursuit performance during smooth pursuit is primarily a consequence of a predictive problem and is not related to the ability to generate an accurate pursuit maintenance response.
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Affiliation(s)
- Irene Nkam
- Rouen University Hospital-Charles Nicolle and Le Rouvray Hospital, Rouen School of Medicine, Rouen, France.
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The psychiatric symptomatology of deficit schizophrenia: a meta-analysis. Schizophr Res 2010; 118:122-7. [PMID: 19887305 DOI: 10.1016/j.schres.2009.10.010] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2009] [Revised: 10/08/2009] [Accepted: 10/09/2009] [Indexed: 11/23/2022]
Abstract
A relatively large literature has emerged supporting the notion that the deficit syndrome reflects a distinct illness within schizophrenia. One topic that has received limited attention is how deficit schizophrenia differs from nondeficit schizophrenia in terms of psychiatric symptomatology. The present study conducted a meta-analysis of 47 published studies to compare deficit and nondeficit patients in severity of positive, disorganization, negative, mood and total psychiatric symptoms. The patient groups did not differ in terms of positive or total psychiatric symptoms but deficit patients showed less severe mood symptoms and slightly more severe disorganization symptoms. Not surprisingly, deficit patients had much more severe negative symptoms. These results are discussed in terms of the construct validity of the deficit syndrome and the larger heterogeneity of schizophrenia. Additionally, diagnostic issues regarding the deficit syndrome are considered.
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Baeza I, Castro-Fornieles J, Deulofeu R, de la Serna E, Goti J, Salvà J, Bernardo M. Plasma homovanillic acid differences in clinical subgroups of first episode schizophrenic patients. Psychiatry Res 2009; 168:110-8. [PMID: 19501918 DOI: 10.1016/j.psychres.2008.04.011] [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: 10/08/2006] [Revised: 12/10/2007] [Accepted: 04/13/2008] [Indexed: 10/20/2022]
Abstract
This study evaluates the relationship between plasma homovanillic acid (pHVA) levels, which have been used to study the role of central dopamine in schizophrenia, and the positive/negative syndrome in first episode schizophrenic patients before and after antipsychotic treatment. Forty neuroleptic-naive first episode schizophrenic patients were monitored at baseline and on days 7, 14 and 28. Clinical status was evaluated with the Scale for the Assessment of Positive Symptoms (SAPS), the Scale for the Assessment of Negative Symptoms (SANS), and the Brief Psychotic Rating Scale. Plasma HVA levels were also measured. Patients were divided into predominantly positive or negative syndrome groups by subtracting SAPS from SANS scores, at baseline. A healthy control group was also enrolled. Schizophrenic patients as a group had significantly higher pHVA levels than controls at baseline (20.50+/-11.85 vs. 13.04+/-7.22 ng/ml). Moreover, 12 predominantly negative syndrome patients had similar mean baseline pHVA levels (21.30+/-12.36 ng/ml) to those of 28 predominantly positive syndrome patients (19.40+/-11.33 ng/ml). During follow-up, there was a different evolution of pHVA levels in the predominantly positive syndrome group than in the predominantly negative syndrome group, with a significantly greater global reduction of pHVA levels in the former. Although both groups showed clinical improvement following 4 weeks of treatment with risperidone, pHVA levels at endpoint were lower (13.29+/-5.91 ng/ml) than at baseline in patients in the predominantly positive syndrome group, while among those in the predominantly negative syndrome group there was no difference in pHVA levels before and after treatment (21.02+/-13.06 ng/ml). The different pHVA level profiles observed in predominantly positive and negative syndrome first episode patients after 4 weeks of treatment with risperidone suggest that each syndrome may have a different underlying neurobiology.
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Affiliation(s)
- Immaculada Baeza
- Department of Child and Adolescent Psychiatry and Psychology, Institut Clínic de Neurociències, Hospital Clínic i Provincial, University of Barcelona, Spain.
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Cortiñas M, Corral MJ, Garrido G, Garolera M, Pajares M, Escera C. Reduced novelty-P3 associated with increased behavioral distractibility in schizophrenia. Biol Psychol 2008; 78:253-60. [DOI: 10.1016/j.biopsycho.2008.03.011] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2007] [Revised: 02/14/2008] [Accepted: 03/14/2008] [Indexed: 10/22/2022]
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Affiliation(s)
- Sandeep Grover
- Department of Psychiatry, Postgraduate Institute of Medical Education and Research, Chandigarh, India
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Dávila R, Zumárraga M, Basterreche N, Arrúe A, Anguiano JB. Plasma homovanillic acid levels in schizophrenic patients: correlation with negative symptoms. Psychiatry Res 2007; 151:163-8. [PMID: 17434602 DOI: 10.1016/j.psychres.2005.07.039] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2003] [Revised: 04/13/2005] [Accepted: 07/20/2005] [Indexed: 11/29/2022]
Abstract
The relation between changes in the levels of plasma homovanillic acid (pHVA) and clinical evolution during neuroleptic treatment of schizophrenic patients has not been satisfactorily characterized, as a number of conflicting findings have been reported. Significant correlations have generally been found using the assessment of positive symptoms as an index of clinical outcome. Nevertheless, attempts to correlate pHVA concentrations with negative symptoms have yielded contradictory results. With a view to evaluating if different responses in negative symptoms are associated with distinct pHVA profiles, we examined the levels of pHVA in 46 neuroleptic-free schizophrenic patients and in these patients after neuroleptic treatment. Negative and positive symptoms were also addressed before and after treatment. Our results reveal that at least two classes of negative symptoms exist; the clinical evolution of the first class of negative symptoms parallels that of positive symptoms, and clinical improvement correlates with reduced dopaminergic activity. In contrast, in the second class, reduced dopaminergic activity is associated with a further deterioration of negative symptoms. These findings corroborate the heterogeneity of negative symptoms and may contribute to a better definition of endophenotypes in the schizophrenic syndrome.
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Affiliation(s)
- Ricardo Dávila
- Departamento de Investigación Neuroquímica, Hospital Psiquiátrico de Zamudio, Servicio Vasco de Salud (Osakidetza), Arteaga Auzoa N degrees 45, E-48170 Zamudio, Vizcaya, Spain.
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Oades RD, Röpcke B, Henning U, Klimke A. Neuropsychological measures of attention and memory function in schizophrenia: relationships with symptom dimensions and serum monoamine activity. BEHAVIORAL AND BRAIN FUNCTIONS : BBF 2005; 1:14. [PMID: 16091141 PMCID: PMC1208853 DOI: 10.1186/1744-9081-1-14] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/10/2005] [Accepted: 08/09/2005] [Indexed: 11/23/2022]
Abstract
BACKGROUND Some clinical symptoms or cognitive functions have been related to the overall state of monoamine activity in patients with schizophrenia, (e.g. inverse correlation of the dopamine metabolite HVA with delusions or visual-masking performance). However, profiles (as presented here) of the relations of the activity of dopamine, noradrenaline and serotonin to neuropsychologic (dys)functions in major patient sub-groups with their very different symptomatic and cognitive characteristics have not been reported. METHODS Serum measures of dopamine, noradrenaline and serotonin turnover were examined by regression analyses for the prediction of performance on 10 neuropsychological measures reflecting left- and right-hemispheric and frontal-, parietal- and temporal-lobe function in 108 patients with schizophrenia and 63 matched controls. The neuropsychological battery included tests of verbal fluency, Stroop interference, trail-making, block-design, Mooney faces recognition, picture-completion, immediate and delayed visual and verbal recall. Paranoid and nonparanoid subgroups were based on ratings from the Positive and Negative Syndrome Scale (PANSS). Groups with high and low ratings of ideas-of-reference and thought-disorder were formed from a median split on the Scale for Assessment of Positive Symptoms (SAPS). RESULTS Verbal-fluency and Stroop-interference (left frontal and fronto-cingulate function) were negatively associated with noradrenergic turnover in nonparanoid and thought-disordered patients. High dopamine turnover related to speeded trail-making (frontal modulation of set switching) in those with many ideas-of-reference. In contrast, low dopamine turnover predicted poor recall in nonparanoid patients and those with little thought disorder. Serotonin metabolism did not independently contribute to the prediction any measure of cognitive performance. But, with regard to the relative activity between monoaminergic systems, increased HVA/5-HIAA ratios predicted visual-reproduction and Mooney's face-recognition performance (right-hemisphere functions) in highly symptomatic patients. Decreased HVA/MHPG predicted non-verbal recall. CONCLUSION Clinical state and function are differentially sensitive to overall levels of monoamine activity. In particular, right-lateralised cerebral function was sensitive to the relative activities of the monoamines. Increased noradrenergic activity was associated with enhanced frontal but impaired temporal lobe function in nonparanoid syndromes. Low dopaminergic activity predicted poor attentional set control in those with ideas-of-reference, but poor recall in nonparanoid patients. These data, especially the HVA/5-HIAA ratios, provide a basis for planning the nature of antipsychotic treatment aimed at patient specific symptom dimensions and cognitive abilities.
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Affiliation(s)
- Robert D Oades
- Biopsychology Research Group, University Clinic for Child and Adolescent Psychiatry, Virchowstr. 174, 45147 ESSEN, Germany
| | - Bernd Röpcke
- Biopsychology Research Group, University Clinic for Child and Adolescent Psychiatry, Virchowstr. 174, 45147 ESSEN, Germany
| | - Uwe Henning
- University Clinic for Psychiatry and Psychotherapy, Bergische Landstr. 2,40629 Düsseldorf, Germany
| | - Ansgard Klimke
- University Clinic for Psychiatry and Psychotherapy, Bergische Landstr. 2,40629 Düsseldorf, Germany
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Louchart-de la Chapelle S, Levillain D, Ménard JF, Van der Elst A, Allio G, Haouzir S, Dollfus S, Campion D, Thibaut F. P50 inhibitory gating deficit is correlated with the negative symptomatology of schizophrenia. Psychiatry Res 2005; 136:27-34. [PMID: 16014313 DOI: 10.1016/j.psychres.2003.04.001] [Citation(s) in RCA: 50] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2003] [Accepted: 04/18/2003] [Indexed: 11/16/2022]
Abstract
Abnormal sensory gating in schizophrenia has frequently been reported. The strength of central inhibitory pathways was measured using the P50 component of the auditory evoked potential in a conditioning-testing paradigm. The relationships between a relative decrease in P50 amplitude to repeated auditory stimuli and clinical symptoms remain controversial. Using the Positive and Negative Syndrome Scale, we studied the P50 auditory conditioning-testing paradigm in 81 schizophrenic subjects, categorized into subgroups with and without prominent negative symptoms, in comparison with 88 control subjects. We found increased ratios of testing stimuli to conditioning stimuli in both schizophrenic subgroups relative to findings in the control group. In addition, we found significantly increased mean latencies of the P50 responses to conditioning (C) and testing (T) stimuli and significantly increased T/C ratios in the subgroup with negative symptoms compared with the subgroup with non-negative symptoms.
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Affiliation(s)
- Sandrine Louchart-de la Chapelle
- Service Hospitalo-Universitaire de Psychiatrie, CHU C. Nicolle et CH du Rouvray, INSERM Unité 614, UFR de Médecine, 1 rue de Germont, 76031 Rouen Cedex, France
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15
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Elman I, Rott D, Green AI, Langleben DD, Lukas SE, Goldstein DS, Breier A. Effects of pharmacological doses of 2-deoxyglucose on plasma catecholamines and glucose levels in patients with schizophrenia. Psychopharmacology (Berl) 2004; 176:369-75. [PMID: 15179540 DOI: 10.1007/s00213-004-1890-y] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2003] [Accepted: 03/17/2004] [Indexed: 11/28/2022]
Abstract
RATIONALE Several lines of evidence suggest that the pathophysiology of schizophrenia may be associated with altered noradrenergic and glucoregulatory function. OBJECTIVE The aim of this study was to investigate these alterations during a perturbed homeostatic state. METHODS Fifteen patients with schizophrenia and 13 healthy individuals were given a glucose deprivation challenge through administration of pharmacological doses of 2-deoxyglucose (2DG; 40 mg/kg), and their plasma was assayed over the next 60 min for concentrations of norepinephrine (NE), the intraneuronal NE metabolite dihydroxyphenylglycol (DHPG), epinephrine and glucose. RESULTS 2DG induced significant increases in plasma NE, epinephrine and glucose levels in both groups with significantly greater NE and glucose increments in patients than in controls. For DHPG, 2DG produced increases in patients and decreases in the control subjects. NE responses correlated positively and significantly with the DHPG and glucose responses in schizophrenics, but not in controls. CONCLUSIONS These findings suggest that patients with schizophrenia have exaggerated NE and glucose responses to an acute metabolic perturbation.
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Affiliation(s)
- Igor Elman
- Department of Psychiatry, McLean Hospital and Harvard Medical School, 115 Mill Street, Belmont, MA 02478, USA.
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Oades RD, Klimke A, Henning U, Rao ML. Relations of clinical features, subgroups and medication to serum monoamines in schizophrenia. Hum Psychopharmacol 2002; 17:15-27. [PMID: 12404703 DOI: 10.1002/hup.368] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Plasma and serum indices of monoaminergic activity reflect partly the illness of schizophrenia (e.g. HVA/deficit syndrome) and sometimes the symptoms (e.g. HVA/anhedonia). But, such studies have rarely taken both metabolites and parent amines or inter-amine activity ratios into account. We hypothesized that comparing the major symptom dimensions to measures of transmitter activity (with and without control for antipsychotic drug treatment) would show differential patterns of activity useful for the design of pharmacological treatments. METHODS Dopamine (DA), noradrenaline (NA), serotonin (5-HT), their three major metabolites and prolactin were measured in the serum of 108 patients with schizophrenia and 63 matched controls: DA D2-receptor blocking-activity was estimated from a regression of butyrophenone displacement in striatum in vitro on to PET reports of drug-binding in vivo. Symptoms were factored into four dimensions (disorganized/thought disorder, nonparanoid/negative, ideas-of-reference and paranoid/positive symptoms). RESULTS (1). Patients' DA activity did not differ from controls: but their 5-HT and NA turnovers increased/decreased, respectively, and the DA/5HT-metabolite ratio was lower. Increased DA-D2-receptor occupancy was predicted by decreased DA-metabolism and its ratio to 5-HT-metabolism. (2). Patients had higher levels of NA, DA-metabolites and DA-/5-HT-metabolite ratios on atypical vs typical drugs. (3). Increased D2-occupancy was associated with lower DA metabolism in paranoid patients but was unrelated to relative increases of DA/5-HT- and NA-metabolism in nonparanoid patients. (4). Low DA-/5-HT-metabolite ratios, high prolactin and low DA-metabolism characterized thought-disordered patients. (5). High DA-/5-HT-metabolite ratios paralleled many ideas-of-reference. The metabolites were sensitive, respectively, to control for D2-occupancy and prolactin. CONCLUSIONS The role of DA in paranoid, and 5-HT in thought-disordered and ideas-of-reference dimensions point both to the mechanisms underlying the features typical of these subgroups and the type of medication appropriate.
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Affiliation(s)
- Robert D Oades
- University of Essen Clinic for Child and Adolescent Psychiatry and Psychotherapy, Essen, Germany.
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Goethals I, Audenaert K, Van Laere K, Van De Wiele C, Dierckx R. Dopaminergic neurotransmission in psychiatry: should selection of patients only be based on DSM or ICD criteria? EUROPEAN JOURNAL OF NUCLEAR MEDICINE 2001; 28:785-7. [PMID: 11504073 DOI: 10.1007/s002590100514] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Abstract
An association between deficit schizophrenia and male gender could be expected, since male schizophrenic subjects have been repeatedly found more severe than females on several dimensions of severity. Surprisingly, very few studies have confirmed such an association. We performed a more definitive test of this association using a meta-analysis. A pooled odds ratio was computed based on the 23 studies that reported the gender ratio in deficit vs. non-deficit schizophrenia. We tested for the heterogeneity of the association and examined the potential impact of the sampling method, the method used to assess the deficit syndrome, the breadth of diagnoses included and the mean duration of illness. A highly significant association between male gender and deficit schizophrenia was observed (pooled odds ratio=1.75). There was no definitive evidence that differences across studies in sampling methods, breadth of diagnoses included, mean duration of illness and methods to assess the deficit syndrome affected the strength of the association. However, the studies using the "Proxy Deficit Syndrome" method to assess the deficit syndrome yielded qualitatively weaker evidence. This significant association between male gender and deficit schizophrenia may reflect the influence of a gender related factor (e.g. sexual hormones) or gender differences in the liability to different etiologies of schizophrenia. The role of gender as a potential confounder must be closely examined in studies comparing deficit and non-deficit SZ.
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Affiliation(s)
- M A Roy
- Centre de recherche Université Laval Robert-Giffard, département de Psychiatrie de la faculté de Médecine de l'Université Laval, Robert-Giffard, 2601 de la Canardière, Beauport, G1J 2G3, Québec, Canada.
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19
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Nkam I, Thibaut F, Denise P, Van Der Elst A, Ségard L, Brazo P, Ménard J, Théry S, Halbeck I, Delamilleure P, Vasse T, Etard O, Dollfus S, Champion D, Levillain D, Petit M. Saccadic and smooth-pursuit eye movements in deficit and non-deficit schizophrenia. Schizophr Res 2001; 48:145-53. [PMID: 11278161 DOI: 10.1016/s0920-9964(99)00165-6] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
We have analyzed eye movement performances in schizophrenics showing primary negative or deficit symptoms (n=16) and non-deficit schizophrenics (n=55), and compared them with those of controls (n=34) in order to study the relationships between negative symptoms and eye movement abnormalities. Patients were subtyped into deficit and non-deficit subgroups using the Schedule for the Deficit Syndrome. Three oculomotor paradigms were used: smooth pursuit, a reflexive saccade paradigm and an antisaccadic task. The smooth pursuit gain was significantly decreased (and the rate of catch-up saccades increased) in schizophrenics as compared with controls, but no difference was observed between patient groups. In the reflexive saccade paradigm, no difference was found between controls and patients, except for latency in deficit patients. In the antisaccade paradigm, the number of errors and the latency of successful antisaccades were significantly increased in schizophrenics as compared with controls. The latency of successful antisaccades in both directions was significantly increased in deficit patients as compared with non-deficit patients. The latency of rightward successful antisaccades was significantly increased as compared with the latency of leftward antisaccades in deficit patients only. However, when patients were classified into negative and non-negative groups using the PANSS, no difference was found in the antisaccade paradigm. Smooth pursuit impairment does not seem to depend on the primary enduring negative symptoms.In deficit schizophrenics, the abnormalities observed in the antisaccadic task are consistent with prefrontal dysfunction, and may suggest parietal lobe dysfunction as well.
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Affiliation(s)
- I Nkam
- Unité de Recherche mixte, INSERM, EPI 9906, Université de Médecine de Rouen, 76183 Cedex, Rouen, France
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20
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Galinowski A, Castelnau C, Spreux-Varoquaux O, Bourdel MC, Olie JP, Loo H, Poirier MF. Evolution of plasma homovanillic acid (HVA) levels during treatment in schizo-affective disorder. Prog Neuropsychopharmacol Biol Psychiatry 2000; 24:1319-28. [PMID: 11125856 DOI: 10.1016/s0278-5846(00)00140-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
1. Plasma Homovanillic Acid (p HVA) levels were measured by HPLC (high performance liquid chromatography) in 5 schizo-affective depressed patients receiving a standardized treatment. (lithium, chlorpromazine and clomipramine) during 4 weeks. 2. Four patients were pretreated, without a washout period. 3. No significant difference was observed between patients and normal controls at baseline. Under treatment, pHVA levels increased (p<0.02) with clinical improvement (MADRS and PANSS scores). 4. Although effects of medications prior to the study period were not controlled, these findings suggest that depressed schizo-affective patients may have normal pHVA levels that increase with clinical improvement, unlike schizophrenic patients whose increased pHVA concentrations decline with neuroleptic treatment.
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Affiliation(s)
- A Galinowski
- University Clinic of Mental Health and Therapeutics, Sainte Anne Hospital (Paris), Cochin Port Royal Faculty of Medicine, France
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Thibaut F, Van Der Elst A, Campion D, Martin C, Coron B, Dollfus S, Frebourg TH, Petit M. Apolipoprotein E-varepsilon4 frequency in deficit schizophrenia. Eur Psychiatry 1999; 14:148-51. [PMID: 10572340 DOI: 10.1016/s0924-9338(99)80733-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
The apolipoprotein E (ApoE) genotype has been found to affect the expression of several neuropsychiatric disorders. We determined ApoE genotype frequencies and their relationship to primary negative symptoms in 61 non-deficit and 45 deficit schizophrenic patients, and compared them with 98 control subjects. No difference was observed when genotype or allele frequencies were compared between the three groups. Our data do not support a role for ApoE in the phenotypic expression of schizophrenia.
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Affiliation(s)
- F Thibaut
- Molecular Genetic Unit (Unité INSERM EPI 9906), IFR 23, CHU de Rouen, Rouen, France
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Amin F, Silverman JM, Siever LJ, Smith CJ, Knott PJ, Davis KL. Genetic antecedents of dopamine dysfunction in schizophrenia. Biol Psychiatry 1999; 45:1143-50. [PMID: 10331106 DOI: 10.1016/s0006-3223(98)00262-5] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
BACKGROUND Relatives of schizophrenic probands frequently manifest attenuated features of this illness including the negative symptoms and the milder positive psychotic symptoms. These two symptom dimensions are hypothesized to be associated with decreased and increased brain dopamine (DA) functions, respectively, raising the possibility that DA abnormalities may be present in the relatives of schizophrenic probands. METHODS Plasma homovanillic acid (HVA), the major DA metabolite and an indicator of brain DA activity, was measured in nonpsychotic, physically healthy first-degree relatives (n = 55) of schizophrenic probands and in normal subjects (n = 20) without a family history of schizophrenia. RESULTS Plasma HVA inversely correlated with negative symptoms and positively correlated with attenuated positive symptoms. Also, relatives had decreased plasma HVA compared to normal subjects, consistent with the fact that these relatives are characterized by negative symptoms. These findings were not related to major peripheral factors that could affect plasma HVA suggesting that the findings may reflect changes in brain DA activity. CONCLUSIONS Negative symptoms indicating a genetic diathesis to schizophrenia in relatives may have a biologic basis in reduced DA activity and the DA dysfunction of schizophrenia may have genetic antecedents. This opens an important new avenue for further study of DA in this illness.
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Affiliation(s)
- F Amin
- Psychiatry Service, Houston VAMC, TX 77030, USA
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