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Fan YS, Xu Y, Li Q, Chen Y, Guo X, Yang S, Guo J, Sheng W, Wang C, Gao Q, Chen H. Systematically mapping gray matter abnormal patterns in drug-naïve first-episode schizophrenia from childhood to adolescence. Cereb Cortex 2023; 33:1452-1461. [PMID: 35396845 DOI: 10.1093/cercor/bhac148] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2022] [Revised: 03/23/2022] [Accepted: 03/24/2022] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Schizophrenia originates early in neurodevelopment, underscoring the need to elaborate on anomalies in the still maturing brain of early-onset schizophrenia (EOS). METHODS Gray matter (GM) volumes were evaluated in 94 antipsychotic-naïve first-episode EOS patients and 100 typically developing (TD) controls. The anatomical profiles of changing GM deficits in EOS were detected using 2-way analyses of variance with diagnosis and age as factors, and its timing was further charted using stage-specific group comparisons. Interregional relationships of GM alterations were established using structural covariance network analyses. RESULTS Antagonistic interaction results suggested dynamic GM abnormalities of the left fusiform gyrus, inferior occipital gyrus, and lingual gyrus in EOS. These regions comprise a dominating part of the ventral stream, a ventral occipitotemporal (vOT) network engaged in early social information processing. GM abnormalities were mainly located in the vOT regions in childhood-onset patients, whereas in the rostral prefrontal cortex (rPFC) in adolescent-onset patients. Moreover, compared with TD controls, patients' GM synchronization with the ventral stream was disrupted in widespread high-order social perception regions including the rPFC and salience network. CONCLUSIONS The current findings reveal age-related anatomical abnormalities of the social perception system in pediatric patients with schizophrenia.
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Affiliation(s)
- Yun-Shuang Fan
- Sichuan Provincial Center for Mental Health, The Center of Psychosomatic Medicine of Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu 611731, China.,School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu 611731, China
| | - Yong Xu
- Department of Psychiatry, First Hospital/First Clinical Medical College of Shanxi Medical University, Taiyuan 030000, China
| | - Qiang Li
- Department of Psychiatry, First Hospital/First Clinical Medical College of Shanxi Medical University, Taiyuan 030000, China
| | - Yuyan Chen
- School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu 611731, China.,MOE Key Lab for Neuroinformation; High-Field Magnetic Resonance Brain Imaging Key Laboratory of Sichuan Province, University of Electronic Science and Technology of China, Chengdu 611731, China
| | - Xiaonan Guo
- School of Information Science and Engineering, Yanshan University, Qinhuangdao 066004, China
| | - Siqi Yang
- School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu 611731, China.,MOE Key Lab for Neuroinformation; High-Field Magnetic Resonance Brain Imaging Key Laboratory of Sichuan Province, University of Electronic Science and Technology of China, Chengdu 611731, China
| | - Jing Guo
- School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu 611731, China.,MOE Key Lab for Neuroinformation; High-Field Magnetic Resonance Brain Imaging Key Laboratory of Sichuan Province, University of Electronic Science and Technology of China, Chengdu 611731, China
| | - Wei Sheng
- School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu 611731, China.,MOE Key Lab for Neuroinformation; High-Field Magnetic Resonance Brain Imaging Key Laboratory of Sichuan Province, University of Electronic Science and Technology of China, Chengdu 611731, China
| | - Chong Wang
- School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu 611731, China.,MOE Key Lab for Neuroinformation; High-Field Magnetic Resonance Brain Imaging Key Laboratory of Sichuan Province, University of Electronic Science and Technology of China, Chengdu 611731, China
| | - Qing Gao
- MOE Key Lab for Neuroinformation; High-Field Magnetic Resonance Brain Imaging Key Laboratory of Sichuan Province, University of Electronic Science and Technology of China, Chengdu 611731, China
| | - Huafu Chen
- Sichuan Provincial Center for Mental Health, The Center of Psychosomatic Medicine of Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu 611731, China.,School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu 611731, China.,MOE Key Lab for Neuroinformation; High-Field Magnetic Resonance Brain Imaging Key Laboratory of Sichuan Province, University of Electronic Science and Technology of China, Chengdu 611731, China
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2
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Priol AC, Denis L, Boulanger G, Thépaut M, Geoffray MM, Tordjman S. Detection of Morphological Abnormalities in Schizophrenia: An Important Step to Identify Associated Genetic Disorders or Etiologic Subtypes. Int J Mol Sci 2021; 22:ijms22179464. [PMID: 34502372 PMCID: PMC8430486 DOI: 10.3390/ijms22179464] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Accepted: 08/06/2021] [Indexed: 12/20/2022] Open
Abstract
Current research suggests that alterations in neurodevelopmental processes, involving gene X environment interactions during key stages of brain development (prenatal period and adolescence), are a major risk for schizophrenia. First, epidemiological studies supporting a genetic contribution to schizophrenia are presented in this article, including family, twin, and adoption studies. Then, an extensive literature review on genetic disorders associated with schizophrenia is reviewed. These epidemiological findings and clinical observations led researchers to conduct studies on genetic associations in schizophrenia, and more specifically on genomics (CNV: copy-number variant, and SNP: single nucleotide polymorphism). The main structural (CNV) and sequence (SNP) variants found in individuals with schizophrenia are reported here. Evidence of genetic contributions to schizophrenia and current knowledge on genetic syndromes associated with this psychiatric disorder highlight the importance of a clinical genetic examination to detect minor physical anomalies in individuals with ultra-high risk of schizophrenia. Several dysmorphic features have been described in schizophrenia, especially in early onset schizophrenia, and can be viewed as neurodevelopmental markers of vulnerability. Early detection of individuals with neurodevelopmental abnormalities is a fundamental issue to develop prevention and diagnostic strategies, therapeutic intervention and follow-up, and to ascertain better the underlying mechanisms involved in the pathophysiology of schizophrenia.
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Affiliation(s)
- Anne-Clémence Priol
- Pôle Hospitalo-Universitaire de Psychiatrie de l’Enfant et de l’Adolescent (PHUPEA), Centre Hospitalier Guillaume Régnier, University of Rennes 1, 35000 Rennes, France; (L.D.); (G.B.); (M.T.)
- Correspondence: (A.-C.P.); (S.T.); Tel.: +33-2-99-51-06-04 (A.-C.P. & S.T.); Fax: +33-2-99-32-46-98 (A.-C.P. & S.T.)
| | - Laure Denis
- Pôle Hospitalo-Universitaire de Psychiatrie de l’Enfant et de l’Adolescent (PHUPEA), Centre Hospitalier Guillaume Régnier, University of Rennes 1, 35000 Rennes, France; (L.D.); (G.B.); (M.T.)
| | - Gaella Boulanger
- Pôle Hospitalo-Universitaire de Psychiatrie de l’Enfant et de l’Adolescent (PHUPEA), Centre Hospitalier Guillaume Régnier, University of Rennes 1, 35000 Rennes, France; (L.D.); (G.B.); (M.T.)
| | - Mathieu Thépaut
- Pôle Hospitalo-Universitaire de Psychiatrie de l’Enfant et de l’Adolescent (PHUPEA), Centre Hospitalier Guillaume Régnier, University of Rennes 1, 35000 Rennes, France; (L.D.); (G.B.); (M.T.)
| | - Marie-Maude Geoffray
- Department of Child and Adolescent Psychiatry, Centre Hospitalier Le Vinatier, 69500 Bron, France;
| | - Sylvie Tordjman
- Pôle Hospitalo-Universitaire de Psychiatrie de l’Enfant et de l’Adolescent (PHUPEA), Centre Hospitalier Guillaume Régnier, University of Rennes 1, 35000 Rennes, France; (L.D.); (G.B.); (M.T.)
- CIC (Clinical Investigation Center) 1414 Inserm, Centre Hospitalier Universitaire (CHU) de Rennes, University of Rennes 1, 35033 Rennes, France
- Integrative Neuroscience and Cognition Center (INCC), CNRS UMR 8002, University of Paris, 75006 Paris, France
- Correspondence: (A.-C.P.); (S.T.); Tel.: +33-2-99-51-06-04 (A.-C.P. & S.T.); Fax: +33-2-99-32-46-98 (A.-C.P. & S.T.)
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3
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Fakorede OO, Ogunwale A, Akinhanmi AO. Premorbid adjustment amongst outpatients with schizophrenia in a Nigerian psychiatric facility. S Afr J Psychiatr 2021; 27:1492. [PMID: 34192076 PMCID: PMC8182469 DOI: 10.4102/sajpsychiatry.v27i0.1492] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2019] [Accepted: 03/07/2021] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Studies from developed countries have shown that poor premorbid adjustment in patients with schizophrenia is associated with poor outcome. However, similar studies in developing countries like Nigeria are few despite the stability of schizophrenia prevalence across cultures. AIM The aim of this study was to assess the prevalence and correlates of poor premorbid adjustment amongst outpatients with schizophrenia. SETTING The Neuropsychiatric Hospital, Abeokuta in Ogun State, Nigeria. METHODS The premorbid adjustment of 300 outpatients with schizophrenia was assessed using the premorbid adjustment scale. Pattern and severity of psychosis, overall illness severity, global assessment of functioning and socio-demographic factors were investigated as correlates of premorbid functioning. RESULTS About half (53.3%) of the respondents had poor premorbid adjustment and most of them were males (56.9%). Poor premorbid adjustment was associated with male gender (χ 2 = 7.81, p = 0.005) whilst good premorbid adjustment was associated with no or borderline illness severity (χ 2 = 8.26, p = 0.016) as well as no or mild impairment in functioning (χ 2 = 7.01, p = 0.029) amongst the respondents. Positive, negative and general symptomatology were predicted by premorbid adjustment at different developmental stages. CONCLUSION Consistent with existing literature, poor premorbid adjustment was prevalent amongst patients with schizophrenia in this study and was associated with male gender, poorer clinical outcomes and greater illness severity. Mental health promotion and other preventative approaches are recommended as possible early intervention strategies in dealing with schizophrenia.
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Affiliation(s)
- Omokehinde O Fakorede
- Department of Mental Health and Behavioural Medicine, Federal Medical Centre, Abeokuta, Nigeria
| | | | - Akinwande O Akinhanmi
- Department of General Adult Psychiatry and Drug Addiction Treatment, Neuropsychiatric Hospital, Abeokuta, Nigeria
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4
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Chestnykh DA, Amato D, Kornhuber J, Müller CP. Pharmacotherapy of schizophrenia: Mechanisms of antipsychotic accumulation, therapeutic action and failure. Behav Brain Res 2021; 403:113144. [PMID: 33515642 DOI: 10.1016/j.bbr.2021.113144] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Revised: 01/21/2021] [Accepted: 01/22/2021] [Indexed: 12/13/2022]
Abstract
Schizophrenia is a multi-dimensional disorder with a complex and mostly unknown etiology, leading to a severe decline in life quality. Antipsychotic drugs (APDs) remain beneficial interventions in the treatment of the disorder, but vary significantly in binding profile, clinical effects and adverse reactions. The present review summarizes the main principles of APD mechanisms of action with a particular focus on recent findings in APD accumulation and its role in the therapeutic efficacy and treatment failure. High and low doses of APDs were shown to be effective in different dimensions of antipsychotic-like behaviour in rodent models. Efficacy of the APDs correlates with high dopamine D2 receptor occupancy, which occurs quickly after drug administration. However, onset and peak of action are delayed up to several days or weeks. APD accumulation via acidic trapping in synaptic vesicles is considered to underlie the time course of APD action. Use-dependent exocytosis, co-release with dopamine and serotonin and inhibition of ion channels impact on the neuronal transmission and determine effects of APDs. Disruption in accumulating properties leads to diminished APD effects. In addition, long-term APD administration at therapeutic doses leads to treatment failure both in animal models and in humans. APD failure was associated with treatment induced neuroadaptations, including a decline in extracellular dopamine levels, dopamine transporter upregulation, and altered neuronal firing. However, enhanced synaptic vesicle release has also been reported. APD loss of efficacy may be reversed through inhibition of the dopamine transporter or switching the administration regimen from continuous to intermittent. Thus, manipulating the accumulation properties of APDs, changes in the administration regimen and doses, or co-administration with dopamine transporter inhibitors may be considered to yield benefits in the development of new effective strategies in the treatment of schizophrenia.
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Affiliation(s)
- Daria A Chestnykh
- Department of Psychiatry and Psychotherapy, University Clinic, Friedrich-Alexander-University Erlangen-Nuremberg, Schwabachanlage 6, 91054, Erlangen, Germany
| | - Davide Amato
- Department of Psychiatry and Psychotherapy, University Clinic, Friedrich-Alexander-University Erlangen-Nuremberg, Schwabachanlage 6, 91054, Erlangen, Germany; Department of Neuroscience, Medical University of South Carolina, Charleston, SC, USA
| | - Johannes Kornhuber
- Department of Psychiatry and Psychotherapy, University Clinic, Friedrich-Alexander-University Erlangen-Nuremberg, Schwabachanlage 6, 91054, Erlangen, Germany
| | - Christian P Müller
- Department of Psychiatry and Psychotherapy, University Clinic, Friedrich-Alexander-University Erlangen-Nuremberg, Schwabachanlage 6, 91054, Erlangen, Germany.
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5
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Madireddy S, Madireddy S. Regulation of Reactive Oxygen Species-Mediated Damage in the Pathogenesis of Schizophrenia. Brain Sci 2020; 10:brainsci10100742. [PMID: 33081261 PMCID: PMC7603028 DOI: 10.3390/brainsci10100742] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Revised: 10/06/2020] [Accepted: 10/15/2020] [Indexed: 12/16/2022] Open
Abstract
The biochemical integrity of the brain is paramount to the function of the central nervous system, and oxidative stress is a key contributor to cerebral biochemical impairment. Oxidative stress, which occurs when an imbalance arises between the production of reactive oxygen species (ROS) and the efficacy of the antioxidant defense mechanism, is believed to play a role in the pathophysiology of various brain disorders. One such disorder, schizophrenia, not only causes lifelong disability but also induces severe emotional distress; however, because of its onset in early adolescence or adulthood and its progressive development, consuming natural antioxidant products may help regulate the pathogenesis of schizophrenia. Therefore, elucidating the functions of ROS and dietary antioxidants in the pathogenesis of schizophrenia could help formulate improved therapeutic strategies for its prevention and treatment. This review focuses specifically on the roles of ROS and oxidative damage in the pathophysiology of schizophrenia, as well as the effects of nutrition, antipsychotic use, cognitive therapies, and quality of life on patients with schizophrenia. By improving our understanding of the effects of various nutrients on schizophrenia, it may become possible to develop nutritional strategies and supplements to treat the disorder, alleviate its symptoms, and facilitate long-term recovery.
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Affiliation(s)
- Samskruthi Madireddy
- Independent Researcher, 1353 Tanaka Drive, San Jose, CA 95131, USA
- Correspondence: ; Tel.: +1-408-9214162
| | - Sahithi Madireddy
- Massachusetts Institute of Technology, 77 Massachusetts Ave, Cambridge, MA 02139, USA;
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6
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Rodrigues-Amorim D, Rivera-Baltanás T, Del Carmen Vallejo-Curto M, Rodriguez-Jamardo C, de Las Heras E, Barreiro-Villar C, Blanco-Formoso M, Fernández-Palleiro P, Álvarez-Ariza M, López M, García-Caballero A, Olivares JM, Spuch C. Plasma β-III tubulin, neurofilament light chain and glial fibrillary acidic protein are associated with neurodegeneration and progression in schizophrenia. Sci Rep 2020; 10:14271. [PMID: 32868793 PMCID: PMC7459108 DOI: 10.1038/s41598-020-71060-4] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2019] [Accepted: 08/10/2020] [Indexed: 12/29/2022] Open
Abstract
Schizophrenia is a progressive disorder characterized by multiple psychotic relapses. After every relapse, patients may not fully recover, and this may lead to a progressive loss of functionality. Pharmacological treatment represents a key factor to minimize the biological, psychological and psychosocial impact of the disorder. The number of relapses and the duration of psychotic episodes induce a potential neuronal damage and subsequently, neurodegenerative processes. Thus, a comparative study was performed, including forty healthy controls and forty-two SZ patients divided into first-episode psychosis (FEP) and chronic SZ (CSZ) subgroups, where the CSZ sub group was subdivided by antipsychotic treatment. In order to measure the potential neuronal damage, plasma levels of β-III tubulin, neurofilament light chain (Nf-L), and glial fibrillary acidic protein (GFAP) were performed. The results revealed that the levels of these proteins were increased in the SZ group compared to the control group (P < 0.05). Moreover, multiple comparison analysis showed highly significant levels of β-III tubulin (P = 0.0002), Nf-L (P = 0.0403) and GFAP (P < 0.015) in the subgroup of CSZ clozapine-treated. In conclusion, β-III tubulin, Nf-L and GFAP proteins may be potential biomarkers of neurodegeneration and progression in SZ.
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Affiliation(s)
- Daniela Rodrigues-Amorim
- Translational Neuroscience Research Group, Galicia Sur Health Research Institute, University of Vigo, CIBERSAM, Vigo, Spain
| | - Tania Rivera-Baltanás
- Translational Neuroscience Research Group, Galicia Sur Health Research Institute, University of Vigo, CIBERSAM, Vigo, Spain
| | - María Del Carmen Vallejo-Curto
- Translational Neuroscience Research Group, Galicia Sur Health Research Institute, University of Vigo, CIBERSAM, Vigo, Spain
| | - Cynthia Rodriguez-Jamardo
- Translational Neuroscience Research Group, Galicia Sur Health Research Institute, University of Vigo, CIBERSAM, Vigo, Spain
| | - Elena de Las Heras
- Translational Neuroscience Research Group, Galicia Sur Health Research Institute, University of Vigo, CIBERSAM, Vigo, Spain
| | - Carolina Barreiro-Villar
- Translational Neuroscience Research Group, Galicia Sur Health Research Institute, University of Vigo, CIBERSAM, Vigo, Spain
| | - María Blanco-Formoso
- Translational Neuroscience Research Group, Galicia Sur Health Research Institute, University of Vigo, CIBERSAM, Vigo, Spain
| | - Patricia Fernández-Palleiro
- Translational Neuroscience Research Group, Galicia Sur Health Research Institute, University of Vigo, CIBERSAM, Vigo, Spain
| | - María Álvarez-Ariza
- Translational Neuroscience Research Group, Galicia Sur Health Research Institute, University of Vigo, CIBERSAM, Vigo, Spain
| | - Marta López
- Translational Neuroscience Research Group, Galicia Sur Health Research Institute, University of Vigo, CIBERSAM, Vigo, Spain
| | | | - José Manuel Olivares
- Translational Neuroscience Research Group, Galicia Sur Health Research Institute, University of Vigo, CIBERSAM, Vigo, Spain.
- Hospital Álvaro Cunqueiro, Bloque Técnico, Galicia Sur Health Research Institute - IISGS, Planta 2, Sala de Investigación, Estrada Clara Campoamor, 341, 36212, Vigo, Spain.
| | - Carlos Spuch
- Translational Neuroscience Research Group, Galicia Sur Health Research Institute, University of Vigo, CIBERSAM, Vigo, Spain.
- Hospital Álvaro Cunqueiro, Bloque Técnico, Galicia Sur Health Research Institute - IISGS, Planta 2, Sala de Investigación, Estrada Clara Campoamor, 341, 36212, Vigo, Spain.
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Maniscalco L, Frédérique BB, Roccella M, Matranga D, Tripi G. A Preliminary Study on Cranio-Facial Characteristics Associated with Minor Neurological Dysfunctions (MNDs) in Children with Autism Spectrum Disorders (ASD). Brain Sci 2020; 10:brainsci10080566. [PMID: 32824853 PMCID: PMC7465923 DOI: 10.3390/brainsci10080566] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Revised: 08/13/2020] [Accepted: 08/17/2020] [Indexed: 11/16/2022] Open
Abstract
Background. Craniofacial anomalies and minor neurological dysfunction (MNDs) have been identified, in literature, as risk factors for neurodevelopmental disorders. They represent physical indicators of embryonic development suggesting a possible contributory role of complications during early, even pre-conceptional, phases of ontogeny in autism spectrum disorders (ASD). Limited research has been conducted about the co-occurrence of the two biomarkers in children with ASD. This study investigates the associative patterns of cranio-facial anomalies and MNDs in ASD children, and whether these neurodevelopmental markers correlate with intensity of ASD symptoms and overall functioning. Methods. Caucasian children with ASD (n = 33) were examined. Measures were based on five anthropometric cranio-facial indexes and a standardized and detailed neurological examination according to Touwen. Relationships between anthropometric z-scores, MNDs and participant characteristics (i.e., age, cognitive abilities, severity of autistic symptoms measured using the Childhood Autism Rating Scale (CARS) checklist) were assessed. Results. With respect to specific MNDs, significant positive correlations were found between Cephalic Index and Sensory deficits (p-value < 0.001), which did not correlate with CARS score. Importantly, CARS score was positively linked with Intercanthal Index (p-value < 0.001), and negatively associated with posture and muscle tone (p-value = 0.027) and Facial Index (p-value = 0.004). Conclusion. Our data show a link between a specific facial phenotype and anomalies in motor responses, suggesting early brain dysmaturation involving subcortical structures in cerebro-craniofacial development of autistic children. This research supports the concept of a “social brain functional morphology” in autism spectrum disorders.
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Affiliation(s)
- Laura Maniscalco
- Department of Biomedicine, Neuroscience and Advanced Diagnostics-BIND-University of Palermo, 90127 Palermo, Italy;
| | | | - Michele Roccella
- Department of Psychological Sciences, Pedagogical and Education, University of Palermo, 90128 Palermo, Italy;
| | - Domenica Matranga
- Department Promozione della Salute, Materno-Infantile, di Medicina Interna e Specialistica di Eccellenza, “G. D’Alessandro”-PROMISE-University of Palermo, 90127 Palermo, Italy;
| | - Gabriele Tripi
- Department Promozione della Salute, Materno-Infantile, di Medicina Interna e Specialistica di Eccellenza, “G. D’Alessandro”-PROMISE-University of Palermo, 90127 Palermo, Italy;
- Department of Childhood Psychiatry for Neurodevelopmentals Disorders, Centre Hospitalier du Chinonais, 37500 Saint-Benoît-la-Forêt, France
- Correspondence:
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8
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Hsu MC, Huang YS, Ouyang WC. Beneficial effects of omega-3 fatty acid supplementation in schizophrenia: possible mechanisms. Lipids Health Dis 2020; 19:159. [PMID: 32620164 PMCID: PMC7333328 DOI: 10.1186/s12944-020-01337-0] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2020] [Accepted: 06/24/2020] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Schizophrenia is a serious long-term psychotic disorder marked by positive and negative symptoms, severe behavioral problems and cognitive function deficits. The cause of this disorder is not completely clear, but is suggested to be multifactorial, involving both inherited and environmental factors. Since human brain regulates all behaviour, studies have focused on identifying changes in neurobiology and biochemistry of brain in schizophrenia. Brain is the most lipid rich organ (approximately 50% of brain dry weight). Total brain lipids is constituted of more than 60% of phospholipids, in which docosahexaenoic acid (DHA, 22:6n-3) is the most abundant (more than 40%) polyunsaturated fatty acid (PUFA) in brain membrane phospholipids. Results from numerous studies have shown significant decreases of PUFAs, in particular, DHA in peripheral blood (plasma and erythrocyte membranes) as well as brain of schizophrenia patients at different developmental phases of the disorder. PUFA deficiency has been associated to psychotic symptoms and cognitive deficits in schizophrenia. These findings have led to a number of clinical trials examining whether dietary omega-3 fatty acid supplementation could improve the course of illness in patients with schizophrenia. Results are inconsistent. Some report beneficial whereas others show not effective. The discrepancy can be attributed to the heterogeneity of patient population. METHODS In this review, results from recent experimental and clinical studies, which focus on illustrating the role of PUFAs in the development of schizophrenia were examined. The rationale why omega-3 supplementation was beneficial on symptoms (presented by subscales of the positive and negative symptom scale (PANSS), and cognitive functions in certain patients but not others was reviewed. The potential mechanisms underlying the beneficial effects were discussed. RESULTS Omega-3 fatty acid supplementation reduced the conversion rate to psychosis and improved both positive and negative symptoms and global functions in adolescents at ultra-high risk for psychosis. Omega-3 fatty acid supplementation could also improve negative symptoms and global functions in the first-episode patients with schizophrenia, but improve mainly total or general PANSS subscales in chronic patients. Patients with low PUFA (particularly DHA) baseline in blood were more responsive to the omega-3 fatty acid intervention. CONCLUSION Omega-3 supplementation is more effective in reducing psychotic symptom severity in young adults or adolescents in the prodromal phase of schizophrenia who have low omega-3 baseline. Omega-3 supplementation was more effective in patients with low PUFA baseline. It suggests that patients with predefined lipid levels might benefit from lipid treatments, but more controlled clinical trials are warranted.
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Affiliation(s)
- Mei-Chi Hsu
- Department of Nursing, I-Shou University, No.8, Yida Road, Jiaosu Village Yanchao District, Kaohsiung, 82445 Taiwan
| | - Yung-Sheng Huang
- College of Medicine, I-Shou University, No.8, Yida Road, Jiaosu Village Yanchao District, Kaohsiung, 82445 Taiwan
| | - Wen-Chen Ouyang
- Department of Geriatric Psychiatry, Jianan Psychiatric Center, Ministry of Health and Welfare, No.539, Yuzhong Rd., Rende Dist., Tainan City, 71742 Taiwan
- Department of Nursing, Shu-Zen Junior College of Medicine and Management, No.452, Huanqiu Rd. Luzhu Dist, Kaohsiung, 82144 Taiwan
- Department of Psychiatry, College of Medicine, Kaohsiung Medical University, No.100, Shin-Chuan 1st Road, Sanmin Dist., Kaohsiung, 80708 Taiwan
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9
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Coulon N, Godin O, Bulzacka E, Dubertret C, Mallet J, Fond G, Brunel L, Andrianarisoa M, Anderson G, Chereau I, Denizot H, Rey R, Dorey JM, Lançon C, Faget C, Roux P, Passerieux C, Dubreucq J, Leignier S, Capdevielle D, André M, Aouizerate B, Misdrahi D, Berna F, Vidailhet P, Leboyer M, Schürhoff F. Early and very early-onset schizophrenia compared with adult-onset schizophrenia: French FACE-SZ database. Brain Behav 2020; 10:e01495. [PMID: 31908151 PMCID: PMC7010576 DOI: 10.1002/brb3.1495] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2019] [Revised: 11/06/2019] [Accepted: 11/11/2019] [Indexed: 12/20/2022] Open
Abstract
OBJECTIVE To compare the clinical symptomatology in patients with Early-Onset Schizophrenia (EOS, N = 176), especially the subgroup Very Early Onset Schizophrenia (VEOS) and Adult Onset Schizophrenia (AOS, N = 551). METHOD In a large French multicentric sample, 727 stable schizophrenia patients, classified by age at onset of the disorder, were assessed using standardized and extensive clinical and neuropsychological batteries: AOS with onset ≥ 18 years and EOS with onset < 18 years (including 22 VEOS < 13 years). RESULTS The importance of better diagnosing EOS group, and in particularly VEOS, appeared in a longer DUP Duration of Untreated Psychosis (respectively, 2.6 years ± 4.1 and 8.1 years ± 5.7 vs. 1.0 years ± 2.5), more severe symptomatology (PANSS Positive And Negative Syndrome Scale scores), and lower educational level than the AOS group. In addition, the VEOS subgroup had a more frequent childhood history of learning disabilities and lower prevalence of right-handedness quotient than the AOS. CONCLUSION The study demonstrates the existence of an increased gradient of clinical severity from AOS to VEOS. In order to improve the prognosis of the early forms of schizophrenia and to reduce the DUP, clinicians need to pay attention to the prodromal manifestations of the disease.
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Affiliation(s)
- Nathalie Coulon
- Fondation FondaMental, Créteil, France.,INSERM U955, Translational Psychiatry laboratory, AP-HP, DHU Pe-PSY, Centre Expert Schizophrénie, Pôle de Psychiatrie et d'Addictologie des Hôpitaux Universitaires Henri Mondor, Université Paris Est Créteil, Créteil, France.,INSERM U894, AP-HP, Department of Psychiatry, Louis Mourier Hospital, Paris Diderot University, Sorbonne Paris Cité, Faculté de médecine, Colombes, France
| | - Ophélia Godin
- Fondation FondaMental, Créteil, France.,INSERM U955, Translational Psychiatry laboratory, AP-HP, DHU Pe-PSY, Centre Expert Schizophrénie, Pôle de Psychiatrie et d'Addictologie des Hôpitaux Universitaires Henri Mondor, Université Paris Est Créteil, Créteil, France
| | - Ewa Bulzacka
- Fondation FondaMental, Créteil, France.,INSERM U955, Translational Psychiatry laboratory, AP-HP, DHU Pe-PSY, Centre Expert Schizophrénie, Pôle de Psychiatrie et d'Addictologie des Hôpitaux Universitaires Henri Mondor, Université Paris Est Créteil, Créteil, France
| | - Caroline Dubertret
- Fondation FondaMental, Créteil, France.,INSERM U894, AP-HP, Department of Psychiatry, Louis Mourier Hospital, Paris Diderot University, Sorbonne Paris Cité, Faculté de médecine, Colombes, France
| | - Jasmina Mallet
- Fondation FondaMental, Créteil, France.,INSERM U894, AP-HP, Department of Psychiatry, Louis Mourier Hospital, Paris Diderot University, Sorbonne Paris Cité, Faculté de médecine, Colombes, France
| | - Guillaume Fond
- Fondation FondaMental, Créteil, France.,EA 3279 : CEReSS -Centre d'Etude et de Recherche sur les Services de Santé et la Qualité de vie, Aix-Marseille Univ, Faculté de Médecine, Marseille, France
| | - Lore Brunel
- Fondation FondaMental, Créteil, France.,INSERM U955, Translational Psychiatry laboratory, AP-HP, DHU Pe-PSY, Centre Expert Schizophrénie, Pôle de Psychiatrie et d'Addictologie des Hôpitaux Universitaires Henri Mondor, Université Paris Est Créteil, Créteil, France
| | - Méja Andrianarisoa
- Fondation FondaMental, Créteil, France.,INSERM U955, Translational Psychiatry laboratory, AP-HP, DHU Pe-PSY, Centre Expert Schizophrénie, Pôle de Psychiatrie et d'Addictologie des Hôpitaux Universitaires Henri Mondor, Université Paris Est Créteil, Créteil, France
| | | | - Isabelle Chereau
- Fondation FondaMental, Créteil, France.,Clermont-Ferrand University Hospital, EA 7280 Auvergne University, BP 69, Clermont-Ferrand, France
| | - Hélène Denizot
- Fondation FondaMental, Créteil, France.,Clermont-Ferrand University Hospital, EA 7280 Auvergne University, BP 69, Clermont-Ferrand, France
| | - Romain Rey
- Fondation FondaMental, Créteil, France.,INSERM U1028, CNRS UMR 5292, Centre de Recherche en Neurosciences de Lyon, Equipe PSYR2, Centre Hospitalier Le Vinatier, Pole Est, Claude Bernard Lyon 1 University, Bron Cedex, France
| | - Jean-Michel Dorey
- Fondation FondaMental, Créteil, France.,INSERM U1028, CNRS UMR 5292, Centre de Recherche en Neurosciences de Lyon, Equipe PSYR2, Centre Hospitalier Le Vinatier, Pole Est, Claude Bernard Lyon 1 University, Bron Cedex, France
| | - Christophe Lançon
- Fondation FondaMental, Créteil, France.,Department of Psychiatry (AP-HM), Sainte-Marguerite University Hospital, Marseille, France
| | - Catherine Faget
- Fondation FondaMental, Créteil, France.,Department of Psychiatry (AP-HM), Sainte-Marguerite University Hospital, Marseille, France
| | - Paul Roux
- Fondation FondaMental, Créteil, France.,Department of Adult Psychiatry, Versailles Hospital, Le Chesnay, France
| | - Christine Passerieux
- Fondation FondaMental, Créteil, France.,Department of Adult Psychiatry, Versailles Hospital, Le Chesnay, France
| | - Julien Dubreucq
- Fondation FondaMental, Créteil, France.,Psychosocial Rehabilitation Reference Center, Alpes Isère Hospital, Grenoble, France
| | - Sylvain Leignier
- Fondation FondaMental, Créteil, France.,Psychosocial Rehabilitation Reference Center, Alpes Isère Hospital, Grenoble, France
| | - Delphine Capdevielle
- Fondation FondaMental, Créteil, France.,INSERM 1061, University Department of Adult Psychiatry, La Colombiere Hospital, CHU Montpellier, University of Montpellier 1, Montpellier, France
| | - Myrtille André
- Fondation FondaMental, Créteil, France.,INSERM 1061, University Department of Adult Psychiatry, La Colombiere Hospital, CHU Montpellier, University of Montpellier 1, Montpellier, France
| | - Bruno Aouizerate
- Fondation FondaMental, Créteil, France.,Department of Adult Psychiatry, Charles Perrens Hospital, University of Bordeaux, Bordeaux, France
| | - David Misdrahi
- Fondation FondaMental, Créteil, France.,Department of Adult Psychiatry, Charles Perrens Hospital, University of Bordeaux, Bordeaux, France
| | - Fabrice Berna
- Fondation FondaMental, Créteil, France.,INSERM U1114, Strasbourg University Hospital, University of Strasbourg, Federation of Translational Psychiatry, Strasbourg, France
| | - Pierre Vidailhet
- Fondation FondaMental, Créteil, France.,INSERM U1114, Strasbourg University Hospital, University of Strasbourg, Federation of Translational Psychiatry, Strasbourg, France
| | - Marion Leboyer
- Fondation FondaMental, Créteil, France.,INSERM U955, Translational Psychiatry laboratory, AP-HP, DHU Pe-PSY, Centre Expert Schizophrénie, Pôle de Psychiatrie et d'Addictologie des Hôpitaux Universitaires Henri Mondor, Université Paris Est Créteil, Créteil, France
| | - Franck Schürhoff
- Fondation FondaMental, Créteil, France.,INSERM U955, Translational Psychiatry laboratory, AP-HP, DHU Pe-PSY, Centre Expert Schizophrénie, Pôle de Psychiatrie et d'Addictologie des Hôpitaux Universitaires Henri Mondor, Université Paris Est Créteil, Créteil, France
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10
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Les troubles de comportement durant l’enfance et l’adolescence des schizophrènes : étude rétrospective. Encephale 2019; 45:221-225. [DOI: 10.1016/j.encep.2018.09.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2018] [Revised: 08/27/2018] [Accepted: 09/01/2018] [Indexed: 11/20/2022]
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11
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Tripathi A, Kar SK, Shukla R. Cognitive Deficits in Schizophrenia: Understanding the Biological Correlates and Remediation Strategies. CLINICAL PSYCHOPHARMACOLOGY AND NEUROSCIENCE 2018; 16:7-17. [PMID: 29397662 PMCID: PMC5810454 DOI: 10.9758/cpn.2018.16.1.7] [Citation(s) in RCA: 116] [Impact Index Per Article: 19.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/15/2017] [Revised: 06/22/2017] [Accepted: 07/16/2017] [Indexed: 12/20/2022]
Abstract
Cognitive deficits are one of the core symptoms of schizophrenia that evolve during the course of schizophrenia, after being originated even before the onset of illness. Existing pharmacological and biological treatment modalities fall short to meet the needs to improve the cognitive symptoms; hence, various cognitive remediation strategies have been adopted to address these deficits. Research evidences suggest that cognitive remediation measures improve the functioning, limit disability bettering the quality of life. The functional outcomes of cognitive remediation in schizophrenia are resultant of neurobiological changes in specific brain areas. Recent years witnessed significant innovations in cognitive remediation strategies in schizophrenia. This comprehensive review highlights the biological correlates of cognitive deficits in schizophrenia and the remedial measures with evidence base.
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Affiliation(s)
- Adarsh Tripathi
- Department of Psychiatry, King George's Medical University, Lucknow, India
| | - Sujita Kumar Kar
- Department of Psychiatry, King George's Medical University, Lucknow, India
| | - Rashmi Shukla
- Department of Psychiatry, King George's Medical University, Lucknow, India
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12
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Dell’Osso B, Carlotta Palazzo M, Carlo Altamura A. Neurodevelopmental and Neurodegenerative Alterations in the Pathophysiology of Schizophrenia: Focus on Neuro-Immuno-Inflammation. NEURODEGENER DIS 2018. [DOI: 10.1007/978-3-319-72938-1_16] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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13
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Altered circadian patterns of salivary cortisol in individuals with schizophrenia: A critical literature review. ACTA ACUST UNITED AC 2017; 110:439-447. [PMID: 28506881 DOI: 10.1016/j.jphysparis.2017.05.002] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2017] [Accepted: 05/10/2017] [Indexed: 12/25/2022]
Abstract
This article focuses on stress vulnerability in schizophrenia through an integrated clinical and biological approach. The objective of this article is to better understand the relationships between vulnerability, stress and schizophrenia. First, the concept of vulnerability is defined and several models of vulnerability in schizophrenia are reviewed. Second, a section is developed on the biology of stress, and more specifically on the stress responses of the hypothalamo-pitutary adrenal (HPA) axis. Then, studies of cortisol circadian rhythms are summarized, suggesting hyper-reactivity of the HPA axis in patients with schizophrenia and high risk individuals for schizophrenia. The results support the models of stress vulnerability in schizophrenia and the hypothesis of high cortisol levels as an endophenotype in this disorder. In conclusion, this article highlights the interest of studying the cortisol circadian rhythms in schizophrenia and opens the perspective to identify high risk individuals for schizophrenia by measuring circadian patterns of salivary cortisol.
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14
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Li Z, Lei W, Deng W, Zheng Z, Li M, Ma X, Wang Q, Huang C, Li N, Collier DA, Gong Q, Li T. Aberrant spontaneous neural activity and correlation with evoked-brain potentials in first-episode, treatment-naïve patients with deficit and non-deficit schizophrenia. Psychiatry Res Neuroimaging 2017; 261:9-19. [PMID: 28092779 DOI: 10.1016/j.pscychresns.2017.01.001] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2016] [Revised: 12/03/2016] [Accepted: 01/02/2017] [Indexed: 02/05/2023]
Abstract
The goals of the study were to analyze spontaneous neural activity between deficit and non-deficit schizophrenia (DS, NDS) using resting-state fMRI, and to investigate the correlation of fMRI with clinical features and evoked brain potentials. The amplitude of low frequency fluctuation (ALFF) was measured in 41 DS participants, 42 NDS participants, and 42 healthy controls. ALFF in the bilateral cerebellum posterior lobe was significantly decreased in patients, while ALFF in the right fusiform gyrus and the bilateral putamen was significantly increased. In schizophrenia patients, ALFF in the right putamen positively correlated with excited/activation on Positive and Negative Syndrome Scale (PANSS-EXC/ACT). In DS patients, ALFF in the right insula was significantly increased than in controls and positively correlated with S2-P50 amplitude of sensory gating P50. ALFF in the left cerebellum posterior lobe negatively correlated with negative symptoms and withdrawn on PANSS (PANSS-NS, PANSS-WIT), ALFF in the right putamen positively correlated with PANSS-WIT. In NDS patients, ALFF in the middle temporal gyrus decreased than in controls and negatively correlated with P3b subcomponent of P300 latency. ALFF in the left cerebellum posterior lobe negatively correlated with PANSS-EXC/ACT. The middle temporal gyrus in NDS or the right insula in DS may show spatiotemporal defects.
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Affiliation(s)
- Zhe Li
- The Mental Health Center and the Psychiatric Laboratory, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China; State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China
| | - Wei Lei
- The Mental Health Center and the Psychiatric Laboratory, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China; State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China; The Psychiatry Department, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan 646000, China
| | - Wei Deng
- The Mental Health Center and the Psychiatric Laboratory, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China; State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China
| | - Zhong Zheng
- The Mental Health Center and the Psychiatric Laboratory, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China; The Neurobiological Laboratory, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China
| | - Mingli Li
- The Mental Health Center and the Psychiatric Laboratory, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China; State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China
| | - Xiaohong Ma
- The Mental Health Center and the Psychiatric Laboratory, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China; State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China
| | - Qiang Wang
- The Mental Health Center and the Psychiatric Laboratory, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China; State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China
| | - Chaohua Huang
- The Mental Health Center and the Psychiatric Laboratory, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China; State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China; The Psychiatry Department, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan 646000, China
| | - Na Li
- The Mental Health Center and the Psychiatric Laboratory, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China; State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China
| | - David A Collier
- Discovery Neuroscience Research, Eli Lilly and Company Ltd., Lilly Research Laboratories, Erl Wood Manor, Windlesham, Surrey, United Kingdom
| | - Qiyong Gong
- MRI Center, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China
| | - Tao Li
- The Mental Health Center and the Psychiatric Laboratory, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China; State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China.
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15
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Abstract
OBJECTIVES Based on clinical, phenomenological and neurobiological observations, psychiatrists often report a deficit in time estimation in patients with schizophrenia. Cognitive models of time estimation in healthy subjects have been proposed and developed for approximately 30 years. The investigation of time perception is pertinent to the understanding of neurobiological and cognitive abnormalities in schizophrenia. Brain lesions and neuroimaging studies have shown that the critical brain structures engaged in time perception include the prefrontal and parietal lobes, thalamus, basal ganglia and cerebellum. These brain areas have been implicated in the physiopathology of schizophrenia in that there is impaired coordination of activity among these regions. Clinical and experimental date strongly suggest that patients with schizophrenia are less accurate in their ability to estimate time than healthy subjects. The specificity of these clinical and behavioral impairments is still in question. The aims of this article are to present an overview of the literature regarding time estimation and schizophrenia, to discuss specific issues related to how perceptual dysfunction in schizophrenia may lead to abnormalities in time perception, and to propose new perspectives towards an integrative approach between phenomenology and neuroscience. METHODS We present a review of the literature describing the current theory in the field of time perception, which is supported by a connectionist model, postulating that temporal judgment is based upon a pacemaker-counter device that depends mostly upon memory and attentional resources. The pacemaker emits pulses that are accumulated in a counter, and the number of pulses determines the perceived length of an interval. Patients with schizophrenia are known to display attentional and memory dysfunctions. Moreover, dopamine regulation mechanisms are involved in both the temporal perception and schizophrenia. DISCUSSION It is still unclear if temporal impairments in schizophrenia are related to a specific disturbance in central temporal processes or are due to certain cognitive problems, such as attentional and memory dysfunctions, or biological abnormalities. While psychopathological and phenomenological work strongly suggests that time perception disturbance may be the key or core symptom in schizophrenia, neuroscience studies have failed to do the same. The question of specificity of temporal perception impairments in schizophrenia remains contested. Neuroscience studies suggest that time symptoms in patients with schizophrenia are only secondary to thought disorders and primary cognitive impairments. This debate refers to the etiologic/organic versus psychogenesis/psychological dichotomy and may be over-taken. CONCLUSION Clinical evidence associated with psychopathological, biological and cognitive theories strongly suggests that patients with schizophrenia have a deficit in time perception. Discrimination and reproduction of durations have been found to be constantly impaired and disorganized. There is still much work to be done to identify the exact sources of variability in temporal judgments in schizophrenia, and the study of developmental course of time perception could be an interesting route. Regardless of the role of temporal deficits in the pathogenesis of schizophrenia (as a general cognitive disorder or a core role), clinical and phenomenological data encourage us to conduct further studies, especially in the field of developmental psychology.
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Golonzhka O, Nord A, Tang PLF, Lindtner S, Ypsilanti AR, Ferretti E, Visel A, Selleri L, Rubenstein JLR. Pbx Regulates Patterning of the Cerebral Cortex in Progenitors and Postmitotic Neurons. Neuron 2015; 88:1192-1207. [PMID: 26671461 DOI: 10.1016/j.neuron.2015.10.045] [Citation(s) in RCA: 48] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2015] [Revised: 08/13/2015] [Accepted: 10/13/2015] [Indexed: 11/27/2022]
Abstract
We demonstrate using conditional mutagenesis that Pbx1, with and without Pbx2(+/-) sensitization, regulates regional identity and laminar patterning of the developing mouse neocortex in cortical progenitors (Emx1-Cre) and in newly generated neurons (Nex1-Cre). Pbx1/2 mutants have three salient molecular phenotypes of cortical regional and laminar organization: hypoplasia of the frontal cortex, ventral expansion of the dorsomedial cortex, and ventral expansion of Reelin expression in the cortical plate of the frontal cortex, concomitant with an inversion of cortical layering in the rostral cortex. Molecular analyses, including PBX ChIP-seq, provide evidence that PBX promotes frontal cortex identity by repressing genes that promote dorsocaudal fate.
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Affiliation(s)
- Olga Golonzhka
- Department of Psychiatry, Neuroscience Program and the Nina Ireland Laboratory of Developmental Neurobiology, University of California San Francisco, San Francisco, CA 94158, USA; Acetylon Pharmaceuticals, 70 Fargo Street, Suite 205, Boston, MA 02210, USA.
| | - Alex Nord
- Departments of Neurobiology, Physiology, and Behavior and Psychiatry and Behavioral Sciences, Center for Neuroscience, University of California Davis, Davis, CA 95618, USA
| | - Paul L F Tang
- Institute for Human Genetics, University of California San Francisco, 513 Parnassus Avenue, San Francisco, CA 94143, USA
| | - Susan Lindtner
- Department of Psychiatry, Neuroscience Program and the Nina Ireland Laboratory of Developmental Neurobiology, University of California San Francisco, San Francisco, CA 94158, USA
| | - Athena R Ypsilanti
- Department of Psychiatry, Neuroscience Program and the Nina Ireland Laboratory of Developmental Neurobiology, University of California San Francisco, San Francisco, CA 94158, USA
| | - Elisabetta Ferretti
- Department of Cell and Developmental Biology, Weill Medical College of Cornell University, 1300 York Avenue, New York, NY 10021, USA; The Danish Stem Cell Center, University of Copenhagen, Blegdamsvej 3B, DK-2200 Copenhagen, Denmark
| | - Axel Visel
- Genomics Division, MS 84-171, Lawrence Berkeley National Laboratory, Berkeley, CA 94720, USA; U.S. Department of Energy Joint Genome Institute, Walnut Creek, CA 94598, USA; School of Natural Sciences, University of California, Merced, Merced, CA 95343, USA
| | - Licia Selleri
- Department of Cell and Developmental Biology, Weill Medical College of Cornell University, 1300 York Avenue, New York, NY 10021, USA
| | - John L R Rubenstein
- Department of Psychiatry, Neuroscience Program and the Nina Ireland Laboratory of Developmental Neurobiology, University of California San Francisco, San Francisco, CA 94158, USA.
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Bourgou Gaha S, Halayem Dhouib S, Amado I, Bouden A. [Neurological soft signs in early onset schizophrenia]. L'ENCEPHALE 2014; 41:209-14. [PMID: 24854724 DOI: 10.1016/j.encep.2014.01.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/04/2013] [Accepted: 01/16/2014] [Indexed: 11/27/2022]
Abstract
INTRODUCTION Neurological soft signs (NSS) are subtle neurological abnormalities that cannot be linked to the achievement of a specific region of the central nervous system and which are not part of a particular neurological syndrome. These signs are observed in the case of diseases supporting the neurodevelopmental model such as schizophrenia in general and its early form defined notably by an age of onset of less than 18 years. Indeed, the NSS belong to a set of clinical, cognitive, electrophysiological and neuroanatomical markers reflecting neurodevelopmental brain abnormalities in patients with schizophrenia. OBJECTIVE The objectives of our study were to determine the prevalence, the scores, and the nature of neurological soft signs (NSS) in adolescent patients suffering from early onset schizophrenia diagnosis in comparison to healthy controls, and to explore the correlations between NSS and the demographic, clinical and therapeutic features of these patients. MATERIALS AND METHODS Twelve adolescents were recruited in the Child Psychiatry Department at the Razi Hospital (Tunisia), with the diagnosis of schizophrenia according to the DSM-IV supplemented by the Kiddie SAD PL. They were matched by age and educational level with twelve healthy controls without psychiatric family or personal history. The clinical status of the patients was assessed using the Positive and Negative Syndrome Scale (PANSS). Neurological soft signs (NSS) were rated with the Neurological Soft Signs Examination (NSSE) by Krebs et al. (2000) for the two groups. This scale is composed of 23 items exploring motor coordination, motor integrative function, sensory integration, involuntary movements and quality of lateralization. RESULTS The mean age of our population was 14.7 years. The average age of onset of the disease was 12.2 years. The sex-ratio was 1.4. Educational level was 7.4 years. The PANSS mean total score was 74.3. The mean daily dose, in chlorpromazine equivalents, was 523.9 mg/day. Four patients received a strict monotherapy of antipsychotics, while the other patients were receiving an association of two neuroleptics. The prevalence of NSS was 100% (cut-off point=11) with a mean total score of 29.3±4.1. The highest score was for the motor coordination (10.1). As for the control group, the mean total score was 7±1.3. A highly significant difference was found between patients and controls for all sub-scores of NSS. Negative correlations were found in patients, between age and neurological soft signs total score (P=0.05; r=-0.57) and also with sensory integration score (P=0.04; r=-0.58). The NSS total score was also correlated with low educational level (P=0.03; r=-0.61). There was no correlation between neurological soft signs scores and PANSS scores or the daily dose of antipsychotics. CONCLUSION The prevalence and NSS scores are high among young people with early onset schizophrenia diagnosis illustrating the existence of structural abnormalities of the brain, themselves consequences of early neurodevelopmental disturbances, which would support the neurodevelopmental hypothesis concerning this pathology.
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Affiliation(s)
- S Bourgou Gaha
- Service de pédopsychiatrie, hôpital Razi, rue des Orangers, 2010 La Manouba, Tunisie; Unité de recherche UR 02/04 : processus cognitifs en pathologie psychiatrique, hôpital Razi, rue des Orangers, 2010 La Manouba, Tunisie.
| | - S Halayem Dhouib
- Service de pédopsychiatrie, hôpital Razi, rue des Orangers, 2010 La Manouba, Tunisie; Unité de recherche UR 02/04 : processus cognitifs en pathologie psychiatrique, hôpital Razi, rue des Orangers, 2010 La Manouba, Tunisie; Faculté de médecine de Tunis, université de Tunis El Manar, rue Jbel lakhdhar, Tunis, Tunisie
| | - I Amado
- Service hospitalo-universitaire, hôpital Saint-Anne, 1, rue Cabanis, 75014 Paris, France; UMR894, Inserm, laboratoire de physiopathologie des maladies psychiatriques, 2 ter, rue d'Alésia, 75014 Paris, France; Faculté de médecine Paris Descartes, 15, rue de l'école de médecine, 75006 Paris, France
| | - A Bouden
- Service de pédopsychiatrie, hôpital Razi, rue des Orangers, 2010 La Manouba, Tunisie; Unité de recherche UR 02/04 : processus cognitifs en pathologie psychiatrique, hôpital Razi, rue des Orangers, 2010 La Manouba, Tunisie; Faculté de médecine de Tunis, université de Tunis El Manar, rue Jbel lakhdhar, Tunis, Tunisie
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18
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Braham A, Bannour AS, Ben Romdhane A, Nelson B, Bougmiza I, Ben Nasr S, Elkissi Y, Ben Hadj Ali B, Ben Hadj Ali B. Validation of the Arabic version of the Comprehensive Assessment of At Risk Mental States (CAARMS) in Tunisian adolescents and young adults. Early Interv Psychiatry 2014; 8:147-54. [PMID: 23347425 DOI: 10.1111/eip.12031] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2012] [Accepted: 10/25/2012] [Indexed: 11/29/2022]
Abstract
AIM The study aimed to examine whether the Arabic version of the Comprehensive Assessment of At Risk Mental States (CAARMS) has good construct validity, concurrent validity and reliability. METHODS Validity was established on a sample of 58 Tunisian adolescents and young adults aged between 16 and 30 years. These subjects were divided into three groups according to the CAARMS scores: ultra-high risk positive subjects (UHR (+) ) (n = 22), ultra-high risk negative subjects (UHR (-) ) (n = 25) and subjects meeting the criteria of a first-episode psychosis (FEP) (n = 11). For construct validity, we used the convergent validity. We used the Positive and Negative Syndrome Scale (PANSS) concomitantly with the CAARMS. For concurrent validity, we studied the correlation between symptoms of the CAARMS and their equivalents in the PANSS. The CAARMS reliability was conducted by the study of interrater reliability. RESULTS The UHR (+) group was shown with intermediate scores of PANSS between the two groups UHR (-) and FEP. That confirms a good construct validity of the Arabic version of the CAARMS. We noted a correlation between the scores in positive and negative sections measured by the CAARMS and their corresponding level of the PANSS. These results show that the CAARMS has a good concurrent validity with the PANSS. For the reliability study, we noted a good correlation between the two raters with a Pearson coefficient ranging from 0.55 to 0.90. CONCLUSION Analysis of the results of construct validity, concurrent validity and reliability of the CAARMS indicates that this version translated into Arabic is valid and reliable.
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Affiliation(s)
- Amel Braham
- Department of Psychiatry, Farhat Hached Hospital
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19
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Neurodevelopment Alterations, Neurodegeneration, and Immunoinflammatory Patterns in the Pathophysiology of Schizophrenia. NEURODEGENER DIS 2014. [DOI: 10.1007/978-1-4471-6380-0_13] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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20
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Li W, Zhou N, Yu Q, Li X, Yu Y, Sun S, Kou C, Chen DC, Xiu MH, Kosten TR, Zhang XY. Association of BDNF gene polymorphisms with schizophrenia and clinical symptoms in a Chinese population. Am J Med Genet B Neuropsychiatr Genet 2013; 162B:538-45. [PMID: 23832605 DOI: 10.1002/ajmg.b.32183] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2012] [Accepted: 06/14/2013] [Indexed: 11/07/2022]
Abstract
The neurodevelopmental hypothesis is well established in schizophrenia. Accumulating evidence has shown that BDNF may be involved in the pathogenesis of schizophrenia. This study aimed to investigate the potential association of BDNF gene polymorphisms with susceptibility to schizophrenia and with the psychopathological symptoms in patients with schizophrenia in a Han Chinese population. Three polymorphisms (rs6265, rs12273539, and rs10835210) of the BDNF gene were analyzed in a case-control study of 709 Han Chinese individuals (375 patients and 334 controls). The patients' psychopathology was assessed using the positive and negative syndrome scale (PANSS). We found no significant differences in the genotype and allele distributions of all three polymorphisms between the patient and control groups; however, we found a trend toward to significant overall difference in the estimated haplotype frequencies, with more frequent haplotype ATC of rs6265-rs12273539-rs10835210 in the schizophrenic patients than in controls (P = 0.027). The quantitative trait analysis by the UNPHASED program showed significant associations between the rs6265 (A)-rs12273539 (C)-rs10835210 (A) haplotype and negative symptom scores from the PANSS (x(2) = 5.79, P = 0.016). Our findings suggest that the BDNF gene polymorphisms may play a small effect on susceptibility to schizophrenia, but may contribute to the negative symptoms of the disease.
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Affiliation(s)
- Wenjun Li
- School of Public Health, Jilin University, Changchun, China
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21
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Altamura AC, Pozzoli S, Fiorentini A, Dell'osso B. Neurodevelopment and inflammatory patterns in schizophrenia in relation to pathophysiology. Prog Neuropsychopharmacol Biol Psychiatry 2013; 42:63-70. [PMID: 23021973 DOI: 10.1016/j.pnpbp.2012.08.015] [Citation(s) in RCA: 55] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2011] [Revised: 08/23/2012] [Accepted: 08/25/2012] [Indexed: 11/18/2022]
Abstract
As for other major psychoses, the etiology of schizophrenia still remains poorly understood, involving genetic and epigenetic mechanisms, as well as environmental contributions. In addition, immune alterations have been widely reported in schizophrenic patients, involving both the unspecific and specific pathways of the immune system, and suggesting that infectious/autoimmune processes play an important role in the etiopathogenesis of the disorder. Cytokines, in particular, are supposed to play a critical role in infectious and inflammatory processes, mediating the cross-talk between the brain and the immune system. In this perspective, even though mixed results have been reported, it seems that schizophrenia is associated with an imbalance in inflammatory cytokines. Alterations in the inflammatory and immune systems, moreover, seem to be already present in the early stages of schizophrenia and connected to the neurodevelopmental hypothesis of the disorder, identifying its roots in brain development abnormalities that do not manifest themselves until adolescence or early adulthood. At the same time, neuropathological and longitudinal studies in schizophrenia also support a neurodegenerative hypothesis and, more recently, a novel mixed hypothesis, integrating neurodevelopmental and neurodegenerative models, has been put forward. The present review aims to provide an updated overview of the connections between the immune and inflammatory alterations and the aforementioned hypotheses in schizophrenia.
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Affiliation(s)
- A Carlo Altamura
- Department of Psychiatry, University of Milan, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Via F. Sforza 35, 20122, Milano, Italy.
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22
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Cermolacce M, Fakra E, Belzeaux R, Adida M, Azorin JM. Endophénotypes schizophréniques et bipolaires : le point de vue de la clinique. Encephale 2012; 38 Suppl 3:S57-61. [DOI: 10.1016/s0013-7006(12)70078-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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23
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Mhalla A, Boussaïd N, Gassab L, Gaha L, Mechri A. [Minor neurological and physical anomalies in patients with first-episode psychosis]. Encephale 2012; 39:149-54. [PMID: 23095597 DOI: 10.1016/j.encep.2012.06.030] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2012] [Accepted: 06/27/2012] [Indexed: 10/27/2022]
Abstract
INTRODUCTION Over the last several decades, there has been an increasing number of neuroanatomical, neuroimaging, neurophysiological, and neuropsychological studies in search of structural, functional, and cognitive correlates of brain insult(s) that could ultimately lead to unravelling the pathophysiology of schizophrenia. A direct, easily administered, and inexpensive way of investigating brain dysfunction in schizophrenia is the study of neurological soft signs and minor physical anomalies, two putative indices of developmental abnormality. The study of these neurodevelopmental markers in the first-episode psychosis allows the detection of the neurodevelopmental abnormalities at the onset of psychosis. AIMS OF THE STUDY The objectives of our study were to determinate the prevalence, the scores, and the nature of neurological soft signs (NSS) and minor physical anomalies (MPA) in patients with first-episode psychosis and to explore the correlations between these neurodevelopmental markers and the demographic, clinical and therapeutic features. METHOD A cross-sectional study was carried-out on 61 patients (mean age: 28.9±9.4years; 86.9% were males), hospitalized for first-episode psychosis (DSM-IV-TR diagnosis of schizophrenia, schizophreniform disorder, brief psychotic disorder, delusional disorder, and psychotic disorder not otherwise specified). The evaluation procedure consisted of a retrospective assessment of the premorbid functioning by the Premorbid Functioning Scale (PAS) and the following clinical scales: Positive and Negative Symptoms Scale (PANSS), Clinical Global Impression (CGI) and Global Assessment of Functioning (GAF), the NSS scale of Krebs et al. (23 items exploring motor coordination, motor integrative function, sensory integration, involuntary movements or posture, quality of lateralization) and the MPA scale of Gourion et al. (41 items, exploring anomalies of face, eyes, ears, mouth, hands and feet). RESULTS The prevalence of NSS was 83.6% (cut-off point=9.5), with a mean total score of 15.3±6.7. The highest score was for the motor coordination. The prevalence of MPA was 62.7% (cut-off point=5), with a mean total score of 5.8±3.2. The most common MPA were the fine hair (50.8%), adherent earlobes (49.2%) and clinodactyly (31.1%). Correlations were found between the NSS total score and the Poor Premorbid Functioning (r=0.32, P=0.04), the PANSS total score (r=0.36, P=0.005), and the negative (r=0.45, P<0.001) and disorganization sub-scores (r=0.41, P=0.001), the CGI-severity of (r=0.30, P=0.02), the impairment functioning in the GAF (r=-0.26, P=0.04) and with extrapyramidal symptoms (r=0.52, P<0.001). However, no correlation was found between the NSS total scores, age, gender, the PANSS positive sub-score, the daily dosage of antipsychotics, the CGI-improvement score and the MPA total score. There was no correlation between MPA total score and demographic, clinical and therapeutic features of patients. Moreover, there was no correlation between the NSS or MPA scores and the short-term evolution (6months to 1year) towards schizophrenia. CONCLUSION These results confirm the data in the literature relating high NSS and MPA scores in patients with a first-episode psychosis. The NSS appear to characterize severe psychotic disorders with more negative and disorganization symptoms and poor social functioning and may be a prognostic indicator.
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Affiliation(s)
- A Mhalla
- Service de psychiatrie, CHU de Monastir, rue 1(er)-Juin, 5000 Monastir, Tunisie
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24
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Lu L, Mamiya T, Koseki T, Mouri A, Nabeshima T. Genetic Animal Models of Schizophrenia Related with the Hypothesis of Abnormal Neurodevelopment. Biol Pharm Bull 2011; 34:1358-63. [DOI: 10.1248/bpb.34.1358] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Affiliation(s)
- Lingling Lu
- The Academic Frontier Project for Private University, Comparative Cognitive Science Institute, Meijo University
- Department of Chemical Pharmacology, Graduate School of Pharmaceutical Sciences, Meijo University
| | - Takayoshi Mamiya
- The Academic Frontier Project for Private University, Comparative Cognitive Science Institute, Meijo University
- Department of Chemical Pharmacology, Graduate School of Pharmaceutical Sciences, Meijo University
- Japanese Drug Organization for Appropriate Use and Research
| | - Takenao Koseki
- The Academic Frontier Project for Private University, Comparative Cognitive Science Institute, Meijo University
- Department of Chemical Pharmacology, Graduate School of Pharmaceutical Sciences, Meijo University
| | - Akihiro Mouri
- The Academic Frontier Project for Private University, Comparative Cognitive Science Institute, Meijo University
- Department of Chemical Pharmacology, Graduate School of Pharmaceutical Sciences, Meijo University
- Japanese Drug Organization for Appropriate Use and Research
| | - Toshitaka Nabeshima
- The Academic Frontier Project for Private University, Comparative Cognitive Science Institute, Meijo University
- Department of Chemical Pharmacology, Graduate School of Pharmaceutical Sciences, Meijo University
- Japanese Drug Organization for Appropriate Use and Research
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Olié JP, Mouaffak F, Krebs MO, Lôo H. [Schizophrenia, a neurodevelopmental illness]. ANNALES PHARMACEUTIQUES FRANÇAISES 2009; 67:251-5. [PMID: 19596098 DOI: 10.1016/j.pharma.2009.02.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2009] [Accepted: 02/12/2009] [Indexed: 10/20/2022]
Abstract
SUMMARY Developmental anomalies have been identified as risk factors for a future schizophrenic illness: low weight at birth, congenital malformations, delayed motor and social learning. Cognitive deficits and neurological soft signs belong to the indices of the schizophrenic spectrum. Neuroimaging has visualized various structural abnormalities present from the very beginning of schizophrenia. These structural changes may represent an exacerbation of normal neurodevelopmental processes. Moreover, vulnerability genes for schizophrenia are involved at different stages of neurodevelopment: the best studied associations are dysfunctional variants of DISC-1 and neuroregulin-1 genes, the role of other genes (dysbindin, BDNF, reelin...) remaining more widely debated. Lastly, the observation of structural chromosomal anomalies in 15% of patients suffering from schizophrenia (versus 5% of controls), more frequent in early onset schizophrenia (32% of cases) suggests a neurodevelopmental cause. Such a dynamic understanding of schizophrenia is consistent with what we know about cerebral plasticity along the life span. This does not preclude the search for cues of degenerative mechanisms. The issue now is a better characterization of the vulnerable phenotype for screening procedures to be implemented prior to disease onset.
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Affiliation(s)
- J-P Olié
- Inserm U894, Center of Psychiatry and Neurosciences, Paris, France.
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26
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La schizophrénie à début précoce : caractéristiques cliniques et endophénotypiques. ANNALES MEDICO-PSYCHOLOGIQUES 2008. [DOI: 10.1016/j.amp.2005.09.026] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Mechri A, Slama H, Bourdel MC, Chebel S, Mandhouj O, Krebs MO, Gaha L. Signes neurologiques mineurs chez les patients schizophrènes et leurs apparentés non malades. Encephale 2008; 34:483-9. [DOI: 10.1016/j.encep.2007.08.009] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2006] [Accepted: 08/06/2007] [Indexed: 10/22/2022]
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Margari F, Presicci A, Petruzzelli MG, Ventura P, Di Cuonzo F, Palma M, Margari L. Very early onset and greater vulnerability in schizophrenia: A clinical and neuroimaging study. Neuropsychiatr Dis Treat 2008; 4:825-30. [PMID: 19043525 PMCID: PMC2536548 DOI: 10.2147/ndt.s2484] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [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
Although schizophrenia has been diagnosed in children, this group of disorders has received too little attention in the clinical and research literature. Preliminary data suggest that early onset schizophrenia (EOS) and very early onset schizophrenia (VEOS) tend to have a worse outcome than adult onset schizophrenia, and seem to be related to a greater familial vulnerability, due to genetic, psychosocial, and environmental factors. Recently, advanced neuroimaging techniques have revealed structural and functional brain abnormalities in some cerebral areas. This paper reports on a case diagnosed as VEOS, with premorbid year-long psychopathological history. The patient showed atypical proton magnetic resonance spectroscopy findings, and normal brain and spine computer tomography and brain magnetic resonance images.
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Affiliation(s)
- Francesco Margari
- Department of Neurologic and Psychiatry Sciences, Psychiatry Unit, University of Bari Italy
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Gebhardt S, Grant P, von Georgi R, Huber MT. Aspects of Piaget's cognitive developmental psychology and neurobiology of psychotic disorders - an integrative model. Med Hypotheses 2008; 71:426-33. [PMID: 18524496 DOI: 10.1016/j.mehy.2008.03.042] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2008] [Revised: 03/21/2008] [Accepted: 03/27/2008] [Indexed: 01/18/2023]
Abstract
Psychological, neurobiological and neurodevelopmental approaches have frequently been used to provide pathogenic concepts on psychotic disorders. However, aspects of cognitive developmental psychology have hardly been considered in current models. Using a hypothesis-generating approach an integration of these concepts was conducted. According to Piaget (1896-1980), assimilation and accommodation as forms of maintenance and modification of cognitive schemata represent fundamental processes of the brain. In general, based on the perceived input stimuli, cognitive schemata are developed resulting in a conception of the world, the realistic validity and the actuality of which is still being controlled and modified by cognitive adjustment processes. In psychotic disorders, however, a disproportion of environmental demands and the ability to activate required neuronal adaptation processes occurs. We therefore hypothesize a failure of the adjustment of real and requested output patterns. As a consequence autonomous cognitive schemata are generated, which fail to adjust with reality resulting in psychotic symptomatology. Neurobiological, especially neuromodulatory and neuroplastic processes play a central role in these perceptive and cognitive processes. In conclusion, integration of cognitive developmental psychology into the existing pathogenic concepts of psychotic disorders leads to interesting insights into basic disease mechanisms and also guides future research in the cognitive neuroscience of such disorders.
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Affiliation(s)
- Stefan Gebhardt
- Department of Psychiatry and Psychotherapy, University of Marburg, Germany.
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Boucard C, Laffy-Beaufils B. Caractérisation des troubles du langage dans la schizophrénie grâce au bilan orthophonique. Encephale 2008; 34:226-32. [DOI: 10.1016/j.encep.2007.04.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2006] [Accepted: 04/24/2007] [Indexed: 10/22/2022]
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31
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Shen Q, Li ZQ, Sun Y, Wang T, Wan CL, Li XW, Zhao XZ, Feng GY, Li S, St Clair D, He L, Yu L. The role of pro-inflammatory factors in mediating the effects on the fetus of prenatal undernutrition: implications for schizophrenia. Schizophr Res 2008; 99:48-55. [PMID: 18065207 DOI: 10.1016/j.schres.2007.10.010] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2007] [Revised: 09/27/2007] [Accepted: 10/18/2007] [Indexed: 12/17/2022]
Abstract
Exposure to prenatal undernutrition or malnutrition increases the risk of schizophrenia, although little is known about the mechanism. Pro-inflammatory factors are critical in brain development, and are believed to play an important role in neurodevelopmental disorders associated with prenatal exposure to infection, including schizophrenia. However it is not known whether pro-inflammatory factors also mediate the effects on the fetus of prenatal malnutrition or undernutrition. In this study, we established a new prenatal undernourished rat model induced by maternal exposure to a diet restricted to 50% of the low (6%) protein diet (RLP50). We observed the disappearance of maternal nest-building behavior in the RLP50 dams, increased levels of TNFA and IL6 in the placentas (P<0.001; P=0.879, respectively) and fetal livers (P<0.001; P<0.05, respectively), and a decrease in the fetal brains (P<0.05; P<0.01, respectively). Our results are similar to previous studies of maternal infection, which implies that a common pathway mediated by pro-inflammatory factors may contribute to the brain development, consequently increasing the risk of schizophrenia and other psychiatric diseases programmed by varied maternal adversities. We also provide a new prenatal undernourished model for researching prenatal problems, which differs from previous malnourished model in terms of the maternal behavior of dams and of observed pro-inflammatory factor levels in fetal tissues.
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Affiliation(s)
- Q Shen
- Institute for Nutritional Sciences, Shanghai Institutes for Biological Sciences, Chinese Academy of Sciences, 294 Taiyuan Road, Shanghai 200031, China
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Ashdown H, Dumont Y, Ng M, Poole S, Boksa P, Luheshi GN. The role of cytokines in mediating effects of prenatal infection on the fetus: implications for schizophrenia. Mol Psychiatry 2006; 11:47-55. [PMID: 16189509 DOI: 10.1038/sj.mp.4001748] [Citation(s) in RCA: 283] [Impact Index Per Article: 15.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Maternal infections with bacterial or viral agents during pregnancy are associated with an increased incidence of schizophrenia in the offspring at adulthood although little is known about the mechanism by which maternal infection might affect fetal neurodevelopment. Exposure of pregnant rodents to the bacterial endotoxin, lipopolysaccharide (LPS), results in behavioral deficits in the adult offspring that are relevant to schizophrenia. It is however unknown whether these effects are due to the direct action of the inflammatory stimulus on the developing fetus, or due to secondary immune mediators (cytokines) activated at maternal/fetal sites. In this study we sought to elucidate the site of action of LPS, following a single intraperitoneal (i.p.) injection, in pregnant rats at gestation day 18. Animals received 5 muCi of iodinated LPS ((125)I-LPS) and its distribution was assessed in maternal/fetal tissues (1-8 h). In addition, induction of the inflammatory cytokines, TNF-alpha, IL-1beta and IL-6, was measured in maternal/fetal tissues following maternal LPS challenge (0.05 mg/kg, i.p.) (2-8 h). (125)I-LPS was detected in maternal tissues and placenta, but not the fetus. This distribution was accompanied by significant increases in TNF-alpha, IL-1beta and IL-6 in maternal plasma and placenta, but not in fetal liver or brain. A significant increase in IL-1beta was however detected in fetal plasma, possibly due to transfer from the maternal circulation or placenta. Collectively, these data suggest that effects of maternal LPS exposure on the developing fetal brain are not mediated by the direct action of LPS, but via indirect actions at the level of the maternal circulation or placenta.
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Affiliation(s)
- H Ashdown
- Department of Psychiatry, McGill University, Douglas Hospital Research Centre, 6875 LaSalle Boulevard, Verdun, Montreal, Quebec, Canada H4H 1R3
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