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Peng TR, Lin HH, Lee MC, Chen SM. Statins as an adjuvant therapy for patients with schizophrenia: An up-to-date systematic review and meta-analysis. Gen Hosp Psychiatry 2024; 89:75-83. [PMID: 38824832 DOI: 10.1016/j.genhosppsych.2024.05.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Revised: 04/30/2024] [Accepted: 05/01/2024] [Indexed: 06/04/2024]
Abstract
BACKGROUND Evidence suggests that inflammatory processes play a role in the pathophysiology of schizophrenia. Statins exert anti-inflammatory and antioxidant effects and may be effective in improving the symptoms of schizophrenia. This study explored whether statins, as an adjunctive therapy, can alleviate the symptoms of schizophrenia. METHODS PubMed, EMBASE, and the Cochrane Library were searched for articles published up to March 2023. The risk-of-bias tool for randomized trials was used to assess study quality. Two researchers independently assessed the risks of bias and extracted data. Pooled data on Positive and Negative Syndrome Scale (PANSS) scores were analyzed. A random-effects model was employed to calculate pooled effect sizes. Statistical heterogeneity across studies was assessed using the I2 statistic. All analyses were performed using RevMan5 and Comprehensive Meta-Analysis software. RESULTS Nine trials enrolling 533 patients in total were included. Add-on statin therapy was found to be associated with a significantly better total PANSS score [standardized mean difference (SMD) = -0.42, 95% confidence interval (CI) -0.75 to -0.09, I2 = 72%; P = 0.01] and PANSS negative subscale score (SMD = -0.26, 95% CI -0.45 to -0.07, I2 = 0%; P = 0.009) in comparison with placebo. However, add-on statin therapy did not appear to improve scores for the PANSS positive and general subscales at the study-defined endpoint (6-24 weeks). CONCLUSIONS Our meta-analysis indicates that adjunctive statin therapy may confer benefits in ameliorating PANSS negative and total scores. It needs more solid data to confirm the results are related to clinical improvement and functioning.
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Affiliation(s)
- Tzu-Rong Peng
- Department of Pharmacy, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei City, Taiwan; School of Pharmacy, College of Pharmacy, Taipei Medical University, Taipei, Taiwan
| | - Hung-Hong Lin
- Department of Pharmacy, Chia-Nan University of Pharmacy and Science, Tainan, Taiwan
| | - Ming-Chia Lee
- School of Pharmacy, College of Pharmacy, Taipei Medical University, Taipei, Taiwan; Department of Pharmacy, New Taipei City Hospital, New Taipei City, Taiwan; Department of Nursing, Cardinal Tien College of Healthcare and Management, Taipei, Taiwan.
| | - Shih-Ming Chen
- School of Pharmacy, College of Pharmacy, Taipei Medical University, Taipei, Taiwan.
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2
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Lorenc-Koci E, Górny M, Chwatko G, Kamińska K, Iciek M, Rogóż Z. The effect of phencyclidine-mediated blockade of NMDA receptors in the early postnatal period on glutathione and sulfur amino acid levels in the rat brain as a potential causative factor of schizophrenia-like behavior in adulthood. Pharmacol Rep 2024:10.1007/s43440-024-00607-3. [PMID: 38904712 DOI: 10.1007/s43440-024-00607-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2024] [Revised: 05/21/2024] [Accepted: 05/22/2024] [Indexed: 06/22/2024]
Abstract
BACKGROUND Phencyclidine, an NMDA receptor antagonist, is frequently used to model behavioral and neurochemical changes correlated with schizophrenia in laboratory animals. The present study aimed to examine the effects of repeated administration of phencyclidine during early postnatal development on the contents of glutathione and sulfur-containing amino acids, as well as the activity of antioxidant enzymes in the brain of 12-day-old rats, and schizophrenia-like symptoms in adulthood. METHODS Male Sprague-Dawley pups were administered phencyclidine (10 mg/kg) or saline subcutaneously on the postnatal days p2, p6, p9 and p12. In 12-day-old pups, 4 h after the last dose of phencyclidine, the levels of glutathione, cysteine, methionine, and homocysteine, and the enzymatic activity of superoxide dismutase (SOD), glutathione peroxidase (GPx), and glutathione reductase (GR) were measured in the frontal cortex, hippocampus, and striatum. In 70-72-day-old rats, schizophrenia-like symptoms were assessed using behavioral tests. RESULTS Biochemical data showed that perinatal phencyclidine treatment significantly reduced glutathione and cysteine levels in all brain structures studied, methionine was diminished in the striatum, and homocysteine in both the frontal cortex and striatum. GR activity was increased in the frontal cortex while SODactivity was decreased in the hippocampus. Behaviorally, perinatal phencyclidine induced long-term deficits in social and cognitive function and a decrease in locomotor activity assessed as the time of walking. Finally, perinatal treatment with phencyclidine resulted in a significant reduction in body weight gain over time. CONCLUSION Our research provides further evidence for the usefulness of the phencyclidine-induced neurodevelopmental model of schizophrenia for studying the pathogenesis of schizophrenia.
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Affiliation(s)
- Elżbieta Lorenc-Koci
- Maj Institute of Pharmacology, Polish Academy of Sciences, 12 Smętna Street, Kraków, 31-343, Poland.
| | - Magdalena Górny
- The Chair of Medical Biochemistry, Jagiellonian University Medical College, 7 Kopernika Street, Kraków, 31-034, Poland
| | - Grażyna Chwatko
- Department of Environmental Chemistry, University of Łódź, 163 Pomorska Street, Łódź, 90-236, Poland
| | - Kinga Kamińska
- Maj Institute of Pharmacology, Polish Academy of Sciences, 12 Smętna Street, Kraków, 31-343, Poland
| | - Małgorzata Iciek
- The Chair of Medical Biochemistry, Jagiellonian University Medical College, 7 Kopernika Street, Kraków, 31-034, Poland
| | - Zofia Rogóż
- Maj Institute of Pharmacology, Polish Academy of Sciences, 12 Smętna Street, Kraków, 31-343, Poland
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Meigal A, Gerasimova-Meigal L, Kuzmina A, Antonen E, Peskova A, Burkin M. Electromyographic Characteristics of Postactivation Effect in Dopamine-Dependent Spectrum Models Observed in Parkinson's Disease and Schizophrenia. Biomedicines 2024; 12:1338. [PMID: 38927545 PMCID: PMC11202052 DOI: 10.3390/biomedicines12061338] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2024] [Revised: 06/14/2024] [Accepted: 06/16/2024] [Indexed: 06/28/2024] Open
Abstract
This study aimed to test the hypothesis that the postactivation effect (PAE, involuntary normal muscle tone) is modified by dopaminergic mechanisms. The PAE was tested with surface electromyography (sEMG) in the "off medication" phase in participants with Parkinson's disease (PDoff) and in the "on medication" state in participants with schizophrenia (SZon), which modeled hypodopaminegic conditions, and in participants with PD "on medication" (PDon) and in participants with SZ "off medication" (SZoff) state which modeled the hyperdopaminergic conditions. Healthy age-matched participants constituted the control group (HC, n = 11). In hyperdopaminergic models, PAE was triggered in 71.3% of participants in SZoff and in 35.7% in PDon conditions. In the hypodopaminergic models, PAE was triggered in 12% in SZon and in 21.4% in PDoff conditions. In the HC group, PAE was present in 91% of participants. In the HC and PD groups, the mean frequency and correlation dimension of sEMG at PAE was higher than that during voluntary isometric contraction. In conclusion, in hypodopaminergic models, PAE triggering was inhibited. The manifestations and EMG characteristics of PAE in people with PD or SZ may indicate dopaminergic dysfunction.
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Affiliation(s)
- Alexander Meigal
- Department of Physiology and Pathophysiology, Petrozavodsk State University, 33, Lenina Pr., 185910 Petrozavodsk, Russia; (L.G.-M.)
| | - Liudmila Gerasimova-Meigal
- Department of Physiology and Pathophysiology, Petrozavodsk State University, 33, Lenina Pr., 185910 Petrozavodsk, Russia; (L.G.-M.)
| | - Anna Kuzmina
- Department of Neurology, Psychiatry and Microbiology, Petrozavodsk State University, 33, Lenina Pr., 185910 Petrozavodsk, Russia
- Republican Psychiatric Hospital, 4, Bol’nichnyy Gorodok, 186131 Matrosy, Russia
| | - Elena Antonen
- Department of Neurology, Psychiatry and Microbiology, Petrozavodsk State University, 33, Lenina Pr., 185910 Petrozavodsk, Russia
| | - Alexandra Peskova
- Department of Physiology and Pathophysiology, Petrozavodsk State University, 33, Lenina Pr., 185910 Petrozavodsk, Russia; (L.G.-M.)
| | - Mark Burkin
- Department of Neurology, Psychiatry and Microbiology, Petrozavodsk State University, 33, Lenina Pr., 185910 Petrozavodsk, Russia
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Shen C, Tong X, Ran J, Sun S, Yang Q, Shen H, Yao XI. Associations between residential environments and late-onset schizophrenia in UK Biobank: Interaction with genetic risk factor. Schizophr Res 2024; 270:85-93. [PMID: 38885569 DOI: 10.1016/j.schres.2024.06.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2023] [Revised: 05/04/2024] [Accepted: 06/08/2024] [Indexed: 06/20/2024]
Abstract
BACKGROUND Environment and genes both contribute to schizophrenia. However, the impact of different natural environments surrounding residential addresses on schizophrenia in urban settings remains unknown. This study aimed to investigate the association of urbanisation, measured by residential environments, with late-onset schizophrenia and explore whether genetic risk for schizophrenia modified the associations. METHODS We examined the associations between residential environments and late-onset schizophrenia and its interaction with genetic risk factors in UK Biobank, followed from 2006 to 2010 (baseline) to Dec 2021. Residential environments, including greenspace, domestic garden, blue space, and total natural environment, were evaluated using land use coverage percentage. The polygenic risk score (PRS) of schizophrenia was derived using a Bayesian approach and adjusted it against ancestry. Cox proportional hazard regression model was used to assess the associations between per interquartile (IQR) increase of each type of residential environments and late-onset schizophrenia. Interactive effects of PRS and residential environments on late-onset schizophrenia were assessed on both additive and multiplicative scales. RESULTS A total of 393,680 participants were included in the analysis, with 844 cases of late-onset schizophrenia being observed after 12.8 years of follow-up. Within 300 m buffer surrounding the residential addresses, per interquartile increase in greenspace (31.5 %) and total natural environment (34.4 %) were both associated with an 11 % (HR = 0.89, 95 % CI 0.80, 0.99) lower risk of late-onset schizophrenia. Domestic garden and blue space did not show significant protective effects on late-onset schizophrenia. A strong dose-response relationship between schizophrenia PRS and schizophrenia was found, while no additive or multiplicative interaction effects were present between residential environments and PRS on late-onset schizophrenia. CONCLUSION Residential greenspace and total natural environment may protect against late-onset schizophrenia in older people regardless of genetic risk. These findings shed light on the prevention of schizophrenia and urban planning to optimise ecosystem benefits linked to schizophrenia.
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Affiliation(s)
- Chen Shen
- MRC Centre for Environment and Health, Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, UK; National Institute for Health Research Health Protection Research Unit in Chemical and Radiation Threats and Hazards, Imperial College London, UK
| | - Xinning Tong
- Department of Orthopaedics, The Eighth Affiliated Hospital, Sun Yat-Sen University, China
| | - Jinjun Ran
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Shengzhi Sun
- School of Public Health, Capital Medical University, Beijing 100069, China
| | - Qian Yang
- MRC Integrative Epidemiology Unit at the University of Bristol, Bristol, UK; Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Huiyong Shen
- Department of Orthopaedics, The Eighth Affiliated Hospital, Sun Yat-Sen University, China; Department of Clinical Research, The Eighth Affiliated Hospital, Sun Yat-sen University, China
| | - Xiaoxin I Yao
- Department of Orthopaedics, The Eighth Affiliated Hospital, Sun Yat-Sen University, China; Department of Clinical Research, The Eighth Affiliated Hospital, Sun Yat-sen University, China.
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Weng T, Zheng Y, Xie Y, Qin W, Guo L. Diagnosing schizophrenia using deep learning: Novel interpretation approaches and multi-site validation. Brain Res 2024; 1833:148876. [PMID: 38513996 DOI: 10.1016/j.brainres.2024.148876] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Revised: 02/28/2024] [Accepted: 03/18/2024] [Indexed: 03/23/2024]
Abstract
Schizophrenia is a profound and enduring mental disorder that imposes significant negative impacts on individuals, their families, and society at large. The development of more accurate and objective diagnostic tools for schizophrenia can be expedited through the employment of deep learning (DL), that excels at deciphering complex hierarchical non-linear patterns. However, the limited interpretability of deep learning has eroded confidence in the model and restricted its clinical utility. At the same time, if the data source is only derived from a single center, the model's generalizability is difficult to test. To enhance the model's reliability and applicability, leave-one-center-out validation with a large and diverse sample from multiple centers is crucial. In this study, we utilized Nine different global centers to train and test the 3D Resnet model's generalizability, resulting in an 82% classification performance (area under the curve) on all datasets sourced from different countries, employing a leave-one-center-out-validation approach. Per our approximation of the feature significance of each region on the atlas, we identified marked differences in the thalamus, pallidum, and inferior frontal gyrus between individuals with schizophrenia and healthy controls, lending credence to prior research findings. At the same time, in order to translate the model's output into clinically applicable insights, the SHapley Additive exPlanations (SHAP) permutation explainer method with an anatomical atlas have been refined, thereby offering precise neuroanatomical and functional interpretations of different brain regions.
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Affiliation(s)
- Tingting Weng
- School of Medical Imaging, Tianjin Medical University, Tianjin 300203, China
| | - Yuemei Zheng
- Department of Medical Imaging, Affiliated Hospital of Jining Medical University, Shandong 100038, China
| | - Yingying Xie
- Department of Radiology and Tianjin Key Laboratory of Functional Imaging, Tianjin Medical University General Hospital, Tianjin 300052, China
| | - Wen Qin
- Department of Radiology and Tianjin Key Laboratory of Functional Imaging, Tianjin Medical University General Hospital, Tianjin 300052, China
| | - Li Guo
- School of Medical Imaging, Tianjin Medical University, Tianjin 300203, China.
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Lányi O, Koleszár B, Schulze Wenning A, Balogh D, Engh MA, Horváth AA, Fehérvari P, Hegyi P, Molnár Z, Unoka Z, Csukly G. Excitation/inhibition imbalance in schizophrenia: a meta-analysis of inhibitory and excitatory TMS-EMG paradigms. SCHIZOPHRENIA (HEIDELBERG, GERMANY) 2024; 10:56. [PMID: 38879590 PMCID: PMC11180212 DOI: 10.1038/s41537-024-00476-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/29/2024] [Accepted: 05/16/2024] [Indexed: 06/19/2024]
Abstract
Cortical excitation-inhibition (E/I) imbalance is a potential model for the pathophysiology of schizophrenia. Previous research using transcranial magnetic stimulation (TMS) and electromyography (EMG) has suggested inhibitory deficits in schizophrenia. In this meta-analysis we assessed the reliability and clinical potential of TMS-EMG paradigms in schizophrenia following the methodological recommendations of the PRISMA guideline and the Cochrane Handbook. The search was conducted in three databases in November 2022. Included articles reported Short-Interval Intracortical Inhibition (SICI), Intracortical Facilitation (ICF), Long-Interval Intracortical Inhibition (LICI) and Cortical Silent Period (CSP) in patients with schizophrenia and healthy controls. Meta-analyses were conducted using a random-effects model. Subgroup analysis and meta-regressions were used to assess heterogeneity. Results of 36 studies revealed a robust inhibitory deficit in schizophrenia with a significant decrease in SICI (Cohen's d: 0.62). A trend-level association was found between SICI and antipsychotic medication. Our findings support the E/I imbalance hypothesis in schizophrenia and suggest that SICI may be a potential pathophysiological characteristic of the disorder.
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Affiliation(s)
- Orsolya Lányi
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary
- Department of Psychiatry and Psychotherapy, Semmelweis University, Budapest, Hungary
| | - Boróka Koleszár
- Department of Psychiatry and Psychotherapy, Semmelweis University, Budapest, Hungary
| | | | - David Balogh
- Department of Psychiatry and Psychotherapy, Semmelweis University, Budapest, Hungary
| | - Marie Anne Engh
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary
| | - András Attila Horváth
- Neurocognitive Research Center, Nyírő Gyula National Institute of Psychiatry and Addictology, Budapest, Hungary
| | - Péter Fehérvari
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary
- Department of Biostatistics, University of Veterinary Medicine Budapest, Budapest, Hungary
| | - Péter Hegyi
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary
- Institute of Pancreatic Diseases, Semmelweis University, Budapest, Hungary
- Institute for Translational Medicine, Medical School, University of Pécs, Pécs, Hungary
| | - Zsolt Molnár
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary
- Department of Anesthesiology and Intensive Therapy, Semmelweis University, Budapest, Hungary
- Department of Anesthesiology and Intensive Therapy, Poznan University of Medical Sciences, Poznan, Poland
| | - Zsolt Unoka
- Department of Psychiatry and Psychotherapy, Semmelweis University, Budapest, Hungary
| | - Gábor Csukly
- Department of Psychiatry and Psychotherapy, Semmelweis University, Budapest, Hungary.
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7
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Ricci V, Sarni A, Martinotti G, Maina G. Comparative analysis of third-generation antipsychotics in first-episode schizophrenia: efficacy, safety, and cognitive impacts. A narrative review. Int Clin Psychopharmacol 2024:00004850-990000000-00141. [PMID: 38941160 DOI: 10.1097/yic.0000000000000559] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/30/2024]
Abstract
BACKGROUND AND OBJECTIVES Schizophrenia is a chronic, complex mental health disorder requiring effective management to mitigate its broad personal and societal impacts. This narrative review assesses the efficacy, effectiveness, and side effects of third-generation antipsychotics (TGAs) like aripiprazole, brexpiprazole, and cariprazine, focusing on their use in first-episode schizophrenia. These drugs aim to reduce side effects typical of earlier antipsychotics while more effectively addressing positive and cognitive symptoms. METHODS Our extensive literature review, using PubMed and Scopus, includes randomized controlled trials and observational studies, showing TGAs may match older antipsychotics in efficacy with fewer side effects, notably in reducing extrapyramidal symptoms and enhancing cognitive outcomes. RESULTS Aripiprazole appears effective in both acute and maintenance phases of schizophrenia, while brexpiprazole and cariprazine show potential in managing negative symptoms and improving social functioning, essential for patient recovery. CONCLUSIONS This review emphasizes the need for personalized treatment and further research to fully determine the long-term benefits and safety of TGAs. These findings can inform clinical decisions and underline the ongoing need for innovation in schizophrenia pharmacotherapy.
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Affiliation(s)
- Valerio Ricci
- Department of Psychiatry, San Luigi Gonzaga Hospital, University of Turin, Orbassano
| | - Alessandro Sarni
- Department of Psychiatry, San Luigi Gonzaga Hospital, University of Turin, Orbassano
| | - Giovanni Martinotti
- Department of Neurosciences, Imaging and Clinical Sciences, Università degli Studi G. D'Annunzio Chieti-Pescara, Chieti and
| | - Giuseppe Maina
- Department of Psychiatry, San Luigi Gonzaga Hospital, University of Turin, Orbassano
- Department of Neurosciences 'Rita Levi Montalcini', University of Turin, Torino, Italy
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Zhong M, Liu Z, Wang F, Yang J, Chen E, Lee E, Wu G, Yang J. Effects of long-term antipsychotic medication on brain instability in first-episode schizophrenia patients: a resting-state fMRI study. Front Pharmacol 2024; 15:1387123. [PMID: 38846088 PMCID: PMC11153814 DOI: 10.3389/fphar.2024.1387123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2024] [Accepted: 05/02/2024] [Indexed: 06/09/2024] Open
Abstract
Early initiation of antipsychotic treatment plays a crucial role in the management of first-episode schizophrenia (FES) patients, significantly improving their prognosis. However, limited attention has been given to the long-term effects of antipsychotic drug therapy on FES patients. In this research, we examined the changes in abnormal brain regions among FES patients undergoing long-term treatment using a dynamic perspective. A total of 98 participants were included in the data analysis, comprising 48 FES patients, 50 healthy controls, 22 patients completed a follow-up period of more than 6 months with qualified data. We processed resting-state fMRI data to calculate coefficient of variation of fractional amplitude of low-frequency fluctuations (CVfALFF), which reflects the brain regional activity stability. Data analysis was performed at baseline and after long-term treatment. We observed that compared with HCs, patients at baseline showed an elevated CVfALFF in the supramarginal gyrus (SMG), parahippocampal gyrus (PHG), caudate, orbital part of inferior frontal gyrus (IOG), insula, and inferior frontal gyrus (IFG). After long-term treatment, the instability in SMG, PHG, caudate, IOG, insula and inferior IFG have ameliorated. Additionally, there was a positive correlation between the decrease in dfALFF in the SMG and the reduction in the SANS total score following long-term treatment. In conclusion, FES patients exhibit unstable regional activity in widespread brain regions at baseline, which can be ameliorated with long-term treatment. Moreover, the extent of amelioration in SMG instability is associated with the amelioration of negative symptoms.
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Affiliation(s)
- Maoxing Zhong
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Zhening Liu
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Feiwen Wang
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Jun Yang
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Eric Chen
- Department of Psychiatry, The University of Hong Kong, Pok Fu Lam, Hong Kong SAR, China
| | - Edwin Lee
- Department of Psychiatry, The University of Hong Kong, Pok Fu Lam, Hong Kong SAR, China
| | - Guowei Wu
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Jie Yang
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
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Peng HX, Zhang LL, Jiang D, Jian N, Zhang TM, Luo JG, Yin HY. CD73 polymorphisms are associated with schizophrenia. Purinergic Signal 2024:10.1007/s11302-024-10004-3. [PMID: 38758511 DOI: 10.1007/s11302-024-10004-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Accepted: 03/18/2024] [Indexed: 05/18/2024] Open
Abstract
Ecto-5'-nucleotidase/CD73 enzyme plays a key role in the regulation of extracellular adenosine levels, thereby exerting influence on adenosine homeostasis. Emerging evidence suggests that perturbations in purines and ecto-5'-nucleotidase activity are associated with an augmented susceptibility to schizophrenia. However, the precise impact of genetic variations in CD73 on individuals with schizophrenia remains poorly understood. Here, our study demonstrated that rs3734442 allele and rs4431401 heterozygote were conferred a significant risk of schizophrenia disease (rs3734442: odds ratio, 0.556; 95% CI, 0.375 to 0.825; p = 0.004; rs4431401: odds ratio, 1.881, 95% CI, 1.117 to 3.166; p = 0.020). Comparing different genders, we observed a significant association between rs3734442 genotypes and male cases (rs3734442: odds ratio, 0.452; 95% CI, 0.257 to 0.796; p = 0.007). Likewise, there was a significant association between rs4431401 genotypes and male patients (rs4431401: odds ratio, 2.570; 95% CI, 1.196 to 5.522; p = 0.015). Based on family history and antipsychotics medication usage, our data reveals that the rs9444348 allele exhibits the most significant association with familial susceptibility to schizophrenia (odds ratio, 1.541; 95% CI, 1.009 to 2.353; p = 0.048 for A vs G). Moreover, individuals carrying variants of rs6922, rs2229523, and rs2065114 while being treated with clozapine demonstrate a higher frequency proportion compared to those receiving risperidone treatment (p = 0.035; p = 0.049; p = 0.027 respectively). Additionally, our results indicate that patients with GG genotype of rs9444348 had significantly higher likelihood of using clozapine instead of sulpiride (p = 0.048). Overall, our data strongly suggest that genetic variations in CD73 are significantly associated with schizophrenia risk and may serve as valuable resources for identifying therapeutic targets.
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Affiliation(s)
- He-Xia Peng
- School of Acupuncture and Tuina, Chengdu University of Traditional Medicine, Chengdu, 610075, China
- Chengdu Jinxin Mental Diseases Hospital, Chengdu, 610063, China
| | - Li-Li Zhang
- School of Acupuncture and Tuina, Chengdu University of Traditional Medicine, Chengdu, 610075, China
- Chengdu Jinxin Mental Diseases Hospital, Chengdu, 610063, China
| | - Dan Jiang
- School of Acupuncture and Tuina, Chengdu University of Traditional Medicine, Chengdu, 610075, China
- Chengdu Jinxin Mental Diseases Hospital, Chengdu, 610063, China
| | - Na Jian
- School of Acupuncture and Tuina, Chengdu University of Traditional Medicine, Chengdu, 610075, China
- Chengdu Jinxin Mental Diseases Hospital, Chengdu, 610063, China
| | - Ting-Mei Zhang
- School of Acupuncture and Tuina, Chengdu University of Traditional Medicine, Chengdu, 610075, China
- Chengdu Jinxin Mental Diseases Hospital, Chengdu, 610063, China
| | - Jia-Guo Luo
- School of Acupuncture and Tuina, Chengdu University of Traditional Medicine, Chengdu, 610075, China.
- Chengdu Jinxin Mental Diseases Hospital, Chengdu, 610063, China.
| | - Hai-Yan Yin
- School of Acupuncture and Tuina, Chengdu University of Traditional Medicine, Chengdu, 610075, China.
- Chengdu Jinxin Mental Diseases Hospital, Chengdu, 610063, China.
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10
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Hirsch F, Bumanglag Â, Zhang Y, Wohlschlaeger A. Diverging functional connectivity timescales: Capturing distinct aspects of cognitive performance in early psychosis. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2024:2024.05.07.24306932. [PMID: 38766002 PMCID: PMC11100938 DOI: 10.1101/2024.05.07.24306932] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2024]
Abstract
Background Psychosis spectrum disorders (PSDs) are marked by cognitive impairments, the neurobiological correlates of which remain poorly understood. Here, we investigate the entropy of time-varying functional connectivity (TVFC) patterns from resting-state fMRI (rfMRI) as potential biomarker for cognitive performance in PSDs. By combining our results with multimodal reference data, we hope to generate new insights into the mechanisms underlying cognitive dysfunction in PSDs. We hypothesized that low-entropy TVFC patterns (LEN) would be more behaviorally informative than high-entropy TVFC patterns (HEN), especially for tasks that require extensive integration across diverse cognitive subdomains. Methods rfMRI and behavioral data from 97 patients in the early phases of psychosis and 53 controls were analyzed. Positron-Emission Tomography (PET) and magnetoencephalography (MEG) data were taken from a public repository (Hansen et al., 2022). Multivariate analyses were conducted to examine relationships between TVFC patterns at multiple spatial scales and cognitive performance in patients. Results Compared to HEN, LEN explained significantly more cognitive variance on average in PSD patients, driven by superior encoding of information on psychometrically more integrated tasks. HEN better captured information in specific subdomains of executive functioning. Nodal HEN-LEN transitions were spatially aligned with neurobiological gradients reflecting monoaminergic transporter densities and MEG beta power. Exploratory analyses revealed a close statistical relationship between LEN and positive PSD symptoms. Conclusion Our entropy-based analysis of TVFC patterns dissociates distinct aspects of cognition in PSDs. By linking topographies of neurotransmission and oscillatory dynamics with cognitive performance, it enhances our understanding of the mechanisms underlying cognitive deficits in PSDs. CRediT Authorship Contribution Statement Fabian Hirsch: Conceptualization, Methodology, Software, Formal analysis, Writing - Original Draft, Writing - Review & Editing, Visualization; Ângelo Bumanglag: Methodology, Software, Formal analysis, Writing - Review & Editing; Yifei Zhang: Methodology, Software, Formal analysis, Writing - Review & Editing; Afra Wohlschlaeger: Methodology, Writing - Review & Editing, Supervision, Project administration.
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Dines M, Kes M, Ailán D, Cetkovich-Bakmas M, Born C, Grunze H. Bipolar disorders and schizophrenia: discrete disorders? Front Psychiatry 2024; 15:1352250. [PMID: 38745778 PMCID: PMC11091416 DOI: 10.3389/fpsyt.2024.1352250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Accepted: 04/16/2024] [Indexed: 05/16/2024] Open
Abstract
Background With similarities in heritability, neurobiology and symptomatology, the question has been raised whether schizophrenia and bipolar disorder are truly distinctive disorders or belong to a continuum. This narrative review summarizes common and distinctive findings from genetics, neuroimaging, cognition and clinical course that may help to solve this ethiopathogenetic puzzle. Methods The authors conducted a literature search for papers listed in PubMed and Google Scholar, using the search terms "schizophrenia" and "bipolar disorder" combined with different terms such as "genes", "neuroimaging studies", "phenomenology differences", "cognition", "epidemiology". Articles were considered for inclusion if they were written in English or Spanish, published as full articles, if they compared subjects with schizophrenia and bipolar disorder, or subjects with either disorder with healthy controls, addressing differences between groups. Results Several findings support the hypothesis that schizophrenia and bipolar disorder are discrete disorders, yet some overlapping of findings exists. The evidence for heritability of both SZ and BD is obvious, as well as the environmental impact on individual manifestations of both disorders. Neuroimaging studies support subtle differences between disorders, it appears to be rather a pattern of irregularities than an unequivocally unique finding distinguishing schizophrenia from bipolar disorder. The cognitive profile displays differences between disorders in certain domains, such as premorbid intellectual functioning and executive functions. Finally, the timing and trajectory of cognitive impairment in both disorders also differs. Conclusion The question whether SZ and BD belong to a continuum or are separate disorders remains a challenge for further research. Currently, our research tools may be not precise enough to carve out distinctive, unique and undisputable differences between SZ and BD, but current evidence favors separate disorders. Given that differences are subtle, a way to overcome diagnostic uncertainties in the future could be the application of artificial intelligence based on BigData. Limitations Despite the detailed search, this article is not a full and complete review of all available studies on the topic. The search and selection of papers was also limited to articles in English and Spanish. Selection of papers and conclusions may be biased by the personal view and clinical experience of the authors.
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Affiliation(s)
- Micaela Dines
- Department of Psychiatry, Instituto de Neurología Cognitiva (INECO), Buenos Aires, Argentina
- Department of Psychiatry, Instituto de Neurociencia Cognitiva y Traslacional (Consejo Nacional de Investigaciones Científicas y Técnicas - Fundación INECO - Universidad Favaloro), Buenos Aires, Argentina
| | - Mariana Kes
- Department of Psychiatry, Instituto de Neurología Cognitiva (INECO), Buenos Aires, Argentina
- Department of Psychiatry, Instituto de Neurociencia Cognitiva y Traslacional (Consejo Nacional de Investigaciones Científicas y Técnicas - Fundación INECO - Universidad Favaloro), Buenos Aires, Argentina
| | - Delfina Ailán
- Department of Psychiatry, Instituto de Neurología Cognitiva (INECO), Buenos Aires, Argentina
- Department of Psychiatry, Instituto de Neurociencia Cognitiva y Traslacional (Consejo Nacional de Investigaciones Científicas y Técnicas - Fundación INECO - Universidad Favaloro), Buenos Aires, Argentina
| | - Marcelo Cetkovich-Bakmas
- Department of Psychiatry, Instituto de Neurología Cognitiva (INECO), Buenos Aires, Argentina
- Department of Psychiatry, Instituto de Neurociencia Cognitiva y Traslacional (Consejo Nacional de Investigaciones Científicas y Técnicas - Fundación INECO - Universidad Favaloro), Buenos Aires, Argentina
| | - Christoph Born
- Department of Psychiatry, Psychiatrie Schwäbisch Hall, Ringstraße, Germany
- Department of Psychiatry, Paracelsus Medical University, Nuremberg, Germany
| | - Heinz Grunze
- Department of Psychiatry, Psychiatrie Schwäbisch Hall, Ringstraße, Germany
- Department of Psychiatry, Paracelsus Medical University, Nuremberg, Germany
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Li S, Jiang J, Zhu W, Wang D, Dong C, Bu Y, Zhang J, Gao D, Hu X, Wan C. Increased cell-free DNA is associated with oxidative damage in patients with schizophrenia. J Psychiatr Res 2024; 175:20-28. [PMID: 38701608 DOI: 10.1016/j.jpsychires.2024.04.047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2023] [Revised: 03/31/2024] [Accepted: 04/25/2024] [Indexed: 05/05/2024]
Abstract
Cell-free DNA (cfDNA) has been found to be elevated in patients with schizophrenia (SZ), potentially derived from activated apoptosis, but the underlying mechanisms remain unknown. Moreover, whether the concentrations of cfDNA are altered with disease stage has not been investigated, which limits its clinical application as an auxiliary diagnostic marker for SZ. Using an improved fluorescence correlation spectroscopy (FCS) method that does not require DNA extraction, we measured the molar concentrations of cfDNA in plasma samples of 191 patients with SZ, 78 patients with mood disorders (MD) and 65 healthy controls (HC). We also analyzed the cfDNA composition from either the nucleus or mitochondria, oxidation markers and biochemical indexes to explore the potential mechanistic associations of the increased cfDNA levels. We found that in SZ patients, the cfDNA levels were significantly increased (P = 0.003) regardless of the different disease stages or antipsychotic medication use. Furthermore, qPCR revealed that cell-free nuclear DNA (cf-nDNA) (P = 0.041) but not cell-free mitochondrial DNA (cf-mtDNA) was elevated in SZ patients. Moreover, decreased SOD activity in SZ patients (P = 0.005) was negatively correlated with cfDNA levels (P = 0.047), and fasting blood glucose was positively correlated with cfDNA levels in SZ patients (P = 0.013). Our study provides evidence to support that the elevated cfDNA may be a convenient, effective and stable trait indicator of SZ. Further analysis showed that it mainly came from nucleus, suggesting increased apoptosis, and potentially related to oxidative stress and high blood glucose levels in patients.
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Affiliation(s)
- Shuhui Li
- Bio-X Institutes, Key Laboratory for the Genetics of Developmental and Neuropsychiatric Disorders, Ministry of Education, School of Life Sciences and Biotechnology, Shanghai Jiao Tong University, Shanghai, 200030, China
| | - Jie Jiang
- Bio-X Institutes, Key Laboratory for the Genetics of Developmental and Neuropsychiatric Disorders, Ministry of Education, School of Life Sciences and Biotechnology, Shanghai Jiao Tong University, Shanghai, 200030, China
| | - Wenli Zhu
- The Fourth People's Hospital of Wuhu, Wuhu, 241003, China
| | - Dandan Wang
- Bio-X Institutes, Key Laboratory for the Genetics of Developmental and Neuropsychiatric Disorders, Ministry of Education, School of Life Sciences and Biotechnology, Shanghai Jiao Tong University, Shanghai, 200030, China
| | - Chaoqing Dong
- School of Chemistry and Chemical Engineering, Shanghai Jiao Tong University, Shanghai, 200240, China
| | - Yangying Bu
- The Fourth People's Hospital of Wuhu, Wuhu, 241003, China
| | - Juan Zhang
- Bio-X Institutes, Key Laboratory for the Genetics of Developmental and Neuropsychiatric Disorders, Ministry of Education, School of Life Sciences and Biotechnology, Shanghai Jiao Tong University, Shanghai, 200030, China
| | - Daiyutong Gao
- Department of Mathematics, Nanjing University, Nanjing, 210093, China
| | - Xiaowen Hu
- Bio-X Institutes, Key Laboratory for the Genetics of Developmental and Neuropsychiatric Disorders, Ministry of Education, School of Life Sciences and Biotechnology, Shanghai Jiao Tong University, Shanghai, 200030, China.
| | - Chunling Wan
- Bio-X Institutes, Key Laboratory for the Genetics of Developmental and Neuropsychiatric Disorders, Ministry of Education, School of Life Sciences and Biotechnology, Shanghai Jiao Tong University, Shanghai, 200030, China; Shanghai Mental Health Center, Shanghai Key Laboratory of Psychiatry Disorders, Shanghai Jiao Tong University, Shanghai, 200030, China.
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Miyano T, Mikkaichi T, Nakamura K, Yoshigae Y, Abernathy K, Ogura Y, Kiyosawa N. Circulating microRNA Profiles Identify a Patient Subgroup with High Inflammation and Severe Symptoms in Schizophrenia Experiencing Acute Psychosis. Int J Mol Sci 2024; 25:4291. [PMID: 38673876 PMCID: PMC11050142 DOI: 10.3390/ijms25084291] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2024] [Revised: 04/06/2024] [Accepted: 04/11/2024] [Indexed: 04/28/2024] Open
Abstract
Schizophrenia is a complex and heterogenous psychiatric disorder. This study aimed to demonstrate the potential of circulating microRNAs (miRNAs) as a clinical biomarker to stratify schizophrenia patients and to enhance understandings of their heterogenous pathophysiology. We measured levels of 179 miRNA and 378 proteins in plasma samples of schizophrenia patients experiencing acute psychosis and obtained their Positive and Negative Syndrome Scale (PANSS) scores. The plasma miRNA profile revealed three subgroups of schizophrenia patients, where one subgroup tended to have higher scores of all the PANSS subscales compared to the other subgroups. The subgroup with high PANSS scores had four distinctively downregulated miRNAs, which enriched 'Immune Response' according to miRNA set enrichment analysis and were reported to negatively regulate IL-1β, IL-6, and TNFα. The same subgroup had 22 distinctively upregulated proteins, which enriched 'Cytokine-cytokine receptor interaction' according to protein set enrichment analysis, and all the mapped proteins were pro-inflammatory cytokines. Hence, the subgroup is inferred to have comparatively high inflammation within schizophrenia. In conclusion, miRNAs are a potential biomarker that reflects both disease symptoms and molecular pathophysiology, and identify a patient subgroup with high inflammation. These findings provide insights for the precision medicinal strategies for anti-inflammatory treatments in the high-inflammation subgroup of schizophrenia.
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Affiliation(s)
- Takuya Miyano
- Translational Science Department II, Daiichi Sankyo Co., Ltd., 1-2-58 Hiromachi, Shinagawa, Tokyo 140-8710, Japan; (T.M.); (K.N.); (Y.Y.); (N.K.)
| | - Tsuyoshi Mikkaichi
- Translational Science Department II, Daiichi Sankyo Co., Ltd., 1-2-58 Hiromachi, Shinagawa, Tokyo 140-8710, Japan; (T.M.); (K.N.); (Y.Y.); (N.K.)
| | - Kouichi Nakamura
- Translational Science Department II, Daiichi Sankyo Co., Ltd., 1-2-58 Hiromachi, Shinagawa, Tokyo 140-8710, Japan; (T.M.); (K.N.); (Y.Y.); (N.K.)
| | - Yasushi Yoshigae
- Translational Science Department II, Daiichi Sankyo Co., Ltd., 1-2-58 Hiromachi, Shinagawa, Tokyo 140-8710, Japan; (T.M.); (K.N.); (Y.Y.); (N.K.)
| | - Kelly Abernathy
- Clinical Research Department, Sirtsei Pharmaceuticals, Inc., 3000 RDU Center Drive, Suite 130, Morrisville, NC 27560, USA;
| | - Yuji Ogura
- Translational Research Department, Daiichi Sankyo RD Novare Co., Ltd., 1-16-13 Kitakasai, Edogawa, Tokyo 134-8630, Japan;
| | - Naoki Kiyosawa
- Translational Science Department II, Daiichi Sankyo Co., Ltd., 1-2-58 Hiromachi, Shinagawa, Tokyo 140-8710, Japan; (T.M.); (K.N.); (Y.Y.); (N.K.)
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Baglioni V, Bozza F, Lentini G, Beatrice A, Cameli N, Colacino Cinnante EM, Terrinoni A, Nardecchia F, Pisani F. Psychiatric Manifestations in Children and Adolescents with Inherited Metabolic Diseases. J Clin Med 2024; 13:2190. [PMID: 38673463 PMCID: PMC11051134 DOI: 10.3390/jcm13082190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2024] [Revised: 03/24/2024] [Accepted: 04/05/2024] [Indexed: 04/28/2024] Open
Abstract
Background: Inherited metabolic disorders (IEMs) can be represented in children and adolescents by psychiatric disorders. The early diagnosis of IEMs is crucial for clinical outcome and treatment. The aim of this review is to analyze the most recurrent and specific psychiatric features related to IEMs in pediatrics, based on the onset type and psychiatric phenotypes. Methods: Following the PRISMA Statement, a systematic literature review was performed using a predefined algorithm to find suitable publications in scientific databases of interest. After removing duplicates and screening titles and abstracts, suitable papers were analyzed and screened for inclusion and exclusion criteria. Finally, the data of interest were retrieved from the remaining articles. Results: The results of this study are reported by type of symptoms onset (acute and chronic) and by possible psychiatric features related to IEMs. Psychiatric phenomenology has been grouped into five main clinical manifestations: mood and anxiety disorders; schizophrenia-spectrum disorders; catatonia; eating disorders; and self-injurious behaviors. Conclusions: The inclusion of a variety of psychiatric manifestations in children and adolescents with different IEMs is a key strength of this study, which allowed us to explore the facets of seemingly different disorders in depth, avoiding possible misdiagnoses, with the related delay of early and appropriate treatments.
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Affiliation(s)
| | - Fabiola Bozza
- Child Neurology and Psychiatry Unit, Department of Human Neuroscience, Sapienza University, Via dei Sabelli 108, 00185 Rome, Italy; (V.B.); (G.L.); (A.B.); (N.C.); (E.M.C.C.); (A.T.); (F.N.); (F.P.)
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Tupinier Martin F, Boudreault J, Campagna C, Lavigne É, Gamache P, Tandonnet M, Généreux M, Trottier S, Goupil-Sormany I. The relationship between hot temperatures and hospital admissions for psychosis in adults diagnosed with schizophrenia: A case-crossover study in Quebec, Canada. ENVIRONMENTAL RESEARCH 2024; 246:118225. [PMID: 38253191 DOI: 10.1016/j.envres.2024.118225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Revised: 01/13/2024] [Accepted: 01/15/2024] [Indexed: 01/24/2024]
Abstract
INTRODUCTION Some studies have found hot temperatures to be associated with exacerbations of schizophrenia, namely psychoses. As climate changes faster in Northern countries, our understanding of the association between temperature and hospital admissions (HA) for psychosis needs to be deepened. OBJECTIVES 1) Among adults diagnosed with schizophrenia, measure the relationship between mean temperatures and HAs for psychosis during summer. 2) Determine the influence of individual and ecological characteristics on this relationship. METHODS A cohort of adults diagnosed with schizophrenia (n = 30,649) was assembled using Quebec's Integrated Chronic Disease Surveillance System (QICDSS). The follow-up spanned summers from 2001 to 2019, using hospital data from the QICDSS and meteorological data from the National Aeronautics and Space Administration's (NASA) Daymet database. In four geographic regions of the province of Quebec, a conditional logistic regression was used for the case-crossover analysis of the relationship between mean temperatures (at lags up to 6 days) and HAs for psychosis using a distributed lag non-linear model (DLNM). The analyses were adjusted for relative humidity, stratified according to individual (age, sex, and comorbidities) and ecological (material and social deprivation index and exposure to green space) factors, and then pooled through a meta-regression. RESULTS The statistical analyses revealed a statistically significant increase in HAs three days (lag 3) after elevated mean temperatures corresponding to the 90th percentile relative to a minimum morbidity temperature (MMT) (OR 1.040; 95% CI 1.008-1.074), while the cumulative effect over six days was not statistically significant (OR 1.052; 95% IC 0.993-1.114). Stratified analyses revealed non statistically significant gradients of increasing HAs relative to increasing material deprivation and decreasing green space levels. CONCLUSIONS The statistical analyses conducted in this project showed the pattern of admissions for psychosis after hot days. This finding could be useful to better plan health services in a rapidly changing climate.
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Affiliation(s)
- Frédéric Tupinier Martin
- Centre intégré universitaire de santé et de services sociaux de la Capitale-Nationale, Quebec City (Quebec), Canada; Department of social and preventive medicine, Laval University, Quebec City (Quebec), Canada; Environmental and occupational health and toxicology unit, Quebec National Institute of Public Health, Quebec City (Quebec), Canada.
| | - Jérémie Boudreault
- Environmental and occupational health and toxicology unit, Quebec National Institute of Public Health, Quebec City (Quebec), Canada; Water Earth and Environment Research Center, National institute of scientific research (INRS), Quebec City (Quebec), Canada.
| | - Céline Campagna
- Department of social and preventive medicine, Laval University, Quebec City (Quebec), Canada; Environmental and occupational health and toxicology unit, Quebec National Institute of Public Health, Quebec City (Quebec), Canada; Water Earth and Environment Research Center, National institute of scientific research (INRS), Quebec City (Quebec), Canada.
| | - Éric Lavigne
- Environmental Health Science and Research Bureau, Health Canada, Ottawa (Ontario), Canada; School of Epidemiology & Public Health, University of Ottawa, Ottawa (Ontario), Canada.
| | - Philippe Gamache
- Bureau d'information et d'études en santé des populations (BIESP), Quebec National Institute of Public Health, Quebec City (Quebec), Canada.
| | - Matthieu Tandonnet
- Bureau d'information et d'études en santé des populations (BIESP), Quebec National Institute of Public Health, Quebec City (Quebec), Canada.
| | - Mélissa Généreux
- Department of Community health sciences, Faculty of medicine and health sciences, Sherbrooke University, Sherbrooke (Quebec), Canada; Estrie's Public Health Department, Sherbrooke (Quebec), Canada.
| | - Simon Trottier
- Service des bibliothèques et archives, Université de Sherbrooke, Sherbrooke (Quebec), Canada.
| | - Isabelle Goupil-Sormany
- Department of social and preventive medicine, Laval University, Quebec City (Quebec), Canada; Environmental and occupational health and toxicology unit, Quebec National Institute of Public Health, Quebec City (Quebec), Canada; Axe Santé des populations et pratiques optimales en santé, Centre de recherche du CHU de Québec - Laval University, Quebec City (Quebec), Canada.
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Wang T, Yu M, Gu X, Liang X, Wang P, Peng W, Liu D, Chen D, Huang C, Tan Y, Liu K, Xiang B. Mechanism of electroconvulsive therapy in schizophrenia: a bioinformatics analysis study of RNA-seq data. Psychiatr Genet 2024; 34:54-60. [PMID: 38441120 DOI: 10.1097/ypg.0000000000000362] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/12/2024]
Abstract
OBJECTIVE The molecular mechanism of electroconvulsive therapy (ECT) for schizophrenia remains unclear. The aim of this study was to uncover the underlying biological mechanisms of ECT in the treatment of schizophrenia using a transcriptional dataset. METHODS The peripheral blood mRNA sequencing data of eight patients (before and after ECT) and eight healthy controls were analyzed by integrated co-expression network analysis and the differentially expressed genes were analyzed by cluster analysis. Gene set overlap analysis was performed using the hypergeometric distribution of phypfunction in R. Associations of these gene sets with psychiatric disorders were explored. Tissue-specific enrichment analysis, gene ontology enrichment analysis, and protein-protein interaction enrichment analysis were used for gene set organization localization and pathway analysis. RESULTS We found the genes of the green-yellow module were significantly associated with the effect of ECT treatment and the common gene variants of schizophrenia ( P = 0.0061; family-wise error correction). The genes of the green-yellow module are mainly enriched in brain tissue and mainly involved in the pathways of neurotrophin, mitogen-activated protein kinase and long-term potentiation. CONCLUSION Genes associated with the efficacy of ECT were predominantly enriched in neurotrophin, mitogen-activated protein kinase and long-term potentiation signaling pathways.
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Affiliation(s)
| | - Minglan Yu
- Medical Laboratory Center, Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan Province
| | - Xiaochu Gu
- Clinical Laboratory, Suzhou Guangji Hospital, The Affiliated Guangji Hospital of Soochow University, Suzhou, Jiangsu Province
| | | | | | | | - Dongmei Liu
- Department of Psychiatry, Yibin Fourth People's Hospital, Yibin
| | - Dechao Chen
- Department of Psychiatry, Yibin Fourth People's Hospital, Yibin
| | | | - Youguo Tan
- Department of Psychiatry, Zigong Mental Health Center, Zigong, Sichuan Province, China
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Cui W, Liu Z, Liang C, Zhao Z. Comparative efficacy of different types of exercise modalities on psychiatric symptomatology in patients with schizophrenia: a systematic review with network meta-analysis. Sci Rep 2024; 14:7019. [PMID: 38528063 DOI: 10.1038/s41598-024-57081-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2024] [Accepted: 03/14/2024] [Indexed: 03/27/2024] Open
Abstract
This network meta-analysis investigated the effects of 8 types of physical exercises on treating positive symptoms, negative symptoms, general psychopathology, and the Positive And Negative Syndrome Scale (PANSS) total score in patients with schizophrenia. The methods adhered to PRISMA guidelines and used the Cochrane risk of bias tool for quality assessment, and Stata software for data analysis. Data were sourced from PubMed, Embase, Web of Science, and the Cochrane database up to August 15, 2023, following PICOS principles. A total of 25 studies including 1441 participants were analyzed. Results showed that resistance exercise seems to be effective for improving positive symptoms, while Yoga was more effective for negative symptoms. Low-intensity aerobic exercise was optimal for general psychopathology, and Yoga was effective in improving the PANSS total score. The study concluded that yoga and aerobic exercise demonstrated superior performance, but the impact of exercise on patients with schizophrenia is also influenced by individual factors and intervention dosages. Therefore, a pre-assessment of patients considering factors such as interests, hobbies, and physical capabilities is crucial for selecting appropriate exercise modalities.
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Affiliation(s)
- Wenlai Cui
- Graduate School, Capital University of Physical Education and Sports, Beijing, China
| | - Zhitao Liu
- School of Physical Education and Sport Science, Fujian Normal University, Fuzhou, Fujian, China
| | - Cheng Liang
- Graduate School, Capital University of Physical Education and Sports, Beijing, China
| | - Zhizhi Zhao
- Institute of Physical Education and Training, Capital University of Physical Education and Sports, Beijing, China.
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Hao J, Tiles-Sar N, Habtewold TD, Liemburg EJ, Bruggeman R, van der Meer L, Alizadeh BZ. Shaping tomorrow's support: baseline clinical characteristics predict later social functioning and quality of life in schizophrenia spectrum disorder. Soc Psychiatry Psychiatr Epidemiol 2024:10.1007/s00127-024-02630-4. [PMID: 38456932 DOI: 10.1007/s00127-024-02630-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Accepted: 01/28/2024] [Indexed: 03/09/2024]
Abstract
PURPOSE We aimed to explore the multidimensional nature of social inclusion (mSI) among patients diagnosed with schizophrenia spectrum disorder (SSD), and to identify the predictors of 3-year mSI and the mSI prediction using traditional and data-driven approaches. METHODS We used the baseline and 3-year follow-up data of 1119 patients from the Genetic Risk and Outcome in Psychosis (GROUP) cohort in the Netherlands. The outcome mSI was defined as clusters derived from combined analyses of thirteen subscales from the Social Functioning Scale and the brief version of World Health Organization Quality of Life questionnaires through K-means clustering. Prediction models were built through multinomial logistic regression (ModelMLR) and random forest (ModelRF), internally validated via bootstrapping and compared by accuracy and the discriminability of mSI subgroups. RESULTS We identified five mSI subgroups: "very low (social functioning)/very low (quality of life)" (8.58%), "low/low" (12.87%), "high/low" (49.24%), "medium/high" (18.05%), and "high/high" (11.26%). The mSI was robustly predicted by a genetic predisposition for SSD, premorbid adjustment, positive, negative, and depressive symptoms, number of met needs, and baseline satisfaction with the environment and social life. The ModelRF (61.61% [54.90%, 68.01%]; P =0.013) was cautiously considered outperform the ModelMLR (59.16% [55.75%, 62.58%]; P =0.994). CONCLUSION We introduced and distinguished meaningful subgroups of mSI, which were modestly predictable from baseline clinical characteristics. A possibility for early prediction of mSI at the clinical stage may unlock the potential for faster and more impactful social support that is specifically tailored to the unique characteristics of the mSI subgroup to which a given patient belongs.
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Affiliation(s)
- Jiasi Hao
- Department of Epidemiology, University Medical Centre Groningen, University of Groningen, Hanzeplein 1, 9713 GZ, Groningen, The Netherlands.
| | - Natalia Tiles-Sar
- Department of Epidemiology, University Medical Centre Groningen, University of Groningen, Hanzeplein 1, 9713 GZ, Groningen, The Netherlands
- Department of Psychiatry, University Medical Centre Groningen, University Centre for Psychiatry, Rob Giel Research Centre, University of Groningen, Groningen, The Netherlands
| | - Tesfa Dejenie Habtewold
- Department of Epidemiology, University Medical Centre Groningen, University of Groningen, Hanzeplein 1, 9713 GZ, Groningen, The Netherlands
| | - Edith J Liemburg
- Department of Psychiatry, University Medical Centre Groningen, University Centre for Psychiatry, Rob Giel Research Centre, University of Groningen, Groningen, The Netherlands
| | - Richard Bruggeman
- Department of Psychiatry, University Medical Centre Groningen, University Centre for Psychiatry, Rob Giel Research Centre, University of Groningen, Groningen, The Netherlands
- Department of Clinical and Developmental Neuropsychology, Faculty of Behavioural and Social Sciences, University of Groningen, Groningen, The Netherlands
- Department of Rehabilitation, Lentis Psychiatric Institute, Zuidlaren, The Netherlands
| | - Lisette van der Meer
- Department of Clinical and Developmental Neuropsychology, Faculty of Behavioural and Social Sciences, University of Groningen, Groningen, The Netherlands
- Department of Rehabilitation, Lentis Psychiatric Institute, Zuidlaren, The Netherlands
| | - Behrooz Z Alizadeh
- Department of Epidemiology, University Medical Centre Groningen, University of Groningen, Hanzeplein 1, 9713 GZ, Groningen, The Netherlands.
- Department of Psychiatry, University Medical Centre Groningen, University Centre for Psychiatry, Rob Giel Research Centre, University of Groningen, Groningen, The Netherlands.
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Engel L, Alvarez-Jimenez M, Cagliarini D, D’Alfonso S, Faller J, Valentine L, Koval P, Bendall S, O’Sullivan S, Rice S, Miles C, Penn DL, Phillips J, Russon P, Lederman R, Killackey E, Lal S, Maree Cotton S, Gonzalez-Blanch C, Herrman H, McGorry PD, Gleeson JFM, Mihalopoulos C. The Cost-Effectiveness of a Novel Online Social Therapy to Maintain Treatment Effects From First-Episode Psychosis Services: Results From the Horyzons Randomized Controlled Trial. Schizophr Bull 2024; 50:427-436. [PMID: 37261464 PMCID: PMC10919787 DOI: 10.1093/schbul/sbad071] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
BACKGROUND Digital interventions have potential applications in promoting long-term recovery and improving outcomes in first-episode psychosis (FEP). This study aimed to evaluate the cost-effectiveness of Horyzons, a novel online social therapy to support young people aged 16-27 years following discharge from FEP services, compared with treatment as usual (TAU) from a healthcare sector and a societal perspective. STUDY DESIGN A cost-effectiveness analysis (CEA), based on the change in social functioning, and a cost-utility analysis (CUA) using quality-adjusted life years were undertaken alongside a randomized controlled trial. Intervention costs were determined from study records; resources used by patients were collected from a resource-use questionnaire and administrative data. Mean costs and outcomes were compared at 18 months and incremental cost-effectiveness ratios were calculated. Uncertainty analysis using bootstrapping and sensitivity analyses was conducted. STUDY RESULTS The sample included 170 participants: Horyzons intervention group (n = 86) and TAU (n = 84). Total costs were significantly lower in the Horyzons group compared with TAU from both the healthcare sector (-AU$4789.59; P < .001) and the societal perspective (-AU$5131.14; P < .001). In the CEA, Horyzons was dominant, meaning it was less costly and resulted in better social functioning. In the CUA, the Horyzons intervention resulted in fewer costs but also yielded fewer QALYs. However, group differences in outcomes were not statistically significant. When young people engaged more with the platform, costs were shown to decrease and outcomes improved. CONCLUSIONS The Horyzons intervention offers a cost-effective approach for improving social functioning in young people with FEP after discharge from early intervention services.
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Affiliation(s)
- Lidia Engel
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Mario Alvarez-Jimenez
- Orygen, Parkville, VIC, Australia
- Centre for Youth Mental Health, University of Melbourne, Melbourne, VIC, Australia
| | - Daniela Cagliarini
- Orygen, Parkville, VIC, Australia
- Centre for Youth Mental Health, University of Melbourne, Melbourne, VIC, Australia
| | - Simon D’Alfonso
- School of Computing and Information Systems, University of Melbourne, Melbourne, VIC, Australia
| | - Jan Faller
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Lee Valentine
- Orygen, Parkville, VIC, Australia
- Centre for Youth Mental Health, University of Melbourne, Melbourne, VIC, Australia
| | - Peter Koval
- Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, VIC, Australia
| | - Sarah Bendall
- Orygen, Parkville, VIC, Australia
- Centre for Youth Mental Health, University of Melbourne, Melbourne, VIC, Australia
| | - Shaunagh O’Sullivan
- Orygen, Parkville, VIC, Australia
- Centre for Youth Mental Health, University of Melbourne, Melbourne, VIC, Australia
| | - Simon Rice
- Orygen, Parkville, VIC, Australia
- Centre for Youth Mental Health, University of Melbourne, Melbourne, VIC, Australia
| | - Chris Miles
- Orygen, Parkville, VIC, Australia
- Centre for Youth Mental Health, University of Melbourne, Melbourne, VIC, Australia
| | - David L Penn
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
- Healthy Brain and Mind Research Centre and School of Behavioural and Health Sciences, Australian Catholic University, Melbourne, VIC, Australia
| | - Jess Phillips
- Orygen, Parkville, VIC, Australia
- Centre for Youth Mental Health, University of Melbourne, Melbourne, VIC, Australia
| | - Penni Russon
- School of Communication, University of Technology Sydney, Sydney, NWS, Australia
| | - Reeva Lederman
- School of Computing and Information Systems, University of Melbourne, Melbourne, VIC, Australia
| | - Eoin Killackey
- Orygen, Parkville, VIC, Australia
- Centre for Youth Mental Health, University of Melbourne, Melbourne, VIC, Australia
| | - Shalini Lal
- School of Rehabilitation, Faculty of Medicine, University of Montreal, Montreal, QC, Canada
- Health Innovation and Evaluation Hub, University of Montreal Hospital Research Centre, Montreal, QC, Canada
- Douglas Mental Health University Institute, Montreal, QC, Canada
| | - Sue Maree Cotton
- Orygen, Parkville, VIC, Australia
- Centre for Youth Mental Health, University of Melbourne, Melbourne, VIC, Australia
| | - Cesar Gonzalez-Blanch
- Centre for Youth Mental Health, University of Melbourne, Melbourne, VIC, Australia
- University Hospital Marques de Valdecilla-IDIVAL, Santander, Spain
| | - Helen Herrman
- Orygen, Parkville, VIC, Australia
- Centre for Youth Mental Health, University of Melbourne, Melbourne, VIC, Australia
| | - Patrick D McGorry
- Orygen, Parkville, VIC, Australia
- Centre for Youth Mental Health, University of Melbourne, Melbourne, VIC, Australia
| | - John F M Gleeson
- Healthy Brain and Mind Research Centre and School of Behavioural and Health Sciences, Australian Catholic University, Melbourne, VIC, Australia
| | - Cathrine Mihalopoulos
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
- Deakin Health Economics, Deakin University, Burwood, VIC, Australia
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20
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Chen WY, Pan CH, Su SS, Yang TW, Chen CC, Kuo CJ. Incidence and Risk Profiles for Suicide Mortality in Patients With Schizophrenia Receiving Homecare Case Management in Taiwan. Schizophr Bull 2024; 50:295-303. [PMID: 37163678 PMCID: PMC10919775 DOI: 10.1093/schbul/sbad067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
Case management (CM)-based community therapy for patients with schizophrenia had little effect on reducing suicide mortality. We investigate the long-term suicide mortality outcome and associated risk factors in patients with schizophrenia receiving homecare (CM) in Taiwan. We enrolled a nationwide cohort of patients with schizophrenia who newly received homecare CM intervention (n = 13 317) between January 1, 2001, and December 31, 2015; their data were derived from Taiwan's National Health Insurance Research Database. We calculated the incidence rate of suicide methods. We examined the demographic and medical utilization profile for suicide and then performed a nested case-control study and multivariate regression to identify independent risk factors for suicide mortality. Among the 13 317 patients who received homecare CM intervention, 1766 died during the study period, of whom 213 died by suicide, which is the leading cause of unnatural death. Jumping from a high place, self-poisoning, and hanging were the top 3 suicide methods. Increased medical utilization was noted for both psychiatric and non-psychiatric services within 3 months of suicide mortality. Comorbidities of depressive disorder, nonspecific heart diseases, pneumonia, and gastrointestinal ulcers were identified as independent risk factors for suicide mortality. Suicide was the leading cause of unnatural mortality in patients with schizophrenia receiving homecare CM intervention in Taiwan. We noted the preferred suicide methods, high medical utilization, and comorbidities before suicide. Thus, we suggest that the CM team should assess lethal methods for suicide and ensure that patients adhere to psychiatry treatment for improving the current care model for this specified population.
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Affiliation(s)
- Wen-Yin Chen
- Taipei City Psychiatric Center, Taipei City Hospital, Taipei, Taiwan
- School of Medicine, College of Medicine, Fu Jen Catholic University, New Taipei City, Taiwan
| | - Chun-Hung Pan
- Taipei City Psychiatric Center, Taipei City Hospital, Taipei, Taiwan
- Department of Psychology, National Chengchi University, Taipei, Taiwan
| | - Sheng-Shiang Su
- Taipei City Psychiatric Center, Taipei City Hospital, Taipei, Taiwan
| | - Tien-Wei Yang
- Taipei City Psychiatric Center, Taipei City Hospital, Taipei, Taiwan
- Psychiatric Research Center, Taipei Medical University Hospital, Taipei, Taiwan
- Department of Psychiatry, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Chiao-Chicy Chen
- Psychiatric Research Center, Taipei Medical University Hospital, Taipei, Taiwan
- Department of Psychiatry, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
- Department of Psychiatry, Mackay Memorial Hospital, Taipei, Taiwan
| | - Chian-Jue Kuo
- Taipei City Psychiatric Center, Taipei City Hospital, Taipei, Taiwan
- Psychiatric Research Center, Taipei Medical University Hospital, Taipei, Taiwan
- Department of Psychiatry, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
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21
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Hao K, Chen F, Xu S, Xiong Y, Xu R, Huang H, Shu C, Wang H, Wang G, Reynolds GP. The role of SIRT3 in mediating the cognitive deficits and neuroinflammatory changes associated with a developmental animal model of schizophrenia. Prog Neuropsychopharmacol Biol Psychiatry 2024; 130:110914. [PMID: 38122862 DOI: 10.1016/j.pnpbp.2023.110914] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Revised: 11/30/2023] [Accepted: 12/10/2023] [Indexed: 12/23/2023]
Abstract
The neuroinflammatory state may contribute to the pathogenesis of many mental disorders including schizophrenia. Nicotinamide adenine dinucleotide (NAD+) is an essential cofactor for activation of proteins involved in mitochondria quality control, such as Sirtuin3 (SIRT3). Our previous study has found that NAD+ supplement could rescue early life stress (ELS)-induced neuroinflammation and down-regulation of SIRT3 in adult offspring. However, it is unclear whether SIRT3 is the key to the neuroprotective effects of NAD+ supplement in this animal model of schizophrenia. The present study used 24 h maternal separation (MS) as ELS to Wistar rat pups on the postnatal day (PND) 9. Schizophrenia-like behaviors and memory impairments were detected by behavioral tests. Microglial activation, pro-inflammatory cytokine expression, and NAD+/SIRT3 expression were detected in the prefrontal cortex and hippocampus. Meanwhile, NAM (a precursor of NAD+), and the SIRT3 activator Honokiol (HNK), and the SIRT3 inhibitor 3-TYP were used as an intervention in vivo. Our results showed that ELS could induce schizophrenia-like behaviors and M1 microglial activation, NAD+ decline, lower expression of SIRT3, and increased acetylated superoxide dismutase 2 expression at the adult stage. NAD+ supplement or HNK administration could block this process and normalize the behavioral alterations of the MS animals. 3-TYP administration in the control group and the NAM-treated MS rats caused M1 microglial activation and cognitive deficits. Our results demonstrated that SIRT3 mediated the stabilizing effect of NAD+ on normalizing M1 microglial activation and behavioral phenotypes in MS rats.
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Affiliation(s)
- Keke Hao
- Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan 430060, China
| | - Fashuai Chen
- Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan 430060, China
| | - Shilin Xu
- Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan 430060, China
| | - Ying Xiong
- Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan 430060, China
| | - Rui Xu
- Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan 430060, China
| | - Huan Huang
- Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan 430060, China
| | - Chang Shu
- Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan 430060, China
| | - Huiling Wang
- Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan 430060, China; Hubei Provincial Key Laboratory of Developmentally Originated Disease, Wuhan 430071, China.
| | - Gaohua Wang
- Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan 430060, China; Hubei Institute of Neurology and Psychiatry Research, Wuhan 430060, China.
| | - Gavin P Reynolds
- Biomolecular Sciences Research Centre, Sheffield Hallam University, Sheffield, United Kingdom
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22
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Mo F, Zhao H, Li Y, Cai H, Song Y, Wang R, Yu Y, Zhu J. Network Localization of State and Trait of Auditory Verbal Hallucinations in Schizophrenia. Schizophr Bull 2024:sbae020. [PMID: 38401526 DOI: 10.1093/schbul/sbae020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/26/2024]
Abstract
BACKGROUND AND HYPOTHESIS Neuroimaging studies investigating the neural substrates of auditory verbal hallucinations (AVH) in schizophrenia have yielded mixed results, which may be reconciled by network localization. We sought to examine whether AVH-state and AVH-trait brain alterations in schizophrenia localize to common or distinct networks. STUDY DESIGN We initially identified AVH-state and AVH-trait brain alterations in schizophrenia reported in 48 previous studies. By integrating these affected brain locations with large-scale discovery and validation resting-state functional magnetic resonance imaging datasets, we then leveraged novel functional connectivity network mapping to construct AVH-state and AVH-trait dysfunctional networks. STUDY RESULTS The neuroanatomically heterogeneous AVH-state and AVH-trait brain alterations in schizophrenia localized to distinct and specific networks. The AVH-state dysfunctional network comprised a broadly distributed set of brain regions mainly involving the auditory, salience, basal ganglia, language, and sensorimotor networks. Contrastingly, the AVH-trait dysfunctional network manifested as a pattern of circumscribed brain regions principally implicating the caudate and inferior frontal gyrus. Additionally, the AVH-state dysfunctional network aligned with the neuromodulation targets for effective treatment of AVH, indicating possible clinical relevance. CONCLUSIONS Apart from unifying the seemingly irreproducible neuroimaging results across prior AVH studies, our findings suggest different neural mechanisms underlying AVH state and trait in schizophrenia from a network perspective and more broadly may inform future neuromodulation treatment for AVH.
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Affiliation(s)
- Fan Mo
- Department of Radiology, The First Affiliated Hospital of Anhui Medical University, Hefei, China
- Research Center of Clinical Medical Imaging, Anhui Province, Hefei, China
- Anhui Provincial Institute of Translational Medicine, Hefei, China
- Anhui Provincial Key Laboratory for Brain Bank Construction and Resource Utilization, Hefei, China
| | - Han Zhao
- Department of Radiology, The First Affiliated Hospital of Anhui Medical University, Hefei, China
- Research Center of Clinical Medical Imaging, Anhui Province, Hefei, China
- Anhui Provincial Institute of Translational Medicine, Hefei, China
- Anhui Provincial Key Laboratory for Brain Bank Construction and Resource Utilization, Hefei, China
| | - Yifan Li
- Department of Radiology, The First Affiliated Hospital of Anhui Medical University, Hefei, China
- Research Center of Clinical Medical Imaging, Anhui Province, Hefei, China
- Anhui Provincial Institute of Translational Medicine, Hefei, China
- Anhui Provincial Key Laboratory for Brain Bank Construction and Resource Utilization, Hefei, China
| | - Huanhuan Cai
- Department of Radiology, The First Affiliated Hospital of Anhui Medical University, Hefei, China
- Research Center of Clinical Medical Imaging, Anhui Province, Hefei, China
- Anhui Provincial Institute of Translational Medicine, Hefei, China
- Anhui Provincial Key Laboratory for Brain Bank Construction and Resource Utilization, Hefei, China
| | - Yang Song
- Department of Pain, The First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Rui Wang
- Department of Radiology, The First Affiliated Hospital of Anhui Medical University, Hefei, China
- Research Center of Clinical Medical Imaging, Anhui Province, Hefei, China
- Anhui Provincial Institute of Translational Medicine, Hefei, China
- Anhui Provincial Key Laboratory for Brain Bank Construction and Resource Utilization, Hefei, China
| | - Yongqiang Yu
- Department of Radiology, The First Affiliated Hospital of Anhui Medical University, Hefei, China
- Research Center of Clinical Medical Imaging, Anhui Province, Hefei, China
- Anhui Provincial Institute of Translational Medicine, Hefei, China
- Anhui Provincial Key Laboratory for Brain Bank Construction and Resource Utilization, Hefei, China
| | - Jiajia Zhu
- Department of Radiology, The First Affiliated Hospital of Anhui Medical University, Hefei, China
- Research Center of Clinical Medical Imaging, Anhui Province, Hefei, China
- Anhui Provincial Institute of Translational Medicine, Hefei, China
- Anhui Provincial Key Laboratory for Brain Bank Construction and Resource Utilization, Hefei, China
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23
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Bakken TL, Askeland Hellerud JM, Kildahl AN, Solheim-Inderberg AM, Berge Helverschou S, Hove O. Schizophrenia in Autistic People with Intellectual Disabilities. Treatment and Interventions. J Autism Dev Disord 2024:10.1007/s10803-024-06286-6. [PMID: 38393435 DOI: 10.1007/s10803-024-06286-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/12/2024] [Indexed: 02/25/2024]
Abstract
Autistic people with intellectual disabilities appear to be at increased risk of schizophrenia. While current recommendations emphasize adapting interventions used for people with schizophrenia in general, few studies to date have investigated treatment of co-occurring schizophrenia in this specific population. To explore what interventions are provided to autistic people with intellectual disabilities and co-occurring schizophrenia in specialized mental health services, and to investigate whether changes in mental health symptoms and challenging behavior occurred during treatment. Using data from a longitudinal, national multicenter study, interventions provided to 26 autistic individuals with intellectual disabilities and co-occurring schizophrenia were explored. Symptoms were measured using the Psychopathology in Autism Checklist (PAC) and the Aberrant Behavior Checklist ABC) at referral (T1), at the end of treatment (T2), and at follow-up 12 months after T2 (T3). A broad range of interventions were provided to the participants, including inpatient admission, psychopharmacological treatment, various psychosocial interventions, and supportive interventions. Scores on the PAC and ABC were significantly lower at T2 than T1 for most scales, and no significant change was found from T2 to T3.Treatment of co-occurring schizophrenia appears feasible and effective in autistic people with intellectual disabilities.
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24
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Georgiadis F, Larivière S, Glahn D, Hong LE, Kochunov P, Mowry B, Loughland C, Pantelis C, Henskens FA, Green MJ, Cairns MJ, Michie PT, Rasser PE, Catts S, Tooney P, Scott RJ, Schall U, Carr V, Quidé Y, Krug A, Stein F, Nenadić I, Brosch K, Kircher T, Gur R, Gur R, Satterthwaite TD, Karuk A, Pomarol-Clotet E, Radua J, Fuentes-Claramonte P, Salvador R, Spalletta G, Voineskos A, Sim K, Crespo-Facorro B, Tordesillas Gutiérrez D, Ehrlich S, Crossley N, Grotegerd D, Repple J, Lencer R, Dannlowski U, Calhoun V, Rootes-Murdy K, Demro C, Ramsay IS, Sponheim SR, Schmidt A, Borgwardt S, Tomyshev A, Lebedeva I, Höschl C, Spaniel F, Preda A, Nguyen D, Uhlmann A, Stein DJ, Howells F, Temmingh HS, Diaz Zuluaga AM, López Jaramillo C, Iasevoli F, Ji E, Homan S, Omlor W, Homan P, Kaiser S, Seifritz E, Misic B, Valk SL, Thompson P, van Erp TGM, Turner JA, Bernhardt B, Kirschner M. Connectome architecture shapes large-scale cortical alterations in schizophrenia: a worldwide ENIGMA study. Mol Psychiatry 2024:10.1038/s41380-024-02442-7. [PMID: 38336840 DOI: 10.1038/s41380-024-02442-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Revised: 01/08/2024] [Accepted: 01/18/2024] [Indexed: 02/12/2024]
Abstract
Schizophrenia is a prototypical network disorder with widespread brain-morphological alterations, yet it remains unclear whether these distributed alterations robustly reflect the underlying network layout. We tested whether large-scale structural alterations in schizophrenia relate to normative structural and functional connectome architecture, and systematically evaluated robustness and generalizability of these network-level alterations. Leveraging anatomical MRI scans from 2439 adults with schizophrenia and 2867 healthy controls from 26 ENIGMA sites and normative data from the Human Connectome Project (n = 207), we evaluated structural alterations of schizophrenia against two network susceptibility models: (i) hub vulnerability, which examines associations between regional network centrality and magnitude of disease-related alterations; (ii) epicenter mapping, which identifies regions whose typical connectivity profile most closely resembles the disease-related morphological alterations. To assess generalizability and specificity, we contextualized the influence of site, disease stages, and individual clinical factors and compared network associations of schizophrenia with that found in affective disorders. Our findings show schizophrenia-related cortical thinning is spatially associated with functional and structural hubs, suggesting that highly interconnected regions are more vulnerable to morphological alterations. Predominantly temporo-paralimbic and frontal regions emerged as epicenters with connectivity profiles linked to schizophrenia's alteration patterns. Findings were robust across sites, disease stages, and related to individual symptoms. Moreover, transdiagnostic comparisons revealed overlapping epicenters in schizophrenia and bipolar, but not major depressive disorder, suggestive of a pathophysiological continuity within the schizophrenia-bipolar-spectrum. In sum, cortical alterations over the course of schizophrenia robustly follow brain network architecture, emphasizing marked hub susceptibility and temporo-frontal epicenters at both the level of the group and the individual. Subtle variations of epicenters across disease stages suggest interacting pathological processes, while associations with patient-specific symptoms support additional inter-individual variability of hub vulnerability and epicenters in schizophrenia. Our work outlines potential pathways to better understand macroscale structural alterations, and inter- individual variability in schizophrenia.
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Affiliation(s)
- Foivos Georgiadis
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital University of Zurich, Zurich, Switzerland.
| | - Sara Larivière
- McGill University, Montreal Neurological Institute, Montreal, QC, Canada
| | - David Glahn
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - L Elliot Hong
- Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD, US
| | - Peter Kochunov
- Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD, US
| | - Bryan Mowry
- Queensland Brain Institute, The University of Queensland, St Lucia, QLD, Australia
| | - Carmel Loughland
- School of Medicine and Public Health, University of Newcastle, Newcastle, NSW, USA
| | - Christos Pantelis
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne, Carlton South, VIC, Australia
| | - Frans A Henskens
- School of Medicine and Public Health, University of Newcastle, Newcastle, NSW, Australia
| | - Melissa J Green
- School of Clinical Medicine, Discipline of Psychiatry and Mental Health, UNSW Sydney, Sydney, NSW, Australia
| | - Murray J Cairns
- School of Biomedical Science and Pharmacy, University of Newcastle, Newcastle, NSW, Australia
| | - Patricia T Michie
- School of Psychological Sciences, University of Newcastle, Newcastle, NSW, Australia
| | - Paul E Rasser
- School of Medicine and Public Health, College of Health, Medicine, and Wellbeing, The University of Newcastle, Callaghan, NSW, Australia
| | - Stanley Catts
- Faculty of Medicine, University of Queensland, St Lucia, QLD, Australia
| | - Paul Tooney
- School of Biomedical Science and Pharmacy, University of Newcastle, Newcastle, NSW, Australia
- Hunter Medical Research Institute, Newcastle, NSW, Australia
| | - Rodney J Scott
- School of Biomedical Science and Pharmacy, University of Newcastle, Newcastle, NSW, Australia
| | - Ulrich Schall
- Hunter Medical Research Institute, Newcastle, NSW, Australia
| | - Vaughan Carr
- School of Clinical Medicine, Discipline of Psychiatry, UNSW Sydney, Sydney, NSW, Australia
| | - Yann Quidé
- School of Clinical Medicine, Discipline of Psychiatry and Mental Health, UNSW Sydney, Sydney, NSW, Australia
| | - Axel Krug
- University Hospital Bonn, Department of Psychiatry and Psychotherapy, Venusberg-Campus 1, 53127, Bonn, Germany
| | - Frederike Stein
- Department of Psychiatry, University of Marburg, Rudolf Bultmann Str. 8, 35039, Marburg, Germany
| | - Igor Nenadić
- Department. of Psychiatry and Psychotherapy, Philipps-University Marburg, Marburg, Germany
| | - Katharina Brosch
- Department of Psychiatry, University of Marburg, Rudolf Bultmann Str. 8, 35039, Marburg, Germany
| | - Tilo Kircher
- Department of Psychiatry, University of Marburg, Rudolf Bultmann Str. 8, 35039, Marburg, Germany
| | - Raquel Gur
- University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - Ruben Gur
- University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | | | - Andriana Karuk
- FIDMAG Germanes Hospitalàries Research Foundation & CIBERSAM, ISCIII, Barcelona, Spain
| | - Edith Pomarol-Clotet
- FIDMAG Germanes Hospitalàries Research Foundation & CIBERSAM, ISCIII, Barcelona, Spain
| | - Joaquim Radua
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | | | - Raymond Salvador
- FIDMAG Germanes Hospitalàries Research Foundation & CIBERSAM, ISCIII, Barcelona, Spain
| | | | - Aristotle Voineskos
- School of Biomedical Science and Pharmacy, University of Newcastle, Newcastle, NSW, Australia
| | - Kang Sim
- West Region, Institute of Mental Health, Singapore, Singapore
| | | | - Diana Tordesillas Gutiérrez
- Department of Radiology, Marqués de Valdecilla University Hospital, Valdecilla Biomedical Research Institute IDIVAL, Santander, Spain
| | - Stefan Ehrlich
- Division of Psychological & Social Medicine and Developmental Neurosciences, Technischen Universität Dresden, Faculty of Medicine, University Hospital C.G. Carus, Dresden, Germany
| | - Nicolas Crossley
- Department of Psychiatry, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Dominik Grotegerd
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
| | - Jonathan Repple
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
| | - Rebekka Lencer
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
| | - Udo Dannlowski
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
| | - Vince Calhoun
- Tri-Institutional Center for Translational Research in Neuroimaging and Data Science (TReNDS), Georgia State, Georgia Tech, Emory, Atlanta, GA, USA
| | - Kelly Rootes-Murdy
- Tri-Institutional Center for Translational Research in Neuroimaging and Data Science (TReNDS), Georgia State, Georgia Tech, Emory, Atlanta, GA, USA
| | - Caroline Demro
- University of Minnesota Department of Psychology, Minneapolis, MN, USA
- Minneapolis VA Health Care System, Minneapolis, MN, USA
| | - Ian S Ramsay
- University of Minnesota Department of Psychiatry & Behavioral Sciences, Minneapolis, MN, USA
| | - Scott R Sponheim
- Minneapolis VA Health Care System, Minneapolis, MN, USA
- University of Minnesota Department of Psychiatry & Behavioral Sciences, Minneapolis, MN, USA
| | - Andre Schmidt
- University of Basel, Department of Psychiatry, Basel, Switzerland
| | | | | | - Irina Lebedeva
- Mental Health Research Center, Moscow, Russian Federation
| | - Cyril Höschl
- National Institute of Mental Health, Topolova 748, 250 67, Klecany, Czech Republic
| | - Filip Spaniel
- National Institute of Mental Health, Topolova 748, 250 67, Klecany, Czech Republic
| | - Adrian Preda
- Department of Psychiatry and Human Behavior, University of California Irvine, Irvine, CA, USA
| | - Dana Nguyen
- Department of Pediatric Neurology, University of California Irvine, Irvine, CA, USA
| | - Anne Uhlmann
- Department of child and adolescent psychiatry, TU Dresden, Dresden, Germany
| | - Dan J Stein
- Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
| | - Fleur Howells
- Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
| | - Henk S Temmingh
- Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
| | - Ana M Diaz Zuluaga
- Research Group in Psychiatry, Department of Psychiatry, School of Medicine, Universidad de Antioquia, Medellin, Colombia
| | - Carlos López Jaramillo
- Research Group in Psychiatry, Department of Psychiatry, School of Medicine, Universidad de Antioquia, Medellin, Colombia
| | - Felice Iasevoli
- University of Naples, Department of Neuroscience, Naples, Italy
| | - Ellen Ji
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital University of Zurich, Zurich, Switzerland
| | - Stephanie Homan
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital University of Zurich, Zurich, Switzerland
| | - Wolfgang Omlor
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital University of Zurich, Zurich, Switzerland
| | - Philipp Homan
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital University of Zurich, Zurich, Switzerland
| | - Stefan Kaiser
- Division of Adult Psychiatry, Department of Psychiatry, Geneva University Hospitals, Geneva, Switzerland
| | - Erich Seifritz
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital University of Zurich, Zurich, Switzerland
| | - Bratislav Misic
- McGill University, Montreal Neurological Institute, Montreal, QC, Canada
| | - Sofie L Valk
- Forschungszentrum Jülich, Jülich, Germany
- Max Planck Institute for Cognitive and Brain Sciences, Leipzig, Germany
| | - Paul Thompson
- Imaging Genetics Center, Stevens Institute for Neuroimaging and Informatics, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Theo G M van Erp
- Department of Psychiatry and Human Behavior, University of California Irvine, Irvine, CA, USA
| | - Jessica A Turner
- Department of Psychiatry and Behavioral Health, the Ohio State University, Columbus, OH, USA
| | - Boris Bernhardt
- McGill University, Montreal Neurological Institute, Montreal, QC, Canada
| | - Matthias Kirschner
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital University of Zurich, Zurich, Switzerland.
- Division of Adult Psychiatry, Department of Psychiatry, Geneva University Hospitals, Geneva, Switzerland.
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25
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Clemmensen L, Lund CN, Andresen BS, Midtgaard J, Glenthøj LB. Study protocol for RUFUS-A randomized mixed methods pilot clinical trial investigating the relevance and feasibility of rumination-focused cognitive behavioral therapy in the treatment of patients with emergent psychosis spectrum disorders. PLoS One 2024; 19:e0297118. [PMID: 38271383 PMCID: PMC10810475 DOI: 10.1371/journal.pone.0297118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2023] [Accepted: 12/17/2023] [Indexed: 01/27/2024] Open
Abstract
INTRODUCTION Psychosis spectrum disorders are characterized by both positive and negative symptoms, but whereas there is good effect of treatment on positive symptoms, there is still a scarcity of effective interventions aimed at reducing negative symptoms. Rumination has been proposed as an important and fundamental factor in the development and maintenance of symptoms across psychiatric diagnoses, and there is a need to develop effective interventions targeting rumination behaviors and negative symptoms in patients with psychotic disorders. The aim of the current study is to investigate the feasibility and acceptability of group rumination-focused cognitive behavioral therapy (RFCBT) in the treatment of young people with psychosis spectrum disorders as well as investigating potential indications of treatment efficacy. METHODS AND ANALYSIS The study is a mixed-method clinical randomized controlled pilot trial with a target sample of 60 patients, who are randomized to either receive 13 weeks of group RFCBT or 13 weeks of treatment as usual (TAU). All patients are examined at the start of the project and at the 13-week follow-up. We will compare changes in outcomes from baseline to posttreatment between group RFCBT and TAU. In addition, qualitative analyzes are carried out to explore feasibility and acceptability and to uncover the patients' experience of receiving the intervention.
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Affiliation(s)
- Lars Clemmensen
- VIRTU Research Group, Copenhagen Research Center on Mental Health (CORE), Copenhagen University Hospital, Copenhagen, Denmark
| | | | | | - Julie Midtgaard
- Center for Applied Research in Mental Health Care (CARMEN), Mental Health Center Glostrup, Glostrup, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Louise Birkedal Glenthøj
- VIRTU Research Group, Copenhagen Research Center on Mental Health (CORE), Copenhagen University Hospital, Copenhagen, Denmark
- Department of Psychology, University of Copenhagen, Copenhagen, Denmark
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26
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Ding H, Zhang Y, Xie Y, Du X, Ji Y, Lin L, Chang Z, Zhang B, Liang M, Yu C, Qin W. Individualized Texture Similarity Network in Schizophrenia. Biol Psychiatry 2024:S0006-3223(24)00029-5. [PMID: 38218309 DOI: 10.1016/j.biopsych.2023.12.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Revised: 12/14/2023] [Accepted: 12/23/2023] [Indexed: 01/15/2024]
Abstract
BACKGROUND Structural covariance network disruption has been considered an important pathophysiological indicator for schizophrenia. Here, we introduced a novel individualized structural covariance network measure, referred to as a texture similarity network (TSN), and hypothesized that the TSN could reliably reveal unique intersubject heterogeneity and complex dysconnectivity patterns in schizophrenia. METHODS The TSN was constructed by measuring the covariance of 180 three-dimensional voxelwise gray-level co-occurrence matrix feature maps between brain areas in each participant. We first tested the validity and reproducibility of the TSN in characterizing the intersubject variability in 2 longitudinal test-retest healthy cohorts. The TSN was further applied to elucidate intersubject variability and dysconnectivity patterns in 10 schizophrenia case-control datasets (609 schizophrenia cases vs. 579 controls) as well as in a first-episode depression dataset (69 patients with depression vs. 69 control participants). RESULTS The test-retest analysis demonstrated higher TSN intersubject than intrasubject variability. Moreover, the TSN reliably revealed higher intersubject variability in both chronic and first-episode schizophrenia, but not in depression. The TSN also reproducibly detected coexistent increased and decreased TSN strength in widespread brain areas, increased global small-worldness, and the coexistence of both structural hyposynchronization in the central networks and hypersynchronization in peripheral networks in patients with schizophrenia but not in patients with depression. Finally, aberrant intersubject variability and covariance strength patterns revealed by the TSN showed a missing or weak correlation with other individualized structural covariance network measures, functional connectivity, and regional volume changes. CONCLUSIONS These findings support the reliability of a TSN in revealing unique structural heterogeneity and complex dysconnectivity in patients with schizophrenia.
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Affiliation(s)
- Hao Ding
- Department of Radiology and Tianjin Key Laboratory of Functional Imaging, Tianjin Medical University General Hospital, Tianjin, China; School of Medical Imaging, Tianjin Medical University, Tianjin, China
| | - Yu Zhang
- Department of Radiology and Tianjin Key Laboratory of Functional Imaging, Tianjin Medical University General Hospital, Tianjin, China
| | - Yingying Xie
- Department of Radiology and Tianjin Key Laboratory of Functional Imaging, Tianjin Medical University General Hospital, Tianjin, China
| | - Xiaotong Du
- Department of Radiology and Tianjin Key Laboratory of Functional Imaging, Tianjin Medical University General Hospital, Tianjin, China
| | - Yi Ji
- Department of Radiology and Tianjin Key Laboratory of Functional Imaging, Tianjin Medical University General Hospital, Tianjin, China
| | - Liyuan Lin
- Department of Radiology and Tianjin Key Laboratory of Functional Imaging, Tianjin Medical University General Hospital, Tianjin, China
| | - Zhongyu Chang
- Department of Radiology and Tianjin Key Laboratory of Functional Imaging, Tianjin Medical University General Hospital, Tianjin, China
| | - Bin Zhang
- Tianjin Anding Hospital, Tianjin Medical University, Tianjin, China; Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China
| | - Meng Liang
- School of Medical Imaging, Tianjin Medical University, Tianjin, China
| | - Chunshui Yu
- Department of Radiology and Tianjin Key Laboratory of Functional Imaging, Tianjin Medical University General Hospital, Tianjin, China; School of Medical Imaging, Tianjin Medical University, Tianjin, China.
| | - Wen Qin
- Department of Radiology and Tianjin Key Laboratory of Functional Imaging, Tianjin Medical University General Hospital, Tianjin, China.
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Johansen IT, Steen NE, Rødevand L, Lunding SH, Hjell G, Ormerod MBEG, Agartz I, Melle I, Lagerberg TV, Nerhus M, Andreassen OA. Sex differences in autonomic adverse effects related to antipsychotic treatment and associated hormone profiles. SCHIZOPHRENIA (HEIDELBERG, GERMANY) 2024; 10:6. [PMID: 38182592 PMCID: PMC10851697 DOI: 10.1038/s41537-023-00430-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Accepted: 12/23/2023] [Indexed: 01/07/2024]
Abstract
Autonomic adverse effects of antipsychotic drugs (APs) cause clinical challenges, but few studies have investigated sex differences and their underlying biological pathways. Sex-specific regulation of relevant hormones could be involved. We investigated sex differences in autonomic adverse effects related to olanzapine, quetiapine, risperidone, and aripiprazole, and the role of hormones related to APs. Patients with severe mental disorders (N = 1318) were included and grouped based on AP monotherapy: olanzapine (N = 364), quetiapine (N = 211), risperidone (N = 102), aripiprazole (N = 138), and no AP (N = 503). Autonomic symptoms from the Udvalg for Kliniske Undersøgelser (UKU) side effect scale was analyzed with logistic regression, adjusting for age, diagnosis, and polypharmacy. Further, we analyzed associations between autonomic symptoms and hormones related to APs. We found associations between autonomic adverse effects and APs, with sex-specific risk for palpitations/tachycardia associated with hormonal changes related to APs. Results showed increased salivation associated with aripiprazole, reduced salivation with quetiapine, and nausea/vomiting and palpitations/tachycardia with olanzapine, and higher risk of nausea/vomiting, diarrhea, constipation, polyuria/polydipsia, and palpitations/tachycardia in females. Significant sex x AP interaction was found for palpitations/tachycardia, with higher risk in risperidone-treated males, which was associated with different hormone profiles of prolactin, cortisol, and insulin. Our findings implicate a role of several hormones in the sex-specific autonomic adverse effects related to APs.
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Grants
- This study was funded by the Research Council of Norway (grant numbers 223273, 300309, 326813), the South-Eastern Norway Regional Health Authority (grant numbers 2017-112, 2019-108, 2022-073) and EU’s H2020 RIA grant number 847776 CoMorMent.
- This study was supported by the Research Council of Norway (grant numbers 223273, 300309, 326813), the South-Eastern Norway Regional Health Authority (grant numbers 2017-112, 2019-108, 2022-073) and EU’s H2020 RIA grant number 847776 CoMorMent.
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Affiliation(s)
- Ingrid T Johansen
- NORMENT Centre, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway.
| | - Nils Eiel Steen
- NORMENT Centre, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Linn Rødevand
- NORMENT Centre, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Synve H Lunding
- NORMENT Centre, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Gabriela Hjell
- NORMENT Centre, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Department of Psychiatry, Ostfold Hospital, Graalum, Norway
| | - Monica B E G Ormerod
- NORMENT Centre, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Ingrid Agartz
- NORMENT Centre, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Department of Psychiatric Research, Diakonhjemmet Hospital, Oslo, Norway
- Department of Clinical Neuroscience, Centre for Psychiatric Research, Karolinska Institute & Stockholm Health Care Services, Stockholm Region, Stockholm, Sweden
| | - Ingrid Melle
- NORMENT Centre, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Trine V Lagerberg
- NORMENT Centre, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Mari Nerhus
- Division of Health Services Research and Psychiatry, Institute of Clinical Medicine, University of Oslo Campus Ahus, Lørenskog, Norway
- Department of Special Psychiatry, Akershus University Hospital, Lørenskog, Norway
| | - Ole A Andreassen
- NORMENT Centre, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway
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Lv Y, Wen L, Hu WJ, Deng C, Ren HW, Bao YN, Su BW, Gao P, Man ZY, Luo YY, Li CJ, Xiang ZX, Wang B, Luan ZL. Schizophrenia in the genetic era: a review from development history, clinical features and genomic research approaches to insights of susceptibility genes. Metab Brain Dis 2024; 39:147-171. [PMID: 37542622 DOI: 10.1007/s11011-023-01271-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Accepted: 07/27/2023] [Indexed: 08/07/2023]
Abstract
Schizophrenia is a devastating neuropsychiatric disorder affecting 1% of the world population and ranks as one of the disorders providing the most severe burden for society. Schizophrenia etiology remains obscure involving multi-risk factors, such as genetic, environmental, nutritional, and developmental factors. Complex interactions of genetic and environmental factors have been implicated in the etiology of schizophrenia. This review provides an overview of the historical origins, pathophysiological mechanisms, diagnosis, clinical symptoms and corresponding treatment of schizophrenia. In addition, as schizophrenia is a polygenic, genetic disorder caused by the combined action of multiple micro-effective genes, we further detail several approaches, such as candidate gene association study (CGAS) and genome-wide association study (GWAS), which are commonly used in schizophrenia genomics studies. A number of GWASs about schizophrenia have been performed with the hope to identify novel, consistent and influential risk genetic factors. Finally, some schizophrenia susceptibility genes have been identified and reported in recent years and their biological functions are also listed. This review may serve as a summary of past research on schizophrenia genomics and susceptibility genes (NRG1, DISC1, RELN, BDNF, MSI2), which may point the way to future schizophrenia genetics research. In addition, depending on the above discovery of susceptibility genes and their exact function, the development and application of antipsychotic drugs will be promoted in the future.
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Affiliation(s)
- Ye Lv
- Advanced Institute for Medical Sciences, Dalian Medical University, Dalian, 116044, China
| | - Lin Wen
- Advanced Institute for Medical Sciences, Dalian Medical University, Dalian, 116044, China
| | - Wen-Juan Hu
- Advanced Institute for Medical Sciences, Dalian Medical University, Dalian, 116044, China
| | - Chong Deng
- Department of Neurosurgery, The Second Affiliated Hospital of Dalian Medical University, Dalian, 116027, China
| | - Hui-Wen Ren
- Advanced Institute for Medical Sciences, Dalian Medical University, Dalian, 116044, China
| | - Ya-Nan Bao
- Advanced Institute for Medical Sciences, Dalian Medical University, Dalian, 116044, China
| | - Bo-Wei Su
- Advanced Institute for Medical Sciences, Dalian Medical University, Dalian, 116044, China
| | - Ping Gao
- Advanced Institute for Medical Sciences, Dalian Medical University, Dalian, 116044, China
| | - Zi-Yue Man
- Advanced Institute for Medical Sciences, Dalian Medical University, Dalian, 116044, China
| | - Yi-Yang Luo
- Advanced Institute for Medical Sciences, Dalian Medical University, Dalian, 116044, China
| | - Cheng-Jie Li
- Advanced Institute for Medical Sciences, Dalian Medical University, Dalian, 116044, China
| | - Zhi-Xin Xiang
- Advanced Institute for Medical Sciences, Dalian Medical University, Dalian, 116044, China
| | - Bing Wang
- Department of Endocrinology and Metabolism, The Central hospital of Dalian University of Technology, Dalian, 116000, China.
| | - Zhi-Lin Luan
- Advanced Institute for Medical Sciences, Dalian Medical University, Dalian, 116044, China.
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Lee H, Kim M, Kim SH, Lee J, Lee TY, Rhee SJ, Roh S, Baik M, Jung HY, Kim H, Han DH, Ha K, Ahn YM, Kwon JS. Proteomic profiling in the progression of psychosis: Analysis of clinical high-risk, first episode psychosis, and healthy controls. J Psychiatr Res 2024; 169:264-271. [PMID: 38052137 DOI: 10.1016/j.jpsychires.2023.11.031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Revised: 11/02/2023] [Accepted: 11/16/2023] [Indexed: 12/07/2023]
Abstract
BACKGROUND AND HYPOTHESIS Recent evidence has highlighted the benefits of early detection and treatment for better clinical outcomes in patients with psychosis. Biological markers of the disease have become a focal point of research. This study aimed to identify protein markers detectable in the early stages of psychosis and indicators of progression by comparing them with those of healthy controls (HC) and first episode psychosis (FEP). STUDY DESIGN The participants comprised 28 patients in the clinical high-risk (CHR) group, 49 patients with FEP, and 61 HCs aged 15-35 years. Blood samples were collected and analyzed using multiple reaction monitoring-mass spectrometry to measure the expression of 158 peptide targets. Data were adjusted for age, sex, and use of psychotropic drugs. STUDY RESULTS A total of 18 peptides (17 proteins) differed significantly among the groups. The protein PRDX2 was higher in the FEP group than in the CHR and HC groups and showed increased expression according to disease progression. The levels of six proteins were significantly higher in the FEP group than in the CHR group. Nine proteins differed significantly in the CHR group compared to the other groups. Sixteen proteins were significantly correlated with symptom severity. These proteins are primarily related to the coagulation cascade, inflammatory response, brain structure, and synaptic plasticity. CONCLUSIONS Our findings suggested that peripheral protein markers reflect disease progression in patients with psychosis. Further longitudinal research is needed to confirm these findings and to identify the specific roles of these markers in the pathogenesis of schizophrenia.
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Affiliation(s)
- Hyunju Lee
- Department of Neuropsychiatry, Seoul National University Hospital, Seoul, Republic of Korea.
| | - Minah Kim
- Department of Neuropsychiatry, Seoul National University Hospital, Seoul, Republic of Korea.
| | - Se Hyun Kim
- Department of Neuropsychiatry, Seoul National University Hospital, Seoul, Republic of Korea.
| | - Junhee Lee
- Department of Psychiatry, Uijeongbu Eulji Medical Center, Uijeongbu, Republic of Korea.
| | - Tae Young Lee
- Department of Neuropsychiatry, Pusan National University Yangsan Hospital, Yangsan, Republic of Korea.
| | - Sang Jin Rhee
- Biomedical Research Institute, Seoul National University Hospital, Seoul, Republic of Korea.
| | - Sungwon Roh
- Department of Neuropsychiatry, Hanyang University Hospital, Seoul, Republic of Korea.
| | - Myungjae Baik
- Department of Psychiatry, Kyung Hee University Medical Center, Kyung Hee University School of Medicine, Seoul, Republic of Korea.
| | - Hee Yeon Jung
- Department of Psychiatry, SMG-SNU Boramae Medical Center, Seoul, Republic of Korea; Department of Psychiatry, Seoul National University College of Medicine, Seoul, Republic of Korea.
| | - Hyeyoon Kim
- Proteomics Core Facility, Biomedical Research Institute, Seoul National University Hospital, Seoul, Republic of Korea.
| | - Do Hyun Han
- Proteomics Core Facility, Biomedical Research Institute, Seoul National University Hospital, Seoul, Republic of Korea; Transdisciplinary Department of Medicine & Advanced Technology, Seoul National University Hospital, Seoul, Republic of Korea.
| | - Kyooseob Ha
- Department of Psychiatry, University of British Columbia, Vancouver, British Columbia, Canada; Department of Psychiatry, Lions Gate Hospital - Vancouver Coastal Health Authority, British Columbia, Canada.
| | - Yong Min Ahn
- Department of Neuropsychiatry, Seoul National University Hospital, Seoul, Republic of Korea; Department of Psychiatry, Seoul National University College of Medicine, Seoul, Republic of Korea; Institute of Human Behavioral Medicine, Seoul National University Medical Research Center, Seoul, Republic of Korea.
| | - Jun Soo Kwon
- Department of Neuropsychiatry, Seoul National University Hospital, Seoul, Republic of Korea; Department of Psychiatry, Seoul National University College of Medicine, Seoul, Republic of Korea; Institute of Human Behavioral Medicine, Seoul National University Medical Research Center, Seoul, Republic of Korea.
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30
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Yang HM, Lung H, Yang MC, Lung FW. DRD4 VNTR 4/4 homozygosity as a genetic biomarker for treatment selection in patients with schizophrenia. Asian J Psychiatr 2024; 91:103831. [PMID: 37988928 DOI: 10.1016/j.ajp.2023.103831] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Revised: 10/03/2023] [Accepted: 11/04/2023] [Indexed: 11/23/2023]
Abstract
OBJECTIVE There seems to be an association between the DRD4 48-bp VNTR polymorphisms and antipsychotic treatment response, but there is a rare reference to confirm this finding. Hence, the present study tried to investigate the association between DRD4 48-bp VNTR polymorphisms and the treatment response of antipsychotics in patients with schizophrenia in Taiwan, using a propensity score matching (PSM) method. METHODS A total of 882 participants were enrolled in this study and completed informed consent, research questionnaires, including demographic information and the revised Chinese version Beliefs about Voices Questionnaire, and blood sampling. For descreasing of the selection bias and confounding variables, the PSM nearest neighbor matching method was used to select 765 paitents with schizophrenia (ratio of 1:8 between 85 persistent auditory hallucination and 680 controls) with matched and controlled the age and gender. RESULTS Schizophrenia patients with DRD4 4 R homozygosity had a lower rate of good antipsychotic treatment response than the other DRD4 genotype carriers (DRD4 non-4/4). Among those 4 R homozygosity carriers, 60 cases of 503 (11.9%) retain persistent auditory hallucinations. Furthermore, this subgroup of patients is accounted for up to 70.6% of cases with poor neuroleptic treatment response. CONCLUSIONS A poor treatment outcome for patients with the 4 R homozygosity had presented,that comparing with those DRD non-4/4 genotype carriers. DRD4 VNTR 4 R homozygosity could be a genetic biomarker to predict poor antipsychotic treatment response in schizophrenia. Patients with DRD 4/4 probably receive novel antipsychotic medications preferentially or in combination with alternative therapy, such as psychotherapy or milieu therapy.
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Affiliation(s)
- Hao-Ming Yang
- Department of Psychiatry, Beitou Branch, Tri-Service General Hospital, Taiwan; Graduate Institute of Medical Science, National Defense Medical Center, Taipei, Taiwan
| | - Hsuan Lung
- Department of Dentistry, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan; School of Dentistry and Institute of Oral Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | | | - For-Wey Lung
- Calo Psychiatric Center, Pingtung County, Taiwan; Graduate Institute of Medical Science, National Defense Medical Center, Taipei, Taiwan; International Graduate Program of Education and Human Development, National SunYat-sen University, Kaohsiung, Taiwan; Institute of Education, National Sun Yat-Sen University, Kaohsiung, Taiwan.
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Wei Z, Wang Y, Hu L, Wang Y, Li C, Sun L. Incidence, prevalence, and mortality of schizophrenia from 2016 to 2020 in Shandong, China. Psychiatry Res 2024; 331:115612. [PMID: 38039652 DOI: 10.1016/j.psychres.2023.115612] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Revised: 11/15/2023] [Accepted: 11/17/2023] [Indexed: 12/03/2023]
Abstract
The epidemiology of schizophrenia has been reported in many countries. However, due to the limitations of those studies, the findings cannot be generalized to other parts of the world, especially in China. In this study, the incidence, prevalence, and mortality of schizophrenia in Shandong, China were calculated using data from the National Severe Mental Disorder Registration System collected between 2016 and 2020 and census data from 2010 to 2020. The overall incidence decreased from 9.61 per 100,000 in 2016 to 4.40 per 100,000 in 2020, the aggregate prevalence was approximately 3.20 per 1000, and the overall mortality ranged from 6.17 per 100,000 to 7.71 per 100,000. The evidence from this study indicated that the incidence, prevalence, and mortality of schizophrenia were higher in rural areas than in urban areas. Females had higher incidence, prevalence, and mortality than males. This study provided epidemiological information on schizophrenia and opened avenues for future research.
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Affiliation(s)
- Zhen Wei
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan 250012, China; National Health Commission of China (NHC) Key Laboratory of Health Economics and Policy Research (Shandong University), Jinan 250012, China; Institute of Health and Elderly Care, Shandong University, Jinan 250012, China
| | - Yanhu Wang
- Department of Social Mental Health, Shandong Mental Health Center, Jinan 250014, China
| | - Lili Hu
- Department of Social Mental Health, Shandong Mental Health Center, Jinan 250014, China
| | - Yifan Wang
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan 250012, China; National Health Commission of China (NHC) Key Laboratory of Health Economics and Policy Research (Shandong University), Jinan 250012, China; Institute of Health and Elderly Care, Shandong University, Jinan 250012, China
| | - Caifeng Li
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan 250012, China; National Health Commission of China (NHC) Key Laboratory of Health Economics and Policy Research (Shandong University), Jinan 250012, China; Institute of Health and Elderly Care, Shandong University, Jinan 250012, China
| | - Long Sun
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan 250012, China; National Health Commission of China (NHC) Key Laboratory of Health Economics and Policy Research (Shandong University), Jinan 250012, China; Institute of Health and Elderly Care, Shandong University, Jinan 250012, China.
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32
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Spark DL, Ma S, Nowell CJ, Langmead CJ, Stewart GD, Nithianantharajah J. Sex-Dependent Attentional Impairments in a Subchronic Ketamine Mouse Model for Schizophrenia. BIOLOGICAL PSYCHIATRY GLOBAL OPEN SCIENCE 2024; 4:229-239. [PMID: 38298794 PMCID: PMC10829638 DOI: 10.1016/j.bpsgos.2023.05.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Revised: 05/16/2023] [Accepted: 05/18/2023] [Indexed: 02/02/2024] Open
Abstract
Background The development of more effective treatments for schizophrenia targeting cognitive and negative symptoms has been limited, partly due to a disconnect between rodent models and human illness. Ketamine administration is widely used to model symptoms of schizophrenia in both humans and rodents. In mice, subchronic ketamine treatment reproduces key dopamine and glutamate dysfunction; however, it is unclear how this translates into behavioral changes reflecting positive, negative, and cognitive symptoms. Methods In male and female mice treated with either subchronic ketamine or saline, we assessed spontaneous and amphetamine-induced locomotor activity to measure behaviors relevant to positive symptoms, and used a touchscreen-based progressive ratio task of motivation and the rodent continuous performance test of attention to capture specific negative and cognitive symptoms, respectively. To explore neuronal changes underlying the behavioral effects of subchronic ketamine treatment, we quantified expression of the immediate early gene product, c-Fos, in key corticostriatal regions using immunofluorescence. Results We showed that spontaneous locomotor activity was unchanged in male and female subchronic ketamine-treated animals, and amphetamine-induced locomotor response was reduced. Subchronic ketamine treatment did not alter motivation in either male or female mice. In contrast, we identified a sex-specific effect of subchronic ketamine on attentional processing wherein female mice performed worse than control mice due to increased nonselective responding. Finally, we showed that subchronic ketamine treatment increased c-Fos expression in prefrontal cortical and striatal regions, consistent with a mechanism of widespread disinhibition of neuronal activity. Conclusions Our results highlight that the subchronic ketamine mouse model reproduces a subset of behavioral symptoms that are relevant for schizophrenia.
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Affiliation(s)
- Daisy L. Spark
- Drug Discovery Biology Monash Institute of Pharmaceutical Sciences, Monash University, Parkville, Victoria, Australia
- Neuroscience & Mental Health Therapeutic Program Area, Monash Institute of Pharmaceutical Sciences, Monash University, Parkville, Victoria, Australia
- Neuromedicines Discovery Centre, Monash Institute of Pharmaceutical Sciences, Monash University, Parkville, Victoria, Australia
| | - Sherie Ma
- Drug Discovery Biology Monash Institute of Pharmaceutical Sciences, Monash University, Parkville, Victoria, Australia
| | - Cameron J. Nowell
- Drug Discovery Biology Monash Institute of Pharmaceutical Sciences, Monash University, Parkville, Victoria, Australia
| | - Christopher J. Langmead
- Drug Discovery Biology Monash Institute of Pharmaceutical Sciences, Monash University, Parkville, Victoria, Australia
- Neuroscience & Mental Health Therapeutic Program Area, Monash Institute of Pharmaceutical Sciences, Monash University, Parkville, Victoria, Australia
- Neuromedicines Discovery Centre, Monash Institute of Pharmaceutical Sciences, Monash University, Parkville, Victoria, Australia
| | - Gregory D. Stewart
- Drug Discovery Biology Monash Institute of Pharmaceutical Sciences, Monash University, Parkville, Victoria, Australia
- Neuroscience & Mental Health Therapeutic Program Area, Monash Institute of Pharmaceutical Sciences, Monash University, Parkville, Victoria, Australia
- Neuromedicines Discovery Centre, Monash Institute of Pharmaceutical Sciences, Monash University, Parkville, Victoria, Australia
| | - Jess Nithianantharajah
- Florey Institute of Neuroscience and Mental Health, University of Melbourne, Parkville, Victoria, Australia
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Cuesta MJ, Gil-Berrozpe GJ, Sánchez-Torres AM, Moreno-Izco L, García de Jalón E, Peralta V. 20-Year trajectories of six psychopathological dimensions in patients with first-episode psychosis: Could they be predicted? Psychiatry Res 2024; 331:115614. [PMID: 38039651 DOI: 10.1016/j.psychres.2023.115614] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Revised: 11/14/2023] [Accepted: 11/17/2023] [Indexed: 12/03/2023]
Abstract
Patients with first-episode psychoses (FEP) exhibit heterogeneity in clinical manifestations and outcomes. This study investigated the long-term trajectories of six key psychopathological dimensions (reality-distortion, negative, disorganization, catatonia, mania and depression) in patients diagnosed with FEP. A total of 243 patients were followed up for 20 years and the trajectories of the dimensions were analysed using growth mixture modelling. These dimensions showed varied course patterns, ranging from two to five trajectories. Additionally, the study examined the predictive value of different factors in differentiating between the long-term trajectories. The exposome risk score showed that familial load, distal and intermediate risk factors, acute psychosocial stressors and acute onset were significant predictors for differentiating between long-term psychopathological trajectories. In contrast, polygenic risk score, duration of untreated psychosis and duration of untreated illness demonstrated little or no predictive value. The findings highlight the importance of conducting a multidimensional assessment not only at FEP but also during follow-up to customize the effectiveness of interventions. Furthermore, the results emphasize the relevance of assessing premorbid predictors from the onset of illness. This may enable the identification of FEP patients at high-risk of poor long-term outcomes who would benefit from targeted prevention programs on specific psychopathological dimensions.
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Affiliation(s)
- Manuel J Cuesta
- Department of Psychiatry, Complejo Hospitalario de Navarra (Pamplona, Spain); Navarra Institute for Health Research (IdiSNA) (Pamplona, Spain).
| | - Gustavo J Gil-Berrozpe
- Department of Psychiatry, Complejo Hospitalario de Navarra (Pamplona, Spain); Navarra Institute for Health Research (IdiSNA) (Pamplona, Spain)
| | - Ana M Sánchez-Torres
- Navarra Institute for Health Research (IdiSNA) (Pamplona, Spain); Departament of Health Sciences, Universidad Pública de Navarra (UPNA), Pamplona, Spain
| | - Lucía Moreno-Izco
- Department of Psychiatry, Complejo Hospitalario de Navarra (Pamplona, Spain); Navarra Institute for Health Research (IdiSNA) (Pamplona, Spain)
| | - Elena García de Jalón
- Navarra Institute for Health Research (IdiSNA) (Pamplona, Spain); Mental Health Department, Servicio Navarro de Salud - Osasunbidea (Pamplona, Spain)
| | - Victor Peralta
- Navarra Institute for Health Research (IdiSNA) (Pamplona, Spain); Mental Health Department, Servicio Navarro de Salud - Osasunbidea (Pamplona, Spain)
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Jonker I, Doorduin J, Knegtering H, van't Hag E, Dierckx RA, de Vries EFJ, Schoevers RA, Klein HC. Antiviral treatment in schizophrenia: a randomized pilot PET study on the effects of valaciclovir on neuroinflammation. Psychol Med 2023; 53:7087-7095. [PMID: 37016791 PMCID: PMC10719624 DOI: 10.1017/s0033291723000430] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Revised: 01/22/2023] [Accepted: 02/03/2023] [Indexed: 04/06/2023]
Abstract
BACKGROUND Patients with schizophrenia experience cognitive impairment, which could be related to neuroinflammation in the hippocampus. The cause for such hippocampal inflammation is still unknown, but it has been suggested that herpes virus infection is involved. This study therefore aimed to determine whether add-on treatment of schizophrenic patients with the anti- viral drug valaciclovir would reduce hippocampal neuroinflammation and consequently improve cognitive symptoms. METHODS We performed a double-blind monocenter study in 24 male and female patients with schizophrenia, experiencing active psychotic symptoms. Patients were orally treated with the anti-viral drug valaciclovir for seven consecutive days (8 g/day). Neuroinflammation was measured with Positron Emission Tomography using the translocator protein ligand [11C]-PK11195, pre-treatment and at seven days post-treatment, as were psychotic symptoms and cognition. RESULTS Valaciclovir treatment resulted in reduced TSPO binding (39%) in the hippocampus, as well as in the brainstem, frontal lobe, temporal lobe, parahippocampal gyrus, amygdala, parietal lobe, occipital lobe, insula and cingulate gyri, nucleus accumbens and thalamus (31-40%) when using binding potential (BPND) as an outcome. With total distribution volume (VT) as outcome we found essentially the same results, but associations only approached statistical significance (p = 0.050 for hippocampus). Placebo treatment did not affect neuroinflammation. No effects of valaciclovir on psychotic symptoms or cognitive functioning were found. CONCLUSION We found a decreased TSPO binding following antiviral treatment, which could suggest a viral underpinning of neuroinflammation in psychotic patients. Whether this reduced neuroinflammation by treatment with valaciclovir has clinical implications and is specific for schizophrenia warrants further research.
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Affiliation(s)
- Iris Jonker
- Department of Psychiatry, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Janine Doorduin
- Department of Nuclear Medicine and Molecular Imaging, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - Henderikus Knegtering
- Department of Psychiatry, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
- Lentis Mental Health Institution, Groningen, The Netherlands
| | - Erna van't Hag
- Department of Psychiatry, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Rudi A. Dierckx
- Department of Nuclear Medicine and Molecular Imaging, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - Erik F. J. de Vries
- Department of Nuclear Medicine and Molecular Imaging, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - Robert A. Schoevers
- Department of Psychiatry, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Hans C. Klein
- Department of Nuclear Medicine and Molecular Imaging, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
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Matsumoto J, Miura K, Fukunaga M, Nemoto K, Koshiyama D, Okada N, Morita K, Yamamori H, Yasuda Y, Fujimoto M, Ito S, Hasegawa N, Watanabe Y, Kasai K, Hashimoto R. Association Study Between White Matter Microstructure and Intelligence Decline in Schizophrenia. Clin EEG Neurosci 2023; 54:567-573. [PMID: 34889128 DOI: 10.1177/15500594211063314] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Patients with schizophrenia can exhibit intelligence decline, which is an important element of cognitive impairment. Previous magnetic resonance imaging (MRI) studies have demonstrated that patients with schizophrenia have altered gray matter structures and functional connectivity associated with intelligence decline defined by a difference between premorbid and current intelligence quotients (IQs). However, it has remained unclear whether white matter microstructures are related to intelligence decline. In the present study, the indices of diffusion tensor imaging (DTI) obtained from 138 patients with schizophrenia and 554 healthy controls were analyzed. The patients were classified into three subgroups based on intelligence decline: deteriorated (94 patients), preserved (42 patients), and compromised IQ (2 patients) groups. Given that the DTI of each subject was acquired using either one of two different MRI scanners, we analyzed DTI indices separately for each scanner group. In the comparison between the deteriorated IQ group and the healthy controls, differences in some DTI indices were noted in three regions of interest irrespective of the MRI scanners, whereas differences in only one region of interest were noted between the preserved IQ group and the healthy controls. However, the comparisons between the deteriorated and preserved IQ groups did not show any reproducible differences. Together with the previous findings, it is thought that gray matter structures and functional connectivity are more promising as markers of intelligence decline in schizophrenia than white matter microstructures.
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Affiliation(s)
- Junya Matsumoto
- National Institute of Mental Health, National Center of Neurology and Psychiatry, Kodaira, Tokyo, Japan
| | - Kenichiro Miura
- National Institute of Mental Health, National Center of Neurology and Psychiatry, Kodaira, Tokyo, Japan
| | - Masaki Fukunaga
- National Institute for Physiological Sciences, Okazaki, Aichi, Japan
| | | | - Daisuke Koshiyama
- Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, Japan
| | - Naohiro Okada
- Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, Japan
- The International Research Center for Neurointelligence (WPI-IRCN), University of Tokyo Institutes for Advanced Study (UTIAS), Bunkyo-ku, Tokyo, Japan
| | | | - Hidenaga Yamamori
- National Institute of Mental Health, National Center of Neurology and Psychiatry, Kodaira, Tokyo, Japan
- Japan Community Health Care Organization Osaka Hospital, Osaka, Osaka, Japan
- Graduate School of Medicine, Osaka University, Suita, Osaka, Japan
| | - Yuka Yasuda
- National Institute of Mental Health, National Center of Neurology and Psychiatry, Kodaira, Tokyo, Japan
- Medical Corporation Foster, Osaka, Osaka, Japan
| | - Michiko Fujimoto
- National Institute of Mental Health, National Center of Neurology and Psychiatry, Kodaira, Tokyo, Japan
- Graduate School of Medicine, Osaka University, Suita, Osaka, Japan
| | - Satsuki Ito
- National Institute of Mental Health, National Center of Neurology and Psychiatry, Kodaira, Tokyo, Japan
- Ochanomizu University, Bunkyo-ku, Tokyo, Japan
| | - Naomi Hasegawa
- National Institute of Mental Health, National Center of Neurology and Psychiatry, Kodaira, Tokyo, Japan
| | | | - Kiyoto Kasai
- Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, Japan
- The International Research Center for Neurointelligence (WPI-IRCN), University of Tokyo Institutes for Advanced Study (UTIAS), Bunkyo-ku, Tokyo, Japan
| | - Ryota Hashimoto
- National Institute of Mental Health, National Center of Neurology and Psychiatry, Kodaira, Tokyo, Japan
- Graduate School of Medicine, Osaka University, Suita, Osaka, Japan
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Wang X, Zhang Y, Huang J, Wang Y, Niu Y, Lui SSY, Hui L, Chan RCK. Revisiting reward impairments in schizophrenia spectrum disorders: a systematic review and meta-analysis for neuroimaging findings. Psychol Med 2023; 53:7189-7202. [PMID: 36994747 DOI: 10.1017/s0033291723000703] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/31/2023]
Abstract
BACKGROUND Abnormal reward functioning is central to anhedonia and amotivation symptoms of schizophrenia (SCZ). Reward processing encompasses a series of psychological components. This systematic review and meta-analysis examined the brain dysfunction related to reward processing of individuals with SCZ spectrum disorders and risks, covering multiple reward components. METHODS After a systematic literature search, 37 neuroimaging studies were identified and divided into four groups based on their target psychology components (i.e. reward anticipation, reward consumption, reward learning, effort computation). Whole-brain Seed-based d Mapping (SDM) meta-analyses were conducted for all included studies and each component. RESULTS The meta-analysis for all reward-related studies revealed reduced functional activation across the SCZ spectrum in the striatum, orbital frontal cortex, cingulate cortex, and cerebellar areas. Meanwhile, distinct abnormal patterns were found for reward anticipation (decreased activation of the cingulate cortex and striatum), reward consumption (decreased activation of cerebellum IV/V areas, insula and inferior frontal gyri), and reward learning processing (decreased activation of the striatum, thalamus, cerebellar Crus I, cingulate cortex, orbitofrontal cortex, and parietal and occipital areas). Lastly, our qualitative review suggested that decreased activation of the ventral striatum and anterior cingulate cortex was also involved in effort computation. CONCLUSIONS These results provide deep insights on the component-based neuro-psychopathological mechanisms for anhedonia and amotivation symptoms of the SCZ spectrum.
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Affiliation(s)
- Xuan Wang
- Neuropsychology and Applied Cognitive Neuroscience Laboratory, 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
| | - Yinghao Zhang
- Division of Psychology and Language Sciences, University College London, London, UK
| | - Jia Huang
- Neuropsychology and Applied Cognitive Neuroscience Laboratory, 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
| | - Yi Wang
- Neuropsychology and Applied Cognitive Neuroscience Laboratory, 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
| | - Yanzhe Niu
- Department of Psychology, University of California, San Diego, La Jolla, USA
| | - Simon S Y Lui
- Department of Psychiatry, School of Clinical Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Li Hui
- Research Center of Biological Psychiatry, Suzhou Guangji Hospital, Medical College of Soochow University, Suzhou, Jiangsu, China
| | - Raymond C K Chan
- Neuropsychology and Applied Cognitive Neuroscience Laboratory, 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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Poorganji M, Goeke K, Zomorrodi R, Voineskos D, Rajji TK, Daskalakis ZJ, Blumberger DM. The use of theta burst stimulation in patients with schizophrenia - A systematic review. Schizophr Res 2023; 261:245-255. [PMID: 37844414 DOI: 10.1016/j.schres.2023.10.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Revised: 06/02/2023] [Accepted: 10/09/2023] [Indexed: 10/18/2023]
Abstract
Transcranial magnetic stimulation (TMS) can offer therapeutic benefits and provide value in neurophysiological research. One of the newer TMS paradigms is theta burst stimulation (TBS) which can be delivered in two patterns: continuous (cTBS - inducing LTD-like effects) and intermittent (iTBS - inducing LTP-like effects). This review paper aims to explore studies that have utilized TBS protocols over different areas of the cortex to study the neurophysiological functions and treatment of patients with schizophrenia. PubMed was searched using the following keywords "schizophrenia", "schizoaffective", or "psychosis", and "theta burst stimulation". Out of the 90 articles which were found, thirty met review inclusion criteria. The inclusion criteria included studying the reported effect (clinical, physiological, or both) of at least one session of TBS on human subjects, and abstracts (at minimum) must have been in English. The main target areas included prefrontal cortex (12 studies - 10 dorsolateral prefrontal cortex (DLPFC), 2 dorsomedial prefrontal cortex (DMPFC)) vermal cerebellum (5), and temporo-parietal cortex (8). Other target areas included inferior parietal lobe (2), and motor cortex (3). TBS neurophysiological effect was explored in 5 studies using functional magnetic resonance image (fMRI), magnetic resonance spectroscopy (MRS), electroencephalography (EEG), electromyography (EMG) and positron emission topography (PET) scan. Overall, TBS can offer great therapeutic potential as it is well-tolerated, feasible, and has few, if any, adverse effects. TBS may be targeted to treat specific symptomatology, as an augmenting intervention to pharmacotherapy, or even improving patient's insight into their diagnosis.
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Affiliation(s)
- Mohsen Poorganji
- Temerty Centre for Therapeutic Brain Intervention, Centre for Addiction and Mental Health, Toronto, ON, Canada; Institute of Medical Science, University of Toronto, Toronto, ON, Canada; Department of Psychiatry, Faculty of Health, University of California San Diego, La Jolla, CA, USA
| | - Katharina Goeke
- Temerty Centre for Therapeutic Brain Intervention, Centre for Addiction and Mental Health, Toronto, ON, Canada; Institute of Medical Science, University of Toronto, Toronto, ON, Canada
| | - Reza Zomorrodi
- Temerty Centre for Therapeutic Brain Intervention, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Daphne Voineskos
- Temerty Centre for Therapeutic Brain Intervention, Centre for Addiction and Mental Health, Toronto, ON, Canada; Institute of Medical Science, University of Toronto, Toronto, ON, Canada; Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada; Krembil Neuroscience Centre, University Health Network, Toronto, Ontario, Canada; Poul Hansen Family Centre for Depression, Toronto Western Hospital, University Health Network, Toronto, Ontario, Canada
| | - Tarek K Rajji
- Temerty Centre for Therapeutic Brain Intervention, Centre for Addiction and Mental Health, Toronto, ON, Canada; Institute of Medical Science, University of Toronto, Toronto, ON, Canada; Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada; Toronto Dementia Research Alliance, University of Toronto, Toronto, Ontario, Canada
| | - Zafiris J Daskalakis
- Temerty Centre for Therapeutic Brain Intervention, Centre for Addiction and Mental Health, Toronto, ON, Canada; Institute of Medical Science, University of Toronto, Toronto, ON, Canada; Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada; Department of Psychiatry, Faculty of Health, University of California San Diego, La Jolla, CA, USA
| | - Daniel M Blumberger
- Temerty Centre for Therapeutic Brain Intervention, Centre for Addiction and Mental Health, Toronto, ON, Canada; Institute of Medical Science, University of Toronto, Toronto, ON, Canada; Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada.
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Karagöl G, Songur E, Rakıcıoğlu N. Dietary total antioxidant capacity and serum 8-OHdG in patients with schizophrenia. Int J Psychiatry Med 2023; 58:544-558. [PMID: 37210638 DOI: 10.1177/00912174231177638] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Abstract
BACKGROUND Dietary total antioxidant capacity serves as an indicator for dietary quality and reflects daily antioxidant intake. This study aimed to determine the oxidative stress status of patients with schizophrenia and to examine the relationship between dietary total antioxidant capacity (dTAC) and 8-hydroxy-2'-deoxyguanosine (8-OHdG), a marker for oxidative stress. METHODS This study was conducted in Turkey and involved 40 patients diagnosed with schizophrenia or schizoaffective disorder according to the Diagnostic and Statistical Manual of Mental Disorders, 5th ed., and 30 healthy controls matched for age and gender. The participants' sociodemographic characteristics and nutritional habits were determined through face-to-face interviews and through the use of questionnaires. The dTAC and dietary oxidative balance scores were calculated using a three-day dietary intake record. 8-OHdG levels were analyzed in the serum samples collected from the subjects. RESULTS Dietary ferric reducing antioxidant power (FRAP-1, FRAP-2), Trolox equivalence antioxidant capacity (TEAC), and oxygen radical absorbance capacity (H-ORAC) values were lower in patients with schizophrenia than in the healthy controls (P < 0.05). Serum 8-OHdG levels were found similar in both groups (P > 0.05). CONCLUSION Nutritional interventions are needed in patients with schizophrenia given that insufficient antioxidant intake may increase oxidative stress, which in turn affects disease development. Therefore, healthy nutrition, especially sufficient intake of dietary antioxidants, should be encouraged in patients with schizophrenia.
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Affiliation(s)
- Gülbin Karagöl
- Faculty of Health Sciences, Department of Nutrition and Dietetics, Hacettepe University, Sıhhiye, Ankara, Turkey
| | - Emrah Songur
- Republic of Turkey Ministry of Health, Yıldırım Beyazıt University, Yenimahalle Education and Research Hospital, Yenimahalle, Ankara, Turkey
| | - Neslişah Rakıcıoğlu
- Faculty of Health Sciences, Department of Nutrition and Dietetics, Hacettepe University, Sıhhiye, Ankara, Turkey
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Soria Bretones C, Roncero Parra C, Cascón J, Borja AL, Mateo Sotos J. Automatic identification of schizophrenia employing EEG records analyzed with deep learning algorithms. Schizophr Res 2023; 261:36-46. [PMID: 37690170 DOI: 10.1016/j.schres.2023.09.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Revised: 07/24/2023] [Accepted: 09/04/2023] [Indexed: 09/12/2023]
Abstract
Electroencephalography is a method of detecting and analyzing electrical activity in the brain. This electrical activity can be recorded and processed to aid in the clinical diagnosis of mental disorders. In this study, a novel system for classifying schizophrenia patients from EEG recordings is presented. The developed algorithm decomposes the EEG signals into a system of radial basis functions using the method of fuzzy means. This decomposition helps to obtain the information from the various electrodes of the EEG and allows separating between healthy controls and patients with schizophrenia. The proposed method has been compared with classical machine learning algorithms, such as, K-Nearest Neighbor, Adaboost, Support Vector Machine, and Bayesian Linear Discriminant Analysis. The results show that the proposed method obtains the highest values in terms of balanced accuracy, recall, precision and F1 score, close to 93 % in all cases. The model developed in this study can be implemented in brain activity analysis systems that help in the prediction of patients with schizophrenia.
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Affiliation(s)
| | - Carlos Roncero Parra
- Departamento de Sistema Informáticos, Universidad de Castilla-La Mancha, 02071 Albacete, Spain
| | - Joaquín Cascón
- Departamento de Ingeniería Eléctrica, Electrónica, Automática y Comunicaciones, Universidad de Castilla-La Mancha, 02071 Albacete, Spain; Expert Group in Medical Analysis, Instituto de Tecnología, Construcción y Telecomunicaciones, Universidad de Castilla-La Mancha, 16071 Cuenca, Spain
| | - Alejandro L Borja
- Departamento de Ingeniería Eléctrica, Electrónica, Automática y Comunicaciones, Universidad de Castilla-La Mancha, 02071 Albacete, Spain.
| | - Jorge Mateo Sotos
- Departamento de Ingeniería Eléctrica, Electrónica, Automática y Comunicaciones, Universidad de Castilla-La Mancha, 02071 Albacete, Spain; Expert Group in Medical Analysis, Instituto de Tecnología, Construcción y Telecomunicaciones, Universidad de Castilla-La Mancha, 16071 Cuenca, Spain
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Carletti B, Banaj N, Piras F, Bossù P. Schizophrenia and Glutathione: A Challenging Story. J Pers Med 2023; 13:1526. [PMID: 38003841 PMCID: PMC10672475 DOI: 10.3390/jpm13111526] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Revised: 10/13/2023] [Accepted: 10/20/2023] [Indexed: 11/26/2023] Open
Abstract
Schizophrenia (SZ) is a devastating mental illness with a complex and heterogeneous clinical state. Several conditions like symptoms, stage and severity of the disease are only some of the variables that have to be considered to define the disorder and its phenotypes. SZ pathophysiology is still unclear, and the diagnosis is currently relegated to the analysis of clinical symptoms; therefore, the search for biomarkers with diagnostic relevance is a major challenge in the field, especially in the era of personalized medicine. Though the mechanisms implicated in SZ are not fully understood, some processes are beginning to be elucidated. Oxidative stress, and in particular glutathione (GSH) dysregulation, has been demonstrated to play a crucial role in SZ pathophysiology. In fact, glutathione is a leading actor of oxidative-stress-mediated damage in SZ and appears to reflect the heterogeneity of the disease. The literature reports differing results regarding the levels of glutathione in SZ patients. However, each GSH state may be a sign of specific symptoms or groups of symptoms, candidating glutathione as a biomarker useful for discriminating SZ phenotypes. Here, we summarize the literature about the levels of glutathione in SZ and analyze the role of this molecule and its potential use as a biomarker.
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Affiliation(s)
- Barbara Carletti
- Laboratory of Neuropsychiatry, Clinical Neuroscience and Neurorehabilitation Department, IRCCS Santa Lucia Foundation, Via Ardeatina 306, 00179 Rome, Italy; (N.B.); (F.P.)
| | - Nerisa Banaj
- Laboratory of Neuropsychiatry, Clinical Neuroscience and Neurorehabilitation Department, IRCCS Santa Lucia Foundation, Via Ardeatina 306, 00179 Rome, Italy; (N.B.); (F.P.)
| | - Fabrizio Piras
- Laboratory of Neuropsychiatry, Clinical Neuroscience and Neurorehabilitation Department, IRCCS Santa Lucia Foundation, Via Ardeatina 306, 00179 Rome, Italy; (N.B.); (F.P.)
| | - Paola Bossù
- Laboratory of Experimental Neuropsychobiology, Clinical Neuroscience and Neurorehabilitation Department, IRCCS Santa Lucia Foundation, Via del Fosso di Fiorano 64, 00143 Rome, Italy;
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Fares J, Mohamed F, Yosra Z, Oumaya H, Riadh B, Jihenne M. Influence of Antipsychotic Agents on the Sexuality of Patients Diagnosed with Schizophrenia. CURRENT THERAPEUTIC RESEARCH 2023; 99:100722. [PMID: 38021266 PMCID: PMC10654135 DOI: 10.1016/j.curtheres.2023.100722] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/07/2023] [Accepted: 10/16/2023] [Indexed: 12/01/2023]
Abstract
Background Sexuality is a natural component of human behavior. The general population has been extensively studied since the first half of the 20th century. On the other hand, regarding patients treated for schizophrenia, discussing sexual disorders was initially considered inappropriate because it was believed they should not be sexually active. Given these findings, this work proposes to study the sexuality of patients with schizophrenia. Objectives Our objectives were to assess the sexuality of patients with schizophrenia, to identify factors associated with sexual dysfunction among these patients, and to determine practitioners' attitudes toward the sexuality of our study population. Methods This is a cross-sectional study carried out in the Psychiatry Department of Kairouan (outpatient department), including 46 patients diagnosed with schizophrenia. A pre-established information sheet was completed for each patient recruited, including sociodemographic and clinical data; on the other hand, 3 scales ensured a sexual psychometric evaluation: Psychotropic-Related Sexual Dysfunction Questionnaire, Arizona Sexual Experiences Scale, and Changes in Sexual Functioning Questionnaire-Male Clinical Version. Results Concerning the evaluation of sexuality according to the scales used, sexual dysfunction according to Psychotropic-Related Sexual Dysfunction Questionnaire scores was observed in 31 patients (67.4%). According to Arizona Sexual Experiences Scale scores, 24 patients (52%) had a sexual dysfunction, and for the total score of the Changes in Sexual Functioning Questionnaire-Male Clinical Version, 27 patients (58.7%) had a sexual dysfunction. We cannot confirm the existence of a relationship between the dose of the current treatment (in chlorpromazine equivalent) used and the results of the test assessing sexuality. In addition to these results, we can deduce the existence of a statistically significant association between the antipsychotic agent used and the results of the Psychotropic-Related Sexual Dysfunction Questionnaire only. Conclusions We recommend that screening for sexual dysfunction in patients followed for schizophrenia should be systematic, regardless of the antipsychotic molecule type and dosage. In this regard, we recommend the establishment of a better therapeutic relationship between caregivers and patients with schizophrenia, based on empathy and trust, so that the latter feel comfortable enough to address the sexual dimension in general and sexual dysfunction in particular.
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Affiliation(s)
- Jaballah Fares
- Department of Psychiatry, Avicenna, Razi Hospital-Mannouba, Tunis El Manar University, Tunis, Tunisia
| | - Ferhi Mohamed
- Department of Psychiatry, Ibn el Jazzar Hospital-Kairouan, Sousse University, Sousse, Tunisia
| | - Zgueb Yosra
- Department of Psychiatry, Avicenna, Razi Hospital-Mannouba, Tunis El Manar University, Tunis, Tunisia
| | - Hazem Oumaya
- Department of Psychiatry, Taher Maamouri Hospital, Nabeul, Tunisia
| | - Bouzid Riadh
- Department of Psychiatry, Taher Maamouri Hospital, Nabeul, Tunisia
| | - Mannaii Jihenne
- Department of Psychiatry, Ibn el Jazzar Hospital-Kairouan, Sousse University, Sousse, Tunisia
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Agarwal SM, Dissanayake J, Agid O, Bowie C, Brierley N, Chintoh A, De Luca V, Diaconescu A, Gerretsen P, Graff-Guerrero A, Hawco C, Herman Y, Hill S, Hum K, Husain MO, Kennedy JL, Kiang M, Kidd S, Kozloff N, Maslej M, Mueller DJ, Naeem F, Neufeld N, Remington G, Rotenberg M, Selby P, Siddiqui I, Szacun-Shimizu K, Tiwari AK, Thirunavukkarasu S, Wang W, Yu J, Zai CC, Zipursky R, Hahn M, Foussias G. Characterization and prediction of individual functional outcome trajectories in schizophrenia spectrum disorders (PREDICTS study): Study protocol. PLoS One 2023; 18:e0288354. [PMID: 37733693 PMCID: PMC10513234 DOI: 10.1371/journal.pone.0288354] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Accepted: 06/23/2023] [Indexed: 09/23/2023] Open
Abstract
Schizophrenia spectrum disorders (SSDs) are associated with significant functional impairments, disability, and low rates of personal recovery, along with tremendous economic costs linked primarily to lost productivity and premature mortality. Efforts to delineate the contributors to disability in SSDs have highlighted prominent roles for a diverse range of symptoms, physical health conditions, substance use disorders, neurobiological changes, and social factors. These findings have provided valuable advances in knowledge and helped define broad patterns of illness and outcomes across SSDs. Unsurprisingly, there have also been conflicting findings for many of these determinants that reflect the heterogeneous population of individuals with SSDs and the challenges of conceptualizing and treating SSDs as a unitary categorical construct. Presently it is not possible to identify the functional course on an individual level that would enable a personalized approach to treatment to alter the individual's functional trajectory and mitigate the ensuing disability they would otherwise experience. To address this ongoing challenge, this study aims to conduct a longitudinal multimodal investigation of a large cohort of individuals with SSDs in order to establish discrete trajectories of personal recovery, disability, and community functioning, as well as the antecedents and predictors of these trajectories. This investigation will also provide the foundation for the co-design and testing of personalized interventions that alter these functional trajectories and improve outcomes for people with SSDs.
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Affiliation(s)
- Sri Mahavir Agarwal
- Schizophrenia Division, Centre for Addiction and Mental Health (CAMH), Toronto, Canada
- Temerty Faculty Institute of Medical Science, University of Toronto, Toronto, Canada
- Department of Psychiatry, University of Toronto, Toronto, Canada
- Banting and Best Diabetes Centre (BBDC), University of Toronto, Toronto, Canada
| | - Joel Dissanayake
- Schizophrenia Division, Centre for Addiction and Mental Health (CAMH), Toronto, Canada
| | - Ofer Agid
- Schizophrenia Division, Centre for Addiction and Mental Health (CAMH), Toronto, Canada
| | - Christopher Bowie
- Schizophrenia Division, Centre for Addiction and Mental Health (CAMH), Toronto, Canada
| | - Noah Brierley
- Schizophrenia Division, Centre for Addiction and Mental Health (CAMH), Toronto, Canada
| | - Araba Chintoh
- Schizophrenia Division, Centre for Addiction and Mental Health (CAMH), Toronto, Canada
| | - Vincenzo De Luca
- Schizophrenia Division, Centre for Addiction and Mental Health (CAMH), Toronto, Canada
| | - Andreea Diaconescu
- Schizophrenia Division, Centre for Addiction and Mental Health (CAMH), Toronto, Canada
| | - Philip Gerretsen
- Schizophrenia Division, Centre for Addiction and Mental Health (CAMH), Toronto, Canada
| | - Ariel Graff-Guerrero
- Schizophrenia Division, Centre for Addiction and Mental Health (CAMH), Toronto, Canada
| | - Colin Hawco
- Schizophrenia Division, Centre for Addiction and Mental Health (CAMH), Toronto, Canada
| | - Yarissa Herman
- Schizophrenia Division, Centre for Addiction and Mental Health (CAMH), Toronto, Canada
| | - Sean Hill
- Schizophrenia Division, Centre for Addiction and Mental Health (CAMH), Toronto, Canada
| | - Kathryn Hum
- Schizophrenia Division, Centre for Addiction and Mental Health (CAMH), Toronto, Canada
| | - Muhammad Omair Husain
- Schizophrenia Division, Centre for Addiction and Mental Health (CAMH), Toronto, Canada
| | - James L. Kennedy
- Schizophrenia Division, Centre for Addiction and Mental Health (CAMH), Toronto, Canada
| | - Michael Kiang
- Schizophrenia Division, Centre for Addiction and Mental Health (CAMH), Toronto, Canada
| | - Sean Kidd
- Schizophrenia Division, Centre for Addiction and Mental Health (CAMH), Toronto, Canada
| | - Nicole Kozloff
- Schizophrenia Division, Centre for Addiction and Mental Health (CAMH), Toronto, Canada
| | - Marta Maslej
- Schizophrenia Division, Centre for Addiction and Mental Health (CAMH), Toronto, Canada
| | - Daniel J. Mueller
- Schizophrenia Division, Centre for Addiction and Mental Health (CAMH), Toronto, Canada
| | - Farooq Naeem
- Schizophrenia Division, Centre for Addiction and Mental Health (CAMH), Toronto, Canada
| | - Nicholas Neufeld
- Schizophrenia Division, Centre for Addiction and Mental Health (CAMH), Toronto, Canada
| | - Gary Remington
- Schizophrenia Division, Centre for Addiction and Mental Health (CAMH), Toronto, Canada
| | - Martin Rotenberg
- Schizophrenia Division, Centre for Addiction and Mental Health (CAMH), Toronto, Canada
| | - Peter Selby
- Schizophrenia Division, Centre for Addiction and Mental Health (CAMH), Toronto, Canada
| | - Ishraq Siddiqui
- Schizophrenia Division, Centre for Addiction and Mental Health (CAMH), Toronto, Canada
| | - Kate Szacun-Shimizu
- Schizophrenia Division, Centre for Addiction and Mental Health (CAMH), Toronto, Canada
| | - Arun K. Tiwari
- Schizophrenia Division, Centre for Addiction and Mental Health (CAMH), Toronto, Canada
| | | | - Wei Wang
- Schizophrenia Division, Centre for Addiction and Mental Health (CAMH), Toronto, Canada
| | - Joanna Yu
- Schizophrenia Division, Centre for Addiction and Mental Health (CAMH), Toronto, Canada
| | - Clement C. Zai
- Schizophrenia Division, Centre for Addiction and Mental Health (CAMH), Toronto, Canada
| | - Robert Zipursky
- Schizophrenia Division, Centre for Addiction and Mental Health (CAMH), Toronto, Canada
| | - Margaret Hahn
- Schizophrenia Division, Centre for Addiction and Mental Health (CAMH), Toronto, Canada
- Temerty Faculty Institute of Medical Science, University of Toronto, Toronto, Canada
- Department of Psychiatry, University of Toronto, Toronto, Canada
- Banting and Best Diabetes Centre (BBDC), University of Toronto, Toronto, Canada
| | - George Foussias
- Schizophrenia Division, Centre for Addiction and Mental Health (CAMH), Toronto, Canada
- Temerty Faculty Institute of Medical Science, University of Toronto, Toronto, Canada
- Department of Psychiatry, University of Toronto, Toronto, Canada
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Same K, Shobeiri P, Rashidi MM, Ghasemi E, Saeedi Moghaddam S, Mohammadi E, Masinaei M, Salehi N, Mohammadi Fateh S, Farzad Maroufi S, Abdolhamidi E, Moghimi M, Abbasi-Kangevari Z, Rezaei N, Larijani B. A Global, Regional, and National Burden and Quality of Care Index for Schizophrenia: Global Burden of Disease Systematic Analysis 1990-2019. Schizophr Bull 2023:sbad120. [PMID: 37738499 DOI: 10.1093/schbul/sbad120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/24/2023]
Abstract
BACKGROUND AND HYPOTHESIS Schizophrenia is a mental disorder usually presented in adulthood that affects roughly 0.3 percent of the population. The disease contributes to more than 13 million years lived with disability the global burden of disease. The current study aimed to provide new insights into the quality of care in Schizophrenia via the implementation of the newly introduced quality of care index (QCI) into the existing data. STUDY DESIGN The data from the global burden of disease database was used for schizophrenia. Two secondary indices were calculated from the available indices and used in a principal component analysis to develop a proxy of QCI for each country. The QCI was then compared between different sociodemographic index (SDI) and ages. To assess the disparity in QCI between the sexes, the gender disparity ratio (GDR) was also calculated and analyzed in different ages and SDIs. STUDY RESULTS The global QCI proxy score has improved between 1990 and 2019 by roughly 13.5%. Concerning the gender disparity, along with a rise in overall GDR the number of countries having a GDR score of around one has decreased which indicates an increase in gender disparity regarding quality of care of schizophrenia. Bhutan and Singapore had 2 of the highest QCIs in 2019 while also showing GDR scores close to one. CONCLUSIONS While the overall conditions in the quality of care have improved, significant disparities and differences still exist between different countries, genders, and ages in the quality of care regarding schizophrenia.
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Affiliation(s)
- Kaveh Same
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Parnian Shobeiri
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad-Mahdi Rashidi
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Erfan Ghasemi
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Sahar Saeedi Moghaddam
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
- Kiel Institute for the World Economy, Kiel, Germany
| | - Esmaeil Mohammadi
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
- Department of Neurological Surgery, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Masoud Masinaei
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Niloufar Salehi
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Sahar Mohammadi Fateh
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Seyed Farzad Maroufi
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Elham Abdolhamidi
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Mana Moghimi
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Zeinab Abbasi-Kangevari
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Negar Rezaei
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
- Digestive Disease Research Center (DDRC), Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Bagher Larijani
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
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Tiego J, Thompson K, Arnatkeviciute A, Hawi Z, Finlay A, Sabaroedin K, Johnson B, Bellgrove MA, Fornito A. Dissecting Schizotypy and Its Association With Cognition and Polygenic Risk for Schizophrenia in a Nonclinical Sample. Schizophr Bull 2023; 49:1217-1228. [PMID: 36869759 PMCID: PMC10483465 DOI: 10.1093/schbul/sbac016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Schizotypy is a multidimensional construct that captures a continuum of risk for developing schizophrenia-spectrum psychopathology. Existing 3-factor models of schizotypy, consisting of positive, negative, and disorganized dimensions have yielded mixed evidence of genetic continuity with schizophrenia using polygenic risk scores. Here, we propose an approach that involves splitting positive and negative schizotypy into more specific subdimensions that are phenotypically continuous with distinct positive symptoms and negative symptoms recognized in clinical schizophrenia. We used item response theory to derive high-precision estimates of psychometric schizotypy using 251 self-report items obtained from a non-clinical sample of 727 (424 females) adults. These subdimensions were organized hierarchically using structural equation modeling into 3 empirically independent higher-order dimensions enabling associations with polygenic risk for schizophrenia to be examined at different levels of phenotypic generality and specificity. Results revealed that polygenic risk for schizophrenia was associated with variance specific to delusional experiences (γ = 0.093, P = .001) and reduced social interest and engagement (γ = 0.076, P = .020), and these effects were not mediated via the higher-order general, positive, or negative schizotypy factors. We further fractionated general intellectual functioning into fluid and crystallized intelligence in 446 (246 females) participants that underwent onsite cognitive assessment. Polygenic risk scores explained 3.6% of the variance in crystallized intelligence. Our precision phenotyping approach could be used to enhance the etiologic signal in future genetic association studies and improve the detection and prevention of schizophrenia-spectrum psychopathology.
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Affiliation(s)
- Jeggan Tiego
- Turner Institute for Brain and Mental Health, Monash University, Clayton, VIC 3800, Australia
- School of Psychological Sciences, Monash University, Clayton, VIC 3800, Australia
- Monash Biomedical Imaging, Monash University, 770 Blackburn Rd, Clayton, VIC 3800, Australia
| | - Kate Thompson
- Turner Institute for Brain and Mental Health, Monash University, Clayton, VIC 3800, Australia
- School of Psychological Sciences, Monash University, Clayton, VIC 3800, Australia
- Monash Biomedical Imaging, Monash University, 770 Blackburn Rd, Clayton, VIC 3800, Australia
| | - Aurina Arnatkeviciute
- Turner Institute for Brain and Mental Health, Monash University, Clayton, VIC 3800, Australia
- School of Psychological Sciences, Monash University, Clayton, VIC 3800, Australia
| | - Ziarih Hawi
- Turner Institute for Brain and Mental Health, Monash University, Clayton, VIC 3800, Australia
- School of Psychological Sciences, Monash University, Clayton, VIC 3800, Australia
| | - Amy Finlay
- Turner Institute for Brain and Mental Health, Monash University, Clayton, VIC 3800, Australia
- School of Psychological Sciences, Monash University, Clayton, VIC 3800, Australia
| | - Kristina Sabaroedin
- Turner Institute for Brain and Mental Health, Monash University, Clayton, VIC 3800, Australia
- School of Psychological Sciences, Monash University, Clayton, VIC 3800, Australia
- Monash Biomedical Imaging, Monash University, 770 Blackburn Rd, Clayton, VIC 3800, Australia
| | - Beth Johnson
- Turner Institute for Brain and Mental Health, Monash University, Clayton, VIC 3800, Australia
- School of Psychological Sciences, Monash University, Clayton, VIC 3800, Australia
| | - Mark A Bellgrove
- Turner Institute for Brain and Mental Health, Monash University, Clayton, VIC 3800, Australia
- School of Psychological Sciences, Monash University, Clayton, VIC 3800, Australia
| | - Alex Fornito
- Turner Institute for Brain and Mental Health, Monash University, Clayton, VIC 3800, Australia
- School of Psychological Sciences, Monash University, Clayton, VIC 3800, Australia
- Monash Biomedical Imaging, Monash University, 770 Blackburn Rd, Clayton, VIC 3800, Australia
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45
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Owen MJ, Legge SE, Rees E, Walters JTR, O'Donovan MC. Genomic findings in schizophrenia and their implications. Mol Psychiatry 2023; 28:3638-3647. [PMID: 37853064 PMCID: PMC10730422 DOI: 10.1038/s41380-023-02293-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Revised: 10/02/2023] [Accepted: 10/03/2023] [Indexed: 10/20/2023]
Abstract
There has been substantial progress in understanding the genetics of schizophrenia over the past 15 years. This has revealed a highly polygenic condition with the majority of the currently explained heritability coming from common alleles of small effect but with additional contributions from rare copy number and coding variants. Many specific genes and loci have been implicated that provide a firm basis upon which mechanistic research can proceed. These point to disturbances in neuronal, and particularly synaptic, functions that are not confined to a small number of brain regions and circuits. Genetic findings have also revealed the nature of schizophrenia's close relationship to other conditions, particularly bipolar disorder and childhood neurodevelopmental disorders, and provided an explanation for how common risk alleles persist in the population in the face of reduced fecundity. Current genomic approaches only potentially explain around 40% of heritability, but only a small proportion of this is attributable to robustly identified loci. The extreme polygenicity poses challenges for understanding biological mechanisms. The high degree of pleiotropy points to the need for more transdiagnostic research and the shortcomings of current diagnostic criteria as means of delineating biologically distinct strata. It also poses challenges for inferring causality in observational and experimental studies in both humans and model systems. Finally, the Eurocentric bias of genomic studies needs to be rectified to maximise benefits and ensure these are felt across diverse communities. Further advances are likely to come through the application of new and emerging technologies, such as whole-genome and long-read sequencing, to large and diverse samples. Substantive progress in biological understanding will require parallel advances in functional genomics and proteomics applied to the brain across developmental stages. For these efforts to succeed in identifying disease mechanisms and defining novel strata they will need to be combined with sufficiently granular phenotypic data.
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Affiliation(s)
- Michael J Owen
- Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, UK.
| | - Sophie E Legge
- Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, UK
| | - Elliott Rees
- Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, UK
| | - James T R Walters
- Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, UK
| | - Michael C O'Donovan
- Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, UK.
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Bakken TL, Kildahl AN, Ludvigsen LB, Bjørgen TG, Dalhaug C, Hellerud JMA, Hove O, Solheim-Inderberg AM, Karlsen K, Helverschou SB. Schizophrenia in autistic people with intellectual disabilities: Symptom manifestations and identification. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2023; 36:1076-1091. [PMID: 37264713 DOI: 10.1111/jar.13127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Revised: 03/17/2023] [Accepted: 05/17/2023] [Indexed: 06/03/2023]
Abstract
BACKGROUND The assessment of schizophrenia in autistic people with intellectual disabilities is challenging. This study aimed to explore the identification of schizophrenia in this population. METHODS Using data from a clinical multi-centre study, reported symptoms in 26 autistic individuals with intellectual disabilities diagnosed with co-occurring schizophrenia were explored. Scores on two checklists (Psychopathology in Autism Checklist [PAC], Aberrant Behaviour Checklist [ABC]) were compared with two comparison groups: autistic individuals with intellectual disabilities and other mental disorders (94), or no mental disorder (63). RESULTS Reported symptoms of schizophrenia in this population met the formal diagnostic criteria. For PAC/ABC scales, only PAC psychosis differed for the schizophrenia group. Among participants with schizophrenia, two were diagnosed with additional mental disorders. Elevated scores for anxiety and depression were common. CONCLUSIONS Emphasising core symptoms seems necessary when assessing co-occurring schizophrenia in autistic people with intellectual disabilities. The PAC may serve as a helpful screening tool.
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Affiliation(s)
- Trine Lise Bakken
- Oslo University Hospital, Oslo Metropolitan University, Oslo, Norway
| | | | | | - Tale Gjertine Bjørgen
- St. Olavs University Hospital, Norwegian University of Science and Technology, Trondheim, Norway
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Su Q, Bi F, Yang S, Yan H, Sun X, Wang J, Qiu Y, Li M, Li S, Li J. Identification of Plasma Biomarkers in Drug-Naïve Schizophrenia Using Targeted Metabolomics. Psychiatry Investig 2023; 20:818-825. [PMID: 37794663 PMCID: PMC10555515 DOI: 10.30773/pi.2023.0121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Revised: 06/05/2023] [Accepted: 06/14/2023] [Indexed: 10/06/2023] Open
Abstract
OBJECTIVE Schizophrenia (SCZ) is a severe psychiatric disorder with unknown etiology and lacking specific biomarkers. Herein, we aimed to explore plasma biomarkers relevant to SCZ using targeted metabolomics. METHODS Sixty drug-naïve SCZ patients and 36 healthy controls were recruited. Psychotic symptoms were assessed using the Positive and Negative Syndrome Scale. We analyzed the levels of 271 metabolites in plasma samples from all subjects using targeted metabolomics, and identified metabolites that differed significantly between the two groups. Then we evaluated the diagnostic power of the metabolites based on receiver operating characteristic curves, and explored metabolites associated with the psychotic symptoms in SCZ patients. RESULTS Twenty-six metabolites showed significant differences between SCZ patients and healthy controls. Among them, 12 metabolites were phosphatidylcholines and cortisol, ceramide (d18:1/22:0), acetylcarnitine, and γ-aminobutyric acid, which could significantly distinguish SCZ from healthy controls with the area under the curve (AUC) above 0.7. Further, a panel consisting of the above 4 metabolites had an excellent performance with an AUC of 0.867. In SCZ patients, phosphatidylcholines were positively related with positive symptoms, and cholic acid was positively associated with negative symptoms. CONCLUSION Our study provides insights into the metabolite alterations associated with SCZ and potential biomarkers for its diagnosis and symptom severity assessment.
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Affiliation(s)
- Qiao Su
- Tianjin Mental Health Institute, Tianjin Anding Hospital, Mental Health Center of Tianjin Medical University, Tianjin, China
| | - Fuyou Bi
- Tianjin Mental Health Institute, Tianjin Anding Hospital, Mental Health Center of Tianjin Medical University, Tianjin, China
| | - Shu Yang
- Tianjin Mental Health Institute, Tianjin Anding Hospital, Mental Health Center of Tianjin Medical University, Tianjin, China
| | - Huiming Yan
- Tianjin Mental Health Institute, Tianjin Anding Hospital, Mental Health Center of Tianjin Medical University, Tianjin, China
| | - Xiaoxiao Sun
- Tianjin Mental Health Institute, Tianjin Anding Hospital, Mental Health Center of Tianjin Medical University, Tianjin, China
| | - Jiayue Wang
- Tianjin Mental Health Institute, Tianjin Anding Hospital, Mental Health Center of Tianjin Medical University, Tianjin, China
| | - Yuying Qiu
- Tianjin Mental Health Institute, Tianjin Anding Hospital, Mental Health Center of Tianjin Medical University, Tianjin, China
| | - Meijuan Li
- Tianjin Mental Health Institute, Tianjin Anding Hospital, Mental Health Center of Tianjin Medical University, Tianjin, China
| | - Shen Li
- Tianjin Mental Health Institute, Tianjin Anding Hospital, Mental Health Center of Tianjin Medical University, Tianjin, China
| | - Jie Li
- Tianjin Mental Health Institute, Tianjin Anding Hospital, Mental Health Center of Tianjin Medical University, Tianjin, China
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48
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Verma KK. Understanding and Managing Cognitive Distortions in Individuals With Schizophrenia. Cureus 2023; 15:e45268. [PMID: 37846265 PMCID: PMC10576840 DOI: 10.7759/cureus.45268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Accepted: 09/12/2023] [Indexed: 10/18/2023] Open
Abstract
INTRODUCTION Schizophrenia is characterized by psychotic symptoms such as delusions, hallucinations, and disorganized thinking and speech. Patients suffering from schizophrenia incited by these delusions react violently in response to real or imagined threats; this engages them in violent behaviours and thus poses a threat. Sparse data are available for patients from India with regard to schizophrenia patients acting on their delusions. The aim of this study was to assess the prevalence of delusional action in patients suffering from schizophrenia and to identify the phenomenological characteristics of those delusions which are associated with action. MATERIAL METHODS This study was conducted on patients with a diagnosis of schizophrenia admitted to the indoor patient department (IPD) of the Department of Psychiatry, K.D. Medical College, Hospital & Research Centre, Mathura, India, during the period of February 2022 to July 2022. A semi-structured, semi-open-ended questionnaire was used for interviewing patients regarding demographics, the course of illness, past medical illness, the family history of psychiatric disturbances, and substance use. The study tool used for delusion was the Maudsley Assessment of Delusions Schedule (MADS). RESULTS Out of 56 selected subjects, 34 acted on delusion and out of these, 19 were male and 15 female. In our study gender did not play any significant role in acting on delusion. Literacy and nuclear living households played a significant role in influencing delusion-driven behaviours, while the distinction between urban and rural living, though noteworthy, fell just short of achieving statistical significance. An emotional state like anger was significantly important to the patient's acting on delusion, which led to violent behaviour or self-harm. CONCLUSION Positive responses are more likely to be associated with leading action on delusion as compared to negative responses, which were also associated with action on delusion; for example, anger was significantly important in the patient's acting on delusion, which led to violent behaviour or self-harm.
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Affiliation(s)
- Kamal K Verma
- Psychiatry, K. D. (Kanti Devi) Medical College, Hospital & Research Center, Mathura, IND
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49
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Dai J, Zhang MZ, He QQ, Chen R. The emerging role of exosomes in Schizophrenia. Psychiatry Res 2023; 327:115394. [PMID: 37536144 DOI: 10.1016/j.psychres.2023.115394] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Revised: 07/25/2023] [Accepted: 07/29/2023] [Indexed: 08/05/2023]
Abstract
Schizophrenia (SCZ), a serious mental disorder, is one of the leading causes of disease burden worldwide. Exosomes, as a natural nanocarrier, are able to cross the blood-brain barrier (BBB) and play a key bridging role in central nervous system (CNS) communication, participating in important physiological processes such as neural regeneration, prominent plasticity, axonal support, and neuroinflammation. In recent years, exosomes have received widespread attention in the field of neurodegenerative diseases and mental disorders, especially Alzheimer's disease. However, there are few reviews on exosomes and SCZ. Therefore, we conducted a literature search in PubMed and Web of Science using the following search terms: "schizophrenia", "mental disorder", "central system", "exosome", "extracellular vesicles" to identify publications from January 2010 to December 2022. Our review summarized exosomes secreted by different cell types in the CNS and the double-edged role of exosomes in the development of SCZ, and discussed their future potential as biomarkers and therapeutic targets. In conclusion, this article provides an up-to-date overview of the current research on the involvement of exosomes in SCZ, while also highlighting the challenges that are currently faced in this field.
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Affiliation(s)
- Jie Dai
- School of Public Health, Wuhan University, Wuhan, China
| | - Min-Zhe Zhang
- School of Public Health, Wuhan University, Wuhan, China
| | - Qi-Qiang He
- School of Public Health, Wuhan University, Wuhan, China; Hubei Biomass-Resource Chemistry and Environmental Biotechnology Key Laboratory, Wuhan University, Wuhan, China
| | - Rui Chen
- School of Public Health, Wuhan University, Wuhan, China.
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50
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Wells AC, Lotfipour S. Prenatal nicotine exposure during pregnancy results in adverse neurodevelopmental alterations and neurobehavioral deficits. ADVANCES IN DRUG AND ALCOHOL RESEARCH 2023; 3:11628. [PMID: 38389806 PMCID: PMC10880762 DOI: 10.3389/adar.2023.11628] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Accepted: 07/28/2023] [Indexed: 02/24/2024]
Abstract
Maternal tobacco use and nicotine exposure during pregnancy have been associated with adverse birth outcomes in infants and can lead to preventable pregnancy complications. Exposure to nicotine and other compounds in tobacco and electronic cigarettes (e-cigarettes) has been shown to increases the risk of miscarriage, prematurity, stillbirth, low birth weight, perinatal morbidity, and sudden infant death syndrome (SIDS). Additionally, recent data provided by clinical and pre-clinical research demonstrates that nicotine exposure during pregnancy may heighten the risk for adverse neurodevelopmental disorders such as Attention-Deficit Hyperactivity (ADHD), anxiety, and depression along with altering the infants underlying brain circuitry, response to neurotransmitters, and brain volume. In the United States, one in 14 women (7.2%) reported to have smoked cigarettes during their pregnancy with the global prevalence of smoking during pregnancy estimated to be 1.7%. Approximately 1.1% of women in the United States also reported to have used e-cigarettes during the last 3 months of pregnancy. Due to the large percentage of women utilizing nicotine products during pregnancy in the United States and globally, this review seeks to centralize pre-clinical and clinical studies focused on the neurobehavioral and neurodevelopmental complications associated with prenatal nicotine exposure (PNE) such as alterations to the hypothalamic-pituitary-adrenal (HPA) axis and brain regions such as the prefrontal cortex (PFC), ventral tegmental area (VTA), nucleus accumbens (NA), hippocampus, and caudate as well as changes to nAChR and cholinergic receptor signaling, long-term drug seeking behavior following PNE, and other related developmental disorders. Current literature analyzing the association between PNE and the risk for offspring developing schizophrenia, attention-deficit hyperactivity disorder (ADHD), autism spectrum disorder (ASD), anxiety, and obesity will also be discussed.
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Affiliation(s)
- Alicia C Wells
- School of Medicine, University of California, Irvine, Irvine, CA, United States
| | - Shahrdad Lotfipour
- School of Medicine, University of California, Irvine, Irvine, CA, United States
- Department of Emergency Medicine, Pharmaceutical Sciences, Pathology and Laboratory Medicine, University of California, Irvine, Irvine, CA, United States
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