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Cognitive Deficit in Schizophrenia: From Etiology to Novel Treatments. Int J Mol Sci 2021; 22:ijms22189905. [PMID: 34576069 PMCID: PMC8468549 DOI: 10.3390/ijms22189905] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Revised: 09/08/2021] [Accepted: 09/10/2021] [Indexed: 01/09/2023] Open
Abstract
Schizophrenia is a major mental illness characterized by positive and negative symptoms, and by cognitive deficit. Although cognitive impairment is disabling for patients, it has been largely neglected in the treatment of schizophrenia. There are several reasons for this lack of treatments for cognitive deficit, but the complexity of its etiology-in which neuroanatomic, biochemical and genetic factors concur-has contributed to the lack of effective treatments. In the last few years, there have been several attempts to develop novel drugs for the treatment of cognitive impairment in schizophrenia. Despite these efforts, little progress has been made. The latest findings point to the importance of developing personalized treatments for schizophrenia which enhance neuroplasticity, and of combining pharmacological treatments with non-pharmacological measures.
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Poddar I, Callahan PM, Hernandez CM, Pillai A, Yang X, Bartlett MG, Terry AV. Chronic oral treatment with risperidone impairs recognition memory and alters brain-derived neurotrophic factor and related signaling molecules in rats. Pharmacol Biochem Behav 2020; 189:172853. [PMID: 31945381 DOI: 10.1016/j.pbb.2020.172853] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2019] [Revised: 01/09/2020] [Accepted: 01/12/2020] [Indexed: 01/09/2023]
Abstract
Antipsychotic drugs (APDs) are essential for the treatment of schizophrenia and other neuropsychiatric illnesses such as bipolar disease. However, they are also extensively prescribed off-label for many other conditions, a practice that is controversial given their potential for long-term side effects. There is clinical and preclinical evidence that chronic treatment with some APDs may lead to impairments in cognition and decreases in brain volume, although the molecular mechanisms of these effects are unknown. The purpose of the rodent studies described here was to evaluate a commonly prescribed APD, risperidone, for chronic effects on recognition memory, brain-derived neurotrophic factor (BDNF), its precursor proBDNF, as well as relevant downstream signaling molecules that are known to influence neuronal plasticity and cognition. Multiple cohorts of adult rats were treated with risperidone (2.5 mg/kg/day) or vehicle (dilute acetic acid solution) in their drinking water for 30 or 90 days. Subjects were then evaluated for drug effects on recognition memory in a spontaneous novel object recognition task and protein levels of BDNF-related signaling molecules in the hippocampus and prefrontal cortex. The results indicated that depending on the treatment period, a therapeutically relevant daily dose of risperidone impaired recognition memory and increased the proBDNF/BDNF ratio in the hippocampus and prefrontal cortex. Risperidone treatment also led to a decrease in Akt and CREB phosphorylation in the prefrontal cortex. These results indicate that chronic treatment with a commonly prescribed APD, risperidone, has the potential to adversely affect recognition memory and neurotrophin-related signaling molecules that support synaptic plasticity and cognitive function.
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Affiliation(s)
- Indrani Poddar
- Department of Pharmacology and Toxicology, Medical College of Georgia, Augusta University, Augusta, GA 30912, United States of America
| | - Patrick M Callahan
- Department of Pharmacology and Toxicology, Medical College of Georgia, Augusta University, Augusta, GA 30912, United States of America.; Small Animal Behavior Core, Augusta University, Augusta, GA 30912, United States of America
| | - Caterina M Hernandez
- Department of Pharmacology and Toxicology, Medical College of Georgia, Augusta University, Augusta, GA 30912, United States of America
| | - Anilkumar Pillai
- Department of Psychiatry and Health Behavior, Medical College of Georgia, Augusta University, Augusta, GA 30912, United States of America
| | - Xiangkun Yang
- Department of Pharmaceutical and Biomedical Sciences, University of Georgia College of Pharmacy, Athens, GA 30607, United States of America
| | - Michael G Bartlett
- Department of Pharmaceutical and Biomedical Sciences, University of Georgia College of Pharmacy, Athens, GA 30607, United States of America
| | - Alvin V Terry
- Department of Pharmacology and Toxicology, Medical College of Georgia, Augusta University, Augusta, GA 30912, United States of America.; Small Animal Behavior Core, Augusta University, Augusta, GA 30912, United States of America.
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Panaccione I, Napoletano F, Forte AM, Kotzalidis GD, Del Casale A, Rapinesi C, Brugnoli C, Serata D, Caccia F, Cuomo I, Ambrosi E, Simonetti A, Savoja V, De Chiara L, Danese E, Manfredi G, Janiri D, Motolese M, Nicoletti F, Girardi P, Sani G. Neurodevelopment in schizophrenia: the role of the wnt pathways. Curr Neuropharmacol 2013; 11:535-58. [PMID: 24403877 PMCID: PMC3763761 DOI: 10.2174/1570159x113119990037] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2012] [Revised: 03/28/2013] [Accepted: 05/12/2013] [Indexed: 02/06/2023] Open
Abstract
OBJECTIVES To review the role of Wnt pathways in the neurodevelopment of schizophrenia. METHODS SYSTEMATIC PUBMED SEARCH, USING AS KEYWORDS ALL THE TERMS RELATED TO THE WNT PATHWAYS AND CROSSING THEM WITH EACH OF THE FOLLOWING AREAS: normal neurodevelopment and physiology, neurodevelopmental theory of schizophrenia, schizophrenia, and antipsychotic drug action. RESULTS Neurodevelopmental, behavioural, genetic, and psychopharmacological data point to the possible involvement of Wnt systems, especially the canonical pathway, in the pathophysiology of schizophrenia and in the mechanism of antipsychotic drug action. The molecules most consistently found to be associated with abnormalities or in antipsychotic drug action are Akt1, glycogen synthase kinase3beta, and beta-catenin. However, the extent to which they contribute to the pathophysiology of schizophrenia or to antipsychotic action remains to be established. CONCLUSIONS The study of the involvement of Wnt pathway abnormalities in schizophrenia may help in understanding this multifaceted clinical entity; the development of Wnt-related pharmacological targets must await the collection of more data.
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Affiliation(s)
- Isabella Panaccione
- NESMOS Department (Neuroscience, Mental Health, and Sensory Organs), Sapienza University, School of Medicine and Psychology, Sant’Andrea Hospital, Rome, Italy
| | - Flavia Napoletano
- NESMOS Department (Neuroscience, Mental Health, and Sensory Organs), Sapienza University, School of Medicine and Psychology, Sant’Andrea Hospital, Rome, Italy
| | - Alberto Maria Forte
- NESMOS Department (Neuroscience, Mental Health, and Sensory Organs), Sapienza University, School of Medicine and Psychology, Sant’Andrea Hospital, Rome, Italy
| | - Giorgio D. Kotzalidis
- NESMOS Department (Neuroscience, Mental Health, and Sensory Organs), Sapienza University, School of Medicine and Psychology, Sant’Andrea Hospital, Rome, Italy
| | - Antonio Del Casale
- NESMOS Department (Neuroscience, Mental Health, and Sensory Organs), Sapienza University, School of Medicine and Psychology, Sant’Andrea Hospital, Rome, Italy
| | - Chiara Rapinesi
- NESMOS Department (Neuroscience, Mental Health, and Sensory Organs), Sapienza University, School of Medicine and Psychology, Sant’Andrea Hospital, Rome, Italy
| | - Chiara Brugnoli
- NESMOS Department (Neuroscience, Mental Health, and Sensory Organs), Sapienza University, School of Medicine and Psychology, Sant’Andrea Hospital, Rome, Italy
| | - Daniele Serata
- NESMOS Department (Neuroscience, Mental Health, and Sensory Organs), Sapienza University, School of Medicine and Psychology, Sant’Andrea Hospital, Rome, Italy
| | - Federica Caccia
- NESMOS Department (Neuroscience, Mental Health, and Sensory Organs), Sapienza University, School of Medicine and Psychology, Sant’Andrea Hospital, Rome, Italy
| | - Ilaria Cuomo
- NESMOS Department (Neuroscience, Mental Health, and Sensory Organs), Sapienza University, School of Medicine and Psychology, Sant’Andrea Hospital, Rome, Italy
| | - Elisa Ambrosi
- NESMOS Department (Neuroscience, Mental Health, and Sensory Organs), Sapienza University, School of Medicine and Psychology, Sant’Andrea Hospital, Rome, Italy
| | - Alessio Simonetti
- NESMOS Department (Neuroscience, Mental Health, and Sensory Organs), Sapienza University, School of Medicine and Psychology, Sant’Andrea Hospital, Rome, Italy
| | - Valeria Savoja
- NESMOS Department (Neuroscience, Mental Health, and Sensory Organs), Sapienza University, School of Medicine and Psychology, Sant’Andrea Hospital, Rome, Italy
| | - Lavinia De Chiara
- NESMOS Department (Neuroscience, Mental Health, and Sensory Organs), Sapienza University, School of Medicine and Psychology, Sant’Andrea Hospital, Rome, Italy
| | - Emanuela Danese
- NESMOS Department (Neuroscience, Mental Health, and Sensory Organs), Sapienza University, School of Medicine and Psychology, Sant’Andrea Hospital, Rome, Italy
| | - Giovanni Manfredi
- NESMOS Department (Neuroscience, Mental Health, and Sensory Organs), Sapienza University, School of Medicine and Psychology, Sant’Andrea Hospital, Rome, Italy
| | - Delfina Janiri
- NESMOS Department (Neuroscience, Mental Health, and Sensory Organs), Sapienza University, School of Medicine and Psychology, Sant’Andrea Hospital, Rome, Italy
| | | | - Ferdinando Nicoletti
- NEUROMED, Pozzilli, Isernia, Italy
- Department of Neuropharmacology, Sapienza University, School of Medicine and Pharmacy, Rome, Italy
| | - Paolo Girardi
- NESMOS Department (Neuroscience, Mental Health, and Sensory Organs), Sapienza University, School of Medicine and Psychology, Sant’Andrea Hospital, Rome, Italy
- Centro Lucio Bini, Rome, Italy
| | - Gabriele Sani
- NESMOS Department (Neuroscience, Mental Health, and Sensory Organs), Sapienza University, School of Medicine and Psychology, Sant’Andrea Hospital, Rome, Italy
- Centro Lucio Bini, Rome, Italy
- IRCCS Santa Lucia Foundation, Department of Clinical and Behavioural Neurology, Neuropsychiatry Laboratory, Rome, Italy
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Ohi K, Hashimoto R, Yasuda Y, Fukumoto M, Nemoto K, Ohnishi T, Yamamori H, Takahashi H, Iike N, Kamino K, Yoshida T, Azechi M, Ikezawa K, Tanimukai H, Tagami S, Morihara T, Okochi M, Tanaka T, Kudo T, Iwase M, Kazui H, Takeda M. The AKT1 gene is associated with attention and brain morphology in schizophrenia. World J Biol Psychiatry 2013; 14:100-13. [PMID: 22150081 DOI: 10.3109/15622975.2011.591826] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
OBJECTIVES A meta-analysis of the associations between genetic variants in the AKT1 gene and schizophrenia found that a single nucleotide polymorphism (SNP5; rs2494732) was associated with schizophrenia in Asian populations. METHODS In this study, we investigated the effects of this SNP on memory and attentional performance and brain structure using magnetic resonance imaging in a Japanese population (117 patients with schizophrenia and 189 healthy subjects). RESULTS The memory performance, particularly attention/concentration score, measured by the Wechsler Memory Scale-Revised in A carriers of SNP5, which was found to be enriched in patients with schizophrenia, was lower than that in individuals with the G/G genotype. We confirmed the association of the SNP with attentional performance using the Continuous Performance Test, which assessed sustained attention and vigilance of attentional function. Patients with A allele demonstrated lower attentional performance than patients with the G/G genotype. Patients with the A allele had smaller gray matter volumes in the right inferior parietal lobule related to attentional processes and in the frontostriatal region related to different SNPs in AKT1 than patients with the G/G genotype. CONCLUSIONS Our results suggest that a genetic variant of AKT1 might be associated with attentional deficits and brain morphological vulnerability in patients with schizophrenia.
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Affiliation(s)
- Kazutaka Ohi
- Department of Psychiatry, Osaka University Graduate school of Medicine, Osaka, Japan
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Abstract
OBJECTIVES A number of studies have reported a genetic association of the AKT1 gene with schizophrenia, although some have failed to replicate the AKT1 association. This study was undertaken to further explore the AKT1 association with more single nucleotide polymorphisms in a British sample. METHODS A total of 221 families, consisting of 148 fathers, 204 mothers and 222 offspring affected with schizophrenia, were recruited for genetic analysis. Analysis for allelic and haplotypic associations was performed with the UNPHASED program, using likelihood-based association analysis for nuclear families with missing parental genotype data. RESULTS Allelic association was detected at rs1130214 (chi(2)=6.28, P=0.012) and at rs11847866 (chi(2)=4.64, P=0.031), although the remaining single nucleotide polymorphisms did not show allelic association with schizophrenia. The global P value of overall associations was 0.059 after 10000 permutations. Assessment using the Haploview program revealed rs1130214, rs2494746 and rs11847866 in the same linkage disequilibrium block and haplotype analysis showed disease association for the rs1130214-rs2494746-rs11847866 haplotypes (chi(2)=10.18, d.f.=4, P=0.037), of which the T-G-A haplotype was excessively transmitted (chi(2)=6.93, uncorrected P=0.008) and this haplotypic association survived Bonferroni correction (P=0.04). CONCLUSION The present results provide further evidence to support the AKT1 association with schizophrenia.
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Ribbe K, Friedrichs H, Begemann M, Grube S, Papiol S, Kästner A, Gerchen MF, Ackermann V, Tarami A, Treitz A, Flögel M, Adler L, Aldenhoff JB, Becker-Emner M, Becker T, Czernik A, Dose M, Folkerts H, Freese R, Günther R, Herpertz S, Hesse D, Kruse G, Kunze H, Franz M, Löhrer F, Maier W, Mielke A, Müller-Isberner R, Oestereich C, Pajonk FG, Pollmächer T, Schneider U, Schwarz HJ, Kröner-Herwig B, Havemann-Reinecke U, Frahm J, Stühmer W, Falkai P, Brose N, Nave KA, Ehrenreich H. The cross-sectional GRAS sample: a comprehensive phenotypical data collection of schizophrenic patients. BMC Psychiatry 2010; 10:91. [PMID: 21067598 PMCID: PMC3002316 DOI: 10.1186/1471-244x-10-91] [Citation(s) in RCA: 49] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2010] [Accepted: 11/10/2010] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Schizophrenia is the collective term for an exclusively clinically diagnosed, heterogeneous group of mental disorders with still obscure biological roots. Based on the assumption that valuable information about relevant genetic and environmental disease mechanisms can be obtained by association studies on patient cohorts of ≥ 1000 patients, if performed on detailed clinical datasets and quantifiable biological readouts, we generated a new schizophrenia data base, the GRAS (Göttingen Research Association for Schizophrenia) data collection. GRAS is the necessary ground to study genetic causes of the schizophrenic phenotype in a 'phenotype-based genetic association study' (PGAS). This approach is different from and complementary to the genome-wide association studies (GWAS) on schizophrenia. METHODS For this purpose, 1085 patients were recruited between 2005 and 2010 by an invariable team of traveling investigators in a cross-sectional field study that comprised 23 German psychiatric hospitals. Additionally, chart records and discharge letters of all patients were collected. RESULTS The corresponding dataset extracted and presented in form of an overview here, comprises biographic information, disease history, medication including side effects, and results of comprehensive cross-sectional psychopathological, neuropsychological, and neurological examinations. With >3000 data points per schizophrenic subject, this data base of living patients, who are also accessible for follow-up studies, provides a wide-ranging and standardized phenotype characterization of as yet unprecedented detail. CONCLUSIONS The GRAS data base will serve as prerequisite for PGAS, a novel approach to better understanding 'the schizophrenias' through exploring the contribution of genetic variation to the schizophrenic phenotypes.
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Affiliation(s)
- Katja Ribbe
- Division of Clinical Neuroscience, Max Planck Institute of Experimental Medicine, Göttingen, Germany
| | - Heidi Friedrichs
- Division of Clinical Neuroscience, Max Planck Institute of Experimental Medicine, Göttingen, Germany
| | - Martin Begemann
- Division of Clinical Neuroscience, Max Planck Institute of Experimental Medicine, Göttingen, Germany
| | - Sabrina Grube
- Division of Clinical Neuroscience, Max Planck Institute of Experimental Medicine, Göttingen, Germany
| | - Sergi Papiol
- Division of Clinical Neuroscience, Max Planck Institute of Experimental Medicine, Göttingen, Germany,DFG Research Center for Molecular Physiology of the Brain (CMPB), Germany
| | - Anne Kästner
- Division of Clinical Neuroscience, Max Planck Institute of Experimental Medicine, Göttingen, Germany
| | - Martin F Gerchen
- Division of Clinical Neuroscience, Max Planck Institute of Experimental Medicine, Göttingen, Germany
| | - Verena Ackermann
- Division of Clinical Neuroscience, Max Planck Institute of Experimental Medicine, Göttingen, Germany
| | - Asieh Tarami
- Division of Clinical Neuroscience, Max Planck Institute of Experimental Medicine, Göttingen, Germany
| | - Annika Treitz
- Division of Clinical Neuroscience, Max Planck Institute of Experimental Medicine, Göttingen, Germany
| | - Marlene Flögel
- Division of Clinical Neuroscience, Max Planck Institute of Experimental Medicine, Göttingen, Germany
| | - Lothar Adler
- Department of Psychiatry and Psychotherapy, Ecumenical Hospital Hainich, Germany
| | - Josef B Aldenhoff
- Hospital of Psychiatry and Psychotherapy, Center for Integrative Psychiatry, Kiel, Germany
| | - Marianne Becker-Emner
- Karl-Jaspers-Hospital, Psychiatric Federation Oldenburger Land, Bad Zwischenahn, Germany
| | - Thomas Becker
- Department of Psychiatry II, Ulm University, District Hospital Günzburg, Germany
| | - Adelheid Czernik
- Department of Psychiatry and Psychotherapy, Hospital Fulda, Germany
| | - Matthias Dose
- Department of Psychiatry and Psychotherapy, Isar-Amper-Hospital, Taufkirchen (Vils), Germany
| | - Here Folkerts
- Department of Psychiatry and Psychotherapy, Reinhard-Nieter Hospital, Wilhelmshaven, Germany
| | - Roland Freese
- Vitos Hospital of Forensic Psychiatry Eltville, Eltville, Germany
| | - Rolf Günther
- Vitos Hospital of Psychiatry and Psychotherapy Merxhausen, Kassel, Germany
| | - Sabine Herpertz
- Department of Psychiatry and Psychotherapy, University of Rostock, Germany
| | - Dirk Hesse
- Hospital of Forensic Psychiatry, Moringen, Germany
| | - Gunther Kruse
- Hospital of Psychiatry and Psychotherapy Langenhagen, Regional Hospitals Hannover, Germany
| | - Heinrich Kunze
- Vitos Hospital of Psychiatry and Psychotherapy, Bad Emstal-Merxhausen, Germany
| | - Michael Franz
- Vitos Hospital of Psychiatry and Psychotherapy, Bad Emstal-Merxhausen, Germany
| | - Frank Löhrer
- Addiction Hospital "Am Waldsee", Rieden, Germany
| | - Wolfgang Maier
- Department of Psychiatry and Psychotherapy, University Medical Center of Bonn, Germany
| | - Andreas Mielke
- Vitos Hospital of Psychiatry and Psychotherapy Merxhausen, Hofgeismar, Germany
| | | | - Cornelia Oestereich
- Department of Psychiatry and Psychotherapy, Regional Hospitals Hannover, Wunstorf, Germany
| | | | - Thomas Pollmächer
- Department of Psychiatry and Psychotherapy, Hospital Ingolstadt, Germany
| | - Udo Schneider
- Department of Psychiatry and Psychotherapy, Hospital Lübbecke, Germany
| | | | | | - Ursula Havemann-Reinecke
- Department of Psychiatry and Psychotherapy, University Medical Center of Göttingen, Germany,DFG Research Center for Molecular Physiology of the Brain (CMPB), Germany
| | - Jens Frahm
- Biomedical NMR Research GmbH, Max Planck Institute of Biophysical Chemistry, Göttingen, Germany,DFG Research Center for Molecular Physiology of the Brain (CMPB), Germany,Founders of the GRAS Initiative
| | - Walter Stühmer
- Department of Molecular Biology of Neuronal Signals, Max Planck Institute of Experimental Medicine, Göttingen, Germany,DFG Research Center for Molecular Physiology of the Brain (CMPB), Germany,Founders of the GRAS Initiative
| | - Peter Falkai
- Department of Psychiatry and Psychotherapy, University Medical Center of Göttingen, Germany,DFG Research Center for Molecular Physiology of the Brain (CMPB), Germany,Founders of the GRAS Initiative
| | - Nils Brose
- Department of Molecular Neurobiology, Max Planck Institute of Experimental Medicine, Göttingen, Germany,DFG Research Center for Molecular Physiology of the Brain (CMPB), Germany,Founders of the GRAS Initiative
| | - Klaus-Armin Nave
- Department of Neurogenetics, Max Planck Institute of Experimental Medicine, Göttingen, Germany,DFG Research Center for Molecular Physiology of the Brain (CMPB), Germany,Founders of the GRAS Initiative
| | - Hannelore Ehrenreich
- Division of Clinical Neuroscience, Max Planck Institute of Experimental Medicine, Göttingen, Germany,DFG Research Center for Molecular Physiology of the Brain (CMPB), Germany,Founders of the GRAS Initiative
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Langenecker SA, Saunders EFH, Kade AM, Ransom MT, McInnis MG. Intermediate: cognitive phenotypes in bipolar disorder. J Affect Disord 2010; 122:285-93. [PMID: 19800130 PMCID: PMC3773480 DOI: 10.1016/j.jad.2009.08.018] [Citation(s) in RCA: 81] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2009] [Accepted: 08/22/2009] [Indexed: 11/28/2022]
Abstract
BACKGROUND Intermediate cognitive phenotypes (ICPs) are measurable and quantifiable states that may be objectively assessed in a standardized method, and can be integrated into association studies, including genetic, biochemical, clinical, and imaging based correlates. The present study used neuropsychological measures as ICPs, with factor scores in executive functioning, attention, memory, fine motor function, and emotion processing, similar to prior work in schizophrenia. METHODS Healthy control subjects (HC, n=34) and euthymic (E, n=66), depressed (D, n=43), or hypomanic/mixed (HM, n=13) patients with bipolar disorder (BD) were assessed with neuropsychological tests. These were from eight domains consistent with previous literature; auditory memory, visual memory, processing speed with interference resolution, verbal fluency and processing speed, conceptual reasoning and set-shifting, inhibitory control, emotion processing, and fine motor dexterity. RESULTS Of the eight factor scores, the HC group outperformed the E group in three (Processing Speed with Interference Resolution, Visual Memory, Fine Motor Dexterity), the D group in seven (all except Inhibitory Control), and the HM group in four (Inhibitory Control, Processing Speed with Interference Resolution, Fine Motor Dexterity, and Auditory Memory). LIMITATIONS The HM group was relatively small, thus effects of this phase of illness may have been underestimated. Effects of medication could not be fully controlled without a randomized, double-blind, placebo-controlled study. CONCLUSIONS Use of the factor scores can assist in determining ICPs for BD and related disorders, and may provide more specific targets for development of new treatments. We highlight strong ICPs (Processing Speed with Interference Resolution, Visual Memory, Fine Motor Dexterity) for further study, consistent with the existing literature.
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Affiliation(s)
- Scott A Langenecker
- Department of Psychiatry, University of Michigan, Depression Center, Ann Arbor, MI, United States.
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Freyberg Z, Ferrando SJ, Javitch JA. Roles of the Akt/GSK-3 and Wnt signaling pathways in schizophrenia and antipsychotic drug action. Am J Psychiatry 2010; 167:388-96. [PMID: 19917593 PMCID: PMC3245866 DOI: 10.1176/appi.ajp.2009.08121873] [Citation(s) in RCA: 224] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Dopamine D(2) receptor antagonism is a unifying property of all antipsychotic drugs in clinical use. Remarkably, the effector molecules through which these medications exert their actions remain poorly characterized. Increasing attention is being focused on Akt/glycogen synthase kinase-3 (GSK-3) and wingless (Wnt) signaling pathways, which have been associated with schizophrenia in a number of genetic and postmortem studies. Antipsychotic medications may treat symptoms of psychosis, at least in part, through modulation of levels and activity of Akt, GSK-3, and Wnt-related intracellular signaling. The authors review evidence that Akt/GSK-3 and Wnt-related pathways are involved in the pathogenesis of schizophrenia as well as details of intracellular events related to these molecules mediated by both typical and atypical antipsychotic medications. Further study of Akt/GSK-3 and Wnt signaling may ultimately lead to alternative therapeutics of schizophrenia-related disorders.
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Affiliation(s)
- Zachary Freyberg
- Department of Psychiatry, Center for Molecular Recognition, College of Physicians and Surgeons, Columbia University, NY 10032, USA.
| | - Stephen J. Ferrando
- Department of Psychiatry, The New York-Presbyterian Hospital, Weill Medical College of Cornell University, New York, NY, USA,Department of Public Health, The New York-Presbyterian Hospital, Weill Medical College of Cornell University, New York, NY, USA
| | - Jonathan A. Javitch
- Department of Psychiatry, College of Physicians and Surgeons, Columbia University, New York, NY, USA,Department of Pharmacology, College of Physicians and Surgeons, Columbia University, New York, NY, USA,Center for Molecular Recognition, College of Physicians and Surgeons, Columbia University, New York, NY, USA,Division of Molecular Therapeutics, New York State Psychiatric Institute, New York, NY, USA
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9
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Liu YC, Huang CL, Wu PL, Chang YC, Huang CH, Lane HY. Lack of association between AKT1 variances versus clinical manifestations and social function in patients with schizophrenia. J Psychopharmacol 2009; 23:937-43. [PMID: 18635704 DOI: 10.1177/0269881108093840] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The elucidation of genotype-phenotype relationships in psychiatric research is at an early stage. V-akt murine thymoma viral oncogene homolog 1 (AKT1) is a serine/threonine kinase known as protein kinase B. Emerging studies have implicated the role of AKT1 in pathogenesis of schizophrenia; however, the findings have not been consistent. This study aims to examine the association of AKT1 polymorphisms with drug-free and post-treatment symptomatology and social function in patients with schizophrenia. One hundred and twenty newly hospitalised patients with acutely exacerbated schizophrenia who had never been treated by atypical antipsychotics were recruited. They received optimal treatment of risperidone for up to 42 days in the inpatient research unit. Clinical manifestations were monitored by Positive and Negative Syndrome Scale (PANSS) and social function by Nurses' Observation Scale for Inpatients Evaluation (NOSIE). Patients were genotyped for eight AKT1 Single Nucleotide Polymorphism (SNPs), which have been previously investigated for association with schizophrenia. At drug-free status and after best possible treatment of risperidone, genotypes of each SNP did not influence performances in NOSIE, PANSS-total, -positive, -negative and -general psychopathology profiles. These results suggest that AKT1 does not play a significant role in clinical and functional manifestations in patients with schizophrenia who receive risperidone treatment. Future research should also focus on the relationships between genotypes of other susceptibility genes and phenotypes or functional outcomes of schizophrenia.
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Affiliation(s)
- Y C Liu
- Department of Psychiatry, Shinyin Hospital, Department of Health, Executive Yuan, Tainan, Taiwan
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Pietiläinen OP, Paunio T, Loukola A, Tuulio-Henriksson A, Kieseppä T, Thompson P, Toga AW, van Erp TG, Silventoinen K, Soronen P, Hennah W, Turunen JA, Wedenoja J, Palo OM, Silander K, Lönnqvist J, Kaprio J, Cannon TD, Peltonen L. Association of AKT1 with verbal learning, verbal memory, and regional cortical gray matter density in twins. Am J Med Genet B Neuropsychiatr Genet 2009; 150B:683-92. [PMID: 19051289 PMCID: PMC2708342 DOI: 10.1002/ajmg.b.30890] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
AKT1, encoding the protein kinase B, has been associated with the genetic etiology of schizophrenia and bipolar disorder. However, minuscule data exist on the role of different alleles of AKT1 in measurable quantitative endophenotypes, such as cognitive abilities and neuroanatomical features, showing deviations in schizophrenia and bipolar disorder. We evaluated the contribution of AKT1 to quantitative cognitive traits and 3D high-resolution neuroanatomical images in a Finnish twin sample consisting of 298 twins: 61 pairs with schizophrenia (8 concordant), 31 pairs with bipolar disorder (5 concordant) and 65 control pairs matched for age, sex and demographics. An AKT1 allele defined by the SNP rs1130214 located in the UTR of the gene revealed association with cognitive traits related to verbal learning and memory (P = 0.0005 for a composite index). This association was further fortified by a higher degree of resemblance of verbal memory capacity in pairs sharing the rs1130214 genotype compared to pairs not sharing the genotype. Furthermore, the same allele was also associated with decreased gray matter density in medial and dorsolateral prefrontal cortex (P < 0.05). Our findings support the role of AKT1 in the genetic background of cognitive and anatomical features, known to be affected by psychotic disorders. The established association of the same allelic variant of AKT1 with both cognitive and neuroanatomical aberrations could suggest that AKT1 exerts its effect on verbal learning and memory via neural networks involving prefrontal cortex.
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Affiliation(s)
- Olli P.H. Pietiläinen
- FIMM, Institute for Molecular Medicine Finland and National Public Health Institute, Biomedicum, Helsinki, Finland
- Department of Medical Genetics, University of Helsinki, Helsinki, Finland
| | - Tiina Paunio
- FIMM, Institute for Molecular Medicine Finland and National Public Health Institute, Biomedicum, Helsinki, Finland
- Department of Psychiatry, University of Helsinki and Helsinki University Central Hospital, Helsinki, Finland
| | - Anu Loukola
- FIMM, Institute for Molecular Medicine Finland and National Public Health Institute, Biomedicum, Helsinki, Finland
| | - Annamari Tuulio-Henriksson
- Department of Mental Health and Alcohol Research, National Public Health Institute, Helsinki, Finland
- Department of Psychology, University of Helsinki, Helsinki, Finland
| | - Tuula Kieseppä
- Department of Mental Health and Alcohol Research, National Public Health Institute, Helsinki, Finland
- Department of Psychology, University of Helsinki, Helsinki, Finland
| | - Paul Thompson
- Department of Neurology, UCLA, Los Angeles, California
| | | | | | | | - Pia Soronen
- FIMM, Institute for Molecular Medicine Finland and National Public Health Institute, Biomedicum, Helsinki, Finland
- Department of Medical Genetics, University of Helsinki, Helsinki, Finland
| | - William Hennah
- FIMM, Institute for Molecular Medicine Finland and National Public Health Institute, Biomedicum, Helsinki, Finland
| | - Joni A. Turunen
- FIMM, Institute for Molecular Medicine Finland and National Public Health Institute, Biomedicum, Helsinki, Finland
- Department of Medical Genetics, University of Helsinki, Helsinki, Finland
| | - Juho Wedenoja
- FIMM, Institute for Molecular Medicine Finland and National Public Health Institute, Biomedicum, Helsinki, Finland
- Department of Medical Genetics, University of Helsinki, Helsinki, Finland
| | - Outi M. Palo
- FIMM, Institute for Molecular Medicine Finland and National Public Health Institute, Biomedicum, Helsinki, Finland
- Department of Medical Genetics, University of Helsinki, Helsinki, Finland
| | - Kaisa Silander
- FIMM, Institute for Molecular Medicine Finland and National Public Health Institute, Biomedicum, Helsinki, Finland
| | - Jouko Lönnqvist
- Department of Psychiatry, University of Helsinki and Helsinki University Central Hospital, Helsinki, Finland
- Department of Mental Health and Alcohol Research, National Public Health Institute, Helsinki, Finland
| | - Jaakko Kaprio
- Department of Mental Health and Alcohol Research, National Public Health Institute, Helsinki, Finland
- Department of Public Health, University of Helsinki, Helsinki, Finland
| | - Tyrone D. Cannon
- Department of Psychology, UCLA, Los Angeles, California
- Department of Psychiatry and Biobehavioral Sciences, UCLA, Los Angeles, California
| | - Leena Peltonen
- FIMM, Institute for Molecular Medicine Finland and National Public Health Institute, Biomedicum, Helsinki, Finland
- Department of Medical Genetics, University of Helsinki, Helsinki, Finland
- The Broad Institute of MIT and Harvard University, Boston, Massachusetts
- Welcome Trust Sanger Institute, Hinxton, Cambridge, UK
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Need AC, Keefe RSE, Ge D, Grossman I, Dickson S, McEvoy JP, Goldstein DB. Pharmacogenetics of antipsychotic response in the CATIE trial: a candidate gene analysis. Eur J Hum Genet 2009; 17:946-57. [PMID: 19156168 DOI: 10.1038/ejhg.2008.264] [Citation(s) in RCA: 82] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
Abstract
The Clinical Antipsychotic Trials of Intervention Effectiveness (CATIE) Phase 1 Schizophrenia trial compared the effectiveness of one typical and four atypical antipsychotic medications. Although trials such as CATIE present important opportunities for pharmacogenetics research, the very richness of the clinical data presents challenges for statistical interpretation, and in particular the risk that data mining will lead to false-positive discoveries. For this reason, it is both misleading and unhelpful to perpetuate the current practice of reporting association results for these trials one gene at a time, ignoring the fact that multiple gene-by-phenotype tests are being carried out on the same data set. On the other hand, suggestive associations in such trials may lead to new hypotheses that can be tested through both replication efforts and biological experimentation. The appropriate handling of these forms of data therefore requires dissemination of association statistics without undue emphasis on select findings. Here we attempt to illustrate this approach by presenting association statistics for 2769 polymorphisms in 118 candidate genes evaluated for 21 pharmacogenetic phenotypes. On current evidence it is impossible to know which of these associations may be real, although in total they form a valuable resource that is immediately available to the scientific community.
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Affiliation(s)
- Anna C Need
- Center for Human Genome Variation, Institute for Genome Sciences & Policy, Duke University, Durham, NC 27708, USA
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