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Blackman G, Kempton MJ, McGuire P. Concerns Regarding Strength of Conclusions in Systematic Review and Meta-Analysis of Neuroradiological Abnormalities in First-Episode Psychosis-Reply. JAMA Psychiatry 2024; 81:109. [PMID: 37966847 DOI: 10.1001/jamapsychiatry.2023.4399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2023]
Affiliation(s)
- Graham Blackman
- Department of Psychiatry, University of Oxford, Warneford Hospital, Oxford, United Kingdom
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Matthew J Kempton
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Philip McGuire
- Department of Psychiatry, University of Oxford, Warneford Hospital, Oxford, United Kingdom
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
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2
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Geenjaar EP, Lewis NL, Fedorov A, Wu L, Ford JM, Preda A, Plis SM, Calhoun VD. Chromatic fusion: Generative multimodal neuroimaging data fusion provides multi-informed insights into schizophrenia. Hum Brain Mapp 2023; 44:5828-5845. [PMID: 37753705 PMCID: PMC10619380 DOI: 10.1002/hbm.26479] [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: 03/09/2023] [Revised: 08/04/2023] [Accepted: 08/24/2023] [Indexed: 09/28/2023] Open
Abstract
This work proposes a novel generative multimodal approach to jointly analyze multimodal data while linking the multimodal information to colors. We apply our proposed framework, which disentangles multimodal data into private and shared sets of features from pairs of structural (sMRI), functional (sFNC and ICA), and diffusion MRI data (FA maps). With our approach, we find that heterogeneity in schizophrenia is potentially a function of modality pairs. Results show (1) schizophrenia is highly multimodal and includes changes in specific networks, (2) non-linear relationships with schizophrenia are observed when interpolating among shared latent dimensions, and (3) we observe a decrease in the modularity of functional connectivity and decreased visual-sensorimotor connectivity for schizophrenia patients for the FA-sFNC and sMRI-sFNC modality pairs, respectively. Additionally, our results generally indicate decreased fractional corpus callosum anisotropy, and decreased spatial ICA map and voxel-based morphometry strength in the superior frontal lobe as found in the FA-sFNC, sMRI-FA, and sMRI-ICA modality pair clusters. In sum, we introduce a powerful new multimodal neuroimaging framework designed to provide a rich and intuitive understanding of the data which we hope challenges the reader to think differently about how modalities interact.
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Affiliation(s)
- Eloy P.T. Geenjaar
- School of Electrical and Computer EngineeringGeorgia Institute of TechnologyAtlantaGeorgiaUSA
- Tri‐Institutional Center for Translational Research in Neuroimaging and Data Science (TReNDS), Georgia State, Georgia Tech, EmoryAtlantaGeorgiaUSA
| | - Noah L. Lewis
- Tri‐Institutional Center for Translational Research in Neuroimaging and Data Science (TReNDS), Georgia State, Georgia Tech, EmoryAtlantaGeorgiaUSA
- School of Computational Science and EngineeringGeorgia Institute of TechnologyAtlantaGeorgiaUSA
| | - Alex Fedorov
- School of Electrical and Computer EngineeringGeorgia Institute of TechnologyAtlantaGeorgiaUSA
- Tri‐Institutional Center for Translational Research in Neuroimaging and Data Science (TReNDS), Georgia State, Georgia Tech, EmoryAtlantaGeorgiaUSA
| | - Lei Wu
- Tri‐Institutional Center for Translational Research in Neuroimaging and Data Science (TReNDS), Georgia State, Georgia Tech, EmoryAtlantaGeorgiaUSA
| | - Judith M. Ford
- San Francisco Veterans Affairs Medical CenterSan FranciscoCaliforniaUSA
- Department of Psychiatry and Behavioral SciencesUniversity of California San FranciscoSan FranciscoCaliforniaUSA
| | - Adrian Preda
- Department of Psychiatry and Human BehaviorUniversity of California IrvineIrvineCaliforniaUSA
| | - Sergey M. Plis
- Tri‐Institutional Center for Translational Research in Neuroimaging and Data Science (TReNDS), Georgia State, Georgia Tech, EmoryAtlantaGeorgiaUSA
- Department of Computer ScienceGeorgia State UniversityAtlantaGeorgiaUSA
| | - Vince D. Calhoun
- School of Electrical and Computer EngineeringGeorgia Institute of TechnologyAtlantaGeorgiaUSA
- Tri‐Institutional Center for Translational Research in Neuroimaging and Data Science (TReNDS), Georgia State, Georgia Tech, EmoryAtlantaGeorgiaUSA
- School of Computational Science and EngineeringGeorgia Institute of TechnologyAtlantaGeorgiaUSA
- Department of Computer ScienceGeorgia State UniversityAtlantaGeorgiaUSA
- Department of PsychologyGeorgia State UniversityAtlantaGeorgiaUSA
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3
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Dissaux N, Neyme P, Kim-Dufor DH, Lavenne-Collot N, Marsh JJ, Berrouiguet S, Walter M, Lemey C. Psychosis Caused by a Somatic Condition: How to Make the Diagnosis? A Systematic Literature Review. CHILDREN (BASEL, SWITZERLAND) 2023; 10:1439. [PMID: 37761400 PMCID: PMC10529854 DOI: 10.3390/children10091439] [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] [Revised: 08/14/2023] [Accepted: 08/18/2023] [Indexed: 09/29/2023]
Abstract
BACKGROUND First episode of psychosis (FEP) is a clinical condition that usually occurs during adolescence or early adulthood and is often a sign of a future psychiatric disease. However, these symptoms are not specific, and psychosis can be caused by a physical disease in at least 5% of cases. Timely detection of these diseases, the first signs of which may appear in childhood, is of particular importance, as a curable treatment exists in most cases. However, there is no consensus in academic societies to offer recommendations for a comprehensive medical assessment to eliminate somatic causes. METHODS We conducted a systematic literature search using a two-fold research strategy to: (1) identify physical diseases that can be differentially diagnosed for psychosis; and (2) determine the paraclinical exams allowing us to exclude these pathologies. RESULTS We identified 85 articles describing the autoimmune, metabolic, neurologic, infectious, and genetic differential diagnoses of psychosis. Clinical presentations are described, and a complete list of laboratory and imaging features required to identify and confirm these diseases is provided. CONCLUSION This systematic review shows that most differential diagnoses of psychosis should be considered in the case of a FEP and could be identified by providing a systematic checkup with a laboratory test that includes ammonemia, antinuclear and anti-NMDA antibodies, and HIV testing; brain magnetic resonance imaging and lumbar puncture should be considered according to the clinical presentation. Genetic research could be of interest to patients presenting with physical or developmental symptoms associated with psychiatric manifestations.
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Affiliation(s)
- Nolwenn Dissaux
- Centre Hospitalier Régional et Universitaire de Brest, 2 Avenue Foch, 29200 Brest, France
- Unité de Recherche EA 7479 SPURBO, Université de Bretagne Occidentale, 29200 Brest, France
| | - Pierre Neyme
- Fondation du Bon Sauveur d’Alby, 30 Avenue du Colonel Teyssier, 81000 Albi, France
| | - Deok-Hee Kim-Dufor
- Centre Hospitalier Régional et Universitaire de Brest, 2 Avenue Foch, 29200 Brest, France
| | - Nathalie Lavenne-Collot
- Centre Hospitalier Régional et Universitaire de Brest, 2 Avenue Foch, 29200 Brest, France
- Laboratoire du Traitement de l’Information Médicale, Inserm U1101, 29200 Brest, France
| | - Jonathan J. Marsh
- Graduate School of Social Service, Fordham University, 113 West 60th Street, New York, NY 10023, USA
| | - Sofian Berrouiguet
- Centre Hospitalier Régional et Universitaire de Brest, 2 Avenue Foch, 29200 Brest, France
- Unité de Recherche EA 7479 SPURBO, Université de Bretagne Occidentale, 29200 Brest, France
| | - Michel Walter
- Centre Hospitalier Régional et Universitaire de Brest, 2 Avenue Foch, 29200 Brest, France
- Unité de Recherche EA 7479 SPURBO, Université de Bretagne Occidentale, 29200 Brest, France
| | - Christophe Lemey
- Centre Hospitalier Régional et Universitaire de Brest, 2 Avenue Foch, 29200 Brest, France
- Unité de Recherche EA 7479 SPURBO, Université de Bretagne Occidentale, 29200 Brest, France
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4
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Geenjaar EPT, Lewis NL, Fedorov A, Wu L, Ford JM, Preda A, Plis SM, Calhoun VD. Chromatic fusion: generative multimodal neuroimaging data fusion provides multi-informed insights into schizophrenia. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2023:2023.05.18.23290184. [PMID: 37292973 PMCID: PMC10246163 DOI: 10.1101/2023.05.18.23290184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
This work proposes a novel generative multimodal approach to jointly analyze multimodal data while linking the multimodal information to colors. By linking colors to private and shared information from modalities, we introduce chromatic fusion, a framework that allows for intuitively interpreting multimodal data. We test our framework on structural, functional, and diffusion modality pairs. In this framework, we use a multimodal variational autoencoder to learn separate latent subspaces; a private space for each modality, and a shared space between both modalities. These subspaces are then used to cluster subjects, and colored based on their distance from the variational prior, to obtain meta-chromatic patterns (MCPs). Each subspace corresponds to a different color, red is the private space of the first modality, green is the shared space, and blue is the private space of the second modality. We further analyze the most schizophrenia-enriched MCPs for each modality pair and find that distinct schizophrenia subgroups are captured by schizophrenia-enriched MCPs for different modality pairs, emphasizing schizophrenia's heterogeneity. For the FA-sFNC, sMRI-ICA, and sMRI-ICA MCPs, we generally find decreased fractional corpus callosum anisotropy and decreased spatial ICA map and voxel-based morphometry strength in the superior frontal lobe for schizophrenia patients. To additionally highlight the importance of the shared space between modalities, we perform a robustness analysis of the latent dimensions in the shared space across folds. These robust latent dimensions are subsequently correlated with schizophrenia to reveal that for each modality pair, multiple shared latent dimensions strongly correlate with schizophrenia. In particular, for FA-sFNC and sMRI-sFNC shared latent dimensions, we respectively observe a reduction in the modularity of the functional connectivity and a decrease in visual-sensorimotor connectivity for schizophrenia patients. The reduction in modularity couples with increased fractional anisotropy in the left part of the cerebellum dorsally. The reduction in the visual-sensorimotor connectivity couples with a reduction in the voxel-based morphometry generally but increased dorsal cerebellum voxel-based morphometry. Since the modalities are trained jointly, we can also use the shared space to try and reconstruct one modality from the other. We show that cross-reconstruction is possible with our network and is generally much better than depending on the variational prior. In sum, we introduce a powerful new multimodal neuroimaging framework designed to provide a rich and intuitive understanding of the data that we hope challenges the reader to think differently about how modalities interact.
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Affiliation(s)
- Eloy P T Geenjaar
- School of Electrical and Computer Engineering, Georgia Institute of Technology, Atlanta, GA, USA
- Tri-Institutional Center for Translational Research in Neuroimaging and Data Science (TReNDS), Georgia State, Georgia Tech, Emory, Atlanta, GA, 30303, USA
| | - Noah L Lewis
- Tri-Institutional Center for Translational Research in Neuroimaging and Data Science (TReNDS), Georgia State, Georgia Tech, Emory, Atlanta, GA, 30303, USA
- School of Computational Science and Engineering, Georgia Institute of Technology, Atlanta, GA, USA
| | - Alex Fedorov
- School of Electrical and Computer Engineering, Georgia Institute of Technology, Atlanta, GA, USA
- Tri-Institutional Center for Translational Research in Neuroimaging and Data Science (TReNDS), Georgia State, Georgia Tech, Emory, Atlanta, GA, 30303, USA
| | - Lei Wu
- Tri-Institutional Center for Translational Research in Neuroimaging and Data Science (TReNDS), Georgia State, Georgia Tech, Emory, Atlanta, GA, 30303, USA
| | - Judith M Ford
- San Francisco Veterans Affairs Medical Center, San Francisco, CA, USA
- Department of Psychiatry and Behavioral Sciences, University of California San Francisco, San Francisco, CA, USA
| | - Adrian Preda
- Department of Psychiatry and Human Behavior, University of California Irvine, Irvine, CA, USA
| | - Sergey M Plis
- Tri-Institutional Center for Translational Research in Neuroimaging and Data Science (TReNDS), Georgia State, Georgia Tech, Emory, Atlanta, GA, 30303, USA
- Dept. of Computer Science, Georgia State University, Atlanta, GA, USA
| | - Vince D Calhoun
- School of Electrical and Computer Engineering, Georgia Institute of Technology, Atlanta, GA, USA
- Tri-Institutional Center for Translational Research in Neuroimaging and Data Science (TReNDS), Georgia State, Georgia Tech, Emory, Atlanta, GA, 30303, USA
- School of Computational Science and Engineering, Georgia Institute of Technology, Atlanta, GA, USA
- Dept. of Computer Science, Georgia State University, Atlanta, GA, USA
- Dept. of Psychology, Georgia State University, Atlanta, GA, USA
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5
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Bellani M, Perlini C, Zovetti N, Rossetti MG, Alessandrini F, Barillari M, Ricciardi GK, Konze A, Sberna M, Zoccatelli G, Lasalvia A, Miceli M, Neri G, Torresani S, Mazzi F, Scocco P, D'Agostino A, Imbesi M, Veronese A, Ruggeri M, Brambilla P. Incidental findings on brain MRI in patients with first-episode and chronic psychosis. Psychiatry Res Neuroimaging 2022; 326:111518. [PMID: 36037703 DOI: 10.1016/j.pscychresns.2022.111518] [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: 02/02/2022] [Revised: 07/19/2022] [Accepted: 07/21/2022] [Indexed: 11/30/2022]
Abstract
Brain incidental findings (IFs) are unexpected brain abnormalities detected by a structural magnetic resonance (MRI) examination. We conducted a study to assess whether brain IFs are associated with first-episode psychosis (FEP) and chronic psychosis (affective vs. non-affective) compared to healthy controls (HC). Chi-squared analyses were run to compare the frequency of several IFs across groups. Logistic regression analyses were run to explore the association between group and IFs, accounting for sex, age, MRI field strength. We observed a higher frequency of most IFs in both FEP and chronic psychosis groups compared to HC, however most of the chi-squared tests did not reach significance. Patients with FEP and chronic psychosis were 3-4 times more likely to show deep white matter hyperintensities (WMH) than HC. Patients with FEP and affective chronic psychosis were 3-4 times more likely to show ventricular asymmetries than HC. All chronic patients were more likely to show periventricular WMH, liquoral spaces enlargements and ventricular system enlargements respectively. Our results suggest that deep WMH and ventricular asymmetries are associated with both the early and the chronic stages of psychosis, thus representing potential vulnerability factors already present before the onset of the symptoms, possibly due to neurodevelopmental insults.
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Affiliation(s)
- Marcella Bellani
- Department of Neurosciences, Biomedicine and Movement Sciences, Section of Psychiatry, University of Verona, AOUI Verona, Verona, Italy.
| | - Cinzia Perlini
- Department of Neurosciences, Biomedicine and Movement Sciences, Section of Clinical Psychology, University of Verona, Verona, Italy
| | - Niccolò Zovetti
- Department of Neurosciences, Biomedicine and Movement Sciences, Section of Psychiatry, University of Verona, AOUI Verona, Verona, Italy
| | - Maria Gloria Rossetti
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Franco Alessandrini
- Neuroradiology Department, Azienda Ospedaliera Universitaria Integrata di Verona, Verona, Italy
| | - Marco Barillari
- Department of Diagnostics and Public Health, University of Verona, Verona, Italy
| | | | - Angela Konze
- Department of Radiology, Azienda USL Toscana Centro, Florence, Italy
| | - Maurizio Sberna
- Department of Neuroradiology, Niguarda Hospital, Milan, Italy
| | - Giada Zoccatelli
- Neuroradiology Department, Azienda Ospedaliera Universitaria Integrata di Verona, Verona, Italy
| | - Antonio Lasalvia
- Department of Neurosciences, Biomedicine and Movement Sciences, Section of Psychiatry, University of Verona, AOUI Verona, Verona, Italy
| | - Maurizio Miceli
- Department of Mental Health and Addiction, Azienda Sanitaria Toscana Centro, Firenze, Italy
| | - Giovanni Neri
- Agenzia Sanitaria e Sociale Regionale, Regione Emilia Romagna, Verona, Italy
| | - Stefano Torresani
- Department of Mental Health, District of Bolzano, Health Service of South Tyrol, Italy
| | | | - Paolo Scocco
- Department of Mental Health, AULSS 6 Euganea, Padua, Italy
| | - Armando D'Agostino
- Department of Health Sciences, Università degli Studi di Milano, Milan, Italy
| | | | | | - Mirella Ruggeri
- Department of Neurosciences, Biomedicine and Movement Sciences, Section of Psychiatry, University of Verona, AOUI Verona, Verona, Italy
| | - Paolo Brambilla
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy; Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
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6
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Rahman MM, Islam MR, Islam MT, Harun-Or-Rashid M, Islam M, Abdullah S, Uddin MB, Das S, Rahaman MS, Ahmed M, Alhumaydhi FA, Emran TB, Mohamed AAR, Faruque MRI, Khandaker MU, Mostafa-Hedeab G. Stem Cell Transplantation Therapy and Neurological Disorders: Current Status and Future Perspectives. BIOLOGY 2022; 11:147. [PMID: 35053145 PMCID: PMC8772847 DOI: 10.3390/biology11010147] [Citation(s) in RCA: 30] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Revised: 12/26/2021] [Accepted: 12/29/2021] [Indexed: 02/07/2023]
Abstract
Neurodegenerative diseases are a global health issue with inadequate therapeutic options and an inability to restore the damaged nervous system. With advances in technology, health scientists continue to identify new approaches to the treatment of neurodegenerative diseases. Lost or injured neurons and glial cells can lead to the development of several neurological diseases, including Parkinson's disease, stroke, and multiple sclerosis. In recent years, neurons and glial cells have successfully been generated from stem cells in the laboratory utilizing cell culture technologies, fueling efforts to develop stem cell-based transplantation therapies for human patients. When a stem cell divides, each new cell has the potential to either remain a stem cell or differentiate into a germ cell with specialized characteristics, such as muscle cells, red blood cells, or brain cells. Although several obstacles remain before stem cells can be used for clinical applications, including some potential disadvantages that must be overcome, this cellular development represents a potential pathway through which patients may eventually achieve the ability to live more normal lives. In this review, we summarize the stem cell-based therapies that have been explored for various neurological disorders, discuss the potential advantages and drawbacks of these therapies, and examine future directions for this field.
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Affiliation(s)
- Mohammad Mominur Rahman
- Department of Pharmacy, Faculty of Allied Health Sciences, Daffodil International University, Dhaka 1207, Bangladesh; (M.M.R.); (M.R.I.); (M.T.I.); (M.H.-O.-R.); (M.I.); (M.B.U.); (S.D.); (M.S.R.); (M.A.)
| | - Mohammad Rezaul Islam
- Department of Pharmacy, Faculty of Allied Health Sciences, Daffodil International University, Dhaka 1207, Bangladesh; (M.M.R.); (M.R.I.); (M.T.I.); (M.H.-O.-R.); (M.I.); (M.B.U.); (S.D.); (M.S.R.); (M.A.)
| | - Mohammad Touhidul Islam
- Department of Pharmacy, Faculty of Allied Health Sciences, Daffodil International University, Dhaka 1207, Bangladesh; (M.M.R.); (M.R.I.); (M.T.I.); (M.H.-O.-R.); (M.I.); (M.B.U.); (S.D.); (M.S.R.); (M.A.)
| | - Mohammad Harun-Or-Rashid
- Department of Pharmacy, Faculty of Allied Health Sciences, Daffodil International University, Dhaka 1207, Bangladesh; (M.M.R.); (M.R.I.); (M.T.I.); (M.H.-O.-R.); (M.I.); (M.B.U.); (S.D.); (M.S.R.); (M.A.)
| | - Mahfuzul Islam
- Department of Pharmacy, Faculty of Allied Health Sciences, Daffodil International University, Dhaka 1207, Bangladesh; (M.M.R.); (M.R.I.); (M.T.I.); (M.H.-O.-R.); (M.I.); (M.B.U.); (S.D.); (M.S.R.); (M.A.)
| | - Sabirin Abdullah
- Space Science Center, Universiti Kebangsaan Malaysia, Bangi 43600, Selangor, Malaysia;
| | - Mohammad Borhan Uddin
- Department of Pharmacy, Faculty of Allied Health Sciences, Daffodil International University, Dhaka 1207, Bangladesh; (M.M.R.); (M.R.I.); (M.T.I.); (M.H.-O.-R.); (M.I.); (M.B.U.); (S.D.); (M.S.R.); (M.A.)
| | - Sumit Das
- Department of Pharmacy, Faculty of Allied Health Sciences, Daffodil International University, Dhaka 1207, Bangladesh; (M.M.R.); (M.R.I.); (M.T.I.); (M.H.-O.-R.); (M.I.); (M.B.U.); (S.D.); (M.S.R.); (M.A.)
| | - Mohammad Saidur Rahaman
- Department of Pharmacy, Faculty of Allied Health Sciences, Daffodil International University, Dhaka 1207, Bangladesh; (M.M.R.); (M.R.I.); (M.T.I.); (M.H.-O.-R.); (M.I.); (M.B.U.); (S.D.); (M.S.R.); (M.A.)
| | - Muniruddin Ahmed
- Department of Pharmacy, Faculty of Allied Health Sciences, Daffodil International University, Dhaka 1207, Bangladesh; (M.M.R.); (M.R.I.); (M.T.I.); (M.H.-O.-R.); (M.I.); (M.B.U.); (S.D.); (M.S.R.); (M.A.)
| | - Fahad A. Alhumaydhi
- Department of Medical Laboratories, College of Applied Medical Sciences, Qassim University, Buraydah 52571, Saudi Arabia;
| | - Talha Bin Emran
- Department of Pharmacy, BGC Trust University Bangladesh, Chittagong 4381, Bangladesh
| | | | | | - Mayeen Uddin Khandaker
- Centre for Applied Physics and Radiation Technologies, School of Engineering and Technology, Sunway University, Bandar Sunway 47500, Selangor, Malaysia;
| | - Gomaa Mostafa-Hedeab
- Pharmacology Department & Health Sciences Research Unit, Medical College, Jouf University, Sakaka 72446, Saudi Arabia;
- Pharmacology Department, Faculty of Medicine, Beni-Suef University, Beni-Suef 62521, Egypt
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7
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Abstract
Niemann-Pick disease type C (NP-C) is a severe neurovisceral lipid storage disease that results in the accumulation of unesterified cholesterol in lysosomes or endosomes. The clinical presentations of NP-C are variable which include visceral symptoms, neurologic symptoms and psychiatric symptoms. Psychosis is the most common psychiatric manifestation of NP-C and is indistinguishable from a typical psychosis presentation of schizophrenia. The common psychotic presentations in NP-C include visual hallucinations, delusions, auditory hallucinations and thought disorders. Psychosis symptoms are more common in adult or adolescent-onset forms compared with pediatric-onset forms. The underlying pathophysiology of psychosis in NP-C is most probably due to dysconnectivity particularly between frontotemporal connectivity and subcortical structures. NP-C sometimes is mistaken for schizophrenia which causes delay in treatment due to lack of awareness and literature review. This review aims to summarize the relevant case reports on psychosis symptoms in NP-C and discuss the genetics and pathophysiology underlying the condition.
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Affiliation(s)
- Leong Tung Ong
- Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
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8
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Filley CM. White Matter Disease and Psychiatric Dysfunction: Clinical and Neurobiological Insights. J Neuropsychiatry Clin Neurosci 2021; 33:178-179. [PMID: 33951920 DOI: 10.1176/appi.neuropsych.21010018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Christopher M Filley
- Director, Behavioral Neurology Section, Professor of Neurology and Psychiatry, University of Colorado School of Medicine, and Senior Scientific Advisor, Marcus Institute for Brain Health, University of Colorado-Anschutz Medical Campus, Aurora, Colo
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9
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Abstract
Schizophrenia is a severe and clinically heterogenous mental disorder
affecting approximately 1% of the population worldwide. Despite
tremendous achievements in the field of schizophrenia research, its
precise aetiology remains elusive. Besides dysfunctional neuronal
signalling, the pathophysiology of schizophrenia appears to involve
molecular and functional abnormalities in glial cells, including
astrocytes. This article provides a concise overview of the current
evidence supporting altered astrocyte activity in schizophrenia, which
ranges from findings obtained from post-mortem immunohistochemical
analyses, genetic association studies and transcriptomic
investigations, as well as from experimental investigations of
astrocyte functions in animal models. Integrating the existing data
from these research areas strongly suggests that astrocytes have the
capacity to critically affect key neurodevelopmental and homeostatic
processes pertaining to schizophrenia pathogenesis, including
glutamatergic signalling, synaptogenesis, synaptic pruning and
myelination. The further elucidation of astrocytes functions in health
and disease may, therefore, offer new insights into how these glial
cells contribute to abnormal brain development and functioning
underlying this debilitating mental disorder.
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Affiliation(s)
- Tina Notter
- Tina Notter, Institute of
Pharmacology and Toxicology, University of Zurich-Vetsuisse, Zurich,
Switzerland. Emails: ;
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10
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Dietz AG, Goldman SA, Nedergaard M. Glial cells in schizophrenia: a unified hypothesis. Lancet Psychiatry 2020; 7:272-281. [PMID: 31704113 PMCID: PMC7267935 DOI: 10.1016/s2215-0366(19)30302-5] [Citation(s) in RCA: 121] [Impact Index Per Article: 30.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2019] [Revised: 07/23/2019] [Accepted: 07/24/2019] [Indexed: 12/11/2022]
Abstract
The cellular neurobiology of schizophrenia remains poorly understood. We discuss neuroimaging studies, pathological findings, and experimental work supporting the idea that glial cells might contribute to the development of schizophrenia. Experimental studies suggest that abnormalities in the differentiation competence of glial progenitor cells lead to failure in the morphological and functional maturation of oligodendrocytes and astrocytes. We propose that immune activation of microglial cells during development, superimposed upon genetic risk factors, could contribute to defective differentiation competence of glial progenitor cells. The resulting hypomyelination and disrupted white matter integrity might contribute to transmission desynchronisation and dysconnectivity, whereas the failure of astrocytic differentiation results in abnormal glial coverage and support of synapses. The delayed and deficient maturation of astrocytes might, in parallel, lead to disruption of glutamatergic, potassium, and neuromodulatory homoeostasis, resulting in dysregulated synaptic transmission. By highlighting a role for glial cells in schizophrenia, these studies potentially point to new mechanisms for disease modification.
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Affiliation(s)
- Andrea G Dietz
- Center for Translational Neuromedicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Steven A Goldman
- Center for Translational Neuromedicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark; Center for Translational Neuromedicine, University of Rochester Medical Center, Rochester, NY, USA.
| | - Maiken Nedergaard
- Center for Translational Neuromedicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark; Center for Translational Neuromedicine, University of Rochester Medical Center, Rochester, NY, USA
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11
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Psychiatric and Cognitive Symptoms Associated with Niemann-Pick Type C Disease: Neurobiology and Management. CNS Drugs 2019; 33:125-142. [PMID: 30632019 DOI: 10.1007/s40263-018-0599-0] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Niemann-Pick disease type C (NPC) is a lysosomal storage disorder that presents with a spectrum of clinical manifestations from infancy and childhood or in early or mid-adulthood. Progressive neurological symptoms including ataxia, dystonia and vertical gaze palsy are a hallmark of the disease, and psychiatric symptoms such as psychosis and mood disorders are common. These latter symptoms often present early in the course of NPC and thus these patients are often diagnosed with a major psychotic or affective disorder before neurological and cognitive signs present and the diagnosis is revised. The commonalities and characteristics of psychotic symptoms in both NPC and schizophrenia may share neuronal pathways and mechanisms and provide potential targets for research in both disorders. The neurobiology of NPC and its relationship to the pattern of neuropsychiatric and cognitive symptoms is described in this review. A number of neurobiological models are proposed as mechanisms by which NPC causes psychiatric and cognitive symptoms, informed from models proposed in schizophrenia and other metabolic disorders. There are a number of symptomatic and illness-modifying treatments for NPC currently available. The current evidence is discussed; focussing on two medications which have shown promise, miglustat and hydroxypropyl-β-cyclodextrin.
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12
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Chen X, Duan H, Xiao L, Gan J. Genetic and Epigenetic Alterations Underlie Oligodendroglia Susceptibility and White Matter Etiology in Psychiatric Disorders. Front Genet 2018; 9:565. [PMID: 30524471 PMCID: PMC6262033 DOI: 10.3389/fgene.2018.00565] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2018] [Accepted: 11/06/2018] [Indexed: 12/19/2022] Open
Abstract
Numerous genetic risk loci are found to associate with major neuropsychiatric disorders represented by schizophrenia. The pathogenic roles of genetic risk loci in psychiatric diseases are further complicated by the association with cell lineage- and/or developmental stage-specific epigenetic alterations. Besides aberrant assembly and malfunction of neuronal circuitry, an increasing volume of discoveries clearly demonstrate impairment of oligodendroglia and disruption of white matter integrity in psychiatric diseases. Nonetheless, whether and how genetic risk factors and epigenetic dysregulations for neuronal susceptibility may affect oligodendroglia is largely unknown. In this mini-review, we will discuss emerging evidence regarding the functional interplay between genetic risk loci and epigenetic factors, which may underlie compromised oligodendroglia and myelin development in neuropsychiatric disorders. Transcriptional and epigenetic factors are the major aspects affected in oligodendroglia. Moreover, multiple disease susceptibility genes are connected by epigenetically modulated transcriptional and post-transcriptional mechanisms. Oligodendroglia specific complex molecular orchestra may explain how distinct risk factors lead to the common clinical expression of white matter pathology of neuropsychiatric disorders.
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Affiliation(s)
- Xianjun Chen
- Department of Psychiatry, Mental Diseases Prevention and Treatment Institute of PLA, PLA 91st Central Hospital, Jiaozuo, China
| | - Huifeng Duan
- Department of Psychiatry, Mental Diseases Prevention and Treatment Institute of PLA, PLA 91st Central Hospital, Jiaozuo, China
| | - Lan Xiao
- Department of Histology and Embryology, Chongqing Key Laboratory of Neurobiology, Army Medical University (Third Military Medical University), Chongqing, China
| | - Jingli Gan
- Department of Psychiatry, Mental Diseases Prevention and Treatment Institute of PLA, PLA 91st Central Hospital, Jiaozuo, China
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13
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Trakadis YJ, Fulginiti V, Walterfang M. Inborn errors of metabolism associated with psychosis: literature review and case-control study using exome data from 5090 adult individuals. J Inherit Metab Dis 2018; 41:613-621. [PMID: 28210873 DOI: 10.1007/s10545-017-0023-9] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2016] [Revised: 01/23/2017] [Accepted: 01/25/2017] [Indexed: 01/26/2023]
Abstract
A literature review was conducted, using the computerized "Online Mendelian Inheritance in Man" (OMIM) and PubMed, to identify inborn errors of metabolism (IEM) in which psychosis may be a predominant feature or the initial presenting symptom. Different combinations of the following keywords were searched using OMIM: "psychosis", "schizophrenia", or "hallucinations" and "metabolic", "inborn error of metabolism", "inborn errors of metabolism", "biochemical genetics", or "metabolic genetics". The OMIM search generated 126 OMIM entries, 40 of which were well known IEM. After removing IEM lacking evidence in PubMed for an association with psychosis, 29 OMIM entries were identified. Several of these IEM are treatable. They involve different small organelles (lysosomes, peroxisomes, mitochondria), iron or copper accumulation, as well as defects in other met-abolic pathways (e.g., defects leading to hyperammonemia or homocystinemia). A clinical checklist summarizing the key features of these conditions and a guide to clinical approach are provided. The genes corresponding to each of these con-ditions were identified. Whole exome data from 2545 adult cases with schizophrenia and 2545 unrelated controls, accessed via the Database of Genotypes and Phenotypes (dbGaP), were analyzed for rare functional variants in these genes. The odds ratio of having a rare functional variant in cases versus controls was calculated for each gene. Eight genes are significantly associated with schizophrenia (p < 0.05, OR >1) using an unselected group of adult patients with schizophrenia. Increased awareness of clinical clues for these IEM will optimize referrals and timely metabolic interventions.
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Affiliation(s)
- Yannis J Trakadis
- Department of Medical Genetics, McGill University Health Centre, Room A04.3140, 1001 Boul. Decarie, Montreal, QC, Canada, H4A 3J1.
| | - Vanessa Fulginiti
- Department of Medical Genetics, McGill University Health Centre, Room A04.3140, 1001 Boul. Decarie, Montreal, QC, Canada, H4A 3J1
| | - Mark Walterfang
- Department of Neuropsychiatry, Royal Melbourne Hospital, Melbourne, Australia
- Melbourne Neuropsychiatry Centre, University of Melbourne, Melbourne, Australia
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14
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Brodowicz J, Przegaliński E, Müller CP, Filip M. Ceramide and Its Related Neurochemical Networks as Targets for Some Brain Disorder Therapies. Neurotox Res 2018; 33:474-484. [PMID: 28842833 PMCID: PMC5766709 DOI: 10.1007/s12640-017-9798-6] [Citation(s) in RCA: 44] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2017] [Revised: 08/01/2017] [Accepted: 08/10/2017] [Indexed: 11/01/2022]
Abstract
Correlational and causal comparative research link ceramide (Cer), the precursor of complex sphingolipids, to some psychiatric (e.g., depression, schizophrenia (SZ), alcohol use disorder, and morphine antinociceptive tolerance) and neurological (e.g., Alzheimer's disease (AD), Parkinson disease (PD)) disorders. Cer generation can occur through the de novo synthesis pathway, the sphingomyelinase pathways, and the salvage pathway. The discoveries that plasma Cer concentration increase during depressive episodes in patients and that tricyclic and tetracyclic antidepressants functionally inhibit acid sphingomyelinase (ASM), the enzyme that catalyzes the degradation of sphingomyelin to Cer, have initiated a series of studies on the role of the ASM-Cer system in depressive disorder. Disturbances in the metabolism of Cer or SM are associated with the occurrence of SZ and PD. In both PD and SZ patients, the elevated levels of Cer or SM in the brain regions were associated with the disease. AD patients showed also an abnormal metabolism of brain Cer at early stages of the disease which may suggest Cer as an AD biomarker. In plasma of AD patients and in AD transgenic mice, ASM activity was increased. In contrast, partial ASM inhibition of Aβ deposition improved memory deficits. Furthermore, in clinical and preclinical research, ethanol enhanced activation of ASM followed by Cer production. Limited data have shown that Cer plays an important role in the development of morphine antinociceptive tolerance. In summary, clinical and preclinical findings provide evidence that targeting the Cer system should be considered as an innovative translational strategy for some brain disorders.
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Affiliation(s)
- Justyna Brodowicz
- Faculty of Pharmacy, Jagiellonian University Medical College, 9 Medyczna Street, 30-688, Kraków, Poland
- Department of Drug Addiction Pharmacology, Institute of Pharmacology, Polish Academy of Sciences, 12 Smętna Street, 31-343, Kraków, Poland
| | - Edmund Przegaliński
- Department of Drug Addiction Pharmacology, Institute of Pharmacology, Polish Academy of Sciences, 12 Smętna Street, 31-343, Kraków, Poland
| | - Christian P Müller
- Department of Psychiatry and Psychotherapy, University Clinic, Friedrich-Alexander-University of Erlangen-Nuremberg, Schwabachanlage 6, 91054, Erlangen, Germany
| | - Malgorzata Filip
- Department of Drug Addiction Pharmacology, Institute of Pharmacology, Polish Academy of Sciences, 12 Smętna Street, 31-343, Kraków, Poland.
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15
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Milleit B, Smesny S, Rothermundt M, Preul C, Schroeter ML, von Eiff C, Ponath G, Milleit C, Sauer H, Gaser C. Serum S100B Protein is Specifically Related to White Matter Changes in Schizophrenia. Front Cell Neurosci 2016; 10:33. [PMID: 27013967 PMCID: PMC4782018 DOI: 10.3389/fncel.2016.00033] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2015] [Accepted: 01/30/2016] [Indexed: 01/26/2023] Open
Abstract
Background: Schizophrenia can be conceptualized as a form of dysconnectivity between brain regions.To investigate the neurobiological foundation of dysconnectivity, one approach is to analyze white matter structures, such as the pathology of fiber tracks. S100B is considered a marker protein for glial cells, in particular oligodendrocytes and astroglia, that passes the blood brain barrier and is detectable in peripheral blood. Earlier Studies have consistently reported increased S100B levels in schizophrenia. In this study, we aim to investigate associations between S100B and structural white matter abnormalities. Methods: We analyzed data of 17 unmedicated schizophrenic patients (first and recurrent episode) and 22 controls. We used voxel based morphometry (VBM) to detect group differences of white matter structures as obtained from T1-weighted MR-images and considered S100B serum levels as a regressor in an age-corrected interaction analysis. Results: S100B was increased in both patient subgroups. Using VBM, we found clusters indicating significant differences of the association between S100B concentration and white matter. Involved anatomical structures are the posterior cingulate bundle and temporal white matter structures assigned to the superior longitudinal fasciculus. Conclusions: S100B-associated alterations of white matter are shown to be existent already at time of first manifestation of psychosis and are distinct from findings in recurrent episode patients. This suggests involvement of S100B in an ongoing and dynamic process associated with structural brain changes in schizophrenia. However, it remains elusive whether increased S100B serum concentrations in psychotic patients represent a protective response to a continuous pathogenic process or if elevated S100B levels are actively involved in promoting structural brain damage.
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Affiliation(s)
- Berko Milleit
- Department of Psychiatry, Jena University HospitalJena, Germany; St. Joseph-KrankenhausDessau-Roßlau, Germany
| | - Stefan Smesny
- Department of Psychiatry, Jena University Hospital Jena, Germany
| | - Matthias Rothermundt
- Department of Psychiatry, University of MuensterMuenster, Germany; Department of Psychiatry, St. Rochus HospitalTelgte, Germany
| | - Christoph Preul
- Department of Neurology, Jena University Hospital Jena, Germany
| | - Matthias L Schroeter
- Max Planck Institute for Human Cognitive and Brain Sciences and Clinic for Cognitive Neurology Leipzig, Germany
| | - Christof von Eiff
- Institute of Medical Microbiology, University of Muenster Muenster, Germany
| | - Gerald Ponath
- Department of Psychiatry, University of MuensterMuenster, Germany; Department of Neurology, School of Medicine, Yale UniversityNew Haven, CT, USA
| | - Christine Milleit
- Department of Psychiatry, Jena University HospitalJena, Germany; Department of Psychiatry, Sophien- und Hufeland-KlinikumWeimar, Germany
| | - Heinrich Sauer
- Department of Psychiatry, Jena University Hospital Jena, Germany
| | - Christian Gaser
- Department of Psychiatry, Jena University HospitalJena, Germany; Department of Neurology, Jena University HospitalJena, Germany
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16
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Kremer D, Göttle P, Hartung HP, Küry P. Pushing Forward: Remyelination as the New Frontier in CNS Diseases. Trends Neurosci 2016; 39:246-263. [PMID: 26964504 DOI: 10.1016/j.tins.2016.02.004] [Citation(s) in RCA: 69] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2015] [Revised: 02/01/2016] [Accepted: 02/09/2016] [Indexed: 01/25/2023]
Abstract
The evolutionary acquisition of myelin sheaths around large caliber axons in the central nervous system (CNS) represented a milestone in the development of vertebrate higher brain function. Myelin ensheathment of axons enabled saltatory conduction and thus accelerated information processing. However, a number of CNS diseases harm or destroy myelin and oligodendrocytes (myelin-producing cells), ultimately resulting in demyelination. In the adult CNS, new oligodendrocytes can be generated from a quiescent pool of precursor cells, which - upon differentiation - can replace lost myelin sheaths. The efficiency of this spontaneous regeneration is limited, which leads to incomplete remyelination and residual clinical symptoms. Here, we discuss CNS pathologies characterized by white matter degeneration and regeneration and highlight drugs that could potentially serve as remyelination therapies.
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Affiliation(s)
- David Kremer
- Department of Neurology, Medical Faculty, University of Düsseldorf, 40225 Düsseldorf, Germany
| | - Peter Göttle
- Department of Neurology, Medical Faculty, University of Düsseldorf, 40225 Düsseldorf, Germany
| | - Hans-Peter Hartung
- Department of Neurology, Medical Faculty, University of Düsseldorf, 40225 Düsseldorf, Germany.
| | - Patrick Küry
- Department of Neurology, Medical Faculty, University of Düsseldorf, 40225 Düsseldorf, Germany.
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17
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Abstract
In the nervous system, axons transmit information in the form of electrical impulses over long distances. The speed of impulse conduction is enhanced by myelin, a lipid-rich membrane that wraps around axons. Myelin also is required for the long-term health of axons by providing metabolic support. Accordingly, myelin deficiencies are implicated in a wide range of neurodevelopmental and neuropsychiatric disorders, intellectual disabilities, and neurodegenerative conditions. Central nervous system myelin is formed by glial cells called oligodendrocytes. During development, oligodendrocyte precursor cells migrate from their origins to their target axons, extend long membrane processes that wrap axons, and produce the proteins and lipids that provide myelin membrane with its unique characteristics. Myelination is a dynamic process that involves intricate interactions between multiple cell types. Therefore, an in vivo myelination model, such as the zebrafish, which allows for live observation of cell dynamics and cell-to-cell interactions, is well suited for investigating oligodendrocyte development. Zebrafish offer several advantages to investigating myelination, including the use of transgenic reporter lines, live imaging, forward genetic screens, chemical screens, and reverse genetic approaches. This chapter will describe how these tools and approaches have provided new insights into the regulatory mechanisms that guide myelination.
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Affiliation(s)
- E S Mathews
- University of Colorado School of Medicine, Aurora, CO, United States
| | - B Appel
- University of Colorado School of Medicine, Aurora, CO, United States
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18
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Li Z, He Y, Fan S, Sun B. Clemastine rescues behavioral changes and enhances remyelination in the cuprizone mouse model of demyelination. Neurosci Bull 2015; 31:617-25. [PMID: 26253956 DOI: 10.1007/s12264-015-1555-3] [Citation(s) in RCA: 94] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2015] [Accepted: 06/10/2015] [Indexed: 12/18/2022] Open
Abstract
Increasing evidence suggests that white matter disorders based on myelin sheath impairment may underlie the neuropathological changes in schizophrenia. But it is unknown whether enhancing remyelination is a beneficial approach to schizophrenia. To investigate this hypothesis, we used clemastine, an FDA-approved drug with high potency in promoting oligodendroglial differentiation and myelination, on a cuprizone-induced mouse model of demyelination. The mice exposed to cuprizone (0.2% in chow) for 6 weeks displayed schizophrenia-like behavioral changes, including decreased exploration of the center in the open field test and increased entries into the arms of the Y-maze, as well as evident demyelination in the cortex and corpus callosum. Clemastine treatment was initiated upon cuprizone withdrawal at 10 mg/kg per day for 3 weeks. As expected, myelin repair was greatly enhanced in the demyelinated regions with increased mature oligodendrocytes (APC-positive) and myelin basic protein. More importantly, the clemastine treatment rescued the schizophrenia-like behavioral changes in the open field test and the Y-maze compared to vehicle, suggesting a beneficial effect via promoting myelin repair. Our findings indicate that enhancing remyelination may be a potential therapy for schizophrenia.
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Affiliation(s)
- Zhifang Li
- Department of Neurology, Affiliated Hospital of Academy of Military Medical Sciences, Beijing, 100071, China.
| | - Yangtao He
- Department of Histology and Embryology, Chongqing Key Laboratory of Neurobiology, Third Military Medical University, Chongqing, 400038, China.
| | - Shuangyi Fan
- Department of Neurology, Affiliated Hospital of Academy of Military Medical Sciences, Beijing, 100071, China
| | - Binbin Sun
- Department of Neurology, Affiliated Hospital of Academy of Military Medical Sciences, Beijing, 100071, China
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19
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Wang C, Aleksic B, Ozaki N. Glia-related genes and their contribution to schizophrenia. Psychiatry Clin Neurosci 2015; 69:448-61. [PMID: 25759284 DOI: 10.1111/pcn.12290] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/08/2015] [Indexed: 12/24/2022]
Abstract
Schizophrenia, a debilitating disease with 1% prevalence in the general population, is characterized by major neuropsychiatric symptoms, including delusions, hallucinations, and deficits in emotional and social behavior. Previous studies have directed their investigations on the mechanism of schizophrenia towards neuronal dysfunction and have defined schizophrenia as a 'neuron-centric' disorder. However, along with the development of genetics and systematic biology approaches in recent years, the crucial role of glial cells in the brain has also been shown to contribute to the etiopathology of schizophrenia. Here, we summarize comprehensive data that support the involvement of glial cells (including oligodendrocytes, astrocytes, and microglial cells) in schizophrenia and list several acknowledged glia-related genes or molecules associated with schizophrenia. Instead of purely an abnormality of neurons in schizophrenia, an additional 'glial perspective' provides us a novel and promising insight into the causal mechanisms and treatment for this disease.
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Affiliation(s)
- Chenyao Wang
- Department of Psychiatry, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Branko Aleksic
- Department of Psychiatry, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Norio Ozaki
- Department of Psychiatry, Nagoya University Graduate School of Medicine, Nagoya, Japan
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20
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Disturbance of oligodendrocyte function plays a key role in the pathogenesis of schizophrenia and major depressive disorder. BIOMED RESEARCH INTERNATIONAL 2015; 2015:492367. [PMID: 25705664 PMCID: PMC4332974 DOI: 10.1155/2015/492367] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/11/2014] [Revised: 11/14/2014] [Accepted: 11/16/2014] [Indexed: 12/22/2022]
Abstract
The major psychiatric disorders such as schizophrenia (SZ) and major depressive disorder (MDD) are thought to be multifactorial diseases related to both genetic and environmental factors. However, the genes responsible and the molecular mechanisms underlying the pathogenesis of SZ and MDD remain unclear. We previously reported that abnormalities of disrupted-in-Schizophrenia-1 (DISC1) and DISC1 binding zinc finger (DBZ) might cause major psychiatric disorders such as SZ. Interestingly, both DISC and DBZ have been further detected in oligodendrocytes and implicated in regulating oligodendrocyte differentiation. DISC1 negatively regulates the differentiation of oligodendrocytes, whereas DBZ plays a positive regulatory role in oligodendrocyte differentiation. We have reported that repeated stressful events, one of the major risk factors of MDD, can induce sustained upregulation of plasma corticosterone levels and serum/glucocorticoid regulated kinase 1 (Sgk1) mRNA expression in oligodendrocytes. Repeated stressful events can also activate the SGK1 cascade and cause excess arborization of oligodendrocyte processes, which is thought to be related to depressive-like symptoms. In this review, we discuss the expression of DISC1, DBZ, and SGK1 in oligodendrocytes, their roles in the regulation of oligodendrocyte function, possible interactions of DISC1 and DBZ in relation to SZ, and the activation of the SGK1 signaling cascade in relation to MDD.
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21
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Mighdoll MI, Tao R, Kleinman JE, Hyde TM. Myelin, myelin-related disorders, and psychosis. Schizophr Res 2015; 161:85-93. [PMID: 25449713 DOI: 10.1016/j.schres.2014.09.040] [Citation(s) in RCA: 93] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2014] [Revised: 09/18/2014] [Accepted: 09/21/2014] [Indexed: 12/14/2022]
Abstract
The neuropathological basis of schizophrenia and related psychoses remains elusive despite intensive scientific investigation. Symptoms of psychosis have been reported in a number of conditions where normal myelin development is interrupted. The nature, location, and timing of white matter pathology seem to be key factors in the development of psychosis, especially during the critical adolescent period of association area myelination. Numerous lines of evidence implicate myelin and oligodendrocyte function as critical processes that could affect neuronal connectivity, which has been implicated as a central abnormality in schizophrenia. Phenocopies of schizophrenia with a known pathological basis involving demyelination or dysmyelination may offer insights into the biology of schizophrenia itself. This article reviews the pathological changes in white matter of patients with schizophrenia, as well as demyelinating diseases associated with psychosis. In an attempt to understand the potential role of dysmyelination in schizophrenia, we outline the evidence from a number of both clinically-based and post-mortem studies that provide evidence that OMR genes are genetically associated with increased risk for schizophrenia. To further understand the implication of white matter dysfunction and dysmyelination in schizophrenia, we examine diffusion tensor imaging (DTI), which has shown volumetric and microstructural white matter differences in patients with schizophrenia. While classical clinical-neuropathological correlations have established that disruption in myelination can produce a high fidelity phenocopy of psychosis similar to schizophrenia, the role of dysmyelination in schizophrenia remains controversial.
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Affiliation(s)
- Michelle I Mighdoll
- Lieber Institute for Brain Development, Johns Hopkins Medical Institutions, 855 N. Wolfe Street, Suite 300, Baltimore, MD 21205, USA.
| | - Ran Tao
- Lieber Institute for Brain Development, Johns Hopkins Medical Institutions, 855 N. Wolfe Street, Suite 300, Baltimore, MD 21205, USA.
| | - Joel E Kleinman
- Lieber Institute for Brain Development, Johns Hopkins Medical Institutions, 855 N. Wolfe Street, Suite 300, Baltimore, MD 21205, USA.
| | - Thomas M Hyde
- Lieber Institute for Brain Development, Johns Hopkins Medical Institutions, 855 N. Wolfe Street, Suite 300, Baltimore, MD 21205, USA; Department of Psychiatry & Behavioral Sciences, Johns Hopkins Medical School, Baltimore, MD 21205, USA; Department of Neurology, Johns Hopkins Medical School, Baltimore, MD 21205, USA.
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22
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Preston MA, Macklin WB. Zebrafish as a model to investigate CNS myelination. Glia 2014; 63:177-93. [PMID: 25263121 DOI: 10.1002/glia.22755] [Citation(s) in RCA: 65] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2014] [Accepted: 09/12/2014] [Indexed: 12/18/2022]
Abstract
Myelin plays a critical role in proper neuronal function by providing trophic and metabolic support to axons and facilitating energy-efficient saltatory conduction. Myelination is influenced by numerous molecules including growth factors, hormones, transmembrane receptors and extracellular molecules, which activate signaling cascades that drive cellular maturation. Key signaling molecules and downstream signaling cascades controlling myelination have been identified in cell culture systems. However, in vitro systems are not able to faithfully replicate the complex in vivo signaling environment that occurs during development or following injury. Currently, it remains time-consuming and expensive to investigate myelination in vivo in rodents, the most widely used model for studying mammalian myelination. As such, there is a need for alternative in vivo myelination models, particularly ones that can test molecular mechanisms without removing oligodendrocyte lineage cells from their native signaling environment or disrupting intercellular interactions with other cell types present during myelination. Here, we review the ever-increasing role of zebrafish in studies uncovering novel mechanisms controlling vertebrate myelination. These innovative studies range from observations of the behavior of single cells during in vivo myelination as well as mutagenesis- and pharmacology-based screens in whole animals. Additionally, we discuss recent efforts to develop novel models of demyelination and oligodendrocyte cell death in adult zebrafish for the study of cellular behavior in real time during repair and regeneration of damaged nervous systems.
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Affiliation(s)
- Marnie A Preston
- Department of Cell and Developmental Biology, University of Colorado School of Medicine, Aurora, Colorado
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23
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Vestal-Laborde AA, Eschenroeder AC, Bigbee JW, Robinson SE, Sato-Bigbee C. The opioid system and brain development: effects of methadone on the oligodendrocyte lineage and the early stages of myelination. Dev Neurosci 2014; 36:409-21. [PMID: 25138998 PMCID: PMC4175303 DOI: 10.1159/000365074] [Citation(s) in RCA: 84] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2014] [Accepted: 06/04/2014] [Indexed: 11/19/2022] Open
Abstract
Oligodendrocytes express opioid receptors throughout development, but the role of the opioid system in myelination remains poorly understood. This is a significant problem as opioid use and abuse continue to increase in two particular populations: pregnant addicts (in whom drug effects could target early myelination in the fetus and newborn) and adolescents and young adults (in whom late myelination of 'higher-order' regions takes place). Maintenance treatments for opioid addicts include the long-lasting opioids methadone and buprenorphine. Similar to our previous findings on the effects of buprenorphine, we have now found that early myelination in the developing rat brain is also altered by perinatal exposure to therapeutic doses of methadone. Pups exposed to this drug exhibited elevated brain levels of the 4 major splicing variants of myelin basic protein, myelin proteolipid protein, and myelin-oligodendrocyte glycoprotein. Consistent with the enrichment and function of these proteins in mature myelin, analysis of the corpus callosum in these young animals also indicated an elevated number of axons with already highly compacted myelin sheaths. Moreover, studies in cultured cells showed that methadone exerts direct effects at specific stages of the oligodendrocyte lineage, stimulating the proliferation of progenitor cells while on the other hand accelerating the maturation of the more differentiated but still immature preoligodendrocytes. While the long-term effects of these observations remain unknown, accelerated or increased oligodendrocyte maturation and myelination could both disrupt the complex sequence of synchronized events leading to normal connectivity in the developing brain. Together with our previous observations on the effects of buprenorphine, the present findings further underscore a crucial function of the endogenous opioid system in the control of oligodendrocyte development and the timing of myelination. Interference with these regulatory systems by opioid use or maintenance treatments could disrupt the normal process of brain maturation at critical stages of myelin formation.
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Affiliation(s)
- Allison A. Vestal-Laborde
- Department of Biochemistry and Molecular Biology, Virginia Commonwealth University School of Medicine, Richmond, Virginia, 23298-0614
| | - Andrew C. Eschenroeder
- Department of Biochemistry and Molecular Biology, Virginia Commonwealth University School of Medicine, Richmond, Virginia, 23298-0614
| | - John W. Bigbee
- Department of Anatomy and Neurobiology, Richmond, Virginia, 23298-0709
| | - Susan E. Robinson
- Institute for Drug and Alcohol Studies and Department of Pharmacology and Toxicology, Virginia Commonwealth University School of Medicine, Richmond, VA 23298-0310
| | - Carmen Sato-Bigbee
- Department of Biochemistry and Molecular Biology, Virginia Commonwealth University School of Medicine, Richmond, Virginia, 23298-0614
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24
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Hattori T, Shimizu S, Koyama Y, Emoto H, Matsumoto Y, Kumamoto N, Yamada K, Takamura H, Matsuzaki S, Katayama T, Tohyama M, Ito A. DISC1 (disrupted-in-schizophrenia-1) regulates differentiation of oligodendrocytes. PLoS One 2014; 9:e88506. [PMID: 24516667 PMCID: PMC3917910 DOI: 10.1371/journal.pone.0088506] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2013] [Accepted: 01/08/2014] [Indexed: 02/05/2023] Open
Abstract
Disrupted-in-schizophrenia 1 (DISC1) is a gene disrupted by a translocation, t(1;11) (q42.1;q14.3), that segregates with major psychiatric disorders, including schizophrenia, recurrent major depression and bipolar affective disorder, in a Scottish family. Here we report that mammalian DISC1 endogenously expressed in oligodendroglial lineage cells negatively regulates differentiation of oligodendrocyte precursor cells into oligodendrocytes. DISC1 expression was detected in oligodendrocytes of the mouse corpus callosum at P14 and P70. DISC1 mRNA was expressed in primary cultured rat cortical oligodendrocyte precursor cells and decreased when oligodendrocyte precursor cells were induced to differentiate by PDGF deprivation. Immunocytochemical analysis showed that overexpressed DISC1 was localized in the cell bodies and processes of oligodendrocyte precursor cells and oligodendrocytes. We show that expression of the myelin related markers, CNPase and MBP, as well as the number of cells with a matured oligodendrocyte morphology, were decreased following full length DISC1 overexpression. Conversely, both expression of CNPase and the number of oligodendrocytes with a mature morphology were increased following knockdown of endogenous DISC1 by RNA interference. Overexpression of a truncated form of DISC1 also resulted in an increase in expression of myelin related proteins and the number of mature oligodendrocytes, potentially acting via a dominant negative mechanism. We also identified involvement of Sox10 and Nkx2.2 in the DISC1 regulatory pathway of oligodendrocyte differentiation, both well-known transcription factors involved in the regulation of myelin genes.
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Affiliation(s)
- Tsuyoshi Hattori
- Department of Molecular Neuropsychiatry, Graduate School of Medicine, Osaka University, Suita, Osaka, Japan
- * E-mail:
| | - Shoko Shimizu
- Division of Molecular Brain Science, Research Institute of Traditional Asian Medicine, Kinki University, Sayama, Osaka, Japan
| | - Yoshihisa Koyama
- Department of Anatomy and Neuroscience, Graduate School of Medicine, Osaka University, Suita, Osaka, Japan
| | - Hisayo Emoto
- Pharmacology Research Laboratories, Dainippon Sumitomo Pharma Co, Ltd, Suita, Osaka, Japan
| | - Yuji Matsumoto
- Pharmacology Research Laboratories, Dainippon Sumitomo Pharma Co, Ltd, Suita, Osaka, Japan
| | - Natsuko Kumamoto
- Department of Neurobiology and Anatomy, Graduate School of Medical Sciences, Nagoya City University, Nagoya, Aichi, Japan
| | - Kohei Yamada
- Department of Child Development & Molecular Brain Science, United Graduate School of Child Development, Osaka University, Kanazawa University and Hamamatsu University School of Medicine, Suita, Osaka, Japan
| | - Hironori Takamura
- Department of Child Development & Molecular Brain Science, United Graduate School of Child Development, Osaka University, Kanazawa University and Hamamatsu University School of Medicine, Suita, Osaka, Japan
| | - Shinsuke Matsuzaki
- Department of Anatomy and Neuroscience, Graduate School of Medicine, Osaka University, Suita, Osaka, Japan
- Department of Child Development & Molecular Brain Science, United Graduate School of Child Development, Osaka University, Kanazawa University and Hamamatsu University School of Medicine, Suita, Osaka, Japan
| | - Taiichi Katayama
- Department of Child Development & Molecular Brain Science, United Graduate School of Child Development, Osaka University, Kanazawa University and Hamamatsu University School of Medicine, Suita, Osaka, Japan
| | - Masaya Tohyama
- Department of Anatomy and Neuroscience, Graduate School of Medicine, Osaka University, Suita, Osaka, Japan
- Department of Child Development & Molecular Brain Science, United Graduate School of Child Development, Osaka University, Kanazawa University and Hamamatsu University School of Medicine, Suita, Osaka, Japan
- Division of Molecular Brain Science, Research Institute of Traditional Asian Medicine, Kinki University, Sayama, Osaka, Japan
| | - Akira Ito
- Department of Molecular Neuropsychiatry, Graduate School of Medicine, Osaka University, Suita, Osaka, Japan
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Shimizu S, Koyama Y, Hattori T, Tachibana T, Yoshimi T, Emoto H, Matsumoto Y, Miyata S, Katayama T, Ito A, Tohyama M. DBZ, a CNS-specific DISC1 binding protein, positively regulates oligodendrocyte differentiation. Glia 2014; 62:709-24. [PMID: 24481677 DOI: 10.1002/glia.22636] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2013] [Revised: 12/21/2013] [Accepted: 01/13/2014] [Indexed: 12/19/2022]
Abstract
Recent studies have shown changes in myelin genes and alterations in white matter structure in a wide range of psychiatric disorders. Here we report that DBZ, a central nervous system (CNS)-specific member of the DISC1 interactome, positively regulates the oligodendrocyte (OL) differentiation in vivo and in vitro. In mouse corpus callosum (CC), DBZ mRNA is expressed in OL lineage cells and expression of DBZ protein peaked before MBP expression. In the CC of DBZ-KO mice, we observed delayed myelination during the early postnatal period. Although the myelination delay was mostly recovered by adulthood, OLs with immature structural features were more abundant in adult DBZ-KO mice than in control mice. DBZ was also transiently upregulated during rat OL differentiation in vitro before myelin marker expression. DBZ knockdown by RNA interference resulted in a decreased expression of myelin-related markers and a low number of cells with mature characteristics, but with no effect on the proliferation of oligodendrocyte precursor cells. We also show that the expression levels of transcription factors having a negative-regulatory role in OL differentiation were upregulated when endogenous DBZ was knocked down. These results strongly indicate that OL differentiation in rodents is regulated by DBZ.
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Affiliation(s)
- Shoko Shimizu
- Department of Molecular Neuropsychiatry, Graduate School of Medicine, Osaka University, Suita, Osaka, Japan; Division of Molecular Brain Science, Research Institute of Traditional Asian Medicine, Kinki University, Osaka-Sayama, Osaka, Japan
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Benjamin S, Lauterbach MD, Stanislawski AL. Congenital and acquired disorders presenting as psychosis in children and young adults. Child Adolesc Psychiatr Clin N Am 2013; 22:581-608. [PMID: 24012075 DOI: 10.1016/j.chc.2013.04.004] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
A review of the published literature found 60 congenital and acquired disorders with symptoms that include psychosis in youth. The prevalence, workup, genetics, and associated neuropsychiatric features of each disorder are described. Eighteen disorders (30%) have distinct phenotypes (doorway diagnoses); 18 disorders (30%) are associated with intellectual disability; and 43 disorders (72%) have prominent neurologic signs. Thirty-one disorders (52%) can present without such distinct characteristics, and are thus more easily overlooked. A systematic and cost-effective differential diagnostic approach based on estimated prevalence and most prominent associated signs is recommended.
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Affiliation(s)
- Sheldon Benjamin
- Departments of Psychiatry and Neurology, University of Massachusetts Medical School, 55 Lake Avenue North, Worcester, MA 01655, USA.
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27
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Hayhow BD, Hassan I, Looi JCL, Gaillard F, Velakoulis D, Walterfang M. The neuropsychiatry of hyperkinetic movement disorders: insights from neuroimaging into the neural circuit bases of dysfunction. Tremor Other Hyperkinet Mov (N Y) 2013; 3:tre-03-175-4242-1. [PMID: 24032090 PMCID: PMC3760049 DOI: 10.7916/d8sn07pk] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2013] [Accepted: 07/08/2013] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND Movement disorders, particularly those associated with basal ganglia disease, have a high rate of comorbid neuropsychiatric illness. METHODS We consider the pathophysiological basis of the comorbidity between movement disorders and neuropsychiatric illness by 1) reviewing the epidemiology of neuropsychiatric illness in a range of hyperkinetic movement disorders, and 2) correlating findings to evidence from studies that have utilized modern neuroimaging techniques to investigate these disorders. In addition to diseases classically associated with basal ganglia pathology, such as Huntington disease, Wilson disease, the neuroacanthocytoses, and diseases of brain iron accumulation, we include diseases associated with pathology of subcortical white matter tracts, brain stem nuclei, and the cerebellum, such as metachromatic leukodystrophy, dentatorubropallidoluysian atrophy, and the spinocerebellar ataxias. CONCLUSIONS Neuropsychiatric symptoms are integral to a thorough phenomenological account of hyperkinetic movement disorders. Drawing on modern theories of cortico-subcortical circuits, we argue that these disorders can be conceptualized as disorders of complex subcortical networks with distinct functional architectures. Damage to any component of these complex information-processing networks can have variable and often profound consequences for the function of more remote neural structures, creating a diverse but nonetheless rational pattern of clinical symptomatology.
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Affiliation(s)
- Bradleigh D. Hayhow
- Neuropsychiatry Unit, Royal Melbourne Hospital, Parkville, Australia
- Melbourne Neuropsychiatry Centre, University of Melbourne and Melbourne Health, Parkville, Australia
| | - Islam Hassan
- Neuropsychiatry Unit, Royal Melbourne Hospital, Parkville, Australia
| | - Jeffrey C. L. Looi
- Academic Unit of Psychiatry & Addiction Medicine, Australian National University Medical School, Canberra Hospital, Canberra, Australia
| | | | - Dennis Velakoulis
- Neuropsychiatry Unit, Royal Melbourne Hospital, Parkville, Australia
- Melbourne Neuropsychiatry Centre, University of Melbourne and Melbourne Health, Parkville, Australia
| | - Mark Walterfang
- Neuropsychiatry Unit, Royal Melbourne Hospital, Parkville, Australia
- Melbourne Neuropsychiatry Centre, University of Melbourne and Melbourne Health, Parkville, Australia
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Walterfang M, Bonnot O, Mocellin R, Velakoulis D. The neuropsychiatry of inborn errors of metabolism. J Inherit Metab Dis 2013; 36:687-702. [PMID: 23700255 DOI: 10.1007/s10545-013-9618-y] [Citation(s) in RCA: 68] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2012] [Revised: 04/29/2013] [Accepted: 04/30/2013] [Indexed: 12/15/2022]
Abstract
A number of metabolic disorders that affect the central nervous system can present in childhood, adolescence or adulthood as a phenocopy of a major psychiatric syndrome such as psychosis, depression, anxiety or mania. An understanding and awareness of secondary syndromes in metabolic disorders is of great importance as it can lead to the early diagnosis of such disorders. Many of these metabolic disorders are progressive and may have illness-modifying treatments available. Earlier diagnosis may prevent or delay damage to the central nervous system and allow for the institution of appropriate treatment and family and genetic counselling. Metabolic disorders appear to result in neuropsychiatric illness either through disruption of late neurodevelopmental processes (metachromatic leukodystrophy, adrenoleukodystrophy, GM2 gangliosidosis, Niemann-Pick type C, cerebrotendinous xanthomatosis, neuronal ceroid lipofuscinosis, and alpha mannosidosis) or via chronic or acute disruption of excitatory/inhibitory or monoaminergic neurotransmitter systems (acute intermittent porphyria, maple syrup urine disease, urea cycle disorders, phenylketonuria and disorders of homocysteine metabolism). In this manuscript we review the evidence for neuropsychiatric illness in major metabolic disorders and discuss the possible models for how these disorders result in psychiatric symptoms. Treatment considerations are discussed, including treatment resistance, the increased propensity for side-effects and the possibility of some treatments worsening the underlying disorder.
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Affiliation(s)
- Mark Walterfang
- Melbourne Neuropsychiatry Centre, University of Melbourne and Melbourne Health, Parkville, Australia.
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29
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Tracking cerebral white matter changes across the lifespan: insights from diffusion tensor imaging studies. J Neural Transm (Vienna) 2013; 120:1369-95. [PMID: 23328950 DOI: 10.1007/s00702-013-0971-7] [Citation(s) in RCA: 83] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2012] [Accepted: 01/04/2013] [Indexed: 12/13/2022]
Abstract
Delineating the normal development of brain white matter (WM) over the human lifespan is crucial to improved understanding of underlying WM pathology in neuropsychiatric and neurological conditions. We review the extant literature concerning diffusion tensor imaging studies of brain WM development in healthy individuals available until October 2012, summarise trends of normal development of human brain WM and suggest possible future research directions. Temporally, brain WM maturation follows a curvilinear pattern with an increase in fractional anisotropy (FA) from newborn to adolescence, decelerating in adulthood till a plateau around mid-adulthood, and a more rapid decrease of FA from old age onwards. Spatially, brain WM tracts develop from central to peripheral regions, with evidence of anterior-to-posterior maturation in commissural and projection fibres. The corpus callosum and fornix develop first and decline earlier, whilst fronto-temporal WM tracts like cingulum and uncinate fasciculus have protracted maturation and decline later. Prefrontal WM is most vulnerable with greater age-related FA reduction compared with posterior WM. Future large scale studies adopting longitudinal design will better clarify human brain WM changes over time.
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Whitford TJ, Ford JM, Mathalon DH, Kubicki M, Shenton ME. Schizophrenia, myelination, and delayed corollary discharges: a hypothesis. Schizophr Bull 2012; 38:486-94. [PMID: 20855415 PMCID: PMC3329979 DOI: 10.1093/schbul/sbq105] [Citation(s) in RCA: 95] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Any etiological theory of schizophrenia must account for at least 3 distinctive features of the disorder, namely its excessive dopamine neurotransmission, its frequent periadolescent onset, and its bizarre, pathognomonic symptoms. In this article, we theorize that each of these features could arise from a single underlying cause--namely abnormal myelination of late-developing frontal white matter fasciculi. Specifically, we suggest that abnormalities in frontal myelination result in conduction delays in the efference copies initiated by willed actions. These conduction delays cause the resulting corollary discharges to be generated too late to suppress the sensory consequences of the willed actions. The resulting ambiguity as to the origins of these actions represents a phenomenologically and neurophysiologically significant prediction error. On a phenomenological level, the perception of salience in a self-generated action leads to confusion as to its origins and, consequently, passivity experiences and auditory hallucinations. On a neurophysiological level, this prediction error leads to the increased activity of dopaminergic neurons in the midbrain. This dopaminergic activity causes previously insignificant events to be perceived as salient, which exacerbates the budding hallucinations and passivity experiences and triggers additional first-rank symptoms such as delusions of reference. The article concludes with a discussion of the implications of the theory and some testable predictions which may form a worthwhile basis for future research.
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Affiliation(s)
- Thomas J. Whitford
- Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women’s Hospital, Harvard Medical School, 1249 Boylston Street, Boston, MA 02215,Melbourne Neuropsychiatry Centre, Department of Psychiatry, University of Melbourne and Melbourne Health, Melbourne, Victoria, Australia,To whom correspondence should be addressed; tel: +1-617-525-6119, fax: +1-617-525-6150, e-mail:
| | - Judith M. Ford
- Department of Psychiatry, University of California, San Francisco, San Francisco, CA,Mental Health Service, San Francisco VA Medical Center, San Francisco, CA
| | - Daniel H. Mathalon
- Department of Psychiatry, University of California, San Francisco, San Francisco, CA,Mental Health Service, San Francisco VA Medical Center, San Francisco, CA
| | - Marek Kubicki
- Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women’s Hospital, Harvard Medical School, 1249 Boylston Street, Boston, MA 02215,Clinical Neuroscience Division, Laboratory of Neuroscience, Department of Psychiatry, Boston Veterans Affairs Healthcare System, Harvard Medical School, Brockton, MA
| | - Martha E. Shenton
- Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women’s Hospital, Harvard Medical School, 1249 Boylston Street, Boston, MA 02215,Clinical Neuroscience Division, Laboratory of Neuroscience, Department of Psychiatry, Boston Veterans Affairs Healthcare System, Harvard Medical School, Brockton, MA
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31
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Eschenroeder AC, Vestal-Laborde AA, Sanchez ES, Robinson SE, Sato-Bigbee C. Oligodendrocyte responses to buprenorphine uncover novel and opposing roles of μ-opioid- and nociceptin/orphanin FQ receptors in cell development: implications for drug addiction treatment during pregnancy. Glia 2012; 60:125-36. [PMID: 22002899 PMCID: PMC3217102 DOI: 10.1002/glia.21253] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2011] [Accepted: 09/20/2011] [Indexed: 01/09/2023]
Abstract
Although the classical function of myelin is the facilitation of saltatory conduction, this membrane and the oligodendrocytes, the cells that make myelin in the central nervous system (CNS), are now recognized as important regulators of plasticity and remodeling in the developing brain. As such, oligodendrocyte maturation and myelination are among the most vulnerable processes along CNS development. We have shown previously that rat brain myelination is significantly altered by buprenorphine, an opioid analogue currently used in clinical trials for managing pregnant opioid addicts. Perinatal exposure to low levels of this drug induced accelerated and increased expression of myelin basic proteins (MBPs), cellular and myelin components that are markers of mature oligodendrocytes. In contrast, supra-therapeutic drug doses delayed MBP brain expression and resulted in a decreased number of myelinated axons. We have now found that this biphasic-dose response to buprenorphine can be attributed to the participation of both the μ-opioid receptor (MOR) and the nociceptin/orphanin FQ receptor (NOP receptor) in the oligodendrocytes. This is particularly intriguing because the NOP receptor/nociceptin system has been primarily linked to behavior and pain regulation, but a role in CNS development or myelination has not been described before. Our findings suggest that balance between signaling mediated by (a) MOR activation and (b) a novel, yet unidentified pathway that includes the NOP receptor, plays a crucial role in the timing of oligodendrocyte maturation and myelin synthesis. Moreover, exposure to opioids could disrupt the normal interplay between these two systems altering the developmental pattern of brain myelination.
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Affiliation(s)
- Andrew C. Eschenroeder
- Department of Biochemistry and Molecular Biology, Virginia Commonwealth University School of Medicine, Richmond, Virginia, 23298-0614
| | - Allison A. Vestal-Laborde
- Department of Biochemistry and Molecular Biology, Virginia Commonwealth University School of Medicine, Richmond, Virginia, 23298-0614
| | - Emilse S. Sanchez
- Department of Biochemistry and Molecular Biology, Virginia Commonwealth University School of Medicine, Richmond, Virginia, 23298-0614
| | - Susan E. Robinson
- Institute for Drug and Alcohol Studies and Department of Pharmacology and Toxicology, Virginia Commonwealth University School of Medicine, Richmond, VA 23298-0310
| | - Carmen Sato-Bigbee
- Department of Biochemistry and Molecular Biology, Virginia Commonwealth University School of Medicine, Richmond, Virginia, 23298-0614
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32
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Canuet L, Ishii R, Pascual-Marqui RD, Iwase M, Kurimoto R, Aoki Y, Ikeda S, Takahashi H, Nakahachi T, Takeda M. Resting-state EEG source localization and functional connectivity in schizophrenia-like psychosis of epilepsy. PLoS One 2011; 6:e27863. [PMID: 22125634 PMCID: PMC3220705 DOI: 10.1371/journal.pone.0027863] [Citation(s) in RCA: 132] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2011] [Accepted: 10/26/2011] [Indexed: 11/28/2022] Open
Abstract
Background It is unclear whether, like in schizophrenia, psychosis-related disruption in connectivity between certain regions, as an index of intrinsic functional disintegration, occurs in schizophrenia-like psychosis of epilepsy (SLPE). In this study, we sought to determine abnormal patterns of resting-state EEG oscillations and functional connectivity in patients with SLPE, compared with nonpsychotic epilepsy patients, and to assess correlations with psychopathological deficits. Methodology/Principal Findings Resting EEG was recorded in 21 patients with focal epilepsy and SLPE and in 21 clinically-matched non-psychotic epilepsy controls. Source current density and functional connectivity were determined using eLORETA software. For connectivity analysis, a novel nonlinear connectivity measure called “lagged phase synchronization” was used. We found increased theta oscillations in regions involved in the default mode network (DMN), namely the medial and lateral parietal cortex bilaterally in the psychotic patients relative to their nonpsychotic counterparts. In addition, patients with psychosis had increased beta temporo-prefrontal connectivity in the hemisphere with predominant seizure focus. This functional connectivity in temporo-prefrontal circuits correlated with positive symptoms. Additionally, there was increased interhemispheric phase synchronization between the auditory cortex of the affected temporal lobe and the Broca's area correlating with auditory hallucination scores. Conclusions/Significance In addition to dysfunction of parietal regions that are part of the DMN, resting-state disrupted connectivity of the medial temporal cortex with prefrontal areas that are either involved in the DMN or implicated in psychopathological dysfunction may be critical to schizophrenia-like psychosis, especially in individuals with temporal lobe epilepsy. This suggests that DMN deficits might be a core neurobiological feature of the disorder, and that abnormalities in theta oscillations and beta phase synchronization represent the underlying neural activity.
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Affiliation(s)
- Leonides Canuet
- Department of Psychiatry and Clinical Neuroscience, Osaka University Graduate School of Medicine, Suita City, Osaka, Japan
| | - Ryouhei Ishii
- Department of Psychiatry and Clinical Neuroscience, Osaka University Graduate School of Medicine, Suita City, Osaka, Japan
- * E-mail:
| | - Roberto D. Pascual-Marqui
- The KEY Institute for Brain-Mind Research, University Hospital of Psychiatry, Zurich, Switzerland
- Department of Neuropsychiatry, Kansai Medical University, Osaka, Japan
| | - Masao Iwase
- Department of Psychiatry and Clinical Neuroscience, Osaka University Graduate School of Medicine, Suita City, Osaka, Japan
| | - Ryu Kurimoto
- Department of Psychiatry and Clinical Neuroscience, Osaka University Graduate School of Medicine, Suita City, Osaka, Japan
| | - Yasunori Aoki
- Department of Psychiatry and Clinical Neuroscience, Osaka University Graduate School of Medicine, Suita City, Osaka, Japan
| | - Shunichiro Ikeda
- Department of Psychiatry and Clinical Neuroscience, Osaka University Graduate School of Medicine, Suita City, Osaka, Japan
| | - Hidetoshi Takahashi
- Department of Psychiatry and Clinical Neuroscience, Osaka University Graduate School of Medicine, Suita City, Osaka, Japan
| | - Takayuki Nakahachi
- Department of Psychiatry and Clinical Neuroscience, Osaka University Graduate School of Medicine, Suita City, Osaka, Japan
| | - Masatoshi Takeda
- Department of Psychiatry and Clinical Neuroscience, Osaka University Graduate School of Medicine, Suita City, Osaka, Japan
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Walterfang M, Velakoulis D, Whitford TJ, Pantelis C. Understanding aberrant white matter development in schizophrenia: an avenue for therapy? Expert Rev Neurother 2011; 11:971-87. [PMID: 21721915 DOI: 10.1586/ern.11.76] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Although historically gray matter changes have been the focus of neuropathological and neuroradiological studies in schizophrenia, in recent years an increasing body of research has implicated white matter structures and its constituent components (axons, their myelin sheaths and supporting oligodendrocytes). This article summarizes this body of literature, examining neuropathological, neurogenetic and neuroradiological evidence for white matter pathology in schizophrenia. We then look at the possible role that antipsychotic medication may play in these studies, examining both its role as a potential confounder in studies examining neuronal density and brain volume, but also the possible role that these medications may play in promoting myelination through their effects on oligodendrocytes. Finally, the role of potential novel therapies is discussed.
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Affiliation(s)
- Mark Walterfang
- Neuropsychiatry Unit, Royal Melbourne Hospital, Melbourne, Australia.
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34
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Xu H, Yang HJ, Rose GM, Li XM. Recovery of behavioral changes and compromised white matter in C57BL/6 mice exposed to cuprizone: effects of antipsychotic drugs. Front Behav Neurosci 2011; 5:31. [PMID: 21747763 PMCID: PMC3130148 DOI: 10.3389/fnbeh.2011.00031] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2011] [Accepted: 06/13/2011] [Indexed: 01/31/2023] Open
Abstract
Recent animal and human studies have suggested that the cuprizone (CPZ, a copper chelator)-fed C57BL/6 mouse may be used as an animal model of schizophrenia. The goals of this study were to see the recovery processes of CPZ-induced behavioral changes and damaged white matter and to examine possible effects of antipsychotic drugs on the recovery processes. Mice were fed a CPZ-containing diet for 5 weeks then returned to normal food for 3 weeks, during which period mice were treated with different antipsychotic drugs. Various behaviors were measured at the end of CPZ-feeding phase as well as on the 14th and 21st days after CPZ withdrawal. The damage to and recovery status of white matter in the brains of mice were examined. Dietary CPZ resulted in white matter damage and behavioral abnormalities in the elevated plus-maze (EPM), social interaction (SI), and Y-maze test. EPM performance recovered to normal range within 2 weeks after CPZ withdrawal. Alterations in SI showed no recovery. Antipsychotics did not alter animals’ behavior in either of these tests during the recovery period. Altered performance in the Y-maze showed some recovery in the vehicle group; atypical antipsychotics, but not haloperidol, significantly promoted this recovery process. The recovery of damaged white matter was incomplete during the recovery period. None of the drugs significantly promoted the recovery of damaged white matter. These results suggest that CPZ-induced white matter damage and SI deficit may be resistant to the antipsychotic treatment employed in this study. They are in good accordance with the clinical observations that positive symptoms in schizophrenic patients respond well to antipsychotic drugs while social dysfunction is usually intractable.
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Affiliation(s)
- Haiyun Xu
- Department of Anatomy, School of Medicine, Southern Illinois University Carbondale Carbondale, IL, USA
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35
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Abstract
The complex phenomenology of white matter dementia and many neuropsychiatric disorders implies that they originate from involvement of distributed neural networks, and white matter neuropathology is increasingly implicated in the pathogenesis of these network disconnection syndromes. White matter disorders produce functional asynchrony of interdependent cerebral regions subserving normal cognitive and emotional functions. Accumulating evidence suggests that white matter dementia primarily reflects disturbed frontal systems connectivity, whereas disruption of frontal and temporal lobe systems is implicated in the pathogenesis of neuropsychiatric disorders. Continued study of normal and abnormal white matter promises to help resolve challenging problems in behavioral neurology and neuropsychiatry.
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Affiliation(s)
- Christopher M Filley
- Behavioral Neurology Section, University of Colorado School of Medicine, 12631 East 17th Avenue, MS B185, Aurora, CO 80045, USA.
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36
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Diffusion tensor imaging, structural connectivity, and schizophrenia. SCHIZOPHRENIA RESEARCH AND TREATMENT 2011; 2011:709523. [PMID: 22937272 PMCID: PMC3420716 DOI: 10.1155/2011/709523] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/08/2011] [Accepted: 06/09/2011] [Indexed: 12/15/2022]
Abstract
A fundamental tenet of the "disconnectivity" theories of schizophrenia is that the disorder is ultimately caused by abnormal communication between spatially disparate brain structures. Given that the white matter fasciculi represent the primary infrastructure for long distance communication in the brain, abnormalities in these fiber bundles have been implicated in the etiology of schizophrenia. Diffusion tensor imaging (DTI) is a magnetic resonance imaging (MRI) technique that enables the visualization of white matter macrostructure in vivo, and which has provided unprecedented insight into the existence and nature of white matter abnormalities in schizophrenia. The paper begins with an overview of DTI and more commonly used diffusion metrics and moves on to a brief review of the schizophrenia literature. The functional implications of white matter abnormalities are considered, particularly with respect to myelin's role in modulating the transmission velocity of neural discharges. The paper concludes with a speculative hypothesis about the relationship between gray and white matter abnormalities associated with schizophrenia.
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37
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Kleffner I, Deppe M, Mohammadi S, Schwindt W, Sommer J, Young P, Ringelstein E. Neuroimaging in Susac's syndrome: Focus on DTI. J Neurol Sci 2010; 299:92-6. [DOI: 10.1016/j.jns.2010.08.028] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2010] [Revised: 08/23/2010] [Accepted: 08/23/2010] [Indexed: 10/19/2022]
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Takahashi N, Sakurai T, Davis KL, Buxbaum JD. Linking oligodendrocyte and myelin dysfunction to neurocircuitry abnormalities in schizophrenia. Prog Neurobiol 2010; 93:13-24. [PMID: 20950668 DOI: 10.1016/j.pneurobio.2010.09.004] [Citation(s) in RCA: 220] [Impact Index Per Article: 15.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2010] [Revised: 09/03/2010] [Accepted: 09/30/2010] [Indexed: 01/05/2023]
Abstract
Multiple lines of evidence in schizophrenia, from brain imaging, studies in postmortem brains, and genetic association studies, have implicated oligodendrocyte and myelin dysfunction in this disease. Recent studies suggest that oligodendrocyte and myelin dysfunction leads to changes in synaptic formation and function, which could lead to cognitive dysfunction, a core symptom of schizophrenia. Furthermore, there is accumulating data linking oligodendrocyte and myelin dysfunction with dopamine and glutamate abnormalities, both of which are found in schizophrenia. These findings implicate oligodendrocyte and myelin dysfunction as a primary change in schizophrenia, not only as secondary consequences of the illness or treatment. Strategies targeting oligodendrocyte and myelin abnormalities could therefore provide therapeutic opportunities for patients suffering from schizophrenia.
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Affiliation(s)
- Nagahide Takahashi
- Conte Center for the Neuroscience of Mental Disorders and the Department of Psychiatry, Mount Sinai School of Medicine, New York, NY 10029, USA
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39
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Hallucinations, conscience et psychoses. Encephale 2010; 36:348-54. [DOI: 10.1016/j.encep.2010.07.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2010] [Accepted: 07/09/2010] [Indexed: 11/18/2022]
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40
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Koch K, Wagner G, Dahnke R, Schachtzabel C, Schultz C, Roebel M, Güllmar D, Reichenbach JR, Sauer H, Schlösser RGM. Disrupted white matter integrity of corticopontine-cerebellar circuitry in schizophrenia. Eur Arch Psychiatry Clin Neurosci 2010; 260:419-26. [PMID: 19915989 DOI: 10.1007/s00406-009-0087-0] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2009] [Accepted: 10/28/2009] [Indexed: 11/27/2022]
Abstract
Evidence for white matter abnormalities in patients with schizophrenia is increasing. Decreased fractional anisotropy (FA) in interhemispheric commissural fibers as well as long-ranging fronto-parietal association fibers belongs to the most frequent findings. The present study used tract-based spatial statistics to investigate white matter integrity in 35 patients with schizophrenia and 35 healthy volunteers. We found that patients exhibited significantly decreased FA relative to healthy subjects in the corpus callosum, the cerebral peduncle, the left inferior fronto-occipital fasciculus, the anterior thalamic radiation, the right posterior corona radiata, the middle cerebellar peduncle, and the right superior longitudinal fasciculus. Increased FA was detectable in the inferior sections of the corticopontine-cerebellar circuit. Present data indicate extended cortical-subcortical alterations of white matter integrity in schizophrenia using advanced data analysis strategies. They corroborate preceding findings of white matter structural deficits in mainly long-ranging association fibers and provide first evidence for neuroplastic changes in terms of an increased directionality in more inferior fiber tracts.
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Affiliation(s)
- Kathrin Koch
- Department of Psychiatry and Psychotherapy, Friedrich-Schiller-University Jena, Jahnstr. 3, Philosophenweg 3, 07740, Jena, Germany.
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41
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Devaux J, Fykkolodziej B, Gow A. Claudin Proteins And Neuronal Function. CURRENT TOPICS IN MEMBRANES 2010; 65:229-253. [PMID: 25013353 DOI: 10.1016/s1063-5823(10)65010-7] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
The identification and characterization of the claudin family of tight junction (TJ) proteins in the late 1990s ushered in a new era for research into the molecular and cellular biology of intercellular junctions. Since that time, TJs have been studied in the contexts of many diseases including deafness, male infertility, cancer, bacterial invasion and liver and kidney disorders. In this review, we consider the role of claudins in the nervous system focusing on the mechanisms by which TJs in glial cells are involved in neuronal function. Electrophysiological evidence suggests that claudins may operate in the central nervous system (CNS) in a manner similar to polarized epithelia. We also evaluate hypotheses that TJs are the gatekeepers of an immune-privileged myelin compartment and that TJs emerged during evolution to form major adhesive forces within the myelin sheath. Finally, we consider the implications of CNS myelin TJs in the contexts of behavioral disorders (schizophrenia) and demyelinating/hypomyelinating diseases (multiple sclerosis and the leukodystrophies), and explore evidence of a possible mechanism governing affective disorder symptoms in patients with white matter abnormalities.
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Affiliation(s)
- Jérôme Devaux
- Département Signalisation Neuronale, CRN2M, UMR 6231, CNRS, Université de la Méditerranée-Université Paul Cézanne, IFR Jean Roche, Marseille, France
| | - Bozena Fykkolodziej
- Center for Molecular Medicine and Genetics, Wayne State University School of Medicine, Detroit, MI, 48201, USA
| | - Alexander Gow
- Center for Molecular Medicine and Genetics, Wayne State University School of Medicine, Detroit, MI, 48201, USA. ; Carman and Ann Adams Dept of Pediatrics, Wayne State University School of Medicine, Detroit, MI, 48201, USA. ; Dept of Neurology, Wayne State University School of Medicine, Detroit, MI, 48201, USA
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42
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Höistad M, Segal D, Takahashi N, Sakurai T, Buxbaum JD, Hof PR. Linking white and grey matter in schizophrenia: oligodendrocyte and neuron pathology in the prefrontal cortex. Front Neuroanat 2009; 3:9. [PMID: 19636386 PMCID: PMC2713751 DOI: 10.3389/neuro.05.009.2009] [Citation(s) in RCA: 61] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2009] [Accepted: 06/16/2009] [Indexed: 11/21/2022] Open
Abstract
Neuronal circuitry relies to a large extent on the presence of functional myelin produced in the brain by oligodendrocytes. Schizophrenia has been proposed to arise partly from altered brain connectivity. Brain imaging and neuropathologic studies have revealed changes in white matter and reduction in myelin content in patients with schizophrenia. In particular, alterations in the directionality and alignment of axons have been documented in schizophrenia. Moreover, the expression levels of several myelin-related genes are decreased in postmortem brains obtained from patients with schizophrenia. These findings have led to the formulation of the oligodendrocyte/myelin dysfunction hypothesis of schizophrenia. In this review, we present a brief overview of the neuropathologic findings obtained on white matter and oligodendrocyte status observed in schizophrenia patients, and relate these changes to the processes of brain maturation and myelination. We also review recent data on oligodendrocyte/myelin genes, and present some recent mouse models of myelin deficiencies. The use of transgenic and mutant animal models offers a unique opportunity to analyze oligodendrocyte and neuronal changes that may have a clinical impact. Lastly, we present some recent morphological findings supporting possible causal involvement of white and grey matter abnormalities, in the aim of determining the morphologic characteristics of the circuits whose alteration leads to the cortical dysfunction that possibly underlies the pathogenesis of schizophrenia.
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Affiliation(s)
- Malin Höistad
- Department of Neuroscience, Mount Sinai School of MedicineNew York, NY, USA
| | - Devorah Segal
- Department of Neuroscience, Mount Sinai School of MedicineNew York, NY, USA
| | - Nagahide Takahashi
- Department of Psychiatry, Mount Sinai School of MedicineNew York, NY, USA
| | - Takeshi Sakurai
- Department of Psychiatry, Mount Sinai School of MedicineNew York, NY, USA
| | - Joseph D. Buxbaum
- Department of Psychiatry, Mount Sinai School of MedicineNew York, NY, USA
| | - Patrick R. Hof
- Department of Neuroscience, Mount Sinai School of MedicineNew York, NY, USA
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Velakoulis D, Walterfang M, Mocellin R, Pantelis C, McLean C. Frontotemporal dementia presenting as schizophrenia-like psychosis in young people: clinicopathological series and review of cases. Br J Psychiatry 2009; 194:298-305. [PMID: 19336778 DOI: 10.1192/bjp.bp.108.057034] [Citation(s) in RCA: 119] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
BACKGROUND Few studies have investigated the relationship between schizophrenia and frontotemporal dementia. AIMS To investigate this relationship through a clinicopathological investigation of young-onset frontotemporal dementia and a review of the case literature. METHOD Cases of young-onset frontotemporal dementia were identified within the local brain bank. The clinical course and pathological findings were collated. For the literature review, cases of frontotemporal dementia identified through Medline were selected according to defined criteria. The demographic, clinical, pathological and genetic characteristics of cases presenting with a psychotic illness were identified. RESULTS In the case series, 5 of 17 patients with frontotemporal dementia had presented with a psychotic illness (schizophrenia/schizoaffective disorder n=4, bipolar disorder n=1) an average of 5 years prior to the dementia diagnosis. Patients with schizophrenia exhibited changes consistent with TDP-43 and ubiquitin-positive frontotemporal dementia. In the cases review, a third of patients aged 30 years or under and a quarter of those aged 40 years or under had been diagnosed with psychosis at presentation. CONCLUSIONS Patients with young-onset frontotemporal dementia may be diagnosed with a psychotic illness years before the dementia diagnosis is made. These findings have implications for clinicians and for our further understanding of the neurobiology of psychotic illness.
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Affiliation(s)
- D Velakoulis
- Neuropsychiatry Unit, Level 2 John Cade Building, Royal Melbourne Hospital, Parkville, Victoria 3052, Australia.
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44
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Freudenreich O, Schulz SC, Goff DC. Initial medical work-up of first-episode psychosis: a conceptual review. Early Interv Psychiatry 2009; 3:10-8. [PMID: 21352170 DOI: 10.1111/j.1751-7893.2008.00105.x] [Citation(s) in RCA: 43] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
AIM To help clinicians carry out a comprehensive, medical diagnostic assessment in first-episode patients who are suspected of developing schizophrenia. METHODS Conceptual review of the published work with emphasis on the diagnostic goals of excluding medical causes of psychosis and establishing a medical baseline. RESULTS There is no agreed-upon standard for the initial medical work-up of first-episode cases. Excluding secondary causes of schizophrenia requires consideration of likelihood of disease; laboratory test performance; and relevance of positive test results. CONCLUSIONS We propose a medical work-up for first-episode psychosis that combines: (i) broad screening; (ii) exclusion of specific diseases informed by treatability and epidemiology; and (iii) medical baseline measures.
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Affiliation(s)
- Oliver Freudenreich
- Massachusetts General Hospital Schizophrenia Program, Freedom Trail Clinic, Harvard Medical School, 25 Staniford Street, Boston, MA 02114, USA.
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45
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Phillips OR, Nuechterlein KH, Clark KA, Hamilton LS, Asarnow RF, Hageman NS, Toga AW, Narr KL. Fiber tractography reveals disruption of temporal lobe white matter tracts in schizophrenia. Schizophr Res 2009; 107:30-8. [PMID: 19028423 PMCID: PMC2655322 DOI: 10.1016/j.schres.2008.10.019] [Citation(s) in RCA: 70] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2008] [Revised: 10/17/2008] [Accepted: 10/21/2008] [Indexed: 10/21/2022]
Abstract
Diffusion tensor imaging (DTI) studies have demonstrated abnormal anisotropic diffusion in schizophrenia. However, examining data with low spatial resolution and/or a low number of gradient directions and limitations associated with analysis approaches sensitive to registration confounds may have contributed to mixed findings concerning the regional specificity and direction of results. This study examined three major white matter tracts connecting lateral and medial temporal lobe regions with neocortical association regions widely implicated in systems-level functional and structural disturbances in schizophrenia. Using DTIstudio, a previously validated regions of interest tractography method was applied to 30 direction diffusion weighted imaging data collected from demographically similar schizophrenia (n=23) and healthy control subjects (n=22). The diffusion tensor was computed at each voxel after intra-subject registration of diffusion-weighted images. Three-dimensional tract reconstruction was performed using the Fiber Assignment by Continuous Tracking (FACT) algorithm. Tractography results showed reduced fractional anisotropy (FA) of the arcuate fasciculi (AF) and inferior longitudinal fasciculi (ILF) in patients compared to controls. FA changes within the right ILF were negatively correlated with measures of thinking disorder. Reduced volume of the left AF was also observed in patients. These results, which avoid registration issues associated with voxel-based analyses of DTI data, support that fiber pathways connecting lateral and medial temporal lobe regions with neocortical regions are compromised in schizophrenia. Disruptions of connectivity within these pathways may potentially contribute to the disturbances of memory, language, and social cognitive processing that characterize the disorder.
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Affiliation(s)
- Owen R. Phillips
- Laboratory of Neuro Imaging, Department of Neurology Geffen School of Medicine at UCLA
| | - Keith H. Nuechterlein
- Department of Psychiatry and Biobehavioral Sciences Geffen School of Medicine at UCLA
| | - Kristi A. Clark
- Ahmanson-Lovelace Brain Mapping Center, Department of Neurology Geffen School of Medicine at UCLA
| | - Liberty S. Hamilton
- Laboratory of Neuro Imaging, Department of Neurology Geffen School of Medicine at UCLA
| | - Robert F. Asarnow
- Department of Psychiatry and Biobehavioral Sciences Geffen School of Medicine at UCLA
| | - Nathan S. Hageman
- Laboratory of Neuro Imaging, Department of Neurology Geffen School of Medicine at UCLA
| | - Arthur W. Toga
- Laboratory of Neuro Imaging, Department of Neurology Geffen School of Medicine at UCLA
| | - Katherine L. Narr
- Laboratory of Neuro Imaging, Department of Neurology Geffen School of Medicine at UCLA
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Xiao L, Xu H, Zhang Y, Wei Z, He J, Jiang W, Li X, Dyck LE, Devon RM, Deng Y, Li XM. Quetiapine facilitates oligodendrocyte development and prevents mice from myelin breakdown and behavioral changes. Mol Psychiatry 2008; 13:697-708. [PMID: 17684494 DOI: 10.1038/sj.mp.4002064] [Citation(s) in RCA: 142] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Recent neuroimaging and postmortem studies have reported abnormalities in white matter of schizophrenic brains, suggesting the involvement of oligodendrocytes in the etiopathology of schizophrenia. This view is being supported by gene microarray studies showing the downregulation of genes related to oligodendrocyte function and myelination in schizophrenic brain compared to control subjects. However, there is currently little information available on the response of oligodendrocytes to antipsychotic drugs (APDs), which could be invaluable for corroborating the oligodendrocyte hypothesis. In this study we found: (1) quetiapine (QUE, an atypical APD) treatment in conjunction with addition of growth factors increased the proliferation of neural progenitors isolated from the cerebral cortex of embryonic rats; (2) QUE directed the differentiation of neural progenitors to oligodendrocyte lineage through extracellular signal-related kinases; (3) addition of QUE increased the synthesis of myelin basic protein and facilitated myelination in rat embryonic cortical aggregate cultures; (4) chronic administration of QUE to C57BL/6 mice prevented cortical demyelination and concomitant spatial working memory impairment induced by cuprizone, a neurotoxin. These findings suggest a new neural mechanism of antipsychotic action of QUE, and help to establish a role for oligodendrocytes in the etiopathology and treatment of schizophrenia.
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Affiliation(s)
- L Xiao
- Neuropsychiatry Research Unit, Department of Psychiatry, University of Saskatchewan, Saskatoon, SK, Canada
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Yücel M, Takagi M, Walterfang M, Lubman DI. Toluene misuse and long-term harms: a systematic review of the neuropsychological and neuroimaging literature. Neurosci Biobehav Rev 2008; 32:910-26. [PMID: 18456329 DOI: 10.1016/j.neubiorev.2008.01.006] [Citation(s) in RCA: 80] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2007] [Revised: 01/12/2008] [Accepted: 01/23/2008] [Indexed: 10/22/2022]
Abstract
Organic solvent abuse is associated with increased risk for serious medical, neurological, and neuropsychological impairments. While animal research suggests that exposure to organic solvents (especially toluene) may be neurotoxic, much less is known about the consequences of long-term exposure in humans. We reviewed neuroimaging and neuropsychological studies examining chronic toluene misuse in humans. Thirty empirical studies fulfilled the inclusion and exclusion criteria, including case studies (n=9) as well as group studies with (n=11) and without a control group (n=10). Our review indicates that toluene preferentially affects white matter (relative to gray matter) structures and periventricular/subcortical (relative to cortical) regions. The lipid-dependent distribution and pharmacokinetic properties of toluene appears to explain the pattern of MRI abnormalities, as well as the common symptoms and signs of toluene encephalopathy. The commonly observed neuropsychological deficits such as impairments in processing speed, sustained attention, memory retrieval, executive function and language, are also consistent with white matter pathology. We discuss the implications of these findings in the context of a neurodevelopmental framework, as well as the neuropathology and pathophysiology of toluene abuse. We also propose a set of recommendations to guide future research in this area.
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Affiliation(s)
- Murat Yücel
- ORYGEN Research Centre, Department of Psychiatry, The University of Melbourne, Victoria, Australia.
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Walterfang M, Evans A, Fietz M, Velakoulis D. Psychosis and vertical supranuclear opthalmoplegia. J Clin Neurosci 2008. [DOI: 10.1016/j.jocn.2007.01.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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49
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Harris JM, Moorhead TWJ, Miller P, McIntosh AM, Bonnici HM, Owens DGC, Johnstone EC, Lawrie SM. Increased prefrontal gyrification in a large high-risk cohort characterizes those who develop schizophrenia and reflects abnormal prefrontal development. Biol Psychiatry 2007; 62:722-9. [PMID: 17509536 DOI: 10.1016/j.biopsych.2006.11.027] [Citation(s) in RCA: 94] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2006] [Revised: 11/03/2006] [Accepted: 11/27/2006] [Indexed: 11/25/2022]
Abstract
BACKGROUND In our cohort considered at high risk (HR) of developing schizophrenia, we previously found a significant difference in extent of right prefrontal cortical folding between those who subsequently developed schizophrenia and a matched group who remained well. This study aimed to determine if this preexisting difference distinguished 17 individuals who developed schizophrenia from the 128 HR individuals in the cohort who remained well and to explore possible underlying differences in cortical composition. METHODS Prefrontal cortical folding was measured by an automated version of the Gyrification Index (A-GI), a ratio reflecting extent of folding. Multivariate logistic regression assessed the probability that prefrontal A-GI predicts diagnostic outcome and subsequently assessed the effect on A-GI of regional cerebrospinal fluid and gray and white matter. RESULTS High-risk individuals who subsequently developed schizophrenia were distinguished from the remaining cohort by increased right prefrontal cortex (PFC) A-GI. Mean right PFC gray matter volume also differed between groups, but white matter volume did not. Correlations of age with gray and white matter further distinguished groups and a linear regression analysis showed a significant interaction between age and diagnosis on mean volume of right PFC white matter. CONCLUSIONS Increased A-GI appears to indicate abnormal right prefrontal development in those who develop schizophrenia.
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Affiliation(s)
- Jonathan M Harris
- Division of Psychiatry, University of Edinburgh, Edinburgh, United Kingdom.
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50
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Yildiz M, Borgwardt S. Apoptosis may be the main cause for acceleration of normal changes in adolescent brain structure, leading to the onset of psychosis. Med Hypotheses 2007; 70:706-7. [PMID: 17683878 DOI: 10.1016/j.mehy.2007.05.051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2007] [Accepted: 05/31/2007] [Indexed: 11/30/2022]
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