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Westhoff MLS, Ladwig J, Heck J, Schülke R, Groh A, Deest M, Bleich S, Frieling H, Jahn K. Early Detection and Prevention of Schizophrenic Psychosis-A Review. Brain Sci 2021; 12:11. [PMID: 35053755 PMCID: PMC8774083 DOI: 10.3390/brainsci12010011] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2021] [Revised: 12/16/2021] [Accepted: 12/20/2021] [Indexed: 01/04/2023] Open
Abstract
Psychotic disorders often run a chronic course and are associated with a considerable emotional and social impact for patients and their relatives. Therefore, early recognition, combined with the possibility of preventive intervention, is urgently warranted since the duration of untreated psychosis (DUP) significantly determines the further course of the disease. In addition to established diagnostic tools, neurobiological factors in the development of schizophrenic psychoses are increasingly being investigated. It is shown that numerous molecular alterations already exist before the clinical onset of the disease. As schizophrenic psychoses are not elicited by a single mutation in the deoxyribonucleic acid (DNA) sequence, epigenetics likely constitute the missing link between environmental influences and disease development and could potentially serve as a biomarker. The results from transcriptomic and proteomic studies point to a dysregulated immune system, likely evoked by epigenetic alterations. Despite the increasing knowledge of the neurobiological mechanisms involved in the development of psychotic disorders, further research efforts with large population-based study designs are needed to identify suitable biomarkers. In conclusion, a combination of blood examinations, functional imaging techniques, electroencephalography (EEG) investigations and polygenic risk scores should be considered as the basis for predicting how subjects will transition into manifest psychosis.
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Affiliation(s)
- Martin Lennart Schulze Westhoff
- Department of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School, D-30625 Hannover, Germany; (J.L.); (R.S.); (A.G.); (M.D.); (S.B.); (H.F.); (K.J.)
| | - Johannes Ladwig
- Department of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School, D-30625 Hannover, Germany; (J.L.); (R.S.); (A.G.); (M.D.); (S.B.); (H.F.); (K.J.)
| | - Johannes Heck
- Institute for Clinical Pharmacology, Hannover Medical School, D-30625 Hannover, Germany;
| | - Rasmus Schülke
- Department of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School, D-30625 Hannover, Germany; (J.L.); (R.S.); (A.G.); (M.D.); (S.B.); (H.F.); (K.J.)
| | - Adrian Groh
- Department of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School, D-30625 Hannover, Germany; (J.L.); (R.S.); (A.G.); (M.D.); (S.B.); (H.F.); (K.J.)
| | - Maximilian Deest
- Department of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School, D-30625 Hannover, Germany; (J.L.); (R.S.); (A.G.); (M.D.); (S.B.); (H.F.); (K.J.)
| | - Stefan Bleich
- Department of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School, D-30625 Hannover, Germany; (J.L.); (R.S.); (A.G.); (M.D.); (S.B.); (H.F.); (K.J.)
| | - Helge Frieling
- Department of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School, D-30625 Hannover, Germany; (J.L.); (R.S.); (A.G.); (M.D.); (S.B.); (H.F.); (K.J.)
| | - Kirsten Jahn
- Department of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School, D-30625 Hannover, Germany; (J.L.); (R.S.); (A.G.); (M.D.); (S.B.); (H.F.); (K.J.)
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Vázquez-Borsetti P, Peña E, Rojo Y, Acuña A, Loidl FC. Deep hypothermia reverses behavioral and histological alterations in a rat model of perinatal asphyxia. J Comp Neurol 2018; 527:362-371. [PMID: 30255933 DOI: 10.1002/cne.24539] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2018] [Revised: 07/03/2018] [Accepted: 08/21/2018] [Indexed: 12/15/2022]
Abstract
The consequences of perinatal asphyxia (PA) include alterations which may manifest as schizophrenia. Characteristic features of this disease include a decrease in specific subpopulations of GABAergic cells and deterioration of social interaction. The purpose of this study is to assess if a deep and short-hypothermic treatment can ameliorate this damage in a model of PA. Rats offsprings were exposed to 19 min of asphyxia by immersing the uterus horns in water at 37 °C followed by 30 min in air at 10 °C that resulted in 15 °C body temperature. At postnatal day 36-38, the rats were tested in the open field and social interaction paradigms and processed for immunostaining of calbindin and reelin. A brief exposure to deep hypothermia reversed the deterioration produced by PA in play soliciting. PA decreased the density of calbindin neurons in layer II of the Anterior Insular Cortex, while deep hypothermia reversed this effect. Paradoxically, in AIC, there was a significant increase in the number of reelin-secreting neurons in layers II and III generated by PA and this increase was reversed by hypothermia. This suggests a compensatory mechanism, where reelin neurons trend to compensate for the loss of calbindin neurons, at least within Anterior Insular Cortex. Finally, the deep hypothermic shock might represent a valuable therapeutic alternative to treat PA.
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Affiliation(s)
- Pablo Vázquez-Borsetti
- Laboratorio de Neuropatología Experimental, Instituto de Biología Celular y Neurociencia "Prof. E. De Robertis" UBA-CONICET, Buenos Aires, Argentina
| | - Elena Peña
- Laboratorio de Neuropatología Experimental, Instituto de Biología Celular y Neurociencia "Prof. E. De Robertis" UBA-CONICET, Buenos Aires, Argentina
| | - Yanina Rojo
- Laboratorio de Neuropatología Experimental, Instituto de Biología Celular y Neurociencia "Prof. E. De Robertis" UBA-CONICET, Buenos Aires, Argentina
| | - Andrés Acuña
- Laboratorio de Neuropatología Experimental, Instituto de Biología Celular y Neurociencia "Prof. E. De Robertis" UBA-CONICET, Buenos Aires, Argentina
| | - Fabián C Loidl
- Facultad de Medicina, Universidad Católica de Cuyo, San Juan, Argentina
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Khan A, Powell SB. Sensorimotor gating deficits in "two-hit" models of schizophrenia risk factors. Schizophr Res 2018; 198:68-83. [PMID: 29070440 PMCID: PMC5911431 DOI: 10.1016/j.schres.2017.10.009] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2017] [Revised: 10/03/2017] [Accepted: 10/06/2017] [Indexed: 02/07/2023]
Abstract
Genetic and environmental models of neuropsychiatric disease have grown exponentially over the last 20years. One measure that is often used to evaluate the translational relevance of these models to human neuropsychiatric disease is prepulse inhibition of startle (PPI), an operational measure of sensorimotor gating. Deficient PPI characterizes several neuropsychiatric disorders but has been most extensively studied in schizophrenia. It has become a useful tool in translational neuropharmacological and molecular genetics studies because it can be measured across species using almost the same experimental parameters. Although initial studies of PPI in rodents were pharmacological because of the robust predictive validity of PPI for antipsychotic efficacy, more recently, PPI has become standard common behavioral measures used in genetic and neurodevelopmental models of schizophrenia. Here we review "two hit" models of schizophrenia and discuss the utility of PPI as a tool in phenotyping these models of relevant risk factors. In the review, we consider approaches to rodent models of genetic and neurodevelopmental risk factors and selectively review "two hit" models of gene×environment and environment×environment interactions in which PPI has been measured.
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Affiliation(s)
- Asma Khan
- Department of Psychiatry, University of California San Diego, 9500 Gilman Dr., La Jolla, CA 92093, United States; Research Service, VA San Diego Healthcare System, La Jolla, CA, United States
| | - Susan B Powell
- Department of Psychiatry, University of California San Diego, 9500 Gilman Dr., La Jolla, CA 92093, United States; Research Service, VA San Diego Healthcare System, La Jolla, CA, United States.
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Teigset CM, Mohn C, Rund BR. Gestational length affects neurocognition in early-onset schizophrenia. Psychiatry Res 2016; 244:78-85. [PMID: 27474856 DOI: 10.1016/j.psychres.2016.07.017] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2015] [Revised: 06/16/2016] [Accepted: 07/09/2016] [Indexed: 12/17/2022]
Abstract
Obstetric complications (OC) have been linked to an increased risk for schizophrenia in offspring, especially in early-onset schizophrenia (EOS). Extensive cognitive deficits occur in EOS, although no study has yet to investigate the relationship between OC and cognition in EOS. This study aims to examine the frequency of OC in EOS compared to controls, and also investigates the relationship between OC and neurocognitive dysfunction in the two groups. Nineteen EOS patients and 53 healthy controls were tested with the MATRICS Consensus Cognitive Battery (MCCB), and the cognitive measures were combined with OC data from the Norwegian Birth Registry. The results indicated no group differences in OC in EOS and healthy controls, but a shorter gestational length in the EOS group led to significant decreases in the overall neurocognitive composite score, and in processing speed. This suggests that the poorer neuropsychological performances commonly found in EOS may be partly attributable to the length of gestation. The worsened neurocognitive functioning did not appear among controls, so gestational length had a different impact on the two groups. Our findings indicated that a shorter gestational length did not increase the risk for developing EOS, but did significantly affect the cognitive difficulties in this group.
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Affiliation(s)
- Charlotte M Teigset
- Vestre Viken Hospital Trust, Research Department, Wergelandsgate 10, 3004 Drammen, Norway.
| | - Christine Mohn
- Vestre Viken Hospital Trust, Research Department, Wergelandsgate 10, 3004 Drammen, Norway.
| | - Bjørn Rishovd Rund
- Vestre Viken Hospital Trust, Research Department, Wergelandsgate 10, 3004 Drammen, Norway; Department of Psychology, University of Oslo, Postboks 1094 Blindern, 0317 Oslo, Norway.
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Cope ZA, Powell SB, Young JW. Modeling neurodevelopmental cognitive deficits in tasks with cross-species translational validity. GENES BRAIN AND BEHAVIOR 2016; 15:27-44. [PMID: 26667374 DOI: 10.1111/gbb.12268] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/31/2015] [Revised: 10/14/2015] [Accepted: 10/27/2015] [Indexed: 12/24/2022]
Abstract
Numerous psychiatric disorders whose cognitive dysfunction links to functional outcome have neurodevelopmental origins including schizophrenia, autism and bipolar disorder. Treatments are needed for these cognitive deficits, which require development using animal models. Models of neurodevelopmental disorders are as varied and diverse as the disorders themselves, recreating some but not all aspects of the disorder. This variety may in part underlie why purported procognitive treatments translated from these models have failed to restore functioning in the targeted patient populations. Further complications arise from environmental factors used in these models that can contribute to numerous disorders, perhaps only impacting specific domains, while diagnostic boundaries define individual disorders, limiting translational efficacy. The Research Domain Criteria project seeks to 'develop new ways to classify mental disorders based on behavioral dimensions and neurobiological measures' in hopes of facilitating translational research by remaining agnostic toward diagnostic borders derived from clinical presentation in humans. Models could therefore recreate biosignatures of cognitive dysfunction irrespective of disease state. This review highlights work within the field of neurodevelopmental models of psychiatric disorders tested in cross-species translational cognitive paradigms that directly inform this newly developing research strategy. By expounding on this approach, the hopes are that a fuller understanding of each model may be attainable in terms of the cognitive profile elicited by each manipulation. Hence, conclusions may begin to be drawn on the nature of cognitive neuropathology on neurodevelopmental and other disorders, increasing the chances of procognitive treatment development for individuals affected in specific cognitive domains.
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Affiliation(s)
- Z A Cope
- Department of Psychiatry, University of California San Diego, La Jolla
| | - S B Powell
- Department of Psychiatry, University of California San Diego, La Jolla.,Research Service, VA San Diego Healthcare System, San Diego, CA, USA
| | - J W Young
- Department of Psychiatry, University of California San Diego, La Jolla.,Research Service, VA San Diego Healthcare System, San Diego, CA, USA
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Kim DR, Bale TL, Epperson CN. Prenatal programming of mental illness: current understanding of relationship and mechanisms. Curr Psychiatry Rep 2015; 17:5. [PMID: 25617041 PMCID: PMC4458064 DOI: 10.1007/s11920-014-0546-9] [Citation(s) in RCA: 134] [Impact Index Per Article: 14.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
The British epidemiologist Dr. David J. Barker documented the relationship between infant birth weight and later onset of hypertension, coronary heart disease, insulin resistance, and type II diabetes. A stressful in utero environment can cause long-term consequences for offspring through prenatal programming. Prenatal programming most commonly occurs through epigenetic mechanisms and can be dependent on the type and timing of exposure as well as the sex of the fetus. In this review, we highlight the most recent evidence that prenatal programming is implicated in the development of psychiatric disorders in offspring exposed to maternal stress during pregnancy. Methodological differences between studies contribute to unavoidable heterogeneity in study findings. Current data suggest that fetal exposure to maternal hypothalamic-pituitary-adrenal axis dysregulation, excessive glucocorticoids, and inflammation with resulting epigenetic changes at both the placental and fetal levels are important areas of continued investigation.
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Affiliation(s)
- Deborah R. Kim
- Department of Psychiatry, Penn Center for Women’s Behavioral Wellness, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA 19104, USA. Room 3050, 3535 Market Street, Philadelphia, PA 19104, USA
| | - Tracy L. Bale
- Department of Neuroscience, University of Pennsylvania School of Veterinary Medicine, Philadelphia, PA, USA
| | - C. Neill Epperson
- Department of Psychiatry, Penn Center for Women’s Behavioral Wellness, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA 19104, USA. Department of Obstetrics and Gynecology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
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Gallagher BJ, Jones BJ, Eaton KE. A Sex-Specified Effect of Obstetrical Complications in Symptoms of Schizophrenia. ACTA ACUST UNITED AC 2014; 8:143-148A. [DOI: 10.3371/csrp.gajo.030113] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Bellon A, Le Pen G, Matricon J, Jay TM, Krebs MO. Potential application as screening and drug designing tools of cytoarchitectural deficiencies present in three animal models of schizophrenia. Expert Opin Drug Discov 2013; 4:257-78. [PMID: 23489125 DOI: 10.1517/17460440902762794] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
BACKGROUND The development of new treatment alternatives for schizophrenia has been prevented by the unknown etiology of the illness and the divergence of results in the field. However, consistent neuropathological findings are emerging from anatomical areas known to be at the core of schizophrenia. If these deficiencies are replicated in animal models then such anomalies could become the target for a new generation of drugs. OBJECTIVE To determine if the methylazoxymethanol acetate (MAM) model, the heterozygote reeler mouse (HRM) and NMDA-antagonists treated rats replicate neuropathological deficits encountered in patients with schizophrenia and to establish if such changes could lead the search for developing novel treatment alternatives. METHODS Databases including MEDLINE, Cochrane and Ovid were searched; search terms included neuropathology, schizophrenia and animal models. RESULTS/CONCLUSIONS NMDA-antagonist treated animals partially replicate schizophrenia anomalies in parvalbumin positive interneurons. In contrast, neuroanatomical deficiencies replicated by the MAM model and the HRM in the hippocampus and the prefrontal cortex seem promising targets for future pharmacological research in schizophrenia. Such neuroanatomical findings along with evidence from molecules and genes associated with schizophrenia suggest new drugs should aim to correct deficits in the formation of dendrites and axons that seems to be implicated in this illness pathophysiology.
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Affiliation(s)
- Alfredo Bellon
- INSERM, Hôpital Sainte-Anne, Centre de Psychiatrie et Neurosciences, Laboratoire de Physiopathologie des Maladies Psychiatriques, U894, 2 ter rue d'Alésia, 75014 Paris, France +33 1 40788634 ; +33 1 45807293 ;
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Jones BJ, Gallagher BJ, Moss DM, McFalls JA. Obstetrical complications, social class and type of schizophrenia. ACTA ACUST UNITED AC 2011; 5:33-9. [PMID: 21459737 DOI: 10.3371/csrp.5.1.5] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
The emerging neurodevelopmental model posits that prenatal and perinatal factors can play an etiological role in schizophrenia. Consistently, the research on obstetrical complications (OCs) reports an association with the development of more severe schizophrenic symptoms. Low socioeconomic status (SES) has also been linked to both limited prenatal healthcare and to worse prognosis of schizophrenic symptoms. A large sample (n=437) of patients from a state hospital population in the U. S. was screened for study variables. A sequential analysis was conducted, first applying cross tabulations using the chi-square test, and then building separate logit models for poor and nonpoor patients. The cross tabulations indicated an association between OCs and negative symptoms for poor schizophrenic patients, but not for nonpoor patients. Multivariate logit models further supported this result. This is the first study to examine the interaction of OCs, schizophrenic symptomatology and SES of origin.
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Affiliation(s)
- Brian J Jones
- Department of Sociology, Villanova University, Villanova, PA 19085, USA.
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Adriano F, Caltagirone C, Spalletta G. Hippocampal volume reduction in first-episode and chronic schizophrenia: a review and meta-analysis. Neuroscientist 2011; 18:180-200. [PMID: 21531988 DOI: 10.1177/1073858410395147] [Citation(s) in RCA: 211] [Impact Index Per Article: 16.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Several magnetic resonance imaging studies have reported hippocampal volume reduction in patients with schizophrenia, but other studies have reported contrasting results. In this review and meta-analysis, the authors aim to clarify whether a reduction in hippocampal volume characterizes patients with schizophrenia by considering illness phase (chronic and first episode) and hippocampus side separately. They made a detailed literature search for studies reporting physical volumetric hippocampal measures of patients with schizophrenia and healthy control (HC) participants and found 44 studies that were eligible for meta-analysis. Individual meta-analyses were also performed on 13 studies of first-episode patients and on 22 studies of chronic patients. The authors also detected any different findings when only males or both males and females were considered. Finally, additional meta-analyses and analyses of variance investigated the role of the factors "illness phase" and "side" on hippocampal volume reduction. Overall, the patient group showed significant bilateral hippocampal volume reduction compared with HC. Interestingly, first-episode and chronic patients showed same-size hippocampal volume reduction. Moreover, the left hippocampus was smaller than the right hippocampus in patients and HC. This review and meta-analysis raises the question about whether hippocampal volume reduction in schizophrenia is of neurodevelopmental origin. Future studies should specifically investigate this issue.
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Affiliation(s)
- Fulvia Adriano
- Laboratory of Clinical and Behavioural Neurology, IRCCS Santa Lucia Foundation, Rome, Italy
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Matevosyan NR. Pregnancy and postpartum specifics in women with schizophrenia: a meta-study. Arch Gynecol Obstet 2010; 283:141-7. [DOI: 10.1007/s00404-010-1706-8] [Citation(s) in RCA: 64] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2010] [Accepted: 09/22/2010] [Indexed: 11/25/2022]
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Gupta S, Kulhara P. What is schizophrenia: A neurodevelopmental or neurodegenerative disorder or a combination of both? A critical analysis. Indian J Psychiatry 2010; 52:21-7. [PMID: 20174514 PMCID: PMC2824976 DOI: 10.4103/0019-5545.58891] [Citation(s) in RCA: 56] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
The etiology of schizophrenia has been the focus of intensive research for a long time. Perspectives have changed drastically with the development of new investigative techniques. Clinical observations made by Kraepelin, Clouston, Bender, and Watt are now being complemented by neuroimaging and genetic studies to prove the neurodevelopmental hypothesis. At the same time, neuropathological and longitudinal studies of schizophrenia often support a neurodegenerative hypothesis. To provide a theoretical basis to the available evidence, another hypothesis called the progressive neurodevelopmental model has also emerged. This review presents some key evidence supporting each of these theories followed by a critical analysis of each.
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Affiliation(s)
- Swapnil Gupta
- Department of Psychiatry, Postgraduate Institute of Medical Education and Research, Chandigarh - 160 012, India
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Abstract
The neurodevelopmental hypothesis of schizophrenia asserts that the underlying pathology of schizophrenia has its roots in brain development and that these brain abnormalities do not manifest themselves until adolescence or early adulthood. Animal models based on developmental manipulations have provided insight into the vulnerability of the developing fetus and the importance of the early environment for normal maturation. These models have provided a wide range of validated approaches to answer questions regarding environmental influences on both neural and behavioral development. In an effort to better understand the developmental hypothesis of schizophrenia, animal models have been developed, which seek to model the etiology and/or the pathophysiology of schizophrenia or specific behaviors associated with the disease. Developmental models specific to schizophrenia have focused on epidemiological risk factors (e.g., prenatal viral insult, birth complications) or more heuristic models aimed at understanding the developmental neuropathology of the disease (e.g., ventral hippocampal lesions). The combined approach of behavioral and neuroanatomical evaluation of these models strengthens their utility in improving our understanding of the pathophysiology of schizophrenia and developing new treatment strategies.
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Affiliation(s)
- Susan B Powell
- University of California, San Diego, 9500 Gilman Dr., La Jolla, CA 92093-0804, USA.
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Developmental disruptions in neural connectivity in the pathophysiology of schizophrenia. Dev Psychopathol 2008; 20:1297-327. [DOI: 10.1017/s095457940800062x] [Citation(s) in RCA: 115] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
AbstractSchizophrenia has been thought of as a disorder of reduced functional and structural connectivity. Recent advances in neuroimaging techniques such as functional magnetic resonance imaging, structural magnetic resonance imaging, diffusion tensor imaging, and small animal imaging have advanced our ability to investigate this hypothesis. Moreover, the power of longitudinal designs possible with these noninvasive techniques enable the study of not just how connectivity is disrupted in schizophrenia, but when this disruption emerges during development. This article reviews genetic and neurodevelopmental influences on structural and functional connectivity in human populations with or at risk for schizophrenia and in animal models of the disorder. We conclude that the weight of evidence across these diverse lines of inquiry points to a developmental disruption of neural connectivity in schizophrenia and that this disrupted connectivity likely involves susceptibility genes that affect processes involved in establishing intra- and interregional connectivity.
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Ballon JS, Dean KA, Cadenhead KS. Obstetrical complications in people at risk for developing schizophrenia. Schizophr Res 2008; 98:307-11. [PMID: 17961986 PMCID: PMC2752444 DOI: 10.1016/j.schres.2007.05.011] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2007] [Accepted: 05/11/2007] [Indexed: 11/18/2022]
Abstract
Many factors have been associated with the development of schizophrenia, yet few studies have looked at these same factors in individuals considered at risk for schizophrenia, but who have not yet reached diagnostic threshold. The rate of obstetrical complications was assessed as part of a comprehensive battery in subjects at risk (N=52), or in the first episode of schizophrenia (N=18), and in normal comparison subjects (N=43). The rate of obstetrical complications was increased in the at risk (46%) and first episode (39%) samples compared to the normal comparison (19%) group, however, follow-up analyses were only significant between the at risk and normal comparison subjects. Obstetrical complications may be an important risk factor in identifying vulnerable subjects and ultimately may, along with other risk factors, be part of an algorithm for determining likelihood of developing schizophrenia.
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Affiliation(s)
- Jacob S Ballon
- Department of Psychiatry, 0810, University of California San Diego, 9500 Gilman Drive, La Jolla, CA 92093-0810, United States
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Amore M, Pisani F, Balista C, Sarchiapone M, McCreadie R. Are obstetric complications related to adult schizophrenia? A case-control study. Acta Neuropsychiatr 2007; 19:338-43. [PMID: 26952998 DOI: 10.1111/j.1601-5215.2007.00190.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND Early environmental events may be relevant to the etiology of schizophrenia. Among such events, interest has focused especially on obstetric complications (OCs). OBJECTIVE Aims of the study were to compare the incidence of OCs in patients, siblings and normal controls and to examine the relationship between OCs and later schizophrenia. METHOD One hundred and thirteen patients with schizophrenia were recruited, as were 140 patients' siblings and 113 controls without schizophrenia. The OCs history of patients, their sibs and controls was obtained through interviews with patients' and controls' mothers. RESULTS The results highlighted that more patients than sibs had at least one definite OC and a higher mean number of OCs; more patients had premature rupture of membranes, threatened abortion and a labor of more than 36 h. CONCLUSIONS Our data provide some evidence for a link between OCs and later schizophrenia. Furthermore, this study highlights how OCs, which may cause fetal distress through a hypoxic-ischemic mechanism, could increase the risk of schizophrenia interacting with genetic susceptibility.
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Affiliation(s)
- Mario Amore
- 1Institute of Psychiatry, University of Parma, Italy
| | | | | | | | - Robin McCreadie
- 4Department of Clinical Research, Crichton Royal Hospital, Dumfries, Scotland, UK
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Devlin B, Klei L, Myles-Worsley M, Tiobech J, Otto C, Byerley W, Roeder K. Genetic liability to schizophrenia in Oceanic Palau: a search in the affected and maternal generation. Hum Genet 2007; 121:675-84. [PMID: 17436020 DOI: 10.1007/s00439-007-0358-7] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2006] [Accepted: 03/20/2007] [Indexed: 12/22/2022]
Abstract
While liability to schizophrenia (Scz) is due to genetic and environmental factors, specific factors are largely unknown. We postulate a two-hit model for Scz, in which initial liability is generated during fetal brain development: this "hit" is precipitated by environmental stressors biologically interacting with maternal genetic vulnerability to the stress. Additional liability to Scz is generated by individual genetic vulnerability. To evaluate these putative levels of vulnerability, we search in the genome of both affected individuals and their mothers for variation that differs, statistically, from that in the general population. For parental analyses, mothers were treated as "affected," rather than their offspring, and the fathers were treated as "controls". We used a sample from the Palauan population: 175 individuals diagnosed with Scz, broadly defined; 87 mothers and 45 fathers of affected individuals. Pedigree and diagnostic data were available on 2,953 living and deceased subjects. DNA from 553 individuals was genotyped for short tandem repeats (STR) spaced approximately every 10 cM across the genome. We tested for association between affection status and STR alleles; such an approach was reasonable, despite the widely spaced markers, because this population has far-ranging linkage disequilibrium (LD). Results for the truly affected individuals were modest, whereas results from the maternal generation were promising. For a recessive model and a test for excess allele matching across mothers, significant findings occurred for D20S481, D10S1221, D6S1021, D13S317, and D18S976. Regions in which at least two adjacent markers produced substantial association statistics include 2p12-11.2, 2q24.1-32.1, 6q12-14.1, 10q23.2-24.21, 12q23.2-24.21 and 17q23.2-23.3.
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Affiliation(s)
- Bernie Devlin
- Department of Psychiatry, University of Pittsburgh School of Medicine, 3811 O'Hara Street, Pittsburgh, PA 15213, USA.
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Nawa H, Takei N. Recent progress in animal modeling of immune inflammatory processes in schizophrenia: implication of specific cytokines. Neurosci Res 2006; 56:2-13. [PMID: 16837094 DOI: 10.1016/j.neures.2006.06.002] [Citation(s) in RCA: 139] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2006] [Revised: 06/01/2006] [Accepted: 06/05/2006] [Indexed: 11/29/2022]
Abstract
Epidemiologic studies demonstrate significant environmental impact of maternal viral infection and obstetric complications on the risk of schizophrenia and indicate their detrimental influences on brain development in this disorder. Based on these findings, animal models for schizophrenia have been established using double stranded RNA, bacterial lipopolysaccharides, hippocampal lesion, or prenatal/perinatal ischemia. Key molecules regulating such immune/inflammatory reactions are cytokines, which are also involved in brain development, regulating dopaminergic and GABAergic differentiation, and synaptic maturation. Specific members of the cytokine family, such as interleukin-1, epidermal growth factor, and neuregulin-1, are induced after infection and brain injury; therefore, certain cytokines are postulated to have a central role in the neurodevelopmental defects of schizophrenia. Recently, to test this hypothesis, a variety of cytokines were administered to rodent pups. Cytokines administered in the periphery penetrated the immature blood-brain barrier and perturbed phenotypic neural development. Among the many cytokines examined, epidermal growth factor (or potentially other ErbB1 ligands) and interleukin-1 specifically induced the most severe and persistent behavioral and cognitive abnormalities, most of which were ameliorated by antipsychotics. These animal experiments illustrate that, during early development, these cytokine activities in the periphery perturbs normal brain development and impairs later psychobehavioral and/or cognitive traits. The neurodevelopmental and behavioral consequences of prenatal/perinatal cytokine activity are compared with those of other schizophrenia models and cytokine interactions with genes are also discussed in this review.
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Affiliation(s)
- Hiroyuki Nawa
- Division of Molecular Neurobiology, Brain Research Institute, Niigata University, 1-757 Asahimachi, Niigata, Japan.
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Bonnot O, Mazet P. Vulnérabilité aux schizophrénies à l'adolescence : revue de la littérature et applications cliniques. ACTA ACUST UNITED AC 2006. [DOI: 10.1016/j.neurenf.2005.11.003] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Faraone SV, Skol AD, Tsuang DW, Young KA, Haverstock SL, Prabhudesai S, Mena F, Menon AS, Leong L, Sautter F, Baldwin C, Bingham S, Weiss D, Collins J, Keith T, Vanden Eng JL, Boehnke M, Tsuang MT, Schellenberg GD. Genome scan of schizophrenia families in a large Veterans Affairs Cooperative Study sample: evidence for linkage to 18p11.32 and for racial heterogeneity on chromosomes 6 and 14. Am J Med Genet B Neuropsychiatr Genet 2005; 139B:91-100. [PMID: 16152571 DOI: 10.1002/ajmg.b.30213] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Genome-wide linkage analyses of schizophrenia have identified several regions that may harbor schizophrenia susceptibility genes but, given the complex etiology of the disorder, it is unlikely that all susceptibility regions have been detected. We report results from a genome scan of 166 schizophrenia families collected through the Department of Veterans Affairs Cooperative Studies Program. Our definition of affection status included schizophrenia and schizoaffective disorder, depressed type and we defined families as European American (EA) and African American (AA) based on the probands' and parents' races based on data collected by interviewing the probands. We also assessed evidence for racial heterogeneity in the regions most suggestive of linkage. The maximum LOD score across the genome was 2.96 for chromosome 18, at 0.5 cM in the combined race sample. Both racial groups showed LOD scores greater than 1.0 for chromosome 18. The empirical P-value associated with that LOD score is 0.04 assuming a single genome scan for the combined sample with race narrowly defined, and 0.06 for the combined sample allowing for broad and narrow definitions of race. The empirical P-value of observing a LOD score as large as 2.96 in the combined sample, and of at least 1.0 in each racial group, allowing for narrow and broad racial definitions, is 0.04. Evidence for the second and third largest linkage signals come solely from the AA sample on chromosomes 6 (LOD = 2.11 at 33.2 cM) and 14 (LOD = 2.13 at 51.0). The linkage evidence differed between the AA and EA samples (chromosome 6 P-value = 0.007 and chromosome 14 P-value = 0.004).
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Affiliation(s)
- S V Faraone
- Genetics Research Program and Department of Psychiatry and Behavioral Sciences, SUNY Upstate Medical University, Syracuse, NY 13210, USA.
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Boog G. Obstetrical complications and subsequent schizophrenia in adolescent and young adult offsprings: is there a relationship? Eur J Obstet Gynecol Reprod Biol 2004; 114:130-6. [PMID: 15140504 DOI: 10.1016/j.ejogrb.2003.09.041] [Citation(s) in RCA: 45] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2003] [Revised: 08/04/2003] [Accepted: 09/10/2003] [Indexed: 11/22/2022]
Abstract
Schizophrenia is a psychiatric disease affecting around 1% of the population, the negative signs of which are correlated with inactivity of the prefrontal dorsolateral cortex, while an increased, more deeply localized, activity in the mesolimbic pathway may explain the positive signs. Several events occurring during pregnancy are likely to be involved in its genesis: hormonal supplementation by diethylstilbestrol, severe maternal denutrition, exposure to influenza virus, repeated psychological stress. From multicentric studies and meta-analyses in the psychiatric literature, the risk of schizophrenia appears to be multiplied by two if pregnancy is complicated, mainly by diabetes, Rhesus incompatibility, bleeding, preeclampsia, premature rupture of membranes and preterm birth. When delivery is linked to an abnormal presentation or happens via a caesarean birth for acute foetal distress, the time when the first signs of psychosis appear seems to be earlier in adolescence or in early adulthood. Cerebral imaging of schizophrenic patients shows ventriculomegaly and gray matter reduction, mainly in hippocampal volumes and in the dorsolateral prefrontal cortex. Similar alterations in the neuronal pathways have been experimentally reproduced in rats after repeated prenatal stress and perinatal hypoxia. A region on the distal portion of chromosome 1 has shown evidence for linkage to schizophrenia. Therefore, a two factor model seems to be able to explain the onset of schizophrenia in which obstetrical complications may interact with a genetic liability and in which the consequences of hypoxic events may lie on a continuum ranging from cerebral palsy in some children to subtle cognitive and behavioural disturbances in others.
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Affiliation(s)
- Georges Boog
- Department of Obstetrics and Gynecology, Pavillon Mère et Enfant 7, Quai Moncousu, 44093 Nantes Cédex 1, France.
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Palmer CGS, Turunen JA, Sinsheimer JS, Minassian S, Paunio T, Lönnqvist J, Peltonen L, Woodward JA. RHD maternal-fetal genotype incompatibility increases schizophrenia susceptibility. Am J Hum Genet 2002; 71:1312-9. [PMID: 12439825 PMCID: PMC378569 DOI: 10.1086/344659] [Citation(s) in RCA: 47] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2002] [Accepted: 09/06/2002] [Indexed: 12/19/2022] Open
Abstract
Fetal events and obstetric complications are associated with schizophrenia. Here we report the results of a family-based candidate-gene study that assesses the role of maternal-fetal genotype incompatibility at the RHD locus in schizophrenia. We adapted the case-parent-trio log-linear modeling approach to test for RHD maternal-fetal genotype incompatibility and to distinguish this effect from a high-risk allele at or near the RHD locus and from a direct maternal effect alone. Eighty-eight patient-parent trios, 72 patient-mother pairs, and 21 patient-father pairs were genotyped at the RHD locus. Of the 181 patients, 62% were male and 81% were second born or later. Only three patients were born after prophylaxis against maternal isoimmunization had become common practice. There was significant evidence for an RHD maternal-fetal genotype incompatibility, and the incompatibility parameter was estimated at 2.6. There was no evidence to support linkage/association with schizophrenia at or near the RHD locus nor any evidence to support the role of maternal genotype effect alone. Our results replicate previous findings that implicate the RHD locus in schizophrenia, and the candidate-gene design of this study allows the elimination of alternative explanations for the role of this locus in disease. Thus, the present study provides increasing evidence that the RHD locus increases schizophrenia risk through a maternal-fetal genotype incompatibility mechanism that increases risk of an adverse prenatal environment (e.g., Rh incompatibility) rather than through linkage/association with the disorder, linkage disequilibrium with an unknown nearby susceptibility locus, or a direct maternal effect alone. This is the first candidate-gene study to explicitly test for and provide evidence of a maternal-fetal genotype incompatibility mechanism in schizophrenia.
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Affiliation(s)
- Christina G S Palmer
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, 90095, USA.
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Powell SB, Geyer MA. Developmental markers of psychiatric disorders as identified by sensorimotor gating. Neurotox Res 2002; 4:489-502. [PMID: 12754162 DOI: 10.1080/10298420290030578] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Prepulse inhibition (PPI) of the acoustic startle reflex is an operational measure of sensorimotor gating that is amenable to cross-species comparisons. Deficits in PPI have been repeatedly reported in patients with schizophrenia or other psychiatric disorders characterized by abnormalities in sensory, cognitive, or motor gating. Because some forms of schizophrenia appear to be attributable to early developmental perturbations, many animal studies have examined the influences of various developmental manipulations on PPI in adulthood. For example, isolation rearing of rats from weaning into adulthood leads to a reorganization of brain circuitry including changes in monoamine systems that modulate PPI. Isolation rearing of rats leads to deficits in PPI that are not evident pre-puberty, are enduring in adulthood, and are developmentally specific, in that isolation of adult rats does not affect PPI. The PPI deficits in isolation-reared rats are reversed by typical or atypical antipsychotic treatments, including raclopride, haloperidol, clozapine, olanzapine, quetiapine, and even the putative antipsychotic M100907. In contrast, other psychoactive drugs, such as chlordiazepoxide, diazepam, prazosin, or amitriptyline, do not normalize PPI in isolation-reared rats. Hence, the isolation-rearing model may help identify novel antipsychotics. Thus, social isolation rearing of rats provides a developmentally specific, non-pharmacological manipulation that leads to deficits in sensorimotor gating that mimic those observed in schizophrenia patients and are responsive to antipsychotic medications.
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Affiliation(s)
- Susan B. Powell
- Department of Psychiatry, University of California, 9500 Gilman Drive, 0804, La Jolla, San Diego, CA 92093, USA
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Bark N. Guest Editor’s Introduction. INTERNATIONAL JOURNAL OF MENTAL HEALTH 2000. [DOI: 10.1080/00207411.2000.11449494] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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