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Hunter SK, Hoffman MC, D’Alessandro A, Wyrwa A, Noonan K, Zeisel SH, Law AJ, Freedman R. Prenatal choline, cannabis, and infection, and their association with offspring development of attention and social problems through 4 years of age. Psychol Med 2022; 52:3019-3028. [PMID: 33491615 PMCID: PMC8310535 DOI: 10.1017/s0033291720005061] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
BACKGROUND Prenatal choline is a key nutrient, like folic acid and vitamin D, for fetal brain development and subsequent mental function. We sought to determine whether effects of higher maternal plasma choline concentrations on childhood attention and social problems, found in an initial clinical trial of choline supplementation, are observed in a second cohort. METHODS Of 183 mothers enrolled from an urban safety net hospital clinic, 162 complied with gestational assessments and brought their newborns for study at 1 month of age; 83 continued assessments through 4 years of age. Effects of maternal 16 weeks of gestation plasma choline concentrations ⩾7.07 μM, 1 s.d. below the mean level obtained with supplementation in the previous trial, were compared to lower levels. The Attention Problems and Withdrawn Syndrome scales on Child Behavior Checklist 1½-5 were the principal outcomes. RESULTS Higher maternal plasma choline was associated with lower mean Attention Problems percentiles in children, and for male children, with lower Withdrawn percentiles. Higher plasma choline concentrations also reduced Attention Problems percentiles for children of mothers who used cannabis during gestation as well as children of mothers who had gestational infection. CONCLUSIONS Prenatal choline's positive associations with early childhood behaviors are found in a second, more diverse cohort. Increases in attention problems and social withdrawal in early childhood are associated with later mental illnesses including attention deficit disorder and schizophrenia. Choline concentrations in the pregnant women in this study replicate other research findings suggesting that most pregnant women do not have adequate choline in their diets.
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Affiliation(s)
- Sharon K. Hunter
- Department of Psychiatry, University of Colorado School of Medicine, Aurora, CO 80045
| | - M. Camille Hoffman
- Department of Psychiatry, University of Colorado School of Medicine, Aurora, CO 80045
- Department of Obstetrics and Gynecology, Division of Maternal and Fetal Medicine, University of Colorado School of Medicine, Aurora, CO 80045
| | - Angelo D’Alessandro
- Department of Biochemistry and Molecular Genetics, University of Colorado School of Medicine, Aurora, CO 80045
| | - Anna Wyrwa
- Department of Psychiatry, University of Colorado School of Medicine, Aurora, CO 80045
| | - Kathleen Noonan
- Department of Psychiatry, University of Colorado School of Medicine, Aurora, CO 80045
| | - Steven H. Zeisel
- Departments of Nutrition and Pediatrics, University of North Carolina, Chapel Hill, NC 27599
| | - Amanda J. Law
- Department of Psychiatry, University of Colorado School of Medicine, Aurora, CO 80045
- Department of Cell and Developmental Biology, University of Colorado School of Medicine, Aurora, CO 80045
| | - Robert Freedman
- Department of Psychiatry, University of Colorado School of Medicine, Aurora, CO 80045
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Freedman R, Hunter SK, Law AJ, Clark AM, Roberts A, Hoffman MC. Choline, folic acid, Vitamin D, and fetal brain development in the psychosis spectrum. Schizophr Res 2022; 247:16-25. [PMID: 33838984 PMCID: PMC8494861 DOI: 10.1016/j.schres.2021.03.008] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2021] [Revised: 03/17/2021] [Accepted: 03/19/2021] [Indexed: 12/18/2022]
Abstract
Choline, folic acid, and Vitamin D are essential for fetal brain development that may be the first steps in the pathogenesis of the psychotic spectrum. Micronutrient deficiencies have been associated with changes in fetal brain development, manifest as early problems in childhood behavior, and cognition, and later as increased incidence of psychotic and autism spectrum disorders. Micronutrient supplements may not only prevent deficiency, but they may also positively affect brain development in the context of other maternal risk factors, including maternal infection, stress, inflammation, and substance abuse. Many genes associated with later psychotic illness are highly expressed in the fetal brain, where they are responsible for various neurodevelopmental mechanisms. Interaction of micronutrient vitamins with these genetically programmed mechanisms to prevent pathological brain development associated with later psychosis is under active investigation. In addition to their effects on brain development, micronutrient vitamins have effects on other aspects of gestation and fetal development, including the prevention of premature delivery and other developmental abnormalities. Supplemental micronutrient vitamins should be part of good prenatal care, as has already happened for folic acid and Vitamin D and is now advocated by the American Medical Association for choline. The benefits of these micronutrient supplements include protection of brain development and the possibility of decreased risk for future psychotic disorders in those children who are either genetically or environmentally vulnerable. The purpose of this review is to present the current evidence supporting the safety and effectiveness of micronutrients in gestation and to suggest areas for future research.
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Affiliation(s)
- Robert Freedman
- Department of Psychiatry, Division of Maternal and Fetal Medicine, University of Colorado School of Medicine, Anschutz Medical Center, Mail Stop F546, Aurora, CO 80045, USA.
| | - Sharon K Hunter
- Department of Psychiatry, Division of Maternal and Fetal Medicine, University of Colorado School of Medicine, Anschutz Medical Center, Mail Stop F546, Aurora, CO 80045, USA
| | - Amanda J Law
- Department of Psychiatry, Division of Maternal and Fetal Medicine, University of Colorado School of Medicine, Anschutz Medical Center, Mail Stop F546, Aurora, CO 80045, USA; Department of Cell and Developmental Biology, Division of Maternal and Fetal Medicine, University of Colorado School of Medicine, Anschutz Medical Center, Mail Stop F546, Aurora, CO 80045, USA; Department of Medicine, Division of Maternal and Fetal Medicine, University of Colorado School of Medicine, Anschutz Medical Center, Mail Stop F546, Aurora, CO 80045, USA
| | - Alena M Clark
- Department of Nutrition and Dietetics, Campus Box 93, University of Northern Colorado, Greeley, CO 80639, USA
| | | | - M Camille Hoffman
- Department of Psychiatry, Division of Maternal and Fetal Medicine, University of Colorado School of Medicine, Anschutz Medical Center, Mail Stop F546, Aurora, CO 80045, USA; Department of Obstetrics and Gynecology, Division of Maternal and Fetal Medicine, University of Colorado School of Medicine, Anschutz Medical Center, Mail Stop F546, Aurora, CO 80045, USA
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Momen NC, Robakis T, Liu X, Reichenberg A, Bergink V, Munk-Olsen T. In utero exposure to antipsychotic medication and psychiatric outcomes in the offspring. Neuropsychopharmacology 2022; 47:759-766. [PMID: 34750566 PMCID: PMC8782838 DOI: 10.1038/s41386-021-01223-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Revised: 10/13/2021] [Accepted: 10/21/2021] [Indexed: 02/03/2023]
Abstract
Information on neurodevelopmental effects of antenatal exposure to antipsychotics is limited to 10 studies, all examining children up to 5 years of age or less. The paper aimed to investigate the association between in utero exposure to antipsychotics and psychiatric outcomes in children using Danish nationwide registers. In total, 9011 liveborn singletons born 1998-2015 in Denmark whose mothers took antipsychotic medication before pregnancy were identified. Children whose mothers continued to take antipsychotics during pregnancy were compared with children of mothers who discontinued antipsychotics before pregnancy. As a negative control, paternal antipsychotic use in the same window was investigated. Hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated using Cox proportional hazards regression for the primary outcome of psychiatric disorders, as well for subcategories of psychiatric disorders. In total, 9.9% of children in the discontinuation group and 11.0% of children in the continuation group received a psychiatric disorder diagnosis during follow-up. The adjusted HR for psychiatric disorders among offspring in the continuation group compared to the discontinuation group was 1.10 (95% CI 0.93-1.30). For antipsychotic use in the fathers, the HR was 1.05 (95% CI 0.89-1.24). The study does not provide evidence of increased risk of psychiatric disorders among children of women who continue antipsychotic treatment during pregnancy. This was observed after accounting for the underlying risk conferred by maternal psychiatric disorders. This suggests women who need to continue antipsychotic medications during pregnancy can do so without adverse psychiatric outcomes for offspring.
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Affiliation(s)
- Natalie C. Momen
- grid.7048.b0000 0001 1956 2722National Centre for Register-based Research, Aarhus University, Aarhus, Denmark
| | - Thalia Robakis
- grid.59734.3c0000 0001 0670 2351Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York City, NY USA
| | - Xiaoqin Liu
- grid.7048.b0000 0001 1956 2722National Centre for Register-based Research, Aarhus University, Aarhus, Denmark
| | - Abraham Reichenberg
- grid.59734.3c0000 0001 0670 2351Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York City, NY USA ,grid.59734.3c0000 0001 0670 2351Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY USA ,grid.59734.3c0000 0001 0670 2351The Mindich Child Health and Development Institute, Icahn School of Medicine at Mount Sinai, New York, NY USA ,grid.59734.3c0000 0001 0670 2351Seaver Center for Research and Treatment, Icahn School of Medicine at Mount Sinai, New York, NY USA
| | - Veerle Bergink
- grid.59734.3c0000 0001 0670 2351Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York City, NY USA ,grid.5645.2000000040459992XDepartment of Psychiatry, Erasmus Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Trine Munk-Olsen
- grid.7048.b0000 0001 1956 2722National Centre for Register-based Research, Aarhus University, Aarhus, Denmark ,grid.452548.a0000 0000 9817 5300iPSYCH-Lundbeck Foundation Initiative for Integrative Psychiatric Research, Aarhus, Denmark ,grid.7048.b0000 0001 1956 2722CIRRAU-Centre for Integrated Register-based Research, Aarhus University, Aarhus, Denmark
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Xia L, Wang D, Wei G, Wang J, Zhou H, Xu H, Tian Y, Dai Q, Xiu M, Chen D, Wang L, Zhang X. P50 inhibition defects with psychopathology and cognitive impairment in patients with first-episode drug naïve schizophrenia. Prog Neuropsychopharmacol Biol Psychiatry 2021; 107:110246. [PMID: 33453321 DOI: 10.1016/j.pnpbp.2021.110246] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Revised: 12/23/2020] [Accepted: 01/09/2021] [Indexed: 01/16/2023]
Abstract
BACKGROUND Many studies have announced that P50 inhibition defects represent sensory gating deficits in schizophrenia, but studies seldom have searched the correlation between P50 inhibition defects and the psychopathology or cognitive impairment of patients with first-episode, drug naïve (FEDN) of schizophrenia. In this study, we investigated the auditory sensory gating deficits in a large number of Han patients with FEDN schizophrenia and their correlation with clinical symptoms and cognitive impairment. METHODS A total of 130 patients with FEDN schizophrenia and 189 healthy controls were recruited in this study. Positive and Negative Syndrome Scale (PANSS) and its five-factor model were used to score the psychopathology of the patients, and P50 inhibition was recorded using the 64-channel electroencephalography (EEG) system. RESULTS Patients exhibited significantly longer S1 and S2 latency, lower S1 and S2 amplitudes and lower P50 difference than healthy controls (all p < 0.05). Significant correlations existed between S1 latency and PANSS negative symptoms or cognitive factor, P50 ratio and general psychopathology, P50 ratio and PANSS total score, P50 difference and general psychopathology, and P50 difference and PANSS total score (all p < 0.05). Multiple regression analysis revealed that S1 latency, sex, age, and education were contributors to negative symptom score (all p < 0.05). S1 latency, S2 latency, sex, age, and smoking status were contributors to cognitive factor (all p < 0.05). CONCLUSIONS Our results show that patients with FEDN schizophrenia have P50 inhibition defects, which may be related to their psychopathological symptoms and cognitive impairment.
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Affiliation(s)
- Luyao Xia
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China; Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Dongmei Wang
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China; Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Gaoxia Wei
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China; Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Jiesi Wang
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China; Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Huixia Zhou
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China; Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Hang Xu
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China; Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Yang Tian
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China; Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Qilong Dai
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China; Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Meihong Xiu
- Beijing HuiLongGuan Hospital, Peking University, Beijing, China
| | - Dachun Chen
- Beijing HuiLongGuan Hospital, Peking University, Beijing, China
| | - Li Wang
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China; Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Xiangyang Zhang
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China; Department of Psychology, University of Chinese Academy of Sciences, Beijing, China.
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Hunter SK, Hoffman MC, D'Alessandro A, Noonan K, Wyrwa A, Freedman R, Law AJ. Male fetus susceptibility to maternal inflammation: C-reactive protein and brain development. Psychol Med 2021; 51:450-459. [PMID: 31787129 PMCID: PMC7263978 DOI: 10.1017/s0033291719003313] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
BACKGROUND Maternal inflammation in early pregnancy has been identified epidemiologically as a prenatal pathogenic factor for the offspring's later mental illness. Early newborn manifestations of the effects of maternal inflammation on human fetal brain development are largely unknown. METHODS Maternal infection, depression, obesity, and other factors associated with inflammation were assessed at 16 weeks gestation, along with maternal C-reactive protein (CRP), cytokines, and serum choline. Cerebral inhibition was assessed by inhibitory P50 sensory gating at 1 month of age, and infant behavior was assessed by maternal ratings at 3 months of age. RESULTS Maternal CRP diminished the development of cerebral inhibition in newborn males but paradoxically increased inhibition in females. Similar sex-dependent effects were seen in mothers' assessment of their infant's self-regulatory behaviors at 3 months of age. Higher maternal choline levels partly mitigated the effect of CRP in male offspring. CONCLUSIONS The male fetal-placental unit appears to be more sensitive to maternal inflammation than females. Effects are particularly marked on cerebral inhibition. Deficits in cerebral inhibition 1 month after birth, similar to those observed in several mental illnesses, including schizophrenia, indicate fetal developmental pathways that may lead to later mental illness. Deficits in early infant behavior follow. Early intervention before birth, including prenatal vitamins, folate, and choline supplements, may help prevent fetal development of pathophysiological deficits that can have life-long consequences for mental health.
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Affiliation(s)
- Sharon K Hunter
- Departments of Psychiatry, University of Colorado Denver School of Medicine, Aurora, Colorado80045, USA
| | - M Camille Hoffman
- Departments of Psychiatry, University of Colorado Denver School of Medicine, Aurora, Colorado80045, USA
- Obstetrics and Gynecology, Division of Maternal and Fetal Medicine, University of Colorado Denver School of Medicine, Aurora, Colorado80045, USA
| | - Angelo D'Alessandro
- Biochemistry and Molecular Genetics, University of Colorado Denver School of Medicine, Aurora, Colorado80045, USA
| | - Kathleen Noonan
- Departments of Psychiatry, University of Colorado Denver School of Medicine, Aurora, Colorado80045, USA
| | - Anna Wyrwa
- Departments of Psychiatry, University of Colorado Denver School of Medicine, Aurora, Colorado80045, USA
| | - Robert Freedman
- Departments of Psychiatry, University of Colorado Denver School of Medicine, Aurora, Colorado80045, USA
| | - Amanda J Law
- Departments of Psychiatry, University of Colorado Denver School of Medicine, Aurora, Colorado80045, USA
- Cell and Developmental Biology, University of Colorado Denver School of Medicine, Aurora, Colorado80045, USA
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6
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Hunter SK, Hoffman MC, McCarthy L, D’Alessandro A, Wyrwa A, Noonan K, Christians U, Nakimuli-Mpungu E, Zeisel SH, Law AJ, Freedman R. Black American Maternal Prenatal Choline, Offspring Gestational Age at Birth, and Developmental Predisposition to Mental Illness. Schizophr Bull 2020; 47:896-905. [PMID: 33184653 PMCID: PMC8266582 DOI: 10.1093/schbul/sbaa171] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Black Americans have increased risk for schizophrenia and other mental illnesses with prenatal origins. Prenatal choline promotes infant brain development and behavioral outcomes, but choline has not been specifically assessed in Black Americans. Pregnant women (N = 183, N = 25 Black Americans) enrolled in a study of prenatal stressors and interactions with prenatal choline. Black American women had lower 16-week gestation plasma choline than Whites. Lower choline was not related to obesity, income, or metabolic genotypes. Pregnant women in rural Uganda have higher choline levels than Black American women. Black Americans' lower choline was associated with higher hair cortisol, indicative of higher stress. Lower maternal choline was associated with offsprings' lower gestational age at birth and with decreased auditory P50 inhibition, a marker of inhibitory neuron development. Behavioral development was assessed on the Infant Behavior Questionnaire-R-SF (IBQ-R) at 3 months. Lower Black American maternal gestational choline was associated with lower infant IBQ-R Orienting/Regulation, indicating decreased attention and relation to caregivers. Additional evidence for developmental effects of choline in Black Americans comes from a randomized clinical trial of gestational phosphatidylcholine supplementation versus placebo that included 15 Black Americans. Phosphatidylcholine increased gestational age at birth and newborn P50 inhibition and decreased Social Withdrawn and Attention problems at 40 months of age in Black Americans' offspring compared to placebo. Inhibitory and behavioral deficits associated with lower prenatal choline in offspring of Black American women indicate potential developmental predispositions to later mental illnesses that might be ameliorated by prenatal choline or phosphatidylcholine supplementation.
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Affiliation(s)
- Sharon K Hunter
- Department of Psychiatry, University of Colorado School of
Medicine, Aurora, CO
| | - M Camille Hoffman
- Department of Psychiatry, University of Colorado School of
Medicine, Aurora, CO,Department of Obstetrics and Gynecology, Division of Maternal and Fetal
Medicine, University of Colorado School of Medicine, Aurora, CO
| | - Lizbeth McCarthy
- Department of Obstetrics and Gynecology, Division of Maternal and Fetal
Medicine, University of Colorado School of Medicine, Aurora, CO,Department of Obstetrics and Gynecology, Denver Health Medical
Center, Denver, CO
| | - Angelo D’Alessandro
- Department of Biochemistry and Molecular Genetics, University of Colorado
School of Medicine, Aurora, CO
| | - Anna Wyrwa
- Department of Psychiatry, University of Colorado School of
Medicine, Aurora, CO
| | - Kathleen Noonan
- Department of Psychiatry, University of Colorado School of
Medicine, Aurora, CO
| | - Uwe Christians
- Department of Anesthesiology, iC42 Clinical Research and Development,
University of Colorado School of Medicine, Aurora, CO
| | - Etheldreda Nakimuli-Mpungu
- Department of Psychiatry, School of Medicine, Makerere University College of
Health Sciences. Kampala, Uganda
| | - Steven H Zeisel
- Departments of Nutrition and Pediatrics, University of North
Carolina, Chapel Hill, NC
| | - Amanda J Law
- Department of Psychiatry, University of Colorado School of
Medicine, Aurora, CO,Department of Cell and Developmental Biology, University of Colorado School of
Medicine, Aurora, CO
| | - Robert Freedman
- Department of Psychiatry, University of Colorado School of
Medicine, Aurora, CO,To whom correspondence should be addressed; Department of Psychiatry F-546,
University of Colorado Denver School of Medicine, Anschutz Medical Center, Aurora, CO
80045, US; tel: 720-224-4638, fax: 303-724-4960, e-mail:
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Freedman R, Hunter SK, Noonan K, Wyrwa A, Christians U, Law AJ, Hoffman MC. Maternal Prenatal Depression in Pregnancies With Female and Male Fetuses and Developmental Associations With C-reactive Protein and Cortisol. BIOLOGICAL PSYCHIATRY: COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2020; 6:310-320. [PMID: 33060035 DOI: 10.1016/j.bpsc.2020.08.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Revised: 07/01/2020] [Accepted: 08/06/2020] [Indexed: 02/08/2023]
Abstract
BACKGROUND Prenatal depression has lasting effects on development in offspring, including later mental illness risk. Maternal responses to depression include inflammation and hypothalamic-pituitary-adrenal axis stimulation. Effects on development of cerebral inhibitory neurocircuits may differ for female and male fetuses. METHODS Mothers (N = 181) were assessed periodically, beginning at 16 weeks' gestation, using the Center for Epidemiologic Studies-Depression Scale. Maternal prenatal C-reactive protein and hair cortisol and cortisone levels were determined. Cortisone was determined in neonatal hair. Development of cerebral inhibitory neurocircuits was assessed in 162 1-month-old newborns by inhibition of P50 electrophysiological responses to repeated sounds. RESULTS Maternal depression was associated with decreased newborn P50 inhibition in both sexes. Maternal C-reactive protein levels were significantly associated with depression only in pregnancies with male fetuses and with decreased newborn P50 inhibition only in male newborns. Maternal cortisol levels were significantly associated with depression only in pregnancies with female fetuses and with decreased newborn P50 inhibition only in female newborns. In pregnancies with male fetuses compared with pregnancies with female fetuses, cortisol was more robustly metabolized to cortisone, which does not activate cortisol receptors. CONCLUSIONS This study finds sex-specific associations of C-reactive protein and cortisol levels with prenatal depression in women and with decreased development of newborn P50 inhibition. Sex-based differences in maternal response to depression with inflammation or cortisol and their developmental effects may reflect evolutionary influences to promote survival in adversity. Decreased newborn P50 inhibition is associated with later childhood behavioral problems, and decreased P50 inhibition is a pathophysiological feature of several mental illnesses.
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Affiliation(s)
- Robert Freedman
- Institute for Children's Mental Disorders, Department of Obstetrics and Gynecology, University of Colorado Denver School of Medicine, Anschutz Medical Center F-546, Aurora, Colorado.
| | - Sharon K Hunter
- Institute for Children's Mental Disorders, Department of Obstetrics and Gynecology, University of Colorado Denver School of Medicine, Anschutz Medical Center F-546, Aurora, Colorado
| | - Kathleen Noonan
- Institute for Children's Mental Disorders, Department of Obstetrics and Gynecology, University of Colorado Denver School of Medicine, Anschutz Medical Center F-546, Aurora, Colorado
| | - Anna Wyrwa
- Institute for Children's Mental Disorders, Department of Obstetrics and Gynecology, University of Colorado Denver School of Medicine, Anschutz Medical Center F-546, Aurora, Colorado
| | - Uwe Christians
- Department of Psychiatry, iC42 Clinical Research and Development, Department of Obstetrics and Gynecology, University of Colorado Denver School of Medicine, Anschutz Medical Center F-546, Aurora, Colorado
| | - Amanda J Law
- Institute for Children's Mental Disorders, Department of Obstetrics and Gynecology, University of Colorado Denver School of Medicine, Anschutz Medical Center F-546, Aurora, Colorado; Department of Anesthesiology, Department of Cell and Developmental Biology, Department of Obstetrics and Gynecology, University of Colorado Denver School of Medicine, Anschutz Medical Center F-546, Aurora, Colorado
| | - M Camille Hoffman
- Institute for Children's Mental Disorders, Department of Obstetrics and Gynecology, University of Colorado Denver School of Medicine, Anschutz Medical Center F-546, Aurora, Colorado; Division of Maternal and Fetal Medicine, Department of Obstetrics and Gynecology, University of Colorado Denver School of Medicine, Anschutz Medical Center F-546, Aurora, Colorado
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Hoffman MC, Hunter SK, D’Alessandro A, Noonan K, Wyrwa A, Freedman R. Interaction of maternal choline levels and prenatal Marijuana's effects on the offspring. Psychol Med 2020; 50:1716-1726. [PMID: 31364525 PMCID: PMC7055467 DOI: 10.1017/s003329171900179x] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
BACKGROUND This study investigated whether higher maternal choline levels mitigate effects of marijuana on fetal brain development. Choline transported into the amniotic fluid from the mother activates α7-nicotinic acetylcholine receptors on fetal cerebro-cortical inhibitory neurons, whose development is impeded by cannabis blockade of their cannabinoid-1(CB1) receptors. METHODS Marijuana use was assessed during pregnancy from women who later brought their newborns for study. Mothers were informed about choline and other nutrients, but not specifically for marijuana use. Maternal serum choline was measured at 16 weeks gestation. RESULTS Marijuana use for the first 10 weeks gestation or more by 15% of mothers decreased newborns' inhibition of evoked potentials to repeated sounds (d' = 0.55, p < 0.05). This effect was ameliorated if women had higher gestational choline (rs = -0.50, p = 0.011). At 3 months of age, children whose mothers continued marijuana use through their 10th gestational week or more had poorer self-regulation (d' = -0.79, p < 0.05). This effect was also ameliorated if mothers had higher gestational choline (rs = 0.54, p = 0.013). Maternal choline levels correlated with the children's improved duration of attention, cuddliness, and bonding with parents. CONCLUSIONS Prenatal marijuana use adversely affects fetal brain development and subsequent behavioral self-regulation, a precursor to later, more serious problems in childhood. Stopping marijuana use before 10 weeks gestational age prevented these effects. Many mothers refuse to cease use because of familiarity with marijuana and belief in its safety. Higher maternal choline mitigates some of marijuana's adverse effects on the fetus.
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Affiliation(s)
- M. Camille Hoffman
- Department of Obstetrics and Gynecology, Division of Maternal and Fetal Medicine, University of Colorado Denver School of Medicine, Aurora, Colorado 80045, USA
- Department of Psychiatry, University of Colorado Denver School of Medicine, Aurora, Colorado 80045, USA
| | - Sharon K. Hunter
- Department of Psychiatry, University of Colorado Denver School of Medicine, Aurora, Colorado 80045, USA
| | - Angelo D’Alessandro
- Department of Biochemistry and Molecular Genetics, University of Colorado Denver School of Medicine, Aurora, Colorado 80045, USA
| | - Kathleen Noonan
- Department of Psychiatry, University of Colorado Denver School of Medicine, Aurora, Colorado 80045, USA
| | - Anna Wyrwa
- Department of Psychiatry, University of Colorado Denver School of Medicine, Aurora, Colorado 80045, USA
| | - Robert Freedman
- Department of Psychiatry, University of Colorado Denver School of Medicine, Aurora, Colorado 80045, USA
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9
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Zhaori G. Professor Robert Freedman and his contributions to psychiatric research. Pediatr Investig 2020; 4:73-76. [PMID: 32851347 PMCID: PMC7331399 DOI: 10.1002/ped4.12201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Accepted: 05/30/2020] [Indexed: 11/13/2022] Open
Affiliation(s)
- Getu Zhaori
- Editorial OfficePediatric InvestigationBeijing Children’s HospitalCapital Medical UniversityNational Center for Children’s HealthBeijingChina
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10
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Freedman R, Olsen-Dufour AM, Olincy A. P50 inhibitory sensory gating in schizophrenia: analysis of recent studies. Schizophr Res 2020; 218:93-98. [PMID: 32061454 PMCID: PMC7299819 DOI: 10.1016/j.schres.2020.02.003] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2019] [Revised: 01/22/2020] [Accepted: 02/07/2020] [Indexed: 02/07/2023]
Abstract
INTRODUCTION Inhibitory sensory gating of the P50 cerebral evoked potential to paired auditory stimuli (S1, S2) is a widely used paradigm for the study of schizophrenia and related conditions. Its use to measure genetic, treatment, and developmental effects requires a metric with more stable properties than the simple ratio of the paired responses. METHODS This study assessed the ratio P50S2μV/P50S1μV and P50S2μV co-varied for P50S1μV in all 27 independent published studies that compared schizophrenia patients with healthy controls from 2000 to 2019. The largest study from each research group was selected. The Colorado research group's studies were excluded to eliminate bias from the first report of the phenomenon. RESULTS Across the 27 studies encompassing 1179 schizophrenia patients and 1091 healthy controls, both P50S2μV co-varied for P50S1μV and P50S2μV/P50S1μV significantly separated the patients from the controls (both P < 0.0001). Effect size for P50S2μV co-varied for P50S1μV is d' = 1.23. The normal distribution of P50S2μV co-varied for P50S1μV detected influences of maternal inflammation and effects on behavior in a recent developmental study, an emerging use for the P50 inhibitory gating measure. P50S2μV/P50S1μV was not normally distributed. Results from two multi-site NIMH genetics collaborations also support the use of P50S2μV as a biomarker. CONCLUSION Both methods detect an abnormality of cerebral inhibition in schizophrenia with high significance across multiple independent laboratories. The normal distribution of P50S2μV co-varied for P50S1μV makes it more suitable for studies of genetic, treatment, and other influences on the development and expression of inhibitory deficits in schizophrenia.
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Affiliation(s)
- Robert Freedman
- Department of Psychiatry, University of Colorado Denver School of Medicine, Anschutz Medical Center, Mail Stop F546, Aurora, CO 80045, USA.
| | - Amanda M. Olsen-Dufour
- Department of Psychiatry, University of Colorado Denver School of Medicine, Anschutz Medical Center, Mail Stop F546, Aurora, CO 80045 USA
| | - Ann Olincy
- Department of Psychiatry, University of Colorado Denver School of Medicine, Anschutz Medical Center, Mail Stop F546, Aurora, CO 80045 USA
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Protective Effect of the MCP-1 Gene Haplotype against Schizophrenia. BIOMED RESEARCH INTERNATIONAL 2019; 2019:4042615. [PMID: 31886209 PMCID: PMC6925699 DOI: 10.1155/2019/4042615] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/13/2019] [Revised: 10/28/2019] [Accepted: 11/15/2019] [Indexed: 12/24/2022]
Abstract
While cytokines and their genetic variants have been intensively studied in schizophrenia, little attention has been focused on chemokines in the last years. The monocyte chemoattractant protein 1 (MCP-1) is known to attract peripheral monocytes to the brain during an inflammatory reaction and to affect the T helper (Th) cell development by stimulating Th2 polarization. Owing to the neuroinflammation in schizophrenia and the variable level of MCP-1 in these patients' sera, we proposed to analyze the impact of functional genetic variants of the MCP-1 gene (MCP-1-2518A/G (rs1024611), MCP-1-362G/C (rs2857656), and MCP-1 int1del554-567 (rs3917887)) in schizophrenic patients. We conducted a case-control study on a Tunisian population composed of 200 patients and 200 controls using RFLP-PCR. Our results indicated that the minor alleles (-2518G and Del554-567) were significantly more prevalent in controls than in patients (P=0.001/adjusted OR = 0.42, P=0.04/adjusted OR = 0.64), whereas, for -362C minor allele, increased risk of schizophrenia was revealed (P=0.001, adjusted OR = 2.38). In conclusion, we have identified the haplotype combination -2581G/-362G/int1del554-567 that could mediate protection against schizophrenia (P=0.0038, OR = 0.19) and the effect could result more strongly from the MCP-1 -2582G with -362G variants, whereas the effect of int1del554-567 may in part be explained by its LD with -362.
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12
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Affiliation(s)
- Joshua L Roffman
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Charlestown
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King E, Campbell A, Belger A, Grewen K. Prenatal Nicotine Exposure Disrupts Infant Neural Markers of Orienting. Nicotine Tob Res 2019; 20:897-902. [PMID: 29059450 DOI: 10.1093/ntr/ntx177] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2016] [Accepted: 08/11/2017] [Indexed: 12/25/2022]
Abstract
Introduction Prenatal nicotine exposure (PNE) from maternal cigarette smoking is linked to developmental deficits, including impaired auditory processing, language, generalized intelligence, attention, and sleep. Fetal brain undergoes massive growth, organization, and connectivity during gestation, making it particularly vulnerable to neurotoxic insult. Nicotine binds to nicotinic acetylcholine receptors, which are extensively involved in growth, connectivity, and function of developing neural circuitry and neurotransmitter systems. Thus, PNE may have long-term impact on neurobehavioral development. The purpose of this study was to compare the auditory K-complex, an event-related potential reflective of auditory gating, sleep preservation and memory consolidation during sleep, in infants with and without PNE and to relate these neural correlates to neurobehavioral development. Methods We compared brain responses to an auditory paired-click paradigm in 3- to 5-month-old infants during Stage 2 sleep, when the K-complex is best observed. We measured component amplitude and delta activity during the K-complex. Results Infants with PNE demonstrated significantly smaller amplitude of the N550 component and reduced delta-band power within elicited K-complexes compared to nonexposed infants and also were less likely to orient with a head turn to a novel auditory stimulus (bell ring) when awake. Conclusions PNE may impair auditory sensory gating, which may contribute to disrupted sleep and to reduced auditory discrimination and learning, attention re-orienting, and/or arousal during wakefulness reported in other studies. Implications Links between PNE and reduced K-complex amplitude and delta power may represent altered cholinergic and GABAergic synaptic programming and possibly reflect early neural bases for PNE-linked disruptions in sleep quality and auditory processing. These may pose significant disadvantage for language acquisition, attention, and social interaction necessary for academic and social success.
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Affiliation(s)
- Erin King
- Department of Psychiatry, University of North Carolina School of Medicine
| | - Alana Campbell
- Department of Psychiatry, University of North Carolina School of Medicine
| | - Aysenil Belger
- Department of Psychiatry, University of North Carolina School of Medicine
| | - Karen Grewen
- Department of Psychiatry, University of North Carolina School of Medicine
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Freedman R, Hunter SK, Law AJ, Wagner BD, D’Alessandro A, Christians U, Noonan K, Wyrwa A, Hoffman MC. Higher Gestational Choline Levels in Maternal Infection Are Protective for Infant Brain Development. J Pediatr 2019; 208:198-206.e2. [PMID: 30879727 PMCID: PMC6707520 DOI: 10.1016/j.jpeds.2018.12.010] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2018] [Revised: 11/14/2018] [Accepted: 12/05/2018] [Indexed: 12/14/2022]
Abstract
OBJECTIVE To assess whether maternal choline decreases effects of mothers' infections on fetal brain circuit development and on expression of infant behavior at 1 year of age. STUDY DESIGN A cross-sectional study was conducted in a public hospital obstetrics and midwifery service, with prenatal assessments of maternal infection, C-reactive protein, and choline level and postnatal assessments of cerebral neuronal inhibition in 162 newborns. At 1 year, 136 parents completed reports of their child's behavior. RESULTS Maternal infection at 16 weeks of gestation, experienced by 41% of mothers, raised mean maternal C-reactive protein (d' = 0.47, P = .002) and decreased the development of cerebral inhibition of auditory response at 1 month of age (d' = 0.39, P < .001). Decreased newborn cerebral inhibition manifested as decreased behavioral self-regulation at 1 year. Greater choline levels in mothers with infections were associated with improved newborn inhibition of auditory cerebral response, mitigating the effect of infection (β = -0.34 [95% CI, -5.35 to -0.14], P = .002). At 1 year of age, children of mothers with infection and greater gestational choline levels had improved development of self-regulation, approaching the level of children of mothers without infection (β = 0.29 [95% CI 0.05-0.54], P = .03). CONCLUSIONS Greater maternal choline, recommended by the American Medical Association as a prenatal supplement, is associated with greater self-regulation among infants who experienced common maternal infections during gestation. Behavioral problems with diminished self-regulation often lead to referrals to pediatricians and might lead to later mental illness.
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Affiliation(s)
- Robert Freedman
- Department of Psychiatry, University of Colorado Denver School of Medicine, Aurora, CO.
| | - Sharon K. Hunter
- Department of Psychiatry, University of Colorado Denver School of Medicine
| | - Amanda J Law
- Department of Psychiatry, University of Colorado Denver School of Medicine,,Department of Cell and Developmental Biology, University of Colorado Denver School of Medicine
| | - Brandie D. Wagner
- Department of Biostatistics and Informatics, Colorado School of Public Health (BDW)
| | - Angelo D’Alessandro
- Department of Biochemistry and Molecular Genetics, University of Colorado Denver School of Medicine
| | - Uwe Christians
- Department of Anesthesiology, University of Colorado Denver School of Medicine
| | - Kathleen Noonan
- Department of Psychiatry, University of Colorado Denver School of Medicine
| | - Anna Wyrwa
- Department of Psychiatry, University of Colorado Denver School of Medicine
| | - M. Camille Hoffman
- Department of Psychiatry, University of Colorado Denver School of Medicine,,Department of Obstetrics and Gynecology, University of Colorado Denver School of Medicine
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Nenciovici L, Allaire-Duquette G, Masson S. Brain activations associated with scientific reasoning: a literature review. Cogn Process 2018; 20:139-161. [DOI: 10.1007/s10339-018-0896-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2017] [Accepted: 12/04/2018] [Indexed: 12/15/2022]
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Freedman R, Hunter SK, Hoffman MC. Prenatal Primary Prevention of Mental Illness by Micronutrient Supplements in Pregnancy. Am J Psychiatry 2018; 175:607-619. [PMID: 29558816 PMCID: PMC6984656 DOI: 10.1176/appi.ajp.2018.17070836] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
Genes, infection, malnutrition, and other factors affecting fetal brain development are a major component of risk for a child's emotional development and later mental illnesses, including schizophrenia, bipolar disorder, and autism. Prenatal interventions to ameliorate that risk have yet to be established for clinical use. A systematic review of prenatal nutrients and childhood emotional development and later mental illness was performed. Randomized trials of folic acid, phosphatidylcholine, and omega-3 fatty acid supplements assess effects of doses beyond those adequate to remedy deficiencies to promote normal fetal development despite genetic and environmental risks. Folic acid to prevent neural tube defects is an example. Vitamins A and D are currently recommended at maximum levels, but women's incomplete compliance permits observational studies of their effects. Folic acid and phosphatidylcholine supplements have shown evidence for improving childhood emotional development associated with later mental illnesses. Vitamins A and D decreased the risk for schizophrenia and autism in retrospective observations. Omega-3 fatty acid supplementation during early pregnancy increased the risk for schizophrenia and increased symptoms of attention deficit hyperactivity disorder, but in later pregnancy it decreased childhood wheezing and premature birth. Studies are complicated by the length of time between birth and the emergence of mental illnesses like schizophrenia, compared with anomalies like facial clefts identified at birth. As part of comprehensive maternal and fetal care, prenatal nutrient interventions should be further considered as uniquely effective first steps in decreasing risk for future psychiatric and other illnesses in newborn children. [AJP at 175: Remembering Our Past As We Envision Our Future July 1959: Longitudinal Observations of Biological Deviations in a Schizophrenic Infant Barbara Fish described the course of an infant born with fluctuating motor problems who developed schizophrenia. (Am J Psychiatry 1959; 116:25-31 )].
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Affiliation(s)
- Robert Freedman
- From the Institute for Children’s Mental Disorders and the Departments of Psychiatry and of Obstetrics and Gynecology, University of Colorado School of Medicine, Aurora
| | - Sharon K. Hunter
- From the Institute for Children’s Mental Disorders and the Departments of Psychiatry and of Obstetrics and Gynecology, University of Colorado School of Medicine, Aurora
| | - M. Camille Hoffman
- From the Institute for Children’s Mental Disorders and the Departments of Psychiatry and of Obstetrics and Gynecology, University of Colorado School of Medicine, Aurora
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Vesterinen HM, Morello-Frosch R, Sen S, Zeise L, Woodruff TJ. Cumulative effects of prenatal-exposure to exogenous chemicals and psychosocial stress on fetal growth: Systematic-review of the human and animal evidence. PLoS One 2017; 12:e0176331. [PMID: 28700705 PMCID: PMC5507491 DOI: 10.1371/journal.pone.0176331] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2016] [Accepted: 03/14/2017] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Adverse effects of prenatal stress or environmental chemical exposures on fetal growth are well described, yet their combined effect remains unclear. OBJECTIVES To conduct a systematic review on the combined impact and interaction of prenatal exposure to stress and chemicals on developmental outcomes. METHODS We used the first three steps of the Navigation Guide systematic review. We wrote a protocol, performed a robust literature search to identify relevant animal and human studies and extracted data on developmental outcomes. For the most common outcome (fetal growth), we evaluated risk of bias, calculated effect sizes for main effects of individual and combined exposures, and performed a random effects meta-analysis of those studies reporting on odds of low birthweight (LBW) by smoking and socioeconomic status (SES). RESULTS We identified 17 human- and 22 animal-studies of combined chemical and stress exposures and fetal growth. Human studies tended to have a lower risk of bias across nine domains. Generally, we found stronger effects for chemicals than stress, and these exposures were associated with reduced fetal growth in the low-stress group and the association was often greater in high stress groups, with limited evidence of effect modification. We found smoking associated with significantly increased odds of LBW, with a greater effect for high stress (low SES; OR 4.75 (2.46-9.16)) compared to low stress (high SES; OR 1.95 (95% CI 1.53-2.48)). Animal studies generally had a high risk of bias with no significant combined effect or effect modification. CONCLUSIONS We found that despite concern for the combined effects of environmental chemicals and stress, this is still an under-studied topic, though limited available human studies indicate chemical exposures exert stronger effects than stress, and this effect is generally larger in the presence of stress.
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Affiliation(s)
- Hanna M. Vesterinen
- Program on Reproductive Health and the Environment, University of California, San Francisco, United States of America
| | - Rachel Morello-Frosch
- Department of Environmental Science, Policy and Management and School of Public Health, University of California, Berkeley, United States of America
| | - Saunak Sen
- Department of Preventive Medicine, University of Tennessee Health Science Center, Memphis, United States of America
| | - Lauren Zeise
- California Environmental Protection Agency Office of Environmental Health Hazard Assessment, Oakland, United States of America
| | - Tracey J. Woodruff
- Program on Reproductive Health and the Environment, University of California, San Francisco, United States of America
- * E-mail:
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Hutchison AK, Hunter SK, Wagner BD, Calvin EA, Zerbe GO, Ross RG. Diminished Infant P50 Sensory Gating Predicts Increased 40-Month-Old Attention, Anxiety/Depression, and Externalizing Symptoms. J Atten Disord 2017; 21:209-218. [PMID: 23757333 PMCID: PMC5849461 DOI: 10.1177/1087054713488824] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE When behavioral problems resulting from attentional difficulties present, often in preschool, it is unknown whether these problems represent preexisting altered brain development or new brain changes. This study examines whether infant sensory gating of auditory evoked potentials predicts parent-reported behavior at 40 months. METHOD P50 sensory gating, an auditory evoked potential measure reflective of inhibitory processes in the brain, was measured in 50 infants around 70 days old. Parents, using the Child Behavior Checklist, reported on the child's behavior at 40 months. RESULTS Controlling for gender, infants with diminished sensory gating had more problems later with externalizing behavior ( F = 4.17, ndf = 1, ddf = 46, p = .047), attentional problems ( F = 5.23, ndf = 1, ddf = 46, p = .027), and anxious/depressed symptoms ( F = 5.36, ndf = 1, ddf = 46, p = .025). CONCLUSION Diminished infant P50 sensory gating predicts attention symptoms 3 years later. These results support the hypothesis that preschool attentional dysfunction may relate to altered brain development that is detectable years prior to symptom onset.
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Affiliation(s)
| | | | | | | | - Gary O Zerbe
- 1 University of Colorado Denver, Aurora, CO, USA
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Wei PP, Hunter SK, Ross RG. Sleep Spindles and Auditory Sensory Gating: Two Measures of Cerebral Inhibition in Preschool-Aged Children are Strongly Correlated. COLORADO JOURNAL OF PSYCHIATRY & PSYCHOLOGY 2017; 2:75-83. [PMID: 33880461 PMCID: PMC8055067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
INTRODUCTION Sleep spindles and P50 sensory gating are both reflective of cerebral inhibition, however, are differentially active during different phases of sleep. Assessing whether sleep spindles and P50 sensory gating correlate is a first step to evaluate whether these 2 forms of cerebral inhibition reflect overlapping neural circuits. METHODS EEG data were collected between midnight and 6:00 AM on 13 healthy preschool-aged children. P50 sensory gating, calculated during REM sleep, negatively correlated with spindle duration (r=-.715, p=.006) and inter-peak density (r=.744, p=.004). There was a trend toward higher S2/S1 ratios being associated with fewer peaks per spindle (r=-.546, p=.053). In 4-year-olds, 2 established physiological measures of sensory gating and are correlated despite being maximally active during different stages of sleep. CONCLUSIONS These results suggest there is an overlap in brain mechanisms underlying each gating mechanism.
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Affiliation(s)
| | | | - Randal G. Ross
- Address correspondence to: Randal G. Ross MD, Department of Psychiatry, School of Medicine, University of Colorado Denver, 13001 E. 17th Place, Campus Box F546, Aurora, CO 80045,
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Ross RG, Hunter SK, Hoffman MC, McCarthy L, Chambers BM, Law AJ, Leonard S, Zerbe GO, Freedman R. Perinatal Phosphatidylcholine Supplementation and Early Childhood Behavior Problems: Evidence for CHRNA7 Moderation. Am J Psychiatry 2016; 173:509-16. [PMID: 26651393 PMCID: PMC5892450 DOI: 10.1176/appi.ajp.2015.15091188] [Citation(s) in RCA: 57] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
OBJECTIVE α7-Nicotinic receptors are involved in the final maturation of GABA inhibitory synapses before birth. Choline at levels found in the amniotic fluid is an agonist at α7-nicotinic receptors. The authors conducted a double-blind placebo-controlled trial to assess whether high-dose oral phosphatidylcholine supplementation during pregnancy to increase maternal amniotic fluid choline levels would enhance fetal development of cerebral inhibition and, as a result, decrease childhood behavior problems associated with later mental illness. METHOD The authors previously reported that newborns in the phosphatidylcholine treatment group have increased suppression of the cerebral evoked response to repeated auditory stimuli. In this follow-up, they report parental assessments of the children's behavior at 40 months of age, using the Child Behavior Checklist. RESULTS At 40 months, parent ratings of children in the phosphatidylcholine group (N=23) indicated fewer attention problems and less social withdrawal compared with the placebo group (N=26). The improvement is comparable in magnitude to similar deficits at this age associated with later schizophrenia. The children's behavior is moderated by CHRNA7 variants associated with later mental illness and is related to their enhanced cerebral inhibition as newborns. CONCLUSIONS CHRNA7, the α7-nicotinic acetylcholine receptor gene, has been associated with schizophrenia, autism, and attention deficit hyperactivity disorder. Maternal phosphatidylcholine treatment may, by increasing activation of the α7-nicotinic acetylcholine receptor, alter the development of behavior problems in early childhood that can presage later mental illness.
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Affiliation(s)
- Randal G Ross
- From the Departments of Psychiatry, Pediatrics, Cellular and Developmental Biology, and Pharmacology, University of Colorado School of Medicine, Aurora; the Department of Biostatistics and Informatics, University of Colorado School of Public Health, Aurora; and the Departments of Obstetrics and Gynecology and Pediatrics, Denver Health Medical Center, Denver
| | - Sharon K Hunter
- From the Departments of Psychiatry, Pediatrics, Cellular and Developmental Biology, and Pharmacology, University of Colorado School of Medicine, Aurora; the Department of Biostatistics and Informatics, University of Colorado School of Public Health, Aurora; and the Departments of Obstetrics and Gynecology and Pediatrics, Denver Health Medical Center, Denver
| | - M Camille Hoffman
- From the Departments of Psychiatry, Pediatrics, Cellular and Developmental Biology, and Pharmacology, University of Colorado School of Medicine, Aurora; the Department of Biostatistics and Informatics, University of Colorado School of Public Health, Aurora; and the Departments of Obstetrics and Gynecology and Pediatrics, Denver Health Medical Center, Denver
| | - Lizbeth McCarthy
- From the Departments of Psychiatry, Pediatrics, Cellular and Developmental Biology, and Pharmacology, University of Colorado School of Medicine, Aurora; the Department of Biostatistics and Informatics, University of Colorado School of Public Health, Aurora; and the Departments of Obstetrics and Gynecology and Pediatrics, Denver Health Medical Center, Denver
| | - Betsey M Chambers
- From the Departments of Psychiatry, Pediatrics, Cellular and Developmental Biology, and Pharmacology, University of Colorado School of Medicine, Aurora; the Department of Biostatistics and Informatics, University of Colorado School of Public Health, Aurora; and the Departments of Obstetrics and Gynecology and Pediatrics, Denver Health Medical Center, Denver
| | - Amanda J Law
- From the Departments of Psychiatry, Pediatrics, Cellular and Developmental Biology, and Pharmacology, University of Colorado School of Medicine, Aurora; the Department of Biostatistics and Informatics, University of Colorado School of Public Health, Aurora; and the Departments of Obstetrics and Gynecology and Pediatrics, Denver Health Medical Center, Denver
| | - Sherry Leonard
- From the Departments of Psychiatry, Pediatrics, Cellular and Developmental Biology, and Pharmacology, University of Colorado School of Medicine, Aurora; the Department of Biostatistics and Informatics, University of Colorado School of Public Health, Aurora; and the Departments of Obstetrics and Gynecology and Pediatrics, Denver Health Medical Center, Denver
| | - Gary O Zerbe
- From the Departments of Psychiatry, Pediatrics, Cellular and Developmental Biology, and Pharmacology, University of Colorado School of Medicine, Aurora; the Department of Biostatistics and Informatics, University of Colorado School of Public Health, Aurora; and the Departments of Obstetrics and Gynecology and Pediatrics, Denver Health Medical Center, Denver
| | - Robert Freedman
- From the Departments of Psychiatry, Pediatrics, Cellular and Developmental Biology, and Pharmacology, University of Colorado School of Medicine, Aurora; the Department of Biostatistics and Informatics, University of Colorado School of Public Health, Aurora; and the Departments of Obstetrics and Gynecology and Pediatrics, Denver Health Medical Center, Denver
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Stuart MJ, Singhal G, Baune BT. Systematic Review of the Neurobiological Relevance of Chemokines to Psychiatric Disorders. Front Cell Neurosci 2015; 9:357. [PMID: 26441528 PMCID: PMC4564736 DOI: 10.3389/fncel.2015.00357] [Citation(s) in RCA: 109] [Impact Index Per Article: 12.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2015] [Accepted: 08/26/2015] [Indexed: 12/13/2022] Open
Abstract
Psychiatric disorders are highly prevalent and disabling conditions of increasing public health relevance. Much recent research has focused on the role of cytokines in the pathophysiology of psychiatric disorders; however, the related family of immune proteins designated chemokines has been relatively neglected. Chemokines were originally identified as having chemotactic function on immune cells; however, recent evidence has begun to elucidate novel, brain-specific functions of these proteins of relevance to the mechanisms of psychiatric disorders. A systematic review of both human and animal literature in the PubMed and Google Scholar databases was undertaken. After application of all inclusion and exclusion criteria, 157 references were remained for the review. Some early mechanistic evidence does associate select chemokines with the neurobiological processes, including neurogenesis, modulation of the neuroinflammatory response, regulation of the hypothalamus–pituitary–adrenal axis, and modulation of neurotransmitter systems. This early evidence however does not clearly demonstrate any specificity for a certain psychiatric disorder, but is primarily relevant to mechanisms which are shared across disorders. Notable exceptions include CCL11 that has recently been shown to impair hippocampal function in aging – of distinct relevance to Alzheimer’s disease and depression in the elderly, and pre-natal exposure to CXCL8 that may disrupt early neurodevelopmental periods predisposing to schizophrenia. Pro-inflammatory chemokines, such as CCL2, CCL7, CCL8, CCL12, and CCL13, have been shown to drive chemotaxis of pro-inflammatory cells to the inflamed or injured CNS. Likewise, CX3CL has been implicated in promoting glial cells activation, pro-inflammatory cytokines secretion, expression of ICAM-1, and recruitment of CD4+ T-cells into the CNS during neuroinflammatory processes. With further translational research, chemokines may present novel diagnostic and/or therapeutic targets in psychiatric disorders.
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Affiliation(s)
- Michael J Stuart
- Psychiatric Neuroscience Lab, Discipline of Psychiatry, University of Adelaide , Adelaide, SA , Australia ; School of Medicine, University of Queensland , Brisbane, QLD , Australia
| | - Gaurav Singhal
- Psychiatric Neuroscience Lab, Discipline of Psychiatry, University of Adelaide , Adelaide, SA , Australia
| | - Bernhard T Baune
- Psychiatric Neuroscience Lab, Discipline of Psychiatry, University of Adelaide , Adelaide, SA , Australia
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Abstract
Endophenotypes are disease-associated phenotypes that are thought to reflect the neurobiological or other mechanisms that underlie the more overt symptoms of a psychiatric illness. Endophenotypes have been critical in understanding the genetics, neurobiology, and treatment of schizophrenia. Because psychiatric illnesses have multiple causes, including both genetic and nongenetic risk factors, an endophenotype linked to one of the mechanisms may be expressed more frequently than the disease itself. However, in schizophrenia research, endophenotypes have almost exclusively been studied in older adolescents or adults who have entered or passed through the age of risk for the disorder. Yet, schizophrenia is a neurodevelopmental disorder where prenatal development starts a cascade of brain changes across the lifespan. Endophenotypes have only minimally been utilized to explore the perinatal development of vulnerability. One major impediment to the development of perinatally-useful endophenotypes has been the established validity criteria. For example, the criterion that the endophenotype be more frequently present in those with disease than those without is difficult to demonstrate when there can be a decades-long period between endophenotype measurement and the age of greatest risk for onset of the disorder. This article proposes changes to the endophenotype validity criteria appropriate to perinatal research and reviews how application of these modified criteria helped identify a perinatally-usable phenotype of risk for schizophrenia, P50 sensory gating, which was then used to propose a novel perinatal primary prevention intervention.
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Affiliation(s)
- Randal G. Ross
- Department of Psychiatry, University of Colorado Denver, Aurora, CO,*To whom correspondence should be addressed; Department of Psychiatry, School of Medicine, University of Colorado Denver, 13001 E. 17th Place, Campus Box F546, Aurora, CO 80045, US; tel: 303-724-6203, fax: 303-724-6207, e-mail:
| | - Robert Freedman
- Department of Psychiatry, University of Colorado Denver, Aurora, CO
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Freedman R, Ross RG. Prenatal choline and the development of schizophrenia. SHANGHAI ARCHIVES OF PSYCHIATRY 2015; 27:90-102. [PMID: 26120259 PMCID: PMC4466850 DOI: 10.11919/j.issn.1002-0829.215006] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/05/2015] [Accepted: 03/29/2014] [Indexed: 11/29/2022]
Abstract
Background The primary prevention of illness at the population level, the ultimate aim
of medicine, seems out of reach for schizophrenia. Schizophrenia has a
strong genetic component, and its pathogenesis begins long before the
emergence of psychosis, as early as fetal brain development. Cholinergic
neurotransmission at nicotinic receptors is a pathophysiological mechanism
related to one aspect of this genetic risk. Choline activates these
nicotinic receptors during fetal brain development. Dietary supplementation
of maternal choline thus emerges as a possible intervention in pregnancy to
alter the earliest developmental course of the illness. Aim Review available literature on the relationship of choline supplementation or
choline levels during pregnancy and fetal brain development. Methods A Medline search was used to identify studies assessing effects of choline in
human fetal development. Studies of other prenatal risk factors for
schizophrenia and the role of cholinergic neurotransmission in its
pathophysiology were also identified. Results Dietary requirements for choline are high during pregnancy because of its
several uses, including membrane biosynthesis, one-carbon metabolism, and
cholinergic neurotransmission. Its ability to act directly at high
concentrations as a nicotinic agonist is critical for normal brain circuit
development. Dietary supplementation in the second and third trimesters with
phosphatidyl-choline supports these functions and is associated generally
with better fetal outcome. Improvement in inhibitory neuronal functions
whose deficit is associated with schizophrenia and attention deficit
disorder has been observed. Conclusion Prenatal dietary supplementation with phosphatidyl-choline and promotion of
diets rich in choline-containing foods (meats, soybeans, and eggs) are
possible interventions to promote fetal brain development and thereby
decrease the risk of subsequent mental illnesses. The low risk and short
(sixmonth) duration of the intervention makes it especially conducive to
population-wide adoption. Similar findings with folate for the prevention of
cleft palate led to recommendations for prenatal pharmacological
supplementation and dietary improvement. However, definitive proof of the
efficacy of prenatal choline supplementation will not be available for
decades (because of the 20-year lag until the onset of schizophrenia), so
public health officials need to decide whether or not promoting choline
supplementation is justified based on the limited information available.
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Affiliation(s)
- Robert Freedman
- Department of Psychiatry, University of Colorado School of Medicine, Aurora, CO, United States
| | - Randal G Ross
- Department of Psychiatry, University of Colorado School of Medicine, Aurora, CO, United States
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Smucny J, Stevens KE, Olincy A, Tregellas JR. Translational utility of rodent hippocampal auditory gating in schizophrenia research: a review and evaluation. Transl Psychiatry 2015; 5:e587. [PMID: 26101850 PMCID: PMC4490287 DOI: 10.1038/tp.2015.77] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2015] [Revised: 04/14/2015] [Accepted: 05/04/2015] [Indexed: 01/15/2023] Open
Abstract
Impaired gating of the auditory evoked P50 potential is one of the most pharmacologically well-characterized features of schizophrenia. This deficit is most commonly modeled in rodents by implanted electrode recordings from the hippocampus of the rodent analog of the P50, the P20-N40. The validity and effectiveness of this tool, however, has not been systematically reviewed. Here, we summarize findings from studies that have examined the effects of pharmacologic modulation on gating of the rodent hippocampal P20-N40 and the human P50. We show that drug effects on the P20-N40 are highly predictive of human effects across similar dose ranges. Furthermore, mental status (for example, anesthetized vs alert) does not appear to diminish the predictive capacity of these recordings. We then discuss hypothesized neuropharmacologic mechanisms that may underlie gating effects for each drug studied. Overall, this review supports continued use of hippocampal P20-N40 gating as a translational tool for schizophrenia research.
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Affiliation(s)
- J Smucny
- Neuroscience Program, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
- Research Service, Denver VA Medical Center, Denver, CO, USA
- Department of Psychiatry, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - K E Stevens
- Department of Psychiatry, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - A Olincy
- Research Service, Denver VA Medical Center, Denver, CO, USA
- Department of Psychiatry, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - J R Tregellas
- Neuroscience Program, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
- Research Service, Denver VA Medical Center, Denver, CO, USA
- Department of Psychiatry, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
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Hunter SK, Gillow SJ, Ross RG. Stability of P50 auditory sensory gating during sleep from infancy to 4 years of age. Brain Cogn 2015; 94:4-9. [PMID: 25596494 DOI: 10.1016/j.bandc.2014.12.004] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2014] [Revised: 11/09/2014] [Accepted: 12/18/2014] [Indexed: 11/28/2022]
Abstract
The stability of cerebral inhibition was assessed across early childhood using a paired-click auditory sensory gating paradigm. The P50 ERP was measured during REM (or its infant analogue, active sleep) and NREM sleep in 14 children at approximately 3 months of age and again at approximately 4 years of age. Evoked response amplitudes, latencies, and the S2/S1 ratio of the amplitudes of the evoked responses were compared between the two visits. Significant reliability was found for the S2/S1 ratio (r = .73, p = .003) during REM but not non REM sleep (r = -.05, p = .88). A significant stimulus number by sleep stage interaction (F(1,12) = 17.1, p = .001) demonstrated that the response to the second stimulus decreased during REM but not NREM sleep. These findings suggest that this measure is stable during REM sleep across early childhood, is not affected by age, and is sleep-state dependent. P50 sensory gating is a biomarker which, if used properly, may provide a mechanism to further explore changes in the developing brain or may help with early screening for psychiatric illness vulnerability.
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Affiliation(s)
- Sharon K Hunter
- Department of Psychiatry, University of Colorado Denver, Aurora, CO, USA
| | | | - Randal G Ross
- Department of Psychiatry, University of Colorado Denver, Aurora, CO, USA.
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Javitt DC, Freedman R. Sensory processing dysfunction in the personal experience and neuronal machinery of schizophrenia. Am J Psychiatry 2015; 172:17-31. [PMID: 25553496 PMCID: PMC4501403 DOI: 10.1176/appi.ajp.2014.13121691] [Citation(s) in RCA: 263] [Impact Index Per Article: 29.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Sensory processing deficits, first investigated by Kraepelin and Bleuler as possible pathophysiological mechanisms in schizophrenia, are now being recharacterized in the context of our current understanding of the molecular and neurobiological brain mechanisms involved. The National Institute of Mental Health Research Domain Criteria position these deficits as intermediaries between molecular and cellular mechanisms and clinical symptoms of schizophrenia, such as hallucinations. The prepulse inhibition of startle responses by a weaker preceding tone, the inhibitory gating of response to paired sensory stimuli characterized using the auditory P50 evoked response, and the detection of slight deviations in patterns of sensory stimulation eliciting the cortical mismatch negativity potential demonstrate deficits in early sensory processing mechanisms, whose molecular and neurobiological bases are increasingly well understood. Deficits in sensory processing underlie more complex cognitive dysfunction and are in turn affected by higher-level cognitive difficulties. These deficits are now being used to identify genes involved in familial transmission of schizophrenia and to monitor potentially therapeutic drug effects for both treatment and prevention. This research also provides a clinical reminder that patients' sensory perception of the surrounding world, even during treatment sessions, may differ considerably from others' perceptions. A person's ability to understand and interact effectively with the surrounding world ultimately depends on an underlying sensory experience of it.
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Affiliation(s)
- Daniel C. Javitt
- Division of Experimental Therapeutics, Department of Psychiatry, Program in Cognitive Neuroscience and Schizophrenia, Nathan Kline Institute for Psychiatric Research/Columbia University Medical Center, New York, NY 10032, USA
| | - Robert Freedman
- Department of Psychiatry, University of Colorado Denver School of Medicine, Mail Stop F546, Aurora, CO, 80045, USA
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Abstract
Attentional deficits are common in a variety of neuropsychiatric disorders including attention deficit-hyperactivity disorder, autism, bipolar mood disorder, and schizophrenia. There has been increasing interest in the neurodevelopmental components of these attentional deficits; neurodevelopmental meaning that while the deficits become clinically prominent in childhood or adulthood, the deficits are the results of problems in brain development that begin in infancy or even prenatally. Despite this interest, there are few methods for assessing attention very early in infancy. This report focuses on one method, infant auditory P50 sensory gating. Attention has several components. One of the earliest components of attention, termed sensory gating, allows the brain to tune out repetitive, noninformative sensory information. Auditory P50 sensory gating refers to one task designed to measure sensory gating using changes in EEG. When identical auditory stimuli are presented 500 ms apart, the evoked response (change in the EEG associated with the processing of the click) to the second stimulus is generally reduced relative to the response to the first stimulus (i.e. the response is "gated"). When response to the second stimulus is not reduced, this is considered a poor sensory gating, is reflective of impaired cerebral inhibition, and is correlated with attentional deficits. Because the auditory P50 sensory gating task is passive, it is of potential utility in the study of young infants and may provide a window into the developmental time course of attentional deficits in a variety of neuropsychiatric disorders. The goal of this presentation is to describe the methodology for assessing infant auditory P50 sensory gating, a methodology adapted from those used in studies of adult populations.
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Talati A, Bao Y, Kaufman J, Shen L, Schaefer CA, Brown AS. Maternal smoking during pregnancy and bipolar disorder in offspring. Am J Psychiatry 2013; 170:1178-85. [PMID: 24084820 PMCID: PMC4086419 DOI: 10.1176/appi.ajp.2013.12121500] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
OBJECTIVE Maternal smoking during pregnancy is associated with a number of adverse externalizing outcomes for offspring from childhood to adulthood. The relationship between maternal smoking and bipolar disorder in offspring, which includes externalizing symptoms among its many manifestations, has not been investigated in depth. The authors examined whether offspring exposed to maternal smoking in utero would be at increased lifetime risk for bipolar disorder after accounting for other factors related to maternal smoking. METHOD Individuals with bipolar disorder (N=79) were ascertained from the birth cohort of the Child Health and Development Study. Case subjects were identified by a combination of clinical, database, and direct mailing sources; all case subjects were directly interviewed and diagnosed using DSM-IV criteria. Comparison subjects (N=654) were matched to case subjects on date of birth (±30 days), sex, membership in the cohort at the time of illness onset, and availability of maternal archived sera. RESULTS After adjusting for potential confounders, offspring exposed to in utero maternal smoking exhibited a twofold greater risk for bipolar disorder (odds ratio=2.014, 95% confidence interval=1.48-2.53, p=0.01). The associations were noted primarily among bipolar offspring without psychotic features. CONCLUSIONS Prenatal tobacco exposure may be one suspected cause of bipolar disorder. However, it will be necessary to account for other unmeasured familial factors before causal teratogenic effects can be suggested.
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Ross RG, Hunter SK, McCarthy L, Beuler J, Hutchison AK, Wagner BD, Leonard S, Stevens KE, Freedman R. Perinatal choline effects on neonatal pathophysiology related to later schizophrenia risk. Am J Psychiatry 2013; 170:290-8. [PMID: 23318559 PMCID: PMC3640283 DOI: 10.1176/appi.ajp.2012.12070940] [Citation(s) in RCA: 109] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
OBJECTIVE Deficient cerebral inhibition is a pathophysiological brain deficit related to poor sensory gating and attention in schizophrenia and other disorders. Cerebral inhibition develops perinatally, influenced by genetic and in utero factors. Amniotic choline activates fetal α7-nicotinic acetylcholine receptors and facilitates development of cerebral inhibition. Increasing this activation may protect infants from future illness by promoting normal brain development. The authors investigated the effects of perinatal choline supplementation on the development of cerebral inhibition in human infants. METHOD A randomized placebo-controlled clinical trial of dietary phosphatidylcholine supplementation was conducted with 100 healthy pregnant women, starting in the second trimester. Supplementation to twice normal dietary levels for mother or newborn continued through the third postnatal month. All women received dietary advice regardless of treatment. Infants' electrophysiological recordings of inhibition of the P50 component of the cerebral evoked response to paired sounds were analyzed. The criterion for inhibition was suppression of the amplitude of the second P50 response by at least half, compared with the first response. RESULTS No adverse effects of choline were observed in maternal health and delivery, birth, or infant development. At the fifth postnatal week, the P50 response was suppressed in more choline-treated infants (76%) compared with placebo-treated infants (43%) (effect size=0.7). There was no difference at the 13th week. A CHRNA7 genotype associated with schizophrenia was correlated with diminished P50 inhibition in the placebo-treated infants, but not in the choline-treated infants. CONCLUSIONS Neonatal developmental delay in inhibition is associated with attentional problems as the child matures. Perinatal choline activates timely development of cerebral inhibition, even in the presence of gene mutations that otherwise delay it.
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Hunter SK, Mendoza JH, D’Anna K, Zerbe GO, McCarthy L, Hoffman C, Freedman R, Ross RG. Antidepressants may mitigate the effects of prenatal maternal anxiety on infant auditory sensory gating. Am J Psychiatry 2012; 169:616-24. [PMID: 22581104 PMCID: PMC3640273 DOI: 10.1176/appi.ajp.2012.11091365] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
OBJECTIVE Prenatal maternal anxiety has detrimental effects on the offspring's neurocognitive development, including impaired attentional function. Antidepressants are commonly used during pregnancy, yet their impact on offspring attention and their interaction with maternal anxiety has not been assessed. The authors used P50 auditory sensory gating, a putative marker of early attentional processes measurable in young infants, to assess the impact of maternal anxiety and antidepressant use. METHOD A total of 242 mother-infant dyads were classified relative to maternal history of anxiety and maternal prenatal antidepressant use. Infant P50 auditory sensory gating was recorded during active sleep at a mean age of 76 days (SD=38). RESULTS In the absence of prenatal antidepressant exposure, infants whose mothers had a history of anxiety diagnoses had diminished P50 sensory gating. Prenatal antidepressant exposure mitigated the effect of anxiety. The effect of maternal anxiety was limited to amplitude of response to the second stimulus, while antidepressant exposure had an impact on the amplitude of response to both the first and second stimulus. CONCLUSIONS Maternal anxiety disorders are associated with less inhibition during infant sensory gating, a performance deficit mitigated by prenatal antidepressant exposure. This effect may be important in considering the risks and benefits of antidepressant use during pregnancy. Cholinergic mechanisms are hypothesized for both anxiety and antidepressant effects, although the cholinergic receptors involved are likely different for anxiety and antidepressant effects.
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31
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Horst NK, Heath CJ, Neugebauer NM, Kimchi EY, Laubach M, Picciotto MR. Impaired auditory discrimination learning following perinatal nicotine exposure or β2 nicotinic acetylcholine receptor subunit deletion. Behav Brain Res 2012; 231:170-80. [PMID: 22433585 DOI: 10.1016/j.bbr.2012.03.002] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2011] [Revised: 02/23/2012] [Accepted: 03/06/2012] [Indexed: 11/24/2022]
Abstract
Maternal smoking during pregnancy can impair performance of the exposed offspring in tasks that require auditory stimulus processing and perception; however, the tobacco component(s) responsible for these effects and the underlying neurobiological mechanisms remain uncertain. In this study, we show that administration of nicotine during mouse perinatal development can impair performance in an auditory discrimination paradigm when the exposed animals are mature. This suggests that nicotine disrupts auditory pathways via nicotinic acetylcholine receptors (nAChRs) that are expressed at an early stage of development. We have also determined that mice which lack nAChRs containing the β2 subunit (β2* nAChRs) exhibit similarly compromised performance in this task, suggesting that β2* nAChRs are necessary for normal auditory discrimination or that β2* nAChRs play a critical role in development of the circuitry required for task performance. In contrast, no effect of perinatal nicotine exposure or β2 subunit knockout was found on the acquisition and performance of a differential reinforcement of low rate task. This suggests that the auditory discrimination impairments are not a consequence of a general deficit in learning and memory, but may be the result of compromised auditory stimulus processing in the nicotine-exposed and knockout animals.
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Affiliation(s)
- Nicole K Horst
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT 06511, USA
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32
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Miwa JM, Freedman R, Lester HA. Neural systems governed by nicotinic acetylcholine receptors: emerging hypotheses. Neuron 2011; 70:20-33. [PMID: 21482353 PMCID: PMC4418790 DOI: 10.1016/j.neuron.2011.03.014] [Citation(s) in RCA: 161] [Impact Index Per Article: 12.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/25/2011] [Indexed: 11/21/2022]
Abstract
Cholinergic neurons and nicotinic acetylcholine receptors (nAChRs) in the brain participate in diverse functions: reward, learning and memory, mood, sensory processing, pain, and neuroprotection. Nicotinic systems also have well-known roles in drug abuse. Here, we review recent insights into nicotinic function, linking exogenous and endogenous manipulations of nAChRs to alterations in synapses, circuits, and behavior. We also discuss how these contemporary advances can motivate attempts to exploit nicotinic systems therapeutically in Parkinson's disease, cognitive decline, epilepsy, and schizophrenia.
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Affiliation(s)
- Julie M. Miwa
- Division of Biology, California Institute of Technology, 1200 E. California Boulevard, Pasadena, CA 91125, USA
| | - Robert Freedman
- Department of Psychiatry and Pharmacology, University of Colorado Denver VA, 13001 F-546, Aurora, CO 80045, USA
| | - Henry A. Lester
- Division of Biology, California Institute of Technology, 1200 E. California Boulevard, Pasadena, CA 91125, USA
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