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Environmental Risk Factors and Cognitive Outcomes in Psychosis: Pre-, Perinatal, and Early Life Adversity. Curr Top Behav Neurosci 2023; 63:205-240. [PMID: 35915384 PMCID: PMC9892366 DOI: 10.1007/7854_2022_378] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Risk for psychosis begins to accumulate as early as the fetal period through exposure to obstetric complications like fetal hypoxia, maternal stress, and prenatal infection. Stressors in the postnatal period, such as childhood trauma, peer victimization, and neighborhood-level adversity, further increase susceptibility for psychosis. Cognitive difficulties are among the first symptoms to emerge in individuals who go on to develop a psychotic disorder. We review the relationship between pre-, perinatal, and early childhood adversities and cognitive outcomes in individuals with psychosis. Current evidence shows that the aforementioned environmental risk factors may be linked to lower overall intelligence and executive dysfunction, beginning in the premorbid period and persisting into adulthood in individuals with psychosis. It is likely that early life stress contributes to cognitive difficulties in psychosis through dysregulation of the body's response to stress, causing changes such as increased cortisol levels and chronic immune activation, which can negatively impact neurodevelopment. Intersectional aspects of identity (e.g., sex/gender, race/ethnicity), as well as gene-environment interactions, likely inform the developmental cascade to cognitive difficulties throughout the course of psychotic disorders and are reviewed below. Prospective studies of birth cohorts will serve to further clarify the relationship between early-life environmental risk factors and cognitive outcomes in the developmental course of psychotic disorders. Specific methodological recommendations are provided for future research.
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Fetal programming: could intrauterin life affect health status in adulthood? Obstet Gynecol Sci 2021; 64:473-483. [PMID: 34670066 PMCID: PMC8595045 DOI: 10.5468/ogs.21154] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Accepted: 10/05/2021] [Indexed: 01/01/2023] Open
Abstract
Intrauterine life is one of the most important periods of life. As the development of the fetus continues, the mechanisms that affect adult health also begin to mature. With the hypothesis denoted "fetal programming," it is thought that the presence of endocrinological disorders, toxins, infectious agents, the nutritional status of a mother, and nutrients related to placental functionality all have an effect on future life. Therefore, the fetus must adapt to the environment for survival. These adaptations may be involved the redistribution of metabolic, hormonal, or cardiac outputs in an effort to protect the brain, which is one of the important organs, as well as the slowing of growth to meet nutritional requirements. Unlike lifestyle changes or treatments received in adult life, the early developmental period tends to have a lasting effect on the structure and functionality of the body. In this review, fetal programming and the effects of fetal programming are discussed.
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Teigset CM, Mohn C, Rund BR. Perinatal complications and executive dysfunction in early-onset schizophrenia. BMC Psychiatry 2020; 20:103. [PMID: 32131788 PMCID: PMC7057649 DOI: 10.1186/s12888-020-02517-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2019] [Accepted: 02/26/2020] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND The present study examined the association between perinatal obstetric complications and executive dysfunction in early-onset schizophrenia (EOS), compared to healthy controls. Higher incidences of obstetric complications and more severe executive dysfunctions characterize EOS. Research shows extensive brain maturation in newborns, suggesting them to be particularly vulnerable for perinatal insults. Executive function is mainly mediated by the prefrontal cortex, an area that matures last during pregnancy. Thus, exposure to perinatal complications may influence executive dysfunction in EOS. METHODS The participants were 19 EOS patients and 54 healthy controls. Executive function was assessed with the D-KEFS Color Word Interference Test and the Wisconsin Card Sorting Test. Information on perinatal obstetric complications and Apgar 5-min scores were obtained from the Norwegian Medical Birth Registry. Associations between perinatal conditions and executive function were studied using stepwise regression analyses. RESULTS Perinatal complications, and especially shorter gestational lengths, were significantly associated with significant executive dysfunctions in EOS. Perinatal complications did not affect executive function among healthy controls. A significant relationship between lower Apgar 5-min scores and executive dysfunction was found among both EOS patients and healthy controls. CONCLUSIONS Exposure to perinatal complications, and particularly a shorter gestational length, was associated with increased executive dysfunction in EOS. Exposed healthy controls did not exhibit similar executive difficulties, suggesting that the EOS patients seemed especially vulnerable for executive deficits due to perinatal insults. The findings indicate that EOS youths learn more slowly and experience more difficulty with problem-solving, which carry important implications for clinical practice. Lower Apgar 5-min scores were associated with executive dysfunction in both groups. Low Apgar score at 5 min may therefore be an important early indicator of executive difficulties among adolescents, independent of diagnosis.
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Affiliation(s)
- Charlotte M. Teigset
- grid.459157.b0000 0004 0389 7802Vestre Viken Hospital Trust, Research Department, Wergelands gate 10, 3004 Drammen, Norway
| | - Christine Mohn
- grid.459157.b0000 0004 0389 7802Vestre Viken Hospital Trust, Research Department, Wergelands gate 10, 3004 Drammen, Norway ,grid.5510.10000 0004 1936 8921NORMENT Norwegian Centre for Mental Disorders Research, Institute of Clinical Medicine, Postboks 4956 Nydalen, 0424 Oslo, Norway
| | - Bjørn Rishovd Rund
- grid.459157.b0000 0004 0389 7802Vestre Viken Hospital Trust, Research Department, Wergelands gate 10, 3004 Drammen, Norway ,grid.5510.10000 0004 1936 8921Department of Psychology, University of Oslo, Postboks 1094 Blindern, 0317 Oslo, Norway
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Studerus E, Corbisiero S, Mazzariello N, Ittig S, Leanza L, Egloff L, Beck K, Heitz U, Andreou C, Stieglitz RD, Riecher-Rössler A. Can neuropsychological testing facilitate differential diagnosis between at-risk mental state (ARMS) for psychosis and adult attention-deficit/hyperactivity disorder (ADHD)? Eur Psychiatry 2020; 52:38-44. [DOI: 10.1016/j.eurpsy.2018.02.006] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2018] [Revised: 02/27/2018] [Accepted: 02/28/2018] [Indexed: 01/22/2023] Open
Abstract
AbstractBackground:Patients with an at-risk mental state (ARMS) for psychosis and patients with attention-deficit/hyperactivity disorder (ADHD) have many overlapping signs and symptoms and hence can be difficult to differentiate clinically. The aim of this study was to investigate whether the differential diagnosis between ARMS and adult ADHD could be improved by neuropsychological testing.Methods:168 ARMS patients, 123 adult ADHD patients and 109 healthy controls (HC) were recruited via specialized clinics of the University of Basel Psychiatric Hospital. Sustained attention and impulsivity were tested with the Continuous Performance Test, verbal learning and memory with the California Verbal Learning Test, and problem solving abilities with the Tower of Hanoi Task. Group differences in neuropsychological performance were analyzed using generalized linear models. Furthermore, to investigate whether adult ADHD and ARMS can be correctly classified based on the pattern of cognitive deficits, machine learning (i.e. random forests) was applied.Results:Compared to HC, both patient groups showed deficits in attention and impulsivity and verbal learning and memory. However, in adult ADHD patients the deficits were comparatively larger. Accordingly, a machine learning model predicted group membership based on the individual neurocognitive performance profile with good accuracy (AUC = 0.82).Conclusions:Our results are in line with current meta-analyses reporting that impairments in the domains of attention and verbal learning are of medium effect size in adult ADHD and of small effect size in ARMS patients and suggest that measures of these domains can be exploited to improve the differential diagnosis between adult ADHD and ARMS patients.
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Bronstein MV, Pennycook G, Joormann J, Corlett PR, Cannon TD. Dual-process theory, conflict processing, and delusional belief. Clin Psychol Rev 2019; 72:101748. [PMID: 31226640 DOI: 10.1016/j.cpr.2019.101748] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2019] [Revised: 04/25/2019] [Accepted: 06/11/2019] [Indexed: 01/10/2023]
Abstract
Many reasoning biases that may contribute to delusion formation and/or maintenance are common in healthy individuals. Research indicating that reasoning in the general population proceeds via analytic processes (which depend upon working memory and support hypothetical thought) and intuitive processes (which are autonomous and independent of working memory) may therefore help uncover the source of these biases. Consistent with this possibility, recent studies imply that impaired conflict processing might reduce engagement in analytic reasoning, thereby producing reasoning biases and promoting delusions in individuals with schizophrenia. Progress toward understanding this potential pathway to delusions is currently impeded by ambiguity about whether any of these deficits or biases is necessary or sufficient for the formation and maintenance of delusions. Resolving this ambiguity requires consideration of whether particular cognitive deficits or biases in this putative pathway have causal primacy over other processes that may also participate in the causation of delusions. Accordingly, the present manuscript critically evaluates whether impaired conflict processing is the primary initiating deficit in the generation of reasoning biases that may promote the development and/or maintenance of delusions. Suggestions for future research that may elucidate mechanistic pathways by which reasoning deficits might engender and maintain delusions are subsequently offered.
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Affiliation(s)
- Michael V Bronstein
- Department of Psychology, Yale University, 2 Hillhouse Ave, New Haven, CT, USA.
| | - Gordon Pennycook
- Hill/Levene Schools of Business, University of Regina, Regina, Saskatchewan, Canada
| | - Jutta Joormann
- Department of Psychology, Yale University, 2 Hillhouse Ave, New Haven, CT, USA
| | - Philip R Corlett
- Department of Psychiatry, Yale University, 300 George Street, New Haven, CT, USA
| | - Tyrone D Cannon
- Department of Psychology, Yale University, 2 Hillhouse Ave, New Haven, CT, USA; Department of Psychiatry, Yale University, 300 George Street, New Haven, CT, USA
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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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Faa G, Manchia M, Pintus R, Gerosa C, Marcialis MA, Fanos V. Fetal programming of neuropsychiatric disorders. ACTA ACUST UNITED AC 2016; 108:207-223. [DOI: 10.1002/bdrc.21139] [Citation(s) in RCA: 89] [Impact Index Per Article: 11.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2016] [Accepted: 09/28/2016] [Indexed: 12/14/2022]
Affiliation(s)
- Gavino Faa
- Division of Pathology, Department of Surgery; University Hospital San Giovanni di Dio; Cagliari Italy
| | - Mirko Manchia
- Section of Psychiatry, Department of Public Health, Clinical and Molecular Medicine; University of Cagliari; Cagliari Italy
- Department of Pharmacology; Dalhousie University; Halifax Nova Scotia Canada
| | - Roberta Pintus
- Neonatal Intensive Care Unit, Neonatal Pathology and Neonatal Section; AOU Cagliari and University of Cagliari; Cagliari Italy
| | - Clara Gerosa
- Division of Pathology, Department of Surgery; University Hospital San Giovanni di Dio; Cagliari Italy
| | - Maria Antonietta Marcialis
- Neonatal Intensive Care Unit, Neonatal Pathology and Neonatal Section; AOU Cagliari and University of Cagliari; Cagliari Italy
| | - Vassilios Fanos
- Neonatal Intensive Care Unit, Neonatal Pathology and Neonatal Section; AOU Cagliari and University of Cagliari; Cagliari Italy
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Gay O, Plaze M, Oppenheim C, Gaillard R, Olié JP, Krebs MO, Cachia A. Cognitive control deficit in patients with first-episode schizophrenia is associated with complex deviations of early brain development. J Psychiatry Neurosci 2016; 41:150267. [PMID: 27673502 PMCID: PMC5373705 DOI: 10.1503/jpn.150267] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2015] [Revised: 02/10/2016] [Accepted: 05/16/2016] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Several clinical and radiological markers of early neurodevelopmental deviations have been independently associated with cognitive impairment in patients with schizophrenia. The aim of our study was to test the cumulative and/or interactive effects of these early neurodevelopmental factors on cognitive control (CC) deficit, a core feature of schizophrenia. METHODS We recruited patients with first-episode schizophrenia-spectrum disorders, who underwent structural MRI. We evaluated CC efficiency using the Trail Making Test (TMT). Several markers of early brain development were measured: neurological soft signs (NSS), handedness, sulcal pattern of the anterior cingulate cortex (ACC) and ventricle enlargement. RESULTS We included 41 patients with schizophrenia in our analysis, which revealed a main effect of ACC morphology (p = 0.041) as well as interactions between NSS and ACC morphology (p = 0.005), between NSS and handedness (p = 0.044) and between ACC morphology and cerebrospinal fluid (CSF) volume (p = 0.005) on CC measured using the TMT-B score - the TMT-A score. LIMITATIONS No 3- or 4-way interactions were detected between the 4 neurodevelopmental factors. The sample size was clearly adapted to detect main effects and 2-way interactions, but may have limited the statistical power to investigate higher-order interactions. The effects of treatment and illness duration were limited as the study design involved only patients with first-episode psychosis. CONCLUSION To our knowledge, our study provides the first evidence of cumulative and interactive effects of different neurodevelopmental markers on CC efficiency in patients with schizophrenia. Such findings, in line with the neurodevelopmental model of schizophrenia, support the notion that CC impairments in patients with schizophrenia may be the final common pathway of several early neurodevelopmental mechanisms.
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Affiliation(s)
- Olivier Gay
- From the INSERM UMR 894, Centre de Psychiatrie & Neurosciences, CNRS GDR 3557, Institut de Psychiatrie, Paris, France (Gay, Plaze, Oppenheim, Gaillard, Olié, Krebs, Cachia); the Université Paris Descartes, Sorbonne Paris Cité, Paris, France (Gay, Plaze, Oppenheim, Gaillard, Olié, Krebs, Cachia); the Service Hospitalo-Universitaire, Centre Hospitalier Sainte-Anne, Paris, France (Gay, Plaze, Gaillard, Olié, Krebs); the Service d’Imagerie Morphologique et Fonctionnelle, Centre Hospitalier Sainte-Anne, Paris, France (Oppenheim); the CNRS UMR 8240, Laboratoire de Psychologie du Développement et de l’Éducation de l’Enfant, Paris, France (Cachia); and the Institut Universitaire de France, Paris, France (Cachia)
| | - Marion Plaze
- From the INSERM UMR 894, Centre de Psychiatrie & Neurosciences, CNRS GDR 3557, Institut de Psychiatrie, Paris, France (Gay, Plaze, Oppenheim, Gaillard, Olié, Krebs, Cachia); the Université Paris Descartes, Sorbonne Paris Cité, Paris, France (Gay, Plaze, Oppenheim, Gaillard, Olié, Krebs, Cachia); the Service Hospitalo-Universitaire, Centre Hospitalier Sainte-Anne, Paris, France (Gay, Plaze, Gaillard, Olié, Krebs); the Service d’Imagerie Morphologique et Fonctionnelle, Centre Hospitalier Sainte-Anne, Paris, France (Oppenheim); the CNRS UMR 8240, Laboratoire de Psychologie du Développement et de l’Éducation de l’Enfant, Paris, France (Cachia); and the Institut Universitaire de France, Paris, France (Cachia)
| | - Catherine Oppenheim
- From the INSERM UMR 894, Centre de Psychiatrie & Neurosciences, CNRS GDR 3557, Institut de Psychiatrie, Paris, France (Gay, Plaze, Oppenheim, Gaillard, Olié, Krebs, Cachia); the Université Paris Descartes, Sorbonne Paris Cité, Paris, France (Gay, Plaze, Oppenheim, Gaillard, Olié, Krebs, Cachia); the Service Hospitalo-Universitaire, Centre Hospitalier Sainte-Anne, Paris, France (Gay, Plaze, Gaillard, Olié, Krebs); the Service d’Imagerie Morphologique et Fonctionnelle, Centre Hospitalier Sainte-Anne, Paris, France (Oppenheim); the CNRS UMR 8240, Laboratoire de Psychologie du Développement et de l’Éducation de l’Enfant, Paris, France (Cachia); and the Institut Universitaire de France, Paris, France (Cachia)
| | - Raphael Gaillard
- From the INSERM UMR 894, Centre de Psychiatrie & Neurosciences, CNRS GDR 3557, Institut de Psychiatrie, Paris, France (Gay, Plaze, Oppenheim, Gaillard, Olié, Krebs, Cachia); the Université Paris Descartes, Sorbonne Paris Cité, Paris, France (Gay, Plaze, Oppenheim, Gaillard, Olié, Krebs, Cachia); the Service Hospitalo-Universitaire, Centre Hospitalier Sainte-Anne, Paris, France (Gay, Plaze, Gaillard, Olié, Krebs); the Service d’Imagerie Morphologique et Fonctionnelle, Centre Hospitalier Sainte-Anne, Paris, France (Oppenheim); the CNRS UMR 8240, Laboratoire de Psychologie du Développement et de l’Éducation de l’Enfant, Paris, France (Cachia); and the Institut Universitaire de France, Paris, France (Cachia)
| | - Jean-Pierre Olié
- From the INSERM UMR 894, Centre de Psychiatrie & Neurosciences, CNRS GDR 3557, Institut de Psychiatrie, Paris, France (Gay, Plaze, Oppenheim, Gaillard, Olié, Krebs, Cachia); the Université Paris Descartes, Sorbonne Paris Cité, Paris, France (Gay, Plaze, Oppenheim, Gaillard, Olié, Krebs, Cachia); the Service Hospitalo-Universitaire, Centre Hospitalier Sainte-Anne, Paris, France (Gay, Plaze, Gaillard, Olié, Krebs); the Service d’Imagerie Morphologique et Fonctionnelle, Centre Hospitalier Sainte-Anne, Paris, France (Oppenheim); the CNRS UMR 8240, Laboratoire de Psychologie du Développement et de l’Éducation de l’Enfant, Paris, France (Cachia); and the Institut Universitaire de France, Paris, France (Cachia)
| | | | - Arnaud Cachia
- Correspondence to: Prof. A. Cachia, Centre de Psychiatrie et Neurosciences, UMR 894, INSERM – Université, Paris Descartes, Hôpital Sainte-Anne, Paris, France;
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Laurens KR, Luo L, Matheson SL, Carr VJ, Raudino A, Harris F, Green MJ. Common or distinct pathways to psychosis? A systematic review of evidence from prospective studies for developmental risk factors and antecedents of the schizophrenia spectrum disorders and affective psychoses. BMC Psychiatry 2015; 15:205. [PMID: 26302744 PMCID: PMC4548447 DOI: 10.1186/s12888-015-0562-2] [Citation(s) in RCA: 80] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2015] [Accepted: 07/14/2015] [Indexed: 01/28/2023] Open
Abstract
BACKGROUND Identifying the unique and shared premorbid indicators of risk for the schizophrenia spectrum disorders (SSD) and affective psychoses (AP) may refine aetiological hypotheses and inform the delivery of universal versus targeted preventive interventions. This systematic review synthesises the available evidence concerning developmental risk factors and antecedents of SSD and AP to identify those with the most robust support, and to highlight remaining evidence gaps. METHODS A systematic search of prospective birth, population, high-risk, and case-control cohorts was conducted in Medline and supplemented by hand searching, incorporating published studies in English with full text available. Inclusion/exclusion decisions and data extraction were completed in duplicate. Exposures included three categories of risk factors and four categories of antecedents, with case and comparison groups defined by adult psychiatric diagnosis. Effect sizes and prevalence rates were extracted, where available, and the strength of evidence synthesised and evaluated qualitatively across the study designs. RESULTS Of 1775 studies identified by the search, 127 provided data to the review. Individuals who develop SSD experience a diversity of subtle premorbid developmental deficits and risk exposures, spanning the prenatal period through early adolescence. Those of greatest magnitude (or observed most consistently) included obstetric complications, maternal illness during pregnancy (especially infections), other maternal physical factors, negative family emotional environment, psychopathology and psychotic symptoms, and cognitive and motor dysfunctions. Relatively less evidence has accumulated to implicate this diversity of exposures in AP, and many yet remain unexamined, with the most consistent or strongest evidence to date being for obstetric complications, psychopathology, cognitive indicators and motor dysfunction. Among the few investigations affording direct comparison between SSD and AP, larger effect sizes and a greater number of significant associations are commonly reported for SSD relative to AP. CONCLUSIONS Shared risk factors for SSD and AP may include obstetric complications, childhood psychopathology, cognitive markers and motor dysfunction, but the capacity to distinguish common versus distinct risk factors/antecedents for SSD and AP is limited by the scant availability of prospective data for AP, and inconsistency in replication. Further studies considering both diagnoses concurrently are needed. Nonetheless, the prevalence of the risk factors/antecedents observed in cases and controls helps demarcate potential targets for preventative interventions for these disorders.
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Affiliation(s)
- Kristin R. Laurens
- Research Unit for Schizophrenia Epidemiology, School of Psychiatry, University of New South Wales, Sydney, Australia ,Schizophrenia Research Institute, Sydney, Australia ,Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, UK ,Black Dog Institute, Prince of Wales Hospital, Sydney, Australia
| | - Luming Luo
- Research Unit for Schizophrenia Epidemiology, School of Psychiatry, University of New South Wales, Sydney, Australia. .,Schizophrenia Research Institute, Sydney, Australia.
| | - Sandra L. Matheson
- Research Unit for Schizophrenia Epidemiology, School of Psychiatry, University of New South Wales, Sydney, Australia ,Schizophrenia Research Institute, Sydney, Australia
| | - Vaughan J. Carr
- Research Unit for Schizophrenia Epidemiology, School of Psychiatry, University of New South Wales, Sydney, Australia ,Schizophrenia Research Institute, Sydney, Australia ,Department of Psychiatry, Monash University, Melbourne, Australia
| | - Alessandra Raudino
- Research Unit for Schizophrenia Epidemiology, School of Psychiatry, University of New South Wales, Sydney, Australia. .,Schizophrenia Research Institute, Sydney, Australia.
| | - Felicity Harris
- Research Unit for Schizophrenia Epidemiology, School of Psychiatry, University of New South Wales, Sydney, Australia. .,Schizophrenia Research Institute, Sydney, Australia.
| | - Melissa J. Green
- Research Unit for Schizophrenia Epidemiology, School of Psychiatry, University of New South Wales, Sydney, Australia ,Schizophrenia Research Institute, Sydney, Australia ,Black Dog Institute, Prince of Wales Hospital, Sydney, Australia ,Neuroscience Research Australia, Sydney, Australia
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Smith GN, Thornton AE, Lang DJ, MacEwan GW, Kopala LC, Su W, Honer WG. Cortical morphology and early adverse birth events in men with first-episode psychosis. Psychol Med 2015; 45:1825-1837. [PMID: 25499574 DOI: 10.1017/s003329171400292x] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
BACKGROUND Reduced cortical gray-matter volume is commonly observed in patients with psychosis. Cortical volume is a composite measure that includes surface area, thickness and gyrification. These three indices show distinct maturational patterns and may be differentially affected by early adverse events. The study goal was to determine the impact of two distinct obstetrical complications (OCs) on cortical morphology. METHOD A detailed birth history and MRI scans were obtained for 36 patients with first-episode psychosis and 16 healthy volunteers. RESULTS Perinatal hypoxia and slow fetal growth were associated with cortical volume (Cohen's d = 0.76 and d = 0.89, respectively) in patients. However, the pattern of associations differed across the three components of cortical volume. Both hypoxia and fetal growth were associated with cortical surface area (d = 0.88 and d = 0.72, respectively), neither of these two OCs was related to cortical thickness, and hypoxia but not fetal growth was associated with gyrification (d = 0.85). No significant associations were found within the control sample. CONCLUSIONS Cortical dysmorphology was associated with OCs. The use of a global measure of cortical morphology or a global measure of OCs obscured important relationships between these measures. Gyrification is complete before 2 years and its strong relationship with hypoxia suggests an early disruption to brain development. Cortical thickness matures later and, consistent with previous research, we found no association between thickness and OCs. Finally, cortical surface area is largely complete by puberty and the present results suggest that events during childhood do not fully compensate for the effects of early disruptive events.
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Affiliation(s)
- G N Smith
- Department of Psychiatry,University of British Columbia,Vancouver,Canada
| | - A E Thornton
- Department of Psychology,Simon Fraser University,Burnaby,Canada
| | - D J Lang
- Department of Radiology,University of British Columbia,Vancouver,Canada
| | - G W MacEwan
- Department of Psychiatry,University of British Columbia,Vancouver,Canada
| | - L C Kopala
- Department of Psychiatry,University of British Columbia,Vancouver,Canada
| | - W Su
- Department of Psychiatry,University of British Columbia,Vancouver,Canada
| | - W G Honer
- Department of Psychiatry,University of British Columbia,Vancouver,Canada
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Twenty Years of Schizophrenia Research in the Northern Finland Birth Cohort 1966: A Systematic Review. SCHIZOPHRENIA RESEARCH AND TREATMENT 2015; 2015:524875. [PMID: 26090224 PMCID: PMC4452001 DOI: 10.1155/2015/524875] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/11/2015] [Revised: 04/24/2015] [Accepted: 04/29/2015] [Indexed: 11/17/2022]
Abstract
Birth cohort designs are useful in studying adult disease trajectories and outcomes, such as schizophrenia. We review the schizophrenia research performed in the Northern Finland Birth Cohort 1966 (NFBC 1966), which includes 10,934 individuals living in Finland at 16 years of age who have been monitored since each mother's mid-pregnancy. By the age of 44, 150 (1.4%) had developed schizophrenia. There are 77 original papers on schizophrenia published from the NFBC 1966. The early studies have found various risk factors for schizophrenia, especially related to pregnancy and perinatal phase. Psychiatric and somatic outcomes were heterogeneous, but relatively poor. Mortality in schizophrenia is high, especially due to suicides. Several early predictors of outcomes have also been found. Individuals with schizophrenia have alterations in brain morphometry and neurocognition, and our latest studies have found that the use of high lifetime doses of antipsychotics associated with these changes. The schizophrenia research in the NFBC 1966 has been especially active for 20 years, the prospective study design and long follow-up enabling several clinically and epidemiologically important findings. When compared to other birth cohorts, the research in the NFBC 1966 has offered also unique findings on course and outcome of schizophrenia.
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Prenatal xenobiotic exposure and intrauterine hypothalamus-pituitary-adrenal axis programming alteration. Toxicology 2014; 325:74-84. [PMID: 25194749 DOI: 10.1016/j.tox.2014.08.015] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2014] [Revised: 08/23/2014] [Accepted: 08/28/2014] [Indexed: 12/18/2022]
Abstract
The hypothalamic-pituitary-adrenal (HPA) axis is one of the most important neuroendocrine axes and plays an important role in stress defense responses before and after birth. Prenatal exposure to xenobiotics, including environmental toxins (such as smoke, sulfur dioxide and carbon monoxide), drugs (such as synthetic glucocorticoids), and foods and beverage categories (such as ethanol and caffeine), affects fetal development indirectly by changing the maternal status or damaging the placenta. Certain xenobiotics (such as caffeine, ethanol and dexamethasone) may also affect the fetus directly by crossing the placenta into the fetus due to their lipophilic properties and lower molecular weights. All of these factors probably result in intrauterine programming alteration of the HPA axis, which showed a low basal activity but hypersensitivity to chronic stress. These alterations will, therefore, increase the susceptibility to adult neuropsychiatric (such as depression and schizophrenia) and metabolic diseases (such as hypertension, diabetes and non-alcoholic fatty liver disease). The "over-exposure of fetuses to maternal glucocorticoids" may be the main initiation factor by which the fetal HPA axis programming is altered. Meantime, xenobiotics can directly induce abnormal epigenetic modifications and expression on the important fetal genes (such as hippocampal glucocorticoid receptor, adrenal steroidogenic acute regulatory protein, et al) or damage by in situ oxidative metabolism of fetal adrenals, which may also be contributed to the programming alteration of fetal HPA axis.
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Córdova-Palomera A, Alemany S, Fatjó-Vilas M, Goldberg X, Leza JC, González-Pinto A, Nenadic I, Fañanás L. Birth weight, working memory and epigenetic signatures in IGF2 and related genes: a MZ twin study. PLoS One 2014; 9:e103639. [PMID: 25171170 PMCID: PMC4149354 DOI: 10.1371/journal.pone.0103639] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2014] [Accepted: 07/01/2014] [Indexed: 01/22/2023] Open
Abstract
Neurodevelopmental disruptions caused by obstetric complications play a role in the etiology of several phenotypes associated with neuropsychiatric diseases and cognitive dysfunctions. Importantly, it has been noticed that epigenetic processes occurring early in life may mediate these associations. Here, DNA methylation signatures at IGF2 (insulin-like growth factor 2) and IGF2BP1-3 (IGF2-binding proteins 1-3) were examined in a sample consisting of 34 adult monozygotic (MZ) twins informative for obstetric complications and cognitive performance. Multivariate linear regression analysis of twin data was implemented to test for associations between methylation levels and both birth weight (BW) and adult working memory (WM) performance. Familial and unique environmental factors underlying these potential relationships were evaluated. A link was detected between DNA methylation levels of two CpG sites in the IGF2BP1 gene and both BW and adult WM performance. The BW-IGF2BP1 methylation association seemed due to non-shared environmental factors influencing BW, whereas the WM-IGF2BP1 methylation relationship seemed mediated by both genes and environment. Our data is in agreement with previous evidence indicating that DNA methylation status may be related to prenatal stress and later neurocognitive phenotypes. While former reports independently detected associations between DNA methylation and either BW or WM, current results suggest that these relationships are not confounded by each other.
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Affiliation(s)
- Aldo Córdova-Palomera
- Unitat d'Antropologia, Departament de Biologia Animal, Facultat de Biologia and Institut de Biomedicina (IBUB), Universitat de Barcelona, Barcelona, Spain
- Centro de Investigaciones Biomédicas en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
| | - Silvia Alemany
- Unitat d'Antropologia, Departament de Biologia Animal, Facultat de Biologia and Institut de Biomedicina (IBUB), Universitat de Barcelona, Barcelona, Spain
- Centro de Investigaciones Biomédicas en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
| | - Mar Fatjó-Vilas
- Unitat d'Antropologia, Departament de Biologia Animal, Facultat de Biologia and Institut de Biomedicina (IBUB), Universitat de Barcelona, Barcelona, Spain
- Centro de Investigaciones Biomédicas en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
| | - Ximena Goldberg
- Unitat d'Antropologia, Departament de Biologia Animal, Facultat de Biologia and Institut de Biomedicina (IBUB), Universitat de Barcelona, Barcelona, Spain
- Centro de Investigaciones Biomédicas en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
| | - Juan Carlos Leza
- Centro de Investigaciones Biomédicas en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
- Department of Pharmacology, Faculty of Medicine, Universidad Complutense, Madrid, Spain, and Instituto de Investigación Hospital 12 de Octubre (I+12), Madrid, Spain
| | - Ana González-Pinto
- Centro de Investigaciones Biomédicas en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
- Psychiatry Service, Santiago Apóstol Hospital, EMBREC, EHU/UPV University of the Basque Country, Vitoria, Spain
| | - Igor Nenadic
- Department of Psychiatry and Psychotherapy, Jena University Hospital, Jena, Germany
| | - Lourdes Fañanás
- Unitat d'Antropologia, Departament de Biologia Animal, Facultat de Biologia and Institut de Biomedicina (IBUB), Universitat de Barcelona, Barcelona, Spain
- Centro de Investigaciones Biomédicas en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
- * E-mail:
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Impairments in Brain-Derived Neurotrophic Factor-Induced Glutamate Release in Cultured Cortical Neurons Derived from Rats with Intrauterine Growth Retardation: Possible Involvement of Suppression of TrkB/Phospholipase C-γ Activation. Neurochem Res 2014; 39:785-92. [DOI: 10.1007/s11064-014-1270-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2013] [Revised: 02/10/2014] [Accepted: 02/25/2014] [Indexed: 10/25/2022]
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Haukvik UK, Rimol LM, Roddey JC, Hartberg CB, Lange EH, Vaskinn A, Melle I, Andreassen OA, Dale A, Agartz I. Normal birth weight variation is related to cortical morphology across the psychosis spectrum. Schizophr Bull 2014; 40:410-9. [PMID: 23419977 PMCID: PMC3932082 DOI: 10.1093/schbul/sbt005] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
BACKGROUND Normal birth weight variation affects schizophrenia risk and cognitive performance in schizophrenia patients and healthy controls. Brain cortical anatomy is altered in psychotic disorders and in low birth weight subjects, but if birth weight variation relates to cortical morphology across the psychosis spectrum is not known. METHODS Magnetic Resonance Imaging brain scans and clinical-, neurocognitive-, and medical birth registry data were collected from 359 adults including patients with a DSM-IV diagnosis of schizophrenia (n = 90, mean age 29.4±10.2 [95% CI], 62% male), bipolar disorder (n = 79, age 29.4±11.8, 39% male) or other psychosis (n = 40, age 26.3±10.0, 56% male), and healthy controls (n = 140, age 30.8±12.0,53% male). We explored the relationship between whole-range birth weight variation and cortical surface area and thickness and their possible associations to cognitive performance. RESULTS Across all groups, lower birth weight was associated with smaller total surface area (t = 3.87, P = .0001), within specific regions of the temporal, parietal, and frontal cortex bilaterally. There were no associations between birth weight and cortical thickness, and no diagnosis by birth weight interaction effects on cortical thickness or surface area. Smaller cortical area (t = 2.50, P = .013) and lower birth weight (t = 2.53, P = .012) were significantly related to poorer working memory performance in all diagnostic groups except schizophrenia. CONCLUSION Birth weight relates to adult cortical surface area, but not cortical thickness, in patients across the psychosis spectrum and in healthy controls. Cortical area appears to be a diagnosis-independent general marker of early neurodevelopment, with a dose-response association to normal birth weight variation.
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Affiliation(s)
- Unn K. Haukvik
- Department of Psychiatric Research, Diakonhjemmet Hospital, Oslo, Norway; ,K. G. Jebsen Centre for Psychosis Research, Institute of Clinical Medicine, University of Oslo, Oslo, Norway;,*To whom correspondence should be addressed; PO Box 85 Vinderen, 0319 Oslo, Norway; tel: +47 22029800, fax: +47 22495862, e-mail:
| | - Lars M. Rimol
- Department of Psychiatric Research, Diakonhjemmet Hospital, Oslo, Norway; ,K. G. Jebsen Centre for Psychosis Research, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - J. Cooper Roddey
- Department of Neurosciences, University of California San Diego, La Jolla, CA
| | | | - Elisabeth H. Lange
- Department of Psychiatric Research, Diakonhjemmet Hospital, Oslo, Norway; ,K. G. Jebsen Centre for Psychosis Research, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Anja Vaskinn
- K. G. Jebsen Centre for Psychosis Research, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - Ingrid Melle
- K. G. Jebsen Centre for Psychosis Research, Institute of Clinical Medicine, University of Oslo, Oslo, Norway;,K. G. Jebsen Centre for Psychosis Research, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - Ole A. Andreassen
- K. G. Jebsen Centre for Psychosis Research, Institute of Clinical Medicine, University of Oslo, Oslo, Norway;,K. G. Jebsen Centre for Psychosis Research, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - Anders Dale
- Department of Neurosciences, University of California San Diego, La Jolla, CA;,Department of Radiology, University of CaliforniaSan Diego, La Jolla, CA
| | - Ingrid Agartz
- Department of Psychiatric Research, Diakonhjemmet Hospital, Oslo, Norway; ,K. G. Jebsen Centre for Psychosis Research, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
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Schaefer J, Giangrande E, Weinberger DR, Dickinson D. The global cognitive impairment in schizophrenia: consistent over decades and around the world. Schizophr Res 2013; 150:42-50. [PMID: 23911259 PMCID: PMC4196267 DOI: 10.1016/j.schres.2013.07.009] [Citation(s) in RCA: 389] [Impact Index Per Article: 35.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2013] [Revised: 07/02/2013] [Accepted: 07/03/2013] [Indexed: 12/17/2022]
Abstract
OBJECTIVE Schizophrenia results in cognitive impairments as well as positive, negative, and disorganized symptomatology. The present study examines the extent to which these cognitive deficits are generalized across domains, potential moderator variables, and whether the pattern of cognitive findings reported in schizophrenia has remained consistent over time and across cultural and geographic variation. METHOD Relevant publications from 2006 to 2011 were identified through keyword searches in PubMed and an examination of reference lists. Studies were included if they (1) compared the cognitive performance of adult schizophrenia patients and healthy controls, (2) based schizophrenia diagnoses on contemporary diagnostic criteria, (3) reported information sufficient to permit effect size calculation, (4) were reported in English, and (5) reported data for neuropsychological tests falling into at least 3 distinct cognitive domains. A set of 100 non-overlapping studies was identified, and effect sizes (Hedge's g) were calculated for each cognitive variable. RESULTS Consistent with earlier analyses, patients with schizophrenia scored significantly lower than controls across all cognitive tests and domains (grand mean effect size, g=-1.03). Patients showed somewhat larger impairments in the domains of processing speed (g=-1.25) and episodic memory (g=-1.23). Our results also showed few inconsistencies when grouped by geographic region. CONCLUSIONS The present study extends findings from 1980 to 2006 of a substantial, generalized cognitive impairment in schizophrenia, demonstrating that this finding has remained robust over time despite changes in assessment instruments and alterations in diagnostic criteria, and that it manifests similarly in different regions of the world despite linguistic and cultural differences.
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Affiliation(s)
- Jonathan Schaefer
- Genes, Cognition and Psychosis Program and Clinical Brain Disorders Branch, IRP, NIMH, NIH, 10 Center Drive, MSC 1379, Bethesda, Maryland 20892 USA
| | - Evan Giangrande
- Genes, Cognition and Psychosis Program and Clinical Brain Disorders Branch, IRP, NIMH, NIH, 10 Center Drive, MSC 1379, Bethesda, Maryland 20892 USA
| | - Daniel R. Weinberger
- Genes, Cognition and Psychosis Program and Clinical Brain Disorders Branch, IRP, NIMH, NIH, 10 Center Drive, MSC 1379, Bethesda, Maryland 20892 USA,Lieber institute for Brain Development, Johns Hopkins University Medical Center 855 North Wolfe Street, Baltimore, Maryland 21205 USA
| | - Dwight Dickinson
- Genes, Cognition and Psychosis Program and Clinical Brain Disorders Branch, IRP, NIMH, NIH, 10 Center Drive, MSC 1379, Bethesda, Maryland 20892 USA
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Chew LJ, Fusar-Poli P, Schmitz T. Oligodendroglial alterations and the role of microglia in white matter injury: relevance to schizophrenia. Dev Neurosci 2013; 35:102-29. [PMID: 23446060 PMCID: PMC4531048 DOI: 10.1159/000346157] [Citation(s) in RCA: 107] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2012] [Accepted: 11/07/2012] [Indexed: 12/12/2022] Open
Abstract
Schizophrenia is a chronic and debilitating mental illness characterized by a broad range of abnormal behaviors, including delusions and hallucinations, impaired cognitive function, as well as mood disturbances and social withdrawal. Due to the heterogeneous nature of the disease, the causes of schizophrenia are very complex; its etiology is believed to involve multiple brain regions and the connections between them, and includes alterations in both gray and white matter regions. The onset of symptoms varies with age and severity, and there is some debate over a degenerative or developmental etiology. Longitudinal magnetic resonance imaging studies have detected progressive gray matter loss in the first years of disease, suggesting neurodegeneration; but there is also increasing recognition of a temporal association between clinical complications at birth and disease onset that supports a neurodevelopmental origin. Presently, neuronal abnormalities in schizophrenia are better understood than alterations in myelin-producing cells of the brain, the oligodendrocytes, which are the predominant constituents of white matter structures. Proper white matter development and its structural integrity critically impacts brain connectivity, which affects sensorimotor coordination and cognitive ability. Evidence of defective white matter growth and compromised white matter integrity has been found in individuals at high risk of psychosis, and decreased numbers of mature oligodendrocytes are detected in schizophrenia patients. Inflammatory markers, including proinflammatory cytokines and chemokines, are also associated with psychosis. A relationship between risk of psychosis, white matter defects and prenatal inflammation is being established. Animal models of perinatal brain injury are successful in producing white matter damage in the brain, typified by hypomyelination and/or dysmyelination, impaired motor coordination and prepulse inhibition of the acoustic startle reflex, recapitulating structural and functional characteristics observed in schizophrenia. In addition, elevated expression of inflammation-related genes in brain tissue and increased production of cytokines by blood cells from patients with schizophrenia indicate immunological dysfunction and abnormal inflammatory responses, which are also important underlying features in experimental models. Microglia, resident immune defenders of the central nervous system, play important roles in the development and protection of neural cells, but can contribute to injury under pathological conditions. This article discusses oligodendroglial changes in schizophrenia and focuses on microglial activity in the context of the disease, in neonatal brain injury and in various experimental models of white matter damage. These include disorders associated with premature birth, and animal models of perinatal bacterial and viral infection, oxygen deprivation (hypoxia) and excess (hyperoxia), and elevated systemic proinflammatory cytokine levels. We briefly review the effects of treatment with antipsychotic and anti-inflammatory agents in models of perinatal brain injury, and comment on the therapeutic potential of these strategies. By understanding the neurobiological basis of oligodendroglial abnormalities in schizophrenia, it is hoped that patients will benefit from the availability of targeted and more efficacious treatment options.
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Affiliation(s)
- Li-Jin Chew
- Center for Neuroscience Research, Children's Research Institute, Children's National Medical Center, Washington, DC 20010, USA.
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An association between both low and high birth weight and increased disorganized and negative symptom severity in schizophrenia and other psychoses. Psychiatry Res 2013; 205:18-24. [PMID: 22985549 DOI: 10.1016/j.psychres.2012.08.026] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2012] [Revised: 08/16/2012] [Accepted: 08/25/2012] [Indexed: 11/21/2022]
Abstract
Longitudinal cohort studies have implicated an association between both low and high birth weight and increased schizophrenia risk. In this study, we investigated the effect of birth weight on the symptom severity of psychotic disorders including schizophrenia in a Finnish schizophrenia family study sample. We used a multivariate GEE (General Estimating Equation) regression model to investigate the association of birth weight and symptom severity in 282 subjects with a primary psychotic disorder, 178 of whom had a diagnosis of schizophrenia. The Scales for the Assessment of Positive and Negative Symptoms (SAPS and SANS) were used as a measure of symptom severity. Sex, place of birth and year of birth were adjusted for in the model. Both low and high birth weight were associated with more severe symptoms with respect to bizarre behaviour, affective flattening and attentional impairment. In addition, low birth weight was associated with more severe symptoms with respect to positive formal thought. Our findings suggest that both low and high birth weight can influence the symptom severity of psychotic disorders. Our results implicate an association between both low and high birth weight and disorganized and negative symptoms.
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Long-term influence of normal variation in neonatal characteristics on human brain development. Proc Natl Acad Sci U S A 2012; 109:20089-94. [PMID: 23169628 DOI: 10.1073/pnas.1208180109] [Citation(s) in RCA: 138] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
It is now recognized that a number of cognitive, behavioral, and mental health outcomes across the lifespan can be traced to fetal development. Although the direct mediation is unknown, the substantial variance in fetal growth, most commonly indexed by birth weight, may affect lifespan brain development. We investigated effects of normal variance in birth weight on MRI-derived measures of brain development in 628 healthy children, adolescents, and young adults in the large-scale multicenter Pediatric Imaging, Neurocognition, and Genetics study. This heterogeneous sample was recruited through geographically dispersed sites in the United States. The influence of birth weight on cortical thickness, surface area, and striatal and total brain volumes was investigated, controlling for variance in age, sex, household income, and genetic ancestry factors. Birth weight was found to exert robust positive effects on regional cortical surface area in multiple regions as well as total brain and caudate volumes. These effects were continuous across birth weight ranges and ages and were not confined to subsets of the sample. The findings show that (i) aspects of later child and adolescent brain development are influenced at birth and (ii) relatively small differences in birth weight across groups and conditions typically compared in neuropsychiatric research (e.g., Attention Deficit Hyperactivity Disorder, schizophrenia, and personality disorders) may influence group differences observed in brain parameters of interest at a later stage in life. These findings should serve to increase our attention to early influences.
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