1
|
Kim DH, Loke H, Thompson J, Hill R, Sundram S, Lee J. The dopamine D2-like receptor and the Y-chromosome gene, SRY, are reciprocally regulated in the human male neuroblastoma M17 cell line. Neuropharmacology 2024; 251:109928. [PMID: 38552780 DOI: 10.1016/j.neuropharm.2024.109928] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Revised: 02/28/2024] [Accepted: 03/15/2024] [Indexed: 04/04/2024]
Affiliation(s)
- Dong-Hyun Kim
- Department of Psychiatry, School of Clinical Sciences, Monash University, Clayton, Victoria, 3168, Australia
| | - Hannah Loke
- Centre for Endocrinology and Metabolism, Hudson Institute of Medical Research, Clayton, Victoria, 3168, Australia
| | - James Thompson
- Department of Psychiatry, School of Clinical Sciences, Monash University, Clayton, Victoria, 3168, Australia
| | - Rachel Hill
- Department of Psychiatry, School of Clinical Sciences, Monash University, Clayton, Victoria, 3168, Australia
| | - Suresh Sundram
- Department of Psychiatry, School of Clinical Sciences, Monash University, Clayton, Victoria, 3168, Australia; Mental Health Program, Monash Health, Clayton, Victoria, 3168, Australia
| | - Joohyung Lee
- Department of Psychiatry, School of Clinical Sciences, Monash University, Clayton, Victoria, 3168, Australia; Centre for Endocrinology and Metabolism, Hudson Institute of Medical Research, Clayton, Victoria, 3168, Australia; Department of Anatomy and Developmental Biology, Monash University, Clayton, Victoria, 3168, Australia.
| |
Collapse
|
2
|
Ouliaris C, Gill N, Castan M, Sundram S. OPCAT: How an international treaty regarding torture is relevant to the Australian mental health system. Aust N Z J Psychiatry 2024; 58:387-392. [PMID: 38217424 PMCID: PMC11055407 DOI: 10.1177/00048674231221419] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/15/2024]
Abstract
The United Nations Subcommittee on the Prevention of Torture visits signatory nations to the Optional Protocol to the Convention against Torture and other Cruel, Inhuman or Degrading Treatment or Punishment (OPCAT). Its role is to monitor and support signatory nations in implementing and complying with the Convention against Torture and other Cruel, Inhuman or Degrading Treatment or Punishment (CAT). In October 2022, the United Nations Subcommittee on the Prevention of Torture visited Australia but was barred from visiting mental health wards in Queensland and all detention facilities in New South Wales leading to the termination of its visit. This breach of Australia's obligations under the OPCAT presents a significant setback for the rights of people with mental illness and other involuntarily detained populations. This piece sets out to demonstrate the relevance of OPCAT to the mental health system in Australia. Individuals who are detained for compulsory treatment in locked facilities such as acute psychiatric inpatient wards and forensic mental health facilities are deprived of their liberty, often out of public view. Thus, it highlights the ethical and professional obligations of all mental health professionals, especially psychiatrists, to safeguard the human rights of individuals being detained in mental health facilities as enshrined in Australia's international legal obligations under the OPCAT. Adhering to these obligations diminishes the risk of future human rights violations of people with mental illness.
Collapse
Affiliation(s)
- Calina Ouliaris
- Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, NSW, Australia
- Training Program, The Royal Australian & New Zealand College of Psychiatrists, Melbourne, VIC, Australia
| | - Neeraj Gill
- Mental Health Policy Unit, Health Research Institute, University of Canberra, Canberra, ACT, Australia
- School of Medicine and Dentistry, Griffith University, Gold Coast, QLD, Australia
- Mental Health and Specialist Services, Gold Coast Health, Southport, QLD, Australia
| | - Melissa Castan
- Faculty of Law, Monash University, Clayton, VIC, Australia
- Castan Centre for Human Rights Law, Monash University, Clayton, VIC, Australia
- Australian Academy of Law, Sydney, NSW, Australia
| | - Suresh Sundram
- Department of Psychiatry, School of Clinical Sciences, Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton, VIC, Australia
- Mental Health Program, Monash Health, Clayton, VIC, Australia
- Cabrini Outreach, Malvern, VIC, Australia
| |
Collapse
|
3
|
Gillespie B, Panthi S, Sundram S, Hill RA. The impact of maternal immune activation on GABAergic interneuron development: A systematic review of rodent studies and their translational implications. Neurosci Biobehav Rev 2024; 156:105488. [PMID: 38042358 DOI: 10.1016/j.neubiorev.2023.105488] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Revised: 11/09/2023] [Accepted: 11/27/2023] [Indexed: 12/04/2023]
Abstract
Mothers exposed to infections during pregnancy disproportionally birth children who develop autism and schizophrenia, disorders associated with altered GABAergic function. The maternal immune activation (MIA) model recapitulates this risk factor, with many studies also reporting disruptions to GABAergic interneuron expression, protein, cellular density and function. However, it is unclear if there are species, sex, age, region, or GABAergic subtype specific vulnerabilities to MIA. Furthermore, to fully comprehend the impact of MIA on the GABAergic system a synthesised account of molecular, cellular, electrophysiological and behavioural findings was required. To this end we conducted a systematic review of GABAergic interneuron changes in the MIA model, focusing on the prefrontal cortex and hippocampus. We reviewed 102 articles that revealed robust changes in a number of GABAergic markers that present as gestationally-specific, region-specific and sometimes sex-specific. Disruptions to GABAergic markers coincided with distinct behavioural phenotypes, including memory, sensorimotor gating, anxiety, and sociability. Findings suggest the MIA model is a valid tool for testing novel therapeutics designed to recover GABAergic function and associated behaviour.
Collapse
Affiliation(s)
- Brendan Gillespie
- Department of Psychiatry, School of Clinical Sciences, Monash University, Clayton, VIC 3168, Australia
| | - Sandesh Panthi
- Department of Psychiatry, School of Clinical Sciences, Monash University, Clayton, VIC 3168, Australia
| | - Suresh Sundram
- Department of Psychiatry, School of Clinical Sciences, Monash University, Clayton, VIC 3168, Australia
| | - Rachel A Hill
- Department of Psychiatry, School of Clinical Sciences, Monash University, Clayton, VIC 3168, Australia.
| |
Collapse
|
4
|
Vinnakota C, Schroeder A, Du X, Ikeda K, Ide S, Mishina M, Hudson M, Jones NC, Sundram S, Hill RA. Understanding the role of the NMDA receptor subunit, GluN2D, in mediating NMDA receptor antagonist-induced behavioral disruptions in male and female mice. J Neurosci Res 2024; 102:e25257. [PMID: 37814998 PMCID: PMC10953441 DOI: 10.1002/jnr.25257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Revised: 07/24/2023] [Accepted: 09/23/2023] [Indexed: 10/11/2023]
Abstract
Noncompetitive NMDA receptor (NMDAR) antagonists like phencyclidine (PCP) and ketamine cause psychosis-like symptoms in healthy humans, exacerbate schizophrenia symptoms in people with the disorder, and disrupt a range of schizophrenia-relevant behaviors in rodents, including hyperlocomotion. This is negated in mice lacking the GluN2D subunit of the NMDAR, suggesting the GluN2D subunit mediates the hyperlocomotor effects of these drugs. However, the role of GluN2D in mediating other schizophrenia-relevant NMDAR antagonist-induced behavioral disturbances, and in both sexes, is unclear. This study aimed to investigate the role of the GluN2D subunit in mediating schizophrenia-relevant behaviors induced by a range of NMDA receptor antagonists. Using both male and female GluN2D knockout (KO) mice, we examined the effects of the NMDAR antagonist's PCP, the S-ketamine enantiomer (S-ket), and the ketamine metabolite R-norketamine (R-norket) on locomotor activity, anxiety-related behavior, and recognition and short-term spatial memory. GluN2D-KO mice showed a blunted locomotor response to R-norket, S-ket, and PCP, a phenotype present in both sexes. GluN2D-KO mice of both sexes showed an anxious phenotype and S-ket, R-norket, and PCP showed anxiolytic effects that were dependent on sex and genotype. S-ket disrupted spatial recognition memory in females and novel object recognition memory in both sexes, independent of genotype. This datum identifies a role for the GluN2D subunit in sex-specific effects of NMDAR antagonists and on the differential effects of the R- and S-ket enantiomers.
Collapse
Affiliation(s)
- Chitra Vinnakota
- Department of PsychiatryMonash UniversityClaytonVictoriaAustralia
| | - Anna Schroeder
- Department of PsychiatryMonash UniversityClaytonVictoriaAustralia
| | - Xin Du
- Department of PsychiatryMonash UniversityClaytonVictoriaAustralia
| | - Kazutaka Ikeda
- Addictive Substance ProjectTokyo Metropolitan Institute of Medical ScienceTokyoJapan
| | - Soichiro Ide
- Addictive Substance ProjectTokyo Metropolitan Institute of Medical ScienceTokyoJapan
| | - Masayoshi Mishina
- Brain Science Laboratory, The Research Organization of Science and TechnologyRitsumeikan UniversityKusatsuJapan
| | - Matthew Hudson
- Department of NeuroscienceMonash UniversityClaytonVictoriaAustralia
| | | | - Suresh Sundram
- Department of PsychiatryMonash UniversityClaytonVictoriaAustralia
- Mental Health ProgramMonash HealthClaytonVictoriaAustralia
| | - Rachel Anne Hill
- Department of PsychiatryMonash UniversityClaytonVictoriaAustralia
| |
Collapse
|
5
|
Sridhar S, Mol BW, Hodges R, Palmer KR, Sundram S, de Carvalho Pacagnella R, Souza RT, Barbosa-Junior F, Mackin D, Said J, Rolnik D, Malhotra A. Feasibility of a pregnancy intervention mimicking viral transmission mitigation measures on the incidence of preterm birth in high-risk pregnant women enrolled in antenatal clinics in Melbourne, Australia: protocol for a pilot, randomised trial. BMJ Open 2023; 13:e075703. [PMID: 38154903 PMCID: PMC10759123 DOI: 10.1136/bmjopen-2023-075703] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Accepted: 11/23/2023] [Indexed: 12/30/2023] Open
Abstract
INTRODUCTION Preterm birth is a leading cause of perinatal morbidity and mortality. During the COVID-19 pandemic, reduction in rates of preterm birth in women exposed to viral mitigation measures was reported by multiple studies. In addition, others and we observed a more pronounced reduction of preterm birth in women who had previously experienced a preterm birth. The aim of this pilot study is to establish the feasibility of a lifestyle intervention based on viral mitigation measures in high-risk pregnancies, with the ultimate aim to reduce the incidence of preterm birth. METHODS AND ANALYSIS One hundred pregnant women, enrolled in antenatal clinics at two tertiary maternity centres in Melbourne, Australia, who have had a previous preterm birth between 22 and 34 weeks gestation will be recruited. This is a two-arm, parallel group, open-label randomised controlled feasibility trial: 50 women will be randomised to the intervention group, where they will be requested to comply with a set of lifestyle changes (similar to the viral mitigation measures observed during the pandemic). Another 50 women will be randomised to the control group, where they will undergo standard pregnancy care. The primary outcome of this trial is feasibility, which will be assessed by measuring patient eligibility rate, recruitment rate, compliance rate and data completion rate. Secondary outcomes include incidence of preterm birth, maternal satisfaction, maternal quality of life and other pregnancy outcomes. Standard methods in statistical analysis for randomised controlled trials on an intention to treat basis will be followed. ETHICS AND DISSEMINATION This trial has been approved by the Monash Human Research Ethics Committee; approval reference number RES-22-0000-122A. Study findings will be reported and submitted to peer-reviewed journals for publication, and presentation at conferences. TRIAL REGISTRATION NUMBER ACTRN12622000753752; Pre-results.
Collapse
Affiliation(s)
- Shivadharshini Sridhar
- Department of Obstetrics and Gynaecology, Monash Medical Centre Clayton, Clayton, Victoria, Australia
- Department of Obstetrics and Gynaecology, Monash University, Clayton, Victoria, Australia
| | - Ben W Mol
- Department of Obstetrics and Gynaecology, Monash Medical Centre Clayton, Clayton, Victoria, Australia
- Department of Obstetrics and Gynaecology, Monash University, Clayton, Victoria, Australia
| | - Ryan Hodges
- Department of Obstetrics and Gynaecology, Monash Medical Centre Clayton, Clayton, Victoria, Australia
- Department of Obstetrics and Gynaecology, Monash University, Clayton, Victoria, Australia
| | - Kirsten R Palmer
- Department of Obstetrics and Gynaecology, Monash Medical Centre Clayton, Clayton, Victoria, Australia
- Obstetrics and Gynaecology, Monash University School of Clinical Sciences at Monash Health, Clayton, Victoria, Australia
| | - Suresh Sundram
- Department of Psychiatry, Monash University, Clayton, Victoria, Australia
- Mental Health Program, Monash Medical Centre Clayton, Clayton, Victoria, Australia
| | | | - Renato T Souza
- Department of Obstetrics and Gynaecology, University of Campinas Institute of Biology, Campinas, Brazil
| | | | - David Mackin
- Department of Maternal Fetal Medicine, Sunshine Hospital, St Albans, Victoria, Australia
| | - Joanne Said
- Department of Maternal Fetal Medicine, Sunshine Hospital, St Albans, Victoria, Australia
- The University of Melbourne, Melbourne, Victoria, Australia
| | - Daniel Rolnik
- Department of Obstetrics and Gynaecology, Monash Medical Centre Clayton, Clayton, Victoria, Australia
- Monash University, Clayton, Victoria, Australia
| | - Atul Malhotra
- Department of Paediatrics, Monash University, Clayton, Victoria, Australia
- Monash Children's Hospital, Clayton, Victoria, Australia
| |
Collapse
|
6
|
Mohamed Saini S, Bousman CA, Mancuso SG, Cropley V, Van Rheenen TE, Lenroot RK, Bruggemann J, Weickert CS, Weickert TW, Sundram S, Everall IP, Pantelis C. Genetic variation in glutamatergic genes moderates the effects of childhood adversity on brain volume and IQ in treatment-resistant schizophrenia. Schizophrenia (Heidelb) 2023; 9:59. [PMID: 37709784 PMCID: PMC10502098 DOI: 10.1038/s41537-023-00381-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Accepted: 07/20/2023] [Indexed: 09/16/2023]
Affiliation(s)
- Suriati Mohamed Saini
- Department of Psychiatry, Faculty of Medicine, Universiti Kebangsaan Malaysia, Jalan Yaacob Latif, Cheras, Kuala Lumpur, Malaysia.
- Department of Psychiatry, Hospital Canselor Tuanku Muhriz, Jalan Yaacob Latif, Cheras, Kuala Lumpur, Malaysia.
| | - Chad A Bousman
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne and Melbourne Health, Parkville, VIC, Australia
- Alberta Children's Hospital Research Institute, Calgary, AB, Canada
- Hotchkiss Brain Institute, University of Calgary, Calgary, AB, Canada
- Department of Medical Genetics, Psychiatry, and Physiology and Pharmacology, The University of Calgary, Calgary, AB, Canada
| | - Serafino G Mancuso
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne and Melbourne Health, Parkville, VIC, Australia
| | - Vanessa Cropley
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne and Melbourne Health, Parkville, VIC, Australia
- Centre for Mental Health, Faculty of Health, Arts and Design, Swinburne University, Melbourne, VIC, Australia
| | - Tamsyn E Van Rheenen
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne and Melbourne Health, Parkville, VIC, Australia
- Centre for Mental Health, Faculty of Health, Arts and Design, Swinburne University, Melbourne, VIC, Australia
| | - Rhoshel K Lenroot
- School of Psychiatry, University of New South Wales, Randwick, NSW, Australia
- Department of Psychiatry and Behavioural Science, University of New Mexico, Albuquerque, NM, USA
| | - Jason Bruggemann
- School of Psychiatry, University of New South Wales, Randwick, NSW, Australia
- Neuroscience Research Australia, Randwick, NSW, Australia
- Schizophrenia Research Institute, Sydney, NSW, Australia
| | - Cynthia S Weickert
- School of Psychiatry, University of New South Wales, Randwick, NSW, Australia
- Department of Neuroscience & Physiology, SUNY Upstate Medical University, NY, USA
- Schizophrenia Research Laboratory, Neuroscience Research Australia, NSW, Australia
| | - Thomas W Weickert
- School of Psychiatry, University of New South Wales, Randwick, NSW, Australia
- Department of Neuroscience & Physiology, SUNY Upstate Medical University, NY, USA
| | - Suresh Sundram
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne and Melbourne Health, Parkville, VIC, Australia
- Department of Psychiatry, School of Clinical Sciences, Monash University, Clayton, VIC, Australia
- Monash Medical Centre, Monash Health, Clayton, VIC, Australia
| | - Ian P Everall
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne and Melbourne Health, Parkville, VIC, Australia
- Florey Institute of Neuroscience and Mental Health, The University of Melbourne, Parkville, VIC, Australia
- Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Christos Pantelis
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne and Melbourne Health, Parkville, VIC, Australia
- Florey Institute of Neuroscience and Mental Health, The University of Melbourne, Parkville, VIC, Australia
- Western Centre for Health Research & Education, Sunshine Hospital, Western Health, St Albans, VIC, 3021, Australia
| |
Collapse
|
7
|
Bennett D, Nakamura J, Vinnakota C, Sokolenko E, Nithianantharajah J, van den Buuse M, Jones NC, Sundram S, Hill R. Mouse Behavior on the Trial-Unique Nonmatching-to-Location (TUNL) Touchscreen Task Reflects a Mixture of Distinct Working Memory Codes and Response Biases. J Neurosci 2023; 43:5693-5709. [PMID: 37369587 PMCID: PMC10401633 DOI: 10.1523/jneurosci.2101-22.2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Revised: 04/28/2023] [Accepted: 06/02/2023] [Indexed: 06/29/2023] Open
Abstract
The trial-unique nonmatching to location (TUNL) touchscreen task shows promise as a translational assay of working memory (WM) deficits in rodent models of autism, ADHD, and schizophrenia. However, the low-level neurocognitive processes that drive behavior in the TUNL task have not been fully elucidated. In particular, it is commonly assumed that the TUNL task predominantly measures spatial WM dependent on hippocampal pattern separation, but this proposition has not previously been tested. In this project, we tested this question using computational modeling of behavior from male and female mice performing the TUNL task (N = 163 across three datasets; 158,843 trials). Using this approach, we empirically tested whether TUNL behavior solely measured retrospective WM, or whether it was possible to deconstruct behavior into additional neurocognitive subprocesses. Overall, contrary to common assumptions, modeling analyses revealed that behavior on the TUNL task did not primarily reflect retrospective spatial WM. Instead, behavior was best explained as a mixture of response strategies, including both retrospective WM (remembering the spatial location of a previous stimulus) and prospective WM (remembering an anticipated future behavioral response) as well as animal-specific response biases. These results suggest that retrospective spatial WM is just one of a number of cognitive subprocesses that contribute to choice behavior on the TUNL task. We suggest that findings can be understood within a resource-rational framework, and use computational model simulations to propose several task-design principles that we predict will maximize spatial WM and minimize alternative behavioral strategies in the TUNL task.SIGNIFICANCE STATEMENT Touchscreen tasks represent a paradigm shift for assessment of cognition in nonhuman animals by automating large-scale behavioral data collection. Their main relevance, however, depends on the assumption of functional equivalence to cognitive domains in humans. The trial-unique, delayed nonmatching to location (TUNL) touchscreen task has revolutionized the study of rodent spatial working memory. However, its assumption of functional equivalence to human spatial working memory is untested. We leveraged previously untapped single-trial TUNL data to uncover a novel set of hierarchically ordered cognitive processes that underlie mouse behavior on this task. The strategies used demonstrate multiple cognitive approaches to a single behavioral outcome and the requirement for more precise task design and sophisticated data analysis in interpreting rodent spatial working memory.
Collapse
Affiliation(s)
- Daniel Bennett
- School of Psychological Sciences, Monash University, Melbourne, Victoria 3180, Australia
| | - Jay Nakamura
- Department of Psychiatry, Monash University, Melbourne, Victoria 3180, Australia
- Laboratory for Molecular Mechanisms of Brain Development, RIKEN Center for Brain Science, Saitama, Japan, 351-0198
| | - Chitra Vinnakota
- Department of Psychiatry, Monash University, Melbourne, Victoria 3180, Australia
| | - Elysia Sokolenko
- Discipline of Anatomy and Pathology, School of Biomedicine, University of Adelaide, Adelaide, South Australia 5005, Australia
| | | | - Maarten van den Buuse
- School of Psychology and Public Health, La Trobe University, Melbourne, Victoria 3086, Australia
| | - Nigel C Jones
- Department of Neuroscience, Central Clinical School, Monash University, Melbourne, Victoria 3004, Australia
- Department of Neurology, Alfred Hospital, Commercial Road, Melbourne, Victoria 3004, Australia
- Department of Medicine, Royal Melbourne Hospital, University of Melbourne, Melbourne, Victoria 3052, Australia
| | - Suresh Sundram
- Department of Psychiatry, Monash University, Melbourne, Victoria 3180, Australia
- Mental Health Program, Monash Health, Clayton, Victoria 3168, Australia
| | - Rachel Hill
- Department of Psychiatry, Monash University, Melbourne, Victoria 3180, Australia
| |
Collapse
|
8
|
Vinnakota C, Hudson MR, Jones NC, Sundram S, Hill RA. Potential Roles for the GluN2D NMDA Receptor Subunit in Schizophrenia. Int J Mol Sci 2023; 24:11835. [PMID: 37511595 PMCID: PMC10380280 DOI: 10.3390/ijms241411835] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Revised: 07/19/2023] [Accepted: 07/22/2023] [Indexed: 07/30/2023] Open
Abstract
Glutamate N-methyl-D-aspartate receptor (NMDAR) hypofunction has been proposed to underlie schizophrenia symptoms. This theory arose from the observation that administration of NMDAR antagonists, which are compounds that inhibit NMDAR activity, reproduces behavioural and molecular schizophrenia-like phenotypes, including hallucinations, delusions and cognitive impairments in healthy humans and animal models. However, the role of specific NMDAR subunits in these schizophrenia-relevant phenotypes is largely unknown. Mounting evidence implicates the GluN2D subunit of NMDAR in some of these symptoms and pathology. Firstly, genetic and post-mortem studies show changes in the GluN2D subunit in people with schizophrenia. Secondly, the psychosis-inducing effects of NMDAR antagonists are blunted in GluN2D-knockout mice, suggesting that the GluN2D subunit mediates NMDAR-antagonist-induced psychotomimetic effects. Thirdly, in the mature brain, the GluN2D subunit is relatively enriched in parvalbumin (PV)-containing interneurons, a cell type hypothesized to underlie the cognitive symptoms of schizophrenia. Lastly, the GluN2D subunit is widely and abundantly expressed early in development, which could be of importance considering schizophrenia is a disorder that has its origins in early neurodevelopment. The limitations of currently available therapies warrant further research into novel therapeutic targets such as the GluN2D subunit, which may help us better understand underlying disease mechanisms and develop novel and more effective treatment options.
Collapse
Affiliation(s)
- Chitra Vinnakota
- Department of Psychiatry, School of Clinical Sciences, Faculty of Medical, Nursing and Health Sciences, Monash University, Clayton, VIC 3168, Australia
| | - Matthew R Hudson
- Department of Neuroscience, Faculty of Medical, Nursing and Health Sciences, Monash University, Melbourne, VIC 3004, Australia
| | - Nigel C Jones
- Department of Neuroscience, Faculty of Medical, Nursing and Health Sciences, Monash University, Melbourne, VIC 3004, Australia
| | - Suresh Sundram
- Department of Psychiatry, School of Clinical Sciences, Faculty of Medical, Nursing and Health Sciences, Monash University, Clayton, VIC 3168, Australia
- Mental Health Program, Monash Health, Clayton, VIC 3168, Australia
| | - Rachel A Hill
- Department of Psychiatry, School of Clinical Sciences, Faculty of Medical, Nursing and Health Sciences, Monash University, Clayton, VIC 3168, Australia
| |
Collapse
|
9
|
Lotan A, Luza S, Opazo CM, Ayton S, Lane DJR, Mancuso S, Pereira A, Sundram S, Weickert CS, Bousman C, Pantelis C, Everall IP, Bush AI. Perturbed iron biology in the prefrontal cortex of people with schizophrenia. Mol Psychiatry 2023; 28:2058-2070. [PMID: 36750734 PMCID: PMC10575779 DOI: 10.1038/s41380-023-01979-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2022] [Revised: 01/10/2023] [Accepted: 01/20/2023] [Indexed: 02/09/2023]
Abstract
Despite loss of grey matter volume and emergence of distinct cognitive deficits in young adults diagnosed with schizophrenia, current treatments for schizophrenia do not target disruptions in late maturational reshaping of the prefrontal cortex. Iron, the most abundant transition metal in the brain, is essential to brain development and function, but in excess, it can impair major neurotransmission systems and lead to lipid peroxidation, neuroinflammation and accelerated aging. However, analysis of cortical iron biology in schizophrenia has not been reported in modern literature. Using a combination of inductively coupled plasma-mass spectrometry and western blots, we quantified iron and its major-storage protein, ferritin, in post-mortem prefrontal cortex specimens obtained from three independent, well-characterised brain tissue resources. Compared to matched controls (n = 85), among schizophrenia cases (n = 86) we found elevated tissue iron, unlikely to be confounded by demographic and lifestyle variables, by duration, dose and type of antipsychotic medications used or by copper and zinc levels. We further observed a loss of physiologic age-dependent iron accumulation among people with schizophrenia, in that the iron level among cases was already high in young adulthood. Ferritin, which stores iron in a redox-inactive form, was paradoxically decreased in individuals with the disorder. Such iron-ferritin uncoupling could alter free, chemically reactive, tissue iron in key reasoning and planning areas of the young-adult schizophrenia cortex. Using a prediction model based on iron and ferritin, our data provide a pathophysiologic link between perturbed cortical iron biology and schizophrenia and indicate that achievement of optimal cortical iron homeostasis could offer a new therapeutic target.
Collapse
Affiliation(s)
- Amit Lotan
- Melbourne Dementia Research Centre, Florey Institute of Neuroscience and Mental Health, The University of Melbourne, Melbourne, VIC, 3010, Australia
- Department of Psychiatry and the Biological Psychiatry Laboratory, Hadassah-Hebrew University Medical Center, Jerusalem, Israel
| | - Sandra Luza
- Melbourne Dementia Research Centre, Florey Institute of Neuroscience and Mental Health, The University of Melbourne, Melbourne, VIC, 3010, Australia
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne & Melbourne Health, Carlton, VIC, Australia
| | - Carlos M Opazo
- Melbourne Dementia Research Centre, Florey Institute of Neuroscience and Mental Health, The University of Melbourne, Melbourne, VIC, 3010, Australia.
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne & Melbourne Health, Carlton, VIC, Australia.
| | - Scott Ayton
- Melbourne Dementia Research Centre, Florey Institute of Neuroscience and Mental Health, The University of Melbourne, Melbourne, VIC, 3010, Australia
| | - Darius J R Lane
- Melbourne Dementia Research Centre, Florey Institute of Neuroscience and Mental Health, The University of Melbourne, Melbourne, VIC, 3010, Australia
| | - Serafino Mancuso
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne & Melbourne Health, Carlton, VIC, Australia
| | - Avril Pereira
- Melbourne Dementia Research Centre, Florey Institute of Neuroscience and Mental Health, The University of Melbourne, Melbourne, VIC, 3010, Australia
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne & Melbourne Health, Carlton, VIC, Australia
| | - Suresh Sundram
- Department of Psychiatry, School of Clinical Sciences, Monash University, Melbourne, VIC, Australia
- Mental Health Program, Monash Health, Melbourne, VIC, Australia
| | - Cynthia Shannon Weickert
- Schizophrenia Research Laboratory, Neuroscience Research Australia, Randwick, NSW, Australia
- School of Psychiatry, Faculty of Medicine, University of New South Wales, Sydney, NSW, Australia
| | - Chad Bousman
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne & Melbourne Health, Carlton, VIC, Australia
- Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
- Alberta Children's Hospital Research Institute, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
- Departments of Medical Genetics, Psychiatry, Physiology & Pharmacology, University of Calgary, Calgary, AB, Canada
- The Cooperative Research Centre (CRC) for Mental Health, Melbourne, VIC, Australia
| | - Christos Pantelis
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne & Melbourne Health, Carlton, VIC, Australia
- North Western Mental Health, Melbourne, VIC, Australia
| | - Ian P Everall
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne & Melbourne Health, Carlton, VIC, Australia
- North Western Mental Health, Melbourne, VIC, Australia
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Ashley I Bush
- Melbourne Dementia Research Centre, Florey Institute of Neuroscience and Mental Health, The University of Melbourne, Melbourne, VIC, 3010, Australia.
- The Cooperative Research Centre (CRC) for Mental Health, Melbourne, VIC, Australia.
| |
Collapse
|
10
|
Hill RA, Malhotra A, Sackett V, Williams K, Fahey M, Palmer KR, Hunt RW, Darke H, Lim I, Newman-Morris V, Cheong JLY, Whitehead C, Said J, Bignardi P, Muraguchi E, Fernandes LCC, Oliveira C, Sundram S. A prospective, longitudinal, case-control study to evaluate the neurodevelopment of children from birth to adolescence exposed to COVID-19 in utero. BMC Pediatr 2023; 23:48. [PMID: 36717903 PMCID: PMC9885906 DOI: 10.1186/s12887-023-03858-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Accepted: 01/19/2023] [Indexed: 01/31/2023] Open
Abstract
BACKGROUND The Coronavirus disease (COVID-19) pandemic has created unprecedented acute global health challenges. However, it also presents a set of unquantified and poorly understood risks in the medium to long term, specifically, risks to children whose mothers were infected with the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) during pregnancy. Infections during pregnancy can increase the risk of atypical neurodevelopment in the offspring, but the long-term neurodevelopmental impact of in utero COVID-19 exposure is unknown. Prospective, longitudinal studies are needed to evaluate children exposed in utero to SARS-CoV2 to define this risk. METHODS We have designed a prospective, case-controlled study to investigate the long-term impacts of SARS-CoV2 exposure on children exposed in utero. Women infected with SARS-CoV-2 during pregnancy will be recruited from Monash Health, the Royal Women's Hospital and Western Health (Melbourne, Australia) and Londrina Municipal Maternity Hospital Lucilla Ballalai and PUCPR Medical Clinical (Londrina, Brazil). A control group in a 2:1 ratio (2 non-exposed: 1 exposed mother infant dyad) comprising women who gave birth in the same month of delivery, are of similar age but did not contract SARS-CoV-2 during their pregnancy will also be recruited. We aim to recruit 170 exposed and 340 non-exposed mother-infant dyads. Clinical and socio-demographic data will be collected directly from the mother and medical records. Biospecimens and clinical and epidemiological data will be collected from the mothers and offspring at multiple time points from birth through to 15 years of age using standardised sample collection, and neurological and behavioural measures. DISCUSSION The mapped neurodevelopmental trajectories and comparisons between SARS-CoV-2 exposed and control children will indicate the potential for an increase in atypical neurodevelopment. This has significant implications for strategic planning in the mental health and paediatrics sectors and long-term monitoring of children globally.
Collapse
Affiliation(s)
- Rachel A. Hill
- grid.1002.30000 0004 1936 7857Department of Psychiatry, School of Clinical Sciences at Monash Health, Monash Medical Centre, Monash University, Level 3, 27-31 Wright St, Clayton, VIC 3168 Australia ,grid.1008.90000 0001 2179 088XFlorey Institute for Neuroscience and Mental Health, University of Melbourne, Parkville, VIC Australia
| | - Atul Malhotra
- grid.1002.30000 0004 1936 7857Department of Paediatrics, Monash University, Clayton, VIC Australia
| | - Vathana Sackett
- grid.1002.30000 0004 1936 7857Department of Paediatrics, Monash University, Clayton, VIC Australia
| | - Katrina Williams
- grid.1002.30000 0004 1936 7857Department of Paediatrics, Monash University, Clayton, VIC Australia ,grid.1008.90000 0001 2179 088XDepartment of Paediatrics, The University of Melbourne, Parkville, VIC Australia ,grid.1008.90000 0001 2179 088XDepartment of Obstetrics and Gynaecology, The University of Melbourne, Parkville, VIC Australia
| | - Michael Fahey
- grid.1002.30000 0004 1936 7857Department of Paediatrics, Monash University, Clayton, VIC Australia
| | - Kirsten R. Palmer
- grid.419789.a0000 0000 9295 3933Monash Women’s, Monash Health, Clayton, VIC Australia ,grid.1002.30000 0004 1936 7857Department of Obstetrics and Gynaecology, Monash University, Clayton, VIC Australia
| | - Rod W. Hunt
- grid.1002.30000 0004 1936 7857Department of Paediatrics, Monash University, Clayton, VIC Australia ,grid.1058.c0000 0000 9442 535XClinical Sciences, Murdoch Children’s Research Institute, Parkville, VIC Australia
| | - Hayley Darke
- grid.1002.30000 0004 1936 7857Department of Psychiatry, School of Clinical Sciences at Monash Health, Monash Medical Centre, Monash University, Level 3, 27-31 Wright St, Clayton, VIC 3168 Australia
| | - Izaak Lim
- grid.1002.30000 0004 1936 7857Department of Psychiatry, School of Clinical Sciences at Monash Health, Monash Medical Centre, Monash University, Level 3, 27-31 Wright St, Clayton, VIC 3168 Australia ,grid.419789.a0000 0000 9295 3933Monash Medical Centre, Early in Life Mental Health Service, Monash Health, Clayton, VIC Australia
| | - Vesna Newman-Morris
- grid.1002.30000 0004 1936 7857Department of Psychiatry, School of Clinical Sciences at Monash Health, Monash Medical Centre, Monash University, Level 3, 27-31 Wright St, Clayton, VIC 3168 Australia ,grid.419789.a0000 0000 9295 3933Monash Medical Centre, Early in Life Mental Health Service, Monash Health, Clayton, VIC Australia
| | - Jeanie L. Y. Cheong
- grid.1008.90000 0001 2179 088XDepartment of Obstetrics and Gynaecology, The University of Melbourne, Parkville, VIC Australia ,grid.1058.c0000 0000 9442 535XClinical Sciences, Murdoch Children’s Research Institute, Parkville, VIC Australia ,grid.416259.d0000 0004 0386 2271Department of Neonatal Services, Royal Women’s Hospital, Parkville, VIC Australia
| | - Clare Whitehead
- grid.1008.90000 0001 2179 088XDepartment of Obstetrics and Gynaecology, The University of Melbourne, Parkville, VIC Australia ,grid.416259.d0000 0004 0386 2271Department of Obstetrics and Gynaecology, Royal Women’s Hospital, Parkville, VIC Australia
| | - Joanne Said
- grid.1008.90000 0001 2179 088XDepartment of Obstetrics and Gynaecology, The University of Melbourne, Parkville, VIC Australia ,grid.490467.80000000405776836Maternal Fetal Medicine, Joan Kirner Women’s & Children’s at Sunshine Hospital, Western Health, Sunshine, VIC Australia
| | - Paulo Bignardi
- grid.412522.20000 0000 8601 0541School of Medicine, Pontifical Catholic University of Paraná, Londrina, Paraná, Brazil
| | - Evelin Muraguchi
- grid.412522.20000 0000 8601 0541School of Medicine, Pontifical Catholic University of Paraná, Londrina, Paraná, Brazil
| | - Luiz Carlos C. Fernandes
- grid.412522.20000 0000 8601 0541School of Medicine, Pontifical Catholic University of Paraná, Londrina, Paraná, Brazil
| | - Carlos Oliveira
- grid.412522.20000 0000 8601 0541School of Medicine, Pontifical Catholic University of Paraná, Londrina, Paraná, Brazil
| | - Suresh Sundram
- grid.1002.30000 0004 1936 7857Department of Psychiatry, School of Clinical Sciences at Monash Health, Monash Medical Centre, Monash University, Level 3, 27-31 Wright St, Clayton, VIC 3168 Australia ,grid.419789.a0000 0000 9295 3933Mental Health Program, Monash Health, Melbourne, VIC Australia
| |
Collapse
|
11
|
Hocking DC, Sundram S. Age and environmental factors predict psychological symptoms in adolescent refugees during the initial post-resettlement phase. Child Adolesc Psychiatry Ment Health 2022; 16:105. [PMID: 36539785 PMCID: PMC9768994 DOI: 10.1186/s13034-022-00538-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Accepted: 11/28/2022] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Adolescent refugees are at high risk of developing mental disorders but are often not recognised early. This pilot study aimed to identify early putative risk factors associated with psychological symptoms in newly resettled refugee youth at potential risk of subsequently developing mental disorders. METHODS Newly resettled adolescent refugees were recruited through English language schools in Melbourne, Australia. Participants were assessed with the MINI-Kid, Achenbach Youth Self-Report and Reaction of Adolescents to Traumatic Stress scale. Parents completed a mental health screening separately. Linear regression models were used to identify predictive factors associated with symptom ratings. RESULTS Seventy-eight, ostensibly well, refugee adolescents (mean age = 15.0 ± 1.6 years) resettled in Australia for 6.1 ± 4.2 months were assessed. Levels of anxiety, depression and post-traumatic stress symptoms were considerably lower than in mainstream population data. Prior displacement was a key determinant of symptomatology. Transitory displacement, irrespective of duration, was associated with elevated scores for depression (t (47) = -4.05, p < 0.0001), avoidance/numbing (U = 466, p < .05) and total trauma (U = 506, p < .05) symptoms. Older age was a unique predictor of depression (F (1,74) = 8.98, p < .01), internalising (F(1,74) = 6.28, p < .05) and total (F(1,74) = 4.10, p < .05) symptoms, whilst parental depression symptoms (t = 2.01, p < 0.05), displacement (t = 3.35, p < 0.01) and, expectedly, trauma exposure (t = 3.94, p < 0.001) were unique predictors of post-traumatic stress symptoms. CONCLUSIONS Displaced status, older age, and parental symptoms predicted psychological symptoms in adolescent refugees in an initial relatively asymptomatic post-resettlement phase. The early recognition of at-risk refugee youth may provide an opportunity for preventative mental health interventions.
Collapse
Affiliation(s)
- Debbie C. Hocking
- Cabrini Outreach, 183 Wattletree Road, Malvern, VIC 3144 Australia ,grid.1002.30000 0004 1936 7857Department of Psychiatry, School of Clinical Sciences, Faculty of Medicine, Nursing and Health Sciences, Monash University, Wellington Rd, Clayton, VIC 3800 Australia
| | - Suresh Sundram
- Cabrini Outreach, 183 Wattletree Road, Malvern, VIC 3144 Australia ,grid.1002.30000 0004 1936 7857Department of Psychiatry, School of Clinical Sciences, Faculty of Medicine, Nursing and Health Sciences, Monash University, Wellington Rd, Clayton, VIC 3800 Australia ,grid.419789.a0000 0000 9295 3933Mental Health Program, Monash Health, 246 Clayton Road, Clayton, VIC 3168 Australia
| |
Collapse
|
12
|
Frattaroli N, Geljic M, Runkowska D, Darke H, Reddyhough C, Mills T, Mitchell M, Hill R, Carter O, Sundram S. Cognitive and perceptual impairments in schizophrenia extend to other psychotic disorders but not schizotypy. Schizophr Res Cogn 2022; 30:100266. [PMID: 35959485 PMCID: PMC9361330 DOI: 10.1016/j.scog.2022.100266] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Revised: 07/22/2022] [Accepted: 07/25/2022] [Indexed: 11/16/2022] Open
Affiliation(s)
- Natalie Frattaroli
- Department of Psychiatry, School of Clinical Sciences, Monash University. Level 3 P-Block, Monash Medical Centre, 246 Clayton Road, Clayton, Victoria 3168, Australia
| | - Mia Geljic
- Department of Psychiatry, School of Clinical Sciences, Monash University. Level 3 P-Block, Monash Medical Centre, 246 Clayton Road, Clayton, Victoria 3168, Australia
| | - Dominika Runkowska
- Department of Psychiatry, School of Clinical Sciences, Monash University. Level 3 P-Block, Monash Medical Centre, 246 Clayton Road, Clayton, Victoria 3168, Australia
| | - Hayley Darke
- Department of Psychiatry, School of Clinical Sciences, Monash University. Level 3 P-Block, Monash Medical Centre, 246 Clayton Road, Clayton, Victoria 3168, Australia
| | - Caitlin Reddyhough
- Melbourne School of Psychological Sciences, Redmond Barry Building, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, VIC 3010, Australia
| | - Taylor Mills
- Department of Psychiatry, School of Clinical Sciences, Monash University. Level 3 P-Block, Monash Medical Centre, 246 Clayton Road, Clayton, Victoria 3168, Australia
- Melbourne School of Psychological Sciences, Redmond Barry Building, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, VIC 3010, Australia
| | - Matthew Mitchell
- Melbourne School of Psychological Sciences, Redmond Barry Building, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, VIC 3010, Australia
| | - Rachel Hill
- Department of Psychiatry, School of Clinical Sciences, Monash University. Level 3 P-Block, Monash Medical Centre, 246 Clayton Road, Clayton, Victoria 3168, Australia
| | - Olivia Carter
- Melbourne School of Psychological Sciences, Redmond Barry Building, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, VIC 3010, Australia
| | - Suresh Sundram
- Department of Psychiatry, School of Clinical Sciences, Monash University. Level 3 P-Block, Monash Medical Centre, 246 Clayton Road, Clayton, Victoria 3168, Australia
- Mental Health Program, Monash Health, Level 3 P-Block, Monash Medical Centre, 246 Clayton Road, Clayton, Victoria 3168, Australia
- Corresponding author at: Department of Psychiatry, School of Clinical Sciences, Monash University, Level 3 P-Block, Monash Medical Centre, 246 Clayton Road, Clayton, Victoria, Australia.
| |
Collapse
|
13
|
Long KM, Haines TP, Clifford S, Sundram S, Srikanth V, Macindoe R, Leung W, Hlavac J, Enticott J. English language proficiency and hospital admissions via the emergency department by aged care residents in Australia: A mixed-methods investigation. Health Soc Care Community 2022; 30:e4006-e4019. [PMID: 35318761 PMCID: PMC10078708 DOI: 10.1111/hsc.13794] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Revised: 11/25/2021] [Accepted: 03/02/2022] [Indexed: 06/14/2023]
Abstract
Residents of Residential Age Care Facilities (RACFs) have particularly high rates of Emergency Department (ED) visits, with up to 55% being potentially avoidable (e.g. not resulting in a hospital admission). This is concerning as ED visits by RACF residents are associated with negative outcomes including longer hospital stays, iatrogenic illness, complications and mortality. Limited English proficiency (LEP) has significant negative impacts on the healthcare quality and outcomes for older people but has not been studied as a factor in ED visits from RACFs. This study aimed to examine if RACF residents with LEP have a lower rate of hospital admission via the ED compared to non-LEP controls and identify any associated factors. We hypothesised that LEP-related communication difficulties would reduce the ability to manage minor health issues in the RACF, leading to a lower proportion of LEP ED transfers being admitted. We used a parallel mixed-methods design, comprising a quantitative matched cohort study of ED visit data from two Local Hospital Networks (LHNs) in South-East Melbourne, Australia and secondary thematic analysis of 25 interviews with LEP residents, family carers and staff from two RACFs in the same region. We found no differences in the proportion of hospital ED transfers that led to admission (LHN1, 87.1% LEP, 85.6% non-LEP controls, p = 0.57; LHN2, 76.0% LEP, 76.9% non-LEP controls, p = 0.41) and no direct qualitative evidence suggesting that resident LEP affected decisions to transfer residents to ED, despite communication difficulties being reported during the transfer process. These results may be due to the high level of family carer involvement in residents' care identified in the qualitative study. However, additional research using different measures of LEP is recommended to further explore a broader range of cultural and linguistic factors in both rates of ED presentations and the decision-making processes underpinning resident transfers to ED.
Collapse
Affiliation(s)
- Katrina M. Long
- School of Primary and Allied Health CareMonash UniversityFrankstonVictoriaAustralia
| | - Terry P. Haines
- School of Primary and Allied Health CareMonash UniversityFrankstonVictoriaAustralia
| | - Sharon Clifford
- Department of General PracticeSchool of Public Health and Preventive MedicineMonash UniversityNotting HillVictoriaAustralia
| | - Suresh Sundram
- Department of PsychiatrySchool of Clinical SciencesMonash UniversityClaytonVictoriaAustralia
- Mental Health ProgramMonash HealthClaytonVictoriaAustralia
| | - Velandai Srikanth
- Peninsula HealthFrankstonVictoriaAustralia
- Peninsula Clinical SchoolCentral Clinical SchoolMonash UniversityFrankstonVictoriaAustralia
- National Centre for Healthy AgeingFrankstonVictoriaAustralia
| | - Rob Macindoe
- SEHCP Inc. (t/a enliven)DandenongVictoriaAustralia
| | - Wing‐Yin Leung
- Department of Psychological SciencesSchool of Health SciencesSwinburne University of TechnologyHawthornVictoriaAustralia
- National Ageing Research InstituteParkvilleVictoriaAustralia
| | - Jim Hlavac
- Translation and Interpreting StudiesSchool of Languages, Literatures, Cultures and LinguisticsMonash UniversityClaytonVictoriaAustralia
| | - Joanne Enticott
- Monash Centre for Health Research and ImplementationClaytonVictoriaAustralia
- Southern SynergyDepartment of PsychiatrySchool of Clinical Sciences, Monash UniversityClaytonVictoriaAustralia
| |
Collapse
|
14
|
Ringin E, Cropley V, Zalesky A, Bruggemann J, Sundram S, Weickert CS, Weickert TW, Bousman CA, Pantelis C, Van Rheenen TE. The impact of smoking status on cognition and brain morphology in schizophrenia spectrum disorders. Psychol Med 2022; 52:3097-3115. [PMID: 33443010 DOI: 10.1017/s0033291720005152] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
BACKGROUND Cigarette smoking is associated with worse cognition and decreased cortical volume and thickness in healthy cohorts. Chronic cigarette smoking is prevalent in schizophrenia spectrum disorders (SSD), but the effects of smoking status on the brain and cognition in SSD are not clear. This study aimed to understand whether cognitive performance and brain morphology differed between smoking and non-smoking individuals with SSD compared to healthy controls. METHODS Data were obtained from the Australian Schizophrenia Research Bank. Cognitive functioning was measured in 299 controls and 455 SSD patients. Cortical volume, thickness and surface area data were analysed from T1-weighted structural scans obtained in a subset of the sample (n = 82 controls, n = 201 SSD). Associations between smoking status (cigarette smoker/non-smoker), cognition and brain morphology were tested using analyses of covariance, including diagnosis as a moderator. RESULTS No smoking by diagnosis interactions were evident, and no significant differences were revealed between smokers and non-smokers across any of the variables measured, with the exception of a significantly thinner left posterior cingulate in smokers compared to non-smokers. Several main effects of smoking in the cognitive, volume and thickness analyses were initially significant but did not survive false discovery rate (FDR) correction. CONCLUSIONS Despite the general absence of significant FDR-corrected findings, trend-level effects suggest the possibility that subtle smoking-related effects exist but were not uncovered due to low statistical power. An investigation of this topic is encouraged to confirm and expand on our findings.
Collapse
Affiliation(s)
- Elysha Ringin
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, University of Melbourne and Melbourne Health, Melbourne, Australia
| | - Vanessa Cropley
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, University of Melbourne and Melbourne Health, Melbourne, Australia
- Centre for Mental Health, Faculty of Health, Arts and Design, School of Health Sciences, Swinburne University, Melbourne, Australia
| | - Andrew Zalesky
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, University of Melbourne and Melbourne Health, Melbourne, Australia
- Department of Electrical and Electronic Engineering, University of Melbourne, Melbourne, VIC, Australia
| | - Jason Bruggemann
- School of Psychiatry, University of New South Wales, New South Wales, Australia
- Neuroscience Research Australia, New South Wales, Australia
| | - Suresh Sundram
- Florey Institute of Neuroscience and Mental Health, Melbourne, Australia
- Department of Psychiatry, School of Clinical Sciences, Monash University, Clayton, Australia
- Mental Health Program, Monash Health, Clayton, Victoria, Australia
| | - Cynthia Shannon Weickert
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, University of Melbourne and Melbourne Health, Melbourne, Australia
- School of Psychiatry, University of New South Wales, New South Wales, Australia
- Neuroscience Research Australia, New South Wales, Australia
- Department of Neuroscience & Physiology, Upstate Medical University, Syracuse, New York 13210, USA
| | - Thomas W Weickert
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, University of Melbourne and Melbourne Health, Melbourne, Australia
- School of Psychiatry, University of New South Wales, New South Wales, Australia
- Neuroscience Research Australia, New South Wales, Australia
- Department of Neuroscience & Physiology, Upstate Medical University, Syracuse, New York 13210, USA
| | - Chad A Bousman
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, University of Melbourne and Melbourne Health, Melbourne, Australia
- Departments of Medical Genetics, Psychiatry, and Physiology & Pharmacology, University of Calgary, Calgary, AB, Canada
| | - Christos Pantelis
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, University of Melbourne and Melbourne Health, Melbourne, Australia
- Florey Institute of Neuroscience and Mental Health, Melbourne, Australia
| | - Tamsyn E Van Rheenen
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, University of Melbourne and Melbourne Health, Melbourne, Australia
- Centre for Mental Health, Faculty of Health, Arts and Design, School of Health Sciences, Swinburne University, Melbourne, Australia
| |
Collapse
|
15
|
Liu ZF, Sylivris A, Gordon M, Sundram S. The association between tryptophan levels and postpartum mood disorders: a systematic review and meta-analysis. BMC Psychiatry 2022; 22:539. [PMID: 35941560 PMCID: PMC9361669 DOI: 10.1186/s12888-022-04178-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Accepted: 07/29/2022] [Indexed: 11/10/2022] Open
Abstract
Over 50% of women experience mood disturbance in the postpartum period, with significant implications for maternal and infant health but identifying those at risk is not easily possible. The essential amino acid, tryptophan (TRP) through its neuroactive metabolites, has been implicated in the pathology of mood disorders. Thus, TRP levels tested in the peripartum period have been proposed as a potential biomarker for subsequent development of postpartum mood disturbances, in particular postpartum depression (PPD). A systematic review and meta-analysis following PROSPERO guidelines [CRD42021252462] was conducted on peer-reviewed, English language studies that measured blood levels of TRP during the postpartum period in women who were also evaluated for postpartum "blues" or PPD. Thirteen studies met the inclusion criteria, of which five studies contained sufficient data to conduct a meta-analysis. Low total TRP levels in postpartum days 1 to 5 were significantly associated with PPD (SMD: -5.39, 95%CI [-7.72, -3.05]). No significant association was found between free TRP levels in the postpartum period and PPD (SMD: -3.43, 95%CI [-7.76, 0.89]). Our findings confirm the necessity for more replicable designed studies regarding TRP and its relationship to postpartum depression. If there were greater clarity regarding TRP metabolism during pregnancy, then the next step would be to consider measuring total plasma TRP levels on postpartum days 1 to 5 to identify women at greater risk of developing PPD.
Collapse
Affiliation(s)
- Zhao Feng Liu
- Department of Psychiatry, School of Clinical Sciences, Monash University, Melbourne, VIC, Australia
| | - Amy Sylivris
- Department of Psychiatry, School of Clinical Sciences, Monash University, Melbourne, VIC, Australia
| | - Michael Gordon
- Department of Psychiatry, School of Clinical Sciences, Monash University, Melbourne, VIC, Australia.,Mental Health Program, Monash Health, Melbourne, VIC, Australia
| | - Suresh Sundram
- Department of Psychiatry, School of Clinical Sciences, Monash University, Melbourne, VIC, Australia. .,Mental Health Program, Monash Health, Melbourne, VIC, Australia. .,Monash Medical Centre, Block P, Level 3, 246 Clayton Rd, Melbourne, 3168, VIC, Australia.
| |
Collapse
|
16
|
Gumley AI, Bradstreet S, Ainsworth J, Allan S, Alvarez-Jimenez M, Birchwood M, Briggs A, Bucci S, Cotton S, Engel L, French P, Lederman R, Lewis S, Machin M, MacLennan G, McLeod H, McMeekin N, Mihalopoulos C, Morton E, Norrie J, Reilly F, Schwannauer M, Singh SP, Sundram S, Thompson A, Williams C, Yung A, Aucott L, Farhall J, Gleeson J. Digital smartphone intervention to recognise and manage early warning signs in schizophrenia to prevent relapse: the EMPOWER feasibility cluster RCT. Health Technol Assess 2022; 26:1-174. [PMID: 35639493 DOI: 10.3310/hlze0479] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND Relapse is a major determinant of outcome for people with a diagnosis of schizophrenia. Early warning signs frequently precede relapse. A recent Cochrane Review found low-quality evidence to suggest a positive effect of early warning signs interventions on hospitalisation and relapse. OBJECTIVE How feasible is a study to investigate the clinical effectiveness and cost-effectiveness of a digital intervention to recognise and promptly manage early warning signs of relapse in schizophrenia with the aim of preventing relapse? DESIGN A multicentre, two-arm, parallel-group cluster randomised controlled trial involving eight community mental health services, with 12-month follow-up. SETTINGS Glasgow, UK, and Melbourne, Australia. PARTICIPANTS Service users were aged > 16 years and had a schizophrenia spectrum disorder with evidence of a relapse within the previous 2 years. Carers were eligible for inclusion if they were nominated by an eligible service user. INTERVENTIONS The Early signs Monitoring to Prevent relapse in psychosis and prOmote Wellbeing, Engagement, and Recovery (EMPOWER) intervention was designed to enable participants to monitor changes in their well-being daily using a mobile phone, blended with peer support. Clinical triage of changes in well-being that were suggestive of early signs of relapse was enabled through an algorithm that triggered a check-in prompt that informed a relapse prevention pathway, if warranted. MAIN OUTCOME MEASURES The main outcomes were feasibility of the trial and feasibility, acceptability and usability of the intervention, as well as safety and performance. Candidate co-primary outcomes were relapse and fear of relapse. RESULTS We recruited 86 service users, of whom 73 were randomised (42 to EMPOWER and 31 to treatment as usual). Primary outcome data were collected for 84% of participants at 12 months. Feasibility data for people using the smartphone application (app) suggested that the app was easy to use and had a positive impact on motivations and intentions in relation to mental health. Actual app usage was high, with 91% of users who completed the baseline period meeting our a priori criterion of acceptable engagement (> 33%). The median time to discontinuation of > 33% app usage was 32 weeks (95% confidence interval 14 weeks to ∞). There were 8 out of 33 (24%) relapses in the EMPOWER arm and 13 out of 28 (46%) in the treatment-as-usual arm. Fewer participants in the EMPOWER arm had a relapse (relative risk 0.50, 95% confidence interval 0.26 to 0.98), and time to first relapse (hazard ratio 0.32, 95% confidence interval 0.14 to 0.74) was longer in the EMPOWER arm than in the treatment-as-usual group. At 12 months, EMPOWER participants were less fearful of having a relapse than those in the treatment-as-usual arm (mean difference -4.29, 95% confidence interval -7.29 to -1.28). EMPOWER was more costly and more effective, resulting in an incremental cost-effectiveness ratio of £3041. This incremental cost-effectiveness ratio would be considered cost-effective when using the National Institute for Health and Care Excellence threshold of £20,000 per quality-adjusted life-year gained. LIMITATIONS This was a feasibility study and the outcomes detected cannot be taken as evidence of efficacy or effectiveness. CONCLUSIONS A trial of digital technology to monitor early warning signs that blended with peer support and clinical triage to detect and prevent relapse is feasible. FUTURE WORK A main trial with a sample size of 500 (assuming 90% power and 20% dropout) would detect a clinically meaningful reduction in relapse (relative risk 0.7) and improvement in other variables (effect sizes 0.3-0.4). TRIAL REGISTRATION This trial is registered as ISRCTN99559262. FUNDING This project was funded by the National Institute for Health and Care Research (NIHR) Health Technology Assessment programme and will be published in full in Health Technology Assessment; Vol. 26, No. 27. See the NIHR Journals Library website for further project information. Funding in Australia was provided by the National Health and Medical Research Council (APP1095879).
Collapse
Affiliation(s)
- Andrew I Gumley
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Simon Bradstreet
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - John Ainsworth
- Division of Psychology and Mental Health, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
| | - Stephanie Allan
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Mario Alvarez-Jimenez
- Orygen, The National Centre of Excellence in Youth Mental Health, Melbourne, VIC, Australia.,Centre for Youth Mental Health, University of Melbourne, Melbourne, VIC, Australia
| | - Maximillian Birchwood
- Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry, UK
| | - Andrew Briggs
- Department of Health Services Research and Policy, London School of Hygiene & Tropical Medicine, London, UK
| | - Sandra Bucci
- Division of Psychology and Mental Health, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK.,Greater Manchester Mental Health NHS Foundation Trust, Manchester, UK
| | - Sue Cotton
- Orygen, The National Centre of Excellence in Youth Mental Health, Melbourne, VIC, Australia
| | - Lidia Engel
- School of Health and Social Development, Deakin University, Melbourne, VIC, Australia
| | - Paul French
- Department of Nursing, Manchester Metropolitan University, Manchester, UK
| | - Reeva Lederman
- School of Computing and Information Systems, Melbourne School of Engineering, University of Melbourne, Melbourne, VIC, Australia
| | - Shôn Lewis
- Division of Psychology and Mental Health, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK.,Greater Manchester Mental Health NHS Foundation Trust, Manchester, UK
| | - Matthew Machin
- Division of Informatics, Imaging and Data Sciences, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
| | - Graeme MacLennan
- Health Services Research Unit, University of Aberdeen, Aberdeen, UK
| | - Hamish McLeod
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Nicola McMeekin
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Cathy Mihalopoulos
- School of Health and Social Development, Deakin University, Melbourne, VIC, Australia
| | - Emma Morton
- Department of Psychiatry, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - John Norrie
- Usher Institute, University of Edinburgh, Edinburgh, UK
| | | | | | - Swaran P Singh
- Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry, UK
| | - Suresh Sundram
- Department of Psychiatry, Monash University, Melbourne, VIC, Australia
| | - Andrew Thompson
- Orygen, The National Centre of Excellence in Youth Mental Health, Melbourne, VIC, Australia.,Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry, UK
| | - Chris Williams
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Alison Yung
- Division of Psychology and Mental Health, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
| | - Lorna Aucott
- Health Services Research Unit, University of Aberdeen, Aberdeen, UK
| | - John Farhall
- Department of Psychology and Counselling, La Trobe University, Melbourne, VIC, Australia.,NorthWestern Mental Health, Melbourne, VIC, Australia
| | - John Gleeson
- Healthy Brain and Mind Research Centre, Australian Catholic University, Melbourne, VIC, Australia
| |
Collapse
|
17
|
Gumley AI, Bradstreet S, Ainsworth J, Allan S, Alvarez-Jimenez M, Aucott L, Birchwood M, Briggs A, Bucci S, Cotton SM, Engel L, French P, Lederman R, Lewis S, Machin M, MacLennan G, McLeod H, McMeekin N, Mihalopoulos C, Morton E, Norrie J, Schwannauer M, Singh SP, Sundram S, Thompson A, Williams C, Yung AR, Farhall J, Gleeson J. The EMPOWER blended digital intervention for relapse prevention in schizophrenia: a feasibility cluster randomised controlled trial in Scotland and Australia. Lancet Psychiatry 2022; 9:477-486. [PMID: 35569503 DOI: 10.1016/s2215-0366(22)00103-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Revised: 03/14/2022] [Accepted: 03/15/2022] [Indexed: 10/18/2022]
Abstract
BACKGROUND Early warning signs monitoring by service users with schizophrenia has shown promise in preventing relapse but the quality of evidence is low. We aimed to establish the feasibility of undertaking a definitive randomised controlled trial to determine the effectiveness of a blended digital intervention for relapse prevention in schizophrenia. METHODS This multicentre, feasibility, cluster randomised controlled trial aimed to compare Early signs Monitoring to Prevent relapse in psychosis and prOmote Well-being, Engagement, and Recovery (EMPOWER) with treatment as usual in community mental health services (CMHS) in Glasgow and Melbourne. CMHS were the unit of randomisation, selected on the basis of those that probably had five or more care coordinators willing to participate. Participants were eligible if they were older than 16 years, had a schizophrenia or related diagnosis confirmed via case records, were able to provide informed consent, had contact with CMHS, and had had a relapse within the previous 2 years. Participants were randomised within stratified clusters to EMPOWER or to continue their usual approach to care. EMPOWER blended a smartphone for active monitoring of early warning signs with peer support to promote self-management and clinical triage to promote access to relapse prevention. Main outcomes were feasibility, acceptability, usability, and safety, which was assessed through face-to-face interviews. App usage was assessed via the smartphone and self-report. Primary end point was 12 months. Participants, research assistants and other team members involved in delivering the intervention were not masked to treatment conditions. Assessment of relapse was done by an independent adjudication panel masked to randomisation group. The study is registered at ISRCTN (99559262). FINDINGS We identified and randomised eight CMHS (six in Glasgow and two in Melbourne) comprising 47 care coordinators. We recruited 86 service users between Jan 19 and Aug 8, 2018; 73 were randomised (42 [58%] to EMPOWER and 31 [42%] to treatment as usual). There were 37 (51%) men and 36 (49%) women. At 12 months, main outcomes were collected for 32 (76%) of service users in the EMPOWER group and 30 (97%) of service users in the treatment as usual group. Of those randomised to EMPOWER, 30 (71%) met our a priori criterion of more than 33% adherence to daily monitoring that assumed feasibility. Median time to discontinuation of these participants was 31·5 weeks (SD 14·5). There were 29 adverse events in the EMPOWER group and 25 adverse events in the treatment as usual group. There were 13 app-related adverse events, affecting 11 people, one of which was serious. Fear of relapse was lower in the EMPOWER group than in the treatment as usual group at 12 months (mean difference -7·53 (95% CI -14·45 to 0·60; Cohen's d -0·53). INTERPRETATION A trial of digital technology to monitor early warning signs blended with peer support and clinical triage to detect and prevent relapse appears to be feasible, safe, and acceptable. A further main trial is merited. FUNDING UK National Institute for Health Research Health Technology Assessment programme and the Australian National Health and Medical Research Council.
Collapse
Affiliation(s)
- Andrew I Gumley
- Glasgow Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK.
| | - Simon Bradstreet
- Glasgow Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - John Ainsworth
- Division of Informatics Imaging and Data Sciences, School of Health Sciences, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, University of Manchester, Manchester, UK
| | - Stephanie Allan
- Glasgow Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Mario Alvarez-Jimenez
- Orygen Melbourne, Melbourne, VIC, Australia; Centre for Youth Mental Health, University of Melbourne, Melbourne, VIC, Australia
| | - Lorna Aucott
- Centre for Healthcare Randomised Trials (CHaRT), University of Aberdeen, Aberdeen, UK
| | - Maximillian Birchwood
- Centre for Mental Health and Wellbeing Research, Warwick Medical School, University of Warwick, Warwick, UK
| | - Andrew Briggs
- Department of Health Services Research and Policy, London School of Hygiene & Tropical Medicine, London, UK
| | - Sandra Bucci
- Division of Psychology and Mental Health, School of Health Sciences, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, University of Manchester, Manchester, UK; Greater Manchester Mental Health NHS Foundation Trust, Manchester, UK
| | - Sue M Cotton
- Orygen Melbourne, Melbourne, VIC, Australia; Centre for Youth Mental Health, University of Melbourne, Melbourne, VIC, Australia
| | - Lidia Engel
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Paul French
- Department of Psychiatry, Manchester Metropolitan University, Manchester, UK
| | - Reeva Lederman
- School of Computing and Information Systems, Faculty of Engineering and Information Technology, University of Melbourne, Melbourne, VIC, Australia
| | - Shôn Lewis
- Division of Psychology and Mental Health, School of Health Sciences, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, University of Manchester, Manchester, UK; Greater Manchester Mental Health NHS Foundation Trust, Manchester, UK
| | - Matthew Machin
- Division of Informatics Imaging and Data Sciences, School of Health Sciences, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, University of Manchester, Manchester, UK
| | - Graeme MacLennan
- Centre for Healthcare Randomised Trials (CHaRT), University of Aberdeen, Aberdeen, UK
| | - Hamish McLeod
- Glasgow Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Nicola McMeekin
- Glasgow Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Cathy Mihalopoulos
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Emma Morton
- Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada
| | - John Norrie
- The Usher Institute, University of Edinburgh, Edinburgh, UK
| | | | - Swaran P Singh
- Centre for Mental Health and Wellbeing Research, Warwick Medical School, University of Warwick, Warwick, UK
| | - Suresh Sundram
- Department of Psychiatry, School of Clinical Sciences, Monash University, Melbourne, VIC, Australia; Mental Health Program, Monash Health, Melbourne, VIC, Australia
| | - Andrew Thompson
- Orygen Melbourne, Melbourne, VIC, Australia; Centre for Mental Health and Wellbeing Research, Warwick Medical School, University of Warwick, Warwick, UK
| | - Chris Williams
- Glasgow Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Alison R Yung
- Division of Psychology and Mental Health, School of Health Sciences, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, University of Manchester, Manchester, UK; School of Medicine, Deakin University, Melbourne, VIC, Australia
| | - John Farhall
- Department of Psychology and Counselling, La Trobe University, Melbourne, VIC, Australia; NorthWestern Mental Health, The Royal Melbourne Hospital, Epping, VIC, Australia
| | - John Gleeson
- Healthy Brain and Mind Research Centre, School of Behavioural and Health Sciences, Australian Catholic University, Melbourne, VIC, Australia
| |
Collapse
|
18
|
Lim I, Newman-Morris V, Hill R, Hoehn E, Kowalenko N, Matacz R, Paul C, Powrie R, Priddis L, Raykar V, Wright T, Newman L, Sundram S. You can't have one without the other: The case for integrated perinatal and infant mental health services. Aust N Z J Psychiatry 2022; 56:586-588. [PMID: 35257590 DOI: 10.1177/00048674221083874] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Izaak Lim
- Department of Psychiatry, School of Clinical Sciences, Monash University, Melbourne, VIC, Australia.,Early in Life Mental Health Service, Monash Medical Centre, Monash Health, Clayton, VIC, Australia
| | - Vesna Newman-Morris
- Department of Psychiatry, School of Clinical Sciences, Monash University, Melbourne, VIC, Australia.,Early in Life Mental Health Service, Monash Medical Centre, Monash Health, Clayton, VIC, Australia
| | - Rebecca Hill
- Perinatal and Infant Mental Health Services, Women's and Children's Health Network, Adelaide, SA, Australia.,Department of Psychiatry, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, SA, Australia
| | - Elisabeth Hoehn
- Queensland Centre for Perinatal and Infant Mental Health, Child and Youth Mental Health Service, Children's Health Queensland Hospital and Health Service, Brisbane, QLD, Australia
| | - Nicholas Kowalenko
- Emerging Minds & Tresillian Family Care Services, Sydney, NSW, Australia
| | - Rochelle Matacz
- School of Arts and Humanities, Pregnancy to Parenthood Clinic, Edith Cowan University, Perth, WA, Australia
| | - Campbell Paul
- Department of Psychiatry, University of Melbourne, Melbourne, VIC, Australia.,Mental Health Service, The Royal Children's Hospital, Melbourne, VIC, Australia
| | - Rosalind Powrie
- Perinatal and Infant Mental Health Services, Women's and Children's Health Network, Adelaide, SA, Australia
| | - Lynn Priddis
- Law School, University of Western Australia, Perth, WA, Australia
| | - Vibhay Raykar
- Child and Adolescent Mental Health Service, Goulburn Valley Health, Shepparton, VIC, Australia.,Department of Rural Health, University of Melbourne, Shepparton, VIC, Australia
| | - Tanya Wright
- Department of Psychological Medicine, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand.,Perinatal, Infant and Te Puawaitanga Mental Health Services, Counties Manukau District Health Board, Auckland, New Zealand
| | - Louise Newman
- Department of Psychiatry, University of Melbourne, Melbourne, VIC, Australia
| | - Suresh Sundram
- Department of Psychiatry, School of Clinical Sciences, Monash University, Melbourne, VIC, Australia.,Mental Health Program, Monash Health, Melbourne, VIC, Australia
| |
Collapse
|
19
|
Nakamura JP, Schroeder A, Gibbons A, Sundram S, Hill RA. Timing of maternal immune activation and sex influence schizophrenia-relevant cognitive constructs and neuregulin and GABAergic pathways. Brain Behav Immun 2022; 100:70-82. [PMID: 34808289 DOI: 10.1016/j.bbi.2021.11.006] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Revised: 10/17/2021] [Accepted: 11/13/2021] [Indexed: 12/24/2022] Open
Abstract
Maternal immune activation (MIA) during pregnancy is an established environmental risk factor for schizophrenia. Timing of immune activation exposure as well as sex of the exposed offspring are critical factors in defining the effects of MIA. However, the specificity of MIA on the component structure of schizophrenia, especially cognition, has been difficult to assess due to a lack of translational validity of maze-like testing paradigms. We aimed to assess cognitive domains relevant to schizophrenia using highly translational touchscreen-based tasks in male and female mice exposed to the viral mimetic, poly(I:C) (5 mg/k, i.p.), during early (gestational day (GD) 9-11) and late (GD13-15) gestational time points. Gene expression of schizophrenia candidate pathways were assessed in fetal brain immediately following poly(I:C) exposure and in adulthood to identify its influence on neurodevelopmental processes. Sex and window specific alterations in cognitive performance were found with the early window of MIA exposure causing female-specific disruptions to working memory and reduced perseverative behaviour, while late MIA exposure caused male-specific changes to working memory and deficits in reversal learning. GABAergic specification marker, Nkx2.1 gene expression was reduced in fetal brains and reelin expression was reduced in adult hippocampus of both early and late poly(I:C) exposed mice. Neuregulin and EGF signalling were initially upregulated in the fetal brain, but were reduced in the adult hippocampus, with male mice exposed in the late window showing reduced Nrg3 expression. Serine racemase was reduced in both fetal and adult brain, but again, adult reductions were specific to male mice exposed at the late time point. Overall, we show that cognitive constructs relevant to schizophrenia are altered by in utero exposure to maternal immune activation, but are highly dependent on the timing of infection and the sex of the offspring. Glutamatergic and epidermal growth factor pathways were similarly altered by MIA in a timing and sex dependent manner, while MIA-induced GABAergic deficits were independent of timing or sex.
Collapse
Affiliation(s)
- J P Nakamura
- Department of Psychiatry, School of Clinical Sciences, Monash University, Clayton, VIC 3168, Australia
| | - A Schroeder
- Department of Psychiatry, School of Clinical Sciences, Monash University, Clayton, VIC 3168, Australia
| | - A Gibbons
- Department of Psychiatry, School of Clinical Sciences, Monash University, Clayton, VIC 3168, Australia
| | - S Sundram
- Department of Psychiatry, School of Clinical Sciences, Monash University, Clayton, VIC 3168, Australia; Mental Health Program, Monash Health, Clayton, VIC 3168, Australia
| | - R A Hill
- Department of Psychiatry, School of Clinical Sciences, Monash University, Clayton, VIC 3168, Australia.
| |
Collapse
|
20
|
Passardi S, Hocking DC, Morina N, Sundram S, Alisic E. Moral injury related to immigration detention on Nauru: a qualitative study. Eur J Psychotraumatol 2022; 13:2029042. [PMID: 35222839 PMCID: PMC8881073 DOI: 10.1080/20008198.2022.2029042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Immigration detention is associated with detrimental mental health outcomes but little is known about the underlying psychological processes. Moral injury, the experience of transgression of moral beliefs, may play an important role. OBJECTIVE Our aim was to explore moral injury appraisals and associated mental health outcomes related to immigration detention on Nauru. METHODS In this retrospective study, we conducted in-depth interviews with 13 individuals who had sought refuge in Australia and, due to arriving by boat, had been transferred to immigration detention on Nauru. At the time of the study, they lived in Australia following medical transfer. We used reflexive thematic analysis to develop themes from the data. RESULTS Major themes included 1) how participants' home country experience and the expectation to get protection led them to seek safety in Australia; 2) how they experienced deprivation, lack of agency, violence, and dehumanization after arrival, with the Australian government seen as the driving force behind these experiences; and 3) how these experiences led to feeling irreparably damaged. The participant statement 'In my country they torture your body but in Australia they kill your mind.' conveyed these three key themes in our analysis. CONCLUSION Our findings suggest that moral injury may be one of the processes by which mandatory immigration detention can cause harm. Although refugees returned to Australia from offshore detention may benefit from interventions that specifically target moral injury, collective steps are needed to diminish deterioration of refugee mental health. Our results highlight the potentially deleterious mental health impact of experiencing multiple subtle and substantial transgressions of one's moral frameworks. Policy makers should incorporate moral injury considerations to prevent eroding refugee mental health.
Collapse
Affiliation(s)
- Sandra Passardi
- Department of Consultation-Liaison Psychiatry and Psychosomatic Medicine, University Hospital of Zurich, University of Zurich, Zurich, Switzerland.,Child and Community Wellbeing Unit, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Australia
| | - Debbie C Hocking
- Department of Psychiatry, School of Clinical Sciences, Monash University, Clayton, Australia.,Cabrini Outreach, Malvern, Australia
| | - Naser Morina
- Department of Consultation-Liaison Psychiatry and Psychosomatic Medicine, University Hospital of Zurich, University of Zurich, Zurich, Switzerland
| | - Suresh Sundram
- Department of Psychiatry, School of Clinical Sciences, Monash University, Clayton, Australia.,Mental Health Program, Monash Health, Clayton, Australia
| | - Eva Alisic
- Child and Community Wellbeing Unit, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Australia
| |
Collapse
|
21
|
Braude M, Phan T, Con D, Woolley I, Sundram S, Clarke D, Dev A, Sievert W. Hepatitis C virus in people with serious mental illness: An analysis of the care cascade at a tertiary health service with a pilot 'identify and treat' strategy. Intern Med J 2021; 53:700-708. [PMID: 34719839 DOI: 10.1111/imj.15604] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Revised: 10/01/2021] [Accepted: 10/25/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND People with serious mental illness (SMI) are underserved from a hepatitis C Virus (HCV) screening and treatment perspective. AIMS To examine the HCV care cascade in people with SMI and to pilot a supported HCV treatment integration program. METHODS HCV prevalence was retrospectively analysed from 4,492 consecutive individuals admitted to a tertiary hospital mental health service between January 2017 and December 2018. Sub-cohort analysis of screening patterns and predictors of seropositive infection was performed. Referral pathways and community care integration were analysed for HCV positive individuals, and a prospective community-based 'identify and treat' HCV program was assessed. RESULTS Screening for HCV had been performed in 18.6% (835/4,492) of the cohort. Seroprevalence was 4.6% (207/4,492). HCV seropositivity was associated with age > 40-years (OR = 9.30, CI 3.69-23.45, p <0.01), injecting drug use (IDU) (OR = 24.26, CI 8.99-65.43, p <0.01), and previous incarceration (OR = 12.26, 4.51-33.31, p <0.01). In a cohort of treatment-eligible individuals, 43.3% (90/208) had neither been referred to specialist services or general practitioners for HCV management. Amongst those referred to specialist services, 64.7% (57/88) did not attend scheduled follow-up, and 48.3% (15/31) of attendees were lost to follow-up. Through an intensified community access program, 10 people were successfully treated for HCV, though 22 could not be engaged. CONCLUSION People with SMI are underserved by traditional models of HCV healthcare. Intensified community-based support can partially bolster the treatment cascade, though investment in innovative screening and management strategies are required to achieve healthcare parity. This article is protected by copyright. All rights reserved.
Collapse
Affiliation(s)
- Michael Braude
- Department of Gastroenterology and Hepatology, Monash Health, Melbourne, Australia.,School of Clinical Sciences, Monash University, Melbourne, Australia
| | - Timothy Phan
- Department of Gastroenterology and Hepatology, Monash Health, Melbourne, Australia
| | - Danny Con
- Department of Gastroenterology and Hepatology, Eastern Health, Melbourne, Australia
| | - Ian Woolley
- School of Clinical Sciences, Monash University, Melbourne, Australia.,Department of Infectious Diseases, Monash Health, Melbourne, Australia
| | - Suresh Sundram
- Department of Mental Health, Monash Health, Melbourne, Australia.,Psychological Medicine, Monash University, Melbourne, Australia
| | - David Clarke
- Department of Mental Health, Monash Health, Melbourne, Australia.,Psychological Medicine, Monash University, Melbourne, Australia
| | - Anouk Dev
- Department of Gastroenterology and Hepatology, Monash Health, Melbourne, Australia.,School of Clinical Sciences, Monash University, Melbourne, Australia
| | - William Sievert
- Department of Gastroenterology and Hepatology, Monash Health, Melbourne, Australia.,School of Clinical Sciences, Monash University, Melbourne, Australia
| |
Collapse
|
22
|
Darke H, Sundram S, Cropper SJ, Carter O. Dynamic face processing impairments are associated with cognitive and positive psychotic symptoms across psychiatric disorders. NPJ Schizophr 2021; 7:36. [PMID: 34376686 PMCID: PMC8355323 DOI: 10.1038/s41537-021-00166-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Accepted: 07/07/2021] [Indexed: 02/07/2023]
Abstract
Impairments in social cognition-including recognition of facial expressions-are increasingly recognised as a core deficit in schizophrenia. It remains unclear whether other aspects of face processing (such as identity recognition) are also impaired, and whether such deficits can be attributed to more general cognitive difficulties. Moreover, while the majority of past studies have used picture-based tasks to assess face recognition, literature suggests that video-based tasks elicit different neural activations and have greater ecological validity. This study aimed to characterise face processing using video-based stimuli in psychiatric inpatients with and without psychosis. Symptom correlates of face processing impairments were also examined. Eighty-six psychiatric inpatients and twenty healthy controls completed a series of tasks using video-based stimuli. These included two emotion recognition tasks, two non-emotional facial identity recognition tasks, and a non-face control task. Symptoms were assessed using the Positive and Negative Syndrome Scale. Schizophrenia and bipolar disorder groups were significantly impaired on the emotion-processing tasks and the non-face task compared to healthy controls and patients without psychosis. Patients with other forms of psychosis performed intermediately. Groups did not differ in non-emotional face processing. Positive symptoms of psychosis correlated directly with both emotion-processing performance and non-face discrimination across patients. We found that identity processing performance was inversely associated with cognition-related symptoms only. Findings suggest that deficits in emotion-processing reflect symptom pathology independent of diagnosis. Emotion-processing deficits in schizophrenia may be better accounted for by task-relevant factors-such as attention-that are not specific to emotion processing.
Collapse
Affiliation(s)
- Hayley Darke
- grid.1008.90000 0001 2179 088XMelbourne School of Psychological Sciences, University of Melbourne, Melbourne, VIC Australia
| | - Suresh Sundram
- grid.418025.a0000 0004 0606 5526The Florey Institute of Neuroscience and Mental Health, Parkville, VIC Australia ,grid.1002.30000 0004 1936 7857Department of Psychiatry, School of Clinical Sciences, Monash University, Melbourne, VIC Australia ,grid.419789.a0000 0000 9295 3933Mental Health Program, Monash Health, Melbourne, VIC Australia
| | - Simon J. Cropper
- grid.1008.90000 0001 2179 088XMelbourne School of Psychological Sciences, University of Melbourne, Melbourne, VIC Australia
| | - Olivia Carter
- grid.1008.90000 0001 2179 088XMelbourne School of Psychological Sciences, University of Melbourne, Melbourne, VIC Australia
| |
Collapse
|
23
|
Dzafic I, Larsen KM, Darke H, Pertile H, Carter O, Sundram S, Garrido MI. Stronger Top-Down and Weaker Bottom-Up Frontotemporal Connections During Sensory Learning Are Associated With Severity of Psychotic Phenomena. Schizophr Bull 2021; 47:1039-1047. [PMID: 33404057 PMCID: PMC8266649 DOI: 10.1093/schbul/sbaa188] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Recent theories in computational psychiatry propose that unusual perceptual experiences and delusional beliefs may emerge as a consequence of aberrant inference and disruptions in sensory learning. The current study investigates these theories and examines the alterations that are specific to schizophrenia spectrum disorders vs those that occur as psychotic phenomena intensify, regardless of diagnosis. We recruited 66 participants: 22 schizophrenia spectrum inpatients, 22 nonpsychotic inpatients, and 22 nonclinical controls. Participants completed the reversal oddball task with volatility manipulated. We recorded neural responses with electroencephalography and measured behavioral errors to inferences on sound probabilities. Furthermore, we explored neural dynamics using dynamic causal modeling (DCM). Attenuated prediction errors (PEs) were specifically observed in the schizophrenia spectrum, with reductions in mismatch negativity in stable, and P300 in volatile, contexts. Conversely, aberrations in connectivity were observed across all participants as psychotic phenomena increased. DCM revealed that impaired sensory learning behavior was associated with decreased intrinsic connectivity in the left primary auditory cortex and right inferior frontal gyrus (IFG); connectivity in the latter was also reduced with greater severity of psychotic experiences. Moreover, people who experienced more hallucinations and psychotic-like symptoms had decreased bottom-up and increased top-down frontotemporal connectivity, respectively. The findings provide evidence that reduced PEs are specific to the schizophrenia spectrum, but deficits in brain connectivity are aligned on the psychosis continuum. Along the continuum, psychotic experiences were related to an aberrant interplay between top-down, bottom-up, and intrinsic connectivity in the IFG during sensory uncertainty. These findings provide novel insights into psychosis neurocomputational pathophysiology.
Collapse
Affiliation(s)
- Ilvana Dzafic
- Department of Medicine, Dentistry & Health Sciences, Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, VIC, Australia.,Queensland Brain Institute, University of Queensland, Brisbane, QLD, Australia.,Australian Research Council Centre of Excellence for Integrative Brain Function, Melbourne, Australia.,Centre for Advanced Imaging, University of Queensland, Brisbane, QLD, Australia
| | - Kit M Larsen
- Queensland Brain Institute, University of Queensland, Brisbane, QLD, Australia.,Australian Research Council Centre of Excellence for Integrative Brain Function, Melbourne, Australia.,Danish Research Centre for Magnetic Resonance, Centre for Functional and Diagnostic Imaging and Research, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark.,Child and Adolescent Mental Health Centre, Mental Health Services Capital Region Copenhagen, University of Copenhagen, Copenhagen, Denmark
| | - Hayley Darke
- Department of Medicine, Dentistry & Health Sciences, Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, VIC, Australia.,Department of Psychiatry, School of Clinical Sciences, Monash University, Melbourne, VIC, Australia
| | - Holly Pertile
- Department of Psychiatry, School of Clinical Sciences, Monash University, Melbourne, VIC, Australia.,Monash Medical Centre, Monash Health, Clayton, VIC, Australia
| | - Olivia Carter
- Department of Medicine, Dentistry & Health Sciences, Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, VIC, Australia
| | - Suresh Sundram
- Department of Psychiatry, School of Clinical Sciences, Monash University, Melbourne, VIC, Australia.,Monash Medical Centre, Monash Health, Clayton, VIC, Australia
| | - Marta I Garrido
- Department of Medicine, Dentistry & Health Sciences, Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, VIC, Australia.,Queensland Brain Institute, University of Queensland, Brisbane, QLD, Australia.,Australian Research Council Centre of Excellence for Integrative Brain Function, Melbourne, Australia.,Centre for Advanced Imaging, University of Queensland, Brisbane, QLD, Australia
| |
Collapse
|
24
|
Ketharanathan T, Pereira A, Reets U, Walker D, Sundram S. Brain changes in NF-κB1 and epidermal growth factor system markers at peri-pubescence in the spiny mouse following maternal immune activation. Psychiatry Res 2021; 295:113564. [PMID: 33229121 DOI: 10.1016/j.psychres.2020.113564] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Accepted: 11/05/2020] [Indexed: 10/23/2022]
Abstract
Environmental risk factors that operate at foetal or neonatal levels increase the vulnerability to schizophrenia, plausibly via stress-immune activation that perturbs the epidermal growth factor (EGF) system, a system critical for neurodevelopment. We investigated potential associations between environmental insults and immune and EGF system changes through a maternal immune activation (MIA) model, using the precocial spiny mice (Acomys cahirinus). After mid-gestation MIA prepubescent offspring showed elevated NF-κB1 protein in nucleus accumbens, decreased EGFR in caudate putamen and a trend for increased PI3K-110δ in ventral hippocampus. Thus, prenatal stress may cause a heightened NF-κB1-mediated immune attenuation of EGF system signalling.
Collapse
Affiliation(s)
- Tharini Ketharanathan
- The Florey Institute of Neuroscience and Mental Health, University of Melbourne, Parkville, VIC 3052, Australia.
| | - Avril Pereira
- The Florey Institute of Neuroscience and Mental Health, University of Melbourne, Parkville, VIC 3052, Australia; Department of Psychiatry, University of Melbourne, Parkville, VIC 3052, Australia
| | - Udani Reets
- Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton, VIC 3168, Australia
| | - David Walker
- School of Health & Biomedical Sciences, RMIT University, Melbourne, VIC 3083, Australia
| | - Suresh Sundram
- Department of Psychiatry, Monash University, Clayton, VIC 3168, Australia
| |
Collapse
|
25
|
Nakamura JP, Gillespie B, Gibbons A, Jaehne EJ, Du X, Chan A, Schroeder A, van den Buuse M, Sundram S, Hill RA. Maternal immune activation targeted to a window of parvalbumin interneuron development improves spatial working memory: Implications for autism. Brain Behav Immun 2021; 91:339-349. [PMID: 33096253 DOI: 10.1016/j.bbi.2020.10.012] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Revised: 09/29/2020] [Accepted: 10/10/2020] [Indexed: 10/23/2022] Open
Abstract
Maternal immune activation (MIA) increases risk for neuropsychiatric disorders such as autism spectrum disorder (ASD) in offspring later in life through unknown causal mechanisms. Growing evidence implicates parvalbumin-containing GABAergic interneurons as a key target in rodent MIA models. We targeted a specific neurodevelopmental window of parvalbumin interneurons in a mouse MIA model to examine effects on spatial working memory, a key domain in ASD that can manifest as either impairments or improvements both clinically and in animal models. Pregnant dams received three consecutive intraperitoneal injections of Polyinosinic:polycytidylic acid (poly(I:C), 5 mg/kg) at gestational days 13, 14 and 15. Spatial working memory was assessed in young adult offspring using touchscreen operant chambers and the Trial-Unique Non-matching to Location (TUNL) task. Anxiety, novelty seeking and short-term memory were assessed using Elevated Plus Maze (EPM) and Y-maze novelty preference tasks. Fluorescent immunohistochemistry was used to assess hippocampal parvalbumin cell density, intensity and co-expression with perineuronal nets. qPCR was used to assess the expression of putatively implicated gene pathways. MIA targeting a window of parvalbumin interneuron development increased spatial working memory performance on the TUNL touchscreen task which was not influenced by anxiety or novelty seeking behaviour. The model reduced fetal mRNA levels of Gad1 and adult hippocampal mRNA levels of Pvalb and the distribution of low intensity parvalbumin interneurons was altered. We speculate a specific timing window for parvalbumin interneuron development underpins the apparently paradoxical improved spatial working memory phenotype found both across several rodent models of autism and clinically in ASD.
Collapse
Affiliation(s)
- Jay P Nakamura
- Department of Psychiatry, School of Clinical Sciences, Monash University, Clayton, Victoria 3168, Australia
| | - Brendan Gillespie
- Department of Psychiatry, School of Clinical Sciences, Monash University, Clayton, Victoria 3168, Australia
| | - Andrew Gibbons
- Department of Psychiatry, School of Clinical Sciences, Monash University, Clayton, Victoria 3168, Australia
| | - Emily J Jaehne
- School of Psychology and Public Health, Department of Psychology, La Trobe University, Victoria 3086, Australia
| | - Xin Du
- Department of Psychiatry, School of Clinical Sciences, Monash University, Clayton, Victoria 3168, Australia
| | - Aaron Chan
- Department of Psychiatry, School of Clinical Sciences, Monash University, Clayton, Victoria 3168, Australia
| | - Anna Schroeder
- Department of Psychiatry, School of Clinical Sciences, Monash University, Clayton, Victoria 3168, Australia
| | - Maarten van den Buuse
- School of Psychology and Public Health, Department of Psychology, La Trobe University, Victoria 3086, Australia; Department of Pharmacology, University of Melbourne, Parkville, Victoria 3010, Australia; The College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, Queensland 4811, Australia
| | - Suresh Sundram
- Department of Psychiatry, School of Clinical Sciences, Monash University, Clayton, Victoria 3168, Australia
| | - Rachel A Hill
- Department of Psychiatry, School of Clinical Sciences, Monash University, Clayton, Victoria 3168, Australia.
| |
Collapse
|
26
|
Hill RA, Kouremenos K, Tull D, Maggi A, Schroeder A, Gibbons A, Kulkarni J, Sundram S, Du X. Bazedoxifene - a promising brain active SERM that crosses the blood brain barrier and enhances spatial memory. Psychoneuroendocrinology 2020; 121:104830. [PMID: 32858306 DOI: 10.1016/j.psyneuen.2020.104830] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2020] [Accepted: 08/11/2020] [Indexed: 12/21/2022]
Abstract
Over 20 years of accumulated evidence has shown that the major female sex hormone 17β-estradiol can enhance cognitive functioning. However, the utility of estradiol as a therapeutic cognitive enhancer is hindered by its unwanted peripheral effects (carcinogenic). Selective estrogen receptor modulators (SERMs) avoid the unwanted effects of estradiol by acting as estrogen receptor antagonists in some tissues such as breast and uterus, but as agonists in others such as bone, and are currently used for the treatment of osteoporosis. However, understanding of their actions in the brain are limited. The third generation SERM bazedoxifene has recently been FDA approved for clinical use with an improved biosafety profile. However, whether bazedoxifene can enter the brain and enhance cognition is unknown. Using mice, the current study aimed to explore if bazedoxifene can 1) cross the blood-brain barrier, 2) rescue ovariectomy-induced hippocampal-dependent spatial memory deficit, and 3) activate neural estrogen response element (ERE)-dependent gene transcription. Using liquid chromatography-mass spectrometry (LC-MS), we firstly demonstrate that a peripheral injection of bazedoxifene can enter the brain. Secondly, we show that an acute intraperitoneal injection of bazedoxifene can rescue ovariectomy-induced spatial memory deficits. And finally, using the ERE-luciferase reporter mouse, we show in vivo that bazedoxifene can activate the ERE in the brain. The evidence shown here suggest bazedoxifene could be a viable cognitive enhancer with promising clinical applicability.
Collapse
Affiliation(s)
- R A Hill
- Department of Psychiatry, Monash University, Clayton, VIC, 3168, Australia; Florey Institute for Neuroscience and Mental Health, Parkville, VIC, 3052, Australia.
| | - K Kouremenos
- Metabolomics Australia, Bio21 Molecular Science & Biotechnology Institute, Parkville, VIC, 3052, Australia
| | - D Tull
- Metabolomics Australia, Bio21 Molecular Science & Biotechnology Institute, Parkville, VIC, 3052, Australia
| | - A Maggi
- Department of Pharmacological and Biomolecular Sciences, University of Milan, Milan, 20133, Italy
| | - A Schroeder
- Department of Psychiatry, Monash University, Clayton, VIC, 3168, Australia
| | - A Gibbons
- Department of Psychiatry, Monash University, Clayton, VIC, 3168, Australia
| | - J Kulkarni
- Monash Alfred Psychiatry Research Centre, Monash University, St Kilda, VIC, 3004, Australia
| | - S Sundram
- Department of Psychiatry, Monash University, Clayton, VIC, 3168, Australia
| | - X Du
- Department of Psychiatry, Monash University, Clayton, VIC, 3168, Australia; Florey Institute for Neuroscience and Mental Health, Parkville, VIC, 3052, Australia
| |
Collapse
|
27
|
Boehm KJ, Ayzman Y, Blake R, Garcia A, Sequoia K, Sundram S, Sweet W. Machine Learning Algorithms for Automated NIF Capsule Mandrel Selection. Fusion Science and Technology 2020. [DOI: 10.1080/15361055.2020.1777673] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
- K.-J. Boehm
- General Atomics, P.O. Box 85608, San Diego, California 92186-5608
| | - Y. Ayzman
- Lawrence Livermore National Laboratory, P.O. Box 808, Livermore, California 94550
| | - R. Blake
- Lawrence Livermore National Laboratory, P.O. Box 808, Livermore, California 94550
| | - A. Garcia
- General Atomics, P.O. Box 85608, San Diego, California 92186-5608
| | - K. Sequoia
- General Atomics, P.O. Box 85608, San Diego, California 92186-5608
| | - S. Sundram
- Lawrence Livermore National Laboratory, P.O. Box 808, Livermore, California 94550
| | - W. Sweet
- General Atomics, P.O. Box 85608, San Diego, California 92186-5608
| |
Collapse
|
28
|
Larsen KM, Dzafic I, Darke H, Pertile H, Carter O, Sundram S, Garrido MI. Aberrant connectivity in auditory precision encoding in schizophrenia spectrum disorder and across the continuum of psychotic-like experiences. Schizophr Res 2020; 222:185-194. [PMID: 32593736 DOI: 10.1016/j.schres.2020.05.061] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2020] [Revised: 05/11/2020] [Accepted: 05/27/2020] [Indexed: 11/24/2022]
Abstract
BACKGROUND The ability to generate a precise internal model of statistical regularities is impaired in schizophrenia. Predictive coding accounts of schizophrenia suggest that psychotic symptoms may be explained by a failure to build precise beliefs or a model of the world. The precision of this model may vary with context. For example, in a noisy environment the model will be more imprecise compared to a model built in an environment with lower noise. However compelling, this idea has not yet been empirically studied in schizophrenia. METHODS In this study, 62 participants engaged in a stochastic mismatch negativity paradigm with high and low precision. We included inpatients with a schizophrenia spectrum disorder (N = 20), inpatients with a psychiatric disorder but without psychosis (N = 20), and healthy controls (N = 22), with comparable sex ratio and age distribution. Bayesian mapping and dynamic causal modelling were employed to investigate the underlying microcircuitry of precision encoding of auditory stimuli. RESULTS We found strong evidence (exceedance P > 0.99) for differences in the underlying connectivity associated with precision encoding between the three groups as well as on the continuum of psychotic-like experiences assessed across all participants. Critically, we show changes in interhemispheric connectivity between the two inpatient groups, with some connections further aligning on the continuum of psychotic-like experiences. CONCLUSIONS While our results suggest continuity in backward connectivity alterations with psychotic-like experiences regardless of diagnosis, they also point to specificity for the schizophrenia spectrum disorder group in interhemispheric connectivity alterations.
Collapse
Affiliation(s)
- Kit Melissa Larsen
- Queensland Brain Institute, The University of Queensland, Australia; Australian Research Council of Excellence for Integrative Brain Function, Australia; Danish Research Centre for Magnetic Resonance, Centre for Functional and Diagnostic Imaging and Research, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark; Child and Adolescent Mental Health Centre, Mental Health Services Capital Region Copenhagen, University of Copenhagen, Denmark.
| | - Ilvana Dzafic
- Queensland Brain Institute, The University of Queensland, Australia; Australian Research Council of Excellence for Integrative Brain Function, Australia; Melbourne School of Psychological Sciences, University of Melbourne, Australia
| | - Hayley Darke
- Melbourne School of Psychological Sciences, University of Melbourne, Australia
| | - Holly Pertile
- Department of Psychiatry, School of Clinical Sciences, Monash University, Clayton, VIC, Australia; Monash Medical Centre, Monash Health, Clayton, VIC, Australia
| | - Olivia Carter
- Melbourne School of Psychological Sciences, University of Melbourne, Australia
| | - Suresh Sundram
- Department of Psychiatry, School of Clinical Sciences, Monash University, Clayton, VIC, Australia; Monash Medical Centre, Monash Health, Clayton, VIC, Australia
| | - Marta I Garrido
- Queensland Brain Institute, The University of Queensland, Australia; Australian Research Council of Excellence for Integrative Brain Function, Australia; Melbourne School of Psychological Sciences, University of Melbourne, Australia; Centre for Advanced Imaging, The University of Queensland, Australia
| |
Collapse
|
29
|
Van Rheenen TE, Cropley V, Fagerlund B, Wannan C, Bruggemann J, Lenroot RK, Sundram S, Weickert CS, Weickert TW, Zalesky A, Bousman CA, Pantelis C. Cognitive reserve attenuates age-related cognitive decline in the context of putatively accelerated brain ageing in schizophrenia-spectrum disorders. Psychol Med 2020; 50:1475-1489. [PMID: 31274065 DOI: 10.1017/s0033291719001417] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
BACKGROUND In schizophrenia, relative stability in the magnitude of cognitive deficits across age and illness duration is inconsistent with the evidence of accelerated deterioration in brain regions known to support these functions. These discrepant brain-cognition outcomes may be explained by variability in cognitive reserve (CR), which in neurological disorders has been shown to buffer against brain pathology and minimize its impact on cognitive or clinical indicators of illness. METHODS Age-related change in fluid reasoning, working memory and frontal brain volume, area and thickness were mapped using regression analysis in 214 individuals with schizophrenia or schizoaffective disorder and 168 healthy controls. In patients, these changes were modelled as a function of CR. RESULTS Patients showed exaggerated age-related decline in brain structure, but not fluid reasoning compared to controls. In the patient group, no moderation of age-related brain structural change by CR was evident. However, age-related cognitive change was moderated by CR, such that only patients with low CR showed evidence of exaggerated fluid reasoning decline that paralleled the exaggerated age-related deterioration of underpinning brain structures seen in all patients. CONCLUSIONS In schizophrenia-spectrum illness, CR may negate ageing effects on fluid reasoning by buffering against pathologically exaggerated structural brain deterioration through some form of compensation. CR may represent an important modifier that could explain inconsistencies in brain structure - cognition outcomes in the extant literature.
Collapse
Affiliation(s)
- Tamsyn E Van Rheenen
- Department of Psychiatry, Melbourne Neuropsychiatry Centre, University of Melbourne and Melbourne Health, Melbourne, Australia
- Centre for Mental Health, Faculty of Health, Arts and Design, School of Health Sciences, Swinburne University, Melbourne, Australia
| | - Vanessa Cropley
- Department of Psychiatry, Melbourne Neuropsychiatry Centre, University of Melbourne and Melbourne Health, Melbourne, Australia
- Centre for Mental Health, Faculty of Health, Arts and Design, School of Health Sciences, Swinburne University, Melbourne, Australia
| | - Birgitte Fagerlund
- Center for Neuropsychiatric Schizophrenia Research and Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research (CINS), Mental Health Center, Glostrup, Denmark
- Department of Psychology, University of Copenhagen, Copenhagen, Denmark
| | - Cassandra Wannan
- Department of Psychiatry, Melbourne Neuropsychiatry Centre, University of Melbourne and Melbourne Health, Melbourne, Australia
| | - Jason Bruggemann
- School of Psychiatry, University of New South Wales, New South Wales, Australia
- Neuroscience Research Australia, New South Wales, Australia
| | - Rhoshel K Lenroot
- School of Psychiatry, University of New South Wales, New South Wales, Australia
- Neuroscience Research Australia, New South Wales, Australia
| | - Suresh Sundram
- Florey Institute of Neuroscience and Mental Health, Melbourne, Australia
- Department of Psychiatry, School of Clinical Sciences, Monash University, Clayton, Australia
- Mental Health Program, Monash Health, Clayton, Victoria, Australia
| | - Cynthia Shannon Weickert
- Department of Psychiatry, Melbourne Neuropsychiatry Centre, University of Melbourne and Melbourne Health, Melbourne, Australia
- School of Psychiatry, University of New South Wales, New South Wales, Australia
- Neuroscience Research Australia, New South Wales, Australia
- Department of Neuroscience & Physiology, Upstate Medical University, Syracuse, New York13210, USA
| | - Thomas W Weickert
- Department of Psychiatry, Melbourne Neuropsychiatry Centre, University of Melbourne and Melbourne Health, Melbourne, Australia
- School of Psychiatry, University of New South Wales, New South Wales, Australia
- Neuroscience Research Australia, New South Wales, Australia
| | - Andrew Zalesky
- Department of Psychiatry, Melbourne Neuropsychiatry Centre, University of Melbourne and Melbourne Health, Melbourne, Australia
- Department of Electrical and Electronic Engineering, University of Melbourne, VIC, Australia
| | - Chad A Bousman
- Department of Psychiatry, Melbourne Neuropsychiatry Centre, University of Melbourne and Melbourne Health, Melbourne, Australia
- Florey Institute of Neuroscience and Mental Health, Melbourne, Australia
- Departments of Medical Genetics, Psychiatry, and Physiology & Pharmacology, University of Calgary, Calgary, AB, Canada
| | - Christos Pantelis
- Department of Psychiatry, Melbourne Neuropsychiatry Centre, University of Melbourne and Melbourne Health, Melbourne, Australia
- Florey Institute of Neuroscience and Mental Health, Melbourne, Australia
- Department of Electrical and Electronic Engineering, University of Melbourne, VIC, Australia
| |
Collapse
|
30
|
Gumley A, Bradstreet S, Ainsworth J, Allan S, Alvarez-Jimenez M, Beattie L, Bell I, Birchwood M, Briggs A, Bucci S, Castagnini E, Clark A, Cotton SM, Engel L, French P, Lederman R, Lewis S, Machin M, MacLennan G, Matrunola C, McLeod H, McMeekin N, Mihalopoulos C, Morton E, Norrie J, Reilly F, Schwannauer M, Singh SP, Smith L, Sundram S, Thomson D, Thompson A, Whitehill H, Wilson-Kay A, Williams C, Yung A, Farhall J, Gleeson J. Early Signs Monitoring to Prevent Relapse in Psychosis and Promote Well-Being, Engagement, and Recovery: Protocol for a Feasibility Cluster Randomized Controlled Trial Harnessing Mobile Phone Technology Blended With Peer Support. JMIR Res Protoc 2020; 9:e15058. [PMID: 31917372 PMCID: PMC6996736 DOI: 10.2196/15058] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2019] [Accepted: 08/27/2019] [Indexed: 12/13/2022] Open
Abstract
Background Relapse in schizophrenia is a major cause of distress and disability and is predicted by changes in symptoms such as anxiety, depression, and suspiciousness (early warning signs [EWSs]). These can be used as the basis for timely interventions to prevent relapse. However, there is considerable uncertainty regarding the implementation of EWS interventions. Objective This study was designed to establish the feasibility of conducting a definitive cluster randomized controlled trial comparing Early signs Monitoring to Prevent relapse in psychosis and prOmote Well-being, Engagement, and Recovery (EMPOWER) against treatment as usual (TAU). Our primary outcomes are establishing parameters of feasibility, acceptability, usability, safety, and outcome signals of a digital health intervention as an adjunct to usual care that is deliverable in the UK National Health Service and Australian community mental health service (CMHS) settings. We will assess the feasibility of candidate primary outcomes, candidate secondary outcomes, and candidate mechanisms for a definitive trial. Methods We will randomize CMHSs to EMPOWER or TAU. We aim to recruit up to 120 service user participants from 8 CMHSs and follow them for 12 months. Eligible service users will (1) be aged 16 years and above, (2) be in contact with local CMHSs, (3) have either been admitted to a psychiatric inpatient service or received crisis intervention at least once in the previous 2 years for a relapse, and (4) have an International Classification of Diseases-10 diagnosis of a schizophrenia-related disorder. Service users will also be invited to nominate a carer to participate. We will identify the feasibility of the main trial in terms of recruitment and retention to the study and the acceptability, usability, safety, and outcome signals of the EMPOWER intervention. EMPOWER is a mobile phone app that enables the monitoring of well-being and possible EWSs of relapse on a daily basis. An algorithm calculates changes in well-being based on participants’ own baseline to enable tailoring of well-being messaging and clinical triage of possible EWSs. Use of the app is blended with ongoing peer support. Results Recruitment to the trial began September 2018, and follow-up of participants was completed in July 2019. Data collection is continuing. The database was locked in July 2019, followed by analysis and disclosing of group allocation. Conclusions The knowledge gained from the study will inform the design of a definitive trial including finalizing the delivery of our digital health intervention, sample size estimation, methods to ensure successful identification, consent, randomization, and follow-up of participants, and the primary and secondary outcomes. The trial will also inform the final health economic model to be applied in the main trial. Trial Registration International Standard Randomized Controlled Trial Number (ISRCTN): 99559262; http://isrctn.com/ISRCTN99559262 International Registered Report Identifier (IRRID) DERR1-10.2196/15058
Collapse
Affiliation(s)
- Andrew Gumley
- Glasgow Institute of Health and Wellbeing, Glasgow Mental Health Research Facility, University of Glasgow, Glasgow, United Kingdom.,NHS Greater Glasgow and Clyde, Glasgow, United Kingdom
| | - Simon Bradstreet
- Glasgow Institute of Health and Wellbeing, Glasgow Mental Health Research Facility, University of Glasgow, Glasgow, United Kingdom
| | - John Ainsworth
- Division of Informatics, Imaging, and Data Sciences, School of Health Sciences, University of Manchester, Manchester, United Kingdom
| | - Stephanie Allan
- Glasgow Institute of Health and Wellbeing, Glasgow Mental Health Research Facility, University of Glasgow, Glasgow, United Kingdom
| | - Mario Alvarez-Jimenez
- Orygen, The National Centre of Excellence in Youth Mental Health, Melbourne, Australia.,Centre for Youth Mental Health, University of Melbourne, Melbourne, Australia
| | - Louise Beattie
- Glasgow Institute of Health and Wellbeing, Glasgow Mental Health Research Facility, University of Glasgow, Glasgow, United Kingdom
| | - Imogen Bell
- Orygen, The National Centre of Excellence in Youth Mental Health, Melbourne, Australia
| | - Max Birchwood
- Division of Mental Health and Wellbeing, University of Warwick, Warwick, United Kingdom
| | - Andrew Briggs
- London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Sandra Bucci
- Division of Psychology and Mental Health, School of Health Sciences, University of Manchester, Manchester, United Kingdom.,Greater Manchester Mental Health NHS Foundation Trust, Manchester, United Kingdom
| | - Emily Castagnini
- La Trobe University, Melbourne, Australia.,NorthWestern Mental Health, Melbourne, Australia
| | - Andrea Clark
- Glasgow Institute of Health and Wellbeing, Glasgow Mental Health Research Facility, University of Glasgow, Glasgow, United Kingdom.,NHS Research Scotland Mental Health Network, Glasgow, United Kingdom
| | - Sue M Cotton
- Orygen, The National Centre of Excellence in Youth Mental Health, Melbourne, Australia
| | | | - Paul French
- Manchester Metropolitan University, Manchester, United Kingdom
| | - Reeva Lederman
- School of Computing and Information Systems, Melbourne School of Engineering, University of Melbourne, Melbourne, Australia
| | - Shon Lewis
- Division of Psychology and Mental Health, School of Health Sciences, University of Manchester, Manchester, United Kingdom.,Greater Manchester Mental Health NHS Foundation Trust, Manchester, United Kingdom
| | - Matthew Machin
- Division of Informatics, Imaging, and Data Sciences, School of Health Sciences, University of Manchester, Manchester, United Kingdom
| | - Graeme MacLennan
- The Centre for Healthcare Randomised Trials, University of Aberdeen, Aberdeen, United Kingdom
| | - Claire Matrunola
- Glasgow Institute of Health and Wellbeing, Glasgow Mental Health Research Facility, University of Glasgow, Glasgow, United Kingdom.,NHS Research Scotland Mental Health Network, Glasgow, United Kingdom
| | - Hamish McLeod
- Glasgow Institute of Health and Wellbeing, Glasgow Mental Health Research Facility, University of Glasgow, Glasgow, United Kingdom.,NHS Greater Glasgow and Clyde, Glasgow, United Kingdom
| | - Nicola McMeekin
- Glasgow Institute of Health and Wellbeing, University of Glasgow, Glasgow, United Kingdom
| | | | - Emma Morton
- Australian Catholic University, Melbourne, Australia
| | - John Norrie
- Usher Institute, University of Edinburgh, Edinburgh, United Kingdom
| | - Frank Reilly
- Scottish Recovery Network, Glasgow, United Kingdom
| | - Matthias Schwannauer
- School of Health and Social Sciences, University of Edinburgh, Edinburgh, United Kingdom
| | - Swaran P Singh
- Division of Mental Health and Wellbeing, University of Warwick, Warwick, United Kingdom
| | - Lesley Smith
- Scottish Recovery Network, Glasgow, United Kingdom
| | | | - David Thomson
- Glasgow Institute of Health and Wellbeing, Glasgow Mental Health Research Facility, University of Glasgow, Glasgow, United Kingdom.,NHS Greater Glasgow and Clyde, Glasgow, United Kingdom
| | - Andrew Thompson
- Orygen, The National Centre of Excellence in Youth Mental Health, Melbourne, Australia.,Division of Mental Health and Wellbeing, University of Warwick, Warwick, United Kingdom
| | - Helen Whitehill
- Glasgow Institute of Health and Wellbeing, Glasgow Mental Health Research Facility, University of Glasgow, Glasgow, United Kingdom.,Scottish Recovery Network, Glasgow, United Kingdom
| | - Alison Wilson-Kay
- Glasgow Institute of Health and Wellbeing, Glasgow Mental Health Research Facility, University of Glasgow, Glasgow, United Kingdom.,NHS Greater Glasgow and Clyde, Glasgow, United Kingdom
| | - Christopher Williams
- Glasgow Institute of Health and Wellbeing, Glasgow Mental Health Research Facility, University of Glasgow, Glasgow, United Kingdom
| | - Alison Yung
- Division of Psychology and Mental Health, School of Health Sciences, University of Manchester, Manchester, United Kingdom
| | - John Farhall
- La Trobe University, Melbourne, Australia.,NorthWestern Mental Health, Melbourne, Australia
| | - John Gleeson
- Australian Catholic University, Melbourne, Australia
| |
Collapse
|
31
|
Wells R, Jacomb I, Swaminathan V, Sundram S, Weinberg D, Bruggemann J, Cropley V, Lenroot RK, Pereira AM, Zalesky A, Bousman C, Pantelis C, Weickert CS, Weickert TW. The Impact of Childhood Adversity on Cognitive Development in Schizophrenia. Schizophr Bull 2020; 46:140-153. [PMID: 31050754 PMCID: PMC6942153 DOI: 10.1093/schbul/sbz033] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Childhood adversity, such as physical, sexual, and verbal abuse, as well as neglect and family conflict, is a risk factor for schizophrenia. Such adversity can lead to disruptions of cognitive function during development, undermining intellectual capabilities and academic achievement. Schizophrenia is a neurodevelopmental disorder that is associated with cognitive impairments that may become evident during childhood. The Australian Schizophrenia Research Bank database comprises a large community cohort (N = 1169) in which we previously identified 3 distinct cognitive groups among people with schizophrenia: (1) Compromised, current, and estimated premorbid cognitive impairment; (2) Deteriorated, substantial decline from estimated premorbid function; and (3) Preserved, performing in the normal cognitive range without decline. The compromised group displayed the worst functional and symptom outcomes. Here, we extend our previous work by assessing the relationship among these categories of cognitive abilities and reported childhood adversity in 836 patients and healthy controls. Exploratory factor analysis of the Childhood Adversity Questionnaire revealed 3 factors (lack of parental involvement; overt abuse; family breakdown and hardship). People with schizophrenia reported significantly more childhood adversity than healthy controls on all items and factors. People with schizophrenia in the compromised group reported significantly more lack of parental involvement and family breakdown and hardship and lower socioeconomic status than those in the deteriorated group. The cognitive groups were not related to family history of psychosis. These findings identify specific social and family factors that impact cognition, highlighting the important role of these factors in the development of cognitive and functional abilities in schizophrenia.
Collapse
Affiliation(s)
- Ruth Wells
- School of Psychiatry, University of New South Wales, Sydney, Australia,Neuroscience Research Australia, Randwick, Sydney, Australia
| | - Isabella Jacomb
- School of Psychiatry, University of New South Wales, Sydney, Australia,Neuroscience Research Australia, Randwick, Sydney, Australia
| | - Vaidy Swaminathan
- Department of Psychiatry, University of Melbourne, Parkville, Australia,Mental Health Program, Monash Medical Centre, Monash Health, Clayton, Australia,Schizophrenia Research Institute, Sydney, Australia,Molecular Psychopharmacology Laboratory, The Florey Institute of Neuroscience and Mental Health, Parkville, Australia
| | - Suresh Sundram
- Department of Psychiatry, University of Melbourne, Parkville, Australia,Mental Health Program, Monash Medical Centre, Monash Health, Clayton, Australia,Molecular Psychopharmacology Laboratory, The Florey Institute of Neuroscience and Mental Health, Parkville, Australia,Department of Psychiatry, School of Clinical Sciences, Monash University, Clayton, Australia
| | - Danielle Weinberg
- School of Psychiatry, University of New South Wales, Sydney, Australia,Neuroscience Research Australia, Randwick, Sydney, Australia,Present address: Clinical Research Support Office, Childrens Hospital of Philadelphia, Philadelphia, PA
| | - Jason Bruggemann
- School of Psychiatry, University of New South Wales, Sydney, Australia,Neuroscience Research Australia, Randwick, Sydney, Australia
| | - Vanessa Cropley
- Department of Psychiatry, University of Melbourne, Parkville, Australia
| | - Rhoshel K Lenroot
- School of Psychiatry, University of New South Wales, Sydney, Australia,Neuroscience Research Australia, Randwick, Sydney, Australia,Schizophrenia Research Institute, Sydney, Australia,Present address: School of Psychiatry and Behavioral Sciences, University of New Mexico, Albuquerque, NM
| | - Avril M Pereira
- Department of Psychiatry, University of Melbourne, Parkville, Australia,Molecular Psychopharmacology Laboratory, The Florey Institute of Neuroscience and Mental Health, Parkville, Australia
| | - Andrew Zalesky
- Department of Psychiatry, University of Melbourne, Parkville, Australia
| | - Chad Bousman
- Department of Psychiatry, University of Melbourne, Parkville, Australia,Present address: Department of Medical Genetics, Psychiatry, and Physiology & Pharmacology, University of Calgary, Alberta, Canada
| | - Christos Pantelis
- Department of Psychiatry, University of Melbourne, Parkville, Australia,Schizophrenia Research Institute, Sydney, Australia
| | - Cynthia Shannon Weickert
- School of Psychiatry, University of New South Wales, Sydney, Australia,Neuroscience Research Australia, Randwick, Sydney, Australia,Schizophrenia Research Institute, Sydney, Australia,Present address: Department of Neuroscience and Physiology, Upstate Medical University, Syracuse, New York
| | - Thomas W Weickert
- School of Psychiatry, University of New South Wales, Sydney, Australia,Neuroscience Research Australia, Randwick, Sydney, Australia,Schizophrenia Research Institute, Sydney, Australia,To whom correspondence should be addressed; tel: +61-02-9399-1730, fax: +61-02-9399-1034, e-mail:
| |
Collapse
|
32
|
Schroeder A, Nakamura JP, Hudson M, Jones NC, Du X, Sundram S, Hill RA. Raloxifene recovers effects of prenatal immune activation on cognitive task-induced gamma power. Psychoneuroendocrinology 2019; 110:104448. [PMID: 31546114 DOI: 10.1016/j.psyneuen.2019.104448] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2019] [Revised: 09/04/2019] [Accepted: 09/13/2019] [Indexed: 12/13/2022]
Abstract
There is currently no treatment available for the cognitive symptoms of schizophrenia, but evidence suggests that selective estrogen receptor modulators (SERMs) may provide relief. Our recent animal model data showed that a lack of female sex hormones in mice impairs the ability of hippocampal neurons to synchronise and generate oscillations within the frequency range of 30-80 Hz (gamma power) leading to cognitive impairment, while both estradiol and the SERM, raloxifene, recovered this. Given that cognitive impairment is accompanied by abnormal gamma power in schizophrenia, this study aimed to determine the effects of raloxifene on gamma power during spatial memory tasks in the prenatal immune challenged (poly-I:C) mouse model with relevance to schizophrenia. Pregnant dams received the viral mimetic poly-I:C (20 mg/kg, i.p.) at gestational day 17. Male and female offspring were treated with placebo or raloxifene implants at adulthood. Local field potentials from the CA1 hippocampus were simultaneously recorded during the Y-maze test of short term spatial memory and the cheeseboard maze test of long-term spatial learning and memory and cognitive flexibility. In female but not male mice, poly I:C exposure reduced gamma power during decision making and prolonged the time spent in the centre (decision making phase) during the Y-maze task. Female poly-I:C exposed mice also showed increased gamma power during acquisition of the cheeseboard long term memory task and perseverative behaviour. Treatment with raloxifene recovered gamma power and decision making deficits in the Y-maze and restored gamma power changes during the cheeseboard maze task as well as perseverative behaviour. Male mice showed no electrophysiological or behavioural effects of poly-I:C or raloxifene treatment. In summary, poly-I:C exposure induced female specific cognitive impairments accompanied by altered neural oscillations in the gamma frequency and raloxifene recovered these abnormalities.
Collapse
Affiliation(s)
- Anna Schroeder
- Psychoneuroendocrinology Laboratory, Florey Institute for Neuroscience and Mental Health, University of Melbourne, Parkville, VIC, 3010, Australia; Behavioural Neuroscience Laboratory, Department of Psychiatry, School of Clinical Sciences, Monash University, 246 Clayton Rd, Clayton, VIC, 3168, Australia
| | - Jay P Nakamura
- Psychoneuroendocrinology Laboratory, Florey Institute for Neuroscience and Mental Health, University of Melbourne, Parkville, VIC, 3010, Australia; Behavioural Neuroscience Laboratory, Department of Psychiatry, School of Clinical Sciences, Monash University, 246 Clayton Rd, Clayton, VIC, 3168, Australia
| | - Matthew Hudson
- Department of Medicine, University of Melbourne, Parkville, VIC, 3010, Australia; Department of Neuroscience, Monash University, Clayton, VIC, 3168, Australia
| | - Nigel C Jones
- Department of Medicine, University of Melbourne, Parkville, VIC, 3010, Australia; Department of Neuroscience, Monash University, Clayton, VIC, 3168, Australia
| | - Xin Du
- Psychoneuroendocrinology Laboratory, Florey Institute for Neuroscience and Mental Health, University of Melbourne, Parkville, VIC, 3010, Australia; Behavioural Neuroscience Laboratory, Department of Psychiatry, School of Clinical Sciences, Monash University, 246 Clayton Rd, Clayton, VIC, 3168, Australia
| | - Suresh Sundram
- Behavioural Neuroscience Laboratory, Department of Psychiatry, School of Clinical Sciences, Monash University, 246 Clayton Rd, Clayton, VIC, 3168, Australia
| | - Rachel A Hill
- Psychoneuroendocrinology Laboratory, Florey Institute for Neuroscience and Mental Health, University of Melbourne, Parkville, VIC, 3010, Australia; Behavioural Neuroscience Laboratory, Department of Psychiatry, School of Clinical Sciences, Monash University, 246 Clayton Rd, Clayton, VIC, 3168, Australia.
| |
Collapse
|
33
|
Nakamura JP, Schroeder A, Hudson M, Jones N, Gillespie B, Du X, Notaras M, Swaminathan V, Reay WR, Atkins JR, Green MJ, Carr VJ, Cairns MJ, Sundram S, Hill RA. The maternal immune activation model uncovers a role for the Arx gene in GABAergic dysfunction in schizophrenia. Brain Behav Immun 2019; 81:161-171. [PMID: 31175998 DOI: 10.1016/j.bbi.2019.06.009] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2019] [Revised: 05/09/2019] [Accepted: 06/05/2019] [Indexed: 12/11/2022] Open
Abstract
A hallmark feature of schizophrenia is altered high frequency neural oscillations, including reduced auditory-evoked gamma oscillatory power, which is underpinned by parvalbumin (PV) interneuron dysfunction. Maternal immune activation (MIA) in rodents models an environmental risk factor for schizophrenia and recapitulates these PV interneuron changes. This study sought to link reduced PV expression in the MIA model with alterations to auditory-evoked gamma oscillations and transcript expression. We further aligned transcriptional findings from the animal model with human genome sequencing data. We show that MIA, induced by the viral mimetic, poly-I:C in C57Bl/6 mice, caused in adult offspring reduced auditory-evoked gamma and theta oscillatory power paralleled by reduced PV protein levels. We then showed the Arx gene, critical to healthy neurodevelopment of PV interneurons, is reduced in the forebrain of MIA exposed mice. Finally, in a whole-genome sequenced patient cohort, we identified a novel missense mutation of ARX in a patient with schizophrenia and in the Psychiatric Genomics Consortium 2 cohort, a nominal association of proximal ARX SNPs with the disorder. This suggests MIA, as a risk factor for schizophrenia, may be influencing Arx expression to induce the GABAergic dysfunction seen in schizophrenia and that the ARX gene may play a role in the prenatal origins of schizophrenia pathophysiology.
Collapse
Affiliation(s)
- Jay P Nakamura
- Florey Institute for Neuroscience and Mental Health, University of Melbourne, Parkville, Victoria 3010, Australia; Department of Psychiatry, School of Clinical Sciences, Monash University, Clayton, Victoria 3168, Australia
| | - Anna Schroeder
- Florey Institute for Neuroscience and Mental Health, University of Melbourne, Parkville, Victoria 3010, Australia
| | - Matthew Hudson
- University of Melbourne, Parkville, Victoria 3010, Australia; Department of Neuroscience, Central Clinical School, Monash University, The Alfred Hospital, Melbourne, Victoria 3004, Australia
| | - Nigel Jones
- University of Melbourne, Parkville, Victoria 3010, Australia; Department of Neuroscience, Central Clinical School, Monash University, The Alfred Hospital, Melbourne, Victoria 3004, Australia
| | - Brendan Gillespie
- Department of Psychiatry, School of Clinical Sciences, Monash University, Clayton, Victoria 3168, Australia
| | - Xin Du
- Florey Institute for Neuroscience and Mental Health, University of Melbourne, Parkville, Victoria 3010, Australia; Department of Psychiatry, School of Clinical Sciences, Monash University, Clayton, Victoria 3168, Australia
| | - Michael Notaras
- Centre for Neurogenetics, Brain and Mind Research Institute, Weill Cornell Medical College, Cornell University, New York 10021, USA
| | - Vaidy Swaminathan
- Department of Psychiatry, School of Clinical Sciences, Monash University, Clayton, Victoria 3168, Australia
| | - William R Reay
- School of Biomedical Sciences and Pharmacy, University of Newcastle, NSW, Australia
| | - Joshua R Atkins
- School of Biomedical Sciences and Pharmacy, University of Newcastle, NSW, Australia
| | - Melissa J Green
- School of Psychiatry, University of NSW, Sydney, NSW 2052, Australia; Neuroscience Research Australia (NeuRA), Barker St, Randwick, NSW 2031, Australia
| | - Vaughan J Carr
- Department of Psychiatry, School of Clinical Sciences, Monash University, Clayton, Victoria 3168, Australia; School of Psychiatry, University of NSW, Sydney, NSW 2052, Australia; Neuroscience Research Australia (NeuRA), Barker St, Randwick, NSW 2031, Australia
| | - Murray J Cairns
- School of Biomedical Sciences and Pharmacy, University of Newcastle, NSW, Australia
| | - Suresh Sundram
- Florey Institute for Neuroscience and Mental Health, University of Melbourne, Parkville, Victoria 3010, Australia; Department of Psychiatry, School of Clinical Sciences, Monash University, Clayton, Victoria 3168, Australia; University of Melbourne, Parkville, Victoria 3010, Australia; Monash Medical Centre, Monash Health, Clayton, Victoria 3168, Australia
| | - Rachel A Hill
- Florey Institute for Neuroscience and Mental Health, University of Melbourne, Parkville, Victoria 3010, Australia; Department of Psychiatry, School of Clinical Sciences, Monash University, Clayton, Victoria 3168, Australia.
| |
Collapse
|
34
|
Harrington A, Darke H, Ennis G, Sundram S. Evaluation of an alternative model for the management of clinical risk in an adult acute psychiatric inpatient unit. Int J Ment Health Nurs 2019; 28:1099-1109. [PMID: 31206989 DOI: 10.1111/inm.12621] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/24/2019] [Indexed: 11/24/2022]
Abstract
Despite their widespread use, typical visual observation practices are not evidence-based and adverse events - such as self-harm and absconding - still occur even under the most intense forms of observation. This study aimed to (i) develop and implement an engagement-focused systematized model of clinical risk management in an adult acute psychiatric inpatient unit; and (ii) prospectively evaluate its effect on rates of violence, self-harm, absconding, sexually inappropriate behaviour, and seclusion. A new model of engagement-focused clinical risk management was developed using a participatory action research framework and implemented in an adult acute psychiatric inpatient unit. Using a mirror-image design, rates of violence/aggression, self-harm, absconding, sexually inappropriate behaviour, and seclusion were compared before and after implementation, and staff satisfaction levels were measured. The clinical engagement-based model was introduced, and 1087 admissions before implementation (24 months) were compared with 965 admissions post-implementation (18 months). The new model was associated with significantly reduced rates of absconding (pre: 10.5/1000 occupied bed days, 95% CI [9.0, 12.1] compared with post: 6.5/1000 occupied bed days [5.2, 8.1], P < 0.001) and seclusion (pre: 43.7/1000 occupied bed days, 95% CI [40.6, 46.9] compared with post: 30.9/1000 occupied bed days [27.9, 34.1], P < 0.0001). Rates of aggression, deliberate self-harm, and sexually inappropriate behaviour were non-significantly decreased. Findings suggest that this engagement-focused model of clinical risk management in an adult psychiatric inpatient unit significantly reduced adverse patient events and was preferred by staff over current practice. Other psychiatric inpatient facilities may see a reduction in adverse events following the introduction of this well-tolerated risk management model.
Collapse
Affiliation(s)
| | - Hayley Darke
- Psychiatry Monash Health, Monash University, Melbourne, Victoria, Australia
| | - Gary Ennis
- North Western Mental Health, Melbourne, Victoria, Australia.,Institute for Health and Social Science Research, Centre for Mental Health Nursing Innovation, Rockhampton, Queensland, Australia.,School of Nursing and Midwifery, Central Queensland University, Rockhampton, Queensland, Australia
| | - Suresh Sundram
- North Western Mental Health, Melbourne, Victoria, Australia.,Psychiatry Monash Health, Monash University, Melbourne, Victoria, Australia.,Department of Psychiatry, University of Melbourne, Melbourne, Victoria, Australia.,Department of Psychiatry, School of Clinical Sciences, Monash University, Melbourne, Victoria, Australia.,Adult Psychiatry, Monash Health, Melbourne, Victoria, Australia
| |
Collapse
|
35
|
Hoffmann C, Van Rheenen TE, Mancuso SG, Zalesky A, Bruggemann J, Lenroot RK, Sundram S, Weickert CS, Weickert TW, Pantelis C, Cropley V, Bousman CA. Exploring the moderating effects of dopaminergic polymorphisms and childhood adversity on brain morphology in schizophrenia-spectrum disorders. Psychiatry Res Neuroimaging 2018; 281:61-68. [PMID: 30253269 DOI: 10.1016/j.pscychresns.2018.09.002] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2017] [Revised: 09/11/2018] [Accepted: 09/11/2018] [Indexed: 12/18/2022]
Abstract
Genetic and environmental etiologies may contribute to schizophrenia and its associated neurobiological profile. We examined the interaction between dopaminergic polymorphisms, childhood adversity and diagnosis (schizophrenia/schizoaffective disorder) on dopamine-related brain structures. Childhood adversity histories and structural MRI data were obtained from 249 (153 schizophrenia/schizoaffective, 96 controls) participants registered in the Australian Schizophrenia Research Bank. Polymorphisms in DRD2 and COMT were genotyped and a dopaminergic risk allelic load (RAL) was calculated. Regression analysis was used to test the main and interaction effects of RAL, childhood adversity and diagnosis on volumes of dopamine-related brain structures (caudate, putamen, nucleus accumbens, dorsolateral prefrontal cortex and hippocampus). A schizophrenia/schizoaffective diagnosis showed significant main effects on bilateral hippocampus, left dorsolateral prefrontal cortex and bilateral putamen volumes. RAL showed a significant main effect on left putamen volumes. Furthermore, across the whole sample, a significant two-way interaction between dopaminergic RAL and childhood adversity was found for left putamen volumes. No brain structure volumes were predicted by a three-way interaction that included diagnosis. Our finding suggests the left putamen may be particularly sensitive to dopaminergic gene-environment interactions regardless of diagnosis. However, larger studies are needed to assess whether these interactions are more or less pronounced in those with schizophrenia/schizoaffective disorders.
Collapse
Affiliation(s)
- Cassandra Hoffmann
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, University of Melbourne and Melbourne Health, Melbourne, Australia
| | - Tamsyn E Van Rheenen
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, University of Melbourne and Melbourne Health, Melbourne, Australia; Centre for Mental Health, Faculty of Health, Arts and Design, School of Health Sciences, Swinburne University, Melbourne, Australia
| | - Serafino G Mancuso
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, University of Melbourne and Melbourne Health, Melbourne, Australia
| | - Andrew Zalesky
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, University of Melbourne and Melbourne Health, Melbourne, Australia
| | - Jason Bruggemann
- School of Psychiatry, University of New South Wales, Australia; Neuroscience Research Australia, New South Wales, Australia; Schizophrenia Research Institute, Sydney, New South Wales, Australia
| | - Rhoshel K Lenroot
- School of Psychiatry, University of New South Wales, Australia; Neuroscience Research Australia, New South Wales, Australia; Schizophrenia Research Institute, Sydney, New South Wales, Australia; Department of Psychiatry and Behavioral Sciences, University of New Mexico, Albuquerque, USA
| | - Suresh Sundram
- Florey Institute of Neuroscience and Mental Health, Australia; Department of Psychiatry, School of Clinical Sciences, Monash University, Clayton, Australia; Mental Health Program, Monash Health, Clayton, Victoria, Australia
| | - Cynthia Shannon Weickert
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, University of Melbourne and Melbourne Health, Melbourne, Australia; School of Psychiatry, University of New South Wales, Australia; Neuroscience Research Australia, New South Wales, Australia; Schizophrenia Research Institute, Sydney, New South Wales, Australia; Department of Neuroscience & Physiology, Upstate Medical University, Syracuse, New York, USA
| | - Thomas W Weickert
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, University of Melbourne and Melbourne Health, Melbourne, Australia; School of Psychiatry, University of New South Wales, Australia; Neuroscience Research Australia, New South Wales, Australia; Schizophrenia Research Institute, Sydney, New South Wales, Australia
| | - Christos Pantelis
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, University of Melbourne and Melbourne Health, Melbourne, Australia; Florey Institute of Neuroscience and Mental Health, Australia; Department of Electrical and Electronic Engineering, University of Melbourne, Victoria, Australia
| | - Vanessa Cropley
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, University of Melbourne and Melbourne Health, Melbourne, Australia; Centre for Mental Health, Faculty of Health, Arts and Design, School of Health Sciences, Swinburne University, Melbourne, Australia
| | - Chad A Bousman
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, University of Melbourne and Melbourne Health, Melbourne, Australia; Departments of Medical Genetics, Psychiatry, and Physiology & Pharmacology, University of Calgary, Calgary, AB, Canada.
| |
Collapse
|
36
|
Kong W, Li H, Qiao K, Kim Y, Lee K, Nie Y, Lee D, Osadchy T, Molnar RJ, Gaskill DK, Myers-Ward RL, Daniels KM, Zhang Y, Sundram S, Yu Y, Bae SH, Rajan S, Shao-Horn Y, Cho K, Ougazzaden A, Grossman JC, Kim J. Polarity governs atomic interaction through two-dimensional materials. Nat Mater 2018; 17:999-1004. [PMID: 30297812 DOI: 10.1038/s41563-018-0176-4] [Citation(s) in RCA: 86] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/25/2017] [Accepted: 08/28/2018] [Indexed: 05/27/2023]
Abstract
The transparency of two-dimensional (2D) materials to intermolecular interactions of crystalline materials has been an unresolved topic. Here we report that remote atomic interaction through 2D materials is governed by the binding nature, that is, the polarity of atomic bonds, both in the underlying substrates and in 2D material interlayers. Although the potential field from covalent-bonded materials is screened by a monolayer of graphene, that from ionic-bonded materials is strong enough to penetrate through a few layers of graphene. Such field penetration is substantially attenuated by 2D hexagonal boron nitride, which itself has polarization in its atomic bonds. Based on the control of transparency, modulated by the nature of materials as well as interlayer thickness, various types of single-crystalline materials across the periodic table can be epitaxially grown on 2D material-coated substrates. The epitaxial films can subsequently be released as free-standing membranes, which provides unique opportunities for the heterointegration of arbitrary single-crystalline thin films in functional applications.
Collapse
Affiliation(s)
- Wei Kong
- Department of Mechanical Engineering, Massachusetts Institute of Technology, Cambridge, MA, USA
| | - Huashan Li
- Department of Materials Science and Engineering, Massachusetts Institute of Technology, Cambridge, MA, USA
- Sino-French Institute for Nuclear Energy and Technology, Sun Yat-Sen University, Guangzhou, China
| | - Kuan Qiao
- Department of Mechanical Engineering, Massachusetts Institute of Technology, Cambridge, MA, USA
| | - Yunjo Kim
- Department of Mechanical Engineering, Massachusetts Institute of Technology, Cambridge, MA, USA
| | - Kyusang Lee
- Department of Mechanical Engineering, Massachusetts Institute of Technology, Cambridge, MA, USA
- Departments of Electrical and Computer Engineering & Materials Science and Engineering, University of Virginia, Charlottesville, VA, USA
| | - Yifan Nie
- Department of Materials Science and Engineering, The University of Texas at Dallas, Richardson, TX, USA
| | - Doyoon Lee
- Department of Mechanical Engineering, Massachusetts Institute of Technology, Cambridge, MA, USA
| | | | | | | | | | | | - Yuewei Zhang
- Department of Electrical and Computer Engineering, The Ohio State University, Columbus, OH, USA
| | - Suresh Sundram
- School of Electrical and Computer Engineering, Georgia Institute of Technology, GT-Lorraine, UMI 2958 Georgia Tech-CNRS, Metz, France
| | - Yang Yu
- Department of Materials Science and Engineering, Massachusetts Institute of Technology, Cambridge, MA, USA
| | - Sang-Hoon Bae
- Department of Mechanical Engineering, Massachusetts Institute of Technology, Cambridge, MA, USA
| | - Siddharth Rajan
- Department of Electrical and Computer Engineering, The Ohio State University, Columbus, OH, USA
| | - Yang Shao-Horn
- Department of Materials Science and Engineering, Massachusetts Institute of Technology, Cambridge, MA, USA
| | - Kyeongjae Cho
- Department of Materials Science and Engineering, The University of Texas at Dallas, Richardson, TX, USA
| | - Abdallah Ougazzaden
- School of Electrical and Computer Engineering, Georgia Institute of Technology, GT-Lorraine, UMI 2958 Georgia Tech-CNRS, Metz, France
| | - Jeffrey C Grossman
- Department of Materials Science and Engineering, Massachusetts Institute of Technology, Cambridge, MA, USA.
| | - Jeehwan Kim
- Department of Mechanical Engineering, Massachusetts Institute of Technology, Cambridge, MA, USA.
- Department of Materials Science and Engineering, Massachusetts Institute of Technology, Cambridge, MA, USA.
- Research Laboratory of Electronics, Massachusetts Institute of Technology, Cambridge, MA, USA.
| |
Collapse
|
37
|
Kelly S, Jahanshad N, Zalesky A, Kochunov P, Agartz I, Alloza C, Andreassen OA, Arango C, Banaj N, Bouix S, Bousman CA, Brouwer RM, Bruggemann J, Bustillo J, Cahn W, Calhoun V, Cannon D, Carr V, Catts S, Chen J, Chen JX, Chen X, Chiapponi C, Cho KK, Ciullo V, Corvin AS, Crespo-Facorro B, Cropley V, De Rossi P, Diaz-Caneja CM, Dickie EW, Ehrlich S, Fan FM, Faskowitz J, Fatouros-Bergman H, Flyckt L, Ford JM, Fouche JP, Fukunaga M, Gill M, Glahn DC, Gollub R, Goudzwaard ED, Guo H, Gur RE, Gur RC, Gurholt TP, Hashimoto R, Hatton SN, Henskens FA, Hibar DP, Hickie IB, Hong LE, Horacek J, Howells FM, Hulshoff Pol HE, Hyde CL, Isaev D, Jablensky A, Jansen PR, Janssen J, Jönsson EG, Jung LA, Kahn RS, Kikinis Z, Liu K, Klauser P, Knöchel C, Kubicki M, Lagopoulos J, Langen C, Lawrie S, Lenroot RK, Lim KO, Lopez-Jaramillo C, Lyall A, Magnotta V, Mandl RCW, Mathalon DH, McCarley RW, McCarthy-Jones S, McDonald C, McEwen S, McIntosh A, Melicher T, Mesholam-Gately RI, Michie PT, Mowry B, Mueller BA, Newell DT, O'Donnell P, Oertel-Knöchel V, Oestreich L, Paciga SA, Pantelis C, Pasternak O, Pearlson G, Pellicano GR, Pereira A, Pineda Zapata J, Piras F, Potkin SG, Preda A, Rasser PE, Roalf DR, Roiz R, Roos A, Rotenberg D, Satterthwaite TD, Savadjiev P, Schall U, Scott RJ, Seal ML, Seidman LJ, Shannon Weickert C, Whelan CD, Shenton ME, Kwon JS, Spalletta G, Spaniel F, Sprooten E, Stäblein M, Stein DJ, Sundram S, Tan Y, Tan S, Tang S, Temmingh HS, Westlye LT, Tønnesen S, Tordesillas-Gutierrez D, Doan NT, Vaidya J, van Haren NEM, Vargas CD, Vecchio D, Velakoulis D, Voineskos A, Voyvodic JQ, Wang Z, Wan P, Wei D, Weickert TW, Whalley H, White T, Whitford TJ, Wojcik JD, Xiang H, Xie Z, Yamamori H, Yang F, Yao N, Zhang G, Zhao J, van Erp TGM, Turner J, Thompson PM, Donohoe G. Widespread white matter microstructural differences in schizophrenia across 4322 individuals: results from the ENIGMA Schizophrenia DTI Working Group. Mol Psychiatry 2018; 23:1261-1269. [PMID: 29038599 PMCID: PMC5984078 DOI: 10.1038/mp.2017.170] [Citation(s) in RCA: 412] [Impact Index Per Article: 68.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2016] [Revised: 05/02/2017] [Accepted: 06/07/2017] [Indexed: 12/15/2022]
Abstract
The regional distribution of white matter (WM) abnormalities in schizophrenia remains poorly understood, and reported disease effects on the brain vary widely between studies. In an effort to identify commonalities across studies, we perform what we believe is the first ever large-scale coordinated study of WM microstructural differences in schizophrenia. Our analysis consisted of 2359 healthy controls and 1963 schizophrenia patients from 29 independent international studies; we harmonized the processing and statistical analyses of diffusion tensor imaging (DTI) data across sites and meta-analyzed effects across studies. Significant reductions in fractional anisotropy (FA) in schizophrenia patients were widespread, and detected in 20 of 25 regions of interest within a WM skeleton representing all major WM fasciculi. Effect sizes varied by region, peaking at (d=0.42) for the entire WM skeleton, driven more by peripheral areas as opposed to the core WM where regions of interest were defined. The anterior corona radiata (d=0.40) and corpus callosum (d=0.39), specifically its body (d=0.39) and genu (d=0.37), showed greatest effects. Significant decreases, to lesser degrees, were observed in almost all regions analyzed. Larger effect sizes were observed for FA than diffusivity measures; significantly higher mean and radial diffusivity was observed for schizophrenia patients compared with controls. No significant effects of age at onset of schizophrenia or medication dosage were detected. As the largest coordinated analysis of WM differences in a psychiatric disorder to date, the present study provides a robust profile of widespread WM abnormalities in schizophrenia patients worldwide. Interactive three-dimensional visualization of the results is available at www.enigma-viewer.org.
Collapse
Affiliation(s)
- S Kelly
- Imaging Genetics Center, Stevens Neuroimaging & Informatics Institute, Keck School of Medicine, University of Southern California, Marina del Rey, CA, USA,Harvard Medical School, Boston, MA, USA,Imaging Genetics Center, Keck School of Medicine, University of Southern California, Marina del Rey, CA 90292, USA. E-mail:
| | - N Jahanshad
- Imaging Genetics Center, Stevens Neuroimaging & Informatics Institute, Keck School of Medicine, University of Southern California, Marina del Rey, CA, USA
| | - A Zalesky
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, University of Melbourne and Melbourne Health, Carlton South, VIC, Australia
| | - P Kochunov
- Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD, USA
| | - I Agartz
- NORMENT, KG Jebsen Centre for Psychosis Research, Division of Mental Health and Addiction, Oslo University Hospital and Institute of Clinical Medicine, University of Oslo, Oslo, Norway,Department of Clinical Neuroscience, Centre for Psychiatry Research, Karolinska Institutet, Stockholm, Sweden,Department of Psychiatric Research, Diakonhjemmet Hospital, Oslo, Norway
| | - C Alloza
- University of Edinburgh, Edinburgh, UK
| | | | - C Arango
- Child and Adolescent Psychiatry Department, Hospital General Universitario Gregorio Marañón, School of Medicine, Universidad Complutense, IiSGM, CIBERSAM, Madrid, Spain
| | - N Banaj
- Laboratory of Neuropsychiatry, Department of Clinical and Behavioral Neurology, IRCCS Santa Lucia Foundation, Rome, Italy
| | - S Bouix
- Department of Psychiatry, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA
| | - C A Bousman
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, University of Melbourne and Melbourne Health, Carlton South, VIC, Australia,Florey Institute of Neuroscience and Mental Health, Parkville, VIC, Australia,Department of General Practice, The University of Melbourne, Parkville, VIC, Australia,Swinburne University of Technology, Melbourne, VIC, Australia
| | - R M Brouwer
- Department of Psychiatry, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands
| | - J Bruggemann
- Neuroscience Research Australia and School of Psychiatry, University of New South Wales, Sydney, NSW, Australia
| | - J Bustillo
- University of New Mexico, Albuquerque, NM, USA
| | - W Cahn
- Department of Psychiatry, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands
| | - V Calhoun
- The Department of Electrical and Computer Engineering, University of New Mexico, Albuquerque, NM, USA,The Mind Research Network, Albuquerque, NM, USA
| | - D Cannon
- Centre for Neuroimaging and Cognitive Genomics (NICOG), Clinical Neuroimaging Laboratory, NCBES Galway Neuroscience Centre, National University of Ireland Galway, Galway, Ireland
| | - V Carr
- Neuroscience Research Australia and School of Psychiatry, University of New South Wales, Sydney, NSW, Australia
| | - S Catts
- Discipline of Psychiatry, School of Medicine, University of Queensland, Herston, QLD, Australia
| | - J Chen
- Department of Computer Science and Engineering, The Ohio State University, Columbus, OH, USA
| | - J-x Chen
- Beijing Huilongguan Hospital, Beijing, China
| | - X Chen
- Worldwide Research and Development, Pfizer, Cambridge, MA, USA
| | | | - Kl K Cho
- Department of Psychiatry, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - V Ciullo
- Laboratory of Neuropsychiatry, Department of Clinical and Behavioral Neurology, IRCCS Santa Lucia Foundation, Rome, Italy
| | - A S Corvin
- Department of Psychiatry and Neuropsychiatric Genetics Research Group, Institute of Molecular Medicine, Trinity College Dublin, Dublin, Ireland
| | - B Crespo-Facorro
- University Hospital Marqués de Valdecilla, IDIVAL, Department of Medicine and Psychiatry, School of Medicine, University of Cantabria, Santander, Spain,CIBERSAM, Centro Investigación Biomédica en Red Salud Mental, Santander, Spain
| | - V Cropley
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, University of Melbourne and Melbourne Health, Carlton South, VIC, Australia
| | - P De Rossi
- Laboratory of Neuropsychiatry, Department of Clinical and Behavioral Neurology, IRCCS Santa Lucia Foundation, Rome, Italy,Department NESMOS, Faculty of Medicine and Psychology, University ‘Sapienza’ of Rome, Rome, Italy,Department of Neurology and Psychiatry, Sapienza University of Rome, Rome, Italy
| | - C M Diaz-Caneja
- Child and Adolescent Psychiatry Department, Hospital General Universitario Gregorio Marañón, School of Medicine, Universidad Complutense, IiSGM, CIBERSAM, Madrid, Spain
| | - E W Dickie
- Center for Addiction and Mental Health, Toronto, ON, Canada
| | - S Ehrlich
- Division of Psychological and Social Medicine and Developmental Neurosciences, Technische Universität Dresden, Faculty of Medicine, University Hospital C.G. Carus, Dresden, Germany
| | - F-m Fan
- Beijing Huilongguan Hospital, Beijing, China
| | - J Faskowitz
- Imaging Genetics Center, Stevens Neuroimaging & Informatics Institute, Keck School of Medicine, University of Southern California, Marina del Rey, CA, USA
| | - H Fatouros-Bergman
- Department of Clinical Neuroscience, Centre for Psychiatry Research, Karolinska Institutet, Stockholm, Sweden
| | - L Flyckt
- University of New South Wales, School of Psychiatry, Sydney, NSW, Australia,The University of Queensland, Queensland Brain Institute and Centre for Advanced Imaging, Brisbane, QLD, Australia
| | - J M Ford
- University of California, VAMC, San Francisco, CA, USA
| | - J-P Fouche
- Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
| | - M Fukunaga
- Division of Cerebral Integration, National Institute for Physiological Sciences, Aichi, Japan
| | - M Gill
- Department of Psychiatry and Neuropsychiatric Genetics Research Group, Institute of Molecular Medicine, Trinity College Dublin, Dublin, Ireland
| | - D C Glahn
- Olin Neuropsychiatric Research Center, Institute of Living, Hartford Hospital and Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| | - R Gollub
- Harvard Medical School, Boston, MA, USA,Departments of Psychiatry and Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - E D Goudzwaard
- Department of Psychiatry and Human Behavior, University of California Irvine, Irvine, CA, USA
| | - H Guo
- Zhumadian Psychiatry Hospital, Henan Province, China
| | - R E Gur
- Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, USA
| | - R C Gur
- Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, USA
| | - T P Gurholt
- NORMENT, KG Jebsen Centre for Psychosis Research, Division of Mental Health and Addiction, Oslo University Hospital and Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - R Hashimoto
- Molecular Research Center for Children's Mental Development, United Graduate School of Child Development, Osaka University, Osaka, Japan,Department of Psychiatry, Osaka University Graduate School of Medicine, Osaka, Japan
| | - S N Hatton
- Brain and Mind Centre, University of Sydney, Sydney, NSW, Australia
| | - F A Henskens
- School of Electrical Engineering and Computer Science, University of Newcastle, Callaghan, NSW, Australia,Health Behaviour Research Group, University of Newcastle, Callaghan, NSW, Australia,Hunter Medical Research Institute, Newcastle, NSW, Australia
| | - D P Hibar
- Imaging Genetics Center, Stevens Neuroimaging & Informatics Institute, Keck School of Medicine, University of Southern California, Marina del Rey, CA, USA
| | - I B Hickie
- Brain and Mind Centre, University of Sydney, Sydney, NSW, Australia
| | - L E Hong
- Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD, USA
| | - J Horacek
- National Institute of Mental Health, Klecany, Czech Republic,Third Faculty of Medicine, Charles University, Prague, Czech Republic
| | - F M Howells
- Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
| | - H E Hulshoff Pol
- Department of Psychiatry, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands
| | - C L Hyde
- Worldwide Research and Development, Pfizer, Cambridge, MA, USA
| | - D Isaev
- Imaging Genetics Center, Stevens Neuroimaging & Informatics Institute, Keck School of Medicine, University of Southern California, Marina del Rey, CA, USA
| | - A Jablensky
- University of Western Australia, Perth, WA, Australia
| | - P R Jansen
- Erasmus University Medical Center, Rotterdam, The Netherlands
| | - J Janssen
- Child and Adolescent Psychiatry Department, Hospital General Universitario Gregorio Marañón, School of Medicine, Universidad Complutense, IiSGM, CIBERSAM, Madrid, Spain,Department of Psychiatry, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands
| | - E G Jönsson
- NORMENT, KG Jebsen Centre for Psychosis Research, Division of Mental Health and Addiction, Oslo University Hospital and Institute of Clinical Medicine, University of Oslo, Oslo, Norway,Department of Clinical Neuroscience, Centre for Psychiatry Research, Karolinska Institutet, Stockholm, Sweden
| | - L A Jung
- Laboratory for Neuroimaging, Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, Goethe University, Frankfurt/Main, Germany
| | - R S Kahn
- Department of Psychiatry, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Z Kikinis
- Department of Psychiatry, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA
| | - K Liu
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, University of Melbourne and Melbourne Health, Carlton South, VIC, Australia
| | - P Klauser
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, University of Melbourne and Melbourne Health, Carlton South, VIC, Australia,Brain and Mental Health Laboratory, Monash Institute of Cognitive and Clinical Neurosciences, School of Psychological Sciences and Monash Biomedical Imaging, Monash University, Clayton, VIC, Australia,Department of Psychiatry, Lausanne University Hospital (CHUV), University of Lausanne, Lausanne, Switzerland
| | - C Knöchel
- Laboratory for Neuroimaging, Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, Goethe University, Frankfurt/Main, Germany
| | - M Kubicki
- Departments of Psychiatry and Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - J Lagopoulos
- Sunshine Coast Mind and Neuroscience Institute, University of the Sunshine Coast QLD, Australia, Brain and Mind Centre, University of Sydney, Sydney, NSW, Australia
| | - C Langen
- Erasmus University Medical Center, Rotterdam, The Netherlands
| | - S Lawrie
- University of Edinburgh, Edinburgh, UK
| | - R K Lenroot
- Neuroscience Research Australia and School of Psychiatry, University of New South Wales, Sydney, NSW, Australia
| | - K O Lim
- Department of Psychiatry, University of Minnesota, Minneapolis, MN, USA
| | - C Lopez-Jaramillo
- Research Group in Psychiatry (GIPSI), Department of Psychiatry, Faculty of Medicine, Universidad de Antioquia, Mood Disorder Program, Hospital Universitario San Vicente Fundación, Medellín, Colombia
| | - A Lyall
- Department of Psychiatry, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA,Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | | | - R C W Mandl
- Department of Psychiatry, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands
| | - D H Mathalon
- University of California, VAMC, San Francisco, CA, USA
| | | | - S McCarthy-Jones
- Department of Psychiatry, Trinity College Dublin, Dublin, Ireland
| | - C McDonald
- Centre for Neuroimaging and Cognitive Genomics (NICOG), Clinical Neuroimaging Laboratory, NCBES Galway Neuroscience Centre, National University of Ireland Galway, Galway, Ireland
| | - S McEwen
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, CA, USA
| | | | - T Melicher
- Third Faculty of Medicine, Charles University, Prague, Czech Republic,The University of Texas Health Science Center at Houston, Houston, TX, USA
| | - R I Mesholam-Gately
- Harvard Medical School and Massachusetts Mental Health Center Public Psychiatry Division of the Beth Israel Deaconess, Medical Center, Boston, MA, USA
| | - P T Michie
- Hunter Medical Research Institute, Newcastle, NSW, Australia,The University of Newcastle, Newcastle, NSW, Australia,Schizophrenia Research Institute, Sydney, NSW, Australia
| | - B Mowry
- Queensland Brain Institute, The University of Queensland, Brisbane, QLD, Australia and Queensland Centre for Mental Health Research, Brisbane and Queensland Centre for Mental Health Research, Brisbane, QLD, Australia
| | - B A Mueller
- Department of Psychiatry, University of Minnesota, Minneapolis, MN, USA
| | - D T Newell
- Department of Psychiatry, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA
| | - P O'Donnell
- Worldwide Research and Development, Pfizer, Cambridge, MA, USA
| | - V Oertel-Knöchel
- Laboratory for Neuroimaging, Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, Goethe University, Frankfurt/Main, Germany
| | - L Oestreich
- Queensland Brain Institute, The University of Queensland, Brisbane, QLD, Australia and Queensland Centre for Mental Health Research, Brisbane and Queensland Centre for Mental Health Research, Brisbane, QLD, Australia
| | - S A Paciga
- Worldwide Research and Development, Pfizer, Cambridge, MA, USA
| | - C Pantelis
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, University of Melbourne and Melbourne Health, Carlton South, VIC, Australia,Florey Institute of Neuroscience and Mental Health, Parkville, VIC, Australia,Schizophrenia Research Institute, Sydney, NSW, Australia,Centre for Neural Engineering (CfNE), Department of Electrical and Electronic Engineering, University of Melbourne, Parkville, VIC, Australia
| | - O Pasternak
- Departments of Psychiatry and Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - G Pearlson
- Olin Neuropsychiatric Research Center, Institute of Living, Hartford Hospital and Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| | - G R Pellicano
- Laboratory of Neuropsychiatry, Department of Clinical and Behavioral Neurology, IRCCS Santa Lucia Foundation, Rome, Italy
| | - A Pereira
- The Florey Institute of Neuroscience and Mental Health, University of Melbourne, Melbourne, VIC, Australia
| | | | - F Piras
- Laboratory of Neuropsychiatry, Department of Clinical and Behavioral Neurology, IRCCS Santa Lucia Foundation, Rome, Italy,School of Biomedical Sciences, Faculty of Health, the University of Newcastle, Callaghan, NSW, Australia
| | - S G Potkin
- Department of Psychiatry and Human Behavior, University of California Irvine, Irvine, CA, USA
| | - A Preda
- Department of Psychiatry and Human Behavior, University of California Irvine, Irvine, CA, USA
| | - P E Rasser
- Hunter Medical Research Institute, Newcastle, NSW, Australia,Priority Centre for Brain and Mental Health Research, The University of Newcastle, Newcastle, NSW, Australia
| | - D R Roalf
- Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, USA
| | - R Roiz
- University Hospital Marqués de Valdecilla, IDIVAL, Department of Medicine and Psychiatry, School of Medicine, University of Cantabria, Santander, Spain,CIBERSAM, Centro Investigación Biomédica en Red Salud Mental, Santander, Spain
| | - A Roos
- SU/UCT MRC Unit on Anxiety and Stress Disorders, Department of Psychiatry, Stellenbosch University, Stellenbosch, South Africa
| | - D Rotenberg
- Center for Addiction and Mental Health, Toronto, ON, Canada
| | - T D Satterthwaite
- Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, USA
| | - P Savadjiev
- Departments of Psychiatry and Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - U Schall
- Hunter Medical Research Institute, Newcastle, NSW, Australia,Priority Centre for Brain and Mental Health Research, The University of Newcastle, Newcastle, NSW, Australia
| | - R J Scott
- Hunter Medical Research Institute, Newcastle, NSW, Australia,School of Biomedical Sciences, Faculty of Health, the University of Newcastle, Callaghan, NSW, Australia
| | - M L Seal
- Murdoch Childrens Research Institute, The Royal Children’s Hospital, Parkville, VIC, Australia
| | - L J Seidman
- Harvard Medical School, Boston, MA, USA,Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA,Harvard Medical School and Massachusetts Mental Health Center Public Psychiatry Division of the Beth Israel Deaconess, Medical Center, Boston, MA, USA
| | - C Shannon Weickert
- Schizophrenia Research Institute, Sydney, NSW, Australia,Neuroscience Research Australia, Sydney, NSW, Australia,School of Psychiatry, University of New South Wales, Sydney, NSW, Australia
| | - C D Whelan
- Imaging Genetics Center, Stevens Neuroimaging & Informatics Institute, Keck School of Medicine, University of Southern California, Marina del Rey, CA, USA
| | - M E Shenton
- Departments of Psychiatry and Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA,VA Boston Healthcare System, Boston, MA, USA
| | - J S Kwon
- Department of Psychiatry, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - G Spalletta
- Laboratory of Neuropsychiatry, Department of Clinical and Behavioral Neurology, IRCCS Santa Lucia Foundation, Rome, Italy,Division of Neuropsychiatry, Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA
| | - F Spaniel
- National Institute of Mental Health, Klecany, Czech Republic,Third Faculty of Medicine, Charles University, Prague, Czech Republic
| | - E Sprooten
- Olin Neuropsychiatric Research Center, Institute of Living, Hartford Hospital and Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| | - M Stäblein
- Laboratory for Neuroimaging, Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, Goethe University, Frankfurt/Main, Germany
| | - D J Stein
- Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa,Department of Psychiatry and MRC Unit on Anxiety and Stress Disorders, University of Cape Town, Cape Town, South Africa
| | - S Sundram
- Florey Institute of Neuroscience and Mental Health, Parkville, VIC, Australia,Department of Psychiatry, School of Clinical Sciences, Monash University and Monash Health, Clayton, VIC, Australia
| | - Y Tan
- Beijing Huilongguan Hospital, Beijing, China
| | - S Tan
- Beijing Huilongguan Hospital, Beijing, China
| | - S Tang
- Chongqing Three Gorges Central Hospital, Chongqing, China
| | - H S Temmingh
- Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
| | - L T Westlye
- NORMENT, KG Jebsen Centre for Psychosis Research, Division of Mental Health and Addiction, Oslo University Hospital and Institute of Clinical Medicine, University of Oslo, Oslo, Norway,Department of Psychology, University of Oslo, Oslo, Norway
| | - S Tønnesen
- NORMENT, KG Jebsen Centre for Psychosis Research, Division of Mental Health and Addiction, Oslo University Hospital and Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - D Tordesillas-Gutierrez
- CIBERSAM, Centro Investigación Biomédica en Red Salud Mental, Santander, Spain,Neuroimaging Unit, Technological Facilities, Valdecilla Biomedical Research Institute IDIVAL, Santander, Spain
| | - N T Doan
- NORMENT, KG Jebsen Centre for Psychosis Research, Division of Mental Health and Addiction, Oslo University Hospital and Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - J Vaidya
- Department of Psychiatry, University of Iowa, Iowa City, IA, USA
| | - N E M van Haren
- Department of Psychiatry, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands
| | - C D Vargas
- Research Group in Psychiatry (GIPSI), Department of Psychiatry, Faculty of Medicine, Universidad de Antioquia, Medellín, Colombia
| | - D Vecchio
- Laboratory of Neuropsychiatry, Department of Clinical and Behavioral Neurology, IRCCS Santa Lucia Foundation, Rome, Italy
| | - D Velakoulis
- Neuropsychiatry Unit, Royal Melbourne Hospital, Parkville, VIC, Australia
| | - A Voineskos
- Kimel Family Translational Imaging-Genetics Research Laboratory, Campbell Family Mental Health Research Institute, CAMH Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - J Q Voyvodic
- Department of Psychiatry, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Z Wang
- Beijing Huilongguan Hospital, Beijing, China
| | - P Wan
- Zhumadian Psychiatry Hospital, Henan Province, China
| | - D Wei
- Luoyang Fifth People's Hospital, Henan Province, China
| | - T W Weickert
- Schizophrenia Research Institute, Sydney, NSW, Australia,Neuroscience Research Australia, Sydney, NSW, Australia,School of Psychiatry, University of New South Wales, Sydney, NSW, Australia
| | - H Whalley
- University of Edinburgh, Edinburgh, UK
| | - T White
- Erasmus University Medical Center, Rotterdam, The Netherlands
| | - T J Whitford
- University of New South Wales, School of Psychiatry, Sydney, NSW, Australia
| | - J D Wojcik
- Harvard Medical School and Massachusetts Mental Health Center Public Psychiatry Division of the Beth Israel Deaconess, Medical Center, Boston, MA, USA
| | - H Xiang
- Chongqing Three Gorges Central Hospital, Chongqing, China
| | - Z Xie
- Worldwide Research and Development, Pfizer, Cambridge, MA, USA
| | - H Yamamori
- Department of Psychiatry, Osaka University Graduate School of Medicine, Osaka, Japan
| | - F Yang
- Beijing Huilongguan Hospital, Beijing, China
| | - N Yao
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| | - G Zhang
- Department of Computer Science and Electrical Engineering, University of Maryland, Baltimore, MD, USA
| | - J Zhao
- Centre for Neuroimaging and Cognitive Genomics (NICOG), Clinical Neuroimaging Laboratory, NCBES Galway Neuroscience Centre, National University of Ireland Galway, Galway, Ireland,School of Psychology, Shaanxi Normal University and Key Laboratory for Behavior and Cognitive Neuroscience of Shaanxi Province, Xi’an, Shaanxi, China
| | - T G M van Erp
- Department of Psychiatry and Human Behavior, University of California Irvine, Irvine, CA, USA
| | - J Turner
- Psychology Department & Neuroscience Institute, Georgia State University, Atlanta, GA, USA
| | - P M Thompson
- Imaging Genetics Center, Stevens Neuroimaging & Informatics Institute, Keck School of Medicine, University of Southern California, Marina del Rey, CA, USA
| | - G Donohoe
- Centre for Neuroimaging and Cognitive Genomics (NICOG), Clinical Neuroimaging Laboratory, NCBES Galway Neuroscience Centre, National University of Ireland Galway, Galway, Ireland
| |
Collapse
|
38
|
Van Rheenen TE, Cropley V, Zalesky A, Bousman C, Wells R, Bruggemann J, Sundram S, Weinberg D, Lenroot RK, Pereira A, Shannon Weickert C, Weickert TW, Pantelis C. Widespread Volumetric Reductions in Schizophrenia and Schizoaffective Patients Displaying Compromised Cognitive Abilities. Schizophr Bull 2018; 44:560-574. [PMID: 28981831 PMCID: PMC5890481 DOI: 10.1093/schbul/sbx109] [Citation(s) in RCA: 41] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
OBJECTIVE Progress toward understanding brain mechanisms in psychosis is hampered by failures to account for within-group heterogeneity that exists across neuropsychological domains. We recently identified distinct cognitive subgroups that might assist in identifying more biologically meaningful subtypes of psychosis. In the present study, we examined whether underlying structural brain abnormalities differentiate these cognitively derived subgroups. METHOD 1.5T T1 weighted structural scans were acquired for 168 healthy controls and 220 patients with schizophrenia/schizoaffective disorder. Based on previous work, 47 patients were categorized as being cognitively compromised (impaired premorbid and current IQ), 100 as cognitively deteriorated (normal premorbid IQ, impaired current IQ), and 73 as putatively cognitively preserved (premorbid and current IQ within 1 SD of controls). Global, subcortical and cortical volume, thickness, and surface area measures were compared among groups. RESULTS Whole cortex, subcortical, and regional volume and thickness reductions were evident in all subgroups compared to controls, with the largest effect sizes in the compromised group. This subgroup also showed abnormalities in regions not seen in the other patient groups, including smaller left superior and middle frontal areas, left anterior and inferior temporal areas and right lateral medial and inferior frontal, occipital lobe and superior temporal areas. CONCLUSIONS This pattern of more prominent brain structural abnormalities in the group with the most marked cognitive impairments-both currently and putatively prior to illness onset, is consistent with the concept of schizophrenia as a progressive neurodevelopmental disorder. In this group, neurodevelopmental and neurodegenerative factors may be important for cognitive function.
Collapse
Affiliation(s)
- Tamsyn E Van Rheenen
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, University of Melbourne and Melbourne Health, Melbourne, Australia,Centre for Mental Health, Faculty of Health, Arts and Design, School of Health Sciences, Swinburne University, Melbourne, Australia,Cognitive Neuropsychiatry Laboratory, Monash Alfred Psychiatry Research Centre (MAPrc), The Alfred Hospital and Central Clinical School, Monash University, Melbourne, Australia,To whom correspondence should be addressed; Melbourne Neuropsychiatry Centre, Level 3, Alan Gilbert Building, 161 Barry Street, Carlton, VIC 3053, Australia; tel: +61-03-9035 8628, e-mail:
| | - Vanessa Cropley
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, University of Melbourne and Melbourne Health, Melbourne, Australia,Centre for Mental Health, Faculty of Health, Arts and Design, School of Health Sciences, Swinburne University, Melbourne, Australia
| | - Andrew Zalesky
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, University of Melbourne and Melbourne Health, Melbourne, Australia,Department of Electrical and Electronic Engineering, University of Melbourne, Parkville, Australia
| | - Chad Bousman
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, University of Melbourne and Melbourne Health, Melbourne, Australia
| | - Ruth Wells
- School of Psychiatry, University of New South Wales, Sydney, Australia,Neuroscience Research Australia, Sydney, Australia
| | - Jason Bruggemann
- School of Psychiatry, University of New South Wales, Sydney, Australia,Neuroscience Research Australia, Sydney, Australia
| | - Suresh Sundram
- Florey Institute of Neuroscience and Mental Health, Parkville, Australia,Mental Health Program, Monash Health, Clayton, Australia,Department of Psychiatry, School of Clinical Sciences, Monash University, Clayton, Australia
| | - Danielle Weinberg
- School of Psychiatry, University of New South Wales, Sydney, Australia,Neuroscience Research Australia, Sydney, Australia
| | - Roshel K Lenroot
- School of Psychiatry, University of New South Wales, Sydney, Australia,Neuroscience Research Australia, Sydney, Australia,Schizophrenia Research Institute, Sydney, Australia
| | - Avril Pereira
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, University of Melbourne and Melbourne Health, Melbourne, Australia,Florey Institute of Neuroscience and Mental Health, Parkville, Australia
| | - Cynthia Shannon Weickert
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, University of Melbourne and Melbourne Health, Melbourne, Australia,School of Psychiatry, University of New South Wales, Sydney, Australia,Neuroscience Research Australia, Sydney, Australia,Schizophrenia Research Institute, Sydney, Australia
| | - Thomas W Weickert
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, University of Melbourne and Melbourne Health, Melbourne, Australia,School of Psychiatry, University of New South Wales, Sydney, Australia,Neuroscience Research Australia, Sydney, Australia,Schizophrenia Research Institute, Sydney, Australia
| | - Christos Pantelis
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, University of Melbourne and Melbourne Health, Melbourne, Australia,Department of Electrical and Electronic Engineering, University of Melbourne, Parkville, Australia,Florey Institute of Neuroscience and Mental Health, Parkville, Australia
| |
Collapse
|
39
|
Bousman CA, Cropley V, Klauser P, Hess JL, Pereira A, Idrizi R, Bruggemann J, Mostaid MS, Lenroot R, Weickert TW, Glatt SJ, Everall IP, Sundram S, Zalesky A, Weickert CS, Pantelis C. Neuregulin-1 (NRG1) polymorphisms linked with psychosis transition are associated with enlarged lateral ventricles and white matter disruption in schizophrenia. Psychol Med 2018; 48:801-809. [PMID: 28826413 DOI: 10.1017/s0033291717002173] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
BACKGROUND Two single-nucleotide polymorphisms (SNPs) (rs4281084 and rs12155594) within the neuregulin-1 (NRG1) gene have been associated with psychosis transition. However, the neurobiological changes associated with these SNPs remain unclear. We aimed to determine what relationship these two SNPs have on lateral ventricular volume and white matter integrity, as abnormalities in these brain structures are some of the most consistent in schizophrenia. METHODS Structural (n = 370) and diffusion (n = 465) magnetic resonance imaging data were obtained from affected and unaffected individuals predominantly of European descent. The SNPs rs4281084, rs12155594, and their combined allelic load were examined for their effects on lateral ventricular volume, fractional anisotropy (FA) as well as axial (AD) and radial (RD) diffusivity. Additional exploratory analyses assessed NRG1 effects on gray matter volume, cortical thickness, and surface area throughout the brain. RESULTS Individuals with a schizophrenia age of onset ⩽25 and a combined allelic load ⩾3 NRG1 risk alleles had significantly larger right (up to 50%, p adj = 0.01) and left (up to 45%, p adj = 0.05) lateral ventricle volumes compared with those with allelic loads of less than three. Furthermore, carriers of three or more risk alleles, regardless of age of onset and case status, had significantly reduced FA and elevated RD but stable AD in the frontal cortex compared with those carrying fewer than three risk alleles. CONCLUSIONS Our findings build on a growing body of research supporting the functional importance of genetic variation within the NRG1 gene and complement previous findings implicating the rs4281084 and rs12155594 SNPs as markers for psychosis transition.
Collapse
Affiliation(s)
- C A Bousman
- Department of Psychiatry,Melbourne Neuropsychiatry Centre, The University of Melbourne and Melbourne Health,Carlton South, VIC,Australia
| | - V Cropley
- Department of Psychiatry,Melbourne Neuropsychiatry Centre, The University of Melbourne and Melbourne Health,Carlton South, VIC,Australia
| | - P Klauser
- Department of Psychiatry,Melbourne Neuropsychiatry Centre, The University of Melbourne and Melbourne Health,Carlton South, VIC,Australia
| | - J L Hess
- Psychiatric Genetic Epidemiology & Neurobiology Laboratory (PsychGENe Lab), Departments of Psychiatry and Behavioral Sciences and Neuroscience and Physiology,SUNY Upstate Medical University,Syracuse, New York
| | - A Pereira
- Florey Institute of Neuroscience and Mental Health, The University of Melbourne,Parkville, VIC,Australia
| | - R Idrizi
- Florey Institute of Neuroscience and Mental Health, The University of Melbourne,Parkville, VIC,Australia
| | - J Bruggemann
- Schizophrenia Research Institute,Sydney,Australia
| | - M S Mostaid
- Department of Psychiatry,Melbourne Neuropsychiatry Centre, The University of Melbourne and Melbourne Health,Carlton South, VIC,Australia
| | - R Lenroot
- Schizophrenia Research Institute,Sydney,Australia
| | - T W Weickert
- Schizophrenia Research Institute,Sydney,Australia
| | - S J Glatt
- Psychiatric Genetic Epidemiology & Neurobiology Laboratory (PsychGENe Lab), Departments of Psychiatry and Behavioral Sciences and Neuroscience and Physiology,SUNY Upstate Medical University,Syracuse, New York
| | - I P Everall
- Department of Psychiatry,Melbourne Neuropsychiatry Centre, The University of Melbourne and Melbourne Health,Carlton South, VIC,Australia
| | - S Sundram
- Florey Institute of Neuroscience and Mental Health, The University of Melbourne,Parkville, VIC,Australia
| | - A Zalesky
- Department of Psychiatry,Melbourne Neuropsychiatry Centre, The University of Melbourne and Melbourne Health,Carlton South, VIC,Australia
| | - C S Weickert
- Schizophrenia Research Institute,Sydney,Australia
| | - C Pantelis
- Department of Psychiatry,Melbourne Neuropsychiatry Centre, The University of Melbourne and Melbourne Health,Carlton South, VIC,Australia
| |
Collapse
|
40
|
Hocking DC, Mancuso SG, Sundram S. Development and validation of a mental health screening tool for asylum-seekers and refugees: the STAR-MH. BMC Psychiatry 2018; 18:69. [PMID: 29548315 PMCID: PMC5857116 DOI: 10.1186/s12888-018-1660-8] [Citation(s) in RCA: 46] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2018] [Accepted: 03/12/2018] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND There is no screening tool for major depressive disorder (MDD) or post-traumatic stress disorder (PTSD) in asylum-seekers or refugees (ASR) that can be readily administered by non-mental health workers. Hence, we aimed to develop a brief, sensitive and rapidly administrable tool for non-mental health workers to screen for MDD and PTSD in ASR. METHODS The screening tool was developed from an extant dataset (n = 121) of multiply screened ASR and tested prospectively (N = 192) against the M.I.N.I. (Mini International Neuropsychiatric Interview) structured psychiatric interview. Rasch, Differential Item Functioning and ROC analyses evaluated the psychometric properties and tool utility. RESULTS A 9-item tool with a median administration time of six minutes was generated, comprising two 'immediate screen-in' items, and a 7-item scale. The prevalence of PTSD &/or MDD using the M.I.N.I. was 32%, whilst 99% of other diagnosed mental disorders were comorbid with one or both of these. Using a cut-score of ≥2, the tool provided a sensitivity of 0.93, specificity of 0.75 and predictive accuracy of 80.7%. CONCLUSIONS A brief sensitive screening tool with robust psychometric properties that was easy to administer at the agency of first presentation was developed to facilitate mental health referrals for asylum-seekers and new refugees.
Collapse
Affiliation(s)
- Debbie C. Hocking
- Cabrini Institute, 154 Wattletree Road, Malvern, VIC 3144 Australia ,0000 0004 0606 5526grid.418025.aFlorey Institute of Neuroscience and Mental Health, 30 Royal Parade (Cnr Genetics Lane), Parkville, VIC 3052 Australia ,0000 0004 1936 7857grid.1002.3Department of Psychiatry, School of Clinical Sciences, Monash University, Clayton, VIC 3168 Australia
| | - Serafino G. Mancuso
- 0000 0001 2179 088Xgrid.1008.9Department of Psychiatry, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Parkville, VIC 3010 Australia
| | - Suresh Sundram
- 0000 0004 0606 5526grid.418025.aFlorey Institute of Neuroscience and Mental Health, 30 Royal Parade (Cnr Genetics Lane), Parkville, VIC 3052 Australia ,0000 0001 2179 088Xgrid.1008.9Department of Psychiatry, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Parkville, VIC 3010 Australia ,0000 0004 1936 7857grid.1002.3Department of Psychiatry, School of Clinical Sciences, Monash University, Clayton, VIC 3168 Australia ,0000 0004 0390 1496grid.416060.5Adult Psychiatry, Monash Medical Centre, Clayton, VIC 3168 Australia
| |
Collapse
|
41
|
Mostaid MS, Lee TT, Chana G, Sundram S, Shannon Weickert C, Pantelis C, Everall I, Bousman C. Elevated peripheral expression of neuregulin-1 (NRG1) mRNA isoforms in clozapine-treated schizophrenia patients. Transl Psychiatry 2017; 7:1280. [PMID: 29225331 PMCID: PMC5802529 DOI: 10.1038/s41398-017-0041-2] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2017] [Revised: 07/13/2017] [Accepted: 09/23/2017] [Indexed: 12/18/2022] Open
Abstract
Differential expression of neuregulin-1 (NRG1) mRNA isoforms and proteins has been reported in schizophrenia, primarily in post-mortem brain tissue. In this study, we examined 12 NRG1 SNPs, eight NRG1 mRNA isoforms (type I, type I(Ig2), type II, type III, type IV, EGFα, EGFβ, pan-NRG1) in whole blood, and NRG1-β1 protein in serum of clozapine-treated schizophrenia patients (N = 71) and healthy controls (N = 57). In addition, using cultured peripheral blood mononuclear cells (PBMC) from 15 healthy individuals, we examined the effect of clozapine on NRG1 mRNA isoform and protein expression. We found elevated levels of NRG1 mRNA, specifically the EGFα (P = 0.0175), EGFβ (P = 0.002) and type I(Ig2) (P = 0.023) containing transcripts, but lower NRG1-β1 serum protein levels (P = 0.019) in schizophrenia patients compared to healthy controls. However, adjusting for smoking status attenuated the difference in NRG1-β1 serum levels (P = 0.050). Examination of clinical factors showed NRG1 EGFα (P = 0.02) and EGFβ (P = 0.02) isoform expression was negatively correlated with age of onset. However, we found limited evidence that NRG1 mRNA isoform or protein expression was associated with current chlorpromazine equivalent dose or clozapine plasma levels, the latter corroborated by our PBMC clozapine exposure experiment. Our SNP analysis found no robust expression quantitative trait loci. Our results represent the first comprehensive investigation of NRG1 isoforms and protein expression in the blood of clozapine-treated schizophrenia patients and suggest levels of some NRG1 transcripts are upregulated in those with schizophrenia.
Collapse
Affiliation(s)
- Md Shaki Mostaid
- 0000 0004 0452 651Xgrid.429299.dMelbourne Neuropsychiatry Center, Department of Psychiatry, The University of Melbourne & Melbourne Health, Parkville, VIC Australia ,The Cooperative Research Center (CRC) for Mental Health, Carlton, VIC Australia
| | - Ting Ting Lee
- 0000 0001 2179 088Xgrid.1008.9Center for Neural Engineering, Department of Electrical and Electronic Engineering, The University of Melbourne, Carlton, VIC Australia
| | - Gursharan Chana
- 0000 0001 2179 088Xgrid.1008.9Center for Neural Engineering, Department of Electrical and Electronic Engineering, The University of Melbourne, Carlton, VIC Australia ,Florey Institute of Neuroscience and Mental Health, The University of Melbourne, Parkville, VIC Australia ,0000 0004 0624 1200grid.416153.4Department of Medicine, Royal Melbourne Hospital, Parkville, VIC Australia
| | - Suresh Sundram
- Florey Institute of Neuroscience and Mental Health, The University of Melbourne, Parkville, VIC Australia ,NorthWestern Mental Health, Melbourne, VIC Australia ,0000 0000 9295 3933grid.419789.aDepartment of Psychiatry, School of Clinical Sciences, Monash University and Monash Health, Clayton, VIC Australia
| | - Cynthia Shannon Weickert
- 0000 0000 8696 2171grid.419558.4Schizophrenia Research Institute, Sydney, NSW Australia ,0000 0000 8900 8842grid.250407.4Schizophrenia Research Laboratory, Neuroscience Research Australia, Baker Street, Sydney, NSW Australia ,0000 0004 4902 0432grid.1005.4School of Psychiatry, Faculty of Medicine, University of New South Wales, Sydney, NSW Australia
| | - Christos Pantelis
- 0000 0004 0452 651Xgrid.429299.dMelbourne Neuropsychiatry Center, Department of Psychiatry, The University of Melbourne & Melbourne Health, Parkville, VIC Australia ,The Cooperative Research Center (CRC) for Mental Health, Carlton, VIC Australia ,0000 0001 2179 088Xgrid.1008.9Center for Neural Engineering, Department of Electrical and Electronic Engineering, The University of Melbourne, Carlton, VIC Australia ,Florey Institute of Neuroscience and Mental Health, The University of Melbourne, Parkville, VIC Australia ,NorthWestern Mental Health, Melbourne, VIC Australia
| | - Ian Everall
- 0000 0004 0452 651Xgrid.429299.dMelbourne Neuropsychiatry Center, Department of Psychiatry, The University of Melbourne & Melbourne Health, Parkville, VIC Australia ,The Cooperative Research Center (CRC) for Mental Health, Carlton, VIC Australia ,0000 0001 2179 088Xgrid.1008.9Center for Neural Engineering, Department of Electrical and Electronic Engineering, The University of Melbourne, Carlton, VIC Australia ,Florey Institute of Neuroscience and Mental Health, The University of Melbourne, Parkville, VIC Australia ,NorthWestern Mental Health, Melbourne, VIC Australia ,0000 0000 8696 2171grid.419558.4Schizophrenia Research Institute, Sydney, NSW Australia
| | - Chad Bousman
- Melbourne Neuropsychiatry Center, Department of Psychiatry, The University of Melbourne & Melbourne Health, Parkville, VIC, Australia. .,The Cooperative Research Center (CRC) for Mental Health, Carlton, VIC, Australia. .,Florey Institute of Neuroscience and Mental Health, The University of Melbourne, Parkville, VIC, Australia. .,Departments of Medical Genetics, Psychiatry, and Physiology & Pharmacology, University of Calgary, Calgary, AB, Canada.
| |
Collapse
|
42
|
Affiliation(s)
- Suresh Sundram
- Monash Medical Centre, Department of Psychiatry, School of Clinical Sciences, Monash University, Melbourne, Clayton, VIC 3168, Australia.
| | - Peter Ventevogel
- Public Health Section, Division of Programme Management and Support, United Nations High Commissioner for Refugees, Geneva, Switzerland
| |
Collapse
|
43
|
Carter O, Bennett D, Nash T, Arnold S, Brown L, Cai RY, Allan Z, Dluzniak A, McAnally K, Burr D, Sundram S. Sensory integration deficits support a dimensional view of psychosis and are not limited to schizophrenia. Transl Psychiatry 2017; 7:e1118. [PMID: 28485725 PMCID: PMC5534945 DOI: 10.1038/tp.2017.69] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2016] [Revised: 01/26/2017] [Accepted: 02/23/2017] [Indexed: 12/16/2022] Open
Abstract
Visual dysfunction is commonplace in schizophrenia and occurs alongside cognitive, psychotic and affective symptoms of the disorder. Psychophysical evidence suggests that this dysfunction results from impairments in the integration of low-level neural signals into complex cortical representations, which may also be associated with symptom formation. Despite the symptoms of schizophrenia occurring in a range of disorders, the integration deficit has not been tested in broader patient populations. Moreover, it remains unclear whether such deficits generalize across other sensory modalities. The present study assessed patients with a range of psychotic and nonpsychotic disorders and healthy controls on visual contrast detection, visual motion integration, auditory tone detection and auditory tone integration. The sample comprised a total of 249 participants (schizophrenia spectrum disorder n=98; bipolar affective disorder n=35; major depression n=31; other psychiatric conditions n=31; and healthy controls n=54), of whom 178 completed one or more visual task and 71 completed auditory tasks. Compared with healthy controls and nonpsychotic patients, psychotic patients trans-diagnostically were impaired on both visual and auditory integration, but unimpaired in simple visual or auditory detection. Impairment in visual motion integration was correlated with the severity of positive symptoms, and could not be accounted for by a reduction in processing speed, inattention or medication effects. Our results demonstrate that impaired sensory integration is not specific to schizophrenia, as has previously been assumed. Instead, sensory deficits are closely related to the presence of positive symptoms independent of diagnosis. The finding that equivalent integrative sensory processing is impaired in audition is consistent with hypotheses that propose a generalized deficit of neural integration in psychotic disorders.
Collapse
Affiliation(s)
- O Carter
- Melbourne School of Psychological Sciences, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Parkville, VIC, Australia,Melbourne School of Psychological Sciences, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Parkville, VIC 3010, Australia. E-mail:
| | - D Bennett
- Melbourne School of Psychological Sciences, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Parkville, VIC, Australia
| | - T Nash
- Melbourne School of Psychological Sciences, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Parkville, VIC, Australia
| | - S Arnold
- Melbourne School of Psychological Sciences, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Parkville, VIC, Australia
| | - L Brown
- Melbourne School of Psychological Sciences, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Parkville, VIC, Australia
| | - R Y Cai
- Melbourne School of Psychological Sciences, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Parkville, VIC, Australia
| | - Z Allan
- Department of Psychiatry, University of Melbourne, Parkville, VIC, Australia
| | - A Dluzniak
- Melbourne School of Psychological Sciences, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Parkville, VIC, Australia
| | - K McAnally
- Melbourne School of Psychological Sciences, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Parkville, VIC, Australia
| | - D Burr
- Department of Psychology, University of Florence, Florence, Italy
| | - S Sundram
- Department of Psychiatry, University of Melbourne, Parkville, VIC, Australia,The Florey Institute of Neuroscience and Mental Health, Parkville, VIC, Australia,Northern Psychiatry Research Centre, North Western Mental Health, Parkville, VIC, Australia,Department of Psychiatry, School of Clinical Sciences, Monash University and Monash Health, Clayton, VIC, Australia
| |
Collapse
|
44
|
Cropley VL, Klauser P, Lenroot RK, Bruggemann J, Sundram S, Bousman C, Pereira A, Di Biase MA, Weickert TW, Weickert CS, Pantelis C, Zalesky A. Accelerated Gray and White Matter Deterioration With Age in Schizophrenia. Am J Psychiatry 2017; 174:286-295. [PMID: 27919183 DOI: 10.1176/appi.ajp.2016.16050610] [Citation(s) in RCA: 123] [Impact Index Per Article: 17.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE Although brain changes in schizophrenia have been proposed to mirror those found with advancing age, the trajectory of gray matter and white matter changes during the disease course remains unclear. The authors sought to measure whether these changes in individuals with schizophrenia remain stable, are accelerated, or are diminished with age. METHOD Gray matter volume and fractional anisotropy were mapped in 326 individuals diagnosed with schizophrenia or schizoaffective disorder and in 197 healthy comparison subjects aged 20-65 years. Polynomial regression was used to model the influence of age on gray matter volume and fractional anisotropy at a whole-brain and voxel level. Between-group differences in gray matter volume and fractional anisotropy were regionally localized across the lifespan using permutation testing and cluster-based inference. RESULTS Significant loss of gray matter volume was evident in schizophrenia, progressively worsening with age to a maximal loss of 8% in the seventh decade of life. The inferred rate of gray matter volume loss was significantly accelerated in schizophrenia up to middle age and plateaued thereafter. In contrast, significant reductions in fractional anisotropy emerged in schizophrenia only after age 35, and the rate of fractional anisotropy deterioration with age was constant and best modeled with a straight line. The slope of this line was 60% steeper in schizophrenia relative to comparison subjects, indicating a significantly faster rate of white matter deterioration with age. The rates of reduction of gray matter volume and fractional anisotropy were significantly faster in males than in females, but an interaction between sex and diagnosis was not evident. CONCLUSIONS The findings suggest that schizophrenia is characterized by an initial, rapid rate of gray matter loss that slows in middle life, followed by the emergence of a deficit in white matter that progressively worsens with age at a constant rate.
Collapse
Affiliation(s)
- Vanessa L Cropley
- From the Melbourne Neuropsychiatry Centre, Department of Psychiatry, and the Department of Electrical and Electronic Engineering, University of Melbourne, and Melbourne Health, Melbourne; the Brain and Mental Health Laboratory, School of Psychological Sciences, Monash Biomedical Imaging, and the Department of Psychiatry, School of Clinical Sciences, Monash University, Clayton, Australia; the Schizophrenia Research Institute and Neuroscience Research Australia, Randwick, Australia; the Molecular Psychopharmacology Laboratory, Florey Institute of Neuroscience and Mental Health, Parkville, Australia; the Faculty of Health, Arts, and Design, Swinburne University of Technology, Hawthorn, Australia; and the School of Psychiatry, Faculty of Medicine, University of New South Wales, Kensington, Australia
| | - Paul Klauser
- From the Melbourne Neuropsychiatry Centre, Department of Psychiatry, and the Department of Electrical and Electronic Engineering, University of Melbourne, and Melbourne Health, Melbourne; the Brain and Mental Health Laboratory, School of Psychological Sciences, Monash Biomedical Imaging, and the Department of Psychiatry, School of Clinical Sciences, Monash University, Clayton, Australia; the Schizophrenia Research Institute and Neuroscience Research Australia, Randwick, Australia; the Molecular Psychopharmacology Laboratory, Florey Institute of Neuroscience and Mental Health, Parkville, Australia; the Faculty of Health, Arts, and Design, Swinburne University of Technology, Hawthorn, Australia; and the School of Psychiatry, Faculty of Medicine, University of New South Wales, Kensington, Australia
| | - Rhoshel K Lenroot
- From the Melbourne Neuropsychiatry Centre, Department of Psychiatry, and the Department of Electrical and Electronic Engineering, University of Melbourne, and Melbourne Health, Melbourne; the Brain and Mental Health Laboratory, School of Psychological Sciences, Monash Biomedical Imaging, and the Department of Psychiatry, School of Clinical Sciences, Monash University, Clayton, Australia; the Schizophrenia Research Institute and Neuroscience Research Australia, Randwick, Australia; the Molecular Psychopharmacology Laboratory, Florey Institute of Neuroscience and Mental Health, Parkville, Australia; the Faculty of Health, Arts, and Design, Swinburne University of Technology, Hawthorn, Australia; and the School of Psychiatry, Faculty of Medicine, University of New South Wales, Kensington, Australia
| | - Jason Bruggemann
- From the Melbourne Neuropsychiatry Centre, Department of Psychiatry, and the Department of Electrical and Electronic Engineering, University of Melbourne, and Melbourne Health, Melbourne; the Brain and Mental Health Laboratory, School of Psychological Sciences, Monash Biomedical Imaging, and the Department of Psychiatry, School of Clinical Sciences, Monash University, Clayton, Australia; the Schizophrenia Research Institute and Neuroscience Research Australia, Randwick, Australia; the Molecular Psychopharmacology Laboratory, Florey Institute of Neuroscience and Mental Health, Parkville, Australia; the Faculty of Health, Arts, and Design, Swinburne University of Technology, Hawthorn, Australia; and the School of Psychiatry, Faculty of Medicine, University of New South Wales, Kensington, Australia
| | - Suresh Sundram
- From the Melbourne Neuropsychiatry Centre, Department of Psychiatry, and the Department of Electrical and Electronic Engineering, University of Melbourne, and Melbourne Health, Melbourne; the Brain and Mental Health Laboratory, School of Psychological Sciences, Monash Biomedical Imaging, and the Department of Psychiatry, School of Clinical Sciences, Monash University, Clayton, Australia; the Schizophrenia Research Institute and Neuroscience Research Australia, Randwick, Australia; the Molecular Psychopharmacology Laboratory, Florey Institute of Neuroscience and Mental Health, Parkville, Australia; the Faculty of Health, Arts, and Design, Swinburne University of Technology, Hawthorn, Australia; and the School of Psychiatry, Faculty of Medicine, University of New South Wales, Kensington, Australia
| | - Chad Bousman
- From the Melbourne Neuropsychiatry Centre, Department of Psychiatry, and the Department of Electrical and Electronic Engineering, University of Melbourne, and Melbourne Health, Melbourne; the Brain and Mental Health Laboratory, School of Psychological Sciences, Monash Biomedical Imaging, and the Department of Psychiatry, School of Clinical Sciences, Monash University, Clayton, Australia; the Schizophrenia Research Institute and Neuroscience Research Australia, Randwick, Australia; the Molecular Psychopharmacology Laboratory, Florey Institute of Neuroscience and Mental Health, Parkville, Australia; the Faculty of Health, Arts, and Design, Swinburne University of Technology, Hawthorn, Australia; and the School of Psychiatry, Faculty of Medicine, University of New South Wales, Kensington, Australia
| | - Avril Pereira
- From the Melbourne Neuropsychiatry Centre, Department of Psychiatry, and the Department of Electrical and Electronic Engineering, University of Melbourne, and Melbourne Health, Melbourne; the Brain and Mental Health Laboratory, School of Psychological Sciences, Monash Biomedical Imaging, and the Department of Psychiatry, School of Clinical Sciences, Monash University, Clayton, Australia; the Schizophrenia Research Institute and Neuroscience Research Australia, Randwick, Australia; the Molecular Psychopharmacology Laboratory, Florey Institute of Neuroscience and Mental Health, Parkville, Australia; the Faculty of Health, Arts, and Design, Swinburne University of Technology, Hawthorn, Australia; and the School of Psychiatry, Faculty of Medicine, University of New South Wales, Kensington, Australia
| | - Maria A Di Biase
- From the Melbourne Neuropsychiatry Centre, Department of Psychiatry, and the Department of Electrical and Electronic Engineering, University of Melbourne, and Melbourne Health, Melbourne; the Brain and Mental Health Laboratory, School of Psychological Sciences, Monash Biomedical Imaging, and the Department of Psychiatry, School of Clinical Sciences, Monash University, Clayton, Australia; the Schizophrenia Research Institute and Neuroscience Research Australia, Randwick, Australia; the Molecular Psychopharmacology Laboratory, Florey Institute of Neuroscience and Mental Health, Parkville, Australia; the Faculty of Health, Arts, and Design, Swinburne University of Technology, Hawthorn, Australia; and the School of Psychiatry, Faculty of Medicine, University of New South Wales, Kensington, Australia
| | - Thomas W Weickert
- From the Melbourne Neuropsychiatry Centre, Department of Psychiatry, and the Department of Electrical and Electronic Engineering, University of Melbourne, and Melbourne Health, Melbourne; the Brain and Mental Health Laboratory, School of Psychological Sciences, Monash Biomedical Imaging, and the Department of Psychiatry, School of Clinical Sciences, Monash University, Clayton, Australia; the Schizophrenia Research Institute and Neuroscience Research Australia, Randwick, Australia; the Molecular Psychopharmacology Laboratory, Florey Institute of Neuroscience and Mental Health, Parkville, Australia; the Faculty of Health, Arts, and Design, Swinburne University of Technology, Hawthorn, Australia; and the School of Psychiatry, Faculty of Medicine, University of New South Wales, Kensington, Australia
| | - Cynthia Shannon Weickert
- From the Melbourne Neuropsychiatry Centre, Department of Psychiatry, and the Department of Electrical and Electronic Engineering, University of Melbourne, and Melbourne Health, Melbourne; the Brain and Mental Health Laboratory, School of Psychological Sciences, Monash Biomedical Imaging, and the Department of Psychiatry, School of Clinical Sciences, Monash University, Clayton, Australia; the Schizophrenia Research Institute and Neuroscience Research Australia, Randwick, Australia; the Molecular Psychopharmacology Laboratory, Florey Institute of Neuroscience and Mental Health, Parkville, Australia; the Faculty of Health, Arts, and Design, Swinburne University of Technology, Hawthorn, Australia; and the School of Psychiatry, Faculty of Medicine, University of New South Wales, Kensington, Australia
| | - Christos Pantelis
- From the Melbourne Neuropsychiatry Centre, Department of Psychiatry, and the Department of Electrical and Electronic Engineering, University of Melbourne, and Melbourne Health, Melbourne; the Brain and Mental Health Laboratory, School of Psychological Sciences, Monash Biomedical Imaging, and the Department of Psychiatry, School of Clinical Sciences, Monash University, Clayton, Australia; the Schizophrenia Research Institute and Neuroscience Research Australia, Randwick, Australia; the Molecular Psychopharmacology Laboratory, Florey Institute of Neuroscience and Mental Health, Parkville, Australia; the Faculty of Health, Arts, and Design, Swinburne University of Technology, Hawthorn, Australia; and the School of Psychiatry, Faculty of Medicine, University of New South Wales, Kensington, Australia
| | - Andrew Zalesky
- From the Melbourne Neuropsychiatry Centre, Department of Psychiatry, and the Department of Electrical and Electronic Engineering, University of Melbourne, and Melbourne Health, Melbourne; the Brain and Mental Health Laboratory, School of Psychological Sciences, Monash Biomedical Imaging, and the Department of Psychiatry, School of Clinical Sciences, Monash University, Clayton, Australia; the Schizophrenia Research Institute and Neuroscience Research Australia, Randwick, Australia; the Molecular Psychopharmacology Laboratory, Florey Institute of Neuroscience and Mental Health, Parkville, Australia; the Faculty of Health, Arts, and Design, Swinburne University of Technology, Hawthorn, Australia; and the School of Psychiatry, Faculty of Medicine, University of New South Wales, Kensington, Australia
| |
Collapse
|
45
|
Mostaid MS, Mancuso SG, Liu C, Sundram S, Pantelis C, Everall IP, Bousman CA. Meta-analysis reveals associations between genetic variation in the 5' and 3' regions of Neuregulin-1 and schizophrenia. Transl Psychiatry 2017; 7:e1004. [PMID: 28094814 PMCID: PMC5545738 DOI: 10.1038/tp.2016.279] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2016] [Accepted: 11/27/2016] [Indexed: 01/07/2023] Open
Abstract
Genetic, post-mortem and neuroimaging studies repeatedly implicate neuregulin-1 (NRG1) as a critical component in the pathophysiology of schizophrenia. Although a number of risk haplotypes along with several genetic polymorphisms in the 5' and 3' regions of NRG1 have been linked with schizophrenia, results have been mixed. To reconcile these conflicting findings, we conducted a meta-analysis examining 22 polymorphisms and two haplotypes in NRG1 among 16 720 cases, 20 449 controls and 2157 family trios. We found significant associations for three polymorphisms (rs62510682, rs35753505 and 478B14-848) at the 5'-end and two (rs2954041 and rs10503929) near the 3'-end of NRG1. Population stratification effects were found for the rs35753505 and 478B14-848(4) polymorphisms. There was evidence of heterogeneity for all significant markers and the findings were robust to publication bias. No significant haplotype associations were found. Our results suggest genetic variation at the 5' and 3' ends of NRG1 are associated with schizophrenia and provide renewed justification for further investigation of NRG1's role in the pathophysiology of schizophrenia.
Collapse
Affiliation(s)
- M S Mostaid
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne, Carlton South, VIC, Australia
| | - S G Mancuso
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne, Carlton South, VIC, Australia
| | - C Liu
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne, Carlton South, VIC, Australia
| | - S Sundram
- Florey Institute of Neuroscience and Mental Health, The University of Melbourne, Parkville, VIC, Australia
- NorthWestern Mental Health, Melbourne Health, Parkville, VIC, Australia
- Department of Psychiatry, School of Clinical Sciences, Monash University and Monash Health, Clayton, VIC, Australia
| | - C Pantelis
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne, Carlton South, VIC, Australia
- Florey Institute of Neuroscience and Mental Health, The University of Melbourne, Parkville, VIC, Australia
- NorthWestern Mental Health, Melbourne Health, Parkville, VIC, Australia
- Centre for Neural Engineering (CfNE), Department of Electrical and Electronic Engineering, The University of Melbourne, Parkville, VIC, Australia
| | - I P Everall
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne, Carlton South, VIC, Australia
- Florey Institute of Neuroscience and Mental Health, The University of Melbourne, Parkville, VIC, Australia
- NorthWestern Mental Health, Melbourne Health, Parkville, VIC, Australia
- Centre for Neural Engineering (CfNE), Department of Electrical and Electronic Engineering, The University of Melbourne, Parkville, VIC, Australia
| | - C A Bousman
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne, Carlton South, VIC, Australia
- Florey Institute of Neuroscience and Mental Health, The University of Melbourne, Parkville, VIC, Australia
- Department of General Practice, The University of Melbourne, Parkville, VIC, Australia
- Swinburne University of Technology, Centre for Human Psychopharmacology, Hawthorn, VIC, Australia
| |
Collapse
|
46
|
Mostaid MS, Lee TT, Chana G, Sundram S, Shannon Weickert C, Pantelis C, Everall I, Bousman C. Peripheral Transcription of NRG-ErbB Pathway Genes Are Upregulated in Treatment-Resistant Schizophrenia. Front Psychiatry 2017; 8:225. [PMID: 29163244 PMCID: PMC5681734 DOI: 10.3389/fpsyt.2017.00225] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2017] [Accepted: 10/23/2017] [Indexed: 12/13/2022] Open
Abstract
Investigation of peripheral gene expression patterns of transcripts within the NRG-ErbB signaling pathway, other than neuregulin-1 (NRG1), among patients with schizophrenia and more specifically treatment-resistant schizophrenia (TRS) is limited. The present study built on our previous work demonstrating elevated levels of NRG1 EGFα, EGFβ, and type I(Ig2) containing transcripts in TRS by investigating 11 NRG-ErbB signaling pathway mRNA transcripts (NRG2, ErbB1, ErbB2, ErbB3, ErbB4, PIK3CD, PIK3R3, AKT1, mTOR, P70S6K, eIF4EBP1) in whole blood of TRS patients (N = 71) and healthy controls (N = 57). We also examined the effect of clozapine exposure on transcript levels using cultured peripheral blood mononuclear cells (PBMCs) from 15 healthy individuals. Five transcripts (ErbB3, PIK3CD, AKT1, P70S6K, eIF4EBP1) were significantly elevated in TRS patients compared to healthy controls but only expression of P70S6K (Pcorrected = 0.018), a protein kinase linked to protein synthesis, cell growth, and cell proliferation, survived correction for multiple testing using the Benjamini-Hochberg method. Investigation of clinical factors revealed that ErbB2, PIK3CD, PIK3R3, AKT1, mTOR, and P70S6K expression were negatively correlated with duration of illness. However, no transcript was associated with chlorpromazine equivalent dose or clozapine plasma levels, the latter supported by our in vitro PBMC clozapine exposure experiment. Taken together with previously published NRG1 results, our findings suggest an overall upregulation of transcripts within the NRG-ErbB signaling pathway among individuals with schizophrenia some of which attenuate over duration of illness. Follow-up studies are needed to determine if the observed peripheral upregulation of transcripts within the NRG-ErbB signaling pathway are specific to TRS or are a general blood-based marker of schizophrenia.
Collapse
Affiliation(s)
- Md Shaki Mostaid
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne and Melbourne Health, Parkville, VIC, Australia.,The Cooperative Research Centre (CRC) for Mental Health, Melbourne, VIC, Australia
| | - Ting Ting Lee
- Centre for Neural Engineering, The University of Melbourne, Carlton, VIC, Australia
| | - Gursharan Chana
- Centre for Neural Engineering, The University of Melbourne, Carlton, VIC, Australia.,Florey Institute of Neuroscience and Mental Health, The University of Melbourne, Parkville, VIC, Australia.,Department of Medicine, Royal Melbourne Hospital, Parkville, VIC, Australia
| | - Suresh Sundram
- Florey Institute of Neuroscience and Mental Health, The University of Melbourne, Parkville, VIC, Australia.,NorthWestern Mental Health, Melbourne, VIC, Australia.,Department of Psychiatry, School of Clinical Sciences, Monash University and Monash Health, Clayton, VIC, Australia
| | - Cynthia Shannon Weickert
- Schizophrenia Research Institute, Sydney, NSW, Australia.,Schizophrenia Research Laboratory, Neuroscience Research Australia, Sydney, NSW, Australia.,Faculty of Medicine, School of Psychiatry, University of New South Wales, Sydney, NSW, Australia
| | - Christos Pantelis
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne and Melbourne Health, Parkville, VIC, Australia.,The Cooperative Research Centre (CRC) for Mental Health, Melbourne, VIC, Australia.,Centre for Neural Engineering, The University of Melbourne, Carlton, VIC, Australia.,Florey Institute of Neuroscience and Mental Health, The University of Melbourne, Parkville, VIC, Australia.,NorthWestern Mental Health, Melbourne, VIC, Australia
| | - Ian Everall
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne and Melbourne Health, Parkville, VIC, Australia.,The Cooperative Research Centre (CRC) for Mental Health, Melbourne, VIC, Australia.,Centre for Neural Engineering, The University of Melbourne, Carlton, VIC, Australia.,Florey Institute of Neuroscience and Mental Health, The University of Melbourne, Parkville, VIC, Australia.,NorthWestern Mental Health, Melbourne, VIC, Australia.,Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Chad Bousman
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne and Melbourne Health, Parkville, VIC, Australia.,The Cooperative Research Centre (CRC) for Mental Health, Melbourne, VIC, Australia.,Department of Medical Genetics, University of Calgary, Calgary, AB, Canada.,Department of Psychiatry, University of Calgary, Calgary, AB, Canada.,Department of Physiology and Pharmacology, University of Calgary, Calgary, AB, Canada
| |
Collapse
|
47
|
Mostaid MS, Lloyd D, Liberg B, Sundram S, Pereira A, Pantelis C, Karl T, Weickert CS, Everall IP, Bousman CA. Neuregulin-1 and schizophrenia in the genome-wide association study era. Neurosci Biobehav Rev 2016; 68:387-409. [DOI: 10.1016/j.neubiorev.2016.06.001] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2016] [Revised: 05/30/2016] [Accepted: 06/03/2016] [Indexed: 12/22/2022]
|
48
|
Bennett D, Dluzniak A, Cropper SJ, Partos T, Sundram S, Carter O. Selective impairment of global motion integration, but not global form detection, in schizophrenia and bipolar affective disorder. Schizophr Res Cogn 2016; 3:11-14. [PMID: 28740802 PMCID: PMC5506721 DOI: 10.1016/j.scog.2015.11.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2015] [Revised: 10/30/2015] [Accepted: 11/02/2015] [Indexed: 11/30/2022]
Abstract
Recent evidence suggests that schizophrenia is associated with impaired processing of global visual motion, but intact processing of global visual form. This project assessed whether preserved visual form detection in schizophrenia extended beyond low-level pattern discrimination to a naturalistic form-detection task. We assessed both naturalistic form detection and global motion detection in individuals with schizophrenia spectrum disorder, bipolar affective disorder, and healthy controls. Individuals with schizophrenia spectrum disorder and bipolar affective disorder were impaired relative to healthy controls on the global motion task, but not the naturalistic form-detection task. Results indicate that preservation of visual form detection in these disorders extends beyond configural forms to naturalistic object processing.
Collapse
Affiliation(s)
- Daniel Bennett
- Melbourne School of Psychological Sciences, The University of Melbourne, Parkville, VIC 3010, Australia
| | - Amy Dluzniak
- Melbourne School of Psychological Sciences, The University of Melbourne, Parkville, VIC 3010, Australia
| | - Simon J. Cropper
- Melbourne School of Psychological Sciences, The University of Melbourne, Parkville, VIC 3010, Australia
| | - Timea Partos
- Melbourne School of Psychological Sciences, The University of Melbourne, Parkville, VIC 3010, Australia
| | - Suresh Sundram
- The Florey Institute of Neuroscience & Mental Health, 30 Royal Parade, Parkville, VIC 3052, Australia
- Department of Psychiatry, School of Clinical Sciences, Monash University and Monash Health, Clayton, VIC, 3168, Australia
| | - Olivia Carter
- Melbourne School of Psychological Sciences, The University of Melbourne, Parkville, VIC 3010, Australia
| |
Collapse
|
49
|
Hocking DC, Kennedy GA, Sundram S. Social factors ameliorate psychiatric disorders in community-based asylum seekers independent of visa status. Psychiatry Res 2015; 230:628-36. [PMID: 26518226 DOI: 10.1016/j.psychres.2015.10.018] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2015] [Revised: 10/05/2015] [Accepted: 10/13/2015] [Indexed: 10/22/2022]
Abstract
The impact of industrialised host nations' deterrent immigration policies on the mental health of forced migrants has not been well characterised. The present study investigated the impact of Australia's refugee determination process (RDP) on psychiatric morbidity in community-based asylum-seekers (AS) and refugees. Psychiatric morbidity was predicted to be greater in AS than refugees, and to persist or increase as a function of time in the RDP. The effect on mental health of demographic and socio-political factors such as health cover and work rights were also investigated. Psychiatric morbidity was measured prospectively on five mental health indices at baseline (T1, n=131) and an average of 15.7 months later (T2, n=56). Psychiatric morbidity in AS significantly decreased between time points such that it was no longer greater than that of refugees at T2. Caseness of PTSD and demoralisation reduced in AS who gained protection; however, those who maintained asylum-seeker status at T2 also had a significant reduction in PTS and depression symptom severity. Reduced PTS and demoralisation symptoms were associated with securing work rights and health cover. Living in the community with work rights and access to health cover significantly improves psychiatric symptoms in forced migrants irrespective of their protection status.
Collapse
Affiliation(s)
- Debbie C Hocking
- Department of Psychiatry and Neuropsychology, Florey Institute of Neuroscience and Mental Health, 30 Royal Parade (Cnr Genetics Lane), Parkville, Victoria 3052, Australia; School of Psychology, Victoria University, St. Albans, Victoria 3021, Australia
| | - Gerard A Kennedy
- School of Psychology, Cairnmillar Institute, Camberwell, Victoria 3124, Australia
| | - Suresh Sundram
- Unit Head, Adult Psychiatry, Monash Medical Centre, Monash Health Department of Psychiatry, Monash University, Level 3, P-Block, 246 Clayton Road, Clayton, Victoria 3168, Australia; Department of Psychiatry, Monash University, Clayton, Victoria 3168, Australia
| |
Collapse
|
50
|
Abstract
As psychiatrists, we assess, diagnose, and manage psychiatric problems in older adults. We also have an important role as their advocates and in promoting positive attitudes toward this group. Only in the 1950s was there increasing recognition that older age did not necessarily equate to senility, that treatment of psychiatric disorders in this group was possible, and could have good outcomes (Roth, 1955). There is, however, still an undercurrent of pervasive negative attitudes toward the elderly, and their psychiatric needs continue to be marginalized, with less attention from the media, funding bodies, and even from our medical and surgical colleagues (Pensonet al., 2004).
Collapse
Affiliation(s)
- Samantha Loi
- Academic Unit for Psychiatry of Old Age,University of Melbourne,St Vincent's Health,St George's Hospital;North Western Aged Mental Health,Melbourne Health,Parkville,Victoria,Australia
| | - Suresh Sundram
- Florey Institute of Neuroscience and Mental Health,Kenneth Myer BuildingParkville;Northern Psychiatry Research Centre,The Northern Hospital,Epping,Victoria,Australia
| |
Collapse
|