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Svancer P, Capek V, Skoch A, Kopecek M, Vochoskova K, Fialova M, Furstova P, Jakob L, Bakstein E, Kolenic M, Hlinka J, Knytl P, Spaniel F. Longitudinal assessment of ventricular volume trajectories in early-stage schizophrenia: evidence of both enlargement and shrinkage. BMC Psychiatry 2024; 24:309. [PMID: 38658884 PMCID: PMC11040899 DOI: 10.1186/s12888-024-05749-5] [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: 10/19/2023] [Accepted: 04/08/2024] [Indexed: 04/26/2024] Open
Abstract
BACKGROUND Lateral ventricular enlargement represents a canonical morphometric finding in chronic patients with schizophrenia; however, longitudinal studies elucidating complex dynamic trajectories of ventricular volume change during critical early disease stages are sparse. METHODS We measured lateral ventricular volumes in 113 first-episode schizophrenia patients (FES) at baseline visit (11.7 months after illness onset, SD = 12.3) and 128 age- and sex-matched healthy controls (HC) using 3T MRI. MRI was then repeated in both FES and HC one year later. RESULTS Compared to controls, ventricular enlargement was identified in 18.6% of patients with FES (14.1% annual ventricular volume (VV) increase; 95%CI: 5.4; 33.1). The ventricular expansion correlated with the severity of PANSS-negative symptoms at one-year follow-up (p = 0.0078). Nevertheless, 16.8% of FES showed an opposite pattern of statistically significant ventricular shrinkage during ≈ one-year follow-up (-9.5% annual VV decrease; 95%CI: -23.7; -2.4). There were no differences in sex, illness duration, age of onset, duration of untreated psychosis, body mass index, the incidence of Schneiderian symptoms, or cumulative antipsychotic dose among the patient groups exhibiting ventricular enlargement, shrinkage, or no change in VV. CONCLUSION Both enlargement and ventricular shrinkage are equally present in the early stages of schizophrenia. The newly discovered early reduction of VV in a subgroup of patients emphasizes the need for further research to understand its mechanisms.
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Affiliation(s)
- Patrik Svancer
- National Institute of Mental Health, Topolova 748, 250 67, Klecany, Czech Republic
- Third Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Vaclav Capek
- National Institute of Mental Health, Topolova 748, 250 67, Klecany, Czech Republic
| | - Antonin Skoch
- National Institute of Mental Health, Topolova 748, 250 67, Klecany, Czech Republic
- Department of Diagnostic and Interventional Radiology, Institute for Clinical and Experimental Medicine, Prague, Czech Republic
| | - Miloslav Kopecek
- National Institute of Mental Health, Topolova 748, 250 67, Klecany, Czech Republic
- Third Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Kristyna Vochoskova
- National Institute of Mental Health, Topolova 748, 250 67, Klecany, Czech Republic
- Third Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Marketa Fialova
- National Institute of Mental Health, Topolova 748, 250 67, Klecany, Czech Republic
- Third Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Petra Furstova
- National Institute of Mental Health, Topolova 748, 250 67, Klecany, Czech Republic
| | - Lea Jakob
- National Institute of Mental Health, Topolova 748, 250 67, Klecany, Czech Republic
- Third Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Eduard Bakstein
- National Institute of Mental Health, Topolova 748, 250 67, Klecany, Czech Republic
- Department of Cybernetics, Faculty of Electrical Engineering, Czech Technical University in Prague, Prague, Czech Republic
| | - Marian Kolenic
- National Institute of Mental Health, Topolova 748, 250 67, Klecany, Czech Republic
- Third Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Jaroslav Hlinka
- National Institute of Mental Health, Topolova 748, 250 67, Klecany, Czech Republic
| | - Pavel Knytl
- National Institute of Mental Health, Topolova 748, 250 67, Klecany, Czech Republic
- Third Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Filip Spaniel
- National Institute of Mental Health, Topolova 748, 250 67, Klecany, Czech Republic.
- Third Faculty of Medicine, Charles University, Prague, Czech Republic.
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Vochoskova K, McWhinney SR, Fialova M, Kolenic M, Spaniel F, Svancer P, Boron P, Okaji Y, Trancik P, Hajek T. Weight and metabolic changes in early psychosis-association with daily quantification of medication exposure during the first hospitalization. Acta Psychiatr Scand 2023; 148:265-276. [PMID: 37528692 DOI: 10.1111/acps.13594] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2023] [Revised: 05/30/2023] [Accepted: 07/06/2023] [Indexed: 08/03/2023]
Abstract
BACKGROUND The most common causes of death in schizophrenia are cardiovascular disorders, which are closely related to metabolic syndrome/obesity. To better understand the development of metabolic alterations early in the course of illness, we quantified daily medication exposure in the first days of the first hospitalization for psychosis and related it to changes in weight and metabolic markers. STUDY DESIGN We recruited participants with first episode psychosis (FEP, N = 173) during their first psychiatric hospitalization and compared them to controls (N = 204). We prospectively collected weight, body mass index, metabolic markers, and exact daily medication exposure at admission and during hospitalization. STUDY RESULTS Individuals with FEP gained on average 0.97 ± 2.26 BMI points or 3.46 ± 7.81 kg of weight after an average of 44.6 days of their first inpatient treatment. Greater antipsychotic exposure was associated with greater BMI increase, but only in people with normal/low baseline BMI. Additional predictors of weight gain included type of medication and duration of treatment. Medication exposure was not directly related to metabolic markers, but higher BMI was associated with higher TGC, TSH, and lower HDL. Following inpatient treatment, participants with FEP had significantly higher BMI, TGC, prolactin, and lower fT4, HDL than controls. CONCLUSION During their first admission, people with FEP, especially those with normal/low baseline BMI, showed a rapid and clinically significant weight increase, which was associated with exposure to antipsychotics, and with metabolic changes consistent with metabolic syndrome. These findings emphasize weight monitoring in FEP and suggest a greater need for caution when prescribing metabolically problematic antipsychotics to people with lower BMI.
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Affiliation(s)
- Kristyna Vochoskova
- National Institute of Mental Health, Klecany, Czech Republic
- Third Faculty of Medicine, Charles University, Prague, Czech Republic
| | | | - Marketa Fialova
- National Institute of Mental Health, Klecany, Czech Republic
- Third Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Marian Kolenic
- National Institute of Mental Health, Klecany, Czech Republic
- Third Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Filip Spaniel
- National Institute of Mental Health, Klecany, Czech Republic
- Third Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Patrik Svancer
- National Institute of Mental Health, Klecany, Czech Republic
- Third Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Petra Boron
- Psychiatric Hospital Bohnice, Prague, Czech Republic
| | - Yurai Okaji
- Psychiatric Hospital Bohnice, Prague, Czech Republic
| | - Pavel Trancik
- Psychiatric Hospital Bohnice, Prague, Czech Republic
| | - Tomas Hajek
- National Institute of Mental Health, Klecany, Czech Republic
- Third Faculty of Medicine, Charles University, Prague, Czech Republic
- Department of Psychiatry, Dalhousie University, Halifax, Canada
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McWhinney S, Kolenic M, Franke K, Fialova M, Knytl P, Matejka M, Spaniel F, Hajek T. Obesity as a Risk Factor for Accelerated Brain Ageing in First-Episode Psychosis-A Longitudinal Study. Schizophr Bull 2021; 47:1772-1781. [PMID: 34080013 PMCID: PMC8530396 DOI: 10.1093/schbul/sbab064] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [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: 12/15/2022]
Abstract
BACKGROUND Obesity is highly prevalent in schizophrenia, with implications for psychiatric prognosis, possibly through links between obesity and brain structure. In this longitudinal study in first episode of psychosis (FEP), we used machine learning and structural magnetic resonance imaging (MRI) to study the impact of psychotic illness and obesity on brain ageing/neuroprogression shortly after illness onset. METHODS We acquired 2 prospective MRI scans on average 1.61 years apart in 183 FEP and 155 control individuals. We used a machine learning model trained on an independent sample of 504 controls to estimate the individual brain ages of study participants and calculated BrainAGE by subtracting chronological from the estimated brain age. RESULTS Individuals with FEP had a higher initial BrainAGE than controls (3.39 ± 6.36 vs 1.72 ± 5.56 years; β = 1.68, t(336) = 2.59, P = .01), but similar annual rates of brain ageing over time (1.28 ± 2.40 vs 1.07±1.74 estimated years/actual year; t(333) = 0.93, P = .18). Across both cohorts, greater baseline body mass index (BMI) predicted faster brain ageing (β = 0.08, t(333) = 2.59, P = .01). For each additional BMI point, the brain aged by an additional month per year. Worsening of functioning over time (Global Assessment of Functioning; β = -0.04, t(164) = -2.48, P = .01) and increases especially in negative symptoms on the Positive and Negative Syndrome Scale (β = 0.11, t(175) = 3.11, P = .002) were associated with faster brain ageing in FEP. CONCLUSIONS Brain alterations in psychosis are manifest already during the first episode and over time get worse in those with worsening clinical outcomes or higher baseline BMI. As baseline BMI predicted faster brain ageing, obesity may represent a modifiable risk factor in FEP that is linked with psychiatric outcomes via effects on brain structure.
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Affiliation(s)
- Sean McWhinney
- Department of Psychiatry, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Marian Kolenic
- National Institute of Mental Health, Klecany, Czech Republic,Third Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Katja Franke
- Structural Brain Mapping Group, Department of Neurology, Jena University Hospital, Jena, Germany
| | - Marketa Fialova
- National Institute of Mental Health, Klecany, Czech Republic
| | - Pavel Knytl
- National Institute of Mental Health, Klecany, Czech Republic
| | - Martin Matejka
- National Institute of Mental Health, Klecany, Czech Republic,Third Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Filip Spaniel
- National Institute of Mental Health, Klecany, Czech Republic,Third Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Tomas Hajek
- Department of Psychiatry, Dalhousie University, Halifax, Nova Scotia, Canada,National Institute of Mental Health, Klecany, Czech Republic,To whom correspondence should be addressed; Department of Psychiatry, Dalhousie University, QEII HSC, A. J. Lane Building, Room 3093, 5909 Veteran’s Memorial Lane, Halifax, Nova Scotia B3H 2E2, Canada; tel: (902) 473-8299, fax: (902) 473-1583, e-mail:
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Libansky P, Adamek S, Broulik P, Fialova M, Kubinyi J, Sedy J, Pafko P, Yershov D, Lischke R. Measurement of intact parathormone during operation for primary hyperparathyroidism. BRATISL MED J 2017; 118:255-257. [PMID: 28516785 DOI: 10.4149/bll_2017_050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
In this prospective study, the role of the intact parathormone (iPHT) levels for the verification of pathologic parathyroid tissue removal during parathyroidectomy, was analyzed in 441 patients diagnosed with primary hyperparathyroidism. The level of intact parathormone was obtained before the initial incision (baseline level) and 10 minutes after the pathologic parathyroid gland removal (control value). In 80 % of cases, the decrease of intact parathormone was more than 50 % of the baseline level. The comparison of preoperative and postoperative intact parathormone levels can also be used as marker of parathyroid hyperplasia or persistent hyperparathyroidism. This method is necessary mainly for performance of focused, miniinvasive approaches as well as in reoperations. This method is of significant benefit in cases of negative preoperative examination methods. The determination of intact parathormone level increases the success of parathyroidectomy (Ref. 26).
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Spaniel F, Tintera J, Rydlo J, Ibrahim I, Kasparek T, Horacek J, Zaytseva Y, Matejka M, Fialova M, Slovakova A, Mikolas P, Melicher T, Görnerova N, Höschl C, Hajek T. Altered Neural Correlate of the Self-Agency Experience in First-Episode Schizophrenia-Spectrum Patients: An fMRI Study. Schizophr Bull 2016; 42:916-25. [PMID: 26685867 PMCID: PMC4903049 DOI: 10.1093/schbul/sbv188] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [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: 11/13/2022]
Abstract
BACKGROUND The phenomenology of the clinical symptoms indicates that disturbance of the sense of self be a core marker of schizophrenia. AIMS To compare neural activity related to the self/other-agency judgment in patients with first-episode schizophrenia-spectrum disorders (FES, n = 35) and healthy controls (HC, n = 35). METHOD A functional magnetic resonance imaging (fMRI) using motor task with temporal distortion of the visual feedback was employed. A task-related functional connectivity was analyzed with the use of independent component analysis (ICA). RESULTS (1) During self-agency experience, FES showed a deficit in cortical activation in medial frontal gyrus (BA 10) and posterior cingulate gyrus, (BA 31; P < .05, Family-Wise Error [FWE] corrected). (2) Pooled-sample task-related ICA revealed that the self/other-agency judgment was dependent upon anti-correlated default mode and central-executive networks (DMN/CEN) dynamic switching. This antagonistic mechanism was substantially impaired in FES during the task. DISCUSSION During self-agency experience, FES demonstrate deficit in engagement of cortical midline structures along with substantial attenuation of anti-correlated DMN/CEN activity underlying normal self/other-agency discriminative processes.
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Affiliation(s)
- Filip Spaniel
- National Institute of Mental Health, Klecany, Czech Republic; 3rd Faculty of Medicine, Charles University, Prague, Czech Republic;
| | - Jaroslav Tintera
- National Institute of Mental Health, Klecany, Czech Republic;,MR-Unit ZRIR, IKEM, Institute for Clinical and Experimental Medicine, Prague, Czech Republic
| | - Jan Rydlo
- National Institute of Mental Health, Klecany, Czech Republic;,MR-Unit ZRIR, IKEM, Institute for Clinical and Experimental Medicine, Prague, Czech Republic
| | - Ibrahim Ibrahim
- National Institute of Mental Health, Klecany, Czech Republic;,MR-Unit ZRIR, IKEM, Institute for Clinical and Experimental Medicine, Prague, Czech Republic
| | - Tomas Kasparek
- Department of Psychiatry, University Hospital Brno, Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - Jiri Horacek
- National Institute of Mental Health, Klecany, Czech Republic;,3rd Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Yuliya Zaytseva
- National Institute of Mental Health, Klecany, Czech Republic
| | - Martin Matejka
- National Institute of Mental Health, Klecany, Czech Republic;,Psychiatric Hospital Bohnice, Prague, Czech Republic
| | - Marketa Fialova
- National Institute of Mental Health, Klecany, Czech Republic;,Psychiatric Hospital Bohnice, Prague, Czech Republic
| | - Andrea Slovakova
- National Institute of Mental Health, Klecany, Czech Republic;,Psychiatric Hospital Bohnice, Prague, Czech Republic
| | - Pavol Mikolas
- National Institute of Mental Health, Klecany, Czech Republic;,Psychiatric Hospital Bohnice, Prague, Czech Republic
| | - Tomas Melicher
- National Institute of Mental Health, Klecany, Czech Republic;,3rd Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Natalie Görnerova
- National Institute of Mental Health, Klecany, Czech Republic;,3rd Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Cyril Höschl
- National Institute of Mental Health, Klecany, Czech Republic;,3rd Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Tomas Hajek
- National Institute of Mental Health, Klecany, Czech Republic;,Department of Psychiatry, Dalhousie University, Halifax, Canada
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Staykov P, Fialova M, Vlaev S. Bubble-bed structural models for hybrid flow simulation: an outlook based on a CFD generated flow image. Chem Eng Res Des 2009. [DOI: 10.1016/j.cherd.2008.10.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Havelka P, Linek V, Sinkule J, Zahradník J, Fialova M. Effect of the ejector configuration on the gas suction rate and gas hold-up in ejector loop reactors. Chem Eng Sci 1997. [DOI: 10.1016/s0009-2509(97)00003-1] [Citation(s) in RCA: 40] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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