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Mihaljevic M, Nagpal A, Etyemez S, Narita Z, Ross A, Schaub R, Cascella NG, Coughlin JM, Nestadt G, Nucifora FC, Sedlak TW, Calhoun VD, Faria AV, Yang K, Sawa A. Neuroimaging alterations and relapse in early-stage psychosis. J Psychiatry Neurosci 2024; 49:E135-E142. [PMID: 38569725 PMCID: PMC10980532 DOI: 10.1503/jpn.230115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Accepted: 01/22/2024] [Indexed: 04/05/2024] Open
Abstract
BACKGROUND Recent reports have indicated that symptom exacerbation after a period of improvement, referred to as relapse, in early-stage psychosis could result in brain changes and poor disease outcomes. We hypothesized that substantial neuroimaging alterations may exist among patients who experience relapse in early-stage psychosis. METHODS We studied patients with psychosis within 2 years after the first psychotic event and healthy controls. We divided patients into 2 groups, namely those who did not experience relapse between disease onset and the magnetic resonance imaging (MRI) scan (no-relapse group) and those who did experience relapse between these 2 timings (relapse group). We analyzed 3003 functional connectivity estimates between 78 regions of interest (ROIs) derived from resting-state functional MRI data by adjusting for demographic and clinical confounding factors. RESULTS We studied 85 patients, incuding 54 in the relapse group and 31 in the no-relapse group, along with 94 healthy controls. We observed significant differences in 47 functional connectivity estimates between the relapse and control groups after multiple comparison corrections, whereas no differences were found between the no-relapse and control groups. Most of these pathological signatures (64%) involved the thalamus. The Jonckheere-Terpstra test indicated that all 47 functional connectivity changes had a significant cross-group progression from controls to patients in the no-relapse group to patients in the relapse group. LIMITATIONS Longitudinal studies are needed to further validate the involvement and pathological importance of the thalamus in relapse. CONCLUSION We observed pathological differences in neuronal connectivity associated with relapse in early-stage psychosis, which are more specifically associated with the thalamus. Our study implies the importance of considering neurobiological mechanisms associated with relapse in the trajectory of psychotic disorders.
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Affiliation(s)
- Marina Mihaljevic
- Departments of Psychiatry (Mihaljevic, Nagpal, Etyemez, Narita, Ross, Schaub, Cascella, Coughlin, Nestadt, Nucifora, Sedlak, Yang, Sawa), Radiology and Radiological Sciences (Faria), Neuroscience (Sawa), Biomedical Engineering (Sawa), Phamarchology (Sawa), and Genetic Medicine (Sawa), Johns Hopkins University School of Medicine; Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Md. (Sawa); Tri-institutional Center for Translational Research in Neuroimaging and Data Science (TReNDS), Georgia State University, Georgia Institute of Technology, Emory University, Atlanta, Ga. (Calhoun)
| | - Anisha Nagpal
- Departments of Psychiatry (Mihaljevic, Nagpal, Etyemez, Narita, Ross, Schaub, Cascella, Coughlin, Nestadt, Nucifora, Sedlak, Yang, Sawa), Radiology and Radiological Sciences (Faria), Neuroscience (Sawa), Biomedical Engineering (Sawa), Phamarchology (Sawa), and Genetic Medicine (Sawa), Johns Hopkins University School of Medicine; Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Md. (Sawa); Tri-institutional Center for Translational Research in Neuroimaging and Data Science (TReNDS), Georgia State University, Georgia Institute of Technology, Emory University, Atlanta, Ga. (Calhoun)
| | - Semra Etyemez
- Departments of Psychiatry (Mihaljevic, Nagpal, Etyemez, Narita, Ross, Schaub, Cascella, Coughlin, Nestadt, Nucifora, Sedlak, Yang, Sawa), Radiology and Radiological Sciences (Faria), Neuroscience (Sawa), Biomedical Engineering (Sawa), Phamarchology (Sawa), and Genetic Medicine (Sawa), Johns Hopkins University School of Medicine; Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Md. (Sawa); Tri-institutional Center for Translational Research in Neuroimaging and Data Science (TReNDS), Georgia State University, Georgia Institute of Technology, Emory University, Atlanta, Ga. (Calhoun)
| | - Zui Narita
- Departments of Psychiatry (Mihaljevic, Nagpal, Etyemez, Narita, Ross, Schaub, Cascella, Coughlin, Nestadt, Nucifora, Sedlak, Yang, Sawa), Radiology and Radiological Sciences (Faria), Neuroscience (Sawa), Biomedical Engineering (Sawa), Phamarchology (Sawa), and Genetic Medicine (Sawa), Johns Hopkins University School of Medicine; Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Md. (Sawa); Tri-institutional Center for Translational Research in Neuroimaging and Data Science (TReNDS), Georgia State University, Georgia Institute of Technology, Emory University, Atlanta, Ga. (Calhoun)
| | - Anna Ross
- Departments of Psychiatry (Mihaljevic, Nagpal, Etyemez, Narita, Ross, Schaub, Cascella, Coughlin, Nestadt, Nucifora, Sedlak, Yang, Sawa), Radiology and Radiological Sciences (Faria), Neuroscience (Sawa), Biomedical Engineering (Sawa), Phamarchology (Sawa), and Genetic Medicine (Sawa), Johns Hopkins University School of Medicine; Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Md. (Sawa); Tri-institutional Center for Translational Research in Neuroimaging and Data Science (TReNDS), Georgia State University, Georgia Institute of Technology, Emory University, Atlanta, Ga. (Calhoun)
| | - Rebecca Schaub
- Departments of Psychiatry (Mihaljevic, Nagpal, Etyemez, Narita, Ross, Schaub, Cascella, Coughlin, Nestadt, Nucifora, Sedlak, Yang, Sawa), Radiology and Radiological Sciences (Faria), Neuroscience (Sawa), Biomedical Engineering (Sawa), Phamarchology (Sawa), and Genetic Medicine (Sawa), Johns Hopkins University School of Medicine; Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Md. (Sawa); Tri-institutional Center for Translational Research in Neuroimaging and Data Science (TReNDS), Georgia State University, Georgia Institute of Technology, Emory University, Atlanta, Ga. (Calhoun)
| | - Nicola G Cascella
- Departments of Psychiatry (Mihaljevic, Nagpal, Etyemez, Narita, Ross, Schaub, Cascella, Coughlin, Nestadt, Nucifora, Sedlak, Yang, Sawa), Radiology and Radiological Sciences (Faria), Neuroscience (Sawa), Biomedical Engineering (Sawa), Phamarchology (Sawa), and Genetic Medicine (Sawa), Johns Hopkins University School of Medicine; Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Md. (Sawa); Tri-institutional Center for Translational Research in Neuroimaging and Data Science (TReNDS), Georgia State University, Georgia Institute of Technology, Emory University, Atlanta, Ga. (Calhoun)
| | - Jennifer M Coughlin
- Departments of Psychiatry (Mihaljevic, Nagpal, Etyemez, Narita, Ross, Schaub, Cascella, Coughlin, Nestadt, Nucifora, Sedlak, Yang, Sawa), Radiology and Radiological Sciences (Faria), Neuroscience (Sawa), Biomedical Engineering (Sawa), Phamarchology (Sawa), and Genetic Medicine (Sawa), Johns Hopkins University School of Medicine; Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Md. (Sawa); Tri-institutional Center for Translational Research in Neuroimaging and Data Science (TReNDS), Georgia State University, Georgia Institute of Technology, Emory University, Atlanta, Ga. (Calhoun)
| | - Gerald Nestadt
- Departments of Psychiatry (Mihaljevic, Nagpal, Etyemez, Narita, Ross, Schaub, Cascella, Coughlin, Nestadt, Nucifora, Sedlak, Yang, Sawa), Radiology and Radiological Sciences (Faria), Neuroscience (Sawa), Biomedical Engineering (Sawa), Phamarchology (Sawa), and Genetic Medicine (Sawa), Johns Hopkins University School of Medicine; Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Md. (Sawa); Tri-institutional Center for Translational Research in Neuroimaging and Data Science (TReNDS), Georgia State University, Georgia Institute of Technology, Emory University, Atlanta, Ga. (Calhoun)
| | - Frederik C Nucifora
- Departments of Psychiatry (Mihaljevic, Nagpal, Etyemez, Narita, Ross, Schaub, Cascella, Coughlin, Nestadt, Nucifora, Sedlak, Yang, Sawa), Radiology and Radiological Sciences (Faria), Neuroscience (Sawa), Biomedical Engineering (Sawa), Phamarchology (Sawa), and Genetic Medicine (Sawa), Johns Hopkins University School of Medicine; Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Md. (Sawa); Tri-institutional Center for Translational Research in Neuroimaging and Data Science (TReNDS), Georgia State University, Georgia Institute of Technology, Emory University, Atlanta, Ga. (Calhoun)
| | - Thomas W Sedlak
- Departments of Psychiatry (Mihaljevic, Nagpal, Etyemez, Narita, Ross, Schaub, Cascella, Coughlin, Nestadt, Nucifora, Sedlak, Yang, Sawa), Radiology and Radiological Sciences (Faria), Neuroscience (Sawa), Biomedical Engineering (Sawa), Phamarchology (Sawa), and Genetic Medicine (Sawa), Johns Hopkins University School of Medicine; Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Md. (Sawa); Tri-institutional Center for Translational Research in Neuroimaging and Data Science (TReNDS), Georgia State University, Georgia Institute of Technology, Emory University, Atlanta, Ga. (Calhoun)
| | - Vince D Calhoun
- Departments of Psychiatry (Mihaljevic, Nagpal, Etyemez, Narita, Ross, Schaub, Cascella, Coughlin, Nestadt, Nucifora, Sedlak, Yang, Sawa), Radiology and Radiological Sciences (Faria), Neuroscience (Sawa), Biomedical Engineering (Sawa), Phamarchology (Sawa), and Genetic Medicine (Sawa), Johns Hopkins University School of Medicine; Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Md. (Sawa); Tri-institutional Center for Translational Research in Neuroimaging and Data Science (TReNDS), Georgia State University, Georgia Institute of Technology, Emory University, Atlanta, Ga. (Calhoun)
| | - Andreia V Faria
- Departments of Psychiatry (Mihaljevic, Nagpal, Etyemez, Narita, Ross, Schaub, Cascella, Coughlin, Nestadt, Nucifora, Sedlak, Yang, Sawa), Radiology and Radiological Sciences (Faria), Neuroscience (Sawa), Biomedical Engineering (Sawa), Phamarchology (Sawa), and Genetic Medicine (Sawa), Johns Hopkins University School of Medicine; Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Md. (Sawa); Tri-institutional Center for Translational Research in Neuroimaging and Data Science (TReNDS), Georgia State University, Georgia Institute of Technology, Emory University, Atlanta, Ga. (Calhoun)
| | - Kun Yang
- Departments of Psychiatry (Mihaljevic, Nagpal, Etyemez, Narita, Ross, Schaub, Cascella, Coughlin, Nestadt, Nucifora, Sedlak, Yang, Sawa), Radiology and Radiological Sciences (Faria), Neuroscience (Sawa), Biomedical Engineering (Sawa), Phamarchology (Sawa), and Genetic Medicine (Sawa), Johns Hopkins University School of Medicine; Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Md. (Sawa); Tri-institutional Center for Translational Research in Neuroimaging and Data Science (TReNDS), Georgia State University, Georgia Institute of Technology, Emory University, Atlanta, Ga. (Calhoun)
| | - Akira Sawa
- Departments of Psychiatry (Mihaljevic, Nagpal, Etyemez, Narita, Ross, Schaub, Cascella, Coughlin, Nestadt, Nucifora, Sedlak, Yang, Sawa), Radiology and Radiological Sciences (Faria), Neuroscience (Sawa), Biomedical Engineering (Sawa), Phamarchology (Sawa), and Genetic Medicine (Sawa), Johns Hopkins University School of Medicine; Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Md. (Sawa); Tri-institutional Center for Translational Research in Neuroimaging and Data Science (TReNDS), Georgia State University, Georgia Institute of Technology, Emory University, Atlanta, Ga. (Calhoun)
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Wang M, Barker PB, Cascella NG, Coughlin JM, Nestadt G, Nucifora FC, Sedlak TW, Kelly A, Younes L, Geman D, Palaniyappan L, Sawa A, Yang K. Longitudinal changes in brain metabolites in healthy controls and patients with first episode psychosis: a 7-Tesla MRS study. Mol Psychiatry 2023; 28:2018-2029. [PMID: 36732587 PMCID: PMC10394114 DOI: 10.1038/s41380-023-01969-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2021] [Revised: 01/13/2023] [Accepted: 01/17/2023] [Indexed: 02/04/2023]
Abstract
Seven Tesla magnetic resonance spectroscopy (7T MRS) offers a precise measurement of metabolic levels in the human brain via a non-invasive approach. Studying longitudinal changes in brain metabolites could help evaluate the characteristics of disease over time. This approach may also shed light on how the age of study participants and duration of illness may influence these metabolites. This study used 7T MRS to investigate longitudinal patterns of brain metabolites in young adulthood in both healthy controls and patients. A four-year longitudinal cohort with 38 patients with first episode psychosis (onset within 2 years) and 48 healthy controls was used to examine 10 brain metabolites in 5 brain regions associated with the pathophysiology of psychosis in a comprehensive manner. Both patients and controls were found to have significant longitudinal reductions in glutamate in the anterior cingulate cortex (ACC). Only patients were found to have a significant decrease over time in γ-aminobutyric acid, N-acetyl aspartate, myo-inositol, total choline, and total creatine in the ACC. Together we highlight the ACC with dynamic changes in several metabolites in early-stage psychosis, in contrast to the other 4 brain regions that also are known to play roles in psychosis. Meanwhile, glutathione was uniquely found to have a near zero annual percentage change in both patients and controls in all 5 brain regions during a four-year follow-up in young adulthood. Given that a reduction of the glutathione in the ACC has been reported as a feature of treatment-refractory psychosis, this observation further supports the potential of glutathione as a biomarker for this subset of patients with psychosis.
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Affiliation(s)
- Min Wang
- Russell H Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- College of Biomedical Engineering and Instrument Science, Zhejiang University, Hangzhou, China
| | - Peter B Barker
- Russell H Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
- F. M. Kirby Research Center for Functional Brain Imaging, Kennedy Krieger Institute, Baltimore, MD, USA.
| | - Nicola G Cascella
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Jennifer M Coughlin
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Gerald Nestadt
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Frederick C Nucifora
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Thomas W Sedlak
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Alexandra Kelly
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Laurent Younes
- Department of Applied Mathematics and Statistics, Johns Hopkins University, Baltimore, MD, USA
| | - Donald Geman
- Department of Applied Mathematics and Statistics, Johns Hopkins University, Baltimore, MD, USA
| | - Lena Palaniyappan
- Robarts Research Institution, University of Western Ontario, London, ON, Canada
- Department of Psychiatry, University of Western Ontario, London, ON, Canada
- Douglas Mental Health University Institute, Department of Psychiatry, McGill University, Montreal, QC, Canada
| | - Akira Sawa
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
- Department of Neuroscience, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
- Department of Biomedical Engineering, Johns Hopkins University, Baltimore, MD, USA.
- Department of Genetic Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
- Department of Pharmacology and Molecular Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
- Department of Mental Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA.
| | - Kun Yang
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
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3
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Etyemez S, Narita Z, Mihaljevic M, Coughlin JM, Nestadt G, Nucifora FC, Sedlak TW, Cascella NG, Batt FD, Hua J, Faria A, Ishizuka K, Kamath V, Yang K, Sawa A. Brain regions associated with olfactory dysfunction in first episode psychosis patients. World J Biol Psychiatry 2023; 24:178-186. [PMID: 35678361 PMCID: PMC10503825 DOI: 10.1080/15622975.2022.2082526] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [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: 12/15/2021] [Revised: 03/03/2022] [Accepted: 03/24/2022] [Indexed: 10/18/2022]
Abstract
OBJECTIVES Olfactory dysfunction is reproducibly reported in psychotic disorders, particularly in association with negative symptoms. The superior frontal gyrus (SFG) has been frequently studied in patients with psychotic disorders, in particular with their associations with negative symptoms. The relationship between olfactory functions and brain structure has been studied in healthy controls (HCs). Nevertheless, the studies with patients with psychotic disorders are limited. Here we report the olfactory-brain relationship in a first episode psychosis (FEP) cohort through both hypothesis-driven (centred on the SFG) and data-driven approaches. METHODS Using data from 88 HCs and 76 FEP patients, we evaluated the correlation between olfactory functions and structural/resting-state functional magnetic resonance imaging (MRI) data. RESULTS We found a significant correlation between the left SFG volume and odour discrimination in FEP patients, but not in HCs. We also observed a significant correlation between rs-fMRI connectivity involving the left SFG and odour discrimination in FEP patients, but not in HCs. The data-driven approach didn't observe any significant correlations, possibly due to insufficient statistical power. CONCLUSION The left SFG may be a promising brain region in the context of olfactory dysfunction and negative symptoms in FEP.
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Affiliation(s)
- Semra Etyemez
- Department of Psychiatry, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Zui Narita
- Department of Psychiatry, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Marina Mihaljevic
- Department of Psychiatry, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Jennifer M. Coughlin
- Department of Psychiatry, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Gerald Nestadt
- Department of Psychiatry, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Frederick C. Nucifora
- Department of Psychiatry, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Thomas W. Sedlak
- Department of Psychiatry, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Nicola G. Cascella
- Department of Psychiatry, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Finn-Davis Batt
- Department of Psychiatry, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Jun Hua
- Department of Radiology and Radiological Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland
- Department of F.M. Kirby Research Center for Functional Brain Imaging, Kennedy Krieger Institute, Baltimore, Maryland
| | - Andreia Faria
- Department of Radiology and Radiological Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Koko Ishizuka
- Department of Psychiatry, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Vidyulata Kamath
- Department of Psychiatry, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Kun Yang
- Department of Psychiatry, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Akira Sawa
- Department of Psychiatry, Johns Hopkins University School of Medicine, Baltimore, Maryland
- Department of Neuroscience, Johns Hopkins University School of Medicine, Baltimore, Maryland
- Department of Biomedical Engineering, Johns Hopkins University School of Medicine, Baltimore, Maryland
- Department of Genetic Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
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Sawa A, Yang K, Cascella NG. Paradigm shift on the concept of schizophrenia that matches with both academic and clinical needs. Schizophr Res 2022; 242:123-125. [PMID: 34991948 PMCID: PMC10503824 DOI: 10.1016/j.schres.2021.12.022] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Revised: 12/13/2021] [Accepted: 12/14/2021] [Indexed: 01/27/2023]
Affiliation(s)
- Akira Sawa
- Department of Psychiatry, Johns Hopkins University School of Medicine, United States; Department of Neuroscience, Johns Hopkins University School of Medicine, United States; Department of Biomedical Engineering, Johns Hopkins University School of Medicine, United States; Department of Genetic Medicine, Johns Hopkins University School of Medicine, United States; Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, United States.
| | - Kun Yang
- Department of Psychiatry, Johns Hopkins University School of Medicine, United States
| | - Nicola G Cascella
- Department of Psychiatry, Johns Hopkins University School of Medicine, United States
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Jaaro-Peled H, Landek-Salgado MA, Cascella NG, Nucifora FC, Coughlin JM, Nestadt G, Sedlak TW, Lavoie J, De Silva S, Lee S, Tajinda K, Hiyama H, Ishizuka K, Yang K, Sawa A. Sex-specific involvement of the Notch-JAG pathway in social recognition. Transl Psychiatry 2022; 12:99. [PMID: 35273151 PMCID: PMC8913639 DOI: 10.1038/s41398-022-01867-4] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Revised: 02/12/2022] [Accepted: 02/24/2022] [Indexed: 12/18/2022] Open
Abstract
Under the hypothesis that olfactory neural epithelium gene expression profiles may be useful to look for disease-relevant neuronal signatures, we examined microarray gene expression in olfactory neuronal cells and underscored Notch-JAG pathway molecules in association with schizophrenia (SZ). The microarray profiling study underscored JAG1 as the most promising candidate. Combined with further validation with real-time PCR, downregulation of NOTCH1 was statistically significant. Accordingly, we reverse-translated the significant finding from a surrogate tissue for neurons, and studied the behavioral profile of Notch1+/- mice. We found a specific impairment in social novelty recognition, whereas other behaviors, such as sociability, novel object recognition and olfaction of social odors, were normal. This social novelty recognition deficit was male-specific and was rescued by rapamycin treatment. Based on the results from the animal model, we next tested whether patients with psychosis might have male-specific alterations in social cognition in association with the expression of NOTCH1 or JAG1. In our first episode psychosis cohort, we observed a specific correlation between the expression of JAG1 and a face processing measure only in male patients. The expression of JAG1 was not correlated with any other cognitive and symptomatic scales in all subjects. Together, although we acknowledge the pioneering and exploratory nature, the present work that combines both human and animal studies in a reciprocal manner suggests a novel role for the Notch-JAG pathway in a behavioral dimension(s) related to social cognition in psychotic disorders in a male-specific manner.
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Affiliation(s)
- Hanna Jaaro-Peled
- grid.21107.350000 0001 2171 9311Department of Psychiatry, Johns Hopkins University School of Medicine, Baltimore, MD 21205 USA
| | - Melissa A. Landek-Salgado
- grid.21107.350000 0001 2171 9311Department of Psychiatry, Johns Hopkins University School of Medicine, Baltimore, MD 21205 USA
| | - Nicola G. Cascella
- grid.21107.350000 0001 2171 9311Department of Psychiatry, Johns Hopkins University School of Medicine, Baltimore, MD 21205 USA
| | - Frederick C. Nucifora
- grid.21107.350000 0001 2171 9311Department of Psychiatry, Johns Hopkins University School of Medicine, Baltimore, MD 21205 USA
| | - Jennifer M. Coughlin
- grid.21107.350000 0001 2171 9311Department of Psychiatry, Johns Hopkins University School of Medicine, Baltimore, MD 21205 USA
| | - Gerald Nestadt
- grid.21107.350000 0001 2171 9311Department of Psychiatry, Johns Hopkins University School of Medicine, Baltimore, MD 21205 USA
| | - Thomas W. Sedlak
- grid.21107.350000 0001 2171 9311Department of Psychiatry, Johns Hopkins University School of Medicine, Baltimore, MD 21205 USA
| | - Joelle Lavoie
- grid.21107.350000 0001 2171 9311Department of Psychiatry, Johns Hopkins University School of Medicine, Baltimore, MD 21205 USA
| | - Sarah De Silva
- grid.21107.350000 0001 2171 9311Department of Psychiatry, Johns Hopkins University School of Medicine, Baltimore, MD 21205 USA
| | - Somin Lee
- grid.21107.350000 0001 2171 9311Department of Psychiatry, Johns Hopkins University School of Medicine, Baltimore, MD 21205 USA
| | - Katsunori Tajinda
- grid.21107.350000 0001 2171 9311Department of Psychiatry, Johns Hopkins University School of Medicine, Baltimore, MD 21205 USA
| | - Hideki Hiyama
- grid.21107.350000 0001 2171 9311Department of Psychiatry, Johns Hopkins University School of Medicine, Baltimore, MD 21205 USA
| | - Koko Ishizuka
- grid.21107.350000 0001 2171 9311Department of Psychiatry, Johns Hopkins University School of Medicine, Baltimore, MD 21205 USA
| | - Kun Yang
- grid.21107.350000 0001 2171 9311Department of Psychiatry, Johns Hopkins University School of Medicine, Baltimore, MD 21205 USA
| | - Akira Sawa
- Department of Psychiatry, Johns Hopkins University School of Medicine, Baltimore, MD, 21205, USA. .,Department of Neuroscience, Johns Hopkins University School of Medicine, Baltimore, MD, 21205, USA. .,Department of Biomedical Engineering, Johns Hopkins University School of Medicine, Baltimore, MD, 21205, USA. .,Department of Genetic Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, 21205, USA. .,Department of Mental Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, 21205, USA.
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6
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Takayanagi Y, Ishizuka K, Laursen TM, Yukitake H, Yang K, Cascella NG, Ueda S, Sumitomo A, Narita Z, Horiuchi Y, Niwa M, Taguchi A, White MF, Eaton WW, Mortensen PB, Sakurai T, Sawa A. From population to neuron: exploring common mediators for metabolic problems and mental illnesses. Mol Psychiatry 2021; 26:3931-3942. [PMID: 33173197 PMCID: PMC8514126 DOI: 10.1038/s41380-020-00939-5] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [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: 07/01/2019] [Revised: 10/05/2020] [Accepted: 10/26/2020] [Indexed: 11/24/2022]
Abstract
Major mental illnesses such as schizophrenia (SZ) and bipolar disorder (BP) frequently accompany metabolic conditions, but their relationship is still unclear, in particular at the mechanistic level. We implemented an approach of "from population to neuron", combining population-based epidemiological analysis with neurobiological experiments using cell and animal models based on a hypothesis built from the epidemiological study. We characterized high-quality population data, olfactory neuronal cells biopsied from patients with SZ or BP, and healthy subjects, as well as mice genetically modified for insulin signaling. We accessed the Danish Registry and observed (1) a higher incidence of diabetes in people with SZ or BP and (2) higher incidence of major mental illnesses in people with diabetes in the same large cohort. These epidemiological data suggest the existence of common pathophysiological mediators in both diabetes and major mental illnesses. We hypothesized that molecules associated with insulin resistance might be such common mediators, and then validated the hypothesis by using two independent sets of olfactory neuronal cells biopsied from patients and healthy controls. In the first set, we confirmed an enrichment of insulin signaling-associated molecules among the genes that were significantly different between SZ patients and controls in unbiased expression profiling data. In the second set, olfactory neuronal cells from SZ and BP patients who were not pre-diabetic or diabetic showed reduced IRS2 tyrosine phosphorylation upon insulin stimulation, indicative of insulin resistance. These cells also displayed an upregulation of IRS1 protein phosphorylation at serine-312 at baseline (without insulin stimulation), further supporting the concept of insulin resistance in olfactory neuronal cells from SZ patients. Finally, Irs2 knockout mice showed an aberrant response to amphetamine, which is also observed in some patients with major mental illnesses. The bi-directional relationships between major mental illnesses and diabetes suggest that there may be common pathophysiological mediators associated with insulin resistance underlying these mental and physical conditions.
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Affiliation(s)
- Yoichiro Takayanagi
- Department of Mental Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA
| | - Koko Ishizuka
- Department of Psychiatry, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Thomas M. Laursen
- National Centre for Register-Based Research, Department of Economics and Business Economics, Aarhus University, Denmark
| | - Hiroshi Yukitake
- Department of Psychiatry, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Kun Yang
- Department of Psychiatry, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Nicola G. Cascella
- Department of Psychiatry, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Shuhei Ueda
- Medical Innovation Center, Kyoto University Graduate School of Medicine, Japan
| | - Akiko Sumitomo
- Medical Innovation Center, Kyoto University Graduate School of Medicine, Japan
| | - Zui Narita
- Department of Psychiatry, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Yasue Horiuchi
- Department of Psychiatry, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Minae Niwa
- Department of Psychiatry, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Akiko Taguchi
- Department of Integrative Aging Neuroscience, National Center for Geriatrics and Gerontology, Japan
| | - Morris F. White
- Division of Endocrinology, Department of Medicine, Boston Children’s Hospital, Harvard Medical School, Boston, MA, USA
| | - William W. Eaton
- Department of Mental Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA
| | - Preben B. Mortensen
- National Centre for Register-Based Research, Department of Economics and Business Economics, Aarhus University, Denmark,The Lundbeck Foundation’s Initiative for Integrative Research, iPSYCH,Center for Integrated Register-based Research at Aarhus University, CIRRAU, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Takeshi Sakurai
- Medical Innovation Center, Kyoto University Graduate School of Medicine, Kyoto, Japan.
| | - Akira Sawa
- Department of Mental Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA. .,Department of Psychiatry, Johns Hopkins University School of Medicine, Baltimore, MD, USA. .,Departments of Neuroscience, Johns Hopkins University School of Medicine, Baltimore, MD, USA. .,Department of Biomedical Engineering, Johns Hopkins University School of Medicine, Baltimore, MD, USA. .,Department of Genetic Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
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7
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Radua J, Vieta E, Shinohara R, Kochunov P, Quidé Y, Green MJ, Weickert CS, Weickert T, Bruggemann J, Kircher T, Nenadić I, Cairns MJ, Seal M, Schall U, Henskens F, Fullerton JM, Mowry B, Pantelis C, Lenroot R, Cropley V, Loughland C, Scott R, Wolf D, Satterthwaite TD, Tan Y, Sim K, Piras F, Spalletta G, Banaj N, Pomarol-Clotet E, Solanes A, Albajes-Eizagirre A, Canales-Rodríguez EJ, Sarro S, Di Giorgio A, Bertolino A, Stäblein M, Oertel V, Knöchel C, Borgwardt S, du Plessis S, Yun JY, Kwon JS, Dannlowski U, Hahn T, Grotegerd D, Alloza C, Arango C, Janssen J, Díaz-Caneja C, Jiang W, Calhoun V, Ehrlich S, Yang K, Cascella NG, Takayanagi Y, Sawa A, Tomyshev A, Lebedeva I, Kaleda V, Kirschner M, Hoschl C, Tomecek D, Skoch A, van Amelsvoort T, Bakker G, James A, Preda A, Weideman A, Stein DJ, Howells F, Uhlmann A, Temmingh H, López-Jaramillo C, Díaz-Zuluaga A, Fortea L, Martinez-Heras E, Solana E, Llufriu S, Jahanshad N, Thompson P, Turner J, van Erp T. Increased power by harmonizing structural MRI site differences with the ComBat batch adjustment method in ENIGMA. Neuroimage 2020; 218:116956. [PMID: 32470572 PMCID: PMC7524039 DOI: 10.1016/j.neuroimage.2020.116956] [Citation(s) in RCA: 104] [Impact Index Per Article: 26.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2020] [Revised: 04/10/2020] [Accepted: 05/15/2020] [Indexed: 11/26/2022] Open
Abstract
A common limitation of neuroimaging studies is their small sample sizes. To overcome this hurdle, the Enhancing Neuro Imaging Genetics through Meta-Analysis (ENIGMA) Consortium combines neuroimaging data from many institutions worldwide. However, this introduces heterogeneity due to different scanning devices and sequences. ENIGMA projects commonly address this heterogeneity with random-effects meta-analysis or mixed-effects mega-analysis. Here we tested whether the batch adjustment method, ComBat, can further reduce site-related heterogeneity and thus increase statistical power. We conducted random-effects meta-analyses, mixed-effects mega-analyses and ComBat mega-analyses to compare cortical thickness, surface area and subcortical volumes between 2897 individuals with a diagnosis of schizophrenia and 3141 healthy controls from 33 sites. Specifically, we compared the imaging data between individuals with schizophrenia and healthy controls, covarying for age and sex. The use of ComBat substantially increased the statistical significance of the findings as compared to random-effects meta-analyses. The findings were more similar when comparing ComBat with mixed-effects mega-analysis, although ComBat still slightly increased the statistical significance. ComBat also showed increased statistical power when we repeated the analyses with fewer sites. Results were nearly identical when we applied the ComBat harmonization separately for cortical thickness, cortical surface area and subcortical volumes. Therefore, we recommend applying the ComBat function to attenuate potential effects of site in ENIGMA projects and other multi-site structural imaging work. We provide easy-to-use functions in R that work even if imaging data are partially missing in some brain regions, and they can be trained with one data set and then applied to another (a requirement for some analyses such as machine learning).
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Affiliation(s)
- Joaquim Radua
- Imaging of Mood- and Anxiety-Related Disorders (IMARD) Group, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; CIBERSAM, Madrid, Spain; Early Psychosis: Interventions and Clinical-detection (EPIC) Lab, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK; Department of Clinical Neuroscience, Stockholm Health Care Services, Stockholm County Council, Karolinska Institutet, Stockholm, Sweden.
| | - Eduard Vieta
- CIBERSAM, Madrid, Spain; Bipolar and depressive disorders, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Barcelona Bipolar Disorders Program, Institute of Neurosciences, Hospital Clinic de Barcelona, Barcelona, Spain; University of Barcelona, Barcelona, Spain
| | - Russell Shinohara
- Penn Statistics in Imaging and Visualization Center, Department of Biostatistics, Epidemiology, and Informatics, University of Pennsylvania, Philadelphia, PA, USA; Center for Biomedical Image Computing and Analytics, University of Pennsylvania, Philadelphia, PA, USA
| | - Peter Kochunov
- Maryland Psychiatric Research Center, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Yann Quidé
- School of Psychiatry, University of New South Wales, Sydney, NSW, Australia; Neuroscience Research Australia, Sydney, NSW, Australia
| | - Melissa J Green
- School of Psychiatry, University of New South Wales, Sydney, NSW, Australia; Neuroscience Research Australia, Sydney, NSW, Australia
| | - Cynthia S Weickert
- School of Psychiatry, University of New South Wales, Sydney, NSW, Australia; Neuroscience Research Australia, Sydney, NSW, Australia; Department of Neuroscience & Physiology, Upstate Medical University, Syracuse, Newyork, NY, USA
| | - Thomas Weickert
- School of Psychiatry, University of New South Wales, Sydney, NSW, Australia; Neuroscience Research Australia, Sydney, NSW, Australia
| | - Jason Bruggemann
- School of Psychiatry, University of New South Wales, Sydney, NSW, Australia; Center for Biomedical Image Computing and Analytics, University of Pennsylvania, Philadelphia, PA, USA
| | - Tilo Kircher
- Department of Psychiatry and Psychotherapy, Philipps-University Marburg, Marburg, Germany
| | - Igor Nenadić
- Department of Psychiatry and Psychotherapy, Philipps-University Marburg, Marburg, Germany
| | - Murray J Cairns
- University of Newcastle, Newcastle, NSW, Australia; Hunter Medical Research Institute, Newcastle, NSW, Australia
| | - Marc Seal
- Murdoch Children's Research Institute, Melbourne, VIC, Australia; The University of Melbourne, Australia
| | - Ulrich Schall
- University of Newcastle, Newcastle, NSW, Australia; Hunter Medical Research Institute, Newcastle, NSW, Australia
| | - Frans Henskens
- Health Behaviour Research Group, School of Medicine and Public Health, University of Newcastle, Newcastle, NSW, Australia
| | - Janice M Fullerton
- School of Medical Sciences, University of New South Wales, Sydney, NSW, Australia; Neuroscience Research Australia, Sydney, NSW, Australia
| | - Bryan Mowry
- Queensland Brain Institute, The University of Queensland, Brisbane, QLD, Australia; Queensland Centre for Mental Health Research, The University of Queensland, Brisbane, QLD, Australia
| | - Christos Pantelis
- Melbourne Neuropsychiatry Centre, Dept. of Psychiatry, University of Melbourne, Melbourne, VIC, Australia; North Western Mental Health, Melbourne Health, Melbourne, VIC, Australia
| | - Rhoshel Lenroot
- School of Psychiatry, University of New South Wales, Sydney, NSW, Australia; Neuroscience Research Australia, Sydney, NSW, Australia; University of New Mexico, Albuquerque, NM, USA
| | - Vanessa Cropley
- Melbourne Neuropsychiatry Centre, Dept. of Psychiatry, University of Melbourne, Melbourne, VIC, Australia
| | | | - Rodney Scott
- University of Newcastle, Newcastle, NSW, Australia
| | - Daniel Wolf
- Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, USA
| | | | - Yunlong Tan
- Psychiatry Research Center, Beijing Huilongguan Hospital, Beijing, China
| | - Kang Sim
- West Region and Research Division, Institute of Mental Health, Singapore, Singapore; Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore; Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore
| | - Fabrizio Piras
- Laboratory of Neuropsychiatry, Department of Clinical and Behavioral Neurology, IRCCS Santa Lucia Foundation, Rome, Italy
| | - Gianfranco 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
| | - Nerisa Banaj
- Laboratory of Neuropsychiatry, Department of Clinical and Behavioral Neurology, IRCCS Santa Lucia Foundation, Rome, Italy
| | - Edith Pomarol-Clotet
- CIBERSAM, Madrid, Spain; FIDMAG Germanes Hospitalàries Research Foundation, Barcelona, Spain
| | - Aleix Solanes
- Imaging of Mood- and Anxiety-Related Disorders (IMARD) Group, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; CIBERSAM, Madrid, Spain; FIDMAG Germanes Hospitalàries Research Foundation, Barcelona, Spain; Department of Psychiatry and Forensic Medicine, School of Medicine, Autonomous University of Barcelona, Barcelona, Spain
| | - Anton Albajes-Eizagirre
- Imaging of Mood- and Anxiety-Related Disorders (IMARD) Group, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; CIBERSAM, Madrid, Spain; FIDMAG Germanes Hospitalàries Research Foundation, Barcelona, Spain
| | - Erick J Canales-Rodríguez
- CIBERSAM, Madrid, Spain; FIDMAG Germanes Hospitalàries Research Foundation, Barcelona, Spain; Department of Radiology, Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne, Switzerland; Signal Processing Lab (LTS5), École Polytechnique Fédérale de Lausanne, Lausanne, Switzerland
| | - Salvador Sarro
- CIBERSAM, Madrid, Spain; FIDMAG Germanes Hospitalàries Research Foundation, Barcelona, Spain; School of Medicine, Universitat Internacional de Catalunya, Barcelona, Spain
| | - Annabella Di Giorgio
- IRCCS Casa Sollievo della Sofferenza, San Giovanni Rotondo, Italy; Department of Basic Medical Science, Neuroscience and Sense Organs, University of Bari 'Aldo Moro', Bari, Italy
| | - Alessandro Bertolino
- Department of Basic Medical Science, Neuroscience and Sense Organs, University of Bari 'Aldo Moro', Bari, Italy
| | - Michael Stäblein
- Dept. of Psychiatry, Psychosomatic Medicine and Psychotherapy, Goethe University Frankfurt, Frankfurt, Germany
| | - Viola Oertel
- Dept. of Psychiatry, Psychosomatic Medicine and Psychotherapy, Goethe University Frankfurt, Frankfurt, Germany
| | - Christian Knöchel
- Dept. of Psychiatry, Psychosomatic Medicine and Psychotherapy, Goethe University Frankfurt, Frankfurt, Germany
| | - Stefan Borgwardt
- Department of Psychiatry, University of Basel, Basel, Switzerland; Department of Psychiatry and Psychotherapy, University Lübeck, Germany
| | - Stefan du Plessis
- University of Stellenbosch, Cape Town, Western Province, South Africa
| | - Je-Yeon Yun
- Seoul National University Hospital, Seoul, Republic of Korea; Yeongeon Student Support Center, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Jun Soo Kwon
- Department of Psychiatry, Seoul National University College of Medicine, Seoul, Republic of Korea; Department of Brain & Cognitive Sciences, College of Natural Sciences, Seoul National University, Seoul, Republic of Korea
| | - Udo Dannlowski
- Department of Psychiatry, University of Münster, Münster, Germany
| | - Tim Hahn
- Department of Psychiatry, University of Münster, Münster, Germany
| | | | - Clara Alloza
- CIBERSAM, Madrid, Spain; Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, Madrid, Spain; Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Madrid, Spain
| | - Celso Arango
- CIBERSAM, Madrid, Spain; Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, Madrid, Spain; Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Madrid, Spain; School of Medicine, Universidad Complutense, Madrid, Spain
| | - Joost Janssen
- CIBERSAM, Madrid, Spain; Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, Madrid, Spain; Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Madrid, Spain
| | - Covadonga Díaz-Caneja
- CIBERSAM, Madrid, Spain; Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, Madrid, Spain; Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Madrid, Spain; School of Medicine, Universidad Complutense, Madrid, Spain
| | | | - Vince Calhoun
- Tri-institutional Center for Translational Research in Neuroimaging and Data Science (TReNDS), Georgia State, Georgia Tech, Emory, Atlanta, GA, USA
| | - Stefan Ehrlich
- Technische Universität Dresden, Faculty of Medicine, Division of Psychological and Social Medicine, Dresden, Germany
| | - Kun Yang
- Departments of Psychiatry, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - Nicola G Cascella
- Departments of Psychiatry, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - Yoichiro Takayanagi
- Department of Neuropsychiatry, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, Toyama, Japan; Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Akira Sawa
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA; Departments of Psychiatry, Neuroscience, and Biomedical Engineering, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | | | | | | | - Matthias Kirschner
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland; Montreal Neurological Institute, McGill University, Montreal, Canada
| | - Cyril Hoschl
- National Institute of Mental Health, Klecany, Czech Republic; Department of Psychiatry and Clinical Psychology, Third Faculty of Medicine, Charles University, Prague, Czech Republic
| | - David Tomecek
- National Institute of Mental Health, Klecany, Czech Republic; Institute of Computer Science, Czech Academy of Sciences, Prague, Czech Republic; Faculty of Electrical Engineering, Czech Technical University in Prague, Prague, Czech Republic
| | - Antonin Skoch
- National Institute of Mental Health, Klecany, Czech Republic; MR Unit, Department of Diagnostic and Interventional Radiology, Institute for Clinical and Experimental Medicine, Prague, Czech Republic
| | - Therese van Amelsvoort
- Department of Psychiatry and Neuropsychology, Maastricht University, Maastricht, The Netherlands
| | - Geor Bakker
- Department of Psychiatry and Neuropsychology, Maastricht University, Maastricht, The Netherlands
| | - Anthony James
- Department of Psychiatry, University of Oxford, Oxford, UK
| | - Adrian Preda
- Department of Psychiatry and Human Behavior, University of California Irvine, Irvine, CA, USA
| | - Andrea Weideman
- Department of Psychiatry and Human Behavior, University of California Irvine, Irvine, CA, USA
| | - Dan J Stein
- SAMRC Unit on Risk & Resilience in Mental Disorders, Dept of Psychiatry and Neuroscience Institute, University of Cape Town, Cape Town, Western Province, South Africa
| | - Fleur Howells
- Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, Western Cape, South Africa; Neuroscience Institute, University of Cape Town, Cape Town, Western Cape, South Africa
| | - Anne Uhlmann
- Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, Western Cape, South Africa; Department of Child and Adolescent Psychiatry, Technische Universität Dresden, Dresden, Germany
| | - Henk Temmingh
- Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, Western Cape, South Africa; Valkenburg Hospital, Observatory, Cape Town, Western Cape, South Africa
| | - Carlos López-Jaramillo
- Research Group in Psychiatry GIPSI, Department of Psychiatry, Faculty of Medicine, Universidad de Antioquia, Medellín, Antioquia, Colombia; Mood Disorders Program, Hospital Universitario San Vicente Fundación, Medellin, Colombia
| | - Ana Díaz-Zuluaga
- Research Group in Psychiatry GIPSI, Department of Psychiatry, Faculty of Medicine, Universidad de Antioquia, Medellín, Antioquia, Colombia
| | - Lydia Fortea
- Imaging of Mood- and Anxiety-Related Disorders (IMARD) Group, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Eloy Martinez-Heras
- University of Barcelona, Barcelona, Spain; Center of Neuroimmunology. Laboratory of Advanced Imaging in Neuroimmunological Diseases. Hospital Clinic de Barcelona, Barcelona, Spain; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Elisabeth Solana
- University of Barcelona, Barcelona, Spain; Center of Neuroimmunology. Laboratory of Advanced Imaging in Neuroimmunological Diseases. Hospital Clinic de Barcelona, Barcelona, Spain; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Sara Llufriu
- University of Barcelona, Barcelona, Spain; Center of Neuroimmunology. Laboratory of Advanced Imaging in Neuroimmunological Diseases. Hospital Clinic de Barcelona, Barcelona, Spain; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Neda Jahanshad
- Imaging Genetics Center, Mark & Mary Stevens Neuroimaging & Informatics Institute, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Paul Thompson
- Imaging Genetics Center, Department of Neurology, University of Southern California, Los Angeles, CA, USA
| | | | - Theo van Erp
- Clinical Translational Neuroscience Laboratory, Department of Psychiatry and Human Behavior, University of California Irvine, Irvine, CA, USA; Center for the Neurobiology of Learning and Memory, University of California Irvine, 309 Qureshey Research Lab, Irvine, CA, 92697, USA
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8
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Barber GS, Sturgeon C, Fasano A, Cascella NG, Eaton WW, McMahon RP, Kelly DL. Elevated zonulin, a measure of tight-junction permeability, may be implicated in schizophrenia. Schizophr Res 2019; 211:111-112. [PMID: 31307857 DOI: 10.1016/j.schres.2019.07.006] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2019] [Revised: 07/03/2019] [Accepted: 07/03/2019] [Indexed: 12/18/2022]
Affiliation(s)
- Gregory S Barber
- University of Maryland Baltimore, School of Medicine, United States of America
| | - Craig Sturgeon
- Massachusetts General Hospital, Center for Celiac Research and Treatment, United States of America
| | - Alessio Fasano
- Massachusetts General Hospital, Center for Celiac Research and Treatment, United States of America
| | - Nicola G Cascella
- Johns Hopkins University, Department of Psychiatry, United States of America
| | - William W Eaton
- Johns Hopkins Hospital, Bloomberg School of Public Health, United States of America
| | - Robert P McMahon
- University of Maryland Baltimore, School of Medicine, United States of America
| | - Deanna L Kelly
- University of Maryland Baltimore, School of Medicine, United States of America.
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9
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Kelly DL, Demyanovich HK, Rodriguez KM, Ciháková D, Talor MV, McMahon RP, Richardson CM, Vyas G, Adams HA, August SM, Fasano A, Cascella NG, Feldman SM, Liu F, Sayer MA, Powell MM, Wehring HJ, Buchanan RW, Gold JM, Carpenter WT, Eaton WW. Randomized controlled trial of a gluten-free diet in patients with schizophrenia positive for antigliadin antibodies (AGA IgG): a pilot feasibility study. J Psychiatry Neurosci 2019; 44. [PMID: 30938127 PMCID: PMC6606425 DOI: 10.1503/jpn.180174] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Approximately one-third of people with schizophrenia have elevated levels of anti-gliadin antibodies of the immunoglobulin G type (AGA IgG) — a higher rate than seen in healthy controls. We performed the first double-blind clinical trial of gluten-free versus gluten-containing diets in a subset of patients with schizophrenia who were positive for AGA IgG. METHODS In this pilot feasibility study, 16 participants with schizophrenia or schizoaffective disorder who had elevated AGA IgG (≥ 20 U) but were negative for celiac disease were admitted to an inpatient unit for a 5-week trial. All participants received standardized gluten-free meals and were randomized in a double-blind fashion to receive a shake containing 10 g of gluten flour or 10 g of rice flour each day. Participants were rated for psychiatric, cognitive and gastrointestinal symptoms at baseline and endpoint. RESULTS Of the 16 participants, 14 completed the 5-week trial (2 discontinued early for administrative reasons). Compared with participants on the gluten-containing diet, participants on the gluten-free diet showed improvement on the Clinical Global Impressions scale (Cohen d = –0.75) and in negative symptoms (Cohen d = –0.53). We noted no improvement in positive or global cognitive symptoms, but did observe an improvement in attention favouring the gluten-free diet (Cohen d = 0.60). Robust improvements in gastrointestinal adverse effects occurred in the gluten-free group relative to the glutencontaining group. Adverse effects were similar between groups. LIMITATIONS This study was limited by its small sample size; larger studies are needed. CONCLUSION This feasibility study suggests that removal of gluten from the diet is associated with improvement in psychiatric and gastrointestinal symptoms in people with schizophrenia or schizoaffective disorder.
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Affiliation(s)
- Deanna L. Kelly
- From the Maryland Psychiatric Research Center (MPRC), School of Medicine, University of Maryland, College Park, MD (Kelly, McMahon, August, Feldman, Liu, Powell, Wehring, Buchanan, Gold, Carpenter); the Department of Orthopedics, School of Medicine, University of Maryland, College Park, MD (Demyanovich); the Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD (Rodriguez, Eaton); the Department of Pathology, Division of Immunology, Immune Disorders Laboratory, Johns Hopkins University, Baltimore, MD (Cˇiháková, Talor); the Spring Grove Hospital Center, Baltimore, MD (Richardson, Vyas, Adams); the Center for Celiac Research and Treatment, Massachusetts General Hospital, Boston, MA (Fasano); the Department of Psychiatry and Behavioral Sciences, Johns Hopkins University, Baltimore, MD (Cascella); the Department of Psychology, Kent State University, Kent, OH (Sayer)
| | - Haley K. Demyanovich
- From the Maryland Psychiatric Research Center (MPRC), School of Medicine, University of Maryland, College Park, MD (Kelly, McMahon, August, Feldman, Liu, Powell, Wehring, Buchanan, Gold, Carpenter); the Department of Orthopedics, School of Medicine, University of Maryland, College Park, MD (Demyanovich); the Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD (Rodriguez, Eaton); the Department of Pathology, Division of Immunology, Immune Disorders Laboratory, Johns Hopkins University, Baltimore, MD (Cˇiháková, Talor); the Spring Grove Hospital Center, Baltimore, MD (Richardson, Vyas, Adams); the Center for Celiac Research and Treatment, Massachusetts General Hospital, Boston, MA (Fasano); the Department of Psychiatry and Behavioral Sciences, Johns Hopkins University, Baltimore, MD (Cascella); the Department of Psychology, Kent State University, Kent, OH (Sayer)
| | - Katrina M. Rodriguez
- From the Maryland Psychiatric Research Center (MPRC), School of Medicine, University of Maryland, College Park, MD (Kelly, McMahon, August, Feldman, Liu, Powell, Wehring, Buchanan, Gold, Carpenter); the Department of Orthopedics, School of Medicine, University of Maryland, College Park, MD (Demyanovich); the Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD (Rodriguez, Eaton); the Department of Pathology, Division of Immunology, Immune Disorders Laboratory, Johns Hopkins University, Baltimore, MD (Cˇiháková, Talor); the Spring Grove Hospital Center, Baltimore, MD (Richardson, Vyas, Adams); the Center for Celiac Research and Treatment, Massachusetts General Hospital, Boston, MA (Fasano); the Department of Psychiatry and Behavioral Sciences, Johns Hopkins University, Baltimore, MD (Cascella); the Department of Psychology, Kent State University, Kent, OH (Sayer)
| | - Daniela Ciháková
- From the Maryland Psychiatric Research Center (MPRC), School of Medicine, University of Maryland, College Park, MD (Kelly, McMahon, August, Feldman, Liu, Powell, Wehring, Buchanan, Gold, Carpenter); the Department of Orthopedics, School of Medicine, University of Maryland, College Park, MD (Demyanovich); the Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD (Rodriguez, Eaton); the Department of Pathology, Division of Immunology, Immune Disorders Laboratory, Johns Hopkins University, Baltimore, MD (Cˇiháková, Talor); the Spring Grove Hospital Center, Baltimore, MD (Richardson, Vyas, Adams); the Center for Celiac Research and Treatment, Massachusetts General Hospital, Boston, MA (Fasano); the Department of Psychiatry and Behavioral Sciences, Johns Hopkins University, Baltimore, MD (Cascella); the Department of Psychology, Kent State University, Kent, OH (Sayer)
| | - Monica V. Talor
- From the Maryland Psychiatric Research Center (MPRC), School of Medicine, University of Maryland, College Park, MD (Kelly, McMahon, August, Feldman, Liu, Powell, Wehring, Buchanan, Gold, Carpenter); the Department of Orthopedics, School of Medicine, University of Maryland, College Park, MD (Demyanovich); the Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD (Rodriguez, Eaton); the Department of Pathology, Division of Immunology, Immune Disorders Laboratory, Johns Hopkins University, Baltimore, MD (Cˇiháková, Talor); the Spring Grove Hospital Center, Baltimore, MD (Richardson, Vyas, Adams); the Center for Celiac Research and Treatment, Massachusetts General Hospital, Boston, MA (Fasano); the Department of Psychiatry and Behavioral Sciences, Johns Hopkins University, Baltimore, MD (Cascella); the Department of Psychology, Kent State University, Kent, OH (Sayer)
| | - Robert P. McMahon
- From the Maryland Psychiatric Research Center (MPRC), School of Medicine, University of Maryland, College Park, MD (Kelly, McMahon, August, Feldman, Liu, Powell, Wehring, Buchanan, Gold, Carpenter); the Department of Orthopedics, School of Medicine, University of Maryland, College Park, MD (Demyanovich); the Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD (Rodriguez, Eaton); the Department of Pathology, Division of Immunology, Immune Disorders Laboratory, Johns Hopkins University, Baltimore, MD (Cˇiháková, Talor); the Spring Grove Hospital Center, Baltimore, MD (Richardson, Vyas, Adams); the Center for Celiac Research and Treatment, Massachusetts General Hospital, Boston, MA (Fasano); the Department of Psychiatry and Behavioral Sciences, Johns Hopkins University, Baltimore, MD (Cascella); the Department of Psychology, Kent State University, Kent, OH (Sayer)
| | - Charles M. Richardson
- From the Maryland Psychiatric Research Center (MPRC), School of Medicine, University of Maryland, College Park, MD (Kelly, McMahon, August, Feldman, Liu, Powell, Wehring, Buchanan, Gold, Carpenter); the Department of Orthopedics, School of Medicine, University of Maryland, College Park, MD (Demyanovich); the Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD (Rodriguez, Eaton); the Department of Pathology, Division of Immunology, Immune Disorders Laboratory, Johns Hopkins University, Baltimore, MD (Cˇiháková, Talor); the Spring Grove Hospital Center, Baltimore, MD (Richardson, Vyas, Adams); the Center for Celiac Research and Treatment, Massachusetts General Hospital, Boston, MA (Fasano); the Department of Psychiatry and Behavioral Sciences, Johns Hopkins University, Baltimore, MD (Cascella); the Department of Psychology, Kent State University, Kent, OH (Sayer)
| | - Gopal Vyas
- From the Maryland Psychiatric Research Center (MPRC), School of Medicine, University of Maryland, College Park, MD (Kelly, McMahon, August, Feldman, Liu, Powell, Wehring, Buchanan, Gold, Carpenter); the Department of Orthopedics, School of Medicine, University of Maryland, College Park, MD (Demyanovich); the Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD (Rodriguez, Eaton); the Department of Pathology, Division of Immunology, Immune Disorders Laboratory, Johns Hopkins University, Baltimore, MD (Cˇiháková, Talor); the Spring Grove Hospital Center, Baltimore, MD (Richardson, Vyas, Adams); the Center for Celiac Research and Treatment, Massachusetts General Hospital, Boston, MA (Fasano); the Department of Psychiatry and Behavioral Sciences, Johns Hopkins University, Baltimore, MD (Cascella); the Department of Psychology, Kent State University, Kent, OH (Sayer)
| | - Heather A. Adams
- From the Maryland Psychiatric Research Center (MPRC), School of Medicine, University of Maryland, College Park, MD (Kelly, McMahon, August, Feldman, Liu, Powell, Wehring, Buchanan, Gold, Carpenter); the Department of Orthopedics, School of Medicine, University of Maryland, College Park, MD (Demyanovich); the Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD (Rodriguez, Eaton); the Department of Pathology, Division of Immunology, Immune Disorders Laboratory, Johns Hopkins University, Baltimore, MD (Cˇiháková, Talor); the Spring Grove Hospital Center, Baltimore, MD (Richardson, Vyas, Adams); the Center for Celiac Research and Treatment, Massachusetts General Hospital, Boston, MA (Fasano); the Department of Psychiatry and Behavioral Sciences, Johns Hopkins University, Baltimore, MD (Cascella); the Department of Psychology, Kent State University, Kent, OH (Sayer)
| | - Sharon M. August
- From the Maryland Psychiatric Research Center (MPRC), School of Medicine, University of Maryland, College Park, MD (Kelly, McMahon, August, Feldman, Liu, Powell, Wehring, Buchanan, Gold, Carpenter); the Department of Orthopedics, School of Medicine, University of Maryland, College Park, MD (Demyanovich); the Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD (Rodriguez, Eaton); the Department of Pathology, Division of Immunology, Immune Disorders Laboratory, Johns Hopkins University, Baltimore, MD (Cˇiháková, Talor); the Spring Grove Hospital Center, Baltimore, MD (Richardson, Vyas, Adams); the Center for Celiac Research and Treatment, Massachusetts General Hospital, Boston, MA (Fasano); the Department of Psychiatry and Behavioral Sciences, Johns Hopkins University, Baltimore, MD (Cascella); the Department of Psychology, Kent State University, Kent, OH (Sayer)
| | - Alessio Fasano
- From the Maryland Psychiatric Research Center (MPRC), School of Medicine, University of Maryland, College Park, MD (Kelly, McMahon, August, Feldman, Liu, Powell, Wehring, Buchanan, Gold, Carpenter); the Department of Orthopedics, School of Medicine, University of Maryland, College Park, MD (Demyanovich); the Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD (Rodriguez, Eaton); the Department of Pathology, Division of Immunology, Immune Disorders Laboratory, Johns Hopkins University, Baltimore, MD (Cˇiháková, Talor); the Spring Grove Hospital Center, Baltimore, MD (Richardson, Vyas, Adams); the Center for Celiac Research and Treatment, Massachusetts General Hospital, Boston, MA (Fasano); the Department of Psychiatry and Behavioral Sciences, Johns Hopkins University, Baltimore, MD (Cascella); the Department of Psychology, Kent State University, Kent, OH (Sayer)
| | - Nicola G. Cascella
- From the Maryland Psychiatric Research Center (MPRC), School of Medicine, University of Maryland, College Park, MD (Kelly, McMahon, August, Feldman, Liu, Powell, Wehring, Buchanan, Gold, Carpenter); the Department of Orthopedics, School of Medicine, University of Maryland, College Park, MD (Demyanovich); the Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD (Rodriguez, Eaton); the Department of Pathology, Division of Immunology, Immune Disorders Laboratory, Johns Hopkins University, Baltimore, MD (Cˇiháková, Talor); the Spring Grove Hospital Center, Baltimore, MD (Richardson, Vyas, Adams); the Center for Celiac Research and Treatment, Massachusetts General Hospital, Boston, MA (Fasano); the Department of Psychiatry and Behavioral Sciences, Johns Hopkins University, Baltimore, MD (Cascella); the Department of Psychology, Kent State University, Kent, OH (Sayer)
| | - Stephanie M. Feldman
- From the Maryland Psychiatric Research Center (MPRC), School of Medicine, University of Maryland, College Park, MD (Kelly, McMahon, August, Feldman, Liu, Powell, Wehring, Buchanan, Gold, Carpenter); the Department of Orthopedics, School of Medicine, University of Maryland, College Park, MD (Demyanovich); the Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD (Rodriguez, Eaton); the Department of Pathology, Division of Immunology, Immune Disorders Laboratory, Johns Hopkins University, Baltimore, MD (Cˇiháková, Talor); the Spring Grove Hospital Center, Baltimore, MD (Richardson, Vyas, Adams); the Center for Celiac Research and Treatment, Massachusetts General Hospital, Boston, MA (Fasano); the Department of Psychiatry and Behavioral Sciences, Johns Hopkins University, Baltimore, MD (Cascella); the Department of Psychology, Kent State University, Kent, OH (Sayer)
| | - Fang Liu
- From the Maryland Psychiatric Research Center (MPRC), School of Medicine, University of Maryland, College Park, MD (Kelly, McMahon, August, Feldman, Liu, Powell, Wehring, Buchanan, Gold, Carpenter); the Department of Orthopedics, School of Medicine, University of Maryland, College Park, MD (Demyanovich); the Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD (Rodriguez, Eaton); the Department of Pathology, Division of Immunology, Immune Disorders Laboratory, Johns Hopkins University, Baltimore, MD (Cˇiháková, Talor); the Spring Grove Hospital Center, Baltimore, MD (Richardson, Vyas, Adams); the Center for Celiac Research and Treatment, Massachusetts General Hospital, Boston, MA (Fasano); the Department of Psychiatry and Behavioral Sciences, Johns Hopkins University, Baltimore, MD (Cascella); the Department of Psychology, Kent State University, Kent, OH (Sayer)
| | - MacKenzie A. Sayer
- From the Maryland Psychiatric Research Center (MPRC), School of Medicine, University of Maryland, College Park, MD (Kelly, McMahon, August, Feldman, Liu, Powell, Wehring, Buchanan, Gold, Carpenter); the Department of Orthopedics, School of Medicine, University of Maryland, College Park, MD (Demyanovich); the Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD (Rodriguez, Eaton); the Department of Pathology, Division of Immunology, Immune Disorders Laboratory, Johns Hopkins University, Baltimore, MD (Cˇiháková, Talor); the Spring Grove Hospital Center, Baltimore, MD (Richardson, Vyas, Adams); the Center for Celiac Research and Treatment, Massachusetts General Hospital, Boston, MA (Fasano); the Department of Psychiatry and Behavioral Sciences, Johns Hopkins University, Baltimore, MD (Cascella); the Department of Psychology, Kent State University, Kent, OH (Sayer)
| | - Megan M. Powell
- From the Maryland Psychiatric Research Center (MPRC), School of Medicine, University of Maryland, College Park, MD (Kelly, McMahon, August, Feldman, Liu, Powell, Wehring, Buchanan, Gold, Carpenter); the Department of Orthopedics, School of Medicine, University of Maryland, College Park, MD (Demyanovich); the Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD (Rodriguez, Eaton); the Department of Pathology, Division of Immunology, Immune Disorders Laboratory, Johns Hopkins University, Baltimore, MD (Cˇiháková, Talor); the Spring Grove Hospital Center, Baltimore, MD (Richardson, Vyas, Adams); the Center for Celiac Research and Treatment, Massachusetts General Hospital, Boston, MA (Fasano); the Department of Psychiatry and Behavioral Sciences, Johns Hopkins University, Baltimore, MD (Cascella); the Department of Psychology, Kent State University, Kent, OH (Sayer)
| | - Heidi J. Wehring
- From the Maryland Psychiatric Research Center (MPRC), School of Medicine, University of Maryland, College Park, MD (Kelly, McMahon, August, Feldman, Liu, Powell, Wehring, Buchanan, Gold, Carpenter); the Department of Orthopedics, School of Medicine, University of Maryland, College Park, MD (Demyanovich); the Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD (Rodriguez, Eaton); the Department of Pathology, Division of Immunology, Immune Disorders Laboratory, Johns Hopkins University, Baltimore, MD (Cˇiháková, Talor); the Spring Grove Hospital Center, Baltimore, MD (Richardson, Vyas, Adams); the Center for Celiac Research and Treatment, Massachusetts General Hospital, Boston, MA (Fasano); the Department of Psychiatry and Behavioral Sciences, Johns Hopkins University, Baltimore, MD (Cascella); the Department of Psychology, Kent State University, Kent, OH (Sayer)
| | - Robert W. Buchanan
- From the Maryland Psychiatric Research Center (MPRC), School of Medicine, University of Maryland, College Park, MD (Kelly, McMahon, August, Feldman, Liu, Powell, Wehring, Buchanan, Gold, Carpenter); the Department of Orthopedics, School of Medicine, University of Maryland, College Park, MD (Demyanovich); the Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD (Rodriguez, Eaton); the Department of Pathology, Division of Immunology, Immune Disorders Laboratory, Johns Hopkins University, Baltimore, MD (Cˇiháková, Talor); the Spring Grove Hospital Center, Baltimore, MD (Richardson, Vyas, Adams); the Center for Celiac Research and Treatment, Massachusetts General Hospital, Boston, MA (Fasano); the Department of Psychiatry and Behavioral Sciences, Johns Hopkins University, Baltimore, MD (Cascella); the Department of Psychology, Kent State University, Kent, OH (Sayer)
| | - James M. Gold
- From the Maryland Psychiatric Research Center (MPRC), School of Medicine, University of Maryland, College Park, MD (Kelly, McMahon, August, Feldman, Liu, Powell, Wehring, Buchanan, Gold, Carpenter); the Department of Orthopedics, School of Medicine, University of Maryland, College Park, MD (Demyanovich); the Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD (Rodriguez, Eaton); the Department of Pathology, Division of Immunology, Immune Disorders Laboratory, Johns Hopkins University, Baltimore, MD (Cˇiháková, Talor); the Spring Grove Hospital Center, Baltimore, MD (Richardson, Vyas, Adams); the Center for Celiac Research and Treatment, Massachusetts General Hospital, Boston, MA (Fasano); the Department of Psychiatry and Behavioral Sciences, Johns Hopkins University, Baltimore, MD (Cascella); the Department of Psychology, Kent State University, Kent, OH (Sayer)
| | - William T. Carpenter
- From the Maryland Psychiatric Research Center (MPRC), School of Medicine, University of Maryland, College Park, MD (Kelly, McMahon, August, Feldman, Liu, Powell, Wehring, Buchanan, Gold, Carpenter); the Department of Orthopedics, School of Medicine, University of Maryland, College Park, MD (Demyanovich); the Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD (Rodriguez, Eaton); the Department of Pathology, Division of Immunology, Immune Disorders Laboratory, Johns Hopkins University, Baltimore, MD (Cˇiháková, Talor); the Spring Grove Hospital Center, Baltimore, MD (Richardson, Vyas, Adams); the Center for Celiac Research and Treatment, Massachusetts General Hospital, Boston, MA (Fasano); the Department of Psychiatry and Behavioral Sciences, Johns Hopkins University, Baltimore, MD (Cascella); the Department of Psychology, Kent State University, Kent, OH (Sayer)
| | - William W. Eaton
- From the Maryland Psychiatric Research Center (MPRC), School of Medicine, University of Maryland, College Park, MD (Kelly, McMahon, August, Feldman, Liu, Powell, Wehring, Buchanan, Gold, Carpenter); the Department of Orthopedics, School of Medicine, University of Maryland, College Park, MD (Demyanovich); the Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD (Rodriguez, Eaton); the Department of Pathology, Division of Immunology, Immune Disorders Laboratory, Johns Hopkins University, Baltimore, MD (Cˇiháková, Talor); the Spring Grove Hospital Center, Baltimore, MD (Richardson, Vyas, Adams); the Center for Celiac Research and Treatment, Massachusetts General Hospital, Boston, MA (Fasano); the Department of Psychiatry and Behavioral Sciences, Johns Hopkins University, Baltimore, MD (Cascella); the Department of Psychology, Kent State University, Kent, OH (Sayer)
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10
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Gault JM, Davis R, Cascella NG, Saks ER, Corripio-Collado I, Anderson WS, Olincy A, Thompson JA, Pomarol-Clotet E, Sawa A, Daskalakis ZJ, Lipsman N, Abosch A. Approaches to neuromodulation for schizophrenia. J Neurol Neurosurg Psychiatry 2018; 89:777-787. [PMID: 29242310 DOI: 10.1136/jnnp-2017-316946] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [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: 07/27/2017] [Revised: 10/09/2017] [Accepted: 10/29/2017] [Indexed: 11/03/2022]
Abstract
Based on the success of deep brain stimulation (DBS) for treating movement disorders, there is growing interest in using DBS to treat schizophrenia (SZ). We review the unmet needs of patients with SZ and the scientific rationale behind the DBS targets proposed in the literature in order to guide future development of DBS to treat this vulnerable patient population. SZ remains a devastating disorder despite treatment. Relapse, untreated psychosis, intolerable side effects and the lack of effective treatment for negative and cognitive symptoms contribute to poor outcome. Novel therapeutic interventions are needed to treat SZ and DBS is emerging as a potential intervention. Convergent genetic, pharmacological and neuroimaging evidence implicating neuropathology associated with psychosis is consistent with SZ being a circuit disorder amenable to striatal modulation with DBS. Many of the DBS targets proposed in the literature may modulate striatal dysregulation. Additional targets are considered for treating tardive dyskinesia and negative and cognitive symptoms. A need is identified for the concurrent development of neurophysiological biomarkers relevant to SZ pathology in order to inform DBS targeting. Finally, we discuss the current clinical trials of DBS for SZ, and their ethical considerations. We conclude that patients with severe symptoms despite treatment must have the capacity to consent for a DBS clinical trial in which risks can be estimated, but benefit is not known. In addition, psychiatric populations should have access to the potential benefits of neurosurgical advances.
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Affiliation(s)
- Judith M Gault
- Department of Neurosurgery, University of Colorado at Denver Anschutz Medical Campus, Aurora, Colorado, USA.,Department of Psychiatry, University of Colorado Anschutz Medical Center, Aurora, Colorado, USA
| | - Rachel Davis
- Department of Psychiatry, University of Colorado Anschutz Medical Center, Aurora, Colorado, USA
| | - Nicola G Cascella
- Department of Psychiatry, School of Medicine, Johns Hopkins University, Baltimore, Maryland, USA
| | - Elyn R Saks
- University of Southern California Law School, Los Angeles, California, USA
| | - Iluminada Corripio-Collado
- Psychiatric Department, Hospital de la Santa Creu i Sant Pau, Institut d'Investigació Biomèdica Sant Pau (IIB-Sant Pau), Universitat Autònoma de Barcelona, Barcelona, Catalonia, Spain.,Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Barcelona, Spain
| | - William S Anderson
- Department of Neurosurgery, Johns Hopkins Hospital, Baltimore, Maryland, USA
| | - Ann Olincy
- Department of Psychiatry, University of Colorado Anschutz Medical Center, Aurora, Colorado, USA
| | - John A Thompson
- Department of Neurosurgery, University of Colorado at Denver Anschutz Medical Campus, Aurora, Colorado, USA
| | - Edith Pomarol-Clotet
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), FIDMAG Germanes Hospitalàries Research Foundation, Barcelona, Spain
| | - Akira Sawa
- Department of Psychiatry, School of Medicine, Johns Hopkins University, Baltimore, Maryland, USA
| | - Zafiris J Daskalakis
- Centre for Addiction and Mental Health Collaborative Program in Neuroscience, University of Toronto, Toronto, Ontario, Canada
| | - Nir Lipsman
- Division of Neurosurgery, Sunnybrook Health Science Centre, University of Toronto, Toronto, Ontario, Canada
| | - Aviva Abosch
- Department of Neurosurgery, University of Colorado at Denver Anschutz Medical Campus, Aurora, Colorado, USA.,Department of Neurology, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
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11
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McLean CK, Narayan S, Lin SY, Rai N, Chung Y, Hipolito MS, Cascella NG, Nurnberger JI, Ishizuka K, Sawa AS, Nwulia EA. Lithium-associated transcriptional regulation of CRMP1 in patient-derived olfactory neurons and symptom changes in bipolar disorder. Transl Psychiatry 2018; 8:81. [PMID: 29666369 PMCID: PMC5904136 DOI: 10.1038/s41398-018-0126-6] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2017] [Accepted: 12/13/2017] [Indexed: 12/17/2022] Open
Abstract
There is growing evidence that lithium used in the treatment of bipolar disorder (BD) affects molecular targets that are involved in neuronal growth, survival, and maturation, but it remains unclear if neuronal alterations in any of these molecules predict specific symptom changes in BD patients undergoing lithium monotherapy. The goals of this study were to (a) determine which molecular changes in the olfactory neurons of symptomatic patients receiving lithium are associated with antimanic or antidepressant response, and (b) uncover novel intraneuronal regulatory mechanisms of lithium therapy. Twenty-two treatment-naïve non-smoking patients, with symptomatic BD underwent nasal biopsies for collection of olfactory tissues, prior to their treatment and following a 6-week course of lithium monotherapy. Sixteen healthy controls were also biopsied. Combining laser capture microdissection with real-time polymerase chain reaction, we investigated baseline and treatment-associated transcriptional changes in candidate molecular targets of lithium action in the olfactory neuroepithelium. Baseline mRNA levels of glycogen synthase kinase 3 beta (GSK3β) and collapsin response mediator protein 1 (CRMP1) genes were significantly associated with BD status and with severity of mood symptoms. Among BD subjects, treatment-associated downregulation of CRMP1 expression was most predictive of decreases in both manic and depressive symptoms. This study provides a novel insight into the relevance of CRMP1, a key molecule in semaphorin-3A signaling during neurodevelopment, in the molecular mechanism of action of lithium, and in the pathophysiology of BD. It supports the use of human-derived olfactory neuronal tissues in the evaluation of treatment response of psychiatric disorders.
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Affiliation(s)
- Charlee K. McLean
- 0000 0001 0547 4545grid.257127.4Department of Psychiatry and Behavioral Sciences, Howard University, Washington, DC USA
| | - Soumya Narayan
- 0000 0001 2171 9311grid.21107.35Department of Psychiatry, Johns Hopkins University, Baltimore, MD USA
| | - Sandra Y. Lin
- 0000 0001 2171 9311grid.21107.35Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University, Baltimore, MD USA
| | - Narayan Rai
- 0000 0001 0547 4545grid.257127.4Department of Psychiatry and Behavioral Sciences, Howard University, Washington, DC USA
| | - Youjin Chung
- 0000 0001 2171 9311grid.21107.35Department of Psychiatry, Johns Hopkins University, Baltimore, MD USA
| | - MariaMananita S. Hipolito
- 0000 0001 0547 4545grid.257127.4Department of Psychiatry and Behavioral Sciences, Howard University, Washington, DC USA
| | - Nicola G. Cascella
- grid.415690.fDepartment of Psychiatry, Sheppard Pratt Health Systems, Baltimore, MD USA
| | - John I Nurnberger
- 0000 0001 0790 959Xgrid.411377.7Department of Psychiatry, Indiana University, Bloomington, IN USA
| | - Koko Ishizuka
- 0000 0001 2171 9311grid.21107.35Department of Psychiatry, Johns Hopkins University, Baltimore, MD USA
| | - Akira S. Sawa
- 0000 0001 2171 9311grid.21107.35Department of Psychiatry, Johns Hopkins University, Baltimore, MD USA
| | - Evaristus A. Nwulia
- 0000 0001 0547 4545grid.257127.4Department of Psychiatry and Behavioral Sciences, Howard University, Washington, DC USA
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12
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Posporelis S, Coughlin JM, Marsman A, Pradhan S, Tanaka T, Wang H, Varvaris M, Ward R, Higgs C, Edwards JA, Ford CN, Kim PK, Lloyd AM, Edden RAE, Schretlen DJ, Cascella NG, Barker PB, Sawa A. Decoupling of Brain Temperature and Glutamate in Recent Onset of Schizophrenia: A 7T Proton Magnetic Resonance Spectroscopy Study. Biol Psychiatry Cogn Neurosci Neuroimaging 2018; 3:248-254. [PMID: 29486866 PMCID: PMC5836506 DOI: 10.1016/j.bpsc.2017.04.003] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/27/2016] [Revised: 03/23/2017] [Accepted: 04/10/2017] [Indexed: 01/09/2023]
Abstract
BACKGROUND Converging evidence suggests that cerebral metabolic and cellular homeostasis is altered in patients with recent onset of schizophrenia. As a possible marker of metabolic changes that might link to altered neurotransmission, we used proton magnetic resonance spectroscopy to estimate brain temperature, and we evaluated its relationship to a relevant metabolite, glutamate, within this study population. METHODS Using proton magnetic resonance spectroscopy at 7T, 20 patients with recent onset (≤24 months after first psychotic symptoms) of schizophrenia and 20 healthy control subjects were studied. We measured levels of N-acetylaspartate and glutamate and estimated brain temperature in a noninvasive manner. RESULTS Healthy control subjects showed a significant negative correlation between glutamate and brain temperature in the anterior cingulate cortex. In contrast, the physiological correlation between glutamate and brain temperature was lost in patients with recent onset of schizophrenia. CONCLUSIONS This study supports the hypothesized disrupted relationship between brain metabolism and neurotransmission in patients with recent onset of schizophrenia. The findings include mechanistic implications that are to be followed up in both preclinical and clinical studies.
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Affiliation(s)
- Sotirios Posporelis
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins Medical Institutions, Baltimore, Maryland; South London and Maudsley National Health Service Foundation Trust, London, United Kingdom
| | - Jennifer M Coughlin
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins Medical Institutions, Baltimore, Maryland; Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins Medical Institutions, Baltimore, Maryland
| | - Anouk Marsman
- Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins Medical Institutions, Baltimore, Maryland
| | - Subechhya Pradhan
- Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins Medical Institutions, Baltimore, Maryland
| | - Teppei Tanaka
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins Medical Institutions, Baltimore, Maryland
| | - Hongxing Wang
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins Medical Institutions, Baltimore, Maryland
| | - Mark Varvaris
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins Medical Institutions, Baltimore, Maryland
| | - Rebecca Ward
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins Medical Institutions, Baltimore, Maryland
| | - Cecilia Higgs
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins Medical Institutions, Baltimore, Maryland
| | - Jamie A Edwards
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins Medical Institutions, Baltimore, Maryland
| | - Candice N Ford
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins Medical Institutions, Baltimore, Maryland
| | - Pearl K Kim
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins Medical Institutions, Baltimore, Maryland
| | - Ashley M Lloyd
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins Medical Institutions, Baltimore, Maryland
| | - Richard A E Edden
- Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins Medical Institutions, Baltimore, Maryland
| | - David J Schretlen
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins Medical Institutions, Baltimore, Maryland
| | - Nicola G Cascella
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins Medical Institutions, Baltimore, Maryland
| | - Peter B Barker
- Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins Medical Institutions, Baltimore, Maryland
| | - Akira Sawa
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins Medical Institutions, Baltimore, Maryland.
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13
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Lavoie J, Gassó Astorga P, Segal-Gavish H, Wu YC, Chung Y, Cascella NG, Sawa A, Ishizuka K. The Olfactory Neural Epithelium As a Tool in Neuroscience. Trends Mol Med 2017; 23:100-103. [PMID: 28108112 DOI: 10.1016/j.molmed.2016.12.010] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2016] [Revised: 12/19/2016] [Accepted: 12/19/2016] [Indexed: 12/31/2022]
Abstract
Capturing both dynamic changes (state) and persistent signatures (trait) directly associated with disease at the molecular level is crucial in modern medicine. The olfactory neural epithelium, easily accessible in clinical settings, is a promising surrogate model in translational brain medicine, complementing the limitations in current engineered cell models.
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Affiliation(s)
- Joëlle Lavoie
- Department of Psychiatry and Behavioral Science, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Patricia Gassó Astorga
- Department of Psychiatry and Behavioral Science, Johns Hopkins University School of Medicine, Baltimore, MD, USA; Current address: Faculty of Medicine, University of Barcelona, Barcelona, Spain
| | - Hadar Segal-Gavish
- Department of Psychiatry and Behavioral Science, Johns Hopkins University School of Medicine, Baltimore, MD, USA; Current address: Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - YeeWen Candace Wu
- Department of Psychiatry and Behavioral Science, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Youjin Chung
- Department of Psychiatry and Behavioral Science, Johns Hopkins University School of Medicine, Baltimore, MD, USA; Current address: Jacobs School of Medicine and Biomedical Sciences, SUNY Buffalo, Buffalo, NY, USA
| | | | - Akira Sawa
- Department of Psychiatry and Behavioral Science, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
| | - Koko Ishizuka
- Department of Psychiatry and Behavioral Science, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
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14
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Horiuchi Y, Kondo MA, Okada K, Takayanagi Y, Tanaka T, Ho T, Varvaris M, Tajinda K, Hiyama H, Ni K, Colantuoni C, Schretlen D, Cascella NG, Pevsner J, Ishizuka K, Sawa A. Molecular signatures associated with cognitive deficits in schizophrenia: a study of biopsied olfactory neural epithelium. Transl Psychiatry 2016; 6:e915. [PMID: 27727244 PMCID: PMC5315541 DOI: 10.1038/tp.2016.154] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2015] [Revised: 06/21/2016] [Accepted: 07/12/2016] [Indexed: 01/10/2023] Open
Abstract
Cognitive impairment is a key feature of schizophrenia (SZ) and determines functional outcome. Nonetheless, molecular signatures in neuronal tissues that associate with deficits are not well understood. We conducted nasal biopsy to obtain olfactory epithelium from patients with SZ and control subjects. The neural layers from the biopsied epithelium were enriched by laser-captured microdissection. We then performed an unbiased microarray expression study and implemented a systematic neuropsychological assessment on the same participants. The differentially regulated genes in SZ were further filtered based on correlation with neuropsychological traits. This strategy identified the SMAD 5 gene, and real-time quantitative PCR analysis also supports downregulation of the SMAD pathway in SZ. The SMAD pathway has been important in multiple tissues, including the role for neurodevelopment and bone formation. Here the involvement of the pathway in adult brain function is suggested. This exploratory study establishes a strategy to better identify neuronal molecular signatures that are potentially associated with mental illness and cognitive deficits. We propose that the SMAD pathway may be a novel target in addressing cognitive deficit of SZ in future studies.
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Affiliation(s)
- Y Horiuchi
- Department of Psychiatry, Johns Hopkins University, Baltimore, MD, USA
| | - M A Kondo
- Department of Psychiatry, Johns Hopkins University, Baltimore, MD, USA
| | - K Okada
- Department of Psychiatry, Johns Hopkins University, Baltimore, MD, USA
| | - Y Takayanagi
- Department of Mental Health, Johns Hopkins University, Baltimore, MD, USA
| | - T Tanaka
- Department of Psychiatry, Johns Hopkins University, Baltimore, MD, USA
| | - T Ho
- Department of Psychiatry, Johns Hopkins University, Baltimore, MD, USA
| | - M Varvaris
- Department of Psychiatry, Johns Hopkins University, Baltimore, MD, USA
| | - K Tajinda
- Department of Psychiatry, Johns Hopkins University, Baltimore, MD, USA
| | - H Hiyama
- Department of Psychiatry, Johns Hopkins University, Baltimore, MD, USA
| | - K Ni
- Pharmacology Research Labs, Astellas Pharma Inc., Tsukuba-shi, Ibaraki, Japan
| | - C Colantuoni
- Lieber Institute for Brain Development, Baltimore, MD, USA
| | - D Schretlen
- Department of Psychiatry, Johns Hopkins University, Baltimore, MD, USA
| | - N G Cascella
- Department of Psychiatry, Johns Hopkins University, Baltimore, MD, USA
| | - J Pevsner
- Department of Psychiatry, Johns Hopkins University, Baltimore, MD, USA,Hugo W Moser Research Institute at Kennedy Krieger, Baltimore, MD, USA
| | - K Ishizuka
- Department of Psychiatry, Johns Hopkins University, Baltimore, MD, USA
| | - A Sawa
- Department of Psychiatry, Johns Hopkins University, Baltimore, MD, USA,Department of Mental Health, Johns Hopkins University, Baltimore, MD, USA,Department of Psychiatry, Johns Hopkins School of Medicine, 600 North Wolfe Street, Meyer 3-166A, Baltimore, MD 21287, USA. E-mail:
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15
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Takayanagi Y, Petersen L, Laursen TM, Cascella NG, Sawa A, Mortensen PB, Eaton WW. Risk of schizophrenia spectrum and affective disorders associated with small for gestational age birth and height in adulthood. Schizophr Res 2014; 160:230-2. [PMID: 25458575 DOI: 10.1016/j.schres.2014.10.018] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2014] [Revised: 10/07/2014] [Accepted: 10/07/2014] [Indexed: 11/29/2022]
Affiliation(s)
- Yoichiro Takayanagi
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA; Department of Neuropsychiatry, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, Toyama, Japan.
| | - Liselotte Petersen
- National Centre for Register-Based Research, Aarhus University, Aarhus, Denmark
| | - Thomas M Laursen
- National Centre for Register-Based Research, Aarhus University, Aarhus, Denmark
| | - Nicola G Cascella
- Neuropsychiatry Program, Sheppard Enoch Pratt Hospital, Baltimore, MD, USA
| | - Akira Sawa
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA; Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Preben B Mortensen
- National Centre for Register-Based Research, Aarhus University, Aarhus, Denmark
| | - William W Eaton
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
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16
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Takayanagi Y, Gerner G, Takayanagi M, Rao V, Vannorsdall TD, Sawa A, Schretlen DJ, Cascella NG. Hippocampal volume reduction correlates with apathy in traumatic brain injury, but not schizophrenia. J Neuropsychiatry Clin Neurosci 2014; 25:292-301. [PMID: 24247856 DOI: 10.1176/appi.neuropsych.12040093] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
Apathy commonly accompanies both traumatic brain injury (TBI) and deficit syndrome schizophrenia (DSZ), despite unclear neurological bases. The authors examined differences in cortical thickness and subcortical/cerebellar regional volumes between adult TBI survivors, patients with DSZ, and healthy-control subjects by use of 3-D magnetic resonance imaging (MRI), and correlated imaging findings with clinical ratings of apathy and selected cognitive test scores. Imaging findings revealed specific areas of volume reduction in TBI survivors and areas of cortical thinning among patients with DSZ. The severity of apathy symptoms was similar across patient groups; however, severity of apathy was only correlated with imaging findings in TBI survivors.
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17
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Takayanagi M, Wentz J, Takayanagi Y, Schretlen DJ, Ceyhan EL, Wang L, Suzuki M, Sawa A, Barta PE, Ratnanather JT, Cascella NG. Reduced anterior cingulate gray matter volume and thickness in subjects with deficit schizophrenia. Schizophr Res 2013; 150:484-90. [PMID: 24035178 PMCID: PMC4076020 DOI: 10.1016/j.schres.2013.07.036] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.5] [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: 04/05/2013] [Revised: 07/12/2013] [Accepted: 07/17/2013] [Indexed: 12/15/2022]
Abstract
BACKGROUND Patients with deficit schizophrenia (D-SZ) differ from patients with the non-deficit form of schizophrenia (ND-SZ) in several aspects such as risk factors, neurobiological correlates, treatment response and clinical outcome. It has been debated if brain morphology could differentiate D-SZ from ND-SZ. Anterior cingulate gyrus (ACG) region regulates cognitive and emotional processing and past studies reported structural changes in this region in patients with SZ. METHODS 1.5-T 3D MRI scans were obtained from 18 D-SZ patients, 30 ND-SZ patients and 82 healthy controls (HCs). We used FreeSurfer-initalized labeled cortical distance mapping (FSLCDM) to measure ACG gray matter volume, cortical thickness, and area of the gray/white interface. Furthermore, cortical thickness was compared among the 3 groups using the pooled labeled cortical distance mapping (LCDM) method. RESULTS The ACG cortex of the D-SZ group was thinner than the ND-SZ group. Pooled LCDM demonstrated that the ACG cortex was bilaterally thinner in both the ND-SZ group and the D-SZ group compared with the control group. The right ACG gray matter volume was significantly reduced in D-SZ patients as compared with healthy controls (p=0.005 CONCLUSION: Our data suggest that qualitative, categorical differences in neuroanatomy may distinguish between deficit and non-deficit subtypes of schizophrenia.
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Affiliation(s)
- Mizuho Takayanagi
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, United States,Department of Neuropsychiatry, University of Toyama, Toyama, Japan
| | - Jacqueline Wentz
- Center for Imaging Science and Institute for Computational Medicine, The Whitaker Biomedical Engineering Institute, Johns Hopkins University, Baltimore, MD, United States
| | - Yoichiro Takayanagi
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
| | - David J. Schretlen
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | | | - Lei Wang
- Department of Psychiatry and Behavioral Sciences, Northwestern University School of Medicine, Chicago, IL, United States
| | - Michio Suzuki
- Department of Neuropsychiatry, University of Toyama, Toyama, Japan
| | - Akira Sawa
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Patrick E. Barta
- Center for Imaging Science and Institute for Computational Medicine, The Whitaker Biomedical Engineering Institute, Johns Hopkins University, Baltimore, MD, United States
| | - J. Tilak Ratnanather
- Center for Imaging Science and Institute for Computational Medicine, The Whitaker Biomedical Engineering Institute, Johns Hopkins University, Baltimore, MD, United States
| | - Nicola G. Cascella
- Department of Psychiatry and Behavioral Sciences, Northwestern University School of Medicine, Chicago, IL, United States
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18
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Horiuchi Y, Kano SI, Ishizuka K, Cascella NG, Ishii S, Talbot CC, Jaffe AE, Okano H, Pevsner J, Colantuoni C, Sawa A. Olfactory cells via nasal biopsy reflect the developing brain in gene expression profiles: utility and limitation of the surrogate tissues in research for brain disorders. Neurosci Res 2013; 77:247-50. [PMID: 24120685 DOI: 10.1016/j.neures.2013.09.010] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.4] [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: 08/21/2013] [Revised: 09/23/2013] [Accepted: 09/24/2013] [Indexed: 12/22/2022]
Abstract
Human olfactory cells obtained by rapid nasal biopsy have been suggested to be a good surrogate system to address brain disease-associated molecular changes. Nonetheless, whether use of this experimental strategy is justified remains unclear. Here we compared expression profiles of olfactory cells systematically with those from the brain tissues and other cells. Principal component analysis indicated that the expression profiles of olfactory cells are very different from those of blood cells, but are closer to those of stem cells, in particular mesenchymal stem cells, that can be differentiated into the cells of the central nervous system.
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Affiliation(s)
- Yasue Horiuchi
- Department of Psychiatry, Johns Hopkins University School of Medicine, Baltimore, MD, USA
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19
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Abstract
Gluten can cause extraintestinal manifestations with or without gastrointestinal symptoms and elevated antitissue transglutaminase 2 (tTG2) autoantibodies. Organ-specific gluten reaction involves immune response toward other transglutaminase (TG) isoforms including tTG3 (expressed in the skin, leading to dermatitis herpetiformis) and tTG6 (expressed in the brain, causing gluten ataxia). This analysis focuses on tTG6 antibodies, which have never been studied before in schizophrenia (SZ) and its relationships to tTG2 and to antigliadin antibodies. We previously showed an increased prevalence of tTG2 antibodies in gluten sensitive SZ patients compared with healthy controls (HC) that was not paralleled by an increased prevalence of antiendomysial antibody. To elucidate this discrepancy, we examined those tTG2 positive SZ patients for the presence of tTG6 antibody. We also searched for tTG6 antibodies in our sample of antigliadin (AGA) positive and AGA and tTG2 negative SZ patients. Seventy-four tTG2 positive SZ patients were compared with 148 age and gender-matched HC. Of the 74 tTG2 positive SZ patients, 16 were positive for tTG6 IgA for a prevalence of 22%. Only 4 HC were positive for tTG6 IgA for a prevalence of 2.7%. Among the AGA positive SZ patients, the prevalence of tTG6 IgA was 21.3% while 13.1% of the AGA and tTG2 negative SZ patients were positive for tTG6 IgA. The HC had a prevalence of 6%. Our results indicate a higher prevalence of tTG6 antibodies in SZ that may represent a biomarker useful to identify SZ patients who would benefit from a gluten-free diet.
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Affiliation(s)
- Nicola G. Cascella
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, 600 North Wolfe Street, Meyer 144, Baltimore, MD 21287,To whom correspondence should be addressed; tel: 410-502-2643, fax: 410-614-1792, e-mail:
| | - Debby Santora
- Department of Medicine, Center for Celiac Research, University of Maryland School of Medicine, Baltimore, MD
| | - Patricia Gregory
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | - Deanna L. Kelly
- Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD
| | - Alessio Fasano
- Department of Medicine, Center for Celiac Research, University of Maryland School of Medicine, Baltimore, MD
| | - William W. Eaton
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
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20
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Schretlen DJ, Peña J, Aretouli E, Orue I, Cascella NG, Pearlson GD, Ojeda N. Confirmatory factor analysis reveals a latent cognitive structure common to bipolar disorder, schizophrenia, and normal controls. Bipolar Disord 2013; 15:422-33. [PMID: 23656284 PMCID: PMC4128168 DOI: 10.1111/bdi.12075] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.9] [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: 06/21/2012] [Accepted: 01/13/2013] [Indexed: 12/22/2022]
Abstract
OBJECTIVE We sought to determine whether a single hypothesized latent factor structure would characterize cognitive functioning in three distinct groups. METHODS We assessed 576 adults (340 community controls, 126 adults with bipolar disorder, and 110 adults with schizophrenia) using 15 measures derived from nine cognitive tests. Confirmatory factor analysis (CFA) was conducted to examine the fit of a hypothesized six-factor model. The hypothesized factors included attention, psychomotor speed, verbal memory, visual memory, ideational fluency, and executive functioning. RESULTS The six-factor model provided an excellent fit for all three groups [for community controls, root mean square error of approximation (RMSEA) <0.048 and comparative fit index (CFI) = 0.99; for adults with bipolar disorder, RMSEA = 0.071 and CFI = 0.99; and for adults with schizophrenia, RMSEA = 0.06 and CFI = 0.98]. Alternate models that combined fluency with processing speed or verbal and visual memory reduced the goodness of fit. Multi-group CFA results supported factor invariance across the three groups. CONCLUSIONS Confirmatory factor analysis supported a single six-factor structure of cognitive functioning among patients with schizophrenia or bipolar disorder and community controls. While the three groups clearly differ in level of performance, they share a common underlying architecture of information processing abilities. These cognitive factors could provide useful targets for clinical trials of treatments that aim to enhance information processing in persons with neurological and neuropsychiatric disorders.
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Affiliation(s)
- David J Schretlen
- Department of Psychiatry and Behavioral Sciences, The Johns Hopkins University School of Medicine, Baltimore, MD, USA; Russell H. Morgan Department of Radiology and Radiological Science, The Johns Hopkins University School of Medicine, Baltimore, MD, USA
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21
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Niwa M, Jaaro-Peled H, Tankou S, Seshadri S, Hikida T, Matsumoto Y, Cascella NG, Kano SI, Ozaki N, Nabeshima T, Sawa A. Adolescent stress-induced epigenetic control of dopaminergic neurons via glucocorticoids. Science 2013; 339:335-9. [PMID: 23329051 DOI: 10.1126/science.1226931] [Citation(s) in RCA: 220] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Environmental stressors during childhood and adolescence influence postnatal brain maturation and human behavioral patterns in adulthood. Accordingly, excess stressors result in adult-onset neuropsychiatric disorders. We describe an underlying mechanism in which glucocorticoids link adolescent stressors to epigenetic controls in neurons. In a mouse model of this phenomenon, a mild isolation stress affects the mesocortical projection of dopaminergic neurons in which DNA hypermethylation of the tyrosine hydroxylase gene is elicited, but only when combined with a relevant genetic risk for neuropsychiatric disorders. These molecular changes are associated with several neurochemical and behavioral deficits that occur in this mouse model, all of which are blocked by a glucocorticoid receptor antagonist. The biology and phenotypes of the mouse models resemble those of psychotic depression, a common and debilitating psychiatric disease.
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Affiliation(s)
- Minae Niwa
- Department of Chemical Pharmacology, Meijo University Graduate School of Pharmaceutical Sciences, Nagoya, Japan
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22
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Jaaro-Peled H, Niwa M, Foss CA, Murai R, de Los Reyes S, Kamiya A, Mateo Y, O'Donnell P, Cascella NG, Nabeshima T, Guilarte TR, Pomper MG, Sawa A. Subcortical dopaminergic deficits in a DISC1 mutant model: a study in direct reference to human molecular brain imaging. Hum Mol Genet 2013; 22:1574-80. [PMID: 23314019 DOI: 10.1093/hmg/ddt007] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023] Open
Abstract
Imaging of the human brain has been an invaluable aid in understanding neuropsychopharmacology and, in particular, the role of dopamine in the striatum in mental illness. Here, we report a study in a genetic mouse model for major mental illness guided by results from human brain imaging: a systematic study using small animal positron emission tomography (PET), autoradiography, microdialysis and molecular biology in a putative dominant-negative mutant DISC1 transgenic model. This mouse model showed augmented binding of radioligands to the dopamine D2 receptor (D2R) in the striatum as well as neurochemical and behavioral changes to methamphetamine administration. Previously we reported that this model displayed deficits in the forced swim test, a representative indicator of antidepressant efficacy. By combining the results of our two studies, we propose a working hypothesis for future studies that this model might represent a mixed condition of depression and psychosis. We hope that this study will also help bridge a major gap in translational psychiatry between basic characterization of animal models and clinico-pharmacological assessment of patients mainly through PET imaging.
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Affiliation(s)
- Hanna Jaaro-Peled
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA
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23
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Coughlin JM, Ishizuka K, Kano SI, Edwards JA, Seifuddin FT, Shimano MA, Daley EL, Zandi PP, Leweke FM, Cascella NG, Pomper MG, Yolken RH, Sawa A. Marked reduction of soluble superoxide dismutase-1 (SOD1) in cerebrospinal fluid of patients with recent-onset schizophrenia. Mol Psychiatry 2013; 18:10-1. [PMID: 22349781 PMCID: PMC4113962 DOI: 10.1038/mp.2012.6] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.7] [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: 11/09/2022]
Affiliation(s)
- JM Coughlin
- Department of Psychiatry, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - K Ishizuka
- Department of Psychiatry, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - SI Kano
- Department of Psychiatry, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - JA Edwards
- Department of Psychiatry, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - FT Seifuddin
- Department of Psychiatry, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - MA Shimano
- Department of Psychiatry, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - EL Daley
- Department of Psychiatry, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - PP Zandi
- Department of Psychiatry, Johns Hopkins University School of Medicine, Baltimore, MD, USA,Bloomberg School of Public Health, Baltimore, MD, USA
| | - FM Leweke
- Central Institute of Mental Health, University of Heidelberg, Mannheim, Germany
| | - NG Cascella
- Department of Psychiatry, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - MG Pomper
- Department of Radiology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - RH Yolken
- Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, MD, USA,The Stanley Medical Research Institute, Chevy Chase, MD, USA
| | - A Sawa
- Department of Psychiatry, Johns Hopkins University School of Medicine, Baltimore, MD, USA
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24
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Takayanagi Y, Cascella NG, Sawa A, Eaton WW. Diabetes is associated with lower global cognitive function in schizophrenia. Schizophr Res 2012; 142:183-7. [PMID: 23031192 PMCID: PMC4004180 DOI: 10.1016/j.schres.2012.08.034] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.2] [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: 05/10/2012] [Revised: 08/27/2012] [Accepted: 08/29/2012] [Indexed: 01/23/2023]
Abstract
BACKGROUND Co-morbidity of schizophrenia (SZ) and metabolic problems such as diabetes mellitus (DM) has been suggested by many studies. Nonetheless, it is still debated whether DM affects cognitive dysfunction associated with SZ and how much treatment for DM is beneficial for cognitive functions in SZ. We addressed these questions by re-assessing the cognitive dataset from the Clinical Antipsychotic Trials of Intervention Effectiveness (CATIE) schizophrenia study. METHODS We identified 1289 SZ patients in which scores for several cognitive domains of verbal memory, vigilance, processing speed, reasoning, and working memory together with the composite score and metabolic characteristics (body mass index, dyslipidemia, hypertension, and DM) were available at baseline of the trial. We performed multiple linear regression analyses to assess the impact of DM on cognitive performance of SZ patients, controlling for a number of other confounding factors including obesity, hypertension, and dyslipidemia. We also conducted analyses of covariance to compare cognitive performance among SZ patients without DM and diabetic SZ sub-groups based on anti-diabetic drugs they were receiving at baseline of the trial. RESULTS Co-morbid DM with SZ predicted worse overall cognitive performance and lower scores for three cognitive domains (vigilance, processing speed, and reasoning), but none of the other metabolic factors (i.e., obesity, hypertension and dyslipidemia) correlated with cognitive function in SZ. Furthermore, SZ patients with untreated DM showed poorer overall cognitive performance and a significantly lower score in the domain of vigilance compared with SZ patients without DM. CONCLUSION Our data suggest that DM negatively affects the overall cognitive function of SZ patients.
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Affiliation(s)
- Yoichiro Takayanagi
- Department of Mental Health, Johns Hopkins Bloomberg School of
Public Health, Baltimore, MD, United States
| | - Nicola G. Cascella
- Neuropsychiatry Program, Sheppard Enoch Pratt Hospital, Baltimore,
MD, United Sates,Correspondence: Nicola G. Cascella M.D., Neuropsychiatry
Program, Sheppard Enoch Pratt Hospital, 6501 N. Charles Street, Towson, Maryland
21204, United Sates,
| | - Akira Sawa
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins
University School of Medicine, Baltimore, MD 21287, United States
| | - William W. Eaton
- Department of Mental Health, Johns Hopkins Bloomberg School of
Public Health, Baltimore, MD, United States
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25
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Abstract
Celiac Disease (CD) is an immune-mediated disease dependent on gluten (a protein present in wheat, rye or barley) that occurs in about 1% of the population and is generally characterized by gastrointestinal complaints. More recently the understanding and knowledge of gluten sensitivity (GS), has emerged as an illness distinct from celiac disease with an estimated prevalence 6 times that of CD. Gluten sensitive people do not have villous atrophy or antibodies that are present in celiac disease, but rather they can test positive for antibodies to gliadin. Both CD and GS may present with a variety of neurologic and psychiatric co-morbidities, however, extraintestinal symptoms may be the prime presentation in those with GS. However, gluten sensitivity remains undertreated and underrecognized as a contributing factor to psychiatric and neurologic manifestations. This review focuses on neurologic and psychiatric manifestations implicated with gluten sensitivity, reviews the emergence of gluten sensitivity distinct from celiac disease, and summarizes the potential mechanisms related to this immune reaction.
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Affiliation(s)
- Jessica R Jackson
- Maryland Psychiatric Research Center, University of Maryland School of Medicine, Box 21247, Baltimore, MD 21228, USA
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26
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Cascella NG, Gerner GJ, Fieldstone SC, Sawa A, Schretlen DJ. The insula-claustrum region and delusions in schizophrenia. Schizophr Res 2011; 133:77-81. [PMID: 21875780 DOI: 10.1016/j.schres.2011.08.004] [Citation(s) in RCA: 50] [Impact Index Per Article: 3.8] [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: 05/01/2011] [Revised: 08/04/2011] [Accepted: 08/08/2011] [Indexed: 10/17/2022]
Abstract
OBJECTIVE We examined the relationship between cerebral gray matter (GM) volume and severity of delusions and hallucinations in adults with schizophrenia. METHOD MRI scans in 43 patients with schizophrenia were acquired. Correlations were computed between GM volume and clinician ratings of hallucinations and delusions. RESULTS The analysis revealed significant inverse correlations between ratings of the severity of delusions and volumes of the left claustrum and right insula. Significant correlations were not observed between cerebral GM volume and ratings of hallucinations. CONCLUSION The insula/claustrum region may be critical to the experience of delusions and more careful scrutiny of the claustrum in relation to schizophrenia appears warranted.
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Affiliation(s)
- Nicola G Cascella
- Department of Psychiatry and Behavioral Sciences Johns Hopkins University School of Medicine,600 North Wolfe Street, Baltimore, MD 21287, USA.
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27
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Cascella NG, Kryszak D, Bhatti B, Gregory P, Kelly DL, Mc Evoy JP, Fasano A, Eaton WW. Prevalence of celiac disease and gluten sensitivity in the United States clinical antipsychotic trials of intervention effectiveness study population. Schizophr Bull 2011; 37:94-100. [PMID: 19494248 PMCID: PMC3004201 DOI: 10.1093/schbul/sbp055] [Citation(s) in RCA: 98] [Impact Index Per Article: 7.5] [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] [Indexed: 12/11/2022]
Abstract
Celiac disease (CD) and schizophrenia have approximately the same prevalence, but epidemiologic data show higher prevalence of CD among schizophrenia patients. The reason for this higher co-occurrence is not known, but the clinical knowledge about the presence of immunologic markers for CD or gluten intolerance in schizophrenia patients may have implications for treatment. Our goal was to evaluate antibody prevalence to gliadin (AGA), transglutaminase (tTG), and endomysium (EMA) in a group of individuals with schizophrenia and a comparison group. AGA, tTG, and EMA antibodies were assayed in 1401 schizophrenia patients who were part of the Clinical Antipsychotic Trials of Intervention Effectiveness study and 900 controls. Psychopathology in schizophrenia patients was assessed using the Positive and Negative Symptoms Scale (PANSS). Logistic regression was used to assess the difference in the frequency of AGA, immunoglobulin A (IgA), and tTG antibodies, adjusting for age, sex, and race. Linear regression was used to predict PANSS scores from AGA and tTG antibodies adjusting for age, gender, and race. Among schizophrenia patients, 23.1% had moderate to high levels of IgA-AGA compared with 3.1% of the comparison group (χ(2) = 1885, df = 2, P < .001.) Moderate to high levels of tTG antibodies were present in 5.4% of schizophrenia patients vs 0.80% of the comparison group (χ(2) = 392.0, df = 2, P < .001). Adjustments for sex, age, and race had trivial effects on the differences. Regression analyses failed to predict PANSS scores from AGA and tTG antibodies. Persons with schizophrenia have higher than expected titers of antibodies related to CD and gluten sensitivity.
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Affiliation(s)
- Nicola G Cascella
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, 600 North Wolfe Street, Meyer 144, Baltimore, MD 21287, USA.
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28
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Vannorsdall TD, Cascella NG, Rao V, Pearlson GD, Gordon B, Schretlen DJ. A morphometric analysis of neuroanatomic abnormalities in traumatic brain injury. J Neuropsychiatry Clin Neurosci 2010; 22:173-81. [PMID: 20463111 DOI: 10.1176/jnp.2010.22.2.173] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [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] [Indexed: 11/30/2022]
Abstract
Cognitive and structural brain abnormalities are common following traumatic brain injury (TBI). The authors compared cognition and brain structure in 14 TBI survivors and 28 matched healthy comparison subjects. TBI survivors showed reduced cerebral volume, due mainly to white matter changes, and poorer attention, psychomotor speed, and memory. Severity of white matter abnormality correlated with worse performance on several cognitive measures that distinguished between groups. Using voxel-based morphometry, regions of reduced white matter concentration were found throughout the cerebrum along with more localized gray matter reductions. Findings suggest that diffuse rather than focal aspects of TBI contribute most to cognitive outcome.
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Affiliation(s)
- Tracy D Vannorsdall
- Johns Hopkins Hospital, 600 N. Wolfe St., Meyer 218, Baltimore, MD 21287, USA
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29
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Cascella NG, Fieldstone SC, Rao VA, Pearlson GD, Sawa A, Schretlen DJ. Gray-matter abnormalities in deficit schizophrenia. Schizophr Res 2010; 120:63-70. [PMID: 20452187 DOI: 10.1016/j.schres.2010.03.039] [Citation(s) in RCA: 66] [Impact Index Per Article: 4.7] [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: 07/29/2009] [Revised: 03/28/2010] [Accepted: 03/30/2010] [Indexed: 11/24/2022]
Abstract
Deficit schizophrenia (D-SZ) has been proposed as a putative disease subtype defined by prominent, primary negative symptoms that endure as trait-like features during periods of clinical stability. In this study, we acquired magnetic resonance images of the whole brain using a 1.5 T scanner in 19 outpatients with D-SZ, 31 with non-deficit schizophrenia (ND-SZ), and 90 healthy adults. Voxel-based morphometry was used to investigate differences in regional gray-matter volume (GMV) between outpatients with D-SZ and ND-SZ, and between the combined patient subgroups and healthy adults. Compared to healthy adults outpatients with schizophrenia showed GMV reductions, especially in left frontal and temporal cortices and in the left insula. The D-SZ subgroup showed reduced GMV in the insula bilaterally and in the left superior frontal, middle temporal and occipital gyri. Regions in which GMV reductions best distinguished D-SZ from ND-SZ patients included the superior frontal gyrus (Brodmann area 8) and superior temporal gyrus (Brodmann areas 22, 38) bilaterally, the left supplementary motor area (Brodmann area 6), left anterior cingulate, left cuneus and right putamen. These results suggest that patients with deficit schizophrenia have brain abnormalities that differ from those of patients with non-deficit schizophrenia. Further, the neuroanatomic differences between these two putative subtypes of schizophrenia involve brain regions that appear to be associated with the negative symptoms that define the deficit syndrome of schizophrenia.
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Affiliation(s)
- Nicola G Cascella
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA.
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30
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Abstract
Deficit schizophrenia (D-SZ) has been proposed as a putative disease subtype defined by prominent, primary negative symptoms that endure as trait-like features during periods of clinical stability. In this study, we acquired magnetic resonance images of the whole brain using a 1.5 T scanner in 19 outpatients with D-SZ, 31 with non-deficit schizophrenia (ND-SZ), and 90 healthy adults. Voxel-based morphometry was used to investigate differences in regional gray-matter volume (GMV) between outpatients with D-SZ and ND-SZ, and between the combined patient subgroups and healthy adults. Compared to healthy adults outpatients with schizophrenia showed GMV reductions, especially in left frontal and temporal cortices and in the left insula. The D-SZ subgroup showed reduced GMV in the insula bilaterally and in the left superior frontal, middle temporal and occipital gyri. Regions in which GMV reductions best distinguished D-SZ from ND-SZ patients included the superior frontal gyrus (Brodmann area 8) and superior temporal gyrus (Brodmann areas 22, 38) bilaterally, the left supplementary motor area (Brodmann area 6), left anterior cingulate, left cuneus and right putamen. These results suggest that patients with deficit schizophrenia have brain abnormalities that differ from those of patients with non-deficit schizophrenia. Further, the neuroanatomic differences between these two putative subtypes of schizophrenia involve brain regions that appear to be associated with the negative symptoms that define the deficit syndrome of schizophrenia.
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Affiliation(s)
- Nicola G Cascella
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA.
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Schretlen DJ, Vannorsdall TD, Winicki JM, Mushtaq Y, Hikida T, Sawa A, Yolken RH, Dickerson FB, Cascella NG. Neuroanatomic and cognitive abnormalities related to herpes simplex virus type 1 in schizophrenia. Schizophr Res 2010; 118:224-31. [PMID: 20153952 DOI: 10.1016/j.schres.2010.01.008] [Citation(s) in RCA: 51] [Impact Index Per Article: 3.6] [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: 08/29/2009] [Revised: 01/14/2010] [Accepted: 01/19/2010] [Indexed: 01/19/2023]
Abstract
Herpes simplex virus 1 (HSV-1) tends to replicate in the temporal cortex and can damage the limbic system. The presence of serum antibodies to HSV-1 is associated with cognitive impairment in adults with schizophrenia, suggesting that cerebral gray matter abnormalities might distinguish patient subgroups defined by HSV-1 exposure. We assessed 43 adult outpatients with schizophrenia. The assessment included clinical interviews, neurocognitive testing, anatomic brain magnetic resonance imaging and measures of serum IgG antibodies specific to herpes simplex viruses 1 and 2. We then compared 25 patients who tested positive for antibodies to HSV-1 with 15 who were seronegative for both HSV-1 and HSV-2. The seropositive patients performed significantly worse than the seronegative patients on four neuropsychological measures of psychomotor speed, executive functioning, and explicit verbal memory. Voxel-based morphometric analyses revealed that the same patients showed reduced gray matter volume in the anterior cingulate and areas of the cerebellum. Finally, performance on the test of psychomotor speed and executive functioning that showed the largest between- group effect size correlated with reduced gray matter volume in some of the same brain regions (cingulate and cerebellum) that distinguished the two HSV-1 subgroups. In these outpatients with schizophrenia, HSV-1 seropositivity and performance on a cognitive test that is highly sensitive to it co-localize to closely overlapping brain regions.
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Affiliation(s)
- David J Schretlen
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States.
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Horiuchi Y, Ishii S, Kano SI, Ishizuka K, Okada Y, Colantuoni C, Valle D, Cascella NG, Akamatsu W, Sawa A, Okano H. Generation of induced pluripotent stem cells from patients with schizophrenia. Neurosci Res 2010. [DOI: 10.1016/j.neures.2010.07.1395] [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: 11/29/2022]
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Ishizuka K, Kano SI, Colantuoni C, Schretlen D, Cascella NG, Sawa A. A translational approach for schizophrenia: Systematic cell/tissue engineering combined with detailed phenotypic characterization and molecular brain imaging. Neurosci Res 2010. [DOI: 10.1016/j.neures.2010.07.315] [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: 11/17/2022]
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Ishizuka K, Tajinda K, Colantuoni C, Morita M, Winicki J, Le C, Lin S, Schretlen D, Sawa A, Cascella NG. Negative symptoms of schizophrenia correlate with impairment on the University of Pennsylvania smell identification test. Neurosci Res 2009; 66:106-10. [PMID: 19819272 DOI: 10.1016/j.neures.2009.10.001] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2009] [Revised: 09/09/2009] [Accepted: 10/01/2009] [Indexed: 10/20/2022]
Abstract
Deficits in odor identification have been most frequently described in schizophrenia (SZ). A relationship between dysfunction in odor identification and negative symptoms of SZ has also been reported. Furthermore, deficit SZ (a subtype of the illness with primary, enduring negative symptoms) has been found to be associated with a particularly poor performance on odor identification tests indicating that deficits in smell identification could be differentially expressed in some subtypes of SZ. We describe correlations of performance on smell identification with positive and negative symptoms of SZ. Patients with SZ (n=15) and normal controls (n=19) were tested by the University of Pennsylvania Smell Identification Test (UPSIT). Psychopathology was assessed with the Scales for the Assessment of Positive and Negative Symptoms (SAPS and SANS). SZ patients performed more poorly on the UPSIT test than did normal controls. Consistent with previous findings, we observed a correlation of SANS with UPSIT performance. In particular, specific subdomains of SANS, such as blunted affect, apathy and anhedonia, were associated with odor identification deficits. Furthermore, UPSIT score predicts these subdomains of negative symptoms. No correlation was observed between positive symptom and odor identification deficits. Our study further reinforces a relation between olfactory identification deficit and negative symptoms in SZ and suggests that smell identification could be a candidate endophenotype relevant to negative symptoms of SZ.
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Affiliation(s)
- Koko Ishizuka
- Department of Psychiatry, Johns Hopkins University School of Medicine, United States
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Sawa A, Cascella NG. Peripheral olfactory system for clinical and basic psychiatry: a promising entry point to the mystery of brain mechanism and biomarker identification in schizophrenia. Am J Psychiatry 2009; 166:137-9. [PMID: 19188289 DOI: 10.1176/appi.ajp.2008.08111702] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Kamiya A, Tan PL, Kubo KI, Engelhard C, Ishizuka K, Kubo A, Tsukita S, Pulver AE, Nakajima K, Cascella NG, Katsanis N, Sawa A. Recruitment of PCM1 to the centrosome by the cooperative action of DISC1 and BBS4: a candidate for psychiatric illnesses. ACTA ACUST UNITED AC 2008; 65:996-1006. [PMID: 18762586 DOI: 10.1001/archpsyc.65.9.996] [Citation(s) in RCA: 115] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
CONTEXT A role for the centrosome has been suggested in the pathology of major mental illnesses, especially schizophrenia (SZ). OBJECTIVES To show that pericentriolar material 1 protein (PCM1) forms a complex at the centrosome with disrupted-in-schizophrenia 1 (DISC1) and Bardet-Biedl syndrome 4 protein (BBS4), which provides a crucial pathway for cortical development associated with the pathology of SZ. To identify mutations in the PCM1 gene in an SZ population. DESIGN Interaction of DISC1, PCM1, and BBS proteins was assessed by immunofluorescent staining and coimmunoprecipitation. Effects of PCM1, DISC1, and BBS on centrosomal functions and corticogenesis in vivo were tested by RNA interference. The PCM1 gene was examined by sequencing 39 exons and flanking splice sites. SETTING Probands and controls were from the collection of one of us (A.E.P.). PATIENTS Thirty-two probands with SZ from families that had excess allele sharing among affected individuals at 8p22 and 219 white controls. MAIN OUTCOME MEASURES Protein interaction and recruitment at the centrosome in cells; neuronal migration in the cerebral cortex; and variant discovery in PCM1 in patients with SZ. RESULTS PCM1 forms a complex with DISC1 and BBS4 through discrete binding domains in each protein. DISC1 and BBS4 are required for targeting PCM1 and other cargo proteins, such as ninein, to the centrosome in a synergistic manner. In the developing cerebral cortex, suppression of PCM1 leads to neuronal migration defects, which are phenocopied by the suppression of either DISC1 or BBS4 and are exacerbated by the concomitant suppression of both. Furthermore, a nonsense mutation that segregates with SZ spectrum psychosis was found in 1 family. CONCLUSIONS Our data further support for the role of centrosomal proteins in cortical development and suggest that perturbation of centrosomal function contributes to the development of mental diseases, including SZ.
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Affiliation(s)
- Atsushi Kamiya
- Department of Psychiatry and Behavioral Sciences, The Johns Hopkins University School of Medicine, 600 N Wolfe St, Baltimore, MD 21287, USA
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Cascella NG, Testa SM, Meyer SM, Rao VA, Diaz-Asper CM, Pearlson GD, Schretlen DJ. Neuropsychological impairment in deficit vs. non-deficit schizophrenia. J Psychiatr Res 2008; 42:930-7. [PMID: 18021807 DOI: 10.1016/j.jpsychires.2007.10.002] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.6] [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: 05/16/2007] [Revised: 09/20/2007] [Accepted: 10/06/2007] [Indexed: 10/22/2022]
Abstract
This study aimed to assess the severity and specificity of cognitive impairments that affect individuals with deficit versus non-deficit schizophrenia. We compared 26 patients with the deficit subtype of schizophrenia (SZ-D) and 79 with non-deficit schizophrenia (SZ-ND) to 316 healthy adults (NC). All study participants completed a battery with 19 individual cognitive measures. After adjusting their test performance for age, sex, race, education and estimated premorbid IQ, we derived regression-based T-scores for each measure and the six derived cognitive domains including attention, psychomotor speed, executive function, verbal fluency, visual memory, and verbal memory. Multivariate analyses of variance revealed significant group effects for every individual measure and domain of cognitive functioning (all ps<0.001). Post hoc comparisons revealed that patients with SZ-D performed significantly worse than NCs in every cognitive domain. They also produced lower scores than the SZ-ND group in every domain, but only the difference for verbal fluency reached statistical significance. The correlations of the effect sizes shown by the SZ-D and SZ-ND patients were of intermediate magnitude for the individual tests (r=0.56, p<0.01) and higher, but not statistically significant for the cognitive domains (r=0.79, p=0.06). Patients with SZ-D demonstrate cognitive deficits that are both common and distinct from those shown by patients with SZ-ND. Their impairment of verbal fluency is consistent with the observation that poverty of speech is a clinically significant feature of patients with SZ-D.
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Affiliation(s)
- Nicola G Cascella
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, 600 North Wolfe Street, Meyer 144, Baltimore, MD 21287, United States.
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Abstract
It has been suggested that disturbances during neurodevelopment may play a crucial role in the etiology of schizophrenia (SZ). This premise is supported by brain imaging, epidemiological, and pathological studies as well as the discovery of susceptibility genes for SZ that appear to be implicated in development of the central nervous system. Here, we discuss the limitations of the current methods and models for studying the neurodevelopmental implications in SZ. We agree with the proposal that the olfactory epithelium, in which neurodevelopment continues throughout life, might represent an alternative model for understanding the pathophysiology of the disorder.
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Affiliation(s)
- Nicola G Cascella
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland 21287, USA.
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Schretlen DJ, Cascella NG, Meyer SM, Kingery LR, Testa SM, Munro CA, Pulver AE, Rivkin P, Rao VA, Diaz-Asper CM, Dickerson FB, Yolken RH, Pearlson GD. Neuropsychological functioning in bipolar disorder and schizophrenia. Biol Psychiatry 2007; 62:179-86. [PMID: 17161829 PMCID: PMC2041824 DOI: 10.1016/j.biopsych.2006.09.025] [Citation(s) in RCA: 188] [Impact Index Per Article: 11.1] [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: 07/22/2006] [Revised: 09/20/2006] [Accepted: 09/21/2006] [Indexed: 01/03/2023]
Abstract
BACKGROUND Some patients with bipolar disorder (BD) demonstrate neuropsychological deficits even when stable. However, it remains unclear whether these differ qualitatively from those seen in schizophrenia (SZ). METHODS We compared the nature and severity of cognitive deficits shown by 106 patients with SZ and 66 patients with BD to 316 healthy adults (NC). All participants completed a cognitive battery with 19 individual measures. After adjusting their test performance for age, sex, race, education, and estimated premorbid IQ, we derived regression-based T-scores for each measure and the six cognitive domains. RESULTS Both patient groups performed significantly worse than NCs on most (BD) or all (SZ) cognitive tests and domains. The resulting effect sizes ranged from .37 to 1.32 (mean=.97) across tests for SZ patients and from .23 to .87 (mean=.59) for BD patients. The Pearson correlation of these effect sizes was .71 (p<.001). CONCLUSIONS Patients with bipolar disorder suffer from cognitive deficits that are milder but qualitatively similar to those of patients with schizophrenia. These findings support the notion that schizophrenia and bipolar disorder show greater phenotypic similarity in terms of the nature than severity of their neuropsychological deficits.
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Affiliation(s)
- David J Schretlen
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland 21287-7218, and Olin Neuropsychiatric Research Center, Hartford Hospital Institute of Living, CT, USA.
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Cascella NG, Takaki M, Lin S, Sawa A. Neurodevelopmental involvement in schizophrenia: the olfactory epithelium as an alternative model for research. J Neurochem 2007. [DOI: 10.1111/j.1471-4159.2007.4628.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Abstract
The authors compared the severity and clinical profiles of patients with two etiologically different apathy syndromes: apathy after traumatic brain injury (TBI) and deficit schizophrenia (DSS). Patients from both groups were equally apathetic, but those with DSS had more severe anhedonia, blunted affect, and alogia, as measured by the Scale for Assessment of Negative Symptoms. These findings suggest that patients with DSS have a more complex presentation of apathy. Their differences may help to identify anatomical correlates of these apathy syndromes and aid in the design of more effective management strategies for both groups of patients.
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Affiliation(s)
- Vani Rao
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins Univ. School of Medicine, Baltimore, MD 21287-7218, USA.
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Holcomb HH, Cascella NG, Thaker GK, Medoff DR, Dannals RF, Tamminga CA. Functional sites of neuroleptic drug action in the human brain: PET/FDG studies with and without haloperidol. Am J Psychiatry 1996; 153:41-9. [PMID: 8540590 DOI: 10.1176/ajp.153.1.41] [Citation(s) in RCA: 149] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
OBJECTIVE The functional pathways through which antipsychotic drugs act in the brain to decrease psychosis remain unknown, despite our knowledge that their site of initial action is through blockade of dopamine D2 receptors. The authors sought to define the brain regions that are functionally altered by neuroleptic drugs. METHODS Regional cerebral glucose metabolism was studied in 12 subjects with schizophrenia while they were receiving a fixed dose of haloperidol, again 5 days after withdrawal of the drug, and a third time 30 days after withdrawal. Positron emission tomography with an [18F]fluorodeoxyglucose tracer was used in a within-subject design. RESULTS The analysis demonstrated a decrease in glucose metabolism in the caudate and putamen 30 days after withdrawal, indicating that haloperidol treatment enhanced glucose utilization in these areas. The thalamus, bilaterally but only in anterior areas, showed the same response to haloperidol. Only in the frontal cortex and in the anterior cingulate had metabolism increased 30 days after withdrawal, indicating that in those two cortical areas haloperidol depressed glucose metabolism. In the 5-day drug free scans, no regions differed significantly from those in the haloperidol condition, despite numerical changes. CONCLUSIONS It appears that 5 days of neuroleptic withdrawal are inadequate to escape the effects of neuroleptic drugs on regional cerebral glucose metabolism. The pattern and localization of changes in metabolic activity between the haloperidol condition and the 30-day drug-free condition suggest that haloperidol exerts its primary antidopaminergic action in the basal ganglia. It is proposed that the additional changes in the thalamus and cortex are secondary to this primary site of drug action, mediated through classically described striato-thalamo-cortical pathways.
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Affiliation(s)
- H H Holcomb
- Maryland Psychiatric Research Center, University of Maryland School of Medicine, Baltimore, USA
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Ross DE, Thaker GK, Holcomb HH, Cascella NG, Medoff DR, Tamminga CA. Abnormal smooth pursuit eye movements in schizophrenic patients are associated with cerebral glucose metabolism in oculomotor regions. Psychiatry Res 1995; 58:53-67. [PMID: 8539312 DOI: 10.1016/0165-1781(95)02724-b] [Citation(s) in RCA: 36] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
The purpose of this study was to test the hypothesis that abnormal smooth pursuit eye movements in schizophrenic patients would be related to cerebral glucose utilization in specific oculomotor regions. Eye movements were assessed with infrared oculography in 11 unmedicated schizophrenic patients and 13 normal comparison subjects. For the patients only, regional cerebral metabolic rate of glucose utilization was measured with positron emission tomography. Abnormal pursuit tracking in the patients was associated with relatively decreased metabolism in the frontal eye fields and increased metabolism in the caudate nuclei. The results are consistent with the hypothesis that these cerebral regions are involved in the pathophysiology of abnormal pursuit as related parts of a cortical-subcortical oculomotor circuit.
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Affiliation(s)
- D E Ross
- Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland at Baltimore 21228, USA
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Cascella NG, Macciardi F, Cavallini C, Smeraldi E. d-cycloserine adjuvant therapy to conventional neuroleptic treatment in schizophrenia: an open-label study. J Neural Transm (Vienna) 1994; 95:105-11. [PMID: 7865165 DOI: 10.1007/bf01276429] [Citation(s) in RCA: 58] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
D-cycloserine, a partial agonist at the strychnine-insensitive glycine site of the NMDA receptor complex, was tested as adjuvant treatment to conventional neuroleptics in chronic schizophrenic volunteers. The drug was administered, o.a.d., at the daily dose of 250 mg for six weeks. Mental status outcome measures were completed at the end of each week of treatment. The major finding was a deterioration of the patients' clinical condition, specifically of their psychotic symptoms. These preliminary results are discussed among others in view of d-cycloserine pharmacologic properties and recent findings on the interaction between NMDA agonists and dopamine system. This study, finally, suggests the need for a controlled dose-finding trial to establish the activity and a therapeutic "window" of this drug in schizophrenia.
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Affiliation(s)
- N G Cascella
- Department of Neuropsychiatric Sciences, H. S. Raffaele, University of Milan, School of Medicine, Italy
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Cascella NG, Tarazi FI, Shirakawa O, Tamminga CA. Savoxepine fails to selectively influence glucose metabolism in the rat limbic system. Psychopharmacology (Berl) 1994; 114:275-80. [PMID: 7838920 DOI: 10.1007/bf02244849] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
The [14C]-2-deoxyglucose method was used to map the in vivo metabolic response of glucose to savoxepine, a novel tetracyclic cyano-dibenzoxepino-azepine. Savoxepine is reported to have higher affinity for dopamine (DA) receptors in the hippocampus than in the striatum and hence should have dose-dependent, anatomically selective actions. Two doses of savoxepine (0.05 mg/kg and 0.5 mg/kg) were compared with haloperidol (1 mg/kg) to test the hypothesis that low doses of savoxepine would display a selective action on limbic brain areas. Results failed to show that low dose savoxepine selectively modifies glucose utilization in the limbic system as previous biochemical studies suggested. In fact, low doses of the drug displayed a potent activity quite similar to haloperidol in effect and localization. The low dose did not produce significantly altered glucose metabolism in the nucleus accumbens or in the lateral habenular nucleus as observed with most other neuroleptics, suggesting a lack of antipsychotic action at this dose. Our findings demonstrate the difficulty of designing a neuroleptic with a preferential blockade of limbic DA receptors and point to the need for functional assessment of regional receptor binding differences.
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Affiliation(s)
- N G Cascella
- University of Maryland School of Medicine, Department of Psychiatry, Baltimore 21228
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Cascella NG, Nagoshi CT, Muntaner C, Walter D, Haertzen CA, Kumor KM. Impulsiveness and subjective effects of intravenous cocaine administration in the laboratory. J Subst Abuse 1994; 6:355-66. [PMID: 7780294 DOI: 10.1016/s0899-3289(94)90278-x] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
Cardiovascular and subjective responses to placebo and 40-mg intravenous (iv) cocaine injections were measured in 29 male iv cocaine users: most subjects received each of these injections on two separate occasions. Most of the subjects also completed various measures of psychopathology and personality. Although the small sample size made any conclusions tentative, an expected significant association between impulsivity and subjective euphoria following 40-mg cocaine administration was obtained, whereas associations of personality measures with cardiovascular responses to cocaine administration were inconsistent.
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Morgan MJ, Cascella NG, Stapleton JM, Phillips RL, Yung BC, Wong DF, Shaya EK, London ED. Sensitivity to subjective effects of cocaine in drug abusers: relationship to cerebral ventricle size. Am J Psychiatry 1993; 150:1712-7. [PMID: 8214181 DOI: 10.1176/ajp.150.11.1712] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
OBJECTIVE The purpose of this study was to assess the functional significance of ventricle-brain ratio (VBR) in terms of how it might affect sensitivity to cocaine, an indirect dopamine agonist. METHOD Relationships between VBR and subjective responses to acute intravenous cocaine hydrochloride were examined in 20 male polydrug abusers. Tests were performed in conjunction with positron emission tomography scans to measure cerebral glucose metabolism. RESULTS Subjective measures of effects of cocaine, including self-report ratings of intensity of the drug effect, scores on the morphine-benzedrine scale of the Addiction Research Center Inventory, and several items on visual analogue scales, correlated negatively with VBR. VBR also differed significantly among subjects who were grouped according to scores on items ("rush" and "crash") of the Cocaine-Sensitive Scale (larger VBR in subjects with weaker responses). VBR was not correlated with cocaine-induced changes in cerebral metabolic rates for glucose. CONCLUSIONS Relative insensitivity to the subjective effects of cocaine in polydrug abusers with ventricle enlargement suggests that ventriculomegaly may reflect changes in periventricular brain regions that mediate these effects of cocaine.
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Affiliation(s)
- M J Morgan
- Addiction Research Center, National Institute on Drug Abuse, Baltimore, MD 21224
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Holcomb HH, Cascella NG, Medoff DR, Gastineau EA, Loats H, Thaker GK, Conley RR, Dannals RF, Wagner HN, Tamminga CA. PET-FDG test-retest reliability during a visual discrimination task in schizophrenia. J Comput Assist Tomogr 1993; 17:704-9. [PMID: 8370824 DOI: 10.1097/00004728-199309000-00007] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
OBJECTIVE Reliability of assessment is important in any kind of neuropsychiatric study, but is particularly pivotal in schizophrenia research where symptom instability is common. MATERIALS AND METHODS Two fluorodeoxyglucose PET scans, 1 week apart, were carried out in schizophrenic patients while they were performing a simple visual discrimination task. Subject and scan conditions were held constant. Regional metabolic rates of glucose utilization were calculated as absolute and scaled; they were compared using correlational statistics. RESULTS Average differences between scans were 5-9% for the parietal and occipital cortices, but 1-3% for other cortical areas, differences comparable with reported variances in normal controls. CONCLUSION These results suggest that test-retest variance in metabolic imaging in schizophrenia is relatively low and that task performance increases metabolic stability in brain areas unrelated to task performance.
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Affiliation(s)
- H H Holcomb
- Maryland Psychiatric Research Center, Baltimore
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Abstract
The dopamine (DA) autoreceptor agonist (-)-3PPP (preclamol) was tested in male schizophrenic volunteers for safety. The drug was administered intramuscularly in a single rising dose design, crossed with a similar "rising dose" placebo period; all evaluations and raters were blind to drug or placebo administration. Pharmacokinetic, endocrine, safety, and mental status outcome measures were completed before and after each single dose of drug or placebo. Pharmacokinetic analysis showed blood levels between 200-500 pmoles/ml after the intramuscular drug doses of 30-40 mg. Drug half life is 2-2.5 hrs. Growth hormone (GH) levels were elevated in a linear fashion to the 30 mg dose; whereafter, the drug failed to affect GH at all. All safety evaluations were negative, including any untoward effects on the major organ systems. After single dose drug administration, evidence of antipsychotic action occurred in two of the four subjects. This study suggests that (-)-3PPP/preclamol is a safe drug for study in the treatment of schizophrenia and may have antipsychotic efficacy.
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Affiliation(s)
- C A Tamminga
- Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Baltimore
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Cascella NG, Pearlson G, Wong DF, Broussolle E, Nagoshi C, Margolin RA, London ED. Effects of substance abuse on ventricular and sulcal measures assessed by computerised tomography. Br J Psychiatry 1991; 159:217-21. [PMID: 1773237 DOI: 10.1192/bjp.159.2.217] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Computerised tomography (CT) was used to assess the possible effects of substance abuse on brain morphology. Polydrug abusers had significantly wider third ventricles than normal controls, with a positive correlation between age and ventricle:brain ratio (VBR). Assuming no effect of age, estimated quantity of substance abuse was not significantly related to ventricular and sulcal measures, except that alcohol consumption correlated positively with VBR and severity of cocaine use correlated negatively with sulcal width. When age of the subjects was partialled out, alcohol use showed a tendency for association with VBR; however, severity of cocaine use did not remain a significant predictor of cortical sulcal width. The findings suggest that chronic use of alcohol, but not necessarily of other commonly abused substances, produces brain atrophy.
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Affiliation(s)
- N G Cascella
- Addiction Research Center, National Institute on Drug Abuse, Baltimore, MD
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